16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY EMERGING TECHNOLOGIES IN ORAL AND MAXILLOFACIAL SURGERY ABSTRACTS JUNE 03 - 04 2022 RIGA, LATVIA 2 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation TELOMERE LENGTH SCREENING IN YOUNG PATIENTS WITH HEAD AND NECK CANCER IS SUITABLE TO DETECT UNDERLYING INHERITED TELOMERE BIOLOGY DISORDERS* Birte Julia Siegmund 1,4 , Fabian Beier 2,4 , Benjamin Rolles 2,4 , Maurice Klein 1,4 , Mark Ooms 1,4 , Philipp Winnand 1,4 , Eva Simons 3,4 , Marcel Bourgeois 2,4 , Gerrit Spanier 5 , Simon Laban 6 , Manuel Weber 7 , Carolin Goetz 8 , Falk Birkenfeld 9 , Kim Kricheldorf 2,4 , Susanne Isfort 2,4 , Martin Kirschner 2,4 , Stephan Hackenberg 3,4 , Frank Hoelzle 1,4 , Tim H. Brümmendorf 2,4 , Mareike Tometten 2,4 1 Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Aachen, Germany 2 Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Aachen, Germany 3 Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital RWTH Aachen, Aachen, Germany 4 Center for Integrated Oncology - Aachen Bonn Cologne Duesseldorf (CIO - ABCD) 5 Department of Oral and Maxillofacial Surgery University Hospital Regensburg, Regensburg, Germany 6 Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Ulm, Ulm, Germany 7 Department of Oral and Maxillofacial Surgery, University Hospital of Erlangen, Erlangen, Germany 8 Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technical University Muenchen, Muenchen, Germany 9 Department of Oral and Maxillofacial Surgery, University Hospital Schleswig - Holste in, Kiel, Germany * Encore - Abstract: Parts of the work were presented at the DGHO annual meeting 2021 and DOESAK - Meeting 2021; the project is still in progress Keywords Screening for underlying inherited Telomere biology disorders (TBD) in young patients with squamous cell cancer of the head and neck (SCCHN) Introduction Telomere biology disorders (TBD) are hereditary disorders characterized by impaired telomere maintenance. TBD patients are predisposed for hematologic and solid cancers at early age, squamous cell carcinoma of the head and neck (SCCHN) represents the most frequent solid tumor entity. Functional TBD read - out is prematurely shortened telome re length (TL). We systematically analyzed TL in a young cohort of SCCHN patients to identify the frequency of underlying TBD cases. 3 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Methods. All patients (pts) were included in the Aachen TBD registry based on clinical suspicion for TBD. Pts < 50y a t initial cancer diagnosis with or without missing risk factors (RF) were eligible. Lymphocyte (L) and granulocyte (G) age - adjusted (aa) TL were analyzed by flow - FISH, next generation sequencing (NGS) for telomere maintenance gene mutations performed in ca ses with TL below the 10th percentile. Results. Six German centers included 40 pts in this ongoing study. Mean age at initial diagnosis was 42.0 ± 7.2 y. Major site and histology was lingual and squamous cell cancer, respectively. Tumor stage and RF available in 29 pts showed 18 (62%) with stage III or IV, smoking in 13 (45%), alcohol abuse in six (20%) and 10 (34%) with no history for both RF. HPV/p16 status was negative in all analyzed cases (15/15). AaTL in L was significantly lower ( - 0.59 (p= 0.017)) compared to healthy controls, while aaTL in G was normal ( 0.45 (p= 0,059)) representing premature aging. TL in L was below the 10 th and 1 st percentile in five and two pts, respectively. NGS screening revealed variants in two cases affecting the telomere maintenance genes CTC1 and NHP2 which were both clas sified as variants of uncertain significance and likely pathogenic. Conclusion. Pending validation in a larger pts cohort, this pilot study establishes systematic TL screening in young SCCHN pts for underlying inherited TBD. 4 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation THE ROLE OF VIRTUAL PLANNING IN THE TREATMENT OF EXTENDED MANDIBLE CHONDROSARCOMA Zaleckas Linas, Assoc. Prof. 1 , 2 , Rutkūnas Vygandas, Prof 1 , Gendviliene Ieva DD, PhD 1 , Sun Yi, PhD 3,4 , Simonaitis Tomas 5 , Kaupas Simonas, MD 6 1 Institute of Odontology Faculty of Medicine Vilnius university, Vilnius, Lithuania 2 Centre of Oral and Maxillofacial Surgery Vilnius university hospital Zalgiris clinic, Vilnius, Lithuania 3 OMFS - IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium 4 Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium 5 DigitorumLAB, Vilnius, Lithuania 6 Medical diagnostic and treatment center, Vilnius, Lithuania linas.zaleckas@zalgirioklinika.lt , lzaleckas@gmail.com Aim. To present the treatment case of the patient with extended mandible chondrosarcoma and to reveal the role of virtual planning and digital technologies in the rehabilitation of masticatory function. Methods. Patient suffered from mandible swelling since 2006. After the surgery on 2007 pathological examination showed no signs of malignancies (mandible chondroma). 