Objectives: This retrospective study aimed to determine the angulation changes of the proximal segment following bilateral sagittal split osteotomy (BSSO) setback and its correlation with the amount of immediate postoperative surgical movement. The correlation between postoperative relapse of the distal and proximal segment at six months postoperatively was also evaluated.
Materials and methods: The CBCT-generated lateral cephalometric images of 39 patients who underwent BSSO setback with or without Le Fort I osteotomy were evaluated preoperatively (T0), immediately postoperative (T1), and six months postoperatively (T2).
Results: The mean surgical setback was 7.28 ± 4.45 mm at B point. The proximal segment's immediate postoperative mean posterior rotation was 2.13 ± 3.59 degrees. Six months after the operation, the mean distal segment relapse was 0.89 ± 3.03 mm at B point. The proximal segment relapse was 0.81 ± 1.63 degrees. A significant moderate correlation was found (P < 0.05) between the surgical movement and the immediate postoperative proximal segment rotation and between the surgical movement and the distal segment relapse. A significant correlation was found between the distal segment relapse and the average and left proximal segment relapse. There was no significant correlation between immediate postoperative proximal segment rotation and distal segment relapse.
Conclusion: The immediate postoperative posterior rotation of the proximal segment had a negligible effect on mandibular relapse. The amount of surgical movement, on the other hand, was more related to distal segment relapse. The intraoperative proximal segment rotation should thus be minimized in cases with a significant surgical setback.
研究目的这项回顾性研究旨在确定双侧矢状面劈开截骨术(BSSO)后近端节段的角度变化及其与术后即刻手术移动量的相关性。此外,还评估了术后 6 个月远端和近端节段复发的相关性:对 39 例接受或未接受 Le Fort I 截骨术的 BSSO 后移患者的 CBCT 头侧造影图像进行术前(T0)、术后即刻(T1)和术后 6 个月(T2)评估:B 点的平均手术后移量为 7.28 ± 4.45 毫米。近节段术后即刻的平均后旋度为 2.13 ± 3.59 度。术后 6 个月,远端节段在 B 点的平均复发率为 0.89 ± 3.03 毫米。近节段复位为 0.81 ± 1.63 度。两者之间存在明显的中度相关性(P术后立即后旋近段对下颌复发的影响微乎其微。另一方面,手术移动量与远段复发的关系更大。因此,在手术复发严重的病例中,应尽量减少术中近节旋转。
{"title":"The Relation Between Mandibular Relapse and the Postoperative Mandibular Ramus Rotation Following BSSO Setback.","authors":"Phathaitip Wittayakornlerk, Yutthasak Kriangcherdsak, Pattamawan Manosuthi","doi":"10.1007/s12663-022-01760-z","DOIUrl":"10.1007/s12663-022-01760-z","url":null,"abstract":"<p><strong>Objectives: </strong>This retrospective study aimed to determine the angulation changes of the proximal segment following bilateral sagittal split osteotomy (BSSO) setback and its correlation with the amount of immediate postoperative surgical movement. The correlation between postoperative relapse of the distal and proximal segment at six months postoperatively was also evaluated.</p><p><strong>Materials and methods: </strong>The CBCT-generated lateral cephalometric images of 39 patients who underwent BSSO setback with or without Le Fort I osteotomy were evaluated preoperatively (<i>T</i>0), immediately postoperative (<i>T</i>1), and six months postoperatively (<i>T</i>2).</p><p><strong>Results: </strong>The mean surgical setback was 7.28 ± 4.45 mm at B point. The proximal segment's immediate postoperative mean posterior rotation was 2.13 ± 3.59 degrees. Six months after the operation, the mean distal segment relapse was 0.89 ± 3.03 mm at B point. The proximal segment relapse was 0.81 ± 1.63 degrees. A significant moderate correlation was found (<i>P</i> < 0.05) between the surgical movement and the immediate postoperative proximal segment rotation and between the surgical movement and the distal segment relapse. A significant correlation was found between the distal segment relapse and the average and left proximal segment relapse. There was no significant correlation between immediate postoperative proximal segment rotation and distal segment relapse.</p><p><strong>Conclusion: </strong>The immediate postoperative posterior rotation of the proximal segment had a negligible effect on mandibular relapse. The amount of surgical movement, on the other hand, was more related to distal segment relapse. The intraoperative proximal segment rotation should thus be minimized in cases with a significant surgical setback.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41761452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-11-24DOI: 10.1007/s12663-023-02032-0
