Facial Trauma

Oral and maxillofacial surgeons are trained, skilled, and uniquely qualified to manage and treat Facial Trauma. Dr. Kienle, Dr. Steinkeler and Dr. Gunawardena are on staff at Holy Redeemer Medical Center and Abington Hospital and Medical Center to provide emergency room coverage for facial injuries including:

  • Facial lacerations
  • Intra oral lacerations
  • Avulsed (knocked out) teeth
  • Fractured facial bones (cheek, nose or eye socket)
  • Fractured jaws (upper and lower jaw)

Injuries to the face, by their very nature, impart a high degree of emotional as well as physical trauma to patients. The science and art of treating these injuries requires special training involving 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 possible causes of facial trauma. Motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries account for many. The types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face.

Soft Tissue Injuries of the Maxillofacial Region

When soft tissue injuries such as lacerations occur on the face, they are repaired by suturing. In addition to the obvious concern of providing a repair that yields the best cosmetic result possible. Care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands, and salivary ducts (or outflow channels). Drs. Kienle, Steinkeler and Gunawardena are highly trained oral and maxillofacial surgeons with vast experience and knowledge proficient at diagnosing and treating all types 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 plan 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, other means have been developed to stabilize facial fractures.

One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. However, certain other 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 allows for healing and eliminates the necessity of having the jaws wired together. This technique is called rigid fixation of a fracture. The relatively recent development and use of “rigid fixation” have profoundly improved the recovery period for many patients by allowing them to return to normal function more quickly. Dr. Kienle is an active member of AONA and regularly attends their conferences.

The treatment of facial fractures should be accomplished in a thorough and predictable manner. 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. At the same time, the incisions that become necessary are designed to be small and, whenever possible, are placed so that the resultant scar is hidden.

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Injuries to the Teeth and Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral and maxillofacial surgeons are primarily involved in treating fractures in the supporting jaw bone and/or in re-implanting teeth which 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 saltwater, milk, or preferably Hank’s Balanced Salt Solution. The sooner the tooth is reinserted into the dental socket, the better for the survival of the tooth. Therefore, the patient should see an oral and maxillofacial surgeon as soon as possible.
Other dental specialists may be called upon such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants placed by the Oral and Maxillofacial Surgeon are now utilized to replace missing teeth.

Please remember all of the procedures described here are surgical procedures. These surgical procedures are best performed by oral and maxillofacial surgeons. Oral and maxillofacial surgeons are the only dental specialists who are fully trained in all of these surgical procedures. Drs. Kienle, Steinkeler and Gunawardena are all fully trained and experienced in these surgical procedures. All doctors in our practice are Board Certified in Oral and Maxillofacial Surgery and in Anesthesia and have also earned both a Medical and a Dental degree.

Dr. Kienle, Dr. Steinkeler and Dr. Gunawardena have the only practice in the Delaware Valley/Tri-State area where all of the surgeons have both their Medical and Dental degrees and are Board Certified in Oral and Maxillofacial Surgery and Anesthesia, and in which all of our surgical facilities are Fully Accredited by the Joint Commission. You can be assured that Drs. Kienle, Steinkeler and Gunawardena have the best training and experience, along with the proper staff and facilities, to provide you with exceptional safety, and comfortable surgical care.