Day 1 :
Keynote Forum
Aliakbar Bahreman
University of Rochester, USA
Keynote: Differential diagnosis of anterior crossbite is the first step of early intervention of class III malocclusion
Time : 09:15-09:45
Biography:
Aliakbar Bahreman graduated from Tehran University in 1961. He did his Pediatric Dentistry Fellowship in 1964 and Specialty in Orthodontic and Dentofacial Orthopedic. He did his MS from Eastman Institute for Oral Health, University of Rochester, New York in 1967. He was the Dean of Dental School, Chair and Founder of both Orthodontic and Pediatric Dentistry departments, National University of Iran from 1967 to 1999. Currently, he is a Clinical Professor at Eastman Institute for Oral Health, University of Rochester, NY. He has more than 14 published papers in national and international journals and serving as an Editorial Board Member of some journals. He is the Author of the book “Early Age Orthodontic Treatment”.
Abstract:
Anterior crossbite is a common problem frequently seen in the primary, mixed or permanent dentition and certainly needs early intervention to prevent further damage to occlusal structures and adverse growth effects to the dentition and basal bones. Anterior cross bite is one of the main symptoms of overall sagittal dentofacial anomalies that can be caused by different structural deformity. Therefore early recognition and differential diagnosis are the first steps toward effective treatment. Generally there are five kinds of anterior crossbites: (1) Simple dental crossbite, (2) Functional crossbite (pseudo class III), (3) Dento-alveolar crossbite, (4) Potential class III, and (5) Skeletal Class III malocclusion. Depending on the origin of the anterior crossbite, and their morphology, etiology and the patient's age, there are several treatment options ranging from simple removable appliance, or comprehensive fixed therapy, to orthopedic approach or orthognathic surgery. The objectives of this presentation are: To inform dental professionals about the etiology, diagnostic criteria and best treatment options of various anterior cross bites; To illustrate simple effective treatment methods for each kind of anterior crossbite from primary and mixed dentition, to non-surgical treatment at permanent dentition. The main goal of this presentation is to highlighting the advantages of early intervention.
Keynote Forum
T P Chiang
Canada China Child Health Foundation, Canada
Keynote: Dentistry role in cleft lip and palate management
Time : 09:45-10:15
Biography:
T P Chiang is the President of Canada China Child Health Foundation, Canada. She has done her BSc, DDS and Doctorate in Dental Medicine from Dalhousie University, Canada. She has completed her Master of Science in Epidemiology from Harvard University. She did her Post-doctoral studies at Massachusetts Institute of Technology, Boston Children's Hospital in Pediatric Dentistry. She is a Professor at University of British Columbia, Beijing Children's Hospital, Beijing Institute of Pediatrics and Children's Hospital of Harbin. She is the Honorary President of Nanjing Medical University Dental Hospital, Consultant at child health hospitals of Guangzhou, Suzhou Health College, and Chongqing Medical University.
Abstract:
Cleft lip and palate is a common congenital maxillofacial deformity, with incidence rate varying among different ethnic groups. There is serious tissue defects with loss of maxillary bone segment and tissue displacement involved, affecting both appearance and function. This deformity causes major challenges because of associated problems, i.e., feeding, conduct disorder high treatment cost, ear infection, hearing loss, language difficulty. With the advancement of science and technology, new surgical techniques and treatments greatly improve the effectiveness of treatment of cleft lip and palate. Current approach to cleft lip and palate treatment is beyond simple surgical repair which include restoration of appearance and function, psychological problem, and changes in growth and developments. Optimal management utilizing an integrated and collaborative and multidisciplinary approach is particularly important and is almost standardized in US and Canada. This collaborative team involves: plastic surgeon, anesthesiologist, pediatric dentist, orthodontist, maxillofacial surgeon, dental surgeon, speech pathologist, audiologist, feeding nurse, pediatrician and otolaryngologist. Dentistry’s role involves the following disciplines: pediatric dentist, orthodontist, maxillofacial surgeon, and prosthodontist. Cleft lip and palate sequential treatment approaches different growth stages with different therapeutic targets. Neonatal period pursue physical appearance and functionality; pre-pubertal period guide arch form development and completion of alveolar bone graft; puberty aims at improve function; orthognathic surgery repair occur following growth and development completion. With respect to the various dental specialties the following are their roles in the treatment of cleft patients; Maxillofacial surgeon: Performs secondary alveolar bone grafts, combines with the orthodontist to correct facial skeletal deformities, augments bone and places implants with the prosthodontist. Prosthodontist: Coordinate with the orthodontist and surgeon during treatment planning, replace missing teeth, restore esthetics, and assure longevity of functional dentition. Orthodontist: Works with the pediatric dentist in the mixed dentition, guidance for the permanent occlusion and maxillo-facial complex, treats the permanent dentition, develops treatment plan for orthognathic surgery with the oral-maxillofacial surgeon and the prosthodontist. Pediatric Dentist: Serves as patient plus parent advocate in infancy and mixed dentition phase treatment , provide unique perspective of the whole child and the preparation of early and overall dental treatment plan (with the team), and finally, its integration and implementation. This program was initially introduced to China in 1999 through multiple exchange programs with Canada and the US. Over the past decade there has been close to 3000 cleft lip and palate patients treated at the Guangzhou Center alone.
