Accepted Abstracts Gallery

The International Association of Oral and Maxillofacial Surgeons (IAOMS) is pleased to collaborate with the European Association  for Cranio Maxillo Facial Surgery (EACMFS) for the IAOMS/EACMFS NextGen Online Conference.

The abstracts published here are the accepted abstracts, as selected by the conference Scientific Committee, from among submissions in four topic categories:  Dental Implants, Oncology-Management of the Neck for Oral Cancer, and Minimally Invasive Aesthetic Cranio-maxillofacial Surgery.

Click on the quick link below to view the title and authors of all accepted abstracts. 

Dental Implants  |  Oncology-Management of the Neck for Oral Cancer  |  Minimally Invasive Aesthetic Cranio-maxillofacial Surgery  |  Video Abstracts

View The 2023 Accepted Abstracts

Dental Implants

• Dental rehabilitation of severe atrophic maxilla using CAD/CAM Patient Specific Implants 

  Primary Author: Konstantinos Katoumas

  Abstract:

  Treatment of severely atrophic maxilla is demanding. Dentures are usually poorly fitting, cannot restore proper function and many patients do not accept them. Placement of conventional implants demands extensive bone augmentation and regularly a bone donor side. Extended healing period is usually required and implants placed are regularly loaded after months. When bone reconstruction is not desired, have failed or immediate dental restoration is demanded the only option until recently was the use of zygoma and pterygoid implants, whose correct positioning is demanding and are more difficult to restore. Purpose: To present two case reports of patients with severely atrophic maxilla that have been treated with CAD/CAM patient specific implants and had immediate prosthodontic restorations. Methods: Two patients a 59-year-old man and a 62-year-old woman, had severe atrophy of the alveolar bone, did not want elaborate bone augmentation surgeries and desired to have immediate dental restorations. In both patients CAD/CAM patient specific implants and placement guides were constructed. Results: In both cases, surgery was performed under general anesthesia. The maxilla was prepared with custom made guides and the patient specific implants were inserted and anchored in placed with titanium screws in the nasal and zygoma buttress areas.  In each patient, a provisional dental restoration was applied after mucosa healing and the final prosthetic restoration was applied after an initial observation period. Conclusion: Dental rehabilitation with patient specific implants was immaculate in both patients which presented with severely resorbed alveolar bone and the wish for immediate dental rehabilitation. Keywords: patient specific implants, atrophic maxilla, CAD/CAM imlpants

   

• External sinus lift using piezoelectric device with staged or simultaneous implant placement: Breaching science with clinical practice. A Clinical and radiological success evaluation of outcomes.

  Primary Author: Carine Tabarani

  Abstract:

  Tooth loss in posterior maxilla is frequently associated with subsequent bone loss, which results in inadequate bone dimensions for implant placement in ideal position. Numerous reconstruction procedures have been proposed to restore bone loss related to sinus pneumatization in order to obtain a sufficient ridge volume for adequate implant placement and prosthodontic rehabilitation. Since many complications can be encountered during the external sinus lift procedure, mainly perforation of the Schneiderian membrane, the piezoelectric device has been introduced as a main solution ensuring  safety and efficiency during the  lateral sinus lift surgery. The aim of the following presentation is to evaluate how far did we get in the lateral sinus lift technique using piezoelectric devices with or without simultaneous implant placement, regarding success criteria and long-term results while presenting some challenging clinical cases with reduced vertical height and maxillary sinus pneumatization, while comparing to other techniques of Shneiderian membrane elevation that are used today and exposing outcomes by breaching science with clinical practice. 

   

• Reversibility of Peri-implantitis with Regenerative Methods: case series report

  Primary Author: Theodore Kao

  Coauthor: Shou-Yen Kao

  Abstract:

  Introduction: Peri-implantitis is a progressive disease associated with bone loss, decreased osseointegration, probing pocket depth(PPD) formation. Patients with dental implants more than ten years are more likely to have peri-implantitis. Previous studies showed peri-implantitis couldn't be predictably treated by non-surgical treatment only, though relieving acute symptom and signs. Surgical interventions could be more predictable. We aimed to evaluate the regenerative methods for treating peri-implantitis. Case Description: Three patients complained about pain with soft tissue bleeding around dental implants. Clinical examination showed peri-implantitis, with 6 dental implants included. The defect morphology were classified using classification introduced by Prof. Hom-Lay Wang in 2019, ranging from class-Ic Gr-M, to Class-III Gr-M. Initial mean PPD was 7.48mm. Soft tissue became consistent by using non-surgical treatment firstly, then surgical intervention was conducted. During operation, we used titanium currette for debridement. Doxycycline (50mg/ml) was applied around implants, combined with Er-YAG laser application. Implantoplasty was performed. After smoothly polished, defects were grafted with FDBA & resorbable membrane. Discussion: The initial percentage of probing sites ≧6mm was 86%, mean PPD was 7.48mm. Mean PPD reduced to 2.83mm after one month of non-surgical therapy. After surgical interventions, periodic X-ray showed radiographic bone fill of average 3.2mm around dental implants.The mean percentage of bone gain was 84%. Conclusion: Regenerative therapy with implantoplasty can successfully arrest peri-imlantitis. The periodic radiographic also manifested optimistic bone gain in those previous destructed sites. After bone graft was stable, soft tissue augmentation can be considered where keratinized tissue were less than 2mm, to improve tissue health and maintenance.

