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1.
Materials (Basel) ; 13(20)2020 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-33053855

RESUMEN

The purpose of this study was to evaluate the clinical efficacy and safety of patient-specific additive-manufactured CaOSiO2-P2O5-B2O3 glass-ceramic (BGS-7) implants for reconstructing zygomatic bone defects at a 6-month follow-up. A prospective, single-arm, single-center, clinical trial was performed on patients with obvious zygoma defects who needed and wanted reconstruction. The primary outcome variable was a bone fusion between the implant and the bone evaluated by computed tomography (CT) at 6 months post surgery. Secondary outcomes, including implant immobilization, satisfaction assessment, osteolysis, subsidence of the BGS-7 implant, and safety, were assessed. A total of eight patients were enrolled in the study. Two patients underwent simultaneous reconstruction of the left and right malar defects using a BGS-7 3D printed implant. Cone beam CT analysis showed that bone fusion at 6 months after surgery was 100%. We observed that the average fusion rate was 76.97%. Osteolysis around 3D printed BGS-7 implants was not observed. The mean distance displacement of all 10 implants was 0.4149 mm. Our study showed no adverse event in any of the cases. The visual analog scale score for satisfaction was 9. All patients who enrolled in this trial were aesthetically and functionally satisfied with the surgical results. In conclusion, this study demonstrates the safety and promising value of patient-specific 3D printed BGS-7 implants as a novel facial bone reconstruction method.

2.
J Clin Med ; 9(4)2020 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-32316310

RESUMEN

OBJECTIVES: The purpose of this study was to evaluate the effectiveness of the intraoral use of subperiosteally placed self-inflating tissue expanders for subsequent bone augmentation and implant integrity. MATERIAL AND METHODS: A prospective, multicenter, randomized controlled trial was performed on patients requiring alveolar bone graft for dental implant insertion. Patients were assigned to three groups: tissue expansion and tunneling graft (TET group), tissue expansion and conventional bone graft (TEG), and control group without tissue expansion. Dimensional changes of soft tissue and radiographic vertical bone gain, retention, and peri-implant marginal bone changes were evaluated and secondary outcomes; clinical complications and thickness changes of expanded overlying tissue were assessed. RESULTS: Among 75 patients screened, a total of 57 patients were included in the final analysis. Most patients showed uneventful soft tissue expansion without any inflammatory sign or symptoms. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p > 0.05). Mean soft vertical and horizontal tissue measurements at the end of its expansion were 5.62 and 6.03 mm, respectively. Significantly higher vertical bone gain was shown in the TEG (5.71 ± 1.99 mm) compared with that in the control patients (4.32 ± 0.97 mm; p < 0.05). Hard tissue retention- measured by bone resorption after 6 months-showed that control group showed higher amount of vertical (2.06 ± 1.00 mm) and horizontal bone resorption (1.69 ± 0.81 mm) compared to that of the TEG group (p < 0.05). CONCLUSION: The self-inflating tissue expander effectively augmented soft tissue volume and both conventional bone graft and tunneling techniques confirmed their effectiveness in bone augmentation. With greater amount of bone gain and better 6 month hard tissue integrity, the TEG group compared to the control group-without tissue expansion-showed that the combined modality of tissue expander use and guided bone regeneration (GBR) technique may improve the outcome and predictability of hard tissue augmentation.

