FACE AHEAD 2022 Abstracts Supplement

Abstract

Objectives: Virtual 3D planning of orthognathic surgery has become the gold standard of modern orthognathic surgery, but questions about precision remain crucial. The objective of the study was to evaluate precision of the digital 3D orthognathic surgery plan for bimaxillary surgery compared to the actual surgical outcome in all three dimensions. Materials and Methods: 30 patients were involved in the present study (11 male; 19 females; average age 23.7 years). 24 patients were Class III and 6 were Class II. The preoperative and postoperative CBCT after bimaxilary surgery of each patient was superimposed. Eleven dental and skeletal points were used for comparisonbetweentherealanddigitaloutcomeinallthreeplanes. Results: In our study, average measurement values for all points were less than 2 mm. After further scrutiny of cases with larger discrepancies it was discovered that those cases were planned without “ piggy-back ” fi nal occlusion de fi nition method. In ad-dition, these cases had pronounced facial asymmetry and occlusal Conclusion: Method of surgical outcome precision analysis presented in this paper provides better insight about discrepancies that may arise from virtual plan to surgical outcome. The results indicate that 3D digital planning of orthodontic surgery, if transferred appropriately, is an accurate assessment of the surgical outcome and there is no clinically signi fi cant difference between the planned and actual position. More improvements and innovations in virtual planning software could further improve surgical outcome precision. AbstractObjectives: Nowadays, one of the most used technologies are using digital assistance such as surgical guides or based on stereolithography. The purpose of this study is to evaluate the advantages of using the digital technology in repairing complex defects of the mandible. Material and Methods: The study was performed on a group of 16 patients with mandible defects following tumor pathology. To reconstruct the defect, using a digital technique, we made preoperatory the surgical guides in 3 cases and, based on the stereolithic printed model, titanium plates were preoperatively shaped in 13 cases. Results: The mandible bone contours were adequately reconstructed with satisfactory restoration of the shape. The complexity and duration of the surgery were decreased, and the precision of the reconstruction was greatly increased. Conclusion: The use of digital assistance methods as an aid to repairing defects located on the mandible is more ef fi cient, implying shorter surgery time, fewer postoperative complications, and also a lower stress level of the surgeons. AbstractObjectives: Bony orbits have usually quite symmetrical volume and surface anatomy of unaffected orbit has been used as a reference in surgical planning of orbital fracture reconstruction. Little is known about the changes in orbit volume and shape symmetry with increasing age. Purpose of this study was to study whether age has an in fl uence in symmetry of bony orbit volume and / or shape. Main hypothesis was that aging would increase the asymmetry in orbital volume and shape. Materials and Methods: Computed tomography (CT) images patients with isolated mandibular trauma without midfacial fractures or notable congenital or acquired facial asymmetry were identi fi ed for this study. Orbital volume was measured using automatic segmentation and volume asymmetry Results: CT images of 83 subjects (46 male, 37 female, mean age 44.1 y (18.1 – 86.33 y) were analyzed for this study. Mean orbital volume vas 27.8 (27.0-28.5 95%CI) / 27.8 (27.1-28.5 95%CI) ml (left/right) and mean volume difference was 0.54 ml (0.44-0.63 95%CI). When assessing shape asymmetrymean 50 th percentile Hausdorff distance was 0.29 mm and mean 95 th percentile Hausdorff distance was 0.89 mm. Orbital volume difference or shape asymmetry were not correlated with age, while orbital volume showed a weak correlation with increasing age (0.26, p = 0.017). Conclusion: These results suggest that bony orbits are quite symmetrical both in volume and shape and that this symmetry seems to be quite constant during aging. Mirrored version of an orbit can therefore be used as a relatively accurate estimate of preinjury anatomy in unilateral injuries. Abstract Class III malocclusion is a heterogeneous dentofacial phenotype characterized by overgrowthofthejaw, maxillary de fi ciency, ora combination of both and can occur either as part of a syndrome or inisolation.Orthognathic surgery hasproven to be an effective treatment for class III skeletal malocclusion. In Chile, the prevalenceoftotal edentulism is 17.6%,soit isnot surprisingthat there is a population of edentulous patients who are candidates for orthognathic surgery. In these patients, the traditional treatment protocol involvesthe use ofa Gunning splint, which isused as the intermediate and / or fi nal splint. These appliances are often not reliably fi xed and even