Majid Ismayilzade, Mahmut Tekecik, Arda Soylu, Hayri Ahmet Burak Nurşen, Bilsev Ince, Mehmet Dadacı
Among the rare congenital malformations, congenital nasal sinuses with blind end are extremely unusual. To the best of our knowledge, a sinus located in the midcolumellar region has not been reported yet. Since there is no consensus about the treatment of midcolumellar sinus, to manage the case as individually as possible was our priority. Considering the patient's age, aesthetic concerns, and requirement of septorhinoplasty in the future, the known inverted V incision was modified to provide surgical excision without any extra scar in the midcolumellar line. This report emphasizes a patient-specific treatment of a 15-year-old female patient presented for congenital sinus in the midcolumellar area.
Supplementary information: The online version contains supplementary material available at 10.1007/s12663-023-02032-0.
在罕见的先天性畸形中,带有盲端的先天性鼻窦极为罕见。据我们所知,位于蝶窦中部的鼻窦尚未见报道。由于目前还没有关于蝶窦中段治疗的共识,我们的首要任务是尽可能个性化地处理该病例。考虑到患者的年龄、对美观的关注以及将来进行鼻中隔成形术的要求,我们对已知的倒 V 形切口进行了改良,使手术切除时不会在颊中线留下任何额外的疤痕。本报告强调了对一名因额中部先天性鼻窦而就诊的 15 岁女性患者的特殊治疗方法:在线版本包含补充材料,可在 10.1007/s12663-023-02032-0获取。
{"title":"Original Location of Congenital Nasal Sinus \"Midcolumella\": A Modified Inverted V Incision Technique.","authors":"Majid Ismayilzade, Mahmut Tekecik, Arda Soylu, Hayri Ahmet Burak Nurşen, Bilsev Ince, Mehmet Dadacı","doi":"10.1007/s12663-023-02032-0","DOIUrl":"https://doi.org/10.1007/s12663-023-02032-0","url":null,"abstract":"<p><p>Among the rare congenital malformations, congenital nasal sinuses with blind end are extremely unusual. To the best of our knowledge, a sinus located in the midcolumellar region has not been reported yet. Since there is no consensus about the treatment of midcolumellar sinus, to manage the case as individually as possible was our priority. Considering the patient's age, aesthetic concerns, and requirement of septorhinoplasty in the future, the known inverted V incision was modified to provide surgical excision without any extra scar in the midcolumellar line. This report emphasizes a patient-specific treatment of a 15-year-old female patient presented for congenital sinus in the midcolumellar area.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12663-023-02032-0.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-04-25DOI: 10.1007/s12663-023-01921-8
Ashwina S Banari, Sanjeev Datana, A N Kunal, Yuvraj Issar
Short face syndrome (SFS) is a condition with a clinical impression of deficient lower anterior facial height, which is an esthetic disharmony based on vertical facial proportions rather than absolute dimensions. Masseter hypertrophy is one of the etiologic factors in which there is an enlargement of unilateral or bilateral masseter muscles. Clinically, it presents as a quadrangular face characterized by bulging of the mandibular angle giving a muscular appearance. Despite the muscular origin, surgery should be aimed toward bony reduction (osteoplasty) followed by supplemented myotomy. This case report addresses one such case of SFS treated with surgery-first approach and supplemented myotomy with a 1-year follow-up. The esthetic facial profile, pleasant smile and overall good treatment outcome remained stable 1 year after orthognathic surgery and orthodontic treatment.
