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1.
BMC Oral Health ; 20(1): 22, 2020 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-31992277

RESUMEN

BACKGROUND: Periodontally accelerated osteogenic orthodontics (PAOO) is a treatment for bone defects associated with a lack of bone graft stability, especially in coronal locations. This study aimed to compare a modified technique of membrane fixation that utilizes periosteal sutures (using a pouch design) with the traditional approach, which does not use membrane fixation. METHODS: Twenty-eight patients with a total of 168 teeth treated were divided into two groups: 1-A, in which patients were treated using the modified technique (with membrane fixation), and group 2-B, in which patients were treated using the traditional technique (without membrane fixation). The postoperative bone thickness was evaluated via radiographic examination. RESULTS: Postoperative improvements in bone augmentation were detected in both groups. At 12 months, the values of the CHBT (measured from the midpoint of the coronal third to the labial cortical surface, 0.84 ± 0.33 mm) and the values of VBL (measured from the alveolar crest to the cemento-enamel junction, - 2.35 ± 0.80 mm)were significantly greater in the modified technique group than those in the traditional technique group (CHBT:0.12 ± 0.21 mm and VBL:-1.39 ± 0.99 mm; P = 0.00 and P = 0.01). CONCLUSIONS: This study shows that compared to the traditional technique, the modified PAOO technique with membrane fixation using periosteal sutures provides improved graft stabilization, superior coronal augmentation and satisfactory vertical volume.


Asunto(s)
Proceso Alveolar/cirugía , Trasplante Óseo/métodos , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteogénesis/fisiología , Osteotomía/métodos , Aumento de la Cresta Alveolar/métodos , Humanos , Ortodoncia Correctiva/instrumentación , Técnicas de Movimiento Dental/métodos , Resultado del Tratamiento
2.
Ann R Coll Surg Engl ; 102(1): 9-13, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31755732

RESUMEN

INTRODUCTION: An increasing number of patients are taking oral antiplatelet agents. As a result, there is an important patient safety concern in relation to the potential risk of bleeding complications following major oral and maxillofacial surgery. Surgeons are increasingly likely to be faced with a dilemma of either continuing antiplatelet therapy and risking serious haemorrhage or withholding therapy and risking fatal thromboembolic complications. While there are national recommendations for patients taking oral antiplatelet drugs undergoing invasive minor oral surgery, there are still no evidence-based guidelines for the management of these patients undergoing major oral and maxillofacial surgery. METHODS: MEDLINE and EMBASE databases were searched to retrieve all relevant articles published to 31 December 2017. FINDINGS: A brief outline of the commonly used antiplatelet agents including their pharmacology and therapeutic indications is discussed, together with the haemorrhagic and thromboembolic risks of continuing or altering the antiplatelet regimen in the perioperative period. Finally, a protocol for the management of oral and maxillofacial patients on antiplatelet agents is presented. CONCLUSIONS: Most current evidence to guide decision making is based upon non-randomised observational studies, which attempts to provide the safest possible management of patients on antiplatelet therapy. Large randomised clinical trials are lacking.


Asunto(s)
Anticoagulantes/administración & dosificación , Procedimientos Quirúrgicos Orales/métodos , Inhibidores de Agregación Plaquetaria/administración & dosificación , Administración Oral , Anticoagulantes/farmacología , Tiempo de Sangría , Pérdida de Sangre Quirúrgica/prevención & control , Sustitución de Medicamentos , Quimioterapia Combinada , Humanos , Procedimientos Quirúrgicos Ortognáticos/métodos , Seguridad del Paciente , Inhibidores de Agregación Plaquetaria/farmacología , Factores de Riesgo , Tromboembolia/prevención & control
3.
Oral Maxillofac Surg Clin North Am ; 32(1): 153-165, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685342

RESUMEN

Many of the aesthetic facial procedures can be performed simultaneously at the time of initial orthognathic surgery. Correction of any residual deformities after surgery, such as mandibular notching, malar asymmetry, labiomental crease, and any camouflage treatment, should be performed as a delayed procedure, when the outcome is more predictable. Additionally, these procedures could be used to enhance the orthodontic result, without the need of osteotomies to reposition the bones.


