Gwen Swennen

Hôpital Universitaire des Enfants Reine Fabiola, Bruxelles, Brussels Capital, Belgium

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Publications (38)48.25 Total impact

  • International Journal of Oral and Maxillofacial Surgery 10/2013; 42(10):1201-1202. DOI:10.1016/j.ijom.2013.07.112 · 1.36 Impact Factor
  • International Journal of Oral and Maxillofacial Surgery 10/2013; 42(10):1255. DOI:10.1016/j.ijom.2013.07.288 · 1.36 Impact Factor
  • International Journal of Oral and Maxillofacial Surgery 10/2013; 42(10):1338. DOI:10.1016/j.ijom.2013.07.588 · 1.36 Impact Factor
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    ABSTRACT: The use of autologous calvarian split thickness bone grafts is a well accepted preprosthetic surgical procedure for reconstruction of the severely atrophied maxilla. Although generally accepted as being a superior bone graft regarding long-term stability, the reported risks in the literature may dissuade the surgeon. A modified cone-beam computed tomography (CBCT) scanning protocol (extended field of view starting from 1cm below the occlusal plane up to the limit of the cranial vault, 0.4 voxel) is proposed that allows assessment of both the cranial donor site as the maxillary receptor site and the sinus conditions with a single scan. Issues regarding quality of the data, radiation dose and clinical practicability are discussed.
    International Journal of Oral and Maxillofacial Surgery 04/2012; 41(7):863-6. DOI:10.1016/j.ijom.2012.03.012 · 1.36 Impact Factor
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    ABSTRACT: The purpose of this prospective study was to evaluate craniofacial morphology in children with complete unilateral cleft lip and palate treated at the Brussels cleft center after a 1-stage complete closure at 3 months and compare the results with a series of children operated on at 3 and 6 months of age according to the Malek surgical protocol. A series of 72 consecutive patients who were operated on for nonsyndromic complete unilateral cleft lip and palate were included in this study at approximately the age of 10 years. Thirty-four were treated according to the Malek surgical treatment protocol: the soft palate was closed at a mean (SD) age of 3.04 (0.20) months, followed by simultaneous repair of the lip and hard palate at 6.15 (0.67) months. Thirty-eight underwent 1-stage all-in-one (AIO) closure of the lip and hard and soft palates at 2.98 (0.16) months. Craniofacial morphology was evaluated by means of a digital cephalometric analysis. Cephalometric data were compared with a noncleft control group (n = 40) matched according to age. The same 2 series of children were followed up until 15 years of age, and the results were again compared. Statistical analysis (analysis of variance with post hoc Tukey test) showed in both groups who were operated on a decreased anteroposterior growth compared with the children without cleft at 10 years but the AIO group only was not different from the group without cleft. The maxillary (MxPI/SN) plane was significantly (P = 0.002) increased in the Malek cleft group compared with the AIO group with cleft. At 15 years of age, a difference was not observed anymore between the 2 groups for the anteroposterior growth or for the maxillary plane inclination. One-stage AIO closure based on the Malek surgical principles provided good anteroposterior midfacial morphology and resulted in less opening of the maxillary plane to the anterior cranial base.
    The Journal of craniofacial surgery 09/2009; 20 Suppl 2:1723-8. DOI:10.1097/SCS.0b013e3181b3ef71 · 0.68 Impact Factor
  • Journal of Cranio-Maxillofacial Surgery 09/2008; 36. DOI:10.1016/S1010-5182(08)71692-5 · 2.60 Impact Factor
  • Journal of Cranio-Maxillofacial Surgery 09/2008; 36. DOI:10.1016/S1010-5182(08)71387-8 · 2.60 Impact Factor
  • Journal of Cranio-Maxillofacial Surgery 09/2008; 36. DOI:10.1016/S1010-5182(08)71501-4 · 2.60 Impact Factor
  • Journal of Cranio-Maxillofacial Surgery 09/2008; 36. DOI:10.1016/S1010-5182(08)71481-1 · 2.60 Impact Factor
  • Journal of Cranio-Maxillofacial Surgery 09/2008; 36. DOI:10.1016/S1010-5182(08)71140-5 · 2.60 Impact Factor
  • Journal of Cranio-Maxillofacial Surgery 09/2008; 36. DOI:10.1016/S1010-5182(08)71687-1 · 2.60 Impact Factor
  • Oral Oncology Supplement 05/2007; 2(1):162-162. DOI:10.1016/S1744-7895(07)70384-X
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    ABSTRACT: The aim of this pilot study was to investigate the potential of calcium phosphate cement in the treatment of orbital wall defect fractures in an adult sheep model, and to compare this alloplastic material to autologous calvaria split-bone grafts. Clinical, volumetric and histological examinations were carried out of both reconstruction materials. The use of cement made intraoperative corrections easier to perform, and increased the precision of reconstruction of the orbital volume. This material also proved to be osseoconductive. The two materials were used successfully in combination. Regions of most intensive remodelling were the anterior orbital floor and the adjacent orbital rim. The preliminary results of this study demonstrate the potential of calcium phosphate cement as a useful biomaterial in the reconstruction of the anterior orbital region. Further animal and clinical trials are necessary to investigate its ability as a carrier for mediators where bone healing requires influence or support.
    International Journal of Oral and Maxillofacial Surgery 02/2007; 36(1):54-61. DOI:10.1016/j.ijom.2006.07.014 · 1.36 Impact Factor
  • Journal of Cranio-Maxillofacial Surgery 09/2006; 34:205-205. DOI:10.1016/S1010-5182(06)60795-6 · 2.60 Impact Factor