   

• An alternative to dental implants: surgical and endodontic management with digital planning and drilling splint for autotransplantation of third molars.

  Primary Author: Silvio Llanos

  Abstract:

  AN ALTERNATIVE TO DENTAL IMPLANTS: SURGICAL AND ENDODONTIC MANAGEMENT WITH DIGITAL PLANNING AND DRILLING SPLINTFOR AUTO TRANSPLANTATION OF THIRD MOLARS. Llanos, Silvio1; García, Henry2; Bonilla, Carolina3; Manresa, Carlos3; Tebres, Julio3; Baasch, Alessandra4.  1 Resident of Oral and Maxillofacial Surgery at Hospital General del Oeste, Magallanes de Catia. 2 Oral and Maxillofacial Surgeon at the Children's Orthopedic Hospital of Caracas, Venezuela. 3 Professor of oral and Maxillofacial Surgeon at the Hospital General del Oeste, Magallanes de Catia. 4 Coordinator of Endodontics, Santa María University. The surgical movement of a tooth from one socket to another, in the same individual, is defined as an autotransplantation. Digital technology has led us to plan these cases to increase the success rate and decrease surgical time. The aim of the study was to evaluate the success rate of dental autotransplantation through digital planning, evaluating autotransplanted teeth from a clinical and radiographical standpoint. Methodology: A digital protocol was designed for 10 patients who met the inclusion criteria, using a CARP model and a drilling splint, after 2 weeks from the surgery, endodontic treatment was performed. All cases were operated by the same surgeon, endodontic treatments were implemented by the same endodontist, and controls by calibrated evaluators. The data was analyzed with descriptive and inferential statistical studies. Results: Follow ups were made, during the first, the third and the sixth month, and then after one year fromautotransplantation. A success rate of 80% was obtained and the treatment failed in 20% of the patients. Evaluations criteria  included the appearance of the gum, depth of the periodontal socket and dental mobility. Furthermore, we observed in radiographic evaluations the absence of periapical pathology,rizalysis and ankylosis. Conclusion: after evaluating the variables, the success rate was related directly to the position of the third molar and the extraoral time of the donor’s tooth. Although this is a procedure depends on the skill of the operator, by establishing a protocol with digital planning, the treatment is more predictable over time.       References: 1. Tsukiboshi M, Yamauchi N, Tsukiboshi Y. Long‐Term outcomes of autotransplantation of teeth: A case series. Dental Traumatology. 2019 Oct 14;35(6):358–67.   2. Lee SJ, Kim E. Minimizing the extra-oral time in autogeneous tooth transplantation: use of computer-aided rapid prototyping (CARP) as a duplicate model tooth. Restorative Dentistry & Endodontics. 2012;37(3):136.   3. Lucas-Taulé E, Llaquet M, Muñoz-Peñalver J, Somoza J, Satorres-Nieto M, Hernández-Alfaro F. Fully Guided Tooth Autotransplantation Using a Multidrilling Axis Surgical Stent: Proof of Concept. Journal of Endodontics. 2020 Oct;46(10):1515–21.   4. Jang Y, Choi YJ, Lee SJ, Roh BD, Park SH, Kim E. Prognostic Factors for Clinical Outcomes in Autotransplantation of Teeth with Complete Root Formation: Survival Analysis for up to 12 Years. Journal of Endodontics;42(2):198–205.   5. Andreasen JO, Paulsen HU, Yu Z, Bayer T. A long-term study of 370 autotransplanted premolars. Part IV. Root development subsequent to transplantation. Eur J Orthod 1990; 12:38–50.

   

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Oncology-Management of the Neck for Oral Cancer

• Ligation of Lingual artery in Tongue resections - our experience.

