RESUMO
Renal artery pseudoaneurysm (RAP) is rare, and has been reported after renal biopsy and percutaneous renal surgery. We report a case of RAP after laparoscopic partial nephrectomy for renal cell carcinoma.
Assuntos
Falso Aneurisma/etiologia , Laparoscopia , Nefrectomia/efeitos adversos , Nefrectomia/métodos , Artéria Renal , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
This study was designed to evaluate the usefulness of the Sonopet UST-2001 (Miwatec Co., Ltd., Kawasaki, Kanagawa, Japan) ultrasonic curettage device, and to assess the outcome after intraoral vertical ramus osteotomy (IVRO). Thirteen Japanese adults (age range 20-41 years, mean age 29.6 years) presented with jaw deformities diagnosed as mandibular prognathism and asymmetry; they all underwent IVRO of the mandible. This procedure was followed by ultrasonic bone curettage using the Sonopet to make a guiding notch or groove in the lateral cortex of the ramus without damaging the vessels and nerves. After surgery, the osteotomy line was evaluated by three-dimensional computed tomography. In all patients, osteotomy with the Sonopet device was achieved safely, with minimal bleeding and no major complications. The distal segment could be moved into its ideal position and all patients achieved their ideal profiles. Ultrasonic bone curettage is a safe method for making a guiding groove, without damage to surrounding tissue, prior to complete IVRO.
Assuntos
Assimetria Facial/cirurgia , Mandíbula/cirurgia , Osteotomia/instrumentação , Prognatismo/cirurgia , Terapia por Ultrassom/instrumentação , Adulto , Humanos , Osteotomia/métodos , Terapia por Ultrassom/métodosRESUMO
The purpose of this study was to evaluate the differences in bite force changes and occlusal contacts after sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) with and without Le Fort I osteotomy. Sixty female patients with diagnosed mandibular prognathism with or without asymmetry were divided into four groups (SSRO, IVRO, SSRO with Le Fort I osteotomy and IVRO with Le Fort I osteotomy). Bite force and occlusal contacts were measured preoperatively and at 1, 3, 6 and 12 months after surgery with pressure-sensitive sheets. The differences among surgical procedures were examined statistically. Maximum bite force and occlusal contacts returned to preoperative levels after between 3 and 6 months. Regarding time-dependent changes in bite force and occlusal contact area, there were no significant differences among the groups. In conclusion, this study suggests that the combination of IVRO or SSRO and Le Fort I osteotomy does not affect postoperative time-dependent changes.
Assuntos
Força de Mordida , Mandíbula/cirurgia , Osteotomia de Le Fort/métodos , Osteotomia/métodos , Adolescente , Adulto , Placas Ósseas , Parafusos Ósseos , Oclusão Dentária , Assimetria Facial/cirurgia , Feminino , Seguimentos , Humanos , Registro da Relação Maxilomandibular/instrumentação , Mandíbula/fisiopatologia , Maxila/fisiopatologia , Maxila/cirurgia , Osteotomia/instrumentação , Prognatismo/cirurgia , Estudos Retrospectivos , Fatores de TempoRESUMO
The purpose of this study was to examine the changes in temporomandibular joint (TMJ) morphology and clinical symptoms after intraoral vertical ramus osteotomy (IVRO) with and without a Le Fort I osteotomy. Of 50 Japanese patients with mandibular prognathism with mandibular and bimaxillary asymmetry, 25 underwent IVRO and 25 underwent IVRO in combination with a Le Fort I osteotomy. The TMJ symptoms and joint morphology, including disc tissue, were assessed preoperatively and postoperatively by magnetic resonance imaging and axial cephalogram. Improvement was seen in just 50% of joints with anterior disc displacement (ADD) that received IVRO and 52% of those that received IVRO with Le Fort I osteotomy. Fewer or no TMJ symptoms were reported postoperatively in 97% of the joints that received IVRO and 90% that received IVRO with Le Fort I osteotomy. Postoperatively, there were significant condylar position changes and horizontal changes in the condylar long axis on both sides in the two groups. There were no significant differences between improved ADD and unimproved ADD in condylar position change and the angle of the condylar long axis, although distinctive postoperative condylar sag was seen. These results suggest that IVRO with or without Le Fort I osteotomy can improve ADD and TMJ symptoms along with condylar position and angle, but it is difficult to predict the amount of improvement in ADD.
