Scheda programma d'esame
THERAPY AND MAXILLOFACIAL PATHOLOGY
AUGUSTO PIETRO CASANI
Academic year2023/24
CourseDENTISTRY AND DENTAL PROSTHODONTICS
Code066FF
Credits9
PeriodSemester 2
LanguageItalian

ModulesAreaTypeHoursTeacher(s)
CHIRURGIA MAXILLO-FACCIALEMED/29LEZIONI30
MARCO NISI unimap
CHIRURGIA ORALEMED/28LEZIONI20
ANTONIO BARONE unimap
CHIRURGIA PLASTICAMED/19LEZIONI20
EMANUELE CIGNA unimap
OTORINOLARINGOIATRIAMED/31LEZIONI20
AUGUSTO PIETRO CASANI unimap
Obiettivi di apprendimento
Learning outcomes
Conoscenze

 

 

ORAL SURGERY module

Il corso di studi da conoscenze pratiche su come deve essere condotto un processo diagnostico e un trattamento adeguato in caso di traumi dentali, sinusiti mascellari di origine odontogena, lesioni osteolitiche dei mascellari. 

 principi di chirurgia plastica

Knowledge

The primary aim of the teaching of Oral Surgery is to provide systematic knowledge of complex pathologic conditions affecting the oral and maxillofacial regions, in order to provide adequate surgical treatment. in the course, the surgical procedures involving both hard and soft tissues in course of benign and malignant diseases are reported.

 

OTORYNOLARINGOIATRY module

The course aims to broaden the knowledge of head and neck pathologies. The physiopathological mechanisms of the nasoparanasal area of the middle ear and the common pathological processes inherent to swallowing and postural control are treated with particular care

 

ORAL SURGERY module

The curriculum gives to the students practical knowledge on how make diagnosis and treatment in case of tooth trauma, maxillary sinusitis with an odontogenic origin, osteolitic jaw lesions and severe tooth impaction.

 

 

 

Modalità di verifica delle conoscenze

Le conoscenze verranno verificate con una prova d'esame orale che verterà su almeno 2 domande del corso di esame che mireranno ad accertare la conoscenza del programma d'esame in linea con la bibliografia di riferimento e i contenuti delle lezioni.

L'esame orale, prevede un voto in trentesimi e ha il duplice scopo di verificare il livello di conoscenza e di comprensione dei contenuti del corso e di valutare l'autonomia di giudizio, la capacità di apprendimento e l'abilità comunicativa

 

chirurgia plastica: esame scritto 3 domande

Assessment criteria of knowledge

The final assessment of the knowledge acquired during the course will consist of an oral exam on the topics discussed during the course, with a particular attention to the use of appropriate scientific terminology

Capacità

lo studente deve essere in grado di inquadrare le varie patologie dell'ambito maxillo facciale ed ipotizzarne il percorso terapeutico

lo studente sarà in grado di gestire ferite, suture, innesti e lembi di competenza odontoiatrico-ricostruttiva

Skills

The students would be able to make diagnosis and treatment of the pathologies in the oral cavity, in addition they would be able to understand clinical implications and need of a multi-disciplinary approach in case of pathologies that go beyound the oral cavity.

Modalità di verifica delle capacità

Prova orale 

 

parte plastica esame scritto

Assessment criteria of skills

Orale and Written examination according to each single module

Prerequisiti (conoscenze iniziali)

Per comprendere le problematiche delle patologie  del distretto maxillo facciale  lo studente deve possedere una preparazione specifica relativa alla anatomia umana, fisiologia ed anatomia patologica

Prerequisites

to understand the pathogenesis of oral and maxillofacial pathologies the students need to have good knowledge about human anatomy and phisiology.

Indicazioni metodologiche

Lezioni frontali interattive 

parte plastica: lezioni frontali e laboratorio di suture

Programma (contenuti dell'insegnamento)

 

PRINCIPI GENERALI NELLA GESTIONE DEL POLITRAUMATIZZATO

 

Valutazione generale del paziente traumatizzato

Manovre inziali in emergenza nel politrauma

Trasporto del paziente

Lo shock ipovolemico

Sequenza delle procedure d’emergenza

Gestione in emergenza delle vie aeree

Riconoscimento dei siti ostruttivi e compromissione del respiro

Manovre per liberare le vie aeree

Approccio chirurgico alle vie aeree

 

LA TRACHEOTOMIA

 

