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S215: Pediatric Maxillofacial Trauma Management
Surgical Clinics Alveolar defects range from small, isolated defects to large areas involving the entire jaw. Various techniques are available for rebuilding these areas prior to placement of dental implants. Growth factors, such as recombinant human bone morphogenic protein (rhBMP-2), are becoming available to form bone without the need for grafting. An overview of this exciting field will be presented including techniques as well as advantages and disadvantages. rhBMP-2 repair does offer significant advantages to the patient. These advantages may include shorter hospital stay, avoidance gait and sensory disturbance, as well as decreased sites for scar formation and possible infection. Also, surgical time is reduced since the surgeon does not have to harvest autogenous bone from a secondary site. In the future, the use of exogenous cytokines, particularly those in the BMP series will become common and the regeneration of osseous defects will likely be brought about through a clinical outpatient procedure.
S215 Pediatric Maxillofacial Trauma Management George M. Kushner, DMD, MD, Louisville, KY Paul S. Tiwana, DDS, MD, MS, Louisville, KY The incidence of trauma in the pediatric population is much less than the adult population. Although many of the principles of adult trauma management apply to the pediatric population, there are certainly distinct differences. This lecture will review the etiology, incidence and management of pediatric maxillofacial trauma. Representative clinical cases will be used to demonstrate treatment of the hard and soft tissue injuries of the maxillofacial region of the pediatric patient.
volve obstruction(s) in the upper airway; from the nostrils and lips to the trachea. There are 10 basic areas in the upper airway that can directly or indirectly create airway obstruction. These include nasal, oral, pharyngeal, and dento-musculo-skeletal structures. This presentation will discuss these 10 areas and the methods to identify and diagnose their involvement. Specific surgical treatment protocols will be demonstrated as well as the rationale and indications for use. Surgical treatment presented will include: 1) Nasal reconstruction (ie, turbinectomies, nasoseptoplasty, external procedures, etc); 2) Oral reconstruction (ie, reduction glossectomy, modified UPPP, etc); 3) Pharyngeal reconstruction (ie, adenoidectomy, tonsillectomy, etc) and 4) Dento-musculo-skeletal reconstruction (ie, double jaw surgery with counter-clockwise rotation, hyoid suspension, genioplasty, etc). The various surgical techniques and their efficacy will be discussed as well as research studies to document the anticipated outcomes. Risks and complications of the various procedures will also be presented. Oral and maxillofacial surgeons involved in the treatment of sleep apnea patients must understand the mechanisms of upper airway obstruction and the most effective methods for correction in order to provide comprehensive, predictable, and optimal treatment outcomes for patients with these conditions. References Mehra P, Wolford LM: Surgical Management of Obstructive Sleep Apnea. Baylor University Medical Center Proceedings, 13:338-342, 2000 Mehra P, Downie M, Pitta MC, Wolford LM: Pharyngeal Airway Space Changes after Counterclockwise Rotation of the Maxillomandibular Complex. AM J Orthod Dentofac Orthop, 120:154-159, 2001 Wolford LM, Mehra P: Modified Uvulopalatopharyngoplasty: The Lateral Inversion Flap Technique. J Oral Maxillofac Surg, 59, 12421243, 2001
References Pediatric Oral and Maxillofacial Surgery. Kaban L (editor) WB Saunders 1990 pages 209-260 Oral and Maxillofacial Surgery Clinics of North America. WB Saunders 1994. Kaban (editor) Posnick (author) pages 169-186 Pediatric facial fractures: recent advances in prevention, diagnosis and management. Zimmerman CE, Troulis MJ, Kaban LB. Int J Oral Maxillofac Surg 2006 Jan 35(1) 2-13
S217 Practical Approach to Diagnosis and Management of TMJ Pain and Dysfunction Patients
S216 Surgical Management of Upper Airway Obstruction and Sleep Apnea
The diagnosis and surgical management of TMJ pain and dysfunction remain more complicated than necessary. This presentation reviews the diagnostic criteria for myofascial pain, internal derangement and osteoarthrosis and presents a practical approach for their management. The focus of the presentation will be on the selection of TMJ patients who would benefit from surgical intervention. The indications, surgical techniques, outcomes and complications for arthrocentesis, arthroscopic lysis and lavage, and arthroplasty will be presented and discussed.
