Perth Children’s Hospital 2023 Residents’ Conference 10-12 August 2023
Cleft and Craniofacial Conference
2019 PCH Cleft and Craniofacial Conference
2019 PCH Cleft and Craniofacial Conference
Cleft and Craniofacial Conference
Perth Children’s Hospital
2023 Residents’ Conference
A warm welcome to the Perth Children’s Hospital 2023 Residents’ Conference hosted by the Department of Dental Medicine at Perth Children’s Hospital.
This three day program draws upon the expertise of clinicians across a range of disciplines at the Cleft Lip and Palate Unit and the Craniofacial Unit predominantly from Perth Children’s Hospital (PCH).
Cleft Lip Palate Unit
The Cleft Lip and Palate Unit at Perth Children’s Hospital is the oldest cleft specialist unit in Australasia. The Cleft Unit was formed at Princess Margaret Hospital in 1956 under the leadership of Plastic and Reconstructive Surgeon Mr Harold McComb, who remained actively involved with cleft care well into the 1990s.
In 1966 our founding Orthodontist Bill Brogan commenced the journey to establish a multi-disciplinary team. He provided the leadership to establish the facilities necessary to deliver required patient care. His objectives were:
To introduce presurgical Orthopaedics.
To create a Dental Department with all the specialties represented. To promote a Team approach in the Dental Department, ensuring open communication between Plastic Surgery, ENT, Dental and Speech Pathology. Key was a monthly interdisciplinary format which continues to this day.
In the 1980s the introduction of a new Outpatient Department at PMH enabled Plastic, ENT, Dental and Speech services to be located in the same area, allowing easy communication. In the 1980s and 1990’s evidence-based protocols for Alveolar Bone Grafting were developed and form the bedrock of clinical practice today.
Across the decades of the 2000’s and 2010’s the Unit engaged research, development and deployment of digital transformations to clinical practice. Important psychosocial research findings were embraced. Going forward in an age of pandemic, the Unit has responded to circumstances with Telehealth being incorporated to assist patients wherever they may live in the vast state of Western Australia. An aspect to telehealth is an emerging capability of virtual clinic to reach out to patients to measure, monitor and manage their treatment.
In 2018 the Unit relocated to the new Perth Children Hospital.
With our founding values of teamwork and communication, we gather in 2023 to learn about the various aspects that contribute to successful cleft and craniofacial outcomes.
Program
Thursday 10th August 2023
7:30 Registration
8:00 Welcome and Introduction
Dr John Winters, Chair of Dental Medicine, PCH
8:10 Antenatal Considerations
Dr David Gillett, Plastic, Reconstructive and Craniomaxillofacial Surgeon
8:50
9:20
9:50
Psychosocial Considerations
Dr Wendy Nicholls, Clinical Research Associate, PCH
Surgical Considerations: Cleft Lip
Dr Vijith Vijayasekaran, Plastic and Reconstructive Surgeon
Pre-surgical Orthopaedics
Dr John Winters, Paediatric Dentist
10:20 Morning Tea
10:50 Nasoalveolar Moulding
Dr Susan Needham, Orthodontist, RCH Melbourne
11:10
Surgical Considerations: Cleft Palate
Dr David Gillett, Plastic Reconstructive and Craniomaxillofacial Surgeon
11:40
Speech Considerations in Cleft
Ms Corina Gill, Senior Speech Pathologist, PCH
12:15 Lunch
12:40
Grand Round: Body Dysmorphia and Facial Appearance
Prof Martin Persson, Kristianstad University, Sweden
14:00
Alveolar Bone Graft Historical Development and Contemporary Considerations, Dr Steven Singer, Orthodontist
14:40 Afternoon Tea
15:10 Cleft, it’s more than a malocclusion: Considerations and Planning in Cleft Orthognathics
Dr Chris Wholley, Orthodontist
15:50 Assessment of Archform
Dr Jilen Patel
16: 20 Embryology Considerations: Typical and Disordered
Craniofacial Growth Development
Mr Mark Walters, Senior Research Scientist, PCH
17:00 Day 1 Concludes
Friday 11th August 2023
7:00 Registration
7:25 Introduction to Day 2
7:30 Rhinoplasty and Lip Revision in the Cleft Patient
Dr Guy Watts, Plastic, Reconstructive and Craniomaxillofacial Surgeon
8:00 ENT Considerations
Dr Hayley Herbert, Ear, Nose and Throat Surgeon
8:35
Surgical Technique – Craniosynostosis
Dr Tim Hewitt, Plastic Reconstructive Surgeon
9:05 Craniofacial Conditions and Surgical Considerations
