Pub Date : 2024-11-01DOI: 10.1016/j.jcms.2024.03.029
Jiansuo Hao , Mohammed Qasem Al-Watary , Yingyou He , Yiyuan Wei , Qing Zhao , Jihua Li
Our study aimed to evaluate a stepwise treatment of class III malocclusion accompanied with flat nasal deformity, using orthodontics, orthognathic surgery, and rhinoplasty, as well as stability during long-term follow-up.
In total, 27 patients with nasomaxillary hypoplasia and skeletal class III malocclusion were enrolled in this study. All patients had accepted orthodontic and orthognathic surgery, followed by rhinoplasty with costal cartilage as the second surgical procedure. Clinical results were evaluated by radiography, medical photography, questionnaire, and cephalometric analysis.
All patients were satisfied with the surgical results and no serious complications occurred. During the follow-up, the patients showed well-corrected midface contour and nasal projection, and stable occlusion. The costal cartilage grafts were well fixed, without obvious absorption deformation. Lateral cephalometric analysis and overlay results showed that the postoperative point A had advanced approximately 5.20 ± 1.43 mm and the SNA angle had increased by approximately 5.59 ± 2.86°. Soft-tissue measurements showed a 14.22 ± 6.56° decrease in the facial lobe, while the nasolabial angle had increased by 16.83 ± 6.65° postoperatively.
The results suggested that stepwise orthodontic-orthognathic surgery and rhinoplasty produce a predictable and stable result in long-term follow-up.
我们的研究旨在评估采用正畸、正颌手术和鼻整形术分步治疗伴有扁平鼻畸形的III类错牙合畸形的方法，以及长期随访的稳定性。本研究共纳入了 27 名鼻颌发育不良和骨骼 III 类错牙合畸形患者。所有患者均接受了正畸和正颌外科手术，并在第二次手术中接受了肋软骨鼻整形术。临床效果通过放射摄影、医学摄影、问卷调查和头颅测量分析进行评估。所有患者对手术效果均表示满意，未出现严重并发症。在随访期间，患者的面中部轮廓和鼻部投影得到了很好的矫正，咬合也很稳定。肋软骨移植固定良好，无明显吸收变形。侧面头颅测量分析和叠加结果显示，术后 A 点前移了约 5.20 ± 1.43 毫米，SNA 角度增加了约 5.59 ± 2.86°。软组织测量结果显示，术后面叶缩小了（14.22 ± 6.56）°，而鼻唇角则增大了（16.83 ± 6.65）°。结果表明，分步正畸-正颌外科手术和鼻整形术在长期随访中能产生可预测的稳定效果。
{"title":"Stepwise surgical management of binder syndrome with skeletal class III malocclusion in adults","authors":"Jiansuo Hao , Mohammed Qasem Al-Watary , Yingyou He , Yiyuan Wei , Qing Zhao , Jihua Li","doi":"10.1016/j.jcms.2024.03.029","DOIUrl":"10.1016/j.jcms.2024.03.029","url":null,"abstract":"<div><div>Our study aimed to evaluate a stepwise treatment of class III malocclusion accompanied with flat nasal deformity, using orthodontics, orthognathic surgery, and rhinoplasty, as well as stability during long-term follow-up.</div><div>In total, 27 patients with nasomaxillary hypoplasia and skeletal class III malocclusion were enrolled in this study. All patients had accepted orthodontic and orthognathic surgery, followed by rhinoplasty with costal cartilage as the second surgical procedure. Clinical results were evaluated by radiography, medical photography, questionnaire, and cephalometric analysis.</div><div>All patients were satisfied with the surgical results and no serious complications occurred. During the follow-up, the patients showed well-corrected midface contour and nasal projection, and stable occlusion. The costal cartilage grafts were well fixed, without obvious absorption deformation. Lateral cephalometric analysis and overlay results showed that the postoperative point A had advanced approximately 5.20 ± 1.43 mm and the SNA angle had increased by approximately 5.59 ± 2.86°. Soft-tissue measurements showed a 14.22 ± 6.56° decrease in the facial lobe, while the nasolabial angle had increased by 16.83 ± 6.65° postoperatively.</div><div>The results suggested that stepwise orthodontic-orthognathic surgery and rhinoplasty produce a predictable and stable result in long-term follow-up.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"52 11","pages":"Pages 1211-1218"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jcms.2024.08.004
Mariam SK. Abdelwahed , Sherif Ali , Ahmed.S. Kamel Abdelwahed , Mohamed M. Aziz , Mohamed S. Bassiouny , Mamdouh S. Ahmed
This prospective study aimed to compare ultra-high molecular weight polyethylene (UHMWPE) with polyetheretherketone (PEEK) in computer-designed patient-specific implants (PSIs) for cranial defect reconstruction, in terms of complications and aesthetic outcomes. Primary or secondary cranioplasty-eligible patients were included, while patients with active infection or hydrocephalus, or unfit for general anesthesia, were excluded from the study. All the implants were designed and fabricated by the same maxillofacial surgeon using CAD/CAM technology.
