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EDITION 2 VOLUME ONE

ATLAS OF ORAL
AND MAXILLOFACIAL
SURGERY PAUL S. TIWANA, DDS, MD, MS,
FACS, FACD
Francis J. Reichmann Professor and Chair
Division of Oral & Maxillofacial Surgery
College of Dentistry;
Professor
Department of Surgery
College of Medicine
The University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma
United States

DEEPAK KADEMANI, DMD, MD, FACS

President and Medical Director
Minnesota Oral & Facial Surgery
Fellowship Director
Oral/Head & Neck Oncologic and Reconstructive Surgery
Minneapolis, Minnesota
United States
 EDITION 2 VOLUME TWO

ORAL
ATLAS OF

AND MAXILLOFACIAL
SURGERY PAUL S. TIWANA, DDS, MD, MS,
FACS, FACD
Francis J. Reichmann Professor and Chair
Division of Oral & Maxillofacial Surgery
College of Dentistry;
Professor
Department of Surgery
College of Medicine
The University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma
United States

DEEPAK KADEMANI, DMD, MD, FACS

President and Medical Director
Minnesota Oral & Facial Surgery
Fellowship Director
Oral/Head & Neck Oncologic and Reconstructive Surgery
Minneapolis, Minnesota
United States
Elsevier
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ATLAS OF ORAL AND MAXILLOFACIAL SURGERY, SECOND EDITION ISBN: 978-­0-­323-­78963-­9

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 This book is dedicated to the following individuals:
To my family for all your love and support.
To my patients who have given me the privilege to care for them.
To students of our specialty in their quest for knowledge.
Deepak Kademani

This book is dedicated to the following individuals:

To my family; especially my wife Karen, and my daughters Jespreet (17), and Simran (15).
To my former residents and fellows.
Paul S. Tiwana
Section Editors
Richard Allen Finn, DDS Paul S. Tiwana, DDS, MD, MS, FACS, FACD
Professor Francis J. Reichmann Professor and Chair
Oral and Maxillofacial Surgery Division Division of Oral & Maxillofacial Surgery
UT Southwestern Medical Center; College of Dentistry;
Chief Professor
Oral and Maxillofacial Surgery Department of Surgery
Veteran’s Administration North Texas College of Medicine
Dallas, Texas The University of Oklahoma Health Sciences Center
United States Oklahoma City, Oklahoma
Part I: Surgical Anatomy of the Head and Neck United States
Part V: Craniofacial Surgery
Deepak G. Krishnan, DDS, FACS
Associate Professor—Surgery Ghali E. Ghali, DDS, MD, FACS, FRCS(Ed)
Division of Oral Maxillofacial Surgery, Director
Department of Surgery Oral and Maxillofacial Surgery
University of Cincinnati; Willis Knighton Health System
Oral Maxillofacial Surgeon Shreveport, Louisiana
Cincinnati Children’s Hospital and Medical Center United States
Cincinnati, Ohio Part VI: Cleft Lip and Palate
United States
Part II: Oral Surgery Alan S. Herford, DDS, MD
Chairman and Professor
Martin B. Steed, DDS, FACS Oral and Maxillofacial Surgery
Professor and James B. Edwards Chair Loma Linda University
Department of Oral and Maxillofacial Surgery Loma Linda, California
Medical University of South Carolina United States
James B. Edwards College of Dental Medicine Part VII: Craniomaxillofacial Trauma
Charleston, South Carolina
United States Eric R. Carlson, DMD, MD, EdM, FACS
Part III: Implant Surgery Professor and Kelly L. Krahwinkel Chairman
Department of Oral and Maxillofacial Surgery
Steven M. Sullivan, DDS, FACS, FACD University of Tennessee Graduate School of Medicine;
Professor and Chair Director
Department of Surgical Sciences/Oral and Maxillofacial Oral/Head and Neck Oncologic Surgery Fellowship
Surgery University of Tennessee Cancer Institute
University of Oklahoma College of Dentistry Knoxville, Tennessee
Oklahoma City, Oklahoma United States
United States Part VIII: Benign Pathology
Part IV: Orthognathic Surgery

vi
 Section Editors vii

Deepak Kademani, DMD, MD, FACS Faisal A. Quereshy, MD, DDS, FACS
President and Medical Director Professor/Program Director
Minnesota Oral & Facial Surgery Oral & Maxillofacial Surgery
Fellowship Director Case Western Reserve University, Cleveland
Oral/Head & Neck Oncologic and Reconstructive Surgery Ohio
Minneapolis, Minnesota United States;
United States Medical Director
Part IX: Malignant Pathology Facial Cosmetic Surgery
Visage Surgical Institute/V-­Spa
Brent B. Ward, DDS, MD, FACS, FACD Medina, Ohio
Professor, Chair and Fellowship Program Director United States
Oral and Maxillofacial Surgery Part XII: Facial Cosmetic Surgery
University of Michigan
Ann Arbor, Michigan Joseph E. Cillo Jr., DMD, MPH, PhD, FACS
United States Division Chief and Program Director
Part X: Reconstructive Surgery Oral and Maxillofacial Surgery
Allegheny General Hospital;
Gary F. Bouloux, MD, DDS, MDSc, FRACDS, Associate Professor
FRACDS(OMS), FRCS (Eng), FACS Oral and Maxillofacial Surgery
J. David Allen Family Professor Allegheny General Hospital
Division Chief Pittsburgh, Pennsylvania
Oral and Maxillofacial Surgery United States
Department of Surgery Part XIII: Obstructive Sleep Apnea
Emory University School of Medicine
Atlanta, Georgia
United States
Part XI: TMJ Surgery
Contributors
A. Omar Abubaker, DMD, PhD Dror M. Allon, DMD
Professor and Chairman Director
Oral and Maxillofacial Surgery Orthognathic and TMJ Surgery Unit;
VCU Medical Center Senior Lecturer
Richmond, Virginia Oral and Maxillofacial Surgery
United States Tel Aviv University
Tel Aviv, Israel
Julio Acero, MD, DMD, PhD, FDSRCS, FEBOMFS
Full Professor Surgery Fernando Almeida, MD, PhD, DDS, FEBOMFS
Alcala University; Clinical Professor
Department Head Department of Surgery
Oral and Maxillofacial Surgery Alcalá University (UAH);
Ramon y Cajal University Hospital Oral & Maxillofacial Surgeon
Madrid, Spain Department of Oral and Maxillofacial Surgery
University Hospital Ramón y Cajal
Ravi Agarwal, DDS Madrid, Spain
Program Director
Oral & Maxillofacial Surgery Brian Alpert, DDS, FACS (Deceased)
Medstar Washington Hospital Center, Washington Professor of Oral and Maxillofacial Surgery
District of Columbia University of Louisville School of Dentistry
United States; Louisville, Kentucky
Chairman United States
Oral & Maxillofacial Surgery
Medstar Washington Hospital Center Mehmet Ali Altay, DDS, PhD
Washington, District of Columbia Associate Professor
United States Oral and Maxillofacial Surgery
Akdeniz University, School of Dentistry
Tara Aghaloo, DDS, MD, PhD Antalya, Turkey
Professor
Oral and Maxillofacial Surgery Felix Jose Amarista, DDS
UCLA School of Dentistry Assistant Professor
Los Angeles, California Department of Oral and Maxillofacial Surgery
United States UT Health San Antonio
San Antonio, Texas
Maryam Akbari, DMD, MD, MPH United States
Oral and Maxillofacial Surgery
Mount Sinai Hatem Amer, MD
New York, New York Associate Professor of Medicine
United States Division of Nephrology and Hypertension and
The William J von Liebig Center for Transplantation and
Kyle P. Allen, MD, MPH Clinical Regeneration
Tampa Bay Hearing and Balance Center; Mayo Clinic
Assistant Clinical Professor Rochester, Minnesota
Otolaryngology—Head and Neck Surgery United States
University of South Florida
Tampa, Florida
United States

viii
 Contributors ix

Suganya Appugounder DMD, MS, FACS, MAJ, USAR, DC
Cleft and Craniofacial Surgery
Charleston Area Medical Center
Charleston, West Virginia
United States
Shahrokh C. Bagheri, DMD, MD, FACS
Oral and Maxillofacial Surgeon
Georgia Oral and Facial Surgery
Atlanta, Georgia
United States

