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Journal of Cranio-maxillo-facial Surgery

Wouter M M T van Hout, Ellen M Van Cann, Ronald Koole, Antoine J W P Rosenberg
: This study investigates treatment outcome in zygomaticomaxillary complex (ZMC) fracture repair. METHODS: The medical records and CT-images of patients that received treatment for a unilateral ZMC fracture in 2005-2011 were studied. ZMC fractures were categorised as incomplete (type A), tetrapod (type B) or comminuted (type C). The incidence of sequelae, wound infection and secondary surgical interventions was analysed per fracture category. RESULTS: A total of 153 patients were treated in the selected period...
September 13, 2016: Journal of Cranio-maxillo-facial Surgery
Marine Hitier, Jean-Luc Cracowski, Cynthia Hamou, Christian Righini, Georges Bettega
OBJECTIVE: We evaluated the feasibility and the tolerance of repeated fluorescent indocyanine green angiography in free flap monitoring, and determined the intraoperative predictive values of flap vitality. BACKGROUND: The free flap failure rate has been significantly reduced, but free flap loss still occurs and remains a costly disaster. Repeated clinical examinations are commonly used for flap monitoring, but they can be unreliable because of their subjectivity...
September 10, 2016: Journal of Cranio-maxillo-facial Surgery
Liqi Li, Lishu Liao, Yuxiang Zhong, Yuangui Li, Li Xiang, Wanshan Li
PURPOSE: To evaluate postoperative variation trends of unilateral cleft lip by stages, and to analyze influential factors of nasolabial symmetry. MATERIALS AND METHODS: A total of 145 patients with unilateral cleft lip were treated by the modified Mohler or Tennison-Randall technique, and received routine anti-scarring treatment postoperatively. Photogrammetry was applied to respectively measure 5 indices by stages preoperatively, the first week (1 w), the third month (3 m), the sixth month (6 m), and the first year (1 y) postoperatively...
September 9, 2016: Journal of Cranio-maxillo-facial Surgery
Willem L J Weijs, Casper Coppen, Ruud Schreurs, Rinaldo D Vreeken, Arico C Verhulst, Matthias A W Merkx, Stefaan J Bergé, Thomas J J Maal
OBJECTIVE: Since reconstruction of composite defects in the head and neck region is a challenging and demanding problem for head and neck surgeons, surgical aids have been sought for decades. The purpose of this study was to evaluate the accuracy of prefabricated surgical resection templates used in mandibular segmental resections in comparison to the virtual surgical plan. MATERIALS AND METHODS: A prospective study was performed in 11 consecutive patients, with a primary T4 oral squamous cell carcinoma or osteoradionecrosis of the mandible...
September 9, 2016: Journal of Cranio-maxillo-facial Surgery
Vinay V Kumar, Supriya Ebenezer, Peer W Kämmerer, P C Jacob, Moni A Kuriakose, Naveen Hedne, Wilfried Wagner, Bilal Al-Nawas
OBJECTIVES: The objective of this study was to assess the difference in success rates of implants when using two or four implant-supported-overdentures following segmental mandibular reconstruction with fibula free flap. METHODS AND DESIGNS: This prospective, parallel designed, randomized clinical study was conducted with 1:1 ratio. At baseline, all participants already had segmental reconstruction of mandible with free fibula flap. The participants were randomized into two groups: Group-I received implant-supported-overdentures on two tissue-level implants and Group-II received implant-supported-overdentures on four tissue-level implants...
September 9, 2016: Journal of Cranio-maxillo-facial Surgery
Amel Ibrahim, Michael Suttie, Neil W Bulstrode, Jonathan A Britto, David Dunaway, Peter Hammond, Patrizia Ferretti
BACKGROUND: Midface hypoplasia as exemplified by Treacher Collins Syndrome (TCS) can impair appearance and function. Reconstruction involves multiple invasive surgeries with variable long-term outcomes. This study aims to describe normal and dysmorphic midface postnatal development through combined modelling of skeletal and soft tissues and to develop a surgical evaluation tool. MATERIALS AND METHODS: Midface skeletal and soft tissue surfaces were extracted from computed tomography scans of 52 control and 14 TCS children, then analysed using dense surface modelling...
September 2, 2016: Journal of Cranio-maxillo-facial Surgery
Takehiro Miki, Toshinori Iwai, Kazunori Kotani, Jianwu Dang, Hideyuki Sawada, Minoru Miyake
PURPOSE: Endoscope-assisted surgery has widely been adopted as a basic surgical procedure, with various training systems using virtual reality developed for this procedure. In the present study, a basic training system comprising virtual reality for the removal of submandibular glands under endoscope assistance was developed. The efficacy of the training system was verified in novice oral surgeons. MATERIAL AND METHODS: A virtual reality training system was developed using existing haptic devices...