UHMWPE PSIs were used in group 1 and PEEK PSIs in group 2. Technically, UHMWPE could be milled to a thinner margin thickness than PEEK, which resulted in better handling properties and a smoother end finish. All patients were evaluated over a period of 6 months in terms of overall complications or implant failure as the primary outcome, according to Clavien-Dindo (CVD) grading, and cosmetic satisfaction with the aesthetic results, using a Likert scale, as the secondary outcome.
In total, 22 cranioplasty patients were included, with a mean age of 30.8 years (SD = 16.3). Across both groups, 17 patients (77.3%) did not develop postoperative complications. These occurred in three patients in group 1 (CVD grade I, II, and IIIb) (27.3%) and in two patients in group 2 (CVD grade II, IIIa, and IIIb) (18.2%), with no statistical difference (p = 0.6). None of the cases in both groups developed any clinical or radiographic signs of infection, or suffered implant failure. The mean satisfaction score was 4.8 in group 1 and 4.5 in group 2 (SD = 0.6). The difference in satisfaction scores between the two was not statistically significant (p = 0.23).
Although UHMWPEE was comparable to PEEK in terms of overall complication rates and cosmesis after craniectomy, UHMWPEE as a material exhibited greater resiliency in technically challenging cases with large, complex/midline-crossing designs, previously fitted meshes, or single-stage resection-reconstruction, allowing better marginal adaptation.
{"title":"Cranioplasty using patient specific implants Polyether ether ketone versus ultra-high molecular weight polyethylene: A prospective study","authors":"Mariam SK. Abdelwahed , Sherif Ali , Ahmed.S. Kamel Abdelwahed , Mohamed M. Aziz , Mohamed S. Bassiouny , Mamdouh S. Ahmed","doi":"10.1016/j.jcms.2024.08.004","DOIUrl":"10.1016/j.jcms.2024.08.004","url":null,"abstract":"<div><div>This prospective study aimed to compare ultra-high molecular weight polyethylene (UHMWPE) with polyetheretherketone (PEEK) in computer-designed patient-specific implants (PSIs) for cranial defect reconstruction, in terms of complications and aesthetic outcomes. Primary or secondary cranioplasty-eligible patients were included, while patients with active infection or hydrocephalus, or unfit for general anesthesia, were excluded from the study. All the implants were designed and fabricated by the same maxillofacial surgeon using CAD/CAM technology.</div><div>UHMWPE PSIs were used in group 1 and PEEK PSIs in group 2. Technically, UHMWPE could be milled to a thinner margin thickness than PEEK, which resulted in better handling properties and a smoother end finish. All patients were evaluated over a period of 6 months in terms of overall complications or implant failure as the primary outcome, according to Clavien-Dindo (CVD) grading, and cosmetic satisfaction with the aesthetic results, using a Likert scale, as the secondary outcome.</div><div>In total, 22 cranioplasty patients were included, with a mean age of 30.8 years (SD = 16.3). Across both groups, 17 patients (77.3%) did not develop postoperative complications. These occurred in three patients in group 1 (CVD grade I, II, and IIIb) (27.3%) and in two patients in group 2 (CVD grade II, IIIa, and IIIb) (18.2%), with no statistical difference (<em>p</em> = 0.6). None of the cases in both groups developed any clinical or radiographic signs of infection, or suffered implant failure. The mean satisfaction score was 4.8 in group 1 and 4.5 in group 2 (SD = 0.6). The difference in satisfaction scores between the two was not statistically significant (<em>p</em> = 0.23).</div><div>Although UHMWPEE was comparable to PEEK in terms of overall complication rates and cosmesis after craniectomy, UHMWPEE as a material exhibited greater resiliency in technically challenging cases with large, complex/midline-crossing designs, previously fitted meshes, or single-stage resection-reconstruction, allowing better marginal adaptation.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"52 11","pages":"Pages 1299-1310"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jcms.2024.08.005
Yu-ting Wang , Yue Liu , Guo-hua Ye , Tao Xu , Yi Zhang , Xiao-jing Liu
