1/15. The reconstruction of bilateral clefts using endosseous implants after bone grafting.This article presents the orthodontic reconstruction of an adult bilateral cleft patient with a severe Class III malocclusion in which endosseous implants were inserted after secondary alveolar bone grafting. The patient was a 21-year-old Japanese male whose lateral incisors were congenitally missing and whose premaxilla was inclined lingually. The occlusion was classified as Angle Class III with an overjet of -8 mm. Orthodontic alignment was initiated to correct the position of the maxillary incisors before bone grafting. After the anterior occlusal relationship was corrected, bilateral alveolar clefts were reconstructed by bone grafting with autogenous particulate marrow and cancellous bone harvested from the iliac crest. ITI-SLA fixtures (Institute Straumann, Waldenburg, switzerland) (length, 10 mm; diameter, 4.1 mm) were placed into the grafted bone for prosthetic restoration of the missing lateral incisors. The results illustrate that this protocol can be expected to provide an acceptable occlusion and good dentoalveolar stability in adult cleft patients.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
2/15. Indications and procedures for segmental dentoalveolar osteotomy: a review of 13 patients.The authors evaluated the surgical area, indications, and procedures for segmental dentoalveolar osteotomy carried out on 16 jaws in 13 patients treated at the Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of medicine, between 1990 and 2001. osteotomy was indicated mainly in cases where tooth repositioning by orthodontic treatment was limited, where social conditions (e.g., age, time, finances) precluded orthodontic treatment, or where revision of orthodontic or surgical treatment was required. In cases of maxillary anterior segmental dentoalveolar osteotomy, the modified Wunderer method was used, where after an incision was made in the palatal mucosa, a mucoperiosteal flap was abraded as much as possible until the area of the osteotomy on the palatal side could be visualized. In maxillary posterior segmental dentoalveolar osteotomy, the operation was carried out in 2 stages because of the risk of necrosis of the bone fragments. In the first stage, an osteotomy was carried out on the vestibular side, since the vestibular gingival pedicle was intact. In the second stage, 3 weeks later, another osteotomy was performed after the palatal mucoperiosteal flap was abraded to visualize the area of the osteotomy as well as that of the maxillary anterior segmental dentoalveolar osteotomy.- - - - - - - - - - ranking = 2.6666666666667keywords = alveolar (Clic here for more details about this article) |
3/15. rehabilitation of a hemophiliac with implants: a medical perspective and case report.A patient suffering from classical hemophilia had previous surgery for ankylosis of the right temporomandibular joint. This was replaced by a costochondral graft and an overlay of temporalis muscle. A bilateral sagittal split was performed for a micrognathic mandible and a sleep apnea problem. That procedure solved the sleep apnea; however, it resulted in a prognathic mandible and an anterior open bite. The lower anterior teeth were periodontally involved with impaired alveolar support. The restricted opening of the oral cavity of 18 mm between maxillary and mandibular centrals and the potential danger of bleeding complicated the surgical and restorative procedures. The patient was prepared medically on each of 4 occasions with factor viii replacement concentrate, and oral antifibrinolytic therapy (tranexamic acid). The treatment of choice was the extraction of the remaining lower incisors and their replacement with an implant-supported temporarily cemented retrievable fixed prosthesis. Serial extractions and chairside temporization provided the surgeon with precise guides for implant placement, and enabled the patient to enjoy unimpaired function through periods of healing and osseointegration.- - - - - - - - - - ranking = 0.33333333333333keywords = alveolar (Clic here for more details about this article) |
4/15. Internal midface distraction in correction of severe maxillary hypoplasia secondary to cleft lip and palate.BACKGROUND: Maxillary hypoplasia is a familiar deformity in patients with cleft lip and palate. A large amount of maxilla advancement is often needed to correct the severe deformity, but local soft-tissue scars around the maxilla restrict maxilla advancement and increase the relapse rate. By gradually lengthening both the bones and the soft tissues, midface distraction can greatly increase postoperative stability and lower the relapse rate. methods: Ten patients with severe maxillary hypoplasia secondary to cleft lip and palate were treated with midface distraction using three kinds of internal distraction devices. Among them, six patients received an alveolar bone graft from the iliac crest during their Le Fort I osteotomy, and a bilateral sagittal split ramus osteotomy was performed simultaneously to push back the mandible in five patients with prognathia, to obtain a normal soft-tissue profile and occlusal relationship. RESULTS: Successful maxillary advancements ranging from 5 to 15 mm were measured from preoperative and postoperative cephalograms. patients' sella-nasion-point A angles increased from an average of 71.25 degrees preoperatively to 79.05 degrees postoperatively. Orthodontic therapies were adopted before and/or after midface distraction. After the consolidation period, dense new bone was found to have formed in the distraction gap. During the follow-up period, the position of the maxilla and the final occlusal relationship were stable and acceptable, and no obvious relapses were seen. CONCLUSION: Midface distraction is an ideal choice for the correction of severe maxillary hypoplasia secondary to cleft lip and/or palate.- - - - - - - - - - ranking = 0.33333333333333keywords = alveolar (Clic here for more details about this article) |
