- Email: [email protected]
Surgical clinics
SURGICAL MONDAY,
Attendancefor each surgicalclinic(SC)is limitedto 20 personswho areAAOMS/GSOMS membersas a priorityand then only to other health careprofessionals registeredas such,and is determinedon a first-come,first-served basis. Ticketsare obtainedby completingand returningthe enclosedpre-registration form. Preregistrationfor each individualis limitedto a total of four (4)(SCsor PCs).Cost per SCis $75.00.Additionalticketsmay be purchasedon-site basedon spaceavailabilityand are subjectto an additional $15.00on-sitefee. Kindlynote AAOMS policy: Refundsfor ticketedevents willnot be granted. AfewSCsareofferedtwiceduringthe courseof the meeting, Sincethe sameclinicis offeredtwice,eachclinicis assignedtwo separatesessionnumbers. Forexample,the clinicentitled“SolvingProblemsin ClinicalUseof Implant Systems”is offeredas SC108on Tuesday,September28, 8:00 am - 10:00am and is repeatedas SC208on Wednesday, September29, 7:30am - 9:30am. Numbersbeginningwith a “2”areusuallyrepeats. An exceptionto this is clinic120 beingpresentedas PartI and PartII. Besureto registerfor the correctsessionnumberfor the correctsessiontime for eachclinicyou wishto attend.
Monday,September27
12:30 pm- 2:30pm(085-090)
SC 085
CLINICS SEPTEMBER
27
SC087 New Concepts is Orthognuthic and TIJ Surgical Procedures LarryM.Wolford,DDS Dallas,TX
Thispresentationwilldiscussmodificationsof surgicaldesign to improvestabilityincludingsubapical,mandibularand maxillaryosteotomies,genioplastyproceduresand double jawsurgery.Improvementsin TMJtechniquesand combined TMJand orthognathicsurgerywillalsobe presented,as well as simultaneousrhinoplasty.Clinicalresearchrelativeto the stabilityof resultswillbe demonstrated.
SC 088 Basic Facial Cosmetic Sur ery Procedures for the Oral and MuxiHofaci d Surgeon R.GregorySmith,DDS,MD PonteVedraBeach,FL The oraland maxillofacial surgeonpossessesall the basic knowledgeof surgicaltechniqueand anatomynecessaryto add facialcosmeticsurgeryto his/herarmamentarium.This surgicalclinicis presentedto familiarizethe practitionerwith the basictechniquesutilizedin proceduressuch as facial augmentation,blepharoplasty,facialpeeling/demrabrasion, face/neckliftingand adjunctiveprocedures.Methodsfor trainingand credentiallingwillalsobe discussed.
SC 089
Cosmetic Surgery of the External Ear
Obtaining propriate Medical Staff Privileges: Ag Step-by-Step Primer
ArdenK.Hegtvedt,DDS,MS
John D. Harwell,MA,JD
Columbus,OH
ManhattanBeach,CA
ToddG. Owsley,DDS,MD Treatmentof structuraldeformitiesinvolvingthe external ear,both congenitaland acquired,arewithin the scopeof oral and maxillofacial surgery.Commonlyused otoplasty techniqueswillbe reviewedand casesdiscussed.Useof auricularcartilagenousand compositegraftsfor facial reconstructionand cosmeticsurgerywillalsobe presented.
Manyoraland maxillofacial surgeonshave found obstaclesto their abilityto obtainappropriatemedicalstaffprivileges, especiallyin the areaof facialsurgery.Thiscourseis designed to providethe surgeonwith a strategyand defined methodologyfor overcomingthe prejudicesand anticompetitiveeffortsof competitorspecialtiesand to obtain privileges.The sessionwillincludea workshopaddressing individualissuesand solutions.
SC 086
SC090
Reconstrwtive Surgery and Prosthetic Repair of Mandibufar Defects
Management of lip Canter and Reconstruction of the lip
Bismarck,ND
JamesB.Murphy,DMD,MSc
RobertA.Ord,DDS,MD
Hershey,PA
EllicottC&v,MD
To restoreform and functionto largemandibulardefects remainsone of the most challengingproblemsin the fieldof reconstructivesurgery.Thispresentationwilladdressthis problemutilizinga varietyof techniquesfeaturingthe latest developmentsin surgeryand biotechnology.
Thisclinicwilldiscussthe pathologyand behaviorof cancer of the lip. The majorityof the presentationwillbe concerned with squamouscellcarcinomaof the lowerlip, and its surgicaltreatment. Caseswillbe shownto illustratethe surgicaltechniquesof lip reconstructionfor lesionslessthan
one-thirdof the lip, to lesionsinvolvingthe entirelip. Tumorsof the upperlip willbe brieflydiscussed.In the managementof advancedlip cancerthe role of neck dissectionfor metastaticdiseasewillbe reviewed,as wellas principlesguidingthe use of prophylacticand functional dissections.
3:00 pm - 5:00pm (091-096) Primary Rhinoplasty BrentD. Kennedy,DDS,MD Murray,UT Methodsand indicationsfor performingrhinoplastyare discussed.Methodsincludeboth closedand open rhinoplastytechniques. Patientselectionand treatment planningare emphasized.A systematicmethod of evaluation is used to diagnoseand defineboth functionaland esthetic problems.Problemsin tip estheticsand profilealignmentare addressed.Methodsof narrowingthe osteocartilaginous vault are discussed.
SC 092 Cervicofacial Lipectomy DurwoodE.Bach,DMD Honolulu,HI Adjunctivesurgicalproceduresto enhancefacialestheticscan be performedwith orthognathicsurgery.Patientswith cervicofacial lipomatosismay not realizeesthetic improvementfrom orthognathicsurgeryalone. Liposuction, performedin conjunctionwith orthognathicsurgery,can optimizethe correctionof hard and soft tissuedisharmonies. Indications,complicationsand surgicaltechniqueswillbe presented.
SC 093 Update on Clinical Pharmacology for the Oral and Maxillofacial Surgeon ArthurA.Gonty,DDS Lexington, KY The purposeof this surgicalclinicis to updatethe oraland maxillofacial surgeonon clinicalpharmacologyof newer antibiotics,and sedativeand generalanestheticagents. Antibioticswillbe reviewedin the firsthour and anesthetic agentsin the second. Someof the more commondrug interactionswillbe addressed.
SC094 Advanced Techniques in Implant Dentistry Joel L. Rosenlicht,DMD Manchester, CT Manypatientspresentwith difficultchallengesfor implant reconstruction.Properdiagnosisand pre-treatmentplanning is imperative.The utilizationof bone graftingtechniques, includingsinuselevationand subantralaugmentationalong with softtissuetechniquesaid in the abilityto restorethese patients. The utilizationof multipleimplantdesigns,such as blades,root formsand subperiosteals, willalsobe discussed. SC 095
Technique of Graft Harvesting from the Ilium, Calvarium, Rib and Tibia RichardE.Scheetz,Jr.,DDS,MS Columbus,OH PeterE.Larsen,DDS Columbus,OH A comprehensivereviewof autogenousbone graftharvesting techniqueswillbe presentedincludingdiscussionof indicationsand contraindications.Variousapplicationswill be mentionedwith majoremphasison actualtechniquesfor harvestingand managementof perioperativedonor site complications.Techniquesfor harvestof costochondral, cranial,anteriorand posterioriliacgraftswillbe included.
SC 096 Harvestin Cancellous Bone from the Proximal ! lbial Metaphysis for Maxillofacial Grafting GuyA.Catone,DMD Monroeville, PA Numerousdonor sitesfor harvestingof cancellousbone have been describedin the surgicalliterature.The primaryuse of the ilium,rib and calvariumwillbe comparedin regardto their fundamentalcomplications,volumeof donor bone and techniquescurrentlyused for procurement.An effortwillbe madeto highlightthe proximaltibia1as a low complication site for cancellousbone harvest. Examplesof the application of such tibia1donorbone willbe provided.
SURGICAL MONDAY,
530 pm - 7:30 pm (097402) SC097 Current Cowe ts in the Diagnosis and Treatment of Prigeminal Weuralgia LloydA.Darlow,DMD,MD Chestmfield, MO Trigeminalneuralgiais a symptomcomplex,elicitedby variouspathologicprocesses.Recentadvancesin diagnostic radiology,medicaltherapeutics,and neurologicalsurgery have shed new light on the etiologyand treatmentof this condition. Thisclinicwill: 1)reviewthe causesof trigeminal neuralgia;2) discussthe applicationof currentimaging technologyin its evaluation;3) developa differential diagnosisfor the facialneuralgias;4) outlinethe latest medicaland surgicaltherapies;and 5) constructa flow diagramfor a randompatient presentingwith facialpain.
SC 098 Guided Tissue Re ereration with Expanded Polytetrafloral Et%ylene (EPTFE) Augmentation Material JayP. Malmquist,DMD Portland,OR Guidedtissueregenerationhas provento be a predictable assetof oraland maxillofacial surgery.Alookat the various clinicalapplicationswillbe presentedalongwith a discussion concerningfutureapplications.Clinicaland animalresearch willbe used to illustratepresentand futureuses.
SC 099 Mana ement of Oral and Maxillofacial Infect t ons: Rationale for Antibiotic Selection LonnieH. Norris,DMD,MPH Boston,MA With understandingof the organismsinvolvedin oraland maxillofacial infections,the appropriateantibioticcan be chosen. Currentantibioticsavailablefor managementof odontogenicinfectionswillbe reviewedand the rationalefor selectionof antibioticsbasedon the oralmicroflorawillbe made. Casepresentationswillbe used to demonstratethe fasciaspacesand the chemotherapyand surgical managementof oral and maxillofacial infections.
CLINICS SEPTEMBER
27
SC100 MaxiRofa&d Reconstructton with Endosseous lmplunts and Guided Tissue Regeueration TimothyB.Welch,DDS LomaLinda,CA
The reconstructionof the atrophicmaxillaand posterior mandiblewith endosseousimplantswillbe discussed. Emphasiswillbe on the preoperativeidentificationand postoperativemanagementof surgicalcomplications. Appropriateuse of autogenousand allogenicbone grafting, guidedtissueregenerationand nerverepositioningwillbe discussedas it relatesto vascularbone grafts,traumaand cleft/syndromepatients. Surgeonsare invitedto bring their own casesfor treatmentplanning.
SC 101/201
Session 201 Tue.,9/28 lo:30 am- I~:30 pm
101-Anatomy and Surgical Therapy of Oral and Maxillofacial Infections 20 1 -Microbiolo and Antibiitic Therapy of Oral and Maxi1 lg’f o acial Infections ThomasR.Flynn,DMD Hartford,CT PLEASE NOTE:Thisis a two-partpresentation.Youmust registerfor eachpart separately;i.e.,registeringfor SC 101 doesnot automaticallyplaceyou in SC201. Each presentationrequiresa separatefee. It is not mandatoryfor you to takeboth PartsI and II; howevertheseclinicsare presentedto be complementaryto each other. 101-Areviewand updateon the clinicallyrelevantanatomy of deep fascialspaceinfections,their surgicaltherapyand complicationsof theseinfections. Pathwaysof the spreadof infectionsto the mediastinumand cranialcontentsare illustrated.Anestheticand airwayconsiderationsand aspirationsof infectedmaterialare alsodiscussed. 201-Areviewand updateon the microbiologyand antibiotic therapyof odontogenicinfections.The most frequent pathogens,their changingnomenclatureand the clinical implicationsof particularpathogensare reviewed.The drugs of choiceand the comparativecost-effectiveness of available oral and parenteralantibioticsare discussed.
Complications in Orthognathic Surgery StephenC. Hill,DDS Richardson,TX
The maturingscienceand art of orthognathicsurgeryhas witnessedthe implementationof many technicaladvances. Duringthis progress,certainproblemsand complications have developedthat have not previouslyreceivedappropriate attention. The main focusof this presentationwillbe the frankand conscientiousdiscussionof actualcomplications associatedwith currentsurgical-orthodontic techniques.
SURGICAL TUESDAY,
I
I I
CLINICS SEPTEMBER
28
Tuesday, September 28
8:00am- 1O:OO am(103408)
SC 106 Overview of Temporomandibular Joint Surgery M. FranklinDolwick,DMD,PhD
SC 103
Gainesville,FL
Complete Mandibular Reconstruction
Today’ssurgeonhas severalchoicesas to the appropriateTMJ operation. Duringthis presentationthe specificindications, techniques,outcomesand complicationsfor TMJ arthrocentesiswith lavage,arthroscopy,arthrotomyand condylotomywillbe discussed.
TerryD.Taylor,DDS,MS Housfon, TX
A simpleworkablemethod for treatmentplanningand treatmentsequencingvarioustypesof mandibulardefects willbe presented. Emphasiswillbe placedon restorationof the defectto a functionallyand estheticallycomplete endpointutilizingmethodsincludingrigidinternalfixation, osseointegration and the appropriateuse of vascularized flaps.
SC 104/204
Session repeats (204)Wed., 9/29 3:00 pm - 5:OO pm
Pediatric Anesthesia JeffreyB.Dembo,DDS,MS Lexington,KY
Avarietyof sedationand generalanesthetictechniquesfor childrenwillbe presentedthat have been provensuccessful by clinicalstudies. The attendeewilllearnhow to perform an accuratepre-anestheticassessment,and how to properly selectappropriatetechniquesfor use. Techniquesunder investigationwill be introduced.
SC105 Advanced Techniques in TMJ Arthroscopy Including Use of the Holmium laser AllenW.Tarro,DMD Lowell, MA Thispresentationon TMJarthroscopywillbe comprehensive but one that willplaceemphasison advancedarthroscopic techniques,includinguse of the holmium:YAGlaser. A synopsisof the objectivesof TMJarthroscopy, instrumentation,ORsetup,normalTMJarthroscopic anatomy,and pathologicalarthroscopicfindingswillbe discussed.Arthroscopicsurgicaltechniques,including advancedtechniquesand the use of the holmium:YAGlaser, willbe presentedin detail. The resultsof over600TMJ arthroscopicsurgicalprocedureswillbe discussedas wellas the rationalefor TMJarthroscopyand definitivetreatment for specifictypesof intracapsularTMJdisorders.The presentationwillbe extensivelysupportedby videotapesof actualcasesof TMJarthroscopicsurgery.Thissurgicalclinic willbe morebeneficialto surgeonswho have had some previousTMJarthroscopiceducationand experience.
