The Comprehensive AOCMF Classification System: Midface Fractures - Level 3 Tutorial
Identifieur interne : 000027 ( Pmc/Curation ); précédent : 000026; suivant : 000028The Comprehensive AOCMF Classification System: Midface Fractures - Level 3 Tutorial
Auteurs : Carl-Peter Cornelius ; Laurent Audigé ; Christoph Kunz ; Carlos H. Buitrago-Téllez ; Randal Rudderman ; Joachim PreinSource :
- Craniomaxillofacial Trauma & Reconstruction [ 1943-3875 ] ; 2014.
Abstract
This tutorial outlines the details of the AOCMF image-based classification system for fractures of the midface at the precision level 3. The topography of the different midface regions (central midface—upper central midface, intermediate central midface, lower central midface—incorporating the naso-orbito-ethmoid region; lateral midface—zygoma and zygomatic arch, palate) is subdivided in much greater detail than in level 2 going beyond the Le Fort fracture types and its analogs. The level 3 midface classification system is presented along with guidelines to precisely delineate the fracture patterns in these specific subregions. It is easy to plot common fracture entities, such as nasal and naso-orbito-ethmoid, and their variants due to the refined structural layout of the subregions. As a key attribute, this focused approach permits to document the occurrence of fragmentation (i.e., single vs. multiple fracture lines), displacement, and bone loss. Moreover, the preinjury dental state and the degree of alveolar atrophy in edentulous maxillary regions can be recorded. On the basis of these individual features, tooth injuries, periodontal trauma, and fracture involvement of the alveolar process can be assessed. Coding rules are given to set up a distinctive formula for typical midface fractures and their combinations. The instructions and illustrations are elucidated by a series of radiographic imaging examples. A critical appraisal of the design of this level 3 midface classification is made.
Url:
DOI: 10.1055/s-0034-1389561
PubMed: 25489392
PubMed Central: 4251725
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<author><name sortKey="Cornelius, Carl Peter" sort="Cornelius, Carl Peter" uniqKey="Cornelius C" first="Carl-Peter" last="Cornelius">Carl-Peter Cornelius</name>
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<front><div type="abstract" xml:lang="en"><p>This tutorial outlines the details of the AOCMF image-based classification system for fractures of the midface at the precision level 3. The topography of the different midface regions (central midface—upper central midface, intermediate central midface, lower central midface—incorporating the naso-orbito-ethmoid region; lateral midface—zygoma and zygomatic arch, palate) is subdivided in much greater detail than in level 2 going beyond the Le Fort fracture types and its analogs. The level 3 midface classification system is presented along with guidelines to precisely delineate the fracture patterns in these specific subregions. It is easy to plot common fracture entities, such as nasal and naso-orbito-ethmoid, and their variants due to the refined structural layout of the subregions. As a key attribute, this focused approach permits to document the occurrence of fragmentation (i.e., single vs. multiple fracture lines), displacement, and bone loss. Moreover, the preinjury dental state and the degree of alveolar atrophy in edentulous maxillary regions can be recorded. On the basis of these individual features, tooth injuries, periodontal trauma, and fracture involvement of the alveolar process can be assessed. Coding rules are given to set up a distinctive formula for typical midface fractures and their combinations. The instructions and illustrations are elucidated by a series of radiographic imaging examples. A critical appraisal of the design of this level 3 midface classification is made.</p>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Craniomaxillofac Trauma Reconstr</journal-id>
<journal-id journal-id-type="iso-abbrev">Craniomaxillofac Trauma Reconstr</journal-id>
<journal-id journal-id-type="doi">10.1055/s-00000151</journal-id>
<journal-title-group><journal-title>Craniomaxillofacial Trauma & Reconstruction</journal-title>
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<issn pub-type="ppub">1943-3875</issn>
<issn pub-type="epub">1943-3883</issn>
<publisher><publisher-name>by AO Foundation AOCMF</publisher-name>
<publisher-loc>Clavadelerstrasse 8 7270 Davos Switzerland</publisher-loc>
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<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>The Comprehensive AOCMF Classification System: Midface Fractures - Level 3 Tutorial</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Cornelius</surname>
<given-names>Carl-Peter</given-names>
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<degrees>MD, DDS</degrees>
<xref rid="AF130888-1" ref-type="aff">1</xref>
<xref rid="CO130888-1" ref-type="author-notes"></xref>
