Download ACOFS Vol II Issue I [Full Text]
Table of Content
(March-May 2014)
Editorial
CRANIOFACIAL TRANSPLANTATION “An Enigma Turned Reality”:PART I
Mohammad Akheel
Mohammad Akheel
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FACE IS A CRITICAL COMPONENT OF AN INDIVIDUAL’S IDENTITY
Craniofacial transplantation represents a paradigm shift in maxillofacial reconstructive surgery. Face is the expression of mind and represents the most important part of the body. Maxillofacial reconstructive surgeons restore, rebuild and make those parts which nature has given but which have been taken away by the fortune. Face reconstruction is usually done for congenital, developmental, traumatic, neoplasms and post ablative surgical defects. At this time reconstructive efforts could only make use of those various body parts in the form of flaps and grafts. Though facial transplantation was once an enigma but it has become a reality from last decade and becoming a boom with latest advancements in Imaging and microvascular surgical techniques. The advent of facial transplantation eliminates donor site limitations and introduces the prospect of restoring injured anatomy by replacing it with an ideal part from a donor. We must consider the best existing imaging techniques and synthesize them into novel way of looking at patients.
The face is a nothing but a soft tissue envelope of the facial skeleton. Any change in the architecture will cause facial disharmony. Facial transplantation may or may not include skeletal elements being transferred; the craniofacial skeleton must be precisely understood for its contours and irregularities with appropriate imaging modality. 3D Computed Tomography(CT) Imaging offers a good modality of the choice. This can also offer a virtual view of a patient’s skin by setting windows of soft tissue density display instead of bone density display. Accurate models can be obtained with commercially available hardware and software and most popular method is stereophotogrammetry and rapid prototyping. 3D CT angiography has been validated in accurately predicting the perforators and their location when there is a need in complex facial reconstruction. The nerves that provide sensory and motor supply to the facial tissues must also be accounted for in designing the optimal face transplant. Looking at these presently available Imaging modalities, it is clear that we can image the majority of the tissues essential for successful facial transplantation with a great degree of consistency and detail to restore the micro and macro esthetics of face. These Imaging requirements are essential to include include mock surgery with patient-specific anatomy instead of cadavers, prefabrication and planning of osteotomy, plates and bone graft templates, and simulation of ideal donor anatomy for a given recipient’s defect simultaneously accounting for relationships between bone, vasculature, nerve and soft-tissue envelope.
The human face is a complex organ tasked with supporting nutrition, respiration, sensation and communication. Facial transplantation is a tremendous exiting procedure with the potential to reverse once-irreparable/irreversible facial defect. It is incumbent upon the maxillofacial reconstructive surgeon to intimately know his patient’s face from every perspective before he embarks upon its restoration. The methods described here may serve as a first step in this direction and the surgical technique will be discussed in the PART II of the article.
Key words: Face,Craniofacial Transplantation
How to cite this Article:Mohammad A,Craniofacial Transplantation,“An Enigma Turned Reality”:Part I.Arch CranOroFac Sc 2014;2(1):93.
Source of Support: Nil
Conflict of Interest:No
Craniofacial transplantation represents a paradigm shift in maxillofacial reconstructive surgery. Face is the expression of mind and represents the most important part of the body. Maxillofacial reconstructive surgeons restore, rebuild and make those parts which nature has given but which have been taken away by the fortune. Face reconstruction is usually done for congenital, developmental, traumatic, neoplasms and post ablative surgical defects. At this time reconstructive efforts could only make use of those various body parts in the form of flaps and grafts. Though facial transplantation was once an enigma but it has become a reality from last decade and becoming a boom with latest advancements in Imaging and microvascular surgical techniques. The advent of facial transplantation eliminates donor site limitations and introduces the prospect of restoring injured anatomy by replacing it with an ideal part from a donor. We must consider the best existing imaging techniques and synthesize them into novel way of looking at patients.
The face is a nothing but a soft tissue envelope of the facial skeleton. Any change in the architecture will cause facial disharmony. Facial transplantation may or may not include skeletal elements being transferred; the craniofacial skeleton must be precisely understood for its contours and irregularities with appropriate imaging modality. 3D Computed Tomography(CT) Imaging offers a good modality of the choice. This can also offer a virtual view of a patient’s skin by setting windows of soft tissue density display instead of bone density display. Accurate models can be obtained with commercially available hardware and software and most popular method is stereophotogrammetry and rapid prototyping. 3D CT angiography has been validated in accurately predicting the perforators and their location when there is a need in complex facial reconstruction. The nerves that provide sensory and motor supply to the facial tissues must also be accounted for in designing the optimal face transplant. Looking at these presently available Imaging modalities, it is clear that we can image the majority of the tissues essential for successful facial transplantation with a great degree of consistency and detail to restore the micro and macro esthetics of face. These Imaging requirements are essential to include include mock surgery with patient-specific anatomy instead of cadavers, prefabrication and planning of osteotomy, plates and bone graft templates, and simulation of ideal donor anatomy for a given recipient’s defect simultaneously accounting for relationships between bone, vasculature, nerve and soft-tissue envelope.
