overview of TMJ ankylosis,
craniomandibular ankylosis, sequelae of temporomandibular joint disorders, functional derangement, aims of surgery and strategies of intervention with possible complications that may follow
Condylar fractures 2 /certified fixed orthodontic courses by Indian dental a...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document describes the steps of a bilateral sagittal split osteotomy (BSSO) procedure to correct jaw alignment. Key steps include making incisions over the external oblique ridge and dissecting soft tissues to expose the lateral and medial surfaces of the mandible. Osteotomies are made through the lingual and buccal cortices and connected along the anterior border of the ramus. The mandible is then split and mobilized. Rigid internal fixation with plates and screws is used to stabilize the segments in the corrected position. Potential complications include unfavorable splits, bleeding, neurologic injury, infection, and relapse.
This document discusses various surgical approaches to the temporomandibular joint (TMJ). It begins by outlining important anatomical structures in the region, including nerves, arteries and layers of fascia. It then describes several common approaches - preauricular, endaural, postauricular, submandibular, retromandibular and intraoral. For each approach, it provides details on the surgical technique, indications, advantages and disadvantages. References are also provided at the end for further reading on the surgical anatomy of the cervical and mandibular distributions of the facial nerve.
This document provides an overview of genioplasty procedures. It begins with an introduction to genioplasty and anatomy. It then discusses preoperative evaluation including facial analysis, cephalometric evaluation, and chin classifications. Next, it covers various techniques for correcting chin deformities including osseous genioplasty procedures like horizontal osteotomy with advancement or reduction, and alloplastic genioplasty. It concludes with a brief discussion of complications. The document provides detailed information on evaluating patients, planning procedures, and technical aspects of different genioplasty techniques.
This document discusses condylar fractures, including their classification, etiology, signs and symptoms, and treatment protocols. It covers different classification systems for condylar fractures including location of the fracture and relationship to surrounding structures. Treatment approaches are discussed as conservative/closed, functional, or surgical depending on factors like displacement and occlusion disturbance. Specific treatment protocols are outlined for different age groups and fracture types.
Apertognathia and its surgical managementHimanshu Soni
Hullihen performed the first "V" shaped osteotomy of the mandible to correct anterior open bites. Kole modified this procedure by excising a wedge of bone from the mandible's symphysis and inferior border to shorten facial height. Thoma suggested Y-shaped and trapezoid mandibular body osteotomies to correct open bites associated with prognathism.
This document provides an overview of maxillary and midface osteotomies. It begins with an introduction discussing the history and goals of orthognathic surgery. It then covers various osteotomy techniques including single tooth, anterior maxillary, posterior maxillary, Lefort I, II, and III osteotomies. For each technique, it discusses the relevant history, indications, surgical approach, complications, and advances. It emphasizes the Lefort I osteotomy as the mainstay procedure, covering its evolution, blood supply considerations, rigid fixation approaches, and indications. In summary, the document comprehensively reviews different maxillary osteotomy techniques for orthognathic surgery.
The presentation deals with the basics required for studying TMJ ankylosis. The text has been simplified and presented. It is well supported with illustrations.
Suggestions and feedback will be well appreciated. :)
Condylar fractures 2 /certified fixed orthodontic courses by Indian dental a...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document describes the steps of a bilateral sagittal split osteotomy (BSSO) procedure to correct jaw alignment. Key steps include making incisions over the external oblique ridge and dissecting soft tissues to expose the lateral and medial surfaces of the mandible. Osteotomies are made through the lingual and buccal cortices and connected along the anterior border of the ramus. The mandible is then split and mobilized. Rigid internal fixation with plates and screws is used to stabilize the segments in the corrected position. Potential complications include unfavorable splits, bleeding, neurologic injury, infection, and relapse.
This document discusses various surgical approaches to the temporomandibular joint (TMJ). It begins by outlining important anatomical structures in the region, including nerves, arteries and layers of fascia. It then describes several common approaches - preauricular, endaural, postauricular, submandibular, retromandibular and intraoral. For each approach, it provides details on the surgical technique, indications, advantages and disadvantages. References are also provided at the end for further reading on the surgical anatomy of the cervical and mandibular distributions of the facial nerve.
This document provides an overview of genioplasty procedures. It begins with an introduction to genioplasty and anatomy. It then discusses preoperative evaluation including facial analysis, cephalometric evaluation, and chin classifications. Next, it covers various techniques for correcting chin deformities including osseous genioplasty procedures like horizontal osteotomy with advancement or reduction, and alloplastic genioplasty. It concludes with a brief discussion of complications. The document provides detailed information on evaluating patients, planning procedures, and technical aspects of different genioplasty techniques.
This document discusses condylar fractures, including their classification, etiology, signs and symptoms, and treatment protocols. It covers different classification systems for condylar fractures including location of the fracture and relationship to surrounding structures. Treatment approaches are discussed as conservative/closed, functional, or surgical depending on factors like displacement and occlusion disturbance. Specific treatment protocols are outlined for different age groups and fracture types.
