Introduction
A person’s countenance depends directly on the skeletal architecture and the overlying soft tissues of the midface (Arora et al., 2017). The midface has been defined as the area between the zygomaticofrontal suturesand the maxillary occlusal plane. These planes converge posteriorly meeting near the foramen magnum. This region encompasses the entire maxilla, zygomatic bones, and nasal orbital ethmoid (NOE) complex along with the nasal substructures. This region holds a high density of vascular, musculoskeletal, and nervous system structures whose injury will often result in substantial morbidity and mortality in cases of severe midface traumas. A comprehensive knowledge of head and neck skeletal and soft tissue anatomy is imperative in understanding how to manage the patients presenting with these patterns of traumas (Khatib et al., 2017). These traumas are significantly more challenging to manage compared to isolated facial or dentoalveolar fractures since there is limited intact and unharmed framework to guide with anatomic reductions. Furthermore, oftentimes, due to the high impact of force that caused these traumas in the first place, these patients present with other significant concomitant traumas that must be managed concurrently (Wang L, 2019). The appropriate surgical approach to a maxillofacial trauma must follow a systematic scheme, necessitating systemic evaluations such as the hemodynamic evaluation, wound extensions, presence or absence of foreign bodies, neural or vascular or glandular ducts involvements, and other requisite evaluations which must be carefully undertaken with preoperative examinations (Bayat and McGrouther, 2005). Inability to directly visualize and reduce all the components of a mid-facial injury along with inadequate stability of the fractured skeletal compartments leads to postoperative deformity. Each case with this type of fracture is unique and requires skill and expertise of the surgeon to restore the pre-traumatic facial anatomy, aesthetics and functions (Sharma and Dhanasekaran, 2015). In this article, we report the management and further oral rehabilitation of a case suffering severe midface trauma following a motor vehicle accident were the patient was hit by a commercial lorry.