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Safe condylectomy using a piezoelectric device
Free Papers—Oral Presentations transferred to a self-developed navigation system. Facial bone re-contouring was performed according to the treatment plan using surgical navigation. Intraoperative control of bone re-contouring by comparing the real with the virtual bone position was performed using surgical navigation. Results: During operation, the surgical instruments and patients were tracked in real-time by navigation system through patient-to-image registration. The recontouring of facial bones was performed successfully using the surgical navigation system. Satisfactory facial symmetry was obtained in all the 7 cases. Conclusions: The self-developed navigation system showed up as a helpful tool in treating the craniofacial fibrous dysplasia. Accurate treatment planning and immediate evaluation of craniofacial surgery outcome are the benefits of the new approach demonstrated. A major drawback of the presented approach is a high consumption of human and financial resources.
and 12 months postoperatively. Maximal mouth opening, masticatory muscle tenderness and TMJ pain were recorded at each follow-up visit. Results: All groups of this study showed improvement in maximal mouth opening, TMJ pain, muscle tenderness, and clicking sounds with variable degrees according to each treatment modality used for each group. Conclusion: Although patients with TMJ internal derangement benefited from each technique to a variable extent, arthrocentesis of TMJ with injection of SH followed by centric splint seemed to be superior in achieving rapid and prolonged improvement in TMJ ID than the other techniques.
doi:10.1016/j.ijom.2009.03.448
J. Garcia Linares ∗ , J. González-Lagunas, J. Rubio Palau Department of Oral and Maxillofacial Surgery, Hospital Quiron, Hospital Vall d’Hebron, Sant Just Desvern, Barcelona, Spain
O12.22 Combined splint and arthrocentesis therapy versus splint or arthrocentesis for treatment of temporomandibular joint internal derangement W.A. Elmohandes Department of Oral and Maxillofacial Surgery, Al-azhar University, Nasr City, Egypt
Background and Objectives: This study was designed to evaluate the efficacy of combined splint and arthrocentesis with sodium hyaluronate (SH) injection therapy versus splint or arthrocentesis with SH injection for treatment of temporomandibular joint (TMJ) internal derangement (ID). Methods: Thirty patients (22 females and 8 males) with mean age 26.5 years comprised the study population. The patients’ complaints were limited mouth opening, TMJ pain and joint noises during function. The patients were randomly divided into 3 groups. Patients in group 1 were treated with centric splint. Arthrocentesis with SH injection was used for patients in group 2. Patients of group 3 were treated with combined splint and arthrocentesis with SH injection. Each group contained patients suffering from anterior disc displacement with and without reduction. Clinical evaluation was done before the procedure, and at 15 days, 1 month, 3 months, 6 months
doi:10.1016/j.ijom.2009.03.449
O12.23 Safe condylectomy using a piezoelectric device
Background and Objectives: We present our experience with the use of a piezoelectric device to perform different osteotomies during open temporomandibular joint (TMJ) surgery. The aim of this paper is to present our experience in six cases of TMJ surgery, where piezosurgery allows a safe bone cutting in the vicinity of important vascular structures. Methods: The same piezosurgery instrument (Mectron Medical Technology, Italy) has been used to perform osteotomies in patients affected by different TMJ problems. During six months, 6 patients affected by TMJ problems and requiring different types of osteotomies have been treated with the aforementioned device. In all cases, a standard preauricular approach to the joint was used. Results: In all 6 patients, the piezosurgery instrument allowed a precise and safe osteotomy cut without visible injuries to the neighbour soft tissues. Osteotomies were easy to carry out. Lengthening of the procedure in time was negligible when performing high condylectomies due to the softness of the bone. No complication directly related to the use of ultrasound was observed. Conclusions: The piezosurgery instrument with the adequate tip can be used safely in many of the osteotomies routinely
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performed in the maxillofacial skeleton. We have presented our experience with this technique in the management of condylar hyperplasia and other conditions of the TMJ as eminectomy or zygomatic arch remodelling. doi:10.1016/j.ijom.2009.03.450
O12.24 Screw retrieval of the proximal fragment: a simple method of reduction and stabilisation of intracapsular condylar fractures S.D. Jones ∗ , A.W. Sugar, M. Mommaerts Department of Oral and Maxillofacial Surgery, University Hospital, Wales, Heath Park, Cardiff, United Kingdom
Background and Objectives: The authors of this paper acknowledge the difficulties that arise when attempting to reduce and stabilise some fractures of the condyle and in particular intracapsular fractures. The purpose of this paper is to highlight the use of screw retrieval of the proximal fragment and the benefits of its use for reduction and stabilisation of the fractured condylar head prior to fixation. Methods: Seven cases of intracapsular condylar fractures were surgically treated at two centres, Morriston Hospital, Swansea in South Wales and the General Hospital St Jean, Brugge in Flanders, Belgium during the period 1998–2007. The use of screw retrieval of the proximal fragment was used in all cases. Three of the cases were unilateral and four cases were bilateral intracapsular fractures. Results: In all cases postoperative scans showed excellent anatomical repositioning and fixation of the proximal fragments. Postoperative follow-up revealed good stable occlusion, excellent mouth opening and no evidence of any facial nerve weakness even for a temporary period. Conclusion: This method of screw retrieval provides an excellent solution to the difficult task of reduction and stabilisation of the proximal fragment in condylar fractures and especially in high fractures. Once the screw is in position, it enables the operator to gain precise control of the fracture. With the ease of manipulation this procedure reduces surgical time significantly. This method of reduction and stabilisation of bone fragments can be extended to other areas of maxillofacial trauma and corrective bone surgery. doi:10.1016/j.ijom.2009.03.451
and 12 months postoperatively. Maximal mouth opening, masticatory muscle tenderness and TMJ pain were recorded at each follow-up visit. Results: All groups of this study showed improvement in maximal mouth opening, TMJ pain, muscle tenderness, and clicking sounds with variable degrees according to each treatment modality used for each group. Conclusion: Although patients with TMJ internal derangement benefited from each technique to a variable extent, arthrocentesis of TMJ with injection of SH followed by centric splint seemed to be superior in achieving rapid and prolonged improvement in TMJ ID than the other techniques.