Apertognathia and its surgical managementHimanshu Soni
Hullihen performed the first "V" shaped osteotomy of the mandible to correct anterior open bites. Kole modified this procedure by excising a wedge of bone from the mandible's symphysis and inferior border to shorten facial height. Thoma suggested Y-shaped and trapezoid mandibular body osteotomies to correct open bites associated with prognathism.
This document provides an overview of maxillary and midface osteotomies. It begins with an introduction discussing the history and goals of orthognathic surgery. It then covers various osteotomy techniques including single tooth, anterior maxillary, posterior maxillary, Lefort I, II, and III osteotomies. For each technique, it discusses the relevant history, indications, surgical approach, complications, and advances. It emphasizes the Lefort I osteotomy as the mainstay procedure, covering its evolution, blood supply considerations, rigid fixation approaches, and indications. In summary, the document comprehensively reviews different maxillary osteotomy techniques for orthognathic surgery.
The presentation deals with the basics required for studying TMJ ankylosis. The text has been simplified and presented. It is well supported with illustrations.
Suggestions and feedback will be well appreciated. :)
This seminar explains about the development, relations, ligaments, various attachments, vascular and nervous supply and various surgical approaches and its modifications to TMJ
This document discusses the anatomy, classification, diagnosis, and management of zygomatic complex fractures. It begins with the anatomical details of the zygomatic bone and its articulations. It then reviews various classification systems for zygomatic fractures, which typically categorize fractures based on the involved bone segments and degree of displacement. Common causes of these fractures are also mentioned. The diagnosis section outlines the clinical exam findings and imaging studies used to evaluate zygomatic fractures. Finally, the management section discusses indications for surgery, different surgical approaches, reduction techniques, and fixation methods like plates and screws. Complications of zygomatic fractures are also briefly outlined.
This document discusses condylar fractures of the mandible. It begins by providing background on condylar fracture development, anatomy, surgical anatomy, blood supply, nerve supply and muscle attachments. It then covers the etiology, associated injuries, mechanisms of injury and various classification systems for condylar fractures. The document outlines the diagnosis process including history, clinical examination and radiographic imaging. It concludes by discussing treatment approaches, focusing on the aims of surgery and indications for conservative versus surgical management.
The document provides information on mandibular fractures including:
1. Anatomy of the mandible and areas prone to fracture such as the angle.
2. Classification of fractures as simple, compound, comminuted.
3. Principles of management including closed or open reduction, immobilization using wires or splints, and open reduction with fixation using plates, screws or wires.
4. Factors such as fracture location, direction, and muscle pull that determine treatment approach.
The document discusses various approaches for reducing fractures of the zygomatic arch. It describes the temporal (Gillies) approach which involves a temporal incision to access the arch. The trans-oral (Keen) approach uses a lateral maxillary vestibular incision for a more direct approach. Quinn's approach and the towel clip technique are also indirect approaches described for reducing depressed zygomatic arch fractures. A bi-coronal incision provides direct visualization of fractures involving multiple facial bones.
This document provides an overview of Lefort I osteotomy, including:
- A brief history describing the development of maxillary osteotomy techniques.
- Anatomical considerations and the biologic basis for maxillary osteotomies, which have shown adequate blood supply can be maintained.
- Indications for Lefort I osteotomy include altering vertical dimension, anteroposterior movements, and surgical expansion of the maxilla.
- Types of Lefort I osteotomies are described, including classic, quadrangular, and segmental variations. Postoperative management and potential complications are also outlined.
Condylar sag is defined as an immediate or late change in the position of the condyle in the glenoid fossa after orthognathic surgery, leading to an undesirable change in occlusion. It can occur after procedures like BSSO, IVRO, and Lefort I osteotomy. Risk factors include incorrect vectoring during condylar positioning and incomplete bone splits. Condylar sag is classified as central or peripheral, and can be diagnosed intraoperatively by examining changes in occlusion. Preventative measures include rigid fixation and intraoperative patient awakening to detect changes.
This document provides an overview of surgical approaches to the temporomandibular joint (TMJ). It discusses several extraoral and intraoral approaches, including the preauricular, endaural, postauricular, coronal, retromandibular, and intraoral vestibular approaches. For each approach, it highlights considerations for exposure and visibility of the joint, avoidance of neurovascular structures, and postoperative aesthetics. Complications are also briefly mentioned. Detailed anatomical descriptions and illustrations are provided to demonstrate the surgical planning and exposure for different approaches.
This document discusses various maxillary osteotomies and orthognathic surgery procedures. It describes common maxillary deformities and the evaluation and planning process. Several maxillary osteotomy techniques are outlined, including segmental, total, Le Fort I, II, and III osteotomies. Key steps for each technique like incisions, osteotomy cuts, down fracture, and fixation are summarized. The roles of presurgical orthodontics and postsurgical orthodontics are also briefly discussed.
This document discusses fractures of the mandibular condyle. It begins with an introduction and overview of the surgical anatomy and classification of condylar fractures. It then covers the etiology, diagnosis, and management of these fractures. Key points include that condylar fractures account for 20-30% of mandibular fractures. Diagnosis involves clinical examination, radiological imaging like CT scans, and the fractures can be classified in various ways. Management involves either conservative treatment with immobilization or functional exercises, or surgical treatment depending on the type and severity of the fracture. The document provides details on techniques, indications, and advantages/disadvantages of different treatment approaches.