Keynote Forum
Johann Lechner
Clinic for Integrative Dentistry, Germany
Keynote: Hyperactivated signaling pathways of chemokine RANTES/CCL5 in osteopathies of jawbone in cancer and autoimmune diseases – Neglected dental cause of systemic diseases?
Time : 10:15-10:45
Biography:
Johann Lechner is a Dentist and a Naturopath. He is the Head of the Clinic for Integrative Dentistry in Munich, Germany since 1980. He is a Member of Executive Board of DAH (German Association for Research on Disturbance Fields and Regulation) and since 1982 Chairman of GZM (International Society for Holistic Dentistry). He has published numerous articles and nine books in German about holistic dentistry and integrative medicine. His researches focus on silent inflammation in jawbone and the implication to systemic diseases.
Abstract:
Background: Despite significant therapeutic advances most malignancies, as well as adenocarcinomas of the breast, remained incurable. At the same time, the importance of the microenvironment surrounding the tumor cells with "silent inflammation" increases.
Objective: To check the suspected tumor-relevant inflammatory cytokine sources in fatty-degenerative osteonecrotic jaw bone (FDOJ), we analyze these conspicuously altered jawbone areas to assess the expression and quantification of cytokine expression.
Material & Method: In 38 tumor patients we determine the levels of cytokines by bead-based Luminex® analysis in samples of FDOJ.
Results: A high content of chemokine RANTES/CCL5 (R/C) in all 38 jawbone tissue samples of cancer patients was observed. A single case is characterized by high R/C levels in FDOJ sample and simultaneously by metastasizing cells inside the FDOJ sample. The R/C expression in all 38 FDOJ samples on an average were 35 fold higher compared to healthy jawbone.
Discussion: R/C interacts on several levels in immune responses and is considered in scientific literature as pathogenetic key point in tumor growth. The study supports a potential mechanism where FDOJ is a mediating link specifically in breast cancer (MaCa) and its metastasis. R/C is thus involved intensively in oncogenic propulsion progress developments.
Conclusion: The authors conclude from the data of FDOJ analysis that these areas express hyperactivated signal transduction of the chemokine R/C, induce pathogenetic autoimmune processes in tumors, MaCa and its metastasis and serve as a possible cause. The authors hypothesize that such changes in areas of improper and incomplete wound healing in the jawbone may lead to hyperactivated signaling pathways, and result in unrecognized sources of silent inflammation which may contribute to systemic disease patterns like cancer. Combining the R/C signal induction of tumors and the information we collect illustrated, it may be suggested to involve FDOJ in an integrative concept for tumor therapy.
- Oral Implantology|Dental Case reports|Dental public health|Pediatric Dentistry|Oral and Maxillofacial Surgery
Location: Forum 11
Chair
Aliakbar Bahreman
University of Rochester, USA
Co-Chair
T P Chiang
Canada China Child Health Foundation, Canada
Session Introduction
Arthur D Goren and Iryna Branets
New York University College of Dentistry, United States
Title: Juvenile dosimetry of panoramic and CBCT imaging for visualizing root resorption
Time : 11:00-11:25
Biography:
1.
Dr. Arthur Goren is Clinical Professor, Department of Cariology and Comprehensive Care, NYU College of Dentistry; Clinical Associate Professor, Department of Prosthodontics and Digital Technology, Clinical Associate Professor, Department of Oral Biology and Pathology, School of Dental Medicine SUNY Stony Brook. He is also a Fellow of the American Academy of Oral And Maxillofacial Radiology. Dr. Goren is a past director of the Division of Radiology, School of Dental Medicine SUNY Stony Brook. He also has over 60 articles published in peer reviewed journals and over 75 published abstracts. He has lectured nationally and internationally on Radiology, plus being a reviewer in Radiology for many dental journals. Dr. Goren also has chaired several committees in the American Academy of Oral and Maxillofacial Radiology. He also has had several research grants.