The aim of this study was to investigate the clinical feasibility of reducing the risk of unfavourable fractures during Le Fort III osteotomy by using a navigation-guided technique. A study was carried out involving 20 patients with Crouzon syndrome treated with Le Fort III osteotomy and distraction osteogenesis from 2018 to 2023 at the International Hospital of Peking University. The Le Fort III osteotomy procedure in experimental group (9 patients) was carried out under the guidance of navigation technique, while in historical control group (11 patients) was carried out by free hand. Immediate postoperative CT scans were acquired within 24h after surgery to observe the osteotomy lines and detect unfavourable fracture lines. There were 4 patients with unfavourable fractures in the navigation group (4/9 = 44%) while 10 patients in the freehand group (10/11 = 91%), with a statistically significant difference in the probability of unfavourable fracture and the number of fracture lines between the two groups (P < 0.05). The difference in unfavourable fracture incidence in the two groups was significant in zygomatic area (P < 0.05) while not significant in mid-palatal area (P > 0.05). And the surgical duration of the navigation group was significantly shorter than that of the freehand group (216 min vs 280 min) (P < 0.05). The above findings suggest that the navigation-guided technique is effective in reducing the risk of unfavourable fractures in Le Fort III osteotomy procedure and decreasing the surgical duration.
本研究旨在探讨在 Le Fort III 截骨术中使用导航引导技术降低不利骨折风险的临床可行性。2018年至2023年，北京大学国际医院开展了一项研究，20名克鲁宗综合征患者接受了Le Fort III截骨术和牵张成骨术治疗。实验组（9 名患者）的 Le Fort III 截骨术在导航技术的指导下进行，而历史对照组（11 名患者）则采用徒手操作。术后 24 小时内立即进行 CT 扫描，以观察截骨线和发现不利的骨折线。导航组有 4 名患者出现不利骨折（4/9 = 44%），而徒手组有 10 名患者出现不利骨折（10/11 = 91%），两组患者出现不利骨折的概率和骨折线数量差异有统计学意义（P 0.05）。导航组的手术时间明显短于徒手组（216 分钟 vs 280 分钟）（P＜0.05）。
{"title":"Reducing the risk of unfavourable fractures in Le Fort III osteotomy via a navigation-guided technique","authors":"Yu-ting Wang , Yue Liu , Guo-hua Ye , Tao Xu , Yi Zhang , Xiao-jing Liu","doi":"10.1016/j.jcms.2024.08.005","DOIUrl":"10.1016/j.jcms.2024.08.005","url":null,"abstract":"<div><div>The aim of this study was to investigate the clinical feasibility of reducing the risk of unfavourable fractures during Le Fort III osteotomy by using a navigation-guided technique. A study was carried out involving 20 patients with Crouzon syndrome treated with Le Fort III osteotomy and distraction osteogenesis from 2018 to 2023 at the International Hospital of Peking University. The Le Fort III osteotomy procedure in experimental group (9 patients) was carried out under the guidance of navigation technique, while in historical control group (11 patients) was carried out by free hand. Immediate postoperative CT scans were acquired within 24h after surgery to observe the osteotomy lines and detect unfavourable fracture lines. There were 4 patients with unfavourable fractures in the navigation group (4/9 = 44%) while 10 patients in the freehand group (10/11 = 91%), with a statistically significant difference in the probability of unfavourable fracture and the number of fracture lines between the two groups (P < 0.05). The difference in unfavourable fracture incidence in the two groups was significant in zygomatic area (P < 0.05) while not significant in mid-palatal area (P > 0.05). And the surgical duration of the navigation group was significantly shorter than that of the freehand group (216 min vs 280 min) (P < 0.05). The above findings suggest that the navigation-guided technique is effective in reducing the risk of unfavourable fractures in Le Fort III osteotomy procedure and decreasing the surgical duration.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"52 11","pages":"Pages 1394-1405"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jcms.2024.08.016
Mosaad Abdaljawwad Khalifah
Although various authors employed various entry points for the double-puncture technique (DPT) for arthrocentesis, the literature is devoid of any comparative studies. Therefore, the current prospective study aimed to evaluate the versatility of these different points. A total of 144 TMJs in 108 patients were included and randomly divided into two categories according to ID stage: category I (disc displacement without reduction with limitation), and category II (disc displacement without reduction without limitation). Patients in every category were randomly divided into 3 groups according to the site of entry point of the second needle: group 1 (20-10 point: 20 mm anterior to the tragus and 2 mm inferior to the cantho-tragus line), group 2 (20-1 point), and group 3 (7-2 point). For all patients, the first entry point was 10-2, and the upper joint cavity was irrigated with 150 ml of Ringer’s solution without subsequent intra-articular injections. Group 3 had better results than group 2 and further than group 1 in categories I and II with regard to the number of second needle relocations, ease of the procedure, duration of the procedure, and nature of the outflow, as well as pain at rest and pain on function at 1, 3, and 6 post-operative months. For the maximum mouth opining, group 3 had better results than group 2 and further than group 1 only in category I. Therefore, techniques depending on the superior posterior entry points (such as 7-2 point) were recommended.
