conference program - ADT Foundation [PDF]

International Conference

CONFERENCE PROGRAM

With generous financial support from our Conference Sponsors

Nobel Biocare

Stryker Maxillofacial

Straumann

Synthes

Digital precision for all indications.

Prosthetic-driven planning optimizes biomechanics, functionality and esthetic outcome.

Anchor pins secure the surgical template for safe and predictable implant treatment.

All components are engineered to work together and delivered ready-to-use from a single source.

NEW

© Nobel Biocare Services AG, 2011. All rights reserved. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare.

NobelGuide

TM

Next generation NobelClinician Software

NobelGuide is a complete treatment concept for diagnostics, prostheticdriven planning and guided implant surgery for all indications – from single missing tooth to fully edentulous jaws, using flapless, mini-flap and/or open flap approaches, even in combination with bone grafting. In the NobelClinician Software,

Implant treatment is planned virtually in easy-to-use NobelClinician Software with intuitive user interface.

implant treatment is planned virtually to optimize biomechanics, functionality and esthetic outcome. After planning, a surgical template and all necessary surgical and prosthetic components for ensuring safe site preparation and controlled placement of the implants, are ordered online. Prior to surgery, a physical master cast can also be

ordered for prefabricating a provisional prosthesis. Nobel Biocare is the world leader in innovative and evidence-based dental solutions. For more information, contact a Nobel Biocare Representative at 02 21/500 85-590 or visit our website www.nobelbiocare.com

Nobel Biocare Deutschland GmbH, Stolberger Straße 200, 50933 Köln, DEUTSCHLAND, Tel.: +49 221 500 85 0, Fax: +49 221 500 85 333, E-Mail: [email protected] Disclaimer: Some products may not be regulatory cleared/released for sale in all markets. Please contact the local Nobel Biocare sales office for current product assortment and availability.

Preshaped to the mandibular anatomy. MatrixMANDIBLE Preformed Reconstruction Plates.

Preformed plates approximating the anatomy of the mandible – Minimizes stress in the plate resulting in increased fatigue strength – Reduces OR time

Sizes cover 2/3 of the mandible circumference – Addresses the majority of tumor resections

Available in 3 sizes: small, medium, large – Addresses the anatomy of the majority of mandibles* *Data on file at Synthes

For further information please contact your local Synthes representative: www.synthes.com

elite 3dMD engineering reflects

superior 3D precision

3D Image Fusion

Quantifying Outcomes

3dMD provides high-precision, ultra-fast 3D surface imaging systems and 3D multi-modal simulation software for patient measurement, evaluation, treatment planning, surgical simulation, progress monitoring, outcome quantification, and now sophisticated airway analysis. The 3dMD™ Systems are the most widely used high-precision 3D photography device in practices, hospitals and teaching institutions worldwide with an outstanding reputation for accuracy and dependability. Registering one-toone with the CT/CBCT, the 3dMD image corrects CBCT surface artifacts caused by patient movement; compensates for soft tissue compression from stabilization aids; eliminates soft tissue draping (supine); supplements missing anatomical data (i.e. nose), and documents natural head position. 3dMD’s software supports a new generation of treatment tools that simulate hard and soft tissue outcomes using the patient’s fused image (CT/CBCT/ 3dMD/digitized dental model) as the foundation. Developed with a network of world respected surgeons, cleft teams, and radiologists, 3dMDvultus™ software is an easy-to-use, functionallyrich 3D patient treatment software built on an industrial-strength communication platform.

3dMDcranial™ System 3dMDface™ System

1,000-plus 3D Cameras Worldwide

Airway Volume Calculation

3D Analysis

• Addenbrooke’s Hospital, Cambridge, UK • The Royal Surrey Hospital, UK • Hôpital Pitié Salpêtrière, Paris • University of Pittsburgh • Universität Würzburg, DE • Childrens Hospital Los Angeles • Seattle Children’s Hospital • University of California, Los Angeles • University of North Carolina, Chapel Hill • UMC St Radboud Nijmegen, NL • Morriston Hospital Swansea, UK • Hospital for Sick Children, Toronto • Cincinnati Children’s Hospital • University of Alabama at Birmingham • University of Illinois at Chicago • Stephen Schendel, DDS MD, USA • UniversitätsSpital Zürich, CH • Children’s National Medical Center, USA • Royal Children’s Hospital, Melbourne • Children’s Hospital Boston/Harvard • British Columbia Children’s Hospital • Universität Tübingen, DE • National Institutes of Health (NIDCR), USA • Cranial Technologies Inc, USA • MD Anderson Cancer Center • Arkansas Children’s Hospital • Johns Hopkins Medical Institute • Lancaster Cleft Palate Clinic • Kennemer Gasthuis, NL • National Naval Medical Center, USA • CS Mott Children’s Medical Center • Princess Margaret Hospital, Perth, AUS • North Thames Cleft Centre/GOSH & Broomfield, UK • Guy’s Hospital, UK • US Air Force/Wilford Hall Medical Center • Hôpital D’Enfants Armand-Trousseau, Paris • University of Michigan • Osaka University, JP • University of Texas Health Science Center, Houston • Universitätsklinikum Freiburg, DE • Children’s Hospital of Zhejiang University, CN • Children’s Memorial Hospital, Chicago • Shanghai Ninth Hospital • Universität Bern, Zahnmedizinische Kliniken, CH • Queen’s Medical Centre, Nottingham, UK • Children’s Hospital at Westmead, AUS • University of Iowa • Chang Gung Memorial Hospital

www.3dMD.com

Americas/Asia/Australia: +1 770 612 8002 Europe: +44 (0) 1483 685660

Table of Contents Welcome Letters

9

Conference Sponsors/Exhibitors

16

Supporting Organizations/Institutions

18

Program Committees

19

Conference Venue

21

Social Activities

22

ADT After work Party Concert

23

Guest Activities

25

Session Chairs

27

Program Schedule

28

Featured Speakers

40

Abstracts

54



Oral Program:



Friday

54



Saturday

98



Sunday



134

Poster Session:



Friday

146

Workshops

183

Index By Author

187

Exhibitor Contact Information

189

4

Materialise CMF Solutions

Surgery planning software* Patient-specific surgical guides* Anatomical models Anaplastology solutions * Through our ProPlan CMF platform in an exclusive partnership with

www.materialise.com/CMF

Minimal Approach – Maximum Quality

ZMKG 7/E/09/10/A

Endoscopes and Instruments for TMJ Arthroscopy

KARL STORZ GmbH & Co. KG, Mittelstraße 8, D-78532 Tuttlingen/Germany, Phone: +49 (0)7461 708-0, Fax: +49 (0)7461 708-105, E-Mail: [email protected] KARL STORZ Endoscopy America, Inc, 2151 E. Grand Avenue, El Segundo, CA 90245-5017, USA, Phone: +1 424 218-8100, Fax: +1 800 321-1304, E-Mail: [email protected] KARL STORZ Endoscopia Latino-America, 815 N. W. 57 Av., Suite No. 480, Miami, FL 33126-2042, USA, Phone: +1 305 262-8980, Fax: +1 305 262-89 86, E-Mail: [email protected] KARL STORZ Endoscopy Canada Ltd., 2345 Argentia Road, Suite 100, Mississauga, Ontario L5N 8K4, Phone: +1 905 816-8100, Fax: +1 905 858-0933, E-Mail: [email protected] www.karlstorz.com

WELCOME TO THE 3rd DIMENSION! WITH GALILEOS.

B-386-76-V0

CAD / CAM SYSTEMS I INSTRUMENTS | HYGIENE SYSTEMS | TREATMENT CENTERS | IMAGING SYSTEMS

One scan for every purpose. Outstanding diagnostics. Integrated workflow. As verified by numerous studies, Sirona 3D imaging is setting new standards in the dental practice with a volume that is fully diagnosable for dental purposes at the lowest radiation dose. Implantologists, oral/maxillofacial surgeons and orthodontists all profit from the perfect display of any view, including 3D, panoramic, CEPH, TSA and highresolution details. The unique, intuitive software guides the user from the 3D scan through the diagnosis and on to implant planning, which is directly connected to surgical guide production – all accomplished in a single user interface. Additionally, DICOM exports to third-party software programs are easy and effi cient. All in all, GALILEOS is introducing a new dimension in diagnostic certainty and treatment quality! It will be a great day. With Sirona. www.sirona.com

B-386-76-V0_7.25x4.5.indd 1

21.03.11 14:01

Welcome Letter Ladies and Gentlemen,

Im Namen der Stadt Freiburg heiße ich alle Teilnehmerinnen und Teilnehmer sowie Referenten und Gäste der 4. Internationalen Konferenz für Advanced Digital Technology in Head and Neck Reconstruction vom 5. bis 8. Mai 2011 im Freiburger Konzerthaus herzlich willkommen. Stadt und Bürgerschaft freuen sich, Gastgeberstadt dieser hochrangigen wissenschaftlichen Tagung sein zu dürfen. Sie unterstreicht einmal mehr den besonderen Rang von Freiburg als international renommiertes Zentrum medizinischer Lehre und Forschung. Die medizinische Wissenschaft ist seit Gründung der Universität im Jahr 1457 in Freiburg zu Hause; heute ist Freiburg Sitz einer der größten deutschen Universitätskliniken mit einer wissenschaftlichen Ausstrahlung und einem exzellenten Ruf weit über die Grenzen des Landes hinaus. Im Mittelpunkt dieser Konferenz steht eine Sparte der medizinischen Wissenschaft, die vielen Menschen nach Unfällen, Verletzungen oder bei schweren Erkrankungen wieder Lebensmut und Lebensqualität geben kann. Das Gesicht gibt einem Menschen unverwechselbare Individualität. Es drückt Empfindungen aus und lässt uns neben der Sprache mit anderen kommunizieren. Heute erlauben es neue Verfahren, Techniken und Materialien der plastischen Chirurgie, nach schlimmen Verletzungen den Menschen wieder Ausdruck, Sprache und Kommunikation zu geben, damit sie wieder selbstbewusst und selbstbestimmt am Leben teilnehmen können. Dieser interdisziplinäre Grenzbereich zwischen Chirurgie, Biotechnologie und Informationstechnologie profitiert von Forschungsergebnissen, die den Patientinnen und Patienten unmittelbar zugute kommen. Nirgendwo sind der regelmäßige Erfahrungsaustausch und das Wissen um neue Techniken, Verfahren und Therapien so sehr von Bedeutung wie in der medizinischen Praxis. Sie sind neben der praktischen Anwendung gleichzeitig wichtige Transmissionsriemen für Innovationen. Im Namen der Stadt und der Freiburger Bürgerschaft wünsche ich allen Teilnehmerinnen und Teilnehmern einen angenehmen und anregenden Aufenthalt in Freiburg mit vielen interessanten Begegnungen!

Mayor of Freiburg, Dr. Dieter Salomon

9

Welcome Letter Ladies and Gentlemen,

It gives me great pleasure to welcome you to the University of Freiburg. As rector I am delighted that the university town Freiburg has been chosen to host the International Conference on Advanced Digital Technology in Head and Neck Reconstruction for the first time ever in Germany. Four years ago the University of Freiburg celebrated the 550th anniversary of its founding. True to its identity as a 21st century comprehensive university, the University of Freiburg unites the entire spectrum of academic disciplines under a single roof – from traditional fields in the humanities, the social and natural sciences, and medicine to modern technical disciplines like computer science and microsystems technology. Medicine has always played a defining role in the university’s profile: The history of the Faculty of Medicine extends all the way back to the founding of the University of Freiburg in 1457. The Faculty of Medicine and the University Medical Center are integral parts of the University of Freiburg and rank according to the German Science Council among the leading medical institutions in the country. The strong research at the Faculty of Medicine and its close integration with the life sciences and concrete health care practice at the medical center are undoubtedly reasons why we not only boast an impressive range of priority programs and high-profile third-party funded projects but were also successful in the Excellence Initiative of the federal and state governments with projects like the Spemann Graduate School of Biology and Medicine (SGBM), an honor which places us among nine universities in Germany with a particularly strong research profile. As far as instruction is concerned, the University Medical Center also plays an important role as a training hospital for students enrolled in the fields of medicine, dentistry, and molecular medicine. I wish you much success at your conference and hope that you find some free time in your busy schedule of talks and discussions to experience some of what the city of Freiburg has to offer.

Prof. Dr. Hans-Jochen Schiewer Rector of the University Freiburg

10

Welcome Letter Ladies and Gentlemen, It is a pleasure and an honor for me to welcome the delegates of the 4th International ADT-Conference in Freiburg, Germany. This conference addresses the spirit of innovations as also our university is dedicated to the improvement of patient care and medical progress. The University of Freiburg with its 550 year history is among the oldest higher education institutions in Germany and has a rich tradition. The humanities and social sciences have traditionally been an important part of our work. Outstanding achievements in philosophy, philology, historical research, economics and law are associated with names such as Heidegger, Husserl, Weber, Eucken and the Nobel Prize winner von Hayek. Further Nobel Prize winners like Spemann, Staudinger, von Hevesy and Krebs have been teaching in Freiburg. With new Faculties of Applied Sciences, micro-system technologies and computer sciences the University of Freiburg has opened innovative fields of study and research. The Faculty of Medicine enjoys a high international reputation for its experimental and clinical research. More than 8,000 doctors, health workers, nurses and employees work at the University Medical Center which cares for nearly 60,000 inpatients and 350,000 ambulatory patients per year in 14 clinics and 30 departments. In 2007 the University of Freiburg became one of nine top universities in Germany to be honored in the Excellence Initiative for outstanding research. The “Centre for Biological Signalling Studies”, approved in 2007, is engaged in interdisciplinary research. The center’s innovative approach will lead to important contributions for the understanding of molecular basics and principles of biological signalling. Many clinics contributed to Freiburg’s national and international reputation. Also the clinic for Oral and Maxillofacial Surgery has for many years been involved in clinically dedicated innovations. The clinic is an academic “light house” well known in the international scientific community. Our Oral & Maxillofacial Surgery Clinic has worked especially on innovative reconstruction procedures contributing to clinical application of stem cells and has published numerous papers on clinical application of navigation and intraoperative imaging since 1997. The team has developed orbital implants, that can be used in patients with trauma and secondary orbital reconstructions. It is not astonishing that this year the ADT is being held here in Freiburg as an international core center for medical innovations and that we can welcome many participants and experts from more than twenty countries. I would like to bring the greetings from the University clinic of Freiburg and wish the conference good success and constructive interdisciplinary and futureoriented discussions.

Prof. Dr. Dr. h.c. mult. Hubert E. Blum Dean of Freiburg’s Faculty of Medicine University Freiburg

11

Welcome Letter Dear colleagues, as the Education and Training Officer of the European Association for Cranio-Maxillo-Facial Surgery (EACMFS), it is a great honor for me to greet all the participants to this important meeting on behalf of our Association. This Conference is dedicated to review the current situation concerning the use of the new technologies in the reconstruction of the head and neck region. Innovations in this field greatly contribute to improve the management of difficult cases in this field thus aiming to obtain the ideal aesthetic and functional results after reconstruction of the defects in this complex area. I am sure that the contributions of all the outstanding speakers and the discussions after the different sessions will be a step forward concerning the incorporation of these innovations and new technologies in the diagnosis, planning and reconstructive treatment of our patients. With best wishes of a fruitful Meeting

Julio Acero

MD DMD PhD FDSRCS FEBOMFS EACMFS Education and Training Officer

12

Welcome Letter Dear participants, dear friends, As the local hosts of our ADT Conference 2011 we would like to welcome you warmly to our University city of Freiburg in the Black Forest. Located between the Rhine River and the Black Forest close to the Alsace, France, and Basel, Switzerland, Freiburg is called the “Tuscany of Germany” because of the usually mild climate and the numerous sunny days. The first ADT Conference in Edmonton in 2002 held by John Wolfaardt, Canada, and Adrian Sugar, Great Britain, was an eye opening experience for many specialists working in the field of head and neck reconstruction. Among a variety of conferences, workshops, symposia, meetings and conventions, growing in number worldwide every year, ADT was the first truly inter- and over-disciplinary meeting dedicated to innovations and advanced technologies. Not only that physicians met physicians from other specialities but professionals and experts from any speciality and any profession could exchange information and contribute to progress in head and neck reconstruction. Since then, the ADT Conferences gradually grew larger but never lost this spirit of focussing on innovations. In 2011 we are very happy to hold the ADT Conference here in Freiburg. We would really like to thank all keynote speakers and the participants to contribute to further progress in reconstructive head and neck surgery for the benefit of our patients. I also thank our partners from the industry for their generous support. Finally, it is wonderful to see that many colleagues who had already visited our clinic and our city before come to the ADT Conference in Freiburg. So for many it will be some kind of “family reunion” in an academical and progress driven environment. We would cordially like to thank all our co-workers in the clinic to prepare the Meeting. Cordial thanks also to RES, the conference organizers with Eben Yancey and his team to effectively set up such a logistically complex meeting with its surrounding workshops. On behalf of ADT and the Oral and Maxillofacial Surgery Group in Freiburg I wish you a successful interesting and intellectually challenging meeting. Welcome to Freiburg.

Rainer Schmelzeisen MD, DDS, PhD, FRCS (London)

13

Planmeca PlanScan The first dental unit integrated impression scanner

Ultra fast real-time 3D scanning Optimal ergonomics – no sprayy nee needed Open connectivity for various CAD/CAM M syst systems tems More information

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11

nS c a n • Pr o M a x • Pla ination for o 3D Pro pen x is mb CA Face me D co D/ Ro ue 3 CA iq M n U

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Sponsorship & Support We wish to thank our sponsors and supporting organizations who made this conference possible through their generous contributions.

16

Sponsors & Exhibitors

Sponsor Nobel Biocare Deutschland GmbH Straumann GmbH Stryker Leibinger GmbH & Co. KG Synthes GmbH

Gold Exhibitor

Silver Exhibitor

Bronze Exhibitor

3dMD

hillus Engineering KG

AOCMF

Brainlab

KLS Martin Group

Karl Storz GMBH & Co. KG

Sirona Dental Systems GmbH

Carl Zeiss Meditec Vertriebsgesellschaft mbH

Materialise

SOREDEX



Geistlich Biomaterials mbH Hager & Meisinger GmbH

Medical Modeling Inc.

Morita – J. Morita Europe

Planmeca Vertriebs GmbH

orangedental GmbH & Co. KG

Sensable 3D Design

SisoMM bvba

Exhibitor Booths are located at: Foyer- Konzerthaus Freiburg

17

Supporting Organizations

Advanced Digital Technology Foundation Association for the Study of Osteosynthesis Association for the Study of Osteosynthesis- Foundation Centre for Applied Reconstructive Technologies in Surgery Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie European Association for Cranio-Maxillo-Facial Surgery Institute for Reconstructive Sciences in Medicine Morriston Hospital Maxillofacial Unit The National Centre for Product Design & Development Research University of Wales Institute, Cardiff

18

Program Committees Scientific Advisory International Committee

Conference Administration

Prof. Ashraf Ayoub, UK Dr. M. Anwar Bamber, UK Ms. Kerstin Bergstrom, SE Dr. John Beumer, US Dr. Richard Bibb, UK Mr. Allan Bocca, UK Mr. Pierre Boulanger, CA Dr. Lawrence Brecht, US Dr. John Brunski, US Dr. Daniel Buchbinder, US Dr. Karen Calhoun, US Mr. Trevor Coward, UK Dr. Michael Crary, US Dr. Betsy Davis, US Mr. Jan De Cubber, BE Prof. Dr. Bernard Devauchelle, FR Dr. Walter Dobrovolsky, CA Mr. Steven Dover, UK Mr. Nick Drage, UK Prof. Michael Ehrenfeld, DE Dr. Harald Eufinger, DE Mr. Peter L. Evans, UK Prof. Dr. Rolf Ewers, AT Dr. Scott Ganz, US Prof. Dr. Nils Gellrich, DE Dr. Sabine Girod, US Prof. Gösta Granström, SE Dr. Simonas Grybauskas, LT Prof. Piet Haers, UK Prof. Bo E.V. Hakansson, SE Prof. Dr. Beat Hammer, CH Dr. Jeffrey Harris, CA Mr. William Hodgetts, CA Mr. Peter Jeynes, UK Dr. Yasuhiro Kizu, JP Prof. Jeremy Knox, UK Dr. David Koppel, UK

RES Seminars 

Prof. J. Thomas Lambrecht, CH Prof. Dr. Marc Metzger, DE Prof. Dr. Friedrich Neukam, DE Dr. Devin Okay, US Dr. Jules Poukens, NL Prof. Dr. Joachim Prein, CH Dr. Donald Raboud, CA Mr. Peter Ramsay-Baggs, UK Dr. Harry Reintsema, NL Dr. David Riesberg, US Dr. Eleni Roumanas, US Prof. Robert Sader, DE Prof. Dr. Rainer Schmelzeisen, DE Prof. Dr. Ralf Schön, DE Prof. Dr. Alexander Schramm, DE Ms. Rosemary Seelaus, CA Dr. Hadi Seikaly, CA Dr. Christoph Sensen, CA Dr Joacim Stalfors, SE Dr. Brad Strong, US Mr. Adrian Sugar, UK Prof. Hishashi Taniguchi, JP Dr. Jonathon Trites, CA Dr. Wesley Turner, US Dr. Mark Urken, US Dr. Robert van Oort, NL Ms. Suzanne Verma, US Dr. Pit Voss, DE Mr. Fraser Walker, UK Dr. Anders Westermark, SE Dr. Gordon Wilkes, CA Dr. John Winder, IR Dr. John Wolfaardt, CA Mr. Steve Worollo, UK Prof. James Xia, UK

19

4425 Cass Street, Suite A  San Diego, CA USA 92109  Tel: 1 (858) 272-1018  Fax: 1 (858) 272-7687  Email: [email protected]

Scientific Advisory Committee Chairs

Scientific Advisory Committee Vice Chairs

Rainer Schmelzeisen Prof. Dr.med. Dr.med.dent.

