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Maxillofacial injury.

This chapter has emphasized the relative infrequency of severe skeletal maxillofacial injuries in children. When they do occur, it is extremely important that they be approached by a team of physicians, each of whom is competent to manage the injury and complications related to his specialty. Particular attention must be given to the issues of general facial bone growth as well as future dental development. All operative procedures must be designed to avoid further injury to unerupted teeth, and the traditional methods of immobilization must be modified in order to avoid the avulsion of deciduous teeth.

Child

Dental aspects of maxillofacial injuries.

The chief progress of maxillofacial surgery in recent years has been the preservation and the retention of functional tissue. The recent advances in microvascular and reimplantation surgery are examples. Similarly the preservation of the masticatory apparatus is best served by the retention of all viable components. Additional benefits derived from this approach include the facilitation with alignment of the bony fragments, proper occlusion of the teeth and maintenance of the vertical relationship between the upper and lower jaws; in addition to the restoration of appearance and the functions of mastication and speech. Although injuries of the teeth and their supporting stuctures at first glance may seem to be simple problems, frequently they turn out to be complicated. The most common injury is partial avulsion of the alveolar bone with loss of attached teeth, which may produce a severe defect in the jaw bone. During healing there is additional resorbtion of alveolar bone, which is quite a normal physiologic phenomenon. Therefore, the eventual defect is likely to be more severe yet. For this reason more concern should be shown for these lesser injuries.

Dentition

Automobile accident studies of maxillofacial injuries.

The use of the available lap and shoulder belts would between 10,000 and 15,000 fatalities annually, and would significantly reduce the number of injuries, particularly those of the face. By mandatory seat belt usage laws a significant reduction in deaths, disfiguring injuries, and hospital bed-days would be realized.

Accidents, Traffic