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Microvasculcar reconstruction of maxillary defects
Symposia
The Use of Transport Distraction Osteogenesis to Close a Maxillary Defect Joseph I. Helman, DMD, Ann Arbor, MI (no abstract provided)
Microvasculcar Reconstruction of Maxillary Defects Remy H. Blanchaert Jr, MD, DDS, Kansas City, MO Microvascular techniques offer a reliable means of primary reconstruction of maxillectomy defects. Advantages of immediate reconstruction include prompt healing allowing early initiation of adjuvant therapy, restoration of form prior to the development of scar contracture, and simultaneous restoration of composite tissue defects. As in all reconstructive endeavors, the selection of the most appropriate reconstructive technique requires careful review of the clinical behavior of the tumor, the ability to perceive or anticipate the ablative deformity, establishment of appropriate surgical goals, and a comprehensive understanding of the versatility and adaptability of the available composite tissue flaps. By no means is microvascular free tissue transfer the only or most appropriate means of reconstruction of
all maxillectomy defects. One of the most challenging and rewarding aspects of reconstructive surgery is selecting the most suitable reconstructive technique for each individual case. This presentation is designed to assist the participants in planning reconstruction of patients following maxillectomy. It is delivered as part of a very well structured seminar on maxillary reconstruction outlining the entire spectrum of reconstructive modalities. This presentation reviews the indications for microvascular free tissue transfer, increases awareness and assists in avoidance of clinical pitfalls, improves comprehension of 3-dimensional reconstruction, and provides a systematic mechanism for the selection of the most suitable free flap donor site in varied clinical situations. References Blanchaert RH: Contemporary principles of surgical reconstruction of the oral cavity, in Ord RA, Blanchaert RH (eds): Oral Cancer: The Dentist’s Role in Diagnosis, Management, Rehabilitation, and Prevention. Chicago, IL, Quintessence, 2000 Davison SP, Sherris DA, Meland NB: An algorithm for maxillectomy defect reconstruction. Laryngoscope 108:215, 1998 Funk GF, Arcuri MR, Frodel JL: Functional dental rehabilitation of massive palatomaxillary defects: Cases requiring free tissue transfer and osseointegrated implants. Head Neck 20:38, 1998 Triana RJ, Uglesic V, Virag M, et al: Microvascular free flap reconstructive options in patients with partial and total maxillectomy defects. Arch Fac Plast Surg 2:91, 2000
SYMPOSIUM ON MANAGEMENT OF IMPACTED NON–THIRD MOLAR TEETH Presented on Thursday, September 11, 3:00 pm– 4:55 pm Moderator: Charles L. Consky, DDS, FRCD(C), Niagara Falls, Ontario, Canada
Diagnosis of Impacted Teeth Speaker TBA
Orthodontic Management of Impacted Teeth Paul M. Thomas, DMD, MS, Durham, NC (no abstract provided)
Surgical Management of Non–Third Molars Deborah L. Zeitler, DDS, MS, Iowa City, IA This presentation will discuss the treatment on non– third molar impacted teeth. Treatment of impacted permanent teeth must be based on clinical and radiographic evaluation as well as determination of future risks. Clearly teeth that are symptomatic, have caused infection in the surrounding tissues, or have evidence of 12
development of radiographic changes (cyst formation, resorption of adjacent teeth, or root resorption of the impacted teeth) require surgical treatment. Treatment of the asymptomatic tooth must take into account many factors, including age, specific prevalence of pathologic conditions, severity of potential pathology associated with impacted teeth, progression of untreated conditions, frequency and severity of potential complications of treatment, potential patient discomfort and inconvenience associated with either treatment or nontreatment, and economic consequences of treatment. Methods of treatment of impacted permanent teeth include orthodontic assistance through surgical exposure with or without attachment of the tooth, surgical uprighting, transplantation, and surgical removal. Impacted teeth other than third molars are relatively common findings. Much can be done to preserve these teeth and allow their functional positioning within the dental arch. Surgical exposure with or without orthodontic guidance, surgical uprighting, and transplantaAAOMS • 2003