Assuntos
Mandíbula/cirurgia , Côndilo Mandibular/anatomia & histologia , Procedimentos Cirúrgicos Bucais/métodos , Prognatismo/cirurgia , Disco da Articulação Temporomandibular/anatomia & histologia , Adulto , Cefalometria , Feminino , Humanos , Luxações Articulares/etiologia , Luxações Articulares/cirurgia , Imageamento por Ressonância Magnética , Masculino , Mandíbula/anormalidades , Osteotomia , Osteotomia de Le Fort , Prognatismo/complicações , Estatísticas não Paramétricas , Transtornos da Articulação Temporomandibular/etiologia , Transtornos da Articulação Temporomandibular/cirurgiaRESUMO
The purpose of this study was to evaluate hypoesthesia of the lower lip using trigeminal somatosensory-evoked potential following 2 types of sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO). There were 30 patients with mandibular prognathism, with and without asymmetry, who were divided into three groups: the Obwegeser method (Ob) group, the Obwegeser-Dal Pont method (ODP) group and the intraoral vertical ramus osteotomy (IVRO) group. The trigeminal somatosensory-evoked potential was recorded in the region of the lower lip and evaluated preoperatively and postoperatively. The average recovery periods from lower lip hypoesthesia in the IVRO and the Ob group were significantly shorter than in the ODP group (P<0.05). In conclusion, IVRO showed the earliest recovery from hypoesthesia or an absence of hypoesthesia, and lower lip hypoesthesia was less with the Ob method than the ODP method.
Assuntos
Hipestesia/etiologia , Mandíbula/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Traumatismos do Nervo Trigêmeo , Nervo Trigêmeo/fisiopatologia , Adolescente , Adulto , Traumatismos dos Nervos Cranianos/diagnóstico , Traumatismos dos Nervos Cranianos/etiologia , Potenciais Somatossensoriais Evocados , Feminino , Humanos , Hipestesia/diagnóstico , Lábio/inervação , Masculino , Procedimentos Cirúrgicos Bucais/efeitos adversos , Osteotomia/efeitos adversos , Osteotomia/métodos , Prognatismo/cirurgiaRESUMO
We examined the expression of bone morphogenetic protein-2 (BMP-2) and proliferating cell nuclear antigen (PCNA) during distraction osteogenesis in the mandible in rabbits. Twenty-four rabbits each had an osteotomy of the left mandibular body, and distraction devices were fixed. The bone was distracted at a rate of 1mm/day for 10 days. Four rabbits were killed at each of 1, 3, 7, 14, and 28 days after completion of distraction, and the mandibles examined radiographically, histologically, and immunohistochemically. Four rabbits that had not been operated on served as controls. Immunohistochemical analysis showed that BMP-2 and PCNA both appeared initially at the edge of the osteogenesis, but tended to disappear after 14 days. After 1, 3, 7, and 14 days after distraction, the ratio of stained cells was significantly higher than in the control group (p<0.05), during the period that active bone formation was shown radiographically and histologically. These results suggest that BMP-2 plays an important part in the induction of bone formation during distraction osteogenesis.
Assuntos
Proteínas Morfogenéticas Ósseas/biossíntese , Regeneração Óssea/fisiologia , Mandíbula/cirurgia , Osteogênese por Distração , Antígeno Nuclear de Célula em Proliferação/biossíntese , Fator de Crescimento Transformador beta/biossíntese , Animais , Proteína Morfogenética Óssea 2 , Imuno-Histoquímica , Masculino , Coelhos , Estatísticas não ParamétricasRESUMO
This report describes multidirectional distraction osteogenesis in a patient with Crouzon syndrome. A RED system and a Hyrax expansion screw were used for lateral expansion of the maxilla. Advancement distraction osteogenesis and a Dyna Form were used for widening distraction osteogenesis of the mandible. The devices were fixed after a quadrangular osteotomy and a bimaxillary midline osteotomy.
