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S435: Alloplastic Reconstruction of the Temporomandibular Joint With a Stock Prosthesis
Surgical Clinics areas of the face to address. As cosmetic surgeons we need to look at the face as a whole and use the rejuvenative techniques available to treat the patient safely and with predictable results. The cosmetic surgery boom continues and we as surgeons need to look at how we can address the patient’s needs as a whole, but in a predictable and safe manner. Experience and case volume are important in treatment planning these cases. References Niamtu J: Oral and Maxillofacial Surgery Clinics 2000 Hamra S: Composite rhytidectomy. Plast Reconstrucive Surg 1994 Taylor CO, Lewis JS Oral and Maxillofacial Surgery 2000
S433 Evaluation and Management of Nasal and Septal Injuries Eric J. Dierks, DMD, MD, Portland, OR This course will discuss the evaluation and acute management of nasal fractures including clinical and CT scan evaluation and treatment planning. The options of closed vs open reduction of the nasal pyramid and/or the nasal septum are presented along with indications, pitfalls and helpful hints. Identification and management options for the telescoping nasal fracture are also discussed. Management of the nasal septum is covered in detail, in terms of acute closed and open reduction as well as secondary septoplasty. Secondary rhinoplasty and NOE fractures are not covered in this course. References Staffel JG., Optimizing treatment of nasal fractures, Laryngoscope. 2002 Oct;112(10):1709-19. PMID: 12368602 Rohrich RJ, Adams WP, Nasal fracture management: minimizing secondary nasal deformities, Plast Reconstr Surg. 2000 Aug;106(2):26673, PMID: 10946923 Pollock RA, Nasal trauma. Pathomechanics and surgical management of acute injuries, Clin Plast Surg. 1992 Jan;19(1):133-47, PMID: 1537215
S434 Maxillary/Alveolar Bone Grafting in the Cleft Lip and Palate Patient: The Evidence John F. Caccamese, Jr, DMD, MD, Baltimore, MD Pat Ricalde, DDS, MD, Tampa, FL
the nasal base and septum, and the dentition. In addition to the typical nasolabial fistula, there are often persistent palatal fistulae, substantial scarring, and unrepaired or dehiscent perioral musculature in the face of several previous surgical procedures. These all have the potential to complicate the reconstruction of the cleft alveolar defect. As with any surgery planned for the growing patient, the issue of timing is controversial. The challenge is to obliterate the fistula and support the developing dentition without detriment to midface and premaxillary growth. Multiple approaches have been described in the literature to include primary bone grafting, gingivoperiosteoplasty, and secondary bone grafting. Most centers advocate secondary bone grafting because it best accomplishes the goals of reconstruction with the least hindrance of maxillary growth. Multiple variations in the technique of cleft reconstruction have been proposed. Outcome studies are lacking which demonstrate clear benefit in any one technique. There is good literature, however, on surgical approaches to be avoided. We will discuss the management of the cleft alveolar defect. We will review the complex anatomy, discuss growth and development, and review the surgical technique of cleft reconstruction and graft harvest. We will also review the literature – old and new – and focus on outcome studies to provide practitioners with information that can be used readily in their practice.
