Oral Rehabilitation of Trauma - a Clinical Report

Abstract

Ozljede glave i vrata od nezgoda u životu na selu nisu česte (4% prema Zachariades na uzorku od 6000 pacijenata). Jedan od najčešćih uzroka među tim nezgodama jesu u vezi s poljoprivrednim strojevima, osobito otvorenima. To su vozila koja ne razvijaju velike brzine , ali upotreba zaštitnih sredstva je rijetka. U slučajevima kada vozač ispaden iz vozila ili se ono prevrne nastaju velike ozljede lica koje su u mnogočemu drugačije od ozljeda u ostalim prometnim nesrećama.. Prikazan je slučaj liječenja pacijenta na Klinici za maksilofacijalnu kirurgiju i Kliničkom zavodu za stomatološku protetiku Kliničke bolnice Dubrava. Pacijent u dobi od 32 godine starosti preživio je prevrtanje traktora, no nagnječena mu je desna strana srednjeg lica. Nakon nekoliko uspješnih rekonstruktivnih zahvata započeta je oralna rehabilitacija. Narav ozljede te preostali broj zuba odredili su način odgovarajuće oralne rahabilitacije.Head and neck injuries caused by accidents associated with rural life are not frequent (4% according to Zachariades on a survey of more than 6000 patients). One of the most frequent among those accidents are agricultural vehicle accidents, especially open vehicles. These vehicles do not develop high speed and helmets are seldom required. Therefore in cases of falling out of a vehicle or turning of the vehicle very extensive facial injury occurs which is quite different from other road traffic accident injuries. A report of the treatment and outcome of a case tretaed at the Clinic for Maxillofacial surgery and Department of Prosthodontics, University Hospital Dubrava is presented. A 32 year-old man survived accident in with the tractor oveerturned During the accident the right side of his midface was smashed. Clinical examination and x-rays revealed a defect of the right cheek including the complete zygomatic bone with the floor of the orbit and lateral upper part of the maxilla including molar teeth with adjacent bone and soft tissue. The skin of the cheek was missing and buccal lining was severely reduced. After initial examination and stabilization, immediate surgery was performed. The patient was satisfied with the appearance, after several major reconstructive procedures (three distant flaps and two local flaps) and oral rehabilitation started. The nature of the injury and the position of the left teeth started the procedure of the oral rehabilitation. The choice was a metal alloy upper partial denture with telescopic crown, and fixed frontal down bridge with attachment and lower partial denture from metal alloy