Asunto(s)
Estética Dental , Cara/cirugía , Lipectomía , Ortodoncia , Procedimientos Quirúrgicos Ortognáticos/métodos , Rinoplastia , Toxinas Botulínicas Tipo A/uso terapéutico , Objetivos , Humanos , Cirugía Ortognática
4.
Oral Maxillofac Surg Clin North Am ; 32(1): 27-37, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685345

RESUMEN

As orthodontic treatment has advanced in complexity and in frequency, more recent techniques, using temporary skeletal anchorage, were developed to help correct more severe occlusal and dentofacial discrepancies that were treated with orthognathic surgery alone previously. These techniques have allowed the orthodontist to move teeth against a rigid fixation, allowing for more focused movements of teeth and for orthopedic growth modification. These types of treatments using rigid fixation have allowed for greater interaction between the orthodontist and the oral and maxillofacial surgeon, and have vastly enhanced the treatment planning for the orthodontist in today's society.


Asunto(s)
Métodos de Anclaje en Ortodoncia , Procedimientos Quirúrgicos Ortognáticos/métodos , Planificación de Atención al Paciente , Técnicas de Movimiento Dental/métodos , Humanos , Diseño de Aparato Ortodóncico
5.
Oral Maxillofac Surg Clin North Am ; 32(1): 105-116, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685348

RESUMEN

Idiopathic condylar resorption (ICR), alternatively called progressive condylar resorption, is an uncommon aggressive form of degenerative disease of the temporomandibular joint seen mostly in adolescent and young women. ICR occurring before the completion of growth results in a shorter mandibular condyloid process, ramus and body, compensatory growth at the gonial angle and coronoid process, as well as an increase in anterior facial vertical dimension. Management options discussed include oral appliances, orthodontics, medical management, orthognathic surgery with and without disc repositioning, and alloplastic temporomandibular joint replacement.


Asunto(s)
Resorción Ósea , Cóndilo Mandibular/cirugía , Ortodoncia Correctiva , Procedimientos Quirúrgicos Ortognáticos/métodos , Trastornos de la Articulación Temporomandibular/cirugía , Adolescente , Resorción Ósea/etiología , Femenino , Humanos , Cóndilo Mandibular/patología , Aparatos Ortopédicos , Articulación Temporomandibular
6.
Oral Maxillofac Surg Clin North Am ; 32(1): 53-69, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31699580

RESUMEN

The transverse dimension is a critical component of comprehensive treatment in orthognathic surgery. Several treatment approaches exist and the team must consider the patient's needs, desires, and limitations when working to correct the malocclusion. Treatment approaches may include only orthodontic expansion or rapid palatal orthodontic expansion; however, in adults, the orthodontist may require surgical assistance to expand the bony maxilla. Segmental maxillary expansion may be indicated in severe transverse deficiencies of the maxillary arch or dentofacial deformity patients also requiring vertical and sagittal corrections. The various treatment options, advantages, and disadvantages, and indications for each surgical approach are discussed.


Asunto(s)
Maloclusión/cirugía , Procedimientos Quirúrgicos Ortognáticos/métodos , Técnica de Expansión Palatina , Adulto , Humanos , Maxilar
7.
Oral Maxillofac Surg Clin North Am ; 32(1): 117-134, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31699581

RESUMEN

Temporomandibular joint (TMJ) arthritis impacts mandibular growth and development. This can result in skeletal deformity, such as facial asymmetry and/or malocclusion asymmetry. This article reviews the unique properties of TMJ and dentofacial growth and development in the setting of juvenile idiopathic arthritis (JIA). Specific orthopedic/orthodontic and surgical management of children with JIA and TMJ arthritis is discussed. The importance of interdisciplinary collaboration is highlighted.