The document discusses condylar fractures, including:
- Anatomy of the condyle and temporomandibular joint
- Various classifications of condylar fractures
- Clinical features like swelling, pain, and limited jaw movement
- Diagnosis using radiographs like panoramic x-rays and CT scans
- Treatment approaches like closed or open reduction
- Indications for non-surgical versus surgical management
In 3 sentences it summarizes that the document discusses the anatomy, classifications, diagnosis, and treatment approaches like closed or open reduction for condylar fractures of the temporomandibular joint.
CARNOY’S SOLUTION AS A SURGICAL MEDICAMENT IN THETREATMENT OF KERATOCYSTIC O...DrKamini Dadsena
The term keratocyst was coined by Philipsen in 1956.
Unlike the other cystic lesion KOT, has got strong tendency for recurrence.
Treatment of these lesions remains controversial and has a number of dilemmas about the choice of treatment whether to use carnoys solution as an adjunct therapy after removal of the lesion.
Detailed discussion on diagnosis and management of TMJ ankylosis. Surgical anatomy and applied aspects of TMJ is discussed. Reconstruction of ramus-condyle unit is also discussed. Compications of TMJ surgery are also discussed
This document discusses temporomandibular joint (TMJ) arthroscopy. It begins by defining arthroscopy as examining the inside of a joint with an arthroscope. TMJ arthroscopy allows direct visualization of the TMJ structures and performing surgeries. The document outlines the techniques, indications, contraindications and complications of diagnostic and therapeutic TMJ arthroscopy. Common pathologies that can be evaluated arthroscopically include adhesions, perforations and folds in the TMJ. The summary emphasizes that TMJ arthroscopy is a less invasive alternative to open surgery that can treat pain and restricted joint mobility through lysis, lavage and release of adhesions.
This document discusses the diagnosis and treatment of mandibular body and symphysis fractures. It describes the signs, symptoms, and diagnostic tools used to identify these fractures. Common diagnostic tools include panoramic x-rays, CT scans, and MRI. Treatment options discussed include closed reduction with fixation, open reduction with plates, screws or wiring, depending on the location and severity of the fracture. Post-operative maxillomandibular fixation times vary from 4-6 weeks depending on the specific treatment approach.
This study reviewed 196 patients who underwent single-incision laparoscopic cholecystectomy (SILC) with routine intraoperative cholangiography (IOC) at a single institution. IOC was successful in 178 patients (90.8%) and detected abnormalities in 21 patients (10.7%), including common bile duct stones in 16 patients. IOC helped accurately identify biliary anatomy and avoided potential bile duct injury in one case. The authors conclude that routine IOC during SILC is feasible and useful for detecting bile duct stones and gaining an accurate picture of biliary anatomy.
A Comparison of The Lateral Tarsal Strip with Everting Sutures and The Quic...Meironi Waimir
Entropion is Inversion or rotation of the margo palpebra towards the eyeball.
Characterized by : Ocular discomfort, epiphora, secondary corneal thinning, vascularization and scarring as well as microbial keratitis and corneal perforation.
This seminar explains about the development, relations, ligaments, various attachments, vascular and nervous supply and various surgical approaches and its modifications to TMJ
This document discusses the anatomy, classification, diagnosis, and management of zygomatic complex fractures. It begins with the anatomical details of the zygomatic bone and its articulations. It then reviews various classification systems for zygomatic fractures, which typically categorize fractures based on the involved bone segments and degree of displacement. Common causes of these fractures are also mentioned. The diagnosis section outlines the clinical exam findings and imaging studies used to evaluate zygomatic fractures. Finally, the management section discusses indications for surgery, different surgical approaches, reduction techniques, and fixation methods like plates and screws. Complications of zygomatic fractures are also briefly outlined.
This document discusses condylar fractures of the mandible. It begins by providing background on condylar fracture development, anatomy, surgical anatomy, blood supply, nerve supply and muscle attachments. It then covers the etiology, associated injuries, mechanisms of injury and various classification systems for condylar fractures. The document outlines the diagnosis process including history, clinical examination and radiographic imaging. It concludes by discussing treatment approaches, focusing on the aims of surgery and indications for conservative versus surgical management.
The document provides information on mandibular fractures including:
1. Anatomy of the mandible and areas prone to fracture such as the angle.
2. Classification of fractures as simple, compound, comminuted.
3. Principles of management including closed or open reduction, immobilization using wires or splints, and open reduction with fixation using plates, screws or wires.
4. Factors such as fracture location, direction, and muscle pull that determine treatment approach.
The document discusses various approaches for reducing fractures of the zygomatic arch. It describes the temporal (Gillies) approach which involves a temporal incision to access the arch. The trans-oral (Keen) approach uses a lateral maxillary vestibular incision for a more direct approach. Quinn's approach and the towel clip technique are also indirect approaches described for reducing depressed zygomatic arch fractures. A bi-coronal incision provides direct visualization of fractures involving multiple facial bones.
