There are three major areas of maxillofacial injury caused by blasts:
Middle-third injuries
The middle third of the face, being comprised of wafer-thin sheets of bone, has similarities to an egg shell.
It sustains external forces up to a point and any force applied above that threshold results in its shattering into small pieces.
Following exposure to a blast, patients therefore may have severely comminuted fractures of the maxillary and ethmoid sinuses and the cribriform plates [7,8].
Fracture of the orbital walls may lead to globe injuries and, if severe, may threaten sight if not recognised [7].
Mandibular injuries
The mandible is more likely to be injured by blast forces striking the face laterally and fractures under shear forces.
The resultant mandibular body fractures are usually unilateral, horizontal and occur below the apices of the teeth.
There is usually no associated soft tissue injury although the patient may show signs of flash burns [7].
Teeth
Teeth fractures due to primary blast injury are usually multiple and occur at the cemento-enamel junction [7].