  Primary Author: Kishore Kumar

  Abstract:

  Ligation of Lingual artery in the lingual triangle is a known procedure. Ligation can be done as an emergency procedure or as an elective procedure.      Materials & methods- The study was carried out in  71 patients   with carcinoma of Tongue ,where in Glossectomy and neck dissection were performed. 30 were male patients (42.2 %),41 were females  patients(57.8%). Age ranges from 33 years to 80 years with an average of 54.5 yrs. Left side is more commonly involved (71.8%) than right side (28.2%). After neck dissection the post.belly of digastric muscle is pulled up , hypoglossal nerve is identified . Then blunt dissection done upwards and medially along the external carotid artery to identify the origin of  lingual and facial arteries.  The ligated facial artery is   pulled up and Lingual artery can be identified by its antero-medial origin and immediate upward U turn bend and disappearing beneath hyoglossus muscle. Then two silk threads are passed around the lingual artery and ligated at one centimetre   distance apart. It is not cut. Then Glossectomy procedure can be carried out.   Discussion- This technique will control the bleeding during resection of tongue. Medial to mandibular first molar lingual artery can also be identified and ligated. Some literature says the chances of secondary-bleeding from Infection, Tip necrosis of tongue, Loosening of sutures due to tongue movements   can be avoided by ligating in the neck. . Conclusion –This method showed good results   with clean surgical resection of tongue with minimal intra-operative (<20 ml) and post-operative bleeding.

   

• Anticoagulation Strategies Following Microvascular Anastomosis In Head And Neck Reconstruction.

  Primary Author: Akash Menon

  Abstract:

  Background: Free flaps for head-neck reconstruction has been the mainstay for decades but despite advancements, there exists a 5–10% rate of anastomotic thrombosis independent of systemic factors. Several anticoagulation regimens have been described. This study aimed to compare the most common protocols. Methods: Patients requiring free flaps in 24-month period were randomised into i) Aspirin monotherapy (325mg/day) ii) Low Molecular Weight Heparin (LMWH) 40-60mg/day + Aspirin 75mg/day iii) LMWH 40-60mg/12hour + Aspirin 75mg/day iv) No anticoagulation Symptoms of microvascular thrombosis triggered urgent reexploration, salvaging which a 24-hour Heparin IV infusion was given. Thereafter planned anticoagulation was restarted. Outcomes measured were flap viability, reexploration, bleeding, haematoma and thromboembolic events. Results: 142 out of 185 patients were included. Flap viability did not vary significantly across the groups (p=0.46), with a cumulative total flap loss of 2.1% (n=3) and partial flap loss of 8.4% (n=12). Reexploration was the highest in those not receiving anticoagulation (n=8), however, the difference was not significant (p=0.064) on intergroup analysis. Haematoma was significantly higher (p=0.042, n= 13) in LMWH/12hour group, while other parameters were non-significant. Conclusion: Prophylactic anticoagulation does not decrease the incidence of flap loss or neck reexploration. Routine LMWH usage can cause worrying haematomas. Meticulous anastomotic technique and flap surveillance can obviate the need for expensive and potentially harmful anticoagulation therapy.

   

• Use of Lugol's Iodine as a Tool for Preliminary Oral Biopsies.

  Primary Author: Tasneem Janmohamed

  Coauthor: Khair Ul Bariya Ali

  Coauthor: Aisha Hassen

  Coauthor: Ashana Gupta

  Abstract:

  Lugol’s iodine solution reacts with glycogen in the cytoplasm, picking up stain, however there is poor uptake in dysplastic cells. Lugol’s is used in theatre, during excisions of oral squamous cell carcinomas (SCC) at margins. The same principle has been applied in our department for incisional biopsies of flat red/white lesions under local anaesthetic, to localise where the biopsies should be taken. A 2-part audit was carried out; a retrospective analysis to assess frequency of repeat biopsies being requested on the histopatholgy report and a prospective exercise to assess if clinicians can blindly identify the biopsy site that Lugol’s highlights. Method/Results Analysis was carried out of all the biopsies performed over a 3-month period under local anaesthetic. All red/white patches identified were stained with Lugol’s and had photographic images taken with and without staining. Over 3 months, 16 lesions were stained, 5 were confirmed as SCC/dysplasia. No repeat biopsies were requested. For the second part of the audit; photographs of lesions prior to staining, were shown to clinicians to assess where they would take a biopsy from. The Lugol’s stained image was then shown to them to see if the area they selected correlated. 6 clinicians identified biopsy sites on images, and this did not always correlate with Lugol’s. Discussion/ Conclusion Lugol’s can be used to prioritise which lesions should be biopsied urgently and to localise the site of preliminary biopsy. This would be a standardised, cost-effective method amongst all clinicians, which is objective compared to current methods of inspection alongside palpation.

   

• A Rare Case Of An Oral Malignant Melanoma.