10,5 years later, at the patient’s age of 63 years, the symptoms recurred. The biopsy confirmed the diagnosis of mandible chondrosarcoma (G 1). The virtual planning of mandible resection from angle to angle and reconstruction with vascularized fibula free - flap using surgical cutting guides was performed. After the successfully surgery and healing period the virtual planning of fully guided imp lant placement and dental restorations was done. Results. The surgical treatment was successful, final pathological diagnosis - bilateral mandible chondrosarcoma pT2N0, LVI (1) (G2), radical resection of chondrosarcoma. The virtual planning of fully guide d implant placement allowed implant placement without removing of reconstruction plate and osteosynthesis screws. Final full - arch full - contour screw - retained zirconia restoration of the mandible was done and masticatory function was completely restored usi ng digital workflow. During the 3 - years follow - up period the patient is disease – free. Conclusions. Virtual planning and digital technologies enables and facilitates the complete restoration of the mandible and masticatory function in severe clinical cases. 5 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation ALUMINA - REINFORCED ZIRCONIA CERAMIC TITANIUM HYBRID IMPLANTS – A GAME CHANGER IN DENTAL IMPLANTOLOGY? Michael Dau 1 , Andreas Methner 1 , Mohamed Elhensheri 1 , Vivien Engel 1 , Nadja Engel 1 , Bernhard Frerich 1 1 Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Rostock, Germany michael.dau@med.uni - rostock.de Keywords dental implant, hybrid implant, animal model, mini pig, titanium, alumina reinforced zirconia ceramic Aim. Ceramic dental implants might provide an alternative to the typical titanium implants and are mainly made of aluminum oxide. Alumina is prone to fracture due to its high hardness and mod ulus of elasticity but relatively low bend strength and fracture toughness, which can lead to implant fractures. Combining titanium and ceramic in a hybrid implant might a good way to address the disadvantages of both materials. Methods. In an animal mod el four different dental implant types (a pure titanium; a pure zirconium dioxide ceramic; two different designs alumina - reinforced zirconia ceramic with pure titanium core) were inserted in each side of the mandible in adult mini pigs via submandibular ap proach. After 2, 8, 12 and 26 weeks the animals were scarified and the mandible was harvested. The decalcified specimens were evaluated histomorphometrically using the software Photoshop CS (Adobe Systems) regarding the bone implant contact (BIC, %). Res ults. For all animals, postoperative healing was uneventful and no complications were observed. Light microscopic analyses showed that all implants were well tolerated. Osteoblast seams as well as newly formed blood vessels, connective tissue, and some mul tinuclear giant cells on the surface of the implants were observed in all groups at each point in time. The BIC increased overtime in all groups with a slightly bigger BIC in the pure titanium group. Conclusions. Overall, the Alumina - reinforced zirconia c eramic titanium hybrid implants showed similar healing like classical pure titanium implants and might be a good candidate to overcome the limitations of pure zirconia ceramic implants. Funding. This research project was supported by Tizio Hybrid Implants GmbH (Germany). 6 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation USING PLATELET RICH FIBRIN TO ENCOURAGE WOUND HEALING IN LOWER THIRD MOLARS’ EXTRACTION SITES Kristina Kull, Resident of Maxillofcial Surgery , Tiia Tamme, MD PhD Maxillofcaial Surgeon , Janne Tiigimäe - Saar, PhD Maxillofacial Surgeon Department of Maxillofacial Surgery , Tartu University Hospital , Tartu , Estonia kristina.kull@gmail.com Background. Third molar removal is one of the most common procedures performed by oral and maxi llofacial surgeons. Pain, swelling and infection are most common complications after third molar extraction. Platelet - rich fibrin is second generation autologous biomaterial that polymerizes slowly. Slow polymerization accelerates wound healing. The aim of this study is to assess the effectiveness of PRF in wound healing by evaluating pain, swelling and bone density after lower third molar removal. Methods 20 patients (10 male, 10 