Max Miller, chirurgien buccal et maxillo-facial

Réduction d’une fracture de la symphyse mandibulaire

IF YOU THOUGHT YOU SAW ALL IMPLANT COMPLICATIONS, YOU WERE WRONG...... This article was just published in the British Journal of Oral and Maxillofacial Surgery ... A 55-year-old woman was referred by her dentist to the department of maxillofacial surgery, ASST Civil Hospital, Brescia, Italy. During the same afternoon, she had had sev- eral dental implants placed in the upper right maxilla. During the procedure, one of the implants was displaced into the sinus, after which the anterior wall of the maxillary sinus was opened to remove it. Unfortunately, the dental practi- tioner was not able to see or remove the implant. The patient was therefore referred to the hospital for orthopantomogra- phy, which showed the implant, but not in an optimal view. A computed tomographic (CT) scan was done and showed that the implant had completely migrated 2 cm into the intra- conal compartment of the right orbit. It was located between the posterior ocular globe, the inferior rectum, and the medial rectum, laterally to, and in contact with, the optic nerve. Superiorly, the apex of the implant was adjacent to the intraorbital vessels. The patient did not experience any visual loss or diplopia. She had limited movement of the eye muscles, and some pain and scotoma during ocular examination. The course of treatment was planned in cooperation with the otolaryngology department, with the goal of removing the implant endoscopically to prevent infection or damage to the optic nerve. Under general anaesthesia with orotracheal intubation, we did an antrostomy, ethmoidectomy, frontal tenotomy, and sphenoidotomy. After endoscopic inspection of the maxillary sinus, the proximal end of the implant was identified and deemed unremovable with a conservative approach. We did an enlarged endoscopic medial maxillectomy with a nasolacrimal duct resection, and removed the medial portion of the orbital floor and the lower portion of the papyrus lamina. This approach made it possible to progressively mobilise the implant and extract it with no intraconal bleeding. The postoperative course was uneventful, and she was discharged after two days.

Merci à Concepts 3DG qui nous ont fait un don de 12 visières pour nous aider à traiter nos urgences pendant cette pandémie de COVID-19!

Réduction d’une fracture de la symphyse mandibulaire

IF YOU THOUGHT YOU SAW ALL IMPLANT COMPLICATIONS, YOU WERE WRONG...... This article was just published in the British Journal of Oral and Maxillofacial Surgery ... A 55-year-old woman was referred by her dentist to the department of maxillofacial surgery, ASST Civil Hospital, Brescia, Italy. During the same afternoon, she had had sev- eral dental implants placed in the upper right maxilla. During the procedure, one of the implants was displaced into the sinus, after which the anterior wall of the maxillary sinus was opened to remove it. Unfortunately, the dental practi- tioner was not able to see or remove the implant. The patient was therefore referred to the hospital for orthopantomogra- phy, which showed the implant, but not in an optimal view. A computed tomographic (CT) scan was done and showed that the implant had completely migrated 2 cm into the intra- conal compartment of the right orbit. It was located between the posterior ocular globe, the inferior rectum, and the medial rectum, laterally to, and in contact with, the optic nerve. Superiorly, the apex of the implant was adjacent to the intraorbital vessels. The patient did not experience any visual loss or diplopia. She had limited movement of the eye muscles, and some pain and scotoma during ocular examination. The course of treatment was planned in cooperation with the otolaryngology department, with the goal of removing the implant endoscopically to prevent infection or damage to the optic nerve. Under general anaesthesia with orotracheal intubation, we did an antrostomy, ethmoidectomy, frontal tenotomy, and sphenoidotomy. After endoscopic inspection of the maxillary sinus, the proximal end of the implant was identified and deemed unremovable with a conservative approach. We did an enlarged endoscopic medial maxillectomy with a nasolacrimal duct resection, and removed the medial portion of the orbital floor and the lower portion of the papyrus lamina. This approach made it possible to progressively mobilise the implant and extract it with no intraconal bleeding. The postoperative course was uneventful, and she was discharged after two days.

Merci à Concepts 3DG qui nous ont fait un don de 12 visières pour nous aider à traiter nos urgences pendant cette pandémie de COVID-19!

Cours d’implants zygomatiques au Zaga à Barcelone avec Carlos Aparicio.

A great course on zygomatic implants ! Un excellent cours sur les implants zygomatiques!