Although deliberate hypotension during surgery may potentially cause organ ischaemia, in particular of the myocardium and cerebrum, it is widely used as an adjuvant technique in oral and maxillofacial surgery aimed at reducing blood loss and improving the surgical field. Deliberate hypotension was reported as the fourth commonest cause...

Pyogenic granulomas are common benign fibrovascular growths of the oral cavity that are non-neoplastic in nature. They may also present as skin lesions. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Verrucous haemangioma is an uncommon congenital vascular malformation which may grow to large sizes. It has a characteristic hyperkeratotic and verrucous surface which resembles angiokeratoma circumscriptum. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Compound tibial fractures are high-energy traumatic injuries, which are frequently associated with high incidence of complications like infection and failure of bony union leading to amputation. The extent of injury is proportional to the magnitude of trauma. This article is available only as a PDF. Please click on “Download PDF”...

I have chosen as the title of my keynote address “New Treatment and Research Strategies for the Improvement of the Care of Cleft Lip and Palate Patients”. The reason for this is that despite the tremendous strides we have made over the past 50 years in the management of...

The aetiology of midfacial hypoplasia in patients with cleft lip and palate has been attributed in the literature to the surgical procedures used for the primary correction of these deformities. Ross reported that approximately 25% of patients developed maxillary hypoplasia that was refractory to orthodontic management alone. This article is...

Tooth avulsion, frequently of the maxillary central incisors, occurs most often in children from 7 to 9 years of age, when the periodontium surrounding the immature erupting teeth is loosely structured, providing minimal resistance to extrusive forces. Falls against hard objects, including those incurred during sports activities, are one...

Ameloblastoma is a benign but locally invasive tumour that affects the jaws. Although it is commonly regarded as a homogeneous group of tumours, detailed investigations have proven its clinicopathologic diversity. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Schimmelpenning syndrome (SS) is characterised by specific skin manifestations, skeletal defects, and central nervous system abnormalities, such as mental deficiency and seizures. Happle has shown that a clinical entity known as “epidermal nevus syndrome”, formerly used as an alternative term to SS, does not exist. This article is available only...

The value of computed tomography (CT) in craniofacial trauma is now well established with progress in imaging modalities. Three-dimensional (3-D) CT has changed the way craniofacial surgery is planned and its valuable contributions and limitations have been studied. This article is available only as a PDF. Please click on “Download...

The concept of distraction osteogenesis was championed by Ilizarov, beginning as early as 1954, for the treatment of a variety of congenital and acquired deformities of enchondral bone. In 1973, Snyder and associates reported on gradual distraction of the mandible using an extraoral device in canines. This article is available...

Secondary alveolar bone grafting, which was pioneered in Europe, was reported in the German literature at the beginning of this century. However, it was not until the 1970s that secondary or delayed bone grafting became popular in the United States. This article is available only as a PDF. Please click...

The management of craniomaxillofacial disorders is not complete without the proper documentation of clinical information and the storage of images. It is usually long-term and has many follow-up sessions. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

The current explosion of molecular biology encompassing genetics, morphogenesis, teratogenesis and pharmacogenomics for targeted drug therapy is about to have a profound impact upon the practice of medicine in the next century. A new discipline of molecular medicine is becoming a feature of clinical practice. This article is available only...

Most of the mucocutaneous diseases are confined to the stratified squamous epithelia and thus may involve oral, genital and other mucosae and skin. Most of these conditions are acquired and have an immunological basis but there is often a hereditary predisposition. This article is available only as a PDF. Please...

Form follows function and adaptation to physiologic demands dictates skeletal form. In the oro-facial region, tooth loss leads to atrophy of the alveolar arches in all planes. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Cranial bone defects can be a result of trauma, congenital defects, infection or iatrogenically induced by surgery. Even for patients with sufficient hair to cover the affected site, hair styling may not be sufficient to mask off the deficient external cranial contour. This article is available only as a PDF....

Fractures involving the orbits are frequent among facial injuries, making up to nearly 40% of the total. Within the wide range of severity, the small group of complex fractures (20% of the total) is responsible for most of the sequelae. This article is available only as a PDF. Please click...

With the advent of regional trauma centres and rapid air transport systems, a larger number of patients with extremely complex craniomaxillofacial trauma are now being seen. The problem of high-velocity facial injuries with multiple facial fractures concerns the severity of the bony injury. This article is available only as a...

The Furlow double opposing Z-plasty has gained considerable popularity since its introduction approximately a decade ago, and is currently a favoured method of both primary and secondary palatoplasty in many centres. Several theoretical advantages make this technique of cleft palate repair attractive. This article is available only as a PDF....