3.
Clin Oral Implants Res ; 31(7): 585-594, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32125718

RESUMEN

OBJECTIVES: Conventional guided bone regeneration (GBR) limits the amount of bone graft due to limited soft tissue expansion. We hypothesize that the use of tissue expander will successfully augment soft tissue prior to bone graft, allowing for sufficient amount of grafting which will lead to a more stable and effective vertical bone graft. The authors aimed to evaluate effectiveness of the novel self-inflating tissue expander for vertical augmentation in terms of soft tissue expansion, clinical outcomes, and related complications. MATERIAL AND METHODS: A prospective, multicenter, randomized controlled trial was performed on patients requiring vertical augmentation. For experimental group patients, the tissue expander was subperiosteally implanted and followed by a tunneling bone graft without full flap reflection. Control patients underwent conventional vertical GBR. Primary objectives were to evaluate the dimensional changes of soft tissue and radiographic vertical bone gain and retention. As a secondary outcome, clinical complications and thickness changes of expanded overlying tissue were assessed and analyzed. RESULTS: Twenty-three patients in each group were included. During a 4-week expansion, two of the experimental group showed over-expansion and one showed mucosal perforation associated with previous severe scars. The other patients showed uneventful expansion and mean tissue augmentation was 6.88 ± 1.64 mm vertically. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p > .05). Significantly higher vertical bone gain was shown in the experimental group (5.12 ± 1.25 mm) compared with that in the control patients (4.22 ± 1.15 mm; p < .05). After a 6-month retention period, the mean vertical bone measurement of the controls had decreased to 1.90 mm (55.0% reduction), which was a significantly greater decrease than that in the experimental group (mean 3.55 mm, 30.7% reduction; p < .05). CONCLUSION: Our results demonstrated the effectiveness of tissue expanders followed by tunneling bone graft for vertical augmentation; however, studies comparing the two techniques without tissue expanders are needed to elucidate the net effect of tissue expansion.


Asunto(s)
Aumento de la Cresta Alveolar , Dispositivos de Expansión Tisular , Proceso Alveolar , Regeneración Ósea , Trasplante Óseo , Implantación Dental Endoósea , Humanos , Estudios Prospectivos , Expansión de Tejido
4.
Angle Orthod ; 90(2): 181-186, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31769700

RESUMEN

OBJECTIVES: To investigate factors associated with spontaneous mesialization of impacted third molars after second molar protraction to close the space caused by a missing mandibular first molar (L-6) or retained deciduous mandibular second molars with a missing succedaneous premolar (L-E). MATERIALS AND METHODS: Panoramic radiographs of patients treated with mandibular second molar protraction to close the space due to missing L-6 or L-E (14 males, 36 females, mean age = 18.6 ± 4.4 years) were analyzed before treatment (T1) and after second molar protraction (T2). Factors associated with the amount of third molar mesialization were investigated using regression analyses. RESULTS: Mandibular second molars were protracted by 5.1 ± 2.1 mm and 5.8 ± 2.7 mm, measured at the crown and root furcation, respectively. After second molar protraction, third molars showed spontaneous mesialization by 4.3 ± 1.6 mm and 3.8 ± 2.6 mm, measured at the crown and root furcation, respectively. Nolla's stage of the third molar at T1 (B = 0.20, P = .026) and second molar protraction time (B = 0.04, P = .042) were significantly associated with the amount of third molar mesialization. CONCLUSIONS: Greater third molar mesialization was observed when Nolla's stage of the third molar was higher before treatment and when the second molar protraction time was longer.


Asunto(s)
Mandíbula , Tercer Molar , Diente Impactado , Adolescente , Adulto , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Diente Molar , Tercer Molar/diagnóstico por imagen , Radiografía Panorámica , Adulto Joven
5.
Am J Orthod Dentofacial Orthop ; 156(2): 178-185, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375227

RESUMEN

INTRODUCTION: This study aimed to identify significant factors affecting the spontaneous angular changes of impacted mandibular third molars as a result of second molar protraction. Temporary skeletal anchorage devices in the missing mandibular first molar (ML-6) or missing deciduous mandibular second molar (ML-E) with missing succedaneous premolar spaces provided traction. METHODS: Forty-one mandibular third molars of 34 patients (10 male and 24 female; mean age 18.3 ± 3.7 years) that erupted after second molar protraction were included in this study. They were classified into upright (U) and tilted (T) groups. Linear and angular measurements were performed at the time of treatment initiation (T1) and of ML-6 or ML-E space closure (T2). Regression analyses were used to identify significant factors related to third molar uprighting. RESULTS: Nolla stage (odds ratio [OR] 4.1), sex (OR 0.003 for male), third molar angulation at T1 (OR 1.1), missing tooth space (OR 0.006), rate of third molar eruption (OR 23.3), and rate of second molar protraction (OR 0.2) significantly affected third molar uprighting. Age, third molar angulation at T1, rate of third molar eruption, and rate of second molar protraction were significant factors for predicting third molar angulation at T2. CONCLUSIONS: Available space for third molar eruption before and after second molar protraction is not associated with uprighting of erupting third molars. Older patients whose third molars are in greater Nolla stage, are in a more upright position at T1, and have a greater eruption rate have a greater chance for third molar uprighting. Alternatively, an increase in second molar protraction rate results in mesial tipping of the third molars.


