Facial Trauma, San Francisco CA

Call San Francisco Office Phone Number 415-813-6400 with any questions or concerns.

As a part of an oral surgeons training, facial trauma is critical in fine-tuning their surgical training.  As a result of an oral surgeons understanding of the mouth, teeth and occlusion, they are the best trained in treating facial fractures and injuries.  Based on this understanding most major Trauma Level I Medical Centers use oral surgeons to treat the most devastating facial injuries.  Additionally, oral surgeons are routinely re-treating facial fractures treated by other surgeons who do not have the understanding of the dentition.

By training we have to be well-versed in emergency care, acute treatment and long-term reconstruction and rehabilitation – not just for physical reasons but emotional as well.  Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients, because its visible to most people.  It was because of this experience that Dr. Massoomi pursued further fellowship-training in facial cosmetic surgery in order to correct the facial scars secondary to facial trauma . The science and art of treating these injuries requires “hands on” experience and an understanding of how the underlying bone supports the overlying soft-tissue.

Being on staff at local hospitals and emergency rooms coverage for facial injuries, which include the following conditions:

  • Extra-oral, Facial lacerations:
  • image of severe facial trauma before image of severe facial trauma afteer
  • Intra-oral lacerations, including tongue
  • tongue laceration on a child
  • Avulsed (knocked out) teeth, with immediate implant placement.  “Tooth in 1 hour” concept
  • knocked out tooth before knocked out tooth after
  • Dog bites
  •  child's lip injury before surgery child's lip injury after surgery
  • Fractured facial bones (skull, cheek, nose or eye socket)
  • 3D scan of facial trauma
  • 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, dog bites, accidental falls, sports injuries, interpersonal violence, and work-related injuries. Types of facial injuries can range from injuries of 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 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). Dr. Massoomi is a well-trained oral and maxillofacial surgeon and is proficient at diagnosing and treating all types of facial lacerations – as seem in the pictures above.

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, 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 to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures = Interal fixation with the use of titanium plates and screws.

One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. 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 of treatment can often allow for healing and obviates 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 has profoundly improved the recovery period for many patients, allowing them to return to normal function more quickly.

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. 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.

Injuries To The Teeth & Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons usually are usually involved in treating fractures in the supporting bone, they are the best when it comes to replacing missing 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 one’s own saliva and replaced in the socket within 2 hours!

The sooner the tooth is re-inserted into the dental socket, the better chance 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 hold the tooth in the jaw are attached and are vital to the success of replanting the tooth. Other dental specialists such as endodontists, who may be asked to perform root canal on the tooth at a later time.  In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.

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