Atlas of Operative Oral and Maxillofacial Surgery E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1765

Veröffentlichungsjahr: 2022

Beschreibung

ATLAS OF OPERATIVE ORAL AND MAXILLOFACIAL SURGERY Comprehensive Learning Resource Covering All Aspects of Oral and Maxillofacial Surgery This textbook marks the second edition of the highly successful Atlas of Operative Oral and Maxillofacial Surgery. The first edition quicky became a staple with surgeons on rounds, in training programs and in preparation for board examinations. This atlas is comprised of concise text and detailed vignettes focusing on surgical indications, contraindications, pertinent anatomy, virtual surgical planning, operative techniques, postoperative management, complications and key points with over 2,000 high-quality images. The Atlas of Operative Oral and Maxillofacial Surgery serves as an innovative, multidisciplinary, surgical atlas covering core aspects of oral and maxillofacial surgery, head and neck reconstructive surgery, and facial cosmetic surgery. Chapters are written by experts in their fields and are designed to provide high-yield information utilizing a case report format. New to this second edition: * Contemporary coverage of dental implants, including digital implant planning, grafting techniques, implant supported restorations of the edentulous arch, immediate implant placement and provisionalization. * Management of facial infections including odontogenic head and neck infections, osteomyelitis and medication related osteonecrosis of the jaws (MRONJ). * Recent advances in facial trauma surgery, orthognathic surgery and facial reconstructive surgery utilizing virtual surgical planning, custom plate fabrication and the latest surgical techniques with case reports. * Expansion of the orthognathic and craniofacial section to include new case reports and chapters on orthognathic surgery in cleft patients, cranial vault surgery and the evaluation and planning of concomitant TMJ and orthognathic surgeries. * Advances in the field of facial cosmetic surgery including cryolipolysis, fat transfer, soft tissue fillers and the latest technique updates. * Elaboration of the facial ablative and reconstructive surgery sections to include virtual surgical planning, custom plate fabrication, osteotomy cuts guides and the latest hard and soft tissue harvest techniques.

Leseprobe

Table of Contents

Cover

Title Page

Copyright Page

List of Contributors

Acknowledgements

About the Companion Website

Part One: Dentoalveolar and Implant Surgery

CHAPTER 1: Anatomic and Legal Considerations in Dentoalveolar Surgery

Infratemporal Fossa

Nasal Cavity

Maxillary Sinus

Mandible

Lingual Nerve

Mental Nerve

Inferior Alveolar Nerve

Legal Considerations with Nerve Injury (Lingual Nerve and Inferior Alveolar Nerve)

Key Points

References

CHAPTER 2: Exposure and Bonding of an Impacted Tooth

Indications

Contraindications

Closed Technique

Open Technique

Postoperative Management

Complications

Early Complications

Late Complications

Key Points

References

CHAPTER 3: Pre‐Prosthetic Surgery

Procedure: Fibrous Tuberosity Reduction

Indications

Contraindications

Surgical Technique: Wedge Reduction

Postoperative Management

Complications

Key Points

Procedure: Torus Mandibularis Reduction

Indications

Contraindications

Anatomy

Surgical Technique

Key Points

Procedure: Torus Palatinus Reduction

Indications

Contraindications

Anatomy

Surgical Technique

Complications of Mandibular and Maxillary Tori Reductions

Key Points

References

CHAPTER 4: Extraction Site (Socket) Preservation

Indications

Contraindications

Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 5: Onlay Bone Grafting

Procedure: Onlay Bone Grafting

Indications

Contraindications

Intraoral Alveolar Ridge Augmentation Technique

Subperiosteal Mandibular Tunnel Grafting Technique

Symphysis (Chin) Graft Technique

Lateral Ramus Graft Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 6: Sinus Lift Grafting

Indications

Contraindications

Anatomy

Direct Sinus Lift: Lateral Wall Technique

Indirect Sinus Lift: Sinus Bump Technique

Postoperative Management

Complications

Intraoperative and Early Complications

Late Complications

Key Points

References

CHAPTER 7: Zygomatic Implants

Procedure: Zygomatic Implants

Indications

Contraindications

Anatomy

Implant Anatomy

Original Surgical Technique

Two‐Zygomatic‐Implant Placement

Modifications of the Original Protocol

Postoperative Management

Complications

Intrasurgical Complications

Postoperative Complications

Key Points

References

CHAPTER 8: Immediate Implant Placement

Indications

Contraindications

Anatomic Considerations

Technique

Postoperative Management

Complications

Key Points: General Considerations

Key Points: Immediate Implants in the Aesthetic Zone (Anterior Implants)

Key Points: Immediate Molar Implants

References

CHAPTER 9: Cone Beam CT Guided Dental Implant Treatment Planning, Surgery, and Temporary Prosthesis Placement

Indications

Contraindications

Anatomy and Guided Surgery Planning Parameters

Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 10: Removable Restoration Options of the Edentulous Arch

Indications

Contraindications

Minimum Required Vertical Restorative (Interocclusal) Space of Various Types of Dental Restorations

Virtual Surgical Planning (VSP) Dual Scan Technique

Surgical Technique for Tissue Supported Guides

Postoperative Management

Complications

Implant Placement Is Key

Key Points

Reference

CHAPTER 11: Immediate Implant‐Supported Restoration of the Edentulous Arch

Indications

Contraindications

Treatment Planning Considerations

Part I – Implant Placement

Technique (Surgical)

Part II – Conversion

Technique (Restorative)

Postoperative Management

Complications

Key Points

References

CHAPTER 12: Implant Complications

Implant Placement Considerations

Clinician‐Related Etiology of Implant Failure

Malposed Implants

Implant Placement Errors

Placement of Implants into Soft Bone (Low Implant Insertional Torque Value)

Suboptimal Definitive Restorations

Poor Treatment Planning

Patient‐Related Etiology of Implant Failure

Key Points

References

Part Two: Infection

CHAPTER 13: Review of Spaces

General Principles of Surgical Infection Management

Vestibular Space

Boundaries

Key Point

Buccal Space (Buccinator Space)

Boundaries

Key Points

Palatal Space

Boundaries

Key Points

Canine Space (Infraorbital Space)

Boundaries

Key Points

Submental Space

Boundaries

Key Points

Submandibular Space (Submaxillary Space, Submylohyoid Space)

Boundaries

Key Points

Sublingual Space

Boundaries

Key Points

Parotid Space

Boundaries

Key Points

Masticator Space (Masticatory Space, Masseter–Mandibulopterygoid Space)

Boundaries

Key Points

Masseteric (Submasseteric) Space

Boundaries

Key Points

Pterygomandibular Space

Boundaries

Key Points

Superficial Temporal Space (Superficial Temporal Pouch)

Boundaries

Key Points

Deep Temporal Space (Deep Temporal Pouch)

Boundaries

Key Points

Infratemporal Space (Postzygomatic Space)

Boundaries

Key Points

Peritonsillar Space (Paratonsillar Space)

Boundaries

Key Points

Pharyngeal Spaces (Lateral and Retropharyngeal Spaces)

Lateral Pharyngeal Space (Parapharyngeal Space, Pharyngomaxillary Space, Pterygopharyngeal Space, Pharyngopterygoid Space, Peripharyngeal Space)

Boundaries

Key Points

Retropharyngeal Space (Retroesophageal Space, Retrovisceral Space, Posterior Visceral Space, Retropharyngeal Part of Visceral Compartment): Posterior Aspect of Grodinsky and Holyoke’s Space 3

Boundaries

Key Points

Pretracheal Space (Perivisceral Space, Paravisceral Space, Paratracheal Space, Anterior Visceral Space, Prevertebral Part of Visceral Compartment): Anterior Aspect of Grodinsky and Holyoke’s Space 3

Boundaries

Key Points

Visceral Space

Boundaries

Key Points

Space of the Carotid Sheath (Visceral Vascular Space, Grodinsky and Holyoke’s Space 3A, “Lincoln’s Highway of the Neck”)

Boundaries

Key Points

Danger Space #4 (Grodinsky and Holyoke’s Space 4)

Boundaries

Key Points

Prevertebral (Grodinsky and Holyoke’s Space 5)

Boundaries

Key Points

Mediastinum

Boundaries

Key Points

Periorbital Space (Preseptal Space)

Boundaries

Key Points

Orbital Space (Postseptal Space)

Boundaries

Key Points

References

CHAPTER 14: Osteomyelitis

General Principles of Management of Osteomyelitis (Acute and Chronic)

Saucerization

Key Points

Decortication

Key Points

Resection (Marginal and Continuity)

Key Points

References

CHAPTER 15: Surgical Management of Medication‐Related Osteonecrosis of the Jaws (MRONJ)

Definition of MRONJ

MRONJ Staging and Treatment

Causes of MRONJ in Patients Receiving Bisphosphonate Therapy

Signs and Symptoms of MRONJ

Diagnosis

Radiographic Evaluation of MRONJ

Radiographic Evidence of MRONJ

Treatment Strategies

Indications for Marginal or Segmental Resection

Contraindications

Surgical Technique

Surgical Technique

Surgical Technique

Postoperative Management

Complications

Early Complications

Late Complications

Key Points

References

Part Three: Maxillofacial Trauma Surgery

CHAPTER 16: Surgical Management of the Airway

Surgical Cricothyrotomy

Indications

Contraindications

Anatomy

Surgical Cricothyrotomy Technique

Complications

Key Points

References

Tracheotomy

Indications

Contraindications

Anatomy

Tracheotomy Procedure

Postoperative Management

Complications

Key Points

References

Submental Intubation

Indications for Submental Intubation

Anatomy

Submental Intubation Procedure

Submental Intubation Complications

Key Points

References

CHAPTER 17: Mandibular Fractures

Surgical Management of Anterior Mandibular Fractures (Symphysis and Parasymphysis)

Indications for Open Reduction of Anterior Mandibular Fractures

Contraindications for Open Reduction of Anterior Mandibular Fractures

Intraoral Surgical Approach and Open Reduction of the Anterior Mandible

Postoperative Management

Complications

Key Points

Procedure: Lag Screw Fixation

Indications

Contraindications

Technique

Key Points

References

Surgical Management of Posterior Mandibular Fractures (Body and Angle)