Asunto(s)
Maloclusión/prevención & control , Maloclusión/fisiopatología , Mandíbula/fisiopatología , Tercer Molar/fisiopatología , Diente Impactado/fisiopatología , Adolescente , Adulto , Puntos Anatómicos de Referencia , Diente Premolar , Femenino , Humanos , Masculino , Maloclusión/diagnóstico por imagen , Mandíbula/anatomía & histología , Mandíbula/diagnóstico por imagen , Diente Molar/anatomía & histología , Diente Molar/diagnóstico por imagen , Diente Molar/fisiopatología , Tercer Molar/anatomía & histología , Tercer Molar/diagnóstico por imagen , Aparatos Ortodóncicos , Cierre del Espacio Ortodóncico , Ortodoncia Correctiva , Erupción Dental , Diente Primario , Diente Impactado/complicaciones , Diente Impactado/diagnóstico por imagen , Adulto Joven
6.
J Craniofac Surg ; 30(6): 1820-1824, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31033678

RESUMEN

OBJECTIVES: The purpose of this study was to compare the lip line cant (LLC) changes after 1 and 2-jaw surgery, and to evaluate the correlations of the craniofacial factors affecting LLC. METHODS: The study subjects were selected (LLC amount within 1.5-6.0°) from among the patients diagnosed with Class III malocclusion who underwent one (n = 20) or 2-jaw surgery (n = 20). Cone beam computed tomography images were obtained immediately before the operation (T1) and 6 months after the operation (T2). Preoperative and postoperative craniofacial measurements were obtained. RESULTS: The study subjects showed 3.12° LLC on average before undergoing 1-jaw surgery, and their LLC changed to 1.27° after the surgery. As for 2-jaw surgery, the subjects showed 3.38° LLC on average before the surgery and 0.98° after the surgery. LLC at pre-treatment may be more affected by a cant of the occlusal plane in the mandible than maxilla. In the comparison of the value of changes of LLC, the value of 2-jaw surgery was bigger than the value of 1-jaw surgery but the difference was statistically insignificant. LIMITATIONS: This study had a limitation in that the muscles were not considered. And the metal bracket or metal crown and bridge, however, can cause noise and blurring artifacts in CT, which can lead to a low resolution. And the limited number of the patients should be considered. CONCLUSIONS: In correlation analysis, both pre-surgery LLC and change of LLC have correlation with almost all the craniofacial measurement. Lip-line cant of patients with facial asymmetry has higher correlation with mandibular cant than with other cants. To improve the LLC, a surgical plan should be established to minimize the mandibular cant using the computer simulation as well as the maxillary cant.


Asunto(s)
Maloclusión de Angle Clase III/diagnóstico por imagen , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Cefalometría , Tomografía Computarizada de Haz Cónico , Oclusión Dental , Asimetría Facial/cirugía , Femenino , Humanos , Labio/anatomía & histología , Masculino , Maloclusión de Angle Clase III/cirugía , Mandíbula/cirugía , Maxilar/cirugía , Procedimientos Quirúrgicos Ortognáticos
7.
J Craniomaxillofac Surg ; 47(1): 138-142, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30501927

RESUMEN

The investigators hypothesized there would be differences between the sexes in recovery pattern following bimaxillary orthognathic surgery as measured by patient responses at 5 weeks postprocedure. A total of 378 participants underwent bimaxillary orthognathic surgery with or without adjunctive procedures. Participants received questionnaires 5 weeks postsurgery when they visited the outpatient clinic. The questionnaires include variances in surgical factors by sex, and postoperative symptoms which were most difficult to tolerate experiences by sex, respectively. Females were more likely to undergo malarplasty (zygoma reduction) than were male participants (P = <.001), and they required larger maxillary setback than did male participants (P = .003). Malarplasty was significantly correlated with ear fullness in total and female participants (p-value .018, .016, respectively). Snoring is significantly associated with malarplasty and segment osteotomy procedure without gender predominance (p-value = .026, .028, respectively). Over half of participants complained of nasal congestion (55.6%), followed by swelling (29.3%), pain (15.4%), breathing difficulty (10.6%). In conclusion, males and females showed different patterns of postoperative recovery following bimaxillary orthognathic surgery.