doi:10.1016/j.ijom.2009.03.448
J. Garcia Linares ∗ , J. González-Lagunas, J. Rubio Palau Department of Oral and Maxillofacial Surgery, Hospital Quiron, Hospital Vall d’Hebron, Sant Just Desvern, Barcelona, Spain
O12.22 Combined splint and arthrocentesis therapy versus splint or arthrocentesis for treatment of temporomandibular joint internal derangement W.A. Elmohandes Department of Oral and Maxillofacial Surgery, Al-azhar University, Nasr City, Egypt
Background and Objectives: This study was designed to evaluate the efficacy of combined splint and arthrocentesis with sodium hyaluronate (SH) injection therapy versus splint or arthrocentesis with SH injection for treatment of temporomandibular joint (TMJ) internal derangement (ID). Methods: Thirty patients (22 females and 8 males) with mean age 26.5 years comprised the study population. The patients’ complaints were limited mouth opening, TMJ pain and joint noises during function. The patients were randomly divided into 3 groups. Patients in group 1 were treated with centric splint. Arthrocentesis with SH injection was used for patients in group 2. Patients of group 3 were treated with combined splint and arthrocentesis with SH injection. Each group contained patients suffering from anterior disc displacement with and without reduction. Clinical evaluation was done before the procedure, and at 15 days, 1 month, 3 months, 6 months
doi:10.1016/j.ijom.2009.03.449
O12.23 Safe condylectomy using a piezoelectric device
Background and Objectives: We present our experience with the use of a piezoelectric device to perform different osteotomies during open temporomandibular joint (TMJ) surgery. The aim of this paper is to present our experience in six cases of TMJ surgery, where piezosurgery allows a safe bone cutting in the vicinity of important vascular structures. Methods: The same piezosurgery instrument (Mectron Medical Technology, Italy) has been used to perform osteotomies in patients affected by different TMJ problems. During six months, 6 patients affected by TMJ problems and requiring different types of osteotomies have been treated with the aforementioned device. In all cases, a standard preauricular approach to the joint was used. Results: In all 6 patients, the piezosurgery instrument allowed a precise and safe osteotomy cut without visible injuries to the neighbour soft tissues. Osteotomies were easy to carry out. Lengthening of the procedure in time was negligible when performing high condylectomies due to the softness of the bone. No complication directly related to the use of ultrasound was observed. Conclusions: The piezosurgery instrument with the adequate tip can be used safely in many of the osteotomies routinely
523
performed in the maxillofacial skeleton. We have presented our experience with this technique in the management of condylar hyperplasia and other conditions of the TMJ as eminectomy or zygomatic arch remodelling. doi:10.1016/j.ijom.2009.03.450
O12.24 Screw retrieval of the proximal fragment: a simple method of reduction and stabilisation of intracapsular condylar fractures S.D. Jones ∗ , A.W. Sugar, M. Mommaerts Department of Oral and Maxillofacial Surgery, University Hospital, Wales, Heath Park, Cardiff, United Kingdom
Background and Objectives: The authors of this paper acknowledge the difficulties that arise when attempting to reduce and stabilise some fractures of the condyle and in particular intracapsular fractures. The purpose of this paper is to highlight the use of screw retrieval of the proximal fragment and the benefits of its use for reduction and stabilisation of the fractured condylar head prior to fixation. Methods: Seven cases of intracapsular condylar fractures were surgically treated at two centres, Morriston Hospital, Swansea in South Wales and the General Hospital St Jean, Brugge in Flanders, Belgium during the period 1998–2007. The use of screw retrieval of the proximal fragment was used in all cases. Three of the cases were unilateral and four cases were bilateral intracapsular fractures. Results: In all cases postoperative scans showed excellent anatomical repositioning and fixation of the proximal fragments. Postoperative follow-up revealed good stable occlusion, excellent mouth opening and no evidence of any facial nerve weakness even for a temporary period. Conclusion: This method of screw retrieval provides an excellent solution to the difficult task of reduction and stabilisation of the proximal fragment in condylar fractures and especially in high fractures. Once the screw is in position, it enables the operator to gain precise control of the fracture. With the ease of manipulation this procedure reduces surgical time significantly. This method of reduction and stabilisation of bone fragments can be extended to other areas of maxillofacial trauma and corrective bone surgery. doi:10.1016/j.ijom.2009.03.451