if these splints are screwed in, the predictability and precision of surgery is believed to be reduced compared to dentate patients. It is in this regard that digital surgical planning has been a fundamental tool to diagnose and treat dentofacial deformities in a stable and predictable way, and even more so in edentulous patients. To achieve satisfactory results, both from an aesthetic and functional point of view, it is essential to transfer the pre-surgical planning to the intraoperative with a high degree of precision. In recent years there have been numerous case reports of edentulous patients undergoing splintless orthognathic surgery with prefabricated osteotomy and osteosynthesis guides. However, one of the disadvantages of this type of surgery is its high cost. In this work we present a complex case of an edentulous patient with a class III dentofacial deformity. CAD / CAM and digital surgical planning softwarewere used to plan splintless orthognathic surgery and immediate in-stallation of osseointegrated implants at a low cost to the patient. Abstract Objectives: Our goal was to evaluate a transgenic mouse strain in which Wnt/ β -catenin signaling is constitutively activated in mature osteoblasts e.g., Da β cat Ot mice to determine if their CMF skeletons phenocopied CDD patients. Unique facial features typically guide clinicians to a diagnosis in cases of genetic syndromes that affect the craniomaxillofacial (CMF) skeleton. For example, patients with craniotubular disorders including van Buchem disease, craniometaphyseal dysplasia (CMD) and craniodiaphyseal Da β cat Ot CMF skeleton. We conclude that constitutive elevation in Wnt/ β -catenin signaling causes hyperostotic CMF bone phenotypes reminiscent of human CDD. AbstractObjectives: Our aim was to clarify how the oral carcinoma patients ended up in treatment. Materials and Methods: Patients evaluated for primary oral epidermoid carcinoma in the Head and Neck Centre, Helsinki University Hospital, Helsinki, Finland January 1, 2016 to the thirty- fi rst of August 2020 were included in this study. Patients who had tumor detection in connection with oral/dental routine control or incidentally were compared with patients seeking treatment due to symptoms. Results: A total of 480 patients were included in the study. The referral to the Head and Neck Centre, Helsinki University Hospital had been made by dentists (37.5%), phy-sicians (34.2%), and maxillofacial surgeons (28.1%). The patients who sought treatment were signi fi cantly more often smokers (p = 0.010), that had more often T3 (p = 0.005) or stage III (p = 0.010) carcinomas, patients lived at home (p = 0.014), symptoms were ulcer (p < 0.001) and/or other resis-tance (p = 0.007) and/or pain (p < 0.001). The current patients were signi fi cantly less likely to have T1 (p < 0.001) or stage I (p < 0.001) carcinomas, lymph node metastases (p = 0.008), patients that had monitored for mucosal changes (p < 0.001), patients lived at nursing home (p = 0.006). Conclusion: Primary oral carcinoma can be detected at early stage by routine oral examination. Dentists are in main role for detecting these tumors. Oral examination by other healthcare professionals in connection with health care contacts could improve early detection of oral malignancy. Abstract Ewing sarcoma (ES) is an uncommon malignancy of the maxillofacial region, primarily affecting the long bones and pelvis of the paediatric population. Within the head and neck, the facial skeleton is responsible for the majority of reported cases. ES poses a challenge to Oral and Maxillofacial Surgeons due to its rarity and its aggressive nature. This case report is of a 35-year-old female with primary ES in the buccal soft tissues – the fi rst reported case of its kind. Objectives: The authors aim to elucidate the prevalence of ES affective the facial soft tissues, as well as the literature surrounding the best available evidence regarding its treatment. Materials and Methods: Case report. Results: Case report. Conclusion: A unique case of a buccal soft tissue Ewing sarcoma in an adult female is presented, which has not been previously reported in the literature. Many different lesions affect the soft tissues of the maxillofacial region but the rarity and lack of published literature regarding ES in the facial soft tissues represents a diagnostic and therapeutic challenge. This report demonstrates that although rarely encountered, ES and other round cell tumours of the face should be considered. A multidisciplinary treatment approach and close surveillance for recurrence is essential for its successful management. AbstractObjectives: Oral squamous cell carcinoma (OSCC) is a common malignancy that involves head and neck areas. Chronic treatment with immunosuppressive agents has been associated with an increased risk for developing different types of cancer, including OSCC, that often display additional aggressiveness characteristics, such as poor differentiation or lymphatic invasion. The a