ABSTRACT
Complications with bilateral sagittal split osteotomy (BSSO) can sometimes result from surgical inexperience. Our aim was to present a 3-dimensional printed mandibular model for BSSO training in a maxillofacial surgical education programme. A polymethacrylate mandibular model obtained from mandibular cone-beam computed tomographic (CT) images was designed and printed for use in training. Twenty-four residents were each asked to do a BSSO according to the Epker/Dal-Pont technique. The session was conducted as a simulation course with a final debriefing. A questionnaire before and after the test was filled in using a 10-point Likert scale to assess the participants' knowledge. The mandibular model provided a realistic way of handling the trabecular bone after cortical osteotomy, as well as in the splitting phase. Significant increases in knowledge and surgical skills were noted for all steps of the BSSO, particularly regarding the use of the piezoelectric device for osteotomy, and for management of wisdom teeth in the splitting zone (3.00 ±2.16 to 6.95 ±2.06 and 2.73 ±1.91 to 5.75 ±2.63, respectively; p1=0.0002 and p2=0.0003). We think that this is a valuable printed mandibular model for the development of surgical skills for BSSO in maxillofacial surgical residents.
Subject(s)
Internship and Residency , Cone-Beam Computed Tomography , Humans , Mandible/diagnostic imaging , Mandible/surgery , Osteotomy, Sagittal Split Ramus , Printing, Three-DimensionalABSTRACT
Intentional cranial deformations (ICD) have been observed worldwide but are especially prevalent in preColombian cultures. The purpose of this study was to assess the consequences of ICD on three cranial cavities (intracranial cavity, orbits, and maxillary sinuses) and on cranial vault thickness, in order to screen for morphological changes due to the external constraints exerted by the deformation device. We acquired CT-scans for 39 deformed and 19 control skulls. We studied the thickness of the skull vault using qualitative and quantitative methods. We computed the volumes of the orbits, of the maxillary sinuses, and of the intracranial cavity using haptic-aided semi-automatic segmentation. We finally defined 3D distances and angles within orbits and maxillary sinuses based on 27 anatomical landmarks and measured these features on the 58 skulls. Our results show specific bone thickness patterns in some types of ICD, with localized thinning in regions subjected to increased pressure and thickening in other regions. Our findings confirm that volumes of the cranial cavities are not affected by ICDs but that the shapes of the orbits and of the maxillary sinuses are modified in circumferential deformations. We conclude that ICDs can modify the shape of the cranial cavities and the thickness of their walls but conserve their volumes. These results provide new insights into the morphological effects associated with ICDs and call for similar investigations in subjects with deformational plagiocephalies and craniosynostoses.
Subject(s)
Plagiocephaly, Nonsynostotic/pathology , Skull/anatomy & histology , Skull/pathology , Adult , Analysis of Variance , Anthropology, Physical , Bolivia , Cephalometry , France , Humans , Imaging, Three-Dimensional , Tomography, X-Ray ComputedABSTRACT
Current knowledge about cranio-facial growth, the identification of different anatomic types by architectural cephalometric analysis, the new therapeutic methods and a multidisciplinary have changed the mode and the results of these treatments. However the key of success is: begin the treatment as soon as possible. The correction of skeletal anomalies and the normalization of all the oro-facial functions need a lot of time. It is advisable to be efficient at the good time with the good appliance. The quality of the result will be estimated at the end of the growth. In this way, a lot of orthognathic surgery can be avoided. So, certainly the results reward the efforts.
Subject(s)
Malocclusion, Angle Class III/prevention & control , Maxillofacial Development , Orthodontics, Preventive/methods , Age Factors , Cephalometry , Child, Preschool , Extraoral Traction Appliances , Humans , Malocclusion, Angle Class III/diagnosis , Orthodontics, Preventive/instrumentationABSTRACT
For a long time, the orthodontists have tried to predict the growth to come. They have atempted to know if there are relationships between height and facial growth and if a better knowledge of general development of child had an interest to their therapeutic decision. The author compare the methods of estimation and prediction of height and facial growth; and he thinks that these methods are not enough exact and safe and they have a little utility to the practionner. The author purpose to replace them by the search of radiologics signs which need anyone measurement and which the good prediction value is very adequate to the daily dento-facial orthopedic pratice.
Subject(s)
Cephalometry/methods , Maxillofacial Development , Age Determination by Skeleton , Body Height , Child , Forecasting , Humans , Subtraction TechniqueABSTRACT
Vertical growth of the cervical spine, of the mandibula and the upper maxilla are normally anatomically and physiologically correlated. At a very early age the relationships are established between the cervical spine and the angle of the mandibula which is normally level with C2's antero-inferior angle. A parallelism can be noticed between the rhythms of the vertical growth of the cervical spine and the changes of the maxillary in relation to the skull. So relationships are gradually established between the palate level, the top of the odontoid, and the foramen magnum. These relationships are well objectivized on a lateral teleradiography by Delaire' analysis. Lateral teleradiography of the situation of the angle of the mandibula, in relation to the basis of the C2 body should be systematic. It provides much information concerning the growth potential of the condylar unit, and makes possible a differential diagnosis between true or false posterior vertical insufficiency (PVI) and true or false posterior vertical excess (PVE) and to recognize clinical types of skeletal class II and class III of vertical origin.