  Primary Author: Alexander Rae

  Abstract:

  We present a 58 year old female who was referred for an pigmented lesion on the hard palate. This poster will outline the diagnosis, investigations, management and current literature regarding an oral melanomas. A 58-year-old patient presented with 5 month history of a pigmented lesion on the right hard palate.  Intra-orally there was a diffuse brown pigmented lesion adjacent to a prominent palatal torus. A provisional diagnosis of an oral melanoma was made and the patient underwent radiological and histopathological investigations. Surgical resection is the preferred treatment modality in combination with adjuvant therapy. Limited cases in the literature have shown a reduction in recurrences post surgery when combined with immuno-chemotherapy. A biopsy was performed which showed hyperkeratinised stratified squamous epithelium overlying fibrovascular connective tissue. The underlying connective tissue was infiltrated by strands and nests of spindle cells with nuclear and cellular pleomorphism, abnormal mitoses and focal melanin deposition. These features confirmed the diagnosis as a mucosal melanoma. The patient underwent a bilateral neck dissection with an extensive palatal resection and had an uneventful post-operative period. The oral melanoma is an extremely rare malignancy of melanocytic origin, accounting for only 1.6% of all head and neck malignancies. The significance lies in early detection of the lesion because oral melanoma has a poor prognosis. The five-year survival rate for oral melanoma ranges from 4.5% to 29%, with a median survival rate of 18.5 months after initial diagnosis. I will cover the current literature and clinical guidance for management and treatment of this aggressive cancer.

   

• Second primary tumors in head and neck cancer patients. A literature review and case report.

  Primary Author: Edgar Luque Acuna

  Coauthor: Johannes Rene Cabello

  Coauthor: Paola Favela Miller

  Abstract:

  Head and neck squamous cell carcinomas represent approximately 3% of all human malignancies and most occur in the upper aerodigestive tract (UADT). Patients with UADT squamous cell carcinomas have a high risk of developing other cancers simultaneously or subsequently. After the third year, the diagnosis of a second primary tumor (SPT) becomes an important cause of morbimortality. Rates of SPT in head and neck cancer (HNC) have been reported as 10–35%. Most SPTs are discovered at least 6 months after the index tumor and referred as metachronous tumors. Epidemiological studies demonstrated an excess risk of developing SPTs in HNC patients. Increased risk of SPTs persist 10 years after diagnosis of the first primary. Risk remains over time during a 30-year follow-up period. Studies have explored the location of the index tumor, clinical stage, human papillomavirus infection, alcohol consumption, smoking and treatments received as possible risk factors. Aerodigestive tract epithelium may be exposed to tobacco and alcohol carcinogens, patients with squamous cell carcinoma of head and neck have increased risk of developing multiple cancers, such as local recurrences, SPT and other sites sharing these risk factors, according to the “field cancerization” phenomenon. Recurrent disease and SPT represent major obstacles to long-term survival in HNC, although patients with SPT may have favorable prognosis than those with recurrence, hence they should be distinguished and analyzed as distinct subgroup of patients. Following the review a clinical case of a patient with 3 primary head and neck tumors is presented.

   

• Epithelial-Mesenchymal Transition Markers for Predicting Lymph Node Metastasis in OSCC.

  Primary Author: Michael Joachim

  Coauthor: Yasmin Ghantus

  Coauthor: Imad Abu El-Naaj

  Abstract:

  In recent years, there has been increasing interest in the study of Epithelial-Mesenchymal transition (EMT) in oral cancer due to its potential role as a therapeutic target. EMT is a complex biological process of great significance in the development and progression of epithelial tumors. During the process of EMT, several key changes occur which grant the epithelial cells mesenchymal-like characteristics, such as motility, invasiveness, and migration. Also, many studies demonstrated that EMT is a key step in developing metastasis in several epithelial tumors. In this study, we mainly investigated EMT markers that would predict the presence of lymph node metastasis in oral cancer. Material and Methods: Molecular data sets of 528 head and neck carcinoma patients were obtained from TCGA data portal (https://cancergenome.nih.gov/) and the Genome Data Analysis Center (GDCA). Genomic processing of the molecular data sets was done using cBioPortal for Cancer Genomic analysis (http://www.cbioportal.org/). Genomic clustering for key EMT genes were done, and a significant relationship between gene expression and the presence of lymph node metastasis was evaluated and then validated using Immunohistochemistry staining of OSCC samples. Results: the present study demonstrated the significance of the “Cadherin switching pathway” in the progression of lymph node metastasis. Also, several key genes were found, in the tumor microenvironment, to play an important role in predicting the presence of lymph node metastasis.