S435 Alloplastic Reconstruction of the Temporomandibular Joint With a Stock Prosthesis Peter D. Quinn, DMD, MD, Philadelphia, PA Indications and contraindications will be presented for reconstruction of the temporomandibular joint with a stock alloplastic prosthesis. Data will be presented showing the results of 434 joints that have been implanted in 268 patients in a ten-year clinical study. Biomaterial principles, surgical technique, complications and study results will establish the safety and efficacy of this stock prosthesis by Biomet Microfixation. References
The surgical management of the maxillary/alveolar cleft defect requires a thorough understanding of the regional anatomy, facial growth and development, as well as the relevant outcome data as it pertains to various surgical techniques and the timeliness of intervention. The cleft alveolar defect is complex and three dimensional, at once involving the maxillary arch, the palate, AAOMS • 2008
Indresano AT: Modern Surgical Management of the Temporomandibular Joint—OMFS Clinics of North America, Vol. 18, No. 3, August 2006 van Loon J, et al: Evaluation of temporomandibular joint prostheses. J Oral Maxillofac Surg 53:984, 1995 Quinn PD: Alloplastic Reconstruction of the Temporomandibular Joint. Selected reading in Oral and Maxillofacial Surgery, Vol. 7, No.5
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S433 Evaluation and Management of Nasal and Septal Injuries Eric J. Dierks, DMD, MD, Portland, OR This course will discuss the evaluation and acute management of nasal fractures including clinical and CT scan evaluation and treatment planning. The options of closed vs open reduction of the nasal pyramid and/or the nasal septum are presented along with indications, pitfalls and helpful hints. Identification and management options for the telescoping nasal fracture are also discussed. Management of the nasal septum is covered in detail, in terms of acute closed and open reduction as well as secondary septoplasty. Secondary rhinoplasty and NOE fractures are not covered in this course. References Staffel JG., Optimizing treatment of nasal fractures, Laryngoscope. 2002 Oct;112(10):1709-19. PMID: 12368602 Rohrich RJ, Adams WP, Nasal fracture management: minimizing secondary nasal deformities, Plast Reconstr Surg. 2000 Aug;106(2):26673, PMID: 10946923 Pollock RA, Nasal trauma. Pathomechanics and surgical management of acute injuries, Clin Plast Surg. 1992 Jan;19(1):133-47, PMID: 1537215
S434 Maxillary/Alveolar Bone Grafting in the Cleft Lip and Palate Patient: The Evidence John F. Caccamese, Jr, DMD, MD, Baltimore, MD Pat Ricalde, DDS, MD, Tampa, FL
the nasal base and septum, and the dentition. In addition to the typical nasolabial fistula, there are often persistent palatal fistulae, substantial scarring, and unrepaired or dehiscent perioral musculature in the face of several previous surgical procedures. These all have the potential to complicate the reconstruction of the cleft alveolar defect. As with any surgery planned for the growing patient, the issue of timing is controversial. The challenge is to obliterate the fistula and support the developing dentition without detriment to midface and premaxillary growth. Multiple approaches have been described in the literature to include primary bone grafting, gingivoperiosteoplasty, and secondary bone grafting. Most centers advocate secondary bone grafting because it best accomplishes the goals of reconstruction with the least hindrance of maxillary growth. Multiple variations in the technique of cleft reconstruction have been proposed. Outcome studies are lacking which demonstrate clear benefit in any one technique. There is good literature, however, on surgical approaches to be avoided. We will discuss the management of the cleft alveolar defect. We will review the complex anatomy, discuss growth and development, and review the surgical technique of cleft reconstruction and graft harvest. We will also review the literature – old and new – and focus on outcome studies to provide practitioners with information that can be used readily in their practice.
S435 Alloplastic Reconstruction of the Temporomandibular Joint With a Stock Prosthesis Peter D. Quinn, DMD, MD, Philadelphia, PA Indications and contraindications will be presented for reconstruction of the temporomandibular joint with a stock alloplastic prosthesis. Data will be presented showing the results of 434 joints that have been implanted in 268 patients in a ten-year clinical study. Biomaterial principles, surgical technique, complications and study results will establish the safety and efficacy of this stock prosthesis by Biomet Microfixation. References
The surgical management of the maxillary/alveolar cleft defect requires a thorough understanding of the regional anatomy, facial growth and development, as well as the relevant outcome data as it pertains to various surgical techniques and the timeliness of intervention. The cleft alveolar defect is complex and three dimensional, at once involving the maxillary arch, the palate, AAOMS • 2008
Indresano AT: Modern Surgical Management of the Temporomandibular Joint—OMFS Clinics of North America, Vol. 18, No. 3, August 2006 van Loon J, et al: Evaluation of temporomandibular joint prostheses. J Oral Maxillofac Surg 53:984, 1995 Quinn PD: Alloplastic Reconstruction of the Temporomandibular Joint. Selected reading in Oral and Maxillofacial Surgery, Vol. 7, No.5
171