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Maxillary osteotomy

Artur Fahradyan, Erik M Wolfswinkel, Noreen Clarke, Stephen Park, Michaela Tsuha, Mark M Urata, Jeffrey A Hammoudeh, Dennis-Duke R Yamashita
BACKGROUND: The maxillary horizontal relapse following Le Fort I advancement has been estimated to be 10% to 50%. This retrospective review examines the direct association between the amounts of maxillary advancement and relapse. We hypothesize that the greater the advancement, the greater the relapse amount. METHOD: Patients with class III skeletal malocclusion underwent maxillary advancement with either a Le Fort I or a Le Fort I with simultaneous mandibular setback (bimaxillary surgery) from 2008 to 2015...
April 2018: Cleft Palate-craniofacial Journal
Koichiro Ueki, Akinori Moroi, Takamitsu Tsutsui, Ryota Hiraide, Akihiro Takayama, Yuki Saito, Momoko Sato, Nana Baba, Tatsuya Tsunoda, Asami Hotta, Kunio Yoshizawa
PURPOSE: The purpose of this study was to compare time-course changes in temporomandibular joint (TMJ) space between mandibular advancement surgery and setback surgery after sagittal split ramus osteotomy (SSRO) and Le Fort I osteotomy. SUBJECTS AND METHODS: The subjects were 46 patients (92 joints) who underwent bi-maxillary surgery. The TMJ disc position was assessed by magnetic resonance imaging (MRI) and the anterior, superior, posterior, medial and lateral joint spaces were assessed by computed tomography (CT), preoperatively and at 1 week and 1 year postoperative...
February 9, 2018: Journal of Cranio-maxillo-facial Surgery
Daniel B Rodrigues, Paulo S F Campos, Larry M Wolford, Jaqueline Ignácio, João R Gonçalves
PURPOSE: Maxillary segmentation involving interdental osteotomies can have an adverse effect on the interdental crestal bone and adjacent teeth. The purpose of the present study was to evaluate the effect of interdental osteotomies on surrounding osseous and dental structures, including adjacent teeth, using cone beam computed tomography (CBCT), in patients who underwent segmental maxillary osteotomies. PATIENTS AND METHODS: The present retrospective cohort study evaluated interdental osteotomy (IDO) sites between the lateral incisors and canines in patients treated with 3-piece Le Fort I osteotomies...
February 19, 2018: Journal of Oral and Maxillofacial Surgery
Keisuke Sugahara, Yoshiharu Katsumi, Masahide Koyachi, Yu Koyama, Satoru Matsunaga, Kento Odaka, Shinichi Abe, Masayuki Takano, Akira Katakura
Background: Along with the advances in technology of three-dimensional (3D) printer, it became a possible to make more precise patient-specific 3D model in the various fields including oral and maxillofacial surgery. When creating 3D models of the mandible and maxilla, it is easier to make a single unit with a fused temporomandibular joint, though this results in poor operability of the model. However, while models created with a separate mandible and maxilla have operability, it can be difficult to fully restore the position of the condylar after simulation...
December 2018: Maxillofacial Plastic and Reconstructive Surgery
Sarina K Mueller, Suzanne K Freitag, Daniel R Lefebvre, Nahyoung G Lee, Benjamin S Bleier
BACKGROUND: Endoscopic dacryocystorhinostomies (eDCRs) show patency rates between 81% and 94%. However, dacryocystorhinostomy (DCR) failure and the need for revision remain a significant challenge. One of the principal challenges in revision eDCR is the need to surgically identify the correct osteotomy site and maintain long-term patency in the setting of previously instrumented and potentially scarred tissue. At the same time, the surgeon must assume that the blood supply to the commonly described anterior and posteriorly pedicled flaps has been compromised...
March 8, 2018: Orbit
Walid El Kininy, Shane Davy, Leo Stassen, Denis Stephen Barry
Variations in the relationship of the retromandibular vein to the facial nerve have been widely reported due to their relevance for surgical approaches in parotid, osteotomy and mandibular condyle surgery. In the context of the retromandibular retroparotid approach, remaining deep to the retromandibular vein is advised to decrease the likelihood of encountering the facial nerve during mandibular condyle surgery. In the present report, an unusual variant of the superficial temporal vein lying superficial to the facial nerve is described...
