O.468 Titanium versus resorbable mesh in maxillofacial reconstruction

Oral Presentations complained TMJ symptoms. Severe condylar remodelling was registered in 8% of patients, 92% showed slight or no remodelling. No statistically significant association was observed between the adequacy of reduction and condylar remodelling. A statistically significant association between the presence of condylar remodelling and poor mouth opening at follow-up was observed. Conclusions: Surgical treatment offers good long-term results with few complications. Retromandibular approach with plates and screws fixation yielded the best results. Based on objective and subjective functional data an extension of surgical indications to borderline cases should be considered. O.465 Surgical treatment of condylar hypertrophy M. Jagielak, J. Piekarczyk, B. Sieminska-Piekarczyk, M. Soltan, P. Rogus. Warsaw Medical University, Warsaw, Poland Aim: The aim of our study is to present our experiences in diagnosis and combined treatment of facial deformities with severe asymmetry caused by condylar hypertrophy. Material and Methods: In the years 1999–2007 in the Department of Orthodontics and in the Clinic of Cranio-Maxillofacial Surgery of Warsaw Medical University 19 patients (aged 16−42) were treated with asymmetric deformities of viscerocranium caused by hyperplastic condyle of mandibular ramus. In 8 cases there was history of trauma of TMJ, in 5 cases infection-all before the pubertal spur. In 6 cases the origin of the deformity was not determined. All patients recived long term (up to 4 years) orthodontic preparation. As for surgical methods different kinds of mandibular or maxillary osteotomies were performed with autogenous bone grafting. In 9 cases mandibular asymmetry was the component of the mandibular prognathism, which was corrected by BSSO. Additionally genioplasty was performed in 9 cases. Modern diagnostic methods as 3D CT and scynthygraphy were applied before the treatment and afterwards for results assessment. Results: In all treated patients improvement of facial features and occlusion was achieved. No major complications were observed. Conclusions: In our observations we achieved better results when we operated after the completion of the inflammation of the TMJ. In these cases bimaxillary osteotomies gave good cosmetic and occlusal result.out of 4 cases when condylectomy was performed, 2 necessisated secondary osteotomies. O.466 The Elastic Internal Traction (EIT) in facial fractures C. Taglialatela Scafati, F. Aliberti, E. Facciuto, Gm. Mangone, S. Taglialatela Scafati, M. Gargiulo, A. Aveta. U.O.S. Chirurgia Maxillo-Facciale di Pronto Soccorso, A.O.R.N. “Antonio Cardarelli”, Napoli, Italy Objectives: Open reduction and rigid fixation of displaced facial fractures require an effective reduction of the bone fragments to avoid an improper occlusion. In this study traditional techniques employed for the reduction of displaced facial fractures are compared to Elastic Internal Traction (EIT), a technique based on the use of monocortical screws and rubber elastic bands. Material and Methods: We have prospectively treated 80 patient with facial fractures in 7 years. The patients were divided in 2 groups, each composed by 20 mandible fractures and 10 fractures of the zygomatico-orbito-maxillary complex (ZOMC). To reduce the fractures, in one group were employed traditional methods while, in the other group, we employed the EIT. Results: In analysing the outcomes, were taken into consideration factors such as: the time required for the operation, necessity to apply Intermaxillary Fixation and the time needed for the recovery of masticatory function. EIT gave better resutes when compared to the traditional techniques. Discussion: EIT is a valuable solution when managing comminuted fractures involving the ZOMC and the mandible as well as classic displaced mandible fractures. It provides an effective

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reduction of the fracture and the temporary fixation of the bone fragments before Rigid Internal Fixation is applied. References Taglialatela Scafati C, Facciuto E, Aliberti F. The Elastic Internal Traction (EIT): an effective method to reduce the displaced facial fractures. Int J Oral Maxillofac Surg. 2004 Oct;33(7):709−12. O.467 The Trans-Masseteric Anterior Parotid (TMAP) technique F. Jacobs, F. Hoogendijk. University Pretoria, Pretoria, Republic of South Africa Objective: To describe a superior and inferior variation of and evaluate the TMAP surgical technique for open reduction and internal fixation (ORIF) of extra-capsular condylar neck and ramus fractures. Materials and Methods: A modified Blair or rhytidectomy skin incision was utilized in the TMAP technique using a superior (above the parotid duct) and inferior (below the parotid duct) approach through masseter muscle guided by the specific Facial nerve branch configuration visually identified. Results: Ten patients with 13 condylar neck fractures, 1 laterally displaced condyle and 2 angle fractures (n = 16) were treated using the TMAP technique. The average operating time (AOT) was 75 min per side with bi-lateral condylar neck fracture operation times 180 min, 105 min & 165 min respectively. The post-trauma age of cases treated 4−97 days (average 44days). Facial n. fallout (House Brackmann) 2 cases with grade 2. Immediate inter incisal opening AV = 24 mm, ranging between 15−35 mm. Conclusion: Initial results of 16 TMAP cases treated by the same surgeon confirm low morbidity and high success rate of this specific technique. O.468 Titanium versus resorbable mesh in maxillofacial reconstruction A. Mahmoud. Al Azhar Univ., Cairo, Egypt Purpose: Compare the efficacy of titanium meshes in craniomaxillofacial reconstruction versus the use of resorbable polylacticpolyglygolic acid meshes. Patients and Methods: Twenty patients were enrolled in this study, complaining of craniomaxillofacial injuries, their ages ranged from 6−52 years with a mean of 24 years. They were selected from the out patient clinic of Oral and Maxillofacial Unit, Ahmed Maher Teaching Hospital, Cairo, Egypt. They were divided into two groups; the 1st was treated using titanium meshes while the second was treated using resorbable meshes. Thorough investigation by clinical examination supplemented by plain radiographs, CT and 3D were done. All patients were operated upon and followed up for a period of one year. Results and Conclusion: Our results showed that the use of titanium meshes were highly advocated in reduction, fixation and reconstruction of large, comminuted, depressed or avulsed defects that continuously subjected to impact forces. While, resorbable meshes were advocated in repair of small to medium size defects in children and young adults in non-load-bearing areas. O.469 Transoral endoscopy-assisted repair of subcondylar fractures G.-Y. Cho Lee, F. Rodr´ıguez Campo, M. Mu˜noz Guerra, L. Naval G´ıas, J. Sastre P´erez, A. Capote Moreno, V. Escorial Hern´andez, M. Mancha de la Plata, S. Ros´on G´omez, F. D´ıaz Gonz´alez. Department of Oral and Maxillofacial Surgery, University Hospital La Princesa, Madrid, Spain Objectives: Treatment of mandibular condyle fractures remains a controversial issue. The transoral approach for reduction of