   

• Advanced non-melanocytic skin cancer in the facial region: versatility of local reconstructive flaps in the outpatient setting.

  Primary Author: Fausto Rispoli

  Abstract:

  Background: Non-melanoma skin cancers (NMSC) include basal cell carcinoma and squamous cell carcinoma. They represent the most frequent forms of neoplasms of the facial skin. The reconstruction in Outpatient Setting of post ablative face defects is a real challenge from the perspective of surgical techniques.  Purpose: This study was conducted to show the versatily and reliability of local flaps in facial reconstruction in Outpatient Setting, with less waiting times for the patient and reduced healthcare costs. Methods: We reviewed 8 patients diagnosed with NMSC on the face between April 2021 and March 2023, surgically managed by a single surgeon (FR) at Gemelli Molise. Medical records were retrospectively reviewed to identify the type of skin cancer, the site of onset, local reconstructive flap, complications, and recurrence during follow-up. Results: 8 patients, affected by NSMC, underwent complete tumor resection and reconstruction after excision of facial skin cancer whit local flaps in Outpatient Setting. The most frequent type of cancer was bas cell carcinoma, the most common sites were the nose and the cheek. Reconstructive flaps choosen where, according to facial region: scalp (1) O-Z flap; temple (1) Limberg rhomboid flap; cheek (2) V-Y advancement flap, rotation flap; nose (2) bilobed flap, rotation flap; lip (1) advancement V-Y flap; neck (1) Z-plasty. No recurrence was reported. Partial necrosis occured for a scalp flap. Conclusions: Local flaps represent a versatile and reliable option for facial reconstruction in Outpatient Setting for patients affected by NSMC, with less waiting times and reduced healthcare costs.

   

• Clinicopathological Study of Orofacial Tumors in Iraq.

  Primary Author: Tahrir Aldelaimi

  Coauthor: Afrah Aldelaimi

  Abstract:

  Oral and maxillofacial lesions and tumors comprise a broad spectrum of benign and malignant lesions that affect the oral cavity and face disorder with various clinical behaviors and histopathological presentation.   Due to their special location, these neoplasms affect speaking and swallowing that may result in movement of teeth, bony expansion and involvement of adjacent craniofacial structures and destruction. This study aims to conduct a clinicopathological study of the management of the craniofacial tumors among patients in Iraq. A total of 586  patients, including  (≈42%) males and  (≈58%) females, enrolled in the study were attending the Ramadi Teaching Hospital, Zuhur Private Hospital, Razi Private Hospital and Rashid Private Hospital for diagnosis and treatment. Of the total collected samples,  (28%) were in the age group of 31- 40 years, (60%) were presented as mass,  (42%) were treated by surgical excision and (22%) were treated by laser surgery.The results of the present study provide valuable information on the prevalence of Oral and maxillofacial lesions and tumors in Iraq. Further studies are necessary to provide more information on head and neck diseases in the general population to develop better future oral health policies. Many cystic and neoplastic pathosis are unique in maxillofacial region due to aesthetic defect and functional impairment which revealed variations in geographical prevalence as well as pattern due to occupational, sociocultural, and climatic factors.

   

• U-Shaped Microvascular Fibula Flap For Maxillary Reconstruction After Similar Le Fort I/II Defect - 5 year follow-up

  Primary Author: Laurindo Moacir Sassi

  Coauthor: Jose Dissenha

  Coauthor: Fernando Zanferrari

  Coauthor: Alfredo Silva

  Coauthor: Paola Pedruzzi

  Abstract:

  The difficulties faced in facial reconstructions and rehabilitations are different for each case. OBJECTIVE: To present a technique using a U-shaped microvascular fibular flap (US-MFF). METHOD: This technique’s indication is for patients who need reconstruction of Le Fort I/II maxillary defects due to resection of tumors, necrosis, trauma. The fibular osteotomy is performed in three segments. The first and third segments are aimed at reconstructing the left and right upper alveolar ridge and the maxillary reinforcement. The middle segment is used to reconstruct the upper anterior region of the maxilla. The flap has a U-shape. System 2.0 miniplates and screws are used, fixing the segments to each other and to the zygomatic-complex (CZ) in the posterior region. In the second surgical procedure, approximately 3 months later, a bone graft from the iliac crest is placed, with two buttresses in the canine fossa joined to the fibula segment with the anterior C-Z. Case Report: Female patient, 20 years old, Caucasian, with a history of a nautical accident with Jet Sky, causing bilateral horizontal maxillary avulsion, type Le Fort I/II. The patient sought the specialized service for late reconstruction of the defects. Reconstruction was proposed and performed using the US-MFF technique. The procedures did not present vascular complications and presented satisfactory stability between the bone segments. After 5 years, satisfactory evolution and installation of dental implants and rehabilitation. Aesthetics and function have been restored. CONCLUSION: US-MFF is believed to be a viable alternative for the reconstruction of extensive maxillary defects.