Indication for Open Reduction of Posterior Mandibular Fractures

Contraindications for Open Reduction of Posterior Mandibular Fractures

Submandibular Approach Layers

Anatomy

Intraoral Surgical Approach and Open Reduction of the Posterior Mandible

Submandibular Approach and Open Reduction of the Posterior Mandible

Postoperative Management

Complications

Key Points

References

Surgical Management of Mandibular Condyle Fractures (Extracapsular and Intracapsular Fractures)

Indications for Open Reduction of Mandibular Condyle Fractures

Contraindications for Open Reduction of Mandibular Condyle Fractures

Retromandibular Approach for Open Reduction of Extracapsular Condylar Fractures

Key Points for Extracapsular Open Reduction

Preauricular Approach for Open Reduction of Intracapsular Condylar Fractures

Key Points for Intracapsular Open Reduction

Postoperative Management

Complications

References

Surgical Management of Atrophic Edentulous Mandibular Fractures

Indications for Open Reduction of Atrophic Edentulous Mandibular Fractures

Contraindications for Open Reduction of Atrophic Edentulous Mandibular Fractures

Transcervical Approach for Open Reduction of Atrophic Edentulous Mandibular Fractures

Postoperative Management

Complications

Key Points

References

Surgical Management of Pediatric Mandibular Fractures

Indications for Open Reduction of Pediatric Mandibular Fractures

Contraindications for Open Reduction of Pediatric Mandibular Fractures

Pediatric Splint Fabrication and Closed Reduction

Closed Reduction via Risdon Cables

Closed Reduction via External Skeletal Fixation (Skeletal Wiring or Drop Wires)

Open Reduction with Resorbable Plates and Screws

Postoperative Management

Complications

Key Points

References

Surgical Management of Comminuted Mandibular Fractures

Indication for Open Reduction of Comminuted Mandibular Fractures

Contraindications for Open Reduction of Comminuted Mandibular Fractures

Postoperative Management

Complications

Key Points

External Fixation of Mandibular Fractures

Indications for External Fixation of Mandibular Fractures

Contraindication for External Fixation of Mandibular Fractures

External Fixation Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 18: Le Fort Fractures

Indications for Reduction of Le Fort Fractures

Contraindications

Anatomy

Le Fort Fracture Signs and Symptoms

Le Fort Reduction Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 19: Isolated Zygoma and Zygomaticomaxillary Complex (ZMC) Fractures

Reduction of Isolated Zygomatic Arch Fractures

Indications

Contraindications

Quinn Approach to the Arch

Gillies Approach to the Arch

Reduction of Zygomaticomaxillary Complex Fractures

Indications

Contraindications

Anatomy

Combined Maxillary Vestibular, Lateral Brow, and Transconjunctival Approach

Postoperative Management

Hemicoronal Approach to the Arch

Postoperative Management

Complications

Key Points

References

CHAPTER 20: Orbital Fractures

Indications for Reduction of Orbital Fractures

Contraindications

Anatomy

Important Orbital Wall Landmarks

Transconjunctival (Retro‐Septal) Approach

Infraorbital (Mid‐Lid Incision) Skin Incision Approach to the Orbital Floor

Upper Eyelid (Superior Blepharoplasty, Supratarsal Fold) Incision Approach

Preoperative Computer Planning and the Use of Patient‐Specific Implants

Postoperative Management

Complications

Early Complications

Late Complications

Key Points

References

Chapter 21: Nasal Fractures

Indications for Closed Reduction of Nasoseptal Fractures

Indications for Open Reduction of Nasoseptal Fractures

Contraindications

Anatomy

Closed Nasoseptal Reduction Technique

Open Nasoseptal Reduction Technique

Postoperative Management

Complications

Early Complications

Late Complications

Key Points

References

CHAPTER 22: Frontal Sinus Fractures

Indications to Frontal Sinus Obliteration

Indication for Frontal Sinus Cranialization

Contraindications for Surgical Management of Anterior Table Frontal Sinus Fractures

Contraindications for Surgical Management of Posterior Table Frontal Sinus Fractures

Anatomy

Coronal Incision Layers

Surgical Management of Anterior Table Frontal Sinus Fractures

Surgical Management of Posterior Table Frontal Sinus Fractures

Postoperative Management

Complications of Frontal Sinus Fractures

Key Points

References

CHAPTER 23: Panfacial and Naso‐Orbito‐Ethmoid (NOE) Fractures

Indications for Reduction of Panfacial and NOE Fractures

Contraindications

Anatomy

Transverse (Horizontal) Facial Buttresses

Vertical Facial Buttresses

Panfacial Fracture and NOE Reduction Technique

Postoperative Management

Complications

Early Complications

Late Complications

Key Points

References

CHAPTER 24: Maxillofacial Gunshot Wounds (GSW)

Low Energy Transfer Gunshot Injuries (Standard Handguns and Shotguns)

High Energy Transfer Gunshot Injuries (Military and Hunting Rifles and Magnum Handguns)

Complications

Early Complications

Late Complications

Key Points

References

CHAPTER 25: Soft Tissue Injuries

Complex Facial Lacerations

Indications

Contraindications

Anatomy

Technique: Complex Facial Laceration Repair

Postoperative Management

Complications

Key Points

Stensen’s Duct Repair

Indications

Contraindications

Anatomy

Technique: Stensen’s (Parotid) Duct Repair

Postoperative Management

Complications

Key Points

References

Facial Nerve Injury

Indications

Contraindications

Anatomy

Technique: Facial Nerve Injury Repair

Postoperative Management

Complications

Key Points

References

Part Four: Orthognathic and Craniofacial Surgery

CHAPTER 26: Virtual Surgical Planning (VSP) in Orthognathic Surgery

Data Collection for Orthognathic Virtual Surgical Planning

Clinical Examination

Clinical Photos

Computed Tomography (CT) Scan (Exported as DICOM Files)

Occlusal Record (Exported as STL Files)

Setting Postsurgical Occlusion

Set Digital Head Position

Planning Surgical Movements

IntraOperative Insights

Surgical Adjuncts

References

CHAPTER 27: Maxillary Osteotomies

Le Fort I Osteotomy (Single Piece)

Indications

Contraindications

Surgical Anatomy

Technique

Postoperative Management

Key Points

Reference

Segmental Maxillary Osteotomy (Two or Three Pieces)

Indications

Contraindication

Segmental Osteotomy Technique

Postoperative Management

Key Points

References

Patient‐Specific Custom Implants for Le Fort Osteotomy

Indications

Virtual Surgical Planning (See Chapter 26‐Virtual Surgical Planning in Orthognathic Surgery)

Surgical Technique

Key Points

Reference

Surgically Assisted Rapid Palatal Expansion (SARPE)

Indications

Contraindications

Anatomy

Technique

Postoperative Management

Key Points

References

Complications

Le Fort I Osteotomy (Single Piece)

Segmental Maxillary Osteotomy (Two or Three Pieces)

Surgically Assisted Rapid Palatal Expansion (SARPE)

CHAPTER 28: Mandibular Osteotomies

Sagittal Ramus Osteotomy (Bilateral Sagittal Split Osteotomy or BSSO)

Indications

Contraindications

Anatomy

Sagittal Ramus Osteotomy (SRO)

Intraoral Vertical Ramus Osteotomy (IVRO)

Extraoral Ramus Osteotomy

Bone Grafting Considerations in Orthognathic Surgery

Postoperative Management

Complications

Intraoperative Complications

Postoperative Complications

Mandible First Sequence

Digital Planning Pearls

Key Points

CHAPTER 29: Atypical Mandibular Osteotomies

Atypical Mandibular Osteotomies

Indications

Contraindications

Intraoral Inverted L Osteotomy Technique

Z Osteotomy Technique

C Osteotomy Technique

Mandibular Subapical Osteotomy Technique

Postoperative Management

Key Points

CHAPTER 30: Genioplasty (Anterior Sliding Osteotomy) and Genioglossus Advancement

Indications

Contraindications

Anatomy

Genioplasty Technique

Genioglossus Advancement Technique

Postoperative Management

Complications

Key Points

Reference

CHAPTER 31: Maxillary and Midface Distraction

Indications

Contraindications

Technique – Le Fort I Rigid External Distractor (RED)

Technique – Le Fort I Internal Osseous Distractor

Technique – Le Fort III Rigid External Distractor (RED)

Postoperative Management

Complications

Key Points

References

CHAPTER 32: Dentoalveolar Cleft Repair

Indications

Contraindication

Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 33: Cleft Palate Repair (Palatoplasty)

Indication

Contraindications

Anatomy

Two‐Flap Palatoplasty Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 34: Cleft Lip Repair (Cheilorhinoplasty)

Indications

Contraindications

Anatomy

Preoperative Treatment

Millard Technique

Unilateral Cheilorhinoplasty Technique

Bilateral Cheilorhinoplasty Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 35: Orthognathic Surgery in the Cleft Patient

Indications

Contraindication

Technique Modifications to Le Fort I Osteotomies for Unrepaired and Repaired Unilateral Alveolar Clefts

Technique Modifications to Le Fort I Osteotomies for Unrepaired and Repaired Bilateral Alveolar Clefts

Postoperative Management

Complications

Key Points

References

CHAPTER 36: Craniosynostosis and Vault Surgery

Indications for Cranial Vault Surgery

Contraindications to Cranial Vault Surgery

Anatomy

Open Cranial Vault Surgery Technique

Postoperative Management

Complications of Cranial Vault Surgery

Key Points

Acknowledgements

References

Part Five: Temporomandibular Joint Surgery

CHAPTER 37: Temporomandibular Joint Imaging

Indications

Contraindications

Relative Contraindications

Definitions

Anatomy

Five Temporomandibular Joint Ligaments

Magnetic Resonance Imaging (MRI) Technique

Articular Disc Function and Common Disorders

Key Points

References

CHAPTER 38: Arthrocentesis of the Temporomandibular Joint

Indications

Contraindications

Anatomy

Technique

Postoperative Management

Complications

References

CHAPTER 39: Arthroscopic Arthroplasty of the Temporomandibular Joint

Indications

Contraindications

Anatomy

Arthroscopic Arthroplasty (Discopexy) Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 40: Alloplastic Reconstruction (TMJ Concepts) of the Temporomandibular Joint and Associated Structures