Assuntos
Disostose Craniofacial/cirurgia , Mandíbula/cirurgia , Maxila/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Osteogênese por Distração , Adolescente , Feminino , Humanos , Má Oclusão Classe III de Angle/terapia , Micrognatismo/cirurgia , Técnica de Expansão PalatinaRESUMO
This study was designed to assess skeletal stability after bilateral sagittal split ramus osteotomy (BSSO) and fixation with a poly-l-lactic acid (PLLA) plate, as compared to that after BSSO and fixation with a titanium plate, and to analyze the change in the condylar long axis after these procedures. The study group comprised 40 patients who had mandibular prognathism (20, titanium group; 20, PLLA group). The groups were randomized to show similar distributions of preoperative SNB. All patients underwent BSSO setback by the Obwegeser method. Fixation was done with bent titanium plates or bent PLLA plates, applied in a similar manner. Lateral, frontal, and submental-vertical cephalograms were analyzed preoperatively and postoperatively. The maximum mouth opening range and the incidence of temporomandibular disorders were also evaluated. There was no significant difference in the right condylar angle or width between the two groups, but the left condylar angle and width, gonial angle, and ramus inclination differed significantly between them (P<0.05). SNA, SNB, and ANB were similar in both groups. There was no significant difference between the groups in maximum mouth opening range or temporomandibular disorders. We conclude that the change in condylar angle after BSSO and fixation with a titanium plate is greater than that after BSSO and fixation with a PLLA plate, but skeletal stability related to the occlusion is similar for the two procedures.
Assuntos
Placas Ósseas , Técnicas de Fixação da Arcada Osseodentária/instrumentação , Côndilo Mandibular/patologia , Prognatismo/cirurgia , Implantes Absorvíveis , Análise de Variância , Cefalometria , Humanos , Ácido Láctico , Mandíbula/anormalidades , Mandíbula/cirurgia , Côndilo Mandibular/fisiopatologia , Procedimentos Cirúrgicos Bucais/instrumentação , Osteotomia , Poliésteres , Polímeros , Estudos Prospectivos , Amplitude de Movimento Articular , Recidiva , Estatísticas não Paramétricas , TitânioRESUMO
This study aimed to evaluate the postoperative changes in masticatory function in patients with jaw deformities with or without asymmetry treated by orthognathic surgery. Thirty female patients who underwent a Le Fort I osteotomy with sagittal split ramus osteotomy (SSRO) were enrolled. The patients were divided into symmetry and asymmetry groups. The bite force, occlusal contact area, and bite force balance were measured before and at 1, 3, and 6 months and 1 year after surgery; these measurements were compared statistically within and between the two groups. In the symmetry group, there was a significant difference in the preoperative bite force and the 1 month postoperative bite force (P=0.0033). In the asymmetry group, the bite force before surgery was significantly different from that at 1 month (P=0.0375) and at 1 year (P=0.0353) after surgery. Significant differences in the bite force were also observed between the following time points: 1 month and 1 year (P=0.0003), 3 months and 1 year (P=0.0034), and 1 month and 6 months (P=0.0486). The occlusal contact area, bite force, and occlusal balance tended to change after Le Fort I osteotomy with SSRO, with a significantly improved bite force in patients with asymmetry before surgery.
Assuntos
Assimetria Facial/fisiopatologia , Mastigação/fisiologia , Cirurgia Ortognática , Prognatismo/cirurgia , Adolescente , Adulto , Força de Mordida , Cefalometria , Oclusão Dentária , Feminino , Humanos , Pessoa de Meia-Idade , Osteotomia de Le Fort , Osteotomia Sagital do Ramo Mandibular , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Cilostazol, a selective type III phosphodiesterase inhibitor, has antiplatelet and vasodilating effects. In this study, the effects of cilostazol on lipid metabolism and lipoprotein lipase (LPL) activity were studied in rats. Cilostazol was administered orally at doses of 30 or 100 mg/kg twice a day for 1-2 weeks to rats. Cilostazol decreased the serum triglyceride level in normolipidemic rats. The serum triglyceride level was reduced and HDL cholesterol level was increased by cilostazol in streptozotocin (STZ)-induced diabetic rats. The disappearance of exogenous triglyceride was accelerated by cilostazol in normolipidemic rats. Cilostazol increased post-heparin plasma LPL activity but had no effect on hepatic triglyceride lipase activity in STZ-induced diabetic rats. Cilostazol also increased LPL activity in the heart in STZ-induced diabetic rats. These findings suggest that an increase in LPL activity is responsible for the serum triglyceride lowering and HDL cholesterol elevating effects of cilostazol in rats.