Ralf Gutwald Prof. Dr.med. Dr.med. dent.

Professor and Medical Director Department of Maxillofacial and Oral Surgery Albert-Ludwigs-University Freiburg, Germany

Freiburg, Germany Marc Metzger PD Dr. med. Dr. med. dent. Freiburg, Germany Sebastian Sauerbier Dr.med. Dr.med.dent. Freiburg, Germany

Adrian Sugar FDSRCS (Eng,Ed) FDSRCPS MDhc

Ralf Schön Prof. Dr. med. Dr. med. dent.

Consultant / Senior Lecturer in Cleft and Maxillofacial Surgery Clinical Director, South Wales Cleft Service Morriston Hospital and Swansea University Medical School ABM University Health Board Swansea, Wales, UK

Freiburg, Germany

Johan Wolfaardt BDS, MDent, PhD Professor, Division of Otolaryngology Head and Neck Surgery Department of Surgery Faculty of Medicine and Dentistry University of Alberta / Director of Clinics and International Relations iRSM, Edmonton, Alberta Canada

20

Conference Organizing Committee Rainer Schmelzeisen, Chairman Prof. Dr.med. Dr.med.dent Freiburg, Germany Gisela Kappenberger, Conference Secretary Freiburg, Germany Marc Metzger PD Dr. med. Dr. med. dent. Freiburg, Germany Sebastian Sauerbier Dr.med. Dr.med.dent. Freiburg, Germany Pit Voss Dr. med. dent. Freiburg, Germany

Conference Venue Conference City Freiburg, Black Forest Freiburg is located in the center of Europe and easily accessible by airplane, train and car. EuroAirport Basel Mulhouse Freiburg (airport codes: BSL or MLH) is connected with a 45 minutes bus ride to the city. Zurich and Frankfurt can be reached with a two-hours train ride from Freiburg.

Conference Site The conference site Konzerthaus is located in the heart of the city adjacent to the train station, bus transportation center and our congress Novotel hotel. Within an easy walk you are in the heart of the city with many restaurants, open public spaces, pedestrian zones, museums, shops and historical sight points. The Freiburg Concert Hall, flooded with sunlight, provides a high-class background for congresses and concerts, for exhibitions and presentations, for receptions and balls, for symposia and for many other events. Capable of catering for up to 1,744 persons when seated in rows and with a gross exhibition surface area of 2500 m², the Concert Hall Freiburg is the ideal forum for our ADT meeting. All of the rooms have sunlight illumination and can be dimmed or darkened on request. State-of-the-art technology is available. Our meeting will take place in the Round Hall The Round Hall on the second floor is designed in the form of an amphitheatre with a surrounding gallery. Facing a podium, it is ideally suited for lectures. The podium is flanked on both sides by stairways so that the surrounding gallery is directly coupled with the floor of the hall. Daylight affords this hall a variety of lighting possibilities.

Located between the Rhine River and the Black Forest close to the Alsace, France and Basel, Switzerland, Freiburg is called the “Tuscany of Germany”. The mild climate allows for various activities as hiking, watersports and mountainbiking. Famous wineries produce outstanding wines, restaurants offer a variety of local and international cuisines. Freiburg straddles the Dreisam river, at the foot of the Schlossberg. Historically, the city has acted as the hub of the Breisgau region on the western edge of the Black Forest in the Upper Rhine Plain. One of the famous old German university towns. Freiburg was incorporated in the early 12th century and developed into a major commercial, intellectual, and ecclesiastical centre of the upper Rhine region. The city is known for its university and its medieval cathedral, as well as for its high standard of living and advanced environmental practices. The Freiburg University was founded in 1457 and hosts over 21.000 students and 160 study paths. The University clinic and the associated faculties have been dedicated to digital technology and biotechnology for many years. An interesting cooperation exists for example with the Department of Microsystems Engineering and the Freiburg Materials Research Center (FMF). The Department of Cranio-Maxillofacial Surgery in Freiburg was founded in 1957, the Dental School and the Medical Faculty have constantly been contributing to medical innovations and perspectives in the fields of osteosynthesis, 3D imaging, intraoperative imaging, rapid prototyping and biological implants.

21

Social Events Thursday, May 5th

Saturday, May 7th

Registration & Welcome Reception (17:00 - 19:00) Foyer- Konzerthaus Freiburg

Conference Luncheon (12:00 - 13:30) Conference Hall- Konzerthaus Freiburg

Make your travel arrangements to arrive late Thursday afternoon and come join us for light appetizers at the conference site. This is a wonderful opportunity to meeting your colleagues and pick up your credentials. A cash bar will be available for your enjoyment. Cost: No cost to conference delegates (included in registration fees) Accompany guest/s will be required to pay the one time Guest Fee: $85 Dress: Casual

Friday, May 6th

Conference Luncheon (12:00 - 13:30) Conference Hall- Konzerthaus Freiburg Lunch is provided on-site and ample time is provided for our colleagues to stop by the exhibit booths to review the latest in technology and services. Cost: No cost to conference delegates (included in registration fees) Dress: Conference attire

Poster Session & Exhibit Reception (17:15 - 19:30) Foyer- Konzerthaus Freiburg We encourage all delegates to support your colleagues who are presenting posters. Poster presenters should set-up their posters at 6:00pm. Our exhibits will be on display and have generously support this evening with a variety of food. A cash bar will be available for your enjoyment. Cost: No cost to conference delegates (included in registration fees) Accompany guest/s will be required to pay the one time Guest Fee: $85 Dress: Conference attire

Lunch is provided on-site and ample time is provided for our colleagues to stop by the exhibit booths for review the latest in technology and services. Cost: No cost to conference delegates (included in registration fees) Dress: Conference attire

ADT After Work Party (19:30 - whenever) Historisches Kaufhaus, Freiburg Everyone should attend this “after work party”. The Historisches Kaufhaus, or Historical Merchants Hall, is a Late Gothic building on the south side of Freiburg’s Münsterplatz. Constructed between 1520 and 1530, it was once the center of the financial life of the region. Its façade is decorated with statues and the coat of arms of four Hapsburg emperors. Located in the heart of old town Historic store is one of the most impressive buildings in Freiburg: With its magnificent red facade and dominates the south side of the cathedral square. Outstanding is the front of the store: its facade with the Erkertürmen and the sculptural decoration with lifesize statues and coats of arms of the Habsburg period of Freiburg. The reliefs and statues reflect the good connection to the city to the Austrian government house. Impressive also are the stone arches and courtyard with direct access to the rooms. Upstairs is, facing the cathedral, the most important and largest of the four rooms: the Emperor’s Hall with its Gothic arched windows. A great venue for our colleagues to network and have fun in historic Freiburg. Food and beverage and entertainment will be provided. Cost: No cost to conference delegates (included in registration fees) Dress: Smart Casual

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ADT After Work Party Concert Saturday 6 May, 19:30

Brenda Boykin Vocals

Frederik Heisler Syndicat

Frederik Heisler Drums

Simon Girard Trombone

Yom Maikranz Bass

23

Emanuel Teschke, Guitar

29 Tickets www.zmf.de 0761 . 50 40 30

Zirkuszelt

Spiegelzelt

Mi 29.6.

20.00 Uhr Silly

20.30 Uhr Ganes

Alles Rot - Live 2011

rai de sorëdl

Do 30.6.

20.00 Uhr Till Brönner At The End Of The Day-Tour Vorprogramm Grand Orientet World Jazz - eine musikalische Reise nach Ost und West

14.30 Uhr Theater Budenzauber Hasenherz und Drachenmut

20.30 Uhr Frl. Mayer‘s Hinterhausjazzer feiern ihr 40stes Jubiläum

Fr 1.7.

19.30 Uhr Georg Schramm und Gäste

22.30 Uhr Irie Révoltés

Kabarett-Abend mit Nordkvark, Ars Vitalis, Jochen Malmsheimer und Georg Schramm

Mouvement Mondial

Sa 2.7.

20.00 Uhr Schandmaul

14.30 Uhr BamBam-Band

Traumtänzer-Festivaltour 2011

Feuerdrache, goldne Lanze - Musik für Kinder & Erwachsene 22.00 Uhr Ólafur Arnalds ‚...and they have escaped the weight of darkness‘

So 3.7.

20.00 Uhr Jacques Brel Nacht

12.00 Uhr Klaviermatinee – Moye Kolodin

Dominique Horwitz und das Philharmonische Orchester Freiburg Leitung: Enrique Ugarte

ZMF-Preisträger 2011 spielt Beethoven u. Schumann 20.30 Uhr Gardi Hutter Die Schneiderin

Mo 4.7.

20.00 Uhr The Human League

20.30 Uhr Hamel

Credo

Nobody’s Tune

Di 5.7.

20.00 Uhr Bryan Ferry Olympia Tour 2011

20.30 Uhr Ayo. Billie-Eve anschl. Jam-Session mit u.a.

Mi 6.7.

20.00 Uhr Joy Denalane Maureen Janelle Monáe The ArchAndroid

14.30 Uhr Freiburger Puppenbühne Der kleine König Eselsohr 21.00 Uhr Frida Gold Juwel Tour 2011

Do 7.7.

20.00 Uhr Juli In Love Tour 2011 Support Bosse

Fr 8.7.

20.00 Uhr Blood Sweat and Tears

Sa 9.7.

20.00 Uhr BAP Die Klassiker – Tour 2011 ZMF-Ehrenpreis 2011 für Wolfgang Niedecken

14.30 Uhr Alex und Joschi Artistik mit Herz und Humor 20.30 Uhr Lingua Loca ELF Tour

So 10.7.

19.00 Uhr ZMF-Gala Giora Feidman zum 75.Geburtstag

11.00 Uhr Klassik-Virtuos von Bach bis Tango

Klassik – Klezmer – Weltmusik Giora Feidman Ensemble, Gershwin Quartett, Perry Robinson & Kaktus-Groove-Band Moderation: Michael Mendl

Enrique Ugarte (acc) & Raúl Alvarellos (cl), Koh Gabriel Kameda (v) & Moye Kolodin (p), Schlagzeug-Duo Behringer-Wäschle (ZMF-Preis 2010) und die Sinfonietta der Musikschule Freiburg, Ltg. Thomas Oertel 20.00 Uhr Vincent Klink & Patrick Bebelaar Sitting Küchenbull

Mo 11.7.

20.00 Uhr A-cappella-Nacht The Swingle Singers Snapshots maybebop Extrem nah dran

20.30 Uhr Iron and Wine

Di 12.7.

20.00 Uhr Lyle Lovett

20.30 Uhr Oquestrada Tasca Beat anschl. Jam-Session Perry Robinson & Kaktus-Groove-Band

Mi 13.7.

20.00 Uhr Dieter Thomas Kuhn & Band

Do 14.7.

20.00 Uhr Bonaparte Circus Show WhoMadeWho, FM Belfast

14.30 Uhr Freiburger Puppenbühne

Fr 15.7.

20.00 Uhr Konstantin Wecker und Hannes Wader

20.00 Uhr 4. Freiburger Omaha records Festival

Kein Ende in Sicht

Nicolas Sturm und das Klingenensemble, Daantje and the Golden Handwerk, Tjian, Staring Girl, crime killing joker man

Sa 16.7.

20.00 Uhr The Baseballs

14.30 Uhr Geschichten aus 1.000 und einem Rhythmus

Strings ’n’ Stripes

Familienkonzert mit Murat Cos¸kun

So 17.7.

20.00 Uhr Razorlight

11.00 Uhr Stars von Morgen Meisterschüler der Internationalen Klavier Akademie Freiburg, Moderation: Jura Margulis 20.30 Uhr The Puppini Sisters The Rise & Fall Of Ruby Woo

Johannes Maikranz Band Projekt

14.30 Uhr Die vergessenen Turnbeutel Kinderlieder zum Mitmachen und Mitsingen 20.30 Uhr Roland Bless Zurück zu Euch - Tour 2011

21.30 Uhr Samy Deluxe & Tsunami Band Live

Spinning Wheel Tour 2011

Kiss Each Other Clean

and his Acoustic Group Die Zeit macht nur vor dem Teufel halt!

ZMF11_AnzProgramm03_DV3_SW.indd 1

t Verleg.7. vom 8

14.30 Uhr Nussknacker, Wölfe und geheimnisvolle Bilder Klassik für Kinder mit Andreas Haas 20.30 Uhr Katzenjammer Das Rock Kasper und das kleine Schlossgespenst

21.00 Uhr Axel und Torsten Zwingenberger Boogie Woogie Brothers

20.30 Uhr Hazmat Modine Cicada Tour

14.04.11 16:52

Guests Activities Friday, May 6th Freiburg City Tour (10:00- 13:00) Follow our charming ‘Black Forest girl’ through the winding alleyways of Freiburg, Black Forest’s splendorous metropolis. We take you into the rambling history of Freiburg and the region. You will learn fascinating and amusing details on this extraordinary walk through the historic Old Town. Let yourself get pampered with champagne, wine and delicacies from Baden. You always wanted to witness the splendor of Christianity’s most beautiful spire? Come on then and follow Bärbel on her tour through the city! Tour includes: Champagne reception in the guesthouse “Zum Roten Bären” and Black Forest ham lunch with Gutedel (Chasselas) in the tavern “Alte Wache” . Cost: $70 USD Per Person

Saturday, May 7th Tour Alsace (08:00 – 16:30) Visit the Colmar old town, the heart of the south Alsace. Our guests will see the many architectural highlights of the city with the house of heads, pfister house, Koifhaus and also the romantic part of the city like tanner’s district and little Venice. The tour will then visit interesting Unterlindenmuseum with the altarpiece by Matthias Grünewald (1512-1516) its impressive collection of sculptures and paintings.

After this fabulous experience, we drive to Munster for lunch, a 3 course menu including wine. We will also visit cheese-makers in the region. Cost: $145 USD Per Person

Monday, May 9 Wednesday, May 11, 2011 Four Country Tour Black Forest, Austria, Switzerland and France Day 1: Start 08:30 Arrival: 17:30 in Feldkirch Our tour begins traveling to the special countryside of the famous black forest, we will visit “Höllental”, past Hinterzarten and stop in wonderful Lake Titisee. After the lake sightseeing, we will visit Bodensee. The next stop is in the romantic city of Meersburg, a very historic interesting little town. Other cities on the agenda are Lindau, and Bregenzer Wald/Montafon. This is a special region of Austria, it is here, you will see the first mountain from the Alps. The guests stay this night in Feldkirch Hotel Weisses Kreuz 4*. Dinner this evening will be a typical Austrian buffet.

Day 2: Start 09.00 Arrival: 17:00 in Buochs Day two starts with a journey to Switzerland via St. Gallen and with stops in Zürich – Einsiedeln – to the Vierwaldstättersee. You will also see

25

Luzern, an old town with old bridges, this is sure to be interesting for all visitors. The foundation of Switzerland is beginning at this region. The view of the very high mountains is fabulous. This day we will have a typical Swiss meal, with 3 courses including cheese fondue.

Day 3: Start 09.00 Arrival: 17:30 in Freiburg We say goodbye to the region of the Alps on day three. We will tour Switzerland Jura to Basel and from the way of Elsässische Weinstrasse to Colmar. The old town with many architectural highlights; building the end of a wonderful trip touring 4 countries. The tour then returns to Freiburg. Cost: Double room: $590 USD Per Person Single room: $656 USD Per Person Price Includes: 2 Night hotel stay, 2 Breakfast Meals,2 Dinner Meals, English Speaking Tour Guide, and Transportation

All tours are subject to change, based on a minimum number of attendee registrations and on availability. The listed per person cost is subject to change based on the conversion rates. The tour times are subject to changed.

26

Session Chairs Friday, May 6th

Concurrent Sessions

SESSION I: Medical Microsystems & Theragnostics

SESSION V: Innovations in Orthodontic and Orthognatic Surgery

09:00 - 10:10 Session Chairs:

10:40 - 11:44 Session Chairs:

Rainer Schmelzeisen and John Wolfaardt

Michael Ehrenfeld and Alexander Schramm

Concurrent Sessions

SESSION VI: Prosthetic and Surgical Craniomaxillofacial Reconstruction and Rehabilitation

SESSION I: Medical Microsystems-Theragnostics

13:30 - 15:26 Session Chairs:

10:40 - 12:00 Session Chairs:

Daniel Buchbinder and Robert Sader

Rolf Mülhaupt and Jürgen Rühe

SESSION VII: Minimal Invasive and Computer-Aided Surgery Procedures

SESSION II: 3 D-Planning and Outcome Analysis in Head & Neck Reconstruction

10:40 - 12:00 Session Chairs:

13:30 - 15:16 Session Chair:

Beat Hammer and Sebastian Sauerbier

Marc Metzger 15:46 - 17:05 Session Chairs:

SESSION VIII: Digital Impact on Facial Prosthetic and Rehabilitation

Rolf Ewers and E. Bradley Strong

13:30 - 15:40 Session Chairs: SESSION III: Integration of New Materials and Innovations

Richard Bibb and Michael P. Grant

10: 40 - 12:00 Session Chairs: Ralf Gutwald and Adrian Sugar

Sunday, May 8th

SESSION IV: New Concepts in Interdisciplinary Work SESSION IX: Integration of Innovations in Teaching and Daily Routine

13:30 - 15:16 Session Chairs: Max Heiland and Siegmar Reinert

09:00 - 10:30 Session Chairs:

15:46 - 17:05 Session Chairs:

Nils-Claudius Gellrich and Masayuki Takano

Julio Acero and Soichi Iwai

10:45 - 12:00 Session Chairs: Shoij Enomoto and Christian Scheifele

Saturday, May 7th SESSION V: Innovations in Orthodontic and Orthognatic Surgery 09:00 - 10:10 Session Chair: Christian Lindqvist

27

Program Schedule The ADT Conference will be accredited with 18 Points The organizer has accepted the guidelines and commandations of the Landesärztekammer BadenWürttemberg for medical education and the European Accreditation Council for Continuing Medical Education (EACCME).