The human face is a complex organ tasked with supporting nutrition, respiration, sensation and communication. Facial transplantation is a tremendous exiting procedure with the potential to reverse once-irreparable/irreversible facial defect. It is incumbent upon the maxillofacial reconstructive surgeon to intimately know his patient’s face from every perspective before he embarks upon its restoration. The methods described here may serve as a first step in this direction and the surgical technique will be discussed in the PART II of the article.
Key words: Face,Craniofacial Transplantation
How to cite this Article:Mohammad A,Craniofacial Transplantation,“An Enigma Turned Reality”:Part I.Arch CranOroFac Sc 2014;2(1):93.
Source of Support: Nil
Conflict of Interest:No
Case Study
Evaluation of Root Resorption, Pulp Vitality, Canine Retraction and Anchorage loss after Dentoalveolar Distraction: A Radiographic and Model Study.
Swati S. Acharya, M.K.Karthikeyan, Satyabrata Patnaik, Dhyan Chand Murmur, Abhishek Pati, Mohammad Akheel
Swati S. Acharya, M.K.Karthikeyan, Satyabrata Patnaik, Dhyan Chand Murmur, Abhishek Pati, Mohammad Akheel
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ABSTRACT
Introduction: Canine retraction through dentoalveolar distraction osteogenesis was introduced to reduce the overall orthodontic treatment period. The amount of canine retraction, root resorption, pulp vitality and anchorage loss after dentoalveolar distraction were evaluated.
Material:The study sample consisted of 20 maxillary canines in 10 adult patients with mean age, 19.53 years. First bicuspids were extracted, the distraction surgical procedure was performed, and a rigid, custom made , intraoral distractor was placed. The cuspids were moved into the extraction sites in 7 to 13 days, at a rate of 1.0 mm per day.
Results:Complete retraction of canines was achieved in a mean time of 9.23 days with minimal anchorage loss. There was insignificant molar intrusion or extrusion with decreased overjet. No radiographic and clinical evidence of complications such as mucosal lacerations, dehiscence of soft tissues, root resorption and periodontal problems were encountered.
Conclusion:There was minimal root resorption , anchorage loss and the distracted canines preserved their pulp vitality at the end of dentoalveolar distraction.
Key words: Dentoalveolar distraction , Canine retraction , Rigid distraction device.
How to cite this Article: Acharya SS,Karthikeyan MK,Patnaik S,Murmur DC,Pati A,Akheel M.Evaluation of Root Resorption, Pulp Vitality, Canine Retraction and Anchorage loss after Dentoalveolar Distraction: A Radiographic and Model Study.Arch CranOroFac Sc 2014;2(1):94-99
Source of Support: Nil
Conflict of Interest:No
Introduction: Canine retraction through dentoalveolar distraction osteogenesis was introduced to reduce the overall orthodontic treatment period. The amount of canine retraction, root resorption, pulp vitality and anchorage loss after dentoalveolar distraction were evaluated.
Material:The study sample consisted of 20 maxillary canines in 10 adult patients with mean age, 19.53 years. First bicuspids were extracted, the distraction surgical procedure was performed, and a rigid, custom made , intraoral distractor was placed. The cuspids were moved into the extraction sites in 7 to 13 days, at a rate of 1.0 mm per day.
Results:Complete retraction of canines was achieved in a mean time of 9.23 days with minimal anchorage loss. There was insignificant molar intrusion or extrusion with decreased overjet. No radiographic and clinical evidence of complications such as mucosal lacerations, dehiscence of soft tissues, root resorption and periodontal problems were encountered.
Conclusion:There was minimal root resorption , anchorage loss and the distracted canines preserved their pulp vitality at the end of dentoalveolar distraction.
Key words: Dentoalveolar distraction , Canine retraction , Rigid distraction device.
How to cite this Article: Acharya SS,Karthikeyan MK,Patnaik S,Murmur DC,Pati A,Akheel M.Evaluation of Root Resorption, Pulp Vitality, Canine Retraction and Anchorage loss after Dentoalveolar Distraction: A Radiographic and Model Study.Arch CranOroFac Sc 2014;2(1):94-99
Source of Support: Nil
Conflict of Interest:No
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Original Article
The Kansal Separator: In Search of "A Better Mouse Trap"*
Arthur Wilcock, Sudhanshu Kansal, Gurkeerat Singh, Pradeep Raghav, Piush Kumar, Arun Kumar
Arthur Wilcock, Sudhanshu Kansal, Gurkeerat Singh, Pradeep Raghav, Piush Kumar, Arun Kumar
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ABSTRACT
Separation of teeth for the purpose of banding is a common orthodontic procedure. A variety of separators are available in the market all with their different advantages and disadvantages. Kansal separator has prove to be an invaluable aid in achieving the separation of teeth with a minimal inherent disadvantage. The authors now describe the separator and the possible adjustments in the spring assembly to enhance its usage in clinical scenario. Also explained is the placement and removal of the Kansal separator.