   

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Minimally Invasive Aesthetic Cranio-maxillofacial Surgery

• Occlusal plane alteration in Orthognathic surgery: aesthetic and functional outcomes

  Primary Author: Mohamed Ghanem

  Abstract:

  Functional and aethtatics outcomes of modern  orthognathic surgery have became very demanding. Straight line movements of single or double jaw Orthognathic surgery is seldom enough to achieve best outcomes.    surgical alteration of the occlusal plane through double jaw surgery  is not only indicated in patients with low occlusal plane or the high occlusal plane angles, but also, with patients having occlusal cant or differential gummy smile. Alteration of the occlusal plane can be done through variaity of rotation points to achieve best functional and aesthetic outcomes. in this presentation we will discuss the principles, indications and technical challenges through presenting a variety of cases, their preparation and outcomes.

   

• Endoscopic Lithectomy in the Treatment of Salivary Glandular Sialolithiasis

  Primary Author: Fernando Almeida-Parra

  Co-Author: Alvaro Ranz Colio

  Co-Author: Angela Bueno-deVicente

  Co-Author: Patricia de Leyva

  Co-Author: Julio Acero Sanz

  Abstract:

  Keywords: sialoendoscopy, salivary glands, lithectomy, inflammatory salivary gland disease Objetives: The sialolithiasis of the salivary glands constitutes one of the most frequent pathologies in maxillofacial diseases. The emergence and development of sialoendoscopy allows the minimally invasive treatment of these patients with promising results, reducing morbidity, lowering health costs and accelerating the recovery of patients with this pathology. We present our experience in the implementation of this technique in an oral and maxillofacial surgery department and the results obtained at the 4 years of its onset. Results: We present 51 cases of inflammatory glandular disease from September 2018 to March 2023 of lithiasis origin, treated by endoscopic lithectomy. In 45 of the 51 cases, the lithectomy was achieved without the appearance of complications. The cases of failure of the procedure were when a lithiasis of 10 mm of diameter were present. No complications have been found in the follow up of the patients. Conclusion: Sialoendoscopy can be served as an organ-preserving approach for the diagnosis and treatment of inflammatory obstructive salivary diseases by lithiasis.

   

• Orthognathic surgery and rhinoplasty

  Primary Author: Angela Bueno-deVicente

  Co-Author: Fernando Almeida-Parra

  Co-Author: Eduardo Sanchez-Jaureguil Alpanes

  Co-Author: Elena Baranda Manterola

  Co-Author: Bianca Lago Beack

  Co-Author: Patricia de Leyva

  Co-Author: Alvaro Ranz Colio

  Co-Author: Alberto Haddad Riesgo

  Co-Author: Julio Acero Sanz

  Abstract:

  Objectives:Alteration of the position of the bone structure have an impact on the facial soft tissue and nasal structure. The purpose is to evaluate nasolabial changes after orthognathic surgery, to predict the need for rhinoplasty and to describe a temporary algorithm. Materals and Methods:A literature review is carried out on the changes that occur in the nasal region after maxillary osteotomy, the ancillary procedures that can be used to try to correct them, and the need for rhinoplasty to manage negative changes. The possibility of performing rhinoplasty simultaneously or in a second surgical stage is discussed. Results:Orthognathic surgery can significantly impact the nasolabial structure and these changes have been well characterized: base widening, tip changes, the most frequent. In some cases these changes improve the nasal appearance; in other, an iatrogenic nasal alteration occurs, which can be anticipated and avoided with different maneuvers: subspinal osteotomy, piriform guttering, septal trimming and fixation, alar cinch suture and V-Y closure. Finally, there are cases in which correction with rhinoplasty is necessary, which can be performed simultaneously or staged, depending on previous nasal structure, the movements to be performed, the approach, and the experience of the surgeon. Conclusion:Altering the position of the maxilla with orthognathic surgery changes the nasal appearance and function. Although some ancillary procedures are possible, in some cases rhinoplasty may be required.The combination of both procedures can significantly improve the results obtained, but it is necessary to make an individualized evaluation to decide if it can be done simultaneously or in a second time.