5/15. Nonsurgical and nonextraction treatment of a skeletal class III adult patient with severe prognathic mandible.AIM: A patient with a skeletal Class III malocclusion, prognathic mandible, anterior open bite, large tongue, and temporomandibular disorders is presented. Treatment objectives included establishing a stable occlusion with normal respiration, eliminating temporomandibular disorder symptoms, and improving facial esthetics through nonextraction and nonsurgical treatment by creating a favorable perioral environment, restoring the harmony to the tongue and perioral environment, improving masticatory muscle function, and creating adequate tongue space for establishment of normal respiration. SUBJECT AND methods: The patient was a Japanese adult male, who had previously been advised to have orthognathic surgery, with tongue-size reduction. An expansion plate was used to expand the maxillary dentoalveolar arch. Distalization of the mandibular arch was achieved by reduced excessive posterior vertical dimension, through uprighting and intruding the mandibular posterior teeth and rotating the mandible slightly counter-clockwise. The height of the maxillary alveolar process and the vertical height of symphysis were increased slightly. The functional occlusal plane was reconstructed by uprighting and intruding the posterior teeth with a full-bracket appliance, combined with a maxillary expansion plate, with short Class III and vertical elastics in the anterior area. myofunctional therapy involved sugarless chewing gum exercises. RESULTS: The excessive posterior vertical occlusal dimension was reduced slightly, creating a small clearance between the posterior maxilla and mandible. At the same time, the interferences in the posterior area were eliminated by the expansion of the maxillary dentoalveolar arch. As a result, the laterally displaced mandible moved to a more favorable jaw relationship, with distalization of the mandibular arch. The functional occlusal plane was reconstructed and an almost-normal overjet and overbite were created. Adequate tongue space for normal respiration was established during the early stage of treatment, by 7 months. A stable occlusion, with adequate posterior support and anterior guidance, was established and maintained at more than 4 years posttreatment.- - - - - - - - - - ranking = 1.0036417154495keywords = alveolar, process (Clic here for more details about this article) |
6/15. An American Board of orthodontics case report. Correction of a Class III mandibular prognathism and asymmetry through orthodontics and orthognathic surgery.The Class III malocclusion with mandibular prognathism can involve many factors, among which are excessive mandibular growth, underdevelopment of the maxilla, environmental factors, and trauma to the jaws. The correction of this malocclusion can involve an orthodontic or a combined orthodontic-orthognathic approach. Skeletal asymmetries can complicate this situation, making treatment either more difficult, more complicated, or both. This case presentation involves treatment with a combined orthodontic-orthognathic approach. [This case was presented to the American Board of orthodontics in partial fulfillment of the requirements for the certification process conducted by the Board.]- - - - - - - - - - ranking = 0.0036417154494673keywords = process (Clic here for more details about this article) |
7/15. An American Board of orthodontics case report. A nonsurgical and nonextraction approach in the treatment of a skeletal and dental Class III malocclusion in a growing patient.This case report is presented following the specifications of the American Board of orthodontics. The patient had a true maxillary retrognathism, a mandibular prognathism, and a lower anterior height deficiency. She was treated with a fixed orthopedic appliance, fixed orthodontic appliances, and intermaxillary elastics. [This case was presented to the American Board of orthodontics in partial fulfillment of the requirement for the certification process conducted by the Board.- - - - - - - - - - ranking = 0.0036417154494673keywords = process (Clic here for more details about this article) |
8/15. Second vertical osteotomy 15 years after initial operation.A case of mandibular prognathism that existed 15 years after a previous attempt at correction has been presented. The initial procedure was the vertical osteotomy done via an extraoral approach. A second attempt at correction was undertaken with use of the same approach. The anatomic changes existing as a result of the first surgical procedure were of extreme interest. A decreased anteroposterior length of the sigmoid notch with posterior placement of the coronoid process was observed. Also, an increased thickness of the mandibular rami in a mediolateral plance was present. The clinical problems encountered as a result of these changes were difficulty in overlapping proximal and distal segments without definite osseous reductions and the inability to set back the mandible further without coronoidectomy. When these procedures were done, the patient's treatment was managed very successfully.- - - - - - - - - - ranking = 0.0036417154494673keywords = process (Clic here for more details about this article) |
9/15. Cephalometric evaluation of surgical orthodontic treatment for the correction of anterior cross-bites.Severe skeletal Class III malocclusion cases were treated by surgical orthodontic techniques. Surgical operations included alveolar osteotomy, horizontal osteotomy of the mandibular ramus, osteotomy of the mandibular body, and sagittal-split osteotomy of the mandibular ramus, according to the type of malocclusion. Comparisons between lateral cephalograms made before and after operation at the prognosis examination were made for the four surgical procedures.- - - - - - - - - - ranking = 0.33333333333333keywords = alveolar (Clic here for more details about this article) |
10/15. Correction of jaw deformities subsequent to treatment of acromegaly.In acromegaly, growth of facial bones and changes of oral and laryngeal mucosa are well accepted facts. orthognathic surgical procedures should in these cases be postponed until the acromegalic process is well controlled. 2 cases of mandibular osteotomies (patients aged 61 and 38 years) are reported. The surgical procedures and the postoperative course of these patients were uneventful and did not deviate from those of otherwise healthy patients.- - - - - - - - - - ranking = 0.0036417154494673keywords = process (Clic here for more details about this article) |
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