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Scientific advances in the diagnosis and treatment of medication related osteonecrosis of the jaws
Abstracts well as their management in the world of virtual surgical planning for orthognathic surgery.
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one hand, and the burden of aesthetic and functional rehabilitation (or deficit) after resection on the other. Evidence remains lacking as to the long term outcome of repeated enucleation.
http://dx.doi.org/10.1016/j.ijom.2015.08.965 http://dx.doi.org/10.1016/j.ijom.2015.08.967 Scientific advances in the diagnosis and treatment of medication related osteonecrosis of the jaws S. Ruggiero
1,2,3
1
New York Center for Orthognathic and Maxillofacial Surgery, New York, USA 2 Stony Brook University, New York, USA 3 Hofstra North Shore-LIJ School of Medicine, New York, USA Osteonecrosis of the jaw (ONJ) related to antiresorptive medications has received a considerable amount of attention in the scientific and lay community since it was first described over 10 years ago. However, only within the past several years has there been significant progress toward understanding the pathogenesis of this disease process. Treatment and prevention guidelines for ONJ continue to evolve as our understanding of the multiple variables associated with its clinical presentation becomes more complete. The recent association of ONJ with certain novel targeted therapies, which are not antiresorptives, underscores the importance of continued surveillance for those patients at risk. This lecture will review the current theories on pathogenesis and focus on the recent advances in basic science and clinical research.
The role of HPV in oral cavity cancer A. Schache 1,2 1 2
University of Liverpool, Liverpool, United Kingdom University Hospital Aintree, Liverpool, United Kingdom
The influence of Human papillomavirus (HPV) on the aetiology of Head & Neck malignancy has become increasing apparent in the last decade. The most striking evidence for the role of HPV in the Head & Neck comes from the Oropharynx; where a profound shift in Oropharyngeal SCC epidemiology has been documented in combination with contrasting prognostic implications for patients, based on primarily the HPV status of their tumours. However controversy remains as to whether the aetiological influence of high risk HPV types extends beyond the oropharynx into oral cavity tumours and salivary malignancies. This presentation will discuss the evidence for the role of HPV in the oral cavity; from viral infection & carriage, to the influence of the virus on oral (pre)malignancy and current controversies facing clinicians. What are the implications for patients, for surgeons and for the research community?
http://dx.doi.org/10.1016/j.ijom.2015.08.966 http://dx.doi.org/10.1016/j.ijom.2015.08.968 Ameloblastomas: current knowledge and evidence for management N. Samman University of Hong Kong, Hong Kong, China Background: Resectional surgery implies a surgical defect requiring functional and aesthetic restoration while nonresectional surgery permits regeneration of missing bone but may predispose to recurrence. Objectives: To deliberate on the decision to resect or not based on a balance of risk versus benefit as gleaned from the literature. Methods: A review of the factors relevant to the decision and the supporting literature. Findings: 1. Nature of the lesion. Cystic lesions may be enucleated but if tumour cells have transgressed beyond the connective tissue cyst wall, recurrence is likely. The prevalence of cyst wall invasion is high in our series (27 out of 29), but this is a retrospective histological diagnosis. Enucleation may be augmented by application of Carnoy’s solution to the bony cavity and adjacent tissues to reduce the risk of recurrence (2 out of 22 [9%] in our series, 10–25% in the literature). 2. Histology. Absolute indication for resection include malignancy and suspicion of malignancy, there is no unequivocal correlation of histology with recurrence after treatment. 3. Location. Anterior mandibular lesions may be treated by nonresectional means, posterior maxillary lesions are better treated by resection due to easier control of recurrence. 4. Reconstructive facilities. Conclusions: The decision to resect or not must strike a balance between the risk and prognosis of possible recurrence on the
Management of post-traumatic zygomatico-orbital deformities R. Schön OMS Clinic, Hagen, Germany Post traumatic zygomatico-orbital deformities can cause severe disfiguring and discomfort due to facial asymmetry, enophthalmos and functional impairment such as diplopia. The correction of posttraumatic zygomatic-orbital deformities is still a challenge for the maxillo facial surgeon. For a satisfying operative correction of such deformities often multiple procedures are performed. To reduce the operative trauma it is mandatory to minimize the number of operative procedures. For the precise analysis of the cause of the deformity a computer assisted evaluation of CT Data is recommended. By mirrowing of the unaffected zygomatico-orbital side the degree of deformity is understood. The preoperative planning is based on this computer assisted analysis and the extend of the surgical correction including the need for surgical approaches is defined. Quality control of the results of the corrective surgery can be performed intraoperatively by computer assisted surgery or if available by intraoperative cone bean CT scan. Due to the intraoperative quality control the need of postoperative corrective surgery can be minimized. Satisfactory results after one time surgery with true to original reconstruction are achieved. http://dx.doi.org/10.1016/j.ijom.2015.08.969
e15
one hand, and the burden of aesthetic and functional rehabilitation (or deficit) after resection on the other. Evidence remains lacking as to the long term outcome of repeated enucleation.