2.
Iryna Branets, DDS is a Clinical Educator in the Department of Cariology and Comprehensive Care, New York University College of Dentistry. Dr. Branets graduated from the Medical University, Ivano-Frankivsk, Ukraine and New York University College of Dentistry. Dr. Branets is a member of the American Dental Association, American Academy of Oral and Maxillofacial Radiology and the American Academy of Facial Esthetics. Research interests are radiation dosimetry, radiation dose reduction and radiation image quality.
Abstract:
Background: No studies have been done to evaluate radiation exposure to a 10 year old juvenile CIRS phantom using OSL dot dosimetry in conjunction with leaded glasses and thyroid shield, utilizing two and three dimensional imaging for orthodontic purposes.
Methods: A juvenile anthropomorphic phantom corresponding to a 10 year old male was used for all exposures. Panoramic radiographs were taken on a Sirona Orthophos XG machine and CBCT scans were taken on a Carestream Kodak 9000 3D machine. The preset pediatric settings were used and with the CBCT, the field of view selected was to image the anterior maxilla, showing the canines and the surrounding area. The images were performed with and without leaded glasses and thyroid shield. Dosimetry was performed using optically stimulated luminescent (OSL) dosimeters. The effective radiation dose was calculated for the organs of the head and neck. Organ fractions irradiated were determined from ICRP-89. Overall effective doses were calculated in micro-Sieverts for the results and were based on the ICRP-103 tissue weighting factors.
Results: The effective doses measured with the panoramic images were significantly less when compared to the CBCT scans. The highest organ dose exposures were in the salivary glands, oral mucosa, and extrathoracic airway. The use of leaded glasses and thyroid shield resulted in a dose reduction of 25% with both the Sirona Orthophos XG and the Kodak 9000 3D machines.
Conclusion: This was the first study to evaluate radiation exposure to a 10 year old juvenile CIRS phantom using OSL dot dosimetry in conjunction with leaded glasses and thyroid shield, using two and three dimensional imaging for orthodontic purposes. Restricting field of view to the anterior maxillary region allows CBCT imaging to be used in specific clinical situations when three dimensional assessment of the presence and severity of root resorption is necessary.
Hiba Asrar
King’s College London, UK
Title: Signaling involved in blood vessel regulation during early tooth development
Time : 11:25-11:50
Biography:
Hiba Asrar has studied the early developmental signaling pathways in the body and how these pathways are regulated in the Department of Craniofacial Development and Stem Cell Biology at King’s College London, UK. Being exposed to recent genetic advancements and laboratory techniques focusing on the potential use of stem cells for various medical therapies has allowed her to further investigate the cellular pathways involved in tooth development and related pathologies.
Abstract:
The vitality of a bio-engineered tooth is a major challenge in regenerative dentistry. The importance of migration and development of blood vessels is essential for tooth survival and optimum function. Blood vessels are a mechanism for transferring oxygen, removing waste and providing a source of nutrients for the dental apparatus. Little research has been done to understand the signaling involved in the migration of blood vessels in early tooth development. However, it is known that Wnt and TGFβ1 signaling are key pathways involved in tooth development. In this research we show that Wnt and Tgfβ1 control vascularization of the tooth by regulating the timing of endothelial cell migration into the dental papilla. In addition to these key signaling pathways, semaphorins have been reported to be involved in vascular patterning. The semaphorin class 3 family has been reported to be essential for regulating the vascular system, with mice with mutations in semaphorin 3F displaying vascular defects. Wnt4 and TGFb1 have been shown to induce semaphorin 3A expression in the dental mesenchyme at early stages. Therefore, we aimed to analyze the molecular mechanisms by which Wnt and TGFb regulate dental papilla vascularization, and whether these signals act via regulation of semaphorin expression. Experiments performed in Mesp1-cre/tdTomato mice, to provide live imaging of the forming vasculature, show that, Wnt and TGFb signaling controls semaphorin3f expression and influence endothelial cell migration into the dental papilla. Future experiments will address the interaction between Wnt and VEGF in dental papilla vascularization. We will analyze the role of cell migration and cell division in this process, taking advantage of time laps live imaging in Mesp1cre/tdTomato and Mesp1cre/Fucci2a tooth explants. This study further enhances our understanding of the underlying mechanism involved in the development of blood vessels in the tooth which will aid in the future of fabricating a successful bioengineered tooth.