Asunto(s)
Maxilar/cirugía , Cirugía Ortognática/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Adulto , Femenino , Humanos , Masculino , Osteotomía Maxilar , Obstrucción Nasal/cirugía , Osteotomía , Complicaciones Posoperatorias/psicología , Factores Sexuales , Encuestas y Cuestionarios , Adulto Joven , Cigoma/cirugía
8.
J Oral Rehabil ; 45(12): 967-973, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30125391

RESUMEN

This study aimed to investigate the possible influence of the regional acceleratory phenomenon (RAP) on dental implant osseointegration. Orthognathic surgery was set as an intervention for RAP, and a multicentre cohort study of two groups was undertaken. Group O included patients with single implant placement at least 4 months after orthognathic surgery and functional loading for more than 1 year, while controls (Group C) were without any major surgery. Clinical and radiographic assessments of implants, including changes in marginal bone levels, were analysed at baseline, 6- and 12-month follow-up. Bivariate analysis of two groups with propensity score matching was performed. After propensity score matching, all 10 confounding variables had acceptable standardised difference scores (<20%), indicating that the matching procedure had efficiently balanced the two groups. Following the propensity score adjustment, the marginal bone loss was significantly higher in Group O than the control at 6 months (1.66 ± 1.05 mm vs 0.59 ± 0.64 mm, P < 0.001) and 12 months (2.30 ± 1.27 mm vs 0.82 ± 0.78 mm, P < 0.001). Compared to Group C, subjects in Group O had a higher incidence of peri-implant mucositis and implantitis (11.8% vs 1.5%, P = 0.033). Impaired osseointegration of dental implants was associated with orthognathic surgery. Special considerations for peri-implant soft and hard tissue stability should be addressed to obtain ideal treatment results and prognosis for patients who have had prior orthognathic surgery.


Asunto(s)
Pérdida de Hueso Alveolar/fisiopatología , Oseointegración/fisiología , Adulto , Implantes Dentales , Análisis del Estrés Dental , Femenino , Humanos , Masculino , Cirugía Ortognática , Puntaje de Propensión , Adulto Joven
9.
J Craniofac Surg ; 29(7): 1880-1883, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30028404

RESUMEN

Bone tissue engineering technology based on scaffold has been applied for cleft lip and palate treatment. However, clinical applications of patient-specific three-dimensional (3D) scaffolds have rarely been performed. In this study, a clinical case using patient-specific 3D-printed bioresorbable scaffold with bone marrow stromal cells collected from iliac crest in the operating room has been introduced. At 6-month after transplantation, the bone volume of the newly regenerated bone was approximately 45% of the total defect volume. Bone mineral density of the newly regenerated bone was about 75% compared to the surrounding bone. The Hounsfield unit value was higher than that of cancellous maxillary alveolar bone and lower than that of the cortical maxillary alveolar bone. Bone-marrow-derived mesenchymal stem cells-seeded 3D-printed patient-specific polycaprolactone scaffolds offer a promising alternative for alveolar cleft reconstruction and other bony defects.


