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Maxillary osteotomy

Juho Suojanen, Junnu Leikola, Patricia Stoor
The use of virtual surgery, patient-specific saw and drill guides, and custom-made osteosynthesis plates is rapidly spreading from deformity surgery to orthognathic surgery. Most of the commercially available systems are using computer-aided design/computer-aided manufacture (CAD/CAM) wafers to produce patient-specific saw guides. However, most plate systems provided are still the conventional "in stock" mini plates that can be individually designed by pre-bending according to the stereolithographic model of the patient...
September 23, 2016: Journal of Cranio-maxillo-facial Surgery
Daisuke Ueno, Takashi Kurokawa, Katsuichiro Maruo, Tsuneaki Watanabe, Jayanetti Asiri Jayawardena
INTRODUCTION: Perforation of the Schneiderian membrane is the most common complication in sinus floor augmentation (SFA). When volume of grafting is qualified to prevent enlargement of the membrane perforation, lack of bone volume may occur in optimal site. CASE PRESENTATION: SFA was performed in sites #24 to 26 in a 63-year-old male. However, a 10-mm size perforation of the Schneiderian membrane occurred in site #26. Although the sinus cavity was grafted with deproteinized bovine bone mineral (DBBM) after repair of membrane perforation, insufficient bone formation was observed on palatal and distal aspects of site #26 at 5 months after SFA...
December 2015: Int J Implant Dent
Jeffrey C Posnick, Elbert Choi, Anish Chavda
PURPOSE: Frequency estimates of surgical site infection (SSI) after orthognathic surgery vary considerably. The purpose of this study was to determine the incidence and site of SSIs and associated risk factors after bimaxillary orthognathic, osseous genioplasty, and intranasal surgery. MATERIALS AND METHODS: The authors executed a retrospective cohort study of patients with a bimaxillary developmental dentofacial deformity (DFD) and symptomatic chronic obstructive nasal breathing...
September 20, 2016: Journal of Oral and Maxillofacial Surgery
E Arnaud, G Paternoster, S James, M-P Morisseau-Durand, V Couloigner, P Diner, C Tomat, V Viot-Blanc, B Fauroux, V Cormier-Daire, G Baujat, M Robert, A Picard, S Antunez, R Khonsari, L Pamphile-Tabuteau, C Legros, M Zerah, P Meyer
The complexity of treatment of faciocraniosynostosis justifies the treatment in a reference center for rare diseases. The growth disturbances in the skull and face being variable according to the type of mutation in the FGFr (Crouzon, Pfeiffer, Apert), the strategy is adapted to the phenotype according to the following principles: posterior expansion with or without distraction around 6 months to limit the descent of the cerebellum tonsils and to prevent the turricephalic development; fronto-facial monobloc advancement with internal distraction around the age of 18 months in case of severe exorbitism or breathing impairment...
October 2016: Annales de Chirurgie Plastique et Esthétique
Dimitrios Kloukos, Piotr Fudalej, Patrick Sequeira-Byron, Christos Katsaros
BACKGROUND: Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults with a repaired cleft. Conventional orthognathic surgery, such as Le Fort I osteotomy, is often performed for the correction of maxillary hypoplasia...
September 30, 2016: Cochrane Database of Systematic Reviews
Yunfeng Li, Zhiai Hu, Bin Ye, Yao Liu, Xiaochun Ren, Songsong Zhu
PURPOSE: Orthognathic surgery is an efficient procedure for cosmetic and functional aims. However, when functional improvement is achieved by mandibular or maxillary operations, additional esthetic corrections may be imperative for some patients. This study aims to introduce our primary practice of simultaneous facial bone contouring and orthognathic surgery for esthetic reasons. PATIENTS AND METHODS: Ten patients with dentofacial deformities as well as a prominent angle, asymmetric deformities, or a high zygoma and zygomatic arch were recruited from West China Hospital of Stomatology, Sichuan University (Chengdu, China), between January 1, 2014, and July 31, 2015...
August 31, 2016: Journal of Oral and Maxillofacial Surgery
Hye-Rim Ann, Young-Soo Jung, Kee-Joon Lee, Hyoung-Seon Baik
OBJECTIVE: The aim of this study was to evaluate the skeletal and dental changes after intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontics by using cone-beam computed tomography (CBCT). METHODS: This retrospective cohort study included 24 patients (mean age, 22.1 years) with skeletal Class III malocclusion who underwent bimaxillary surgery with IVRO. The patients were divided into the preorthodontic orthognathic surgery (POGS) group (n = 12) and conventional surgery (CS) group (n = 12)...