28

Thursday, 5 May 08:00-17:00

Session I Medical Microsystems and Theragnostics

AOCMF Clinical Priority Program Research Workshop on Imaging and Planning of Surgery

10:00-16:00

Regional Group Meetings (invitation only)

10:00-12:00

1. North America

14:00-16:00 17:00-19:00

Round Hall Abstract #

Featured Speakers

09:00

1

Rolf Mülhaupt Biomaterials and Biofunctional Processing

2. Japan

09:20

2

Registration and Welcome Reception Foyer, Konzerthaus Freiburg

Jürgen Rühe (IMTEK) Microsystems for Medical Applications

09:40

3

Heinrich Hofmann Multifunctional Nanoparticles: A Potential Tool for Theragosis

Friday, 6 May 08:45

Session Chairs: Rainer Schmelzeisen and John Wolfaardt

Opening Ceremony and Announcements Round Hall, Konzerthaus Freiburg

10:00

Questions & Discussion

10:10

AM Break- Exhibit Review Conference Foyer

Session Chairs: Rolf Mülhaupt and Jürgen Rühe

Musical introduction: Hanna Schüly, saxophonist

Round Hall

Thomas Stoffel On behalf of Dr. Salomon, mayor of the city

10:40

4

Hiroaki Ishibashi Newly Regulation Strategy Against Tumor Angiogenesis and Chemosensitivity Using Decoy System

10:48

5

Michele Maglione Tridimensional Visualization of Bone Tissue in Peri-Implantitis: An X-Ray Computed Micro-Tomography (XMT) Analysis

10:56

6

Joanna Gilewicz The Bioimplant, an Innovative Concept in Cranio – Maxillo – Facial Oncologic Reconstructive Treatment, Using Tissue Engineering and Advanced Digital Technology

11:04

7

Ralf Smeets Modern Biomaterials and New Technologies in Tissue Engineering for Reconstruction of the Head and Neck-Region

11:12

8

Enrico Salvador Bone Regeneration with Adipose-Derived Stem Cells in Rabbit Calvarium

11:20

9

Fabian Duttenhoefer Pre-Vascularization of 3D Scaffolds for Tissue Engineering Application in Critical Size Bone Defects

Univ.-Prof. Dr. Anca-Ligia Grosu Universitätsklinikum Freiburg Univ.-Prof. Dr. Dr. Rainer Schmelzeisen Universitätsklinikum Freiburg

Oral Abstracts

Opening Ceremony Introduction Music by

Hanna Schüly



Saxophonist

Featured Speaker 11:28 11:50

29

10

Nils Petersen The Potential of Nanotechnology for Medicine Questions & Discussion

12:00

Conference Lunch Main Entrance (1st Floor)

Session Chairs: Rolf Ewers and Brad Strong Round Hall 15:46

20

Suzanne Verma Surgical Navigational Systems: Bridging the Gap Between Virtual Preoperative Planning, Intraoperative Applications, and Physical Prototyping

15:54

21

Matthew Hanasono Improving the Speed and Accuracy of Mandibular Reconstruction Using Preoperative Virtual Planning and Rapid Prototype Modeling

16:02

22

Maciej Rysz Surgical Navigation Dedicated to Bone Resection and Reconstruction in Maxillo - Facial Surgery in Oncologic Cases. Bioimplant – An Experimental Study

16:10

23

Alan Bocca Post-Traumatic Zygomatic Osteotomy; The Value of 3D Planning and Customixed Repositioning Templates

16:18

24

Willem Weijs 3D Virtual Planning of a Complex Facial Reconstruction After Radiation Induced Facial Asymmetry

16:26

25

Roman Skoracki Complex Mid-Facial Reconstruction using Virtual Planning, Rapid Prototype Modeling and Stereotactic Navigation

16:34

26

Katie Weimer Virtual Surgical Planning (VSP) and Clinical Transfer via Templates: Assessing Surgical Outcomes

16:42

27

Shilei Zhang Navigation-Guided Correction of Midface Posttraumatic Deformities (Shanghai Experience with 40 Cases)

Session II 3 D-Planning and Outcome Analysis in Head and Neck Reconstruction Session Chair: Marc Metzger Round Hall Featured Speakers 13:30

11

Oleh M. Antonyshyn 3D-Models for Design and Outcome Analysis in Craniofacial Surgery

13:50

12

Gerald Grant Laser/Non-Invasive Imaging and Prototyping Technology in the Reconstruction of War Trauma Injuries

14:10

13

Dominic Eggbeer Evaluating State of the Art Cranioplasty Plate Design and Fabrication

14:18

14

Bernd Lethaus A Treatment Algorithm for Customized Implants in Patients with Large Skull Bone Defects and First Results

14:26

15

Lisa Korus Custom Polymethylmethacrylate Implant Cranioplasty

14:34

16

Jasper Snaathorst Calvarial Reconstruction with CAD/CAM Fabricated Titanium Plate Implants

14:42

17

Rosemary Seelaus ICAT Imaging, Virtual Modeling and Patient-Specific Prototyping in the Planning for Combined Bilateral Autologous Reconstruction and Baha® Placement in Patients with Microtia: A Report of Innovative, Technology-Based Team Planning Toward Improved Treatment

16:50

14:50

18

Nazan Adali Comparison of Intraoperator and Interoperator Repeatability of Soft Tissue Landmark Identification Using Two 3D Facial Imaging Software Systems

14:58

19

Erin Stevens 3D Stereophotogrammetry for Craniofacial Analysis: The Effects of Head Inclination on the Reliability and Precision of Anthropometric Measurements

15:06

Questions & Discussion

15:16

PM Break - Exhibit Review Conference Foyer

30

28

Rutger Schepers 3D digitally planned dental implant insertion in a free vascularised fibula for immediate prosthetic loading during reconstruction of a mandible

Friday, 6 May Continued

Oral Abstracts 14:10

36

Michael A. Ermer Interdisciplinary Treatment Algorithm of Potentially Life-Threatening Vascular Malformations of the Head and Neck

14:18

37

Miller Smith 2-Dimensional and 3-Dimensional Normative Airway Comparative Measures using 772 Cone Beam Computed Tomography Scans

14:26

38

Michael Krimmel 3-D Assessment of Facial Development in Children with Cleft Lip and Cleft Lip and Palate

14:34

39

Susanne Kluba Significance of High-Resolution Ultrasound in the Differential Diagnosis of Infantile Cranial Deformity

14:42

40

Michael Krimmel Facial Morphology Of Children With Pierre Robin Sequence

14:50

41

Susanne Kluba Importance of Entrance Age for Optimizing Helmet Therapy in Positional Plagiocephaly?

CONCURRENT SESSION Session III Integration of New Materials and Innovations Session Chairs: Ralf Gutwald and Adrian Sugar Conference Room 9 Featured Speaker 10:40

29

Adrian Sugar Continuous Integration of New Materials in Head and Neck Reconstruction Oral Abstracts

11:04

11:12

11:20

30

31

32

Hisham El Fattah Cone-Beam Computed Tomographic Evaluation of Using Bio-Absorbable PolyMilk and Poly-Glycol Polymers as Bone Void Filler in Large Mandibular and Maxillary Defects Surgeries Divya Mehrotra Hydroxyapatite/Collagen Scaffold for Platelet Rich Plasma in Temporomandibular Ankylosis for Condylar Regeneration Jean-Marie Donsimoni What’s Following on Titanium? The PEEK! A New Material for Support of Weak Tissues, For Bone Reconstruction in Maxillo-Facial Squelet, for Fixation of Prosthodontics

14:58

Questions & Discussion

15:16

PM Break - Exhibit Review Conference Foyer

Session Chair: Soichi Iwai and Julio Acero Conference Room 9 Oral Abstracts

Featured Speaker 11:28

33

Hans-Florian Zeilhofer Visions in Imaging and Biomaterials

11:50

Questions & Discussion

12:00

Conference Lunch Main Entrance (1st Floor)

Session IV New Concepts in Interdisciplinary Work

15:46

42

Jules Poukens Skull Defects Treated by CAD-CAM Custom Implants : Why a New Classification?

15:54

43

Tara Lynn Stewart Quantitative Computerized Tomographic Thresholds in Management of Asymptomatic Isolated Orbital Floor Fractures

16:02

44

Arnulf Baumann Computer-Assisted Intraoperative Navigation in Orbita Decompression

16:10

45

Mathias Vogel Orbital Volume Reduction after Blow Out Fractures Adapted by Intra-Operative, Preoperative Model Adapted or Assembled Preformed Orbita Mesh Implants - An in Vitro Study

Session Chairs: Max Heiland and Siegmar Reinert Conference Room 9 Featured Speakers 13:30

34

Don Juzwishin Health Technology Assessment – Emerging Issues and Opportunities

13:50

35

Ben King Collaboration, Technology and Medicine 2.0 – An Industrial Designer’s Perspective

31

16:18

46

Peter Evans The Evolution of Customised Titanium Implants for Post-Traumatic Orbital Wall Reconstruction

Session Chairs: Michael Ehrenfeld and Alexander Schramm Round Hall Oral Abstracts

16:26

47

Marc Metzger Orbital Reconstruction using Cone Beam CT Scan and Preformed Titanium Mesh. A Farewell To CAS?

10:40

53

Pravin Patel A Finite Element Analysis of Custom Electron Beam Melting (EBM) Plating System for Maxillofacial Surgery

16:34

48

Andres Stricker Augmentation Procedures In Dental Implantology - Changing Paradigms by 3D Evaluation

10:48

54

Adel Abou-ElFetouh Evaluation of Computer-Guided Condylar Positioning Device in Bilateral Sagittal Split Ostetomies: A Preliminary Report

16:42

49

Kariem Mizbah The Clinical Relevance of Bifid and Trifid Mandibular Canals

10:56

55

16:50

50

Katja Nelson The use of Synchrotron Radiation in Implant-Dentistry

Yuhji Kabasawa Three-Dimensional Evaluation of Nasal Morphological Changes after Le Fort 1 Osteotomy: Comparison by Incision Lines of Le Fort 1 Osteotomy

11:04

56

Majeed Rana Computerassisted Planing in Orthognatic Surgery

11:12

57

Samir Aboul-Hosn Centenero 3D Planning in Orthognathic Surgery. CAD/ CAM Surgical Splints and Prediction of the Soft and Hard Tissues Results. Our Experience in 16 Cases

11:20

58

David Morris Bringing Three-Dimensional Plans for Orthognathic Surgery to Reality: One Center’S Experience with Rapid-Prototype Splints and Cutting Guides

11:28

59

Claudio Marchetti Magellan Project: A “Geographic” Way to Navigate in Orthognathic Surgery

11:36

60

Joanneke Plooij Comparison of 3D Preoperative Planning and Surgical Outcome in Bimaxillary Procedures

16:58

Questions & Discussion

17:10

Session Adjourns

17.15-19.30

Poster Session and Exhibit Reception Foyer, Konzerthaus Freiburg

Saturday, 7 May 08:45

Announcements

Session V Innovations in Orthodontic and Orthognatic Surgery Session Chair: Christian Lindqvist Round Hall Featured Speakers 09:00

51

Beat Hammer Individualization and Integration of Imaging in Orthognathic Surgery

09:20

52

Christian Scheifele Clinician’s Guide to Cone-Beam CT (CBCT)

09:40

52B

Ralf Schön Merging of Imaging and Surgery in Endoscopic and Minimal invasive Surgical Procedures

09:55

Featured Speaker 11:44

AM Break- Exhibit Review

32

61

Marc Metzger Introduction of Preformed Spare Parts and Data Collections in Surgery

12:08

Questions & Discussion

12:18

Conference Lunch Main Entrance (1st Floor)

Saturday, 7 May Continued

Featured Speaker 15:06

71

Session VI Prosthetic and Surgical Craniomaxillofacial Reconstruction and Rehabilitation Session Chairs: Daniel Buchbinder and Robert Sader

15:26

Questions & Discussion

15:40

Session Adjourns

Round Hall Featured Speakers 13:30

13:50

62

63

Daniel Buchbinder Innovations in Computer-Assisted Planning in Head and Neck Reconstruction Michael Ehrenfeld How Much Planning is Needed for Mandible Reconstruction?

CONCURRENT SESSION Session VII Minimal Invasive and Computer-Aided Surgery Procedures Session Chairs: Beat Hammer and Sebastian Sauerbier Conference Room 9 Featured Speaker 10:40

72

Oral Abstracts 14:10

64

Alex Greenberg Experience with a New Software Planning System with Rapid Printed Custom Surgical Templates for Dental Implant Placement

14:18

65

Jamil Al-Jamali Reconstruction of Midface and Skull Base Defects with Microvascular Free Flaps

14:26

66

Marina Andreiotelli Reconstruction of the Severely Atrophic Jaw Prior to Implant Prosthetic Rehabilitation using a Stereolithographic Model. A Case Presentation

14:34

67

Esben Aagaard Combining Alloplastic TMJ Reconstruction with Orthognathic Movements via Digital Preoperative Planning and Custom Prostheses

14:42

68

John Lo Use of Surgical Navigation in Mandibular Reconstruction with Small Condylar Segment - A Preliminary Study

14:50

69

Andrew Christensen Setting a Surgical Results Baseline for Mandible Reconstruction using the Fibula Free Flap: Comparing Non-Virtually Planned Cases to Virtually Planned Cases

14:58

70

Soichi Iwai Usefulness of New Reconstruction System using Fibular Flap after Mandibulectomy

Robert Sader Imaging and Therapy Control Options in Head and Neck Reconstruction

Julio Acero Role of Innovations in Oncologic Reconstructive Surgery. Benefits for the Patient and Implications for a Specialty Oral Abstracts

11:04

73

Luc Verhamme Validation of Implant Placement in the Edentulous Maxilla using a Mucosally Supported Surgical Template

11:12

74

Heinz-Theo Lübbers Registration Techniques In Edentulous Patients

11:20

75

Giovanni Badiali Vector Control in Mandibular Distraction Osteogenesis through Simulation-Guided Navigation

11:28

76

Marco Ellis Development and Outcome of the PatientSpecific Distractor Position Guide for Craniofacial Distraction Osteogenesis

11:36

77

Jun Shimada Sagittal Split Ramus Osteotomy to Prevent Inferior Alveolar Nerve Damage using the Ultrasonic Bone Cutting Device and Endoscope

11:44

78

Maja Schlittler Comparison of Endoscopically Assisted Versus Nonendoscopically Assisted Fxation of Condylar Neck Fractures – A Randomized Controlled Trial

11:52

Questions & Discussion

12:02

Conference Lunch Main Entrance (1st Floor)

33

Session Chairs: Richard Bibb and Michael P. Grant

Saturday, 7 May ADT After Work Party

Conference Room 9

Historisches Kaufhaus

Session VIII Digital Impact on Facial Prosthetic and Rehabilitation

Featured Speakers 13:30

13:50

79

80

19:30

Musicians:

Michael P. Grant Surgical Management of Thyroid Orbitopathy: Improving Outcomes with Digital Technology

Brenda Boykin, Vocals Frederik Heisler, drums Simon Girard, Thrombone

Alexander Schramm Digital Impact on Orbital Reconstructions

Yom Maikranz, Bass

Oral Abstracts

Please see page 23 for more information about the After Work Party Concert After concert entertainment:

Emanuel Teschke, Guitar

14:10

81

Ariane Farah Colour Stability of Silicone Elastomer used in Maxillofacial Prosthetic Rehabilitation

14:18

82

Anne-Marie Riedinger Artistic Considerations and Optimal Management for an OI Facial Prosthesis

14:26

83

Richard Bibb A Critical Comparison of Rapid Prototyping and Additive Manufacturing in Extra-Oral Prosthesis Body Production

14:34

84

Rosemary Seelaus Evolution of Surgical Guide Design for Implant-Retained Facial Prosthetic Treatment: An Evaluation of Clinical Utility

14:42

85

Joerd Van Der Meer Digitally Designed Surgical Guides for Dental Implants to be Placed in the Nasal Floor

14:50

86

Shizhu Bai Ear in an Hour: An Early Report on Immediate Implant Retained Auricular Prosthesis

14:58

87

Steffan Daniel Design Criteria Hierarchy for Auricular Prosthesis Retention Mechanisms

15:06

88

Clemente Maia S. Fernandes Proposal of a Hybrid Digital/Laboratorial Surgical and Prosthetic Planning for an Auricular Alloplastic Reconstruction Through Implant-Retained Prostheses

15:14

89

Stephen C K Tam Surgical Navigation for ImplantSupported Ear Prosthesis Manufactured by CAD/CAM Technology

15:26

Questions & Discussion

15:40

Session Adjourns

Buddy Bel Paso, DJ Star of the turn table

34

Sunday, 8 May

11:09

99

Max Heiland Intraoperative Cone-Beam Computed Tomography in Oral and Maxillofacial Surgery Using A C-Arm - From First Experiences to New Prototypes with Flat Panel-Detectors

11:17

100

Christian Scheifele Clinical Results of Intraoperative 3D Image Reconstruction By C-Arm-Based Cone Beam Computed Tomography (CBCT)

Session IX Integration of Innovations in Teaching and Daily Routine Session Chairs: Nils-Claudius and Masayuki Takano Round Hall Featured Speakers 09:00

90

Nils-Claudius Gellrich Surgical Workflow Changes by Development of an Interactive Imaging Analyzing Platform

09:20

91

Rolf Ewers 3D-Planning and Computer Assisted Surgery: Past and Perspectives

11:25

Oral Abstracts

11:40

Questions & Discussion

Yasas Shri Nalaka Jayaratne 3-D Facial Anthropometric Norms for the Southern Chinese

12:00

Meeting Adjourns

12:00-16:00

ADT Board Meeting- invitation only

9:40

92

9:48

93

Masayuki Takano Usefulness and Capability of 3D Full-HD Movie for Surgical Practice

9:56

94

Baiba Ozola The Association Between Resorption of Mandibular Residual Ridge and General Bone Mineral Density

10:04

95

Marion Paris Dental Ankylosis Diagnosed by CT with Tridimensional Reconstructions

10:12

Questions & Discussion

10:30

AM Break- Exhibit Review

Featured Speaker

Session Chair: Shoij Enomoto and Christian Scheifele Round Hall 10:45

96

Pierre Boulanger Three Dimensional Tracking of Maxillofacial Shape Variations Over Long Time Periods

10:53

97

Niek Gerlach Reproducibility of 3 Different Tracing Methods Based on Cone Beam Computed Tomography In Determining The Anatomical Position of the Mandibular Canal

11:01

98

André Eckardt Cone-Beam Computerized Tomography (CBCT) as an Diagnostic Aid in CranioMaxillofacial Surgery - An Institutional Survey From 2007-2010

35

101

Brad Strong Navigation: Development and “Perspectives”

Poster Presentations Friday, May 6th

P11

Andrew Grosvenor In Vitro Deposition Measurement of Inhaled Micrometer-Sized Particles in Nasal Airways of School Age Children and Adolescents

P12

Andrew Grosvenor Three Dimensional Digital Pathway from Data Acquisition to Final Output

P13

Margaret Hamilton Virtually Created Prefabricated Surgical Guide for Navigation of Small Odontogenic Tumors

P14

Russell Harris Physical Simulation Phantoms for Otolaryngology Surgery Training

P15

Ken Inohara Using Rapid Prototype Models of the Vocal Tract to Predict Acoustic Transmission in Maxillectomy

P16

Tomoki Itamiya Clinical Application of the Very Lightweight and Highly Precise 3D Model Making Technology from CT/MRI Images

P17

Toshinori Iwai Intraoperative Three-Dimensional Imaging During Open Reduction and Internal Fixation of Condylar Head and Neck Fractures

P18

Fariborz Karimi-Boushehri Three Dimensional Reconstruction of an Ear by Means of a Five Axis Laser Scanner

P19

Hiromasa Kawana Telerobotic Bone Drilling System Based on Bilateral Control

P20

Moon Key Kim Stitching and Merging the Sectional ConeBeam Computed Tomographic Images

P21

Yasuhiro Kizu Biomechanical Three-Dimensional FiniteElement Analysis of Zygomatic Implant of Outside of Maxillary Bone

P22

Ho Beom Kwon A Three Dimensional Finite Element Analysis of Stress Distributions in Unsplinted Implants Retaining Maxillary Overdenture with Reduced Palatal Coverage

P23

Juen Bin Lai Computer-Assisted Designed - ComputerAssisted Manufactured (CAD-CAM) Polyetheretherketone (PEEK) Prosthesis for Complex Fronto-Orbito-Temporal Defect

P24

Heinz-Theo Lűbbers Computer Assisted Surgery Of The Lower Jaw

Poster # P1

Richard Barkhuysen The Tripple Template Method In Oromandibular Reconstruction

P2

Alberto Bianchi Valuation of the Head Positioning During 3D Photogrammetry

P3

Vincent Biron Revision Fibular Free Flap Mandibular Reconstruction Facilitated by Rapid Prototyping: Case Report and Review of the Literature

P4

Anne-Gaelle Bodard 3D Reconstruction in the Treatment of Anomalies of the First Branchial Arch

P5

Jörn Brom Epithetic Rehabilitation of a Large Mid Face Defect with Oral Implants

P6

Valero Diego Bisphosphonate-Associated Osteo Necrosis of the Jaw. Experience and Treatment in the Department of Dentistry Oral and Maxillofacial Surgery.  German HospitalBuenos Aires-Argentina

P7

P8

Maryam Esmaeili Influence of Cytotoxic T Lymphocyte Antigen-4 (CTLA-4) Gene Polymorphisms In Periodontitis Ana Celia Faria Volumetric Analysis of the Pharynx in Patients with Obstructive Sleep Apnea Syndrome Treated with Maxillomandibular Advancement

P9

Benjamin Foley Error Analysis of Mandibular Reconstruction Utilizing Computer-Aided Design and Computer Aided Manufacturing for the Fabrication of a Custom Surgical Resection Guide and Reconstruction Plate

P10

Bo Gao The Osteogenic Effect of Calcium Phosphate Coatings Produced by Laser Rapid Forming on Titanium

36

Poster Presentations Friday, May 6th Continued

P37

Hisashi Sawamura Preoperative Planning of Osteocutaneus Flaps with Volume-Rendered Computed Tomography Angiography

P38

Ewelina Swiatek-Najwer The Computer Aided Implantoprothetic Treatment for Cranio-Maxillo-Facial Reconstruction

P25

Koutaro Maki Orthognathic Treatment Planning Based On CBCT and FEM

P38

P26

Eriko Marukawa Evaluation of Changes in the Bone Volume after Sinus Floor Augmentation with Autogenous Bone and ß-TCP

Eirini Tripodaki Alternative Approaches in Designing CAD/ CAM Frameworks for Anterior Fixed Parcial Dentures

P40

P27

Satoshi Miyamoto Considering Angulation and Direction of Dental Implants in Prosthetic Treatments: Three-Dimensional Finite Element Analysis

Pit Jacob Voss Treatment of Bisphosponate-Associated Osteonecrosis of the Jaw with Mesenchymal Stem Cells

P41

P28

Jooyoung Ohe Evaluation of Three-Dimensional Changes after Sinus Floor Augmentation with Hydroxyapatite ?-TCP Mixed with Concentrate Growth Factor(CGF)

Kai Wolfgang Wagner Comparison of Imaging Quality of Two C-Arms, Five Cone-Beam Computed Tomographs and One Computed Tomograph