Assuntos
HDL-Colesterol/sangue , Lipase Lipoproteica/metabolismo , Inibidores de Fosfodiesterase/farmacologia , Inibidores da Agregação Plaquetária/farmacologia , Tetrazóis/farmacologia , Triglicerídeos/sangue , Animais , Anticoagulantes/farmacologia , Glicemia/análise , Cilostazol , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/enzimologia , Heparina/farmacologia , Lipídeos/sangue , Miocárdio/enzimologia , Ratos , Ratos WistarRESUMO
Among various categories of antiplatelet drugs, cAMP-elevating agents and GP IIb/IIIa antagonists have been reported to inhibit platelet aggregation stimulated by a wide variety of platelet agonists. To clarify the qualitative difference between these two agents, their effects on various platelet responses in washed platelets evoked by thrombin (0.05 U/mL) were compared in vitro. Two types of cAMP-elevating drugs, cilostazol (a phosphodiesterase III inhibitor) and prostaglandin E1 (an adenylate cyclase activator), both inhibited platelet aggregation, thromboxane A2 formation, and platelet factor 4 release in a concentration-dependent manner. In addition, both agents suppressed intracellular Ca++ elevation induced by thrombin. However, two classes of GP IIb/IIIa antagonists, abciximab (Fab fragment of antibody) and tirofiban (a synthetic compound), showed no inhibitory effects against thromboxane A2 formation and platelet factor 4 release, although these drugs inhibited platelet aggregation. Essentially the same results were obtained in platelet-rich plasma stimulated with high concentration (100 microM) of thrombin receptor activating peptide. In contrast to these different profiles on thromboxane A2 formation and release reaction, both cAMP-elevating agents and GP IIb/IIIa antagonists potently suppressed procoagulant activity in thrombin-stimulated platelets. These results suggest that the development of platelet procoagulant activity induced by thrombin is exclusively dependent on platelet aggregation or aggregation-dependent processes. These observations also indicate that cAMP-elevating agents possess wider inhibitory effects on platelet responses evoked by strong agonists than GP IIb/IIIa antagonists.
Assuntos
AMP Cíclico/agonistas , Inibidores da Agregação Plaquetária/farmacologia , Agregação Plaquetária/efeitos dos fármacos , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/antagonistas & inibidores , Abciximab , Alprostadil/farmacologia , Anticorpos Monoclonais/farmacologia , Plaquetas/efeitos dos fármacos , Plaquetas/fisiologia , Células Cultivadas , Cilostazol , AMP Cíclico/fisiologia , Avaliação Pré-Clínica de Medicamentos , Hemostáticos/farmacologia , Humanos , Fragmentos Fab das Imunoglobulinas/farmacologia , Masculino , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/fisiologia , Tetrazóis/farmacologia , Trombina/farmacologia , Tirofibana , Tirosina/análogos & derivados , Tirosina/farmacologiaRESUMO
Thrombus formation in the carotid artery is one of the common causes of transient ischemic attacks and stroke. Platelet aggregation seems to be an essential component in these processes. The present study was conducted to determine the ability of cilostazol, a phosphodiesterase III inhibitor, to prevent formation of totally occlusive thrombus in a porcine carotid artery, in comparison with ticlopidine. Castrated male Yorkshire pigs were allocated to control (n=8), cilostazol (30 mg/kg, twice a day [b.i.d] for 2 days, n=8), and ticlopidine (50 mg/kg, b.i.d. for 3 days, n=7) groups. The endothelium of the right common carotid artery was injured with electrical stimulation (150 microA) without constriction and blood flow in this region was monitored by Doppler flow probe. Arterial blood was sampled during electrical stimulation for the measurement of platelet aggregation. Total occlusion rates within 240 minutes were 87.5% (7:8), 37.5% (3:8), and 85.7% (6:7) in the control, cilostazol, and ticlopidine groups, respectively. Compared with the control group, the time to total occlusion was significantly prolonged in the cilostazol group, but not in the ticlopidine group. Consistently, platelet aggregation was significantly inhibited only in the cilostazol group. Because ticlopidine increases blood flow in the intact carotid artery before injury to a greater extent than cilostazol, direct antiplatelet action is thought to be responsible for cilostazol's beneficial effect in preventing thrombotic occlusion. These results suggest that cilostazol may be useful for the inhibition of the thrombus formation in the carotid artery and for the prevention of cerebral ischemic events.