The Use of Transport Distraction Osteogenesis to Close a Maxillary Defect Joseph I. Helman, DMD, Ann Arbor, MI (no abstract provided)
Microvasculcar Reconstruction of Maxillary Defects Remy H. Blanchaert Jr, MD, DDS, Kansas City, MO Microvascular techniques offer a reliable means of primary reconstruction of maxillectomy defects. Advantages of immediate reconstruction include prompt healing allowing early initiation of adjuvant therapy, restoration of form prior to the development of scar contracture, and simultaneous restoration of composite tissue defects. As in all reconstructive endeavors, the selection of the most appropriate reconstructive technique requires careful review of the clinical behavior of the tumor, the ability to perceive or anticipate the ablative deformity, establishment of appropriate surgical goals, and a comprehensive understanding of the versatility and adaptability of the available composite tissue flaps. By no means is microvascular free tissue transfer the only or most appropriate means of reconstruction of
all maxillectomy defects. One of the most challenging and rewarding aspects of reconstructive surgery is selecting the most suitable reconstructive technique for each individual case. This presentation is designed to assist the participants in planning reconstruction of patients following maxillectomy. It is delivered as part of a very well structured seminar on maxillary reconstruction outlining the entire spectrum of reconstructive modalities. This presentation reviews the indications for microvascular free tissue transfer, increases awareness and assists in avoidance of clinical pitfalls, improves comprehension of 3-dimensional reconstruction, and provides a systematic mechanism for the selection of the most suitable free flap donor site in varied clinical situations. References Blanchaert RH: Contemporary principles of surgical reconstruction of the oral cavity, in Ord RA, Blanchaert RH (eds): Oral Cancer: The Dentist’s Role in Diagnosis, Management, Rehabilitation, and Prevention. Chicago, IL, Quintessence, 2000 Davison SP, Sherris DA, Meland NB: An algorithm for maxillectomy defect reconstruction. Laryngoscope 108:215, 1998 Funk GF, Arcuri MR, Frodel JL: Functional dental rehabilitation of massive palatomaxillary defects: Cases requiring free tissue transfer and osseointegrated implants. Head Neck 20:38, 1998 Triana RJ, Uglesic V, Virag M, et al: Microvascular free flap reconstructive options in patients with partial and total maxillectomy defects. Arch Fac Plast Surg 2:91, 2000
SYMPOSIUM ON MANAGEMENT OF IMPACTED NON–THIRD MOLAR TEETH Presented on Thursday, September 11, 3:00 pm– 4:55 pm Moderator: Charles L. Consky, DDS, FRCD(C), Niagara Falls, Ontario, Canada
Diagnosis of Impacted Teeth Speaker TBA
Orthodontic Management of Impacted Teeth Paul M. Thomas, DMD, MS, Durham, NC (no abstract provided)
Surgical Management of Non–Third Molars Deborah L. Zeitler, DDS, MS, Iowa City, IA This presentation will discuss the treatment on non– third molar impacted teeth. Treatment of impacted permanent teeth must be based on clinical and radiographic evaluation as well as determination of future risks. Clearly teeth that are symptomatic, have caused infection in the surrounding tissues, or have evidence of 12
development of radiographic changes (cyst formation, resorption of adjacent teeth, or root resorption of the impacted teeth) require surgical treatment. Treatment of the asymptomatic tooth must take into account many factors, including age, specific prevalence of pathologic conditions, severity of potential pathology associated with impacted teeth, progression of untreated conditions, frequency and severity of potential complications of treatment, potential patient discomfort and inconvenience associated with either treatment or nontreatment, and economic consequences of treatment. Methods of treatment of impacted permanent teeth include orthodontic assistance through surgical exposure with or without attachment of the tooth, surgical uprighting, transplantation, and surgical removal. Impacted teeth other than third molars are relatively common findings. Much can be done to preserve these teeth and allow their functional positioning within the dental arch. Surgical exposure with or without orthodontic guidance, surgical uprighting, and transplantaAAOMS • 2003