http://dx.doi.org/10.1016/j.ijom.2015.08.965 http://dx.doi.org/10.1016/j.ijom.2015.08.967 Scientific advances in the diagnosis and treatment of medication related osteonecrosis of the jaws S. Ruggiero
1,2,3
1
New York Center for Orthognathic and Maxillofacial Surgery, New York, USA 2 Stony Brook University, New York, USA 3 Hofstra North Shore-LIJ School of Medicine, New York, USA Osteonecrosis of the jaw (ONJ) related to antiresorptive medications has received a considerable amount of attention in the scientific and lay community since it was first described over 10 years ago. However, only within the past several years has there been significant progress toward understanding the pathogenesis of this disease process. Treatment and prevention guidelines for ONJ continue to evolve as our understanding of the multiple variables associated with its clinical presentation becomes more complete. The recent association of ONJ with certain novel targeted therapies, which are not antiresorptives, underscores the importance of continued surveillance for those patients at risk. This lecture will review the current theories on pathogenesis and focus on the recent advances in basic science and clinical research.
The role of HPV in oral cavity cancer A. Schache 1,2 1 2
University of Liverpool, Liverpool, United Kingdom University Hospital Aintree, Liverpool, United Kingdom
The influence of Human papillomavirus (HPV) on the aetiology of Head & Neck malignancy has become increasing apparent in the last decade. The most striking evidence for the role of HPV in the Head & Neck comes from the Oropharynx; where a profound shift in Oropharyngeal SCC epidemiology has been documented in combination with contrasting prognostic implications for patients, based on primarily the HPV status of their tumours. However controversy remains as to whether the aetiological influence of high risk HPV types extends beyond the oropharynx into oral cavity tumours and salivary malignancies. This presentation will discuss the evidence for the role of HPV in the oral cavity; from viral infection & carriage, to the influence of the virus on oral (pre)malignancy and current controversies facing clinicians. What are the implications for patients, for surgeons and for the research community?
http://dx.doi.org/10.1016/j.ijom.2015.08.966 http://dx.doi.org/10.1016/j.ijom.2015.08.968 Ameloblastomas: current knowledge and evidence for management N. Samman University of Hong Kong, Hong Kong, China Background: Resectional surgery implies a surgical defect requiring functional and aesthetic restoration while nonresectional surgery permits regeneration of missing bone but may predispose to recurrence. Objectives: To deliberate on the decision to resect or not based on a balance of risk versus benefit as gleaned from the literature. Methods: A review of the factors relevant to the decision and the supporting literature. Findings: 1. Nature of the lesion. Cystic lesions may be enucleated but if tumour cells have transgressed beyond the connective tissue cyst wall, recurrence is likely. The prevalence of cyst wall invasion is high in our series (27 out of 29), but this is a retrospective histological diagnosis. Enucleation may be augmented by application of Carnoy’s solution to the bony cavity and adjacent tissues to reduce the risk of recurrence (2 out of 22 [9%] in our series, 10–25% in the literature). 2. Histology. Absolute indication for resection include malignancy and suspicion of malignancy, there is no unequivocal correlation of histology with recurrence after treatment. 3. Location. Anterior mandibular lesions may be treated by nonresectional means, posterior maxillary lesions are better treated by resection due to easier control of recurrence. 4. Reconstructive facilities. Conclusions: The decision to resect or not must strike a balance between the risk and prognosis of possible recurrence on the
Management of post-traumatic zygomatico-orbital deformities R. Schön OMS Clinic, Hagen, Germany Post traumatic zygomatico-orbital deformities can cause severe disfiguring and discomfort due to facial asymmetry, enophthalmos and functional impairment such as diplopia. The correction of posttraumatic zygomatic-orbital deformities is still a challenge for the maxillo facial surgeon. For a satisfying operative correction of such deformities often multiple procedures are performed. To reduce the operative trauma it is mandatory to minimize the number of operative procedures. For the precise analysis of the cause of the deformity a computer assisted evaluation of CT Data is recommended. By mirrowing of the unaffected zygomatico-orbital side the degree of deformity is understood. The preoperative planning is based on this computer assisted analysis and the extend of the surgical correction including the need for surgical approaches is defined. Quality control of the results of the corrective surgery can be performed intraoperatively by computer assisted surgery or if available by intraoperative cone bean CT scan. Due to the intraoperative quality control the need of postoperative corrective surgery can be minimized. Satisfactory results after one time surgery with true to original reconstruction are achieved. http://dx.doi.org/10.1016/j.ijom.2015.08.969