This document provides an overview of Lefort I osteotomy, including:
- A brief history describing the development of maxillary osteotomy techniques.
- Anatomical considerations and the biologic basis for maxillary osteotomies, which have shown adequate blood supply can be maintained.
- Indications for Lefort I osteotomy include altering vertical dimension, anteroposterior movements, and surgical expansion of the maxilla.
- Types of Lefort I osteotomies are described, including classic, quadrangular, and segmental variations. Postoperative management and potential complications are also outlined.
Condylar sag is defined as an immediate or late change in the position of the condyle in the glenoid fossa after orthognathic surgery, leading to an undesirable change in occlusion. It can occur after procedures like BSSO, IVRO, and Lefort I osteotomy. Risk factors include incorrect vectoring during condylar positioning and incomplete bone splits. Condylar sag is classified as central or peripheral, and can be diagnosed intraoperatively by examining changes in occlusion. Preventative measures include rigid fixation and intraoperative patient awakening to detect changes.
This document provides an overview of surgical approaches to the temporomandibular joint (TMJ). It discusses several extraoral and intraoral approaches, including the preauricular, endaural, postauricular, coronal, retromandibular, and intraoral vestibular approaches. For each approach, it highlights considerations for exposure and visibility of the joint, avoidance of neurovascular structures, and postoperative aesthetics. Complications are also briefly mentioned. Detailed anatomical descriptions and illustrations are provided to demonstrate the surgical planning and exposure for different approaches.
This document discusses various maxillary osteotomies and orthognathic surgery procedures. It describes common maxillary deformities and the evaluation and planning process. Several maxillary osteotomy techniques are outlined, including segmental, total, Le Fort I, II, and III osteotomies. Key steps for each technique like incisions, osteotomy cuts, down fracture, and fixation are summarized. The roles of presurgical orthodontics and postsurgical orthodontics are also briefly discussed.
This document discusses fractures of the mandibular condyle. It begins with an introduction and overview of the surgical anatomy and classification of condylar fractures. It then covers the etiology, diagnosis, and management of these fractures. Key points include that condylar fractures account for 20-30% of mandibular fractures. Diagnosis involves clinical examination, radiological imaging like CT scans, and the fractures can be classified in various ways. Management involves either conservative treatment with immobilization or functional exercises, or surgical treatment depending on the type and severity of the fracture. The document provides details on techniques, indications, and advantages/disadvantages of different treatment approaches.
The document discusses condylar fractures, including:
- Anatomy of the condyle and temporomandibular joint
- Various classifications of condylar fractures
- Clinical features like swelling, pain, and limited jaw movement
- Diagnosis using radiographs like panoramic x-rays and CT scans
- Treatment approaches like closed or open reduction
- Indications for non-surgical versus surgical management
In 3 sentences it summarizes that the document discusses the anatomy, classifications, diagnosis, and treatment approaches like closed or open reduction for condylar fractures of the temporomandibular joint.
CARNOY’S SOLUTION AS A SURGICAL MEDICAMENT IN THETREATMENT OF KERATOCYSTIC O...DrKamini Dadsena
The term keratocyst was coined by Philipsen in 1956.
Unlike the other cystic lesion KOT, has got strong tendency for recurrence.
Treatment of these lesions remains controversial and has a number of dilemmas about the choice of treatment whether to use carnoys solution as an adjunct therapy after removal of the lesion.
Detailed discussion on diagnosis and management of TMJ ankylosis. Surgical anatomy and applied aspects of TMJ is discussed. Reconstruction of ramus-condyle unit is also discussed. Compications of TMJ surgery are also discussed
This document discusses temporomandibular joint (TMJ) arthroscopy. It begins by defining arthroscopy as examining the inside of a joint with an arthroscope. TMJ arthroscopy allows direct visualization of the TMJ structures and performing surgeries. The document outlines the techniques, indications, contraindications and complications of diagnostic and therapeutic TMJ arthroscopy. Common pathologies that can be evaluated arthroscopically include adhesions, perforations and folds in the TMJ. The summary emphasizes that TMJ arthroscopy is a less invasive alternative to open surgery that can treat pain and restricted joint mobility through lysis, lavage and release of adhesions.
This document discusses the diagnosis and treatment of mandibular body and symphysis fractures. It describes the signs, symptoms, and diagnostic tools used to identify these fractures. Common diagnostic tools include panoramic x-rays, CT scans, and MRI. Treatment options discussed include closed reduction with fixation, open reduction with plates, screws or wiring, depending on the location and severity of the fracture. Post-operative maxillomandibular fixation times vary from 4-6 weeks depending on the specific treatment approach.
This study reviewed 196 patients who underwent single-incision laparoscopic cholecystectomy (SILC) with routine intraoperative cholangiography (IOC) at a single institution. IOC was successful in 178 patients (90.8%) and detected abnormalities in 21 patients (10.7%), including common bile duct stones in 16 patients. IOC helped accurately identify biliary anatomy and avoided potential bile duct injury in one case. The authors conclude that routine IOC during SILC is feasible and useful for detecting bile duct stones and gaining an accurate picture of biliary anatomy.
