Bulow KW: Treatment of Facial Cleft Deformities: An IllustratedGuide. St Louis, MO, Ishiyaku EuroAmerica Publishers, 1995

Kapetansky DI: Techniques in Cleft Up Nose and Palate Reconstruc-tion. New York, NY, Gower Medical Publishing Ltd, 1987

Shprintzen R, Bardash J: Cleft Palate Speech Management. A Multi-disciplinary Approach. New York, NY, Mosby–Year Book, 1995

S401Recognition and Treatment of ImplantComplicationsCharles A. Babbush, DDS, MScD, Lyndhurst, OH

For all the years that dental implants have been uti-lized, there has always been a segment of cases thatdevelop complications and/or are failures. Over the 35years that I carried out implant reconstruction, I havetried a variety of techniques to salvage these implantsand/or to treat the secondary effects of failure.

In order to establish the proper sequence of therapy,proper diagnosis and treatment planning must be carriedout to determine the appropriate bone quality and quan-tity as well as the proper size and the number of implantsso that the bio-engineering of the case overall is appro-priate.

Implants fail for three main reasons:1. The system2. The patient3. The doctor

With the current generation and sophistication of theimplant systems that are now being utilized, there isvirtually no longer a problem with system failures.Therefore, the major factors that play into the develop-ment of complications and failures are based on doctorgenerated or patient generated etiology.

This presentation will deal with some of the etiologi-cal factors which generate complications and failures:surgical insertion, design of the prosthesis, soft tissuefactors, maintenance and hygiene, and para-functionalhabits.

Over the past four years, I have developed a protocolfor the treatment of these problems:

1. Recognition of the etiological factors causing theproblem.

2. In most cases antibiotic therapy is institutedprior to surgical intervention.

3. The use of growth factors in Autologous PlateletConcentrate (APC�) as well as various substratematerials will be reviewed.

4. A protocol for surgical intervention.A series of cases will then be presented to demonstratethe above concepts.

References

Babbush CA: Dental Implants: The Art and Science. Philadelphia, PA,Saunders, 2001

Sclar AG: Soft Tissue and Esthetic Considerations in Implant Den-tistry. Chicago, IL, Quintessence Publishing Co, 2003

Babbush CA, Kevy SV, Jacobson MS: An in vitro and in vivo evalua-tion of autologous platelet concentrate in oral reconstruction. ImplantDent 12:24, 2003

S402Submental Liposuction: A Great Place toStartJohn E. Fidler, Jr, DDS, Goldsboro, NC

The practice of oral and maxillofacial surgery is anever-expanding field. With this expansion, many sur-geons are becoming more interested in facial cosmeticsurgery. The submental region is one in which minimallyinvasive surgery can greatly enhance the appearance ofone’s face. Liposuction surgery has been around forquite some time. Over the years, there have been manychanges in the philosophy, instrumentation, and tech-niques of this procedure. It has gone from a majorundertaking in the operating room to an in-office proce-dure. Changes in instrumentation and techniques havemade submental liposuction a great adjunct to our prac-tice. The surgeon interested in submental liposuctionwill learn of the changes throughout the history of theprocedure. The procedure will be discussed in a step-wise fashion, including preoperative appointments, thetechnique of the procedure, and the postoperativecourse. In addition, the indications, contraindications,risks, and complications will be discussed. On comple-tion of this course, the surgeon should have a goodunderstanding of this procedure, and a great start toincorporating submental liposuction into the practice.

References

Ota BG: Cervicomental lipectomy as an adjunct to orthognathicsurgery. Oral Maxillofac Surg Clin North Am 3: 1996

Kennedy B: Submental lipectomy of the youthful neck. Oral Maxil-lofac Surg Clin North Am 2: 1990

S403The Pectoralis Major Flap in Oral andFacial ReconstructionDale A. Baur, DDS, MD, Evans, GACharles L. Clark, DDS, Salado, TX

The excision of large lesions, both benign and malig-nant, of the oral and maxillofacial region often results ina significant soft tissue defect. These areas often lackadequate tissue to effectively close the defect withoutexcessive tension, or cause obliteration of the normalanatomy. In areas that require a secondary bone graft, itis often difficult to obtain normal form due to the defi-

Surgical Clinics

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