Oral and Maxillofacial Surgery

• Rowes – Williams disimpaction forceps: Forward & downward movement for maxilla disimpaction.
• Transnasal wiring: Used for naso – orbito – ethmoidal fractures.
• Pulse test: Vertical digital pressure on globe to examine fractured orbital floor via endoscope.
• Sheridan – Gardiner test: Practical for children unable to read letters (ocular function post – trauma).
• Comminuted mandibular fractures: Bilateral condyle fractures → crossbite & ↑ inter – angular distance.
• ORIF indications (condyle fracture):
  • Fragment angle >37°
  • Longitudinal displacement >4 mm
• Bilateral displaced condylar fracture: Treat at least one side with ORIF.
• Condyle fracture fixation:
  • 2 miniplates at posterior & anterior borders restore tension/compression trajectories.
  • Highest tensile strain: Anterior/lateral surfaces.
  • Highest compressive strain: Posterior surface.
• Immobilization (young patients):
  • Unilateral fracture: 10 – 14 days.
  • Bilateral fracture: 3 weeks.