A Comparison of The Lateral Tarsal Strip with Everting Sutures and The Quic...Meironi Waimir
Entropion is Inversion or rotation of the margo palpebra towards the eyeball.
Characterized by : Ocular discomfort, epiphora, secondary corneal thinning, vascularization and scarring as well as microbial keratitis and corneal perforation.
1) Multiple infection prevention measures were used in 54 patients undergoing ACL reconstruction surgery, including preoperative skin washing and bathing, intraoperative use of sterile drapes and instruments soaked in vancomycin solution, and postoperative rehabilitation.
2) No postoperative infections occurred in any patients over 6-18 months of follow-up. Knee function scores improved significantly from pre-operation levels.
3) The study suggests that using multiple prevention measures can successfully prevent infections after ACL reconstruction surgery and allow for good postoperative recovery of knee function.
Dr. Magda Mensi presents a case study of a 40-year old patient with aggressive periodontitis who received an Alpha-Bio Tec SPI dental implant and aesthetic restoration. The patient's bone height was 4mm below the maxillary sinus floor. Dr. Mensi performed a crestal sinus elevation procedure using autologous CGF and inserted an 8mm implant. A temporary crown was placed and after 15 days, a final ceramic crown was cemented using an aesthetic abutment. A 6-month follow-up x-ray showed good integration of the implant and prosthetic restoration with no crestal bone loss.
This document provides an overview of temporomandibular joint (TMJ) ankylosis, including its history, classification, clinical features, radiological features, and surgical treatment approaches. It discusses the etiology and pathogenesis of TMJ ankylosis, as well as various classification systems. Surgical treatment involves aggressive resection of the ankylotic mass, coronoidectomy, lining the joint with soft tissue, and reconstruction of the ramus condylar unit (RCU) using materials such as the resected ankylotic mass, coronoid process, vertical or L-shaped ramus osteotomies, costochondral grafts, or distraction osteogenesis. The goals of RCU reconstruction are
Journal club on Minimally Invasive Single Implant Treatment (M.I.S.I.T.) base...Shilpa Shiv
Journal club on Minimally Invasive Single Implant Treatment (M.I.S.I.T.) based on ridge preservation and contour augmentation in patients with a high aesthetic risk profile, JCP 2015
This clinical report describes the immediate loading of a dental implant with a provisional crown to replace a missing central incisor. After 3 months of healing and soft tissue maturation with the provisional crown, an impression was made using a customized post to capture the established soft tissue contours. Finally, a definitive screw-retained all-ceramic crown was placed, which has had good results over 18 months of follow up without complications.
This document summarizes a surgical technique called L-shaped corticotomy with vascularized bone flap sliding for treating chronic osteomyelitis of the tibia. Some key points:
- Traditional Ilizarov techniques have long treatment times and risks of complications, so this technique aims to shorten treatment.
- It involves radical debridement followed by an L-shaped bone cut preserving blood supply, then sliding the bone flap to increase contact area for healing.
- A study of 34 patients found this technique reduced the external fixation time and index compared to traditional methods, with no major complications.
- By preserving blood supply and increasing contact area, it may promote faster bone formation and healing compared to traditional Il
simplified drilling technique does not decrease dental implant osseointegrationNeppoliyan S
This study evaluated the effects of a simplified drilling technique using fewer drills compared to a conventional technique using multiple increasing diameter drills on dental implant osseointegration. 72 implants were placed in dog tibias using both techniques and evaluated after 1, 3, and 5 weeks. The study found no significant differences in bone-to-implant contact percentage or bone area fraction between the techniques at any time point. Both techniques resulted in direct bone contact and new bone formation around the implants. The simplified technique using fewer drills did not decrease osseointegration compared to the conventional technique.
Results of incisional hernia repair are poor. Centralized hernia surgery is a prerequisite for improvement of clinical outcomes. Center for a hernia and abdominal wall reconstruction should be an essential component of a university hospital. A hernia and abdominal wall reconstructive surgery is a practical and academic sub-specialization.
Bobic Vladimir - Partial resurfacing - SICOT Montreal 12th October 2018Vladimir Bobic
This document discusses partial resurfacing implants, specifically the BioPoly implant. It provides details on the BioPoly material which is a combination of UHMWPE and hyaluronic acid. It then summarizes a registry study of 35 patients who received the BioPoly implant with results showing significant improvement in clinical outcomes and one revision. The conclusion is that partial resurfacing implants have limited primary indications but can be useful for failed cartilage repair procedures.
COMPOSITE GRAFT: ANTROPYLORUS TRANSPOSITION AND GLUTEUS MAXIMUS WRAPDr Amit Dangi
THIS PRESENTATION DESCRIBES THE NOVEL SURGICAL TECHNIQUE OF TOTAL ANORECTAL RECONSTRUCTION WITH ANTROPYLORUS TRANSPOSITION AND GLUTEOPLASTY AND ITS RESULTS.
