Simultaneous osteotomy of the maxilla and the mandible in correction of pronounced mandibular prognathism

Pronounced mandibular prognathism was corrected by simultaneous movement of the maxilla and the mandible in a 19-year-old male patient. Good aesthetic and functional results were achieved. The standardized modified osteotomy techniques, carried out in this case, are discussed.     

Surgical correction of an equine deviated anterior maxilla

The surgical correction of midfacial deformities of the horse have rarely been undertaken. This article describes the successful management of a submucous cleft of the maxilla in a young colt. Details of the operative and perioperative medical and surgical management are described. The horse, now 5 years of age, has sired eight normal progeny.     

Surgical correction of a median cleft of the mandible

We report a rare case of a boy with median clefts of the lower lip and mandible. In addition, there was a fibrous band extending from the symphysis of the mandible to the suprasternal notch. We repaired the mandibular cleft using autologous iliac bone grafts. The separated mandibular bones were reconnected by rigid fixation with titanium miniplates. Z-plasty with cervical skin was also performed. The fibrous band extending from the mandibular symphysis to the suprasternal notch was dissected. The suprasternal notch end of the band was cut off, and a fibrous soft-tissue pedicled superior flap was formed. The flap was turned over and transferred to the mental region subcutaneously to correct the microgenia. The appearance of this child was greatly improved by this procedure.     

经口内途径方颌畸形的外科矫治

对２８例方颌形的Ｘ线片进行测量分析,并采用经口内途径下颌角及部分嚼肌切除成形术进行矫治,一些患者还辅以颏成形术获得满意矫治效果。文章对这类畸形的临床和Ｘ线表现特征,手术方法和注意事项进行了详细讨论。     

Congenital fusion of the maxilla and mandible

Congenital fusion of the maxilla and mandible (syngnathia) is rare and can present in a wide range of severity from single mucosal bands (synechiae) to complete bony fusion (synostosis). Congenital synostosis of the mandible and maxilla is even less common than synechiae, with only 25 cases reported in the literature. Most of them presented as an incomplete, unilateral fusion. A 4-year-old boy was referred to the authors' emergency unit with asphyxia after vomiting. The authors found the child could not open his mouth. His upper and lower jaws were fused, with only a 2- to 3-mm gap in the anterior part. X-rays and computed tomography scans showed that there was a bony fusion of the ramus of the mandible to the zygomatic complex and the posterior part of the maxilla. In addition, there was significant mandible hypoplasia. After performing an osteotomy (to treat the fusion between the bilateral ramus mandible, maxilla, and zygoma), the authors performed a temporomandibular joint reconstruction using a silicon block. After the completion of these procedures, they observed that the mouth could be opened 32 mm. After 2 years of mandibular lengthening performed with an external distracter, the patient's facial appearance and occlusion became more acceptable. An extremely rare case is described, and the existing literature is reviewed.     

Congenital unilateral fusion of the maxilla and mandible

We present an uncommon severe first branchial arch congenital malformation, in which complete unilateral bony fusion between the maxillary and mandibular processes was found in a newborn exposed to carbamazepine medication all through pregnancy. This condition interferes with oral feeding, intubation, growth and development. In a review of previously reported cases it was found that this anomaly was commonly associated with other abnormalities. The etiology of this malformation was uncertain in our case, as carbamazepine was not proven to be the definite cause.     

The skeletal and dentoalveolar stability of the maxilla after LeFort I osteotomy for cant correction

Objectives: The aim of this study was to assess the stability of the maxilla after LeFort I osteotomy for correction of maxillary canting caused by skeletal or dentoalveolar disorders.

Methods: The patients underwent conventional LeFort I osteotomy for correction of maxillary canting. Frontal cephalograms were obtained before surgery (T1), immediately after surgery (T2) and more than 1 year after surgery (T3). The angles between the line connecting bilateral latero-orbitales (Lo-Lo^′) and zygoma planes (ZPs) or occlusal planes (OPs) were measured, and the distances from the Lo-Lo^′ or ZP to the left and right upper first molars were also measured to assess skeletal or dentoalveolar disorders at three time points (T1-T3).

Results: In cases in which the Lo-ZP was more than 2^° before surgery (T1), the Lo-ZP changed from 2.28^° (T1) to 1.57^° (T2) or 1.50^° (T3). In cases in which the Lo-ZP changed less than two degrees and the Lo-OP changed more than 2^°, the Lo-OP changed from 2.69^° (T1) to 1.41^° (T2) or 1.08^° (T3), and these changes were significant. Lo-ZP was nearly stable across the time points. The distances from the Lo-Lo^′ or ZP to left and right upper first molars were nearly stable from T2 to T3.

Conclusion: Skeletal and dentoalveolar stabilities were obtained regardless of whether the canting was caused by skeletal or dentoalveolar disorder.