http://hdl.handle.net/11434/181 2026-07-04T22:52:01Z 2026-07-04T22:52:01Z Dimitroulis, George http://hdl.handle.net/11434/2326 2025-04-17T05:43:26Z 2024-06-01T00:00:00Z

Title: A guide for temporomandibular joint surgery using a simple surgical classification - A narrative-style review. Epworth Authors: Dimitroulis, George Abstract: The aim of this narrative style review is to clarify the role of TMJ surgery in the management of specific TMJ disorders by introducing a simple and practical surgical classification. A decade ago, a new surgical classification was published which, like the Wilkes classification, included the five escalating degrees of joint pathology, but with more practical definitions and proposed surgical options for each of the disease categories. The classification begins with Category 1 - painful but otherwise structurally normal joints, which are largely managed nonsurgically. Categories 2 and 3 denote reducing and nonreducing disc displacement of the TMJ, respectively, with the former treated by TMJ arthrocentesis or level 1 arthroscopy and the latter best managed with disc repositioning or discopexy. Category 4 describes degenerative changes to the disc itself, where the disc cannot be salvaged and is thus removed with TMJ discectomy. Lastly, Category 5 refers to end-stage joint disease, where none of the joint components can be salvaged; both the disc and condylar head are sacrificed, and the TMJ is reconstructed with a prosthetic total joint replacement. In the decade since its publication, various studies have served to validate the usefulness of the TMJ surgical classification, and how it can be applied to better understand the role of TMJ surgery in everyday clinical practice.

2024-06-01T00:00:00Z Dimitroulis, George http://hdl.handle.net/11434/2116 2022-07-27T02:28:28Z 2022-02-01T00:00:00Z

Title: The atrophic edentulous alveolus. A preliminary study on a new generation of subperiosteal implants. Epworth Authors: Dimitroulis, George Abstract: The aim of this cohort case series is to present a new subperiosteal implant device that uses CAD-CAM technologies together with 3D metal printing capabilities to produce direct bone-anchored dental prosthetic solutions for the management of atrophic edentulous alveolus and jaws. The clinical experience of 21 subperiosteal devices implanted over a 4-year period is presented. The results of this study showed 14 of the 21 cases were successful (66.7%), while 7 cases had complications including exposure of the metal frame (5 cases), mobility of the device (1 case) and 1 case failed for reasons unrelated to the device. Four of the 7 cases were successfully salvaged resulting in an overall success rate of 85.7% (18 /21 cases). This study supports the use of fully customized subperiosteal jaw implants as a simple and reliable alternative for dental rehabilitation of atrophic edentulous cases which would otherwise require bone grafts for conventional fixed dental implant solutions. With more research, the clinical potential for this device is significant as it not only avoids the need for complex and lengthy reconstructive jaw surgery but also allows for the placement of immediate prosthetic teeth at the time of implantation.

2022-02-01T00:00:00Z Wong, Amy Magarey, Matthew http://hdl.handle.net/11434/1976 2021-06-09T05:27:59Z 2021-02-01T00:00:00Z

Title: Endoscopic removal of ectopic dentition in ethmoid sinus. Epworth Authors: Wong, Amy; Magarey, Matthew Abstract: A 66-year-old woman presented with a 6-month history of unilateral right nasal obstruction and rhinorrhoea not responding to medical therapy. She had a history of dental implantation for an unerupted tooth on the right side 3 years ago. Physical examination including flexible nasendoscopy demonstrated yellow debris in the right middle meatus. CT paranasal sinuses demonstrated a radiopaque lesion in the right anterior ethmoid sinus and resembled the unerupted tooth. The tooth was removed endoscopically from the right nasal cavity without complications. This case highlights the importance of eliciting an accurate dental history and considering ectopic dentition as a differential diagnosis in a patient with unilateral symptoms of sinusitis.

2021-02-01T00:00:00Z Cribb, Benjamin http://hdl.handle.net/11434/1953 2021-01-22T03:54:40Z 2020-12-01T00:00:00Z

Title: Cultural competency in otolaryngology-head and neck surgery training in Aotearoa, New Zealand. Epworth Authors: Cribb, Benjamin Abstract: Worldwide, indigenous communities experience diminished health status and poorer health outcomes in comparison to the dominant non‐indigenous population. Four phenomena – historical trauma, institutionalized racism, social determinants of health and culturally inaccessible or unfriendly health services – contribute to this health inequality. To fulfil RACS vision of serving our community with excellence, achieving indigenous health equity must become one of the core values of RACS. This novel survey demonstrates that both OHNS supervisors and trainees largely understand and acknowledge the importance of providing culturally appropriate health services for Māori but are less familiar with the importance of appraising personal and institutional attitudes towards culture. In conjunction with the New Zealand based surgical training committees, the Māori Health Advisory Group is developing a formalized cultural safety teaching and assessment programme to meet this need and which will form part of a broader RACS strategy to address Māori health equity. However, while skills can be developed through courses and educational material, meaningful change only occurs when we enact this in our offices, on our wards and in our operating theatres. The informal and hidden curriculum guides our learners – unless we model the importance and value of delivering culturally safe care and actively engage in the improving the health of Māori, the changes needed will not occur.

2020-12-01T00:00:00Z