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    ABSTRACT: Reconstruction of mandibular defects after tumor resection in infants is a particular challenge. Although autogenous rib grafts have no relevance nowadays for restoration of mandibular bone defects after ablative tumor surgery because of limited bone stock and the availability of other donor areas, they are a useful surgical alternative after tumor surgery in infants. We here report on a 6-month, 5-year, and 10-year follow-up of three children who were diagnosed with benign tumors of the mandible with osseous destruction at the ages of 4 months, 6 months, and 2 years, respectively. Histologic diagnoses were melanotic neuroectodermal tumor, hemangioendothelioma of the mandible, and ameloblastoma. After continuity resection of the mandible, latero-mandibular bone defects were restored using autogenous rib grafts. Both clinical and radiologic follow-up visits in all children were performed to assess growth of the facial skeleton as well as the mandibular growth. Cephalometric measurements on Panorex films and three-dimensional computed tomographic scans revealed slight vertical growth excess and transversal growth inhibition of the reconstructed mandible in comparison with the nonoperated side. Although further growth of rib grafts is difficult to predict and occlusal disharmony may occur because of physiologic maxillary growth and growth of the unaffected mandible, we think that autogenous rib grafts can be ideally used for restoration of mandibular continuity defects in newborns and young children. Clinical follow-up visits on a yearly basis and orthodontic controls are useful for early orthodontic treatment of growth deficits. Further corrective surgery with bone augmentation or osseous distraction is required after completion of growth of the facial skeleton.
    Journal of Craniofacial Surgery 04/2006; 17(2):255-60. DOI:10.1097/00001665-200603000-00009 · 0.68 Impact Factor
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    ABSTRACT: The purpose of this retrospective of prospectively acquired data was to evaluate and to compare global evolution in children with complete unilateral cleft lip and palate treated at the Brussels cleft centre following two different surgical treatment protocols. A series of forty-four patients operated for non-syndromic complete unilateral cleft lip and palate were included in this study at the age of approximately ten years. Twenty-six children (17 males, 9 females) were treated according to the Malek surgical treatment protocol: the soft palate was closed at a mean age of 3 months, followed by simultaneous repair of the lip and hard palate at a mean age of 6 months. Eighteen children (15 males, 3 females) underwent one-stage "all-in-one" closure of the lip, hard and soft palate at a mean age of 3 months. Craniofacial morphology was evaluated by means of digital lateral cephalometric analysis. Cephalometric data were compared to a control, non-cleft group (n = 40) matched according to age. Data concerning otological status and speech were collected in the same series of children. Statistical analysis showed that the inclination of the maxillary (MxPVSN) plane to the anterior cranial base was significantly increased (p <0.001) in both cleft groups compared to the non-cleft group and significantly increased (p = 0.002) in the Malek cleft group compared to the "all-in-one" cleft group. Otological status was not improved by an early complete closure but by close follow-up and the repeated placement of ventilating tubes. Speech was found to be satisfactory in the majority of children of both groups at six years after speech therapy. Only 15% needed further surgery with pharyngeal flaps. There were no significant differences in anteroposterior midfacial morphology between the Malek and "all-in-one" protocols at ten years of age. One-stage "all-in-one" closure resulted in less downward inclination of the maxillary plane to the anterior cranial base compared to the Malek protocol at ten years of age. Early complete closure of the cleft resulted in no significant change in otological status or the occurrence of nasality. However, early complete closure of the cleft allowed for earlier intelligibility of speech compared to the staged later closure.
    B-ENT 02/2006; 2 Suppl 4:44-50. · 0.08 Impact Factor
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    ABSTRACT: Aim of this study was to determine the success of implants that were inserted in patients with cleft of the lip, alveolus and palate (CLAP) and to identify prognosis-relevant factors. In a prospective evaluation, 75 implants inserted in combination with bone grafting at cleft sites of 45 patients were examined. The observation period extended 5.5 years in average (minimum 1.5, maximum 11.3 years). Implant success was evaluated clinically and radiographically and was compared to age- and gender-matched control groups. Statistic assessment included Kaplan-Meier survival analysis, Log rank tests and Cox regression analysis. In total, 10 implants were lost in 8 patients, resulting in an implant survival rate of 82.2% at the end of the observation period. Patient-related parameters of age, gender or type of cleft had no significant influence. The length of an implant was significantly related to an improved survival rate (P<0.01). Implant survival was less in CLAP patients when compared to implant insertions in a non-cleft control group, but improved when compared to patients with bone grafting for other indications. It is concluded that implants combined with bone grafting can offer a reliable alternative in patients with CLAP.
    International Journal of Oral and Maxillofacial Surgery 11/2005; 34(7):715-21. DOI:10.1016/j.ijom.2005.04.014 · 1.36 Impact Factor