Dr Ben Grave, Craniofacial and OMF Surgeon, Adelaide
9:45 Orthognathic Surgery
Dr Evan Kakulas, Oral & Maxillofacial Surgeon
10:20 Morning Tea
10:50 Orthognathics, Prof Michael Woods
11:20
Alveolar Bone Graft Surgery
Dr Linda Monshizadeh, Plastic, Reconstructive and Craniomaxillofacial Surgeon
11:45 History of Alveolar Bone Graft
Adj Prof Albert Tan
12:20 Lunch
12:45 Workshop 1: Speech Pathology (Open to all registrars/students)
13:30
Psychosocial Considerations
Prof Martin Persson, Kristianstad University, Sweden
14:30 Afternoon Tea
Friday
15:00
Stream 1
15:00 Dental
Malformations in Cleft
Dr Gregory Celine, Paediatric Dentist
15:20
15:20 Oligodontia
Clin A/Prof Glen
Liddelow, Prosthodontist
16:00
16:00 Placement of Benefit Temporary
Anchor Devices
Dr John Winters, Paediatric Dentist
16:30
16:30 Orthodontics
Dr Siva Vasudavan, Orthodontist
Stream 2
15:00 Paediatrics
Dr Jilen Patel, Paediatric Dentist
15:20 Ear Considerations for Cleft Palate Patients
Dr Alessandra Locatelli Smith, ENT
16:00 Airway
Dr Peter Ricciardo, Oral and Maxillofacial Surgeon
16:30 Oral Medicine
A/Prof Ramesh Balasubramaniam, Oral Medicine Specialist
Saturday 12th August 2023 - Registrar Workshops
8:30 Workshop 2b: Specialist Alveolar Bone Graft
Stream 3
15:00 Cleft
Prosthodontics
Dr Joshua Graieg, Prosthodontist
15:20 Oral Medicine
Dr Janina Christoforou Oral Medicine
15:45 Amelogenesis
Imperfecta
Dr Anna Buckeridge, Paediatric Dentist
16:10 Oral Surgery
Dr Nathan Vujcich, Oral and Maxillofacial Surgeon
16:40 Amelogenesis
Imperfecta
Dr Graham Carmichael, Prosthodontist
(restricted workshop for Registrars in Plastics, OMFS and Periodontics)
8:30 Workshop 3: Software used in Orthognathic Planning
(restricted workshop for Orthodontic and Surgical Registrars)
9:15 Workshop 4: Alveolar Bone Grafting
(restricted workshop for Paediatric Dental, Orthodontic and Surgical Registrars)
10:00 Morning tea
10:30 Workshop 5: Considerations and Timing of Orthognathic Surgery
(restricted workshop for Orthodontic and Surgical Registrars)
11:30 Workshop 6: Pre-Surgical Orthopaedics
(restricted workshop for Paediatric Dental, Orthodontic and Surgical Registrars)
12:30 Conference Concludes
Workshop 1
Speech Pathology (Open to all registrars/students)
12:45pm, Friday 11th August 2023
Presenter: Corina Gill Senior, Senior Speech Pathologist, PCH
Venue: Auditorium
Duration: 45 minutes
Objectives
Explore the variables that define speech
Key time points in Speech during growth, development and treatment
Content
Interactive workshop.
Explore speech characteristics of hypernasal, clarity intelligibility.
We will supply required teaching material
Please bring your best voice!
Outcomes
Students develop an appreciation of speech considerations in Cleft.
The role of the Speech Pathologist in the Cleft team. The importance of speech outcomes to a Cleft Patient.
Workshops 2a & 2b
Specialist Alveolar Bone Graft Sessions (Plastics Registrars)
Leader: Mr Mark Walters, Senior Research Scientist, PCH
Venue: tbc
2a 14:00pm, Friday 11th August
2:00 Anatomy and Histology of the Alveolar Cleft
Mr Mark Walters, Senior Research Scientist, PCH
2:20 Referral and the Multidisciplinary Clinic
Dr Chris Wholley, Orthodontist
2:40 Periodontic Preparation and Review
Dr Albert Tan and Dr Melanie McAlpine, Periodontists
3:20 Literature Review and Evidence for Current Management for Bone Healing in Alveolar Bone Graft
Dr Linda Monshizadeh, Craniofacial Plastic and Reconstructive Surgeon
3:40 Principles of Surgery (Consent and Compliance): Unilateral Cleft and Bilateral (Planning / Surgical steps / Post-surgical Care)
Dr David Gillett, Craniofacial Plastic and Reconstructive Surgeon
2b 8:30am, Saturday 12th August
8:30 Introduction to Workshop
9:00 Supervised Treatment Planning Session
9:30 Presentations of Proposed Surgical Approaches and Treatment Objectives
10:00 Morning Tea
10:30 Simulated Surgery on Models Session
12:00 Assessment and Discussion
12:30 Workshop Concludes
Workshop 3
Software used in Orthognathic Surgery Planning
Introduction to Digital Cephalometrics and Model Simulations
8:30am, Saturday 7th August
Presenters: Dr Christopher Wholley and Dr Steven Singer, Consultant Orthodontists
Venue: Auditorium
Duration: 45 minutes
Objective
This is an introductory class to the use of software commonly utilised in Orthognathic Surgery planning.
