Recent and Latest Advances in Oral and Maxillofacial surgery, Dr. Lidetu Afew...LIDETU AFEWORK
Every one should update himself according to the recent advances in every single profession/department. These are some of advancements We got in OMFS. We have also some latest advances and future advances under study that is going to be released in near future. BE HIGHTECH HIGH QUALITY UPDATED AND INFORMED PROFESSION.
Classification of Impaction and Methods & Techniques of Third molar/Manidibular impaction removal,Flap designs of impaction removal techniques and more
Instruments used in oral and maxillofacial surgeryCing Sian Dal
Instruments used in oral and maxillofacial surgery
Copyright (c) Dr. Ko Ko Maung
Department of Oral & Maxillofacial Surgery
University of Dental Medicine, Yangon
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine, Al-Azhar University. Mandibular angle fractures account for 23% to 42% of all facial fractures. Fracture of mandibular angle can be classified as (A) Vertical favorable or unfavorable, (B) Horizontally favorable of unfavorable. Traditionally, mandibular angle fractures have been treated with either closed reduction and inter-maxillary fixation or open reduction and internal fixation with or without inter-maxillary fixation. Patients treated with inter-maxillary fixation have a restricted airway and loose excess weight. Rigid internal fixation and early return to function have eliminated the use of wire osteosenthysis and prolonged use of inter-maxillary fixation. The principal of rigid fixation, however, have inherent set of disadvantages including damage to the inferior alveolar nerve and the marginal mandibular branch of facial nerve. Postoperative malocclusion rates are also high. With the introduction of semi-rigid technique fracture of the mandibular angle could be treated according to Champy’s Ideal lines of osteosenthysis. The technique involves placement of a single monocortial miniplate on the superior border of the mandible. However, some studies suggested using a second miniplate along the inferior border. Wether one or two miniplates should be used is still debatable. The application of 3D plates may provide additional stability in 3 dimension and good resistance against torque forces.
Dear Readers,
this is my ppt was made from a book of BAGHERI ( Current therapy in oral and maxillofacial surgery)- 2012 PLUS other sources.. hope you find it beneficial.
have a nice day,
hanan
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine, Al-Azhar University. Condylar fractures represent one of the most controversial issues in maxillofacial traumatology regarding classification, diagnoses and therapeutic management. Classification systems of condylar fracture is discussed. Diagnosis is usually based on history clinical examination and radiographic finding. Treatment ranges from observation, jaw exercises to closed or opened interventions. For years closed reduction was thought to be essentially complication-free. Several serious complications however have been reported including temporomandibular joint ankyloses, malocclusion, mandibular deviation and the generative joint pathology. The absolute and relative indications for open reduction is given. The debate between supporters of open or closed reduction is still continuing and the issue has not been resolved. However, the final choice treatment modality should takes into account the location of the fracture, age of the patient, presence or absence of other associated injuries, cosmetic impact of the surgery and presence of other systemic medical conditions.
Recent and Latest Advances in Oral and Maxillofacial surgery, Dr. Lidetu Afew...LIDETU AFEWORK
Every one should update himself according to the recent advances in every single profession/department. These are some of advancements We got in OMFS. We have also some latest advances and future advances under study that is going to be released in near future. BE HIGHTECH HIGH QUALITY UPDATED AND INFORMED PROFESSION.
Classification of Impaction and Methods & Techniques of Third molar/Manidibular impaction removal,Flap designs of impaction removal techniques and more
Instruments used in oral and maxillofacial surgeryCing Sian Dal
Instruments used in oral and maxillofacial surgery
Copyright (c) Dr. Ko Ko Maung
Department of Oral & Maxillofacial Surgery
University of Dental Medicine, Yangon
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine, Al-Azhar University. Mandibular angle fractures account for 23% to 42% of all facial fractures. Fracture of mandibular angle can be classified as (A) Vertical favorable or unfavorable, (B) Horizontally favorable of unfavorable. Traditionally, mandibular angle fractures have been treated with either closed reduction and inter-maxillary fixation or open reduction and internal fixation with or without inter-maxillary fixation. Patients treated with inter-maxillary fixation have a restricted airway and loose excess weight. Rigid internal fixation and early return to function have eliminated the use of wire osteosenthysis and prolonged use of inter-maxillary fixation. The principal of rigid fixation, however, have inherent set of disadvantages including damage to the inferior alveolar nerve and the marginal mandibular branch of facial nerve. Postoperative malocclusion rates are also high. With the introduction of semi-rigid technique fracture of the mandibular angle could be treated according to Champy’s Ideal lines of osteosenthysis. The technique involves placement of a single monocortial miniplate on the superior border of the mandible. However, some studies suggested using a second miniplate along the inferior border. Wether one or two miniplates should be used is still debatable. The application of 3D plates may provide additional stability in 3 dimension and good resistance against torque forces.