Shyam Prasad Aravindaksha, BDS, MDS Jonathan Bailey, DMD, MD, FACS
Private Practice Clinical Professor
Oral Maxillofacial Surgery Department of Surgery
Greater Michigan Oral Surgeons Carle Illinois College of Medicine;
Flint, Michigan Associate Medical Director of Specialty Surgery
United States Division of Oral and Maxillofacial Surgery and Division of
Head and Neck Cancer
Sharon Aronovich, DMD Carle Foundation Hospital
Clinical Associate Professor Urbana, Illinois
Oral and Maxillofacial Surgery United States
University of Michigan
Ann Arbor, Michigan Andrew M. Baker, MD, DDS
United States Oral and Maxillofacial Surgery
Providence Cancer Institute
Leon Assael, BA, DMD, CMM Portland, Oregon
Professor Emeritus United States
Oral and Maxillofacial Surgery
Oregon Health & Science University Karim Bakri, MBBS
Portland, Oregon; Consultant
Affiliate Associate Professor Division of Plastic Surgery
Public Health Mayo Clinic
University of California San Francisco Rochester, Minnesota
San Francisco, California United States
United States
Suzanne Barnes, DMD
Michael Awadallah, DDS, MD Assistant Professor
Assistant Professor of Surgery Oral and Maxillofacial Surgery
Weill Cornell Medicine University of Louisville
New York, New York Louisville, Kentucky
United States United States

Shahid R. Aziz, DMD, MD, FACS, FRCS (Ed) Brian Bast, DMD, MD
Division Director Professor and Chair
Oral & Maxillofacial Surgery Oral and Maxillofacial Surgery
Hackensack University Medical Center; University of California, School of Dentistry
Clinical Professor San Francisco, California
Oral and Maxillofacial Surgery United States
Rutgers School of Dental Medicine
Newark, New Jersey; Hussam Batal, DMD
Clinical Professor Clinical Professor
Otolaryngology Oral and Maxillofacial Surgery
Hackensack Meridian School of Medicine Boston University Henry M. Goldman School of Dental
Nutley, New Jersey Medicine
United States; Boston, Massachusetts
Visiting Professor United States
Oral and Maxillofacial Surgery
Update Dental College
Dhaka, Bangladesh
x Contributors

Dale A. Baur, DDS, MD Behnam Bohluli, DMD, FRCD(C)

Professor and Chair, Vice Dean Clinical Instructor
Oral and Maxillofacial Surgery Oral and Maxillofacial Surgery
Case Western Reserve University School of Dental University of Toronto
Medicine; Toronto, Ontario
Division Chief, Canada
Oral and Maxillofacial Surgery
University Hospitals/Cleveland Medical Center Genevieve C. Bonin, BSc, MASc, DMD, FRCD(c),
Cleveland, Ohio Dipl. ABOMS
United States Oral and Maxillofacial surgeon
Department of Oral and Maxillofacial Surgery
Edmond Bedrossian, DDS, FACD, FACOMS, FAO, FITI Verdun Hospital, University of Montreal
Professor Montreal, Quebec
Oral and Maxillofacial Surgery Canada
University of the Pacific
San Francisco, California Gary F. Bouloux, MD, DDS, MDSc, FRACDS,
United States FRACDS(OMS), FRCS (Eng), FACS
J. David Allen Family Professor
Edmond Armand Bedrossian, DDS Division Chief
Private Practice Oral and Maxillofacial Surgery
San Francisco, California Department of Surgery
United States Emory University School of Medicine
Atlanta, Georgia
R. Bryan Bell, MD, DDS, FACS, FRCS (Ed) United States
Physician Executive and Director
Division of Surgical Oncology, Radiation Oncology and Meaghan Bradley, DMD
Clinical Programs Oral and Maxillofacial Surgery
Providence Cancer Institute; Boston University
Medical Director Boston, Massachusetts
Providence Head and Neck Cancer Program United States
Providence Cancer Institute;
Associate Member Omar Breik, BDSc (Hons) MBBS, MClinSc, FRACDS
Earle A. Chiles Research Institute (OMS)
Providence Cancer Institute Consultant Maxillofacial/Head and Neck Surgeon
Portland, Oregon Department of Oral and Maxillofacial Surgery
United States Royal Brisbane and Women’s Hospital;
Senior Lecturer
David A. Bitonti, DMD School of Dentistry/School of Medicine
Clinical Associate Professor University of Queensland
Department of Surgery Brisbane, Queensland
F. Edward Hébert School of Medicine, Uniformed Services Australia
University of the Health Sciences
Bethesda, Maryland; Hans C. Brockhoff II, DDS, MD, FACS
Dental Service Chief Chief, Oral/Head and Neck Oncology and Microvascular
Oral and Maxillofacial Surgeon Reconstructive Surgery
Hampton Veterans Affairs Medical Center Oral and Maxillofacial Surgery
Hampton, Virginia El Paso Children’s Hospital, University Medical Center of
United States El Paso;
Assistant Professor
Department of Surgery
Texas Tech University Health Sciences Center;
Program Director
El Paso Head & Neck and Microvascular Surgery
Fellowship;
High Desert Oral & Facial Surgery
El Paso, Texas
United States
 Contributors xi

Daniel Buchbinder, DMD, MD Eric R. Carlson, DMD, MD, EdM, FACS

Professor and System Chief, Division of Maxillofacial
Surgery
Department of Otolaryngology, Head and Neck Surgery
Icahn School of Medicine at Mount Sinai
New York, New York
United States
Tuan G. Bui, MD, DMD
Affiliate Assistant Professor
Oral and Maxillofacial Surgery
Oregon Health and Sciences University;
Head and Neck Surgical Associates
Portland, Oregon
United States
Professor and Kelly L. Krahwinkel Chairman
Department of Oral and Maxillofacial Surgery
University of Tennessee Graduate School of Medicine;
Director
Oral/Head and Neck Oncologic Surgery Fellowship
University of Tennessee Cancer Institute
Knoxville, Tennessee
United States
Nardy Casap, DMD, MD
Professor
Oral and Maxillofacial Surgery
Hebrew University-­Hadassah Medical Center
Jerusalem, Israel

Patrick Byrne, MD, MBA Carrie E. Cera Hill, MD, MBA

Chairman Pure Dermatology PLLC
The Head and Neck Institute Denver, Colorado
Cleveland Clinic United States
Cleveland, Ohio
United States Swagnik Chakrabarti, MBBS, MS, MCh
Chairperson
John Francis Caccamese Jr., MD, DMD, FACS Chandan Cancer Institute
Professor and Vice Chairman Lucknow, Uttar Pradesh
Oral-Maxillofacial Surgery India
University of Maryland Dental School;
Clinical Professor Ravi Chandran, DMD, PhD, FACS
Pediatrics and Otorhinolaryngology Chairman and Residency Director
University of Maryland School of Medicine; Oral and Maxillofacial Surgery/Pathology
Co-Director University of Mississippi Medical Center
Randolph B. Capone Cleft Program at GBMC; Jackson, Mississippi
Adjunct Professor United States
Bioengineering
University of Maryland; Blake Chaney, DDS, MD
Baltimore, Maryland Oral and Maxillofacial Surgery
United States University of Pittsburgh
Pittsburgh, Pennsylvania
Ron Caloss, DDS, MD United States
Private Practice
Aligned Oral and Facial Surgery Allen C. Cheng, MD, DDS, FACS
Baptist Medical Center; Medical Director
Professor Head and Neck Surgical Associates
Oral and Maxillofacial Surgery Head and Neck Surgery;
University of Mississippi Medical Center Attending Surgeon
Jackson, Mississippi Providence Oral, Head and Neck
United States Providence Health;
Assistant Professor
Courtney Caplin, MD, DMD Oral and Maxillofacial Surgery
Cosmetic Surgery Affiliates; Oregon Health Sciences University;
Clinical Assistant Professor Medical Director
Oral and Maxillofacial Surgery Oral/Head and Neck Oncology
University of Oklahoma Legacy Good Samaritan
Oklahoma City, Oklahoma Portland, Oregon
United States United States
xii Contributors