female) participated in the study. Lower third molars were removed bilaterally during single appointment. Control site was used to evaluate swelling. The Numerical Pain Rating Scale (NRS) was used to evaluate pain. Panoramic dental X - rays were used to evaluate bone density. Results. The pain at the control site was more intensive and lasted longer than at the PRF site. The swelling was more intensiv e at the control site. Bone density was higher at Conclusion. PRF seems to be effective material to encourage wound healing after third molar removal. PRF could be used routinely after third molar removal. Keywords Third molar, PRF, Swelling, Pain, Platelet - rich fibrin, wisdom teeth removal 7 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation LONG - TERM RESULTS IN PRE - ADOLE S CENT PATIENTS HAVING U - CLAP. THE BALTIC CLEFT NETWORK STUDY Jan - Hendrik Lenz 1 , Ilze Akota 2 , Linas Zaleckas 3 , Marianne Soots 4 , Ieva Bagante 2 , Irena Rogovska 5 , Bernhard Frerich 1 , Karsten Gundlach 1 1 Dept. for Oral and Maxillofacial Plastic Surgery (chair: Prof. Dr. Dr. Bernhard Frerich), Rostock University, Rostock, Germany 2 Dept. for Oral and Maxillofacial Surgery (chair: Prof. Dr. Ilze Akota), Riga Stradins University, Riga, Latvia 3 Centre of Oral and Maxillofacial Surgery (chair: Assoc. Prof. Dr. Zaleckas), Institute of Odontology, Faculty of Medicine Vilnius University, Vi lnius University Hospital Zalgiris Clinic, Vilnius, Lithuania 4 Institute of Dentistry (chair: Assoc Prof. Dr. Ülle Voog - Oras ), Tartu University, Medical Faculty, Tartu, Estonia 5 Dep. of Doctoral Studies (chair: Prof. Dr. Sandra Lejniece) Riga Stradins Univ ersity, Riga, Latvia jan - hendrik.lenz@med.uni - rostock.de Aim. This multicenter study aimed at comparing different techniques of lip and nose repair with or without NAM and primary anterior rhinoplasty in pre - adolescent children. Material and Methods Patients with unilateral clefts of lip, alveolus, and palate who had undergone cleft lip and nose repair (from 2001 to 2018) were evaluated in a prospective three - centre study using standardized monochromatic, cropped photographs. Four cleft surgeons evaluated the aesthetics of the central part of the face when the pati ents had reached age ten years. Results Seventy - six sets of photographs out of 87 patients were evaluated. The overall ratings of lips and noses did not differ much between centres. However, noses of centres 1 (mean 0.74; SD 0.57) and 2 (mean 0.76; SD 0 .60) had been rated better than centre 3 (mean 1.32; SD 0.78; p = 0.0078), especially “Deformation of upper part of nostril rim or poor position of alar cartilage”. Centre 3 had produced better looking scars (mean 0.33; SD 0.48); p = 0.0036. Conclusions Apparently better noses are to be found following either NAM or primary anterior rhinoplasty plus postoperative nasal stents. The latter seems to be particularly favorable and reduces the number of secondary interventions. Different techniques result in minor lip differences. 8 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation ORTHODONTIC FINDINGS AND SPEECH OUTCOMES IN PATIENTS WITH UNILATERAL CLEFT LIP AND PALATE Ann Dieckmann 1 , Susanne Josko 1 , Karsten Gundlach 1 , Franka Stahl 2 , Bernhard Frerich 1 , Jan - Hendrik Lenz 1 1 Department of Oral and Maxillofacial and Facial Plastic Surgery, University of Rostock, Rostock, Germany 2 Department of Orthodontics, University of Rostock, Rostock, Germany Aim. To evaluate malocclusion in the primary dentition and speech in patients with unilateral cleft, lip, alveolous and palate and compare speech with dynamic and static orofacial dysfunctions Material. 50 patients with unilateral total clefts of lip, alveolus and palate (Q.37.5) from 2 dif ferent European cleft palate centers at the age of 5 years with a self developed protocol for minimal documentation. Methods. To determine malocclusions with 5 - year - old Index according to Mars and evaluate primary orofacial functions (like breathing, sucking, chewing, biting, swallowing and tongue rest position) as well as secondary functions (like speech and voice) with standard ized objective tests: payne - technique according to Garliner, functional tonometer according to Thiele, articulation test according to Dieckmann/Dieckmann and A - I - check according to Gutzmann. Pearson’s chi square test was used for statistical analysis and p ≤0.05 was defined as significant. Results. The frequently most found category of the 5 - year - Index was category II in both cleft centers. Open mouth posture (40%), unphysiological tongue rest position (37%) and visceral swallowing pattern (79%) were the