The use of bone-anchored implants for absent ear

The sample of patients analyzed has been selected from 66 cases treated for extraoral bone-anchored implantology at the Plastic and Reconstructive Surgery Department of the "Tor Vergata" University of Rome. Optimal results can be obtained in the ear district because of the low surgical risks and few postsurgical complications. Advantages offered by extraoral bone integrated implants are obvious when compared with more traditional techniques: it is possible to obtain a better cosmetic result only from 2 surgical sessions; and adhesive prosthesis may be better placed without the usual local irritation, achieving a correct positioning. The authors present their experiences in using extraoral implants for the reconstruction of the ear area malformation.     

Occlusal alterations in unilateral coronal craniosynostosis

There are few studies on maxillomandibular skeletal alterations. Twenty-one patients with unilateral coronal craniosynostosis were analysed and compared with controls. Landmarks analysed were: sella-nasion-point A and B angles, point A-nasion-point B angle, interincisal angle, angle of superior incisor axis on the sella-nasion plane, lower incisor to mandibular plane angle, Frankfort mandibular plane angle, zygomatic-frontal suture (Z), point on the most concave part of pyramidal apophysis of the upper maxilla (Mx), antegonial incisure (AG), upper (UMT) and lower (LMT) molar teeth. Differences were significant for class II dentoskeletal occlusion (p < 0.0001), mandibular hyperdivergence (p < 0.0001), lingualization of superior incisor (p < 0.005), deviation of inferior interincisal contralateral line to the synostosis (p < 0.0001) in the plagiocephalic population. Compared with contralateral counterpoints, Z (p < 0.05), Mx (p < 0.005) and UMT (p < 0.0005) on the affected side were closer to the midline; AG (p < 0.0005) and LMT (p < 0.05) were further from it. On the frontal plane, Z, Mx, UMT, LMT and AG on the affected side were higher. Vertical and transversal contraction of the jaw of the synostotic side and laterodeviation of the mandibular interincisal line of the contralateral synostotic were clear. The altered position of the glenoid cavity, anteriorized in unilateral coronal craniosynostosis, could be the cause of mandibular dentoskeletal asymmetry.