Radhika Chigurupati, DMD, MS David Collette, DMD, MD

Associate Professor Medical Director
Oral and Maxillofacial Surgery The Oral Surgery Center Of Albuquerque
Boston University Albuquerque, New Mexico
Boston, Massachusetts United States
United States
Gisela Contasti-Bocco, DDS
Nam Cho, DDS, MD Assistant Professor
Assistant Clinical Professor Orthodontics Department
Oral & Maxillofacial Surgery Nova Southern University
Ostrow School of Dentistry Fort Lauderdale, Florida
Los Angeles, California United States
United States
Bernard J. Costello, DMD, MD, FACS
Joli Chou, DMD, MD Associate Dean for Faculty Affairs
Associate Professor Professor and Fellowship Program Director
Department of Oral and Maxillofacial Surgery Department of Oral and Maxillofacial Surgery
Sidney Kimmel Medical College University of Pittsburgh, School of Dental Medicine;
Thomas Jefferson University Chief
Philadelphia, Pennsylvania Pediatric Oral and Maxillofacial Surgery Children’s Hospital
United States of Pittsburgh;
Professor and Fellowship Program Director
Louis J. Christensen, DDS Department of Oral and Maxillofacial Surgery
Oral & Maxillofacial Surgery University of Pittsburgh Medical Center Eye and Ear
HealthPartners; Institute UPMC
Department of Oral & Maxillofacial Surgery Pittsburgh, Pennsylvania
Regions Hospital United States
Saint Paul, Minnesota;
Assistant Clinical Professor Sebastian Cotofana, MD, PhD
Division of Oral & Maxillofacial Surgery Associate Professor of Anatomy
University of Minnesota School of Dentistry Department of Clinical Anatomy
Minneapolis, Minnesota Mayo Clinic
United States Rochester, Minnesota
United States
Joseph E. Cillo Jr., DMD, MPH, PhD, FACS
Division Chief and Program Director Marcus A. Couey, DDS, MD
Oral and Maxillofacial Surgery Assistant Professor
Allegheny General Hospital; Department of Oral and Maxillofacial Surgery
Associate Professor Boston University
Oral and Maxillofacial Surgery Boston, Massachusetts
Allegheny General Hospital United States
Pittsburgh, Pennsylvania
United States Larry Cunningham Jr., MD, DDS
Professor and Chair
Scott T. Claiborne, DDS, MD Oral and Maxillofacial Surgery
Minnesota Oral and Facial Surgery University of Pittsburgh School of Dental Medicine
Co-Fellowship Director Pittsburgh, Pennsylvania
Oral/Head and Neck Oncologic and Reconstructive United States
Surgery
Minneapolis, Minnesota William J. Curtis, DMD, MD
United States Oral and Maxillofacial Surgery
Northern Nevada Oral & Maxillofacial Surgery
Reno, Nevada
United States
 Contributors xiii

Angelo L. Cuzalina, MD, DDS Jean-­Charles Doucet, DMD, MD, MSc, FRCDC
Cosmetic Surgery Assistant Professor and Division Head of Oral and
Private Practice Maxillofacial Surgery
Tulsa Surgical Arts; Oral and Maxillofacial Sciences
Adjunctive Faculty Dalhousie University;
OSU Medical School Staff Surgeon
Otolaryngology Department IWK Cleft Palate and Craniofacial Team
Tulsa, Oklahoma IWK Health Centre;
United States Staff Surgeon
Oral and Maxillofacial Surgery
Rushil R. Dang, BDS, DMD QEII Health Science Centre
Maxillofacial Oncology and Reconstructive Surgery Fellow Halifax, Nova Scotia
Oral and Maxillofacial Surgery Canada
Boston Medical Center and Boston University
Boston, Massachusetts Stephanie Joy Drew, DMD
United States Associate Professor
Emory School of Medicine
Renie Daniel, MD, DMD, FACS Atlanta, Georgia
Assistant Professor United States
Department of Oral & Maxillofacial Surgery
The University of North Carolina Donita Dyalram, DDS, MD, FACS
Chapel Hill, North Carolina Associate Professor; Program Director/Associate Fellowship
United States Director
Oral and Maxillofacial Surgery
David J. Dattilo, DDS University of Maryland Medical Center
Director of Oral and Maxillofacial Surgery (Retired) Baltimore, Maryland
Allegheny Health System United States
Allegheny General
Hospital Sean P. Edwards, DDS, MD
Pittsburgh, Pennsylvania Clinical Associate Professor;
United States; Director, Residency Program;
Associate Professor of Surgery Chief, Pediatric Oral, and Maxillofacial Surgery
Drexel University School of Medicine Oral and Maxillofacial Surgery/Hospital Dentistry
Philadelphia, Pennsylvania University of Michigan Health System
United States Ann Arbor, Michigan
United States
Jeffrey S. Dean, DDS, MD, FACS
Oral and Maxillofacial Surgery Hany Emam, BDS, MS, FACS
Dakota Dunes, South Dakota Associate Professor and Interim Chair
United States Oral and Maxillofacial Surgery
The Ohio State University College of Dentistry
Shaun C. Desai, MD Columbus, Ohio
Associate Professor United States
Facial Plastic and Reconstructive Surgery
Johns Hopkins University School of Medicine Max R. Emmerling, MD, DDS
Baltimore, Maryland Division of Oral and Maxillofacial Surgery
United States Cook County Health
Chicago, Illinois
Jasjit K. Dillon, MBBS, DDS, FDSRCS, FACS United States
Professor, Chief & Program Director
Oral & Maxillofacial Surgery
University of Washington
Seattle, Washington
United States
xiv Contributors

Mark Engelstad, DDS, MD, MHI Rui P. Fernandes, MD, DMD, FACS, FRCS (Ed)
Associate Professor Professor
Oral & Maxillofacial Surgery OMS, Neurosurgery, Orthopedic, Surgery
Oregon Health & Science University University of Florida College of Medicine
Portland, Oregon Jacksonville, Florida
United States United States

Helaman Erickson, DDS, MD, FACS Richard Allen Finn, DDS

Oral and Maxillofacial Surgery Professor
Permian Basin Oral Surgery and Dental Implant Center Surgery—Div OMFS
Midland, Texas UTSWMC;
United States Chief
OMFS
Maria Evasovich, MD Veteran’s Administration North Texas
Associate Professor Dallas, Texas
Department of Surgery United States
University of Minnesota
Minneapolis, Minnesota Peter B. Franco, DMD, FACS
United States Carolinas Center for Oral and Facial Surgery
Charlotte, North Carolina
Adam P. Fagin, DMD, MD United States
Private Practice
Peninsula Oral and Facial Surgery David Gailey, DDS, FACS
San Mateo, California Surgical Cleft Director
United States Pediatric Surgery
Providence Children’s Hospital;
Christopher A. Fanelli, DDS, FRCD(C) President
Private Practice Inland Oral Surgery
Interface—Centre for OMFS Spokane, Washington
London, Ontario United States
Canada;
Attending Surgeon—Consultant Pooja Gangwani, DDS, MPH
Surgery—Oral Maxillofacial Surgery Assistant Professor
London Health Sciences Centre, St Thomas Elgin General Oral and Maxillofacial Surgery
Hospital University of Rochester Medical Center
St. Thomas, Ontario Rochester, New York
Canada United States

Joseph J. Fantuzzo, MD, DDS, FACS Ghali E. Ghali, DDS, MD, FACS, FRCS(Ed)
Clinical Associate Professor Director
Oral & Maxillofacial Surgery Oral and Maxillofacial Surgery
University of Rochester Medical Center Willis Knighton Health System
Rochester, New York Shreveport, Louisiana
United States United States

Tirbod Fattahi, DDS, MD, FACS Waleed Gibreel, MBBS

Professor and Chair Assistant Professor
Department of Oral and Maxillofacial Surgery Craniofacial Surgery
University of Florida, College of Medicine Division of Plastic Surgery
Jacksonville, Florida Mayo Clinic
United States Rochester, Minnesota
United States
 Contributors xv

Sabine C. Girod, MD, DDS, PhD, FACS Cesar A. Guerrero, DDS

Professor Emeritus Private Practice
Department of Surgery ClearChoice Houston
School of Medicine, Stanford University The Heights Hospital
Stanford, California Houston, Texas
United States United States

Brent Golden, DDS, MD, FACS Danny Hadaya, DDS, PhD

Fellowship Program Director Resident
Pediatric Craniomaxillofacial Surgery Oral and Maxillofacial Surgery
Orlando Health Arnold Palmer Medical Center UCLA School of Dentistry
Orlando, Florida Los Angeles, California
United States United States