August 31, 2016: Journal of Cranio-maxillo-facial Surgery
Lucas J Poort, Charlotte C Kiewiet, Jack P M Cleutjens, Ruud Houben, Frank J P Hoebers, Peter A W H Kessler
OBJECTIVES: The aim of this study was to compare the influence of implant surface treatment and irradiation dose on implant stability and osseointegration of 144 extraoral implants in irradiated frontal bone of minipigs. MATERIAL AND METHODS: 144 implants with 3 different surface treatments (machined, etched and HAVD-coated) were implanted in the frontal bone of 16 Göttingen minipigs. Three groups of four pigs received radiation with equivalent doses of 25, 50 and 70 Gy, and one group served as control...
August 31, 2016: Journal of Cranio-maxillo-facial Surgery
Jean-Marc Foletti, Luc Wajszczak, Marie Gormezano, Laurent Guyot, Narcisse Zwetyenga, Cyrille Chossegros
INTRODUCTION: Parotid gland duct lithiasis is preferentially managed using minimally-invasive techniques such as sialendoscopy and lithotripsy. However, these 2 techniques cannot remedy all obstructions and other techniques such as the Transoral Stensen's Duct Approach (TSDA) may sometimes be helpful. MATERIAL AND METHODS: A retrospective study of patients treated with TSDA was conducted to evaluate this procedure between 2006 and 2013. Criteria for inclusion were: failures for lithiases (22 patients and 28 lithiases) treated with sialendoscopy and/or lithotripsy for parotid gland duct obstruction...
August 26, 2016: Journal of Cranio-maxillo-facial Surgery
David Robla Costales, Luis Junquera, Eva García Pérez, Sara Gómez Llames, María Álvarez-Viejo, Álvaro Meana-Infiesta
PURPOSE: The aims of this study were twofold: first, to evaluate the production of cartilaginous tissue in vitro and in vivo using a novel plasma-derived scaffold, and second, to test the repair of experimental defects made on ears of New Zealand rabbits (NZr) using this approach. MATERIALS AND METHODS: Scaffolds were seeded with chondrocytes and cultured in vitro for 3 months to check in vitro cartilage production. To evaluate in vivo cartilage production, a chondrocyte-seeded scaffold was transplanted subcutaneously to a nude mouse...
August 26, 2016: Journal of Cranio-maxillo-facial Surgery
Wen-Bo Zhang, Yao Yu, Yang Wang, Chi Mao, Xiao-Jing Liu, Chuan-Bin Guo, Guang-Yan Yu, Xin Peng
While vascularized iliac crest flap is widely used for mandibular reconstruction, it is often challenging to predict the clinical outcome in a conventional operation based solely on the surgeon's experience. Herein, we aimed to improve this procedure by using computer-assisted techniques. We retrospectively reviewed records of 45 patients with mandibular tumor who underwent mandibulectomy and reconstruction with vascularized iliac crest flap from January 2008 to June 2015. Computer-assisted techniques including virtual plan, stereomodel, pre-bending individual reconstruction plate, and surgical navigation were used in 15 patients...
August 25, 2016: Journal of Cranio-maxillo-facial Surgery
Christian Mertens, Christian Freudlsperger, Jens Bodem, Michael Engel, Jürgen Hoffmann, Kolja Freier
BACKGROUND: Treatment of post-resective defects of the maxilla can be challenging and usually requires dental obturation or microvascular reconstruction. As compared to soft-tissue microvascular grafts, bone reconstruction can additionally allow for facial support and retention of dental implants. The aim of this study was to evaluate scapular tip grafts with respect to their applicability for maxillary reconstruction and their potential to retain dental implants for later dental rehabilitation...
August 25, 2016: Journal of Cranio-maxillo-facial Surgery
Christian Mertens, Jose de San Jose Gonzalez, Christian Freudlsperger, Jens Bodem, Johannes Krisam, Jürgen Hoffmann, Michael Engel
BACKGROUND: Patients with hemimaxillectomy defects after tumor surgery can alternatively be rehabilitated with dental obturators or microvascular flaps. When general medical or oncologic conditions do not permit microvascular surgery, dental obturators are the only solution, yet retention for edentulous patients is often poor. The aim of this study was to evaluate whether CAD/CAM suprastructures supported by implants placed in both residual alveolar ridges and contralateral zygomatic bone could enhance obturator stability and improve functional outcomes...