Nilufer Balcioglu
Istanbul university, Turkey
Title: Recent update to the augmentation procedures in oral implantology
Time : 11:50-12:15
Biography:
Nilufer Balcioglu is an Associate Professor in the Department of Oral Implantology at Istanbul University, Faculty of Dentistry. She has completed her Graduation and PhD degree in the Faculty of Dentistry. She has given lectures as an Invited Speaker in various symposiums, particularly about PRF and bone augmentation.
Abstract:
The most important factors that affect the long term success of implants are adequate soft and hard tissue volume. Implant operations can be classified as relatively easy operations if adequate tissue volume is available. However, in cases with insufficient soft and hard tissue volume, augmentation procedures are required before implant surgery. In addition, resorption can be avoided by biomaterials placed in the extraction socket in planned tooth extraction. In this presentation, current biomaterials and surgical techniques used for augmentation will be explained with case presentations.
Raphael Boudas
Strasbourg University, France
Title: Bonding bridge ceramic on veneer in failure implant case for young adult or teenager: Case report
Time : 12:15-12:40
Biography:
Raphael Boudas has completed his DMD at Strasbourg University and Post-doctoral studies in Aesthetic Dentistry at Strasbourg University School of Dental Medicine. He is Dental Surgeon Specialist in Dental Cosmetic and Global Rehabilitation at private practice. He is member of MIMESIS specialist group in aesthetic dentistry with French language. He has published three papers in reputed journals.
Abstract:
The new techniques of bonding ceramic by ARC adhesive restoration in ceramic created a wonderful opportunity for new treatment in pediatric dentistry and treatment of aesthetics cases. The aim of this study is to illustrate solutions for trauma causes in anterior sector by new techniques which are invasive in case where there is no possibility of implantology. The approach of the smile restoration of teenagers or young adult would be revolutionized for anterior unitary edentulous by technique of bonding bridge ceramic with base in lithium disilicate associated with technique veneers. So, the techniques which were predominant were bonding bridge with one fin in metal. Today, the more innovating techniques initiated by Dr. Gil Tirlet (Paris, France) are for the cases which requires aesthetic integration for the use of bonding bridge ceramic in lithium disilicate associated with or without veneers. The problem in case of children or teenagers having suffered a trauma from accidents or a tooth loss due to a pathological process is to find a solution to restore the smile in a sustainable manner for the child. Apart from that, surgical implant treatment is not always possible mainly because of the facial growth preventing notably for the boy to realize an implant until an advanced age. In spite of that the surgical site does not always permit the placement of an implant in favorable conditions despite the techniques of bone grafting. This article proposes to expose this new technique of bonded ceramic bridge to a fin as a reference treatment of the unitary edentulous in aesthetic sector making it possible to rehabilitate in a sustainable and non-invasive manner the smile of the teenagers.
- Pediatric Dentistry|Oral Cancer|Oral Implantology|Endodontics|Prosthodontics
Location: Forum 11
Session Introduction
Heidy Stefanie Yonathan
Padjadjaran University, Indonesia
Title: Correlation between family economic status and dental caries risk aged 0-3 years: A study to prevent caries in the earliest age
Time : 13:40-14:05
Biography:
Heidy Stefanie Yonathan is a Valedictorian and has completed her Bachelor of Dental Science at Padjadjaran University, Bandung, Indonesia. She has won national and international awards, such as: 1st place in 13th Student Scientific Conference Universiti Sains Malaysia in 2015 and; a runner up of Padjajaran University Faculty of Dentistry Award as Mahasiswa Berprestasi in Indonesia in 2014. Currently, she is employed as a Co-assistant at Padjadjaran University Dental Hospital in Bandung, Indonesia.
Abstract:
Family economic status is an important indicator to determine dental caries in children, especially in their younger age, or 0-3 years. This study aimed to see the correlation between family economic status and dental caries risk in children aged 0-3 years, using caries-risk assessment, as a method to prevent caries in the earliest age. This analytical correlational study used multistage random sampling technique. Family economic status and dental caries risk were measured in 109 children aged 0-3 years, which had been registered in 5 mother-children integrated center (Posyandu) Bandung City, using scale, based on Nielsen Media Research and American Academy of Pediatric Dentistry’s Caries-risk Assessment Tool. The correlation of variables was analyzed using Wilcoxon Signed Rank Test. The result showed that children with low family economic status have high dental caries risk. Statistic calculation using Wilcoxon Signed Rank Test with α=5% showed coefficient correlation Z=-8,315, with significance p-value=0.000. The conclusion of this study shows that there is correlation between family economic status and dental caries risk aged 0-3 years, which is, the lower the family economic status, the higher the dental caries risk.
