Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.227
Filtrar
1.
Rev. esp. cir. oral maxilofac ; 42(3): 107-118, jul.-sept. 2020. ilus, tab
Artículo en Español | IBECS | ID: ibc-196626

RESUMEN

OBJETIVOS: El objetivo es presentar el protocolo de trabajo, resultados clínicos y cambios en la vía aérea superior de una cohorte de 20 pacientes con síndrome de apnea/hipopnea obstructiva del sueño, intervenidos de avance maxilomandibular con rotación antihoraria. MATERIAL Y MÉTODOS: Un comité multidisciplinar determina la indicación quirúrgica, que los pacientes consienten. Se llevan a cabo tomografías computarizadas y polisomnografías antes y después de la cirugía, como protocolo habitual de trabajo. El comité ético de investigación clínica regional aprobó el estudio. Longitudes, volúmenes, área mínima, dimensión anteroposterior, dimensión transversal y otras medidas son determinadas en la vía aérea. El análisis estadístico es descriptivo y comparativo por pares con p < 0,05. RESULTADOS: Los movimientos planificados son 10,40 mm de avance y 2,11 mm de impactación anterior. El índice de apnea/hipopnea se reduce 30,50 puntos y la saturación de oxígeno capilar periférica mínima aumenta 5,00 puntos. Los resultados clínica y estadísticamente significativos son: 10,98 mm de acortamiento y 6,26 mm3 de incremento de volumen, especialmente en el compartimento retro-palatal; 91,45 mm2, 3,68 mm y 8,00 mm de aumento de área, dimensión antero-posterior y dimensión transversal respectivamente; el hioides avanza 1,92 mm. CONCLUSIONES: El avance maxilomandibular con rotación antihoraria en síndrome de apnea/hipopnea del sueño moderado-severo logra a corto plazo índice de apnea/hipopnea < 15 en el 80 % y saturación de oxígeno periférica capilar > 85 en el 75 % de nuestra serie. Los principales cambios en vía aérea son: acortamiento, incremento de volumen y áreas, forma elíptica y posicionamiento antero-superior del hioides


OBJECTIVES: To present the working protocol, clinical outcomes and upper airway changes of a 20-patient cohort with moderate-severe obstructive sleep apnea/hypopnea syndrome undergoing maxillo-mandibular advancement with counterclockwise rotation. MATERIAL AND METHODS: A multidisciplinary committee determines the surgical indication, which patients consent. Computed tomographies and polysomnographies are performed before and after surgery, as the usual clinical practice protocol. The clinical investigation ethics institutional review board approved the study. Lengths, volumes, minimum area, antero-posterior dimension, transverse dimension and other measurements are determined in the upper airway. Statistical analysis is descriptive and comparative by pairs with p < 0.05. RESULTS: Planned movements are 10.40 mm of advance and 2.11 mm of anterior impaction. Apnea/hypopnea index reduces by 30.50 points and minimum peripheral capillary oxygen saturation increases by 5.00 points. Clinically and statistical significant findings are: 10.98 mm of shortening and 6.26 mm3 of volume enlargement, especially in the retro-palatal compartment; 91.45 mm2, 3.68 mm and 8.00 mm of area, antero-posterior dimension and transverse dimension widening respectively; hyoid bone advances 1.92 mm. CONCLUSIONS: Maxillo-mandibular advancement with counterclockwise rotation in moderatesevere obstructive sleep apnea/hypopnea syndrome achieves in short-term follow-up apnea/hypopnea index < 15 in 80 % and minimum peripheral capillary oxygen saturation > 85 in 75 % of our series. Main upper airway changes are: shortening, volume and area increase, elliptical shape, and antero-superior hyoid bone movement


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Apnea Obstructiva del Sueño/cirugía , Elevación del Piso del Seno Maxilar/métodos , Anomalías Maxilomandibulares/cirugía , Sistema Respiratorio/anatomía & histología , Manejo de la Vía Aérea/métodos , Cuidados Posoperatorios/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Polisomnografía/estadística & datos numéricos
2.
Rev. Soc. Odontol. La Plata ; 30(58): 13-17, jul. 2020. ilus, graf
Artículo en Español | LILACS | ID: biblio-1119236

