口腔颌面部损伤

1、口腔颌面部损伤口腔颌面部损伤Oral & Maxillofacial TraumaChapter 72022-2-212Vocabulary2022-2-213Vocabulary2022-2-214Vocabulary2022-2-215Vocabulary2022-2-216Vocabulary2022-2-217Definition of trauma(from Cambridge Advanced Learners Dictionary)2022-2-218IncidenceTraffic AccidentSportsFallingBustupLabor injury2022-

2、2-21924万万14.2万人万人10亿元亿元1993年年1997年年2001年年30万万19万人万人18.5亿元亿元75.5万万54.6万人万人3.09b RMBFinancial Financial LossLoss致伤人数致伤人数No of traffic No of traffic accidentaccidentTraffic Accident2022-2-2110Traffic Accident2022-2-2111Effect of Trauma on the Human Body2022-2-21122022-2-2113Debridement Time: 24 48 hTen

3、d to hematoma, edemaRespiratory tractAsphyxiaAbility to anti-infection, regenerationWound healing2022-2-2114 Cerebral concussion Cerebral contusion Intracranial hematoma Skull base fracture Increase infectious incidence Malocclusion caused - Diagnosis Occlusion regained - Treatment2022-2-2115Mouth o

4、pening, mastication, swallowingBleedingParalysis瘫痪Leading difficulty breathingdietworse oral hygieneAsphyxia 窒息2022-2-2116 InfectionOral cavityNasal cavityPharyngeal cavityOrbitParanasal sinusBacteriaTempHumidity2022-2-2117Parotid GlandFacial N. Trigeminal N.Salivary fistulaFacial paralysisRegional

5、numbness2022-2-2118 Facial contour Psychological trauma2022-2-2119Evaluate trauma soonIdentify the key trauma, manage the fatal firstCareful history taking, thorough physical examRescue in timeManagement in orderGeneral Rules2022-2-21202022-2-2121Dysphoria, sweating, inhaling respirationDifficult to

6、 inhale, hypopnea, nasal alar movement, labial cyanosisThree concave signs、Rapid breathing, weak pulse, decreased BPPupils diluted, No reflection to lightProdrome2022-2-2122 Foreign body obstructionInspiratory AsphyxiaLow AirwaySwellingForeign bodyBlood, salivaVomitUpper airwayTissue dislocation Obs

7、tructive Asphyxia2022-2-2123Clear foreign body in upper airwaySuspend maxillaIntubationHold the tongue outObstructive Asphyxia 吸入性窒息吸入性窒息气管切开术气管切开术2022-2-2124Two steps：Judge bleeding situationChoose the way to stop bleeding2022-2-2125Three categoriesArterialCapillaryVenousBased on origin2022-2-2126压

8、迫止血压迫止血指压止血法指压止血法包扎止血法包扎止血法填塞止血法填塞止血法结扎止血法结扎止血法药物止血法药物止血法2022-2-2127(2) Purpose of anti-shock(1) Definition & Classification Traumatic shockExsanguine shock 20% Body weightToxic shockInfectious shock Restore circulation2022-2-2128(4) Principles of Treatment (3) Features of ShockEarly stage: Dysp

9、horia, quick & superficial breath, sweating, palenessMiddle stage: Tingle to supression, emotional faint, unconsciousness, decrease BP, labial palenessLate stage: weaker pulsation, unmeasurable BP, hyponuria, anuria 30ml/hHemostasis, blood transfusion, pain control, fluid transfusion, sedation20

10、22-2-2129(1) JudgementConsciousness, pulse, BP, respiration, pupil(2) Early discovery, early managementRetrograde obliviscenceCerebral concussionIntermediate wake-upExtradural hematomaCerebral fluid leakSkull base fracture2022-2-21302022-2-2131DebridementWound closureAntibiotics2022-2-21322022-2-213

11、3Abrasions 擦伤Contusions挫伤Contusions & Lacerations挫裂伤Incised & Puncture Wound切割伤及刺伤 Bite Wound 咬伤 Types of injuries2022-2-21341. Abrasions2022-2-21351. Abrasions2022-2-21362. Contusions2022-2-2137Property: Blunt object with high mechanical force3. Contusions & LacerationsCharacterlIrregul

12、ar wound edge, saw-toothedlBig lacerationlw/wo necrotic tissue & open fracturesManagementl Debridementl Wound Closure2022-2-21383. Contusions & Lacerations2022-2-2139Property: Sharp object or instruments4. Incised & Puncture WoundCharater l Regular wound edgel Bleedingl Small access, but

13、 deep woundManagementl Debridementl Wound closure2022-2-2140Property: Animal (Wolf, dog, Bear) or human beingsCharacterl Tooth tracedl Heavy contaminationl Tend to infectionManagementl Thorough debridementl Infection controll Skin graft after granular tissue regeneratedl Vaccination of Tetanus, Rabi

14、es5. Bite Wound2022-2-2141Debridement2022-2-21421. wash wound Time：6-12h Solution: soap water, saline, hydrogen dioxideDebridement3. Closure2. Clean wound Removal of foreign body Trimming of necrotic tissue2022-2-21432022-2-2144Management of soft tissure injuries2022-2-2145Management of soft tissure

15、 injuries2022-2-21462022-2-21472022-2-21481. Tooth injuries 1.1 Contusion of TeethEtiology: Extrinsic force blunt tooth injuriesPeriodontal ligaments or dental pulpCharacter: l Extrusion of toothl Mobilityl Percussion & Toothache when chewingManagementl Tooth restl Tooth groundl Simple ligation2

16、022-2-21491. Tooth injuries 1.2 Luxation of TeethClassificationCharacterl Tooth dislocated or exfoliatedManagementl Tooth protection priorityl Reductionl Fixationl ReimplantationPartial luxationComplete luxation- Tooth dislocation- Semi luxation- Intrusive movement2022-2-2150Gingival or labial swell

17、ing, lacerationAdjacent teeth or alveolar process movement when one affected tooth touchedFragment dislocation, MalocclusionIn accordance with tooth luxation or fracture2. Fracture of Alveolar ProcessCharacters2022-2-2151l Extrinsic force to dental alveolar process, mainly to upper jawl Reduction un

18、der LAl Arch bar applied2. Fracture of Alveolar ProcessEtiologyManagement 2022-2-21522. Fracture of Alveolar Process2022-2-2153Stainless steel wire ligation, Arch bars2022-2-21541. Describe the characteristics of OMF Trauma?2. Describe the etiology, clinical features and management of asphyxia.3. Describe the ways of hemastasis.4. What is debridement?5. Describe the common site of dental alveolar process fracture, and their clinical manifestati