Asunto(s)
Artritis Juvenil/complicaciones , Deformidades Dentofaciales , Maloclusión , Procedimientos Quirúrgicos Ortognáticos/métodos , Trastornos de la Articulación Temporomandibular/complicaciones , Articulación Temporomandibular/patología , Niño , Humanos , Desarrollo Maxilofacial
8.
Oral Maxillofac Surg Clin North Am ; 32(1): 1-14, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31699582

RESUMEN

This article provides an overview of the digital workflow process for Combined orthodontics and Orthognathic surgery treatment starting from data acquisition (3-dimensional scanning, cone-beam computed tomography), data preparation, processing and Creation of a three-dimensional virtual augmented model of the head. Establishing a Proper Diagnosis and Quantification of the Dentofacial Deformity using 3D diagnostic model. Furthermore, performance of 3-dimensional Virtual orthognathic surgical treatment, and the construction of a surgical splint (via 3-dimensional printing) to allow transfer of the treatment plan to the actual patient during surgery.


Asunto(s)
Imagenología Tridimensional , Ortodoncia/métodos , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos/métodos , Cirugía Asistida por Computador/métodos , Flujo de Trabajo , Diseño Asistido por Computadora , Tomografía Computarizada de Haz Cónico , Humanos , Planificación de Atención al Paciente , Interfaz Usuario-Computador
9.
Oral Maxillofac Surg Clin North Am ; 32(1): 71-82, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31744601

RESUMEN

Complications in orthognathic surgery are commonly a result of inadequate preoperative planning and communication between the surgeon and orthodontist. Unfavorable outcomes can often be avoided when overall treatment goals along with a surgical and orthodontic plan are developed and agreed upon by the orthodontist, surgeon, and patient before the start of active tooth movement or any surgical procedures. Continuous evaluation of the patient's progress throughout treatment and subsequent communication between the surgeon and orthodontist are recommended to prevent frequent errors, such as inadequate dental decompensation, poor appliance selection or management, and occasional contraindicated orthodontic elastic traction or tooth movements.


Asunto(s)
Maloclusión , Ortodoncia Correctiva/métodos , Ortodoncia , Cirugía Ortognática/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Planificación de Atención al Paciente , Humanos , Grupo de Atención al Paciente , Complicaciones Posoperatorias
10.
J Craniomaxillofac Surg ; 47(12): 1848-1854, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31810851

RESUMEN

PURPOSE: The aim of this study was to evaluate the impact of extubation time on postoperative complications in patients undergoing bimaxillary orthognathic surgery. We therefore retrospectively compared the effect of early extubating (EE) in the operating room versus delayed extubating (LE) on the intensive care unit (ICU) regarding postoperative complications and length of ICU/hospital stay (LOICUS/LOHS). Furthermore, we analyzed the influence of the PAS change on postoperative complications. METHODS: The clinical data of 117 patients were retrospective analyzed regarding postoperative complications using Clavian-Dindo Classification. Volumetric calculations of the pre- and postoperative PAS were conducted using ITK-SNAP software. The Fisher's exact test was performed to evaluate the significance of differences between categorical variables. Continuous variables were analyzed using the Mann-Whitney U-Test or the Kruskal-Wallis one-way analysis of variance. Regression analysis was used estimating predictors for postoperative complications. RESULTS: EE led to significant shortening of LOICUS (p < 0.001) and LOHS (p = 0.023). In total, we recorded 38 complications (minor n = 30; major n = 8) within the hospital stay. Complication rates were without significant differences with respect to the postoperative ventilation strategy. Large changes in PAS volume led to an increase in the major complication rates (p = 0.031). Increase or decrease of PAS was independent from postoperative complication rates (p = 1.000). Higher body mass index (p = 0.04) and a higher ASA PS score (p = 0.016) were associated with increased major complication rates. CONCLUSION: Early extubation after surgery is a safe procedure and is associated with a reduced LOICUS and LOHS. Complications seem to occur more frequently in marked changes of the PAS and should be considered in perioperative risk stratification.


Asunto(s)
Procedimientos Quirúrgicos Ortognáticos/efectos adversos , Complicaciones Posoperatorias/etiología , Apnea Obstructiva del Sueño/cirugía , Adolescente , Adulto , Extubación Traqueal , Femenino , Humanos , Tiempo de Internación , Masculino , Osteotomía Mandibular/efectos adversos , Osteotomía Mandibular/métodos , Tempo Operativo , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos/métodos , Complicaciones Posoperatorias/epidemiología , Periodo Posoperatorio , Estudios Retrospectivos , Apnea Obstructiva del Sueño/etiología
11.
J Craniomaxillofac Surg ; 47(12): 1868-1874, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31812310