RESUMEN

Las compresiones del maxilar superior son alteraciones transversales por discrepancia óseo-dentaria. .En la dentición mixta temprana puede establecerse la estrechez mediante índices que relacionan el tamaño dental con el ancho transversal del arco dentario. Se analizaron 33 modelos superiores de niños en el tercer período de desarrollo clínico según Barnett. Se estableció la estrechez realizando el análisis métrico del arco dental mediante el índice de Pont. Se describió la anomalía de posición anterior según las siguientes variables: A) Apiñamiento dentario: 1-Escalón de los dientes anterosuperiores; 2-Rotación mesial de los cuatro incisivos; 3-Rotación mesial de los incisivos centrales y rotación distal de los incisivos laterales y 4-Rotación distal de los incisivos centrales. B) Ausencia de apiñamiento: 1-Reabsorción atípica y 2- Ausencia de reabsorción atípica. Las anomalías de posición y/o reabsorciones atípicas anteriores en este período de desarrollo clínico se asocian a estrechez transversal del maxilar superior Siendo la malposición más frecuente la rotación mesial de los cuatro incisivos, siguiendo las reabsorciones atípicas y el escalón de los dientes anterosuperiores, luego la rotación mesial de los incisivos centrales y distal de los laterales y por último la rotación distal de los incisivos centrales (AU)


Inside the traverse alteration of the maxillary the compressions are described as uni or bilateral where an imbalance is settled down between the dental size and the size of the maxillary causing alterations in the position of the teeth. In the early mixed teething the narrowness of the maxillary can be settled by means of indexes that relate the dental size with the traverse width of the dental arch. Thirty models of the maxillary of children according to Barnett's third development period were analyzed. The metrical analysis of the dental arch form was carried out through Pont's index. The theoretic values were compared with the real ones establishing the deviations of the norm that is to say the narrow nest. Out of the 30 cases analyzed, 40% presented mesial rotation of the 4 incisors; 27% showed a stop of the front teeth; 27% atypical reabsorption; 20% mesial rotation of the central incisors and distal rotation of the lateral incisors and the 10% presented a distal rotation of the central incisors. With regard to the front atypical discrepancy 36.66% of the cases had a discrepancy above 6 mm and the 23.33% below 3 mm (AU)


Asunto(s)
Humanos , Masculino , Femenino , Niño , Arco Dental/anomalías , Dentición Mixta , Diagnóstico Precoz , Anomalías Maxilomandibulares/diagnóstico , Análisis Estadístico , Incisivo/anomalías , Maloclusión/diagnóstico , Maxilar/anomalías
3.
J Med Life ; 13(1): 102-106, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32341710

RESUMEN

Children suffering from conductive or mixed hearing loss may benefit from a bone-anchored hearing aid system (BAHA Attract implantable prosthesis). After audiological rehabilitation, different aspects of development are improving. The objective of this case report is to propose a comprehensive framework for monitoring cortical auditory function after implantation of a bone-anchored hearing aid system by using electrophysiological and neuropsychological measurements. We present the case of a seven-year-old boy with a congenital hearing loss due to a plurimalformative syndrome, including outer and middle ear malformation. After the diagnosis of hearing loss and the audiological rehabilitation with a BAHA Attract implantable prosthesis, the cortical auditory evoked potentials were recorded. We performed a neuropsychological evaluation using the Wechsler Intelligence Scale for Children - Fourth Edition, which was applied according to a standard procedure. The P1 latency was delayed according to the age (an objective biomarker for quantifying cortical auditory function). The neuropsychological evaluation revealed that the child's working memory and verbal reasoning abilities were in the borderline range comparing with his nonverbal reasoning abilities and processing abilities, which were in the average and below-average range, respectively. Cortical auditory evoked potentials, along with neuropsychological evaluation, could be an essential tool for monitoring cortical auditory function in children with hearing loss after a bone-anchored hearing aid implantation.


Asunto(s)
Corteza Auditiva/fisiología , Fenómenos Electrofisiológicos , Audífonos , Niño , Oído Externo/anomalías , Oído Externo/fisiopatología , Potenciales Evocados/fisiología , Humanos , Anomalías Maxilomandibulares/fisiopatología , Masculino , Microstomía/fisiopatología
4.
J Craniofac Surg ; 31(5): 1270-1273, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32282689

RESUMEN

INTRODUCTION: Latent cranial suture fusions may present with mild or absent phenotypic changes that make the clinical diagnosis challenging. Recent reports describe patients with sagittal synostosis and a normal cranial index (CI), a condition termed normocephalic sagittal craniosynostosis (NSC). The goal of this study is to evaluate the shape and intracranial volume (ICV) in a cohort of NSC patients using quantitative cranial shape analysis (CSA). METHODS: We identified 19 patients (7.5 ±â€Š2.28 years) between 2011 and 2016, who presented to our hospital with NSC. Cranial index and CSA were measured from the computed tomography image. Cranial shape analysis calculates the distances between the patient's cranial shape and its closest normal shape. Intracranial volume was measured and compared to an established age-matched normative database. RESULTS: Cranial index revealed 15 (78.9%) patients within the mesocephalic range and 4 patients (21.1%) in the brachycephalic range. Detailed CSA identified 15 (78.9%) patients with subtle phenotypic changes along the scaphocephalic spectrum (ie, subtle anterior and posterior elongation with inter-parietal narrowing) and 1 patient (5.3%) with isolated overdevelopment on the posterior part of the right parietal bone. Three patients (15.8%) had a CSA close to normal. Mean ICV was 1410.5 ±â€Š192.77cc; most patients (78.9%) fell within ±2 standard deviations. CONCLUSION: Quantitative CSA revealed that most of the patients with NSC had cranial shape abnormalities, consistent with a forme fruste scaphocephaly that could not be otherwise recognized by clinical observation or CI. Given these findings, we propose the term occult scaphocephaly to describe this condition. The associated incidence of intracranial hypertension is unknown.