{"title":"A comparative study of the versatility of various entry points for double-puncture TMJ arthrocentesis: A randomized controlled study","authors":"Mosaad Abdaljawwad Khalifah","doi":"10.1016/j.jcms.2024.08.016","DOIUrl":"10.1016/j.jcms.2024.08.016","url":null,"abstract":"<div><div>Although various authors employed various entry points for the double-puncture technique (DPT) for arthrocentesis, the literature is devoid of any comparative studies. Therefore, the current prospective study aimed to evaluate the versatility of these different points. A total of 144 TMJs in 108 patients were included and randomly divided into two categories according to ID stage: category I (disc displacement without reduction with limitation), and category II (disc displacement without reduction without limitation). Patients in every category were randomly divided into 3 groups according to the site of entry point of the second needle: group 1 (20-10 point: 20 mm anterior to the tragus and 2 mm inferior to the cantho-tragus line), group 2 (20-1 point), and group 3 (7-2 point). For all patients, the first entry point was 10-2, and the upper joint cavity was irrigated with 150 ml of Ringer’s solution without subsequent intra-articular injections. Group 3 had better results than group 2 and further than group 1 in categories I and II with regard to the number of second needle relocations, ease of the procedure, duration of the procedure, and nature of the outflow, as well as pain at rest and pain on function at 1, 3, and 6 post-operative months. For the maximum mouth opining, group 3 had better results than group 2 and further than group 1 only in category I. Therefore, techniques depending on the superior posterior entry points (such as 7-2 point) were recommended.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"52 11","pages":"Pages 1311-1318"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jcms.2024.03.031
Enno Lilienthal , Shih-Jan Chin , Reinhard E. Friedrich
The optic nerve canal (ONC) is a fine skeletal structure that contains the optic nerve. However, it has not been thoroughly examined. This necessitates establishing a baseline knowledge of the geometrical and volumetric parameters of the ONC. The data of twenty patients who received a cone beam computed tomography examination were prepared using a voxel-based segmentation. The measurement was performed separately by two examiners on virtual skull models in stereolithography format in Geomagic Wrap®. The results showed that the volume of the ONC varied between 92.48 mm3 and 162.7 mm3 (M = 123.46 mm3, SD = 26.61 mm3). Sex-specific statistically significant differences in volume were detected only for the right side. The angle of the ONC to the skull base was independent of the diameter of the canal. Both the intrarater and interrater comparisons of the measurements showed high values of reproducibility of the results. This study showed that a virtual anatomical model provides a feasible and reliable method to investigate the ONC. The examination technique could have a wider range of application in anthropology and application in clinical medicine. Advances in the automation of radiological diagnostics and the digital analysis of X-ray images could help to reduce examination times.