SC 107
The Use of Holmium laser for TMJ Art hroscopic Surgery MichaelG. Koslin,DMD Birmingham, Al Thispresentationwilldemonstratethe safeand effectiveuse of the holmiumlaserin arthroscopicsurgicalmaneuversof the TMJ.Results,upcomingadvancesand pitfallswillbe discussed.
SC 108/208
Session reoeats (208) Wed., 9/29 7:30 am - 9:30 am
Solving Problems in Clinical Use of Implant Systems PhilipJ. Boyne,DMD,MS,DSc loma Linda,CA Newclinicalproceduresusing intraosseousimplantsin bone compromisedsiteswillbe presented. Bonegrafts,bone graft substitutes,and inductivematerialswillbe appliedto clinical problemareas. Casespresentingdifficultiesin treatment planningand surgicaltechniqueswillbe emphasized.
lo:30am- 12:30pm (109-l13,201) SC 109 Comprehensive Management of the MultipleOperated TMJ Patient KevinL.McBride,DDS Dallas,TX The multiple-operated TMJpatientpresentsa varietyof problemsnot usuallyfound duringfirstor secondsurgical procedures.Thispresentationwillreviewthe complex problemsfound in multiple-operated patientsand discussthe managementof the intracapsularand extracapsular soft tissue damageand degeneration Varioussurgicaltechniqueswill be comparedand the resultsevaluated.Postoperative physicaltherapyand managementof the occlusionand parafunctionalhabitswillbe reviewed.
SURGICAL TUESDAY,
SC 113/2 13
SC110 Dental
ia the Growimg Jaws
R.GilbertTriplett,DDS,PhD SunAntonio,TX
Session repeats
CLINICS SEPTEMBER
(213)Wed.,
28
9/29 7:30 om - 9:30 om
Printlpks of Hard aad Soft Tissue Reconstruction of the Jaws RobertE.Marx,DDS
Frequently,childrenand young adultsloseteeth fromtrauma and disease.Fixedbridgereplacementsareusually contraindicatedbecauseof the potentialdamageto adjacent teeth, and a removableappliancecan be a management problemfor the patient. The use of dentalimplantsin theseindicationswouldseem to providean idealsolution. If prosthesiscouldbe implantborne,the patientcouldrealizethe benefitof a fixed restorationwithout jeopardyto the adjacentteeth with large pulps. Thereare a numberof considerationsfor implantsin the growingjawwhich include1) timingof implantplacement, 2) positionof placement,3) effecton growth,and 4) longterm prognosisand outcome. Thisclinicwilldiscuss indicationsand contraindicationsfor implantsin children, timingfor implantplacementand potentialuse of implants in growingjaws. Congenitaland acquiredanodontiawillbe addressed, includingsingletooth replacement,acquiredand congenital problemssuch as failureof eruption,odontogenicdysplasia, ectodermaldysplasiaand clefts.
Miami,FL
Reconstructionof continuitydefectswithin the maxillofacial skeletontodayrequiresan expertisein both hard and soft tissuereconstruction.Softtissueprovidescells,blood supply, and coverfor bony reconstructionsand may takethe formof randompatterntissuetransfers,myocutaneousflaps,or free vascularanastomotictransfers.Hardtissuereconstruction requirestransplantinga cellularosteogenesisand recruiting thesecellsto forma functionalbone ossiclevia osteoinductionand osteoconduction.Hardtissue reconstructionmay take severalformstoday,but the most predictableremainsparticulatecancellousbone within a crib form of allogeneicbone. Thesepracticalmethodsof reconstruction,as wellas otherswillbe discussedrelatedto both biologyand technique.
SC 201 Microbiolog and Antibiotic Therapy of Oral and Maxillo ‘fo&l Infections PartII of SC101,Monday,September27,530 pm - 7:30pm
SC 111 Surgical-Orthodontic Reconstruction of Craniofacial Microsoma and Mandibulofacial Dysostosis TimothyA.Turvey,DDS ChapelHill,NC
The timing and sequencingof surgeryand orthodonticsis criticalin the managementof craniofacialmicrosomiaand mandibulofacial dysostosis.Avarietyof expressionsof both conditionswillbe presentedto demonstratesurgeryand orthodonticsin these populationsduringchildhoodand adulthood.
SC 112 Tbe C TMJ/Ortbogaatbic Clinical Dfkwntna
Patient: A
RobertA. Bays,DDS Atlanta,GA
Numeroustemporomandibulardisorder(TMD)patientshave significantmalocclusions,and numerousorthognathic patientshave clinicalor subclinicalevidenceof TMD. Diagnosis,treatmentplanning,sequencing,pre-and postoperativemanagementand specialconsideration regardingthe orthognathicpatientwith TMDand viceversa willbe discussed.
1:00pm - 3:00pm (114-119) SC 114 Open TMJ Surgery and Rehabilitation of Joint Function RobertV. Walker,DDS Dallas,TX
A reviewof the indicationsand work-upfor open temporomandibularjoint surgerywillbe givenwith an assessmentof the technicalrequirementsessentialto each procedure.Mostimportantly,methodsfor rehabilitationof the TMJbackto normaluse aftersurgerywillbe thoroughly discussedwith stepby-stepdetailsgiventhrough fully illustratedcasereportsand their long-termfollow-ups.
SURGICAL TUESDAY,
CLINICS SEPTEMBER
28
SC 115
SC 118
Maxillary Onlay, Inlay and Interpositional Composite Bone Grafts (Autogenous Iliac Bone and Titanium Endosseous Implants)
Treatment of Temporomandibular Joint Dysfunction by Intraoral Vertical Ramus Osteotomy
EugeneE.Keller,DDS,MSD Rochester, MN
WilliamH. Bell,DDS Dallas,TX
Compositebone graftsfor maxillofacial reconstructionhave been utilizedat our medicalcentersince1984. The compositegraftsconsistof autogenousblock corticocancellous iliacbone and endosseoustitanium threadedcylindricalimplants. Thispresentationwilldetail the surgicalproceduresrequiredto reconstructthe severely resorbedand/or malpositionedmaxilla. Maxillary discontinuity,includingedentulouscongenitalcleftpatients, willbe discussed.
Patientswith anteriordiscdisplacementwith reductionand associatedsevereTMJpain and dysfunctioncan be selectively and successfully treatedby bilateralintraoralverticalramus osteotomies,without interosseousfixationof the proximal segment,2-3weeksof maxillomandibular fixation,and systematicneuromuscularrehabilitationafterreleaseof maxillomandibular fixation. Investigationsof casestreated by relativelysmallmovementsof the mandibleindicatedthat gooddental and skeletalstabilitywereachieved.
SC 116
SC 119
Rhinoplasty Adjunctive to Orthognathic Surgery
Total TMJ Reconstruction-CAD/CAM Custom Prosthesis
PeterD. Waite,MPH,DDS,MD
LouisG. Mercuri,DDS,MS Maywood, IL
Bimingham, AL
The basictechniqueof rhinoplastywillbe describedand demonstrated.The indicationsand contraindicationswith orthognathicsurgerywillbe explained. SC 117
Thetopic of totalTMJreconstructionwillbe discussed.The pathologicentitiesamenableto this treatmentand the therapeuticapproachesto thesecaseswillbe presentedas will the multiplyoperated,anatomicallymultilatedjoint and its replacementwith a CAD/CAM customprosthesis.
Arthroscopy: Indications and Use A.ThomasIndresano,DMD Milwaukee, WI Arthroscopyof the temporomandibularjoint has becomea firstline operativetechniqueoverthe last 10years. Abrief historyof its developmentwith a descriptionof past and presenttechnologiclimitationswillset the stagefor current practices.A discussionof joint pathology,especiallyinternal derangementand degenerativejoint disease,willestablishthe role of surgeryin the temporomandibularjoint patient. Patientexperienceand resultsof arthroscopicsurgeryover 7 yearswillbe discussed.Opensurgicalprocedureswillbe comparedto arthroscopicsurgicalprocedureswhere applicable.Theuse of the laserwillbe introducedby a discussionof laserphysicsand the developmentof the tool in combinationwith arthroscopy.Indicationsand usageof the laserwillalsobe discussed.
3:30 pm - 530 pm (120425) SC
120/220
Session 220 Wed., 9/29 3:OO pm - 5:OO pm
Management of the Medically Compromised Patient-Parts I & II StevenM. Roser,DMD,MD NewYork,NY PLEASE NOTE:Thisis a two-partpresentation.Youmust registerfor each part separately;i.e.,registeringfor SC120 doesnot automaticallyplaceyou in SC220. Each presentationrequiresa separatefee. It is not mandatoryfor you to takeboth PartsI and II, howeverthese clinicsare presentedto be complementaryto each other. The managementof surgicalpatientswith concomitant medicalproblemswillbe discussed.Emphasiswillbe placed on the preoperativeevaluationand managementof the medicalconditions. The topicswillbe dividedinto parts. Participationby the attendeeswillbe encouraged.
SURGICAL TUESDAY, WEDNESDAY,
a( Tehiques
for
MichaelS.Block,DMD NewOrleans, LA The clinicwilldiscusssinusgrafting,the placementof implantsinto freshextractionsites,preparationof thin ridges for implant placement,anteriorimplantplacementfor estheticrestorationsand simultaneousLeFortI osteotomies with bone graftingand implantplacement,in detail.
SEPTEMBER SEPTEMBER
28 29
results. Useof the coronal(skin)flap,an intracranial approach,complexsegmentalorbitalosteotomies,cranial bone grafting,internal(miniand microplate)fixation,the use of freetissuetransfersand microneuralrepairshave greatlyimprovedthe functionaland estheticreconstructions that can be offeredtoday. Thesetechniquesand concepts willbe reviewedthrough the patientexamples.
SC 125 Analytic Model Surgery KimErickson,DDS GrandRapids,Ml
SC 122 Expanded Tecbniqser of Exposure and Reconstruction in TMJ Surgery DavidH. Perrott,DDS,MD SanFrancisco,CA
Constructionfreconsttion of the TM]is a challengefor the oral and maxillofacial surgeon. Thispresentationwilladdress the use of hemi and coronalflapfor exposureof the TMJand reconstructivetechniquesusingthe temporalisfasciamuscle flap and costochondralgraft. Postoperativerehabilitation and complicationswillbe discussed.
SC 123 Orbital Evafuetion Techniques for Surgical Repair, Reconstruction and Decompression MarkW. Ochs,DMD,MD ~~~~Tg~,
CLINICS
PA
Thispresentationwillcoverpertinentsurgicalanatomy, clinicaland radiographicevaluation,and treatmentplanning for conditionsaffectingthe orbit. Avarietyof orbital approachesand techniquesfor traumaticinjuries,secondary reconstruction,biopsyor neoplasiaremoval,and decompressionwillbe discussed.Coordinationof treatment with an ophthalmologistwillbe stressed.
SC 124 Upper FaGal Asymmetries: A Craaiofadal Approwk for Recaastruction JeffreyC. Posnick,DMD,MD Washington,DC The managementof facialasymmetriespresentsthe clinician with someof the most difficultand perplexingproblemsof all the facialdeformities.Thiscoursereviews:a method of evaluatingcomplexupperfaceesthetics;the typesof congenital,developmental,traumaticand neoplastic disordersthat presentwith upper faceasymmetries;and, a craniofacialapproachfor their resolution. A quantitativeCT scan-basedassessmentof the crania-orbitalzygomaticregion willbe reviewed,which assiststhe surgeonin understanding regionaldysmorphologyand the analysisof reconstructive
Surgicalmovementsof the jaware complicated,threedimensionalproblemsof geometricallycomplexstructures.A systematicmethod is presentedfor integratingthe clinical examand predictiontracingswith articularmounted models. Treatmentplans are translatedinto “surgicalprescriptions.” Wholejawand jawsegmentmovementsare accurately quantifiedin three planesof space.
Wednesday, September29 7:30am - 9:30am (126~131,208,213) SC 126 Disc Replacement, Partial and Total Reconstruction of the TMJ John N. Kent,DDS NewOrleans,L4 Reconstructive TMJsurgerymay includediscreplacement with temporaryalloplast,fascia,cartilage,dermis,or nothing; condyleresurfacingor replacementwith cartilage,muscle/ fascia,rib, toe, scapula,fibulaor osteotomy;and fossa/ condylereplacementas in total joint reconstruction.This presentationdiscussesresultsof severalhundredprocedures basedon indications,verticalloss,occlusalabnormality, supportinganimaland in vitrobiomechanicalloadtestsand data,numberof previoussurgicalprocedures,surgical techniquevariations,selectionand behaviorof autogenous, homogenousor alloplasticmaterials,postoperativephysical therapyincludingCPM,retrospectiveand prospectivepatient outcomeindicators,and life tableanalysis.
~SURGICAL
CLINICS
WEDNESDAY,
SEPTEMBER
29
SC 127
SC 131
Reconstruction of the Traumatic Frontal-Nasal-Orbital Structures
Microvascular Soft Tissue and Bone Reconstruction in the Head and Neck
StuartN. Kline,DDS Miami,FL MarkR.Stevens,DMD Miami,FL Thisclinicwilladdressthe managementof crania-facial injuriesas it pertainsto the front0basilarskull,frontalsinus, and naso-ethmoidalareas. Specialconsiderationson nasal injuriesand their immediateand late reconstructionwillalso be discussed.
DieterHellner,MD,DDS Hamburg,GERMANY RainerSchmelzeisen, MD,DDS,PhD
SC 128 Techniques of Myocutaneous Flaps OrestisHadjianghelou,MD,DMD Cologne,GERMANY UweFrohberg,MD,DMD Cologrre, GERMANY Our &year experiencewith myocutaneousflapsin more than 100patientsis reviewed.Technicalaspectsincluding donor sitelocation,flapdesign,elevationand flapinset are discussed.Casereportscoverreconstructionafter glossectomy,and closureof perforationand skullbase defects. Selectedcasesarepresentedfor discussion.
