Can palatal splint improve stability of segmental Le Fort I osteotomies?

OBJECTIVES: The purpose of this study was to evaluate the influence of a palatal splint on stability in multi-segment maxillary osteotomies. SETTING AND SAMPLE POPULATION: Retrospective series of fifty-one adult patients, consecutively operated with bilateral sagittal split osteotomy (BSSO) and three-piece maxillary osteotomies, divided according to the use of a palatal splint (Group 1, n = 30) or no palatal splint (Group 2, n = 21). MATERIALS AND METHODS: Maxillary surgical casts (T1) and post-retention casts (T2), taken at least six months after discontinuation of orthodontic retention, were digitized (MicroScribe-3DX), measured and compared. Fifty-one landmarks were identified on the maxillary, transverse dimension changes and arch length were calculated. Longitudinal changes in all measurements were assessed by t test. RESULTS: Post-surgical transverse instability in group 1 ranged from 0.3 ± 0.4 to -1.3 ± 0.2 mm and was statistically significantly smaller than in group 2 that ranged from -1.0 ± 0.3 to -2.5 ± 0.5 mm. CONCLUSIONS: The use of a palatal splint after segmental Le Fort I maxillary osteotomy improved transverse stability in the posterior region. The post-surgical transverse instability occurred only between canine gingival points and thus suggesting no clinical relevance.

Effect of the association of nystatin with a tissue conditioner on its ultimate tensile strength.

PURPOSE: This study evaluated the ultimate tensile strength of a tissue conditioner without nystatin incorporation (GI-control group) and the same tissue conditioner modified by the addition of nystatin in two concentrations: GII-500,000 International Units (U) and GIII-1,000,000 U, in which each milligram of the medicament corresponded to 6079 U. MATERIALS AND METHODS: Dumbbell-shaped specimens (N= 7) with a central cross-sectional area of 33 x 6 x 3 mm were produced for the three experimental groups. After polymerization following manufacturer's instructions, specimens were immersed in distilled water at 37 degrees C for either 24 hours or 7 days and then tested in tension in the MTS 810 at 40 mm/minute. Data were analyzed by two-way ANOVA followed by Tukey's test, at 95% level of confidence. RESULTS: The means (force-grams (gf) +/- standard deviation) of the ultimate tensile strength were: GI-634.29 +/- 122.80; GII-561.92 +/- 133.56; and GIII-547.30 +/- 73.47 for 24-hour storage, and GI-536.68 +/- 54.71; GII-467.50 +/- 143.51; and GIII-500.62 +/- 159.76 for 7-day storage. There were no statistically significant differences among the three experimental groups (p > 0.05). The ultimate tensile strength means of all experimental groups after 7 days were significantly lower than those observed after 24 hours (p= 0.04). CONCLUSIONS: The results of this study suggest that the addition of nystatin into the tissue conditioner investigated in concentrations below 1,000,000 U did not affect its ultimate tensile strength.