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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
Debraj Howlader, Dichen P Bhutia, U Vignesh, Divya Mehrotra
Facial asymmetry is one of the commonest facial anomalies, with reported incidence as high as 34%. Hemifacial microsomia (HFM) has an incidence of 1 in every 4000-5600 children and is one of the commonest causes of facial asymmetry. The standard treatment of HFM is orthognathic surgery by bilateral saggital split osteotomy (BSSO) or distraction osteogenesis (DO) of the mandible, both of which involve prolonged periods of occlusal adjustments by an orthodontist. Here, we present distraction of the mandible by means of a novel modified step osteotomy to correct the facial asymmetry in a case of hemifacial microsomia without disturbing the occlusion...
September 2016: Journal of Oral Biology and Craniofacial Research
Christopher M Runyan, Vishal Sharma, David A Staffenberg, Jamie P Levine, Lawrence E Brecht, Leonard H Wexler, David L Hirsch
BACKGROUND: Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction. METHODS: A woman with maxillary Ewing sarcoma successfully treated at age 9 with neoadjuvant chemotherapy, right hemimaxillectomy, and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit, and hypernasality...
October 14, 2016: Journal of Craniofacial Surgery
Harsh Pipalia, Praveen Ganesh, Samarth Shetty, Paul C Salins, Rohan Raut, Kiran Kumar Boyina
Three-dimensional virtual surgery programs are widely available for orthognathic surgery. The advent of imaging software programs has proved to be useful for diagnosis, treatment planning, outcome measurement, and three-dimensional surgical simulation. Complex maxillofacial malformations continue to present challenges in analysis and correction beyond modern technology. Orthomorphic correction for mandibular dysmorphology refers to basal bone movement without any change in dental component. The purpose of this paper is to present a virtual surgery planning for surgeons to perform the orthomorphic surgery with precision and quantification...
October 14, 2016: Journal of Craniofacial Surgery
Juliana Dreyer da Silva de Menezes, Lucas Borin Moura, Renato Parsekian Martins, Eduardo Hochuli-Vieira
Porous polyethylene implants have been used as an alternative in the treatment of patients with zygomatic and paranasal projections deficiency. These implants promote a facial rejuvenating effect due to the attenuation of the nasal and chin prominences. The advantages of porous polyethylene include biocompatibility, dimensional stability, easy adaptation and fixation, low complication rate, and its availability in different sizes and shapes. A 27-year-old woman presenting vertical deficiency associated with midface hypoplasia was treated with orthognathic surgery...
October 14, 2016: Journal of Craniofacial Surgery
Jimoh Olubanwo Agbaje, Elke Van de Casteele, Marjolein Hiel, Ciska Verbaanderd, Ivo Lambrichts, Constantinus Politis
OBJECTIVE: To report the incidence of trigeminal neuropathy seen among new patients in a referral center within a period of 1 year (2013). The cause of damage, method of management and treatment outcome was assessed after 1-year follow-up. MATERIALS AND METHODS: The records of all new patients visiting the oral and maxillofacial unit of the University hospital of Leuven in 2013 were screened for a history of damage to branches of the trigeminal nerve. The selected records were examined and the duration of nerve damage, received treatment as well as the outcome of the neuropathy after treatment was noted after 1-year follow-up...
September 2016: Journal of Maxillofacial and Oral Surgery
Hideyuki Suenaga, Asako Taniguchi, Kazumichi Yonenaga, Kazuto Hoshi, Tsuyoshi Takato
INTRODUCTION: Computer-assisted preoperative simulation surgery is employed to plan and interact with the 3D images during the orthognathic procedure. It is useful for positioning and fixation of maxilla by a plate. We report a case of maxillary retrusion by a bilateral cleft lip and palate, in which a 2-stage orthognathic procedure (maxillary advancement by distraction technique and mandibular setback surgery) was performed following a computer-assisted preoperative simulation planning to achieve the positioning and fixation of the plate...
October 4, 2016: International Journal of Surgery Case Reports
Fawaz L Almutairi, Samantha J Hodges, Nigel P Hunt
OBJECTIVE: To investigate the treatment outcome in terms of the malocclusion features and the changes in the occlusion of patients undergoing orthodontic/orthognathic treatment using the Peer Assessment Rating (PAR) and the Index of Complexity, Outcome and Need (ICON) and to test the application of the Index of Orthognathic Functional Treatment Need (IOFTN) on this sample as a measure of orthognathic pre-treatment need. DESIGN: Retrospective longitudinal cohort study...
October 17, 2016: Journal of Orthodontics
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
S Lin, C Chen, C-F Yao, Y-A Chen, Y-R Chen
Sixty-three consecutive patients undergoing bimaxillary surgery between June and August 2015 were included in this study. Twenty-one patients were included in each of three study groups. In group 1, sevoflurane was the sole maintenance anaesthesia agent used; in group 2, propofol was the predominant agent, in addition to a reduced amount of sevoflurane; in group 3, patients received sevoflurane until fixation was completed, at which point it was switched to propofol. The mean intraoperative blood loss (ml) was 707...
