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An automatic controlled haptic robot to avoid excessive drilling in bone surgery
e88
Oral Presentation
The opposite effects between tumor protein D52 and D54 on anchorage-independent proliferation of squamous cell carcinoma cells K. Kato ∗ , Y. Mukudai, H. Motohashi, C. Ito, S. Kondo, T. Shirota Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, Tokyo, Japan Background: Tumor protein D52 (TPD52) family proteins include TPD52, 53, 54 and 55. Previous studies suggest that these proteins may be involved in tumor growth, invasion and metastasis in oral squamous cell carcinoma (OSCC). We recently revealed that TPD54 modulates cell adhesion to extra cellular matrix (ECM) and migration in OSCC, and also relieves tumorization against the other TPD52 family proteins. Objectives: The objective in this study is to investigate the interactions between TPD52 family proteins on tumorigenesis of OSCC cell lines. Methods: We measured the cell growth, migration and clonogenesis in vitro. The stable clones that over-express or knock-down of TPD54 were constructed from OSCC derived SAS cells. Co-expression of TPD52 and TPD53 was performed by using pCMV-HA vector. These vectors were transfected to SAS cells mentioned above. Findings and conclusions: MTT assay showed no significant differences on all transfected cell lines in monolayer culture. TPD54 over-expression decreased cell migration. Neither TPD54 over-expression nor knock-down affected cell growth in a colony formation assay. However, over-expression of TPD52 restricted colony formation, compared to control and TPD54 knock-down cells. Interestingly, regardless of transient over-expression or knock-down, the over-expression of TPD54 inhibited colonies more than diameter 100 m. Our results showed that TPD52 increase tumorigenesis in an anchorage-independent manner and TPD54 is capable of restricting the effects of TPD52. http://dx.doi.org/10.1016/j.ijom.2015.08.625 Evaluation of effectiveness of use of negative pressure system in the sinus membrane-lifting operation R. Kaura ∗ , G. Giraddi Government Dental College and Research Institute, Bengaluru, India Background and objectives: To study the effectiveness of sinus lift procedure by means of negative pressure by assessing alveolar bone height gain at regular intervals and complications associated such as perforation, graft contamination, infection and post-op sinusitis. Methods: In a prospective randomized study, 10 sinus lift procedures in 8 patients were done and success was evaluated over a period of 3 months by measurement of the gain in alveolar bone height. A bony window was prepared by performing a rectangular osteotomy using a 2-3 mm diamond round bur. An opening was made with a 702 bur superodistally to this window through the maxillary bone wall and the sinus mucosa. A suction tube was positioned and kept functioning over this opening to establish negative pressure inside the maxillary sinus for the membrane to lift. OPG were taken preoperatively, immediately, after 1 month, and after 3 months of the procedure to assess the height of the alveolar bone.
Findings: The results at the end of procedure showed 17.60 ± 1.07 mm of bone height, at the end of 3rd month 11.10 ± 2.64 mm of bone height. No cases developed postoperative complications and bone height gain was comparatively more and sufficient for successful placement of implants. Conclusion: The use of negative pressure in the maxillary sinus can permit safer sinus lift procedure by better visualization of the membrane – bone junction and increases the graft space which decreases the chances of infection and membrane rupture/perforations and dilacerations during the procedure. http://dx.doi.org/10.1016/j.ijom.2015.08.626 Excision of pseudogout in temporomandibular joint using image-guided navigation system T. Kawakami ∗ , N. Ueda, N. Yamakawa, Y. Matsusue, M. Takashima, T. Kirita Department of Oral and Maxillofacial Surgery, Nara Medical University, Japan Background: Image guided navigation system implies an improvement in surgical great accuracy with the aid of software based on the images captured from CT or MRI and a tracking system for the surgical instrument. Objectives: We report the usability of excision of pseudogout in temporomandibular joint (TMJ) using image-guided navigation system. Materials and methods: The representative patient was a 58year-old female. On imaging, the middle meningeal artery was present near the medial side of the lesion, and the right internal carotid artery and vein were present on the dorsomedial side. We used an optical sensor-type infrared CCD camera (Brain LAB Co.) to trace a surgical instrument with a light-emitting diode to recognize the position and the surface method for registration, in which positioning is performed based on 2 factors such as markers and anatomical landmarks, and 40 surface areas on the face. Findings: Total excision was performed using the image-based navigation system under general anesthesia. Intraoperatively, it was confirmed that the internal carotid artery ran inside the lesion, and the middle meningeal artery ran adjacent to it. We could perform detachment in the internal area without injuring the middle meningeal artery, and safe incision of the lesion was possible using the navigation system as a guide. Conclusions: TMJ surgery using the image guided navigation system enabled safe and appropriate excision, showing its usefulness in TMJ surgery. http://dx.doi.org/10.1016/j.ijom.2015.08.627 An automatic controlled haptic robot to avoid excessive drilling in bone surgery H. Kawana 1,∗ , S. Usuda 1 , K. Yu 2 , T. Nakagawa 1 , K. Ohnishi 2 1 Division of Oral and Maxillofacial Surgery, Department of Dentistry and Oral Surgery, School of Medicine, Keio University, Tokyo, Japan 2 Department of System Design Engineering, Graduate School of Science and Technology, Keio University, Kanagawa, Japan