Asunto(s)
Implantes Absorbibles , Proceso Alveolar/anomalías , Proceso Alveolar/cirugía , Trasplante de Células Madre Mesenquimatosas , Andamios del Tejido , Proceso Alveolar/diagnóstico por imagen , Regeneración Ósea , Niño , Humanos , Masculino , Maxilar/cirugía , Células Madre Mesenquimatosas , Poliésteres , Impresión Tridimensional , Ingeniería de Tejidos/métodos
11.
J Craniofac Surg ; 29(3): 731-732, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29419598

RESUMEN

Reduction malarplasty is utilized to reshape the facial form into an oval shape. However, complications and unfavorable results in reduction malarplasty have been reported. Reoperation of a nonunion malar complex is difficult relative to the achievement of a satisfactory outcome using the intraoral approach with a narrow surgical field because the normal anatomy has been destroyed, and previous surgery may have caused asymmetry. In this situation, computer-aided simulation surgery and surgical guides can serve as effective solutions to overcome the limitations of reoperative malarplasty using the intraoral approach.In this report, the authors present a case with successful treatment outcomes for a nonunion malar complex using a three-dimensional-printed zygoma repositioner.


Asunto(s)
Impresión Tridimensional , Procedimientos Quirúrgicos Reconstructivos , Cirugía Asistida por Computador , Cigoma/cirugía , Oclusión Dental , Asimetría Facial/cirugía , Humanos , Procedimientos Quirúrgicos Reconstructivos/instrumentación , Procedimientos Quirúrgicos Reconstructivos/métodos , Reoperación , Cirugía Asistida por Computador/instrumentación , Cirugía Asistida por Computador/métodos , Resultado del Tratamiento
12.
Int J Oral Maxillofac Implants ; 33(3): e73­e76, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-28817741

RESUMEN

Dental implants positioned in severely atrophied anterior maxillae require esthetic or functional compromises. This case report describes the rehabilitation of a severely atrophied alveolar ridge with a three-dimensional (3D) computer-aided design/computer-aided manufacture (CAD/CAM) surgical guide. A 50-year-old woman had a severely atrophied anterior maxilla with unfavorably positioned dental implants. Functional and esthetic prosthodontic restoration was difficult to achieve. An anterior segmental osteotomy was planned to reposition the dental implants. A 3D surgical guide was designed for precise relocation of the segment. The surgical guide firmly grasped the impression copings of the dental implants, minimizing surgical errors. Three-dimensional gingival simulation was used preoperatively to estimate the appropriate position of the gingiva. Rigid fixation to the surrounding bone allowed immobilization of the implant-bone segment. Satisfactory esthetic and functional outcomes were attained 6 months after surgery. Finally, a severely atrophied alveolar ridge with unfavorably positioned dental implants was recovered with minimal esthetic and functional deterioration using gingival simulation and a 3D CAD/CAM surgical guide.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Diseño Asistido por Computadora , Implantación Dental Endoósea/métodos , Prótesis Dental de Soporte Implantado/métodos , Femenino , Encía/cirugía , Humanos , Maxilar/cirugía , Persona de Mediana Edad , Osteotomía/métodos , Impresión Tridimensional , Resultado del Tratamiento
13.
Maxillofac Plast Reconstr Surg ; 39(1): 22, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28824888

RESUMEN

BACKGROUND: Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery. METHODS: A prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring. RESULTS: Among 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers. CONCLUSIONS: This study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.

14.
Medicine (Baltimore) ; 96(22): e6873, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28562535

RESUMEN

Bimaxillary surgery is the traditional treatment of choice for correcting class III malocclusion which is reported to cause an alteration of oropharyngeal structures and upper airway narrowing that might be a predisposing factor for obstructive sleep apnea (OSA). This study aimed to analyze sleep parameters in class III malocclusion subjects and ascertain the prevalence of snoring or OSA following bimaxillary surgery.A total of 22 patients with Le Fort I osteotomy and mandibular setback for class III malocclusion were prospectively enrolled. All patients received endoscopic examination, cephalometry, 3-dimensional computed tomography (3D-CT), and sleep study twice at 1 month before and 3 months after surgery.The patient population consisted of 5 males and 17 females with a mean body mass index of 22.5 kg/m and mean age of 22.1 years. No patients complained of sleep-related symptoms, and the results of sleep study showed normal values before surgery. Three patients (13%) were newly diagnosed with mild or moderate OSA and 6 patients (27%) showed increased loudness of snoring (over 40 dB) after bimaxillary surgery. According to cephalometric analysis and 3D-CT results, the retropalatal and retroglossal areas were significantly narrowed in class III malocclusion patients, showing snoring and sleep apnea after surgery. In addition, the total volume of the upper airway was considerably reduced following surgery in the same patients.Postoperative narrowing of the upper airway and a reduction of total upper airway volume can be induced, and causes snoring and OSA in class III malocclusion subjects following bimaxillary surgery.