Asunto(s)
Craneosinostosis/cirugía , Cráneo/cirugía , Niño , Preescolar , Estudios de Cohortes , Craneosinostosis/diagnóstico por imagen , Femenino , Humanos , Anomalías Maxilomandibulares , Masculino , Cráneo/diagnóstico por imagen , Tomografía Computarizada por Rayos X
5.
Av. odontoestomatol ; 36(1): 21-26, ene.-abr. 2020.
Artículo en Español | IBECS | ID: ibc-192996

RESUMEN

INTRODUCCIÓN: Las anomalías dentomaxilares corresponden a un grupo de alteraciones que dificultan el desarrollo armónico de los maxilares, donde encontramos las anomalías transversales. La expansión rápida del maxilar (ERM) se utiliza como tratamiento de anomalías transversales, su objetivo es aumentar la distancia transversal por la separación de ambas hemiarcadas a nivel de la sutura palatina, utilizando un aparato expansor fijo y rígido. Los disyuntores más utilizados son los expansores Hass, Hyrax y de McNamara. OBJETIVO: El objetivo de la presente revisión es identificar los riesgos de la RME reportados en la literatura relacionados con disyuntores Hass, Hyrax y Mc Namara. METODOLOGÍA: Se realizó una búsqueda en PubMed, Scielo, Science Direct, Trip Database y Google Acadèmico utilizando los tèrminos: "Rapid Maxillary Expansion", "Risks", "Child", "Maxillary Expansion", "RME", "Palatal Expansion", "Hyrax", "Hass". Se incluyeron estudios en inglès y español, sin límites en el año de publicación o tipo de estudio. Como criterios de exclusión consideramos la expansión quirúrgica, expansión lenta u otro tratamiento simultáneo durante la fase de expansión activa. RESULTADOS: De los artículos encontrados, veinte cumplieron los criterios de inclusión. Dentro de los riesgos se encuentran: deglución accidental del dispositivo de activación del expansor, bacteremia transitoria, desviación del septum nasal, reabsorción radicular, compromiso periodontal, cambio posicional de los cóndilos, cambios faciales de tejido blando y cambios esqueletales. CONCLUSIÓN: La ERM es un procedimiento ortopèdico eficaz, sus indicaciones en el tratamiento precoz han aumentado debido a resultados positivos. De acuerdo con la bibliografía encontrada los beneficios superan considerablemente a los efectos negativos


INTRODUCTION: The dentomaxillary anomalies correspond to a group of alterations that hinder the harmonic development of the jaws, where we find the transversal anomalies. Rapid Maxillary Expansion (RME) is used as a treatment for transverse anomalies, its objective is to increase the transversal distance by separating both hemiarchies at the level of the palatal suture, using a fixed and rigid expander. The most used are the Hass, Hyrax and McNamara expanders. OBJECTIVE: The objective of this review is to identify the EMR risks reported in the literature related to Hass, Hyrax and Mc Namara expander. METHODOLOGY: A search was made in PubMed, Scielo, Science Direct, Trip Database and Google Scholar using the terms: "Rapid Maxillary Expansion", "Risks", "Child", "Maxillary Expansion", "RME", "Palatal Expansion", "Hyrax", "Hass". Studies in English and Spanish were included, without limits in the year of publication or type of study. As exclusion criteria, we consider surgical expansion, slow expansion or other simultaneous treatment during the active expansion phase. RESULTS: Of the articles found, twenty met the inclusion criteria. Among the risks are: accidental swallowing of the expander activation device, transient bacteremia, deviation of the nasal septum, root resorption, periodontal involvement, positional change of the condyles, soft tissue facial changes and skeletal changes. CONCLUSION: RME is an effective orthopedic procedure, its indications in early treatment have increased due to positive results. According to the bibliography found, the benefits considerably outweigh the negative effects