Background: Surgeons are required advanced techniques and experiences to handle the cutting device correctly. The lack of these may bring on an over cut and damages to the surrounding tissue. This situation has risks of causing the subsequent
Oral Presentation
e89
Simplify augmentation – a concept to avoid bone-blocs in dental implantology
condyle might differ between normal muscle tone while awake and relaxation under general anaesthesia leading to a difference in planned and real position of the condylar segment in sagittal split osteotomies. In neurosurgery temporary reduction of general anaesthesia to conscious sedation is a well established method for intraoperative control of various sensory and motoric functions. Objectives: From 2005 we used conscious sedation for intraoperative control of occlusion in orthognathic surgery: 32 patients with Sagittal Split Osteotomy, 22 patients with Le Fort I Osteotomy, 40 patients with both (Bimaxillary Osteotomy). Before wound closure anaesthesia was reduced to conscious sedation. The patient was asked to move the mandible. Occlusion was checked and – if correct – anaesthesia was deepened for wound closure. If differences occurred anaesthesia was deepened and correction was performed followed by another reduction of anaesthesia. Findings: 89 of 94 patients moved their mandible according to our instructions. 5 patients did not comply. 75 patients showed the planned occlusion. 10 patients had a malocclusion undergoing further correction. 4 patients had a malocclusion without further correction for various reasons. Postoperative occlusion was correct in 81 patients (+ 4 patients without compliance). 9 patients required elastic treatment for 3 weeks for minor discrepancies. No patient remembered the wake up procedure. Conclusion: We conclude that intraoperative temporary reduction of general anaesthesia to conscious sedation is an easy adjunct to the predictability of the outcome of orthognathic surgery.
M. Keweloh ∗ , J. Riedasch
http://dx.doi.org/10.1016/j.ijom.2015.08.630
complications or life-threatening accidents by heavy bleeding and nerve damage. Objectives: In order to solve this problem of any surgeons, we developed a haptic drilling robot. Methods: The system consists of a master robot and a slave robot. The master robot is a robot that surgeons operate, and the slave robot is a robot that interacts with the cutting material. The force and position of robots are transmitted in both directions by bilateral control. Pine and Balsa woods were used as phantoms. They have same hardness of porous cortical bone and dense trabecular bone as mentioned in Misch’s bone density classification. They were drilled continuously and the value of the force scaling function was calculated from the maximum motor torque and the cutting force. Findings and conclusions: Although the force of master robot was increased, the force scaling function decreased the force of slave robot. It made slave robot stopped around the position limitation and the error was in 60 m. It was only 2.5% of 2 mm margin. The validity of the proposal was confirmed using phantoms individually. The drill could successfully stopped within safe position from the position limitation. Higher accuracy was expected by fine adjustment in force scaling. http://dx.doi.org/10.1016/j.ijom.2015.08.628
Stauferklinikum Schwäbisch-Gmünd, Oral-Maxillofacial-Surgery, Mutlangen, Germany Introduction: According to literature in 20–30% of bone-bloc grafting, complications as wound healing disorder or exposed graft may arise. In order to avoid huge augmentations in dental implantology a reliable concept has been created to minimize surgeries with high morbidity. Methods: After gently tooth extraction autologous and xenogenous hard- and soft-tissue materials are used to compose the implant-bed. Depending on the number of missing teeth and the width of the defect a one- or two-stage procedure has to be chosen. In a few cases it was possible to have a split-mouth-design with autologous bone or soft-tissue graft on one site and artificial bone respectively soft tissue on the other. The reduction of permeability of the mucosa by switching the biotype is essential prior to hard tissue augmentation in this study. Results: Patients benefit from a modest morbidity. Surgeons benefit from a lower complication-rate. Based on the experience of 8 years practice with this modified guided bone and tissue regeneration concept, it appears to be a suitable method for a long-time implant success even in the esthetic zone. http://dx.doi.org/10.1016/j.ijom.2015.08.629 Ten years experience with intraoperative control of occlusion in orthognathic surgery by temporary reduction of general anaesthesia to conscious sedation (wake up procedure) A. Kerscher 1,∗ , T. Körner 1 , S. Kerscher 2 1 2