SC 129 Indications and Protocols for Salvage Surgery of the TMJ RobertB.Macintosh,DDS Detroit,Ml Undesirablesequelaeof temporomandibularjoint surgery havebecomeincreasinglyfrequent. The managementof patientswith ongoingjoint dysfunction(sometimesmore severethan the originaldifficulties)followingopen temporomandibularjoint intervention,has becomea growingfocusof surgicalattention. Thispresentation suggeststreatmentprotocolsfor recoverysurgeryof the temporomandibularjointsin a varietyof such scenarios.
Hannover,GERMON
Differentialindicationsfor intra-and extraoralsoft tissue reconstructionare demonstrated.Indicationsespeciallyfor jejunalgrafts,radialforearmflapsand rectusand gracilis muscleflapsarepointedout. The applicationof different microvascular bone graftsare demonstratedand the different indicationsdiscussed.
SC 208 Solvin Problems in Clinical Use of Imp3ant Systems Repeatof SC108,Tuesday,September28,8:00am - 1O:OO am
SC 213 Principles of Hard and Soft Tissue Reconstruction of the Jaws Repeatof SC113,Tuesday,September28, 10~30am - 12:30pm
390 pm - 5:OO pm (132-137, 204,220) SC 132 Surgical (and Medical) Management of Controversial Pathologic Entities of the Head and Neck ThomasP. Williams,DDS Dubuque,IA
SC130
Thispresentationwilldiscussthe managementof selected controversiallesionsthat involveboth the jawsand soft tissueof the head and neckincludingodontogeniccystsand tumors,mucosaldisease,systemicdiseasesinvolvingthe jaws and salivaryglandneoplasms.
Surgical Treatment of the Medically Compromised Patient in the Office Setting
SC 133
DonaldL. Hoffman,DDS,PhD H@zland Park,IL Apracticalapproachto the oralsurgicaltreatmentof the patientpresentingwith one or more of the commonmaladies of our populationwillbe presented. Howcurrenttheoriesof the medicalmanagementand pathophysiologyof cardiovascular/respiratory disease,endocrinedysfunction, immune deficiencysyndrome,neurologicdisordersand coagulationdisordersaffectsurgicaltreatmentplanningin the officesetting.
Nasal-Ethmoidal and Frontal Basal Reconstruction MichaelEhrenfeld,MD,DMD Tubingen,GERMXNY
Aftera short reviewof the functionalanatomy,the etiologies of pathologicalprocesses(trauma,tumor, inflammation)in the naso-ethmoidaland frontalbasalregionare shown. The roleof modernimagingtechniquesin diagnosisand treatmentplanningwillbe illustrated.
SURGICAL WEDNESDAY, THURSDAY, Surgicalapproachesto the naso-ethmoidand frontalskull basewillbe explained.Dependingon the defect,post trauma/tumorreconstructionswith localand distantflaps,as wellas with alloplasticmaterialwillbe demonstrated.
SC134
CMICS SEPTEIRBER SEPTElUlBER
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SC 137 y of life, As ects OR Palliative Therap , an !i Pain Therapy in the Hea !I and Neck Cancer Patient
Co le
AndreBckardt,MD,DDS Hannover,GERMANY DieterWeingart,MD,DDS Muenster,GERMANY
Freiburg,GERMANY
Variouspalliativetreatmentconceptsincludingsurgery, chemotherapyand radiotherapyare currentlyused for advancedor recurrenthead and neckcancer. Theseconcepts willbe outlinedand discussedwith casereports.
t Sur ery (Osteotomies, Bone nes, i(\ icroneurosurgery): Gra ts, German aml Americun Experience WiifriedSchilli,MD,DDS
7
LeonA.Assael,DMD Farmington,CT
Problemsof anatomicform for implantplacementsinclude insufficientbone qualityand quantity. Repairof these conditionswith osteotomies,bone grafts,microneurosurgery and membraneswith simultaneousimplant placementwith IT1and Branemarkimplantsare shown. The Germanand Americanexperienceswith differentmembranes,bank bone, etc., are presented.
SC 135
SC 204 Pediatric Anesthesia Repeatof SC104,Tuesday,September28,890 am - 1090 am
Management of the Medically Compromised Patient PartII of SC120on Tuesday,September28,3:30pm - 530 pm
StephenA.Sachs,DDS Lake Success,NY
Contemporaryoral and maxillofacial surgeryhas become wideand diversein its scope.Orthognathicand reconstructivesurgeryoften interweavewith surgicaloral pathologyand surgicaloncology. Throughthree modules, orthognathicsurgeryfor the specialpatient,surgeryand reconstructionof benign jawlesions,and a protocolfor reconstructionof the oralcancerpatient,these interrelationships will be illustrated.
SC 136 Periorbital and Orbital Reconstruction PeterStoll,MD,DMD Freiburg,GERMANY
Primaryand secondaryreconstructiontechniqueswillbe presented. Multipleaccessapproacheswillbe outlined. The use of graftmaterialsand fixationtechniqueswillbe reviewed.Treatmentplanning,resultsand complicationswill be includedin this presentation.
Thursday,September30 7:30am - 9:30am (138-145) SC 138 Management of the Neck in ~ Head and Neck Malignancy DanielD. Lydia&DDS,MD Omaha,NE Treatmentof the neckin patientswith head and neckcancer continuesto evolve. Modifications of the radicalneck dissection,(sparinguninvolvedstructures),and selectiveneck dissections,(dissectingonly nodesat risk),are most noteable developments.The history,safety,efficacy,indications, contraindicationsand techniquesof these dissectionswillbe discussed.
SC 139 ment of the John F. Helfrick,DDS,MS Houston,TX Diagnosisand managementof the cleftpatientfrombirth to age21 willbe reviewed.Emphasiswillbe placedon surgical managementof skeletaland dentoalveolarcleftdeformities.
URGICAL HURSDAY,
CLINIC 1s SEPTEMBER
30
SC 140
SC 144
Periapical Surgery: Endodontic Surgery
Basal Cell Carcinoma (Skin Tumors)
MartenN. Ladman,DMD
NorbertA.Schwenzer,MD,DMD
Morganville, N\
Tubingen,GERMANY
BertramBlum,DDS
MichaelBergermann,MD,DMD Welver,GERMANY
ForestHills,NY
Dentoalveolar surgeryremainsthe most commonly requestedoralsurgicalservice.The surgeon’sabilityto provideperiapicalsurgeryis often essentialto successful officepractices.The historyand indicationsfor periapical surgery,as wellas surgicaltreatmentdesignsand rationale willbe presented. SC 141
Clinical A plications of Dermabrasion and Chemical %eel John P.Tanner,MS,DDS,MD
Basalcellcarcinomais the singlemost commonneoplasmof the skin. About9O?hof thesetumorsarelocatedin the head and neckarea. Etiologyand pathologyof this tumor willbe discussed.With regardto tumor size,localizationand infiltrationof surroundingstructures’surgicaltreatmentwill be presented. Specialemphasisis givento reconstructive procedures.
SC 145 Correction of late Sequelae FriedrichW.Neukam,MD,DDS,PhD
KansasCity,MO
Hannover,GERMANY
Dermabrasion and chemicalpeelingare adjunctive proceduresoften used for facialrejuvenation,skin surface recontouring,and alterationof somepigmentarydisorders. Skinanatomy,histopathology,and wound healingwillbe discussed.The indicationsand contraindicationsfor each procedurewillbe emphasizedto guidethe surgeonin patient selection,and in tailoringabrasionand/or peeling techniquesto meet the patient’sneeds. Avarietyof dermabrasionand chemicalexfoliationtechniqueswillbe reviewed,and a thoroughdiscussionof the managementof unfavorableresultsis planned.
The data of 172multiplyinjuredpatientswith facialinjuries wereevaluatedfor late sequelaein a retrospectivestudy. Six casesof anosmia,four casesof diplopia,twenty-sixpatients with hypesthesiaor paresthesiawerefound. Thirteen fractureshave healedin malposition,and fifteenpatients presentedwith malocclusionand without impairmentof masticatoryfunction. Ten patientsexhibitedankylosisof the TMJwith limitationof mouth opening. Thistotal of 74 complicationsoccurredin 37 patients,so that it can be concludedthat the incidenceof late sequelaeis low in facial injuries. Treatmentplanningand use of secondary reconstructiontechniquesof deficientsoft and hard tissue willbe describedand presentedin a numberof casereports.
SC 142 Management of Nasal Fractures CharlesE.Graper,DDS,MD Gainesville, FL Areasof discussionwillincludeappliedanatomy, physiology,treatmentoptions,diagnosticconsiderations, such as historyand physicalexam,imaging,surgical techniquesand mechanismsof injury. Openand closed reductionof the bony cartilagenousstructureswillbe discussedincludinginstrumentation,dressing,packing,and sutures. Managementof possiblecomplicationswillalsobe addressed. SC 143
Techniques of Neck Dissection KarstenK.H.Gundlach,MD,DDS,MSD Restock,GERMANY
Thissurgicalclinicwillbeginwith a seriesof slides depictinga radicalneckdissection.Allrelevantanatomical structureswillbe pointedout in detail. Explanationsof variationsof this classicoperation(conservative, supraomohyoid,suprahyoid,etc.)willbe presented.
3:30 pm - 5:30 pm (146-153) SC 146 Immediate Mandibular Reconstruction at the Time of Ablative Cancer Surgery AllenSclaroff,DDS St.Louis,MO Variousreconstructivetechniquescan be used to restoreform and functionto a patientwho has undergonecompleteor marginalmandibularresectionfor cancercure. This discussionwillincludechoiceof implants(onevs. two stage), donor site selection(hip versusfibula),as wellas determine soft tissueneeds,radiotherapyand its influenceson the reconstructivetechniquein relationto donor site and implantchoice. Finally,outcomedata willbe presentedin relationto implant,flapand patient survival.Helpfuldo’s and don’tsto makethe reconstructiveprocedureeasierwillbe interjectedthroughoutthe lecture.
SURGICAL THURSDAY,
SEPTEABBER
30
SC150
Sf 147 Sur id
CLINICS
Treatmeat of the Cleft lip, Palate
an 8 Alveab
Process
JamesE.Bertz,DDS,MD Scottsdale, AZ Thispresentationwillcoverthe embryology,etiology,and surgicalrepairof the cleftlip with MillardAdvancement RotationRepairs,for both the unilateraland bilateralcleftlip. The one stagerepairof the palate,the stagedrepairand the reasonsfor each,as wellas the bone graftingof the alveolar processwillbe discussed.
SC 148 Advanced Concepts in Implent Reconstruction Using tke Brtmemark Blethod of Osseointegration KenjiHiguchi,DDS,MS Spokane,WA The successfulreplacementof a lost dentitionutilizinga tissue-integrated prosthesishas revolutionizedpm-prosthetic oral and maxillofacial surgery.Branemarkand colleagues initiallyfocusedon applyingthe principlesof osseointegration to the fullyedentulouspatient. Overthe past 10years,the scopeof applicationhas expandedto includetreatmentin areaspreviouslydeferred.Thissession willreviewthe presenter’s10yearexperiencein the managementof complexconditionsincludingthe extremely resorbedmaxillaand mandible,bone graftingapproachesto the maxilla,managementof the posteriorfixtureplacement in the partiallyedentulous,and the hypodontic-oligodontic patient. Theuse of fixturesas intraoralorthodontic anchoragewillbe discussedincludingapplicationsin orthognathicsurgery.The currentstatusof osseointegrated fixturessecuringcrania-facial prostheseswillbe summarized.
SC 149 TMJ Artkroscopic Surger : Rationale, Treatment an ETManagement
Computer Treatment
ations in Orthognathic ing.
MarkA.Conover,DDS,MS Hewret, CA MelvynS.Wishan,DDS,MDS Beverly Hills,CA Thisclinicwillexplorethe use of computer-aideddiagnosis and treatmentplanningfor orthognathicand cosmeticfacial surgery.Boththe scientificbasisfor computerevaluationand planning,as wellas multimediatechniques(imaging, graphics,video,sound)for patient presentationand counsellingwillbe discussed.
SC 151 Surgical Aspects of Apicoectomies StuartE.Lieblich,DMD Avon,CT Surgicaland anatomicprinciplesof endodontictreatment willbe reviewed.A literaturereviewand discussionof alternativesto amalgamwillalsobe included.
SC 152 Presurgical Orthodontics for the Oral and Maxillofacial Surgeon PaulM.Thomas,DMD,MS Durham,NC
Orthodonticpreparationfor orthognathicsurgeryoften involvestreatmentgoalsand extractionpatternswhich differ from those commonlyused in orthodonticcamouflage.In addition,certainaspectsof treatmentcan be accomplished more efficientlyand with greaterstabilityif managed surgically.Thispresentationwillcovertreatmentplanning conceptsand a sequenceof preparationand finishingwhich has provenclinicallysuccessful.
SC 153
JeffreyJ. Moses,DDS
Maxillofacial Cancer Diagnosis and Treatment
Erzcinitas,CA
JamesD. Ruskin,DMD,MD Gainesville, FL
Didacticrationalefor the techniqueof TMJarthroscopic surgery,as wellas the pre-and postoperativemanagementof the patient for consistentresultsare presented. Independent researchinvestigatingthe relationshipsof discpositionand mobilityto clinicalsuccessand preoperativesymptomswill be reviewed.
Thispresentationwilldealwith the diagnosisand treatment of cancerof the oraland maxillofacial region. In additionto a reviewof the pertinentanatomyand diagnosticmodalities involved,overalltreatmentprinciplesand site specific therapywillbe presented.
SURGICAL FRIDAY,
CLINICS
OCTOBER
1
Friday,October1 7:30am - 9:30am (154-161) SC154 Comprehensive Management of Panfacial Fractures Including Rigid Fixation
orthognathicsurgery.Detailswillbe givenalsoin the use of platesin reconstructionsurgery.In additionto basic techniquesin the use of plates,emphasiswillbe givenduring this presentationto someof the creativemodificationsin plateuse and waysto avoidpitfalls.
SC158 Midface and Panfacial Fractures
Dallas,TX
RolfEwers,MD,DMD Vienna,AUSTRlA
Facialtraumacontinuesto be a mainstayof contemporary oraland maxillofacial surgery.Thisclinicwilldiscussall aspectsof facialfracturemanagementincluding:pertinent statisticson the impactof traumato society,historical highlightsof fracturetreatment,initialpatient assessment and management,specificfracturetreatmentwith RIF, complicationsand residualdeformities.
