Orofacial Disorders, Elective and Trauma

Details

Title

Orofacial Disorders, Elective and Trauma

Type

Stage One

Module code

HPE402

Requirement

Compulsory

Module objective

This module covers the planning of cases for orofacial surgery, the production of analogue and digital plans for orofacial surgery, and the oral and written advice the Consultant Clinical Scientist provides to the MDT. By the end of this module the Clinical Scientist in HSST will be able to analyse, synthesise, evaluate and apply their expert knowledge of orofacial disorder, trauma and their treatment, including the analysis of multimodal investigations (analogue and digital data), and be able to manipulate the data to provide concise simulated surgical plans for MDT discussions. They will be able to design devices for surgical planning and guidance to improve treatment outcomes. They should consistently demonstrate the attitudes and behaviours necessary for the role of a Consultant Clinical Scientist, prioritising patient safety and placing the patient at the centre of care.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will analyse, synthesise, critically evaluate and apply their expert knowledge with respect to:

• the anatomy of the mouth, jaws, and teeth, skull;
• the anatomy of the orofacial skeleton, nasal bones, orbit and contents;
• pathological disruption of the anatomy caused by orofacial disorders and trauma;
• genomics, genetics and disruption during embryological development;
• cephalometrics: skeletal and dental occlusal relationships, facial reference points; characteristics of orofacial syndromes and the analysis of this data;
• surgical procedures that may be undertaken and the risks associated with them;
• the devices used in surgery to stabilise osteotomies or fractures and the customisation of those for specific patients, e.g. custom adaption of a trauma plate in the laboratory;
• manufacturing techniques for the devices used to support the planning and surgery and the risks/benefits associated with them, e.g. laboratory made surgical wafers;
• the sterilisation protocols involved prior to theatre or clinical use and the various options available to suit the medical device, e.g. heat – low steam, or no heat – argon gas;
• legal and regulatory aspects of the devices manufactured;
• the process and principles of CAD when applied to orofacial surgery and trauma settings;
• the principles and function of custom and patient-specific devices utilised in orofacial disorders, e.g. vectors in bone transport distracters;
• the effects and presentation of biocompatibility/toxicity associated with implantable devices, e.g. titanium, hydroxyapatite, PEEK, etc.;
• the role of data interpretation in consenting patients for specific procedures in conjunction with the appropriate medical or dental consultant and MDT;
• the effects of the incorporation of these evolving technologies on the other services supported or carried out by Reconstructive Science on patient pathways;
• the range of stakeholders and their potential requirements, sensitivities and aspirations;
• the roles of regulatory agencies involved in monitoring and licensing of specific custom devices and their potential adverse effects (MHRA and hospital governance committees).

Technical and clinical skills

By the end of this module the Clinical Scientist in Reconstructive Science will be expected to reflect critically on their practice and knowledge of digital planning and manufacture used in Reconstructive Science. They will be expected to apply in practice a range of clinical technical and communication skills to design, manufacture and communicate effectively with patients, carers and the MDT.

Custom Device Manufacture

• manufacture and oversee the service delivery of a broad range of devices utilised in the management of orofacial disorders and facial trauma;
• develop innovative devices to support surgical techniques and solutions for planning in orofacial and trauma surgery;
• accurately purvey the required outcome for the patient to commercial companies after multidisciplinary discussions, acting as the liaison for the NHS in terms of design, manufacture and cost imperatives;
• have responsibility for the monitoring and licensing of specific custom devices and the communication with the regulatory agencies involved if there are any adverse effects (MHRA and hospital governance committees);
• be able to relate device design data to patients, carers and the MDT;
• remain up to date with MHRA alerts and respond appropriately.

Surgery Planning

As part of the multidisciplinary craniofacial team the Consultant Clinical Scientist in Reconstructive Science may undertake part of the patient assessment prior to orofacial surgical planning, including :

• dental facebow registration, dental impressions, preoperative occlusal registration and measurements to assist in the planning phase;
• manipulate multiple digital and analogue data sets such as soft tissue, bone, teeth and muscle to build a complex 3D planning environment;
• producing complex custom plans to analyse with the MDT, e.g. bi-maxillary osteotomy plans;
• use of CAD tools to show pre- and postoperative predictive planning;
• remain open to advice from other health professionals on the application of technology and computer design and manufacture;
• participate in adverse medical device events and reporting processes in relation to new innovative practice and implanted devices;
• analyse qualitatively and quantitatively the performance of planning and medical devices, using pre- and postoperative outcome comparisons .

Trauma Planning

The Clinical Scientist in HSST will also be able to select, use, interpret and adapt if necessary a range of tools and processes to ensure patient care is safe and meets the needs of the service users and will:

• assist the MDT assessment of the patient prior to trauma surgery intervention to facilitate planning, including dental models, preoperative occlusal registration and measurements to assist in the planning phase;
• analyse and interpret analogue and digital data of the head and neck for patients requiring trauma surgery;
• utilise 3D rapid prototyping and manufacture in the design and planning process to improve patient outcomes;
• manipulate multiple types of tissue, bone, teeth, muscle and soft tissue to build a complex 3D planning environment using CAD;
• review this planning data in a multidisciplinary environment, manipulating the data to show pre- and postoperative predictive planning;
• analyse qualitatively and quantitatively the performance of planning and medical devices, using pre- and postoperative outcome comparisons;
• analyse and critically appraise changes to services and interventions carried out or supported by Reconstructive Science, considering the perspective of patients and service users affected.

In addition they will be aware of their own attitudes, values, professional capabilities and ethics and critically reflect on (i) their professional practice and (ii) the challenges of applying research to practice in relation to these areas of practice, identifying opportunities to improve practice building on a critique of available evidence.