Indications

Contraindications

Diagnosis and Surgical Planning

Indications for a One‐Piece Stereolithic Model

Indications for a Two‐Piece Stereolithic Model

One‐Stage Alloplastic Reconstruction (See Case Report 40.1)

Specific Indications for One‐Stage Alloplastic Reconstruction

Two‐Stage Alloplastic Reconstruction (See Case Report 40.2)

Specific Indications for Two‐Stage Alloplastic Reconstruction

TMJ Concepts Virtual Surgical Planning

Surgical Technique and Insertion of Custom TMJ Prostheses

Presurgical Preparation

Preauricular Approach

Modified Retromandibular Approach

Condylar Resection Without Massive Ankylosis

Condylar Resection with Massive Ankylosis: Two‐Stage Alloplastic Reconstruction

Prostheses Placement: One‐ or Two‐Stage Alloplastic Reconstruction

Postoperative Management

Complications

Early

Late

Key Points

Initial Injury Radiographs

Four‐Year Status Post Bilateral Condylar and Symphysis Fractures (Development of Bony Ankylosis)

Virtual Surgical Planning (VSP) of Bilateral TMJ Bony Ankylosis

Stage I Surgery: Gap Arthroplasty

TMJ Concepts Work‐Up Status Post Gap Arthroplasty

Stage II Surgery: Custom Prostheses Placement

References

CHAPTER 41: Autogenous Reconstruction of the Temporomandibular Joint

Indications

Contraindications

Autogenous TMJ Replacement Procedure: Costochondral Graft

Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 42: Eminectomy

Indications

Contraindications

Anatomy

Preauricular Dissection Layers

Technique

Postoperative Management

Complications

Early Complications

Late Complications

Key Points

References

CHAPTER 43: Concomitant Temporomandibular Joint Replacement and Orthognathic Surgery

Indications for TMJ Replacement

Indications for Orthognathic Surgery with TMJ Replacement

Contraindications for Concomitant TMJ and Orthognathic Surgery

Preoperative Management and Planning

Virtual Surgical Planning (VSP)

Concomitant TMJ Replacement with Orthognathic Surgery Technique

Postoperative Management

Complications of Concomitant TMJ Replacement and Orthognathic Surgery

Key Points

References

Part Six: Facial Cosmetic Surgery

CHAPTER 44: Innovations in Facial Cosmetic Surgery

Non‐invasive Management of Submental Lipomatosis

Cryolipolysis

Indications

Contraindications

Procedure: Submental and Submandibular Cryolipolysis

Early Complications

Late Complications:

Key Points

Injectable Chemolipolysis: Deoxycholic Acid (Kybella, Allergan USA Inc., Madison, NJ)

Indications

Contraindications

Technique

Complications

Key Points

Management of the Submentum: Non‐invasive Skin Tightening Modalities

Indications

Contraindications

Complications

Key Points

Invasive Adjuncts to Facial Liposuction and Skin Tightening Modalities

Indications

Contraindications

Technique: Internal and External Radiofrequency with FaceTite (InMode Corp., Toronto, Canada)

Complications

Key Points

References

CHAPTER 45: Neuromodulator (Botox) Management of Facial Rhytids

Facial Aesthetic Indications

Contraindications

Anatomy

Technique

Postoperative Management

Complications

Early Complications

Late Complications

Key Points

References

CHAPTER 46: Soft Tissue Volumizers

Indications

Contraindications

Anatomy

Injection Technique

Postinjection Management

Complications

Early Complications (0–7 Days Postinjection)

Late Complications (Greater Than 7 Days Postinjection)

Key Points

References

CHAPTER 47: Chemical Peels

Indications

Contraindications

Anatomy

Pretreatment Protocol for Chemical Peel Patients

Technique: Medium Depth Chemical Peel

Postoperative Management

Early Complications

Late Complications

Key Points

Chemical Peels for Melasma or Dark‐Skinned Patients

Indications

Contraindications

Technique: Melanage Skin Brightening System

Key Points

References

CHAPTER 48: Facial CO

2

Laser Resurfacing

Indications

Contraindications

Anatomy

Technique

Postoperative Management

Complications

Late Complications

Key Points

References

CHAPTER 49: Brow Lift

General Indications

General Contraindications

Anatomy

Preoperative Markings

Endoscopic (Closed) Brow Lift

Indications

Contraindications

Technique

Key Points: Endoscopic Brow Lift

Treatment Plan

Trichophytic Brow Lift

Indications

Contraindications

Technique (Subgaleal Brow Lift)

Key Points

Treatment Plan

Coronal Brow Lift

Indications

Contraindications

Technique

Key Points

Postoperative Management for Brow Lift Procedures

Early Complications

Late Complications

Key Points

References

CHAPTER 50: Rhytidectomy

Indications

Contraindications

Anatomy

Superficial (Supra‐SMAS) Rhytidectomy Technique

Postoperative Management

Complications

Early Complications

Late Complications

Key Points

References

CHAPTER 51: Upper and Lower Lid Blepharoplasty and Tear Trough Implants

Upper Lid Blepharoplasty Procedure

Indications

Contraindications

Anatomy and Definitions: Upper Lid

Upper Blepharoplasty Preoperative Assessment and Markings

Upper Lid Blepharoplasty Procedure

Complications

Key Points

References

Lower Lid Blepharoplasty Procedure

Indications

Contraindications

Anatomy and Definitions: Lower Lid

Transconjunctival Lower Lid Blepharoplasty Procedure

Transcutaneous Lower Lid Blepharoplasty Procedure

Key Points

Complications

Postoperative Management: Upper and Lower Lid Blepharoplasties

References

Tear Trough Implants

Indications

Contraindications

Anatomy

Transcutaneous Approach to the Placement of a Tear Trough Implant

Transconjunctival Approach to Placement of a Tear Trough Implant

Intraoral Approach to Placement of a Tear Trough Implant

Complications

Key Points

References

CHAPTER 52: Rhinoplasty

Indications

Correction of Functional Nasal Deformities

Correction of Aesthetic Deformities as a Result of Congenital and Acquired (Trauma) Deformities

Contraindications

Anatomy

Septal Procedures

Turbinate Anatomy and Procedures

Nasal Valves Anatomy and Procedures

Nasal Skin‐Soft Tissue Envelope (S‐STE)

Nasal Skeleton

Initial Nasal Examination

Septal Access: Killian and Transfixion Incisions

Killian Incision

Transfixion Incisions

Open Approach Rhinoplasty

Indications

Contraindications

Technique

Key Points: Open Rhinoplasty

Closed (Endonasal) Rhinoplasty

Indications

Contraindications (Relative)

Technique: Closed (Endonasal) Rhinoplasty

Key Points: Closed (Endonasal) Rhinoplasty

Correction of Specific Nasal Deformities

Upper Bony Vault/Middle Cartilaginous Vault

Nasal Tip

Alar Base and Nostrils

Postoperative Management

Early Complications

Late Complications

Key Points

References

Part Seven: Maxillofacial Pathology Surgery

CHAPTER 53: Benign Cysts of the Jaws

Odontogenic Cysts

Periapical Cysts

Dentigerous Cysts

Keratinizing Odontogenic Tumor (Odontogenic Keratocyst)

Calcifying Odontogenic Cyst (Gorlin’s Cyst)

Non‐odontogenic Cysts

Nasopalatine Duct Cyst (Incisive Canal Cyst)

Aneurysmal Bone Cyst

Traumatic Bone Cyst (Idiopathic Bone Cavity)

Procedure: Enucleation and Curettage

Key Points

References

CHAPTER 54: Benign Tumors of the Jaws

Non‐odontogenic Tumors

Tumors of Connective Tissue

Vascular and Reactive Lesions

Odontogenic Tumors

Odontogenic Epithelial Tumors

Ectomesenchymal Tumors

Mixed Odontogenic Tumors

Technique: Mandibular Resection

Key Points

References

CHAPTER 55: Palatal Pathology

Indications

Contraindications

Technique: Wide Local Excision ± Palatectomy

Technique: Infrastructure Maxillectomy

Postoperative Management

Complications

Key Points

References

CHAPTER 56: Ocular Enucleation and Evisceration

Indications

Contraindications

Anatomy

Technique: Enucleation

Technique: Evisceration

Postoperative Care

Complications

Intraoperative Complications

Early Postoperative Complications

Late Postoperative Complications

Key Points

References

CHAPTER 57: Transcervical Styloidectomy and the Forgotten Triangles of the Neck

Lesser’s Triangle

Pirogov’s Triangle

Beclard’s Triangle

Transcervical Styloidectomy

Indications

Technique

Complications

References

CHAPTER 58: Surgical Management of the Neck

Indications

Contraindications

Neck Dissection Classification

Selectivity

Anatomy

Surgical Technique

Selective Neck Dissection, Levels I–III

Radical Neck Dissection

Complications and Postoperative Management

Neurologic Injury

Chyle Leak

Bleeding

Key Points

References

CHAPTER 59: Surgical Management of Lip Cancer

Lip Switch Flaps: Abbe and Estlander Flaps

Indications

Contraindications

Flap Anatomy

Technique: Abbe Flap

Technique: Estlander Flap

Postoperative Management

Complications

Key Points

References

Full‐thickness Wedge Resection (V Shaped, V‐Y Shaped, and W Shaped)

Indications

Contraindications

Flap Anatomy

Surgical Technique: Full‐Thickness V‐Shaped Wedge Resection

Postoperative Management

Complications

Key Points

References

CHAPTER 60: Salivary Gland Pathology

Mucocele (Mucous Extravasation Phenomenon) Excision

Indications

Contraindications

Anatomy

Technique

Postoperative Management

Complications

Key Points

References

Sublingual Gland Excision

Indications

Contraindications

Anatomy

Technique: Intraoral Ranula and Sublingual Gland Excision

Technique: Intraoral Sublingual Gland Excision Without Associated Ranula

Technique: Transcutaneous Plunging Ranula and Sublingual Gland Excision

Postoperative Management

Complications

Key Points

References

Submandibular Gland Resection

Indications

Contraindications

Anatomy

Technique: Extraoral Submandibular Gland Excision

Postoperative Management

Complications

Key Points

References

Sialodochoplasty

Indications

Contraindications

Anatomy

Technique

Postoperative Management

Complications

Key Points

References

Superficial Parotidectomy

Indications

Contraindications

Anatomy

Surgical Landmarks to Identify the Main Nerve Trunk (MNT) of the Facial Nerve

Procedure: Superficial Parotidectomy

Postoperative Management

Complications

Key Points

References

Part Eight: Maxillofacial Reconstructive Surgery

CHAPTER 61: Closure of Oral‐Antral Communications

Indications

Contraindications

General Considerations for Fistulectomy

Specific Surgical Techniques for Oral‐Antral Communications and Oral‐Antral Fistulae Closure