Midfaceand panfacialfractureshave to be treated immediatelyif the patient’sgeneralhealth allowsa repositioningand fixationprocedure.Thereis a possibilityto treatin the firstor evensecondweek,whichis referredto as late primarytreatment. ARfracturesshouldbe stabilizedby osteo-synthesis methodswith good occlusionand, if possible, from an intra-oralapproach.
RichardA.Finn,DDS
SC 159 Comprehensive Mana ement of Mandibular Trauma via a Transora1 /Percutaneous Approach with Application of Rigid Fixation N. RayLee,DDS Newport News,VA
Managin the Orthognathic/TMJ When ans How?
Patient:
GaryOrentlicher,DMD Scarsdale,NY
Varioussurgicaltechniquesfor applicationof rigidinternal fixationvia a transoral/percutaneous approachin the treatmentof mandibulartraumawillbe presented. This clinicwillalsodiscusssurgicalanatomy,diagnostic considerationsfor techniqueselectionand managementof potential complications.
Patientswith internalderangementsand/or myofascialpain and dysfunctionin combinationwith dentofacialdeformities willbe discussed.Preoperativerecords,bite registration, intraoperativecondylarposition,and rigidfixationaffectthe temporomandibularjoint. It is instrumentalto establisha reproduciblecentricrelationpositionprior to surgery. Splints,which typesand when, willbe illustrated.
SC 156
SC 160
Management of Gunshot Wounds
Correction of Surgical Defects of the Face Using Local Flaps
J. HamilWilloughby,DDS Hempsiead,NY
The drug-abuseepidemicthroughoutthis countryand the escalatingviolenceassociatedwith the drug tradehas resulted in a significantincreasein the numberof oraland maxillofacial injuriessecondaryto gunshotwounds. This coursewitlreviewthe ballisticsand pathogenesisof maxillofacial injuriessecondaryto projectilesfrom low velocityhandguns. Initialmanagementconsiderationsand treatmentobjectiveswillbe discussed.Specificcaseswillbe reviewedwith emphasison casemanagement.
SC 157 Techniques of Immediate Plate Placement BeatHammer,MD,DDS Basel, SWfTZERLAND The presentationwill reviewthe techniquesof immediate
rigidfixationplacementin the followingsituations: mandibularfractures,midfaceand orbitalfracturesand
BemdGattinger,MD,DMD Linz,AUSTRIA
Basedon clinicalexamples,the use of localflapsfor defect reconstructionin the differentregionsof the facewillbe discussed.The specialestheticand functionalrequirements and the fundamentalguidelinesof this type of procedure have to be differentiated.
SC 161 Open Rhinoplasty BruceN. Epker,DDS,MSD,PhD Ft. Worth,TX
The indications,detailsof surgicaltechnique,treatment
results,and complicationsof open rhinoplastywillbe discussed.Integrationof rhinoplastyand orthognathic surgerywillbe detailed.
SURGICAL FRIDAY,
3:30 pm - 530 pm (162-169)
SC 166
SC 162
RobertW. Alexander,MD,DMD
Nerve Injuries: Evalaation and Microsurgical Repair RogerA.Meyer,DDS,MD Marietta,GA
Peripheraltrigeminalnerve injuriescausingsignificant sensoryaberrationsmay be repairedby microsurgical techniquesin selectedpatients. Guidelinesbasedon research and clinicalexperiencehavebeen establishedfor evaluation and timelytreatmentof nerveinjuries. The author analyzes his resultsof 295 microneurosurgical operations.
SC 163/263
Session repeats
(263) Sat., IO/~ 3:30 pm - 5:30 pm
Trigeminai Nerve injuries and Repair John P. LaBanc,DMD Sprinsfield,MO
Thissurgicalclinicwillcoverthe pathophysiologyof nerve injury and recovery,diagnosticevaluation,algorithmfor management,and microsurgical techniquesof repair. Most traumaticsensorydisturbancesresolve,a fewpersistand somebecomepainful. Algorithmshavebeen developedto logicallymanagenerve injuriesincludingpharmacologic, physiologicand surgicaltherapies.
SC 164/264
Session repeats
(264) Sat., IO/~ 3:30 pm - 5:30 pm
Sinus lift Procedures MartinS. Lebowitz,DDS,MS St.Petersburg, FL
Thisprogramlooksat the developmentof this techniqueand the instrumentation.The lateralwalland crestalridge approachesare discussed.Differentaugmentationmaterials areexamined. Adiscussionof implantsbest suitedfor the posteriormaxillaare part of this program. Radiographic interpretation,complicationsand long-termresultsare reviewed.
SC 165 Advanced Techniques with Endosseous Implants NeilB.Hagen,DDS Chicago,I1
Thissurgicalclinicwillcoverthe currentapplicationsof maxillofacial reconstructionusing the Branemarkendosseous implant. Bonegraftingtechniques,new products,as wellas new diagnostictools and treatmentplaningideaswillbe describedand discussedin an effortto treat the previously untreatablepatient.
CLINICS OCTOBER
1
Blepharoplasty Edmonak,WA
Thoroughdiscussionof structuraland diagnostic considerationsfor estheticreconstructionof the eyelids. Patientevaluationand selectionis emphasized.Step-by-step techniqueof surgicalreconstructionof the eyelidwillbe presented. Recognitionand managementof common complicationswillbe reviewed.
SC 167 Monitoring Equipment and ECG Review for Office Surgery ThomasA.Nique,DDS,MD Warren,Ml
The presentationwillcoverthe essentialphysiologic monitorsrequiredfor safeoutpatientoral and maxillofacial surgerycare;how they work,what parametersare significant, when they shouldbe used,reviewof commonpathologic ECGpatterns,their clinicalsignificanceand treatmentwill alsobe discussed.Finally,what emergencydrugsshouldbe at hand and aspectsof properrecordkeeping,as wellas future considerations,willbe addressed.
SC 168 Implants in Oncology UlrichSchwarz,MD,DMD Freiburg,Germany
The clinicwillpresentmaterialon the use of implantsin reconstructionafteroncologicsurgery.The placement techniquesutilizedduringimmediateand delayed reconstructionwill be emphasized.
SC 169 The Role of Arthroscopy in the Treatment of TMJ lntracapsular and Dysfunction RobertD. Schwartz,DMD Chicago,IL
Temporomandibular joint (TMJ)disordersare a majorcause of patientpain and dysfunctionand an importantfocusof attentionby healthcareproviders.Basedon specificcriteria, surgicalmodalitiesmay be the indicatedform of treatment for certainTMJdisorders.Recentadvancesin smalljoint arthroscopictechnologyhave openedan importantnew option in the managementof TMJdisorders,anaiogousto the impactof arthroscopyfor largejoint (e.g.,knee,shoulder, etc.)disorders.
SURGICAL SATURDAY,
CLINICS OCTOBER
2
7:30am - 9:30am (170477)
surgicalaspectsof variousdefectsituationsand to the use of differentkindsof graftsin a numberof casereports. Results and complicationsat both the donor and the recipientsite willbe presentedand discussed.
SC 170
SC 174
Upper Facial Rejuvenation
Modified Condylotomy for Painful Internal Derangement of the TMJ
Saturday,October2
Clark0. Taylor,DDS,MD Bismarck,ND
Thisclinicwillfocuson the clinicalestheticevaluationof the upperfacialthird to includeforeheadand eyes. Thiswillbe followedby appropriatetreatmentselectionand a step-bystep presentationof the techniquesof coronal,trichophyllic, midforeheadand directbrowlift as wellas upper and lower lid blepharoplasty.Participantsshouldfeelcomfortableat the conclusionof the clinicin the evaluationand treatmentof estheticdeformitiesof the upper facialthird.
SC 171 Orthognathic Surgery in the Asian Patient GeorgeM. Yellich,DDS,MS Sunlose,CA Orthognathicsurgeryin the Asianpatienthas many considerationsin treatmentplanning. Thisprogramwill reviewthe clinicalnormsfor Asians,as wellas the skeletal deformitiesassociatedwith b&maxillary protrusion. Specialized surgicalprocedures,splint fabrication,pre-and postsurgicalorthodontics,and the attendantcomplications with thesetechniqueswillbe reviewedin detail. The historicalperspectiveof Asiansin Americaenhancesthe concernfor treatmentplanningof these patients.
SC 172 Basic Fundamentals of the Successful Implant Practice AndreU. Buchs,DMD Orlando,FL
ThisSCwillcoverpatient selection,radiographic examination,oral evaluation,treatmentplanningand surgicaltechniquesfor the DenarSteri-Oss and Core-Vent implantsystems.The importanceof the team approachto treatmentplanningand the managementof complicationsto minimizefailureswillbe emphasized.The restorationof the edentulousand partiallyedentulousmandibleand maxilla,as wellas the singletooth defectwillbe covered. Detailed statisticswillbe presented.
SC 173 ,
Implants and Bone Grafts HenningSchliephake,MD,DDS Hannover,GERMANY
The use of implantsand bone graftsin oralrehabilitationwill be describedin detail. Particularattentionwillbe paid to the
H. DavidHall,DMD,MD Nashville,TN
The history,rationaleand resultsof condylotomywillbe reviewed.The modifiedopen techniquedevelopedby Nickersonwillbe emphasized.Sufficientdetailsof patient selection,operativetechniqueand postoperativecarewillbe presentedto enablethe participantto duplicatethe resultsof modifiedcondylotomy.
SC 175 Contem orary TMJ Management “On” or “Off” t/e Disc: Treatment Alternatives and Rationale CharlesE.Repa,DDS Houston,TX
The goalof this sessionis to reviewmanagementof the joint dysfunctionpatient in the “trenches”of clinicalpractice.The use of arthrocentesis,arthroscopy,arthroplasty,and the verticalramusosteotomywillbe discussed.The use of splint therapy,tomography,MRI,clinicalexamand historyto assist in this processwillalsobe examined.
SC 176 The Holmium YAG laser in TMJ Arthroscopic Surgery BarryH. Hendler,DDS,MD Philadelphia,PA
A new pulsedmidinfraredlaserhas becomeavailablefor use in arthroscopicsurgeryof the TMJ.Becausethe Ho:YAG laser can preciselyand rapidlyresectcartilaginoustissues,can functionin a salineenvironment,and can be transmitted throughopticalfibers,it has the potentialof becominga usefulsystemfor TMJarthroscopicsurgery.
SC177 Total Reconstruction of the Temporomandibular Joint DavidC. Hoffman,DDS StatenIsland,NY The purposeof this clinicwillbe to presentan all inclusive discussionon total temporomandibularjoint reconstructive surgery.It willcombineboth an orthopedicperspective, maxillofacial surgeryperspectiveand ultimatelykey in on
SURGICAL SATURDAY,
clinicalapplications.It wouldbe of benefitto anyonewho has had TMJsurgicalexperienceand is now interestedin total joint reconstruction.In addition,it will specifically help in understandingthe treatmentof a patientwho has had multiplesurgicalproceduresand hopefullyoffera good reviewof the fundamentalknowledgeneededto proceed with a total joint system.
3:30 pm - 5:30pm (178-183, 263-264) SC 178 Guided Bone Graft Augmentation and Osseointeyated Implants OleT.Jensen,DDS,MS Denver,CO In orderto improvethe osseointegrating capacityof osseous deficientimplant sites,variousbone graftingstrategiesare suggested.The biologicalbasisfor bone graftincorporation, remodelingand repairas it relatesto dentalimplantswillbe reviewed.Osseousloadingprescriptions,site developmentas it relatesto implantation,memberapplicationand optimal surgicaltechniqueare described.Useof the Branemark implant in the anteriorand posteriormaxillais emphasized.
SC 180 Current Concepts in Treatment Planning for Osseointegrated Implants ChristopherSmith, DDS SanAntonio,TX Failureof osseointegrated implants,althoughminimal,occurs more frequentlywhen the implantsareused in clinical situationsother than in the anteriormandible. Implantsin the posteriormandibleand maxilla,as wellas implants placedin augmentedareas,presenta slightlyhigher percentageof failure. The prosthodonticmanipulationof these implantscan be criticalto their success.Current conceptsto enhancesuccessin prosthodontictreatmentof the completelyedentulousand partiallyedentuloussituations willbe presented.
SC 181 Clinical Neurosensory Examination John R.Zuniga,DMD,MS,PhD ChapelHill,NC The objectiveof this presentationis to providea conciseand meaningfulapproachto the clinicalexaminationof patients with orofacialnerveinjuries. The reliability,sensitivity, specificityand performanceof each testingmethod willbe illustratedon site so that clinicalinterpretationwillbe responsibleand valid.
CLINICS OCTOBER
2
SC182 Predktable Correction of Maxikry Bone Deficiency to Allow Successful Prosthetic Rehabilitation BillC. Terry,DDS ChapelHill,NC
Bonelossin the anteriormaxillaand associatedsofttissue and vestibulardeformitiesas wellas the lesscommon completelyresorbedalveolus,“flatmaxilla,”can be predictablycorrected.An implant restoredmandible functioningagainstthe edentulous,compromisedmaxilla raisesadditionalconcerns. Selectionof specificprocedures, surgicaldetailsand long term results,including complications,willbe discussedand illustrated.
SC 183 Advanced Surgical Technique for III-I lant Reconstruction, Sinus, Nerve, Vesti lL leplasty CharlesA.Babbush,DDS,MScD Beachwood,OH
Thispresentationwilldealwith those procedureswhichmake the reconstructionof the partiallyand totallyedentulous individualspossiblewhen there is a lackof sufficientquality and quantityof hard and soft tissues.Byutilizingthe advancedtechnologyof CTScanningwith 3-Dreconstruction presurgicaldiagnosisand treatmentplanninghave been greatlyenhanced. When implantplacementis anticipated and a lackof osseousreceptorsiteis present,ancillary proceduressuch as maxillaryantroplasty(sinuslift),nerve transpositionand repositioningand vestibuloplastyhave madetheseprocedurespossible.Avarietyof materialssuch as hydroxylapatite, freezedriedand autogenousbone as well as barriermembraneshave addedto the successof these procedures.Thispresentationwillreviewall of these techniquesand concepts.