   

• Severe Facial Soft Tissue Injuries & Our Management In Libya

  Primary Author: Kurdi Salahn

  Abstract:

  The aim of study to assess the treatment of severe soft tissue injuries in maxillofacial region operated in the department of Oral & Maxillofacial Surgery, Abuslim Trauma center in Tripoli -Libya. In this paper the most common etiology  in civilian life, severe soft tissue trauma is often associated with motor vehicle accidents and subsequent injury is usually severe and consists of multiple damage and the most of the patients with severe soft tissue injuries require definite soft tissue rehabilitation with a combined multidisciplinary approach.

   

• Minimally invasive Methods for the Elimination of the Residual Facial Asymmetry in Patients after Facial Paresis.

  Primary Author: Nigar Sultanova

  Abstract:

  Introduction. Surgical reconstruction of facial paresis is divided into two main groups: static and dynamic reconstructions. The static ones aim to restore symmetry of the face at rest, while the dynamic ones strive to recreate muscle function of the mouth and the eye respectively to improve closing function. A successful reconstruction is a major challenge, and it is often necessary to use several different surgical techniques to achieve a satisfactory result. Purpose: to eliminate of the residual facial asymmetry in patients after facial paresis. Materials and methods. 6 patients applied to the maxillofacial surgery department of the Azerbaijan Medical University, with residual facial asymmetry after facial paresis, between 2021 to 2023. The patients passed the following types of examination: clinical, photography, anthropometry, computer simulation. The patients underwent 3D facial scanning using a Bellus- Arc 7 scanner (California, USA).  The patients underwent microlipografting of the middle part of the face, gliding brow lifting, upper blepharoplasty, gliding lip corners lift of the one half of the face. The quantity of the fat was established individually . Results. Postoperative follow-up was performed after 2 and 4 weeks, 3, 6 and 12 months and consisted of a clinical examination, anthropometry, comparison of photos and videos before and after mini invasive surgery. A reasonable aesthetic and functional result was obtained in all patients. Conclusion. Microlipografting, gliding brow lifting, upper blepharoplasty, gliding lip corners lift of the half part of the face are minimally invasive and effective procedure for the elimination of residual facial asymmetry in patients after facial paresis.

   

• Resolving Post Operative Sialoceles - A quick and easy technique using an indigenously designed stent

  Primary Author: Tulasi Nayak

  Abstract:

  Purpose: To demonstrate an easy and effective way to manage sialoceles formed after ablative head and neck surgery  Methods  Sioloflo- An indigenously designed tapered stent was threaded into the sialoceles using the seldinger manoeuvre. The stent is designed to have side ports to prevent blockages and a flange to be secured with sutures. The stent decompresses the sialocele and allows natural healing and fibrosis. Results  11 patients with sialoceles were successfully treated using this stent. All the sialoceles resolved in 4-6 days. Conclusion  Sialoceles post ablative head and neck surgeries are a common and annoying problem. The sialoflo stent is a useful tool which allows for a minimally invasive, quick and easy resolution to sialoceles.

   

• Long Term Clinical Outcome Of Temporomandibular Joint Ankylosis Treated With Buccal Fat Pad As Interpositional Material and quality of life after surgery

  Primary Author: Satnam Jolly

  Co-Author: Vidya Rattan

  Abstract:

  Abstract Purpose : To evaluate the recurrence rate of TMJ ankylosis treated by interpositional arthroplasty with buccal fat pad and quality of life after surgery Material and Methods: 50 patients treated for TMJ ankylosis from January 2011 to November 2020, by interpositional arthroplasty with a buccal fat pad were included in the study. All the patients were evaluated for the latest postoperative mouth opening, and jaw excursion movements using a vernier caliper, and the results were compared with preoperative records. Group A(n=36) included patients of age 12 years and above and Group B(n=14) included patients less than 12 years of age. Both the group of patients filled out the same TMJAQoL questionnaire which had global ratings score and four domains of Oral Health Impact Profile i.e., symptoms, functional limitation, psychological wellbeing, and social wellbeing domain. Results:. The recurrence rate was 0% after a mean follow-up period of 51.08±23.70 months. The latest postoperative mouth opening (mean±SD 35.36±9.25) had significantly(p<.001) increased when compared to preoperative(mean±SD 6.92±6.33) and immediate postoperative mouth opening(mean±SD 28.74±6.94). Postoperative ipsilateral movement(mean±SD 6.565±2.99) & contralateral movement(mean±SD 2.783±2.49) had significantly(p<.001) increased when compared to the preoperative ipsilateral(mean±SD 2.09±2.26) and contralateral movements(mean±SD 0.848±1.15). The postoperative protrusive movement had non-significantly(p=0.31) increased compared to preoperative protrusive movement. There was an overall statistically significant improvement in Oral Health Impact Profile in both Group A (p<.001) and Group B (p=.002) patients. The global rating score which defines the overall quality of life and health-related quality of life was statistically significant in both Group A and Group B patients. Conclusion: This study shows that the recurrence of TMJ ankylosis can be effectively reduced using a buccal fat pad as an interpositional material and also improve the quality of life of an individual.