Tecnica chirurgica

La tracheotomia in emergenza e in elezione

Le varie tipologie di cannule tracheotomiche

GESTIONE DEI TRAUMI FACCIALI

Valutazione radiografica dei traumi cranio facciali

Gestione delle ferite dei tessuti molli della faccia

Lesioni di strutture che richiedono un trattamento particolare (nervo facciale; dotto di Stenone)

Conseguenze ocluari dei traumi facciali

Disordini del visus

Disordini della motilità oculare

Distopia del globo oculare

 

PRINCIPI DI TRATTAMENTO DELLE FRATTURE FACCIALI

Concetti classici di guarigione del tessuto osseo

Principi di fissazione per le fratture del distretto facciale

Le fratture di mandibola

Calssificazione delle fratture di mandibola

Diagnosi delle fratture di mandibola

Principi generali del trattamento delle fratture di mandibola

 Storia del trattamento

Tecnica per la riduzione chirurgica e fissazione delle fratture

Complicanze associate alle fratture di mandibola

Frattura del complesso orbito zigomatico e dell’arco

Diagnosi di frattura del complesso orbito zigomatico

Trattamento di frattura del complesso orbito zigomatico

Fratture delle pareti orbitarie

Diagnosi e trattamento delle fratture delle pareti orbitarie

Diagnosi e trattamento delle fratture centro facciali

Classificazione delle fratture centro facciali

Fratture della mascella

Classificazione secondo Le Fort delle fratture mascellari

Diagnosi e trattamento delle fratture centro facciali

 

SINDROME DELLE APNEE NOTTURNE (OSAS)

Definizione della sindrome delle apnee notturne

Anatomia delle vie aeree superiori

Fisiologia del sonno e dei disordini respiratori

Bilanciamento delle forze e del resistore di Starling

La Polisonnografia

Stadiazione clinica dei disordini respiratori del sonno

Uso della ventilazione a pressione positiva (CPAP) per la cura delle apnee

Uso degli apparecchi di avanzamento di mandibola (MAD) per la gestione delle apnee notturne

Protocollo di trattamento per l’uso dei MAD

Trattamento chirurgico delle OSAS

Chirurgia nasale per la gestione delle apnee notturne

Chirurgia del palato e dell’orofaringe

Chirurgia scheletrica: mascella e mandibola

Razionale dell’avanzamento maxillo mandibolare per l’OSAS

Procedura tecnica per l’avanzamento maxillo mandibolare

Gestione perioperatoria

Risultati funzionali

 

OSTEODISTRAZIONE CRANIOFACCIALI

 

Basi biologiche della formazione di nuovo osso durante la distrazione osteogenetica

Allungamento mandibolare ed ampliamento

Distrazione osteogenetica mandibolare utilizzando apparecchi extraorali , endorali e iuxtaossei

Insufficienza respiratoria neonatale trattata con distrazione osteogenica

Distrazione craniale

Osteodistrazione craniofacciale per la correzione delle deformità centrofacciali e craniche

 

CHIRURGIA ORTOGNATICA

la valutazione estetica del volto

Valutazione del paziente con deformità dentofacciale

Planning cefalometrico e computerizzato dell’intervento osteotomico

Analisi estetica dentofacciale

Trattamento della fase prechirurgica

Fase del trattamento chirurgico

le procedure chirurgiche basilari: osteotomia tipo Le Fort 1; osteotomia sagittale bilaterale dei rami mandibolari; mentoplastica ossea

L’uso della distrazione osteogenetica nei casi di ipoplasia mandibolare grave

 

 

Syllabus

 

  • Osteonecrosis and osteomyelitis of the jaws
    • Etiology
    • Classification
    • Treatment
    • Osteoradionecrosis and management of patient treated with radiotherapy
    • Medication-related osteonecrosis of the jaws

 

  • Oncologic surgery
    • Benign and malignant oral lesions
  • Prevention
  • Incidence
  • Etiology
  • Classification
  • Diagnosis
  • Treatment
    • Pre-cancerous lesions and conditions
      • Classification and treatment
    • Surgical biopsy
      • Incisional biopsy
      • Excisional biopsy
      • Fine needle aspiration
    • Benign and malignant oral soft tissue lesions
      • Papilloma
      • Fibroma
      • Lipoma
      • Hemangioma
    • Benign odontogenic tumors of the jaws
      • Tumors arising from odontogenic epithelium without ecto-mesenchyme: anmeloblastoma, squamous odontogenic tumor, Pindborg tumor, clear cell odontogenic tumor
      • Tumors arising from odontogenic epithelium with ecto-mesenchyme: ameloblastic fibroma, ameloblastic fibrodentinoma, odonto-ameloblastoma, ameloblastic fibro-odontoma, adenomatoid odontogenic tumor, calcifying odontogenic cyst, complex and compound odontoma
      • Tumors arising from odontogenic epithelium with or without ecto-mesenchyme: odontogenic fibroma, odontogenic myxoma, benign cementoblastoma, cementifying fibroma
      • Non odontogenic benign tumors of the jaws: chondroma, osteochondroma, osteoblastoma, osteoid osteoma, osteoma
      • Malignant neoplasms of the oral cavity: oral squamous cell carcinoma, sarcoma