SC 263 Trigeminal Nerve Injuries and Repair Repeatof SC163on Friday,October1,3:30pm - 530 pm
SC 264 Sinus lift Procedures Repeatof SC164on Friday,October1, 3:30pm - 530 pm
Attendancefor each surgicalclinic(SC)is limitedto 20 personswho areAAOMS/GSOMS membersas a priorityand then only to other health careprofessionals registeredas such,and is determinedon a first-come,first-served basis. Ticketsare obtainedby completingand returningthe enclosedpre-registration form. Preregistrationfor each individualis limitedto a total of four (4)(SCsor PCs).Cost per SCis $75.00.Additionalticketsmay be purchasedon-site basedon spaceavailabilityand are subjectto an additional $15.00on-sitefee. Kindlynote AAOMS policy: Refundsfor ticketedevents willnot be granted. AfewSCsareofferedtwiceduringthe courseof the meeting, Sincethe sameclinicis offeredtwice,eachclinicis assignedtwo separatesessionnumbers. Forexample,the clinicentitled“SolvingProblemsin ClinicalUseof Implant Systems”is offeredas SC108on Tuesday,September28, 8:00 am - 10:00am and is repeatedas SC208on Wednesday, September29, 7:30am - 9:30am. Numbersbeginningwith a “2”areusuallyrepeats. An exceptionto this is clinic120 beingpresentedas PartI and PartII. Besureto registerfor the correctsessionnumberfor the correctsessiontime for eachclinicyou wishto attend.
Monday,September27
12:30 pm- 2:30pm(085-090)
SC 085
CLINICS SEPTEMBER
27
SC087 New Concepts is Orthognuthic and TIJ Surgical Procedures LarryM.Wolford,DDS Dallas,TX
Thispresentationwilldiscussmodificationsof surgicaldesign to improvestabilityincludingsubapical,mandibularand maxillaryosteotomies,genioplastyproceduresand double jawsurgery.Improvementsin TMJtechniquesand combined TMJand orthognathicsurgerywillalsobe presented,as well as simultaneousrhinoplasty.Clinicalresearchrelativeto the stabilityof resultswillbe demonstrated.
SC 088 Basic Facial Cosmetic Sur ery Procedures for the Oral and MuxiHofaci d Surgeon R.GregorySmith,DDS,MD PonteVedraBeach,FL The oraland maxillofacial surgeonpossessesall the basic knowledgeof surgicaltechniqueand anatomynecessaryto add facialcosmeticsurgeryto his/herarmamentarium.This surgicalclinicis presentedto familiarizethe practitionerwith the basictechniquesutilizedin proceduressuch as facial augmentation,blepharoplasty,facialpeeling/demrabrasion, face/neckliftingand adjunctiveprocedures.Methodsfor trainingand credentiallingwillalsobe discussed.
SC 089
Cosmetic Surgery of the External Ear
Obtaining propriate Medical Staff Privileges: Ag Step-by-Step Primer
ArdenK.Hegtvedt,DDS,MS
John D. Harwell,MA,JD
Columbus,OH
ManhattanBeach,CA
ToddG. Owsley,DDS,MD Treatmentof structuraldeformitiesinvolvingthe external ear,both congenitaland acquired,arewithin the scopeof oral and maxillofacial surgery.Commonlyused otoplasty techniqueswillbe reviewedand casesdiscussed.Useof auricularcartilagenousand compositegraftsfor facial reconstructionand cosmeticsurgerywillalsobe presented.
Manyoraland maxillofacial surgeonshave found obstaclesto their abilityto obtainappropriatemedicalstaffprivileges, especiallyin the areaof facialsurgery.Thiscourseis designed to providethe surgeonwith a strategyand defined methodologyfor overcomingthe prejudicesand anticompetitiveeffortsof competitorspecialtiesand to obtain privileges.The sessionwillincludea workshopaddressing individualissuesand solutions.
SC 086
SC090
Reconstrwtive Surgery and Prosthetic Repair of Mandibufar Defects
Management of lip Canter and Reconstruction of the lip
Bismarck,ND
JamesB.Murphy,DMD,MSc
RobertA.Ord,DDS,MD
Hershey,PA
EllicottC&v,MD
To restoreform and functionto largemandibulardefects remainsone of the most challengingproblemsin the fieldof reconstructivesurgery.Thispresentationwilladdressthis problemutilizinga varietyof techniquesfeaturingthe latest developmentsin surgeryand biotechnology.
Thisclinicwilldiscussthe pathologyand behaviorof cancer of the lip. The majorityof the presentationwillbe concerned with squamouscellcarcinomaof the lowerlip, and its surgicaltreatment. Caseswillbe shownto illustratethe surgicaltechniquesof lip reconstructionfor lesionslessthan
one-thirdof the lip, to lesionsinvolvingthe entirelip. Tumorsof the upperlip willbe brieflydiscussed.In the managementof advancedlip cancerthe role of neck dissectionfor metastaticdiseasewillbe reviewed,as wellas principlesguidingthe use of prophylacticand functional dissections.
3:00 pm - 5:00pm (091-096) Primary Rhinoplasty BrentD. Kennedy,DDS,MD Murray,UT Methodsand indicationsfor performingrhinoplastyare discussed.Methodsincludeboth closedand open rhinoplastytechniques. Patientselectionand treatment planningare emphasized.A systematicmethod of evaluation is used to diagnoseand defineboth functionaland esthetic problems.Problemsin tip estheticsand profilealignmentare addressed.Methodsof narrowingthe osteocartilaginous vault are discussed.
SC 092 Cervicofacial Lipectomy DurwoodE.Bach,DMD Honolulu,HI Adjunctivesurgicalproceduresto enhancefacialestheticscan be performedwith orthognathicsurgery.Patientswith cervicofacial lipomatosismay not realizeesthetic improvementfrom orthognathicsurgeryalone. Liposuction, performedin conjunctionwith orthognathicsurgery,can optimizethe correctionof hard and soft tissuedisharmonies. Indications,complicationsand surgicaltechniqueswillbe presented.
SC 093 Update on Clinical Pharmacology for the Oral and Maxillofacial Surgeon ArthurA.Gonty,DDS Lexington, KY The purposeof this surgicalclinicis to updatethe oraland maxillofacial surgeonon clinicalpharmacologyof newer antibiotics,and sedativeand generalanestheticagents. Antibioticswillbe reviewedin the firsthour and anesthetic agentsin the second. Someof the more commondrug interactionswillbe addressed.
SC094 Advanced Techniques in Implant Dentistry Joel L. Rosenlicht,DMD Manchester, CT Manypatientspresentwith difficultchallengesfor implant reconstruction.Properdiagnosisand pre-treatmentplanning is imperative.The utilizationof bone graftingtechniques, includingsinuselevationand subantralaugmentationalong with softtissuetechniquesaid in the abilityto restorethese patients. The utilizationof multipleimplantdesigns,such as blades,root formsand subperiosteals, willalsobe discussed. SC 095
Technique of Graft Harvesting from the Ilium, Calvarium, Rib and Tibia RichardE.Scheetz,Jr.,DDS,MS Columbus,OH PeterE.Larsen,DDS Columbus,OH A comprehensivereviewof autogenousbone graftharvesting techniqueswillbe presentedincludingdiscussionof indicationsand contraindications.Variousapplicationswill be mentionedwith majoremphasison actualtechniquesfor harvestingand managementof perioperativedonor site complications.Techniquesfor harvestof costochondral, cranial,anteriorand posterioriliacgraftswillbe included.
SC 096 Harvestin Cancellous Bone from the Proximal ! lbial Metaphysis for Maxillofacial Grafting GuyA.Catone,DMD Monroeville, PA Numerousdonor sitesfor harvestingof cancellousbone have been describedin the surgicalliterature.The primaryuse of the ilium,rib and calvariumwillbe comparedin regardto their fundamentalcomplications,volumeof donor bone and techniquescurrentlyused for procurement.An effortwillbe madeto highlightthe proximaltibia1as a low complication site for cancellousbone harvest. Examplesof the application of such tibia1donorbone willbe provided.
SURGICAL MONDAY,
530 pm - 7:30 pm (097402) SC097 Current Cowe ts in the Diagnosis and Treatment of Prigeminal Weuralgia LloydA.Darlow,DMD,MD Chestmfield, MO Trigeminalneuralgiais a symptomcomplex,elicitedby variouspathologicprocesses.Recentadvancesin diagnostic radiology,medicaltherapeutics,and neurologicalsurgery have shed new light on the etiologyand treatmentof this condition. Thisclinicwill: 1)reviewthe causesof trigeminal neuralgia;2) discussthe applicationof currentimaging technologyin its evaluation;3) developa differential diagnosisfor the facialneuralgias;4) outlinethe latest medicaland surgicaltherapies;and 5) constructa flow diagramfor a randompatient presentingwith facialpain.
SC 098 Guided Tissue Re ereration with Expanded Polytetrafloral Et%ylene (EPTFE) Augmentation Material JayP. Malmquist,DMD Portland,OR Guidedtissueregenerationhas provento be a predictable assetof oraland maxillofacial surgery.Alookat the various clinicalapplicationswillbe presentedalongwith a discussion concerningfutureapplications.Clinicaland animalresearch willbe used to illustratepresentand futureuses.
SC 099 Mana ement of Oral and Maxillofacial Infect t ons: Rationale for Antibiotic Selection LonnieH. Norris,DMD,MPH Boston,MA With understandingof the organismsinvolvedin oraland maxillofacial infections,the appropriateantibioticcan be chosen. Currentantibioticsavailablefor managementof odontogenicinfectionswillbe reviewedand the rationalefor selectionof antibioticsbasedon the oralmicroflorawillbe made. Casepresentationswillbe used to demonstratethe fasciaspacesand the chemotherapyand surgical managementof oral and maxillofacial infections.
CLINICS SEPTEMBER
27
SC100 MaxiRofa&d Reconstructton with Endosseous lmplunts and Guided Tissue Regeueration TimothyB.Welch,DDS LomaLinda,CA
The reconstructionof the atrophicmaxillaand posterior mandiblewith endosseousimplantswillbe discussed. Emphasiswillbe on the preoperativeidentificationand postoperativemanagementof surgicalcomplications. Appropriateuse of autogenousand allogenicbone grafting, guidedtissueregenerationand nerverepositioningwillbe discussedas it relatesto vascularbone grafts,traumaand cleft/syndromepatients. Surgeonsare invitedto bring their own casesfor treatmentplanning.
SC 101/201
Session 201 Tue.,9/28 lo:30 am- I~:30 pm
101-Anatomy and Surgical Therapy of Oral and Maxillofacial Infections 20 1 -Microbiolo and Antibiitic Therapy of Oral and Maxi1 lg’f o acial Infections ThomasR.Flynn,DMD Hartford,CT PLEASE NOTE:Thisis a two-partpresentation.Youmust registerfor eachpart separately;i.e.,registeringfor SC 101 doesnot automaticallyplaceyou in SC201. Each presentationrequiresa separatefee. It is not mandatoryfor you to takeboth PartsI and II; howevertheseclinicsare presentedto be complementaryto each other. 101-Areviewand updateon the clinicallyrelevantanatomy of deep fascialspaceinfections,their surgicaltherapyand complicationsof theseinfections. Pathwaysof the spreadof infectionsto the mediastinumand cranialcontentsare illustrated.Anestheticand airwayconsiderationsand aspirationsof infectedmaterialare alsodiscussed. 201-Areviewand updateon the microbiologyand antibiotic therapyof odontogenicinfections.The most frequent pathogens,their changingnomenclatureand the clinical implicationsof particularpathogensare reviewed.The drugs of choiceand the comparativecost-effectiveness of available oral and parenteralantibioticsare discussed.
Complications in Orthognathic Surgery StephenC. Hill,DDS Richardson,TX
The maturingscienceand art of orthognathicsurgeryhas witnessedthe implementationof many technicaladvances. Duringthis progress,certainproblemsand complications have developedthat have not previouslyreceivedappropriate attention. The main focusof this presentationwillbe the frankand conscientiousdiscussionof actualcomplications associatedwith currentsurgical-orthodontic techniques.
SURGICAL TUESDAY,
I
I I
CLINICS SEPTEMBER
28
Tuesday, September 28
8:00am- 1O:OO am(103408)
SC 106 Overview of Temporomandibular Joint Surgery M. FranklinDolwick,DMD,PhD
SC 103
Gainesville,FL
Complete Mandibular Reconstruction
Today’ssurgeonhas severalchoicesas to the appropriateTMJ operation. Duringthis presentationthe specificindications, techniques,outcomesand complicationsfor TMJ arthrocentesiswith lavage,arthroscopy,arthrotomyand condylotomywillbe discussed.
TerryD.Taylor,DDS,MS Housfon, TX
A simpleworkablemethod for treatmentplanningand treatmentsequencingvarioustypesof mandibulardefects willbe presented. Emphasiswillbe placedon restorationof the defectto a functionallyand estheticallycomplete endpointutilizingmethodsincludingrigidinternalfixation, osseointegration and the appropriateuse of vascularized flaps.
SC 104/204
Session repeats (204)Wed., 9/29 3:00 pm - 5:OO pm
Pediatric Anesthesia JeffreyB.Dembo,DDS,MS Lexington,KY
Avarietyof sedationand generalanesthetictechniquesfor childrenwillbe presentedthat have been provensuccessful by clinicalstudies. The attendeewilllearnhow to perform an accuratepre-anestheticassessment,and how to properly selectappropriatetechniquesfor use. Techniquesunder investigationwill be introduced.
SC105 Advanced Techniques in TMJ Arthroscopy Including Use of the Holmium laser AllenW.Tarro,DMD Lowell, MA Thispresentationon TMJarthroscopywillbe comprehensive but one that willplaceemphasison advancedarthroscopic techniques,includinguse of the holmium:YAGlaser. A synopsisof the objectivesof TMJarthroscopy, instrumentation,ORsetup,normalTMJarthroscopic anatomy,and pathologicalarthroscopicfindingswillbe discussed.Arthroscopicsurgicaltechniques,including advancedtechniquesand the use of the holmium:YAGlaser, willbe presentedin detail. The resultsof over600TMJ arthroscopicsurgicalprocedureswillbe discussedas wellas the rationalefor TMJarthroscopyand definitivetreatment for specifictypesof intracapsularTMJdisorders.The presentationwillbe extensivelysupportedby videotapesof actualcasesof TMJarthroscopicsurgery.Thissurgicalclinic willbe morebeneficialto surgeonswho have had some previousTMJarthroscopiceducationand experience.
