Christopher J. Haggerty

Repositioning of a traumatically displaced globe with maxillary antrostomy: review of the literature and treatment recommendations.

Complete dislocation of the globe, inferiorly into the maxillary sinus, medially into the ethmoid sinus, or superiorly into the anterior cranial fossa, can occur with significant blunt facial trauma. The degree of injury to the globe, its adnexal structures, and the optic nerve is dependent on the extent of the dislocation. Complete traumatic subluxation of the globe into the maxillary sinus is associated with severe injury to the periocular structures and represents a challenging and unique reconstructive process rarely encountered in published studies. The present case report represents only the 15th reported case of complete orbital prolapse into the maxillary sinus. Controversy exists regarding the definitive treatment of traumatic globe dislocations, the risk of sympathetic ophthalmia (SO), the sequela of postenucleation socket syndrome, and prophylactic steroid treatment to decrease the incidence of SO and traumatic optic neuropathy.

Simple Bone Augmentation for Alveolar Ridge Defects

Dental implant procedures, both surgical placement and preimplant bone augmentation, have become an integral aspect of the oral and maxillofacial surgeons practice. The number of dental implants placed each year continues to increase as a result of increasing patient exposure and awareness of dental implants, the increased functional and esthetic dental demands of general practitioners and patients, the overall increase in age of the US patient population, and expanded insurance coverage of dental implant-related procedures. This article outlines relevant surgical procedures aimed toward reconstructing alveolar ridge defects to restore intra-arch alveolar discrepancies before restoration-driven dental implant placement.

Autogenous Reconstruction of the Temporomandibular Joint

Recently, the temporomandibular joint has been reconstructed with a variety of alloplastic materials; however, functional results are often limited, and long-term stability of the reconstruction is questionable. In contrast, costochondral rib grafting with rigid internal fixation and a temporoparietal fascia flap allows complete functional reconstruction of the temporomandibular joint with autogenous tissue. Thirteen joint reconstructions in 11 patients were followed for up to 7 years and stability of the reconstruction was confirmed. The anterior incisal opening improved from a mean of 14 to 31 mm. Normal occlusal relationships were either reestablished or preserved. Joint pain was ameliorated. The preferred reconstruction of the temporomandibular joint is by autogenous tissue for disc and joint replacement. The treatment provides primary therapy in total joint reconstruction where tumor, trauma, or failed prosthetic joint replacement necessitate complete reconstruction.