Maxillomandibular Transverse Osteodistraction: A Multidisciplinary Case Report with 30-Month Follow-Up.

AIM: To describe a multidisciplinary treatment to correct a severe II class malocclusion with reduced both maxillary and mandibular transverse dimensions and dental crowding. Case Report. A 17-year-old young woman presented with an increased overjet complaining chiefly of forwardly placed upper front teeth and unpleasant smile aesthetics. The patient facially exhibited a gently convex profile, severe mentalis strain on lip closure, and dark buccal corridors. The intraoral assessment indicates Class II molar relationship bilaterally, mandibular and maxillary anterior crowding, and narrow shape of upper and lower arches. The cephalometric evaluation of the lateral radiograph of the skull evidences a skeletal Class II with a reduction of lower face height. Based upon the diagnostic records and consultation with the patient, surgically assisted expansion of both arches using bone-borne distractors, comprehensive orthodontic treatment, and combined jaw surgery was planned. RESULTS: This approach permitted achieving most of the desired objectives in approximately 30 months. The follow-up records 30 months after treatment conclusion showed a stable occlusion. No complications were clinically and radiographically noticeable during the follow-up.

The maxillary protraction treatment: description of a laser Er:Yag-assisted surgical technique. Case report.

The surgically aided rapid maxillary expansion (SARME) is indicated to treat the hypoplasia of the upper jaw, with a reduction of the palatal transverse diameters, even in absence of mono- or bilateral crossbite, in the adult patient. In such cases, maxillary osteotomies are made in order to reduce the sutural resistance and facilitate the expansion of the maxillary complex. A case of surgically-aided expansion of the maxilla by the use of laser Er:Yag is reported. This device is able to guarantee targeted osteotomies of the bone, without inducing iatrogenic damages of the soft tissues. The orthodontic treatment has been performed using a bonded palatal expander (type Hyrax) in association with a class III orthopedic traction (face mask). After this a fixed appliance at both the arches was bonded. The preliminary radiographic examination and the cefalometric evaluation have been repeated at the end of the maxillary protraction (60 days after surgery) and at the end of the orthodontic treatment. The entire duration of the treatment was 18 months. The use of the laser Er:Yag has showed several advantages if compared to the traditional tools (bur), as more safety, more cutting precision and less probability to determine side effects on the soft tissue. The orthodontic treatment has been performed according to the standard protocol and the results were similar to the referred in literature.

Odontogenic tumors in childhood: a retrospective study of 86 treated cases. Importance of a correct histopathologic diagnosis.

The odontogenic tumors are an unusual group of lesions of the jaws derived from embryologic tooth-forming tissues and presenting in a large number of histologic patterns. More common in pediatric age and adolescence than in adult age, the odontogenic tumors can be observed casually or after the appearance of nonspecific symptoms. Because of their slow-growth tendency, usually they do not cause pain. The odontogenic tumors grow in the jaw, through the haversian system, without metastasis but with and high probability of relapse. A retrospective study of 86 cases treated between 1997 and 2005 is reported. The percent of diagnosed cases that were benign was 98.8%, and just one case of malign neoplasm is reported. The most frequent tumor accounted for in the reported sample was odontoma (39.5%) followed by odontogenic fibroma (12.8%). Ameloblastoma and myxoma showed the same incidence (11.6%). Early diagnosis, together with a correct histologic diagnosis, allows a preservative and effective surgical treatment and is necessary to reduce the risk of relapse.