Abstract:

Craniofacial skeletal surgery continues to command special interest from patients and clinicians dealing with skeletal defects. Autologous bone grafts remain the standard treatment by which bone substitutes are compared. A continued interest in avoiding donor sites and realizing "off the shelf convenience" has fostered the use of biomaterial bone substitutes. The first generation of implant materials used for cranial reconstruction were not specifically designed for biomedical applications. Methylmethacrylate was adopted for cranial applications after use in implant fixation for hip arthroplasty by Charnley, The development of this material did not employ sophisticated implant evaluation and mainly focused on standard mechanical properties demonstrated on the benchtop.

Authors:

Matthew Songer, M.D. - Marquette, Mich.

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Abstract:

Use of biomaterials as an implant device for TMJ joint reconstruction in oral maxillofacial surgery has been an ever-increasing dilemma for the oral maxillofacial surgeon. The decision to choose the best procedure and device/material in providing longevity wirh satisfaction to the patient has become a demanding factor. Maxillofacial surgeons are faced with a "young age" patient population and are in a continual struggle to find the proper device to maintain long-term survivorship without recurrent multiple operations. This multiple operation(s) factor can cause a further complication in itself, and also reduce the survivorship of implant devices. There has been a steady decrease in recent years in the number of TMJ surgical procedures performed by accredited OMS residency training programs; this may be due to the many short-term survivorship failures with certain alloplastic devices (Proplast/Teflon and Silastic) as well as the short-term survivorship of autologous tissue implants (Fascia and Grafts) and the added factor of enhanced complications with multiple surgeries. So the question asked by many oral maxillofacial surgeons is: what other procedure or biomaterial/device, if any, is available to avert the ever-present TMJ disease process and disorder?

Authors:

Albert L. Lippincott III, B.S.E. - Engineering Consulting Services, Inc. Prior Lake, Minn.; Donald C. Chase, D.D.S. - University of Tennessee Medical Center and Graduate School of Medicine, Knoxville, Tenn.; Robert W. Christensen, D.D.S. - College of Engineering and Science, Clemson, South Carolina

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Abstract:

For the last 13 years we have been using the CO2 laser ray in plastic surgery, indicating it strictly in cases of restorative surgery of cavernous hemangiomas and eventually in benign dermatologic lesions. With the advent of new laser technologies, its indication extended to the resurfacing field, where results depend on patient selectivity. In our experience, we noticed that the CO2 laser rays had poor results in attempts to remove tattooing and in incisions of skin and mucosa. Four years ago, we experimented with the radiofrequency equipment, whose mechanism of action in the tissues is very similar to that of the CO2 laser rays (cellular volatilization). Following experimental studies in rats and human skin, we began to employ radiosugery in daily clinical practice.

Authors:

Aymar E. Sperli, M.D. - Medical School Santa Casa de São Paulo, São Paulo, Brazil

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Abstract:

Vertical mammaplasty is among a group of mammaplasty procedures designed to minimize the extent of skin excision, and thus the potential for aesthetically unpleasing scars. However, these less traditional techniques have not enjoyed the same usage as classic inverted-mammaplasties, and thus the accumulated experience in these techniques is less. Vertical mammaplasty can yield excellent results when applied appropriately, but the learning curve can be significant. Details of operative technique are presented along with potential compfications, with the objective of maximizing the safety and outcome of vertical mammaplasty.

Authors:

Richard J. Restifo, M.D.; Wendy Gottlieb, M.D.; Barbara A. Ward, M.D. - Yale University School of Medicine, New Haven, Conn.; Janice F. Lalikos, M.D. - East Carolina University School of Medicine, Greenville, N.C.

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