This document provides information about a thesis project on evaluating the outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction using semitendinosus and gracilis tendon grafts through a modified transtibial technique. The study will be conducted by Dr. Md. Rakiz Khan at the National Institute of Traumatology and Orthopaedic Rehabilitation from 2018-2023. The study aims to assess clinical and functional outcomes and complications of the procedure. Thirty-six patients between 20-40 years old with ACL injuries will be included. Outcomes will be evaluated using Lachman test, Lysholm score, range of motion, and complications.
This journal club presentation summarizes a study on using autologous semitendinosus tendon grafts as meniscal transplants. The study aimed to see if these tendon grafts could function as meniscal replacements and reduce post-meniscectomy symptoms. Early results from 7 patients found improvements in pain and quality of life scores at 12 months follow-up. MRI scans also indicated the grafts were transforming into a more meniscus-like structure. While limitations included a small sample size and short follow-up, the results suggest autologous tendon grafts may be a promising alternative to current meniscal transplant methods.
This document discusses HECOLCAP, a new product being developed by B2S to treat bone infections. HECOLCAP aims to enable sustained local delivery of antibiotics while also actively promoting bone regeneration in a single surgery, improving on current treatment which requires multiple surgeries and weeks of intravenous antibiotics. It has the potential to more effectively eradicate infections, reduce treatment time, and lower healthcare costs. An estimated 800,000 cases of bone infection in the US and Europe each year could benefit from HECOLCAP. The company is seeking €2.7 million in funding to complete product development and clinical studies.
1) The study examined the effect of surgical treatment without antibiotics for experimentally induced peri-implantitis around four different implant types in dogs.
2) After 40-50% bone loss was created, surgical cleaning of the implant surfaces was performed without antibiotics.
3) Two TiUnite implants were lost after surgery. Turned, TiOblast and SLA implants showed bone gain, while TiUnite implants showed additional bone loss. Peri-implantitis resolved around turned and TiOblast surfaces.
4) The outcome of peri-implantitis treatment was influenced by the implant surface characteristics. Resolution was possible without antibiotics but some surfaces fared better than others.
Analysis of buccolingual dimensional changes of the extraction socket using t...MD Abdul Haleem
The document summarizes a study that evaluated buccal-lingual dimensional changes after tooth extraction and socket preservation using the "ice cream cone" flapless grafting technique. 11 sites in 11 patients were treated with this technique, which involves placing a bone allograft and collagen membrane shaped like an ice cream cone into the extraction socket. Measurements from CBCT scans, dental casts, and digital scans showed a mean buccal-lingual ridge width loss of 1.32 mm 6 months post-treatment. Despite this minor loss of width, the regenerated bone volume was sufficient for implant placement and osseointegration in all cases. The study concluded that the ice cream cone technique resulted in less contour changes
Journal Club on Clinical comparison of ultrasonic surgery and conventional su...Dr Bhavik Miyani
This document summarizes a study comparing ultrasonic surgery to conventional surgical techniques for removing jaw cysts. Eighty-two cysts were removed from 68 patients, with 34 patients undergoing ultrasonic surgery and 34 undergoing conventional surgery. Ultrasonic surgery took longer on average but provided better visibility of the surgical field. No major complications occurred with either technique, and there were no recurrences of cysts. The study found that while ultrasonic surgery increases operation time, it reduces risks of damaging vital structures like nerves when removing cysts in difficult areas requiring delicate manipulation.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
2. ∗ CMJ anatomy overview
∗ Definition of CMJ ankylosis
∗ Etiology
∗ Classification
∗ Clinical presentation
∗ Management strategies
∗ Complications
∗ Current understanding…presentation of Prof Guthua
Presentation Outline
University of Nairobi ISO 9001:2008 2 Certified http://www.uonbi.ac.ke
3. ∗ Bilateral diarthrosis – right & left function together
∗ Articular surface covered by fibrocartilage instead of
hyaline cartilage
∗ Only joint in human body to have a rigid end-point of
closure that of the teeth making occlusal contact.
∗ CMJ is last diarthrodial joints joint to start develop,
7th week in-utero.
∗ Structured like 2 joints. Has 2 synovial cavities
∗ Capable of the largest proportion of translation and
rotation.
Peculiarity of CMJ
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4. Anatomy of CMJ; Components
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5. ∗ The articular surface lined by a layer of fibrocartilage.
Absorbs masticatory forces better than hyaline cartilage
Superior reparative process.
∗ Articular disc attached to the fibrous capsule at the
peripheries
∗ The articular disc maximizes the congruency within
the CMJ to reduce contact pressure
Cont…
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6. ∗ Fibrous capsule
The capsule is relatively firm medially and laterally ,
providing stability to the joint during lateral movements
during mastication.
capsule is relatively lax anteriorly and posteriorly,
allowing the condyle and disc to translate forward when
the mouth is opened.
∗ Lateral ligament(temporomandibular ligament)
Primary lig. Has oblique and horizontal fibres)
∗ Accessory ligs..spheno and stylomandibular ligs.
Located medial to the joint capsule. Suspend the
mandible to the cranium
Cont…
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8. ∗ Stability factors
Static..