SC 107
The Use of Holmium laser for TMJ Art hroscopic Surgery MichaelG. Koslin,DMD Birmingham, Al Thispresentationwilldemonstratethe safeand effectiveuse of the holmiumlaserin arthroscopicsurgicalmaneuversof the TMJ.Results,upcomingadvancesand pitfallswillbe discussed.
SC 108/208
Session reoeats (208) Wed., 9/29 7:30 am - 9:30 am
Solving Problems in Clinical Use of Implant Systems PhilipJ. Boyne,DMD,MS,DSc loma Linda,CA Newclinicalproceduresusing intraosseousimplantsin bone compromisedsiteswillbe presented. Bonegrafts,bone graft substitutes,and inductivematerialswillbe appliedto clinical problemareas. Casespresentingdifficultiesin treatment planningand surgicaltechniqueswillbe emphasized.
lo:30am- 12:30pm (109-l13,201) SC 109 Comprehensive Management of the MultipleOperated TMJ Patient KevinL.McBride,DDS Dallas,TX The multiple-operated TMJpatientpresentsa varietyof problemsnot usuallyfound duringfirstor secondsurgical procedures.Thispresentationwillreviewthe complex problemsfound in multiple-operated patientsand discussthe managementof the intracapsularand extracapsular soft tissue damageand degeneration Varioussurgicaltechniqueswill be comparedand the resultsevaluated.Postoperative physicaltherapyand managementof the occlusionand parafunctionalhabitswillbe reviewed.
SURGICAL TUESDAY,
SC 113/2 13
SC110 Dental
ia the Growimg Jaws
R.GilbertTriplett,DDS,PhD SunAntonio,TX
Session repeats
CLINICS SEPTEMBER
(213)Wed.,
28
9/29 7:30 om - 9:30 om
Printlpks of Hard aad Soft Tissue Reconstruction of the Jaws RobertE.Marx,DDS
Frequently,childrenand young adultsloseteeth fromtrauma and disease.Fixedbridgereplacementsareusually contraindicatedbecauseof the potentialdamageto adjacent teeth, and a removableappliancecan be a management problemfor the patient. The use of dentalimplantsin theseindicationswouldseem to providean idealsolution. If prosthesiscouldbe implantborne,the patientcouldrealizethe benefitof a fixed restorationwithout jeopardyto the adjacentteeth with large pulps. Thereare a numberof considerationsfor implantsin the growingjawwhich include1) timingof implantplacement, 2) positionof placement,3) effecton growth,and 4) longterm prognosisand outcome. Thisclinicwilldiscuss indicationsand contraindicationsfor implantsin children, timingfor implantplacementand potentialuse of implants in growingjaws. Congenitaland acquiredanodontiawillbe addressed, includingsingletooth replacement,acquiredand congenital problemssuch as failureof eruption,odontogenicdysplasia, ectodermaldysplasiaand clefts.
Miami,FL
Reconstructionof continuitydefectswithin the maxillofacial skeletontodayrequiresan expertisein both hard and soft tissuereconstruction.Softtissueprovidescells,blood supply, and coverfor bony reconstructionsand may takethe formof randompatterntissuetransfers,myocutaneousflaps,or free vascularanastomotictransfers.Hardtissuereconstruction requirestransplantinga cellularosteogenesisand recruiting thesecellsto forma functionalbone ossiclevia osteoinductionand osteoconduction.Hardtissue reconstructionmay take severalformstoday,but the most predictableremainsparticulatecancellousbone within a crib form of allogeneicbone. Thesepracticalmethodsof reconstruction,as wellas otherswillbe discussedrelatedto both biologyand technique.
SC 201 Microbiolog and Antibiotic Therapy of Oral and Maxillo ‘fo&l Infections PartII of SC101,Monday,September27,530 pm - 7:30pm
SC 111 Surgical-Orthodontic Reconstruction of Craniofacial Microsoma and Mandibulofacial Dysostosis TimothyA.Turvey,DDS ChapelHill,NC
The timing and sequencingof surgeryand orthodonticsis criticalin the managementof craniofacialmicrosomiaand mandibulofacial dysostosis.Avarietyof expressionsof both conditionswillbe presentedto demonstratesurgeryand orthodonticsin these populationsduringchildhoodand adulthood.
SC 112 Tbe C TMJ/Ortbogaatbic Clinical Dfkwntna
Patient: A
RobertA. Bays,DDS Atlanta,GA
Numeroustemporomandibulardisorder(TMD)patientshave significantmalocclusions,and numerousorthognathic patientshave clinicalor subclinicalevidenceof TMD. Diagnosis,treatmentplanning,sequencing,pre-and postoperativemanagementand specialconsideration regardingthe orthognathicpatientwith TMDand viceversa willbe discussed.
1:00pm - 3:00pm (114-119) SC 114 Open TMJ Surgery and Rehabilitation of Joint Function RobertV. Walker,DDS Dallas,TX
A reviewof the indicationsand work-upfor open temporomandibularjoint surgerywillbe givenwith an assessmentof the technicalrequirementsessentialto each procedure.Mostimportantly,methodsfor rehabilitationof the TMJbackto normaluse aftersurgerywillbe thoroughly discussedwith stepby-stepdetailsgiventhrough fully illustratedcasereportsand their long-termfollow-ups.
SURGICAL TUESDAY,
CLINICS SEPTEMBER
28
SC 115
SC 118
Maxillary Onlay, Inlay and Interpositional Composite Bone Grafts (Autogenous Iliac Bone and Titanium Endosseous Implants)
Treatment of Temporomandibular Joint Dysfunction by Intraoral Vertical Ramus Osteotomy
EugeneE.Keller,DDS,MSD Rochester, MN
WilliamH. Bell,DDS Dallas,TX
Compositebone graftsfor maxillofacial reconstructionhave been utilizedat our medicalcentersince1984. The compositegraftsconsistof autogenousblock corticocancellous iliacbone and endosseoustitanium threadedcylindricalimplants. Thispresentationwilldetail the surgicalproceduresrequiredto reconstructthe severely resorbedand/or malpositionedmaxilla. Maxillary discontinuity,includingedentulouscongenitalcleftpatients, willbe discussed.
Patientswith anteriordiscdisplacementwith reductionand associatedsevereTMJpain and dysfunctioncan be selectively and successfully treatedby bilateralintraoralverticalramus osteotomies,without interosseousfixationof the proximal segment,2-3weeksof maxillomandibular fixation,and systematicneuromuscularrehabilitationafterreleaseof maxillomandibular fixation. Investigationsof casestreated by relativelysmallmovementsof the mandibleindicatedthat gooddental and skeletalstabilitywereachieved.
SC 116
SC 119
Rhinoplasty Adjunctive to Orthognathic Surgery
Total TMJ Reconstruction-CAD/CAM Custom Prosthesis
PeterD. Waite,MPH,DDS,MD
LouisG. Mercuri,DDS,MS Maywood, IL
Bimingham, AL
The basictechniqueof rhinoplastywillbe describedand demonstrated.The indicationsand contraindicationswith orthognathicsurgerywillbe explained. SC 117
Thetopic of totalTMJreconstructionwillbe discussed.The pathologicentitiesamenableto this treatmentand the therapeuticapproachesto thesecaseswillbe presentedas will the multiplyoperated,anatomicallymultilatedjoint and its replacementwith a CAD/CAM customprosthesis.
Arthroscopy: Indications and Use A.ThomasIndresano,DMD Milwaukee, WI Arthroscopyof the temporomandibularjoint has becomea firstline operativetechniqueoverthe last 10years. Abrief historyof its developmentwith a descriptionof past and presenttechnologiclimitationswillset the stagefor current practices.A discussionof joint pathology,especiallyinternal derangementand degenerativejoint disease,willestablishthe role of surgeryin the temporomandibularjoint patient. Patientexperienceand resultsof arthroscopicsurgeryover 7 yearswillbe discussed.Opensurgicalprocedureswillbe comparedto arthroscopicsurgicalprocedureswhere applicable.Theuse of the laserwillbe introducedby a discussionof laserphysicsand the developmentof the tool in combinationwith arthroscopy.Indicationsand usageof the laserwillalsobe discussed.
3:30 pm - 530 pm (120425) SC
120/220
Session 220 Wed., 9/29 3:OO pm - 5:OO pm
Management of the Medically Compromised Patient-Parts I & II StevenM. Roser,DMD,MD NewYork,NY PLEASE NOTE:Thisis a two-partpresentation.Youmust registerfor each part separately;i.e.,registeringfor SC120 doesnot automaticallyplaceyou in SC220. Each presentationrequiresa separatefee. It is not mandatoryfor you to takeboth PartsI and II, howeverthese clinicsare presentedto be complementaryto each other. The managementof surgicalpatientswith concomitant medicalproblemswillbe discussed.Emphasiswillbe placed on the preoperativeevaluationand managementof the medicalconditions. The topicswillbe dividedinto parts. Participationby the attendeeswillbe encouraged.
SURGICAL TUESDAY, WEDNESDAY,
a( Tehiques
for
MichaelS.Block,DMD NewOrleans, LA The clinicwilldiscusssinusgrafting,the placementof implantsinto freshextractionsites,preparationof thin ridges for implant placement,anteriorimplantplacementfor estheticrestorationsand simultaneousLeFortI osteotomies with bone graftingand implantplacement,in detail.
SEPTEMBER SEPTEMBER
28 29
results. Useof the coronal(skin)flap,an intracranial approach,complexsegmentalorbitalosteotomies,cranial bone grafting,internal(miniand microplate)fixation,the use of freetissuetransfersand microneuralrepairshave greatlyimprovedthe functionaland estheticreconstructions that can be offeredtoday. Thesetechniquesand concepts willbe reviewedthrough the patientexamples.
SC 125 Analytic Model Surgery KimErickson,DDS GrandRapids,Ml
SC 122 Expanded Tecbniqser of Exposure and Reconstruction in TMJ Surgery DavidH. Perrott,DDS,MD SanFrancisco,CA
Constructionfreconsttion of the TM]is a challengefor the oral and maxillofacial surgeon. Thispresentationwilladdress the use of hemi and coronalflapfor exposureof the TMJand reconstructivetechniquesusingthe temporalisfasciamuscle flap and costochondralgraft. Postoperativerehabilitation and complicationswillbe discussed.
SC 123 Orbital Evafuetion Techniques for Surgical Repair, Reconstruction and Decompression MarkW. Ochs,DMD,MD ~~~~Tg~,
CLINICS
PA
Thispresentationwillcoverpertinentsurgicalanatomy, clinicaland radiographicevaluation,and treatmentplanning for conditionsaffectingthe orbit. Avarietyof orbital approachesand techniquesfor traumaticinjuries,secondary reconstruction,biopsyor neoplasiaremoval,and decompressionwillbe discussed.Coordinationof treatment with an ophthalmologistwillbe stressed.
SC 124 Upper FaGal Asymmetries: A Craaiofadal Approwk for Recaastruction JeffreyC. Posnick,DMD,MD Washington,DC The managementof facialasymmetriespresentsthe clinician with someof the most difficultand perplexingproblemsof all the facialdeformities.Thiscoursereviews:a method of evaluatingcomplexupperfaceesthetics;the typesof congenital,developmental,traumaticand neoplastic disordersthat presentwith upper faceasymmetries;and, a craniofacialapproachfor their resolution. A quantitativeCT scan-basedassessmentof the crania-orbitalzygomaticregion willbe reviewed,which assiststhe surgeonin understanding regionaldysmorphologyand the analysisof reconstructive
Surgicalmovementsof the jaware complicated,threedimensionalproblemsof geometricallycomplexstructures.A systematicmethod is presentedfor integratingthe clinical examand predictiontracingswith articularmounted models. Treatmentplans are translatedinto “surgicalprescriptions.” Wholejawand jawsegmentmovementsare accurately quantifiedin three planesof space.
Wednesday, September29 7:30am - 9:30am (126~131,208,213) SC 126 Disc Replacement, Partial and Total Reconstruction of the TMJ John N. Kent,DDS NewOrleans,L4 Reconstructive TMJsurgerymay includediscreplacement with temporaryalloplast,fascia,cartilage,dermis,or nothing; condyleresurfacingor replacementwith cartilage,muscle/ fascia,rib, toe, scapula,fibulaor osteotomy;and fossa/ condylereplacementas in total joint reconstruction.This presentationdiscussesresultsof severalhundredprocedures basedon indications,verticalloss,occlusalabnormality, supportinganimaland in vitrobiomechanicalloadtestsand data,numberof previoussurgicalprocedures,surgical techniquevariations,selectionand behaviorof autogenous, homogenousor alloplasticmaterials,postoperativephysical therapyincludingCPM,retrospectiveand prospectivepatient outcomeindicators,and life tableanalysis.
~SURGICAL
CLINICS
WEDNESDAY,
SEPTEMBER
29
SC 127
SC 131
Reconstruction of the Traumatic Frontal-Nasal-Orbital Structures
Microvascular Soft Tissue and Bone Reconstruction in the Head and Neck
StuartN. Kline,DDS Miami,FL MarkR.Stevens,DMD Miami,FL Thisclinicwilladdressthe managementof crania-facial injuriesas it pertainsto the front0basilarskull,frontalsinus, and naso-ethmoidalareas. Specialconsiderationson nasal injuriesand their immediateand late reconstructionwillalso be discussed.
DieterHellner,MD,DDS Hamburg,GERMANY RainerSchmelzeisen, MD,DDS,PhD
SC 128 Techniques of Myocutaneous Flaps OrestisHadjianghelou,MD,DMD Cologne,GERMANY UweFrohberg,MD,DMD Cologrre, GERMANY Our &year experiencewith myocutaneousflapsin more than 100patientsis reviewed.Technicalaspectsincluding donor sitelocation,flapdesign,elevationand flapinset are discussed.Casereportscoverreconstructionafter glossectomy,and closureof perforationand skullbase defects. Selectedcasesarepresentedfor discussion.
