To Fraktur Mandibula

Teknik Operasi :Fraktur Fraktur Mandibula Mandibula BUDDY SETIAWAN SEBASTIANIYAN ASIANA SYAFAATWAHYU PRIATMOKO

1

History of the ProcedureHistory of the Procedure 1650 The first description of mandible fractures in Egyptian papyrus: examination, diagnosis, and treatment of mandible fractures.

Hippocrates: reapproximation and immobilization using circumdental wires + external bandaging

1180 importance of establishing proper occlusion first was described in a textbook written in Salerno, Italy.

1492 Maxillomandibular fixation first was mentioned in Cyrugia. Chopart and Desault used dental prosthetic devices to immobilize fracture segments.

2

History of the ProcedureHistory of the Procedure the 19th century external bandage or wrap occasionally used in conjunction with a bridle wire throughout.

Guglielmo Salicetti first accomplished the use of intermaxillary fixation. Orthodontic bands and arches were used for intermaxillary fixation.

Gilmer reformed the treatment of fractures when he fixated full arch bars on both the mandible and the maxilla.

Buck and Kinlock described the use of wire ligature for the immobilization of mandible fractures in the middle of the 19th century.

In 1888, Schede was the first to use a solid steel plate held by 4 screws for fixation.

3

EtiologyEtiology

4

Fractures sitesFractures sites

5

Muscles

6

7

8

Types of Fracture

9

Clinical assessment Clinical assessment and diagnosis and diagnosis

10

Clinical Examination

11

13

Classification Classification by Anatomic Regionby Anatomic Region

14

15

Definitive Treatment Definitive Treatment

Objective: Restoration of functional alignment of the

bone fragments in anatomically precise position utilizing the present teeth for

guidance 16

Principles of TreatmentPrinciples of Treatment

17

1818

Close Close ReductionReduction

18

1919

Close ReductionClose Reduction

19

Application of Arch BarsApplication of Arch Bars

20

21

Gunning’s SplintGunning’s Splint

22

Open Reduction Open Reduction and Fixationand Fixation

23

24

Intraoral Approach

25

26

27

28

Extraoral Approach

29

Extraoral Approach

30

Extraoral Approach

31

Extraoral Approach

32

Wire FixationWire Fixation

33

Wire FixationWire Fixation

34

Wire Wire FixationFixation

35

3636

Rigid FixationRigid Fixation

36

Treatment by Types of Fracture

37

Treatment by Types of Fracture

38

39

General Principle of Reduction and Fixation

40

Plate and Screw FixationPlate and Screw Fixation

41

MaterialsMaterials

42

MaterialsMaterials

43

MaterialsMaterials

44

Instruments :Instruments :

45

Instruments: Instruments:

46

Instruments: Instruments: bender/plierbender/plier

47

Instruments: Instruments: cuttercutter

48

Plate & ScrewsPlate & Screws

49

50

51

52

5353

Reconstruction Reconstruction PlatePlate

53

Lag Screws

54

Fracture mandible in Fracture mandible in childrenchildren

55

Follow Up

56

Complications

57

Reference Redies M., 2008. Internal Fixation of Mandibular Fracture. AO Surgery. AO Research Institute, Davos (Swiszerland).

Joseph J., Hidalgo D., 2007. Mandible Reconstruction. Grabb and Smith’s Plastic Surgery 6th ed. Lipincott Williams & Wilkins, Philadelphia

Moore J, 2010. Mandibular Fracture in Submandibular Approach. Principles of Oral and Maxillofacial Surgery 6th Ed. Wiley-Blackwell.

58

59