mo st frequently diagnosed primary orofacial dysfunctions with all test persons. There were no significant differences between the participating cleft palate centers. Malarticulation and hypernasality (being secondary orofacial dysfunctions) were diagnosed in 35% and 82% of all subjects respectively with significant differences between the 2 cleft palate centers. This can be explained by the differences in treatment plans. Non significant differences in velopharyngeal function were found among these two groups at 5 years of age. Conclusions. The high frequency of malocclusions and primary and secondary orofacial dysfunctions in patients with unilateral clefts of lip, alveolus and palate require an early finding, treatment and intervention. 9 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentat ion RIGA CLEFT LIP AND PALATE CENTRE LONG - TERM EXPERIENCE OF ALVEOLAR BONE GRAFTING Julianna Muceniece , Ilze Akota, Ieva Bagante, Inese Maulina, Ieva Maulina, Inta Zepa Cleft Lip and Palate Centre, Riga Stradins University Institute of Stomatology, Riga, Latvia julianna.kuz@gmail.com Aim. The objectives of this study was to evaluate the outcome of the alveolar bone grafting in unilateral complete cleft lip, alveolus and palate (UCLP) patients in our centre performed from January 2000 to Decemb er 2019. Methods Data were collected from the medical records, 2D x - rays, photos and casts. The results were analyzed with respect to the height of the bone in grafted area, wound healing, condition of erupting teeth and the space c losure in the dental arch. Results Out of 90 operated patients, 76 (47 male and 27 female) patients were included in the study. Left side was mostly affected ( 54 vs 22). The average age of the patients at bone grafting was 10.00 years (range 6.9 - 30.3) The primary healing was observed in 73 (96.06%) patients while wound dehiscence occurred in 3 (3.94%) cases. The intra - oral radiographic observation period was 7.9month (range 5month to 2.11years). Eighty eight percent of our patients had alveolar bony h eight between the teeth bordering the former cleft more than 75% of the normal height of the alveolar process. If bone grafting was perform before canine or second incisor eruption, in 89% of cases alveolar arch was closed by orthodontic means. Prosthodont icaly closure was observed in 11% of our patients. Conclusion Long term results of bone grafting showed high rate of success. Gap closure by orthodontic means was achieved in 89% of our patients with bone grafting performed before adjusted teeth eruption 10 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation PEER - ASSISTED ASSESSMENTS IN AN ELECTRONIC OBJECTIVE STRUCTURED CLINICAL EXAMINATION (E - OSCE) OF PRE - FINAL YEAR STUDENTS Jan - Hendrik Lenz 1,2 , Steffen Emmert 2 , Anke Busse 3 , Anne Port 4 , Susanne Fröhlich 5 , Bernd Romeike 2 , Juliane Kröplin 1 , Cadja Bachmann 2 1 Department of OMF and Facial Plastic Surgery, Rostock Medical Faculty 2 Deans Office for Student Affairs, Rostock Medical Faculty 3 Department of Radiology, Rostock Medical Faculty 4 Department of Forensic Medicin e, Rostock Medical Faculty 5 Department of Orthopedics, Rostock Medical Faculty Rostock University, City of Rostock, Germany jan - hendrik.lenz@med.uni - rostock.de Aim Peer - assisted learnings (PAL) are well known in higher education and implemented in many medical curricula. COVID - 19 pandemic derived effects have promoted an increase of digital educational assessments (i.e. E - OSCE). This study examined the assessment of medical peer - t utors in an interdisciplinary clinical E - OSCE. Methods 24 peer - tutors (qualified in teaching, feedback and rating of clinical skills) applied PAL with first clinical year students regularly in internal medicine and surgery over 2 years. Then nine tutors acted as raters in an E - OSCE for pre - final year medical students covering analysis of doctor - peer - patient consultations, videotaped physical examinations (PE) and clinical findings of PE ́s, X - ray ́s and death certificates. 