Guide surgery osteotomy system (GSOS) a new device for treatment in orthognathic surgery.

INTRODUCTION: This article proposes an innovative and revolutionary diagnostic and therapeutic protocol for performing dentoalveolar osteotomies in office under local anaesthesia with piezoelectric surgery using a surgical acrylic guide produced through software-based planning. METHODS: The method was applied in the correction of crossbites, changing in the curve of Spee, incisal decompensations and dental ankylosis. Performing a preoperative CT with a special splint, optical scanning of the models and the subsequent planning with software has enabled us to produce a model with rapid prototyping with the design of the osteotomy on which the surgical guide was shaped, the use of the guide associated with piezoelectric surgery, allowed to perform surgery under local anaesthesia, with minimal invasiveness and high accuracy. RESULTS: Dentoalveolar immediate movements, with preservation of the roots of teeth involved, allow for rapid treatment of malocclusions which would be long and often difficult if not impossible to treat with orthodontics only. Dentoalveolar osteotomies associated to osteodistraction concepts, allow the orthodontist to achieve with accuracy the objectives required by the treatment plan. CONCLUSIONS: GSOS is a new method, which, utilizing 3D optical scanning images of models, software and piezoelectric surgery, allows to perform dentoalveolar movements which may be dangerous to the roots or for the periodontal support, with orthodontics only. It dramatically reduces total surgical-orthodontic treatment time, with obvious great patient satisfaction.

Orthodontic-surgical treatment: neuromuscular evaluation in open and deep skeletal bite patients.

BACKGROUND: The aim of this study was to compare electromyographic data of two groups of patients (open and deep skeletal bite) before and after surgical orthodontic treatment. METHODS: All patients who underwent orthognathic surgery at the Department of Orthodontics (University of Milan) were subjected to periodic electromyographic evaluation of the masticatory muscles (masseter and anterior temporal muscles) and to electrokinesiographic evaluation of mandibular movements. The sample comprised 72 patients (35 open skeletal bite patients and 37 deep skeletal bite patients) at the end of craniofacial growth. The electromyographic instruments used in the study included a Freely and a K6-I electromyograph. Statistical evaluation was carried out with Student's t tests for independent samples. RESULTS: Lots of differences between open and deep skeletal bite patients have been underlined by the analysis of the electromyographic data obtained. These results have been obtained with both electromyographic systems. Muscular activity in microvolts is higher in deep skeletal bite patients at the beginning of the treatment than in open bite ones, but during the following phases of the treatment, the two values became similar. CONCLUSIONS: Morphologic differences between open and deep bite patients can also be demonstrated by instrumental examinations, and their correction after surgical treatment is observable on electromyographic and electrognatographic exams.

The effect of hyperbaric oxygen therapy on improving bony stability in LeFort I maxillary advancement.

OBJECTIVE: The present study was designed to investigate the effect of hyperbaric oxygen therapy (HBO2T) on improving bony stability in LeFort I maxillofacial surgery. METHODS: Sixteen cases (n = 16) with severe skeletal anteroposterior discrepancies and who had ceased growing were used as subjects. The samples were categorized into two groups: Group A comprised one-piece LeFort I procedures with HBO2T administered seven days after surgery (n = 8), and Group B comprised the same surgical procedure without HBO2T (n = 8). Lateral cephalometric radiographs were taken for each subject to record the occurrence of bony relapse: prior to surgery (T1); seven days after surgery (T2); and a third (T3) taken 12 months after surgery. Each patient underwent preoperative and postoperative full-fixed orthodontic treatment. The first group was administered HBO2T for 60 minutes, at 2.5 ATA (atmospheres absolute) for five consecutive days after the T2 stage, and the second group served as a control, as they had not received HBO2T. For both groups the mean values of T1 stages were calculated and compared to those of T2 and T3 stages in the same group. RESULTS: Comparison between the two groups regarding the percentage of change in measurements at T2 and at T3 showed that there were significant differences between groups in all measurements at T3. In the HBO2T group, there was no statistical significant difference in all parameters between the mean values of T2 and T3, indicating minor or no relapse. Meanwhile in the group without HBO2T, there was a highly significant statistical difference in the mean values between T2 and T3 in all studied parameters, indicating significant relapse. CONCLUSIONS: It is suggested that administration of hyperbaric oxygen therapy may aid in the postoperative stability of orthognathic LeFort I surgical corrections of patients with severe dentofacial deformities.