Asunto(s)
Humanos , Técnica de Expansión Palatina/efectos adversos , Anomalías Maxilomandibulares/terapia , Técnica de Expansión Palatina/instrumentación , Factores de Riesgo , Aparatos Ortopédicos , Bacteriemia/complicaciones , Placa Dental/microbiología , Placa Dental/prevención & control , Tabique Nasal/anomalías , Resorción Radicular
6.
J Craniofac Surg ; 31(4): e391-e393, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32168129

RESUMEN

Syngnathia is a rare facial anomaly associated with neonatal problems, including a compromised airway, and the inability to take in solids and/or liquids. Syngnathia is included within the spectrum of oromandibular limb hypogenesis syndrome, an extremely rare condition characterized by varying degrees of congenital malformation involving the tongue, mandible, and limbs. In this report, we describe the case of a 41-day-old Caucasian female infant who was unable to open her mouth beginning at birth. The authors performed osteotomies to separate fused bone, and placed a bite block at the osteotomy sites to prevent bone fusion recurrence. At 2 years of follow-up patient remained with 14 mm of mouth opening.


Asunto(s)
Anomalías Maxilomandibulares/diagnóstico por imagen , Anomalías de la Boca/diagnóstico por imagen , Anomalías Múltiples , Femenino , Humanos , Lactante , Anomalías Maxilomandibulares/cirugía , Mandíbula/anomalías , Anomalías de la Boca/cirugía , Osteotomía , Lengua/anomalías
7.
J Craniofac Surg ; 31(4): 940-944, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32149974

RESUMEN

: A question that remains unanswered is at what level of surgical correction does the public perceive a head shape to be "normal" or "acceptable?" For most cases of non-syndromic asymptomatic craniosynostosis, the parents desire for surgical correction is to improve the cosmetic appearance of head shape. At the time of this writing, the intraoperative surgeons' perspective of what constitutes an acceptable head shape is the target for surgical correction. In introducing an improved objectively cosmetic goal, an appropriate outcome measure would be to assess what the general public considers a normal or acceptable head shape in children with craniosynostosis. METHOD: Twenty-two unique images were presented via an online crowdsourcing survey of a severe case of non-syndromic sagittal craniosynosis gradually corrected to an age and gender matched normalized head shape. Participants were recruited via the Sick Kids Twitter account. Participants were invited to rate the head shapes as "normal" or "abnormal." RESULTS: The 538 participants completed the online survey. Participants were able to reliably and consistently identify normal and abnormal head shapes with a Kappa Score >0.775. Furthermore, participants indicated that a correction of 70% is required in order for the cranial deformity to be regarded as "normal." This threshold closely reflects a normal Cranial Index, which is a widely used morphometric outcome in craniosynostosis. CONCLUSION: Crowdsourcing provides an ideal method for capturing the general population's perspective on what constitutes a normal and acceptable head shape in children with sagittal craniosynostosis. Laypersons are able to reliably and consistently distinguish cranial deformities from a "normal" head shape. The public indicates a threshold correction of 70% in sagittal craniosynosis to regard it as a "normal" head shape.


Asunto(s)
Craneosinostosis/cirugía , Cabeza , Anomalías Maxilomandibulares/cirugía , Niño , Huesos Faciales , Humanos , Encuestas y Cuestionarios
8.
J Craniofac Surg ; 31(3): 692-696, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31977684

RESUMEN

Unicoronal craniosynostosis is the second most common type of nonsyndromic craniosynostosis: it is characterized by ipsilateral forehead and fronto-parietal region flattening with contralateral compensatory bossing. It is a complex condition; therefore, which is difficult to treat because of the asymmetry in the orbits, cranium, and face. The aim of this study is to understand optimal osteotomy locations, dimensions, and force requirements for surgical operations of unicoronal craniosynostosis using a patient-specific finite element model and - at the same time - to evaluate the potential application of a new device made from Nitinol which was developed to expand the affected side of a unicoronal craniosynostosis skull without performing osteotomies. The model geometry was reconstructed using Simpleware ScanIP. The bone and sutures were modeled using elastic properties to perform the finite element analyses in MSc Marc software. The simulation results showed that expanding the cranium without osteotomy requires a significant amount of force. Therefore, expansion of the cranium achieved by Nitinol devices may not be sufficient to correct the deformity. Moreover, the size and locations of the osteotomies are crucial for an optimal outcome from surgical operations in unicoronal craniosynostosis.