March 3, 2018: Folia Morphologica (Warsz)
Michael R Bykowski, Amber Hill, Catherine Garland, William Tobler, Joseph E Losee, Jesse A Goldstein
BACKGROUND: Although rare, pseudoaneurysms (PA) can develop following Le Fort I osteotomy and lead to life-threatening hemorrhage. However, the typical presentation of a PA following a Le Fort I osteotomy is not well characterized. Evidence-based guidelines are not currently available for evaluation of PA following Le Fort I osteotomy. METHODS: A case report is presented of a 27-year-old man who underwent Le Fort I advancement and subsequently developed a bleeding PA...
March 1, 2018: Journal of Craniofacial Surgery
Willian Saranholi da Silva, Ana Lúcia Pompéia Fraga de Almeida, Maria Giulia Rezende Pucciarelli, Karin Hermana Neppelenbroek, Juliana Dreyer da Silva de Menezes, Renato Yassutaka Faria Yaedú, Thais Marchini Oliveira, Flavia M R N Cintra, Simone Soares
This retrospective observational study aimed to evaluate and identify the relapse rate after orthognathic surgery for maxillary advancement (Le Fort I maxillary osteotomy) in oral cleft patients through digitized cephalograms and 3D dental models, following 2 years. Lateral cephalograms and dental casts of 17 individuals, enrolled in Orthodontics Department in Hospital of Rehabilitation of Craniofacial Anomalies, were carried out. The digital cephalometric tracings were evaluated in: T1-before surgery, T2-immediate after surgery, T3-6-month to 1-year after surgery...
March 1, 2018: Odontology
Miki Watanabe, Akira Watanabe, Nobuo Takano, Chikara Saito, Takahiko Shibahara
OBJECTIVE: The present study aimed to determine the structure and morphology of the maxilla in patients with cleft lip and palate to ensure safe Le Fort I osteotomy. PATIENTS: A total of 34 sides of 17 patients with unilateral cleft lip and palate (nonsyndromic cases) were included in this study. The control group included 10 sides of 5 patients who exhibited skeletal mandibular protrusion without malformation. METHODS: Finite element analysis was performed to examine the distribution of occlusal force over the maxilla, and continuous 3-dimensional measurement was performed at the sites of stress concentration...
January 1, 2018: Cleft Palate-craniofacial Journal
Max J H Witjes, Rutger H Schepers, Joep Kraeima
PURPOSE OF REVIEW: This review describes the advances in 3D virtual planning for mandibular and maxillary reconstruction surgical defects with full prosthetic rehabilitation. The primary purpose is to provide an overview of various techniques that apply 3D technology safely in primary and secondary reconstructive cases of patients suffering from head and neck cancer. RECENT FINDINGS: Methods have been developed to overcome the problem of control over the margin during surgery while the crucial decision with regard to resection margin and planning of osteotomies were predetermined by virtual planning...
April 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Konstantinos Lazaridis, Maria Lazaridou, Athanasios E Athanasiou
Introduction: Le Fort I and sagittal split ramus osteotomies are the most commonly performed orthognathic surgery procedures on the maxilla and mandible, respectively. Techniques: Despite progress in the techniques, these procedures may still be associated with morbidity, expressed as inflammation, inadequate bony union, periodontal damages or in extreme cases even total bone loss. Discussion: Through a comprehensive review of the literature, the influences of maxillary and mandibular surgery on Pulpal Blood Flow (PBF), pulp sensitivity and pulp vitality are examined...
2018: Open Dentistry Journal
José Thiers Carneiro Júnior, Paulo Hemerson de Moraes, Douglas Voss de Oliveira, Nayara Cristina Monteiro Carneiro
Patients with considerable maxillomandibular anteroposterior discrepancies and maxillary hypoplasia require corrective treatment through orthognathic surgery. However, in the treatment of severe maxillary retrognathism, it is necessary to reconstruct areas of bone deficiency through grafting techniques in addition to maxillary advancement using only the Le Fort I osteotomy. Treatment in these patients is more challenging and requires high surgical predictability. Alloplastic materials often have been used for the reconstruction of poor bone contours...
January 31, 2018: Journal of Oral and Maxillofacial Surgery
C Michelle Giacomino, Jarom J Ray, James A Wealleans
Endodontic microsurgery (EMS) techniques have increased success rates over traditional approaches. Despite surgical advances, anatomically challenging scenarios can preclude EMS in certain cases. The aim of this article was to introduce targeted EMS, which uses 3-dimensional-printed surgical guides (3DSGs) and trephine burs to achieve single-step osteotomy, root-end resection, and biopsy in complex cases. In each of 3 cases, a 3DSG with a trephine port was printed using computer-aided design/computer-aided manufacturing implant planning software...