Beliz Guray
Istanbul University, Turkey
Title: Positional assessment of impacted canines: A CBCT study
Time : 14:05-14:30
Biography:
Beliz Güray completed her Graduation from Faculty of Dentistry, Yeditepe University in 2011. She started her career in Department of Oral and Maxillofacial Radiology at Istanbul University, since 2013. Presently, she is an Assistant Professor at Istanbul University.
Abstract:
Impacted canines as being eruptive disorders are usually painless and do not have symptoms, however, some clinical implications associated have been defined. Impaction of canines may be found in both jaws; while maxillary impacted canines are more common than the mandibular ones. Most of the cases are unilateral. Even though panoramic radiography is an accepted technique for the examination of the impacted teeth it is not an ideal imaging method depending on various reasons. The localization of the impacted teeth or the resorption, internal or external, might not be assessed completely by means of panoramic radiography. Therefore, cone beam computed tomography (CBCT) remains as an excellent technique for the positional assessment, and resorptional consideration. The present study would reveal the incidence and morphological characteristics of impacted canines and their clinical features on panoramic and CBCT imaging in a Turkish population with a comparative approach. Since the early diagnosis of impacted canines has clinically a paramount importance, these data including the incidence and localizations would cab be added to the literature.
Cosimo Nardi
University of Florence, Italy
Title: The role of cone beam CT with large field of view in Goldenhar syndrome
Time : 14:30-14:55
Biography:
Cosimo Nardi is a Medical Doctor, specialized in Radiodiagnosis at University of Florence, Italy. He is a PhD student expert in Dentomaxillofacial Imaging. He is an Author of book entitled “Dental and oral-maxillo-facial imaging” and 11 papers in reputed journals. Furthermore, he is a Reviewer for some prestigious international dental and radiological journals.
Abstract:
Introduction: Goldenhar syndrome is a rare disease with hemifacial microsomia and craniofacial disorders originating from the first and second branchial arches such as ocular, auricular and vertebral anomalies. Complexity and variety of the spectrum of disease presentation usually require several examinations. This study aimed to evaluate the efficacy of cone beam CT in Goldenhar syndrome.
Methods: Ten patients (7–14 years) were evaluated via NewTom5G CBCT with large field of view (18x16 cm). Ten anatomical facial landmarks were identified to measure the following distances, bilaterally: sella turcica (ST)-mandibular angle, ST-condyle, ST-mastoid, ST-mental foramen, ST-frontozygomatic suture, ST-zygomaticotemporal suture, ST-zygomaticofacial foramen, ST-sphenopalatine fossa, mandibular angle-mandibular symphysis, and mandibular angle-condyle. The following six volumes were calculated, bilaterally: orbit, maxillary sinus, condyle, external ear canal, middle ear, and internal auditory canal. The aforementioned linear and volumetric measurements were performed to assess skeletal asymmetries comparing the non-affected side with the affected side by Wilcoxon test. Cervical spine anomalies were classified in fusion anomalies and posterior arch deficiencies.
Results: All patients showed a deficit of skeletal development in the affected side. Statistically significant differences between the non-affected side and affected side (p-value=0.043) were recorded for all measurements, except for ST-frontozygomatic suture, mandibular angle-mandibular symphysis, and maxillary sinus volume. Vertebral fusion anomalies and posterior arch deficiencies were found in seven and four patients, respectively.
Conclusions: CBCT with large field of view was able to (1) accurately identify craniofacial and vertebral skeletal anomalies at one time, and (2) quantify asymmetries between non-affected side and affected side providing quantitative data appropriate for maxillofacial medical/surgical planning.
Ilknur Ozcan
Istanbul University, Turkey
Title: The relationship among concha bullosa, mucosal thickening and maxillary sinusitis based on CBCT finding
Time : 14:55-15:20
Biography:
Ilknur Ozcan has completed her PhD in Department of Oral and Maxillofacial Radiology at Istanbul University in 1991. She has published more than 30 papers in reputed journals and has supervised many PhD theses. She is the Head of Department of Oral and Maxillofacial Radiology at Istanbul University.
