Pioneers in Modern Craniofacial Surgery: Assessing the Academic Impact of Drs. Joseph Gruss and Paul Manson.

BACKGROUND: The authors conducted this study to assess the impact that Drs. Joseph Gruss and Paul Manson have had on craniofacial surgery through their individual contributions and through their trainees. METHODS: This was a retrospective analysis of fellows trained by either Dr. Gruss or Dr. Manson. Demographic and bibliometric measures were recorded for each fellow. Demographic factors included years since completion of fellowship training, current practice of craniomaxillofacial surgery, academic practice, and academic leadership roles. Bibliometric measures included number of publications, number of citations, and h-index. To adjust for scholarly activity before fellowship training, only contributions published after fellowship training were included. RESULTS: Over a 39-year period, a total of 86 surgeons completed fellowship training with either of the two principal surgeons. The mean time since completion of training was 18.7 ± 11.4 years. Seventy-nine percent of surgeons had active practices in craniomaxillofacial surgery; 54 percent had academic practices. The mean number of publications was 26.4 ± 69.3, the mean number of citations was 582 ± 2406, and the average h-index was 6.7 ± 10.6. Among academic surgeons, the average h-index was 10.7 ± 13.1, 89 percent practiced in North America, 89 percent had active practices in craniomaxillofacial surgery, and nearly 50 percent had achieved a leadership role. CONCLUSIONS: Modern craniofacial reconstruction has evolved from principles used in trauma and correction of congenital differences. The extensive impact that Drs. Paul Manson and Joseph Gruss have had on the field, and plastic surgery at large, is evident through their primary contributions and the immense impact their trainees have had on the field.

A History of Orthognathic Surgery in North America.

This review highlights the contributions of American oral and maxillofacial surgeons to the field of orthognathic surgery. The present state of the art and science of orthognathic surgery is the harvest of yesterday's innovation and research. An improved understanding of the biological and surgical principles and the routine involvement of orthodontics have fueled widespread adoption of a coordinated approach to the treatment of dentofacial problems. Technologic advances in rigid internal fixation, virtual surgical planning with computer-aided manufacturing of occlusal splints and cutting guides, custom implants, and worldwide interest in the correction of dentofacial and craniofacial deformities have resulted in highly predictable, efficient, and safe treatment, which scarcely resembles the situation 70 years ago.

[Temporo-mandibular joints and orthognathic surgery]. / Articulations temporo-mandibulaires et chirurgie orthognathique.

Temporo-Mandibular Joints (TMJ) and orthognathic surgery are closely linked. In the past, some authors have even described (with mixed results) the correction of some dysmorphosis through direct procedures on the TMJs. Nowadays, performing orthognathic surgery involves the TMJ in three different occasions: (1) TMJ disorders potentially responsible for dento-maxillary dysmorphosis, (2) effects of orthognathic surgery on TMJs, and (3) condylar positioning methods in orthognathic surgery. These three chapters are developed in order to focus on the close relationships between TMJ and orthognathic surgery. Some perspectives close this article.

Evolution of esthetic considerations in orthodontics.

The importance of facial esthetics to the practice of orthodontics has its origins at the beginning of our specialty. In 1900, Edward H. Angle believed that an esthetic or a "harmonious" face required a full complement of teeth, but many who came after him questioned this notion. In the 1930s, the development of cephalometrics laid the foundation for studying growth and development, treatment effects, facial forms, and esthetics. By the 1950s, the importance of diagnosing and planning treatment for an esthetic result was established, but the measurement of soft tissue variables was lacking, and this became an important area of research. In the 1970s, researchers were looking at the stability of hard tissue changes over time, and they were also interested in how the soft tissues change with age. Although the early studies of esthetics in orthodontic treatment focused on how clinicians viewed their patients, changing demographics and cultural attitudes led researchers to look more seriously at consumer preferences and the public's attitudes. Their findings--that consumers preferred fuller lips--led to a swing back toward nonextraction treatment. Expansion appliances and molar distalization techniques became popular, and surgical procedures to obtain more ideal esthetic results became more common. Since the 1990s, advances in computers and technology have allowed us to study, predict, and produce esthetic results previously thought unattainable. Today, more so than at any other time in our specialty, we have the ability to provide esthetic results to our patients.

[Commemoration. In honour of György Huszár (1911-2002) and Béla Berényi (1911-2005) -- on the centenary of their births]. / Megemlékezés Huszár György (1911-2002) és Berényi Béla (1911-2005) születésének századik évfordulóján.

100 years ago two outstanding teachers of the Faculty of Dentistry of the Semmelweis University (Budapest) were born. Dr. Huszár was a prosthodontist, an expert on metal and other dental materials, as well as a geroprosthodontist and medical historian. Professor Berényi was internationally recognized as an expert on salivary gland surgery and also orthognatic surgery. Both of them published several textbooks and many hundreds of scientific papers in Hungarian and in foreign languages. They were internationally recognized scientists, members of several national and international societies, as well as editors of national and international dental journals.

Historical development of alloplastic temporomandibular joint replacement after 1945 and state of the art.

The variety of temporomandibular joint (TMJ) prostheses and condylar reconstruction plates available is in contradiction to their rare application. This emphasizes that alloplastic TMJ reconstruction is still evolving. This article reviews the history of TMJ reconstruction. Medline as well as public and private libraries have been searched. Current systems are reviewed. Prosthetic devices can be differentiated into fossa-eminence prostheses, ramus prostheses and condylar reconstruction plates, and total joint prostheses. Fossa and total joint prostheses are recommended when the glenoid fossa is exposed due to excessive stress (degenerative disorders, arthritis, ankylosis, multiply operated pain patients). Singular replacement of the condyle is preferred as a temporary solution in ablative surgery. The use of prosthetic devices for long-term replacement should be restricted to selected cases, taking care to retain the disk, in order to prevent penetration into the middle cranial fossa. The term 'condylar reconstruction plate' reflects this more clearly than 'ramus prosthesis' which suggests permanent reconstruction. Long-term studies comparing the functional and aesthetic results of the various prostheses and condylar reconstruction plates are not available, which leaves the choice to personal experience.