• Fractured facial bones (cheek, nose, or eye socket) 
  
• Fractured jaws (upper and lower jaw)  
  
• Facial and Oral lacerations 
  
• Complex lacerations of the facial region
  
• Knocked out (Avulsed) teeth 
  

Injuries to the face, by their very nature, impart a high degree of emotional and physical trauma to patients. There may be other injuries that require management by a trauma team in an orderly fashion. The science and art of treating these injuries requires special training involving a "hands on" experience and an understanding of how the treatment provided will influence the patient's long term function and appearance.

The Nature of Maxillofacial Trauma

There are a number of causes of facial trauma. Motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work related injuries account for many cases. Types of 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 involving the skin, lips, tongue and gums; bony injuries (fractures); or injuries to special regions (such as the eyes, 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 by "fine (plastic) suturing." In complex injuries, specially designed incisions are created to develop tissue flaps for rearrangement to “hide” scars or obtain closure over a severe defect. In addition to providing a repair that yields the optimum cosmetic result, care is taken in management of injuries to structures such as nerves, salivary glands and salivary ducts. Dr. Cullum has extensive training and experience in Maxillofacial Trauma and Plastic techniques and is proficient in diagnosis and treatment of facial lacerations.

Bone Injuries of the Maxillofacial Region

Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture, and the age and 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, treatment may involve wiring the jaws together for certain fractures. However, certain types of fractures of the jaw are best treated and stabilized by the surgical placement of small "plates and screws" at the involved site. This technique is called "rigid fixation" and often allows for healing without having the jaws wired together. The development and use of "rigid fixation" has profoundly improved the recovery period for many patients by allowing them to return to normal function more quickly.

The treatment of facial fractures should be accomplished in a thorough and predictable manner. Importantly, the patient's facial appearance should be minimally affected. Access to the facial bones can be through the mouth or are designed to “minimize” or "hide" the incision.

The proper treatment of facial injuries and emergency care is essential for long-term esthetic reconstruction and rehabilitation of the patient. Dr. Cullum, as a specialist, is well versed in the acute treatment and comprehensive management of facial injuries.