Dear Readers,
this is my ppt was made from a book of BAGHERI ( Current therapy in oral and maxillofacial surgery)- 2012 PLUS other sources.. hope you find it beneficial.
have a nice day,
hanan
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine, Al-Azhar University. Condylar fractures represent one of the most controversial issues in maxillofacial traumatology regarding classification, diagnoses and therapeutic management. Classification systems of condylar fracture is discussed. Diagnosis is usually based on history clinical examination and radiographic finding. Treatment ranges from observation, jaw exercises to closed or opened interventions. For years closed reduction was thought to be essentially complication-free. Several serious complications however have been reported including temporomandibular joint ankyloses, malocclusion, mandibular deviation and the generative joint pathology. The absolute and relative indications for open reduction is given. The debate between supporters of open or closed reduction is still continuing and the issue has not been resolved. However, the final choice treatment modality should takes into account the location of the fracture, age of the patient, presence or absence of other associated injuries, cosmetic impact of the surgery and presence of other systemic medical conditions.
Fixed prosthodontic treatment can offer exceptional satisfaction for both patient and the dentist. Fixed Prosthodontics can transform an unhealthy, unattractive dentition with poor function into a comfortable, healthy occlusion capable of giving years of further service while greatly enhancing esthetics.
Nothing is more important in the construction of fixed partial dentures than an adequate diagnosis and a well-devised treatment plan. Although these two subjects are usually considered together. Astute dentists must recognize their subtle differences. Diagnosis is an evaluation of the condition of the patient when he presents for treatment. Treatment planning concerns the treatment procedures by which the dentist will restore the patient to an optimum state of dental health.
The periodontium and pulp are two most important entities of the tooth, infection from one can travel towards other by different pathways. Neglect of either one can lead to failure. This presentation will help you learn clear steps towards diagnosis and treatment planning of such lesions
ABSTRACT
Objective: To evaluate the role of age as a moderator of bone regeneration patterns and
symphysis remodeling after genioplasty.
Method: Fifty-four patients who underwent genioplasty at the end of their orthodontic treatment
were divided into three age groups: younger than 15 years at the time of surgery (group 1), 15 to
19 years (group 2), and 20 years or older (group 3). Twenty-three patients who did not accept
genioplasty and had a follow-up radiograph 2 years after the end of their orthodontic treatment
were used as a control group. Patients were evaluated at three time points: immediate preoperative
(T1), immediate postoperative (T2,) and 2 years postsurgery (T3).
Results: The mean genial advancement at surgery was similar for the three age groups, but the
extent of remodeling around the repositioned chin was greater in group 1, less in group 2, and still
less in group 3. Symphysis thickness increased significantly during the 2-year postsurgery interval
for the three groups, and this increase was significantly greater in group 1 than in group 3.
Remodeling above and behind the repositioned chin also was greater in the younger patients. This
was related to greater vertical growth of the dentoalveolar process in the younger patients. There
was no evidence of a deleterious effect on mandibular growth.
Conclusion: The outcomes of forward-upward genioplasty include increased symphysis
thickness, bone apposition above B point, and remodeling at the inferior border. When indications
for this type of genioplasty are recognized, early surgical correction (before age 15) produces a
better outcome in terms of bone remodeling. (Angle Orthod. 0000;00:000–000.)
this lecture shows the relation between periodontal and pulpal tissues, pathways of transmission of bacteria and the different lesions of endodontic periodontal lesions.
Comprehensive Care Treatment Plan Presentation, Part II | Dr. Alfred KhalloufAlfred Khallouf
Dr. Alfred Khallouf revisits the world of comprehensive care and how to develop an effective treatment plan. Please visit AlfredKhallouf.com to learn more.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
3. CASE REPORT
NAME :- Subhadraben Senma
AGE/SEX :- 42 Years/Female
OCCUPATION :- Housewife
ADDRESS :- Kansa
OPD NO. :- 12680-I
3
4. CHIEF COMPLAINT
• Patient complaint of pain in bilaterally ear region,
& also complaint of bleeding from mouth.
4
5. HISTORY OF PRESENT ILLNESS
Patient was relatively asymptomatic before 4 days.
Then on 7 th Feb. 2020 around 5:40 pm ,she met with a road traffic accident
while she was travelling with her husband on bike, she fell down due to bike
collision with cart which was coming from opposite side.
H/o bleeding from mouth for a while.
No H/O unconsciousness after trauma.
No H/O – Epistaxis, Bleeding from ear, Vomiting.
Then she shifted to Nootan general hospital, (Emergency Room)with above
mentioned chief complaint.
