Orbital reconstruction using patient specific implants providing reference information

Abstracts segmental surgery. A method to retain the expansion will be presented. Splitting along inferior border in Sagittal Split Ramus Osteotomy (SSRO): the Dal-Pont modification of the SSRO is commonly used in the United States. However, if the inferior border of the mandible and part of the lingual cortex remains attached to the proximal segment, a gap along the inferior border can occur after the mandible is advanced. This can occasionally result in a “notch” that is visible in thin people. The technique can be modified to achieve a split between the buccal and lingual cortices of the inferior border, preventing a gap after mandibular advancement. This will be demonstrated. Fixation requirements of the SSRO: plates, screws, or combinations can successfully stabilise the SSRO. However, not all plates are created equally and functional deformation of the plates with resulting malocclusion can occur. Satisfactory techniques for fixation of the SSRO will be presented. Treating transverse arch incompatibilities in the mandible: most commonly, transverse arch incompatibilities are treated by maxillary expansion. However, for patients who are scheduled for isolated mandibular surgery, arch incompatibilities can just as easily be treated by narrowing the mandible. The technique will be presented. http://dx.doi.org/10.1016/j.ijom.2017.02.059 Orbital reconstruction using patient specific implants providing reference information H. Essig ∗ , T. Gander, M. Wagner, M. Rücker University Hospital Zurich, Zurich, Switzerland Reconstruction of orbital wall fractures can be challenging due to the complex anatomy and the limited surgical approach. For precise reconstruction computer-assisted planning and intraoperative control with navigation or intraoperative imaging is very supportive. A sophisticated approach using individually manufactured titanium implants for daily routine is presented to further increase precision in orbital reconstruction and decrease surgical time. Therefore preoperative three-dimensional imaging (computed tomography [CT]; cone-beam CT) is used to generate construction data for patient specific implants (PSI). This technique allows to include reference information for primary and secondary reconstruction. Especially in secondary reconstruction with osteosynthesis material in place, position of existing screws could be implemented into the computer assisted planning and design of patient specific reconstruction. Thus, PSI implants could also indicate the planned position as reference marker. PSI could be considered superior to manually bent titanium implants and osteosynthesis. http://dx.doi.org/10.1016/j.ijom.2017.02.060

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Ultra-short implants versus augmentation and bone transplants R. Ewers The University Hospital for Cranio Maxillofacial and Oral Surgery, Vienna, Austria Since 2011 we are performing studies with 4 mm × 5 mm ultrashort implants on tumour patients after microanastomosed fibula transplantation as well as on patients with extreme atrophy of the maxilla with less than 6 mm bone and extreme atrophy of the mandible with less than 7 mm bone. Until now we applied on 40 patients either in the maxilla in the interantral and/or in the mandible in the interforaminal region respectively four 4 mm × 5 mm ultra-short implants. In our over 4-year follow-up experience we are able to report about extremely good result with less than 3% implant losses due to missing osseointegration. Osseointegrated implants we have not lost yet. Similar good results we also observe in patients with complicated re-implantations or in compromised bone. Should these very good results also be observed over a longer follow up time than 5 years, the statement should be allowed that it will be not necessary any more to perform extensive augmentations and bone enhancement operations with good results as I will show in my over 30 years’ experience and recall statistics but there are much higher risks, morbidity and costs. http://dx.doi.org/10.1016/j.ijom.2017.02.061 Structural grafting in rhinoplasty T. Fattahi University of Florida, United States Grafting in open rhinoplasty is an integral part of contemporary rhinoplasty. The purpose of this presentation is to familiarise the audience with the latest principles of cartilage grafting in open structure rhinoplasty. Various techniques as well as indications for several grafting procedures will be described. Emphasis will be placed on both functional benefits and aesthetic advantages of grafting procedures. Case presentations will highlight the grafting techniques. http://dx.doi.org/10.1016/j.ijom.2017.02.062 In vitro fabrication of mucocutaneous constructs for use in lip reconstruction S. Feinberg ∗ , G. Bayar, S. Kuo, C. Marcelo University of Michigan, Ann Arbor, MI, United States Objective: To develop a technique for the construction of a mucocutaneous junction (MCJ) equivalent to be used in the fabrication of the lip. Methods: Cultured primary human skin and oral mucosal keratinocytes at premixed ratios on a dermal equivalent to create a MCJ equivalent with a lip or transitional zone (vermilion) using a novel three-dimensional (3D) culture device with a barrier to separate co-cultured skin and oral cells. Different cell ratios were compared by staining for specific differentiation markers to define the different areas of skin and mucosa. Results: Immunohistochemical results showed MCJ equivalents seeded with premixed cells were similar to differentiation patterns