Primary Closure

Indication

Contraindication

Technique: Buccal Advancement Flap

Indication

Contraindications

Surgical Anatomy

Technique: Palatal Rotational Advancement Flap

Buccal Fat Pad Advancement

Indications

Contraindications

Anatomy

Technique: Buccal Fat Pad Advancement

Bone Graft

Indications

Contraindications

Technique: Bone Graft

Temporalis Muscle Flap

Indication

Contraindications

Anatomy

Technique: Temporalis Muscle Flap

Temporoparietal Galea Flap

Indications

Contraindications

Anatomy

Technique: Temporoparietal Galea Flap

Postoperative Management

Complications

Key Points

References

CHAPTER 62: Anterior Iliac Crest Bone Graft

Indications

Contraindications

Anatomy

Sensory cutaneous nerves (3):

Anterior Iliac Crest Bone Graft (AICBG) Harvesting Technique (Medial Approach)

Postoperative Management

Complications

Early Complications

Key Points

References

CHAPTER 63: Posterior Iliac Crest Bone Graft

Indications

Contraindications

Anatomy of the Posterior Ilium

Posterior Iliac Crest Bone Graft (PICBG) Harvesting Technique

Posterior Iliac Approach

Corticocancellous (Unicortical) Harvesting

Cancellous‐Only Harvesting: The Trapdoor Technique

Closure

Postoperative Management

Complications

Key Points

References

CHAPTER 64: Proximal Tibial Bone Graft

Indications

Contraindications

Anatomy

Technique: Lateral Approach to the Proximal Tibia

Postoperative Management

Complications

Key Points

References

CHAPTER 65: Parietal Bone Graft

Indications

Contraindications

Anatomy

Split‐Thickness Parietal Bone Graft Harvest Procedure

Postoperative Management

Complications

Key Points

References

CHAPTER 66: Costochondral Graft

Indications

Contraindications

Anatomy

Costochondral Graft (CCG) Harvest Technique

Postoperative Management

Complications

Immediate or Early Complications

Late Complications

Key Points

References

CHAPTER 67: Tongue Flap Reconstruction of Lip Defects

Indications

Contraindications

Flap Anatomy

Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 68: Paramedian Forehead Flap

Indications

Contraindications

Anatomy

Technique: Stage I (Flap Harvest and Transfer)

Technique: Stage II (Pedicle Separation and Flap Inset)

Postoperative Care

Complications

Key Points

References

CHAPTER 69: Pectoralis Major Myocutaneous Flap

Procedure: Pectoralis Major Myocutaneous Flap (i.e., Pec Flap)

Indications

Contraindications

Anatomy

Pectoralis Major Muscle

Pectoralis Major Myocutaneous Flap Surgical Technique

Postoperative Management

Complications

Early Complications

Late Complications

Key Points

References

CHAPTER 70: Latissimus Dorsi Free Flap

Indications

Relative Contraindications

Anatomy

Preoperative Management

Technique

Postoperative Management

Complications

Early Complications

Late Complications

Key Points

References

CHAPTER 71: Microvascular Principles

Indications for Microvascular Reconstruction of Maxillofacial Defects

Contraindications for Microvascular Reconstruction of Maxillofacial Defects

Microvascular Principles and Technique

Complications

Key Points

References

CHAPTER 72: Free Vascularized Fibula Graft Harvest

Indications

Contraindications

Preoperative Studies

Flap Anatomy

Surgical Anatomy

Preoperative Preparation

Surgical Procedure

Technique: Fibula Harvest

Complications

Key Points

References

CHAPTER 73: Anterolateral Thigh (ALT) Perforator Free Flap

Indications

Contraindications

Anatomy

Surgical Technique

Postoperative Management

Complications

Key Points

References

CHAPTER 74: Radial Forearm Free Flap

Indications

Contraindications

Anatomy

Radial Forearm Flap Landmarks

Radial Forearm Flap Layers

Radial Forearm Flap Technique

Complications

Key Points

References

CHAPTER 75: Nerve Harvest and Repair

Procedure: Trigeminal Nerve Repair

Indications

Contraindications

Nonsurgical Management

Anatomy

Surgical Technique for Trigeminal Nerve Repair

Lingual Nerve Repair

Access Phase

Preparation Phase

Microsuture Phase

Wound Closure

Inferior Alveolar Nerve Repair

Access Phase

Preparation Phase

Infraorbital Nerve Repair

Access Phase

Postoperative Management

Complications

Key Points

References

Technique: Autogenous Nerve Graft and Harvest

Indications

Contraindications

Anatomy

Surgical Technique for Trigeminal Nerve Graft Repair

Great Auricular Nerve Graft

Access

Harvesting

Wound Closure

Postoperative Management

Complications

Key Points

References

Nerve Allograft Reconstruction

Indications

Contraindications

Technique: Avance

®

Nerve Graft (Axogen, Alachua, Florida, USA)

Complications

Key Points

References

Index

End User License Agreement

List of Tables

Chapter 1

Table 1.1. Seddon and Sunderland classification of nerve injuries.

Chapter 25

Table 25.1. Suture removal times based on suture site.

Chapter 45

Table 45.1. Recommended concentration of Botulinum Toxin A per area of inje...

Chapter 46

Table 46.1. Common injectables.

Chapter 58

Table 58.1. Clinical and radiographic signs of lymph node metastasis.

Table 58.2. The evolution of neck dissection classification systems and ind...

List of Illustrations

Chapter 1

Figure 1.1. Cone beam CT scan depicting maxillary third molar displaced with...

Figure 1.2. Coronal CBCT image depicting an impacted inverted mesiodens loca...

Figure 1.3. Tooth #1 traumatically displaced into the overlying maxillary si...

Figure 1.4. Schematic demonstrating the location of the inferior alveolar ne...

Figure 1.5. Three‐dimensional image depicting the inferior alveolar nerve co...

Figure 1.6. Lower wisdom tooth extracted from the patient in Figure 1.5. The...

Figure 1.7. Photographic documentation of a lingual nerve (LN) injury.

Figure 1.8. Photographic documentation of an inferior alveolar nerve (IAN) i...

Figure 1.9. Two‐dimensional film demonstrates impacted tooth #32 with divers...

Figure 1.10. Cone beam computed tomography coronal view demonstrating the in...

Figure 1.11. Periapical film demonstrating a coronectomy of tooth #32. Note ...

Figure 1.12. Two‐dimensional film demonstrating interruption of the white li...

Figure 1.13. Cone beam computed tomography coronal view demonstrating the in...

Figure 1.14. Tooth #32 extraction site demonstrating an intact inferior alve...

Chapter 2

Figure 2.1. Orthopantomogram demonstrating retained primary teeth c and h an...

Figure 2.2. Cone beam computed tomography sagittal views demonstrating the p...

Figure 2.3. Occlusal view of impacted teeth #6 and #11.

Figure 2.4. 14‐year‐old patient in full orthodontics with c and h acting as ...

Figure 2.5. Extraction of primary teeth c and h. Crestal incision and reflec...

Figure 2.6. Removal of the dental follicles and surrounding bone to expose t...

Figure 2.7. Placement of acid etch on impacted teeth #6 and #11.

Figure 2.8. A low‐profile mesh bracket with dental composite is utilized to ...

Figure 2.9. The bracket is bonded to impacted tooth #11, excessive composite...

Figure 2.10. Gold chains secured to the orthodontic arch wire using 4‐0 silk...

Figure 2.11. Bilateral palatal flaps are closed with interrupted 4‐0 chromic...

Figure 2.12. Orthopantomogram demonstrating vertically erupting tooth #6 and...

Figure 2.13. Cone beam computed tomography sagittal view demonstrating the l...

Figure 2.14. Crestal incision and reflection of a full‐thickness mucoperiost...

Figure 2.15. Removal of the dental follicle and surrounding bone to expose t...

Figure 2.16. Placement of bracket, removal of excessive composite flash, rem...

Figure 2.17. The clinical crowns of teeth #6 and #11 exposed with a #15c bla...

Figure 2.18. Surgical packs are placed over the exposed clinical crowns and ...

Figure 2.19. The orthodontist has created sufficient spacing for the eruptio...

Figure 2.20. Impacted tooth #6 is exposed to its CEJ. The soft tissue flap i...

Figure 2.21. A cellulose crown is modified and fitted over the clinical crow...

Figure 2.22. Occlusal view of cellulose crown in place.

Figure 2.23. Orthopantomogram depicting delayed eruption of teeth #6, #11, a...

Figure 2.24. Cone beam computed tomography sagittal view demonstrating the l...

Figure 2.25. Note atrophy of buccal alveolar bone width due to the apically ...

Figure 2.26. A crestal incision bisecting the keratinized tissue is designed...

Figure 2.27. A bulge is noted along the buccal plate of bone indicating the ...

Figure 2.28. The clinical crown of tooth #27 is exposed to its CEJ, the dent...

Figure 2.29. The site is closed primarily and in a tension‐free manner with ...

Figure 2.30. Orthopantomogram depicting impacted teeth #18, #19, #30, and #3...

Figure 2.31. Teeth #18, #19, #30, and #31 are exposed and bone is reduced to...

Figure 2.32. Three weeks postoperative, a power chain is placed to protract ...

Figure 2.33. Eight weeks postoperative, the first molar teeth are vertically...

Figure 2.34. Eight weeks postoperative orthopantomogram illustrating tooth m...

Figure 2.35. Orthopantomogram depicting impacted tooth #11 and gross overlyi...