Assuntos
3',5'-AMP Cíclico Fosfodiesterases/antagonistas & inibidores , Artérias Carótidas/fisiopatologia , Tetrazóis/farmacologia , Trombose/sangue , Trombose/prevenção & controle , Animais , Artérias Carótidas/metabolismo , Cilostazol , Nucleotídeo Cíclico Fosfodiesterase do Tipo 3 , Modelos Animais de Doenças , Estimulação Elétrica , Endotélio Vascular/lesões , Hemodinâmica/efeitos dos fármacos , Masculino , Orquiectomia , Agregação Plaquetária/efeitos dos fármacos , Serotonina/sangue , Suínos , Trombose/etiologia , Tromboxano B2/sangue , Ticlopidina/farmacologiaRESUMO
We examined the effect of cilostazol (CZ), antiplatelet agent and potent vasoactive compound, which has an inhibitory effect on tissue phosphodiesterase, on peripheral nerve in streptozotocin-induced diabetic rats. Diabetic rats were fed for 12 weeks with a chow containing 0.01% or 0.03% CZ (w/w) and the results were compared with untreated diabetic rats. The 0.03% CZ treatment significantly improved motor nerve-conduction velocity and restored nerve Na+, K(+)-ATPase activity in diabetic rats without affecting body weight and glycated hemoglobin levels, but the effects of 0.01% CZ treatment did not reach statistical difference. Elevated sorbitol and reduced myo-inositol levels in diabetic nerve tissues were not influenced by CZ treatment. Structural analysis of the sural nerve demonstrated a partial but significant effect on decreased mean myelinated fiber area and atrophic changes of the axon in diabetic rats treated with 0.01% CZ. CZ treatment inhibited reduction of pericyte area of endoneurial microvessels in diabetic rats. Expansion of endoneurial microvessels and luminal area in relation to vascular area also tended to be inhibited by CZ treatment. Thus CZ treatment ameliorated, although not completely, functional and structural abnormalities in peripheral nerve of diabetic rats without effecting the polyol pathway. These results support the contention that vascular factors may play an important role in the etiology of experimental diabetic neuropathy and suggest that CZ may have a beneficial therapeutic effect on diabetic neuropathy.
