Labour prognosis is closely linked to clinical prognosis, and depends on it, although does not always coincide with it.

The major distinguishing criteria of temporal disability is favourable clinical and labour prognosis which is characterized by complete or partial recovery of jaw malfunctions caused by an injury, and recovery from disability within a relatively short period of time.

To ascertain disability and its period it is necessary:

1.  to thoroughly examine the patient;

2. to establish the cause of the injury [occupational, non-occupational, in the state of alcoholic intoxication]; 

3. to detect anatomical and physiological alterations and dysfunctions;

4. to perform complex medical procedures;

5. to check working and living conditions of a patient;

6. To identify the remoteness of a patient’s home from the patient-care facility.

Rehabilitation from disability caused by jaw fractures is characterized by:

– the degree to which the damaged jaw functions can be recovered which is verified by good consolidation of the fractured pieces of bone in the right position;

–  normal physiological occlusion;

– sufficient mobility of temporomandibular joints;

– absence of apparent blood- and lymphokinesia disorders;

– absence of pains or other complications related to the damage of peripheral nerves of maxillofacial area;

Temporal disability caused by maxillofacial traumatic injuries may be the result of industrial and non-industrial accidents. To identify the cause of temporal disability is one of important tasks of a dental surgeon, because in this case s/he has to deal with both medical and legal issues.

In order to conduct an expert examination it is necessary to determine the view and the cause of injuries which can be followed by both occupational and non-occupational accidents (domestic, transport, street, sport).

The period of disability depends on the type of an injury.

III periods of disability for different types of traumatic injuries.

Mandibular (Lower jaw) fractures account for 60-90% of all fractures of facial bones. Clinical and labour prognoses depend on the type of fracture, the course of recovery process, inflammatory complications, and the patient’s age.

In the case of uncomplicated fractures of the lower jaw in middle-aged patients, primary callus can occur in 2-3 weeks and secondary callus - in 6-8 weeks. Periods of fusion (healing) of mandibular fractures in the region of a branch (process of maxilla, maxillary process) is shorter than in other parts of a jaw. If displacement of bone fragments is not eliminated, the period of immobilization is extended for one more week; in case of developing traumatic osteomyelitis, it is extended for 2 weeks.

Periods of disability of the injured:

uncomplicated solitary mandibular fracture in persons who do hard manual labour	25-28 days 40-43 days
double mandibular fractures in persons who do hard manual labour	29-32 days 44-47 days
multiple mandibular fractures	30-50 days
– in case of complex fractures the period extends for	12-16 days

  Maxillary fractures

 This is a severe facial trauma. Clinical and labour prognoses for the injured are serious.

Periods of disability of the injured:

 

– in case of the fracture of alveolar process of maxilla in case of complications	– 7 days (до 10 дней) (up to 10 days)
– fractures to the body of maxilla	– 36-60 days
Le Fort I fractures	– 56 days
Le Fort II fractures	– – 65 days
Le Fort III fractures	– 75 days
the duration of disability for complicated fractures amounts to	– 120-130 дней

In case of complicated and multiple fractures of maxilla, disability is determined by a neurologist, otolaringologist, ophthalmologist, or a trauma surgeon.

The period of disability depends on the type of fixation of bone fragments: in case of a surgical intervention – up to 76 days.

Zygomatic arch fractures

Clinical and labour prognoses are favourable. After reposition of bone fragments, outpatient treatment is indicated. Inpatient treatment in hospital is administered to those who are to have surgical fragments fixation or are to undergo maxillary sinusotomy (in case of penetrating injuries).

Periods of disability of the injured:

 

In case of conservative modality of bone fragments fixation	– 8-10 days
In case of surgical fragments fixation	– 15-20 days
when maxillary sinusotomy is applied	– 18-22 days