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Do we need routiner postoperative radiographic assessment in orbital repair?
86 Conclusion: The OMFS team were meeting national targets and the work within the unit on violence and prevention had helped to reduce alcohol related injuries. http://dx.doi.org/10.1016/j.ijom.2017.02.305 The precise orientation of preformed titanium plates in digital surgery technology assisted in reconstruction operations of mandibular segmental defects Y. Liang ∗ , W.J. Wang, C.H. Jiang, J. Chen, Y.G. Liu Xiangya Hospital, Central South University, Changsha, China Objective: To explore the precise method of orientating preformed titanium plates in digital surgery technology assisted in the reconstruction operations of mandibular segmental defects. Methods: Seven cases of segmental resections in mandibles with simultaneous free fibula flap reconstructions from oral and maxillofacial surgery in Xiangya Hospital were selected, using cone-beam computed tomography (CBCT) and CT scanning mandibles and fibulas to collect data respectively. Expected mandibular models were printed after surgical simulations. Titanium plates were preformed for expected mandibular models. CBCT used to scan the sample to obtain composite models composed of titanium plates and expected models. Finally, designing the osteotomy guide plates with location holes. Osteotomy guide plates were emplaced during operation, resecting mandibular lesions after being drilled and fixed, and emplacing preformed titanium plates by existed holes. CBCT reconstruction models were checked after operation, analysing the absolute deviation of special, and describing deviation by percentiles in the collected statistics. Findings: Seven cases with preformed titanium plates were emplaced reliably, obtained good recovery in occlusal relationship and were satisfied with the contour of reconstructed mandibles. The absolute deviation of postoperative reconstructed mandibles compared with expected operative models were: P25 = 0.26 mm, P75 = 1.17 mm; the absolute deviation of titanium plates were: P25 = 0.08 mm, P75 = 0.43 mm. Conclusion: The position relationship between preformed titanium plates and mandibles could be obtained by CBCT scanning the composite models composed of preformed titanium plates and expected mandibular models, and the osteotomy guide plates with location holes could meet the demands for orientating titanium plates in clinical operations, which deserve the clinical expansion. http://dx.doi.org/10.1016/j.ijom.2017.02.306 Do we need routiner postoperative radiographic assessment in orbital repair? O. Lieger ∗ , F. Schlittler Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland Objective: The purpose of this study was to retrospectively assess the incidence of implant malposition and revision surgeries in orbital repair in a large trauma centre, where postoperative computed tomography (CT) assessments are performed routinely. Methods: This observational study was conducted at the Department of Cranio-Maxillofacial Surgery at the University Hospital
of Bern, Switzerland. 71 adult patients were treated with a titanium mesh between September 2008 and December 2015. The primary indication for surgical repair was the presence of an isolated or combined orbital fracture causing a functional or aesthetical deficit. Exclusion criteria included missing postoperative follow-up documentation and/or CT scans. Preoperative CT scans were obtained to assess the size and location of the fracture. To evaluate accuracy in reconstruction, postoperative CT scans were performed routinely and the results were classified. Findings: A total of 71 patients with 73 implants were included in this study (49 male, mean age 56). The mean defect size was 2.81. Twelve patients (17%) were confronted with an unsuccessful treatment outcome and needed revision intervention. The main risk factor for revision was a poor postoperative outcome assessment (P < 0.001). Conclusions: Patients with extensive orbital defects who require surgical treatment with a titanium mesh are at high risk for implant malposition. Since an insufficient position of the implant is the main reason for a surgical revision, we postulate that a postoperative radiographic control should be done routinely. Only then long-term sequel due to inappropriate reconstruction can be avoided. http://dx.doi.org/10.1016/j.ijom.2017.02.307 Patients perception of good occlusion and functional rehabilitation following open reduction and internal fixation of fractured mandible R. Madattigowda ∗ , S. Vempaty, M. Perry Northwick Park Hospital, Harrow, London, United Kingdom Background: Open reduction and internal fixation of the fractured mandible is a common procedure undertaken in Oral and Maxillofacial surgical specialty. In our unit over 200 of them were performed over a year. Objective assessment of occlusion on the table while the patient was under general anaesthesia is the usual practice. It is not possible to get patients feedback about their proprioception of occlusion when the teeth were put together before the fixation. Objective: To evaluate the patient’s perception of their occlusion and functional satisfaction following fixation. Methods: A retrospective study of postsurgical occlusal and functional satisfaction among this patient group was done over the telephone. The survey was undertaken using a template questionnaire focussing on 1) perception of bite (occlusion), 2) mouth opening and 3) chewing ability. All the patients in the study were six months postsurgery. Findings and Conclusion: In our study all our patients were under general anaesthesia one has to relay on objective assessment of occlusion by surgeons. Majority of our patients have reported satisfied with the achieved occlusion by the surgeons. They have achieved normal functional ability to their satisfaction following the fixation. However, those who had hypodontia prior to surgery and those who had extractions at the time of surgery reported to have low level of satisfaction. http://dx.doi.org/10.1016/j.ijom.2017.02.308
of Bern, Switzerland. 71 adult patients were treated with a titanium mesh between September 2008 and December 2015. The primary indication for surgical repair was the presence of an isolated or combined orbital fracture causing a functional or aesthetical deficit. Exclusion criteria included missing postoperative follow-up documentation and/or CT scans. Preoperative CT scans were obtained to assess the size and location of the fracture. To evaluate accuracy in reconstruction, postoperative CT scans were performed routinely and the results were classified. Findings: A total of 71 patients with 73 implants were included in this study (49 male, mean age 56). The mean defect size was 2.81. Twelve patients (17%) were confronted with an unsuccessful treatment outcome and needed revision intervention. The main risk factor for revision was a poor postoperative outcome assessment (P < 0.001). Conclusions: Patients with extensive orbital defects who require surgical treatment with a titanium mesh are at high risk for implant malposition. Since an insufficient position of the implant is the main reason for a surgical revision, we postulate that a postoperative radiographic control should be done routinely. Only then long-term sequel due to inappropriate reconstruction can be avoided. http://dx.doi.org/10.1016/j.ijom.2017.02.307 Patients perception of good occlusion and functional rehabilitation following open reduction and internal fixation of fractured mandible R. Madattigowda ∗ , S. Vempaty, M. Perry Northwick Park Hospital, Harrow, London, United Kingdom Background: Open reduction and internal fixation of the fractured mandible is a common procedure undertaken in Oral and Maxillofacial surgical specialty. In our unit over 200 of them were performed over a year. Objective assessment of occlusion on the table while the patient was under general anaesthesia is the usual practice. It is not possible to get patients feedback about their proprioception of occlusion when the teeth were put together before the fixation. Objective: To evaluate the patient’s perception of their occlusion and functional satisfaction following fixation. Methods: A retrospective study of postsurgical occlusal and functional satisfaction among this patient group was done over the telephone. The survey was undertaken using a template questionnaire focussing on 1) perception of bite (occlusion), 2) mouth opening and 3) chewing ability. All the patients in the study were six months postsurgery. Findings and Conclusion: In our study all our patients were under general anaesthesia one has to relay on objective assessment of occlusion by surgeons. Majority of our patients have reported satisfied with the achieved occlusion by the surgeons. They have achieved normal functional ability to their satisfaction following the fixation. However, those who had hypodontia prior to surgery and those who had extractions at the time of surgery reported to have low level of satisfaction. http://dx.doi.org/10.1016/j.ijom.2017.02.308