September 2016: Korean Journal of Orthodontics
Ümit Taşkın, Timur Batmaz, Mehmet Erdil, Salih Aydın, Kadir Yücebaş
The basic aim of our study is to compare the results of the conventional and piezoelectric osteotomy in rhinoplasty by complete subperiosteal degloving of nasal bone to minimize soft-tissue injury. The study was designed as a prospective, double-blind, randomized, and controlled study. Setting is a tertiary referral hospital in Turkey. Ninety patients who underwent primary open rhinoplasty with osteotomy, performed by either the conventional instruments or the piezoelectric device. The complete subperiosteal degloving of the entire nasal bone was done up to the nasal maxillary sulcus, medial canthus, and nasion in all patients, independent of the type of osteotomy device used...
September 17, 2016: European Archives of Oto-rhino-laryngology
Jeffrey C Posnick, Jorge Perez, Anish Chavda
PURPOSE: The purpose of this study was to assess for the maintenance of a corrected occlusion and ongoing mandibular growth in a group of patients younger than 26 years with hemimandibular elongation (HME) who underwent bimaxillary orthognathic reconstruction. MATERIALS AND METHODS: We conducted a retrospective cohort study of HME patients operated on by a single surgeon at 1 institution between 1999 and 2013. At a minimum, all patients underwent Le Fort I and bilateral sagittal ramus osteotomies...
August 24, 2016: Journal of Oral and Maxillofacial Surgery
Christopher R DeSesa, Philip Metzler, Rajendra Sawh-Martinez, Derek M Steinbacher
BACKGROUND: Le Fort I osteotomy imparts significant changes to the nasolabial region. Past studies have relied on 2-dimensional data and have not delineated differences among various Le Fort I subtypes. The purpose of this study is to 3-dimensionally analyze Le Fort I-induced nasal and lip changes comparing advancement alone versus widening alone [surgically assisted maxillary expansion (SAME)] versus advancement and widening. We hypothesize that the combination of maxillary advancement with widening will result in the most profound changes...
August 2016: Plastic and Reconstructive Surgery. Global Open
Seungil Chung, Sanghoon Park
BACKGROUND: Although Le Fort I osteotomy superior impaction during bimaxillary surgery is beneficial for patients with a long face, achieving satisfactory results can be challenging due to the redundant upper lip. However, upper-lip reduction has rarely been performed during or following bimaxillary surgery because of the difficulty in estimating the required amount of cutaneous resection needed and the apparent horizontal scars left behind. Therefore, no simultaneous cutaneous upper-lip reduction with orthognathic surgery has been reported...
September 9, 2016: Journal of Craniofacial Surgery
Yao Liu, Wen Du, Jing Hu, Chuhang Liao, Wei Fei, En Luo
OBJECTIVE: With the inclusion criteria of patients confirmed and the therapeutic effects and stability evaluated, this article presents the clinical value of bimaxillary orthognathic surgery without bone graft of maxillofacial asymmetric deformities in patients treated for unilateral temporomandibular joint (TMJ) ankylosis. STUDY DESIGN: From 2008 to 2012, 12 patients with dentomaxillofacial asymmetric deformities secondary to unilateral TMJ ankylosis who had undergone TMJ reconstruction as the primary surgery were included in the study...
November 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Franco Carlino, Giuseppe Pantaleo, Fabio Ciuffolo, Pier Paolo Claudio, Antonio Cortese
INTRODUCTION: A surgical technique to widen the mandible is the mandibular midline distraction: the most common indications for mandibular midline distraction are severe mandibular anterior crowding, severe mandibular transverse deficiency, uni- or bilateral crossbite, impacted anterior teeth with inadequate space, and tipped teeth. Commonly used distraction devices can be divided into 2 systems: bone-borne distraction system appliance, dental-borne distraction systems. Each system has peculiar advantages, disadvantages, and different indications...