August 24, 2016: Journal of Cranio-maxillo-facial Surgery
Stevo J Najman, Vladimir J Cvetković, Jelena G Najdanović, Sanja Stojanović, Marija Đ Vukelić-Nikolić, Ivica Vučković, Dragan Petrović
Bone defects represent a serious problem in cranio-maxillofacial surgery. Autologous adipose-derived stromal vascular fraction (SVF) cells in combination with biological factors and bone substitutes were previously proposed as alternative to bone grafting. By simulating an intraoperative procedure we examined osteogenic capacity of the combination of two autologous components, freshly isolated adipose-derived SVF cells, and platelet-rich plasma (PRP), delivered on bone mineral matrix (BMM) carrier (SPB group) in mice ectopic bone forming model...
August 24, 2016: Journal of Cranio-maxillo-facial Surgery
Renato Marano, Alfio Jose Tincani
The aim of this study was to compare the effectiveness of porous polyethylene, titanium mesh, and castor oil-derived biopolymer randomized in orbital reconstructions of defects larger than 1 cm in length on the inferior and medial walls. A total of 63 patients (64 orbits) were evaluated to determine the presence of diplopia, enophthalmos ocular motility, and infraorbital nerve paraesthesia in both the preoperative and postoperative periods. The surgeons' opinions of the ease in handling the implants were also obtained after each procedure...
August 23, 2016: Journal of Cranio-maxillo-facial Surgery
Roman H Khonsari, Benjamin Way, Johan Nysjö, Guillaume A Odri, Raphaël Olszewski, Robert D Evans, David J Dunaway, Ingela Nyström, Jonathan A Britto
A major concern in FGFR2 craniofaciosynostosis is oculo-orbital disproportion, such that orbital malformation provides poor accommodation and support for the orbital contents and peri-orbita, leading to insufficient eyelid closure, corneal exposure and eventually to functional visual impairment. Fronto-facial monobloc osteotomy followed by distraction osteogenesis aims to correct midfacial growth deficiencies in Crouzon-Pfeiffer syndrome patients. Fronto-facial bipartition osteotomy followed by distraction is a procedure of choice in Apert syndrome patients...
August 21, 2016: Journal of Cranio-maxillo-facial Surgery
Bernhard Pommer, Dieter Busenlechner, Rudolf Fürhauser, Georg Watzek, Georg Mailath-Pokorny, Robert Haas
INTRODUCTION: Minimally invasive implantology using reduced implant dimensions as well as virtual treatment planning and CAD/CAM stereolithographic templates has gained popularity in recent years. The aim of the present investigation was to analyze prevailing trends in clinical utilization of these graftless therapeutic options. MATERIAL AND METHODS: A total of 12.865 dental implants were placed in 5.365 patients at the Academy for Oral Implantology in Vienna, of which 5...
August 21, 2016: Journal of Cranio-maxillo-facial Surgery
Elise Weber, Christophe Meyer, Alain Czorny, Brice Chatelain, Mourad Benassarou
INTRODUCTION: Craniosynostoses affecting the forehead sutures can not only cause brain damage, but can also have an esthetic impact, because of the associated orbito-naso-frontal deformations. Reshaping the orbito-naso-frontal bandeau (ONFB) is difficult to appreciate perioperatively and should ideally be customized to each child. The aim of this study was to develop a template to guide the surgeon preoperatively towards an ideal customized remodelling of the ONFB. MATERIALS AND METHODS: A previous study conducted on computed tomography scans obtained from healthy children allowed us to conclude that the whole ONFB shape could be accurately described just by the distance measured between the fronto-zygomatic sutures (FZD), independently of age and gender...
August 21, 2016: Journal of Cranio-maxillo-facial Surgery
Sergio Olate, Carlos Zaror, John N Blythe, Maurice Y Mommaerts
OBJECTIVE: The aim was to determine the soft-to-hard tissue ratios in profile view in bimaxillary orthognathic surgical corrections. MATERIAL AND METHODS: A systematic review of studies published in different languages was performed by searching the Medline, Embase, Cochrane Library, Lilacs, Scopus, and Science Direct databases up to August 2015. Additional studies were identified by reference analyses. The methodological quality was evaluated using the instrument developed by the Effective Public Health Practice Project and the Level of Evidence using the Level of Evidence scale from the Oxford Centre for Evidence-based Medicine...
August 21, 2016: Journal of Cranio-maxillo-facial Surgery
Bin Zhang, Mingliang Yang, Qing Zhou, Qiang Liu
PURPOSE: To share our experience in the open reduction and single screw internal fixation of delayed bilateral condylar head fractures with fragmentation and evaluate its feasibility and outcomes. PATIENTS AND METHODS: The study involved 6 males and 1 female. All patients had multiple injuries at different body sites and failed non-surgical treatment of bilateral condylar head fractures. The mean period between the injury and the operation was 5.7 (4-8) weeks. According to the preoperative computer-aided design, and the clinical manifestations, the fracture fragments were reduced and fixed with a single screw...
August 21, 2016: Journal of Cranio-maxillo-facial Surgery
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