{"title":"Management of Short Face Syndrome with Masseter Muscle Hypertrophy: A Surgery-First Approach.","authors":"Ashwina S Banari, Sanjeev Datana, A N Kunal, Yuvraj Issar","doi":"10.1007/s12663-023-01921-8","DOIUrl":"10.1007/s12663-023-01921-8","url":null,"abstract":"<p><p>Short face syndrome (SFS) is a condition with a clinical impression of deficient lower anterior facial height, which is an esthetic disharmony based on vertical facial proportions rather than absolute dimensions. Masseter hypertrophy is one of the etiologic factors in which there is an enlargement of unilateral or bilateral masseter muscles. Clinically, it presents as a quadrangular face characterized by bulging of the mandibular angle giving a muscular appearance. Despite the muscular origin, surgery should be aimed toward bony reduction (osteoplasty) followed by supplemented myotomy. This case report addresses one such case of SFS treated with surgery-first approach and supplemented myotomy with a 1-year follow-up. The esthetic facial profile, pleasant smile and overall good treatment outcome remained stable 1 year after orthognathic surgery and orthodontic treatment.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42007777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-08-19DOI: 10.1007/s12663-023-01979-4
E S Shobha, H P Raghuveer, Suresh Nagesh, Neha Nainoor, Nithin Shaju, N S Punyakoti
Background: The research paper emphasizes on virtual simulation of craniofacial skeleton to understand its Biomechanics.
Methods: In this study, a 3D finite element model of the skull was created using CT scan data. All complexities of the skull geometry are simulated using ABAQUS software. The model was validated and then, subjected to frontal impact. Energy plots for the same were obtained. Impact analysis was done, and weak areas susceptible to fracture and hence, failure are identified.
Results & discussion: One of the emerging areas of applications of computational bio-mechanics is to understand the behavior of the skull during a traumatic injury, such as head impact during accidents. Finite element study is one such part where significant amount of research is being carried out to understand and predict the craniofacial injuries. For the head and brain trauma analysis, there are many software packages available, including ANSYS, LS-DYNA and ABAQUS. Research is being carried out towards developing high-fidelity human models, especially of the human skull to understand the bio-mechanical behavior when subjected to external impact. Impact analysis done in our study showed that a small change in impact velocity can result in a large change in damage that can happen.
Conclusion: The study is expected to complement the existing treatment methodologies. Further, appropriate knowledge of fracture biomechanics can be used to design and develop safety measures in automobiles, sport guards, helmets to prevent and reduce facial injuries.
{"title":"Stress Propagation in the Craniofacial Skeleton on Frontal Impact-A Virtual Simulation Study.","authors":"E S Shobha, H P Raghuveer, Suresh Nagesh, Neha Nainoor, Nithin Shaju, N S Punyakoti","doi":"10.1007/s12663-023-01979-4","DOIUrl":"10.1007/s12663-023-01979-4","url":null,"abstract":"<p><strong>Background: </strong>The research paper emphasizes on virtual simulation of craniofacial skeleton to understand its Biomechanics.</p><p><strong>Methods: </strong>In this study, a 3D finite element model of the skull was created using CT scan data. All complexities of the skull geometry are simulated using ABAQUS software. The model was validated and then, subjected to frontal impact. Energy plots for the same were obtained. Impact analysis was done, and weak areas susceptible to fracture and hence, failure are identified.