February 6, 2018: Journal of Endodontics
Hoon Kim, Kyung-Suk Cha
Objective: The aim of this study is to quantitatively evaluate the stability of the skeletal and dental widths using cone-beam computed tomography (CBCT) after segmental Le Fort I osteotomy in adult patients with skeletal Class III malocclusion requiring maxillary expansion. Methods: In total, 25 and 36 patients with skeletal Class III malocclusion underwent Le Fort I osteotomy (control group) and segmental Le Fort I osteotomy (experimental group), respectively...
January 2018: Korean Journal of Orthodontics
P Aktop, S Biren, S Aktop, M Motro, C Delilbasi, G Gurler, G Dergin
We compared and evaluated the effects of two techniques used for surgically assisted rapid maxillary expansion (SARME) using three-dimensional (3D) cone-beam computed tomography, focusing on changes in soft and hard tissue in the malar region. A conventional Le Fort I osteotomy group (10 patients, mean age: 19.3 years) and a high Le Fort I group (12 patients, mean age: 20.4 years) underwent 3D analyses. Changes in hard and soft tissue of the malar region were compared. The average increases in the bone malar width and soft malar width in the high Le Fort I group between the pre- and postoperative periods were 1...
January 2018: Nigerian Journal of Clinical Practice
D Séblain, J Bourlet, R H Khonsari, P Roy, A Gleizal, J Chauvel Picard
OBJECTIVE: Compare literature-reported efficiency and complications of the standard maxillary advancement surgery with those of a minimally invasive mucosal approach in patients with CL/P requiring Le Fort 1 osteotomy. DESIGN: Meta-analysis vs. retrospective analysis of 18 consecutive cases. SETTING: Department of maxillofacial surgery at a tertiary-level public general hospital. PARTICIPANTS: The meta-analysis encompassed Medline, Embase, and Cochrane, years 1990 to 2014, inclusive...
February 2, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Yong-Chan Ha, Se Jin Han
PURPOSE: Two- and 3-dimensional studies on changes of the pharyngeal airway after a Le Fort I osteotomy have been conducted, but there are few studies on the change of nasal structure. The nasal cavity is the first passage through which air enters during respiration. Movement of the maxilla by Le Fort I osteotomy affects the shape of the nasal cavity and the shape of other parts of the airway. This study compared preoperative and postoperative changes of the nasal cavity volume after a maxillary Le Fort I osteotomy...
January 10, 2018: Journal of Oral and Maxillofacial Surgery
P U Abdul Wahab, Marimuthu Madhulaxmi, Periyasamy Senthilnathan, Marimuthu Ramaswamy Muthusekhar, Yogaen Vohra, Rajendra Prabhu Abhinav
PURPOSE: The aim of this study was to analyze and compare the healing of scalpel and diathermy incision wounds in the oral mucosa. MATERIALS AND METHODS: This is a prospective split-mouth study conducted from January 2015 to April 2017 among patients undergoing either Le Fort I or anterior maxillary osteotomy (or both). The study groups were classified based on the different techniques used to make the incision (group A, incision made by a scalpel; group B, incision made by diathermy)...
January 4, 2018: Journal of Oral and Maxillofacial Surgery
S Salman, T Fattahi, R Fernandes, B Steinberg
The aim of this study was to evaluate the dynamic perfusion of the maxilla during various stages of a Le Fort I osteotomy using indocyanine green (ICG) dye angiography. This was a retrospective evaluation of patients who underwent a Le Fort I osteotomy. ICG was used to assess perfusion at specific time points during the procedure. Twenty-four patients underwent a Le Fort I osteotomy with dynamic perfusion ICG angiography. Statistically significant differences in perfusion were noted at all three locations assessed between preoperative (T0), post down-fracture (T1), and postoperative (T2) time points...
February 2, 2018: International Journal of Oral and Maxillofacial Surgery
A Esen, E Soganci, E Dolanmaz, D Dolanmaz
Surgically-assisted rapid maxillary expansion (SARME) is commonly used to treat skeletally mature patients with transverse discrepancies. Some osteotomies are made in areas that resist expansion, but there is no clear consensus about the sequence in which the osteotomies are made. Some clinicians do the pterygomaxillary osteotomy last, while others do it before the midpalatal osteotomy. We used the finite element method to measure the stresses on the midface, cranial base and pterygoid plates at the time of midpalatal osteotomy in two models, one with and one without pterygomaxillary dysjunction (PMD)...
January 30, 2018: British Journal of Oral & Maxillofacial Surgery
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