Cleft Lip and Palate: LeFort I Distraction with Halo and Hybrid Internal Maxillary Distractors.

Distraction osteogenesis is a viable treatment option for patients with a cleft associated with severe maxillary retrusion. A rigid external distraction device and a hybrid internal maxillary distractor have been used to advance the maxilla allowing for predictable and stable results. These techniques can be applied by itself or as an adjunct to traditional orthognathic procedures. The technical aspects are presented. These procedures tend to be simpler and demonstrate great stability compared to traditional surgical methods. The reasons for stability are discussed.

Multidisciplinary care for a patient with syndromic craniosynostosis: A case report with 20 years of special care.

AIM: The functional and structural complexities accompanying syndromic craniosynostosis make dental care for these patients particularly challenging. We report a case of long-term care for a syndromic craniosynostosis patient. The objective of this report is to introduce special care guidance and clinical recommendation, so that oral health care providers, as key members of a multidisciplinary care team, can provide optimal diagnosis, treatment, and management for the patient with syndromic craniosynostosis. CASE REPORT: The patient of this case report had a medical history of syndromic craniosynostosis involving multiple comorbidities. Over the past 20 years, a multidisciplinary care team has successfully treated the patient. Dental and medical procedures that the patient has received include cranial surgeries, prophylactic dental care, caries control, growth hormone therapy, comprehensive orthodontic treatment in conjunction with orthognathic surgeries, and plastic surgery. CONCLUSION: Oral health care providers can play essential roles in multidisciplinary care for patients with craniosynostosis by understanding the patients' unique oral health conditions and dentofacial deformities. To provide optimal oral health care in a multidisciplinary team, clear communication between the members of the care team is crucial.

Biomechanical study of SonicWeld Rx pin in cortical bone graft layering technique.

PURPOSE: The purpose of this in vitro study was to determine the biomechanical values of the SonicWeld Rx pin system in comparison with titanium screws for use in onlay cortical bone grafting. MATERIALS AND METHODS: In this study, 2.1-mm SonicWeld Rx pins and 1.5-mm titanium screws, measuring 7 mm in length, were used. Sawbone blocks were positioned to simulate an onlay bone graft, and the pins and screws were used to replicate bicortical fixation. Four groups were designated for vertical load application, and failure of the fixation was determined when stability was compromised. Study groups consisted of fixation material types and number of fixation appliances. A Bose Electroforce 3300 system was used to deliver the force and to obtain data. RESULTS: Comparison of SonicWeld Rx 1-pin fixation with titanium 1-screw fixation showed similar peak resistance loads. Average peak loading resistance for SonicWeld Rx 1-pin fixation was 65.54 N and that for titanium 1-screw fixation was 59.37 N, with no significant difference (P = .9698). Average peak strength of SonicWeld Rx 2-pin and titanium 2-screw fixations was 110.24 and 97.3 N, respectively, with no significant difference (P = .1041). CONCLUSION: Based on the measured biomechanical values, SonicWeld Rx fixation can withstand similar peak load forces compared with that of titanium screw fixation. The SonicWeld Rx fixation can be an alternative method of fixation for onlay bone grafting in dentoalveolar ridge augmentation.

Mandibular "tripod" advancement of a Class II Division 2 deepbite malocclusion.

This case report describes the treatment of a 25-year-old woman with a Class II malocclusion, secondary to mandibular skeletal deficiency, and mild overclosure. Inferior surgical repositioning of the maxilla is often the treatment of choice for patients with maxillary vertical deficiency; however, this patient had borderline vertical deficiency that was treated with a mandibular "tripod" advancement (leveling of the mandibular arch after surgery) coupled with a setback and down-grafting genioplasty. The surgical-orthodontic treatment plan, combined with cosmetic dentistry, resulted in dramatically improved facial esthetics and occlusal relationships.