</p><p><strong>Results & discussion: </strong>One of the emerging areas of applications of computational bio-mechanics is to understand the behavior of the skull during a traumatic injury, such as head impact during accidents. Finite element study is one such part where significant amount of research is being carried out to understand and predict the craniofacial injuries. For the head and brain trauma analysis, there are many software packages available, including ANSYS, LS-DYNA and ABAQUS. Research is being carried out towards developing high-fidelity human models, especially of the human skull to understand the bio-mechanical behavior when subjected to external impact. Impact analysis done in our study showed that a small change in impact velocity can result in a large change in damage that can happen.</p><p><strong>Conclusion: </strong>The study is expected to complement the existing treatment methodologies. Further, appropriate knowledge of fracture biomechanics can be used to design and develop safety measures in automobiles, sport guards, helmets to prevent and reduce facial injuries.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44038705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Frontal Bone Osteotomy for Excision of Large Lacrimal Gland Pleomorphic Adenoma: A Rare Case Report.","authors":"Bijnya Panda, Kiran Kumar Boyina, Abid Majeed Rather, Pritinanda Mishra, D Aditya","doi":"10.1007/s12663-023-01967-8","DOIUrl":"10.1007/s12663-023-01967-8","url":null,"abstract":"","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42315196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-08-19DOI: 10.1007/s12663-023-01986-5
Romir Navaneetham, Anuradha Navaneetham, Vaibhav Nagaraj, N Gnapika, Gayitri Sankarnarayan
Introduction: Tempormandibular Joint (TMJ) Disorders require early diagnosis with a prompt and effective treatment. Arthrocentesis has been found to be a valuable treatment aid for patients with early stage internal derangement of temporomandibular joints. The use of this procedure has been well documented in literature and had been performed for decades. Arthrocentesis under local anaesthesia can be performed in two different techniques i.e Single puncture and Double puncture techniques.
Aims and objectives: Our study was done to show the effectiveness of each of these techniques in aiding the patient as well as time taken to perform this procedure. Our study compares the two techniques to allow us to draw a proper conclusion on which can be put to use for better and less traumatic treatment of these patients.
Materials and method: For this study 50 patients with Internal Derangement, group A was 25 patients that were treated with Arthrocentesis of 200 ml RL using OnePrick TMJ Arthrocentesis System with Single Puncture technique and group B consisted of 25 patients who were treated with Arthrocentesis of 200 ml RL using Double Puncture technique.
Result: We found a significant increase in maximal mouth opening in patients undergoing arthrocentesis regardless of the technique. Comparison of mean duration of surgery performed among different groups were assessed using sample T test. Mean duration of technique A is around 17.18 minutes whereas for technique B is 20.90 minutes. The mean difference for two techniques performed is -3.722 with P value of 0.001. In technique A 24% of subjects needed additional lavage whereas in techniques B it is 20 %. On an average, total of 22 % of subjects needed additional lavage for better results. The resultant p value is around 0.733.
Discussion: The traditional double puncture technique involves the insertion of two needles into the upper joint space. Difficulties in accurate triangulation, positioning of the needle, and frequent intraoperative needle dislocations lead to longer operating times and are often encountered with the double puncture technique. On comparing the two arthrocentesis techniques in terms of easiness to operator a study done showed the group treated with single needle techniques found it easier than the double needle technique. The difference between groups was significant. The mean difference for two techniques performed was seen to be above three minutes in our study which was statistically significant.
Conclusion: Single needle technique is advantageous in the fact that it takes a shorter duration to perform, is less invasive and easier for the operator to complete successfully.