Asunto(s)
Craneosinostosis/diagnóstico por imagen , Craneosinostosis/cirugía , Anomalías Maxilomandibulares/diagnóstico por imagen , Anomalías Maxilomandibulares/cirugía , Humanos , Lactante , Masculino , Osteotomía , Cráneo/cirugía , Cirugía Asistida por Computador
9.
J Craniofac Surg ; 31(3): e245-e247, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31934975

RESUMEN

Many methods have been devised to repair cranial defects. Here, we report the use of a simple technique for the repair of a congenital cranial defect associated with aplasia cutis congenita (ACC).A newborn baby at 39 weeks of gestation was consulted with a scalp and cranial defect at the vertex measuring 3 × 1.5 cm. A 3-D CT scan of the skull confirmed the presence of a cranial defect at the sagittal suture and a normal brain structure. On the 13 day of life, the newborn was taken to an operating room. An autologous bone graft was harvested from adjacent normal parietal bone and grafted into the debrided congenital cranial defect. The soft tissue defect was then covered by rotation flaps.The postoperative 3-D CT scan presented a well-positioned autologous bone graft. At 1 month postoperatively, the skull contour was normal and there was no palpable defect.We report a successful surgical outcome for a congenital cranial and soft tissue defect in ACC treated using an autologous bone graft and rotation flaps. Although conservative therapy may be an alternative option, we recommend appropriate surgical reconstruction in patients at risk of potentially fatal complications.


Asunto(s)
Trasplante Óseo , Displasia Ectodérmica/cirugía , Anomalías Maxilomandibulares/cirugía , Suturas Craneales , Displasia Ectodérmica/diagnóstico por imagen , Humanos , Recién Nacido , Anomalías Maxilomandibulares/diagnóstico por imagen , Hueso Parietal/anomalías , Hueso Parietal/diagnóstico por imagen , Hueso Parietal/cirugía , Cuero Cabelludo/cirugía , Colgajos Quirúrgicos , Tomografía Computarizada por Rayos X , Trasplante Autólogo
10.
J Craniofac Surg ; 31(1): e84-e89, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31634311

RESUMEN

Agnathia-otocephaly complex (AOC) is a rare malformation complex of the first pharyngeal arch that is characterized by agnathia/dysgnathia, microstomia, aglossia/hypoglossia and variable displacement of the ears. Only 11 post-infancy patients with severe AOC have been described in the literature, and the incidence of this malformation complex is estimated to be 1 per 70,000 births. In this brief clinical study, the authors describe the case of an 18-year-old female diagnosed with AOC who underwent a 3-step mandibular distraction protocol with an external distraction device. The surgical protocol the authors used was unique in that we first placed a tissue expander in the submental area to enlarge the skin envelope in an effort to mitigate skeletal relapse from soft tissue forces. Furthermore, the way in which the authors slowed the activation of the distraction device to allow for soft tissue healing behind the pins was a novel component of the patient's treatment. The 3-step mandibular distraction protocol the authors present in this study increased the length of the mandible by 20 mm, and nearly doubled the size of the patient's mandible from an initial volume of 3.62 cm to a post-operative volume of 6.89 cm. Future surgeries will aim to improve the function of our patient's expanded mandible. Most important of all, the surgical treatment authors are presenting led to a significant improvement in our patient's physical appearance and 3d quality of life.


Asunto(s)
Anomalías Craneofaciales/cirugía , Anomalías Maxilomandibulares/cirugía , Mandíbula/cirugía , Adolescente , Anomalías Craneofaciales/diagnóstico por imagen , Femenino , Humanos , Anomalías Maxilomandibulares/diagnóstico por imagen , Mandíbula/diagnóstico por imagen , Osteogénesis por Distracción , Calidad de Vida
12.
Int J Oral Maxillofac Surg ; 49(4): 505-514, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31590998

RESUMEN

Syngnathia is a rare congenital anomaly that presents as fusion of the jaws. The aims of this study were to review the clinical profile of reported cases of syngnathia available in the literature with a view to suggesting a classification that may simplify the understanding of syngnathia and to propose an appropriate management protocol. A PubMed database search of articles published in English was conducted. Selected articles were analyzed according to year of publication, type of article, number of cases per article, patient biodata, description of syngnathia, and associated anomalies. Data were analyzed using IBM SPSS version 19; the level of statistical significance was set at P≤ 0.05. Cases were categorized according to a proposed classification, and a review of the management of congenital syngnathia from 153 previously reported cases (in 110 articles) was done to propose a treatment protocol based on the proposed classification model. The findings are presented under three headings: pre-surgical considerations, surgical (intraoperative) considerations, and post-surgical considerations. The proposed classification categorizes syngnathia into soft tissue union (type 1) and hard tissue union (type 2). These two types were found to have similar frequencies in the literature, while their management differed in terms of mode of anaesthesia and surgical approach.