Praxisklinik Kronshagen, Kronshagen, Germany Anästhesiepraxis an der Schlei, Brodersby, Germany
Background: Predictability of occlusion in orthognathic surgery is a constant challenge. The location of the mandibular
Comparative evaluation of treatment outcome after arthrocentesis versus class IV laser therapy in the internal derangement of temporomandibular joint: a randomized controlled trial Y. Kholakiya ∗ , A. Roychodhury, O. Bhutia, R. Pandey Institute of Medical Sciences, New Delhi, India Background: Temporomandibular joint (TMJ) internal derangement a common intra-articular disorder. The disorder has been associated with characteristic clinical findings such as pain, joint sounds and deviating jaw function which presents a therapeutic challenge. Objective: To evaluate the efficiency of arthrocentesis and class IV laser in reduction of TMJ pain, sounds and increasing the range of motion in case of internal derangement and to compare the treatment outcomes. Method: A randomized controlled trial was conducted between two groups which includes total 60 patients with the internal derangement of TMJ with 30 patients in each group. The patients in one group underwent arthrocentesis and the patients in another group underwent 5 sessions of class IV laser therapy of affected TMJ. Clinical recordings were obtained preoperatively and postoperatively at 1 week, 1month, 3 months and 6 months. Findings: The mean pain score in arthrocentesis group was 5.73 pre-operatively and 0.66 post-operatively at 6months whereas in class IV laser group it was 5.43 pre-operatively and 2.15 post-operatively. The mean maximal mouth opening in arthrocentesis group was 37.93 pre-operatively and 43.5 post-operatively at 6 months whereas in class IV laser group it was 37.36 preoperatively and 40.1 post-operatively. Conclusion: Arthrocentesis is an effective treatment modality in terms of improvements in pain and mouth opening. Class IV
Oral Presentation
The opposite effects between tumor protein D52 and D54 on anchorage-independent proliferation of squamous cell carcinoma cells K. Kato ∗ , Y. Mukudai, H. Motohashi, C. Ito, S. Kondo, T. Shirota Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, Tokyo, Japan Background: Tumor protein D52 (TPD52) family proteins include TPD52, 53, 54 and 55. Previous studies suggest that these proteins may be involved in tumor growth, invasion and metastasis in oral squamous cell carcinoma (OSCC). We recently revealed that TPD54 modulates cell adhesion to extra cellular matrix (ECM) and migration in OSCC, and also relieves tumorization against the other TPD52 family proteins. Objectives: The objective in this study is to investigate the interactions between TPD52 family proteins on tumorigenesis of OSCC cell lines. Methods: We measured the cell growth, migration and clonogenesis in vitro. The stable clones that over-express or knock-down of TPD54 were constructed from OSCC derived SAS cells. Co-expression of TPD52 and TPD53 was performed by using pCMV-HA vector. These vectors were transfected to SAS cells mentioned above. Findings and conclusions: MTT assay showed no significant differences on all transfected cell lines in monolayer culture. TPD54 over-expression decreased cell migration. Neither TPD54 over-expression nor knock-down affected cell growth in a colony formation assay. However, over-expression of TPD52 restricted colony formation, compared to control and TPD54 knock-down cells. Interestingly, regardless of transient over-expression or knock-down, the over-expression of TPD54 inhibited colonies more than diameter 100 m. Our results showed that TPD52 increase tumorigenesis in an anchorage-independent manner and TPD54 is capable of restricting the effects of TPD52. http://dx.doi.org/10.1016/j.ijom.2015.08.625 Evaluation of effectiveness of use of negative pressure system in the sinus membrane-lifting operation R. Kaura ∗ , G. Giraddi Government Dental College and Research Institute, Bengaluru, India Background and objectives: To study the effectiveness of sinus lift procedure by means of negative pressure by assessing alveolar bone height gain at regular intervals and complications associated such as perforation, graft contamination, infection and post-op sinusitis. Methods: In a prospective randomized study, 10 sinus lift procedures in 8 patients were done and success was evaluated over a period of 3 months by measurement of the gain in alveolar bone height. A bony window was prepared by performing a rectangular osteotomy using a 2-3 mm diamond round bur. An opening was made with a 702 bur superodistally to this window through the maxillary bone wall and the sinus mucosa. A suction tube was positioned and kept functioning over this opening to establish negative pressure inside the maxillary sinus for the membrane to lift. OPG were taken preoperatively, immediately, after 1 month, and after 3 months of the procedure to assess the height of the alveolar bone.
