First bite syndrome secondary to open TMJ surgery

e264

E-Poster Presentation

extraction, cyst extirpation, apicectomy, alveolectomy, maxillary oro-antral fistula closure, mandibular torusplasty, epulis removal, drainage of subperiosteal abscesses, and tooth transplantation. Objectives and methods: In a hands-on workshop, fifty Japanese GPs practiced on this surgical model with 68% of these GPs possessing ten or more years of clinical experience. After the training, the workshop participants were asked to fill out a questionnaire about the value of this new training model. Findings and conclusions: The results showed over 80% of positive responses for all training simulations, in particular, the undermining technique for oro-antral fistula closure which could also be applied to periodontal and dental implant surgery. We conclude that this training model is a useful educational tool for GPs as part of their professional lifelong learning. http://dx.doi.org/10.1016/j.ijom.2015.08.244 First bite syndrome secondary to open TMJ surgery A. Mohindra ∗ , M. Venkatasami, J. Green Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom Background: First bite syndrome (FBS) is an uncommon neuropathic pain syndrome associated with the autonomic supply to the parotid gland. Patients experience a brief excruciating pain associated with the first bite on the affected gland. On subsequent bites, the pain abates but recurs on the first bite of subsequent meals. It has been a presenting sign of a tumour, but is often a consequence of surgery. Recognised sites and approaches associated with FBS include the dissection in the parapharyngeal space or surgery affecting the deep lobe of parotid. Additionally surgery involving the sympathetic supply (associated with the external carotid artery) also has a high incidence of FBS post operatively. Objective: We present a new presentation of FBS associated with open TMJ surgery. To our knowledge, the occurrence of FBS associated with this approach has not been previously documented. Findings: We present the case of a 41 year old lady who underwent bilateral total joint replacement for degenerative osteoathritic disease. The surgical approach was an Al Kayat and Bramley modification of the preauricular approach. The joint was exposed laterally with no extension into the parapharyngeal space. Four months after surgery she developed symptoms of FBS. Having been offered neuropathic medications as well as botox, she went to improve her symptoms independent of any treatment. Conclusions: This highlights another potential surgical approach that a head and neck surgeon must appreciate may potentially cause the complication of FBS. Therefore consideration must be given to inform the patient of this potential complication. http://dx.doi.org/10.1016/j.ijom.2015.08.245

Hypotensive anaesthesia for orthognathic surgery and blood changes M. Monnazzi 1,∗ , M.A.C. Gabrielli 1 , M.F.R. Gabrielli 1 , E. Carlos 2 1

Faculty of Dentistry of Araraquara (UNESP), Araraquara, Brazil 2 SAARA Anesthesiology clinic of Araraquara, Araraquara, Brazil Hypotensive anaesthesia during orthognathic surgeries has been done for a while, and has been shown great advantages for this kind of surgery in terms of improving the surgical field and diminishing the blood transfusion necessities afterwards. This study was to determine the differences in some blood gases and renal function in patients submitted to orthognathic surgeries. The medical records of 52 patients were assessed to determine and quantify the changes in the blood pH, HCO3 , PaCO2 , BE, renal clearance, ETCO2 , urea, glycemic control and creatinine in patients submitted to hypotensive anaesthesia. The blood gases did not presented significate differences, with exception of the ETCO2 that presented differences in the patients. Regarding the renal function, the renal clearance show some difference when compared to the baseline values, suggesting that the hypotensive anaesthesia did interfere with the renal function, even if it was in low degree. The hypotensive anaesthesia is a great advance in anaesthesia for surgeries like orthognathic surgeries; however, further studies are required to make a deeper investigation in the patients submitted to it.1

Reference Yoshikawa, F., Kohase, H., Umino, M., & Fukayama, H. (2009). Blood loss and endocrine responses in hypotensive anaesthesia with sodium nitroprusside and nitroglycerin for mandibular osteotomy. Int J Maxillofac Surg, 38(11), 1159–1164.

http://dx.doi.org/10.1016/j.ijom.2015.08.246 Use of autogenous bone and beta-tricalcium phosphate in maxillary sinus lifting volumetric tomographic study M. Monnazzi ∗ , F. Boos, L. Gorla, E. Hochuli-Vieira Faculty of Dentistry of Araraquara (UNESP), Araraquara, Brazil The correction of bone defects can be performed using bone grafts or alloplastic implants. Intending to minimize the morbidity for the patients the use of alloplastic implants has grown over the years. In order to evaluate and compare the repair process using three different substratum as graft, this study used computed tomography and a 3D manipulation software to compare Autogenous bone, bone associated to Beta-Tricalcium Phosphate 1:1 (Chronos® /Synthes) and Beta-Tricalcium Phosphate alone as graft material for sinus lifting of 32 patients. The volumetric changes of the human sinus grafts were evaluated by comparing CT scans obtained in the immediate postoperative period (5–7 days) and 6 months late in each group through three-dimensional reconstruction with OsiriX software (OsiriX Foundation, Geneva/CH). The results showed an average reabsorption of 38.3 ± 16.6% for the autogenous bone group I, 43.8 ± 18.4% for the autogenous