Jorge Gonzalez, DDS David Hamlar, MD, DDS

Private Practice Assistant Professor
Advanced Dental Implant Solutions Otolaryngology/Head and Neck Surgery
Fort Worth, Texas University of Minnesota Medical Center
United States Minneapolis, Minnesota
United States
Marianela Gonzalez, DDS, MS
Clinical Associate Professor and Director Daniel A. Hammer, DDS, FACD, FACS
Oral and Maxillofacial Surgery Vice Chair and Director of Research
Texas A&M Health Science Center, College of Dentistry Department of Oral and Maxillofacial Surgery and Dentistry
Baylor University Dallas, Texas Naval Medical Center San Diego
United States San Diego, California;
Associate Professor of Surgery
Eric J. Granquist, DMD, MD Department of Surgery
Assistant Professor Uniformed Services University
Oral and Maxillofacial Surgery Bethesda, Maryland;
University of Pennsylvania; Voluntary Clinical Assistant Professor of Surgery
Director Department of Otolaryngology
UPenn Center For Temporomandibular Joint Disorders UC San Diego School of Medicine,
Hospital of the University of Pennsylvania San Diego, California
Philadelphia, Pennsylvania United States
United States
Curtis Hanba, MD
Jaime Grant, MBChB, BDS (Hons), MRCS (Ed), FRCS (Ed) Otolaryngology—Head and Neck Surgery
(OMFS) The University of Minnesota
Consultant Craniofacial/Maxillofacial Surgeon Minneapolis, Minnesota
Craniofacial/Maxillofacial Surgery United States
Birmingham Children’s Hospital/Queen Elizabeth
University Hospital Andrew Alistair Heggie, AM, MBBS, MDSc, BDSc,
Birmingham, United Kingdom FRACDS (OMS), FFDRSC(I), FRCS (Ed)
Clinical Professor, Oral and Maxillofacial Surgery
Mingyang Liu Gray, MD, MPH Department of Plastic and Maxillofacial Surgery
Resident Physician Royal Children’s Hospital of Melbourne
Otolaryngology—Head and Neck Surgery Parkville, Victoria
Icahn School of Medicine at Mount Sinai Australia
New York, New York
United States
xvi Contributors

Mariana Henriquez, DDS Reem H. Hossameldin, BDS, MSc, PhD

Santa Rosa Maxillofacial Surgery Center Associate Professor
Central University of Venezuela Oral and Maxillofacial Surgery
Caracas, Venezuela Faculty of Dentistry, Cairo University
Cairo, Egypt
Andrew Henry, DMD, MD
Assistant Professor Tsung-­yen Hsieh, MD
Associate Director of Residency Training Assistant Professor
Department of Oral and Maxillofacial Surgery Department of Otolaryngology—Head & Neck Surgery,
Boston University Goldman School of Dental Medicine Division of Facial Plastic & Reconstructive Surgery
Boston, Massachusetts University of Cincinnati College of Medicine
United States Cincinnati, Ohio
United States
Alan S. Herford, DDS, MD
Chairman and Professor Allen Huang, DDS, MD
Oral and Maxillofacial Surgery Assistant Professor
Loma Linda University Oral and Maxillofacial Surgery
Loma Linda, California University of Southern California
United States Los Angeles, California
United States
Brandyn Herman, DMD
Assistant Professor Pamela J. Hughes, DDS
Oral and Maxillofacial Surgery Oral and Maxillofacial Surgery
University of Kentucky College of Dentistry Kaiser Permanente
Lexington, Kentucky Portland, Oregon
United States United States

David Hinkl, DMD Tanisha Hutchinson, MD

Oral and Maxillofacial Surgery Facial Plastic Surgery
University of Oklahoma Glasgold Group
Oklahoma City, Oklahoma Princeton, New Jersey
United States United States

Anthony David Holmes, AO, MB.BS, FRACS Matthew R. Idle, BDS (Hons), MFDS, MBChB, FRCS (OMFS)
Diplomate, American Board of Plastic Surgery Consultant
Clinical Professor, University of Melbourne Oral and Maxillofacial/Head and Neck Surgery
Dept. of Plastic and Maxillofacial Surgery University Hospitals Birmingham
Royal Children’s Hospital Birmingham, United Kingdom
Melbourne, Victoria
Australia Shyam Sunder Indrakanti, DDS, MD
Private Practice
James B. Holton, DDS, MSD Department of Oral and Maxillofacial Surgery
Staff Parkland Memorial Hospital
Oral and Maxillofacial Surgery Dallas, Texas
UT Health Tyler United States
Tyler, Texas
United States Michael Jaskolka, DDS, MD, FACS
Director, Maxillofacial Surgery
Mehran Hossaini-­Zadeh, DMD Director, Cleft and Craniofacial Program
Professor and Chair Physician Executive, Novant Health, Children’s Institute,
Oral and Maxillofacial Surgery Coastal Region
Temple University School of Dentistry Novant Health, New Hanover Regional Medical Center
Philadelphia, Pennsylvania Wilmington, North Carolina
United States United States
 Contributors xvii

Jonathan James Jelmini, DDS, MD Vasiliki Karlis, DMD, MD, FACS

Department of Oral and Maxillofacial Surgery Associate Professor
Oregon Health & Sciences University; Director OMS Training Program
Resident Department of Oral and Maxillofacial Surgery
Trauma and Oral and Maxillofacial Surgery Service College of Dentistry
Legacy Emanuel Medical Center New York University
Portland, Oregon Bellevue Hospital Center
United States New York, New York
United States
Ole T. Jensen, DDS, MS
Adjunct Professor Beomjune Kim, DMD, MD, FACS
Department of Oral and Maxillofacial Surgery Head and Neck/Microvascular Surgeon
School of Dentistry, University of Utah Cancer Treatment Centers of America – Part of City of Hope
Salt Lake City, Utah Newnan, Georgia
United States United States

Ashok R. Jethwa, MD D. David Kim, DMD, MD, FACS

Head and Neck Surgical Oncology/Microvascular Jack W. Gamble Endowed Chairman
Reconstruction Oral and Maxillofacial/Head and Neck Surgery
Otolaryngology Louisiana State University Health Sciences Center
University of Minnesota Shreveport;
Minneapolis, Minnesota Edward and Freda Green Endowed Professor
United States Oral and Maxillofacial/Head and Neck Surgery
LSU Health Science Center Shreveport;
Baxter Jones, DDS Fellowship Director, Head and Neck Oncology and
Resident Microvascular Reconstruction
Department of Oral and Maxillofacial Surgery Oral and Maxillofacial Surgery
Carle Foundation Hospital LSU Health Science Center Shreveport
Urbana, Illinois Shreveport, Louisiana
United States United States

Deepak Kademani, DMD, MD, FACS Roderick Y. Kim, DDS, MD, MBA, FACS
President and Medical Director Director of Research, Co-­Fellowship Director, Vice Division
Minnesota Oral & Facial Surgery Director
Fellowship Director Oral and Maxillofacial Surgery
Oral/Head & Neck Oncologic and Reconstructive Surgery John Peter Smith Health Network;
Minneapolis, Minnesota Assistant Professor
United States Surgery
Texas Christian University
David R. Kang, MD, DDS Fort Worth, Texas
Medical Director United States
Surgery, Head & Neck Surgery
Methodist Dallas Medical Center Paul Kloostra, DDS, MD
Dallas, Texas Fellowship Director
United States Cleft & Craniofacial Surgery
Charleston Area Medical Center
Herman Kao, DDS, MD Charleston, West Virginia
Vice Chairman United States
Oral and Maxillofacial Surgery
John Peter Smith Health Network; Antonia Kolokythas, DDS, MSc, MSed, FACS
Associate Professor Professor and Chair
Surgery Department of Oral and Maxillofacial Surgery
TCU and UNTHSC Medical School Augusta Univerity
Fort Worth, Texas Dental College of Georgia
United States Augusta, Georgia
United States
xviii Contributors

David A. Koppel, MB, BS, BDS, FDS, FRCS James B. Lewallen, DDS, MD, MSc
Associate Professor Private Practice
Faculty of Medicine/Faculty of Dental Medicine & Oral Southern Oral and Facial Surgery
Health Sciences Franklin, Tennessee
McGill University United States;
Montreal, Quebec Affiliate Staff
Canada Oral and Maxillofacial Surgery
Vanderbilt University Medical Center
Deepak G. Krishnan, DDS, FACS Nashville, Tennessee
Associate Professor—Surgery United States
Division of Oral Maxillofacial Surgery, Department of
Surgery Stanley Yung-­Chuan Liu, MD, DDS, FACS
University of Cincinnati; Associate Professor of Otolaryngology
Oral Maxillofacial Surgeon And by Courtesy, of Plastic & Reconstructive Surgery
Division of Oral Maxillofacial Surgery Director, Sleep Surgery Fellowship
Department of Surgery Service Chief, Maxillofacial Surgery
Cincinnati Children’s Hospital and Medical Center Stanford University School of Medicine
Cincinnati, Ohio Stanford, California
United States United States