September 2016: Journal of Craniofacial Surgery
Siamak Hemmatpour, Fatemeh Kadkhodaei Oliadarani, Ali Hasani, Vahid Rakhshan
INTRODUCTION: The aim of this before-after clinical trial was to evaluate nasolabial soft tissue changes in the frontal plane after bimaxillary surgery. METHODS: A total of 20 skeletal Class III Iranian patients needing bimaxillary Le Fort I osteotomy plus mandibular setback surgery were enrolled in this trial. Patients underwent 4.02 ± 1.02 mm of maxillary advancement (Le Fort I osteotomy, 4.33 ± 1.21 mm in men, 3.81 ± 0.86 mm in women) and 7.13 ± 1...
August 31, 2016: Journal of Orofacial Orthopedics, Fortschritte der Kieferorthopädie
F X Wong, A A Heggie, J M Shand, P M Schneider
The stability of surgical maxillary advancement in a consecutive series of patients with cleft lip and palate who underwent Le Fort I osteotomy with and without simultaneous mandibular setback surgery was evaluated. Preoperative, postoperative, and follow-up lateral cephalograms of 21 patients were assessed to compare differences in surgical movement and postoperative relapse between two groups: those who underwent maxillary surgery alone and those who underwent bimaxillary surgery. Differences in the number of patients who experienced relapse of <2mm, 2-4mm, and >4mm between the groups were also compared...
August 26, 2016: International Journal of Oral and Maxillofacial Surgery
Kamil Henryk Nelke, Wojciech Pawlak, Klaudiusz Łuczak
Many types of surgical osteotomies of the cranio-facial skeleton relay on adequate surgical field preparation. Placement and stabilization of nasotracheal tube during orthognathic surgery is very important. In most cases, long-lasting surgery includes various surgical maneuvers around patient's skull, which depend on accurate nasotracheal tube stabilization. Usage of adhesive plasters for heavy anesthetic tube connector placement and stability might result in tube instability and local disfigurement of nasal projection and visibility in the nasal and infraorbital areas...
October 2016: Journal of Craniofacial Surgery
Sung Woon On, Hyun Jun Kim, Jayoun Kim, Jin Wook Choi, Young Wook Jung, Seung Il Song
OBJECTIVES: The aims of this study were to investigate the availability of Hounsfield unit (HU) measurement of computed tomography (CT) in evaluating the bone density of certain sites by comparing bone density between CT and dual-energy x-ray absorptiometry (DEXA), and to evaluate the effects of osteoporosis on osteotomy sites in orthognathic surgery. METHODS: This retrospective study included 80 patients who had undergone both facial CT and DEXA at our hospital...
October 2016: Journal of Craniofacial Surgery
Susie Lin, Samuel J McKenna, Chuan-Fong Yao, Yu-Ray Chen, Chit Chen
PURPOSE: The objective of this study was to evaluate the efficacy of hypotensive anesthesia in reducing intraoperative blood loss, decreasing operation time, and improving the quality of the surgical field during orthognathic surgery. A systematic review and meta-analysis of randomized controlled trials addressing these issues were carried out. MATERIALS AND METHODS: An electronic database search was performed. The risk of bias was evaluated with the Jadad Scale and Delphi List...
July 25, 2016: Journal of Oral and Maxillofacial Surgery
J Kraeima, J Jansma, R H Schepers
To analyse the accuracy of maxillary positioning after Le Fort I osteotomy, we retrospectively assessed the outcome in three patients (mean (range) age 40 (21 - 60) years) who had been treated with patient-specific CAD-CAM osteosynthesis plates as part of a bimaxillary osteotomy. Virtual surgical planning in each case was based on cone-beam computed tomography (CT) (Simplant® O&O, Dentsply Implants NV, Kessel-Lo, Belgium), and patient-specific CAD-CAM drilling guides and osteosynthesis plates were produced for maxillary positioning and fixation...
August 13, 2016: British Journal of Oral & Maxillofacial Surgery
Altan Varol, Onur Atali, Aysegul Sipahi, Selcuk Basa
PURPOSE: The aim of this 4-year retrospective follow-up study was to investigate treatment outcomes, including implant survival rate and marginal bone loss, in patients with maxillary Cawood type VI atrophy pattern who underwent Le Fort I downgrafting and iliac block augmentations for implant rehabilitation. MATERIALS AND METHODS: Retrognathic edentulous Class III patients with severe maxillary resorption (Cawood VI) were enrolled. Reconstructive procedures performed included Le Fort I maxillary osteotomy, iliac block grafting, labial sulcoplasties, and dental implant placement...
August 15, 2016: International Journal of Oral & Maxillofacial Implants
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