247 pre - final year students took part in the E - OSCE: First of all they received video - links, videos and diagnostic findings for preparation. Then students performed E - OSCE examinations and documented the results via an intranet - gateway. Assessments were evaluated by peer - tutors using a five - point scale after secondary training supervised by clinical experts Results Peer - assessments showed minimum differences due to individual variances, students ́ results varied from good (PEs:mean 1.86) to very good (PE - documentations:mean 1.44). Tec hnical as staff efforts (e.g. matching of results) were extensive. Finally students evaluation showed high acceptance of the E - OSCE. Conclusions E - OSCE rating by peer - tutors seems to be a reliable method for futural PAL - studies. The E - OSCE seems to be valuable tool regarding students learning outcomes. Intranet - based gateways seem to be a basic precondition for all E - OSCE observations. Increased IT support and an increased number of peer - tutors are recommendable for futural E - OSCE ́s. 11 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentati on EVOLUTION OF O RAL H EALTH P ROFESSIONAL’S EDUCATION IN EUROPE : THE O - HEALTH - EDU PROJECT OUTCOMES Ilze Akota 1 , Julia R. Davi e s 2 , Jonathan Dixon 3 , James Field 4 , Gabor Gerber 5 , Maria - Cristina Manzanares - Cespedes 6 , Denis Murphy 7 , Corrado Paganelli 8 , Barry Quinn 9 , Valerie Roger - Leroi 10 , Stephanie Tubert - Jeannin 10 , Sibille Vital 11 1 Riga Stradins University, Riga, Latvia, 2 Malmö University, Malmö, Sweden, 3 University of Sheffield, Sheffield, UK 4 University of Cardiff, Cardiff, UK, 5 Semmelweis Egyetem, B udapest, Hungary, 6 Universitat de Barcelona, Barcelona, Spain, 7 Association of Dental Education in Europe, Dublin, Ireland, 8 University of Brescia, Brescia, Italy, 9 University of Liverpool, Liverpool, UK, 10 Clermont Auvergne University, Clermont - Ferrand, France, 11 Université de Paris, AP - HP, Paris, France Numerous projects (DentEd, Dent CPD) and other activities ha ve been carried out to harmonise dental education and quality assurance systems in Europe. The Association for Dental Education in Europe (ADEE) has played an important role by enhancing the quality of education, advancing the professional development of dental educators , and supporting research in education and training of Oral Health Professio nals (OHPs) Currently work continues on the EU Erasmus + project entitled O - Health - Edu “Advancing Oral Health : A vision for dental Education”. This project is coordinated by the University of Clermont Auvergne (France) with the Association for Dental Ed ucation in Europe (ADEE) and 8 other university partners , including Riga Stradins University The o bjectives of this project are to gain a valid understanding of the realities of dental education within Europe, to enable a shared understanding and a common vision for the future of OHP Education among European stakeholders and policy makers , and finally , to defin e priorities for a strategic vision and support changes for OHP education. A recent scoping review revealed significant gaps in our knowledge of how education of OHPs is implemented and delivered across Europe, being both limited and somewhat outdated (D ixon et al., 2021). One specific outcome of the project is created resource where terms specifically related to OHPs education are clearly defined and explained, called “Articulate”. The resource is now freely available online and feedback from the OHP edu cation community is expected. This can be found, with free online access, at https://o - health - edu.org/articulate 12 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 The process of collect ion of programme - level data on OHP s Education across Europe is underway Outcomes will also improve the visibility of OHP programmes across Europe, to all interested stakeholders. The O - Health - Edu data hub presents a ‘summary card’ for each institution that has completed the survey and created a prof ile This information is accessible at https://o - health - edu.org/ohe - datahub - directory O - Health - Edu’s longitudinal vision for the education of OHPs in Europe into the future, to 2040 acts in the best interests of both students and patients, and sits within the context of a wider strategy for general health. The involvement of multiple stakeholders (educators and clinicians, international and national bodies, r egulators and students) has enabled the creation of a shared vision, built through consensus. The Vision is now freely available online (Field et al 2022) and a representative visual can also be accessed at www. adee.org/ohe/vision - and - charter 13 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation AUTOMATED VIRTUAL PLANNING OF MANDIBULAR RECONSTRUCTIONS WITH MICROVASCULAR FIBULA FLAPS Igors Litvinovs 1 , Ali Modabber 1 , Frank Hölzle 1 , Florian Peters 1 , Ezgi Cevik 1 , Tobias Pankert 1 , Thomas Roth 1 , Stefan Raith 1 1 Department of Oral and Maxillofacial Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany ilitvinovs@ukaachen.de Aim. Restoration of the mandible in cases of extensive continuity defects is an extremely difficult task. Due to the variety of