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COMMENTARY
Year : 2014  |  Volume : 7  |  Issue : 3  |  Page : 278  

Osteo-odonto-keratoplasty: A maxillofacial surgeon's perspective


Department of Oral and Maxillofacial Surgery, AME'S Dental College Hospital and Research Centre, Raichur, Karnataka, India

Date of Web Publication18-Mar-2014

Correspondence Address:
Yadavalli Guruprasad
Department of Oral and Maxillofacial Surgery, AME'S Dental College Hospital and Research Centre, Raichur - 584 103, Karnataka
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Guruprasad Y. Osteo-odonto-keratoplasty: A maxillofacial surgeon's perspective. Med J DY Patil Univ 2014;7:278

How to cite this URL:
Guruprasad Y. Osteo-odonto-keratoplasty: A maxillofacial surgeon's perspective. Med J DY Patil Univ [serial online] 2014 [cited 2021 Jan 19];7:278. Available from: https://www.mjdrdypu.org/text.asp?2014/7/3/278/128949

The publishing of the article "A new vision through combined osteo-odonto-keratoplasty (OOKP): A review" brings into focus that OOKP a combined oral and ocular procedure for treatment of end stage corneal blindness has evolved through the field of dentistry.

OOKP is a complex artificial cornea (keratoprosthetic) surgical procedure in which a dental root lamina and buccal mucosal graft are used to secure a clear acrylic optic cylinder in anterior segment of the eye. It was developed some 40 years ago by Strampelli and uses the patient's own tooth root and alveolar bone to support an optical cylinder. [1],[2] After a long interval the technique is finally gaining widespread recognition by corneal surgeons world-wide as the treatment of choice for patients with end stage inflammatory corneal disease. OOKP is based on the principle of using the patient's own tooth to form a biological frame to support an acrylic optic to restore sight in patients with end-stage ocular surface disease where conventional grafts fail due to vascularization, rejection or desiccation. In diseases with severe ocular surface inflammation and dry eyes this technique has been found to be more successful than other purely synthetic prostheses. [3],[4] Pre-surgical assessment requires a multidisciplinary team including an ophthalmologist, maxillofacial surgeon, radiologist, psychologist and other support staff. Maxillofacial surgeon plays a vital role in selecting buccal mucosal graft donor site and appropriate tooth to form dentin/bone lamina. Buccal mucosa with severe scarring may compromise the successful harvest and habits like smoking and betel nut chewing will compromise tissue quality. The ideal tooth for lamina is a healthy tooth with a single root and adequate alveolar bone. The surrounding anatomy is assessed to avoid possible complications and to reduce the cosmetic defect to a minimum. There also needs to be adequate space between the teeth to harvest the tooth without damage to its neighbor. The assessment therefore involves careful evaluation of these factors. The overall oral health with particular reference to oral hygiene and periodontal bone loss must be assessed.

 
  References Top

1.Strampelli B. Keratoprosthesis with osteodontal tissue. Am J Ophthalmol 1963;89:1029-39.  Back to cited text no. 1
    
2.Marchi V, Ricci R, Pecorella I, Ciardi A, Di Tondo U. Osteo-odonto-keratoprosthesis. Description of surgical technique with results in 85 patients. Cornea 1994;13:125-30.  Back to cited text no. 2
    
3.Liu C, Paul B, Tandon R, Lee E, Fong K, Mavrikakis I, et al. The osteo-odonto-keratoprosthesis (OOKP). Semin Ophthalmol 2005;20:113-28.  Back to cited text no. 3
    
4.Tay AB, Tan DT, Lye KW, Theng J, Parthasarathy A, Por YM. Osteo-odonto-keratoprosthesis surgery: A combined ocular-oral procedure for ocular blindness. Int J Oral Maxillofac Surg 2007;36:807-13.  Back to cited text no. 4
    




 

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