P42

Raymond Wong Using Custom Central Locator, Cutting and Positioning Guides for Zygomatic Osteotomy- Case Report of a Novel Method

P43

Samuel Xavier Treatment Option for Extensive Maxillary Ameloblastoma: Hemi-Maxillectomy Followed by Immediate Free Fibular Flap Reconstruction: Case Report

P44

Fumi Yoshioka Innovative Approach to Immediate Facial Prostheses using 3D Milling Machine

P45

Sean Young Comparison of Simulated and Actual Reduction of Complex Mandibular Fractures in an Edentulous Patient Utilizing Virtual Surgery Planning Software

P29

Raphael Olszewski Three-Dimensional Surgical Guide for Frontonasal Separation in Lefort III Osteotomy Based on Rapid Prototyping Technique

P30

Kazuhiro Otani Preoperative Planning of Secondary Alveolar Bone Grafting using 3D-CT

P31

Yasuhiro Ozawa Biomechanical Three-Dimensional FiniteElement Analysis of All-On-4 Concept for the Edentulous Maxilla. Design of Placement Angulations and Direction of Implants

P32

Mônica Da Costa Serra Informed Consent in Maxillofacial Reconstructions Performed using New Digital Technologies

P33

Wiebke Schupp Hemangioma Causing a Cleft Lip

P34

Wiebke Semper Position Accuracy of Re-Positioned Abutments in Implant Systems with a Tapered Implant-Abutment Connection

P35

Diana Shaw Modeling Services in a Healthcare Environment: The iRSM Experience

P36

Ralf Smeets A New Tool In Guided-Tissue Regeneration: Modified Silk Membranes

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Workshops Saturday, May 7th 16:00 - 18:30

CONCURRENT WORKSHOPS

Workshop #1

Sebastian Sauerbier Stem Cell Based Bone Augmentations Hosted at University Clinic

Workshop #2

Marc Metzger and Brad Strong Advanced Planning and Navigation in Head & Neck Surgery Hosted at University Clinic

Workshop #3

Wolfram Brugger, Oliver Hauschild, Lutz Hein, Marcus Heufelder and Pit Voss Update and New Strategies on Treatment of Patients with Bisphosphonates Hosted at University Clinic

Workshop #4

Dominic Eggbeer, Peter Evans, Peter Grosvenor, Ben King and Rosemary Seelaus An Exploration of Digital Technologies in Facial Prosthetic Rehabilitation Round Hall

Workshop #5

Gerald Grant and Shayne Kondor New Approaches to Rapid Prototyping Materials and Techniques in Head and Neck Reconstruction Conference Room 2-3

Workshop #6 PART 1

Ralf Schön, Cyrille Chossegros and Pit Voss Endoscopic Maxillofacial Surgery: Condylar Head Salivary Glands, Paranasal Sinus, TMJ Arthroscopy and Skull Base Hosted at University Clinic

Sunday, May 8th 13:30-17:30

CONCURRENT WORKSHOPS

Workshop #6

Ralf Schön, Cyrille Chossegros and Pit Voss Endoscopic Maxillofacial Surgery: Condylar Head Salivary Glands, Paranasal Sinus, TMJ Arthroscopy and Skull Base

PART 2

Hosted at University Clinic Workshop #7

Ralf Gutwald and Pascal Tomakidi Research Tools for 3D and Tissue Engineering Work in Maxillofacial Surgery Hosted at University Clinic

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Featured Speakers

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Julio Acero, PhD Department of Oral and Maxillofacial Surgery Complutense University, Gregorio Marañon Hospital, Madrid, Spain Dr. Julio Acero is Consultant Specialist at the Department of Oral and Maxillofacial Surgery at the “Gregorio Marañón” University Hospital in Madrid, Spain, Head of Department of Maxillofacial Surgery, Quiron Hospital, Madrid (Spain) and Associate Professor of Maxillofacial Surgery at the Complutense University of Madrid with accreditation for Full Professor. He studied Medicine and Dentistry and obtained his PhD at the university in Madrid. Julio Acero has been appointed as invited Professor in different universities around the world and Doctor Honoris Causa (University of Iasi, Romania). Dr. Acero is the Education and Training Officer of the European Association of CranioMaxillofacial Surgery and Chairman of the Educational Committee of the IAOMS

Oleh M. Antonyshyn, MD, FRCS(C) Division of Plastic Surgery, University of Toronto, Toronto, Ontario, Canada Dr. Oleh Antonyshyn is an associate professor in the Division of Plastic Surgery at the University of Toronto, with a subspecialty practice in craniomaxillofacial surgery. He earned his medical degree from the University of Toronto in 1980, and completed his surgical residency at the University of Western Ontario in 1985. Following his certification in Plastic Surgery, he pursued an additional 4 years of subspecialty fellowship training in craniofacial surgery including a travelling fellowship in Europe and Mexico City. Dr. Antonyshyn established the Adult Craniofacial Program at Sunnybrook Hospital in 1996 to address the specific needs of adult patients with post-traumatic, post-ablative, and developmental craniofacial deformities, and is currently the Head of the Program. A former member of the Examination Board in Plastic Surgery for the Royal College, Dr. Antonyshyn remains active in the education of residents and practicing surgeons., and was awarded the A. Freiberg Plastic Surgery Resident Teaching Award in 2008. He established a Clinical Fellowship in Adult Craniofacial Surgery in 1993, providing post-residency specialized training in adult craniofacial surgery to candidates from Canada, the United States, Ireland, Israel and the Middle East. He has served on the Education Committees of the Canadian Society of Plastic Surgeons and the American Society of Maxillofacial Surgeons and is actively involved in multiple CME programs. He has recently been appointed to the Global Advisory Board of the Advanced Cranio-Maxillo-Facial Forum. Research interests have remained focused on the development and implementation of technologies to allow computer assisted imaging, modelling, and rapid prototyping in the planning, execution, and morphological outcome analysis of facial surgical procedures. He has been invited to lecture at multiple national and international symposia, and is the author of over 80 journal publications and book chapters. Currently, Dr. Antonyshyn’s clinical practice is focused in all aspects of facial surgery, including facial cosmetic surgery, facial reconstruction and craniomaxillofacial surgery.

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Daniel Buchbinder, DMD, MD Prof. Dept. of Computing Science, University of Alberta, Edmonton, Alberta, Canada Daniel Buchbinder is a graduate of University of Montreal School of Dental Medicine (DMD) and the Mount Sinai School of Medicine (MD). He received his certificate in OMFS from the Mount Sinai School of Medicine and is a Diplomat of the American Board of Oral, Maxillofacial surgery . He is professor of clinical OMFS and chief of the division of Maxillofacial Surgery, Department of Otolaryngology Beth Israel Medical Center, N.Y. where he is also the director of the OMFS residency. Dr. Buchbinder has published over 88 peer reviewed articles, a number of textbook chapters, and has lectured extensively on CMF trauma and reconstruction. He is the General editor of the AOCMF Surgery reference, an award winning freely accessible Internet based resource dedicated to improving CMF fracture care. It describes hundreds of surgical procedures in great detail, giving decision-making support for treatment options, offering overviews of clinical studies, helping with diagnoses, and illustrating everything with thousands of images and videos. . Dr. Buchbinder is a member of the multidisciplinary team at the Institute for Head and Neck & Thyroid Cancer and serves on the board of directors and the scientific advisory board for the Thyroid & Head and Neck Cancer (THANC) Foundation. He also serves as chairman of the fracture and trauma reconstruction expert group (FTREG) of the AO technical commission as well as the board of trustees of the AO ASIF foundation, a non-profit organization based on a network of surgeons who are committed to the study, practice, and teaching of AO principles and their advancement in the field of trauma and musculoskeletal surgery.

Michael Ehrenfeld, Prof. Dr. med. Dr. med. dent. Director Department of Oral and Maxillofacial Surgery Ludwig-Maximilians-Universität, München, Germany Prof Ehrenfeld graduated Dental college at the Johann-Wolfgang-GoetheUniversity, Frankfurt am Main, Germany, from 1974 to 1979, and medical college from 1977 to 1982. He completed his DDS degree in 1980, his state medical degree in May 1982, and MD degree: 1985, all at Johann-WolfgangGoethe-University, Frankfurt am Main, Germany. He completed training in Maxillofacial Surgery from June 1982 - October 1986 at the Department for Maxillofacial Surgery (Head: Prof. Dr. Dr. N. Schwenzer), Eberhard-KarlsUniversity, Tübingen, Germany. In October 1987 he became Senior Physician at the Department for Maxillofacial Surgery, University of Tübingen, Germany. In 1988 he was awarded the Hans-von-Seemen-Award, German Association of Plastic and Reconstructive Surgery. Then in 1989 he received his PhD degree (habilitation) at Eberhard-KarlsUniversity, Tübingen, Germany . In 1990 he became Deputy Director of the Department for Maxillofacial Surgery, University of Tübingen, Germany and was awarded the Martin-Waßmund-Award, German Association of Maxillofacial Surgery. In 1996 he became Professor, Director and Chairman Department for Oral and Maxillofacial Surgery, Ludwig-Maximilians-University, München In 1999 he was elected Chairman of AO European Craniomaxillofacial Education and Steering Committee, reelected 2002, and again in 2004. In 2005 he was elected Chairman of the International AO CMF Specialty Board. In 2008 he was elected Chairman of the Scientific Board of the German Association of Oral and Maxillofacial Surgery. Fields of activity include: Microsurgery, treatment of malformations, traumatology, plastic and reconstructive surgery, preprosthetic surgery, including dental implantology.

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Rolf Ewers, MD, DMD, PhD Chairman of the University Hospital of Cranio Maxillofacial and Oral Surgery, Medical University of Vienna Austria Chairman and Head of the University Hospital of Cranio-Maxillofacial and Oral Surgery of the Medical School, University of Vienna, Austria Main interests: Traumatology, Reconstructive Oral, Maxillofacial and Craniofacial Surgery, Preprosthetic Surgery and Implantology, Microsurgery in the field of Cranio-Maxillofacial and Oral Surgery, investigation of bone replacement material with porous hydroxyapatite material, bone inductive proteins and bioengineered bone production. Inventor of the porous hydroxyapatite material Algipore®, development of 3-D-reconstruction models by means of stereolithography and first clinical use of an intraoperative navigation system by means of the augmented reality and clinical implementation of the VPS-Virtual Patient System with Telesurgery.

Nils-Claudius Gellrich, MD, DMD Chairman, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany Starting in 1982, Nils-Claudius Gellrich studied both dentistry and medicine at the Christian-Albrechts-University in Kiel, Germany, with study periods in Bangor (North Wales/Great Britain, 2 months), Montgomery and Birmingham (Alabama/USA, 4 months) and Zurich (Switzerland, 4 months). After acquiring his license as D.M.D. in 1987 and as M.D. in 1989, he started his specialist training in Oral and Maxillofacial Surgery at the Ruhr-University Bochum, Germany, in 1990. He obtained his board certification for Oral and Maxillofacial Surgery in January 1994 and the qualification in Regional Plastic Surgery in 1996. In 1997 he became the deputy of the chairman at the Department of Oral and Maxillofacial Surgery at the Albert-Ludwigs-University Freiburg, rising to the position as Associate Professor in 2001. He is holding a chairman position at Hannover Medical School, Department of Oral and Maxillofacial Surgery, in Hannover, Germany, since October 2004. In the course of his career Prof. Gellrich was always very active in research. His major research interests focus on tissue engineering, traumatic optic nerve lesion, neuroprotection, computer-assisted planning using virtual models in craniofacial surgery and intraoperative navigation using non-invasive registration for reconstructive surgery. He was given several grants, mainly by the German National Research Foundation, for research in these fields. His work was already rewarded with several awards, for example the Hans-Pichler-Award of the Austrian Association for Oral and Maxillofacial Surgery in 2000, the German Skull Base Society Poster Award in 2003 and the award of the DÖSAK (German-Austrian-Swiss Working Group of Head and Neck Tumors) in 2004. Prof. Gellrich is an experienced lecturer and teacher. Apart from giving lectures for dental and medical students, he is a skilled instructor in oral and maxillofacial surgery, first at Bochum and Freiburg, now at Hannover Medical School, Germany. He has been invited speaker at numerous scientific meetings and conferences and faculty member and chairman at multiple national and international workshops and courses, especially on osteosynthesis, reconstructive craniofacial surgery, microvascular reconstruction and dental implantology.

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Gerald Grant, DMD Prosthodontics Bethesda Maryland, United States Captain Grant received his D.M.D. Degree from University of Louisville, School of Dentistry in 1985. He received a certificate in Prosthodontics from the Naval Postgraduate Dental School, Bethesda, MD. in 1995 and a certificate in Maxillofacial Prosthetics from Naval Postgraduate Dental School in 1999. He is a Diplomate and of the American Board of Prosthodontics, Fellow of the ACP, AAMP and Specialty Leader to the Surgeon General for Maxillofacial Prosthetics and Implant Dentistry. Captain Grant served as Chairman and Program Director for the Maxillofacial Fellowship Officer program, Naval Postgraduate Dental School from 2004 – 2008, professor at the Naval Post-graduate and the Washington VA’s Prosthodontics Residency Program, and currently is the Director of Craniofacial Imaging research at the Naval Postgraduate Dental School (NPDS) and Service Chief of the 3D Medical Applications Department at National Naval Medical Center, Bethesda, MD and Walter Reed Army Medical Center, Washington DC.

Michael P. Grant, MD, PhD, FACS Director of Cosmetic Surgical Services and Assistant Professor of Ophthalmology and Plastic Surgery, Eye Institute Johns Hopkins University School of Medicine, Baltimore, Maryland Dr. Michael P. Grant is Director of Oculoplastic Surgery at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Dr Grant also serves as head of the Ocular and Orbital Trauma Center at the Wilmer Eye Institute and Johns Hopkins Hospital. Prior to joining the faculty, Dr Grant completed two residency training program at Johns Hopkins, the first in Ophthalmology at the Wilmer Eye Institute, and the second in Plastic Surgery at Johns Hopkins Hospital. He is board certified in both disciplines. Dr Grant is a recognized expert in the fields of primary and secondary orbital reconstruction, peri-ocular soft tissue reconstruction, and facial aesthetic surgery.

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Beat Hammer, DDS, MD Interdisciplinary Craniofacial Centre (cfc) Hirslanden Aarau, Switzerland Dr. Hammer went to the Dental and Medical School, University Zürich and graduated in Dental Medicine in 1976 and Medicine in 1980. In 1980 – 1982 he attended Cranio - Maxillofacial surgery residency at the University Hospital Zürich (under Prof. H. Obwegeser) and completed his general surgery residency at the University Hospital Kiel, Germany. In 1986 he attended the Cranio - Maxillofacial surgery residency, University Hospital Basel (under Prof. B. Spiessl) and in 1987 attended Plastic surgery residency, University Hospital Basel (under Prof. N. Lüscher). Dr. Hammer was a senior resident in 1988 at the clinic for reconstructive surgery at the University Hospital Basel (Prof. J. Prein) and in 1988 – 2003 was Associate Professor , Clinic for reconstructive surgery , University Hospital Basel (Head: Prof. J. Prein). Since January, 2003 he is a consultant cfc Hirslanden (Cranio-Facial Centre), Aarau, Switzerland Fellowships: 1989- Plastic surgery fellowship (2 months), Baltimore (Prof. P. Manson) and Toronto (Prof . J. Gruss). 1999- Craniofacial fellowship (6 months), Adelaide (Prof. D. David) Memberships: Swiss Medical Association (FMH), Swiss Society of Maxillofacial Surgery (SGKG), German Society of Oral and Maxillofacial Surgery (DGMKG), German Society of Skull Base Surgery (DGSB), International Society of Craniofacial Surgery (ISCFS) (Associate member), Croatian Society for Maxillofacial, Plastic and Reconstructive Head and Neck Surgery (Honorary member) and Swiss Ophthalmological Society ( Associate member )

Heinrich Hofmann, PhD Director, The ERU Surface, Coating, and Particle Engineering (SPERU) Ecole Polytechnique de Lausanne, EPFL, Switzerland Heinrich Hofmann studied Materials science at Technical Universität Berlin and received his PhD in Material science and engineering at the Max-PlankInstitute for Metal Research, Stuttgart. Between 1985 and 1993 was he with Alusuisse-Lonze and responsible for research and development of new inorganic powders. Since 1993 he is full professor at EPFL. His research interests are nanoparticles for medical application, nanostructured ceramic coatings and colloidal behaviour of nanoparticles.

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Donald W. M. Juzwishin Ph.D Director of Health Technology Assessment and Innovation at Alberta Health Service, Edmonton, Alberta, Canada B.A., Political Science (Alberta) 1977 MHSA (Alberta) 1980 PhD (Alberta) 2005 Dr. Juzwishin is Director of Health Technology Assessment and Innovation at Alberta Health Services. He holds adjunct associate professor status at the University of Alberta in the School of Public Health, University of Calgary in Community Health Sciences and University of Victoria in Health Information Science. He is a member of the Alberta Advisory Committee on Health Technologies whose responsibility is to assist the government in the provincial review of health technologies and services, a member of the Canadian Agency for Drugs and Technology in Health HTA Exchange, and a member of the Canadian College of Health Service Executives Ethics Committee. Dr. Juzwishin’s management experience is in complex medical teaching hospitals, health authorities, and research funding. His research interests are in health care reform, health technology assessment, health research funding and evidence based policy making.

Ben King, IDSA Industrial Design, iRSM, Edmonton, Alberta Canada Ben King is an Industrial Designer at iRSM (Institute for Reconstructive Sciences in Medicine) with extensive experience in computer-aided design, rapid prototyping, visual communication as well as product visualization and development. Ben teaches courses on 3D modeling to a variety of medical and technical professionals with the goal of enhancing the abilities of health care professionals through the integration of digital technologies.

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Marc Christian Metzger, MD DDS PhD Department of Craniomaxillofacial Surgery, University Hospital Freiburg, Germany Dr. Metzger went to the Medical and Dental School in Freiburg and graduated in Medicine in 2001 and in Dental Medicine in 2004. Since 2004 he is attending the craniomaxillofacial department Freiburg. 2008 he completed the CMF residency, 2010 PhD in shape analysis of anatomical structures and development of preformed plates.

Rolf Mülhaupt Macromolecular Chemistry Institute for Macromolecular Chemistry, Freiburg, Germany Prof. Dr. Rolf Mülhaupt (born 1954) studied chemistry in Freiburg (1973-1978) and got his PhD at ETH Zürich in 1981. After industrial polymer research at Du Pont Central Research in Wilmington/DE, USA, and at Ciba in Marly, CH, he was appointed full professor for macromolecular chemistry and director of the Institute of Macromolecular Chemistry at the University of Freiburg in 1989. Since 1992 he is also the managing director of the Freiburg Materials Research Center and since 2000 member of the Heidelberg Academy of Science. He has published more than 300 refereed papers and 90 patents. His research includes tailor-made polymers, blends, engineering plastics, biomaterials, nanocomposites, nanotechnology, polymerization catalysis, functional processing and 3D printing.

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Nils Petersen National Research Council and University of Alberta Edmonton, Alberta, Canada Dr. Nils Petersen is currently the Director General at the National Research Council of Canada in the role of leading the National Institute for Nanotechnology – a joint initiative between the Federal Government of Canada, the Provincial Government of Alberta, the National Research Council, and the University of Alberta.  Prior to this, he served as Vice-President Research at the University of Western Ontario in London, Ontario and in several other university administrative positions. Dr. Petersen continues his own research as a Professor of Chemistry at the University of Alberta.  While he is trained as a physical chemist, he has dedicated his research to understanding how proteins and lipids interact within cell membranes.  In his interdisciplinary research he has developed novel imaging tools to study molecular events in living cells and in lung surfactants and provided new insights into the mechanisms whereby signal transduction occurs at the cell membrane level.  Dr. Petersen is a graduate of the University of Western Ontario and the California Institute of Technology and has pursued his research career at Cornell University, Washington University Medical School, University of Western Ontario, and University of Alberta.