RESUMEN

BACKGROUND: Maxillary advancement may affect speech in cleft patients. AIMS: To evaluate whether the amount of maxillary advancement in Le Fort I osteotomy affects velopharyngeal function (VPF) in cleft patients. METHODS: Ninety-three non-syndromic cleft patients (51 females, 42 males) were evaluated retrospectively. All patients had undergone a Le Fort I or bimaxillary (n = 24) osteotomy at Helsinki Cleft Palate and Craniofacial Center. Preoperative and postoperative lateral cephalometric radiographs were digitized to measure the amount of maxillary advancement. Pre- and postoperative speech was assessed perceptually and instrumentally by experienced speech therapists. Student's t-test and Mann-Whitney's U-test were used in the statistical analyses. Kappa statistics were calculated to assess reliability. RESULTS: The mean advancement of A point was 4.0 mm horizontally (range: -2.8-11.3) and 3.9 mm vertically (range -14.2-3.9). Although there was a negative change in VPF, the amount of maxillary horizontal or vertical movement did not significantly influence the VPF. There was no difference between the patients with maxillary and bimaxillary osteotomy. CONCLUSIONS: The amount of maxillary advancement does not affect the velopharyngeal function in cleft patients.


Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Osteotomía Maxilar/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteotomía Le Fort/métodos , Habla/fisiología , Insuficiencia Velofaríngea/fisiopatología , Adolescente , Adulto , Cefalometría/métodos , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Femenino , Finlandia , Humanos , Masculino , Avance Mandibular/métodos , Maxilar/anomalías , Maxilar/cirugía , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios Retrospectivos , Trastornos del Habla/fisiopatología , Trastornos del Habla/cirugía , Resultado del Tratamiento , Insuficiencia Velofaríngea/cirugía , Adulto Joven
12.
J Craniomaxillofac Surg ; 47(12): 1855-1860, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31813754

RESUMEN

PURPOSE: To identify the most prevalent types of complications associated with orthognathic surgery and its possible risk factors. METHODS: This study was a retrospective investigation of records of 485 patients who underwent orthognathic surgery between 2008 and 2014 at the Oral and Maxillofacial Surgery Service at the Federal University of Paraná, Curitiba, Brazil. Types of complications were recorded. Independent variables such as sex, age, duration of surgery and hospitalization, number of surgeries, surgical site, and types of osteotomy performed were evaluated. Complications were also evaluated based on the treatment according to the Clavien-Dindo Classification. Data were submitted to statistical analysis with a significance level of 0.05. RESULTS: A total of 93 complications were reported (19.2%), including postoperative malocclusion, hemorrhage, inferior alveolar nerve injury, bad split, and infection. Complications were more common in men (p = 0.029). The number of complications was higher in surgeries that took more time to perform (p < 0.05) when the entire sample was taken into consideration. The prevalence of complications was related to a higher number of procedures per surgery (p = 0.019). Complications were more frequent in mandibular procedures (p = 0.010), particularly in bilateral sagittal split osteotomies (p < 0.001). Related to treatment, Clavien-Dindo grade I complications were the most frequent (72.04%). There was no association between sex, age, surgery duration, length of hospitalization, or surgical site with complication grades according to the Clavien-Dindo classification (p ≥ 0.05). CONCLUSION: Postoperative malocclusion, hemorrhage, inferior alveolar nerve injury, bad split and infection are the most prevalent complication in orthognathic surgery. They seem to be related to sex, duration of surgery, number of surgeries, surgical site, and the type of osteotomy performed. With these in mind, it is possible to explain to the patient the different levels of severity of complications related to the surgery.


