1/46. Correction of posttraumatic maxillary deficiency by anterolateral alveolar osteotomy.Anterolateral alveolar osteotomy was performed in a patient who experienced facial trauma in a traffic accident. Bony sequela had remained in the maxilla after the emergency surgery, affecting the facial appearance. A different technique of osteotomy for this unusual type of deformity is presented.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
2/46. Treatment planning and biomechanics of distraction osteogenesis from an orthodontic perspective.As in traditional combined surgical and orthodontic procedures, the orthodontist has a role in the planning and orthodontic support of patients undergoing distraction osteogenesis. This role includes predistraction assessment of the craniofacial skeleton and occlusal function in addition to planning both the predistraction and postdistraction orthodontic care. Based on careful clinical evaluation, dental study models, photographic analysis, cephalometric evaluation, and evaluation of three-dimensional computed tomographic scans, the orthodontist, in collaboration with the surgeon, plans distraction device placement and the predicted vectors of distraction. Both surgeon and orthodontist closely monitor the patient during the active distraction phase, using intermaxillary elastic traction, sometimes combined with guide planes, bite plates, and stabilization arches, to mold the newly formed bone (regenerate) while optimizing the developing occlusion. Postdistraction change caused by relapse is minimal. growth after mandibular distraction is variable and appears to be dependent on the genetic program of the native bone and the surrounding soft tissue matrix. A significant advantage of distraction osteogenesis is the gradual lengthening of the soft tissues and surrounding functional spaces. Distraction osteogenesis can be applied at an earlier age than traditional orthognathic surgery because the technique is relatively simple and bone grafts are not required for augmentation of the hypoplastic craniofacial skeleton. In this new technique, the surgeon and the orthodontist have become collaborators in a process that gradually alters the magnitude and direction of craniofacial growth.- - - - - - - - - - ranking = 0.0062670341472726keywords = process (Clic here for more details about this article) |
3/46. Half nose with ipsilateral eye and ear anomalies and facial asymmetry: report of a case with cephalometric analysis and orthodontic treatment.OBJECTIVE: Unilateral nostril agenesis together with ipsilateral alterations of the eye, ear, and face make up a spectrum of anomalies. The aim of this study is to report a case in a Japanese girl, 14 years, 5 months of age. Cephalometric analysis is provided, and orthodontic treatment is discussed. DESIGN: Lateral and frontal cephalograms were compared to a Japanese control group. Outcome of the orthodontic treatment was evaluated by comparing cephalograms taken before and after orthodontic treatment. RESULTS: The lateral cephalometric analysis showed a severely hypoplastic maxilla in both sagittal and vertical dimensions, coupled with a decreased posterior cranial base. The mandibular rami were asymmetric. The frontal cephalogram showed decreased cranial width and maxillary alveolar width, together with an increased interorbital distance. CONCLUSIONS: Serial lateral cephalograms during the orthodontic treatment from the age of 14 to 20 years demonstrated no significant maxillary growth and some mandibular growth, coupled with labial tipping of the maxillary central incisors.- - - - - - - - - - ranking = 0.2keywords = alveolar (Clic here for more details about this article) |
4/46. Idiopathic condylar resorption: diagnosis, treatment protocol, and outcomes.Idiopathic condylar resorption is a poorly understood progressive disease that affects the TMJ and that can result in malocclusion, facial disfigurement, TMJ dysfunction, and pain. This article presents the diagnostic criteria for idiopathic condylar resorption and a new treatment protocol for management of this pathologic condition. Idiopathic condylar resorption most often occurs in teenage girls but can occur at any age, although rarely over the age of 40 years. These patients have a common facial morphology including: (1) high occlusal and mandibular plane angles, (2) progressively retruding mandible, and (3) Class II occlusion with or without open bite. Imaging usually demonstrates small resorbing condyles and TMJ articular disk dislocations. A specific treatment protocol has been developed to treat this condition that includes: (1) removal of hyperplastic synovial and bilaminar tissue; (2) disk repositioning and ligament repair; and (3) indicated orthognathic surgery to correct the functional and esthetic facial deformity. patients with this condition respond well to the treatment protocol presented herein with elimination of the disease process. Two cases are presented to demonstrate this treatment protocol and outcomes that can be achieved. Idiopathic condylar resorption is a progressive disease that can be eliminated with the appropriate treatment protocol.- - - - - - - - - - ranking = 0.0062670341472726keywords = process (Clic here for more details about this article) |
5/46. Transmission of the dysgnathia complex from mother to daughter.We report the first observation of parent-to-child transmission of dysgnathia, a rare disorder characterized by severe mandibular hypoplasia or agenesis, ear anomalies, microstomia, and microglossia. Patient 1 was noted prenatally by ultrasound to have severe micrognathia and, after birth, abnormal ears with canal stenosis and non-contiguous lobules located dorsally to the rest of the pinnae, normal zygomata, severe jaw immobility and microstomia with an opening of only 4 to 5 mm, hypoplastic tongue, and cleft palate. The 21-year-old mother of patient 1 was born with severe micrognathia requiring tracheostomy, microglossia, cleft palate with filiform alveolar bands, abnormal pinnae, and decreased conductive hearing. Dysgnathia is thought to result from a defect in the development of the first branchial arch. A similar phenotype has been seen in Otx2 haplo-insufficiency and endothelin-1 homozygous null mice, suggesting that these genes contribute to branchial arch development. Our report of a long-surviving mother and her daughter with non-syndromal dysgnathia may lead to identification of the molecular basis of these findings and provide insight into the genetics of first branchial arch formation. The survival of patient 1 and patient 2 beyond the neonatal period has implications for improvements in prenatal diagnosis and counseling and for neonatal treatment of this condition.- - - - - - - - - - ranking = 0.2keywords = alveolar (Clic here for more details about this article) |