Moni A. Kuriakose, MD, FRCS Christian A. Loetscher, DDS, MS

Professor and Director Private Practice
Surgical Oncology Chief Head and Neck Oncology Oral & Maxillofacial Surgery
Mazumdar Shaw Cancer Center; Atlanta Oral & Maxillofacial Surgery, PC
Director Alpharetta, Georgia
Mazumdar Shaw Centre for Translational Research United States
Narayana Health Center
Bangalore, Karnataka Patrick J. Louis, DDS, MD
India Professor
Oral & Maxillofacial Surgery
Li Han Lai, DDS University of Alabama at Birmingham;
Oral and Maxillofacial Surgery Chairman
University of Washington Oral & Maxillofacial Surgery
Seattle, Washington University of Alabama at Birmingham
United States Birmingham, Alabama
United States
Zvi Laster, DMD
Maxillofacial Surgery Department Joshua E. Lubek, MD, DDS, FACS
Poriya Governmental Hospital Professor & Fellowship Director
Tiberias, Israel Oral-Head & Neck Surgery/Microvascular Surgery
Marlene & Stewart Greenebaum Comprehensive Cancer
Amir Laviv, DMD, MPH Center &
Senior Lecturer Department of Oral & Maxillofacial Surgery
Department of Oral & Maxillofacial Surgery University of Maryland
Tel-­Aviv University Baltimore, Maryland
Tel Aviv, Israel United States

Andrew W. C. Lee, MSc, DDS, MD, FRCD(C), FACS Ricardo Lugo, DDS, MD
Argyle Associates Oral & Maxillofacial Surgery Assistant Clinical Professor
Department of Surgery Department of Oral & Maxillofacial Surgery
The Ottawa Hospital; University of California, San Francisco & Alameda Health
Lecturer System
Faculty of Medicine Oakland, California
University of Ottawa United States
Ottawa, Canada
 Contributors xix

Sofia Lyford-­Pike, MD Ashley E. Manlove, DMD, MD, FACS

Associate Professor Residency Program Director
Otolaryngology Head and Neck Surgery Oral and Maxillofacial Surgery
University of Minnesota Carle Foundation Hospital;
Minneapolis, Minnesota Director Cleft Lip and Palate Team
United States Oral and Maxillofacial Surgery
Carle Foundation Hospital
George M. Kushner, DMD, MD, FACS Urbana, Illinois
Professor and Chairman United States
Oral and Maxillofacial Surgery
University of Louisville School of Dentistry Samir Mardini, MD
Louisville, Kentucky Professor and Chair
United States Plastic Surgery
Mayo Clinic
Colin MacIver, MBChB, FRCS, BDS, FDS, FRCS (Ed), FRCS Rochester, Minnesota
(OMFS) United States
Consultant Maxillofacial/Head and Neck Surgeon
Maxillofacial Surgery Michael R. Markiewicz, DDS, MD, MPH, FAAP, FACS,
SSMC/Mayo Clinic Abu Dhabi; FRCD(c)
Adjunct Professor Professor and Chair
Department of Surgery School of Dental Medicine
Khalifa University Oral and Maxillofacial Surgery
Abu Dhabi Clinical Professor
United Arab Emirates Department of Neurosurgery and Department of Surgery
Jacobs School of Medicine and Biomedical Sciences
Stephen P. R. MacLeod, BDS, MB ChB, FDSRCS University at Buffalo
(ED&ENG), FRCS (ED), FFSTRCS (ED), FACS Co-Director
Joseph R and Louise Ada Jarabak Professor of Surgery Craniofacial Center of Western New York
Oral and Maxillofacial Surgery John R. Oishei Children’s Hospital
Loyola University Medical Center Attending Surgeon
Maywood, Illinois Department of Head & Neck and Plastic & Reconstructive
United States Surgery
Roswell Park Comprehensive Cancer Center
Caitlin B. L. Magraw, MD, DDS, FACS Buffalo, New York
The Head and Neck Institute United States
Head and Neck Surgical Associates;
Associate Clinical Professor Jeffrey S. Marschall, DMD, MD, MS
Oral and Maxillofacial Surgery Pediatric Craniomaxillofacial Surgery
Oregon Health and Sciences University Arnold Palmer Hospital for Children
Portland, Oregon Orlando, Florida
United States United States

Nicholas M. Makhoul, BSc, DMD, MD, FRCD(C), FACS Nigel Shaun Matthews, BDS, FDS, MBBS, FRCS, FRCS
Dip ABOMS (OMFS)
Chair, Associate Dean Clinical Professor and Chairman
Oral and Maxillofacial Surgery Associate Dean for Hospital Affairs
McGill University; Director, TMJ Institute
Associate Professor Department of Oral and Maxillofacial Surgery
Faculty of Dentistry Indiana University School of Dentistry
McGill University Indianapolis, Indiana
Montreal, Quebec United States
Canada
xx Contributors

Joseph P. McCain, DMD, FACS Louis G. Mercuri, DDS, MS

Oral & Maxillofacial Surgery Visiting Professor
Massachusetts General Hospital—Harvard Orthopaedic Surgery
Boston, Massachusetts Rush University Medical Center
United States Chicago Illinois
United States;
J. Michael McCoy, DDS, FACS Consultant
Professor Clinical Affairs
Oral and Maxillofacial Surgery; TMJ Concepts
Professor Ventura, California
Pathology; United States
Professor
Radiology; Brett A. Miles, DDS, MD, FACS
Medical Director Professor and Chair
In-­Patient Hyperbaric Oxygen Therapy Otolaryngology/Head and Neck Surgery
University of Tennessee Graduate School of Medicine Northwell Health/Lenox Hill/Manhattan Eye Ear Hospital
Knoxville, Tennessee New York, New York
United States United States

Samuel J. McKenna, DDS, MD, FACS Meagan Miller, DDS

Professor and Chairman Oral and Maxillofacial Surgery
Oral and Maxillofacial Surgery Loma Linda University
Vanderbilt University Medical Center Loma Linda, California
Nashville, Tennessee United States
United States
Justine Moe, MD, DDS, FRCDC, FACS
Daniel J. Meara, MS, MD, DMD, MHCDS, FACS Clinical Assistant Professor and Residency Program
Chair Director
Oral and Maxillofacial Surgery & Hospital Dentistry Oral and Maxillofacial Surgery
Christiana Care Health System; University of Michigan
Director of Research Ann Arbor, Michigan
Oral and Maxillofacial Surgery United States
Christiana Care Health System
Wilmington, Delaware; Hwi Sean Moon, MD, DDS
Affiliate Faculty Cleft and Craniofacial Surgery
Physical Therapy El Paso Children’s Hospital
University of Delaware El Paso, Texas
Newark, Delaware United States
United States
Marina Morante Silva, MD, FEBOMFS
Paulo Jose Medeiros, DDS, MS, PhD Department of Oral and Maxillofacial Surgery
Professor and Chairman University of Florida, College of Medicine
Oral and Maxillofacial Surgery Jacksonville, Florida
Rio De Janiero State University United States
Rio De Janiero, Brazil
Christopher Morris, DDS, MD, FACS
Pushkar Mehra, BDS, DMD, MS, FACS Private Practice
Professor and Chair Katy Center for Oral and Facial Surgery
Oral and Maxillofacial Surgery Katy, Texas
Boston University Medical Center United States
Boston, Massachusetts
United States
 Contributors xxi