Findings: The results at the end of procedure showed 17.60 ± 1.07 mm of bone height, at the end of 3rd month 11.10 ± 2.64 mm of bone height. No cases developed postoperative complications and bone height gain was comparatively more and sufficient for successful placement of implants. Conclusion: The use of negative pressure in the maxillary sinus can permit safer sinus lift procedure by better visualization of the membrane – bone junction and increases the graft space which decreases the chances of infection and membrane rupture/perforations and dilacerations during the procedure. http://dx.doi.org/10.1016/j.ijom.2015.08.626 Excision of pseudogout in temporomandibular joint using image-guided navigation system T. Kawakami ∗ , N. Ueda, N. Yamakawa, Y. Matsusue, M. Takashima, T. Kirita Department of Oral and Maxillofacial Surgery, Nara Medical University, Japan Background: Image guided navigation system implies an improvement in surgical great accuracy with the aid of software based on the images captured from CT or MRI and a tracking system for the surgical instrument. Objectives: We report the usability of excision of pseudogout in temporomandibular joint (TMJ) using image-guided navigation system. Materials and methods: The representative patient was a 58year-old female. On imaging, the middle meningeal artery was present near the medial side of the lesion, and the right internal carotid artery and vein were present on the dorsomedial side. We used an optical sensor-type infrared CCD camera (Brain LAB Co.) to trace a surgical instrument with a light-emitting diode to recognize the position and the surface method for registration, in which positioning is performed based on 2 factors such as markers and anatomical landmarks, and 40 surface areas on the face. Findings: Total excision was performed using the image-based navigation system under general anesthesia. Intraoperatively, it was confirmed that the internal carotid artery ran inside the lesion, and the middle meningeal artery ran adjacent to it. We could perform detachment in the internal area without injuring the middle meningeal artery, and safe incision of the lesion was possible using the navigation system as a guide. Conclusions: TMJ surgery using the image guided navigation system enabled safe and appropriate excision, showing its usefulness in TMJ surgery. http://dx.doi.org/10.1016/j.ijom.2015.08.627 An automatic controlled haptic robot to avoid excessive drilling in bone surgery H. Kawana 1,∗ , S. Usuda 1 , K. Yu 2 , T. Nakagawa 1 , K. Ohnishi 2 1 Division of Oral and Maxillofacial Surgery, Department of Dentistry and Oral Surgery, School of Medicine, Keio University, Tokyo, Japan 2 Department of System Design Engineering, Graduate School of Science and Technology, Keio University, Kanagawa, Japan
Background: Surgeons are required advanced techniques and experiences to handle the cutting device correctly. The lack of these may bring on an over cut and damages to the surrounding tissue. This situation has risks of causing the subsequent
Oral Presentation
e89
Simplify augmentation – a concept to avoid bone-blocs in dental implantology
condyle might differ between normal muscle tone while awake and relaxation under general anaesthesia leading to a difference in planned and real position of the condylar segment in sagittal split osteotomies. In neurosurgery temporary reduction of general anaesthesia to conscious sedation is a well established method for intraoperative control of various sensory and motoric functions. Objectives: From 2005 we used conscious sedation for intraoperative control of occlusion in orthognathic surgery: 32 patients with Sagittal Split Osteotomy, 22 patients with Le Fort I Osteotomy, 40 patients with both (Bimaxillary Osteotomy). Before wound closure anaesthesia was reduced to conscious sedation. The patient was asked to move the mandible. Occlusion was checked and – if correct – anaesthesia was deepened for wound closure. If differences occurred anaesthesia was deepened and correction was performed followed by another reduction of anaesthesia. Findings: 89 of 94 patients moved their mandible according to our instructions. 5 patients did not comply. 75 patients showed the planned occlusion. 10 patients had a malocclusion undergoing further correction. 4 patients had a malocclusion without further correction for various reasons. Postoperative occlusion was correct in 81 patients (+ 4 patients without compliance). 9 patients required elastic treatment for 3 weeks for minor discrepancies. No patient remembered the wake up procedure. Conclusion: We conclude that intraoperative temporary reduction of general anaesthesia to conscious sedation is an easy adjunct to the predictability of the outcome of orthognathic surgery.
