Do maxillary dentures protect the skull base from penetration injury?

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Medical Device Intervention

Background:

• Penetrating injuries from foreign bodies entering the oral cavity pose significant risks to surrounding soft tissues and vital structures.
• Accidental falls can lead to severe trauma, with objects like gardening tools causing deep tissue penetration.
• Maxillary dentures are commonly used for tooth replacement but their potential role in mitigating trauma is rarely considered.

Observation:

• A 73-year-old male sustained a penetrating injury when gardening scissors entered his mouth, passing through the maxillary sinus and exiting below the zygomatic arch.
• The patient was wearing a maxillary denture at the time of the accident.
• The trajectory and force of the scissors were significantly altered upon contact with the metal frame of the denture.

Findings:

• The maxillary denture is hypothesized to have absorbed and deflected some of the kinetic energy from the scissors.
• The denture's presence redirected the scissors' path, preventing deeper penetration into critical anatomical regions such as the brain or major blood vessels.
• This event highlights an unusual protective role of an oral prosthetic device in a severe penetrating trauma scenario.

Implications:

• Maxillary dentures may offer an unexpected protective buffer against certain types of penetrating oral and facial trauma.
• This case underscores the importance of considering all anatomical and prosthetic elements when evaluating complex facial injuries.
• Further investigation into the biomechanical interactions between oral appliances and penetrating foreign bodies could inform trauma management and device design.