 

  • Salivary glands surgery
    • Inflammatory diseases: sialoadenitis, sialodochitis, sialoadenosis
    • Cystic lesions: mucus retention/extravasation cysts, ranula
    • Sialolytiasis: incidence, etiology, symptoms, treatment
    • Benign and malignant neoplasms: incidence, diagnosis, treatment

 

  • Maxillofacial and Tooth trauma
    • Epidemiology
    • Etiology
    • History and clinical examination
    • Classification: Ellis (I-IX), WHO (1995)
    • Treatment
    • Soft tissue lesions
    • Hard tissue lesions

 

  • Cysts
    • Classification of cystic lesions of the maxillary bones
    • Odontogenic non-inflammatory cysts: gingival cysts of infants, gingival cysts of adults, lateral periodontal cyst, dentigerous cyst, keratocyst, calcifying odontogenic cyst, sialo-odontogenic cyst
    • Odontogenic inflammatory cysts: radicular cyst, residual cyst, inflammatory lateral periodontal cyst, paradental cyst
    • Non-odontogenic cysts: naso-palatine cyst, naso-labial cyst
    • Etiology of inflammatory radicular cysts

Surgical treamtnet: cystotomy, cystectomy, decompression

 

INTRODUCTION TO PLASTIC SURGERY

SCAR AND WOUND HEALING

GRAFTING AND REGENERATIVE SURGERY

FLAPS

SKIN PLASTICS

MICROVASCULAR FLAPS AND RECONSTRUCTIVE MICROSURGERY

BURNS

MALFORMATIONS

BREAST SURGERY AND ABDOMINAL WALL SURGERY

HAND SURGERY AND RECONSTRUCTION OF THE LIMBS

 

OTORYNOLARINGOIATRY module program  

EAR

Ear anatomy, physiology and semeiotics.

Elements of audiology: Tone and speech audiometry, Impedance, Auditory evoked potentials Vestibular apparatus and examination of vestibular function.

External ear diseases, acute and chronic otitis media: clinical forms, complications and therapy. Otosclerosis. Tinnitus, Cupulolithiasis. Meniere's disease and menieriform syndromes.

Neurolabrintitis and acoustic neuritis. Tumors of VIII. Facial paralysis. Deaf mute. Medical, surgical, prosthetic and rehabilitation therapy of sensorineural hearing loss.

Otoneurological manifestations of temporomandibular dysfunctions.

NOSE AND SINUSES

Anatomy, physiology and semeiotics of the nose and paranasal sinuses.

Pathophysiology of smell. Pathology of the nasal septum, trauma of the nose and facial massif. Acute and chronic rhinitis. Allergic and vasomotor rhinopathy. Nasal polyposis. Epistaxis.

Acute and chronic sinusitis and their complications. Mucocele. Tumors of the nose, sinuses and facial mass. Nasal and cranial pain syndromes. Surgical therapy of atrophies of the upper jaw. Craniofacial growth and audiological implications.

PHARYNX

Anatomy, physiology and semeiotics of the pharynx. Acute and chronic adenoiditis and tonsillitis. Acute and chronic pharyngitis. Peritonsillar and retropharyngeal abscess.

Benign and malignant tumors of the oropharynx and nasopharynx.

Outline of the anatomy of the cranial nerves and nerve complications of nasopharyngeal tumors.

 

LARYNX

Anatomy, physiology and semeiotics of the larynx. Indications and technique of tracheostomy. Acute and chronic laryngitis. Benign and malignant tumors of the larynx. Recurrent paralysis. Tracheo - bronchial and upper digestive tract foreign bodies.

Phono - speech therapy.

DISEASE OF THE SALIVARY GLANDS

Acute and chronic sialadenitis. Benign and malignant tumors of the salivary glands.

