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J.-L. Béziat B. Babic S. Ferreira A. Gleizal 《Revue de stomatologie et de chirurgie maxillo-faciale》2009,110(6):323-326
Introduction
Our aim was to study the reliability of sagittal split osteotomy and Le Fort I osteotomy respectively, and to try to judge objectively the impact of their order for the final result of bimaxillary osteotomy.Patients and method
Fifty patients were included. For each we calculated the errors generated by sagittal split osteotomies on one hand and Le Fort I osteotomy on the other hand, by performing a peroperative splint after each osteotomy.Results
After sagittal split osteotomies changes in the anteroposterior direction were present in 74% of cases with an average amplitude of 0.32 mm. They were less frequent in the transversal direction, 54% of cases, with a smaller amplitude (0.19 mm). After Le Fort I osteotomy, there was no difference in 92% of cases with an average error of 0.02 mm in the anteroposterior direction. No errors were observed in the transverse direction.Discussion and conclusion
Le Fort I positioning is remarkably accurate contrary to the sagittal split. Using Le Fort I osteotomy first and mandibular sagittal split second has for drawback to perpetuate the errors of the sagittal split. The reverse order, beginning with the mandible, allows correction of sagittal split mistakes with the Le Fort I osteotomy. So it seems that the latter order is more logical and preferable. 相似文献8.
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Steve M Ernenwein D Chaine A Bertolus C Goudot P Ruhin-Poncet B 《Revue de stomatologie et de chirurgie maxillo-faciale》2011,112(5):286-292
Introduction
Osteosarcoma (OS) is the most frequent bone malignant tumor. It is usually found on long bones, 5 to 10% are located on jaws, accounting for 0.5 to 1% of all facial tumors. There is little published data which concerns only few patients. Our aim was to study retrospectively cases of facial bone OS in adults, and to compare our results with published data to suggest an optimal management scheme.Patients and method
Thirty-three patients were managed for an OS, from January 1997 to January 2007. Fourteen patients with a maxillary and mandibular OS, treated in first-intention in our unit, were included. The following data were analyzed: age; personal history; circumstance of discovery; clinical, functional, and physical signs; loco-regional extension and metastasis radiological investigation. The histological slides were systematically reviewed. The protocol, therapeutic outcome, and follow-up were studied.Results
The mean age at diagnosis was 43. Swelling was the most frequent functional sign. The mean delay before management was 3.4 months. The most frequent radiological presentation was a lytic and hyperdense image. The diagnosis was suggested after CT scan in 57.1% of cases. The biopsy was correlated to the anatomopathological analysis in 78.6% of cases. The most common treatment was surgical exeresis completed by chemotherapy. The 5-year survival rate was 50%.Discussion
Jaw OS are specific because of their localization and specific bone ultrastructure. Their management remains controversial: should they be managed like limb OS or treated more specifically? Neoadjuvant chemotherapy, even if it delays exeresis for 3 months, seems to stop the growth or reduce the tumor. An early anatomopathological analysis of the surgical piece determines adjuvant therapy. The negative prognostic factors are: maxillary localization because of limited exeresis margins, tumoral size, and osteoblastic sub-type. 相似文献12.
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S. Nitassi M. Oujilal M. Boulaich L. Essakalli M. Kzadri 《Revue de stomatologie et de chirurgie maxillo-faciale》2009,110(6):350-352