SC 129 Indications and Protocols for Salvage Surgery of the TMJ RobertB.Macintosh,DDS Detroit,Ml Undesirablesequelaeof temporomandibularjoint surgery havebecomeincreasinglyfrequent. The managementof patientswith ongoingjoint dysfunction(sometimesmore severethan the originaldifficulties)followingopen temporomandibularjoint intervention,has becomea growingfocusof surgicalattention. Thispresentation suggeststreatmentprotocolsfor recoverysurgeryof the temporomandibularjointsin a varietyof such scenarios.
Hannover,GERMON
Differentialindicationsfor intra-and extraoralsoft tissue reconstructionare demonstrated.Indicationsespeciallyfor jejunalgrafts,radialforearmflapsand rectusand gracilis muscleflapsarepointedout. The applicationof different microvascular bone graftsare demonstratedand the different indicationsdiscussed.
SC 208 Solvin Problems in Clinical Use of Imp3ant Systems Repeatof SC108,Tuesday,September28,8:00am - 1O:OO am
SC 213 Principles of Hard and Soft Tissue Reconstruction of the Jaws Repeatof SC113,Tuesday,September28, 10~30am - 12:30pm
390 pm - 5:OO pm (132-137, 204,220) SC 132 Surgical (and Medical) Management of Controversial Pathologic Entities of the Head and Neck ThomasP. Williams,DDS Dubuque,IA
SC130
Thispresentationwilldiscussthe managementof selected controversiallesionsthat involveboth the jawsand soft tissueof the head and neckincludingodontogeniccystsand tumors,mucosaldisease,systemicdiseasesinvolvingthe jaws and salivaryglandneoplasms.
Surgical Treatment of the Medically Compromised Patient in the Office Setting
SC 133
DonaldL. Hoffman,DDS,PhD H@zland Park,IL Apracticalapproachto the oralsurgicaltreatmentof the patientpresentingwith one or more of the commonmaladies of our populationwillbe presented. Howcurrenttheoriesof the medicalmanagementand pathophysiologyof cardiovascular/respiratory disease,endocrinedysfunction, immune deficiencysyndrome,neurologicdisordersand coagulationdisordersaffectsurgicaltreatmentplanningin the officesetting.
Nasal-Ethmoidal and Frontal Basal Reconstruction MichaelEhrenfeld,MD,DMD Tubingen,GERMXNY
Aftera short reviewof the functionalanatomy,the etiologies of pathologicalprocesses(trauma,tumor, inflammation)in the naso-ethmoidaland frontalbasalregionare shown. The roleof modernimagingtechniquesin diagnosisand treatmentplanningwillbe illustrated.
SURGICAL WEDNESDAY, THURSDAY, Surgicalapproachesto the naso-ethmoidand frontalskull basewillbe explained.Dependingon the defect,post trauma/tumorreconstructionswith localand distantflaps,as wellas with alloplasticmaterialwillbe demonstrated.
SC134
CMICS SEPTEIRBER SEPTElUlBER
29 30
SC 137 y of life, As ects OR Palliative Therap , an !i Pain Therapy in the Hea !I and Neck Cancer Patient
Co le
AndreBckardt,MD,DDS Hannover,GERMANY DieterWeingart,MD,DDS Muenster,GERMANY
Freiburg,GERMANY
Variouspalliativetreatmentconceptsincludingsurgery, chemotherapyand radiotherapyare currentlyused for advancedor recurrenthead and neckcancer. Theseconcepts willbe outlinedand discussedwith casereports.
t Sur ery (Osteotomies, Bone nes, i(\ icroneurosurgery): Gra ts, German aml Americun Experience WiifriedSchilli,MD,DDS
7
LeonA.Assael,DMD Farmington,CT
Problemsof anatomicform for implantplacementsinclude insufficientbone qualityand quantity. Repairof these conditionswith osteotomies,bone grafts,microneurosurgery and membraneswith simultaneousimplant placementwith IT1and Branemarkimplantsare shown. The Germanand Americanexperienceswith differentmembranes,bank bone, etc., are presented.
SC 135
SC 204 Pediatric Anesthesia Repeatof SC104,Tuesday,September28,890 am - 1090 am
Management of the Medically Compromised Patient PartII of SC120on Tuesday,September28,3:30pm - 530 pm
StephenA.Sachs,DDS Lake Success,NY
Contemporaryoral and maxillofacial surgeryhas become wideand diversein its scope.Orthognathicand reconstructivesurgeryoften interweavewith surgicaloral pathologyand surgicaloncology. Throughthree modules, orthognathicsurgeryfor the specialpatient,surgeryand reconstructionof benign jawlesions,and a protocolfor reconstructionof the oralcancerpatient,these interrelationships will be illustrated.
SC 136 Periorbital and Orbital Reconstruction PeterStoll,MD,DMD Freiburg,GERMANY
Primaryand secondaryreconstructiontechniqueswillbe presented. Multipleaccessapproacheswillbe outlined. The use of graftmaterialsand fixationtechniqueswillbe reviewed.Treatmentplanning,resultsand complicationswill be includedin this presentation.
Thursday,September30 7:30am - 9:30am (138-145) SC 138 Management of the Neck in ~ Head and Neck Malignancy DanielD. Lydia&DDS,MD Omaha,NE Treatmentof the neckin patientswith head and neckcancer continuesto evolve. Modifications of the radicalneck dissection,(sparinguninvolvedstructures),and selectiveneck dissections,(dissectingonly nodesat risk),are most noteable developments.The history,safety,efficacy,indications, contraindicationsand techniquesof these dissectionswillbe discussed.
SC 139 ment of the John F. Helfrick,DDS,MS Houston,TX Diagnosisand managementof the cleftpatientfrombirth to age21 willbe reviewed.Emphasiswillbe placedon surgical managementof skeletaland dentoalveolarcleftdeformities.
URGICAL HURSDAY,
CLINIC 1s SEPTEMBER
30
SC 140
SC 144
Periapical Surgery: Endodontic Surgery
Basal Cell Carcinoma (Skin Tumors)
MartenN. Ladman,DMD
NorbertA.Schwenzer,MD,DMD
Morganville, N\
Tubingen,GERMANY
BertramBlum,DDS
MichaelBergermann,MD,DMD Welver,GERMANY
ForestHills,NY
Dentoalveolar surgeryremainsthe most commonly requestedoralsurgicalservice.The surgeon’sabilityto provideperiapicalsurgeryis often essentialto successful officepractices.The historyand indicationsfor periapical surgery,as wellas surgicaltreatmentdesignsand rationale willbe presented. SC 141
Clinical A plications of Dermabrasion and Chemical %eel John P.Tanner,MS,DDS,MD
Basalcellcarcinomais the singlemost commonneoplasmof the skin. About9O?hof thesetumorsarelocatedin the head and neckarea. Etiologyand pathologyof this tumor willbe discussed.With regardto tumor size,localizationand infiltrationof surroundingstructures’surgicaltreatmentwill be presented. Specialemphasisis givento reconstructive procedures.
SC 145 Correction of late Sequelae FriedrichW.Neukam,MD,DDS,PhD
KansasCity,MO
Hannover,GERMANY
Dermabrasion and chemicalpeelingare adjunctive proceduresoften used for facialrejuvenation,skin surface recontouring,and alterationof somepigmentarydisorders. Skinanatomy,histopathology,and wound healingwillbe discussed.The indicationsand contraindicationsfor each procedurewillbe emphasizedto guidethe surgeonin patient selection,and in tailoringabrasionand/or peeling techniquesto meet the patient’sneeds. Avarietyof dermabrasionand chemicalexfoliationtechniqueswillbe reviewed,and a thoroughdiscussionof the managementof unfavorableresultsis planned.
The data of 172multiplyinjuredpatientswith facialinjuries wereevaluatedfor late sequelaein a retrospectivestudy. Six casesof anosmia,four casesof diplopia,twenty-sixpatients with hypesthesiaor paresthesiawerefound. Thirteen fractureshave healedin malposition,and fifteenpatients presentedwith malocclusionand without impairmentof masticatoryfunction. Ten patientsexhibitedankylosisof the TMJwith limitationof mouth opening. Thistotal of 74 complicationsoccurredin 37 patients,so that it can be concludedthat the incidenceof late sequelaeis low in facial injuries. Treatmentplanningand use of secondary reconstructiontechniquesof deficientsoft and hard tissue willbe describedand presentedin a numberof casereports.
SC 142 Management of Nasal Fractures CharlesE.Graper,DDS,MD Gainesville, FL Areasof discussionwillincludeappliedanatomy, physiology,treatmentoptions,diagnosticconsiderations, such as historyand physicalexam,imaging,surgical techniquesand mechanismsof injury. Openand closed reductionof the bony cartilagenousstructureswillbe discussedincludinginstrumentation,dressing,packing,and sutures. Managementof possiblecomplicationswillalsobe addressed. SC 143
Techniques of Neck Dissection KarstenK.H.Gundlach,MD,DDS,MSD Restock,GERMANY
Thissurgicalclinicwillbeginwith a seriesof slides depictinga radicalneckdissection.Allrelevantanatomical structureswillbe pointedout in detail. Explanationsof variationsof this classicoperation(conservative, supraomohyoid,suprahyoid,etc.)willbe presented.
3:30 pm - 5:30 pm (146-153) SC 146 Immediate Mandibular Reconstruction at the Time of Ablative Cancer Surgery AllenSclaroff,DDS St.Louis,MO Variousreconstructivetechniquescan be used to restoreform and functionto a patientwho has undergonecompleteor marginalmandibularresectionfor cancercure. This discussionwillincludechoiceof implants(onevs. two stage), donor site selection(hip versusfibula),as wellas determine soft tissueneeds,radiotherapyand its influenceson the reconstructivetechniquein relationto donor site and implantchoice. Finally,outcomedata willbe presentedin relationto implant,flapand patient survival.Helpfuldo’s and don’tsto makethe reconstructiveprocedureeasierwillbe interjectedthroughoutthe lecture.
SURGICAL THURSDAY,
SEPTEABBER
30
SC150
Sf 147 Sur id
CLINICS
Treatmeat of the Cleft lip, Palate
an 8 Alveab
Process
JamesE.Bertz,DDS,MD Scottsdale, AZ Thispresentationwillcoverthe embryology,etiology,and surgicalrepairof the cleftlip with MillardAdvancement RotationRepairs,for both the unilateraland bilateralcleftlip. The one stagerepairof the palate,the stagedrepairand the reasonsfor each,as wellas the bone graftingof the alveolar processwillbe discussed.
SC 148 Advanced Concepts in Implent Reconstruction Using tke Brtmemark Blethod of Osseointegration KenjiHiguchi,DDS,MS Spokane,WA The successfulreplacementof a lost dentitionutilizinga tissue-integrated prosthesishas revolutionizedpm-prosthetic oral and maxillofacial surgery.Branemarkand colleagues initiallyfocusedon applyingthe principlesof osseointegration to the fullyedentulouspatient. Overthe past 10years,the scopeof applicationhas expandedto includetreatmentin areaspreviouslydeferred.Thissession willreviewthe presenter’s10yearexperiencein the managementof complexconditionsincludingthe extremely resorbedmaxillaand mandible,bone graftingapproachesto the maxilla,managementof the posteriorfixtureplacement in the partiallyedentulous,and the hypodontic-oligodontic patient. Theuse of fixturesas intraoralorthodontic anchoragewillbe discussedincludingapplicationsin orthognathicsurgery.The currentstatusof osseointegrated fixturessecuringcrania-facial prostheseswillbe summarized.
SC 149 TMJ Artkroscopic Surger : Rationale, Treatment an ETManagement
Computer Treatment
ations in Orthognathic ing.
MarkA.Conover,DDS,MS Hewret, CA MelvynS.Wishan,DDS,MDS Beverly Hills,CA Thisclinicwillexplorethe use of computer-aideddiagnosis and treatmentplanningfor orthognathicand cosmeticfacial surgery.Boththe scientificbasisfor computerevaluationand planning,as wellas multimediatechniques(imaging, graphics,video,sound)for patient presentationand counsellingwillbe discussed.
SC 151 Surgical Aspects of Apicoectomies StuartE.Lieblich,DMD Avon,CT Surgicaland anatomicprinciplesof endodontictreatment willbe reviewed.A literaturereviewand discussionof alternativesto amalgamwillalsobe included.
SC 152 Presurgical Orthodontics for the Oral and Maxillofacial Surgeon PaulM.Thomas,DMD,MS Durham,NC
Orthodonticpreparationfor orthognathicsurgeryoften involvestreatmentgoalsand extractionpatternswhich differ from those commonlyused in orthodonticcamouflage.In addition,certainaspectsof treatmentcan be accomplished more efficientlyand with greaterstabilityif managed surgically.Thispresentationwillcovertreatmentplanning conceptsand a sequenceof preparationand finishingwhich has provenclinicallysuccessful.
SC 153
JeffreyJ. Moses,DDS
Maxillofacial Cancer Diagnosis and Treatment
Erzcinitas,CA
JamesD. Ruskin,DMD,MD Gainesville, FL
Didacticrationalefor the techniqueof TMJarthroscopic surgery,as wellas the pre-and postoperativemanagementof the patient for consistentresultsare presented. Independent researchinvestigatingthe relationshipsof discpositionand mobilityto clinicalsuccessand preoperativesymptomswill be reviewed.
Thispresentationwilldealwith the diagnosisand treatment of cancerof the oraland maxillofacial region. In additionto a reviewof the pertinentanatomyand diagnosticmodalities involved,overalltreatmentprinciplesand site specific therapywillbe presented.
SURGICAL FRIDAY,
CLINICS
OCTOBER
1
Friday,October1 7:30am - 9:30am (154-161) SC154 Comprehensive Management of Panfacial Fractures Including Rigid Fixation
orthognathicsurgery.Detailswillbe givenalsoin the use of platesin reconstructionsurgery.In additionto basic techniquesin the use of plates,emphasiswillbe givenduring this presentationto someof the creativemodificationsin plateuse and waysto avoidpitfalls.
SC158 Midface and Panfacial Fractures
Dallas,TX
RolfEwers,MD,DMD Vienna,AUSTRlA
Facialtraumacontinuesto be a mainstayof contemporary oraland maxillofacial surgery.Thisclinicwilldiscussall aspectsof facialfracturemanagementincluding:pertinent statisticson the impactof traumato society,historical highlightsof fracturetreatment,initialpatient assessment and management,specificfracturetreatmentwith RIF, complicationsand residualdeformities.