Dynamic
∗ Movements …produced by attachments of muscles
of mastication
Protrusion and retraction
Elevation and depression
Lateral excursions
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Athrokinematics of CMJ
9. ∗ Rotational movement
Mandibular condyle rolls relative to the inferior surface
of the disc.
Happens in the lower joint compartment
∗ Translational movement
Mandibular condyle and disc slide essentially together.
The disc usually moves in the direction of the translating
condyle.
The upper joint compartment
Athrokinematics of CMJ
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10. ∗ Early phase, constituting the first 35% to 50% of the
range of motion
involves primarily rotation of the mandible relative to
the cranium
∗ Late phase - 50% to 65% of the total range of motion.
Is marked by a gradual transition from primary rotation
to primary translation
Athrokinematics of CMJ
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19. ∗ Facial growth distortion… Aesthetics
∗ Nutritional impairment
∗ Respiratory disorders
∗ Malocclusion
∗ Poor oral hygiene
∗ Multiple carious and impacted teeth
Sequelae of CMJ Ankylosis
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20. ∗ Release ankylosed mass and creation of a gap
∗ Creation of functional joint (improve patient’s oral
hygiene, nutrition and good speech)
∗ To reconstruct the joint and restore the vertical
height of the ramus
∗ To prevent recurrence
∗ To restore normal facial growth pattern
Aims of Management
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21. Principles of Management
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∗ Early surgical intervention
∗ Elaborate resection
∗ Early mobilization
∗ Aggressive physiotherapy for at least 6 months post
operatively
22. ∗ Ipsilateral coronoidectomy and contralateral
coronoidectomy for longstanding ipsilateral CMJ
ankylosis
∗ Psychological rehabilitation
Principles of Management
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23. ∗ Non-surgical management vs Surgical treatment
∗ Surgical Management
1. Condylectomy
2. Gap arthroplasty
3. Interpositional arthroplasty
4. Total joint reconstruction
Management Strategies
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24. • Fibrous ankyloses
• Pre-auricular incision is made
• Cut at the level of the condylar neck
• The head (condyle) should be separated from the
superior attachment carefully
• The wound is then sutured in layers
• The usual complication of this procedure is an
ipsilateral deviation to the affected side and anterior
open bite if the procedure was bilaterally.
Condylectomy
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25. ∗ Extensive bony ankylosis.
∗ Consists of two horizontal osteotomy cuts
∗ Removal of bony wedges for creation of a gap
between the roof of the glenoid fossa and the ramus
of the mandible.
∗ This gap permits mobility
∗ Minimum gap should be 1cm to avoid re-ankylosis
Gap Arthroplastry
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26. ∗ Improvement/modification on gap arthroplasty
∗ Currently the surgical protocol of choice
∗ Involves the creation of gap, with a barrier is inserted
between the two surfaces to avoid re-occurrence and
to maintain the vertical height of the ramus
Interpositional Arthroplasty
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28. ∗ Re-ankylosis
∗ Resorption
∗ Overgrowth
∗ Fracture
∗ Pain
Post-op. Complications
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29. ∗ Inadequate gap btw fragments
∗ Inadequate coverage of glenoid fossa
∗ Inadequate post-op physiotherapy
∗ Fracture of costochondral graft
∗ High osteogenic potential and periosteal osteogenic
power responsible for high recurrence in children
Recurrence of CMJ Ankylosis
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30. ∗ The results of the meta-analysis showed that IPG
results in a significant improvement in MIO and lower
recurrence rate when compared to GA.
∗ IPG showed a greater improvement in MIO and
comparable recurrence rate when compared to CCG
reconstruction.
∗ GA and CCG reconstruction had a comparable
recurrence rate.
∗ CCJ provides greater MIO when compared to AJR,
whereas AJR was superior to CCJ in reducing pain.
Al-moraissi ea et al. A systematic review and meta-analysis of the clinical outcomes for various surgical modalities in the
management of temporomandibular joint ankylosis. Int J Oral Maxillofac Surg. 2015 apr;44(4):470-82.
Studies
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31. ∗ 17 studies with 740 participants were included in the
final analysis. The IPG therapy showed a significantly
greater MIO when compared to GA.
∗ The analysis showed that IPG was more effective and
displayed a lower recurrence rate, followed by AR and
GA, in treating CMJ ankylosis.
∗ Analysis provides strong evidence supporting IPG as a
first-line therapy for CMJ ankylosis.
Liu x et al. (2015) effectiveness of different surgical modalities in the management of temporomandibular joint
ankylosis: a meta-analysis. Article · Literature Review in International Journal of Clinical and Experimental
Medicine 2015 Nov. 15;8(11):19831-9.
Studies
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32. ∗ Retrospective study evaluated the cause of CMJ
ankylosis and the 36-month postoperative results of
gap arthroplasty in 50 patients (62 joints).
∗ Result. Trauma to the CMJ was documented as a
major etiologic factor in 86% of cases.
∗ The recurrence rate was 2%.
∗ The long-term functional results of gap arthroplasty
are satisfactory and comparable to other modalities
∗ Postoperative exercises play a crucial role in lasting
success.