Asunto(s)
Maloclusión de Angle Clase III/cirugía , Maxilar/cirugía , Faringe/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagen , Síndromes de la Apnea del Sueño/complicaciones , Síndromes de la Apnea del Sueño/diagnóstico por imagen , Cefalometría , Femenino , Humanos , Imagenología Tridimensional , Masculino , Maloclusión de Angle Clase III/complicaciones , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/epidemiología , Tamaño de los Órganos , Procedimientos Ortopédicos/efectos adversos , Complicaciones Posoperatorias/epidemiología , Prevalencia , Estudios Prospectivos , Síndromes de la Apnea del Sueño/epidemiología , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto Joven
15.
Aesthetic Plast Surg ; 41(4): 930-937, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28364182

RESUMEN

BACKGROUND: A slender or slim face with narrow facial features is considered esthetically appealing in Asian people. Plastic surgery to obtain an oval face, called a 'V-line,' is popular among young people. MATERIALS AND METHODS: A total of 20 Korean patients were included in this study. The patients underwent mandibular anguloplasty with three-dimensional computer-aided design and manufacturing surgical guides that were accurately fitted to the upper and lower teeth, allowing for precise replication of a virtual surgery during a real surgical procedure. RESULTS: There were no significant complications, including severe bleeding, facial nerve injury, or airway obstruction. All patients were satisfied with the esthetic and functional results, except for one who was neutral toward the result. The mean satisfaction score was 4.75, which was between 'satisfied' and 'very satisfied.' CONCLUSION: The V-line guide and gooseneck saw allowed for safe and fast resection of bone in the mandibular angle area. This technique provides consistent results during surgery as well as minimizing surgical complications. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .


Asunto(s)
Imagenología Tridimensional , Osteotomía Mandibular/métodos , Cirugía Plástica/métodos , Adulto , Grupo de Ascendencia Continental Asiática , Estudios de Cohortes , Diseño Asistido por Computadora , Estética , Femenino , Estudios de Seguimiento , Humanos , Masculino , Seguridad del Paciente , Procedimientos Quirúrgicos Reconstructivos/métodos , República de Corea , Estudios Retrospectivos , Medición de Riesgo , Resultado del Tratamiento , Adulto Joven
16.
J Oral Maxillofac Surg ; 75(8): 1668-1678, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28282517

RESUMEN

PURPOSE: Cysts are common pathologic entities in the oral and maxillofacial region. Enucleation is commonly used for treatment and is occasionally followed by bone grafting. However, no studies have evaluated factors affecting the failure of grafts used for cystic defects in the oral and maxillofacial region. Therefore, the present study was conducted to determine the risk factors for postoperative graft failure in patients treated with cyst enucleation and simultaneous bone grafting. MATERIALS AND METHODS: Clinical data for 305 patients who had undergone cyst enucleation with simultaneous bone grafting were retrospectively investigated in this multicenter case-and-control study. The predictor variables included host, pathologic, and treatment factors. The outcome variable was success or failure of the bone graft. Descriptive statistics were computed, and the P value was set at .05. RESULTS: Bone graft failure was observed in 48 cases. The mean duration from surgery to failure was 38.7 days. Multivariable logistic regression analysis showed a significant association between graft failure and younger age (odds ratio [OR] = 1.033; P = .016), smoking (OR = 2.598; P = .017), preoperative infection (OR = 4.660; P = .001), large cysts (OR = 1.052; P = .010), impaction of the mandibular third molar in the cystic cavity (OR = 3.021; P = .007), perilesional osteosclerosis (OR = 4.973; P = .001), and the use of mixed non-autogenous and autogenous bone grafts (OR = 3.891; P = .007). CONCLUSIONS: This study provides a list of important factors that should be considered by clinicians planning enucleation and simultaneous bone grafting for cysts in the oral and maxillofacial region.