{"title":"Three-dimensional anatomical analysis of the optic nerve canal with virtual model based on CBCT","authors":"Enno Lilienthal , Shih-Jan Chin , Reinhard E. Friedrich","doi":"10.1016/j.jcms.2024.03.031","DOIUrl":"10.1016/j.jcms.2024.03.031","url":null,"abstract":"<div><div>The optic nerve canal (ONC) is a fine skeletal structure that contains the optic nerve. However, it has not been thoroughly examined. This necessitates establishing a baseline knowledge of the geometrical and volumetric parameters of the ONC. The data of twenty patients who received a cone beam computed tomography examination were prepared using a voxel-based segmentation. The measurement was performed separately by two examiners on virtual skull models in stereolithography format in Geomagic Wrap®. The results showed that the volume of the ONC varied between 92.48 mm<sup>3</sup> and 162.7 mm<sup>3</sup> (M = 123.46 mm<sup>3</sup>, SD = 26.61 mm<sup>3</sup>). Sex-specific statistically significant differences in volume were detected only for the right side. The angle of the ONC to the skull base was independent of the diameter of the canal. Both the intrarater and interrater comparisons of the measurements showed high values of reproducibility of the results. This study showed that a virtual anatomical model provides a feasible and reliable method to investigate the ONC. The examination technique could have a wider range of application in anthropology and application in clinical medicine. Advances in the automation of radiological diagnostics and the digital analysis of X-ray images could help to reduce examination times.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"52 11","pages":"Pages 1219-1227"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jcms.2024.02.005
Jie Liang , Yue Liu , Xiaojing Liu , Yi Zhang , Xiangliang Xu
Purpose
This study aims to investigate the anatomical features relating to nasofrontal and septum osteotomy during Le Fort Ⅲ osteotomy among patients with syndromic craniosynostosis, and to compare them with normal controls using computed tomographic cephalometry.
Materials and methods
A total of 63 subjects were included (syndromic craniosynostosis, n = 21; controls, n = 42). The craniosynostosis subjects were subdivided into group A (craniosynostosis patients without history of previous surgery, n = 8) and group B (craniosynostosis patients with history of previous surgery, n = 13). Cephalometric measurements based on computed tomographic images were analyzed.
Results
The angle between the refencing plane (HP) of the anterior cranial base and the most inferior point of the sphenoid sinus via Nasion (∠HP-N-ISS) was 23.85 ± 3.10°, 21.15 ± 4.64° and 28.32 ± 2.92° for group A, group B and the control group, respectively. The angle between HP and the posterior nasal spine (PNS) via nasion (∠HP- N- PNS) was 42.63 ± 2.02°, 38.50 ± 4.84° and 47.68 ± 2.62° for group A, group B and the control group, respectively.
Conclusion
This study characterized the surgically relevant anatomical features in nasofrontal osteotomy during Le Fort Ⅲ osteotomy. The safe range for osteotomy angle is significantly different between normal and syndromic craniosynostosis subjects. Awareness of this difference may prevent further complications.
目的：本研究旨在调查综合征颅颧突出症患者在 Le Fort Ⅲ 截骨术中鼻额骨和鼻中隔截骨的相关解剖特征，并使用计算机断层扫描头颅测量法与正常对照组进行比较：共纳入 63 名受试者（综合征颅骨发育不良，21 人；对照组，42 人）。颅骨发育不良受试者被细分为 A 组（既往无手术史的颅骨发育不良患者，n = 8）和 B 组（既往有手术史的颅骨发育不良患者，n = 13）。分析了基于计算机断层扫描图像的头颅测量结果：结果：A 组、B 组和对照组的前颅底反折面（HP）与经 Nasion 的蝶窦最下点之间的角度（∠HP-N-ISS）分别为 23.85 ± 3.10°、21.15 ± 4.64°和 28.32 ± 2.92°。A 组、B 组和对照组的 HP 与经鼻孔的后鼻骨脊柱（PNS）之间的角度（∠HP- N- PNS）分别为 42.63 ± 2.02°、38.50 ± 4.84°和 47.68 ± 2.62°：本研究描述了 Le Fort Ⅲ截骨术中鼻额部截骨的相关解剖特征。截骨角度的安全范围在正常人和综合征颅脑发育不良患者之间存在显著差异。认识到这一差异可预防进一步的并发症。
{"title":"A cephalometric study on Le Fort Ⅲ osteotomy related anatomical features of anterior cranial base in syndromic craniosynostosis.","authors":"Jie Liang , Yue Liu , Xiaojing Liu , Yi Zhang , Xiangliang Xu","doi":"10.1016/j.jcms.2024.02.005","DOIUrl":"10.1016/j.jcms.2024.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to investigate the anatomical features relating to nasofrontal and septum osteotomy during Le Fort Ⅲ osteotomy among patients with syndromic craniosynostosis, and to compare them with normal controls using computed tomographic cephalometry.</div></div><div><h3>Materials and methods</h3><div>A total of 63 subjects were included (syndromic craniosynostosis, n = 21; controls, n = 42). The craniosynostosis subjects were subdivided into group A (craniosynostosis patients without history of previous surgery, n = 8) and group B (craniosynostosis patients with history of previous surgery, n = 13). Cephalometric measurements based on computed tomographic images were analyzed.</div></div><div><h3>Results</h3><div>The angle between the refencing plane (HP) of the anterior cranial base and the most inferior point of the sphenoid sinus via Nasion (∠HP-N-ISS) was 23.85 ± 3.10°, 21.15 ± 4.64° and 28.32 ± 2.92° for group A, group B and the control group, respectively. The angle between HP and the posterior nasal spine (PNS) via nasion (∠HP- N- PNS) was 42.63 ± 2.02°, 38.50 ± 4.84° and 47.68 ± 2.62° for group A, group B and the control group, respectively.</div></div><div><h3>Conclusion</h3><div>This study characterized the surgically relevant anatomical features in nasofrontal osteotomy during Le Fort Ⅲ osteotomy. The safe range for osteotomy angle is significantly different between normal and syndromic craniosynostosis subjects. Awareness of this difference may prevent further complications.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"52 11","pages":"Pages 1406-1410"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jcms.2024.03.013