Asunto(s)
Deformidades Dentofaciales/cirugía , Maloclusión/cirugía , Procedimientos Quirúrgicos Ortognáticos/métodos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Infección de la Herida Quirúrgica/epidemiología , Adulto , Brasil/epidemiología , Deformidades Dentofaciales/epidemiología , Femenino , Humanos , Masculino , Nervio Mandibular , Persona de Mediana Edad , Cirugía Ortognática , Hemorragia Posoperatoria , Estudios Retrospectivos
13.
J Craniomaxillofac Surg ; 47(11): 1676-1681, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31711996

RESUMEN

The aim of this study was to evaluate, if and with what accuracy perioperative blood loss can be calculated by a machine learning algorithm prior to orthognathic surgery. The investigators implemented a random forest algorithm to predict perioperative blood loss. 1472 patients who underwent orthognathic surgery from 01/2006 to 06/2017 at our institution were screened and 950 patients were included and separated 80%/20% in a training set - utilized to generate the prediction model - and a testing set - utilized to estimate the accuracy of the model. The outcome variable was the correlation between actual perioperative blood loss and predicted perioperative blood loss in the testing set. Other study variables were the difference of actual and predicted perioperative blood loss and important factors influencing perioperative blood loss using random forest feature importance. Descriptive and bivariate statistics were computed and the P value was set at 0.05. There was a statistically significant correlation between actual perioperative blood loss and predicted perioperative blood loss (p < 0.001). The mean difference was 7.4 ml with a standard deviation of 172.3 ml. The results of this study suggest that the application of a machine-learning algorithm allows a prediction of perioperative blood loss prior to orthognathic surgery.


Asunto(s)
Pérdida de Sangre Quirúrgica , Aprendizaje Automático , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos/métodos , Procedimientos Ortopédicos , Humanos , Valor Predictivo de las Pruebas , Resultado del Tratamiento
14.
Georgian Med News ; (294): 62-68, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31687951

RESUMEN

Recently, there has been a tendency for the growth of dentognathic deformities of various origins, accompanied by phonetic abnormalities. Aim - to increase the effectiveness of orthodontic treatment of dentognathic deformities, accompanied by phonetic disorders, by developing and justifying a set of diagnostic and therapeutic measures based on a multidisciplinary approach. The influence of the state of ENT organs on the formation of dentognathic deformities and phonetic disturbances is studied in 155 children. A clinical dental examination and orthodontic treatment is performed in 82 patients aged 6-12 years. Individual corrective speech therapy work has been carried out to overcome the defects of the phonological side of speech. A certain pathological "chain" of cause-effect relationships of dentognathic deformities with phonetic disorders and diseases of the ENT organs became the basis for a multidisciplinary approach to solving the problems identified. The qualitative and quantitative dependence of sound deterioration on the type of orthognathic deformities is established. A complex of diagnostic and therapeutic measures for patients with dental deformities accompanied by phonetic disorders, consisting of motivational, diagnostic and therapeutic blocks, has been developed and introduced into practice. The proposed complex of diagnostic and treatment measures made it possible to increase the efficiency of orthodontic treatment of children with dentognathic deformities with disturbances of sound pronunciation depending on the type of bite by means of a multidisciplinary approach involving an otolaryngologist, speech therapist, children's therapist and surgeon, which was confirmed in 86.6% of patients by the improvement of electromyography, anthropometric measurements of scanned models of jaws, cephalometry; the analysis of cone-beam computed tomography data showed a significant increase in the upper respiratory tract volume by 53.8±4.2%.


Asunto(s)
Anomalías Maxilofaciales/diagnóstico , Anomalías Maxilofaciales/cirugía , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Fonética , Prognatismo/cirugía , Trastornos del Habla/cirugía , Cefalometría , Niño , Humanos , Imagenología Tridimensional , Prognatismo/diagnóstico por imagen , Reproducibilidad de los Resultados , Trastornos del Habla/diagnóstico , Resultado del Tratamiento
15.
J Craniofac Surg ; 30(8): 2530-2532, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31609960