Figure 2.36. CBCT sagittal view demonstrating the position of tooth #11 with...

Figure 2.37. Occlusal view showing loss of horizontal and labial hard and so...

Figure 2.38. After tooth extraction, significant horizontal and vertical def...

Figure 2.39. The site was grafted with a 50/50 combination of xenograft and ...

Figure 2.40. A connective tissue graft from the palate was placed and the si...

Figure 2.41. After 3 months of hard and soft tissue graft healing, CT‐guided...

Figure 2.42. Implant placement at site #11.

Figure 2.43. Implant placed palatally for screw retained final restoration. ...

Figure 2.44. Preoperative orthopantomogram demonstrating orthodontics in pla...

Figure 2.45. 9‐month postoperative orthopantomogram illustrating changes to ...

Figure 2.46. Note intrusion of the maxillary teeth due to ankylosis of the i...

Chapter 3

Figure 3.1. The area of tissue to be excised is determined and the incision ...

Figure 3.2. A full‐thickness elliptical incision is created and the interven...

Figure 3.3. The site is closed primarily in a tension‐free manner with resor...

Figure 3.4. Axial CBCT scan image depicting large bilateral mandibular lingu...

Figure 3.5. Large mandibular tori that are near touching in the midline.

Figure 3.6. Chronic tissue irritation and frenal impingement from the bilate...

Figure 3.7. Local anesthesia containing a vasoconstrictor is injected direct...

Figure 3.8. A full‐thickness mucoperiosteal flap is elevated, and a subperio...

Figure 3.9. Excess tissue remains after large tori removal/reduction. The ex...

Figure 3.10. Bilateral tori have been reduced, excess tissue has been trimme...

Figure 3.11. Bilateral tori removal. Note segment of tissue that was excised...

Figure 3.12. Pre‐ (a) and post‐reduction coronal (b) CBCT scan depicting the...

Figure 3.13. Four weeks status post reduction of bilateral tori. Note tissue...

Figure 3.14. Patients with large palatal tori typically develop food impacti...

Figure 3.15. Palatal prosthesis fabricated for the patient in Figure 3.14. T...

Figure 3.16. Double‐“Y” incision is outlined over the midline palatal tori....

Figure 3.17. Elevation of full‐thickness mucoperiosteal tissue flap and comp...

Figure 3.18. Adequate reduction of the palatal tori and removal of all bone ...

Figure 3.19. Primary closure is obtained with interrupted resorbable sutures...

Chapter 4

Figure 4.1. Failing tooth #5 and edentulous site #4.

Figure 4.2. Tooth #5 is extracted atraumatically with complete preservation ...

Figure 4.3. Particulate graft is hydrated with sterile water and placed with...

Figure 4.4. Tb syringe filled with 0.5 g particulate bone graft material. A ...

Figure 4.5. Tb application syringe is placed within the extraction site and ...

Figure 4.6. Graft material is placed to the level of the buccal and lingual ...

Figure 4.7. Collagen membrane is placed and secured with 4‐0 chromic sutures...

Chapter 5

Figure 5.1. Common sources of autogenous bone.

Figure 5.2. Mucoperiosteal flap reflection revealed alveolar ridge bony exos...

Figure 5.3. The recipient site is recontoured to remove areas of bony exosto...

Figure 5.4. The lateral ramus is osteotomized posterior to the dentition.

Figure 5.5. The ramus block onlay graft is secured to the donor site with po...

Figure 5.6. Orthopantomogram depicting failing teeth #7 and #10 with associa...

Figure 5.7. Axial cone beam computed tomography image depicting anterior max...

Figure 5.8. Patient with sufficient vertical bone height, but insufficient b...

Figure 5.9. A mucoperiosteal tissue flap is elevated with vertical releases ...

Figure 5.10. A round bur is used to stimulate bleeding of the recipient site...

Figure 5.11. A particulate graft consisting of bovine bone and fibrin sealan...

Figure 5.12. A resorbable membrane is placed over the particulate graft.

Figure 5.13. The recipient site is closed in a tension‐free manner with reso...

Figure 5.14. Axial cone beam computed tomography (CBCT) image 6 months after...

Figure 5.15. Tissue condition and ridge width after 6 months of healing.

Figure 5.16. Cone beam computed tomography–generated guide is fabricated to ...

Figure 5.17. Dental implants are placed utilizing a flapless technique to mi...

Figure 5.18. Postoperative orthopantomogram depicting the placement of denta...

Figure 5.19. Postoperative axial cone beam computed tomography image demonst...

Figure 5.20. Preoperative orthopantomogram depicting root tips #31 and edent...

Figure 5.21. Preoperative coronal CBCT scan image depicting gross atrophy of...

Figure 5.22. Note gross horizontal atrophy at site #30.

Figure 5.23. Crestal incision is created to bisect the keratinized tissue an...

Figure 5.24. Tisseel fibrin sealant and Emdogain protein‐based regenerative ...

Figure 5.25. Graft material is placed within the extraction site and edentul...

Figure 5.26. A collagen membrane is placed over the graft material.

Figure 5.27. Site closed primarily in a tension‐free manner with resorbable ...

Figure 5.28. Three weeks postoperative. Note immature tissue regeneration ov...

Figure 5.29. Three months status post grafting, implants are placed in a fla...

Figure 5.30. Postoperative reformatted orthopantomogram.

Figure 5.31. Postoperative coronal views of implants #30 (a) and #31 (b) pla...

Figure 5.32. Preoperative orthopantomogram showing missing tooth #30 with ra...

Figure 5.33. Preoperative coronal CBCT scan depicting loss of the buccal pla...

Figure 5.34. Occlusal view of site #30 demonstrating loss of the buccal plat...

Figure 5.35. Incision is placed anterior to the buccal defect site and a sub...

Figure 5.36. A 1‐mL Tb syringe is modified to act as a carrier for the parti...

Figure 5.37. The modified 1‐mL Tb syringe is placed within the subperiosteal...

Figure 5.38. The anterior incision is closed with resorbable sutures.

Figure 5.39. Postoperative orthopantomogram obtained 3 months after grafting...

Figure 5.40. Three‐month postoperative coronal CBCT scan depicting reconstru...

Figure 5.41. Postoperative films depicting implant #30 placed with ideal rec...

Figure 5.42. Sulcular approach to the mandibular symphysis region. Preoperat...

Figure 5.43. The symphysis is exposed, the mental nerves are visualized and ...

Figure 5.44. Corticocancellous block grafts harvested from the mandibular sy...

Figure 5.45. Sulcular and vertical releasing incisions are closed primarily....

Figure 5.46. Preoperative view of the right ascending ramus.

Figure 5.47. The lateral and ascending ramus are exposed via a sulcular inci...

Figure 5.48. Standard lateral ramus osteotomy is created utilizing piezoelec...

Figure 5.49. Donor site is inspected after graft harvest.

Figure 5.50. Standard 30 mm (length) × 12 mm (height) cortical block graft f...

Figure 5.51. A combined ramus‐coronoid graft can be obtained when larger qua...

Chapter 6

Figure 6.1. Various diameter sinus lift osteotomes utilized for performing i...

Figure 6.2. Preoperative orthopantomogram depicting insufficient vertical he...

Figure 6.3. Sagittal CBCT view depicting lack of vertical bone volume for im...

Figure 6.4. A sulcular‐crestal incision is made with a posterior release to ...

Figure 6.5. Lateral sinus bone has been removed with a round bur to expose t...

Figure 6.6. Tisseel fibrin sealant is added to particulate bovine grafting m...

Figure 6.7. Graft material is placed along the sinus floor and compacted med...

Figure 6.8. A 4.1 × 10 mm parallel wall implant is placed into the sinus gra...

Figure 6.9. A collagen membrane is placed and the soft tissues are closed wi...

Figure 6.10. Postoperative orthopantomogram depicting simultaneous graft and...

Figure 6.11. Sufficient horizontal and vertical sinus augmentation for the i...

Figure 6.12. Orthopantomogram illustrating recent sinus lift and implant pla...

Figure 6.13. A vestibular semilunar incision is created at the location of t...

Figure 6.14. A round bur with copious irrigation is used to remove the later...

Figure 6.15. The sinus membrane is elevated superiorly to create space for t...

Figure 6.16. Graft medium is placed along the medial, anterior, posterior an...

Figure 6.17. The site is closed with continuous 4‐0 chromic sutures.

Figure 6.18. Three‐month postoperative orthopantomogram showing sufficient v...

Figure 6.19. Virtual surgical planning (VSP) is utilized to allow for precis...

Figure 6.20. Edentulous sites #3, #4, and #5.

Figure 6.21. Tooth‐supported surgical guide in place.

Figure 6.22. Parallel pins confirm implant angulation, 10 mm vertical implan...

Figure 6.23. Implants are placed in a flapless fashion to minimize postopera...

Figure 6.24 Implants and soft tissue healing 6 weeks after implant placement...

Figure 6.25. Scan bodies are placed.

Figure 6.26. i‐TERO digital impression with scan bodies in place is used to ...

Figure 6.27. A physical model is milled from the exported STL file. Implant ...

Figure 6.28. Preoperative cone beam computed tomography (CBCT) showing a pne...

Figure 6.29. Semilunar incision is made at the mucogingival junction, follow...

Figure 6.30. Creation of an oval window using a large diamond bur.

Figure 6.31. The Schneiderian membrane is exposed, and a sinus window with a...

Figure 6.32. The sinus membrane with the attached central bony island is ele...

Figure 6.33. Initial sinus window is enlarged by removing bone with a Kerris...

Figure 6.34. Tooth #5 is atraumatically extracted, and the particulate graft...

Figure 6.35. The graft is compacted against the medial and anterior walls of...

Figure 6.36. Implant osteotomies are carried to completion through the gingi...

Figure 6.37. Additional particulate graft is placed and compacted lateral to...

Figure 6.38. A rhBMP–collagen sponge is placed along the lateral wall of the...

Figure 6.39. Postoperative cone beam computed tomography illustrating suffic...

Figure 6.40. Failing and infected tooth #14.

Figure 6.41. Tooth #14 was extracted and an immediate short implant (6 mm le...