6/46. Treatment of a patient with a Class II malocclusion, impacted canine, and severe malalignment.A case report of the orthodontic treatment of a male adolescent with a unilateral dental Class II malocclusion, an impacted canine, severe maxillary malalignment, and a canted maxillary anterior occlusal plane. Treatment consisted of full fixed appliances, extraction of the maxillary right first premolar, and surgical exposure of the impacted canine. Treatment vastly improved the patient's facial and dental esthetics. A Class I skeletal and dental relationship was established, along with a functional anterior guidance. The dental arches were coordinated and the dental midlines coincident with the midsagittal plane. This case report was presented to the American Board of orthodontics in partial fulfillment of the requirements for the certification process conducted by the Board.- - - - - - - - - - ranking = 0.0062670341472726keywords = process (Clic here for more details about this article) |
7/46. Fibrous ankylosis after distraction osteogenesis of a costochondral neomandible in a patient with grade III hemifacial microsomia.Distraction osteogenesis has recently become a mainstay for treatment of craniofacial syndromes with mandibular hypoplasia. This article presents the difficult case of a patient with a previous costochondral rib graft who underwent mandibular distraction and developed a fibrous pseudoarthrosis at the distraction site. This was attributed in part to an associated temporomandibular joint ankylosis. Resorption of the pseudoarthrosis occurred once the distractor was removed. It appears that distraction osteogenesis of a mandible with an ankylosed temporomandibular joint can result in healing with a fibrous union, presumably because of movement at the distraction site when masticating. This can result in a pseudo "temporomandibular joint" at the distraction site. A temporomandibular joint arthroplasty was performed, followed by repeat distraction. We conclude that if there is an ankylosed temporomandibular joint or a stiff temporomandibular joint that may ankylose during the course of the distraction process, then a temporomandibular joint arthroplasty should be performed before or at the time the distractor is placed.- - - - - - - - - - ranking = 0.0062670341472726keywords = process (Clic here for more details about this article) |
8/46. Craniofacial and dental manifestations of proteus syndrome: a case report.The proteus syndrome is a rare congenital hamartomatous condition that is characterized by a wide range of malformations, sometimes involving the face. Common manifestations include partial gigantism, congenital lipomas, and plantar hyperplasia. In this report we describe the craniofacial clinicopathological development in a girl with proteus syndrome from age 6 to 20 years. The patient had pronounced hemifacial hypertrophy, exostoses in the left parietal region, and enlargement of the inferior alveolar nerve and mandibular canal in the affected region. The dental development of the affected left mandible and maxilla was characterized by extremely premature development and eruption of the primary and permanent teeth and by pronounced idiopathic root resorptions. The multidisciplinary management of the patient and the treatment outcome is reported. A review of the Proteus patients in the literature who exhibited manifestation in the craniofacial region is presented.- - - - - - - - - - ranking = 0.2keywords = alveolar (Clic here for more details about this article) |
9/46. Combined surgical therapy of temporomandibular joint ankylosis and secondary deformity using intraoral distraction.temporomandibular joint (TMJ) ankylosis is a pathological process caused by damage of the mandibular condyle. When this event takes place in subjects during the developmental age, it results in an alteration of the entire maxillofacial complex. Therefore, surgical methods able to remove the temporomandibular ankylosis also include necessary operations to correct the secondary maxillofacial deformity. The distraction osteogenesis has induced our center to modify the surgical protocol for the therapy of patients who have developed TMJ ankylosis and secondary maxillomandibular deformity. We have treated four patients with monolateral ankylosis of the TMJ and serious deformities of the maxillomandibular complex secondary to functional limitation. During the same operation, arthroplasty was performed with the removal of the ankylotic block and the interposition of a temporal muscle flap in the new articular space; an intraoral osteodistractor was also positioned to lengthen the mandible. All patients showed recovery of the eurhythmy of the face and good re-establishment of the symmetry. An average 12-month follow-up showed the average opening of the mouth to be at least 35 mm. The combination of TMJ arthroplasty and intraoral osteodistraction provides good functional and aesthetic results in patients affected by ankylosis who have developed secondary maxillofacial deformities.- - - - - - - - - - ranking = 0.0062670341472726keywords = process (Clic here for more details about this article) |
10/46. The use of distraction osteogenesis to treat hemifacial microsomia: a clinical report.Distraction osteogenesis is a method of forming bone through osteotomy and sequential stretching of the healing callus. This process is accomplished with the aid of a distraction device, which is secured with screws placed directly into bone for a predetermined length of time. This clinical report describes the use of distraction osteogenesis to treat mandibular asymmetry in a patient with Goldenhar's syndrome, a form of hemifacial microsomia. After treatment, the patient had a more rounded facial contour and corrected occlusal plane.- - - - - - - - - - ranking = 0.0062670341472726keywords = process (Clic here for more details about this article) |
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