RESUMEN
Rigid external distraction is currently performed to correct cases of severe maxillary hypoplasia. As an improvement of this technique, we propose the use of an intranasal bone-borne traction hook. This study is a retrospective chart review of the intranasal bone-borne traction hooks used in the treatment of severe maxillary hypoplasia. There were 110 patients treated with the hooks from 2005 to 2017. The maximum traction force was 7.75 kg, and there were few complications encountered during distraction. There were 76 patients who had the hooks removed under local anaesthesia. A cephalometric analysis was conducted in 56 patients. The average advancement of A-point was 9.9 ± 4.2 mm, 8.4 ± 2.5 mm, 11.0 ± 3.7 mm, 17.9 ± 4.4 mm for the trans-sutural distraction osteogenesis (DO), maxillary anterior segment DO, Le Fort I osteotomy DO and Le Fort III/II osteotomy DO, respectively. The average changes of sella-nasion-point A (SNA) were 8.89 ± 4.30 degrees, 8.21 ± 3.17 degrees, 10.49 ± 3.26 degrees, and 15.10 ± 4.00 degrees, respectively. The A point-nasion-B point (ANB) also showed increases in all procedures with P < 0.001. In conclusion, this technique sufficiently advances the midface and ensures the scars are concealed in the nasal base. The traction hook can bear a large traction force, causes minimal complications and is easily removed.
Asunto(s)
Anomalías Maxilofaciales/cirugía , Osteogénesis por Distracción/métodos , Osteotomía Le Fort/métodos , Instrumentos Quirúrgicos , Tracción/instrumentación , Adolescente , Adulto , Anestesia Local/métodos , Huesos , Cefalometría/métodos , Niño , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Femenino , Humanos , Masculino , Anomalías Maxilofaciales/diagnóstico , Nariz , Osteogénesis por Distracción/instrumentación , Osteotomía Le Fort/efectos adversos , Osteotomía Le Fort/instrumentación , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Adulto JovenAsunto(s)
Anomalías Maxilofaciales/cirugía , Cirugía Bucal , Antibacterianos/uso terapéutico , Atención Odontológica Integral , Diagnóstico por Imagen/métodos , Documentación , Asimetría Facial , Humanos , Hiperplasia/cirugía , Consentimiento Informado , Maloclusión/cirugía , Maloclusión de Angle Clase III/cirugía , Mandíbula/cirugía , Maxilar/cirugía , Mordida Abierta/cirugía , Osteotomía , Evaluación de Resultado en la Atención de Salud , Planificación de Atención al Paciente , Odontología Pediátrica , Medición de Riesgo , Factores de Riesgo , Síndromes de la Apnea del Sueño/cirugía , Apnea Obstructiva del Sueño/cirugía , Cirugía Bucal/métodosRESUMEN
Common practice of establishing occlusal vertical dimension by adopting traditional method for patients with long-term pathological conditions has left the results much less than desired, since the degree of pathological condition for each patient varies from one patient to another, and traditional methods to determine vertical dimension are mostly intended for normal patients. Ideally, the occlusal vertical dimension should be dictated by, and conformed to patient's comfort range for the physiological accommodation to each patient's condition. This article describes a method of a double checking system for occlusion determination by increasing vertical dimension of occlusion (VDO) by 1/2 mm each week to find the most comfort zone and beyond for patient, and then to gradually decrease ½ mm of the VDO each week to the original VDO to double check the comfort zone for the patient. During the process, Bi-Digital O-Ring Test was employed to corroborate, to determine, and to individualize the occlusal vertical dimension for patients with pathological abnormalities. Traditional methods of vertical dimension determination were merely used as a guiding reference in our treatment of those patients. Patient's comfort and discomfort were carefully recorded, compared and studied before the denture prosthesis was fabricated.
Asunto(s)
Anomalías Maxilofaciales/cirugía , Prostodoncia/métodos , Adulto , Diseño de Dentadura , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prostodoncia/instrumentación , Dimensión VerticalAsunto(s)
Anomalías Maxilofaciales/cirugía , Atención Odontológica Integral , Asimetría Facial/cirugía , Humanos , Complicaciones Intraoperatorias , Anomalías Maxilomandibulares/cirugía , Maloclusión/cirugía , Procedimientos Quirúrgicos Ortognáticos/métodos , Planificación de Atención al Paciente , Complicaciones Posoperatorias , Procedimientos de Cirugía Plástica/métodos , Medición de Riesgo , Síndromes de la Apnea del Sueño/cirugía , Resultado del TratamientoRESUMEN
Maxillofacial and dental defects often have detrimental effects on patient health and appearance. A holistic approach of restoring lost dentition along with bone and soft tissue is now the standard treatment of these defects. Recent improvements in reconstructive techniques, especially osseointegration, microvascular free tissue transfer, and improvements in bone engineering, have yielded excellent functional and aesthetic outcomes. This article reviews the literature on these modern reconstructive and rehabilitation techniques.
Asunto(s)
Anomalías Maxilofaciales/cirugía , Traumatismos Maxilofaciales/cirugía , Neoplasias de la Boca/cirugía , Procedimientos Quirúrgicos Orales/métodos , Procedimientos de Cirugía Plástica/métodos , Regeneración Ósea , Carcinoma de Células Escamosas/rehabilitación , Carcinoma de Células Escamosas/cirugía , Irradiación Craneana/efectos adversos , Implantes Dentales , Prótesis Dental , Humanos , Técnicas de Fijación de Maxilares/instrumentación , Anomalías Maxilofaciales/rehabilitación , Traumatismos Maxilofaciales/rehabilitación , Neoplasias de la Boca/diagnóstico por imagen , Neoplasias de la Boca/rehabilitación , Osteogénesis por Distracción , Osteorradionecrosis/etiología , Osteorradionecrosis/prevención & control , Radiografía , Colgajos Quirúrgicos/irrigación sanguínea , Ingeniería de TejidosRESUMEN
La cirugía de las deformidades maxilofaciales ha evolucionado de manera importante en las últimas décadas y el número de pacientes que reciben este tipo de tratamiento ha aumentado de forma considerable.Uno de los temas más debatidos en la literatura reciente se refiere a la necesidad de autodonación sanguinea preoperatoria. hacemos una revisiónde las publicaciones relevantes en años recientes, que demuestran puntos de vista opuestos
Surgery for maxillofacial deformities has seen important developments over the last decades and the number of patients undergoing these types of treatment has increased considerably. One of the most debated issues in the recent literature concerns the need for preoperative autologous blood donation. A revision of therelevant publications of recent years reveals opposite views
Asunto(s)
Humanos , Transfusión de Sangre Autóloga , Procedimientos Quirúrgicos Orales/métodos , Anomalías Maxilofaciales/cirugía , Cuidados Preoperatorios/métodos , Pérdida de Sangre Quirúrgica/prevención & controlRESUMEN
The use of a laryngeal mask airway (LMA) on two occasions, in a 53-day-old and 270-day-old male infant with Tessier N.3 and N.4 facial defects, using sedation and topical anaesthesia is described. The LMA was used to manage the airway and facilitate inhalation induction of anaesthesia as the facial deformities were thought to be too extensive for the safe use of a facemask. The LMA is an alternative to a facemask and secures the airway and facilitates the inhalation induction of anaesthesia in paediatric patients with severe facial deformities.