  • A Eckardt, G Swennen, P Brachvogel
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    ABSTRACT: Reconstruction of mandibular defects following tumor resection in infants is a particular challenge. Although autologous rib grafts have no relevance nowadays for restoration of mandibular bone defects following ablative tumor surgery due to limited bone stock and the availability of other donor areas, they are a useful surgical alternative following tumor surgery in infants. We here report on the 5- and 10-year follow-up of two children who were diagnosed with benign tumors of the mandible with osseous destruction at the age of 4 and 6 months, respectively. Histological diagnoses were melanotic neuroectodermal tumor and hemangioendothelioma of the mandible. Following continuity resection of the mandible lateral mandibular bone defects were restored using autologous rib grafts. Yearly clinical and radiological follow-up visits in both children were performed to assess growth of the facial skeleton as well as mandibular growth. Cephalometric measurements on panorex films as well as 3D CT scans revealed slight vertical growth excess and transversal growth inhibition of the reconstructed mandible in comparison with the non-operated side. Although further growth of rib grafts is difficult to predict and occlusal disharmony may occur due to physiologic maxillary growth and growth of the unaffected mandible, we believe that autologous rib grafts can be ideally used for restoration of mandibular continuity defects in newborns. Clinical follow-up visits on a yearly basis and orthodontic controls are useful for early orthodontic treatment of growth deficits. Further corrective surgery with bone augmentation or osseous distraction is required following completion of growth of the facial skeleton.
    Mund- Kiefer- und Gesichtschirurgie 04/2005; 9(2):66-70. DOI:10.1007/s10006-005-0598-4
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    ABSTRACT: Abstract Introduction: Computer-guided navigation has proven a valuable tool in several surgical disciplines. During oral implant placement, its application is intended to accomplish optimal implant localization and to reduce the risk of damage to adjacent structures. The aim of this study was to compare the precision limits of conventional vs. navigated implant insertion in practice. Materials and methods: In cast models of the maxilla, implants were inserted to replace the left central incisor (n = 40) and the right canine (n = 40); each of those were inserted either conventionally (n = 20) or navigated (n = 20). Implant position, angulation and insertion depth were calculated from computer tomography scans of the implants that were connected to an index abutment of 40 cm length. Results: The variations of implant positions were reduced for implants that were inserted by navigation (P < 0.05). In both the axial and the transversal plane, the variations of implant angulations were reduced for implants that were inserted by a navigation protocol (P < 0.05). The variations of insertion depth were less (P < 0.05) when the implants were placed by navigation in comparison with conventional insertion procedures. Conclusions: Given the experimental conditions, although they tried to mimic a clinical situation, no final conclusions can be drawn. The in vitro application of a navigation system resulted in an improved precision of insertion surgery regarding the position, angulation and depth of an implant. Clinical studies will have to prove if routine image guidance will result in superior surgical outcome.
    Clinical Oral Implants Research 02/2005; 16(1):60-8. DOI:10.1111/j.1600-0501.2004.01058.x · 3.12 Impact Factor
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    ABSTRACT: In this retrospective study we analyzed our experience with mucoepidermoid carcinoma (MEC) of the salivary glands and compared our results with those reported in the literature. A total of 42 patients were treated between January 1983 and December 2002 at the Department of Oral and Maxillofacial Surgery, Hanover Medical School. Thirty-three tumors were classified as low grade carcinomas, 9 tumors as high grade carcinomas. Tumor sites were the parotid gland in 11 cases, sublingual and submandibular gland in 6 cases, oral cavity and oropharynx in 22 cases and nasal cavity and maxillary sinus in 3 cases. There were 23 T1-, 6 T2-, 5 T3- and 8 T4-tumors with 35 N0-, 5 N1- and 2 N2-necks, all M0 at presentation. Resection remained incomplete for 9 patients. Six patients received postoperative radiation. Overall survival rates, overall local control rates and overall regional control rates at 5 and 10 years were 79.1% and 65.5%, 89.1% and 80.8%, 92.3% and 87.7%. None of our patients developed distant failure. Grade, stage and margin status significantly influenced prognosis. MEC is a rare tumor entity and should be treated in specialist centres within randomised prospective multicentric trials.
    Oral Oncology 02/2005; 41(1):3-10. DOI:10.1016/j.oraloncology.2004.01.017 · 3.03 Impact Factor

Publication Stats

717 Citations
48.25 Total Impact Points

Institutions

  • 2009
    • Hôpital Universitaire des Enfants Reine Fabiola
      Bruxelles, Brussels Capital, Belgium
  • 2008
    • St. John's Hospital
      Springfield, Illinois, United States
  • 2004–2005
    • Center For Oral & Maxillofacial Surgery
      Georgia, United States
  • 2000–2004
    • Hannover Medical School
      • Center of Dental, Oral and Maxillofacial Science
      Hanover, Lower Saxony, Germany
  • 1999–2000
    • University Hospital Brussels
      Bruxelles, Brussels Capital Region, Belgium