导言:颞下颌关节(TMJ)疾病需要早期诊断和及时有效的治疗。关节腔穿刺术被认为是治疗颞下颌关节早期内部病变患者的重要辅助手段。这种方法在文献中已有详细记载,并且已经应用了几十年。局部麻醉下的关节穿刺术有两种不同的技术,即单穿刺技术和双穿刺技术:我们的研究旨在显示这两种技术在帮助患者方面的有效性以及实施该手术所需的时间。我们的研究对这两种技术进行了比较,以便得出正确的结论,即哪种技术能更好地用于治疗这些患者,并减少对患者的创伤:在这项研究中,有 50 名内出血患者,A 组的 25 名患者使用 OnePrick TMJ 关节腔穿刺系统和单穿刺技术进行了 200 毫升 RL 关节腔穿刺术,B 组的 25 名患者使用双穿刺技术进行了 200 毫升 RL 关节腔穿刺术:结果:我们发现,无论采用哪种技术,接受关节穿刺术的患者的最大张口度都有明显增加。使用样本 T 检验对不同组间的平均手术时间进行了比较。A 技术的平均手术时间约为 17.18 分钟,而 B 技术为 20.90 分钟。两种技术的平均差异为-3.722,P 值为 0.001。在 A 技术中,24% 的受试者需要额外灌洗,而在 B 技术中,这一比例为 20%。平均而言,共有 22% 的受试者需要额外灌洗以获得更好的效果。由此得出的 p 值约为 0.733:传统的双穿刺技术需要将两根针插入上关节间隙。传统的双穿刺技术需要将两根针插入上关节间隙,难以准确三角定位和定位针,而且术中经常出现针脱位,导致手术时间延长。一项研究比较了两种关节穿刺技术对操作者的难易程度,结果显示,使用单针技术的组别比使用双针技术的组别更容易操作。组间差异显著。在我们的研究中,两种技术的平均时间差在三分钟以上,具有统计学意义:结论:单针技术的优势在于其操作时间更短、创伤更小、操作者更容易成功完成。
{"title":"Single-Puncture Versus Double-Puncture Technique Arthrocentesis in the Treatment of Internal Derangement of TM Joint-A Comparative Clinical Study.","authors":"Romir Navaneetham, Anuradha Navaneetham, Vaibhav Nagaraj, N Gnapika, Gayitri Sankarnarayan","doi":"10.1007/s12663-023-01986-5","DOIUrl":"10.1007/s12663-023-01986-5","url":null,"abstract":"<p><strong>Introduction: </strong>Tempormandibular Joint (TMJ) Disorders require early diagnosis with a prompt and effective treatment. Arthrocentesis has been found to be a valuable treatment aid for patients with early stage internal derangement of temporomandibular joints. The use of this procedure has been well documented in literature and had been performed for decades. Arthrocentesis under local anaesthesia can be performed in two different techniques i.e Single puncture and Double puncture techniques.</p><p><strong>Aims and objectives: </strong>Our study was done to show the effectiveness of each of these techniques in aiding the patient as well as time taken to perform this procedure. Our study compares the two techniques to allow us to draw a proper conclusion on which can be put to use for better and less traumatic treatment of these patients.</p><p><strong>Materials and method: </strong>For this study 50 patients with Internal Derangement, group A was 25 patients that were treated with Arthrocentesis of 200 ml RL using OnePrick TMJ Arthrocentesis System with Single Puncture technique and group B consisted of 25 patients who were treated with Arthrocentesis of 200 ml RL using Double Puncture technique.</p><p><strong>Result: </strong>We found a significant increase in maximal mouth opening in patients undergoing arthrocentesis regardless of the technique. Comparison of mean duration of surgery performed among different groups were assessed using sample T test. Mean duration of technique A is around 17.18 minutes whereas for technique B is 20.90 minutes. The mean difference for two techniques performed is -3.722 with P value of 0.001. In technique A 24% of subjects needed additional lavage whereas in techniques B it is 20 %. On an average, total of 22 % of subjects needed additional lavage for better results. The resultant p value is around 0.733.</p><p><strong>Discussion: </strong>The traditional double puncture technique involves the insertion of two needles into the upper joint space. Difficulties in accurate triangulation, positioning of the needle, and frequent intraoperative needle dislocations lead to longer operating times and are often encountered with the double puncture technique. On comparing the two arthrocentesis techniques in terms of easiness to operator a study done showed the group treated with single needle techniques found it easier than the double needle technique. The difference between groups was significant. The mean difference for two techniques performed was seen to be above three minutes in our study which was statistically significant.</p><p><strong>Conclusion: </strong>Single needle technique is advantageous in the fact that it takes a shorter duration to perform, is less invasive and easier for the operator to complete successfully.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41741005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-11-19DOI: 10.1007/s12663-023-02039-7
K Mustafa, Shehzana Fatima, M V Ashith, Jay Nandkishor Goyal, Amrutha Varshini, Aafreen Aftab
Introduction: Primary cleft lip repair techniques do not address the nasal deformity adequately resulting in nasal asymmetry. Maneuvers employed to minimize this have varying degrees of success.