RESUMEN

Osteogenesis imperfecta (OI) is characterized by brittle bones, premature hearing loss, blue sclera, dental abnormalities, and short stature. Maxillofacial pathology is marked in many OI patients and includes a high incidence of class III malocclusion secondary to a retrusive maxilla relative to both the mandible and cranial base.Review of literature shows that most of the orthognathic surgeries performed in the setting of OI are double jaw surgeries, in the form of maxillary advancement and mandibular setback. However, severe maxillary hypoplasia is usually not correctable with single-stage maxillary advancement. Distraction osteogenesis (DO) is a technique that relies on the normal healing process that occurs between controlled, surgically osteotomized bone segments and it is a relatively widely used technique in modern management of craniofacial conditions.Distraction osteogenesis has been reported in only several patients with OI. There is only 1 previously documented case of maxillary distraction in the craniofacial literature. The authors present here the successful management of a patient with OI and severe class III malocclusion using LeFort I osteotomy and DO with an external rigid distractor.At 12 months follow-up, the patient had no complications and maintained stable maxillary position with normal occlusion, improvement of facial appearance, obstructive airway symptoms, speech, and chewing.This case serves to reinforce the safety and efficacy of DO in patients with OI. The authors did not significantly change our distraction protocol and did not have any complications, therefore the authors believe that DO should be the preferable treatment technique for severe malocclusion in OI patient population.


Asunto(s)
Osteogénesis Imperfecta/cirugía , Osteogénesis por Distracción , Adolescente , Humanos , Masculino , Mandíbula/patología , Maxilar/cirugía , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteogénesis por Distracción/métodos
16.
Am J Orthod Dentofacial Orthop ; 156(4): 531-544, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582125

RESUMEN

Progressive condylar resorption, also known as idiopathic condylar resorption, is an uncommon, aggressive, degenerative disease of the temporomandibular joint (TMJ) seen mostly in adolescent girls and young women. This condition leads to loss of condylar bone mass, decrease of mandibular ramal height, steep mandibular and occlusal plane angles, and an anterior open bite. In 3 case reports, we review the pathogenesis of TMJ degenerative disease and the clinical management of TMJ arthrosis. We emphasize that TMJ arthritic disease should be discussed in dental circles as a pathologic entity in the same way that orthodontists discuss arthritic disease in orthopedic circles. Regarding the degenerative pathology of the TMJ, treatment goals include restored function and pain reduction. The treatment methods used to achieve these goals can range from noninvasive therapy to minimally invasive and invasive surgery. Most patients can be treated noninvasively, and the importance of disease prevention and conservative management in the overall treatment of TMJ disease must be acknowledged. The decision to manage TMJ osteoarthrosis surgically must be based on evaluation of the patient's response to noninvasive treatments, mandibular form and function, and effect of the condition on his or her quality of life.


Asunto(s)
Resorción Ósea/diagnóstico por imagen , Resorción Ósea/cirugía , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteoartritis/diagnóstico por imagen , Osteoartritis/cirugía , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/terapia , Adulto , Resorción Ósea/patología , Niño , Terapia Combinada , Progresión de la Enfermedad , Femenino , Humanos , Cóndilo Mandibular/patología , Cóndilo Mandibular/cirugía , Osteoartritis/patología , Calidad de Vida , Trastornos de la Articulación Temporomandibular/patología , Resultado del Tratamiento
17.
Am J Orthod Dentofacial Orthop ; 156(3): 412-419, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474271

RESUMEN

An 8-day-old male infant with unilateral cleft lip, alveolus, and palate had a wide alveolar defect, soft tissue deformity, and a markedly sunken nasal wing at the cleft side. The patient was treated with a series of 3D-printed molding plates and synchronously with a nasal hook. The cleft edges moved closer by 9 mm at the alveolar ridge and the nasal wing was lifted considerably. Split-type 3D printing of presurgical nasoalveolar molding helped to reduce the cleft gap, improve the arch form, approximate lip segments, and distinctly improve the morphology of the nose by correcting the flattened nasal wings.


Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Impresión Tridimensional , Procedimientos Quirúrgicos Reconstructivos/métodos , Proceso Alveolar/cirugía , Labio Leporino/diagnóstico por imagen , Fisura del Paladar/diagnóstico por imagen , Diseño Asistido por Computadora , Técnica de Impresión Dental , Modelos Dentales , Humanos , Recién Nacido , Masculino , Nariz/cirugía , Procedimientos Quirúrgicos Ortognáticos/métodos , Paladar (Hueso)/cirugía , Resultado del Tratamiento
18.
J Craniofac Surg ; 30(6): 1745-1749, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31449217