Stefania Troise , Emanuele Carraturo , Umberto Committeri , Simona Barone , Giovanna Norino , Giacomo De Riu , Luigi Angelo Vaira , Vincenzo Abbate , Domenico Mariniello , Luigi Califano , Pasquale Piombino
Most maxillofacial traumas are caused by road traffic collisions and, in particular, by motorcycle accidents. Helmets represent an efficient protective tool in these traumas but they do not provide complete protection. The aim of this study was to perform an epidemiological analysis of facial fractures pattern in relation to the helmet type worn during the accident. The study was a retrospective analysis of 282 patients with a diagnosis of maxillofacial fracture caused by a motorcycle accident. The patients were divided in three groups based on helmet type (Group A: full-face helmet; Group B: modular [half-face] helmet; Group C: open-face helmet). For each group, fractures type and trauma severity, using the Comprehensive Facial Injury (CFI) scale, were recorded. Results showed that isolated midface fractures were strongly related to full-face helmet wearing (p < 0.001), while mandibular fractures and panfacial trauma/combined fractures were negatively correlated (p < 0.001). Mandibular fractures (p < 0.001) and panfacial trauma/combined fractures (p < 0.001) were strongly related to open helmet. Moreover, severe trauma (CFI 8.16) was recorded for open-face helmet wearing. In conclusion, full-face helmet wearing reduced the risk of facial fracture, in particular panfacial trauma/combined fractures, while open-face helmet wearing increased the risk of these fractures.
{"title":"Epidemiological analysis of the facial fractures pattern in relation to motorcycle helmet type: A retrospective study on 282 patients","authors":"Stefania Troise , Emanuele Carraturo , Umberto Committeri , Simona Barone , Giovanna Norino , Giacomo De Riu , Luigi Angelo Vaira , Vincenzo Abbate , Domenico Mariniello , Luigi Califano , Pasquale Piombino","doi":"10.1016/j.jcms.2024.03.013","DOIUrl":"10.1016/j.jcms.2024.03.013","url":null,"abstract":"<div><div>Most maxillofacial traumas are caused by road traffic collisions and, in particular, by motorcycle accidents. Helmets represent an efficient protective tool in these traumas but they do not provide complete protection. The aim of this study was to perform an epidemiological analysis of facial fractures pattern in relation to the helmet type worn during the accident. The study was a retrospective analysis of 282 patients with a diagnosis of maxillofacial fracture caused by a motorcycle accident. The patients were divided in three groups based on helmet type (Group A: full-face helmet; Group B: modular [half-face] helmet; Group C: open-face helmet). For each group, fractures type and trauma severity, using the Comprehensive Facial Injury (CFI) scale, were recorded. Results showed that isolated midface fractures were strongly related to full-face helmet wearing (p < 0.001), while mandibular fractures and panfacial trauma/combined fractures were negatively correlated (p < 0.001). Mandibular fractures (p < 0.001) and panfacial trauma/combined fractures (p < 0.001) were strongly related to open helmet. Moreover, severe trauma (CFI 8.16) was recorded for open-face helmet wearing. In conclusion, full-face helmet wearing reduced the risk of facial fracture, in particular panfacial trauma/combined fractures, while open-face helmet wearing increased the risk of these fractures.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"52 11","pages":"Pages 1319-1324"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jcms.2024.03.007
Orthognathic surgery enables patients with severe jaw malocclusions to normalise their chewing function and, as such, to improve their quality of life. Over the last few years, digitalisation has been set in motion by intraoral scanners and the improvement of planning software in the field of oral and maxillofacial surgery. Previous studies based on plaster cast models showed that the virtual occlusion based on digitally scanned models can be comparable to conventional methods. This retrospective crossover study aimed to prove that the virtual occlusion finding with the IPS CaseDesigner® (version 2.3.5.2, KLS Martin, Tuttlingen, Germany) is accurate enough to use intraoral scans exclusively.