Assuntos
Diabetes Mellitus Experimental/fisiopatologia , Fibras Nervosas Mielinizadas/efeitos dos fármacos , Sistema Nervoso Periférico/efeitos dos fármacos , Inibidores de Fosfodiesterase/farmacologia , Tetrazóis/farmacologia , Animais , Cilostazol , Estudos de Coortes , Diabetes Mellitus Experimental/induzido quimicamente , Relação Dose-Resposta a Droga , Inositol/análise , Masculino , Microcirculação/efeitos dos fármacos , Microcirculação/fisiologia , Neurônios Motores/efeitos dos fármacos , Neurônios Motores/fisiologia , Fibras Nervosas Mielinizadas/fisiologia , Fibras Nervosas Mielinizadas/ultraestrutura , Condução Nervosa/efeitos dos fármacos , Condução Nervosa/fisiologia , Sistema Nervoso Periférico/fisiologia , Sistema Nervoso Periférico/ultraestrutura , Distribuição Aleatória , Ratos , Ratos Wistar , Análise de Regressão , Nervo Isquiático/química , Nervo Isquiático/efeitos dos fármacos , Nervo Isquiático/enzimologia , ATPase Trocadora de Sódio-Potássio/metabolismo , Sorbitol/análise , Nervo Sural/irrigação sanguínea , Nervo Sural/efeitos dos fármacos , Nervo Sural/ultraestruturaRESUMO
INTRODUCTION: The purpose of this study was to investigate the relationship between temporomandibular joint (TMJ) morphology, including discal tissue and clinical symptoms in class III dentofacial deformity patients. MATERIAL AND METHODS: Forty-four patients were examined with lateral, frontal and axial cephalograms. They were divided into two groups, consisting of a class III symmetry and a class III asymmetry group. By using magnetic resonance imaging the 88 joints could be classified into four types on the basis of disc position and shape: anteriorly displaced disc, anterior type, fully-covered type and posterior type. Furthermore, TMJ morphology was measured tomographically in the sagittal plane. RESULTS: Anteriorly displaced discs in the asymmetry group (56.8%) occurred significantly more frequently than in the symmetry group (18.2%; p <0.05). TMJ symptoms (clicking, crepitus, closed lock, pain) were seen in 17/44 joints (38.6%) of the symmetry and 24/44 joints (54.5%) of the asymmetry group, for a total of 41/88 joints (46.6%). There were no differences in joint space ratio and condyle ratio. However, the fossa ratio on the deviation side was significantly higher than on the nondeviation side in the asymmetry group (p<0.05). CONCLUSION: The incidence of internal derangement in asymmetrical class III patients is higher than in symmetrical mandibular prognathism, and this difference is associated with a difference in TMJ morphology of both sides.
Assuntos
Má Oclusão Classe III de Angle/patologia , Prognatismo/patologia , Disco da Articulação Temporomandibular/patologia , Articulação Temporomandibular/patologia , Adulto , Anatomia Transversal , Cefalometria , Distribuição de Qui-Quadrado , Assimetria Facial/patologia , Feminino , Humanos , Incidência , Luxações Articulares/classificação , Luxações Articulares/patologia , Imageamento por Ressonância Magnética , Masculino , Côndilo Mandibular/patologia , Estatísticas não Paramétricas , Osso Temporal/patologia , Transtornos da Articulação Temporomandibular/classificação , Transtornos da Articulação Temporomandibular/patologia , Tomografia por Raios XRESUMO
The purpose of this study was to examine the changes in border movement of the mandible before and after mandibular ramus osteotomy in patients with prognathism. The subjects were 73 patients with mandibular prognathism who underwent sagittal split ramus osteotomy (SSRO) with and without Le Fort I osteotomy. Border movement of the mandible was recorded with a mandibular movement measure system (K7) preoperatively and at 6 months postoperatively. Of the 73 patients, 21 had measurements taken at 1.5 years postoperative. Data were compared between the pre- and postoperative states, and the differences analyzed statistically. There was no significant difference between SSRO alone and SSRO with Le Fort I osteotomy in the time-course change. The values at 6 months postoperative were significantly lower than the preoperative values for maximum vertical opening (P=0.0066), maximum antero-posterior movement from the centric occlusion (P=0.0425), and centric occlusion to maximum opening (P=0.0300). However, there were no significant differences between the preoperative and 1.5 years postoperative measurements. This study suggests that a postoperative temporary reduction in the border movement of the mandible could recover by 1.5 years postoperative, and the additional procedure of a Le Fort I osteotomy does not affect the recovery of mandibular motion after SSRO.
Assuntos
Má Oclusão Classe III de Angle/fisiopatologia , Má Oclusão Classe III de Angle/cirurgia , Mandíbula/fisiopatologia , Mandíbula/cirurgia , Procedimentos Cirúrgicos Ortognáticos , Adulto , Feminino , Humanos , Masculino , Movimento/fisiologia , Osteotomia Sagital do Ramo Mandibular , Resultado do TratamentoRESUMO
The purpose of this study was to compare retrospectively postoperative differences in maxillary stability after Le Fort I osteotomy and fixation with an unsintered hydroxyapatite (u-HA)/poly-l-lactic acid (PLLA) plate with or without self-setting α-tricalcium phosphate (Biopex(®)) as interpositional material. Subjects comprised 45 patients diagnosed with mandibular prognathism with maxillary retrognathism and mandibular prognathism with bimaxillary asymmetry. All patients underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy with fixation by uHA/PLLA plates. Patients were divided into 4 groups consisting of 9 maxillary impaction cases with Biopex(®) (group 1) to fill the gap between the bone segments, 14 maxillary advancement cases with Biopex(®) (group 2), 8 maxillary impaction cases without Biopex(®) (group 3) and 14 maxillary advancement cases without Biopex(®) (group 4). Changes in cepahalometric parameters at time intervals (1, 3 and 12 months) between the groups were compared. Results showed that stability did not depend on the use or otherwise of Biopex(®).