Abstract:
Concha bullosa (CB) or middle turbinate pneumatization is one of the most common variations of sinonasal anatomy. The frequency of concha bullosa has been reported between 14-53% in previous studies. Several authors have assessed the relationship between sinonasal anatomic variants and the incidence of sinusitis. The purpose of this study is to evaluate the prevalence and types of concha bullosa and determine its relationship with mucosal thickening and maxillary sinusitis. 2140 CBCT scans taken at Istanbul University Faculty of Dentistry from December 2015 to April 2017 were retrospectively reviewed for the presence of concha bullosa, mucosal thickening of maxillary sinus and maxillary sinusitis. 250 patients have concha bullosa (127 unilateral, 123 bilateral), 57 patients have mucosal thickening and 15 of patients who had concha bullosa also had evidence of maxillary sinusitis. Although the presence of concha bullosa may be a risk factor for inflammatory diseases of paranasal sinus, concha bullosa is not significantly related to maxillary sinusitis.
Mehmet Sefa Hacibektasoglu
Istanbul University, Turkey
Title: Oral implant surgery in patients on medications
Time : 15:35-16:00
Biography:
Mehmet Sefa Hacibektasoglu has completed his Dentistry Graduate Education from the Faculty of Dentistry, Marmara University. He started his PhD in Department of Oral Implantology at Istanbul University in 2016 and is currently, working in Department of Oral Implantology at Istanbul University.
Abstract:
Considering oral implant surgery in patients with systemic diseases might be a challenge in certain cases. Medical evaluation of dental implant patients should be perfectly evaluated in order to avoid major complications and achieve better outcomes. One of the main factors that should be assessed in the medical evaluation of these patients is the use of drugs by patients. The pharmacological effects of common medications used by the patient, the complications that the implant can cause, and the precautions to take are absolutely necessary to be considered by the surgeon. Particularly, certain medications used in the treatment of diseases such as type II diabetes mellitus, hypertension, heart disorders and osteoporosis expose some risks for implant therapy. In this presentation; dental implant planning, some critical factors to be considered in the surgical stage and the success of implant placement in patients who are on various medications will be evaluated.
Quazi Billur Rahman
Banganbandhu Sheikh Mujib Medical University, Bangladesh
Title: Update in management of oral cancer - Our experience
Time : 16:00-16:25
Biography:
Dr. Quazi Billur Rahman studied PHD at Omsk State Medical Academy. He studied Dentistry at Tver State Medical Academy. He Went to Sripur Degree College, Magura. Currently he was the Professor & Chairman at BSMMU (Banganbandhu Sheikh Mujib Medical University), Dhaka, Bangladesh.
Abstract:
Oral cancer is one of the common neoplasm among the all malignancies occur in the human body. Squamous cell carcinoma accounts for more than 90 percent of all oral malignancies. This malignant lesion can arise in any part or oral cavity and frequently occur in the area of buccal mucosa including sulcus, retro molar trigon, tongue and floor of the mouth. The smokeless tobacco especially user of betel nut is still the prime causative factor of the oral squamous cell carcinoma in our country. The management of oral cancer should be coordinated by a multidisciplinary team, including oral and maxillofacial surgeons, oncologists, radiotherapists, speech therapists and other personnel involved in rehabilitation. The choice of treatment depends on a number of factors including patient preference, biological age, general health, site and staging of tumor. Biopsy followed by histopathological study is still the main procedure for confirmative diagnosis of the oral cancer. At the same time, the conventional CT scan and MRI are remaining as the main investigative procedure for detection of invasion in hard and soft tissues. The PET CT scan added the new dimension in detection of metastasis and primary lesion. Although, the conventional FNAC is the prime procedure for detection of lymph node metastasis, nowadays ultrasound and CT guided FNAC and lymphoscintigraphy are the remarkable procedures in detection of poorly or confusingly palpable lymph nodes. Management of the primary lesion, regional nodal and distant metastasis is the three major components of the treatment of the oral cancer. Wide three dimensional surgical excision of the primary lesion followed by neck dissection is still the main protocol of treatment for all operable cases. 3-D tissue defect is an obvious issue in surgical management of oral cancer. Anatomical and functional deficiencies due to fibrosis and scar formation, muscle contraction and trismus, deviation of lower jaw and occlusal disharmony are the ultimate results without proper reconstruction of tissue defects. This anatomical and functional deficiencies increase significantly after additional adjuvant radiation therapy and chemotherapy in postoperativehttps://annualmeeting.conferenceseries.com/dentists/ period oral cancer. For this reason the reconstruction is a major concerning issue in treatment oral and maxillofacial cancer and there no alternative of flap surgery for better treatment outcome.