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The role of orthodontics in managing paediatric condylar fractures
e190
E-Poster Presentation
Conclusions: We conclude that Th22 cells have a substantial impact on the carcinogenesis of HNSCCs and on their metastasis and could serve as a potential therapeutic target to modulate antitumour response in HNSCC. http://dx.doi.org/10.1016/j.ijom.2015.08.023 The rationality for mandibular resection combined with replantation in the treatment of AVMS of mandible ∗
X. Bai , X. Wang, L. Lu Hospital of Stomatology, China Medical University, Shenyang, China Background: With the progress of Interventional Radiology, most of high flow intraosseous mandibular arteriovenous malformations (AVMs) could be successfully treated by embolization. However, surgical managements are performed by maxillofacial surgeons from time to time. The aim of this article is to evaluate the rationality for mandibular resection combined with replantation in the treatment of AVM of mandible. Methods: Three patients who accepted mandibular resection combined with replantation for the treatment of mandibular AVMs were followed up and literature were reviewed. Results: The patients showed no functional disability, or disfigurement during the period of follow-up. The main points of the treatment were summarized up from our own experience as well as the literature. What we could benefit from this procedure is the mandibular deformity might be corrected along with the remove of the intraosseous lesion. This method also can be applied in the recurrent cases after tansarterial embolization or the cases refractory to endovascular therapy. We also found that the recurrence is rare after the surgical management. However, surgeons should be cautious for using this method in growing patients for the concern of interference of jaw development. Conclusion: It is suggested that mandibular resection combined with replantation could be an option for the treatment of mandibular AVMs. http://dx.doi.org/10.1016/j.ijom.2015.08.024 Maxillofacial pseudoaneurysm as a complication of facial bone fractures: report of two rare cases A. Bakathir
1,∗
2
3
, A. Al Hashmi , N. Al Saadi , F. Al Azri
1
1
Sultan Qaboos University Hospital, Muscat, Oman 2 Al Nahda Hospital, Muscat, Oman 3 Oman Medical Specialty Board, Muscat, Oman Pseudoaneurysms of the facial arterial system are uncommon and rare vascular complications in the practice of oral and maxillofacial surgery. Maxillofacial pseudoaneurysm may occur following maxillofacial trauma, orthognathic surgery or facial surgical treatment and may appear immediately or weeks to months after the initial injury. The clinical diagnosis may be difficult initially but quick recognition and management is necessary to avoid the devastating consequences. In this poster we report two rare cases of pseudoaneurysm that occurred following facial bone fractures, the first was related to the internal maxillary artery that occurred as a complication of complex untreated mandibular fracture with bilateral temporomandibular joints dislocation and presented clinically as severe bleeding during surgical repair, and the second case was related to the internal carotid artery occurring secondary to unilateral displaced mandibular condyle
fracture. The poster will highlight the clinical presentations and the procedures that have led to the diagnosis. As part of the management our first patient underwent endovascular embolization with titanium coil and for the second case the patient had intracranial stent insertion. Both patients had satisfactory resolution of the complication related to the pseudoaneurysm with a final successful outcome. http://dx.doi.org/10.1016/j.ijom.2015.08.025 The role of orthodontics in managing paediatric condylar fractures I. Balasundaram ∗ , S. Singh, R. Lee, M. Millwaters Royal London Hospital, London, UK Background: The appropriate management of paediatric condylar fractures (PCF) is still subject to debate. If mismanaged, such injuries can result in aesthetic and functional problems. The conservative approach is preferred to surgery as condylar regeneration and remodeling occurs and surgery may cause growth disturbances. Conservative options include physiotherapy, intermaxillary fixation (IMF) and functional appliances. The aim of this paper is to present a case series of paediatric patients who sustained condylar fractures who were treated successfully with orthodontic functional appliances. Methods: Two paediatric patients were identified from the maxillofacial trauma database who sustained condylar fractures and were subsequently treated successfully with orthodontic functional appliances. Findings: Both cases sustained parasymphyseal and bilateral condylar fractures. In both cases the parasymphysis was treated surgically. Despite this one case suffered a 15 mm overjet and the second case developed an anterior open bite with a reduced posterior facial height. Both cases were subsequently treated successfully with functional appliances by orthodontics. Radiography confirmed condylar remodeling. Conclusions: PCF are quite often missed and can be left undiagnosed until they present with a growth disturbance. Most patients present to the maxillofacial trauma clinic and we recommend early referral to the joint orthodontic/orthagnathic clinic. http://dx.doi.org/10.1016/j.ijom.2015.08.026 Evaluation of experience and outcome in orthognathic surgery: a patient’s perception G. Stonier, A. Mohammed, M. Vanat, I. Balasundaram ∗ , N. Ali, M. Millwataers Royal London Hospital, London, UK Background: Patient’s expectations of orthognathic surgery and experience before and after surgery are significant factors in determining the success of treatment. The aim of this study was to develop and implement an online patient satisfaction survey to assess the patient’s experience of treatment from first clinic appointment till one year post completion of treatment. Method: A survey previously developed and validated was adapted and modified following a focus group consisting of health care professionals involved in patient care. The questionnaire consisted of 52 questions was emailed to all patients who completed treatment in 2012–2013 at the Royal London Hospital. We evaluated all aspects of treatment including orthodontics, surgery and hospital stay.