Roychoudhury et al. Functional restoration by gap arthroplasty in temporomandibular joint ankyloses.Oral surg oral med
oral pathol oral radiol endod 1999;87:166-9
Studies
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33. 1. Mérida-velasco JR et al. Development of the human temporomandibular joint. The anatomical record.1999
may 1;255(1):20-33.
2. Akama, M.K., Guthua, S., Chindia, M.L., Kahuho, S.K. Management of bilateral temporomandibular joint
ankylosis in children: case report. East Afr Med J. 2009;86:45–48.
3. Illustrated dental embryology, histology, and anatomy, bath-balogh and fehrenbach, 2011, page 266.
4. Malik, N.A. Textbook of oral and maxillofacial surgery. Jaypee Brothers Medical Publishers Ltd, New
Delhi; 2002:207–218.
5. Roychoudhury et al. Functional restoration by gap arthroplasty in temporomandibular joint ankyloses.Oral
surg oral med oral pathol oral radiol endod 1999;87:166-9
6. Xiang g et al. (2014) A retrospective study of temporomandibular joint ankylosis secondary to surgical
treatment of mandibular condylar fractures. Br J oral maxillofac surg 52: 270-274.
7. Madhumati.S. et al. CMJ ankylosis: management with reconstruction and interpositional arthroplasty. Int J
Oral Maxillofac Surg. 2015 oct-dec;24(4):374-9.
8. Khadka, A., Hu, J. Autogenous grafts for condylar reconstruction in treatment of CMJ ankylosis: current
concepts and considerations for the future. Int J Oral Maxillofac Surg. 2012;41:94–102.
9. Al-moraissi ea et al. A systematic review and meta-analysis of the clinical outcomes for various surgical
modalities in the management of temporomandibular joint ankylosis. Int J Oral Maxillofac Surg. 2015
apr;44(4):470-82.
10. Liu x et al. (2015) Effectiveness of different surgical modalities in the management of temporomandibular
joint ankylosis: a meta-analysis. Article · Literature Review in International Journal of Clinical and
Experimental Medicine 2015 Nov. 15;8(11):19831-9.
11. Https://clinicalgate.Com
References and Bibliography
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Working/rotating vs balancing side/orbiting side
Diathrosis..articulation that permits free movt..
This work establishes three phases in CMJ development: 1) the blastematic stage (weeks 7-8 of development); 2) the cavitation stage (weeks 9-11 of development); and 3) the maturation stage (after week 12 of development). This study identifies the critical period of CMJ morphogenesis as occurring between weeks 7 and 11 of development.
This is the last growth center of bone in the body and is multidirectional in its growth capacity, unlike a typical long bone. This area of cartilage within the bone grows in length by appositional growth as the individual grows to maturity.
Develops from 2 different blastemal condylar and temporal
Components of CMJ .Mandibular condyle, articular surface of the temporal bone, capsule, articular disc, ligamanet and muscles of mastication.
Articular surfaces lined by fibrocartilage
Upper compartment larger than the lower compartment …hinging movt lower and gliding upper compartment
Dissipation of the pressure
Articular disc…avascular in the centre and no sensory innervation
Triangular lig. Base at the zygomatic process of temporal bone and articular tubercle base at the lateral side of the neck of the mandible
a forward and downward sliding motion- translation
Translation..changes the axis of rotation
The resting position of the temporomandibular joint is not with the teeth biting together. Instead, the muscular balance and proprioceptive feedback allow a physiologic rest for the mandible, an interocclusal clearance or freeway space, which is 2 to 4 mm between the teeth.[2]
Decline..better understanding of management of condylar fractures..use of antibiotics..decline of otitis media
Pathologies among others ankyloses, dislocation, arthritis
True ankyloses Intra-capsular condition - fusion of the bony surfaces of the joint - the condyle and glenoid fossa.
Pseudo-ankylosis Mechanical interference - joint hypomobility and the joint is normal.
Fibrous ankylosis, coronoid hyperplasia or fusion of coronoid process with the tuberosity of maxilla or zygoma are examples of pseudoankylosis
Others malignancies, post surgery, post radiation, iatrogenic
Infections include NOMA;gangrenous stomatitis
Imaging modalities OPG or Lateral Cephalogram, transcranial , Reverse Townes views, CMJ tomograms,transpharyngeal …CT, and 3 D printing models.
MRI for joint derangement…articular disc
Is a serious and disabling condition in children
Aims..look from children vs adult perspective…for children restoring normal growth pattern is important.
Non surgical…physiotherapy
Condyles are not the primary determinants of the mandibular growth
Costochondral graft allows for growth of the ramus …= 1.5cm of costochondral bone rib 5-7 rib. Cosmetic surgery follows after completion of growth..complication…2nd surgery site, overgrowth..donor site complication,,,pneumothorax, pleuritic pain..
MIO= maximal interincisor opening CCG=costochondral graft, GA= gap arthroplasty . Alloplastic joint reconstruction =AJR costochondral joint= (CCJ)
International journal of oral and maxillofacial surgery..