Assuntos
Implantes Absorvíveis , Materiais Biocompatíveis/uso terapêutico , Cimentos Ósseos/uso terapêutico , Placas Ósseas , Fosfatos de Cálcio/uso terapêutico , Durapatita/química , Maxila/patologia , Osteotomia de Le Fort/métodos , Poliésteres/química , Adolescente , Adulto , Materiais Biocompatíveis/química , Cefalometria/métodos , Sulfatos de Condroitina/uso terapêutico , Assimetria Facial/cirurgia , Feminino , Seguimentos , Humanos , Hidroxiapatitas/uso terapêutico , Incisivo/patologia , Técnicas de Fixação da Arcada Osseodentária/instrumentação , Masculino , Mandíbula/cirurgia , Maxila/cirurgia , Pessoa de Meia-Idade , Osso Nasal/patologia , Osteotomia de Le Fort/instrumentação , Osteotomia Sagital do Ramo Mandibular/métodos , Prognatismo/cirurgia , Estudos Retrospectivos , Sela Túrcica/patologia , Succinatos/uso terapêutico , Adulto JovemRESUMO
The purpose of this study was to examine the changes in lip pressure before and after orthognathic surgery for skeletal class III patients. The subject groups were 32 female and 31 male patients diagnosed with mandibular prognathism and/or maxillary retrognathism who underwent orthognathic surgery. Control groups consisted of 20 women and 20 men with normal occlusion without dento-alveolar deformity. Maximum and minimum lip closing force was measured with Lip De Cum® for the control groups and subject groups preoperatively and 6 months postoperatively. The difference between the pre- and postoperative values of the groups was examined statistically. The maximum lip closing force in men was significantly larger than that in women in both the preoperative class III group (p=0.0330) and the control group (p=0.0097). The preoperative class III group was significantly smaller than the control group in maximum lip closing force in both men (p<0.0001) and women (p<0.0001). The postoperative maximum lip closing force was significantly larger than the preoperative value in both men (p=0.0037) and women (p=0.0273) in the Class III group. This study suggested that the maximum lip closing force increases after orthognathic surgery in Class III patients.
Assuntos
Lábio/fisiopatologia , Má Oclusão Classe III de Angle/fisiopatologia , Procedimentos Cirúrgicos Ortognáticos/métodos , Adulto , Cefalometria/métodos , Feminino , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Má Oclusão Classe III de Angle/cirurgia , Osteotomia Mandibular/métodos , Maxila/anormalidades , Maxila/cirurgia , Osteotomia de Le Fort/métodos , Osteotomia Sagital do Ramo Mandibular/métodos , Pressão , Prognatismo/fisiopatologia , Prognatismo/cirurgia , Fatores Sexuais , Estresse MecânicoRESUMO
The purpose of this study was to compare postoperative changes in maxillary stability after Le Fort I osteotomy in three groups: with an unsintered hydroxyapatite (u-HA)/poly-L-lactic acid (PLLA) plate; a PLLA plate; and a titanium plate. Subjects comprised 60 Japanese patients diagnosed with mandibular prognathism. All patients underwent Le Fort I osteotomy and bilateral sagittal split ramus osteotomy. All patients were randomized in groups of 20 to a u-HA/PLLA group, a PLLA plate group and a titanium plate group. Changes in postoperative time intervals between the plate groups were compared using lateral and posteroanterior cephalography. The uHA/PLLA group had significantly larger values than the PLLA group regarding change of mx1-S perpendicular to SN between 3 and 12 months (T3) (P=0.0269). The uHA/PLLA group had a significantly larger value than the PLLA group regarding change of S-A perpendicular to SN between baseline and 1 month (T1) (P=0.0257). There was no significant difference in the other measurements. This study suggests that maxillary stability with satisfactory results could be obtained in the u-HA/PLLA, PLLA plate and titanium plate groups, although there was a slight difference between the u-HA/PLLA and PLLA plate systems in Le Fort I osteotomy.