This class is in preparation for Workshop 4.
Content
Examine Dolphin Imaging and Suresmile
Dolphin Imaging
How to prepare a Cephalometric tracing
How to prepare a surgical treatment objective tracing
Creating Digital Model Simulations in Suresmile
Teaching materials will be provided
Access to computer terminal with Dolphin Imaging, Suresmile Software and patient records
Outcomes
Students will be familiarised with the software.
The software will be used in Workshop 5.
Workshop 4
Planning for Alveolar Bone Grafting
9:15am, Saturday 7th August
Presenters: Dr Christopher Wholley and Dr Steven Singer, Consultant Orthodontists
Venue: Auditorium
Duration: 45 minutes
Objective
Treatment planning of two cleft cases
Planning considerations for ABG
Timing of ABG surgery
Pre-surgical Orthodontics
Splinting
Content
Discussion of the criteria to determine timing and method of graft
Teaching materials will be provided
Clinical Photos, images, models
Outcomes
Students develop an appreciation of the purpose of ABG, and treatment considerations
Workshop 5
Considerations and Timing of Orthognathic Surgery
10:30am, Saturday 7th August
Presenters: Dr Christopher Wholley and Dr Steven Singer, Consultant Orthodontists
Duration: 60 minutes
Objective
Considerations and treatment planning for two cleft cases
Content
Discussion of the criteria to determine timing, method and options of orthognathic surgery
Teaching materials will be provided
Dolphin Imaging and Suresmile Clinical Photos, images, models
Outcomes
Students develop an appreciation of the considerations in Cleft Orthognathics
A computer-based training exercise Plan and prepare two cleft patients
Awareness of speech
Surgery first or traditional decompensation: when is it the right time?
Interdisciplinary considerations
Workshop 6
Pre-Surgical Orthopaedics
11:30am Saturday 7th August
Presenter: Dr John Winters, Paediatric Dentist
Venue: Auditorium
Duration: 45 to 60 minutes
Objective: Introduction to preparing, supervising and adjusting appliances for both methods of PSO and NAM.
Teaching materials will be provided
3D printed models
Wax, wax knives, heat source to allow blocking out Lab instruction sheet
Examples of lab work pre-prepared.
Content
Introduction lab talk to the steps for model preparation
Hands on exercise for students to block out 3d models
Students prepare lab slip
Students examine pre-prepared lab work
Outcome
Students develop an awareness of the fabrication steps and an awareness of the clinical issues.
Notes
Contributors
Dr John Winters Chair of Dental Medicine, Perth Children’s Hospital; Paediatric Dentist
Adj Prof Albert Tan Periodontist
Dr Alessandra Ear, Nose and Throat Surgeon Locatelli Smith
Dr Anna Buckeridge Paediatric Dentist
Dr Ben Grave Craniofacial and Oral & Maxillofacial Surgeon, Adelaide
Dr Chris Wholley Orthodontist
Ms Corina Gill Senior Speech Pathologist, PCH
Dr David Gillett Plastic, Reconstructive & Craniomaxillofacial Surgeon
Dr Evan Kakulas Oral & Maxillofacial Surgeon
Clin A/Prof Glen Liddelow Prosthodontist
Dr Graham Carmichael Prosthodontist
Dr Greg Celine Paediatric Dentist
Dr Guy Watts Plastic, Reconstructive & Craniomaxillofacial Surgeon
Dr Hayley Herbert Ear, Nose and Throat Surgeon
Dr Janina Christoforou Oral Medicine Specialist
Dr Jilen Patel Paediatric Dentist
Dr Joshua Graieg Prosthodontist
Dr Linda Monshizadeh Plastic, Reconstructive & Craniomaxillofacial Surgeon
Prof Martin Persson, Faculty of Health Science, Kristianstad University, Sweden
Dr Melanie McAlpine Periodontist
Mr Mark Walters Senior Research Scientist, PCH
Prof Michael Woods Orthodontist
Dr Nathan Vujcich Oral & Maxillofacial Surgeon
Dr Peter Ricciardo Oral & Maxillofacial Surgeon
A/Prof Ramesh Oral Medicine Specialist Balasubramaniam
Dr Siva Vasudavan Orthodontist
Dr Steven Singer Orthodontist
Dr Susan Needham Orthodontist, RCH Melbourne
Dr Tim Hewitt Plastic Reconstructive Surgeon
Dr Vijith Vijayasekaran Plastic, Reconstructive & Craniomaxillofacial Surgeon
Dr Wendy Nicholls Clinical Research Associate PCH