5
6. PAST MEDICAL HISTORY :-
- No H/O previous hospitalization
- No H/O any systemic diseases like Hypertension,
Diabetes Mellitus, Hepatitis
PAST DENTAL HISTORY :-
- No relevant past dental history
DRUG HISTORY :-
- No relevant drug allergy
FAMILY HISTORY :-
- No relevant family history
6
7. PERSONAL HISTORY :-
- Habits :-No any harmful habit.
- Diet :- Vegetarian
- Marital status :- Married
- Brushing :- Once a day with toothbrush
7
8. • Conscious
• Cooperative
• Well Oriented to time, place and person
• Built :-Well built
• Nourishment :- Well nourished
• Gait :- Normal
Vital signs :-
Temperature: Afebrile
Blood pressure: 136/88 mmHg
Pulse rate: 84 beats/min
Respiratory rate: 17 cycles/min
GENERAL EXAMINATION
8
9. • Face :- Facial asymmetry due to swelling present over right and left
side on TMJ region.
• Skin and soft tissue :- CLW (1*1 cm)present irt with lower chin region.
• Lips :- Incompetent
• Jaw movement :- Restricted due to pain.
• TMJ :- Tenderness on both TMJ region.
• Mouth Opening :- 38 mm.
1. EXTRA- ORAL EXAMINATION
9
18. OPG is showing fracture line starting from crest
of alveolar ridge between 33 and 34 tooth and passing
inferior and backward direction involving inferior border
of mandible suggestive of Parasymphysis fracture. There
is also presence of fracture line passing from
48 inferior and backward direction involving basal bone
suggestive of simple fracture.
18
OPG
23. 23
CASE SUMMARY
A 42 years old female patient named Subhadraben Senma
came to ER with complaint of pain in both ear region and bleeding from
mouth. Patient gave history of RTA while she was travelling with her
husband on bike, she fallen down from bike due to bike collision with
cart which was coming from opposite side on 7th Feb. 2020 around 5:40
pm at Kansa. There was H/O- Bleeding from mouth for a while and No
H/O- Unconsciousness, Vomiting, Epistaxis and bleeding from ear. Then
she shifted to NGH where primary treatment given.
24. 24
On taking Patient’s past medical, dental, family and drug
history, all were insignificant. On taking patient’s general examination,
patient was conscious, co-operative and well oriented to time, place
and person. Patient was well built and well nourished with all vital signs
were within normal limit at time of examination in our department.
Patient’s GCS score was E4V5M6 = 15/15 on time of examination in our
department. On taking patient’s local extraoral examination, facial
asymmetry was present due to swelling on bilateral TMJ region. Also
tenderness present on both TMJ region. Jaw movement was restricted
and mouth opening was 38 mm interincisally.
25. 25
On taking patient’s local intraoral examination, there were all the
teeth present except 48. Occlusion was disturbed (Anterior openbite). Step
deformity was palpated (31-32) & (45-46). Segmental mobility irt with (31-45)
mandibular anterior segment. There was gingival laceration present in 31,32
and 45,46 tooth region. Coleman’s sign positive. Based on all positive clinical
finding we have made our provisional diagnosis as Bilateral Condylar Fracture
and mandibular right parasymphysis fracture. We have advised various
investigations and came to our final diagnosis as Medially displaced bilateral
condylar fracture along with right coronoid process fracture and mandibular
right parasymphysis fracture. Treatment plan decided to do IMF F/B ORIF.
34. 34
DISCUSSION
• Condylar and subcondylar fractures
constitute 26-40% of all mandible
fractures.
• Given the unique geometry of the
mandible and temporomandibular
joints (TMJs), these fractures can
result in marked pain, dysfunction,
and deformity if not recognized
and treated appropriately.
INTRODUCTION
36. 2 schools of thought:
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1. Conservative-functional therapy
2. Surgical treatment
37. Conservative therapy
37
• Involves no surgical intervention of the fracture site
instead it reduces the fracture taking occlusion as a key
factor.
• Immobilization usually involves fixation with arch bars,
eyelet wires or splints.
• Period of immobilization varies from 7-17 days.
40. Functional exercise:
• > 40 mm interincisal distance (adult)
• > 10 mm lateral excursion
• > 12 mm protrusion
Types of exercise:
• Maximal mouth opening
• Right lateral excursion
• Left lateral excursion
• Protrusive action
40
Department of OMFS, NPDCH, SPU.
41. OPEN REDUCTION
41
ABSOLUTE
INDICATIONS
• Fracture dislocation of condyle into middle cranial fossa.
• Foreign body into joint capsule.
• Lateral dislocation of condyle.
• Inability to achieve occlusion by closed reduction due to the interlocking of the
fractured condylar segments.
RELATIVE
INDICATIONS
• Bilateral / unilateral condylar fractures where in IMF is not recommended due to
systemic conditions.