   

• Orthognathic Surgery: From Conventional To Minimally Invasive. Ours Team Experience.

  Primary Author: Luis Manuel Bustos Aguilera

  Co-Author: Maria Ramirez Medina

  Abstract:

  Orthognathic Surgery: From Conventional To Minimally Invasive. Ours Team Experience. There is currently a boom in the term minimally invasive surgery. In orthognathic surgery there are few articles that talk about minimally invasive orthognathic surgery, such as standardizing a protocol and long-term results. There are no scientific articles about the learning curve of the minimally invasive orthognathic surgery. That is why we want to present how our real experience has been in the transition from conventional orthognathic surgery to minimally invasive surgery. We currently follow the IBMF Philosophy of Minimally Invasive Orthognathic Surgery, by Dr. Jonathas Claus and his team. We perform a specific protocol in each patient, standardization of the surgical procedure, we present minimally invasive orthognathic surgeries in a period of 18 months, operated by the same surgeon, the same surgical team and the same surgical technique. An analysis of variables is performed: diagnosis, treatment plan, surgical time, bleeding, hospital stay and complications; to be able to compare it with the existing information with conventional orthognathic surgery. In this way we can determine the learning curve, what is needed for training in this technique and establish a protocol in minimally invasive orthognathic surgery and the benefits it presents.

   

• Management of Florid Cemento Osseous Dysplasia Case Series

  Primary Author: Aisha Hassen

  Co-Author: Tasneem Janmohamed

  Co-Author: Khair Ul Bariya Ali

  Abstract:

  Florid cemento-osseous Dysplasia (FCOD) is a benign, multifocal process which causes replacement of trabecular bone in the mandible and maxilla with abnormal osseous bone and cementum. Predominantly in women of African descent, it can be an incidental finding on radiographs. Diagnosis is through radiographic presentation of mixed radiolucent and radiopaque masses in 3-4 quadrants of either the maxilla or mandible or widespread in one quadrant. Biopsies may not always be required in FCOD but would histologically show dense sclerotic calcified cementum like masses. This paper will focus on 5 cases diagnosed and managed in our department. 2 cases are of asymptomatic patients with radiographic confirmation of diagnosis. The other 2 cases were symptomatic presentations, bone biopsies confirmed histological diagnosis. The last case requires secondary care of surgical debridement and primary closure of sequestrum, this is due failure to heal post extraction in primary care. The purpose of this paper is to emphasise intervention with surgical treatment only when required and in cases where a biopsy is performed, clinicians should actively consider the risks including poor healing, sequestrum formation, infection and jaw fractures. Primary closure is of key importance perioperatively to reduce the risks and complications.    Authors: Dr Aisha Hassen (DCT2), Dr Tasneem Janmohamed (DCT2), Dr Khair Ul Bariya Ali (DCT1) and Mr Kandasamy Ganesan (Oral Surgery Consultant)

   

• Is Virtual Planning a Tool for Nasal Reconstruction?

  Primary Author: Liseth Chacon

  Co-Author: Paolo Verona

  Co-Author: Nicolas Solano

  Co-Author: Hermann Pulgar

  Abstract:

  Purpose: Computer Aided Design and Aided Manufacturing software have evolved rapidly in the last decade to improve virtual surgical planning in craniomaxillofacial surgery, developing the precise manufacturing of cutting guides, stereolithographic models, and custom implants. This technology facilitates the visualization and manipulation of the craniomaxillofacial skeleton, allowing the surgeon to plan and anticipate challenges, which improves surgical precision and accuracy, optimizes results, and reduces surgical time. We present the development, evolution, and use of virtual surgical planning and stereolithographic models in allogeneic transplantation for nasal reconstruction. Methods: Descriptive field research, clinical case study. Female patient who is 16 years old with Crouzon Syndrome, high aesthetic requirements, however, she refused very invasive craniofacial surgeries, for which it was decided to perform maxillomandibular orthognathic surgery and advancement genioplasty, plus primary rhinoplasty with graft preservation technique costochondral and placement of facial prostheses. Results: The optimal facial aesthetic correction is achieved through virtual planning; the printing of the stereolithographic models allowed the carving of costochondral grafts for nasal reconstruction with precision and decreased surgery time. Conclusion: Virtual planning is currently considered an integral complement for the planning and execution of complex craniomaxillofacial surgeries with high aesthetic requirements, since it improves precision, efficiency and reduces surgical time compared to traditional techniques.

   

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