Materials and methods
A total of 23 orthognathic surgery patients receiving an intraoral scan for their treatment were included in this study. Two experienced maxillofacial surgeons haptically performed the occlusion finding on three-dimensional (3D) stereolithographic models using the fully digital pathway. One surgeon repeated the procedure a second time to evaluate intra-observer variability. The study aimed to show the difference between these two planning methods by upholding the surgical accuracy of less than 2 mm in translation and 2° in rotation. The conventional haptic occlusion was set as a reference throughout the whole study. The data were tested with a one-sample Wilcoxon test for the fit into the surgical accuracy.
Results
The difference between the virtual and conventional groups was significantly smaller than the surgical accuracy (all p < 0.001). Both translational movements (anterior/posterior (median 0.51 mm [0.28, 0.88]), left/right (median 0.46 mm [0.20, 0.87]), cranial/caudal (median 0.37 mm [0.11, 0.69])) and rotations (Roll (median 0.71° [0.29, 1.35]), Pitch (median 0.72° [0.29, 1.44]), Yaw (median 1.09° [0.33, 1.60])) were in the range of surgical accuracy (2 mm/2°). The most significant differences were found in the anterior/posterior translation (median 0.51 mm [0.28, 0.88]) and the Yaw rotation (median 1.09° [0.33, 1.60]).
Conclusion
These results demonstrate that the entirely virtual workflow in orthognathic surgery, including intraoral scanning and the virtual semi-automatic occlusion finding, represents a reliable and state-of-the-art alternative to the conventional haptic method.
正颌外科手术使严重颌面畸形患者的咀嚼功能恢复正常，从而提高他们的生活质量。过去几年中，口内扫描仪和规划软件的改进推动了口腔颌面外科领域的数字化进程。之前基于石膏模型的研究表明，基于数字化扫描模型的虚拟咬合可以与传统方法相媲美。这项回顾性交叉研究旨在证明，使用 IPS CaseDesigner®（2.3.5.2 版，KLS Martin，德国图特林根）进行虚拟咬合计算的准确性足以完全取代口内扫描。两名经验丰富的颌面外科医生使用全数字化途径在三维立体模型上进行了咬合测量。一名外科医生第二次重复了这一过程，以评估观察者内部的变异性。该研究旨在显示这两种规划方法之间的差异，即手术精确度在平移和旋转时分别小于 2 毫米和 2°。在整个研究过程中，传统的触觉咬合被设定为参照物。结果虚拟组和传统组之间的差异明显小于手术精确度（所有 p 均为 0.001）。平移（前/后（中位数 0.51 mm [0.28, 0.88]）、左/右（中位数 0.46 mm [0.20, 0.87]）、头颅/尾（中位数 0.37 mm [0.11, 0.69]）和旋转（滚动（中位数为 0.71° [0.29, 1.35]）、俯仰（中位数为 0.72° [0.29, 1.44]）、偏航（中位数为 1.09° [0.33, 1.60]））均在手术精度（2 mm/2°）范围内。）前后平移（中位数 0.51 mm [0.28, 0.88]）和偏航旋转（中位数 1.09° [0.33, 1.60]）的差异最大。
{"title":"Fully digital occlusion planning in orthognathic surgery – A crossover study","authors":"","doi":"10.1016/j.jcms.2024.03.007","DOIUrl":"10.1016/j.jcms.2024.03.007","url":null,"abstract":"<div><div>Orthognathic surgery enables patients with severe jaw malocclusions to normalise their chewing function and, as such, to improve their quality of life. Over the last few years, digitalisation has been set in motion by intraoral scanners and the improvement of planning software in the field of oral and maxillofacial surgery. Previous studies based on plaster cast models showed that the virtual occlusion based on digitally scanned models can be comparable to conventional methods. This retrospective crossover study aimed to prove that the virtual occlusion finding with the IPS CaseDesigner® (version 2.3.5.2, KLS Martin, Tuttlingen, Germany) is accurate enough to use intraoral scans exclusively.</div></div><div><h3>Materials and methods</h3><div>A total of 23 orthognathic surgery patients receiving an intraoral scan for their treatment were included in this study. Two experienced maxillofacial surgeons haptically performed the occlusion finding on three-dimensional (3D) stereolithographic models using the fully digital pathway. One surgeon repeated the procedure a second time to evaluate intra-observer variability. The study aimed to show the difference between these two planning methods by upholding the surgical accuracy of less than 2 mm in translation and 2° in rotation. The conventional haptic occlusion was set as a reference throughout the whole study. The data were tested with a one-sample Wilcoxon test for the fit into the surgical accuracy.