Dean Morton, BDS, MS Erik Jon Nuveen, MD, DMD, FAACS

Professor Director of Fellowship
Department of Prosthodontics Cosmetic Surgery Affiliates
Director Oklahoma City, Oklahoma and Jacksonville Beach, Florida;
Center for Implant, Esthetic and Innovative Dentistry Voluntary Assistant Professor
Indiana University School of Dentistry Oral and Maxillofacial Surgery
Indianapolis, Indiana The University of Oklahoma College of Dentistry
United States Oklahoma City, Oklahoma
United States
Reza Movahed, DMD, FACS
Clinical Assistant Professor George Obeid, DDS
Department of Orthodontics Senior Attending
Saint Louis University Oral and Maxillofacial Surgery
Saint Louis, Missouri Medstar Washington Hospital Center
United States Washington, District of Columbia
United States
Elena Mujica, DDS
Private Practice Devin Joseph Okay, DDS
Santa Rosa Maxillofacial Surgery Attending Faculty
Caracas, Venezuela Department of Otolaryngology Head and Neck Surgery
Mount Sinai Health System;
Robert Nadeau, DDS, MD, FACS Director
Interim Division Director and Program Director for Oral Division of Prosthodontics and Maxillofacial Prosthetics
and Maxillofacial Surgery Mount Sinai Health System
Department of Developmental and Surgical Sciences New York, New York
University of Minnesota; United States
Surgical Service Lead, OMS
M Health Fairview Hospitals and Clinics Petra Olivieri, DMD, MD
Minneapolis, Minnesota Clinical Assistant Professor
United States Case Western Reserve University
MetroHealth Hospital
John M. Nathan, MD, DDS Department of Oral and Maxillofacial Surgery
Division of Oral and Maxillofacial Surgery Cleveland, Ohio
Mayo Clinic United States
Rochester, Minnesota
United States Robert Ord, MB, BCh (Hons), BDS, FRCS, FACS, MS, MBA
Professor and Chairman
Gregory M. Ness, DDS, FACS Oral and Maxillofacial Surgery
Professor Emeritus—Clinical University of Maryland;
Oral and Maxillofacial Surgery and Anesthesiology Professor
The Ohio State University College of Dentistry Oncology Program
Columbus, Ohio Greenbaum Cancer Center
United States Baltimore, Maryland
United States
Craig Norbutt, DMD, MD
Assistant Clinical Professor Daniel Oreadi, DMD
Oral & Maxillofacial Surgery Associate Professor
Carle Foundation Hospital Oral and Maxillofacial Surgery
Champaign, Illinois Tufts University School of Dental Medicine
United States Boston, Massachusetts
United States
xxii Contributors

Neeraj Panchal, DDS, MD, MA Jon D. Perenack, MD, DDS

Assistant Professor Adjunct Associate Clinical Professor and Director of
Oral and Maxillofacial Surgery Fellowship in Facial Cosmetic Surgery
University of Pennsylvania; Oral and Maxillofacial Surgery
Section Chief Louisiana State University;
Oral and Maxillofacial Surgery Medical and Surgical Director
Penn Presbyterian Medical Center; Williamson Cosmetic Center and Perenack Esthetic
Section Chief Surgery
Oral and Maxillofacial Surgery Baton Rouge, Louisiana
Philadelphia Veterans Affairs Medical Center United States
Philadelphia, Pennsylvania
United States Yuliya Petukhova, DDS
Oral and Maxillofacial Surgery Resident
Sat Parmar, BChD, BMBS, BMedSci, FDSRCS, FRCS Mr Oral and Maxillofacial Surgery
Oral and Maxillofacial Surgery Mayo Clinic
University Hospitals Birmingham Rochester, Minnesota
Birmingham, United Kingdom United States

Ashish A. Patel, MD, DDS, FACS Laurence D. Pfeiffer, MD, DDS

Fellowship Director Oral and Maxillofacial Surgeon
Head and Neck Surgical Oncology and Microvascular Surgery Department of Dentistry
Providence Cancer Institute; Bassett Medical Center
Director of Reconstructive Microsurgery Cooperstown, New York
Head and Neck Institute United States
Head and Neck Surgical Associates;
Medical Director Matthew H. Pham, DMD, MD
Cranio-Oral and Maxillofacial and Neck Trauma Private Practice
Legacy Emanuel Medical Center Carolina’s Center for Oral & Facial Surgery
Portland, Oregon Columbia, South Carolina
United States United States

Zachary S. Peacock, DMD, MD, FACS John N. Phelan, PhD

Associate Professor of Oral and Maxillofacial Surgery Associate Professor (Retired)
Massachusetts General Hospital Cell Biology
Harvard School of Dental Medicine UT Southwestern Medical School
Boston, Massachusetts Dallas, Texas
United States United States

Karl Pennau, DDS Joan Pi-­Anfruns, DMD

Oral & Maxillofacial Surgery Assistant Clinical Professor
Oral Surgery Associates of Colorado Springs Oral and Maxillofacial Surgery/Restorative Dentistry
Colorado Springs, Colorado UCLA School of Dentistry
United States Los Angeles, California
United States
Vincent J. Perciaccante, DDS, FACS
Adjunct Associate Professor Brendan H. G. Pierce, MD
Department of Surgery, Division of Oral & Maxillofacial Otolaryngology
Surgery Palo Alto Medical Foundation
Emory University School of Medicine Palo Alto, California
Atlanta, Georgia United States
United States;
Private Practice
South Oral and Maxillofacial Surgery
Peachtree City, Georgia
United States
 Contributors xxiii

Daniel Joseph Pinkston, DDS Prav Praveen, FRCS, MRCS, MBchBFDSRCS, FFDRCSI
ClearChoice Dental Implant Centers Consultant Oral and Maxillofacial Surgeon
St. Louis, Missouri Oral and Maxillofacial Surgery
United States University Hospitals Birmingham NHS Trust
Birmingham, West Midlands
Waldemar D. Polido, DDS, MS, PhD United Kingdom
Clinical Professor
Oral and Maxillofacial Surgery David S. Precious, CM, DDS, MSc, FRCDC, FRCS, Dhc
Co-Director Dean Emeritus and Professor
Center for Implant, Esthetic and Innovative Dentistry Oral and Maxillofacial Surgery
Indiana University School of Dentistry Dalhousie University
Indianapolis, Indiana Halifax, Nova Scotia
United States Canada

Jeffrey C. Posnick, DMD, MD, FRCS(C), FACS Faisal A. Quereshy, MD, DDS, FACS
Adjunct Professor Professor/Program Director
Plastic and Reconstructive Surgery Oral & Maxillofacial Surgery
Johns Hopkins School of Medicine Case Western Reserve University
Baltimore, Maryland Cleveland Ohio
United States; United States;
Professor Emeritus Medical Director
Plastic and Reconstructive Surgery and Pediatrics Facial Cosmetic Surgery
Georgetown University; Visage Surgical Institute/V-­Spa
Professor Medina, Ohio
Oral and Maxillofacial Surgery United States
Howard University College of Dentistry
Washington DC, Washington Peter D. Quinn, DMD, MD
United States; Chief Executive Physician
Professor of Orthodontics University of Pennsylvania Health System
University of Maryland University of Pennsylvania;
Baltimore College of Dental Surgery Schoenleber Professor of Oral & Maxillofacial Surgery
Baltimore, Maryland University of Pennsylvania
United States School of Dental Medicine
Philadelphia, Pennsylvania
David B. Powers, MD, DMD, FACS, FRCS (Ed) United States
Professor of Surgery
Director, Duke Craniomaxillofacial Trauma Program Matthew Radant, MD, DDS
Fellowship Director, Craniomaxillofacial Trauma and Assistant Clinical Professor
Reconstructive Surgery Fellowship Department of Oral and Maxillofacial Surgery
Vice Chair, Division of Plastic, Maxillofacial and Oral The University of Oklahoma
Surgery Oklahoma City, Oklahoma
Department of Surgery United States
Duke University Medical Center
Durham, North Carolina Christopher K. Ray, DDS
United States Eastern Oklahoma Oral and Maxillofacial Surgeons;
Clinical Assistant Professor Department of Oral and
Janine Prange-­Kiel, PhD Maxillofacial Surgery
Associate Professor and Chief of Section of Anatomy The University of Oklahoma
Department of Surgery Oklahoma City, Oklahoma
University of Texas Southwestern Medical Center United States
Dallas, Texas
United States
xxiv Contributors

Andrew Read-­Fuller, DDS, MD, FACS, FACD Carrie E. Robertson, MD

Clinical Assistant Professor and Graduate Program Director Associate Professor of Neurology
Oral & Maxillofacial Surgery College of Medicine
Texas A&M University School of Dentistry Mayo Clinic
Dallas, Texas Rochester, Minnesota
United States United States