Midfaceand panfacialfractureshave to be treated immediatelyif the patient’sgeneralhealth allowsa repositioningand fixationprocedure.Thereis a possibilityto treatin the firstor evensecondweek,whichis referredto as late primarytreatment. ARfracturesshouldbe stabilizedby osteo-synthesis methodswith good occlusionand, if possible, from an intra-oralapproach.
RichardA.Finn,DDS
SC 159 Comprehensive Mana ement of Mandibular Trauma via a Transora1 /Percutaneous Approach with Application of Rigid Fixation N. RayLee,DDS Newport News,VA
Managin the Orthognathic/TMJ When ans How?
Patient:
GaryOrentlicher,DMD Scarsdale,NY
Varioussurgicaltechniquesfor applicationof rigidinternal fixationvia a transoral/percutaneous approachin the treatmentof mandibulartraumawillbe presented. This clinicwillalsodiscusssurgicalanatomy,diagnostic considerationsfor techniqueselectionand managementof potential complications.
Patientswith internalderangementsand/or myofascialpain and dysfunctionin combinationwith dentofacialdeformities willbe discussed.Preoperativerecords,bite registration, intraoperativecondylarposition,and rigidfixationaffectthe temporomandibularjoint. It is instrumentalto establisha reproduciblecentricrelationpositionprior to surgery. Splints,which typesand when, willbe illustrated.
SC 156
SC 160
Management of Gunshot Wounds
Correction of Surgical Defects of the Face Using Local Flaps
J. HamilWilloughby,DDS Hempsiead,NY
The drug-abuseepidemicthroughoutthis countryand the escalatingviolenceassociatedwith the drug tradehas resulted in a significantincreasein the numberof oraland maxillofacial injuriessecondaryto gunshotwounds. This coursewitlreviewthe ballisticsand pathogenesisof maxillofacial injuriessecondaryto projectilesfrom low velocityhandguns. Initialmanagementconsiderationsand treatmentobjectiveswillbe discussed.Specificcaseswillbe reviewedwith emphasison casemanagement.
SC 157 Techniques of Immediate Plate Placement BeatHammer,MD,DDS Basel, SWfTZERLAND The presentationwill reviewthe techniquesof immediate
rigidfixationplacementin the followingsituations: mandibularfractures,midfaceand orbitalfracturesand
BemdGattinger,MD,DMD Linz,AUSTRIA
Basedon clinicalexamples,the use of localflapsfor defect reconstructionin the differentregionsof the facewillbe discussed.The specialestheticand functionalrequirements and the fundamentalguidelinesof this type of procedure have to be differentiated.
SC 161 Open Rhinoplasty BruceN. Epker,DDS,MSD,PhD Ft. Worth,TX
The indications,detailsof surgicaltechnique,treatment
results,and complicationsof open rhinoplastywillbe discussed.Integrationof rhinoplastyand orthognathic surgerywillbe detailed.
SURGICAL FRIDAY,
3:30 pm - 530 pm (162-169)
SC 166
SC 162
RobertW. Alexander,MD,DMD
Nerve Injuries: Evalaation and Microsurgical Repair RogerA.Meyer,DDS,MD Marietta,GA
Peripheraltrigeminalnerve injuriescausingsignificant sensoryaberrationsmay be repairedby microsurgical techniquesin selectedpatients. Guidelinesbasedon research and clinicalexperiencehavebeen establishedfor evaluation and timelytreatmentof nerveinjuries. The author analyzes his resultsof 295 microneurosurgical operations.
SC 163/263
Session repeats
(263) Sat., IO/~ 3:30 pm - 5:30 pm
Trigeminai Nerve injuries and Repair John P. LaBanc,DMD Sprinsfield,MO
Thissurgicalclinicwillcoverthe pathophysiologyof nerve injury and recovery,diagnosticevaluation,algorithmfor management,and microsurgical techniquesof repair. Most traumaticsensorydisturbancesresolve,a fewpersistand somebecomepainful. Algorithmshavebeen developedto logicallymanagenerve injuriesincludingpharmacologic, physiologicand surgicaltherapies.
SC 164/264
Session repeats
(264) Sat., IO/~ 3:30 pm - 5:30 pm
Sinus lift Procedures MartinS. Lebowitz,DDS,MS St.Petersburg, FL
Thisprogramlooksat the developmentof this techniqueand the instrumentation.The lateralwalland crestalridge approachesare discussed.Differentaugmentationmaterials areexamined. Adiscussionof implantsbest suitedfor the posteriormaxillaare part of this program. Radiographic interpretation,complicationsand long-termresultsare reviewed.
SC 165 Advanced Techniques with Endosseous Implants NeilB.Hagen,DDS Chicago,I1
Thissurgicalclinicwillcoverthe currentapplicationsof maxillofacial reconstructionusing the Branemarkendosseous implant. Bonegraftingtechniques,new products,as wellas new diagnostictools and treatmentplaningideaswillbe describedand discussedin an effortto treat the previously untreatablepatient.
CLINICS OCTOBER
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Blepharoplasty Edmonak,WA
Thoroughdiscussionof structuraland diagnostic considerationsfor estheticreconstructionof the eyelids. Patientevaluationand selectionis emphasized.Step-by-step techniqueof surgicalreconstructionof the eyelidwillbe presented. Recognitionand managementof common complicationswillbe reviewed.
SC 167 Monitoring Equipment and ECG Review for Office Surgery ThomasA.Nique,DDS,MD Warren,Ml
The presentationwillcoverthe essentialphysiologic monitorsrequiredfor safeoutpatientoral and maxillofacial surgerycare;how they work,what parametersare significant, when they shouldbe used,reviewof commonpathologic ECGpatterns,their clinicalsignificanceand treatmentwill alsobe discussed.Finally,what emergencydrugsshouldbe at hand and aspectsof properrecordkeeping,as wellas future considerations,willbe addressed.
SC 168 Implants in Oncology UlrichSchwarz,MD,DMD Freiburg,Germany
The clinicwillpresentmaterialon the use of implantsin reconstructionafteroncologicsurgery.The placement techniquesutilizedduringimmediateand delayed reconstructionwill be emphasized.
SC 169 The Role of Arthroscopy in the Treatment of TMJ lntracapsular and Dysfunction RobertD. Schwartz,DMD Chicago,IL
Temporomandibular joint (TMJ)disordersare a majorcause of patientpain and dysfunctionand an importantfocusof attentionby healthcareproviders.Basedon specificcriteria, surgicalmodalitiesmay be the indicatedform of treatment for certainTMJdisorders.Recentadvancesin smalljoint arthroscopictechnologyhave openedan importantnew option in the managementof TMJdisorders,anaiogousto the impactof arthroscopyfor largejoint (e.g.,knee,shoulder, etc.)disorders.
SURGICAL SATURDAY,
CLINICS OCTOBER
2
7:30am - 9:30am (170477)
surgicalaspectsof variousdefectsituationsand to the use of differentkindsof graftsin a numberof casereports. Results and complicationsat both the donor and the recipientsite willbe presentedand discussed.
SC 170
SC 174
Upper Facial Rejuvenation
Modified Condylotomy for Painful Internal Derangement of the TMJ
Saturday,October2
Clark0. Taylor,DDS,MD Bismarck,ND
Thisclinicwillfocuson the clinicalestheticevaluationof the upperfacialthird to includeforeheadand eyes. Thiswillbe followedby appropriatetreatmentselectionand a step-bystep presentationof the techniquesof coronal,trichophyllic, midforeheadand directbrowlift as wellas upper and lower lid blepharoplasty.Participantsshouldfeelcomfortableat the conclusionof the clinicin the evaluationand treatmentof estheticdeformitiesof the upper facialthird.
SC 171 Orthognathic Surgery in the Asian Patient GeorgeM. Yellich,DDS,MS Sunlose,CA Orthognathicsurgeryin the Asianpatienthas many considerationsin treatmentplanning. Thisprogramwill reviewthe clinicalnormsfor Asians,as wellas the skeletal deformitiesassociatedwith b&maxillary protrusion. Specialized surgicalprocedures,splint fabrication,pre-and postsurgicalorthodontics,and the attendantcomplications with thesetechniqueswillbe reviewedin detail. The historicalperspectiveof Asiansin Americaenhancesthe concernfor treatmentplanningof these patients.
SC 172 Basic Fundamentals of the Successful Implant Practice AndreU. Buchs,DMD Orlando,FL
ThisSCwillcoverpatient selection,radiographic examination,oral evaluation,treatmentplanningand surgicaltechniquesfor the DenarSteri-Oss and Core-Vent implantsystems.The importanceof the team approachto treatmentplanningand the managementof complicationsto minimizefailureswillbe emphasized.The restorationof the edentulousand partiallyedentulousmandibleand maxilla,as wellas the singletooth defectwillbe covered. Detailed statisticswillbe presented.
SC 173 ,
Implants and Bone Grafts HenningSchliephake,MD,DDS Hannover,GERMANY
The use of implantsand bone graftsin oralrehabilitationwill be describedin detail. Particularattentionwillbe paid to the
H. DavidHall,DMD,MD Nashville,TN
The history,rationaleand resultsof condylotomywillbe reviewed.The modifiedopen techniquedevelopedby Nickersonwillbe emphasized.Sufficientdetailsof patient selection,operativetechniqueand postoperativecarewillbe presentedto enablethe participantto duplicatethe resultsof modifiedcondylotomy.
SC 175 Contem orary TMJ Management “On” or “Off” t/e Disc: Treatment Alternatives and Rationale CharlesE.Repa,DDS Houston,TX
The goalof this sessionis to reviewmanagementof the joint dysfunctionpatient in the “trenches”of clinicalpractice.The use of arthrocentesis,arthroscopy,arthroplasty,and the verticalramusosteotomywillbe discussed.The use of splint therapy,tomography,MRI,clinicalexamand historyto assist in this processwillalsobe examined.
SC 176 The Holmium YAG laser in TMJ Arthroscopic Surgery BarryH. Hendler,DDS,MD Philadelphia,PA
A new pulsedmidinfraredlaserhas becomeavailablefor use in arthroscopicsurgeryof the TMJ.Becausethe Ho:YAG laser can preciselyand rapidlyresectcartilaginoustissues,can functionin a salineenvironment,and can be transmitted throughopticalfibers,it has the potentialof becominga usefulsystemfor TMJarthroscopicsurgery.
SC177 Total Reconstruction of the Temporomandibular Joint DavidC. Hoffman,DDS StatenIsland,NY The purposeof this clinicwillbe to presentan all inclusive discussionon total temporomandibularjoint reconstructive surgery.It willcombineboth an orthopedicperspective, maxillofacial surgeryperspectiveand ultimatelykey in on
SURGICAL SATURDAY,
clinicalapplications.It wouldbe of benefitto anyonewho has had TMJsurgicalexperienceand is now interestedin total joint reconstruction.In addition,it will specifically help in understandingthe treatmentof a patientwho has had multiplesurgicalproceduresand hopefullyoffera good reviewof the fundamentalknowledgeneededto proceed with a total joint system.
3:30 pm - 5:30pm (178-183, 263-264) SC 178 Guided Bone Graft Augmentation and Osseointeyated Implants OleT.Jensen,DDS,MS Denver,CO In orderto improvethe osseointegrating capacityof osseous deficientimplant sites,variousbone graftingstrategiesare suggested.The biologicalbasisfor bone graftincorporation, remodelingand repairas it relatesto dentalimplantswillbe reviewed.Osseousloadingprescriptions,site developmentas it relatesto implantation,memberapplicationand optimal surgicaltechniqueare described.Useof the Branemark implant in the anteriorand posteriormaxillais emphasized.
SC 180 Current Concepts in Treatment Planning for Osseointegrated Implants ChristopherSmith, DDS SanAntonio,TX Failureof osseointegrated implants,althoughminimal,occurs more frequentlywhen the implantsareused in clinical situationsother than in the anteriormandible. Implantsin the posteriormandibleand maxilla,as wellas implants placedin augmentedareas,presenta slightlyhigher percentageof failure. The prosthodonticmanipulationof these implantscan be criticalto their success.Current conceptsto enhancesuccessin prosthodontictreatmentof the completelyedentulousand partiallyedentuloussituations willbe presented.
SC 181 Clinical Neurosensory Examination John R.Zuniga,DMD,MS,PhD ChapelHill,NC The objectiveof this presentationis to providea conciseand meaningfulapproachto the clinicalexaminationof patients with orofacialnerveinjuries. The reliability,sensitivity, specificityand performanceof each testingmethod willbe illustratedon site so that clinicalinterpretationwillbe responsibleand valid.
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SC182 Predktable Correction of Maxikry Bone Deficiency to Allow Successful Prosthetic Rehabilitation BillC. Terry,DDS ChapelHill,NC
Bonelossin the anteriormaxillaand associatedsofttissue and vestibulardeformitiesas wellas the lesscommon completelyresorbedalveolus,“flatmaxilla,”can be predictablycorrected.An implant restoredmandible functioningagainstthe edentulous,compromisedmaxilla raisesadditionalconcerns. Selectionof specificprocedures, surgicaldetailsand long term results,including complications,willbe discussedand illustrated.
SC 183 Advanced Surgical Technique for III-I lant Reconstruction, Sinus, Nerve, Vesti lL leplasty CharlesA.Babbush,DDS,MScD Beachwood,OH
Thispresentationwilldealwith those procedureswhichmake the reconstructionof the partiallyand totallyedentulous individualspossiblewhen there is a lackof sufficientquality and quantityof hard and soft tissues.Byutilizingthe advancedtechnologyof CTScanningwith 3-Dreconstruction presurgicaldiagnosisand treatmentplanninghave been greatlyenhanced. When implantplacementis anticipated and a lackof osseousreceptorsiteis present,ancillary proceduressuch as maxillaryantroplasty(sinuslift),nerve transpositionand repositioningand vestibuloplastyhave madetheseprocedurespossible.Avarietyof materialssuch as hydroxylapatite, freezedriedand autogenousbone as well as barriermembraneshave addedto the successof these procedures.Thispresentationwillreviewall of these techniquesand concepts.
SC 263 Trigeminal Nerve Injuries and Repair Repeatof SC163on Friday,October1,3:30pm - 530 pm
SC 264 Sinus lift Procedures Repeatof SC164on Friday,October1, 3:30pm - 530 pm