Temporomandibular joint disc reposition and condylar regeneration with orthodontic treatment

Abstracts surgery. This presentation will serve as an operation manual for surgeons wanting to incorporate CASS into their clinical practice. http://dx.doi.org/10.1016/j.ijom.2017.02.216 Temporomandibular joint disc reposition and condylar regeneration with orthodontic treatment C. Yang Shanghai Ninth People’s Hospital, Shanghai, China Objectives: To evaluate the influence of functional orthodontic treatment on the temporomandibular joints (TMJ) condylar regeneration after surgical disc reposition by quantitative assessment of the condylar morphological features on magnetic resonance imaging (MRI) and comparison between groups with/without anterior repositioning appliance (ARA). Methods: This study is a controlled longitudinal study. Consecutive juvenile anterior disc displacement (JADD) cases undergone arthroscopic disc reposition with no history of TMJ infection, injuries to the jaws, or congenital, developmental and systematic disorders that may affect the craniofacial growth were collected. Patients’ age at both first visit (preoperation) and revisit (6–12 months postoperation) was recorded. Pictures of MRI were selected to measure the shape of the condyle (condylar height and condylar width). Differences between pre- and postoperation were evaluated, and comparison in the increase of condylar volume between ARA group and follow-up group was made. Meanwhile, effect of different kinds of ARA, including anterior repositioning splint (ARS), twin-block appliance (TB) and Herbst appliance, on condylar regeneration was compared. Results: Condylar regeneration was found in most cases after disc reposition, whereas in the ARA group nearly all cases represented new bone growing and remodelling condylar head to various extents. Significant more active new bone growing was found in the ARA group compared to the follow-up group according to metric evaluation of condylar volume: more increases in condylar height and anteroposterior width were noticed. Moreover, cases that underwent Herbst appliance treatment demonstrate more condylar regeneration, while not much difference was found between ARS group and TB group.

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Conclusions: The results showed that after repositioning therapy, JADD patients gained a chance to regenerate. Proper guidance to such compensatory potentials with functional appliance could enhance such favourable change. Furthermore, this phenomenon could be utilised to improve patients’ occlusion and profile. http://dx.doi.org/10.1016/j.ijom.2017.02.217 Impact of digital technology on clinical practices — perspectives form oral and maxillofacial surgery Y. Zhang Peking University School and Hospital of Stomatology, Beijing, China Digital medical technologies or computer aided medical procedures refer to imaging, three-dimensional (3D) reconstruction, virtual design, 3D printing, navigation guided surgery and robotic assisted surgery techniques. These techniques are integrated into conventional surgical procedures to create new clinical protocols that are known as ‘digital surgical techniques’. Conventional health care is characterised by subjective experiences, while digital medical technologies bring quantifiable information, transferable data, repeatable methods and predictable outcomes into clinical practices. Digital surgical techniques facilitate surgical care by improving outcomes and reducing risks through integration of modern technologies with clinical experiences. Digital techniques are becoming increasingly popular in trauma surgery, orthopaedics, neurosurgery, plastic and reconstructive surgery, imaging and anatomic sciences. Robotic assisted surgery is also evolving and being applied in general surgery, cardiovascular surgery and orthopaedic surgery. Rapid development of digital medical technologies is changing healthcare and clinical practices. It is therefore important for all clinicians to purposefully adapt to these technologies and improve their clinical outcomes. http://dx.doi.org/10.1016/j.ijom.2017.02.218