Asunto(s)
Anomalías Maxilomandibulares , Anomalías de la Boca , Humanos
13.
Acta odontol. Colomb. (En linea) ; 10(2): 137-146, 2020. ilus, ilus, ilus, ilus, ilus
Artículo en Inglés | LILACS, COLNAL | ID: biblio-1123485

RESUMEN

Background: The lip stabilization technique (LipStaT®) is a novel surgical approach for the management of gummy smile. It is an outpatient technique, minimally invasive, with low risk of morbidity and low incidence of complications. The goal of the technique is to reduce the excessive gingival display during smile. Objective: to describe the LipStaT® technique including its indications, preoperative evaluation, surgical approach and patient post procedure care instructions. Clinical Cases: the authors present two female patients, aged 20 and 31 years, with excessive gingival display (over 3mm) and with experiences of failures with other procedures. The LipStaT® technique allowed to achieve aesthetic, harmonic and functional results. Conclusion: The LipStaT® technique is a safe outpatient procedure that allows to obtain predictable results, which are well accepted by patients.


Introducción: La técnica de estabilización labial (LipStaT®), es un novedoso abordaje quirúrgico para el manejo de la sonrisa gingival. Es una técnica ambulatoria, mínima-mente invasiva, con baja morbilidad e incidencia de complicaciones. La meta de la técni-ca es reducir la excesiva cantidad de encía que se visualiza durante la sonrisa. Objetivo:Describir la técnica LipStaT® incluyendo sus indicaciones, evaluación preoperatoria, abordaje quirúrgico y las indicaciones posteriores a la intervención. Presentación del caso: Los autores presentan dos pacientes, mujeres, entre 20 y 31 años, con visuali-zación excesiva de la encía de más de 3mm al sonreír y con experiencias de fracasos con otros procedimientos. La técnica LipStaT® permitió lograr un resultado estético, armónico y funcional. Conclusión: Este es un procedimiento seguro, ambulatorio, que permite obtener resultados predecibles y bien aceptados por los pacientes.


Asunto(s)
Humanos , Sobrecrecimiento Gingival , Procedimientos Quirúrgicos Ambulatorios , Estética Dental , Enfermedades de las Encías , Anomalías Maxilomandibulares
14.
BMJ Case Rep ; 12(11)2019 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-31791995

RESUMEN

A 27-year-old woman with moderate congenital ptosis and a positive Marcus-Gunn jaw winking reflex underwent levator resection surgery to correct the ptosis. Preoperatively, a normal Bell's reflex was documented. Postoperatively, she developed an inverse Bell's reflex and increased symptoms of ocular surface exposure. The Bell's reflex normalised in a week, with resolution of the corneal exposure. Reversal of the Bell's reflex can be an unforeseen complication following maximal levator resection. The early postoperative care in such cases is crucial, and the cornea must be protected from exposure changes. Accurate documentation of the Bell's phenomenon preoperatively is vital to recognise this rare event and plan management.


Asunto(s)
Blefaroptosis/cirugía , Cardiopatías Congénitas/cirugía , Anomalías Maxilomandibulares/cirugía , Enfermedades del Sistema Nervioso/cirugía , Trastornos de la Motilidad Ocular/etiología , Músculos Oculomotores/cirugía , Complicaciones Posoperatorias/etiología , Adulto , Blefaroptosis/congénito , Blefaroptosis/fisiopatología , Femenino , Cardiopatías Congénitas/fisiopatología , Humanos , Anomalías Maxilomandibulares/fisiopatología , Enfermedades del Sistema Nervioso/congénito , Enfermedades del Sistema Nervioso/fisiopatología , Reflejo Anormal
15.
Rev. esp. cir. oral maxilofac ; 41(4): 197-201, oct.-dic. 2019. ilus, tab
Artículo en Español | IBECS | ID: ibc-191807

RESUMEN

La signatia es una rara malformación congénita en la que se encuentra una fusión ósea del maxilar con la mandíbula. Puede ser unilateral o completa y se caracteriza por la incapacidad de abrir la boca del recién nacido. Esta puede clasificarse de acuerdo con su presentación clínica. Las complicaciones de esta anomalía pueden ser muy graves: incompatibilidad con la vida, incapacidad de proteger la vía aérea, dificultades para la alimentación, así como alteraciones en el crecimiento. Se han referido casos con distintos abordajes, por lo que el protocolo terapéutico-quirúrgico estará dado según las particularidades de cada individuo. En el presente caso se hace referencia de un lactante femenino que se presentó con fusión del complejo cigomático-maxilar con la mandíbula unilateral, el abordaje y seguimiento