Subject(s)
Cervical Vertebrae/growth & development , Face/surgery , Maxillofacial Development/physiology , Orthodontics, Corrective , Orthognathic Surgical Procedures , Adolescent , Adult , Cephalometry , Child , Child, Preschool , Diagnosis, Differential , Female , Foramen Magnum/anatomy & histology , Humans , Infant , Infant, Newborn , Male , Malocclusion, Angle Class II/diagnosis , Malocclusion, Angle Class II/therapy , Malocclusion, Angle Class III/diagnosis , Malocclusion, Angle Class III/therapy , Mandible/anatomy & histology , Mandible/growth & development , Mandibular Condyle/growth & development , Maxilla/anatomy & histology , Maxilla/growth & development , Odontoid Process/anatomy & histology , Palate/anatomy & histology , Skull/growth & development , Vertical DimensionABSTRACT
The authors show the responsibility of antimitotic chemotherapy on the disturbances in dental development in the young children. They insist on doing an odonto-stomatologic check-up at the beginning of the treatment and to keep a constant watch during the treatment and until the end of dental evolution.
Subject(s)
Antineoplastic Agents/adverse effects , Neoplasms/drug therapy , Odontogenesis/drug effects , Tooth/drug effects , Adolescent , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Brain Neoplasms/drug therapy , Child , Child, Preschool , Dental Care for Children , Female , Humans , Infant , Leukemia/drug therapy , Male , Neoplasms, Germ Cell and Embryonal/drug therapy , Tooth Abnormalities/chemically induced , Tooth Diseases/chemically induced , Tooth Eruption/drug effects , Tooth, Deciduous/drug effectsABSTRACT
The Class II show a lot of varieties of skeletal support. The DELAIRE's architectural, structural and dento-skeletic analysis put in prominent their specifities. The purpose of this investigation was to study the Class II with vertical cause which are the most difficult to treat.
Subject(s)
Malocclusion, Angle Class II/therapy , Vertical Dimension , Cephalometry , Humans , Malocclusion, Angle Class II/pathology , Mandible/pathology , PrognosisABSTRACT
The authors show disturbances in dental development in three children who have received radiation and antimitotic chemotherapy. They think that, in these cases, chemotherapy induces dental abnormalities and in one case a cumulative effect or potentiation of radiation with chemotherapy cannot be excluded.
Subject(s)
Abnormalities, Drug-Induced , Abnormalities, Radiation-Induced , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Radiotherapy/adverse effects , Tooth Abnormalities/etiology , Adolescent , Child , Histiocytosis, Langerhans-Cell/drug therapy , Histiocytosis, Langerhans-Cell/radiotherapy , Humans , Male , Neuroblastoma/drug therapy , Neuroblastoma/radiotherapy , Rhabdomyosarcoma/drug therapy , Rhabdomyosarcoma/radiotherapy , Tooth Abnormalities/chemically inducedABSTRACT
The "Fonctionnal Lingual Elevator" changes the lingual situation and dynamic. The tongue becomes in a higher and forwards situation. This new situation generates biomécanics modifications of the labio-lingual and lingual pharyngal complex which induce secondary structural modifications.
Subject(s)
Orthodontic Appliances, Removable , Orthodontics, Corrective/methods , Humans , Orthodontics, Corrective/instrumentation , TongueABSTRACT
Dento-skeletal analysis complete the architectural and structural analysis allowing to give precise details about: The dimensions and situations anomalies of maxillary and mandible, directly showing chances of succeeding the treatment. The nature and amplitude of orthopedics and/or orthodontics movements to effect. The control in the end of treatment to see if the tests required for treatment durability are respected. It facilitates the dialogue between the surgeon and the orthodontist in surgico-orthopedic cases.
Subject(s)
Cephalometry/methods , Dental Occlusion , Jaw/anatomy & histology , Nose/anatomy & histology , Tooth/anatomy & histology , Adult , Child , Humans , Orthodontics, Corrective , Vertical DimensionABSTRACT
A 13-year-old boy presented with Seckel's syndrome, still called bird's head nanism, characterized by: --nanism, mental retardation, microcephaly, and protrusio of the middle third of the face. The typical facial appearance enabled a detailed study to be conducted of both clinical and radiological features, including, particularly, an architectural and structural analysis of profile teleradiographic images, providing objective data on the craniofacial deformities. Skeletal and systemic anomalies are also described, together with elements documented in the literature but absent in the present case. The etiology of this syndrome remains unknown.
