Binder's syndrome (maxillonasal dysplasia) different treatment modalities: Our experience.

AIM: Being an uncommon congenital condition, the treatment modalities of maxillonasal dysplasia are not clearly defined. Our aim is to discuss the availability and utility of various treatment options to achieve optimum results. In patients with Binder's syndrome, the midface appears flattened, the columella is short and the upper lip slants backwards. MATERIALS AND METHODS: We report here 15 patients with Binder's syndrome who were operated over a period of 5 years. Different treatment options in the form of correction of the depressed nasal dorsum and maxillary hypoplasia with split cranial bone graft or synthetic materials such as high-density porous polyethylene implant were used. Two patients with Angle class III malocclusion underwent a Le Fort I osteotomy for maxillary advancement. The patients were followed over a period of 3 years. RESULTS: We achieved a reasonable augmentation of the nose and the maxilla in our patients. We faced complications in two of our patients; in one patient there was fracture of the dorsal nasal bone graft and the other patient had protrusion of paranasal screws into the palate, which were removed. CONCLUSION: In this series of cases, we were able to utilise various treatment modalities appropriately to achieve satisfactory outcome with no significant complications.

Osseous genioplasty: A case series.

INTRODUCTION: The chin (mentum) is vital to the human facial morphology as it contributes to the facial aesthetics and harmony both on frontal and lateral views. Osseous genioplasty, the alteration of the chin through skeletal modification, can lead to significant enhancement of the overall facial profile. AIM AND STUDY DESIGN: A case series was designed to study the long-term results of osseous genioplasty in Indian patients with regard to patient satisfaction, complications, and long-term stability. MATERIALS AND METHODS: All subjects who underwent osseous genioplasty either alone or as a component of orthognathic surgery between January 1992 and December 2010, with a minimum follow-up of 2 years, were included. The genioplasty was performed using standard protocols of assessment and execution. Post-operative evaluation included patient satisfaction, complications and radiological evidence of long-term stability. A comprehensive score was formulated for the purpose of the study. RESULTS: Thirty-seven subjects underwent osseous genioplasty with at least 2 years of follow-up in the study period. This included 17 male and 20 female subjects, with a mean age of 22.8 years (15-52 years) and a mean follow-up of 3 years 4 months (2 years to 4 years and 11 months). Nineteen subjects underwent isolated genioplasty while 18 underwent genioplasty as a part of orthognathic surgery. The procedures included advancement (22), pushback (9), side-to-side (4) and vertical reduction (2) genioplasty. Thirty-six subjects (97.3%) were extremely pleased with the results with only one subject expressing reservations, without, however, demanding any further procedure. There were no significant complications. The osteotomised segment was well maintained in its new position with good bony union and minimal resorption. Overall, 35 (94.6%) cases had excellent results and 2 (4.4%) cases had good results, according to the comprehensive score. CONCLUSIONS: Osseous genioplasty is a safe and effective means of creating a beautiful and balanced facial profile by producing alterations in the chin morphology with minimal complications and excellent and stable long-term results.

Ectodermal dysplasia - Maxillary and mandibular alveolar reconstruction with dental rehabilitation: A case report and review of the literature.

Ectodermal dysplasia is a rare group of inherited disorders characterized by aplasia or dysplasia of tissues of ectodermal origin, such as hair, nails, teeth and skin. Dental manifestations include hypodontia, complete anodontia or malformed teeth. Oral rehabilitation is the major surgical challenge in such patients. It frequently requires alveolar reconstruction followed by dental implants. We report a case of hypohidrotic ectodermal dysplasia, which was managed with reconstruction of both the upper and the lower alveolus using free fibula flaps with dental rehabilitation using osseointegrated implants.