applications, the autologous fibula flap is often the graft of choice. The aim of study was to develop and evaluate software capable of providing individualized planning of mandibular reconstruction using a fibula flap graft, considering the individual geometric specificities of the patient. Methods. The algorith m developed is based on curves following characteristic anatomical features. The geometric data of the physiological mandible and fibula were used to create different defects, and the geometric correspondence was investigated to demonstrate the applicabili ty of the method with different reconstruction parameters. Results. It has been shown that the present method can be used by surgeons as an automated planning tool with the ability to account for individual geometric parameters. In addition, the study showed that the approach could be easily integrated into a highly autom ated process. The usability of the presented software was found to be excellent, given the fact that surgeons could work with the software directly after a brief introduction. Conclusions. A new algorithm for computer - guided planning of mandibular reconst ruction using fibular grafts proved to be applicable to the desired goal while meeting stringent requirements. Parametric studies with different segment lengths have shown that the approach is able to automatically generate reconstruction proposals that ca n be critically evaluated by experienced surgeons and used as a template for subsequent planning of mandibular reconstructions. 14 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation IMPLEMENTATION OF 3D - PRINTED PERFUSION BIOREACTORS FOR STEM CELL SEEDING IN BONE SCAFFOLDS FOR FUTURE CHAIRSIDE APPLICATIONS Nadja Engel 1 , Carsten Fechner 1 , Robert Ott 2 , Paul Cherkasov 3 , Valeria Khaimov 2 , Stefan Siewert 2 , Klaus - Peter Schmitz 2 , Bernd Joachim Krause 4 , Bernhard Frerich 5* 1 Experimental research laboratory, Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Rostock University Medical Center, Schillingallee 35, D - 18057 Rostock, Germany. 2 Institute for ImplantTechnology and Biomaterials e.V., Friedrich - Barne witz - Str. 4, D - 18119 Rostock, Germany. 3 RoweMed AG – Medical 4 Life, Juri - Gagarin - Ring 4, D - 19370 Parchim, Germany. 4 Department of Nuclear Medicine, Rostock University Medical Center, Gertrudenplatz 1, D - 18057 Rostock, Germany. 5 Department of Oral and Maxi llofacial Surgery, Facial Plastic Surgery, Rostock University Medical Center, Schillingallee 35, D - 18057 Rostock, Germany. nadja.engel@med.uni - rostock.de Aim. There undoubtedly is a substantial need for new regenerative strategies in the management of craniofacial bone deficits, for example before implantation in dental surgery. Regardless of which approach is used, devices and methods are required to ensure eff ective, homogeneous, and reproducible seeding of scaffolds or carrier materials with stem cell or other endogenous material. A clinically acceptable seeding system should be self - contained, and the process should be completed within a defined short period of time. In this study we aimed to design a 3D - printable perfusion bioreactor for chairside applications in terms of a fast and homogeneous stem cell distribution within approved bone substitute materials (Fig. 1). Methods. Different bioreactor geometries with varying connector geometries were numerically modelled and thereafter printed with a Formlabs Form2 3D printer. Perfusion experiments were performed with adipose - derived stem cells, isolated from lipoaspirate samples which were collected from patient s undergoing liposuction or lipofilling procedures. Using the combination of positron emission tomography (PET) and computed tomography (CT) within a micro - PET/CT, [18F]FDG - labeled stem cells can be monitored during perfusion processes to assess both, the colonization in three dimensions and the vitality of the cells within opaque scaffolds. Initial cell attachment and spreading within the scaffold was visualized by scanning electron microscopy. Osteogenic differentiation was proven by immunohistochemistry and osteogenic marker expression. 