Craniomaxillofacial

Reconstructive and

Corrective Bone Surgery:

Principles of Internal

Fixation Using

the AO/ASIF Technique

Alex M. Greenberg, DDS

Joachim Prein, MD, DDS,

Editors

Springer

Craniomaxillofacial Reconstructive

and Corrective Bone Surgery

Alex M. Greenberg, DDS

Assistant Clinical Professor, Division of Oral and Maxillofacial Surgery, Columbia University School of Dental and Oral Surgery; Clinical Instructor, Division of Oral and Maxillofacial Surgery, Mount Sinai School of Medicine; and Assistant Attending, Division of Oral and Maxillofacial Surgery, Beth Israel Medical Center, and Associate Attending, Division of Oral and Maxillofacial Surgery, St. Luke’s/Roosevelt Hospital, New York, New York, USA

Joachim Prein, MD, DDS

Professor of Maxillofacial Surgery; and Head, Clinic for Reconstructive Surgery, Kantonsspital Basel, Basel, Switzerland

Editors

Craniomaxillofacial

Reconstructive and

Corrective Bone Surgery

Principles of Internal Fixation Using

the AO/ASIF Technique

With 863 Illustrations, 87 in Color

Alex M. Greenberg, DDS	Joachim Prein, MD, DDS
Assistant Clinical Professor	Professor of Maxillofacial Surgery
Division of Oral and Maxillofacial Surgery	and
Columbia University School of Dental	Head, Clinic for Reconstructive Surgery
and Oral Surgery	Kantonsspital Basel
and	CH-4031 Basel, Switzerland
Clinical Instructor
Division of Oral and Maxillofacial Surgery
Mount Sinai School of Medicine
and
Assistant Attending
Division of Oral and Maxillofacial Surgery
Beth Israel Medical Center
and
Associate Attending
Division of Oral and Maxillofacial Surgery
St. Luke’s/Roosevelt Hospital
New York, NY, USA

Library of Congress Cataloging-in-Publication Data

Craniomaxillofacial reconstructive and corrective bone surgery : principles of internal fixation using the AO/ASIF technique / edited by Alex M. Greenberg, Joachim Prein.

p. cm.
Includes bibliographical references and index.
ISBN 0-387-94686-1 (hardcover : alk. paper)
1. Facial bones—Surgery. 2. Jaw—Surgery. 3. Skull—Surgery.	4. Internal fixation in
fractures. I. Greenberg, Alex M. II. Prein, J. (Joachim), 1938–
[DNLM: 1. Facial Bones—surgery. 2. Bone Diseases—surgery. 3. Surgery,
Plastic—methods. 4. Internal Fixators. 5. Bone Plates. 6. Skull—surgery. WE 705 C8909 1997]
RD523 .C73 1997
617.5 2059—dc20	96-035162

Printed on acid-free paper.

© 2002 Springer-Verlag New York, Inc.

All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer-Verlag New York, Inc., 175 Fifth Avenue, New York, NY 10010, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden.

The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights.

While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.

Production coordinated by Chernow Editorial Services, Inc., and managed by Terry Kornak; manufacturing supervised by Joe Quatela.

Typeset by Matrix Publishing Services, York, PA.

Printed and bound by Walsworth Publishing Co., Marceline, MO. Printed in the United States of America.

9 8 7 6 5 4 3 2 1

ISBN 0-387-94686-1 SPIN 10524755

Springer-Verlag New York Berlin Heidelberg

A member of BertelsmannSpringer Science Business Media GmbH

To my wife, Sigal Greenberg, and

my daughter, Aurie Greenberg,

for their special love, support, and inspiration

To my father, Rubin Greenberg, for his love and devotion to his family

In loving memory of my mother, Nancy Greenberg

AMG

This book represents my tribute and thanks to so many surgical colleagues worldwide for their help, collaboration, fellowship, and lifelong friendship over my professional career.

JP

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Preface

These are exciting times for the diverse group of surgeons who perform craniomaxillofacial surgery. The AO/ASIF (Swiss Association of Internal Fixation) has played a crucial role in the growth of this field through its leadership in research, teaching, and cooperation with industry. As clinicians fascinated by the extraordinary progress in the field, the goal is to advance this new knowledge by teaching AO/ASIF courses and writing textbooks that supplement these courses and related workshops.

This textbook adopts the case presentation format used in Craniomaxillofacial Fractures: Principles of Internal Fixation Using the AO/ASIF Technique. The breadth of the subject meant that a coeditor was advisable and, fortunately, Joachim Prein accepted that role. To make this a comprehensive textbook, 75 international authorities wrote chapters in the areas of oral and maxillofacial surgery, plastic and reconstructive surgery, and otolaryngology and head and neck surgery.

This textbook presents progress in craniomaxillofacial surgery through the technical and scientific advances in biomaterials, microvascular surgery, dental implantology, and surgical techniques. Section I covers basic considerations in the diagnosis of craniomaxillofacial defects and disorders. Section II comprises chapters on the biomechanics and biocompatability of internal fixation and dental osseointegration implantology. These developments have helped to revolutionize craniomaxillofacial bone surgery by providing the structural support that also meets the functional needs of the patient. Section III is the first of three sections on specific considerations in craniomaxillofacial reconstructive and bone surgery. This first section includes the AO/ASIF mandibular hardware system and basic aesthetic considerations. Section IV provides a regional approach to each section of the midface and mandible that may require reconstruction because of defects resulting from trauma, infections, and tumors. Section V reviews elective osteotomies of the skull and facial bones, including the maxilla, mandible, upper midface, and skull. The two appendices present updated material on the ITI dental implant system and distraction osteogenesis of the mandible. Chapters 22 and 41, in particular, also present up-to-date information on the AO/ASIF hardware systems of instrumentation and implants separate and distinct from the other chapters to allow easier understanding of these biomaterials.

The editors hope that this textbook will be an indispensable reference for medical students, residents in training, and attending surgeons in the diverse fields of craniomaxillofacial surgery. Surgery cannot develop without honoring the achievements of the past and the assimilation of current knowledge; this textbook is intended to assist in this process.

Alex M. Greenberg, DDS

New York, New York, USA

Joachim Prein, MD, DDS

Basel, Switzerland

January 2002

vii

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Acknowledgments

The editors would like to acknowledge the many individuals who have contributed to this book. First are the many chapter authors from Europe, Asia, North America, and South America who represent all aspects of the discipline. They are a truly outstanding group of surgeons, who have contributed greatly to the progress evident in this book. Many have been AO/ASIF (Swiss Association for Internal Fixation) faculty members and have been active in teaching courses all over the world.

We also thank Synthes Maxillofacial, Paoli, Pennsylvania; the Institut Strauman, Waldenburg, Switzerland; and Professor Tomas Albrektsson, Department of Biomaterials/Handicap Research, Gothenburg University, Gothenburg, Sweden, for providing financial support to reproduce the many color figures in this textbook.

We are also appreciative of the assistance of Fr. Inge Jundt, Secretary, Clinic for Reconstrucitve Surgery, at Kantonsspital Basel, Basel, Switzerland, for her role in the preparation of the manuscript; Synthes Maxillofacial, Paoli, Pennsylvania; and STRATEC, Oberdorf, Switzerland, for advice concerning technical aspects of AO/ASIF hardware and instrumentation, and Ms. Laurel Lhowe for her outstanding illustrations.

Alex M. Greenberg, DDS

New York, New York, USA

Joachim Prein, MD, DDS

Basel, Switzerland

ix

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