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1、Diagnostic Radiology Of MaxillofacialPart of Injury1Most common responsibleFallAutomobile accidentBlows from foreign bodies strkingOthers 2头部、颌面部受伤的处理l危险的颅内出血。l意识消失或神智模糊，呼吸困难，呕吐，抽搐，手脚麻痹，口或鼻腔流血或透明的液体，剧烈头痛持续不止等等。l原则：先处理颅脑症状，稳定全身生命体征，后治疗颌面部损伤。 3Applied radiology The prescription of appropriate film can
2、 be made only after a careful clinical examination4 Radiology aids in identifying the location and orientation of fractures and indicates the degree of separation or displacement of fracture margins. Radiographs are very useful after an injury5Test technics Waters position （华氏位、鼻颏位）（华氏位、鼻颏位） Panoram
3、ic 曲面断层片（全景）曲面断层片（全景） Cephalometric (X线头影测量片线头影测量片)or lateral film(侧位片）侧位片） Occlusal film咬合片咬合片 Submentovertex （颅底位、颏顶位、颧弓位）（颅底位、颏顶位、颧弓位） Zygomatic bone-PA（颧骨后前位、顶颏位）颧骨后前位、顶颏位） Postanterior position（下颌骨后前位）（下颌骨后前位） Obligue lateral projection（下颌骨斜侧位）（下颌骨斜侧位） Schullars position （薛氏位、颞下颌关节片）（薛氏位、颞下颌关节片
4、） CT and MRI6Diagnostic principle1. position and number2. types3. displacement4. relation between the fracture line and teeth5. differentiate from nutrition canal and normal sutures6. concrescence of fractures7position and number of fractures8Types9Displacement10 relation between the fracture line a
5、nd teeth11differentiate from nutrition canal and normal sutures12Alveolar fracture13Alveolar fracture company with tooth inlay14Maxillary fractureFracture Types of maxillar bone Lefort Lefort Lefort 15 Lefort(horizontal fracture )16Lefort 17Lefort 18Lefort fracture19Waters positionRight-lefort left-
6、lefort and20Waters position（眶（眶-上颌上颌-颧骨颧骨OMZ、复合骨折）、复合骨折）21Fractures of Zygomatic bone and arch22After operation23Comminute Fracture of zygomatic arch24“M” type of submentovertex25Fracture of nose bone26Pay attention to the maxillary bone fracture!1、双侧眼眶及上颌窦大小不一，窦腔积液昏暗、双侧眼眶及上颌窦大小不一，窦腔积液昏暗2、骨折线多样，骨折块移
7、位，左右眶下缘不在、骨折线多样，骨折块移位，左右眶下缘不在 、同一水平、同一水平3 、牙弓不对称、牙弓不对称4、颌间间隙形态不对称、颌间间隙形态不对称5、张口受限是否由于喙突受压？、张口受限是否由于喙突受压？6、骨折是否波及颅及颅底？、骨折是否波及颅及颅底？27Fracture of mandibleThe most ommon fracture sites mental body angle condyle and its neck28Classification of the condyle fracturePlease look at book P158P16129Panoramic v
8、iew30Panoramic viewY字型字型31Panoramic view32Panoramic view33Panoramic view34Panoramic view35Postanterior position(PA)36Postanterior position37CT view3D dimension reconstruction38Tomographic view and CT-3D39Pathologic fracturelOriented from tumors ,Osteomyelitis, tooth extraction, operation etc.40陈旧性骨折lX-ray appearanceltime41异物定位横向位片轴向位片定位针42Questions ？l骨折后1-2月照片发现原来的骨折线更加变宽，为什么？l上颌骨骨折引起张口受限在上颌骨骨折引起张口受限在X X线片上主要可观察到线片上主要可观察到什么征象什么征象？l成人和儿童髁突骨折有哪些不同？l髁突骨折有哪些种类？髁突骨折有哪些种类？l全景片上的髁突骨折和后前位有哪些不同？l什么情况下容易引起误诊？什么情况下容易引起误诊？43The end44