15 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Results. In our experiments, we could show that numerical modelling is able to predict the homogeneity and efficiency of seeding depending on defined parameters such as bioreactor geometry, perfusion rate and cell density of the perfusate. A particular challenge poses the imaging of seeded cells in opaque scaffolds, which could be reliably realized with dynamic micro - PET/CT. Compared to conventional histological or laser scanning microscopic imaging, this m ethod saves time, is non - destructive and allows a higher throughput of experiments. By testing different geometries for the in - and outlets of the bioreactor, the conical form proved to be the most effective for homogeneous colonization. Furthermore, the e ncasement of scaffolds plays an important role to prevent leakage flow around the scaffolds. Consequently, a silicone encasement for individually structured scaffolds was generated. However, through the combined use of conical inlets and a custom - made sili cone encasement the cell seeding homogeneity was significantly increased. If an oscillating perfusion mode is additionally used, the homogeneity of the cell distribution can be further increased resulting in a low Hoover coefficient of 0.24. In summary, th is study shows that an individual bioreactor can be easily and quickly generated with a conventional 3D printing process, which can also be adapted to the individual geometry of the patient's bone substitute material. Conclusions. This bioreactor is enables homogeneous seeding of individual scaffolds with stem cells in less than an hour. The following four parameters were decisive for efficient cell colonization of the scaffold in the present investigations: 1. cell concentrations of 0.5 to 1.0 × 10 6 cells/ml, 2. a low perfusion rate of 0.5 – 1.0 ml/min, 3. scaffold encasement with a silicone sleeve, and 4. an oscillating perfusion mode. Fig. 1 Schematic graphical presentation of a 3D - printed perfusion bioreactor with subsequent PET/CT or histological analysis of cell homogeneity and cell spread. LSM: laser scanning microscopy. IHC: immunohistochemistry. 16 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation A DEEP LEARNING APPROACH FOR OSTEOPOROSIS IDENTIFICATION USING CONE - BEAM COMPUTED TOMOGRAPHY Laura Neimane 1,2 , Anda Slaidiņa 3 , Oskars Radziņš 2,4 , Ivars Namatēvs 5 , Kaspars Sudars 5 1 Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia 2 Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia 3 Department of Prosthodontics, Riga Stradins University, Riga, Latvia 4 Riga Stradins University Institute of Stomatology, Riga, Latvia 5 Institute of Electronics and Computing Science, Riga, Latvia Aim. T o develop a method to identify osteoporosis risk for postmenopausal women in the jawbones region, create an end - to - end deep learning prototype model, and apply quantitative and qualitative radiology bone density indices in cone beam computed tomography (CBCT) examinations. Methods. In the present study are planning to included 220 postmenopausal females aged 55 - 95 years who underwent CBCT (i - CAT Next gener ation, Kavo, Germany) examinations due to implant planning. Bone mineral density measurements of lumbar spine and both femoral necks by dual energy X - ray absorptiometry (DEXA) (Lunar DEXA DPX - NT, GE Medical Systems) will be performed. The worst T - score readings will be taken into account. The CBCT images are analyz ed with OnDemand3D Dental, Kavo, Germany software. By analysing CBCT images and threshold values we will develop an osteoporosis risk identification method, followed by indexing mental and mandibular cortical indices. Based on the image analysis dataset, t he deep neural network training will be performed by using existed (3D U - Net, V - Net) and new (Visual Transfomer) deep neural network architectures. Results. Using a Deep Learning (DL) approach, a Computer Vision method will be elaborated which can identif y more quickly and accurately the risk of osteoporosis in women. Consequently, it facilitates the early treatment of the disease as well as prevents osteoporotic fractures. Conclusions. DL approach is is a perspective tool that could be used to identify osteoporosis risk for postmenopausal women in the jawbones region examined by CBCT. Funding This work was supported by the “ Fundamental and Applied Research Projects ”, g rant number: lzp - 2021/1 - 0031 17 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation EMPIRICAL FINDINGS OF A 7 - YEAR TMJ ARTHROSCOPY SURGERY EXPERIENCE Marijus Leketas PhD, DDS, MD 1 , Vykintas Pliavga SDS 2 , Abdulla Varoneckas DDS 1 1 Lithuanian University of Health Sciences, Department of Maxillofacial Surgery, Kaunas, Lithuania 2 Lithuanian University of Health Sciences, Faculty of Odontology, Kaunas, Lithuania mleketas@gmail.com Aim. To present the achievements of a 7 - year clinical experience along with conducted research in the field of TMJ arthroscopy. Methods. Clinical experience of 7 years, case - control studies, RCTs, and systematic reviews in Kaunas Clinics were summarized. Results. Clinical practice