Keywords: Kansal Separator, Molar Separation.
How to cite this Article: Wilcock A, Kansal S, Singh G, Raghav P, Kumar P, Kumar A.The Kansal Separator: In Search of "A Better Mouse Trap"Arch CranOroFac Sc 2014;2(1):100-103.
Source of Support: Nil.
Conflict of Interest:Dr. Sudhanshu Kansal is the innovator of Kansal Separator. He owns the Intellectual Property (IP) Rights and has financial and professional interest.
Separation of teeth for the purpose of banding is a common orthodontic procedure. A variety of separators are available in the market all with their different advantages and disadvantages. Kansal separator has prove to be an invaluable aid in achieving the separation of teeth with a minimal inherent disadvantage. The authors now describe the separator and the possible adjustments in the spring assembly to enhance its usage in clinical scenario. Also explained is the placement and removal of the Kansal separator.
Keywords: Kansal Separator, Molar Separation.
How to cite this Article: Wilcock A, Kansal S, Singh G, Raghav P, Kumar P, Kumar A.The Kansal Separator: In Search of "A Better Mouse Trap"Arch CranOroFac Sc 2014;2(1):100-103.
Source of Support: Nil.
Conflict of Interest:Dr. Sudhanshu Kansal is the innovator of Kansal Separator. He owns the Intellectual Property (IP) Rights and has financial and professional interest.
Case Report
Diode Laser as a Treatment for Oral Submucous Fibrosis- A Case Report
Ramanupam Tripathy , Satyabrata Patnaik, Swati S. Acharya , Mohammad Akheel
Ramanupam Tripathy , Satyabrata Patnaik, Swati S. Acharya , Mohammad Akheel
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ABSTRACT
Introduction: Oral submucous fibrosis is a chronic debilitating disease of the oral cavity characterized by inflammation and progressive fibrosis of the submucosal tissues leading to restricted mouth opening. The most common surgical procedure is excision of the fibrotic bands. Due to limited range of mouth opening bleeding during the procedure increases lack of accessibility and visibility. Diode Laser has proved to overcome these problems than any other conventional procedures.
Method: Treatment started following preoperative evaluation and review of the initial histopathological diagnosis. The excision of the bands using diode laser 5 W per square centimeter renders a definitive tool for the procedure .
Results: There was minimal bleeding, postoperative pain, swelling and discomfort.
Conclusion: This case report illustrates the usefulness of diode laser giving a hemostatic effect and thus proves suitable for the surgical treatment of oral submucous fibrosis.
Keywords: Oral Submucous Fibrosis, Diode laser, Fibrotic Bands, Hemostatic
How to cite this Article: Tripathy R, Patnaik S, Acharya SA, Akheel M, Diode Laser as a Treatment for Oral Submucous Fibrosis- A Case Report .Arch CranOroFac Sc 2014;2(1):104-106
Source of Support: Nil
Conflict of Interest:No
Ethical Clearance: Cleared
Introduction: Oral submucous fibrosis is a chronic debilitating disease of the oral cavity characterized by inflammation and progressive fibrosis of the submucosal tissues leading to restricted mouth opening. The most common surgical procedure is excision of the fibrotic bands. Due to limited range of mouth opening bleeding during the procedure increases lack of accessibility and visibility. Diode Laser has proved to overcome these problems than any other conventional procedures.
Method: Treatment started following preoperative evaluation and review of the initial histopathological diagnosis. The excision of the bands using diode laser 5 W per square centimeter renders a definitive tool for the procedure .
Results: There was minimal bleeding, postoperative pain, swelling and discomfort.
Conclusion: This case report illustrates the usefulness of diode laser giving a hemostatic effect and thus proves suitable for the surgical treatment of oral submucous fibrosis.
Keywords: Oral Submucous Fibrosis, Diode laser, Fibrotic Bands, Hemostatic
How to cite this Article: Tripathy R, Patnaik S, Acharya SA, Akheel M, Diode Laser as a Treatment for Oral Submucous Fibrosis- A Case Report .Arch CranOroFac Sc 2014;2(1):104-106
Source of Support: Nil
Conflict of Interest:No
Ethical Clearance: Cleared