</div></div><div><h3>Results</h3><div>The difference between the virtual and conventional groups was significantly smaller than the surgical accuracy (all p < 0.001). Both translational movements (anterior/posterior (median 0.51 mm [0.28, 0.88]), left/right (median 0.46 mm [0.20, 0.87]), cranial/caudal (median 0.37 mm [0.11, 0.69])) and rotations (Roll (median 0.71° [0.29, 1.35]), Pitch (median 0.72° [0.29, 1.44]), Yaw (median 1.09° [0.33, 1.60])) were in the range of surgical accuracy (2 mm/2°). The most significant differences were found in the anterior/posterior translation (median 0.51 mm [0.28, 0.88]) and the Yaw rotation (median 1.09° [0.33, 1.60]).</div></div><div><h3>Conclusion</h3><div>These results demonstrate that the entirely virtual workflow in orthognathic surgery, including intraoral scanning and the virtual semi-automatic occlusion finding, represents a reliable and state-of-the-art alternative to the conventional haptic method.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"52 11","pages":"Pages 1348-1353"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140277169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Role of platelet rich fibrin in neurosensory recovery following bilateral sagittal split osteotomy - A randomized control trial","authors":"Padmaraj Hegde, Vikram Shetty, Saiswarup Badrinath","doi":"10.1016/j.jcms.2024.02.015","DOIUrl":"10.1016/j.jcms.2024.02.015","url":null,"abstract":"","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"52 11","pages":"Pages 1390-1393"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jcms.2024.02.017
Luis Capitán , Daniel Simon , Devin Coon , Javier Gutiérrez Santamaría , Raúl J. Bellinga , Carlos Bailón , Miguel Pérez de Perceval Tara , Thiago Tenório , Fermín Capitán-Cañadas
The soft tissues have a considerable impact on whether the results of facial feminization surgery are favorable. Complications or suboptimal results related to the soft tissue may be due to poor choice of surgical approach, improper execution of the surgical technique, a lack of assistance when resuspending the soft tissues during closure, or deficient readaptation of the overlying soft tissue to the new bone contour. This article identifies the possible poor soft-tissue outcomes that may occur after facial feminization bone surgery, describing strategies to prevent them and treatment alternatives.
{"title":"Soft-tissue complications after facial feminization bone surgery","authors":"Luis Capitán , Daniel Simon , Devin Coon , Javier Gutiérrez Santamaría , Raúl J. Bellinga , Carlos Bailón , Miguel Pérez de Perceval Tara , Thiago Tenório , Fermín Capitán-Cañadas","doi":"10.1016/j.jcms.2024.02.017","DOIUrl":"10.1016/j.jcms.2024.02.017","url":null,"abstract":"<div><div>The soft tissues have a considerable impact on whether the results of facial feminization surgery are favorable. Complications or suboptimal results related to the soft tissue may be due to poor choice of surgical approach, improper execution of the surgical technique, a lack of assistance when resuspending the soft tissues during closure, or deficient readaptation of the overlying soft tissue to the new bone contour. This article identifies the possible poor soft-tissue outcomes that may occur after facial feminization bone surgery, describing strategies to prevent them and treatment alternatives.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"52 11","pages":"Pages 1383-1389"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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