16 International Keynote Speakers
CV Eddy Becking
• Professor and head of the residency training program in Oral and Maxillofacial Surgery at the department of Oral and Maxillofacial Surgery of the Amsterdam University Medical Centre, and the Academic Centre for Dentistry Amsterdam (ACTA), the Netherlands
• Consultant and co-founder of Oral and Maxillofacial Surgeon, MKA Kennemer & Meer Haarlem, the Netherlands
Eddy Becking (MD, DDS, PhD, FEBOMFS) studied dentistry in Groningen and medicine at VUmc Amsterdam, the Netherlands, was trained in Oral and Maxillofacial Surgery (1992) in the VU medical center in Amsterdam. His PhD thesis (VU, 1998) was on orthognathic surgery. He was appointed Fellow of the European Board of Oral and Maxillofacial Surgeons (Edinburgh,2000) and International Fellow of the American Academy of Craniomaxillofacial Surgeons (2020). Since 2001 he is working as a consultant Oral and Maxillofacial in Haarlem. He is full professor in growth and developmental disorders of the oral and maxillofacial region the Amsterdam University Medical Centre and ACTA since 2011. From 2014-2020 he was international president of the Strassbourg Osteosynthesis Research Group (S.O.R.G.) and is currently still active as member of the SORG board. He is president of the board of the Dutch Association for Oral and Maxillofacial Surgery.
His clinical and scientifical interests are facial asymmetry, orthognathic surgery and orbito-craniofacial surgery and reconstruction including computer assisted planning and navigational surgery. He authored many scientific, peer-reviewed publications and book chapters. He is a renowned international invitational lecturer on orthognathic surgery, diagnosis and management of asymmetry and reconstruction. He is keen on communicating pitfalls, complications and trick in orthognathic surgery.
Complications in orthognathic surgery: case selection
Unfortunately complications cannot be prevented in orthognathic surgery (OGS). Contemporary social media and even more scientific presentations may present an illusional image of limitless possibilities for improving, especially, facial esthetics with OGS which, in name, has been upgraded to Orthofacial Surgery (OFS). This all tends to lead to higher expectations, demands and attracts different patient categories to match at individual orthofacial consultations and it needs a deepened cooperation between orthodontists and maxillofacial surgeons.
Case selection is the first and probably most important step in preventing complications in OFS. In a classification for origin of complications, patient-factors, technical factors and system factors can be identified. Technical factors are far most represented in both orthodontics and surgical platforms: “what happened and how I fix it”. System related flaws have become very apparent in pandemic times with delay’s, organisational and financial draw-backs.
Patient factors in complications are unmistaken correlated with case-selection. First of all, the psycho-social contours need to be explored to match demands, indications and possibilities. Any mistake made builds in high risks to result in disappointment. Most appealing challenge is of course to identify body dysmorphic disorders, but also different psycho-social issues influence decision-making and sublimation of problems towards facial dysmorphia. An import factor in this category is grinding and clenching, this may produce complications in fixation and bone-healing and may lead to re-operations with higher morbidity. Precautions can and need to be made in these situations
General medical issues need to be addressed as usual in any surgical work-up and may be of tremendous influence on outcomes, including life-treathening situations. For orthofacial surgery some specifics need to be addressed, like obstructive sleep apnea, motoric disturbances of the facial and masticatory musculature.
Anatomic malformations which hamper routine orthognathic procedures need to identified on beforehand. In this respect CBCT scanning has made an extraordinary positive impact on identifying anatomic deviations which may prevent complications like bad splits, lack of fixation options, pre-existing sinusitis and nerve relationships.
Prevention is paramount, however complications are part of life and will occur. Sharing and discussing them among professionals, instead of ignoring and hiding is extremely important to steepen the learning curve of oneself and many others.