• Bilateral condylar fractures in edentulous patients where splinting is not
recommended.
• Bilateral condylar fractures with comminuted midface fractures.
• Bilateral condylar fractures in patients with orthognathic problems such as
retrognathia or prognathia.
44. Transmasseteric Anterior Parotid Approach for Treatment of
Mandibular Subcondylar Fractures
Yemei Qian, MD, Weihong Wang, MD,y Biao Xu, MD, ZhiRong Zou, MD,y Chun Yang, MD,z and Shenjie Shao, MD
Abstract: This study demonstrated the application of transmasseteric anterior parotid
approach for open reduction of mandibular subcondylar fractures depending on the basis
of the anatomical study of the temporomandibular joint and parotid gland area. The
anatomical study was performed on 5 Chinese adult cadavers fixed by 10% formalin. The
temporomandibular joints and parotid regions were studied. In the clinical study, 26
patients with mandibular subcondylar fractures were recruited between July 2014 and
December 2017. All 26 patients with mandibular subcondylar fractures received satisfactory
occlusions and normal mouth opening: no postoperative facial paralysis occurred in these
patients. It is crucial to know the anatomy of both temporomandibular joint and parotid
region for reducing significantly the surgical trauma and complications. Transmasseteric
anterior parotid approach is a feasible approach for the surgical treatment of the
mandibular subcondylar fractures. This method can provide adequate exposure, minimal
facial nerve injury, open reduction easily, and inconspicuous scarring.
Department of OMFS, NPDCH, SPU.
44
45. Paediatric Condylar Fractures
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• Most common pediatric mandibular fracture.
• Prior to age 6, most fractures are intracapsular, whereas after that age they occur
most frequently in the neck of the mandible.
• When normal occlusion is present, fractures of the condylar region are treated
conservatively with close observation, soft diet, and pain medication.
• When there is malocclusion, a short course of maxillary–mandibular fixation is
warranted.
• Limiting fixation to 7 to 10 days helps limit the chance of joint ankylosis, although
postoperative physiotherapy may still be beneficial.
46. • Choice of technique is largely dependent on the age of the child and,
more importantly, the quality and quantity of dentition.
• When possible, intradental wires with arch bars maybe placed.
• If not possible, intermaxillary fixation using 1-point circumandibular wiring
should be used
• Due to the possibility of injuring nonerupted teeth, intermaxillary fixation
screws should not be placed.
• It is important to discuss chin deviation during chewing and the possibility of
long- term growth abnormalities of the jaw with patients’ parents.
46
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47. CONDYLAR TRAUMA?
Clinical Sign
Malocclusion
Deviation
Range of motion
Negative clinical exam
(-)Malocclusion
Minimal pain
Normal range of motion
No deviation on opening
Observation
Radiographs
Lateral oblique
OPG
CT scan
No radiographic
evidence of condylar#
hemathrosis
Jointeffusion
(+) Condylar fracture
Normal occlusion Malocclusion
ORIF?
RMO
Pain
Deviation
Conservative IMF (7-21 days)
ORIF Other # ?
IMF (7-21 days)
Yes
89Follow up
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YesNo
No
No
Reduction/fixation of other #
47
48. 48
• Intracapsular fractures are best treated by closed reduction.
• Fractures in children are best treated closed except when the
fracture itself anatomically prohibits jaw function.
• Physical therapy is integral to good patient care and is the primary
factor influencing successful outcomes, whether the patient is
treated open or closed.
• When open reduction is indicated, the procedure must be
performed well, with an appreciation for the patient's occlusal
relationships, and must be supported by an appropriate physical
therapy and follow-up regimen.
CONCLUSION
49. REFERENCES
49
1. Oral & maxillofacial trauma-Fonseca & walker.
2. Oral & maxillofacial trauma-Rowe & Williams Vol 2.
3. Principles of Oral & maxillofacial surgery-Peterson.
4. Transmasseteric anterior parotid approach for treatment of mandibular
subcondylar fractures: Yemei qian, MD, weihong wang, md,y biao xu, MD, zhirong zou, md,y
chun yang, md,z and shenjie shao, MD.
5. Transmasseteric anterior parotid approach for condylar fractures: experience
of 129 cases: Vinod Narayanan, Ashok Ramadorai, Poornima Ravi, Natarajan Nirvikalpa.
6. Preauricular transmasseteric anteroparotid approach for extracorporeal
fixation of mandibular condyle fractures: Rajasekhar Gali, Sathya Kumar Devireddy,
Kishore Kumar Rayadurgam Venkata, Sridhar Reddy Kanubaddy, Chaithanyaa Nemaly, Mallikarjuna
Dasari
Department of OMFS, NPDCH, SPU.