Figure 6.42. Implant #14 osseointegrated and was restored and functional for...

Figure 6.43. After 3 months of healing, 5 mm of vertical bone height was pre...

Figure 6.44. Implant placement is planned to utilize a 10 mm length implant....

Figure 6.45. Osseodensification drill (Versah, Jackson, Michigan, USA) kit. ...

Figure 6.46. A 10‐mm implant is placed simultaneously with an indirect crest...

Chapter 7

Figure 7.1. Preoperative orthopantomogram demonstrating pneumatized maxillar...

Figure 7.2. Quad‐zygomas placed using the original technique via the intrasi...

Figure 7.3. Postoperative orthopantomogram demonstrating ideal implant posit...

Figure 7.4. Implants are uncovered and healing abutments are placed after 4 ...

Figure 7.5. Final prosthesis in place.

Figure 7.6. Preoperative orthopantomogram demonstrating adequate maxillary b...

Figure 7.7. Computed tomography (CT) scan demonstrating a lack of bone heigh...

Figure 7.8. Computer‐assisted virtual treatment planning showing the potenti...

Figure 7.9. Placement of four anterior traditional dental implants and two z...

Figure 7.10. Occlusal view of implant placement. Note the crestal location o...

Figure 7.11. Postoperative orthopantomogram demonstrating the ideal placemen...

Figure 7.12. Implants are uncovered and healing abutments are placed after 4...

Figure 7.13. Final fixed‐hybrid prosthesis in place.

Chapter 8

Figure 8.1. Contra‐angle torque wrench used for posterior placement of cover...

Figure 8.2. X‐Guide navigational unit within the author’s operatory.

Figure 8.3. X‐clip in place within the contralateral arch. Once calibrated, ...

Figure 8.4. Each drill is calibrated prior to use.

Figure 8.5. Atraumatic and flapless extraction of tooth #19. Thorough debrid...

Figure 8.6. Guide pin placed into pilot osteotomy (2 mm drill) with excellen...

Figure 8.7. PA film of guide pin in place to asses prosthetic alignment.

Figure 8.8. Implant osteotomy is enlarged and completed. Final implant osteo...

Figure 8.9. Particulate xenograft placed and compacted against the lateral w...

Figure 8.10. Implant insertion under navigational guidance.

Figure 8.11. Immediate implant placed with cover screw and additional xenogr...

Figure 8.12. Placement of anatomical PEEK healing abutment with ideal gingiv...

Figure 8.13. Immediate postoperative PA film of immediate implant #19.

Figure 8.14. Final screw retained implant crown in place after 4 months of h...

Figure 8.15. Ideal soft tissue architecture due to anatomical PEEK healing a...

Figure 8.16. PA film of restored implant. Note implant is positioned 3 mm ap...

Figure 8.17. Non‐restorable tooth #4.

Figure 8.18. Digital planning is performed using DTX implant studio. During ...

Figure 8.19. Tooth #4 extracted in an atraumatic and flapless fashion. Note ...

Figure 8.20. Lateral window is created for an open sinus lift. Note intact s...

Figure 8.21. Gold sinus curettes are utilized to elevate the sinus membrane ...

Figure 8.22. Micro‐ronguers are used to enlarge the lateral window after mem...

Figure 8.23. Particulate xenograft is placed after sinus membrane elevation....

Figure 8.24. Collagen membrane placed over the lateral sinus window.

Figure 8.25. Implant osteotomy is initiated with a side cutting Lindeman bur...

Figure 8.26. Prior to implant placement, xenograft is placed and compacted a...

Figure 8.27. Immediate implant insertion with cover screw placement. Xenogra...

Figure 8.28. Using an implant replica and lab handle, the subgingival contou...

Figure 8.29. Anatomical PEEK healing abutment in place and creating an ideal...

Figure 8.30. PA (periapical) film during IOS appointment prior to definitive...

Figure 8.31. PA film 1 year after final crown placement. Note ideal crown co...

Figure 8.32. Fractured tooth #10 within the aesthetic zone in a patient with...

Figure 8.33. Digital planning revealed thin and angulated alveolar bone apic...

Figure 8.34. Implant intentionally placed palatal to allow for 2 mm of space...

Figure 8.35. Connective tissue (CT) graft harvested from the palate for soft...

Figure 8.36. Palatal donor site lateral to the premolars is closed with a ho...

Figure 8.37. Subepithelial connective tissue graft is placed and sutured thr...

Figure 8.38. Temporary cylinder in place. Exposed implant threads, the gap b...

Figure 8.39. Three‐year postoperative PA film.

Figure 8.40. Final screw retained implant #10 crown in place. Note ideal gin...

Chapter 9

Figure 9.1. The use of a tapered implant within the anterior maxilla allows ...

Figure 9.2. Thin biotype, poor soft tissue architecture and only 1.5 mm of s...

Figure 9.3. At the time of implant placement, 2 mm of vertical bone was redu...

Figure 9.4. Stock healing abutment in place and the site closed with interru...

Figure 9.5. Eight weeks postoperative view with stock 6 mm (width) by 4 mm (...

Figure 9.6. Healing abutment removed to reveal 3.5 mm of soft tissue height ...

Figure 9.7. Virtual surgical planning (VSP) for absent teeth #19, #20, #21, ...

Figure 9.8. Implants are planned at least 1.5 mm from the implant shoulder t...

Figure 9.9. Reformatted orthopantomogram showing parallel implants spaced id...

Figure 9.10. Digital impression of scan body implant #19. The digital impres...

Figure 9.11. The STL file may be exported to a CERAC unit for a custom mille...

Figure 9.12. The STL file may be exported to preferred dental laboratory for...

Figure 9.13. The STL file may be exported for the fabrication of a custom mo...

Figure 9.14. Final crown interproximal contacts are adjusted and occlusal eq...

Figure 9.15. Initial orthopantomogram depicting congenitally missing teeth #...

Figure 9.16. Orthopantomogram after appropriate orthodontic movement of the ...

Figure 9.17. i‐TERO (Align Technology, Inc., San Jose, CA, USA) digital scan...

Figure 9.18. Three‐dimensional reconstruction of the CBCT scan before adjust...

Figure 9.19. Three‐dimensional reconstruction of the CBCT scan after adjusti...

Figure 9.20. Masking the anatomy of the arch of interest and separating it f...

Figure 9.21. Occlusal reference points from the STL and DICOM files are alig...

Figure 9.22. Occlusal view of the hard tissue 3D reconstruction of the DICOM...

Figure 9.23. Occlusal view of the hard tissue 3D reconstruction of the DICOM...

Figure 9.24. Virtual crowns are designed to fit the restorative spaces.

Figure 9.25. Virtual crowns are designed to occlude ideally against the oppo...

Figure 9.26. Implants are virtually placed after crown design (crown‐down te...

Figure 9.27. Implant #7 is planned 3–4 mm apical to the CEJ of the adjacent ...

Figure 9.28. Implant #10 is planned to emerge through the cingulum of the vi...

Figure 9.29. Surgical guide virtually designed to articulate with the dentit...

Figure 9.30. Surgical guide is 3D printed, inserted into the oral cavity, an...

Figure 9.31. Immediate postoperative reformatted orthopantomogram depicting ...

Figure 9.32. Coronal CBCT scan obtained at the time of implant placement dem...

Figure 9.33. PA films after 6 weeks of healing illustrate ideal osseointegra...

Figure 9.34. Soft tissue architecture 6 weeks after flapless implant placeme...

Figure 9.35. 4.5 mm of soft tissue height due to the position of the implant...

Figure 9.36. Scan bodies placed to obtain digital impression.

Figure 9.37. i‐TERO scan used to create STL file to export to the dental lab...

Figure 9.38. i‐TERO model with modification to accept dental implant analogs...

Figure 9.39. A precision bite registration is paramount for the accuracy of ...

Figure 9.40. Three‐dimensional model with implant analogs in place. The 3D m...

Figure 9.41. Restorative abutments articulating with the implant analogs.

Figure 9.42. i‐TERO model with implant analogs, restorative abutments, and f...

Figure 9.43. Final screw‐retained implant crowns in place. Note ideal blanch...

Figure 9.44. Orthopantomogram depicting failing anterior teeth. Tooth #11 ha...

Figure 9.45. Treatment option #1. Digital wax‐up including seven total teeth...

Figure 9.46. Treatment option #2. Digital wax‐up including five total teeth....

Figure 9.47. Terminal anterior dentition and buccal (horizontal) defect of b...

Figure 9.48. Teeth are extracted atraumatically with preservation of the fac...

Figure 9.49. Combined socket and onlay grafting performed with particulate c...

Figure 9.50. Resorbable collagen membrane placed and graft sites closed in a...

Figure 9.51. Essix provisional retainer placed at the time of extractions an...

Figure 9.52. Three‐month postoperative orthopantomogram depicting graft cons...

Figure 9.53. Case is planned for four implants. Implants are planned paralle...

Figure 9.54. Implants are planned to emerge through the cingulums of the vir...

Figure 9.55. Axial CBCT scan depicts consolidation of the grafted anterior m...

Figure 9.56. Tooth‐supported surgical guide with fixation pin. For edentulou...

Figure 9.57. Grafted and edentulous site immediately prior to implant placem...

Figure 9.58. Surgical guide in place with additional stability achieved thro...

Figure 9.59. Stock healing abutments in place immediately postoperative.

Figure 9.60. Essix retainer is placed to act as a temporary removable prosth...

Figure 9.61. Six weeks after implant placement.

Figure 9.62. Implants with 3–4 mm of soft tissue height. Continued adaptatio...

Figure 9.63. Scan bodies in place for TRIOS digital impression.

Figure 9.64. TRIOS (3Shape, New Providence, NJ, USA) impression will be expo...

Figure 9.65. Final prosthesis in place. Note ideal soft tissue architecture ...

Figure 9.66. Final screw‐retained prosthesis with occlusion adjusted to take...

Figure 9.67. Aesthetics of final prosthesis. Patient will be returning for m...

Figure 9.68. Orthopantomogram depicting grafted site #8.

Figure 9.69. Virtual custom healing abutment is designed to be screw retaine...

Figure 9.70. Virtual implant is centered within the restorative site and 3 m...