RESUMEN

Maxillary hypoplasia is a common developmental deformity affecting patients with cleft lip and palate. Various surgical techniques including conventional orthognathic surgery, total maxillary distraction osteogenesis, and anterior maxillary segmental distraction have been applied to address the deformity. With the evolution of 3D computed tomography imaging, the visualization of skeletal complexities in different perspectives is greatly enhanced and comprehensive surgical planning is achieved. Intraoperative efficiency is also improved with the fabrication of 3D-printed templates. The study aims to present different surgical techniques with virtual surgical planning (VSP) and 3D-printed surgical templates and the solution of representative cases. From January 2014 to January 2019, VSP was transferred to actual surgery or distraction precisely in 80 adult patients with cleft-related maxillary hypoplasia. The accuracy was analyzed and the relapse was also estimated and observed in 18 patients after 1-year follow-up. Based on our experience, VSP provides a more reliable and effective option to conventional model surgery. It facilitates the preoperative planning and accurately transfers the virtual plan to correct the cleft-related maxillary hypoplasia.


Asunto(s)
Maxilar/cirugía , Micrognatismo/cirugía , Adulto , Labio Leporino/complicaciones , Labio Leporino/cirugía , Recolección de Datos , Femenino , Humanos , Masculino , Micrognatismo/etiología , Procedimientos Quirúrgicos Ortognáticos/métodos , Procedimientos Ortopédicos , Impresión Tridimensional , Recurrencia , Adulto Joven
19.
J Craniofac Surg ; 30(8): 2601-2603, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31449227

RESUMEN

Correction of facial asymmetry caused by active unilateral condylar hyperplasia (CH) requires proper diagnosis, arrested ongoing condylar growth, and ultimately orthognathic surgery. Traditionally, prior to performing orthognathic surgery, active CH is addressed either by: awaiting natural cessation of condylar overgrowth, or performing an interval high condylectomy (to stop growth). However, these strategies both add to the total treatment time, by either waiting and confirming no active growth, or performing a first stage growth-arresting procedure. In this report, the authors describe concurrent high condylectomy, and 3-jaw orthognathic surgery, to address the root of the problem and provide aesthetic correction in the same setting. This clinical series illustrates a detailed description of this approach, highlighting operative order, and an analysis of outcomes.


Asunto(s)
Asimetría Facial/cirugía , Mandíbula/cirugía , Procedimientos Quirúrgicos Ortognáticos , Adolescente , Adulto , Femenino , Humanos , Cóndilo Mandibular/cirugía , Persona de Mediana Edad , Procedimientos Quirúrgicos Ortognáticos/métodos , Adulto Joven
20.
Am J Orthod Dentofacial Orthop ; 156(1): 125-136, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256825

RESUMEN

This case report describes the successful treatment of a 14-year-old girl with severe bilateral idiopathic condylar resorption and resultant mandibular retrusion, increased overjet, and anterior open bite. The nonextraction treatment plan included (1) aligning and leveling the teeth in both arches, (2) performing Le Fort I maxillary osteotomy, bilateral condylectomy, and mandibular joint replacement, and (3) postsurgical correction of the malocclusion. The orthodontic treatment was initiated with the use of custom lingual appliances followed by orthognathic surgery planned with virtual surgical planning. Patient-fitted and customized temporomandibular joint implants were designed and manufactured based on the patient's stereolithic bone anatomic model. Treatment was concluded with detailed orthodontic finishing. Optimum esthetic and functional results were achieved with the cooperation of 2 specialties and the use of state-of-the-art technology.


Asunto(s)
Tirantes , Prótesis Articulares , Cóndilo Mandibular/cirugía , Mordida Abierta/cirugía , Mordida Abierta/terapia , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Trastornos de la Articulación Temporomandibular/terapia , Adolescente , Puntos Anatómicos de Referencia , Resorción Ósea/complicaciones , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/cirugía , Resorción Ósea/terapia , Cefalometría , Estética Dental , Femenino , Humanos , Imagenología Tridimensional , Mandíbula/cirugía , Cóndilo Mandibular/diagnóstico por imagen , Maxilar/cirugía , Mordida Abierta/diagnóstico por imagen , Aparatos Ortodóncicos , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/instrumentación , Osteotomía , Planificación de Atención al Paciente , Radiografía Panorámica , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/cirugía , Resultado del Tratamiento
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