Likith Reddy, MD, DDS, FACS Jason Rogers, DDS

Professor, Department Head Oral and Maxillofacial Surgeon
Oral and Maxillofacial Surgery Private Practice
Texas A&M University School of Dentistry; Santa Rosa and Rohnert Park Oral Surgery
Section Chief Santa Rosa, California
Oral & Maxillofacial Surgery United States
Baylor University Medical Center;
Clinical Professor Brian Louis Ruggiero, MD, DMD
Texas A&M University School of Medicine Oral and Maxillofacial Surgery
Dallas, Texas University of Michigan
United States Ann Arbor, Michigan
United States
Shravan Renapurkar, BDS, DMD, FACS
Associate Professor Ramon L. Ruiz, DMD, MD
Oral and Maxillofacial Surgery Director
Virginia Commonwealth University Pediatric Craniomaxillofacial Surgery
Richmond, Virginia Arnold Palmer Hospital for Children;
United States; Associate Professor
Program Director Department of Surgery
Oral and Maxillofacial Surgery University of Central Florida College of Medicine
Virginia Commonwealth University Orlando, Florida
Richmond, Virginia United States
United States
Mary Ann C. Sabino, DDS, PhD
Johan P. Reyneke, B ChD, M ChD, FCMFOS (SA), PhD Oral and Maxillofacial Surgery
Director Hennepin County Medical Center;
Centre for Orthognathic Surgery Adjunct Clinical Professor
Cape Town Mediclinic; Oral and Maxillofacial Surgery
Extraordinary Professor University of Minnesota
Maxillofacial and Oral Surgery Minneapolis, Minnesota
University of the Western Cape United States
Cape Town, South Africa;
Clinical Professor Sepideh Sabooree, MD, DMD
Oral and Maxillofacial Surgery Georgia Oral and Facial Reconstructive Surgery
University of Oklahoma Atlanta, Georgia
Oklahoma City, Oklahoma; United States
Clinical Professor
Oral and Maxillofacial Surgery Andrew Salama, MD, DDS, FACS
Florida University Chief
Gainesville, Florida Oral and Maxillofacial Surgery
United States Northwell Health—Long Island Jewish Medical Center
New Hyde Park, New York
Fabio G. Ritto, DDS, MD, MS, PhD United States
Professor and Program Director
Oral and Maxillofacial Surgery
The University of Oklahoma Health Science Center
Oklahoma City, Oklahoma
United States
Another random document with
no related content on Scribd:
IMANDRA

Silloin minä, minä tanssisin kanssanne lähteellä. Osaatteko soittaa

huilua?

PRINSSI

Minä rakastan tietoa, taitoa, soittoa ja — teitä, armollinen

autuuteeni.

IMANDRA

Joko taas! Mutta kuulkaas, hyppikäämme harakkaa!

PRINSSI

Harakkaa? En minä osaa!

IMANDRA (alkaa hyppiä)

Katsokaas, näin!

OTRO

Hahhaa!

IMANDRA

Kuka nauroi!

OTRO

Harakka!
IMANDRA

Näin minä hyppään häissäkin. Hahhaa!

HOVIROUVA (ja hoviherra rientävät esille)

Mikä häväistys! Prinsessa! Nouskaa heti! (Hovikumarruksia.)

HOVIHERRA

Pieni, kiltti prinsessa, muistakaahan, että te olette suuren

Suvikunnan valtijatar!

OTRO

Kaukovallan prinssin puolesta saan minä kunnian kosia

Suvikunnan valtijatarta ja huomenlahjana tuon minä tämän
ihmeellisen peilin, joka tekee ruman kauniiksi ja päinvastoin.

IMANDRA (katsoo äkkiä peiliin ja kirkaisee)

Mitä minä näen? Oman irvikuvani! Hyi! Uskallatte tehdä pilkkaa!

(Heittää peilin permannolle.) Kas noin!

OTRO

Oi, mitä te teitte! Te särjitte taikapeliin!

IMANDRA

Taikapeilin? Hui, hai! (Juoksee tiehensä.)

HOVIROUVA
 Kultakruunuineen ja kultakengät jaloissa täytyy prinsessan heti
palata pyytämään anteeksi suur'armolliselta, hänen korkeudeltaan
Kaukovallan prinssiltä. (Menee hullunkurisesti niiaten.)

PRINSSI (Poimien peilinpalasia, jotka hän kätkee taskuunsa.)

Älkäähän toki…! Kuulkaas, herra hoviherra, mitä me nyt teemme,

minä olen aivan hullaantunut teidän tuittupää prinsessaanne!

OTRO

Prinsessan omista puheista sain minä oivan ajatuksen. Teidän

korkeutenne, pukeutukaa paimenpojaksi! Minulla on mukanani tuolla
pilarieteisessä paimenviitta, hattu, huilu, keltainen tekotukka.

PRINSSI

Otro, sinä olet aina kekseliäs! Mene tuomaan valepukuni!

OTRO

Vanha valepukunne, jota usein olette matkoillanne käyttänyt. Minä

juoksen heti noutamaan! (Menee.)

PRINSSI

Hoviherra, me näyttelimme usein hovissani paimennäytelmiä.

HOVIHERRA

Toista on näytellä paimenelämää ja toista on elää paimenelämää.

Se olisi opettavaista prinsessallekin.
PRINSSI

Aivan niin, hyvä hoviherra.

OTRO (palaa)

Kas tässä, teidän korkeutenne, tulkaa tänne! (Vetäytyvät syrjään,

prinssi pukeutuu paimenvaatteisiin ja -kenkiin.) Minä tunnen teidät
yhtä hyvänä näyttelijänä kuin valtijaana ja naissielun hallitsijana. Kas
noin, vielä hiukan keltamaalia kulmakarvoihin!

PRINSSI

Minä olen valmis. Nyt alkaa näytelmä, minkä toivon päättyvän

onnekseni.

HOVIHERRA

Hyvä, minä menen sanomaan prinsessalle, että täällä odottaa

eräs paimenpoika. (Menee.)

OTRO

Ja minä menen edeltäpäin valmistamaan metsästysretkeä.

(Menee.)

IMANDRA (tulee kultakruunu päässä ja kultakengät jaloissa,

vastahakoisesti, pyyhkien kyyneliään, katsoen maahan, samassa
alkaa hän nauraa väkinäisesti.)

Minä tulin pyytämään… Ei! Oh, minä nauran, vaikka pitäisi itkeä.
Kas, eihän täällä ole prinssiä! Paimenpoika, mitä sinä haet?
PRINSSI

He, en minä tiedä.

IMANDRA

Mikä on nimesi, tiedätkö sen.

PRINSSI

Metsä-Matiksihan minua sanotaan.

IMANDRA

Sinussa on metsän tuoksua.

PRINSSI

Kerrotaan, että tässä linnassa olisi hyvin kaunis mutta häijy

prinsessa.

IMANDRA

Minäkö häijy! Mutta missä minä olen ennen kuullut sinun äänesi?

PRINSSI

Ehkä unissanne.

IMANDRA

Ihmeellistä, niin minä olen kuullut sen kuin unissani, se on

ikäänkuin kutsunut minua metsään, vuorille, virroille, lähteelle, jonka
luona minä olen istunut sitoen kukkaseppeltä.

PRINSSI

Minä olen niin usein, usein kulkenut linnan ohi ja kurkistanut

ikkunoihin.

IMANDRA (veitikkamaisesti)

Mitä varten? Kyllä minä arvaan.

PRINSSI

Niin, arvatkaas!

IMANDRA

Ehkä minun tähteni, hihii.

PRINSSI (huokaillen)

Nii — niin.

IMANDRA

Nii — niin. Että uskalsit kurkistella korkeata prinsessaa, jolla on

kultakruunu päässä ja kultakengät jaloissa.

PRINSSI

Minä olen vain köyhä paimenpoika. Hohoo, niin.

IMANDRA (huokaillen)
 Hohoo, niin. Mutta merkillistä, kuinka sinä olet Kaukovallan
prinssin näköinen.

PRINSSI

Niin sanovat ihmiset. Meitä voisi luulla kaksosiksi.

IMANDRA

Oletko sinä koskaan nähnyt Kaukovallan prinssiä?

PRINSSI

Kyllä, kyllä, useinkin… Olin kerran Kaukovallan hovissa.

IMANDRA

Mitä sinä siellä teit?

PRINSSI

Minä kerron. Palvelin kerran prinssin hovissa…

IMANDRA

Ja opit hiukan hovitapoja?

PRINSSI

Minut oli otettu sinne yhdennäköisyyteni takia.

IMANDRA
 En ymmärrä.

PRINSSI

Minun toimenani oli olla ylimpänä kättelijänä.

IMANDRA

Kättelijänä? Nyt ymmärrän sinua vielä vähemmin.

PRINSSI

Minun piti kätellä kaikkia armonanojia, kun prinssi valtaistuinjuhlien

aikana väsyi kattelemaan kansaa.

IMANDRA

Elit kättesi työllä, hahhaa!

PRINSSI

Mutta sitten alkoivat hoviherrat epäillä minua yhdennäköisyyteni

takia.