October 10, 2016: International Journal of Oral and Maxillofacial Surgery
Sandro Pelo, Gianmarco Saponaro, Giulio Gasparini, Paolo De Angelis, Andrea Spota, Umberto Garagiola, Enrico Foresta, Alessandro Moro
The introduction of "surgery first" has resulted in a new requirement to compare and resolve medical legal problems which previously did not exist in traditional orthognathic surgery. The first issue relates to the relationship between the doctor and the patient and, in particular, the need to create a new informed consent form for surgery first. The second problem that has arisen with the arrival of surgery first concerns the relationship between health workers, namely the surgeon, and the orthodontist. The authors of this article propose a new template for informed consent specifically created for surgery first and also a model for the new working relationship between surgeons and orthodontists which will facilitate and improve co-operation between them...
October 2016: Journal of Craniofacial Surgery
Safoura Seifi, Shabnam Sohanian, Oveis Khakbaz, Farida Abesi, Fatemeh Aliakbarpour, Arezoo Rayani
INTRODUCTION: The ectopic ciliated cyst is a rare non-odontogenic cyst which occurs as a delayed complication after maxillary sinus radical surgery; this lesion emerges due to the destruction of the sinus mucosa during the surgery and entrapment of the respiratory epithelium in the region. This lesion has been observed in very rare cases following genioplasty and bimaxillary orthognathic surgery. CASE REPORT: We reported a case of the ectopic ciliated cyst in in the mandible of a 37-year-old Iranian woman following genioplasty and Lefort 1 surgery after 2 years...
September 2016: Iranian Journal of Otorhinolaryngology
Fernanda P Bragatto, Mariliani Chicarelli, Amanda Vb Kasuya, Wilton M Takeshita, Liogi Iwaki-Filho, Lilian Cv Iwaki
INTRODUCTION: The golden proportion has been used in dentistry in an attempt to improve facial function and, possibly, esthetics by simplifying the diagnosis of facial and dental disharmony. The aim of this study is to analyze pre- and postoperative cephalometric tracings of lateral cephalograms of patients with class II and III deformities submitted to orthognathic surgery, and verify if the 13 dental-skeletal patterns (ratios), as defined by Ricketts, moved closer to or further away from the golden proportion...
September 1, 2016: Journal of Contemporary Dental Practice
Hianne Miranda de Torres, José Valladares-Neto, Érica Miranda de Torres, Rogério Zambonato Freitas, Maria Alves Garcia Silva
PURPOSE: To evaluate the effect of genioplasty on the size of the pharyngeal airway space (PAS) in a sample of patients without obstructive sleep apnea syndrome (OSAS) undergoing maxillomandibular advancement (MMA) surgery. MATERIALS AND METHODS: Lateral cephalometric radiographs of 52 patients who underwent orthognathic surgery for MMA were obtained before (T1) and after (T2) surgery. The radiographs were digitized and the anteroposterior dimensions of the PAS were measured at the nasopharynx, oropharynx, and hypopharynx levels...
September 15, 2016: Journal of Oral and Maxillofacial Surgery
Jean-Baptiste Charrier, Nathan Moreau
INTRODUCTION: Facial symmetry has always been a longstanding objective of orthognathic surgery. Patients that present significant facial asymmetry desire functional dental occlusion but also seek to enhance their facial esthetics. In that regard, different surgical techniques have been proposed to enhance facial recontouring. MATERIALS AND METHODS: Through a clinical case report and a literature review, this article explores the use of allopastic microporous titanium implants in volumetric corrections of the face...
September 2016: L' Orthodontie Française
K Y Tian, Q Q Li, X J Liu, X X Wang, Z L Li, X Wang
Objective: To establish a computer-aided surgical simulation procedure based on the natural head position(NHP) for orthognathic surgery and to access the effect for correcting facial asymmetry for skeletal Class Ⅲ deformity. Methods: Thirty-five patients(male: 14 and female: 21, mean age: [21.5±2.3] years) of skeletal Class Ⅲ deformity with facial asymmetry were included and divided into virtual group (16 patients) and control group(19 patients). The computer-aided surgical simulation procedure was used in the virtual group and the intermediate and final splints were fabricated using the rapid protyping technique...
October 9, 2016: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
M Marqués-Mateo, M Puche-Torres, M-E Iglesias-Gimilio
The temporomandibular joint (TMJ) dislocation can be categorised into three groups: acute, habitual or recurrent and long-standing. The long-standing or protracted lower jaw dislocation refers to a condition that persists for more than one month without reduction. There are a great variety of methods for its treatment, from the manual or non-surgical, to surgical ones like the indirect approach (conservative surgical approach) and direct approach (open joint). Additional procedures in unsuccessful cases may include extra-articular orthognathic techniques to correct a malocclusion until joint replacement...
October 1, 2016: Medicina Oral, Patología Oral y Cirugía Bucal
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
J V Dos S Canellas, H L M Barros, P J D Medeiros, F G Ritto
The objective of this study was to evaluate, through cone beam computed tomography, the immediate changes in pharyngeal airway space (PAS) after orthognathic surgery in class III patients, and to determine the influence of surgery on the development of obstructive sleep apnoea hypopnoea syndrome (OSAHS). A prospective study was conducted; 33 patients were divided into three groups: mandibular setback surgery (nine patients), bimaxillary surgery (18 patients), and maxillary advancement surgery (six patients)...
September 26, 2016: International Journal of Oral and Maxillofacial Surgery
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