Jürgen Rühe, PhD Department, Institution Name City, State or Province, Country Dr. Rühe studied chemistry at the Westfälische-Wilhelms-Universität Münster from 1981-1986. In 1986-1989 held a position of Research Associate at the Max Planck Institute for Polymer Research, Mainz, PhD in the field of electrically conductive polymers and in 1989-1990, Post-Doc IBM Almaden Research Center, San Jose, USA, working for the coating of computer hard drives. In 1991-1995 he was Research Associate and Liebig scholarship or fellowship for German Research Foundation at the University of Bayreuth, Habilitation in Macromolecular Chemistry at the University of Bayreuth. In 1995-1999 he was Head of MPS Group “surface chemistry” on a C3-position of the MaxPlanck-Gesellschaft at the Max Planck Institute for Polymer Research, Mainz. Since 1999, Dr. Rühe has been Professor and Chair of “Chemistry and Physics of Interfaces” at the Institute for Microsystems Technology (IMTEK), Albert-Ludwigs-Universität Freiburg and Director of the Institute for Microsystems Technology (IMTEK) 2000-2006. Since 1.4.2008 he is part-time vice-rector for international affairs and technology transfer of the Albert-Ludwigs-Universität Freiburg Current research includes: • Polymers for Microsystems Technology • Tailor-made surfaces • New methods for micro-structuring • Biomaterials

• Surface analysis • Nanochemistry • Biochips

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Robert Sader, Prof. Dr. Dr. Dr. (M.D., D.D.S., Ph.D.) Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Goethe-University, Frankfurt, Germany Prof. Robert Sader is professor, head and chair of Oral, Cranio-Maxillofacial and Facial Plastic Surgery at the Goethe-University in Frankfurt. His department offers the whole field of oral-cranio-maxillofacial-plastic surgery from implantology, traumatology, orthognatics, oncology and craniofacial surgery. Main research topics are innovative technologies from 3D-simulation, material sciences to molecular medicine. Outcome of more than 300 scientific publications proves his high research standard. He is member of numerous national and international associations and has won several outstanding scientific awards. Membership of several scientific boards of associations, foundations and journals shows a sound standing political work. He is also leading member of the HFZ Basel – Center for Transdisciplinary Research in Cranio-Maxillofacial Surgery in Switzerland. He is president of the “German Academy of Aesthetic Dentistry” and the “Frankfurt Society of Dentistry 1863”. Since 2010 he is one of the deans of the Medical Faculty.

Dr. med. dent. Christian Scheifele, Director, Department for Oral and Maxillofacial Surgery and Dental Radiology Center for Oral and Maxillofacial Surgery, Berlin, Germany 1987-1993: Dental College, Fakultät für Zahnmedizin, Freie Universität Berlin, Germany. 1993-2000: Assistant Professor, Department for Oral Surgery and Dental Radiology (Head: Prof. Dr. Peter A. Reichart FDSRCS), Zentrum für Zahnmedizin, Medizinische Fakultät Charité der HumboldtUniversität zu Berlin. 1998 DDS, 2000 DMD. 2000-2008: Associate Professor, Department for Oral Surgery and Dental Radiology (Head: Prof. Dr. Peter A. Reichart FDSRCS), Zentrum für Zahnmedizin; 2008-2010 Department for Oral Medicine, Dental Radiology and Oral Surgery (Head: Prof. Dr. A.-M. Schmidt-Westhausen), Zentrum für Zahnmedizin, Charité – Universitätsmedizin Berlin. 2010: Leiter Sektion Röntgen, Klinik für Mund, Kiefer- und Gesichtschirurgie (Head: Prof. Dr. Dr. R. Schmelzeisen), Universitätsklinikum Freiburg, Germany. Chairman of the Working Group on Dental Radiology, Deutsche Gesellschaft für Zahn-, Mundund Kieferheilkunde (DGZMK).

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Ralf Schön, MD, DDS, PhD Head of Department of Oral and Maxillofacial Surgery St. Josefshospital Uerdingen Krefeld, Germany Ralf Schön attended the Dental and Medical School at HeinrichHeine University Düsseldorf, Germany. He received his OMS training at the University of Hannover and since 1997 at the University of Freiburg, Germany. As a Monbusho research fellow he spend two years at the Showa University in Tokyo, Japan to evaluate miniplate fixation and osseointegration in microsurgically revascularized iliac crest bone grafts for mandibular reconstruction. He performed experimental studies in pigs on distraction osteogenesis for his professorial thesis. He has studied overseas in Japan, USA and Australia. In 1999 he worked at the Kantonspital, Basel, Schweiz and in 2003 as a staff specialist and guest lecturer for four months at the University of Queensland, Royal Brisbane Hospital, Brisbane, Australia. Since 2004 he is holding the position as assistant Professor at the Department of Oral and CranioMaxillofacial Surgery at the University Hospital of Freiburg. His interest is in the fields of reconstructive cranio-maxillofacial surgery in head and neck oncology including microsurgery and craniofacial trauma with special considerations to minimal invasive endoscopic techniques in maxillofacial trauma management and computer assisted orbital and craniofacial reconstruction.

Alexander Schramm, MD DDS PhD Military Hospital Ulm, Academic Hospital of the University of Ulm, Germany Medical and Dental School in Freiburg. CMF training in Freiburg and Basel. PhD in computer-assisted maxillofacial surgery. 2004 vice chairman and associate professor, Medical School Hannover. Since 2007 professor and chairman, Military Hospital Ulm, Academic Hospital of the University of Ulm, Germany.

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E. Bradly Strong, M.D., F.A.C.S. Associate Professor, Computer Modeling, Facial Trauma and Sinus, UC Davis Health System, Department of Otolaryngology Sacramento, California, United States Dr. Strong has formal training in both Facial Plastic Surgery as well as Otolaryngology. His clinical interests focus on orbital/midface trauma as well as computer aided endoscopic sinus and skull base surgery. Dr. Strong is internationally recognized for his expertise in the treatment of facial trauma and post traumatic facial deformities. He has helped pioneered minimally invasive, endoscopic approaches for the treatment of orbital blow out and frontal sinus fractures, as well as computer assisted techniques for facial reconstruction.

Adrian Sugar FDSRCS (Eng,Ed) FDSRCPS MDhc hon fellow(UWIC)

Consultant / Senior Lecturer in Cleft and Maxillofacial Surgery Clinical Director, South Wales Cleft Service Morriston Hospital and Swansea University Medical School ABM University Health Board Swansea, Wales, UK Adrian Sugar’s main interests are craniofacial deformity and trauma, craniofacial and oral implants. He established in Wales in 1987 the first UK multidisciplinary team for the use of craniofacial implants and in 1994 the first UK team to carry out distraction osteogenesis in the head and neck. He is Director of the South Wales Cleft Unit and Training Director for OMFS in Wales. He has a special interest in the treatment of hemifacial microsomia and secondary cleft deformities as well as in the use of 3D planning technology. Adrian is an active lecturer internationally with AO, is Chair of the international AO Research Fund and sits on the International AO Specialty Board for Cranio-Maxillofacial Surgery. He chairs the UK NHS Cleft Development Group which oversees all cleft care in the UK.

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Professor Hans-Florian Zeilhofer, Dr. h.c., MD DDS Head of the Departments of Cranio-Maxillofacial Surgery, University Hospital Basel/Switzerland and of Kantonsspital Aarau/Switzerland, Head of Hightech Research Center of CMF-Surgery of the University of Basel, Spokesman of the research coalition “Clinical Morphology & Biomedical Engineering (CMBE)” of the Medical Faculty of Basel/ Switzerland, President of Swiss Society of Maxillo-Facial Surgery SSMFS. University Hospital Basel, Switzerland Hans-Florian Zeilhofer was born 16th November 1952 in Freising/Germany. He graduated as a stipendiary of the “Studienstiftung des Deutschen Volkes” in Munich/Germany, from Ludwig-Maximilians-University and from University of Technology of Munich in Medicine and Dentistry, and from Jesuit College of Munich in Philosophy. 1997-2002 he was assistant medical director at the Department of Oral and Maxillofacial Surgery of Technical University Munich, 2000-2002 he was also external research manager at “ceasar” (center of advanced european studies and research) in Bonn. 2001 he founded the “hightech research center for advanced cranio-maxillofacial surgery” at the University Hospital of TU Munich. 2002-2005 he was spokesman of the Bavarian Research Network for Tissue Engineering and Rapid Prototyping (FORTEPRO), a network with 14 Institutes from 5 Universities and 18 industrial partners. Since June 2002 he is Professor of CMF-Surgery at the University of Basel, Head of the Department of Cranio-Maxillofacial Surgery at the University Hospital Basel, and Head of the Department of Maxillofacial Surgery at Kantonsspital Aarau/Switzerland. Since July 2004 he is also Head of the Hightech Research Center of CMF-Surgery which he established at the University of Basel. 14 interdisciplinary research teams are currently working there. Since 2005 he is in addition spokesman of the multidisciplinary research coalition “Clinical Morphology & Biomedical Engineering CMBE” of the University Basel, and also project leader and member of management committee for Computer Aided and Image Guided Medical Interventions (CO-ME) at the National Center of Competence in Research, NCCR, Switzerland. In 2005 he became also Doctor honoris causa of the University of Medicine and Pharmacy „Iuliu Hatieganu“, Cluj-Napoca/Romania. In July 2005 he inaugurated the “International Bernd-Spiessl-Symposium for Innovative and Visionary Technologies in Cranio-Maxillofacial Surgery”, in November 2005 he was Congress President of Swiss Society of MaxilloFacial Surgery, SSMFS. In September 2006 he was elected for Councillor for Switzerland at the European Association for CranioMaxillofacial Surgery, EACMFS. Since 2007 he is member of Scientific Advisory Board of the Graduate School in Advanced Optical Technologies (SAOT), University Erlangen-Nürnberg/Germany. In 2007 and 2008 he was President of the German Austrian Swiss Association for Tumours of the Head and Neck (DÖSAK). Since October 2007 Zeilhofer is President of the Swiss Society of Maxillo-Facial Surgery, SSMFS. His main fields of clinical work are econstructive surgery with 3D technologies and intraoperative navigation systems, orthognathic surgery, surgery of cranio-maxillofacial anomalies, tumor surgery, traumatology and reconstructive plastic surgery. His main fields of interest in research are Computer Assisted Surgery (CAS), intraoperative navigation systems, 3D-technologies (e.g. medical rapid manufacturing) and 3D surgery planning. Virtual reality in surgery environment, scientific networking and telemedicine. Laser treatment and laser surgery. Tumorbiology. New materials for CMF-surgery. Tissue engineering and new implant technologies.

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Abstracts All abstracts are published as submitted by author.

Oral Program Friday, 6th May 2011

The specially developed and CE-certified centrifuge can be used inside the operating facility (A). The tube for the processing of autologous thrombin is placed in the blue counter weight and the two-chamber container opposite (B). Red blood cells are kept under the floating shelf in the large chamber while the mononuclear cells and thrombocytes settle in the small chamber (left side of C). Close up of the small chamber after most of the supernatant has been removed (D). The amber coloured fluid is the supernatant. The white line is composed of mononuclear cells. This layer floats on top of the thrombocytes.

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1

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Biomaterials and Biofunctional Processing

Microsystems for Medical Applications

Mülhaupt, R

Rühe, J. University of Freiburg – IMTEK

Abstract to go here..

Department of Microsystems Engineering Freiburg, Germany Recent progress in the field of microengineering has opened new horizons for the development of new types of medical devices. These devices monitor the well-being of a person for extended periods of time and detect any critical situations such as unusually elevated or reduced level of blood sugar, unhealthy high or low blood pressure, or an unexpected immune reaction. They respond to any severe problem they encounter either by communicating the problem to the patient or by directly alarming an emergency response unit over cellular phone. Smart sensor/ microdevice couples will intervene in critical situations or in situations that require a planned intervention, directly through the controlled release of a drug. Aside from all issues that concern the technical principles connected to such devices the interaction of microsystems with a biological environment is of critical importance and properties such as hemocompatibility are often crucial. In this presentation strategies and principles are described that help to understand such interactions. Especially surface-attached polymer layers were found to be interesting interfacial architectures in this regard and can be successfully used to control protein adsorption and cell adhesion of microsystems in a reliable way and also help to generate highly sensitive lab-on-chip devices.

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Notes

Multifunctional Nanoparticles: A Potential Tool for Theragnostic Hofmann, H. *1, Salaklang, J.2, Fink-Petri, A.2, Bernau, V.1, Hofmann, M.3 1) Powder Technology Laboratory, Ecole Polytechnique Federale de Lausanne,EPFL, Switzerland 2) Powder Technology Laboratory, EPFL, now University of Fribourg, Switzerland 3) MatSearch Consulting, Pully Switzerland Based on the clinical unmet needs and recent research in biomarkers the main objective of our work is to develop a nanotechnology based novel diagnostic tool for easy and early detection of biomarkers by using modified superparamagnetic nanoparticles (SPION) for (A) bioassay (ex-vivo application) and (B) MRI (invivo detection). On the other hand, we like to use the same nanoparticles a therapeutic tool for drug delivery or local heating. A new technology based on multiple functionalized single nanoparticles or small beads specifically entering/attaching to cells or organelles in living cells was developed to detect, separate and identify low abundance biomarkers. In this presentation a detailed description of the concept using inorganic nanoparticles for protein separation out of living cells and as MRI contrast agent for molecular imaging will be given. A special focus will be given on the newest results regarding targeting of organelles and, especially important regarding the above mentioned project, the specific separation of proteins from living cells and their potential use for identification of new biomarkers. Finally the further potential of inorganic nanoparticles as therapeutic tool will be discussed based on recent results regarding gene delivery and hyperthermia.

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SESSION I:

synthesis. We transferred these ODNs into cultured oral squamous cell carcinoma cells (SAS cells) using the hemagglutinating virus of Japan (HVJ)–liposome method.

Medical MicrosystemsTheragnostics

4 Newly Regulation Strategy Against Tumor Angiogenesis and Chemosensitivity Using Decoy System. Ishibashi, H.* Katoh,T. Koike,H. Karino,M. Tsunematsu,K. Sekine.J.

Hideshima,K.

Shimane University Faculty of Medicine Oral and Maxillofacial Surgery Izumo, Shimane, JP Purpose: Vasculature development is thought to be an important aspect in the growth and metastasis of solid tumors. Among the many angiogenic factors produced by tumor cells, vascular endothelial growth factor (VEGF) is considered to play a key role in angiogenic processes. The synthesis of VEGF is modulated through hypoxia-inducible factor-1 (HIF-1) function following hypoxic microenvironment of growing cancer tissue. HIF-1 transactivation by hypoxia also plays an important role in chemosensitivity for anticancer agents via induction of multidrug resistance (MDR1). Methods & Materials: To inhibition of HIF-1 activation, oligodeoxynucleotides (ODNs) were synthesized and transferred with either the consensus sequence for HIF-1 binding or a mutated form of this sequence. If we could transfer ODNs excessively in the cancer cell nucleus, activated HIF-1 might bind to the ODNs, resulting in inhibition of hypoxia-induced VEGF and MDR1 synthesis. We transferred these ODNs into cultured oral squamous cell carcinoma cells (SAS cells) using the hemagglutinating virus of Japan (HVJ)–liposome method. Methods & Materials: To inhibition of HIF-1 activation, oligodeoxynucleotides (ODNs) were synthesized and transferred with either the consensus sequence for HIF-1 binding or a mutated form of this sequence. If we could transfer ODNs excessively in the cancer cell nucleus, activated HIF-1 might bind to the ODNs, resulting in inhibition of hypoxia-induced VEGF and MDR1

Results: The hypoxia-mediated expression of VEGF and MDR1 by the cancer cells could be simultaneously suppressed by transfection of HIF-1 decoy ODNs, but not by mutated HIF-1 decoy ODNs. HIF-1 decoy ODNs transfection also inhibited the protein synthesis of VEGF and P-glycoprotein, and increased the drug sensitivity for anti-cancer agents. Conclusion: These results suggest that the transfection with HIF-1 decoy ODNs would be simultaneously effective for regulating tumor growth and chemosensitivity by reducing VEGF and MDR1. In addition, HIF-1 has been known to be related to the thrombus formation in blood vessels. Thus necrosis of the reconstruction flap due to thrombus could be also inhibited using HIF-1 decoy strategy.

5 Tridimensional Visualization of Bone Tissue in Peri-Implantitis: An X-Ray Computed Micro-Tomography (XMT) Analysis. Maglione, M.*, Costantinides F, Zanini F, Tromba G, Rizzardi C. University of Trieste, School of Specialization in Oral Surgery, Dental Clinic, Trieste, IT Purpose: Implant failures are due to different causes as mobility, abutment fracture, occlusal overloading, and peri-implantitis. Peri-implantitis is defined as an inflammatory process affecting the tissue around an osseointegrated implant in function, resulting in loss of supporting bone. Aim of the work was to perform a tridimensional microtomographyc examination of hard tissue surrounding implants failed because of peri-implantitis. Methods & Materials: Dental implants with diagnosis of peri-implantitis were surgically retrieved. Bone tissue entrapped on implant surface was demineralised, detached from the implant surface and analyzed by X-ray computed Micro-Tomography (XMT), then

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fixed and processed for histological examination. Source of x-rays was synchrotron light radiation.

Notes

Results: XMT gives a clear visualization of the whole samples and allows a precise characterization of the interface. Images show irregularities of bone surfaces and empty spaces in areas of bone sequesters. These data are confirmed by histological specimens. Conclusion: Clinical cases of implant retrieved for peri-implantitis and their features are shown. X-ray computed Micro-Tomography (XMT) provides three-dimensional information on the structural and morphological information of bone and gives a full insight of the inner architecture of the mineralized tissues. It is not destructive and it does not require a specific sample preparation. Microscopical pattern is extremely important in identifying the causal determinants of implant failure and permits to confirm diagnosis on implants failure cause. X-ray computed Micro-Tomography (XMT) represents a new approach for not destructive analysis of mineralized tissues surrounding dental implants

6 The Bioimplant, an Innovative Concept in Cranio – Maxillo – Facial Oncologic Reconstructive Treatment, Using Tissue Engineering and Advanced Digital Technology Gilewicz, J.*, Jaworowski, J., Rysz, M. Maria Sklodowska-Curie Memorial Cancer Center, Head and Neck Cancer Department Warsaw, PL Purpose: Bioimplant is an interdisciplinary project of medical and engineering teams of Polish researchers. It is aimed at developing an alternative to post ablative microvascular flap reconstruction in major oncologic bone defects in cranio - maxillo – facial region. The aim of this project is to develop and clinically use a custom made tissue engineered bone implant (Bioimplant)

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for restoration of major oncologic bone defects of the head and neck. It involves implanting a self absorbing scaffold made of biomaterials and, on the other hand, titanium scaffolds which are simultaneously colonized with stem cells. These are induced by tissue engineering methods to cause reconstruction and regeneration of patients’ own bone in the postresection site. The scaffolding is custom prepared by rapid prototyping using imaging technology based on virtual models from highly sensitive CT scans. The implantation of the Bioimplant would be performed under control of intraoperative navigation systems, based on virtual planning custom made software. Methods & Materials: The project is subdivided into three main phases. Phase 1: the development of technology of tissue engineered products (nanotechnological scaffold, its’ ingredients, materials and shaping; stem cells inducement; other biological factors) for the prototype of the bone implant and methods of computer assisted placement of the implant. Phase2: preclinical in vitro research and in vivo studies on small (mice) and large (sheep) animals. Phase3: preclinical and clinical trials on a model patient, preparation for implantation by computer assisted surgery, ethical and economical assessment of clinical usage of the final product. Results: Currently Phase 1 of the research is conducted. The presentation will encompass the up-to-date stages of the project and the achieved milestones. Conclusion: The Bioimplant concept can be helpful in developing new procedures for reconstructive treatment of hard tissue benign and malign tumors in the head and neck, with stress on the improvement of patients’ quality life. It could also simplify resection, reconstruction and rehabilitation of facial skeleton tumors eliminating complications of graft harvesting and morbidity of the donor site of the osteocutaneous microvascular flaps.

7 Modern Biomaterials and New Technologies in Tissue Engineering for Reconstruction of the Head and Neck-Region Smeets, R.*, Blessmann, M., Kolk, A., Heiland, M. Aachen, DE Purpose: Today there are several optional methods available which constitute an interesting alternative to complex reconstructions by autologuous transplants or at least serve as an addition to the latter. Tissue engineering (in vitro and in vivo) is one of these options. Beside suitable scaffolds different cells and cytokines are essential. However the bottom line is a sufficient vascular nutricial supply of the cells and newly formed tissue. New interesting approaches are recently developed individual scaffolds on the basis of ß-TCPceramic, which are produced by selective laser melting or N-Fibroin based silk-scaffolds and membranes having a high number of interconnecting pores. They deliver growth- and differentiating factors by gene transfer. A further key goal is new drug delivery systems for these growth- and differentiating factors. Recently our own research group has introduced a thrombine delivery system for locally controlled labored coagulation e.g. of anticoagulated patients undergoing dental or regional orthopeadic surgery. Conclusion: Furthermore a nerve regeneration system resting upon a gene activated silk membrane is in progress. By this overview current methods in the sense of state of the art and alternative future perspectives will be presented.

