Heather Logan

Title: Maxillofacial prosthodontics - current concepts - the way we do it at iRSM

Maxillary and mandibular defects due to head and neck oncology treatment leave a trail of anatomic, functional and psychological deficiencies. Management of these defects includes surgical and/or prosthodontic modalities. Prosthodontic modalities permit monitoring of the defect site; however, the patient is constantly reminded of the defect and the disease.  Although feasible and preferable in smaller defects, Surgical closure with soft tissue does compromise prosthetic rehabilitation in a large defect due to poor prosthodontic support.

In larger defects, using bone-containing microvascular free flap transfer techniques has significantly improved jaw reconstruction in head and neck oncology.  However, there are challenges consisting of the accuracy of the position and insertion of bone flaps and the time scales for oral rehabilitation for these patients, which could extend anywhere from 3 – 5 years or more.  The advent of advanced digital technologies has allowed surgical management to be raised to new levels of precision and accuracy. This has led to combining the resection, reconstruction and rehabilitation pathways in head and neck oncology. It has significantly reduced oral rehabilitation times ranging from 6-12 months for benign conditions to 12-18 months for malignant diseases, along with its attendant improvements in function and aesthetics. 

To achieve this level of sophistication, along with the convergence of various technologies, it is important that a team of specialists from diverse fields carry out the planning and management.   At the Institute for Reconstructive Sciences in Medicine (iRSM), Edmonton, Canada, colleagues from Maxillofacial Prosthodontics, Head and Neck Surgery, Surgical Design and Simulation, Dental Lab Technology, among others, work with each other.  In this presentation series, we hope to share with our colleagues at the BSSPD Platinum Jubilee conference how our team leverages advanced digital technologies for better outcomes for our patients.

Aims and objectives:

• To understand the use of surgical design and simulation in planning jaw reconstruction and oral rehabilitation in head and neck oncology.
• To appreciate the need for a team of specialists to be involved in planning and management in head and neck oncology.
• To recognize the improved patient outcomes in head and neck oncology when advanced digital technologies are employed in its management.

Biography:
Heather completed her Bachelor of Design at the University of Alberta in 2009 and went on to finish a Master of Science in Rehabilitation Science with a specialization in surgical design and simulation at the UofA. Heather joined the Institute for Reconstructive Sciences in Medicine in 2012 as Surgical Design Simulationist. She holds an Adjunct Assistant Professor position at the University of Alberta in the Faculty of Rehabilitation Medicine. Heather’s clinical responsibilities involve design and fabrication of anatomical models and patient specific surgical guides and templates primarily in head and neck reconstruction, but she also has experience in other surgical disciplines. Her research interests are in the development and implementation of surgical design and simulation workflows and creating efficiency and effectiveness for the user with the intent to improve patient outcomes. Heather’s teaching experience includes courses in 3D Printing and the application of advanced digital technologies in surgical design and simulation workflows.