Prefabricated iliac crest transplant.

PURPOSE: Our aim was to augment the extremely atrophic mandibular alveolar crest with a pedicled transplant as the best option for a satisfactory preprosthetic outcome. MATERIALS AND METHODS: After computed tomography of the mandible, a model was milled for 6 patients. The iliac crest transplant with its vascular pedicle was harvested and, after preliminary preparation, fixed to the model. The transplant was then placed in the axilla. After 3 months, the graft was removed and fixed to the mandible. RESULTS: The prefabricated transplant fit exactly in all 6 patients. The length of the pedicle and coverage with the newly developed alveolar mucous membrane were satisfactory. The grafts allowed prosthetic reconstruction with good functional outcomes. No bone loss was observed during 7 years of follow-up. Additionally, indocyanine green angiography showed good perfusion in 4 patients after 6 months. CONCLUSIONS: The results suggest that carefully prefabricated pedicled transplants can augment an atrophied mandibular alveolar crest.

The influence of the Tübingen soft palate plate and early cleft closure on the nasopharyngeal airway for the management of airway obstruction in an infant with Pierre Robin sequence: A case report.

INTRODUCTION: A Tübingen palate plate and early cleft closure for successful airway management is described in a newborn with Pierre Robin sequence. PRESENTATION OF CASE: A three-day-old newborn with an acute airway obstruction underwent primary treatment with a Tübingen soft palate plate. DISCUSSION: After stabilization of the airway, the cleft soft palate was closed after three months. CONCLUSION: The Tübingen soft palate plate proved to be a very satisfactory treatment for the infant.

Psychologic implications of orthognathic surgery in patients with skeletal Class II or Class ill malocclusion.

The psychologic profile of 100 consecutive patients undergoing orthognathic surgery for correction of Class II or Class III malocclusion was monitored in a prospective observational study. Patients and their relatives or friends completed questionnaires about their self-image before surgery, 6 weeks postoperatively, and 6 months postoperatively. Preoperatively, patients with Class III malocclusion felt significantly less attractive (P = .03), had slightly higher attention to physical appearance, and had slightly stronger feelings of insecurity regarding their facial appearance compared with Class II patients. Grading of attractiveness/self-confidence improved significantly in Class III patients at 6 weeks postoperatively (P = .006), while in Class II patients the improvement was less pronounced and only significant at 6 months postoperatively (P = .002). Grading of attractiveness/self-confidence by relatives/friends of patients with Class II and Class III was similar preoperatively, but was significantly higher for Class III patients 6 weeks postoperatively in comparison with Class II patients (P = .048). These data indicate that the psychologic profiles are significantly different between Class II and Class III patients preoperatively and show different dynamics postoperatively.