E-Poster Presentation
Conclusions: We conclude that Th22 cells have a substantial impact on the carcinogenesis of HNSCCs and on their metastasis and could serve as a potential therapeutic target to modulate antitumour response in HNSCC. http://dx.doi.org/10.1016/j.ijom.2015.08.023 The rationality for mandibular resection combined with replantation in the treatment of AVMS of mandible ∗
X. Bai , X. Wang, L. Lu Hospital of Stomatology, China Medical University, Shenyang, China Background: With the progress of Interventional Radiology, most of high flow intraosseous mandibular arteriovenous malformations (AVMs) could be successfully treated by embolization. However, surgical managements are performed by maxillofacial surgeons from time to time. The aim of this article is to evaluate the rationality for mandibular resection combined with replantation in the treatment of AVM of mandible. Methods: Three patients who accepted mandibular resection combined with replantation for the treatment of mandibular AVMs were followed up and literature were reviewed. Results: The patients showed no functional disability, or disfigurement during the period of follow-up. The main points of the treatment were summarized up from our own experience as well as the literature. What we could benefit from this procedure is the mandibular deformity might be corrected along with the remove of the intraosseous lesion. This method also can be applied in the recurrent cases after tansarterial embolization or the cases refractory to endovascular therapy. We also found that the recurrence is rare after the surgical management. However, surgeons should be cautious for using this method in growing patients for the concern of interference of jaw development. Conclusion: It is suggested that mandibular resection combined with replantation could be an option for the treatment of mandibular AVMs. http://dx.doi.org/10.1016/j.ijom.2015.08.024 Maxillofacial pseudoaneurysm as a complication of facial bone fractures: report of two rare cases A. Bakathir
1,∗
2
3
, A. Al Hashmi , N. Al Saadi , F. Al Azri
1
1
Sultan Qaboos University Hospital, Muscat, Oman 2 Al Nahda Hospital, Muscat, Oman 3 Oman Medical Specialty Board, Muscat, Oman Pseudoaneurysms of the facial arterial system are uncommon and rare vascular complications in the practice of oral and maxillofacial surgery. Maxillofacial pseudoaneurysm may occur following maxillofacial trauma, orthognathic surgery or facial surgical treatment and may appear immediately or weeks to months after the initial injury. The clinical diagnosis may be difficult initially but quick recognition and management is necessary to avoid the devastating consequences. In this poster we report two rare cases of pseudoaneurysm that occurred following facial bone fractures, the first was related to the internal maxillary artery that occurred as a complication of complex untreated mandibular fracture with bilateral temporomandibular joints dislocation and presented clinically as severe bleeding during surgical repair, and the second case was related to the internal carotid artery occurring secondary to unilateral displaced mandibular condyle
fracture. The poster will highlight the clinical presentations and the procedures that have led to the diagnosis. As part of the management our first patient underwent endovascular embolization with titanium coil and for the second case the patient had intracranial stent insertion. Both patients had satisfactory resolution of the complication related to the pseudoaneurysm with a final successful outcome. http://dx.doi.org/10.1016/j.ijom.2015.08.025 The role of orthodontics in managing paediatric condylar fractures I. Balasundaram ∗ , S. Singh, R. Lee, M. Millwaters Royal London Hospital, London, UK Background: The appropriate management of paediatric condylar fractures (PCF) is still subject to debate. If mismanaged, such injuries can result in aesthetic and functional problems. The conservative approach is preferred to surgery as condylar regeneration and remodeling occurs and surgery may cause growth disturbances. Conservative options include physiotherapy, intermaxillary fixation (IMF) and functional appliances. The aim of this paper is to present a case series of paediatric patients who sustained condylar fractures who were treated successfully with orthodontic functional appliances. Methods: Two paediatric patients were identified from the maxillofacial trauma database who sustained condylar fractures and were subsequently treated successfully with orthodontic functional appliances. Findings: Both cases sustained parasymphyseal and bilateral condylar fractures. In both cases the parasymphysis was treated surgically. Despite this one case suffered a 15 mm overjet and the second case developed an anterior open bite with a reduced posterior facial height. Both cases were subsequently treated successfully with functional appliances by orthodontics. Radiography confirmed condylar remodeling. Conclusions: PCF are quite often missed and can be left undiagnosed until they present with a growth disturbance. Most patients present to the maxillofacial trauma clinic and we recommend early referral to the joint orthodontic/orthagnathic clinic. http://dx.doi.org/10.1016/j.ijom.2015.08.026 Evaluation of experience and outcome in orthognathic surgery: a patient’s perception G. Stonier, A. Mohammed, M. Vanat, I. Balasundaram ∗ , N. Ali, M. Millwataers Royal London Hospital, London, UK Background: Patient’s expectations of orthognathic surgery and experience before and after surgery are significant factors in determining the success of treatment. The aim of this study was to develop and implement an online patient satisfaction survey to assess the patient’s experience of treatment from first clinic appointment till one year post completion of treatment. Method: A survey previously developed and validated was adapted and modified following a focus group consisting of health care professionals involved in patient care. The questionnaire consisted of 52 questions was emailed to all patients who completed treatment in 2012–2013 at the Royal London Hospital. We evaluated all aspects of treatment including orthodontics, surgery and hospital stay.