Introduction:
Bone grafts are commonly used in oral and maxillofacial surgery, helping to restore missing bone structure and provide
osseous support. In spite of their reported success, complications can and do arise. Examples include loosening and
resorption of the graft, infection, and complete loss of the graft. These complications can potentially lead to larger
defects, necessitating additional procedures to correct the problem. This not only causes great discomfort to the patient,
but also drains considerable time and resources away from the clinician. Thus, improvements on identifying ways to
identify and prevent these complications are constantly being sought. We have performed a literature review and
identified several areas in the field of optics that could potentially help solve our problem.
Optical Techniques:
Raman spectroscopy has been shown to provide a transcutaneous measurement of bone mineral and matrix Raman
bands. This could potentially provide surgeons with the ability to more accurately assess bone graft osseointegration.
In-vivo near-infrared optical imaging could potentially provide accurate diagnosis of pathologic lesions such as
osteosarcoma. Contrast-enhanced ultrasound could be used to detect vascular disturbances and other information related
to the transplantation of osseous components.
Conclusion:
Bone graft complications can be one of the most devastating consequences of osseous surgery. As surgeons, we are
constantly searching for ways to identify them earlier and prevent them. We hope that by presenting areas that could be
used, we can gain a better insight to ways in which both fields can benefit.
Introduction: Radiofrequency ablation (RFA) refers to a high-frequency current that heats and coagulates tissue. In the
standard RFA setup, three components are used: a generator, an active electrode, and a dispersive electrode. RFA has
garnered support in many of the surgical fields as an alternative to traditional procedures used in tumor removal. Other
methods can prove to be more invasive and disfiguring to the patient, in addition to the unwarranted side effects;
however, RFA provides a more localized treatment, resulting in decreased co-morbidity to the patient. Currently, its use
in the field of oral and maxillofacial surgery is limited, as its technology has not reached our field. By describing its
limited use to the optics community, we hope to expand its uses and provide patients with one more alternative treatment
option.
Methods and Uses: We will describe the use of RFA on three types of pathology: lymphangioma,
rhabdomyoscarcoma, oral squamous cell carcinoma, and neoplastic osseous metastasis. The majority of treatments
geared towards these pathologies involve surgical resection, followed by reconstruction. However, damage to vital
structures coupled with esthetic disfigurement makes RFA a more valuable alternative. In many of the cases, the tumors
were successfully removed without recurrence.
Conclusion: While the use of RFA has been scarce in our field, we believe that with more exposure it can gain
momentum as an alternative to current treatment options. However, there are improvements that we feel can be made,
helping to maximize its effectiveness.
In recent years, advances in technology are propelling the field of oral and maxillofacial surgery into new realms. With a relatively thin alveolar mucosa overlying the underlying bone, significant diagnostic and therapeutic advantages are present; however, there remains an enormous gap between advancements in physics, in particular optics, and oral and maxillofacial surgery. Improvements in diagnosis, classification, and treatment of the various bone pathologies are still being sought after as advancements in technology continue to progress. Combining the clinical, histological, and pathological characteristics with these advancements, patients with debilitating pathologies may have more promising treatment options and prognosis. Defects in the facial bones, particularly in the jaws, may be due to a number of reasons: pathology, trauma, infections, congenital deformities, or simply due to atrophy. Bone grafting is commonly employed to correct such defects, and allows new bone formation through tissue regeneration. Growing use of dental implants has focused attention on osseointegration and its process. Osseointegration refers to the actual process of the direct contact between bone and implant, without an intervening soft tissue layer. The theories proposed regarding this process are many, yet a clear, unified stance on the actual process and its mechanisms has not emerged. Further investigation using optical probes could provide that unifying answer. The primary goal of this manuscript is to introduce pioneers in the field of optics to the field of oral and maxillofacial surgery. With a brief introduction into the procedures and techniques, we are hopeful to bridge the ever-widening gap between the clinical science and the basic sciences.
Introduction: In the field of oral and maxillofacial surgery, there are many applications for lasers and optics. The first part of this manuscript is to discuss laser therapy and garner suggestions on how it can be improved. The second part is to present a case in which complications of a bone graft delayed healing and a return to normalcy for the patient. It is the goal of this paper to utilize the new advancements in optics so that patient care can be improved. Laser Therapy: Laser ablation and low-level laser therapy have been used in a variety of joint adhesion cases, including arthritis of the hand and foot. In the field of oral and maxillofacial surgery, this method has been used to treat pain and mobility dysfunction in patients with temporomandibular joint disease. While the outcomes have been promising, lack of familiarity with the device or doubt about its effects have reduced its use. This reduction in use has left the actual process of laser therapy relatively unchanged. Case Presentation: A 28 year-old female presented for a mandibular resection due to an ossifying fibroma. In the next several months her reconstructed area displayed significant signs of infection, as well as graft failure. X-rays, unfortunately, did not display the actual metabolic activity. Although the patient was reconstructed successfully thereafter, with more advanced technology available the patient could have endured a more comfortable treatment. Conclusion: While there are many more areas of oral and maxillofacial surgery that could potentially benefit from advances in optical technology, we have chosen to highlight these two areas due to their prevalence within our community.
Introduction: In recent years, advances in technology are propelling the field of oral and maxillofacial surgery into new realms. With a relatively thin alveolar mucosa overlying the underlying bone, significant diagnostic and therapeutic advantages are present. However, there remains an enormous gap between advancements in physics, in particular optics, and oral and maxillofacial surgery.
Bone Pathology: Improvements in diagnosis, classification, and treatment of the various bone pathologies are still being sought after as advancements in technology continue to progress. Combining the clinical, histological, and pathological characteristics with these advancements, patients with debilitating pathologies may have more promising treatment options and prognosis.
Bone Grafting: Defects in the facial bones, in particular the jaws, may be due to a number of reasons: pathology, trauma, infections, congenital deformities, or simply due to atrophy. Bone grafting is commonly employed to correct such defects, and allows new bone formation through tissue regeneration.
Osseointegration: Growing use of dental implants has focused attention on osseointegration and its process. Osseointegration refers to the actual process of the direct contact between bone and implant, without an intervening soft tissue layer. The theories proposed regarding this process are many, yet there lacks a clear, unified stance on the actual process and its mechanisms. Further investigation using optical probes could provide that unifying answer.
Conclusion: The primary goal of this lecture is to introduce pioneers in the field of optics to the field of oral and maxillofacial surgery. With a brief introduction into the procedures and techniques, we are hopeful to bridge the ever-widening gap between the clinical science and the basic sciences.
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