There are a variety of pathological conditions that present in the oral cavity. While clinical and radiographic examination will suggest a provisional diagnosis, histological examination is often required to confirm or exclude a suspected diagnosis. This article is available only as a PDF. Please click on “Download PDF” on top...

Multiple segment osteotomy (MSO) orthognathic surgery serves to combine total or segmental maxillary and mandibular correction of dentofacial deformities with concurrent diastematic procedures to provide immediate repositioning of dental-osseous elements. In addition, splitting the palate may often be necessary to correct a functionally poor relationship of the maxilla to...

With the control of most infectious diseases and malnutrition, congenital malformations are now one of the most important causes of morbidity and mortality among infants in Singapore. Children born with cleft deformities require specialised multidisciplinary care from infancy till adulthood. This article is available only as a PDF. Please click...

Craniofacial development is a complex multidimensional process that depends in large part on growth in the cranial base at several growth centres posteriorly and a suture anteriorly. Coordinated development of these sites produces the normal shape of the skull. This article is available only as a PDF. Please click on...

Cleft palate morphology and palatal dimensional changes due to growth and treatment have been analysed by numerous quantitative techniques. Many of these methods, however, produce two-dimensional measurements of the three-dimensional cleft palate deformity. This article is available only as a PDF. Please click on “Download PDF” on top to view...

Distraction osteogenesis is rapidly becoming a mainstream treatment modality for the early management of the patient with mandibular hypoplasia. Following early clinical experience with external distracters, intraoral buried internal distracters have been developed that offer specific advantages over the external device. This article is available only as a PDF. Please...

The mandible occupies a unique position in the facial skeleton, being both the aesthetic and functional foundation of the lower third of the face. Its prominence makes it particularly susceptible to trauma, and it is one of the most commonly fractured facial bones. This article is available only as a...

Apart from the nasal bone, the mandible is the most commonly fractured bone in the face. It is also the 10th most often broken bone in the body. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

The understanding of blood supply is the cornerstone of successful tissue transfer in reconstructive surgery. This understanding has been derived largely from cadaveric dissections, combined with injections to outline the blood supply. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

Allogeneic tissue and organ transplantation has long been an important medical issue, as it provides an effective treatment alternative for a broad spectrum of medical problems. It is essential to establish the animal models used for a specific type of allogeneic tissue or organ transplantation prior to its clinical...

The mandible is a unique bone in the human skeleton and occupies a prominent position in the craniofacial region. Traumatic injury to the face, especially in the lower third, may result in fractures of the mandible. This article is available only as a PDF. Please click on “Download PDF” on...

Large benign tumours of the breast cause gross enlargement with compression of normal breast tissue. Following removal of the tumour, the affected side has a large redundant skin envelope and the breast volume may be reduced or distorted compared with the normal side. This article is available only as a...

The spread of human immunodeficiency virus (HIV) disease has pursued a relentless course since it was first recognised in the early 1980s and if current trend continues, it is most likely to carry on well into the 21st century. Asia and South Asia are expected to shoulder the greatest...

In the last decades, the exponential growth in the sophistication of the medical/dental knowledge and technologies has made the current dental curriculum more cramped and inevitably compartmentalised. This paradigm shift has caused, globally and regionally, a great demand on dental schools to produce dentists who can differentiate the quality...

I would like to express my gratitude to the Chapter of Surgeons and the Academy of Medicine, Singapore for the honour of presenting this 5th Yahya Cohen Lecture. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Cleidocranial dysplasia is an autosomal dominant skeletal disorder characterized by short stature, brachycephaly, delayed closure of the fontanelles and sutures, Wormian bones, midface hypoplasia, unerupted teeth, supernumerary permanent teeth, aplasia or hypoplasia of the clavicles, and other skeletal anomalies, such as hypoplastic iliac wings and brachydactyly. This article is available...

A 19-year-old Indian male with a past history of “Ludwig’s angina” was seen at the Accident and Emergency Department of National University Hospital complaining of an acute swelling at the floor of the mouth for 2 days. The patient was seen the day before in an outpatient clinic and...

The floor of the mouth takes form as early as in the fourth week of gestation with the downward growth and subsequent degeneration of the ectoderm surrounding the peripheral of the tongue, forming the lingual sulcus separating the tongue and the floor of the mouth. The anterior boundary is...

Ameloblastoma is a true neoplasm of enamel organ type tissue which does not undergo differentiation to the point of enamel organ. This type of tumour occurs mostly in the mandible and grows slowly with variable clinical and histological characteristics, but it is histologically benign. This article is available only as...

Six patients with unusual presentations of head and neck disease were presented for diagnosis by discussants at the conference. Images were accompanied by brief details and the differential diagnosis was explored by the discussants. This article is available only as a PDF. Please click on “Download PDF” on top to...

