THE HARLEY TECHNICIANS STUDY CLUB – Orthognatic Surgery Leave a comment

The Harley Technicians Study Club met again in November for an evening of sharing experiences and new ideas – or just ideas not ordinarily covered in their day-today laboratory work. The group has been in existence since 1947,  when a group of technicians got together to share with each other their experiences and knowledge in their mutual
interest of restorative dental technology, and the day-to-day changes and differences they experienced. The association has gone from strength to strength over the years, and continues to invite interesting and interested
speakers from all areas of dentistry.

This group of interested technicians has been meeting on a monthly basis for a very long time, due to celebrate their 70th birthday next year, just like this magazine – and certainly longer than any other technicians’ group anywhere in the country! You can access their running schedule by going online to www.htsc.info and checking out their  published list of future meetings.

As an IDEA Centre and learning provider, the format makes it enjoyable and interesting to keep up to date and gather the necessary verifiable and certificated CPD provided to all those who attend on club nights. You can join and become a regular member, or attend as a guest (which is a bit more expensive). All the dental team are welcome, and it is a worthwhile few hours a month socialising and learning amongst your colleagues in dentistry.

This November, I attended at 11 Chandos Street, London W1, to listen to Daniel Shaw, Maxillofacial Laboratory Manager from the Maxillofacial Department of Chesterfield Royal Hospital, speaking on his role in planning for orthognatic  surgery. We are all aware of the potential for mal-formed jaws and jaw relationships, but Daniel and his colleagues at Chesterfield deal with those cases that are well beyond the normal restorative solutions and in need of serious
bone shape and position alteration. Usually these cases are referred by dentists and often via a specialist orthodontist.

Daniel spoke of the various techniques available for designing and preparing for surgical alteration, which often involves major movement of both jaws with due care for the vital anatomical structure involved. Sometimes the distances being covered by the required movement are in excess of 15mm. Daniel described the phenomena of osseo-distraction whereby separated sections of the jaws are moved slowly by screw adjustable splints over many days, with the bone forming the new structures during healing. Clearly this is an area of reconstructive dentistry
which requires teamwork and clear lines of communication. The technician, in collaboration with the surgical team, must construct guiding and retaining splints to position the jaw sections in harmony with the planned  repositioning.

Using his study models constructed as split casts, the amount of movement is agreed and built into the split casts with the sections retained by magnets, a form of LEGO blocks, or a combination of both.

The working casts are carefully mounted and the required alterations carried out with various splints, some as thin as bite wafers, being used to accurately locate the teeth to the desired relationship as a guide for the bone positioning. Clearly there is a very close and trusting relationship required between the various disciplines of technical and clinical expertise in order to understand the difficulties and challenges each faces for the ultimate restoration according to the patients’ needs and wishes. It is truly a most interesting and demanding aspect of technical dentistry with the patients’ eventual restoration very much in the hands of the technical support.

We are of course in the age of digital techniques, and Daniel went on to cover the use of such within the orthognatic surgical planning and reconstructive area. He presented interesting and dramatic images of the patient and the virtual result, having included the radiographic and scanning information as part of the treatment planning process. This underlines the advantages of virtual planning and the noninvasive nature of the method but, just like us, there is a learning curve for all involved to make the most of the advantages offered by combining both the traditional and the  innovative digital techniques to improve the outcome for the patient. As digital applications improve and the  potential for more accurate and dependable techniques are developed it will become even more necessary for technical input into the planning, maintaining that vital link between the imagined and the realistic.

It really was a very interesting and stimulating evening, which is what the HTSC has become known and respected for. There was yet again a good turn out and as usual the catering was excellent.

Considering the study club has been there for so long and also considering it is welcoming to any one involved in the dental team, I am amazed more people have not made a bigger effort to be involved! It takes place each month at the same address at the Royal Society of Medicine, 11 Chandos Street, London W1. Refreshments are provided after
the speaker finishes and there is a lively and very friendly group of professional technicians from many of the technical disciplines meeting to enjoy the learning and the social interaction – and together with a CPD certificate for each person who attends. They invite very many well known speakers from clinical and technical dentistry and are a great source of interested discussion on the political, technical and everyday involvement in restorative and Technical dentistry.

If you are interested in attending, please phone 020 8902 4775 and speak to Teresa.