Syngnathia is a rare congenital malformation in which a fusion of the mandible with the maxilla is found, it can be unilateral or complete and is characterized by the inability to open the mouth of the newborn, this can be classified according to its clinical presentation. The complications of this anomaly can be inability to protect the airway, difficulties for feeding, as well as alterations in growth. There have referred cases with different approaches, thus the therapeutic-surgical protocol will be given according to the particularities of each individual. In the present case reference is made of female infant with unilateral maxillo-mandibular-zygomatic fusion, diagnosis and follow-up


Asunto(s)
Humanos , Femenino , Recién Nacido , Anomalías Maxilomandibulares/diagnóstico por imagen , Cigoma/anomalías , Reconstrucción Mandibular/métodos , Anomalías Maxilomandibulares/cirugía , Cigoma/cirugía , Impresión Tridimensional
16.
Med Arch ; 73(4): 282-284, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31762566

RESUMEN

Introduction: Marcus Gunn syndrome is a rare phenomenon with very less number of cases reported in literature. It may be congenital or acquired. Aim: The aim of this case report was to report the clinical characteristics of Marcus Gunn patient from our Clinic. Case report: A comprehensive opthalmologic examination, CDVA (corrected distance visual acuity), fundus examination and photography, was conducted in Marcus Gunn patient. Clinical findings of patient presented as - chin positioned slightly upwards, extraocular motility normal on both eyes, cover test with normal findings, pupillary examination normal on both eyes. Left upper eyelid was in a lower position than the right one. On right eye, rima interpalpebrarum was 9 mm with upgaze of 13mm. On the left eye, rima interpalpebrarum was 5 mm with upgaze of 6 mm, and with open mouth, left rima interpalpebrarum was 10 mm. Visual acuity on both eyes was 1.0. Cycloplegic refraction on both eyes was +0,75 diopters (D), and Lang test was normal. In the differential diagnosis of patients with ptosis, Marcus Gunn jaw winking syndrome should be considered especially if it improves during feeding, sucking, chewing, smiling or any kind of mouth movement. In case of ptosis always do the jaw test. Have the infant bottle-feed. An older child can chew gum. Have the patient open the mouth, move the jaw from side to side, or protrude the jaw forward. Conclusion: Address first to treatment of any amblyopia if present - eyeglasses, patching etc., or strabismus. Think twice before deciding to operate.


Asunto(s)
Blefaroptosis/diagnóstico , Cardiopatías Congénitas/diagnóstico , Anomalías Maxilomandibulares/diagnóstico , Enfermedades del Sistema Nervioso/diagnóstico , Blefaroptosis/patología , Blefaroptosis/fisiopatología , Niño , Párpados/patología , Músculos Faciales/inervación , Músculos Faciales/fisiopatología , Cardiopatías Congénitas/patología , Cardiopatías Congénitas/fisiopatología , Humanos , Anomalías Maxilomandibulares/patología , Anomalías Maxilomandibulares/fisiopatología , Masculino , Boca/fisiopatología , Movimiento/fisiología , Enfermedades del Sistema Nervioso/patología , Enfermedades del Sistema Nervioso/fisiopatología , Reflejo Anormal
17.
Rev. Cient. CRO-RJ (Online) ; 4(2): 35-41, May-Aug. 2019.
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1024848

RESUMEN

Introduction: The aim of this study was to explore the influence of Myosin 1H on the soft tissue profile of African American females. Methods: Fourteen African American females from the University of Pittsburgh School of Dental Medicine Dental Registry and DNA Repository with the ancestral genotype GG, marker rs10850110, locus 12q24.11 were analyzed. For this investigation, measurements were taken of the eleven items that comprise the Holdaway soft tissue analysis. Profile differences between ethnicity and corresponding normative values were explored by independent-sample t tests for all facial profile measurements. Student's t test for independent means was used to determine differences with accepted norms. Significance was set a p<0.05. Results: There were significant differences between four of the eleven Holdaway values and the reported values for African Americans. The mean convexity value of the African American female group was 1.0 mm less the normative value of 5.7 mm (p>0.000). In contrast, the H angle of the African American females was larger than the normative value. Conclusions: Our study confirms previous research that Myosin 1H contributes to mandibular prognathism. It agrees with the idea that Myosin 1H is less influential in the maxillary soft tissue complex. Understanding the genetic influence of soft tissue growth would allow improved therapies and prevention approaches.