of TMJ arthroscopy has started in Kaunas Clinics by performing first arthroscopic surg ery in 2014 October. Since then, more than 300 successful TMJ arthroscopies were performed. Later, a systematic review comparing different intraarticular injection substances (PRFG and HA) followed by TMJ arthroscopy. The results showed a tendency towards the superiority of PRFG over other treatments in pain management. However, a lack of randomized controlled trials (RCTs) that compared both substances made it hard to conclude which substance enhances recovery and effectiveness the most, therefore this was followed by a RCT that compared the effect of HA and PRGF injections on the early postoperative period after TMJ arthroscopy in 77 patients. Lately, the object of interest has become the most advanced procedure in TMJ arthroscopy surgery – discopexy. A s ystematic review was carried out evaluating the effectiveness of different TMJ arthroscopic discopexy techniques. Conclusions. TMJ arthroscopy surgeries have proven themselves to be a successful way of helping particular TMD patients. Despite that, to thi s day, the scientific field of TMJ arthroscopy has shown us that this procedure is not extensively researched. 18 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation TEMPOROMANDIBULAR JOINT SURGERY FROM ARTHROCENTHESIS TO ALLOPLASTIC RECONSTRUCTION - IS THERE AN ALGORITHM? Birte Julia Siegmund , Ali Modabber, Frank Hölzle Department of Craniomaxillofacial and Facial Plastic Surgery, University Hospital of RWTH Aachen, Germany bsiegmund@ukaachen.de Keywords Temporomandibular diseases and disorders, TMJ reconstruction, surgical therapy of temporomandibular joint, alloplastic prosthetic total joint systems Aim. Treatment of temporomandibular disorders and diseases is commonly based on conservative therapy (physical therapy, splint therapy, botulinum toxin). The number of patients treated surgically is on rise. Depending on the entity of TMJ disease and the severi ty of TMD, treatment varies in the degree of surgical invasion and should be regarded as a kind of level scheme. Methods. Patients with different TMJ disorders and diseases where treated successfully in the last years two years in our department. Surgica l intervention, combined with conservative and orthognathic methods has to be regarded as a kind of algorithm for successful treatment and stable results. Results. Especially surgical treatment of the temporomandibular joint has many different aspects and should be selected for every patient individually. Regarding the invasiveness and the irreversibility of this approach, the use of alloplastic total systems is stil l under debate and should be seen as an ultima ratio in TMJ surgery as the top of a level scheme. Conclusion. For successful and stable results, surgical treatment has to be seen as one part in a combination of surgical and conservative treatment method s. The top of a level scheme is the alloplastic reconstruction using prosthetic total joint systems. This is a very promisingly approach and results of stock systems are comparable with CAD/CAM - Systems. Nevertheless, indication has to be made carefully reg arding medical history and risk factors. In some cases CAD/CAM - systems are recommended and should stay as a gold standard. Regarding diagnostics, it is necessary to reevaluate the effectiveness and the diagnostic accuracy of MRI and compare the results to clinical and surgical findings. 19 16 TH JOINT SYMPOSIUM OF ROSTOCK UNIVERSITY AND RIGA STRADIŅŠ UNIVERSITY AND 10 TH CONGRESS OF BALTIC ASSOCIATION FOR MAXILLOFACIAL AND PLASTIC SURGERY 03 - 04 JUNE 2022 Oral Presentation ADVANCED HIGH HYDROSTATIC PRESSURE BASED PROCESSING OF TISSUE GRAFTS Michael Dau 1 , Janine Waletzko - Hellwig 1 , Michael Sämann 2 , Christoph Drobek 3 , Anika Jonitz - Heincke 2 , Hermann Seitz 3 , Rainer Bader 2 , Bernhard Frerich 1 1 Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Rostock, Germany 2 Biomechanics and Implant Technology Research Laboratory, Department of Orthopedics, University Medical Center Rostock, Rostock, Germany 3 Department of Mechanical Engineering, University of Rostock, Rostock, Germany michael.dau@med.uni - rostock.de Keywords high hydrostatic pressure, devitalization, decellularization, cleaning, allograft, regenerative medicine, bone regeneration Aim. Reconstructing severe bone defects is a clinical challenge. While the use of autografts is still considered as the gold standard, the available amounts o f autograft and the donor site morbidity are limiting factors. Following the processing, allografts often lose the mechanical properties and the extrace