Aim: To assess the outcome of different treatment modalities employed to establish nasal symmetry in unilateral cleft lip.
Methods: 100 patients with complete unilateral cleft lip/ palate operated for primary cheiloplasty with modified Millard's rotation advancement technique were divided into five groups. Group 1: lip repair alone, Group 2: NAM followed by lip repair, Group 3: lip repair followed by placement of conformers, Group 4: NAM followed by lip repair and placement of conformers, Group 5: lip repair with semi-open rhinoplasty. Objective assessment was done using measurable parameters after 12 months post-operatively on a 1:1 standard photograph.
Results: Group 5 showed statistical significance in all parameters assessed. Progressive improvement in nasal symmetry was noted from Group 1 to Group V.
Conclusion: In our study, group V, i.e., modified Millard's repair with semi-open rhinoplasty improved the results in terms of all the objective parameters assessed. The results of the other groups showed improvement though not consistent in all parameters. Naso-alveolar molding is an effective adjunct. Additionally, nasal conformers proved to be of great value in retaining the results obtained post-surgery.
{"title":"Treatment Modalities to Achieve Nasal Symmetry in Unilateral Cleft Lip/Nasal Deformity: An Objective and Comparative Evaluation.","authors":"K Mustafa, Shehzana Fatima, M V Ashith, Jay Nandkishor Goyal, Amrutha Varshini, Aafreen Aftab","doi":"10.1007/s12663-023-02039-7","DOIUrl":"https://doi.org/10.1007/s12663-023-02039-7","url":null,"abstract":"<p><strong>Introduction: </strong>Primary cleft lip repair techniques do not address the nasal deformity adequately resulting in nasal asymmetry. Maneuvers employed to minimize this have varying degrees of success.</p><p><strong>Aim: </strong>To assess the outcome of different treatment modalities employed to establish nasal symmetry in unilateral cleft lip.</p><p><strong>Methods: </strong>100 patients with complete unilateral cleft lip/ palate operated for primary cheiloplasty with modified Millard's rotation advancement technique were divided into five groups. Group 1: lip repair alone, Group 2: NAM followed by lip repair, Group 3: lip repair followed by placement of conformers, Group 4: NAM followed by lip repair and placement of conformers, Group 5: lip repair with semi-open rhinoplasty. Objective assessment was done using measurable parameters after 12 months post-operatively on a 1:1 standard photograph.</p><p><strong>Results: </strong>Group 5 showed statistical significance in all parameters assessed. Progressive improvement in nasal symmetry was noted from Group 1 to Group V.</p><p><strong>Conclusion: </strong>In our study, group V, i.e., modified Millard's repair with semi-open rhinoplasty improved the results in terms of all the objective parameters assessed. The results of the other groups showed improvement though not consistent in all parameters. Naso-alveolar molding is an effective adjunct. Additionally, nasal conformers proved to be of great value in retaining the results obtained post-surgery.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-12-05DOI: 10.1007/s12663-023-02053-9
Nalla Viveka Vardhan Reddy, Abhinand Potturi, Ritesh Rajan, Dinesh Jhawar, Y W Bharath Bhushan, Anitha Pasupuleti
Introduction/background: Perfect facial symmetry has always been considered a hallmark of beauty, but, is almost elusive in nature. However, clinically evident skeletal facial asymmetry on the other hand is quite common, which can result from congenital deformities, developmental abnormalities, secondary to maxillofacial trauma and it is an entity maxillofacial surgeons deal with on a regular basis. Surgical correction of facial asymmetry is challenging, as it not only involves the correction of the skeletal asymmetry for an aesthetic outcome, but, also the improvement of the soft tissue drape and dental occlusal harmony. This results in rehabilitation of functional components of orofacial complex like speech, deglutition and phonation.