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8 Bone Regeneration with Adipose-Derived Stem Cells in Rabbit Calvarium Salvador, E.*(1), Maglione, M. (1), Ruaro, M.E. (2), Melato, M. (1), Di Lenarda, R. (1), Bregantini, F. (3), Tromba, G. (4), Dreossi, D. (4), Sodini, N. (4) (1)University of Trieste, Trieste, Italy (2)Sissa, Trieste, Italy (3)Geistlich Italia (4)Elettra, Trieste, Italy (1)Unit of Oral Surgery, Dentistry and Stomatology Clinic, Department of Biomedicine, University of Trieste, Trieste, Italy, Trieste, IT Purpose: Stem cells have given copiously proof to be able to calcificate both in vitro and in vivo implanted under the skin, if conveniently differentiated. However nowadays, it doesn’t exist yet in scientific literature a study on their efficiency in the osseous regeneration, and this task is the real aim of this experimentation. Methods & Materials: 8 White Rabbit New Zealand, have been submitted to a first operation which consisted in a sampling of adipose interscapular tissue, from which have been isolated, expanded and differentiated towards the osteogenic line some adult stem cells, following the protocol published by Kakudo (Kakudo et al., 2008). In a second operation have been created 5 different defects on every animal’s calvarium, which had a 0,6 cm diameter and were 0,2 cm deep (these measures have been taken by an appropriate caliber). 4 defects have been regenerated using 2 different conveniently modified scaffolds produced by Geistlich®, with and without the aid of stem cells. After the insertion the part has been covered with a collagen membrane fixed by 5 modified titan pins (Altapin ®). The defect in the front has been left empty on purpose as an internal control to each animal. These animals have been sacrificed in pairs, respectively after 2, 4, 6, 10 weeks. The samples have been submitted through MicroCT analysis to a synchrotron light, through the attainment of 1200 slices for every sample. Once slices have been binarizated through an Otsu algorithm, stereologic parameters have been calculated and after that each sample has been submitted to histological analysis. Results: Histological analysis: Regeneration has occurred in an optimal way in every sample treated with scaffolds. The use of adult stem cells combined with scaffolds, seems to accelerate some steps of the normal osseous

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Notes

regeneration: in fact we assist to a precocious new deposition and calcification of the extra-cellular matrix. Only the non-regenerated defect shows a deficit in the calcification of the sample up to the 10th week. MicroCT analysis: When comparing the histograms obtained for both Bioss and Bioss with stem cells, the quantity of new bone for the Bioss+ stem cells samples is higher than for the Bioss alone ones, when the age is considered. The same conclusion was obtained by the histological analysis. Conclusion: The use of adult stem cells combined with scaffolds, seems to accelerate some steps of the normal osseous regeneration. Next studies on this subject will individuate the best biomaterial to sustain the potential shown by these cells and will quantify the effective contribution to the regeneration.

9 Pre-Vascularization of 3D Scaffolds for Tissue Engineering Application in Critical Size Bone Defects Duttenhoefer, F. (1,2)*, Sauerbier, S. (2), Benneker, L. (3), Richards, G. (1), Alini, M. (1), Verrier, S. (1) 1. AO Research Institute Davos, Switzerland 2. Department of Oral and Maxillofacial Surgery, Albert-Ludwigs-University, Freiburg, Germany 3. Department of Spine Surgery, Inselspital, University of Bern, Switzerland Davos, CH

seeded with autologous Endothelial Progenitor Cells (EPC) and bone marrow Mesenchymal Stem Cells (BMSC) Methods & Materials: BMSCs were isolated from human bone marrow (KEK Bern126/03) by Ficoll-Paque densitygradient centrifugation. EPC (CD133+ and CD34+ cells) were further isolated from the BMSC fraction using MACS® magnetic MicroBeads kit (Miltenyi-Biotec). Tubular forming capacity of EPCs alone or in association with BMSCs was first assessed on 2D Matrigel® (BD) coating. The cells were stained either with Fluorescent Cell Linker Kit® (Sigma) PKH67-green (EPC) or PKH26red (BMSC) and imaged via confocal microscopy at different time points. In a 2nd set of experiments, cells were co-seeded in a 3D polyurethane scaffold in presence of Platelet Rich Plasma (PRP). The seeded scaffolds were subsequently cultured in different media conditions. Samples were harvested at day 7 and 21 and cryosectioned. Further histological (toluidine blue) and immunostaining (endothelial markers) were performed. Results: On Matrigel® assay, EPCs showed the capacity to re-organize themselves in a cellular network typical for endothelial cells. When co-cultured with BMSCs, an improved conjoint tube-like formation was observed. In the 3D scaffolds, both cell types participated in forming complex arrangements leading to tubular-like structures formation from day 7. Immunostaining showed positive staining using antibodies specific for endothelial cells (CD31, vWB). Conclusion: Co-culturing of EPCs and BMSCs in 2D and 3D cultures increased EPC and BMSCs enhanced formation of early tubular structures within the scaffolds. Our results showed that both cell types are participating to these cells re-organization.

Purpose: One of the foremost challenges in reconstructive surgery is the treatment of critical sized bone defects (CSD). To date, the gold standard treatment of CSDs is the use of autologous bone grafts. However, it involves donor site morbidity and has limited availability. Over the last decades, tissue engineering approaches have been developed. Based on the association of a supporting scaffold with autologous cells, they aim to restore the damaged tissue. Early neovascularization of these constructs, needed to prevent hypoxia, cell death and implant failure, is still the major obstacle. Consequently, the goal of our research is to develop a pre-vascularised hybrid bone graft made of a scaffold

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10

Notes

The Potential of Nanotechnology for Medicine Petersen, N. Medical School Hannover Department of Oral and Maxillofacial Surgery, Regional Plastic Surgery Hannover, Germany Nanotechnology offers a pervasive, persistent, and powerful approach to changing the way we develop new materials, devices, and products.  Nanotechnology is on the path to drive a trillion dollar economy over the next decade.  Nanotechnology will directly impact the field of medicine – or more broadly health and wellness – by providing better tools for diagnosis and management of diseases, by introducing novel approaches to treatment, by facilitating drug discovery, and by allowing fundamentally new ways to study biological systems.  This presentation will highlight why nano-scale science and technology is different and provide some examples of new impacts in the medical field, and point to some exciting opportunities for the physical scientists, engineers, and medical practitioners to work together in new ways.

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SESSION II: 3 D-Planning and Outcome Analysis in Head & Neck Reconstruction

The use of this technology will be demonstrated in: 1. The guiding and positioning of osteotomy segments. 2. The reconstruction of skeletal defects with autogenous bone grafts. 3. Facial skeletal augmentation with autogenous grafts and bone substitutes.

11 3D Models for Design and Outcome Analysis in Craniofacial Surgery Antonyshyn, Oleh M.

12

Sunnybrook Health Sciences Centre

Laser/Non-Invasive Imaging and Prototyping Technology in the Reconstruction of War Trauma Injuries

Plastic, Cosmetic and Craniomaxillofacial Surgery Head, Craniofacial Program Division of Plastic & Reconstructive Surgery

Grant, G.

Toronto, ON Canada

Bethesda, MD, US

Craniofacial deformities are characterized by deficiencies, and disproportions, or asymmetries of the craniofacial skeleton. These features can be clearly imaged pre-operatively and computer modeling can be very effectively employed to perform optimal virtual reconstructions. However, Intraoperative implementation of these virtual reconstructions remains problematic.

Most medical application of Rapid prototype fabrication is base on computed tomography (CT) or Cone beam CT images to capture soft and hard tissue tomography. Advances in Laser scanning and photo mapping techniques have given rise to 3d camera systems that can accurately capture soft tissue contours for fabrication of prostheses and adjunctive medical devices. This paper will provide a review of technology, techniques, and case studies using non-invasive scanning.

This presentation describes our use of mechanical templates, molds and forming tools to transfer virtual surgical designs to the patient in the operating room. Application of the technology will be demonstrated primarily in the reconstruction of the upper half of the facial skeleton. Virtual 3D reconstruction is initially based on a quantitative derivation of the missing or the desired geometry. This is based on asymmetry analysis, or interpolation from reference skulls in database, or on direct extrapolation of skeletal changes resulting from soft tissue surface manipulation. Haptic modeling is then further employed to modify the optimized virtual 3D models to meet clinical requirements or limitations. The completed virtual 3D reconstructions are then used to print 3D physical prototypes that are sterilized and taken to the operating room to be used as anatomical molds or templates, and forming tools.

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Notes

Evaluating State of the Art Cranioplasty Plate Design and Fabrication Eggbeer, D.*, Bibb, R. Loughborough University, University of Wales Institute Cardiff Loughborough Design School, The National Centre for Product Design & Development Research Cardiff, UK Purpose: Many methods of cranioplasty production are used in the UK, with some methods more clinically widespread than others. The application of computeraided technologies is now common in most clinical cases; however, the degree to which technology is used varies. The most common application of technology is rapid prototyping, which is used to produce a replica model of the defect, with lab-based techniques employed to complete the process. The use of computer-aided design to reconstruct the defect is gaining popularity in regular clinical practice, but it still relies upon lab techniques to produce the final implant. Full computer-aided cranioplasty implant design and additive manufacture (CAD/AM) is now available; however, it is not yet in widespread application. There is a need to measure the cost and clinical effectiveness of the most common techniques in order to understand the appropriateness for application. This research investigates common methods of cranioplasty construction and critically evaluates the methods in terms of efficiency and clinical effectiveness. Methods & Materials: Three titanium cranioplasty production methods were studied: RP models with lab techniques; computer-aided defect reconstruction with lab techniques; full CAD/AM. Cases from major UK maxillofacial/neurological units were compared. A relatively common, hemicraniotomy case style was chosen to study and suitable patient cases identified at each unit. Records were kept of lab technician time, material costs, equipment used and equipment lead-time. Qualitative investigations into why technology is used or is not used were also made.

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Results: Initial results highlight the need to develop more efficient CAD/AM methods that ensure economic competitiveness against more conventional, lab-based techniques. Final results on efficiency and the implication of digital technologies on the work flow will be concluded. Conclusion: This research provides a critical analysis of the most commonly used methods in cranioplasty production and compares them with state of the art in CAD/AM.

14 A Treatment Algorithm for Customized Implants in Patients with Large Skull Bone Defects and First Results Lethaus, B.*, Poort Ter Laak, M., Poukens, J., Beerens, M., Koper, D., Kessler, P. Maastricht University Medical Center Department of Cranio-Maxillofacial Surgery

patients a secondary reconstruction was performed after failure of primary reconstructive attempts using autogenous bone. Four patients did not have any other reconstruction intervention before the insertion of the CAD/Cam designed plates. Results: In all cases the customized implants fitted accurately into the bony circumference of the defect. No adjustments had to be performed to the implants or the skull bone. The average operation time was 105 minutes (range 75-151 minutes). The follow-up ranges from one to 45 months. The average time of hospitalization was 4.5 days. In only one patient a reentry operation was necessary. No other complications were noted. Conclusion: A treatment algorithm for patients with large skull bone defects of various origins has proven its reliability in a series of 12 consecutive patients. The first results are promising and demonstrate the state-of-the-art techniques today. Prerequisites for a successful treatment are a precise scan protocol, a close cooperation between engineer and surgeon during the planning period, a valid up to date data set based on a CT-scan of the patient’s skull and the technical possibility of manufacturing skull implants.

Department of Neurosurgery IDEE Instrument Development Engineering & Evaluation Maastricht, NL Purpose: Purpose of this study is to present our treatment algorithm in the reconstruction of large skull bone defects which is based on the close interaction of radiologists, computer engineers and cranio-maxillofacial surgeons. We present our first clinical results in patients of the Department of Cranio-Maxillofacial Surgery at the Maastricht University Medical Centre (MUMC). Methods & Materials: Between June 2006 and April 2010 twelve consecutive patients have been operated and have followed the same treatment protocol. Titanium and Polyetheretherketone (PEEK) were used to manufacture the implants. All patients were presented by the Department of Neurosurgery of the MUMC. The average age at operation was 44.5 years. Reasons for the skull defects were operations due to treatment of intracranial abscesses, cerebral hemorrhages, epilepsy and fractures. In eight

15 Custom Polymethylmethacrylate Implant Cranioplasty Korus, L.*, Kwan-Wong, T., Grosvenor, A., Louie, G. University of Alberta and The Institute for Reconstructive Sciences in Medicine Department of Surgery, Division of Plastic Surgery Edmonton, CA Purpose: Polymethylmethacrylate (PMMA), first described in 1940 for use in cranioplasty, is a popular choice for reconstruction of calvarial defects. Traditionally PMMA implants are fabricated intraoperatively by cold curing followed by manual molding of desired contour. Disadvantages of this technique are high temperatures and that large, complex defects are poorly addressed in terms of cosmesis, strength, and stability. Advances in digital imaging technology now allows for

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custom fabrication of PMMA patient specific implants. The purpose of our study is to evaluate the outcome of custom PMMA implants in alloplastic cranioplasty.

Notes

Methods & Materials: A retrospective chart review was undertaken of all patients who have undergone alloplastic cranioplasty using custom PMMA implants supplied by the Institute for Reconstructive Sciences in Medicine (iRSM) in Edmonton, Canada between 20062010. Implants were designed and built using CAD-CAM technology. Computed Tomography dicom data was imported and edited in Mimics® 9.11-13.1 software, (Materialise, Ann Arbor, MI, USA) then subsequently loaded into Freeform Modeling Plus software (SensAble Technologies Inc., Woburn, MA, USA). Wax prototype of the implant was printed in Thermojet Sold Object and the defect in Invision SR (3D Systems, Valencia, CA, USA). The wax prototype was adapted and refined to fit the model of the defect area. This custom implant was fabricated in PMMA in a pressed mold of the wax prototype. Results: Forty-seven patients underwent cranioplasty with fifty custom PMMA implants. Average age was 41.8 (5-76). Most commonly implants were used as salvage for infected bone flaps although 17 were for primary cranioplasty. Indications for cranioplasty were trauma, malignancy, intracranial hemorrhage, epilepsy surgery, and CNS infections. Ten of the 47 (23%) patents required additional surgery after the PMMA cranioplasty. Five (10. 6%) had removal of implants for infection, only one of which was successfully replaced with a second PMMA implant. Out of 3 patients requiring revision for implant exposure, 2 were salvaged. Thus 42/47 (89.4%) were successfully reconstructed. Previous infection at site of cranioplasty had higher risk of subsequent complication (20%) vs. (14%). The remaining two complications requiring additional surgery were contour deformity and CSF leak. Conclusion: Custom PMMA cranioplasty is a reliable option in complex calvarial reconstruction

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16 Calvarial Reconstruction with CAD/CAM Fabricated Titanium Plate Implants Snaathorst, J.*, Wolvius, EB., Bijvoet, HW., Dumans, AG. Erasmus Medical Centre Oral and Maxillofacial Surgery Rotterdam, NL Purpose: Decompressive craniectomy might be required in the case of tumours, intracranial bleeding and trauma. Primary calvarial defects are seen following trauma and secondary defects may result from bone flap loss due to infection, i.e. osteomyelitis and osteoradionecrosis. Protection of the brain, a satisfying cosmetic result and “Syndrome of the trephined” are indications for cranioplasty. Materials used for cranioplasty may either be synthetic or autologous. Computer-aided-design and reconstruction has lead to reduced operation time and improved cosmetics. The most commonly used materials for reconstruction are titanium, polymers, ceramics, hydroxylapetite and polyetheretherketone. Literature has reported cranioplasty with titanium plates to be suitable for calvarial reconstruction of all sizes, providing the lowest complication rate, reasonable costs regarding complications and removal rates over long-term periods, and the possibility of acceptable postoperative imaging. In this retrospective analysis we present our experience with cranioplasty using titanium implants in 22 patients.

of these 22 patients. The recorded data included indications, size, location, primary or secondary reconstruction, complications and co-morbidity. Results: Our group consisted of 10 female and 12 male patients. Calvarial defects were due to intracranial bleeding in 9 patients (traumatic or vascular), due to trauma in 1 patient, due to tumours in 11 patients. One patient was treated for fibrous dysplasia (occipital). The mean follow-up was 17 months (range 1 – 67 months). There were 5 complications leading to loss of the titanium implant which accounts to a rate of 23%. Three of these patients were secondary reconstructions, of which one was an IV drugs user with poor nutritional status. In one patient the skin was severely compromised due to previous trauma. In one there was documented difficulty with skin closure. The other 2 failures both were treated with radiotherapy prior to implant placement. The 3 patients who were primarily reconstructed with a computer-aided manufactured titanium plate were all successful. The fit was perfect. Conclusion: Although the in the literature reported rates for success of cranioplasty with titanium plates seem to be fairly high, in this study 23% of the plates were lost. Compromised vascularity of the surrounding (skin-tissue) seemed to play an important role. Accurate pre-operative planning and optimizing quality and quantity of the overlying skin is of utmost importance for primary and secondary cranioplasty. For future cases, computer-aided resection and reconstruction seems to be a reliable method.

Methods & Materials: Between 2003 and 2010 titanium cranioplasty was performed on 22 patients in the Erasmus University Medical Centre. In 20 cases with an existing cranial defect a preoperative, highresolution computed tomographic scan of the patient was initially obtained. Subsequently, the model was waxed up and after assuring the right dimensions a titanium plate was manually fabricated. Holes for fixation were pre-drilled. In most cases the plate was punctured with holes for reducing weight, x-ray disturbance and dural suspension. In 3 patients the skin was expanded before implant placement. In one case a giant frontal meningeoma was planned for resection and reconstruction in one procedure using software from Materialize (Leuven, Belgium). A second case of occipital fibrous dysplasia and a third case of frontoparietal meningeoma were treated accordingly. The data were collected from the medical files

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Notes

ICAT Imaging, Virtual Modeling and PatientSpecific Prototyping in the Planning for Combined Bilateral Autologous Reconstruction and Baha® Placement in Patients with Microtia: A Report of Innovative, Technology-Based Team Planning Toward Improved Treatment Outcomes. Seelaus, R. *, Silverman, A., Cager, G., Cohen, M. University of Illinois College of Medicine The Craniofacial Center, Division of Plastic and Reconstructive Surgery, Department of Surgery Chicago, IL, US Purpose: Congenital conductive hearing loss is associated with patients presenting with microtia. The Baha®, introduced in the early 1980’s and subsequently approved for use in children in the US in the late 90’s, has been effective in the rehabilitation of patients with a conductive hearing loss. Preoperative planning for Baha® implant placement becomes essential in patients with microtia when auricular reconstruction is anticipated. Coordinated surgical planning utilizing 3D digital technologies offers enhanced potential for achieving optimal treatment outcomes. This presentation demonstrates innovative techniques in computer-assisted pre-operative team planning for optimal Baha® placement, with special consideration for future autologous reconstruction. Methods & Materials: 2D &3D radiographic and photographic data were acquired for virtual surgical planning for a five year old female with bilateral microtia and conductive hearing loss. 2D & 3D photographic data were acquired from the patient’s brother as ‘eardonor’. Ear position was virtually planned using ‘donor’ ear images, then verified clinically. Radio-opaque markers were used to delineate area of intended ear position on the patient for the iCAT scan. iCAT data were then imported for virtual surgical planning of bilateral Baha® implants. Two implants were planned for each side. Optimal implant positions were identified virtually with special consideration of: calvarial thickness; position of lambdoidal and squamosal suture lines; placement of the incision & subcutaneous tunnel necessary for first stage ear reconstruction; and final position of the reconstructed ears.

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Patient-specific medical models were fabricated for translation of the virtual surgical plan to the operating theatre. Soft tissue fitting surgical guides were used intraoperatively to indicate planned ear and implant positions bilaterally. Results: Second stage surgery will be performed for bilateral Baha® abutment connection and rehabilitation. Implant connection will be determined using original virtual & physical surgical planning models from first stage implant surgery. Pre-operative patient and ‘ear donor data’ will then be used for planning of future autologous reconstructive procedures. Conclusion: Early and comprehensive capture of digital patient image data combined with virtual planning enables careful and coordinated rehabilitative treatment with clearly-defined outcomes objectives. Technologybased virtual planning offers increased efficiency in the operating theater, improved predictability of treatment outcomes and facilitates team communication and collaboration through virtual modeling.

18 Comparison of Intraoperator and Interoperator Repeatability of Soft Tissue Landmark Identification Using Two 3D Facial Imaging Software Systems.

facial images using two different software programmes (Cloud Software and Di3D Imaging Software). Methods & Materials: This study was a single centre laboratory study with two operators. The facial scans of 5 subjects (4 female, 1 male) without dentofacial deformity were obtained prospectively using the Di3D Imaging System. The definitions of twenty-eight standard soft tissue anthropometric landmarks were agreed between the operators. These were located on the facial scans by each operator on two separate occasions. The scans were viewed using the Cloud Software (without colour but with vertical and horizontal profile lines) and the associated Di3D Imaging Software (with colour but without profile lines). Reference places for all images were standardized before landmark identification. The difference between the x, y, and z coordinates of each of the landmarks were analyzed using the 95% Limits of Agreement by the method of Bland and Altman and Lin’s Concordance Coefficient. Results: With a small number of exceptions, the intraoperator data were found to be repeatable to within 1 SD in all three planes of space. The interoperator repeatability was lower with fewer landmarks showing 1 SD difference. Some landmarks showed lower repeatability than others. Conclusion: The intraoperator and interoperator repeatability of soft tissue landmarks between the Cloud Software and Di3D Imaging Software Program were comparable, with a higher precision of landmark identification for a single operator.