M. Keweloh ∗ , J. Riedasch
http://dx.doi.org/10.1016/j.ijom.2015.08.630
complications or life-threatening accidents by heavy bleeding and nerve damage. Objectives: In order to solve this problem of any surgeons, we developed a haptic drilling robot. Methods: The system consists of a master robot and a slave robot. The master robot is a robot that surgeons operate, and the slave robot is a robot that interacts with the cutting material. The force and position of robots are transmitted in both directions by bilateral control. Pine and Balsa woods were used as phantoms. They have same hardness of porous cortical bone and dense trabecular bone as mentioned in Misch’s bone density classification. They were drilled continuously and the value of the force scaling function was calculated from the maximum motor torque and the cutting force. Findings and conclusions: Although the force of master robot was increased, the force scaling function decreased the force of slave robot. It made slave robot stopped around the position limitation and the error was in 60 m. It was only 2.5% of 2 mm margin. The validity of the proposal was confirmed using phantoms individually. The drill could successfully stopped within safe position from the position limitation. Higher accuracy was expected by fine adjustment in force scaling. http://dx.doi.org/10.1016/j.ijom.2015.08.628
Stauferklinikum Schwäbisch-Gmünd, Oral-Maxillofacial-Surgery, Mutlangen, Germany Introduction: According to literature in 20–30% of bone-bloc grafting, complications as wound healing disorder or exposed graft may arise. In order to avoid huge augmentations in dental implantology a reliable concept has been created to minimize surgeries with high morbidity. Methods: After gently tooth extraction autologous and xenogenous hard- and soft-tissue materials are used to compose the implant-bed. Depending on the number of missing teeth and the width of the defect a one- or two-stage procedure has to be chosen. In a few cases it was possible to have a split-mouth-design with autologous bone or soft-tissue graft on one site and artificial bone respectively soft tissue on the other. The reduction of permeability of the mucosa by switching the biotype is essential prior to hard tissue augmentation in this study. Results: Patients benefit from a modest morbidity. Surgeons benefit from a lower complication-rate. Based on the experience of 8 years practice with this modified guided bone and tissue regeneration concept, it appears to be a suitable method for a long-time implant success even in the esthetic zone. http://dx.doi.org/10.1016/j.ijom.2015.08.629 Ten years experience with intraoperative control of occlusion in orthognathic surgery by temporary reduction of general anaesthesia to conscious sedation (wake up procedure) A. Kerscher 1,∗ , T. Körner 1 , S. Kerscher 2 1 2
Praxisklinik Kronshagen, Kronshagen, Germany Anästhesiepraxis an der Schlei, Brodersby, Germany
Background: Predictability of occlusion in orthognathic surgery is a constant challenge. The location of the mandibular
Comparative evaluation of treatment outcome after arthrocentesis versus class IV laser therapy in the internal derangement of temporomandibular joint: a randomized controlled trial Y. Kholakiya ∗ , A. Roychodhury, O. Bhutia, R. Pandey Institute of Medical Sciences, New Delhi, India Background: Temporomandibular joint (TMJ) internal derangement a common intra-articular disorder. The disorder has been associated with characteristic clinical findings such as pain, joint sounds and deviating jaw function which presents a therapeutic challenge. Objective: To evaluate the efficiency of arthrocentesis and class IV laser in reduction of TMJ pain, sounds and increasing the range of motion in case of internal derangement and to compare the treatment outcomes. Method: A randomized controlled trial was conducted between two groups which includes total 60 patients with the internal derangement of TMJ with 30 patients in each group. The patients in one group underwent arthrocentesis and the patients in another group underwent 5 sessions of class IV laser therapy of affected TMJ. Clinical recordings were obtained preoperatively and postoperatively at 1 week, 1month, 3 months and 6 months. Findings: The mean pain score in arthrocentesis group was 5.73 pre-operatively and 0.66 post-operatively at 6months whereas in class IV laser group it was 5.43 pre-operatively and 2.15 post-operatively. The mean maximal mouth opening in arthrocentesis group was 37.93 pre-operatively and 43.5 post-operatively at 6 months whereas in class IV laser group it was 37.36 preoperatively and 40.1 post-operatively. Conclusion: Arthrocentesis is an effective treatment modality in terms of improvements in pain and mouth opening. Class IV