Figure 9.71. Surgical guide and custom screw‐retained healing abutment.

Figure 9.72. Edentulous site prior to implant placement. Note poor soft tiss...

Figure 9.73. Tooth‐supported surgical guide in place.

Figure 9.74. Preplanned implant drilling protocol will determine implant ang...

Figure 9.75. Horizontal lines of the implant placement device allow for prec...

Figure 9.76. Transfer assembly in place after surgical guide removal.

Figure 9.77. Implant is placed in a flapless fashion to allow for minimally ...

Figure 9.78. #15 blade is utilized to remove sufficient soft tissue for comp...

Figure 9.79. Custom screw‐retained healing abutment in place. This abutment ...

Figure 9.80. Six weeks after custom healing abutment placement. Ideal hygien...

Figure 9.81. Ideal sulcular depth and morphology after 6 weeks of healing.

Figure 9.82. A 13‐year‐old patient pre‐orthodontic image depicting a 90% dee...

Figure 9.83. Pre‐orthodontic occlusal view demonstrating excess maxillary sp...

Figure 9.84. A 17‐year‐old post‐orthodontic image showing improved occlusion...

Figure 9.85. Post‐orthodontic occlusal view depicting a lingual fixed retain...

Figure 9.86. Reformatted orthopantomogram depicting appropriate space at sit...

Figure 9.87. Virtual surgical planning. Immediate implants are planned to en...

Figure 9.88. Custom screw‐retained healing abutments are designed virtually....

Figure 9.89. Custom screw‐retained healing abutment are 3D printed based on ...

Figure 9.90. Surgical sites with deciduous teeth letters c, h, and j present...

Figure 9.91. Deciduous teeth letters c, h, and j extracted atraumatically, i...

Figure 9.92. Surgical guide is placed immediately after extractions.

Figure 9.93. Autogenous bone is harvested from the flutes of the implant dri...

Figure 9.94. Surgical guide is removed after implant placement. Implant tran...

Figure 9.95. Custom temporary screw‐retained healing abutments in place.

Figure 9.96. Postoperative orthopantomogram depicting guided implant placeme...

Figure 9.97 PA films taken 6 weeks after implant osseointegration demonstrat...

Figure 9.98. Occlusal view of final implant crowns. All crowns are screw‐ret...

Figure 9.99. Gingival architecture shaped with custom healing abutments.

Figure 9.100. Crowns seating with ideal gingival contours.

Figure 9.101. PA films depicting final crown placement and crestal bone heig...

Figure 9.102. Preoperative reformatted orthopantomogram depicting missing to...

Figure 9.103. Digital impression is obtained and a virtual temporary crown i...

Figure 9.104. Virtual surgical planning is performed to orient the dental im...

Figure 9.105. Screw access through the cingulum is established on the virtua...

Figure 9.106. Articulated model with implant analog in place prior to implan...

Figure 9.107. Temporary screw‐retained crown and implant model.

Figure 9.108. Occlusion verified on articulated model.

Figure 9.109. Surgical guide with facial and palatal orientation markings.

Figure 9.110. Edentulous site #9.

Figure 9.111. Tooth‐supported surgical guide with orientation markings is pl...

Figure 9.112. Implant osteotomy is created following the preplanned implant ...

Figure 9.113. Surgical guide is removed after osteotomy completion.

Figure 9.114. Four millimeters of tissue is removed circumferentially around...

Figure 9.115. Guided implant is placed through the surgical guide to a prede...

Figure 9.116. Transfer assembly in place to assess implant position and soft...

Figure 9.117. Temporary crown in placed and appears too high.

Figure 9.118. The temporary crown is removed, the surgical guide is placed, ...

Figure 9.119. Orientation marking on the surgical guide is referenced on the...

Figure 9.120. Temporary crown is now in an ideal position.

Figure 9.121. Screw access through the cingulum is obliterated with a cotton...

Figure 9.122. Light‐bodied clear polyvinylsiloxane (PVS) is placed to fill t...

Figure 9.123. Postoperative PA film depicting complete seating of the tempor...

Figure 9.124. Temporary crown on repose.

Figure 9.125. Temporary crown on animation.

Figure 9.126. Six weeks status post implant and temporary crown placement. P...

Figure 9.127. Gingival contours are significantly improved compared to a sto...

Figure 9.128. Gingival architecture is ideal after 6 weeks of temporary cust...

Figure 9.129. Scan body is placed for final digital impression.

Figure 9.130. i‐TERO impression will be exported in the form of an STL file ...

Figure 9.131. Reformatted orthopantomogram depicting failing maxillary anter...

Figure 9.132. Axial CBCT scan demonstrates significant horizontal bone loss ...

Figure 9.133. Reformatted orthopantomogram after repair of teeth #6 and #11 ...

Figure 9.134. Axial CBCT scan illustrating sufficient horizontal bone augmen...

Figure 9.135. Before (a) and after (b) onlay ridge augmentation.

Figure 9.136. Three‐dimensional evaluation of the digital scan revealed a Cl...

Figure 9.137. Virtual crowns are designed to compensate for Class III malocc...

Figure 9.138. Virtual implant locations are planned after the crowns are des...

Figure 9.139. Coronal view of hard and soft tissue and position of virtual i...

Figure 9.140. Essix retainer is fabricated to act as a short‐term temporary ...

Figure 9.141. Prefabricated tooth‐supported surgical guide.

Figure 9.142. Immediately after flapless implant placement, scan bodies are ...

Figure 9.143. The scan body impression is converted to an STL file for impla...

Figure 9.144. i‐TERO digital impression shows ideal implant spacing and para...

Figure 9.145. Stock healing abutments are placed after scan bodies are remov...

Figure 9.146. Essix retainer in place with dental implants emerging through ...

Figure 9.147. Custom temporary fixed bridge is designed virtually and is int...

Figure 9.148. Custom temporary designed to be screw retained.

Figure 9.149. Virtual (a) versus actual (b) fixed temporary custom prosthesi...

Figure 9.150. Stock healing abutment removed 1 week postoperative. Note idea...

Figure 9.151. Custom screw retained fixed temporary in place. Additional sof...

Figure 9.152. Access sites through the cingulums are obliterated with cotton...

Figure 9.153. Custom temporary fixed bridge in place and out of occlusion.

Figure 9.154. PA films depicting complete seating of the temporary fixed bri...

Figure 9.155. Patient temporized with good lip support to correct for Class ...

Figure 9.156. Six weeks after wearing custom fixed prosthesis. Note ideal su...

Chapter 10

Figure 10.1. For patients without a pre‐existing removable prosthesis, a den...

Figure 10.2. Case planned for four implants for locator attachments. The wax...

Figure 10.3. Virtual surgical plan depicting maximum A‐P spread of the impla...

Figure 10.4. Final implant placement. Note accuracy of implant placement as ...

Figure 10.5. A well‐fitting tissue supported surgical guide should evenly bl...

Figure 10.6. Reformatted orthopantomogram showing advanced periodontal disea...

Figure 10.7. Reformatted orthopantomogram 12 weeks after extractions and gra...

Figure 10.8. Fiducial stickers will be applied to the removable appliances t...

Figure 10.9. Fiducial reference stickers are applied to the buccal and lingu...

Figure 10.10. Radiolucent material used to allow for ideal adaptation and vi...

Figures 10.11 Completed reline of the dentures with a radiolucent soft tissu...

Figure 10.12. The removable prosthesis is scanned in a CBCT scanner with the...

Figure 10.13. (a and b) DICOM and STL files are exported and merged in a 3D ...

Figure 10.14. VSP session demonstrating symmetry, parallelism, and angulatio...

Figure 10.15. Maxillary implants are designed to emerge through the lateral ...

Figure 10.16. (a and b) Implants are planned to emerge through the lingual/p...

Figure 10.17. (a and b) Augmented mandibular and maxillary arches prior to i...

Figure 10.18. Tissue supported guide in place. Skeletal fixation pins are ut...

Figure 10.19. (a and b) Mandibular and maxillary surgical guides in place. I...

Figure 10.20. (a and b) Surgical guides have been removed. Implants are in p...

Figure 10.21. (a and b) Stock healing abutments in place.

Figure 10.22. Implant #11 had a low insertion torque value. Upon identifying...

Figure 10.23. (a and b) Alginate or pressure indicating paste is used to tak...

Figure 10.24. (a and b) Sites of the healing abutments and the prominent inc...

Figure 10.25. (a and b) Five‐year follow‐up visit of mandibular and maxillar...

Figure 10.26. (a and b) Five‐year follow‐up of locator supported removable d...

Figure 10.27. Appearance of patient after 5 years of denture and locator use...

Figure 10.28. CBCT scan has been converted to a DICOM file to allow for eval...

Figure 10.29. Current prosthesis has been converted to an STL file. Due to l...

Figure 10.30. Implants are planned to emerge through the denture based on th...

Figure 10.31. VSP image depicting final implant placement. Note location of ...

Figure 10.32. Edentulous mandibular ridge prior to surgery.

Figure 10.33. Custom guide based on the lower denture is placed to allow gui...

Figure 10.34. The guide is removed. Note the sites of the skeletal fixation ...

Figure 10.35. A full‐thickness mucoperiosteal tissue flap bisecting the kera...

Figure 10.36. Alveoloplasty reduction guide is placed and secured in positio...

Figure 10.37. Alveoloplasty is performed with a large round bur or sagittal ...

Figure 10.38. The implant osteotomy guide is secured to the alveoloplasty re...

Figure 10.39. Implants are placed through the surgical guide with full contr...

Figure 10.40. The implant surgical guide is removed. Implants are shown in a...

Figure 10.41. Stock healing abutments are placed and tissue closure is perfo...

Figure 10.42. Wound dehiscence from the unfavorable strain of the mentalis m...

Figure 10.43. Six weeks after implant placement. Wound dehiscence has healed...

Figure 10.44. Orthopantomogram depicting posterior mandibular edentulism. Th...

Figure 10.45. An i‐TERO digital impression is obtained to create an STL file...

Figure 10.46. Four implants are planned within the posterior mandible for lo...

Figure 10.47. Implants are planned at similar platform levels, parallel and ...

Figure 10.48. Custom model and implant surgical guide.