Adali, N.S.*, Coward, T. J. King’S College London Dental Institute King’S College Hospital NHS Foundation Trust London, U.K. Fixed and Removable Prosthodontics London, UK Purpose: The evaluation of facial morphology in three dimensions requires the accurate positioning of soft tissue landmarks. A number of methods of visualizing the face in three dimensions have been developed including three dimensional stereophotogrammetry. Several software systems are used to analyze these images, each with inherent advantages and disadvantages. The aim of this study was to compare the intraoperator and interoperator repeatability of locating 28 standard soft tissue landmarks identified on

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19

Notes

3D Stereophotogrammetry for Craniofacial Analysis: The Effects of Head Inclination on the Reliability and Precision of Anthropometric Measurements Stevens, E.*, Seelaus, R., Zhao, L., Dixon, S. University of Illinois at Chicago, The Craniofacial Center, Department of Surgery, College of Medicine Chicago, IL, US Purpose: The ability to obtain three-dimensional virtual models of facial surface data using non-invasive imaging technologies, such as 3D stereophotogrammetry, offers clinicians an alternative means of acquiring facial morphological information, while avoiding more invasive techniques, such as conventional impressions or radiographic imaging. However, inconsistencies exist among reported protocols for head positioning when employing such technology for data acquisition. In this study, the effects of head inclination on the reproducibility of facial anthropometric measurements from 3D stereophotogrammetric images were explored. Methods & Materials: Ten adult volunteers (age 18+) were imaged with the 3D stereophotogrammetric 2-pod system 3dMDface® (3dMD Ltd, Atlanta, USA). Each subject was imaged at five different head inclinations: 0° (Frankfort Horizontal), +5°, +10°, +15°, and +20°. Statistical analysis was conducted to assess variance in landmark localization for 32 facial landmarks and 31 point-to-point distance measurements at all five conditions. Test-retest reliability and precision were assessed on the same 3D image at a minimum of 48 hours apart. All 32 landmarks were localized on five images taken at each condition, and the variance of the xyz coordinates for each landmark was assessed. The effect of the head inclination was examined using ANOVA tests. Results: Pearson’s Correlation Coefficient of 0.99 and Mean Absolute Difference of 0.04 mm suggest high intra-observer reliability and precision when obtaining landmark distances from images taken at different head inclinations. However, ANOVAs indicate that recorded landmark distance measurements demonstrate significant variance among different conditions (head inclinations), especially for those acquired from images taken at +15° and +20°.

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Conclusion: Results of this study suggest that facial landmark distance measurements can be influenced by head inclination during imaging. Implications for the design and execution of clinical protocols using 3D stereophotogrammetry as a means of facial data acquisition are discussed. Keywords: 3d stereophotogrammetry, head position, inclination, anthropometric measurement, reproducibility.

20 Surgical Navigational Systems: Bridging the Gap between Virtual Preoperative Planning, Intraoperative Applications, and Physical Prototyping Verma, S.N.*, Gonzalez, M., Ding, M.P Baylor College of Dentistry Texas A&M Health Science Center Department of Oral & Maxillofacial Surgery Dallas, TX, US Purpose: Surgical Navigational systems provide the benefit of virtual preoperative planning, real time intraoperative visualization, and eliminate the need of a physical surgical guide. They offer features that allow the user to go beyond the surgical planned procedure, and into the next step of designing a physical prototype or custom implant. This technology was utilized preoperatively for implant and prosthetic planning, and intraoperatively to place craniofacial bone anchored implants (CBAI) for patients receiving an implant retained facial prosthesis. Navigational systems contributed to the final prosthetic restoration by exporting a digitally designed prototype based on mirrored anatomical structures. Methods & Materials: Using a navigational planning system, (Stryker Navigation), virtual visualizations of soft tissue and bone were created by segmenting images acquired from spiral CT data. For patients with unilateral facial defects receiving treatment with an

implant retained facial prosthesis, the unaffected soft tissue anatomy from the CT data was mirrored onto the skull of the defect side to visualize the future prosthesis. When preoperative planning for patients with bilateral defects or disfigured opposing anatomy, the patient’s spiral CT data was paired with “digital donor anatomy “ from a bank of CT data, an imported .stl file, or Cone Beam CT (CBCT) data of scanned casts made from impressions. Using navigational software, implant locations were planned in the anatomical area with appropriate bone height that would lead to the best aesthetic prosthetic result. The surgical sites were located intra-operatively using integrated navigational instrumentation, allowing implants to be placed in the planned sites without using a physical surgical guide. For select restorative cases, a prototype of the missing anatomical form was designed by manipulating the segmented and mirrored CT data, and exporting a .stl file for physical output through rapid prototyping. Results: For (CBAI) retained facial prosthetic cases, the implant locations were determined solely by virtual planning using navigational technology. This eliminated the need for preoperative measurements, impressions, and fabrication of a CT template and surgical guide. The use of virtual planning versus traditional surgical guides saved the anaplastologist 10-12 hours of preoperative clinical and laboratory time, including the elimination of two preoperative clinical visits with the patient. The real time visualization and virtual representation of the mirrored anatomy gave the surgical team the ability to make any necessary intraoperative repositioning decisions based on the future prosthetic outcome. Preoperative planning using the navigational system improved the accuracy of implant placement by the oral maxillofacial surgeon, thus leading to more predictable prosthetic result. The ability to create an exportable file of the mirrored anatomy enabled the team to take specific craniofacial planning to the next step and create physical prototypes or custom anatomical implants. Conclusion: The utilization of navigational systems in prosthetic reconstructions enhanced clinical efficiency, eliminated the need for a traditional or prototyped surgical guide, enabled prosthetic driven intraoperative repositioning, and aided in the design of physical prototypes, thus providing improved prosthetic treatment outcomes.

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Improving the Speed and Accuracy of Mandibular Reconstruction using Preoperative Virtual Planning and Rapid Prototype Modeling Hanasono, M.*, Jacob, R., Skoracki, R. University of Texas MD Anderson Cancer Center Plastic Surgery Houston, TX, US Purpose: Reconstruction of oncologic segmental mandibular can be extremely challenging and timeconsuming. Our goal was to incorporate preoperative virtual planning and rapid prototype modeling to improve the speed and accuracy of mandibular reconstruction. Methods & Materials: Between 2005 and 2009, 32 patients underwent mandibular reconstruction using VP/RPM based on computed tomography data. All mandibular reconstructions were performed with a fibula free flap. Titanium plates were pre-bent using the models to increase the accuracy of the reconstruction and decrease the operative time. Direct plate bending on the native mandible to accurately restore occlusion would not have been possible in 12 patients with exophytic tumors, 6 patients with a prior segmental mandibulectomy and 6 patients with pathologic fractures. In the most recent 19 cases, computer-generated cutting guides were utilized to facilitate osteotomies. Results: The mean operative time including resection was 9.1±0.9 hours compared to a defect-matched control group operative time of 10.5±0.1 hours (p=0.03) when models were not used. The mean number of osteotomies made was 2.1±1.0. Centric occlusion was achieved in 27 (90%) patients. Of patients with malocclusion, all had undergone resection of one temporomandibular joint. Complications included: 3 venous thromboses without flap loss, 2 neck wound dehiscences, 2 donor site complications, 1 hematoma and 1 pneumonia. The mean length of follow-up was 18.1±19.7 months. Eight patients have undergone dental restoration with osseointegrated implants and 10 patients are awaiting implant placement. Comparison of postoperative 3-dimensional CT reconstructions with preoperative virtual plans showed excellent concordance.

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Conclusion: VP/RPM increases the speed of mandibular reconstruction by allowing prebending of reconstruction plates and simplifying osteotomies. VP/RPM may increase the accuracy of reconstruction, especially in the restoration of the anterior curvature and mandibular angle, and in reestablishing the correct height of the vertical portion of the mandible (i.e., the ramus and condyle). Our experience suggests this technique is especially useful for cases in which the original architecture of the mandible has been distorted or destroyed.

22 Surgical Navigation Dedicated to Bone Resection and Reconstruction in Maxillo - Facial Surgery in Oncologic Cases.

experiments was built from components identical with those used in StealthStation S7 Medtronic. Customized surgical instruments are manufactured from titanium. Standard surgical equipment – Anspach® saw and drill - are adapted and calibrated for navigation system. The software was customized in C++ programming language. Results: Standard Anspach® saw navigation with our software enables a precise resection of bone fragments in planned shape and range based on virtual models from CT scans. It is also possible to cut long bone parts in a planned angle. In post ablative reconstruction navigated drills enable proper location of osteosynthesis screws and plates for ideal placement of a free osteocutaneous microvascular flap or, in the future, the Bioimplant. Even in very thin bone segments, computer assisted surgery plays an important role in placement of dental implants for final oral rehabilitation in oncologic patients.

Bioimplant - An Experimental Study. Rysz, M.*, Jaworowski, J., Gilewicz, J. Maria Sklodowska-Curie Memorial Cancer Center Head and Neck Cancer Department, Warsaw, PL Purpose: Surgical navigation systems have for many years been used in variable fields of medicine – especially neurosurgery and orthopedics. Also, among surgical procedures conducted in maxillo facial surgery, some can be supported by surgical navigation, shortening the operation time and improving its’ precision. Computer assisted surgery in CMF region requires some modifications of the equipment and software, which we are proposing. Realizing Bioimplant project – a custom made tissue engineered bone implant for reconstruction of major oncologic hard tissue defects of facial skeleton, we have started experimental studies on surgical navigation system modifications.

Conclusion: The end point of our project is a precise reconstruction of the partially resected facial skeleton with a bone implant. Thanks to the proper function of our customized navigation system, the Bioimplant will suit in “key to the lock” manner to the reconstructed area.

23 Post-Traumatic Zygomatic Osteotomy: The Value of 3D Planning and Customised Repositioning Templates Bocca, A.*, Sugar, AW., Bhatia, S., Evans, PL., Key, SJ., Mustafa, SF. Morriston Hospital, Swansea Maxillofacial Unit Swansea, UK

Methods & Materials: In this study we are basing on experiences from almost 200 surgical procedures conducted with support from Medtronic Treon navigation system in 2009 and 2010 in the Memorial Cancer Center in Warsaw. Technical part is being conducted by The Technical University in Wroclaw. Navigation system for laboratory

Purpose: Over the last 2 decades improved radiological assessment, open reduction and stable fracture fixation have improved the primary management of severe facial fractures and reduced the need to perform secondary corrective procedures. Secondary

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correction of mal-aligned facial fractures is frequently a surgical challenge. We describe a method of planning the correction of such cases using 3D software, rapid prototyping and customized repositioning templates.

Notes

Methods & Materials: Following clinical assessment, patients are scanned using high resolution CT with slices of 0.5mm thickness. The DICOM files are then imported into Mimics® software (Materialise NV, Leuven, Belgium) where the CT images are processed to create a three dimensional view of the skull. When the deformity is largely unilateral, for example a displaced zygomatic complex fracture, a midline sagittal plane is created. The unaffected zygomatic bone is highlighted and mirror-imaged onto the affected side to demonstrate the ideal position. Virtual osteotomy cuts of the affected zygomatic bone are made on the 3D plan and the bone is virtually moved to the desired position. Screen measurements are taken of the new position. To transfer the reconstruction and planned new position of the zygomatic bone to the patient at the time of surgery, a surgical template is constructed either virtually in combination with rapid prototyping of the template or on a stereolithographic (SLA) model. Fixation plates and, when required, titanium mesh for the orbital floor can also be pre-bent on the SLA model to the contours of the zygomatic bone & orbital floor in the new position. Results: This technique has been used successfully with stable results in a series of cases allowing the accurate reproduction of pre-planned osteotomy movements. A balanced and symmetrical appearance of the midface with good zygomatic projection will be illustrated in this presentation Conclusion: Although this technique is labour intensive involving increased cost it compares favourably with other methods such as CMF navigation. We feel that its use is therefore justified to achieve the desired aesthetic & functional results in secondary reconstruction

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24 3D Virtual Planning of a Complex Facial Reconstruction after Radiation Induced Facial Asymmetry Weijs, W.L.J.*, Maal, T.J.J., Barkhuysen, R., Dieleman, F.J., Bergé, S.J. Radboud University Nijmegen Medical Centre Oral and Maxillofacial Surgery

surgical procedures in an accurate and predictable manner. Furthermore, computer aided design of templates allows the surgeons to transfer this extensive planning to the operating theatre. 1. New possibilities for reconstructing extensive jaw defects with prefabricated microvascular fibula transplants and ITI implants. Rohner D, Kunz C, Bucher P, Hammer B, Prein J. Mund Kiefer Gesichtschir. 2000 Nov; 4(6):365-72.

Nijmegen, NL Purpose: Reconstruction of a composite defect in a formerly irradiated region remains one of the most difficult surgical challenges the reconstructive head and neck surgeon can encounter. Due to radiation therapy at young age, severe facial growth retardation occurs resulting in obvious facial asymmetry. The aim was to restore facial symmetry in a 17 year old female patient using extensive 3D pre-operative planning and computer aided design. Methods & Materials: At the age of 7 months an embryonic rhabdomyosarcoma of the soft palate was diagnosed and treated with surgery followed by chemo-radiotherapy. Complete remission occurred. However, due to the late effects of radiotherapy over time, facial asymmetry developed. Before computer planning could be started, a CT scan of the head and neck region was acquired. Furthermore, a CTangiography was made to gather accurate information about the fibular anatomy and vascular supply. A two stage procedure according to Rohner (1) was planned. Using computer aided planning and design, implants were placed in the fibula. In the second stage, symmetry was restored using a CAD/CAM titanium zygoma implant combined with a fibula free flap transplant to restore the maxilla. Furthermore, a BSSO was carried out to level the occlusal plane. Finally, the position of the induced enophthalmus was corrected. Results: Using extensive computer aided preoperative planning and computer aided design facial symmetry was restored in the zygomatic region as well as the mandibular and orbital regions. Conclusion: 3D preoperative planning gives the opportunity to prepare and visualize complex

25 Complex Mid-Facial Reconstruction using Virtual Planning, Rapid Prototype Modeling, and Stereotactic Navigation Skoracki, R.*, Jacob, R., Bidaut, L., Robb, G., Hanasono, M. University of Texas M.D. Anderson Cancer Center Plastic Surgery Houston, TX, US Purpose: Restoration of the complex threedimensional form of the bony mid-face is one of the most challenging reconstructive surgeries. Our goal was to improve the speed and accuracy of our reconstructions using virtual planning, rapid prototype modeling, and stereotactic navigation. Methods & Materials: Twenty-seven reconstructions were performed for mid-facial defects resulting from oncologic resection. Virtual planning was performed to help accurately replace missing bone with appropriately shaped fibula free flaps. Rapid prototype models were created to guide osteotomies and act as templates for pre-bending titanium hardware. Stereotactic navigation was used to assist with flap insetting through limited incisions. Results: Twelve reconstructions were performed immediately after maxillectomy and 15 were delayed. In delayed cases, as well as cases in which the original bony architecture was destroyed by disease, the native maxilla would not have been available to act as a guide

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for shaping the reconstruction. The mean operative time was 12.3 hours. Postoperatively, all patients exhibited 100% speech intelligibility. Seventeen patients consume a regular diet and 10 patients consume a soft diet. Fifteen patients have undergone dental restoration with osseointegrated implants and 2 patients are awaiting implant placement. Comparison of postoperative three-dimensional CT reconstructions with preoperative virtual plans showed excellent concordance.

Notes

Conclusion: Utilizing computer-based technologies, we have developed a technique that not only the increases reconstructive accuracy of mid-facial reconstruction, but also the efficiency by decreasing the time spent making osteotomies and bending titanium plates. Stereotactic navigation allows accurate positioning of the free flap through limited incisions.

26 Virtual Surgical Planning (VSP) and Clinical Transfer via Templates: Assessing Surgical Outcomes Weimer, K.A.*, Christensen, A.M., Flannery, N.M.P. Medical Modeling Inc. Golden, CO, US Purpose: VSP encompasses a medical-image based approach to planning a surgical procedure in a digital environment and providing models, guides and templates for clinical transfer of the digital plan to the operating room. For the first time, surgeons are able to evaluate their surgical outcomes because they now have a precise plan to evaluate their surgical results against; the VSP. The purpose of this study is to demonstrate the different ways of assessing surgical outcomes both qualitatively and quantitatively on patients who underwent VSP for planning cranio-maxillofacial procedures. Methods & Materials: Preoperative CT scans (0.75mm1.25mm slice spacing, 0.3mm-0.45mm pixel size) were taken of patients needing orthognathic, TMJ replacement, facial trauma, reconstruction, or dental implant placement surgery. The medical images were imported into a virtual surgical planning software and three-dimensional models were created using

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traditional segmentation techniques. The surgery was digitally planned in an online webmeeting with the surgeon and an engineer at the modeling company. The requested models, guides and templates were designed and fabricated from the finalized VSP and sent to the surgeon for use in the operating room to transfer the digital plan to surgery. To compare the preoperative VSP to actual surgical results, postoperative CT scans were acquired, converted into threedimensional digital models and superimposed onto the preoperative plan. Once the datasets were registered, the following comparison techniques were used: geometric measurements, point-to-point measurements, plane-to-plane measurements, surface-to-surface (color mapping), and overall shape comparison. Results: The pre and postoperative comparisons were broken down into multiple components and each was analyzed using the most appropriate comparison technique. The following categories were analyzed: accuracy of osteotomies, shape of fixation plate, position of graft relative to native anatomy, position of implant relative to bony anatomy, accuracy of bony movements, and overall shape of reconstruction. Conclusion: By breaking down the surgical result into multiple components surgeons can identify their surgical results when compared to the VSP. Insight into errors between the planned and actual outcomes can be driven by both qualitative and quantitative measures. This type of comparison allows for a useful performance evaluation for both the surgical and engineering design teams.

27 Navigation-Guided Correction of Midface Posttraumatic Deformities (Shanghai Experience with 40 Cases) Zhang, S.L.* Shen, G.F. Bing, X Gui, H.J. Affiliated Shanghai Ninth People’s Hospital, School of Medcine, Shanghai Jiao Tong University Department of Oral and Maxillofacial Surgery Shanghai, CN Purpose: To evaluate the effectiveness of navigationguided open reduction and rigid fixation in the treatment of mid-facial post-traumatic deformities. Methods & Materials: 40 patients with mid-facial post-traumatic deformities between 2007 and 2010 were involved in this study. With preoperative planning and 3-dimensional (3D) simulation, the normal anatomic structures of the deformed area were created by superimposing and comparing the unaffected with the affected side. The position of dislocated bone for reduction was determined and displayed, and surgical simulation was performed. All patients were treated by open reduction and rigid fixation under the guidance of the navigation system. Results: Through registration, an accurate match between the intra-operative anatomy and 3D virtual model was achieved with a systematic error of 1 mm difference. With the guidance of the navigation system, anatomical structures and the position of surgical instruments were shown real-time on the screen. Fracture reduction was checked by postoperative CT scans, with a good match with preoperative planning noted. The maximal deviation between the fracture reduction and preoperative planning was less than 1 mm. Based on 1-2 years follow up evaluation, most clinical symptoms were eliminated and postoperative facial appearance was improved remarkably. Conclusion: Navigation-guided open reduction and rigid fixation in the treatment of midfacial post-traumatic deformities can be regarded as an ideal and valuable option for this potentially complicated procedure.

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3D digitally planned dental implant insertion in a free vascularised fibula for immediate prosthetic loading during reconstruction of a mandible Schepers R*, Raghoebar G, Roodenburg J, Reintsema H, Lahoda L, Witjes M University Medical Center Groningen, The Netherlands Introduction: Implant supported dentures enhance the masticatory and speech function in edentulous patients. Prefabrication of the fibula in cases of secondary reconstruction allows the planning of implant insertion in the fibula before harvesting the fibula. Here the first case is described of a 3D digitally planned implant placement and immediate prosthetic reconstruction of a mandible with a free vascularised fibula in a two step surgical approach. Methods: A 54 year old male treated for oral squamous cell carcinoma developed osteoradionecrosis of the mandible. Reconstruction of the mandible with fibula bone was digitally planned from CT scans. The osteonecrosis of the mandible was virtually resected in the software. Next, the upper dentition and new lower prosthesis were digitally scanned and imported into the software in an anatomical correct position. Two pieces of the digitized fibula were virtually placed in the correct position in the mandible to support the lower dental prosthesis. Implants were digitally planned in the fibula bone for support of the prosthesis. Drilling guides were printed from the software to fit on the actual fibula. First operation: the drilling guide was used to insert the dental implants in the fibula bone while still in position in the lower leg. After the actual insertion in the fibula, the position of the dental implants was digitized and the further prosthetic planning was done from these data. The wound was closed and left for 5 weeks for osseointegration of the implants. After this a suprastructure and prosthesis were made and a cutting guide was digitally planned and printed. Second operation: the osteoradionecrosis was resected, fibula was harvested and osteotomies performed according to the cutting guide. The suprastructure with denture was fixed on the pre-

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inserted implants after which the fibula was placed in the mandible followed by the vascular anastomosis. Conclusion: It was possible to digitally plan backward from the desired occlusion of the dental prosthesis to the necessary implant position in the fibula. This new and exciting approach yields an optimal placement of the fibula bone in the jaw and immediate loading of the implant supported denture inserted in fibula bone.