Larry M. Wolford, DMD, Dallas, TX Sleep apnea problems can cause disruption of the performance of normal life activities as well as create major medical and life threatening conditions. Although central and pulmonary factors can cause sleep apnea, the most common areas contributing to this condition in118
M. Franklin Dolwick, DMD, PhD, Gainesville, FL
AAOMS • 2009
S215 Pediatric Maxillofacial Trauma Management George M. Kushner, DMD, MD, Louisville, KY Paul S. Tiwana, DDS, MD, MS, Louisville, KY The incidence of trauma in the pediatric population is much less than the adult population. Although many of the principles of adult trauma management apply to the pediatric population, there are certainly distinct differences. This lecture will review the etiology, incidence and management of pediatric maxillofacial trauma. Representative clinical cases will be used to demonstrate treatment of the hard and soft tissue injuries of the maxillofacial region of the pediatric patient.
volve obstruction(s) in the upper airway; from the nostrils and lips to the trachea. There are 10 basic areas in the upper airway that can directly or indirectly create airway obstruction. These include nasal, oral, pharyngeal, and dento-musculo-skeletal structures. This presentation will discuss these 10 areas and the methods to identify and diagnose their involvement. Specific surgical treatment protocols will be demonstrated as well as the rationale and indications for use. Surgical treatment presented will include: 1) Nasal reconstruction (ie, turbinectomies, nasoseptoplasty, external procedures, etc); 2) Oral reconstruction (ie, reduction glossectomy, modified UPPP, etc); 3) Pharyngeal reconstruction (ie, adenoidectomy, tonsillectomy, etc) and 4) Dento-musculo-skeletal reconstruction (ie, double jaw surgery with counter-clockwise rotation, hyoid suspension, genioplasty, etc). The various surgical techniques and their efficacy will be discussed as well as research studies to document the anticipated outcomes. Risks and complications of the various procedures will also be presented. Oral and maxillofacial surgeons involved in the treatment of sleep apnea patients must understand the mechanisms of upper airway obstruction and the most effective methods for correction in order to provide comprehensive, predictable, and optimal treatment outcomes for patients with these conditions. References Mehra P, Wolford LM: Surgical Management of Obstructive Sleep Apnea. Baylor University Medical Center Proceedings, 13:338-342, 2000 Mehra P, Downie M, Pitta MC, Wolford LM: Pharyngeal Airway Space Changes after Counterclockwise Rotation of the Maxillomandibular Complex. AM J Orthod Dentofac Orthop, 120:154-159, 2001 Wolford LM, Mehra P: Modified Uvulopalatopharyngoplasty: The Lateral Inversion Flap Technique. J Oral Maxillofac Surg, 59, 12421243, 2001
References Pediatric Oral and Maxillofacial Surgery. Kaban L (editor) WB Saunders 1990 pages 209-260 Oral and Maxillofacial Surgery Clinics of North America. WB Saunders 1994. Kaban (editor) Posnick (author) pages 169-186 Pediatric facial fractures: recent advances in prevention, diagnosis and management. Zimmerman CE, Troulis MJ, Kaban LB. Int J Oral Maxillofac Surg 2006 Jan 35(1) 2-13
S217 Practical Approach to Diagnosis and Management of TMJ Pain and Dysfunction Patients
S216 Surgical Management of Upper Airway Obstruction and Sleep Apnea
The diagnosis and surgical management of TMJ pain and dysfunction remain more complicated than necessary. This presentation reviews the diagnostic criteria for myofascial pain, internal derangement and osteoarthrosis and presents a practical approach for their management. The focus of the presentation will be on the selection of TMJ patients who would benefit from surgical intervention. The indications, surgical techniques, outcomes and complications for arthrocentesis, arthroscopic lysis and lavage, and arthroplasty will be presented and discussed.
Larry M. Wolford, DMD, Dallas, TX Sleep apnea problems can cause disruption of the performance of normal life activities as well as create major medical and life threatening conditions. Although central and pulmonary factors can cause sleep apnea, the most common areas contributing to this condition in118
M. Franklin Dolwick, DMD, PhD, Gainesville, FL
AAOMS • 2009