Figure 10.49. Edentulous posterior mandible prior to surgery.

Figure 10.50. Implant osteotomes and implants are placed in a fully guided f...

Figure 10.51. Stock healing abutments are placed. Implant #19 was changed fr...

Figure 10.52. Postoperative orthopantomogram.

Figure 10.53. Locator abutments in place after 8 weeks of implant integratio...

Figure 10.54. Final removable partial denture (RPD) design with locator hous...

Figure 10.55. Final removable partial denture in place and secured with a co...

Figure 10.56. Virtual surgical planning for four maxillary implants. Implant...

Figure 10.57. Implants are intentionally placed with 12° of angulation knowi...

Figure 10.58. Custom bar supported on 4 maxillary implants is placed 6 weeks...

Figure 10.59. Bar retained maxillary palateless complete denture.

Chapter 11

Figure 11.1. Pretreatment panoramic radiograph; note existing anterior maxil...

Figure 11.2. After extraction, the maxillary alveolus is leveled with a reci...

Figure 11.3. The sinus is located. The drill demonstrates the proposed angle...

Figure 11.4. Maxilla immediately after surgery and before the restorative pr...

Figure 11.5. Mandibular arch after extraction of teeth and the creation of a...

Figure 11.6. Mandibular arch status post implant placement demonstrating the...

Figure 11.7. Mandible immediately after surgery and before the restorative p...

Figure 11.8. Impression copings placed within the mandibular arch.

Figure 11.9. Injection of a medium‐body impression material under the bis‐ac...

Figure 11.10. A rigid‐bite registration material completes the impression.

Figure 11.11. A heavy‐body impression material is used to locate the abutmen...

Figure 11.12. Temporary cylinders are in place and a rubber dam is placed ov...

Figure 11.13. The mandibular denture is completely seated and held in place ...

Figure 11.14. Intaglio surface of the mandibular denture after the pickup of...

Figure 11.15. Occlusal view of the completed mandibular provisional restorat...

Figure 11.16. Retracted frontal view of completed restorations.

Figure 11.17. Completed restorations upon animation.

Figure 11.18. A 3‐mm soft mouth guard provides cushioning during occlusal fo...

Figure 11.19. Postoperative panoramic radiograph demonstrates ideal implant ...

Figure 11.20. A CR splint is fabricated to protect the prosthesis in the pat...

Figure 11.21. Initial condition of patient with a pre‐existing maxillary com...

Figure 11.22. Post‐extraction mandibular ridge prior to bone reduction.

Figure 11.23. Bone reduction to achieve adequate prosthetic space and to lev...

Figure 11.24. Parallel pins are placed within the implant osteotomy sites to...

Figure 11.25. Four implants placed; the two distal implants are tilted 30 de...

Figure 11.26. Clinical verification of seating of an angle correcting abutme...

Figure 11.27. Reduction of excess bone distal of an angled implant to allow ...

Figure 11.28. Radiographic verification of complete seating of the distal po...

Figure 11.29. Angle correcting transmucosal abutments placed on the two dist...

Figure 11.30. Same day interim restoration delivered on four immediate impla...

Figure 11.31. Final implant‐supported mandibular prosthesis delivered after ...

Figure 11.32. Implant failure after first removal of the interim prosthesis....

Figure 11.33. Distal extension fracture on an interim hybrid prosthesis. Thi...

Figure 11.34. Distal inadequate esthetic evaluation and bone reduction that ...

Chapter 12

Figure 12.1. Unhygienic single crown restoration with a large facial overhan...

Figure 12.2. Radiograph depicting malposed implants with resulting large can...

Figure 12.3. Mandibular posterior implant demonstrating exposed implant thre...

Figure 12.4. Radiograph illustrating implants placed with no treatment plann...

Figure 12.5. Radiograph depicting poor bone quality, exposed implant threads...

Figure 12.6. Two‐dimensional view shows acceptable implant position at site ...

Figure 12.7. Three‐dimensional view shows the implant with no lingual bone s...

Figure 12.8. Patient presents with failing dentition with advanced periodont...

Figure 12.9. Two‐dimensional orthopantomogram shows lytic lesions to his rem...

Figure 12.10. Immediate postoperative implant placement CBCT scan revealing ...

Figure 12.11. After 8 weeks of masticating a textured diet, the patient frac...

Figure 12.12. At the 8‐week postoperative visit, the left posterior implant ...

Figure 12.13. The patient was converted to overdenture attachments utilizing...

Figure 12.14. Implant placed at site #30 after successful healing of the gra...

Figure 12.15. Cross‐sectional view immediately status post implant placement...

Figure 12.16. Images taken 4 months status post implant placement depicting ...

Figure 12.17. A 30‐year‐old patient presents with painful and mobile dentiti...

Figure 12.18. Radiographs demonstrate dental protrusion, root loss to the an...

Figure 12.19. Postoperative orthopantomogram showing the placement of two ma...

Figure 12.20. At routine follow‐up, the mandibular prosthesis was removed an...

Figure 12.21. Intraoral view of the four integrated implants in the anterior...

Figure 12.22. Intraoral view immediately after the removal of the bilateral ...

Figure 12.23. The failed prosthesis with the loss of the posterior short imp...

Figure 12.24. A tissue‐borne overdenture was fabricated on the anterior impl...

Figure 12.25. Periapical film showing a cement‐retained crown. Implant place...

Figure 12.26. Inflamed gingiva with bleeding and exudate upon probing.

Figure 12.27. A full‐thickness mucoperiosteal tissue flap reflected, reveali...

Figure 12.28. Implant and abutment surfaces were debrided and the flap was c...

Figure 12.29. Two weeks follow‐up examination revealed no exudate and a heal...

Figure 12.30. Periapical radiograph depicting an open margin and a clean imp...

Figure 12.31. Two years post debridement views with a new abutment and crown...

Figure 12.32. Periapical radiograph depicting gross vertical and circumferen...

Figure 12.33. After implant removal, cement was visible on the implant (arro...

Figure 12.34. Orthopantomogram showing failing maxillary and mandibular impl...

Figure 12.35. Maxillary anterior implants with exposed implant threads and a...

Figure 12.36. Note extreme proximity of the implants. Ideally, implants shou...

Figure 12.37. Exposed implant threads as a result of poor bone support from ...

Figure 12.38. Cross‐sectional CBCT scan view illustrating the lack of facial...

Chapter 13

Figure 13.1. Submental abscess presentation with edema and erythema of the s...

Figure 13.2. Sterile aspirate obtained and ready to submit for aerobic, anae...

Figure 13.3. Intraoral drainage incision sites.

Figure 13.4. Coronal contrast‐enhanced computed tomography scan demonstratin...

Figure 13.5. Typical presentation of a buccal space abscess with marked chee...

Figure 13.6. (A) Gillies incision; (B) submental incision; (C) submandibular...

Figure 13.7. Anatomy of the buccal and palatal spaces.

Figure 13.8. Anatomy of the submental space.

Figure 13.9. Coronal contrast‐enhanced computed tomography scan demonstratin...

Figure 13.10. Sagittal contrast‐enhanced computed tomography scan demonstrat...

Figure 13.11. Surgical site is prepped and draped. Note overlying tissue ery...

Figure 13.12. Intubated patient with pointing submental abscess.

Figure 13.13. Incision is made at the apex of the abscess at a point that wi...

Figure 13.14. A hemostat is used to bluntly dissect into the submental space...

Figure 13.15. Blunt finger dissection with the surgeon’s dominant hand is ut...

Figure 13.16. Drains are placed within the submental space. A Penrose drain ...

Figure 13.17. Anatomy of the sublingual and submandibular spaces.

Figure 13.18. Coronal contrast‐enhanced computed tomography scan demonstrati...

Figure 13.19. Axial contrast‐enhanced computed tomography scan demonstrating...

Figure 13.20. The incision is marked caudal to the inferior border of the ma...

Figure 13.21. The incision is carried to the level of the platysma muscle. A...

Figure 13.22. Purulence is expressed once the submandibular space is entered...

Figure 13.23. Blunt finger dissection is utilized to ensure that the entire ...

Figure 13.24. Drain placement within the right submandibular, sublingual, an...

Figure 13.25. Minor salivary gland biopsy from the lower lip.

Figure 13.26. A 62‐year‐old patient presents with right‐sided parotid edema ...

Figure 13.27. Purulence exuding from Stenson’s duct.

Figure 13.28. Axial contrast‐enhanced computed tomography scan demonstrating...

Figure 13.29. Coronal contrast‐enhanced computed tomography scan demonstrati...

Figure 13.30. Markings are made to include the parotid abscess boundaries, t...

Figure 13.31. Subplatysmal flap is elevated to expose the inferior aspect of...

Figure 13.32. Blunt dissection is made through the parotid capsule (SDCF) to...

Figure 13.33. Cultures obtained to allow for ideal antibiotic selection and ...

Figure 13.34. Parotid space is opened with blunt finger dissection and the p...

Figure 13.35. The site is irrigated with copious irrigation after exploratio...

Figure 13.36.  Biopsy is taken of the parotid gland.

Figure 13.37. Drains are placed within the superficial lobe and between the ...

Figure 13.38. Postoperative axial computed tomography scan demonstrating dra...

Figure 13.39. Postoperative coronal contrast‐enhanced computed tomography sc...

Figure 13.40. Immediately status post drain removal at postoperative day #5....

Figure 13.41. Four weeks after parotid space incision and drainage.

Figure 13.42. Anatomy of the masticator space.

Figure 13.43. Coronal contrast‐enhanced computed tomography scan demonstrati...

Figure 13.44. Axial contrast‐enhanced computed tomography scan depicting lef...

Figure 13.45. A 12‐year‐old patient with obvious left masticator space edema...

Figure 13.46. Axial contrast‐enhanced computed tomography scan demonstrating...

Figure 13.47. Coronal contrast‐enhanced computed tomography scan demonstrati...

Figure 13.48. Anatomical markings to include the inferior border of the mand...

Figure 13.49. Purulence was identified once the masticator space was entered...

Figure 13.50. A through‐and‐through drain (buccal vestibule–submandibular in...

Figure 13.51. Drains were positioned within the left masseteric space, ptery...