CONCURRENT SESSION SESSION III: Integration of New Materials and Innovations

29 Continuous Integration of New Materials in Head and Neck Reconstruction Sugar, A Abstract to go here...

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Cone-Beam Computed Tomographic Evaluation of using Bio-Absorbable Poly-Milk and PolyGlycol Polymers as Bone Void Filler in Large Mandibular and Maxillary Defects Surgeries. El Fattah, H.M.* National Cancer Institute, Cairo University 0ral & Maxillofacial Unit Cario, EG Purpose: This study evaluates the Use Bio-absorbable poly-milk and poly-glycol polymers as augmented material in large mandibular bone voids Surgeries. Recently with the advent of imaging modalities it could be logic to use cone-beam CT for this evaluation because differences in density may permit more accurate evaluation of quality bone healing. Methods & Materials: Defects were scanned preoperative, within first week post operative and every three months for nine months. This study evaluated 17 large mandibular and maxillary different defects. Results: The results in this case show that Bioabsorbable poly-milk and poly-glycol polymers particles in the Bone Void are osteoconductive. Significant resorption of Bio-absorbable poly-milk and polyglycol polymers particles is inspected 3–6 months after placement. At 9 months after void preservation, the small residual amount of Nano-Hydroxyapatite (HA) graft did not compromise the bone healing. Conclusion: Nano-Hydroxyapatite seems to be a very promising system for bone reconstructive or regenerative maxillofacial surgery.

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31 Hydroxyapatite/Collagen Scaffold for Platelet Rich Plasma in Temporomandibular Ankylosis for Condylar Regeneration

required to follow their growth pattern and observe them for developing any facial deformity as they grow.

Mehrotra, D.*, Dhasmana, S., Mohammad, S. CSM Medical University (King George’s Medical University) Oral & Maxillofacial Surgery Lucknow, IN Purpose: Objective: Various modalities of treatment have been undertaken from time to time for temporomandibular ankylosis. The aim of this study was to analyze the results of condylar regeneration using preshaped hydroxyapatite/collagen condyle with platelet rich plasma, with temporal fascia interpositional arthroplasty in cases of temporomandibular ankylosis and assess if a neocondyle could be regenerated. Methods & Materials: Study Design: This clinical study comprised 19 children with temporomandibular joint ankylosis (25 joints), managed where condylar regeneration was attempted using preshaped hydroxyapatite/collagen condyle with platelet rich plasma, fixed to ramus by titanium miniplate and temporal fascia interpositioning. These patients were evaluated with regard to type of ankylosis, pre and postoperative mouth opening, deviation on mouth opening, lateral excursion, protrusion, postoperative anterior openbite and other associated complications. All patients were followed for a period ranging from 6-18 months. Results: All cases showed significant improvement in mouth opening and jaw excursions. There were a few complications like temporary involvement of facial nerve which improved with time. None of the bilateral cases had postoperative openbite. Range of mandibular movements improved considerably in the postoperative phase. Although radiographic evaluation at 3 months showed a less opaque condyle, the opacity increased at 6 months, suggesting a newly formed condyle. Conclusion: Preshaped hydroxyapatite/collagen condylar scaffold with platelet rich plasma allows regeneration of neocondyle in TMJ ankylosis cases and improves both esthetics and function. However, a long term study is

32 What’s Following on Titanium? The PEEK! A New Material for Support of Weak Tissues, for Bone Reconstruction in Maxillo-Facial Squelet, for Fixation of Prosthodontics. Donsimoni, J.M. (*), Louis, M., Meningaud, J.P.(**) Clinique Milan, Paris (**) CHU Henri-Mondor, Créteil Maxillo-Facial Surgery Paris, FR Purpose: By means of its structure, bone has to be seen as a composite material. Reconstruction materials for maxillo-facial bone and implants, for to perform well in bone and to have an efficacy as bone, have to approach physical properties of bone. As physical properties of bone tissue are differing individually we see no way to a full success via the “Titanium-way” of today’s surgery because an individualization of implants for the exact purpose is not possible. The PEEK as reconstruction material will be presented for its same density, the almost same physical and biomechanical proprieties as cortical bone and this composite-texture which permits individualization of design, volume, height, direction, elasticity and cell affinity; being a thermoplast, adaptation to the special requests of each case is easy in the operation theatre. As well-known in a decade’s clinical experiences in neurosurgery and orthopedic surgery the PEEK is biocompatible; total lack of antigenicity and cytotoxicity is proven. The close interface to an isoelastic medium shall encourage osteoconduction. The isoelasticity shall prevent of “stress shielding”. Methods & Materials: The question of isoelasticity with maxillo-facial bone structure will be controlled in theoretical conditions (Finite Elements Model), in biomechanical examination (dynamic and static compression tests) and in clinical application.

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Results: The FEM showed that in the chosen configurations of an endo-osseous implant and plate for osteosynthesis the material will resist to up to 270 daN. In the mechanical experimentation for the same “case” no fracture and no deformation arised even after 5 millions cycles between 1,2 daN and 12 daN. In the clinical application, it was easy to give to implants and plates the desired geometrie by cutting and using the thermoplasticity advantages refering to the preoperative 3D-scanner-exploration. No visible deterioration has happened after repeated autoclave-sterilizations.

Notes

Conclusion: We can conclude that the many scientific publications have confirmed the PEEK material as suitable to be used for implantation in the long term in the human body. According to our research, it appears that the pure PEEK OPTIMA is an excellent material, perfectly suited, in terms of biomechanics, able to support and transfer the usual high stress conditions placed upon the jaws and facial bones during mastication. PEEK OPTIMA can be used as a reinforcing material and as bone replacement and is used as backing material for soft tissue. It is able to provide the base for the integration of implants in bone reinforced by PEEK and as oral basal implant altogether. We have verified by analysis of finite elements and mechanical stress experimentation that the PEEK OPTIMA material is a material at least as effective as titanium and perfectly appropriate for our indications in maxillofacial surgery. But, if we add the many advantages that even the titanium and other materials used up to now do not provide, such as radio-transparency, easy cutting in the operating room, lack of corrosion effect, the possibilities of strengthening and integration of the modulus of elasticity in individual cases, stimulation of bone formation by tight matching, then we can expect that the PEEK OPTIMA composite will very well behave in the composite host as well : the maxillofacial bone.

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33 Visions in Imaging and Biomaterials Zeilhofer, H.F. Abstract to go here...

CONCURRENT SESSION SESSION IV: New Concepts in Interdisciplinary Work

34 Health Technology Assessment – Emerging Issues and Opportunities Juzwishin, D. W. M.* Director, Health Technology Assessment & innovation Alberta Health Services Edmonton, Alberta, Canada Purpose: The objective of this paper is explore the issues and opportunities for an interdisciplinary collaboration of health technology assessment (HTA) and advanced digital technologies. An increased understanding of the respective needs and challenges of the disciplines will result in an improved capacity and ability of policy and decision makers to address funding questions. Methods & Materials: A review of current challenges facing health technology assessment as a health care policy tool and advanced digital technologies is undertaken with a view to identifying challenges and opportunities for advancement of both fields. Results: Health technology is defined as prevention and rehabilitation, vaccines, pharmaceuticals and devices, medical and surgical procedures, and the systems within which health is protected and maintained. Health care technology assessment in health care is a multidisciplinary field of policy analysis. It studies the medical, social, ethical, and economic implications of development, diffusion, and use of health technology. The primary challenges facing health technology assessment in respect to ADT for informing health care policy makers are: •

having access to adequate primary studies to inform questions about clinical and cost effectiveness of health care interventions,

•

reducing the degree of uncertainty about the effectiveness and cost effectiveness of ADT interventions,

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•

ensuring that outcomes are clearly identified and explicated,

•

addressing the ethical issues in differentiating what are deemed medically necessary versus personal enhancement procedures in the context of publicly funded health care services, and

•

utilizing dissemination and knowledge translation mechanisms to improve uptake of new knowledge.

Notes

Conclusion: The emerging conditions of constraint in demanding more definitive conclusions (decreasing uncertainty) about the clinical and cost effectiveness of health care technologies is encouraging the development of new techniques and processes for addressing the issues in HTA. If research studies documenting the outcomes of ADT were increasingly conscious of the requirements of HTA it is likely that the results would be utilized to inform policy decisions.

35 Collaboration, Technology and Medicine 2.0 – An Industrial Designer’s Perspective King, B. Industrial Design, iRSM, Edmonton, Alberta Canada Presentation abstract: Health care is particularly reliant on exploring the wake of other industry’s technological waves, and as such, may be hindered in incorporating advancements in the realms of computer-aided design, rapid prototyping and digital communication. As stronger bonds are forged between health care and a variety of disciplines, technological tools are tailored to the medical world’s specific needs. Unfortunately, there are always growing pains associated with these burgeoning relationships, and the design process and eventual end products may diverge from the required intent simply because language and communication differs so greatly across differing disciplines. As the health care industry transitions to digital workflows, communication tools may provide the necessary visual translation to facilitate these relationships and ensure streamlined patient care. App design provides a gateway for clinicians to more effectively communicate with collaborators such as designers

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and engineers without investing countless hours into the intricacies of computer-aided design. This presentation will discuss the merits of non-traditional digital communication tools within health care and the development of an app that aims to enable a variety of professionals to participate in medical modeling and surgical planning while circumventing the constraints of traditional communications.

36 Interdisciplinary Treatment Algorithm of Potentially Life-Threatening Vascular Malformations of the Head and Neck Ermer, M.A. (1)*, Gutwald, R. (1), Schumacher, M. (2), Schmelzeisen, R. (1) University Hospital Freiburg (1) Department of Oral and Maxillofacial Surgery (2) Department of Neuroradiology Freiburg, DE

challenging today. In extensive vascular malformations of the head and neck, a complete surgical removal often is not possible because of proximity to vital structures, severe disfigurement and functional compromises that are associated with higher risk of complications and mortality. Endovascular embolisation is limited by the location of the AVM and can potentially cause stroke, ischemia, necrosis, bleeding, blindness, adverse haemodynamic changes and pulmonary embolism. Magnetic resonance imaging (MRI) and angiography procedures represent the “gold-standard” to evaluate the nature and extent of the AVM lesions and give valuable decision aspects on treatment possibilities.

37 2-Dimensional and 3-Dimensional Normative Airway Comparative Measures Using 772 Cone Beam Computed Tomography Scans. Smith, M.H.*, Edwards, S.P., Conley, R.S., Smith, J.M. University of Michigan Health System Department of Oral Maxillofacial Surgery (MHS, SPE)

Purpose: Extracranial arteriovenous malformations (AVM) of the head and neck are rare conditions with the majority of primary sites in the mid-face. Progression of these anomalies can lead to massive life-threatening bleeding incidents. Treatment of choice is the combination of selective embolisation followed by surgical resection. Diagnosis and management of AVM has been facilitated in recent years by the progress in imaging techniques and various microsurgical and endovascular embolisation procedures. Methods & Materials: The current report describes the interdisciplinary approach to and treatment of recent cases of AVM in our department and emphasizes the progress in digital imaging technologies as well as surgical and endovascular embolisation expertise. Results: Preoperative magnetic resonance angiography and 3D imaging followed by superselective embolisation and consecutive resection of the lesion within a few days was performed in all cases. Clinical and angiographic follow-up showed incomplete obliteration of the AVM and lead to additional embolisations. Conclusion: Combined treatment of extensive AVM is still

Department of Orthodontics (RSC, JMS) Ann Arbor, MI, US Purpose: Digital imaging and software continues to evolve and provide the surgeon with limitless possibilities for diagnosis and evaluation in two and three dimensions (2D & 3D). Obtaining an appreciation of the normative airway will assist to provide a predictive measure for evaluating and treating patients with obstructive sleep apnea in the future. Methods & Materials: 772 CBCT scans (539 females and 233 males) were evaluated using Dolphin 10.5 for 2D cephalometric analysis and 3dMD Vultus for 3D airway analysis. Patients were evaluated according to gender, age groupings, and a combination thereof, using custom cephalometric skeletal and airway measures as well as 3D linear airway dimensions, airway length, airway volume, and minimum cross-sectional area size and location. Means, standard deviations and differences between groups were calculated for all 2D and 3D measures. Results: Females demonstrated narrowing of the airway with increasing age, and the narrowest measure of the

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airway in 2D was statistically significant, located most commonly at the level of the occlusal plane. Males demonstrated a greater mean mandibular plane to hyoid distance. In 3-dimensions there were a number of gender differences. The mean length of the airway in males is 59.6 mm and in females is 46.9 mm. Total airway volume is males is a mean of 16.4 cm3 and in females is a mean of 11.8 cm3. Airway volume tends to decrease with increasing age in females only. The minimum cross-sectional area moved superiorly with age in both genders and was significantly larger in males (172.14 mm2 versus 149.58 mm2 in females). There is a high correlation at the level of the palatal plane, occlusal plane, superior of C3 and inferior of C3.

Notes

Conclusion: 2D measures correlate well with 3D measures and possess certain gender differences. There are numerous deficits in studying small populations as representative values can not be obtained. This study helps to bridge the limitations by presenting a large number of scans, which can poentially be useful for comparison to the diseased airway, which is currently being studied further.

38 3-D Assessment of Facial Development in Children with Cleft Lip and Cleft Lip and Palate Krimmel, M.*, Kluba, S., Breidt, M., Bacher, M., Dietz, K., Buelthoff, H., Reinert, S. University Tübingen Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Germany Tübingen, DE Purpose: Residual cleft deformity and growth analysis is regularly performed clinically and with 2-D cephalometry and 2-D photography. With the advent of 3-D surface scanners a new tool is available to analyze the characteristics of cleft children. Methods & Materials: In a prospective, cross-sectional study 344 healthy children, 30 children with unilateral cleft lip (UCL) and 34 children with unilateral cleft lip and palate (UCLP) below the age of 8 years were

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scanned 3-dimensionally. 21 standard anthropometric landmarks were identified and the images were superimposed. Growth curves for normal facial development were calculated. The facial morphology of cleft children was compared to healthy children. Results: Children with UCL demonstrated an increased transversal distance of the orbits and a broadening of the nose. In the sagittal direction there was no difference to healthy controls. In the vertical direction we found a discrete asymmetry with a more caudal position of the landmarks of the alar wing on the cleft side. In UCLP there was an even more pronounced tendency to hypertelorism. The nose was significantly broadened. In the sagittal dimension we found a significant ageindependent midface retrusion. In the vertical direction there was only a mild asymmetry of the landmarks on the columella, in an otherwise regular buildup of the face. Conclusion: The study shows, that the real challenge to cleft surgery remains the correction of the nose. Although there is a correction to the width of the nose, it remains too broad in comparison to controls. In addition, UCLP patients suffer from an age independent midfacial growth deficit, which must be addressed by orthodontics and possibly by surgery.

39 Significance of High-Resolution Ultrasound in the Differential Diagnosis of Infantile Cranial Deformity Kluba, S.*, Krimmel1, M., Will, B.(2), Wolff, M. (3), Haas-Lude, K. (3) Schaefer, J. (4), Schuhmann, M. (2), Reinert, S. (1) University Hospital Tübingen 1. Department of Oral and Maxillofacial Surgery, University Hospital Tübingen, Germany 2. Section of Pediatric Neurosurgery, Department of Neurosurgery, University Hospital Tübingen, Germany 3. Department of Pediatric Neurology, University Children´S Hospital Tübingen, Germany 4. Pediatric Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Germany Tübingen, , DE Purpose: Aim: Secondary to the increase of deformational plagiocephaly a growing number of infants with cranial deformity presents to craniofacial teams. CT is diagnostic, but uses ionizing radiation. The purpose of this study was to evaluate ultrasound as a screening test for the patency of cranial sutures. Methods & Materials: Material and Methods: The cranial sutures of fifty-four infants with cranial deformity were assessed by ultrasound. Sutures were read as patent or fused if a hypoechoic gap could or could not be demonstrated between the hyperechoic clavarial bones, respectively. Results: Seven children suffered from true craniosynostosis (CS) of either the sagittal or the lambdoid suture. In five cases the ultrasound findings were diagnostic for a fused suture, in 2 cases the results were inconclusive. In one case additional plain in radiographs, in the other a 3D CT examination were performed demonstrating partial fusion of the sagittal and the lambdoid suture respectively. Forty-seven infants presented with deformational plagiocephaly. Ultrasound examination demonstrated patent sutures in 45 cases and was inconclusive in two cases. CT examination revealed in these cases normal patent

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sutures. All 47 children diagnosed with positional cranial deformity had clinical follow-up of 3 to 10 months with no further evidence of CS. Under the premise, that the inconclusive US findings are regarded as false positive and false negative results, the method had at least a sensitivity of 71.4% (95% confidence interval: 35.5%, 100%), a specifity of 95,7% (89.9%, 100%), a positive predictive value of 71.4% (35.5%, 100%) and a negative predictive value of 95.7% (89.9%, 100%).

Notes

Conclusion: Summary: Sonography of the cranial sutures is an excellent screening tool to distinguish fused from patent cranial sutures and avoids the radiation exposure associated with CT examinations.

40 Facial Morphology of Children with Pierre Robin Sequence Krimmel, M.*(1), Kluba, S. (1), Breidt, M. (2), Bacher, M. (3), Dietz, K. (4), Buelthoff, H. (2), Reinert, S. (1) Kluba, S.* (1), Kraut,W. (1), Blecher, C. (2), Krimmel, M. (1), Reinert, S. (1) 1. University Hospital Tübingen 2. Cranio Department of Oral and Maxillofacial Surgery Tübingen, DE Purpose: Newborns with Pierre Robin sequence suffer from mandibular hypoplasia, glossoptosis and possibly cleft palate. Respiratory distress is the leading clinical symptom after birth. The facial appearance of the newborns is characteristic with a severely retruded chin. The further development of the face, however, is controversial in the literature. The aim of this study was to analyze 3-dimensionally the face of Pierre Robin children. Methods & Materials: In a prospective, cross-sectional study 344 healthy children and 37 children with Pierre Robin sequence and cleft palate were scanned 3-dimensionally at the age of 0 to 8 years. The technique of stereophotogrammetry was applied. 21 standard anthropometric landmarks were identified and the images were then superimposed. Growth

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curves for normal facial development were calculated. Finally the facial morphology of Pierre Robin children was compared to the group of healthy children. For statistical analysis the Pearson test was applied. Results: Facial growth of Pierre Robin children in the transversal direction was normal. In the vertical dimension there was a significant underdevelopment of the chin. In the sagittal direction the anticipated mandibular deficit was confirmed. Except for the orbital landmarks and nasion, however, also all landmarks of the midface demonstrated a significant deficit. This difference to healthy children remained constant throughout the complete observation period. Conclusion: Discussion: Pruzansky, Richmond and Figueroa and others support the hypothesis, that the mandible shows a catch-up growth during the first year of life and a normal development thereafter. Our study cannot confirm this theory, because up to the age of 36 months 13 of 27 children have a sagittal position of pogonion below the third percentile. With the limitation of a cross-sectional study, a catch-up growth cannot be observed. The sagittal deficit of the midface could be observed in all ages. This indicates that Pierre Robin children also suffer from a very early, severe and persistent underdevelopment of this part of the face. Although it is not the clinically leading problem in the newborn, this disturbance must be addressed in early childhood with orthodontic and speech therapy.

41 Importance of Entrance Age for Optimizing Helmet Therapy in Positional Plagiocephaly? Kluba, S.* (1), Kraut,W. (1), Blecher, C. (2), Krimmel, M. (1), Reinert, S. (1) 1. University Hospital Tübingen 2. Cranio Department of Oral and Maxillofacial Surgery Tübingen, DE Purpose: The increasing incidence of positional plagiocephaly over the last two decades has been accompanied by a rising number of consultations and

an increasing need of treatment. Although helmet therapy as a treatment option for severe cases is widely accepted, treatment regimes especially concerning entrance age still differ and are discussed controversially. This study investigated the importance of entrance age and the dynamic of helmet treatment in order to optimize the management of helmet therapy. Methods & Materials: 62 infants with severe positional plagiocephaly were treated with a helmet for about 16 weeks in median (range 4-28) and enrolled in this prospective longitudinal study. 24 started therapy younger than 6 months of life (group 1), 38 were 6 months or older (group 2). Cranial diagonals measurements were taken with an anthropometric metal caliber at every consultation. Resulting differences and CVAI-values (cranial vault asymmetry index) were compared categorized by age at initiation of therapy. The variables were analyzed with Mann-Whitney-U- test. Results: More than half of the patients (61.3 %) were referred after the 6th month of age. There were no statistically significant differences between both groups with respect to sex and severity of deformation at the beginning of helmet therapy. Duration of therapy was significantly shorter in the group of younger infants with 14 weeks compared to 18 weeks in group 2 (p=0.013) with concomitant significantly better CVAI at the end of therapy (p=0,021). The CVAI in group 1 was in median reduced to a normal CVAI < 3.5 % (3.1%). Infants, who started later than 6 months of life with helmet therapy did not reduce their asymmetry to normal CVAI-values (median CVAI at the end=4.5%). The relative individual improvement of asymmetry was significantly better with 75.3% in group 1 compared to 60.6% improvement in group 2 (p= 0.001). Differences between both groups were not only statistically significant at the end of treatment. Although in both groups the major part of the total improvement was achieved within the first weeks of treatment, there was already at the time of first control after 4-11 weeks a better absolute (p