1/4. "Cat's cradle" midfacial fixation in distraction osteogenesis after Le Fort III osteotomy.Distraction osteogenesis has provided a powerful technique for the treatment of severe midfacial hypoplasia. Skeletal fixation is a critical component of successful distraction osteogenesis. This is a report on the development of a new approach to bone fixation for distraction osteogenesis of the midface, based on circumferential suspension of the entire midfacial skeleton using surgical wires placed through the soft palate. This technique offers the advantages of (1) complete control of the attitude of the midface in terms of a precise dispersion of forces that can determine the desired pitch, yaw, and roll of this skeletal complex during the active phase of distraction, (2) being compatible with young children in the deciduous dentition stage because it obviates the need for rigid fixation devices on the maxillary lateral walls in the proximity of numerous dental follicles of the unerupted adult dentition, (3) actually serving as the instrument for posterior maxillary "lift" in cases of skeletal open bite malocclusions (frequently seen in the craniosynostoses), thereby allowing the clinician to determine the final occlusal and palatal planes and simultaneously close the open bite. An illustrative case of a 5(1/2)-year-old girl with Apert syndrome is presented wherein her ventilatory obstruction and ocular proptosis were significantly improved.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/4. cleft palate and beckwith-wiedemann syndrome.OBJECTIVE: patients with beckwith-wiedemann syndrome suffer numerous anomalies, which vary somewhat from case to case. cleft palate in combination with this syndrome has rarely been reported in the literature. Through two cases, this report examines the staging of the surgical repairs and the role of macroglossia in cleft palate and the consequences of the scarred palate on mandibular development. RESULTS: Of four patients with beckwith-wiedemann syndrome, only two had a cleft palate. The timing of the repair in these two children was different. speech development was satisfactory in the first case but mediocre in the second. This result seemed to be related to a poor social environment. Mandibular prognathism persisted in both cases. CONCLUSION: The treatment of patients with cleft palate and beckwith-wiedemann syndrome remains complex. It is preferable not to operate on a cleft palate before performing a tongue reduction plasty, but rather to combine these two surgical interventions. This would reduce the risks of anesthesia and enable the palate to heal more efficiently. Surgical treatment should be performed after the age of 6 months and before problems in speech development occur. An orthognathic surgery at adolescence could be performed if prognathism persists. While the origin of the cleft palate is still being discussed, we cannot claim that macroglossia is related to the development of cleft palate, nor that the scarred palate has an impact on the mandibular development.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
3/4. Modified maxillary protraction headgear for the correction of class III skeletal malocclusion with anterior open bite.This is a case report of a 10-year-old girl with a hyper divergent class III skeletal malocclusion caused primarily due to maxillary retrognathism. Treatment involved the use of a modified maxillary protraction face mask that carries the point of force application extra orally to pass through the centre of resistance of the maxillary dentoalveolar complex. After 8 months, the maxilla was displaced anteriorly without rotation. Maxillary occlusal plane showed a clockwise rotation. Maxillary incisors were extruded and retroclined. mandible was displaced downward and backward. Another 18 months were required for fixed orthodontic treatment to achieve perfect interdigitation.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
4/4. A complex Class II case with crowding and missing teeth.Frankel appliance treatment was used from the age of 9 years 3 months to 10 years 7 months, which is 16 months overall. At 12 years 2 months, region. At 14 years 5 months, fixed appliances were placed for a period of 16 months. A positioner was used from 14 years 8 months until 16 years 3 months, which is an 18 month period.- - - - - - - - - - ranking = 4keywords = complex (Clic here for more details about this article) |