Facial Trauma

Experience Matters

Dr. Mueller is extensively trained to manage and treat craniofacial trauma. He was trained in craniofacial trauma, advanced trauma life support (ATLS) and general surgery at The Cook County and University of Illinois hospitals in Chicago.  Cook County Hospital is one of the busiest Level 1 trauma centers in the US, treating nearly 6000 trauma patients per year.  Dr. Mueller is a member of the Level 1 facial trauma team for the Sentara Hospital System.  In addition, Dr. Mueller trains residents in craniofacial trauma as an assistant professor in the Departments of Otolaryngology, Head and Neck Surgery at the Eastern Virginia Medical School and Oral & Maxillofacial Surgery at VCU’s Medical College of Virginia.

What is Craniofacial Trauma Reconstruction?

There are an infinite number of ways in which the face can be damaged and thus need some type of reconstruction. Accidents, falls, automobile accidents and interpersonal violence are among the most common causes. Some of the main types of facial injuries resulting from these instances are soft tissue lacerations, fractured teeth, fractured jaws, fractured facial bones, and avulsed teeth.

  • Soft Tissue Injuries
    Soft tissue trauma includes lacerations to the skin and any kind of intraoral soft tissue damage which can include lacerations, abrasions and avulsed tissues of the facial skin, neck, scalp and intraoral tissues.
    Before After
  • Avulsed TeethInjuries to the teeth are very common and must be dealt with immediately to insure success of re-implantation.  Generally, teeth that are completely avulsed need to be replanted within 45 minutes or they will not heal.  The best recommendations are to either place the tooth immediately back into the socket or place it in milk.  Either way, you will need to call Dr. Mueller immediately to expeditiously treat the tooth.
  • Bony Injuries
    High velocity injuries to the head and face can cause fractures of the skull forehead, eye sockets, check bones, nose, and upper and lower jaws.

Facial Reconstruction

3-D reconstruction CT scan of a patient with a fractured midface, including upper jaw, nose, eye sockets, cheek bone and a front tooth.  Dr Mueller was able to completely reconstruct this patients face using small titanium plates.

3-D reconstruction CT scan of a patient with a fractured midface, including upper jaw,
nose, eye sockets, cheek bone and a front tooth. Dr Mueller was able to completely reconstruct
this patients face using small titanium plates.

If facial bones have been fractured, they will be treated in much the same way as any other broken bone. Of course, a plaster cast cannot be applied to a cheekbone, but the bones can be held firmly together by the insertion of small titanium plates and screws. No, the plates will not set off the metal detectors at the airport.  Soft tissue lacerations will be treated immediately by way of suture (stitching).

In cases where a tooth has been completely avulsed from the mouth, there is still a possibility of reinserting it. The quicker a re-insertion can be performed, the greater the likelihood that the natural tooth will survive. In the event that the tooth cannot be replanted, Dr. Mueller can place a dental implant to restore both functionality and aesthetic appearance. Dr. Mueller can also “splint” displaced teeth using structural support such as bonding or wiring with a good amount of success. Root canal therapy is also a possibility for loose or broken teeth.

Dr. Mueller will conduct a thorough examination as well as request specific imaging studies. This may involve CT and MRI studies, x-rays, and at times, 3-D model reconstructions from these studies. Once all injuries are documented, Dr. Mueller will formulate a comprehensive treatment plan.

Reasons for Facial Trauma Reconstruction

Aside from the obvious cosmetic/aesthetic reasons for repairing damage to the face, there are also a number of serious health and dental concerns that can arise from even a small amount of trauma. Facial injuries should not be taken lightly. Depending on the exact location of the injury, respiration, speech and swallowing can be greatly impaired.

Though Dr. Mueller treats most broken facial bones in the operating room, damage to the teeth can be quickly dealt with urgently in his outpatient center.

Failure to treat dental and facial trauma can lead to the following longer term problems:

  • Loss of Functionality: When teeth have fallen victim to trauma, they may become loose in their sockets and make eating and speaking much more difficult.
  • Smile Aesthetics: Chipped, broken or missing teeth can be detrimental to a beautiful smile. The dentist is able to repair chips and fractured teeth easily. Dr. Mueller can replace lost teeth with implants.
  • Bite/Jaw Irregularities: After trauma, it is possible that the teeth will become badly aligned. The poor alignment of the teeth can lead to TMJ, uneven teeth wear and other complications.