Objective: With this paper, we intend to throw a light on this challenging aspect of maxillofacial surgery, along with giving the next generation of maxillofacial surgeons a direction to explore the topic further.
Conclusion: Meticulous evaluation and diagnosis of the patient's problems with latest diagnostic methods like 3-dimensional imaging and surgical treatment with orthognathic surgery, gap arthroplasty or distraction osteogenesis, utilizing cutting edge 3-D virtual planning will result in better outcomes.This review will collate the information available in the literature, along with the authors' recommendations for better planning and execution of this challenging puzzle of facial asymmetry.
{"title":"Facial Asymmetry-Demystifying the Entity.","authors":"Nalla Viveka Vardhan Reddy, Abhinand Potturi, Ritesh Rajan, Dinesh Jhawar, Y W Bharath Bhushan, Anitha Pasupuleti","doi":"10.1007/s12663-023-02053-9","DOIUrl":"https://doi.org/10.1007/s12663-023-02053-9","url":null,"abstract":"<p><strong>Introduction/background: </strong>Perfect facial symmetry has always been considered a hallmark of beauty, but, is almost elusive in nature. However, clinically evident skeletal facial asymmetry on the other hand is quite common, which can result from congenital deformities, developmental abnormalities, secondary to maxillofacial trauma and it is an entity maxillofacial surgeons deal with on a regular basis. Surgical correction of facial asymmetry is challenging, as it not only involves the correction of the skeletal asymmetry for an aesthetic outcome, but, also the improvement of the soft tissue drape and dental occlusal harmony. This results in rehabilitation of functional components of orofacial complex like speech, deglutition and phonation.</p><p><strong>Objective: </strong>With this paper, we intend to throw a light on this challenging aspect of maxillofacial surgery, along with giving the next generation of maxillofacial surgeons a direction to explore the topic further.</p><p><strong>Conclusion: </strong>Meticulous evaluation and diagnosis of the patient's problems with latest diagnostic methods like 3-dimensional imaging and surgical treatment with orthognathic surgery, gap arthroplasty or distraction osteogenesis, utilizing cutting edge 3-D virtual planning will result in better outcomes.This review will collate the information available in the literature, along with the authors' recommendations for better planning and execution of this challenging puzzle of facial asymmetry.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138808896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-01-06DOI: 10.1007/s12663-022-01834-y
Avapati Pravallika, Col Suresh Menon, M E Sham, S Archana, Sheron Mathews
Condylar hyperplasia is a rare pathology characterised by excessive bone growth that presents virtually unilaterally, resulting in facial asymmetry. The aetiology of this disorder is not well understood. This pathology has been reported to be a rare entity with very few cases being reported in the literature, mostly seen between 11 and 30 years of age, with males and females being equally affected and having no predominance to the left or right side. It has also been reported to be a self-limiting condition, that is, the active growth can cease at any point in time. We report two cases of unilateral condylar hyperplasia in 24- and 19-year-old male and female patients, where the first was treated by condylectomy and BSSO, and the latter was treated by high condylectomy and recontouring of the mandible.