Assuntos
Materiais Biocompatíveis/classificação , Placas Ósseas/classificação , Maxila/cirurgia , Osteotomia de Le Fort/instrumentação , Adolescente , Adulto , Materiais Biocompatíveis/química , Parafusos Ósseos , Cefalometria/métodos , Queixo/patologia , Durapatita/química , Feminino , Seguimentos , Humanos , Incisivo/patologia , Técnicas de Fixação da Arcada Osseodentária , Ácido Láctico/química , Masculino , Maxila/patologia , Pessoa de Meia-Idade , Dente Molar/patologia , Osso Nasal/patologia , Procedimentos Cirúrgicos Ortognáticos/instrumentação , Osteotomia Sagital do Ramo Mandibular/métodos , Poliésteres/química , Polímeros/química , Prognatismo/cirurgia , Estudos Prospectivos , Sela Túrcica/patologia , Titânio/química , Adulto Jovem , Zigoma/patologiaRESUMO
Cephalometric studies show significant gender differences in the size of the pharyngeal airway space. This study aimed to investigate and compare morphologic changes after mandibular setback or two-jaws surgery on the pharyngeal airway in men and women using computed tomography (CT). The sample included 34 women and 13 men diagnosed with Class III skeletal deformities, who had been treated by mandibular setback or bimaxillary surgery (maxillary advancement and mandibular setback). Anteroposterior, lateral and cross-sectional area dimensions of the airway, at the level of soft palate and base of tongue, were measured pre- and postoperatively on CT images. In the mandibular setback group, the anteroposterior and cross-sectional area of the pharyngeal airway at the level of the soft palate and base of tongue were significantly reduced for men or women (P<.05). In the two-jaws surgery group, only midsagittal anteroposterior dimensions at the same levels were significantly decreased for men or women (P<.05). The difference between any values measured between men and women who received bilateral sagittal split ramus osteotomy setback surgery or two-jaws surgery for the treatment of class III anteroposterior discrepancy were not statistically significant (P>.05). This study suggests that oropharyngeal airway measurements, important for airway patency, do not demonstrate sex dimorphism.
Assuntos
Má Oclusão Classe III de Angle/cirurgia , Mandíbula/cirurgia , Procedimentos Cirúrgicos Bucais , Faringe/anatomia & histologia , Caracteres Sexuais , Adolescente , Adulto , Povo Asiático , Cefalometria , Feminino , Humanos , Masculino , Osteotomia de Le Fort , Faringe/diagnóstico por imagem , Período Pós-Operatório , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
The authors evaluated changes in position and angle of the proximal segment, including the condyle, after intraoral vertical ramus osteotomy (IVRO) with and without a Le Fort I osteotomy to verify whether displacement of the proximal segment could induce postoperative complications. Changes in condylar angle, ramus angle, and displacement of proximal segment were measured pre- and postoperatively. The position of the temporomandibular joint (TMJ) disc was examined pre- and postoperatively. Trigeminal nerve hypoesthesia in the lower lip was assessed bilaterally. The postoperative horizontal condylar angle was significantly smaller than the preoperative one on the deviated and non-deviated sides (P<0.0001). The postoperative coronal condylar angle was significantly larger than the preoperative one on the deviated side (P=0.0483). The postoperative sagittal ramus angle was larger than the preoperative one on the deviated (P<0.0001) and non-deviated (P=0.00005) side. Most joints with an anteriorly-displaced disc with and without reduction improved on the non-deviated side; 5 of 16 joints improved on the deviated side. Results suggest the position and angle of the proximal segment, including the condyle, could change after IVRO. This could be associated with symptomatic improvement in TMJ, and extreme medial displacement of the proximal segment could delay recovery from lower lip hypoesthesia.