IMANDRA

Entä sitten?

PRINSSI

Sitten ajoivat minut pois.

IMANDRA
 Poika parka!

PRINSSI

Mutta prinssi hankki minulle kuninkaallisen karjankaitsijan viran.

IMANDRA

Todellakin! Sinä olet kuin prinssin kuva, eikä sinua erottaisi juuri
muusta kuin puvusta ja tukasta.

PRINSSI

Mitäpä te, korkea prinsessa, välitätte paimenparasta, jolla on

paraat päällä ja loput kainalossa.

IMANDRA

Mitä sinulla on siellä kainalossa?

PRINSSI (pyyhkien silmiään)

Paimenhuiluni, ainoa iloni!

IMANDRA

Mutta mitä sinä itket?

PRINSSI (tukahuttaen itkuaan)

Pidättekö kovin prinssistä?

IMANDRA
 Kuules poika! Soitapa huilulla, niin minä tanssin. Tästä tulee
hauskaa!

PRINSSI

Minä soitan vain yhdellä ehdolla.

IMANDRA

Sano se pian!

PRINSSI

En minä kehtaa.

IMANDRA

Kyllä sinä saat kehdata.

PRINSSI

Niin, että minä saan yhden suunannin jokaisesta paimenpolskasta.

IMANDRA

Suunanti, hihii, mitä se on?

PRINSSI

Sitä, että minä asetan huuleni teidän huuliinne.

IMANDRA
 Eikö sen kummempaa. No!

PRINSSI

No, nouskaa varpaillenne. Noin!

IMANDRA

Ah, kuinka se oli makeaa, makeampaa kuin kaikki kuninkaallisen

kyökkimestarin mesikakut. No!

PRINSSI

No, mutta minä soitan ensin.

IMANDRA

Ei sinun tarvitse soittaa, soita sitten metsässä! No! (nousee

varpailleen, prinssi aikoo suudella. Hovirouva ja hoviherra tulevat.)

HOVIROUVA

Mutta prinsessa, tämähän on kauheata, te annatte suuta vieraalle

paimenpojalle!

IMANDRA

Niin minä teenkin, en minä enään huoli pitkistä enkä pienistä

prinsseistä.

HOVIHERRA
 Holhoojana otan minä kultakruunun päästänne, te ette ole enään
arvokas sitä kantamaan.

IMANDRA

Minä lähden tämän paimenen kanssa, minä sidon päähäni

kukkaisen kruunun.

HOVIROUVA

Tapahtukoon tahtonne! Minä pesen käteni.

IMANDRA

Hajuvedessä! Metsässä on ihanampi tuoksu.

HOVIROUVA (suuttuvinaan)

Menkää, me emme enään vastaa teoistanne!

IMANDRA

Minä vastaan itse teoistani. Tiedän, etten kulje väärillä poluilla.

HOVIHERRA

Kaikki polut vievät kuitenkin kotiin. Hyvästi prinsessa!

IMANDRA

Hyvästi — vaan, hyvä hoviherra ja te — hovirouva! (Tekee

kömpelöitä hovikumarruksia.) Nöyrin palvelijanne! Paimenpoika,
soita nyt huilullasi! (Prinssi soittaa, Imandra tarttuu hänen
käsivarteensa, ikäänkuin tanssien poistuvat molemmat.)

HOVIROUVA (käyttäen hajuvesipulloa)

Lähettäkäämme kuitenkin kamarineiti mukaan.

HOVIHERRA

Tehkäämme niin. Saanko tarjota käsivarteni. (Hoviherra ja

hovirouva tekevät hullunkurisia kumarruksia.) Oi, nuoruus, oi, vihreä
nuoruus, minun kuningattareni! Äst!

HOVIROUVA

Mitä te teitte?

HOVIHERRA

Anteeksi, minä aivastin.

HOVIROUVA

Oo, te…

HOVIHERRA

Teidän hajuvetenne…

HOVIROUVA (aivastaa)

Äst! Oo, anteeksi…!

HOVIHERRA (aivastaa)

Äst! Terveydeksenne!
NÄYTÖS II

Metsä.

IMANDRA (tulee paimeneksi puetun prinssin seurassa)

Missä me nyt olemme?

PRINSSI

Metsässä, Kaukovallan prinssin valtakunnassa.

IMANDRA

Kaukovallan prinssin, oh!

PRINSSI

Muistatko häntä vielä?

IMANDRA

Minulle on kaikki kuin unta!

PRINSSI
 Tämä on ihanaa unta valveilla.

IMANDRA

Me olemme kulkeneet kauan ja kauvas. Minä olen väsynyt, minä

en astu enää askeltakaan.

PRINSSI

Olemme eksyksissä.

IMANDRA

Mitä me nyt teemme?

PRINSSI

Levätkäämme!

IMANDRA

Oi, tässä on lähde ja kukkia! Sido minulle seppele!

PRINSSI (sitoo seppelettä)

Se hoviherra otti sinun kultakruunusi. Se oli minun syyni. Miksi

tulin linnaan?

IMANDRA

Eipäs kuin oma syyni. Tämä suvinen seppele on keveämpi. Enkö

minä nyt ole kuin se ihmeen ihana metsätyttö?
PRINSSI

Et ole syntynyt metsässä vaan hovissa.

IMANDRA

Täällä on niin kummallinen rauha. Minä ja sinä yksin. Mutta minä

en tunne sinua vielä. Minusta tuntuu kuin et sinäkään olisi syntynyt
metsässä. Minä olen kai nähnyt sinut unissani.

PRINSSI

Jatkukoon tämä uni aina.

IMANDRA

Mutta hovissa minä aina heräsin painajaiseen. Olenko minä paha?

Nyt minä tahdon nähdä kuvani. Onko sinulla peiliä?

PRINSSI

Vain peilin siru. Minä löysin sen hovin lattialta.

IMANDRA

Kaukovallan prinssin noitapeilin? Minä en uskalla siihen katsoa.

PRINSSI

Katsele nyt vaan!

IMANDRA
 Luulikohan prinssi tällä noitapeilillä lumoovansa? Siinä erehtyi!

PRINSSI

Et uskalla.

IMANDRA

Minä tahtoisin katsella, minä en tohdi, mutta… minä katson vaan.

Voi, kuinka minä olen ruma, nenä on väärässä, se venyy, venyy ja
silmät! Silmät ovat nurin päässä! (Viskaa peilin maahan.)

PRINSSI (kätkee peilin)

No, no! Kukaan ei voi nähdä itseään mistään peilistä. Onnellisinta

on nähdä kuvansa toisen olennon silmässä.

IMANDRA

Mutta lähteensilmä! Minä katson siitä. Minähän seison ihan

päälläni!
Onko tämä metsä noiduttu?

PRINSSI

Niin tosiaankin, tämä metsä on omituinen.

IMANDRA

Minä tunnen niin omituista — täällä. (Osoittaa vatsaansa.) Minä

kuulen ikäänkuin pieni kissanpoikanen naukuisi. Mitä se on?

PRINSSI
 Se on pieni peikko.

IMANDRA

Peikko, uh!

PRINSSI

Nälkä.

IMANDRA

Minä en ole koskaan kärsinyt nälkää.

PRINSSI

Kiitä kyökkimestaria.

IMANDRA

Kiittääkö kyökkimestaria? Miksi?

PRINSSI

Täällä on kyökkimestarina mestari Nälkä (Kohottaa olkapäitään.)

IMANDRA

Kyökkimestari laittoi niin makeita mesikakkuja.

PRINSSI

Tässä on ketunleipiä, taikinanmarjoja ja juopukoita.

 IMANDRA (syö ahneesti)

Anna, anna! Minä syön ja syön, mutta se peikko vain parkuu. Oh,
kuinka minun on nälkä! Ja minä luulin, että tämä oli niin ihanaa. Sinä
olet paha poika. Tuo paikalla mesikakkuja!

PRINSSI

Mistä minä ne tuon? Mutta prinsessa sanoi silloin hovissa, että

suunanti oli makeampaa kuin mesikakut. Koetelkaamme!

IMANDRA

Niin — hovissa. Elääkö sillä?

PRINSSI

Ei sillä elä sen enempää kuin kuunvalollakaan.

IMANDRA

Hyi, sinä kiusaat minua, sinä pilkkaat minua, sinä, sinä…

PRINSSI

So, so, itsehän sinä suostuit tulemaan kanssani.

IMANDRA

Mitähän hoviherra ja hovirouva nyt tekevät?

PRINSSI