Introduçâo: O objetivo desse estudo foi determinar a influência da miosina 1H nos tecidos moles de mulheres americanas negras. Métodos: Foram estudadas quatorze mulheres americanas negras participantes do projeto Dental Registry and DNA Repository da Faculdade de Odontologia da Universidade de Pittsburgh com o genótipo comum GG do marcador rs10850110, localizado no lócus 12q24.11. Medidas de onze parâmetros que compõem a análise de tecidos moles de Holdaway foram utilizadas. Diferenças entre etnicidade e medidas normais correspondentes, foram exploradas através do teste t de Student de amostras independentes para todas as medidas faciais. O teste t de Student para médias independentes foi usado para determinar diferenças em comparação à medidas normais. A significância foi estabelecida em p<0,05. Resultados: Houve uma diferença estatisticamente significante entre quatro das onze medidas de Holdaway. A convexidade média da mulher americana negra foi de 1,0 mm a menos que o valor normal de 5.7 mm (p>0.000). Em contraste, o ângulo H das mulheres americanas negras foi maior que o valor normal. Conclusões: O nosso estudo confirma resultados anteriores que a miosina 1H contribui para o prognatismo mandibular. Nossos resultados concordam com a ideia de que a miosina 1H tem menor influência nos tecidos moles da maxila. Entender a influência genética no crescimento dos tecidos moles irá possivelmente permitir melhorar as abordagens de tratamento e prevenção atuais.


Asunto(s)
Anomalías Maxilomandibulares , Prognatismo , Miosinas , Mandíbula
18.
J Craniofac Surg ; 30(8): e784-e787, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31348202

RESUMEN

PURPOSE: The aim of the authors study is to demonstrate the soft tissues changes in the eyelid-brow area (ELBA) in patients with long-face syndrome after LeFort I osteotomy and impaction movements. MATERIALS AND METHODS: To perform this study the authors have analyzed retrospectively orthognathic patients with at least 1 years of completely follow-up. The inclusion criteria were: long-face syndrome according to Farkas' studies and vertical maxillary shortening movement without considering whether movements have been made in the other 2 planes of space (sagittal and horizontal).Orthognathic patients in which the maxillary impaction movement did not correlate to the long-face syndrome represented the control group. In this group too the authors did not consider if other movements were performed.Size and shape of the eyelid and the eyebrow was assessed on the frontal patients photos calibrated on the three-dimensional soft tissue volume imported from cone beam computed tomography.Two reference lines were taken: a horizontal line from the nasal point passing through both medial canthal angles and a perpendicular line through the pupil centre bilaterally. Then the measures were taken.The same operator (A.C.) took all of the measurements.In both groups, the preoperative measures were then compared with the postoperative ones. Then the soft tissue changes in both groups were compared. RESULTS: The results demonstrate different reaction of the ELBA after orthognathic surgery. The ELBA's position changes in long-face patients in a higher position after maxillary impaction. The authors did not obtain the same results in patients who do not have long-face syndrome. CONCLUSIONS: Repositioning skeletal bases in patients with long face causes a change in the ELBA's morphology.


Asunto(s)
Párpados/cirugía , Anomalías Maxilomandibulares/cirugía , Adolescente , Adulto , Tomografía Computarizada de Haz Cónico , Párpados/diagnóstico por imagen , Femenino , Humanos , Imagenología Tridimensional/métodos , Anomalías Maxilomandibulares/diagnóstico por imagen , Masculino , Maxilar/cirugía , Procedimientos Quirúrgicos Ortognáticos/métodos , Estudios Retrospectivos , Diente Impactado , Adulto Joven
19.
Middle East Afr J Ophthalmol ; 26(1): 37-39, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31114123

RESUMEN

Marcus Gunn jaw-winking syndrome (MGJWS) is a rare form of congenital blepharoptosis and one of the congenital cranial dysinnervation disorders (CCDD). In addition, morning glory disc anomaly (MGDA) is a congenital optic disc anomaly of unknown etiology. The present report is the first to describe an association between MGJWS and MGDA in an otherwise healthy 7-year-old boy. He also had counting finger vision, anisometropia, esotropia, and monocular elevation deficiency in the same eye. In the literature, both MGJWS and MGDA have been reported to be associated with Duane retraction syndrome, a form of CCDD.


Asunto(s)
Blefaroptosis/etiología , Anomalías del Ojo/complicaciones , Cardiopatías Congénitas/etiología , Anomalías Maxilomandibulares/etiología , Enfermedades del Sistema Nervioso/etiología , Disco Óptico/anomalías , Anisometropía/etiología , Anisometropía/fisiopatología , Blefaroptosis/diagnóstico , Blefaroptosis/fisiopatología , Niño , Esotropía/etiología , Esotropía/fisiopatología , Cardiopatías Congénitas/diagnóstico , Cardiopatías Congénitas/fisiopatología , Humanos , Anomalías Maxilomandibulares/diagnóstico , Anomalías Maxilomandibulares/fisiopatología , Masculino , Enfermedades del Sistema Nervioso/diagnóstico , Enfermedades del Sistema Nervioso/fisiopatología , Reflejo Anormal
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...