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<contrib contrib-type="author"><name><surname>Audigé</surname>
<given-names>Laurent</given-names>
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<degrees>DVM, PhD</degrees>
<xref rid="AF130888-2" ref-type="aff">2</xref>
<xref rid="AF130888-3" ref-type="aff">3</xref>
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<contrib contrib-type="author"><name><surname>Kunz</surname>
<given-names>Christoph</given-names>
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<degrees>MD, DDS</degrees>
<xref rid="AF130888-4" ref-type="aff">4</xref>
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<contrib contrib-type="author"><name><surname>Buitrago-Téllez</surname>
<given-names>Carlos H.</given-names>
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<degrees>MD</degrees>
<xref rid="AF130888-5" ref-type="aff">5</xref>
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<contrib contrib-type="author"><name><surname>Rudderman</surname>
<given-names>Randal</given-names>
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<degrees>MD, FACS</degrees>
<xref rid="AF130888-6" ref-type="aff">6</xref>
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<contrib contrib-type="author"><name><surname>Prein</surname>
<given-names>Joachim</given-names>
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<degrees>MD, DDS</degrees>
<xref rid="AF130888-4" ref-type="aff">4</xref>
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<aff id="AF130888-1"><label>1</label>
<institution>Department of Oral and Maxillofacial Surgery, Ludwig Maximilians Universität München, Germany</institution>
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<aff id="AF130888-2"><label>2</label>
<institution>AO Clinical Investigation and Documentation, AO Foundation, Dübendorf, Switzerland</institution>
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<aff id="AF130888-3"><label>3</label>
<institution>Research and Development Department, Schulthess Clinic, Zürich, Switzerland</institution>
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<aff id="AF130888-4"><label>4</label>
<institution>Clinic for Oral and Craniomaxillofacial Surgery, University Hospital Basel, Basel, Switzerland</institution>
</aff>
<aff id="AF130888-5"><label>5</label>
<institution>Imaging Center Aarau, Institute of Radiology Zofingen Hospital, Zofingen, Switzerland</institution>
</aff>
<aff id="AF130888-6"><label>6</label>
<institution>Plastic, Reconstruction & Maxillofacial Surgery, Alpharetta, Georgia</institution>
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<author-notes><corresp id="CO130888-1"><bold>Address for correspondence </bold>
Carl-Peter Cornelius, MD, DDS <institution>Department of Oral and Maxillofacial Surgery</institution>
<addr-line>Ludwig Maximilians Universität, Lindwurmstrasse 2A, D-80337 München</addr-line>
<country>Germany</country>
<email>peter.cornelius@med.lmu.de</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>12</month>
<year>2014</year>
</pub-date>
<volume>7</volume>
<issue>Suppl 1</issue>
<fpage>S068</fpage>
<lpage>S091</lpage>
<history></history>
<permissions><copyright-statement>© Thieme Medical Publishers</copyright-statement>
</permissions>
<abstract><p>This tutorial outlines the details of the AOCMF image-based classification system for fractures of the midface at the precision level 3. The topography of the different midface regions (central midface—upper central midface, intermediate central midface, lower central midface—incorporating the naso-orbito-ethmoid region; lateral midface—zygoma and zygomatic arch, palate) is subdivided in much greater detail than in level 2 going beyond the Le Fort fracture types and its analogs. The level 3 midface classification system is presented along with guidelines to precisely delineate the fracture patterns in these specific subregions. It is easy to plot common fracture entities, such as nasal and naso-orbito-ethmoid, and their variants due to the refined structural layout of the subregions. As a key attribute, this focused approach permits to document the occurrence of fragmentation (i.e., single vs. multiple fracture lines), displacement, and bone loss. Moreover, the preinjury dental state and the degree of alveolar atrophy in edentulous maxillary regions can be recorded. On the basis of these individual features, tooth injuries, periodontal trauma, and fracture involvement of the alveolar process can be assessed. Coding rules are given to set up a distinctive formula for typical midface fractures and their combinations. The instructions and illustrations are elucidated by a series of radiographic imaging examples. A critical appraisal of the design of this level 3 midface classification is made.</p>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>fracture classification</kwd>
<kwd>central and lateral midface</kwd>
<kwd>zygoma</kwd>
<kwd>tooth injuries</kwd>
</kwd-group>
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</front>
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