{"title":"Condylar Hyperplasia: Case Report and Literature Review.","authors":"Avapati Pravallika, Col Suresh Menon, M E Sham, S Archana, Sheron Mathews","doi":"10.1007/s12663-022-01834-y","DOIUrl":"10.1007/s12663-022-01834-y","url":null,"abstract":"<p><p>Condylar hyperplasia is a rare pathology characterised by excessive bone growth that presents virtually unilaterally, resulting in facial asymmetry. The aetiology of this disorder is not well understood. This pathology has been reported to be a rare entity with very few cases being reported in the literature, mostly seen between 11 and 30 years of age, with males and females being equally affected and having no predominance to the left or right side. It has also been reported to be a self-limiting condition, that is, the active growth can cease at any point in time. We report two cases of unilateral condylar hyperplasia in 24- and 19-year-old male and female patients, where the first was treated by condylectomy and BSSO, and the latter was treated by high condylectomy and recontouring of the mandible.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46462685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-06-03DOI: 10.1007/s12663-023-01917-4
Georges Khoury, Stephanie Mrad, Joseph Bassil, Nabil Ghosn, Ronald Younes
Purpose: A buccal bone thickness (BBT) of at least 1.8-2 mm is necessary to ensure long-term implant stability, and a bone grafting procedure is commonly needed to restore this BBT. This study aims to prove the effectiveness of a novel bone augmentation technique in which minero-organic bone substitutes are solely used to restore adequate BBT, excluding the need for coverage membranes.
Methods: Fifty partially edentulous patients having a residual bone width ranging between 5 and 6 mm were enrolled in this study. The horizontal buccal defects were grafted simultaneously at implant placement. Minero-organic collagen bovine bone blocks (CBBB) were placed on the outer side of the buccal bone wall, and adapted to the defect morphology through slow compressive movements. The grafted sites were not covered with any type of membrane nor stabilized with fixation pins. Cone-beam computed tomography scans were obtained pre-operatively, immediately post-surgery, and four months later. Scans were superimposed on the ITK-Snap software to measure the amount of bone gain and assess the percentage of CBBB resorption. Measurements were effectuated at four different levels apically to crestal level.
Results: Radiographic findings showed BBT increase and CBBB resorption in all cases, four months post-grafting. A mean horizontal bone gain of 1.39 mm was calculated at a crestal level.
Conclusion: Based on these findings, it appears that this novel and user-friendly bone grafting technique can achieve positive outcomes from both clinical and radiographic perspectives.
{"title":"A New Concept of Horizontal Bone Augmentation Using Collagen Bovine Bone Blocks Without Membrane at Implant Placement: A Preliminary Study.","authors":"Georges Khoury, Stephanie Mrad, Joseph Bassil, Nabil Ghosn, Ronald Younes","doi":"10.1007/s12663-023-01917-4","DOIUrl":"10.1007/s12663-023-01917-4","url":null,"abstract":"<p><strong>Purpose: </strong>A buccal bone thickness (BBT) of at least 1.8-2 mm is necessary to ensure long-term implant stability, and a bone grafting procedure is commonly needed to restore this BBT. This study aims to prove the effectiveness of a novel bone augmentation technique in which minero-organic bone substitutes are solely used to restore adequate BBT, excluding the need for coverage membranes.</p><p><strong>Methods: </strong>Fifty partially edentulous patients having a residual bone width ranging between 5 and 6 mm were enrolled in this study. The horizontal buccal defects were grafted simultaneously at implant placement. Minero-organic collagen bovine bone blocks (CBBB) were placed on the outer side of the buccal bone wall, and adapted to the defect morphology through slow compressive movements. The grafted sites were not covered with any type of membrane nor stabilized with fixation pins. Cone-beam computed tomography scans were obtained pre-operatively, immediately post-surgery, and four months later. Scans were superimposed on the ITK-Snap software to measure the amount of bone gain and assess the percentage of CBBB resorption. Measurements were effectuated at four different levels apically to crestal level.</p><p><strong>Results: </strong>Radiographic findings showed BBT increase and CBBB resorption in all cases, four months post-grafting. A mean horizontal bone gain of 1.39 mm was calculated at a crestal level.</p><p><strong>Conclusion: </strong>Based on these findings, it appears that this novel and user-friendly bone grafting technique can achieve positive outcomes from both clinical and radiographic perspectives.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43054513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}