NECK

Neck cysts and fistulas. Primary and secondary latero-cervical adenopathies

 

PROGRAM OF THE THE MAXILLO-FACIAL SURGERY MODULE

BASIC PRINCIPLES IN THE MANEGEMENT OF TRAUMATIC INJURIES

Systematic evaluation of the traumatized patient

Initial assessment and intensive care of the trauma patient

Patient transport

Hypovolemic shock

Primary survey

Secondary assessment

Emergency airway management in the traumatized patient

Recognition of airway obstruction and breathing compromise

Airway maneuvers and adjuncts

Surgical airway

Tracheotomy

Surgical technique

 emergency tracheotomy and elective tracheotomy

Various types of tracheostomy cannulas

Radiographic evaluation of facial injuries

Management of soft tissue injuries

Injuries of structure requiring special treatment (facial nerve; parotid gland duct)

Ophtalmic consequences of maxillo facial injuries

Disorders of ocular motility

Displacement of the globe

Priciples of fixation for maxillo facial trauma

Classic concept of bone healing

Mandibular fractures

History of treatment

Calssification of mandibular fractures

Diagnosi of mandibular fractures

General principles in the treatment of mandibular fractures

Tchniques for open reduction and fixation

Complications associated with mandibular fractures

Fractures of the Zygomatic complex and arch

Diagnosis of the Zygomatic complex fractures

Treatment of the Zygomatic complex fractures

Diagnosis and treatment of midface fractures

Fractures of the mid face

Fractures of the maxilla

Le Fort Classification

Orbtal wall fractures: diagnosis and surgical treatment

SLEEP APNEA SYNDROME

Obstructive sleep apnea

Upper airway anatomy

Physiology of sleep disorders breathing

Blanace of forces and starling resistor

Polisonno graphy

Clinical staging for sleep disorders breathing

Continuos positive airway pressure in obstructive sleep apnea syndrome

Non surgical manegement: oral applicance

Treatment option others than surgery or CPAP

Treatment protocol for oral appliance

Nasal surgery for sleep apnea patients

Surgery of the palate and oropharynx

Skeletal technique: mandible and maxilla

Rationale for maxillomandibular advancement

maxillomandibular advancement procedure

perioperative management

surgical outcames

CRANIOFACIAL DISTRACTION OSTEOGENESIS

Biologic basis of new bone formation during dstraction osteogenesis

Mandibular lenghthening and widening

Mandibular distraction osteogenesis using extraoral and endoral devices

Pediatric sleep apnea treated with distraction osteogenensis

Cranial distraction

Craniofacial distraction osteogenesis for correction of midface and cranial hypoplasia

ORTHOGNATIC SURGERY

Evaluation of patients with dentofacial deformity

Two dimensional cephalometry and computerized surgical treatment planning

Three dimensional computerized orthognatic surgical treatment planning

The aesthetic dentofacial analisys

Presurgical treatment phase

Surgical treatment phase

The surgical tools: the Le Fort 1, bilateral sagittal split osteotomy of the mandible and the osseus genioplasty

Distraction osteogenesis in severe mandibular hypoplasia

 

 

Bibliografia e materiale didattico

 

 

MATERIALE DIDATTICO DEL MODULO DI CHIRURGIA MAXILLO-FACCIALE

Slides del docente.

Trattato di patologia chirurgica maxillo facciale

della SICMF

 

Bibliography

SCUDERI N - Plastic Surgery - Piccin Manual ed. 2014 collaboration with Diego Ribuffo

Bibliography form of oral surgery:

     Illustrated manual of oral surgery. Matteo Chiapasco. Elsevier-Masson
     Odontostomatological surgery. SIDCO (Italian Society of Oral Surgery). Minerva Medica editions
     Illustrated manual of oral surgery. SICOI. Elsevier-Masson

TEACHING MATERIALS OF THE MAXILLO-FACIAL SURGERY MODULE

Slides by the teacher. 

 

 

Bibliography form of OTORYNOLARINGOIATRY module

SUGGESTED TEXTS:

COMPENDIUM OF OTORYNOLARINGOIATRY Author: G. Rossi

MINERVA publishing house

Indicazioni per non frequentanti

le lezioni sono obbligatorie per ottenere il credito

Non-attending students info

There are no specific indications for non-attending students, as attendance to the courses is mandatory.

Modalità d'esame

 

 

 

Prova orale 

Assessment methods

talks, term paper

Oral surgery module: Theoretical-practical internship at the OU. of Odontostomatology and Oral Cord Surgery

 

OTORYNOLARYNGOIATRY module:

exam carried out online

 

METHOD OF EXAMINATION OF THE MAXILLO-FACIAL SURGERY MODULE

The exam takes place with an oral test (de visu until 2019 and then via the web in the covid era).

 

Updated: 30/04/2024 12:13