The Internet is a global network of networks that connect computers all over the world, so that anyone from any point in the network can communicate with others on the network through a service provider. The Transmission Control Protocol/Internet Protocol (TCP/IP) and the World Wide Web (www) technology have...

Bisphosphonates are commonly prescribed for the treatment (and prevention) of postmenopausal and corticosteroid induced osteoporosis, Paget’s disease, hypercalcemia associated with malignancy and osteolysis (and bone pain) associated with metastatic bone disease (e.g. in metastatic breast and prostate cancers). This article is available only as a PDF. Please click on “Download...

Recurrent aphthous stomatitis (RAS) is a common condition of the oral mucosa of unknown aetiology. Several predisposing factors have been suggested including haematinic deficiencies, reactions to foodstuffs and local trauma. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Human immunodeficiency virus (HIV) infection is a major global health problem. It is estimated that the number of people living with HIV infection in India, by the end of 2002, is 4 to 5 million. This article is available only as a PDF. Please click on “Download PDF” on top...

Betel quid/areca nut use has been common in South and Southeast Asia and the Asia Pacific region for a long time and is common among migrated communities in Africa, Europe and North America. Because of its ancient history, its use is socially acceptable among all sections of society, including...

The primary function of the immune system of the mouth is to protect the teeth, jaws, gingivae and the rest of the oral mucosa against infection. The oral immune system is part of an extensive and specialised compartmentalised mucosa-associated lymphoid tissue (MALT). This article is available only as a PDF....

The practice of Dentistry in Singapore has advanced rapidly, with the development and recognition of several specialty practices, coupled with the support of established specialty training programmes abroad as well as locally. In this respect, the Academy of Medicine, Singapore (AMS) had led and played a pivotal role in...

Flap prefabrication is one of the most exciting areas in Plastic Surgery because of its bridging role between conventional reconstructive surgery and tissue engineering. Using this technique, tissues such as bone, cartilage, skin and muscle can be pre-assembled to form precise composites that will fit any defect. This article is...

We report a rare case of multi-focal ductal carcinoma in situ (DCIS) of the breast associated with Poland syndrome. A skin-sparing mastectomy of the left breast with immediate reconstruction using ipsilateral deep inferior epigastric perforator (DIEP) flap was performed. This article is available only as a PDF. Please click on...

Deformity refers to distortion of any part of the body. The term dentofacial is related to the dental arches and their effects on facial contours. Dentofacial deformity has been described as a deformity that affects primarily the jaws and dentition, although the mid and lower faces are also affected. This...

Benign lesions of the parotid gland constitute about 80% of parotid tumours. They include various lesions (Table 1), the commonest being pleomorphic adenoma, followed by adenolymphoma. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Diabetes mellitus (DM) is a common and growing global health problem. It is highly prevalent in Asian communities. Hong Kong, Pakistan, and Singapore are among the countries with the highest prevalence of diabetes in the adult population. This article is available only as a PDF. Please click on “Download PDF”...

During the growth and development of a person, the facial structures are primarily dependent on the genetic makeup and secondarily on the environmental factors. If the facial structures grow abnormally or disproportionately, a dentofacial deformity occurs. This article is available only as a PDF. Please click on “Download PDF” on...

The mandibular advancement device (MAD) consists of upper and lower splints attached to the teeth and postures the mandible forward. The rationale for use of the MAD is that the forward movement of the mandible moves the tongue forward since the tongue is attached to the genial tubercles of...

Vascular anomalies of the head and neck can be categorised as either haemangiomas or vascular malformations. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

The idea of having an Academy of Medicine in Singapore was first proposed by some 20 medical specialists on 19 July 1957 and was named then as “Academy of Physicians & Surgeons”. It was officially formed by 34 founding members (comprising Dental Surgeons, Physicians and Surgeons) and was renamed...

Breast reconstruction is an integral part of breast cancer management. One of the aims of breast reconstruction is the creation of a new breast that is aesthetically appealing and symmetrical to the opposite breast. This article is available only as a PDF. Please click on “Download PDF” on top to...

Osteomas are benign, slow-growing tumours of the bone which may be classified as solitary or multiple. Multiple osteomas are mainly associated with Gardner’s syndrome while solitary osteomas can be further classified as peripheral, central or extra skeletal depending on the origin. This article is available only as a PDF. Please...

Coronavirus disease 2019 (COVID-19) is caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was first reported to the World Health Organization (WHO) as pneumonia of unknown aetiology in the Chinese city of Wuhan on 31 December 2019. Since then, COVID-19 has spread across the globe and...