Craniofacial Trauma

Facial Trauma

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Dr. Ciminello is well versed in emergency care, acute treatment, and the long-term reconstruction and rehabilitation of severe facial trauma. Dr. Ciminello is trained, skilled, and uniquely qualified to manage and treat facial trauma. Injuries to the face, by their very nature, impart a high degree of both emotional and physical trauma to patients. The science and art of treating these injuries requires special training, hands-on experience, and an understanding of how the treatment provided will influence the patient’s long-term function and appearance.

 

Dr. Ciminello meets and exceeds these modern standards. He is trained, skilled, and uniquely qualified to manage and treat facial trauma, including:

• Facial Lacerations

• Intra-Oral Lacerations

• Avulsed (knocked out) Teeth

• Fractured Facial Bones (Forehead, Cheek, Nose, and/or Eye Socket)

• Fractured Jaws (Upper and Lower jaw)

 

The Nature Of Maxillofacial Trauma

There are a number of possible causes of facial trauma, such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. Facial injuries can range from injuries of the teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves, or the salivary glands).

Soft Tissue Injuries Of The Maxillofacial Region

When soft tissue injuries such as lacerations occur on the face, they are repaired with sutures. In addition to repairing the injury in a way that yields the best cosmetic result possible, care is taken to inspect and treat injuries to important structures such as facial nerves, salivary glands, and salivary ducts (or outflow channels). Dr. Ciminello is a well-trained oral and maxillofacial surgeon who is an expert at diagnosing and treating all types of facial lacerations.

Bone Injuries Of The Maxillofacial Region

Fractures of the bones of the face are treated much in the same way that fractures in other parts of the body are treated. The specific form of treatment is determined by various factors, including the location of the fracture, the severity of the fracture, the patient’s age, and the general health of the patient. When an arm or a leg is fractured, a cast is often applied to stabilize the bone and allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.

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One option for treatment involves wiring the jaws together for certain fractures of the upper and/or lower jaw. Other types of jaw fractures are best treated and stabilized by the surgical placement of small plates and screws at the involved site. This technique of treatment can often allow for healing and avoids the need for having the jaws wired together. This technique is called “rigid fixation” of a fracture. The relatively recent development and use of rigid fixation has greatly improved the recovery time for many patients, allowing them to return to normal function more quickly.

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The treatment of facial fractures should be accomplished in a thorough and predictable manner. More importantly, the patient’s facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions necessary is always made. The necessary incisions made are designed to be small and, whenever possible, are placed so that the resulting scar is hidden.

Injuries To The Teeth & Surrounding Dental Structures

Isolated injuries to the teeth are quite common and may require the expertise of various dental specialists. Oral surgeons are usually involved in treating fractures in the supporting bone or in replanting teeth that have been displaced or knocked out. These types of injuries are treated by one of a number of forms of splinting (stabilizing by wiring or bonding teeth together). If a tooth is knocked out, it should be placed in salt water or milk. The sooner the tooth is re-inserted into the dental socket, the better the chances are that it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that holds the tooth in the jaw are attached and are vital to the success of replanting the tooth. Other dental specialists such as endodontists may be called upon to perform root canal therapy, and restorative dentists may be called upon to repair or rebuild fractured teeth. The treatment team varies by injury. In the event that injured teeth cannot be saved or repaired, dental implants are often utilized as replacements for missing teeth.

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The proper treatment of facial injuries is now the realm of specialists who are well versed in the emergency care, acute treatment, long-term reconstruction, and rehabilitation of the patient.