Asunto(s)
Trasplante Óseo , Rechazo de Injerto/etiología , Enfermedades Maxilomandibulares/cirugía , Quistes Odontogénicos/cirugía , Complicaciones Posoperatorias/etiología , Adulto , Factores de Edad , Infecciones Bacterianas/etiología , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , República de Corea , Estudios Retrospectivos , Factores de Riesgo , Estadística como Asunto
17.
J Oral Maxillofac Surg ; 74(7): 1501.e1-1501.e15, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27060494

RESUMEN

A woman presented with a long history of mandibular defects posterior to the left lower first premolar caused by inadequate reconstruction after removal of a tumor on the left side of the mandible. In the frontal view, extreme facial asymmetry was apparent. The dental midline of the mandible was deviated 10 mm to the left compared with the dental midline of the maxilla, and all maxillary teeth were inclined to the left owing to dental compensation. There was an 8-mm maxillary occlusal cant relative to the maxillary first molar. Bimaxillary surgery using computer-assisted designed and computer-assisted manufactured devices without an intermediate occlusal splint was performed to align the maxilla and mandible at the correct position, and reconstructive surgery for the mandible using a 3-dimensional printed titanium mandible was concurrently performed. In particular, during the virtual mandible design, 2 abutments that enabled the prosthetic restoration were included in the mandible using a computer-assisted design program. This report describes the successful functional and esthetic reconstruction of the mandible using electron beam melting technology, an alternative technique for reconstruction of mandibles that did not undergo radiation therapy.


Asunto(s)
Asimetría Facial/cirugía , Prótesis Mandibular , Reconstrucción Mandibular/métodos , Maxilar/cirugía , Impresión Tridimensional , Adulto , Electrones , Estética Dental , Asimetría Facial/etiología , Femenino , Humanos , Neoplasias Mandibulares/complicaciones , Neoplasias Mandibulares/cirugía , Diseño de Prótesis , Titanio
18.
Anesth Prog ; 62(4): 166-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26650496

RESUMEN

After 2-jaw surgery, difficulty in breathing through the mouth and the nose is common due to nasal airway obstruction, intraoral bleeding, and sometimes maxillomandibular fixation. A partially withdrawn nasotracheal tube can be used economically with equal efficacy to the nasopharyngeal airway to provide supplemental oxygen after 2-jaw surgery.


Asunto(s)
Intubación Intratraqueal/instrumentación , Procedimientos Quirúrgicos Ortognáticos/instrumentación , Diseño de Equipo , Femenino , Humanos , Nasofaringe , Terapia por Inhalación de Oxígeno/instrumentación
19.
J Oral Maxillofac Surg ; 73(10): 2024-9, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25869979

RESUMEN

Currently, virtual orthognathic surgery using the CAD/CAM program and three-dimensional printing technology has provided a valuable tool supporting accurate surgical planning and precise surgery. However, despite the advancements in CAD/CAM virtual surgical planning, accurately reproducing surgical planning from a virtual surgery to the operating field is still challenging. Here, we report the Keyhole system as a method that has constantly provided us with consistent results during double-jaw surgery, especially during this age of ever increasing aesthetic demand from patients.


Asunto(s)
Diseño Asistido por Computadora , Mandíbula/cirugía , Maxilar/cirugía , Cirugía Ortognática/instrumentación , Cirugía Asistida por Computador/instrumentación , Humanos
20.
Cleft Palate Craniofac J ; 50(2): 231-6, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20828270

RESUMEN

Primary cheiloplasty in adult patients with unrepaired complete bilateral cleft lip and palate is quite challenging due to severe premaxillary anterior projection. To get the best repair results, the author carried out repositioning of the premaxilla and repair of the lip deformity in a single stage. Positive results for the primary lip repair and appropriate repositioning of the premaxilla were achieved. No avascular necrosis of the premaxilla was observed. Repositioning of the premaxilla and repair of the lip deformity in a single operation appears to be a reliable method for treating adult patients with previously unrepaired or poorly repaired bilateral cleft lip and palate.


Asunto(s)
Labio Leporino , Fisura del Paladar , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Humanos , Lactante , Posicionamiento del Paciente
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