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

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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.

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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.

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EtiologyEtiology

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Fractures sitesFractures sites

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Muscles

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Types of Fracture

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Clinical assessment Clinical assessment and diagnosis and diagnosis

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Clinical Examination

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Classification Classification by Anatomic Regionby Anatomic Region

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Definitive Treatment Definitive Treatment

Objective: Restoration of functional alignment of the

bone fragments in anatomically precise position utilizing the present teeth for

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Principles of TreatmentPrinciples of Treatment

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Close Close ReductionReduction

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Close ReductionClose Reduction

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Application of Arch BarsApplication of Arch Bars

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Gunning’s SplintGunning’s Splint

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Open Reduction Open Reduction and Fixationand Fixation

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Intraoral Approach

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Extraoral Approach

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Extraoral Approach

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Extraoral Approach

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Extraoral Approach

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Wire FixationWire Fixation

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Wire FixationWire Fixation

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Wire Wire FixationFixation

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Rigid FixationRigid Fixation

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Treatment by Types of Fracture

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Treatment by Types of Fracture

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General Principle of Reduction and Fixation

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Plate and Screw FixationPlate and Screw Fixation

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MaterialsMaterials

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MaterialsMaterials

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MaterialsMaterials

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Instruments :Instruments :

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Instruments: Instruments:

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Instruments: Instruments: bender/plierbender/plier

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Instruments: Instruments: cuttercutter

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Plate & ScrewsPlate & Screws

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Reconstruction Reconstruction PlatePlate

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Lag Screws

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Fracture mandible in Fracture mandible in childrenchildren

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Follow Up

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Complications

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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.

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