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Andreas Naros Bassem Bayazeed Ulrich Schwarz Heiner Nagursky Siegmar Reinert Rainer Schmelzeisen Sebastian Sauerbier 《Journal of cranio-maxillo-facial surgery》2019,47(2):233-238
Purpose
The aim of the present study was the histomorphometric and cephalometric comparison of autogenous bone grafting of the anterior iliac crest and the application of bovine bone substitute concerning new bone formation and postoperative stability in patients undergoing orthognathic Le Fort I osteotomy.Patients and methods
Twenty-five patients requiring orthognathic surgery with Le Fort I osteotomy were included in this study. Patients were randomly divided into three groups receiving either autogenous iliac crest BONE grafting (BONE; n = 8) or xenogenic bovine bone grafting (Bio-Oss®) in INTER (n = 12) or in ONLAY (n = 5) position. Histomorphometric analysis was performed using trephine bone biopsies from the autogenous, respectively xenogenic bone grafting region. Postoperative stability was evaluated using teleradiographies of three different timepoints.Results
All groups showed comparable mineralized fractions in bone biopsies of 50.2% (±13.2%) INTER, 46.48% (±12.3%) ONLAY and 57.1% (±20.6%) BONE as well as comparable percentage of connective tissue. Patients in the INTER-group revealed the lowest relapse rate of 20.5% (INTER) compared to 30.3% (ONLAY) and 33.0% (BONE). All groups underwent comparable maxillary advancement and healing time.Conclusions
Present results indicate that block shaped bovine bone substitute is a promising alternative to autogenous bone grafting to bridge the Le Fort I osteotomy gap in orthognathic surgery. 相似文献3.
Sunil Richardson Shreya Krishna Rakshit V. Khandeparker 《Journal of cranio-maxillo-facial surgery》2018,46(2):356-361
Aim
To describe a comprehensive management protocol to treat cleft maxillary hypoplasia specific to the patient's age, degree of hypoplasia and presence or absence of velopharyngeal incompetence (VPI).Materials and methods
A total of 359 patients suffering from cleft maxillary hypoplasia were retrospectively studied from January 2004 till June 2015. Lateral cephalograms were taken to assess the degree of deformity and advancement achieved at three intervals. Patients were treated by four treatment modalities: Facemask therapy, Anterior maxillary advancement, Total maxillary osteogenesis and LeFort I advancement.Results
359 patients of cleft maxillary hypoplasia were treated and followed up for a mean of 25 ± 3.6 months. Group I had 20 patients, all in the pre-pubertal age group with less than 11 mm discrepancy. 25% of patients in this group had relapse; Group II: 196 patients who were all above 11 years of age and included all grades of hypoplasia, only 6.25% patients had relapse; Group III had 36 patients all with severe form of hypoplasia and were above 5 years of age. Relapse in this group was 16.6%; Group IV had 102 patients who were above 16 years of age and had mildmoderate severity of hypoplasia. Relapse rate was 18.75%.Conclusion
Extensive literature search and our institutional study has helped us formulate a protocol that delineates the most appropriate treatment modality for a specific age group and degree of hypoplasia also considering the effect of treatment on velopharyngeal incompetence. 相似文献4.
Michael Engel Moritz Berger Jürgen Hoffmann Reinald Kühle Thomas Rückschloss Oliver Ristow Christian Freudlsperger Katinka Kansy 《Journal of cranio-maxillo-facial surgery》2019,47(3):420-430
Introduction
Le Fort III distraction osteogenesis with a rigid external distraction device is a powerful procedure to correct both exorbitism and impaired airways in faciocraniosynostosis. The aim of this study was to investigate treatment effect, perioperative parameters and volumetric outcomes after Le Fort III distraction osteogenesis in patients with Crouzon syndrome in a retrospective study design and to explore potential strengths and weaknesses of this procedure.Materials and methods
From June 2013 to February 2015, a total of nine children with Crouzon syndrome underwent Le Fort III distraction osteogenesis with a rigid external distraction device (RED device, KLS Martin, Tuttlingen, Germany). Along with perioperative parameters, sleep study reports, traditional cephalometric analysis, three-dimensional imaging and photographs were evaluated for severity of disease and therapeutic effect and structural and functional changes of the upper airway preoperatively, after device removal and one year postoperatively.Results
Surgery for Le Fort III distraction was performed at a median age of 12.5 years (SD 2.5 months) with an average weight of 43.0 kg (SD 12.9 kg). Mean estimated blood loss was 535.7 ml (SD 128.1 ml), not requiring any red blood cell transfusions. Mean duration of surgery was 240 min (SD 30.6min), average hospital stay eight days (SD 0.5 days) with a planned median ICU stay of 1.7 days (SD 0.4 days) for all patients.There were a total of five minor complications. Exorbitism and Angle class III malocclusions were corrected in all patients. No patient showed velopharyngeal problems postoperatively. The average amount of distraction was 18.4 mm (14–26 mm). Average length of the distraction period was 18.3 days (SD 0.4 days), with a total distraction plus consolidation time of three months (SD 0.25 months). In two patients, vector correction was performed during distraction. A counterclockwise movement despite vector correction, clinically resulting in an open bite, was observed in one of these two patients. Eight of the nine patients showed a frontal overbite at the end of the distraction period.Cephalometric analysis revealed a significant increase of Sella-Nasion-Point A angle (SNA) from 76.0° (+/? 2.9; T1) to 86.0° (+/? 3.4; T2) (p = 0.006) and growth-related point A-Nasion-point B angle (ANB) from ?4.8° (+/?3.7) to 5.7° (+/?4.8) (p = 0.001) from preoperatively to device removal and stable results one year postoperatively.Upper airway structure and respiratory function were improved clinically after the Le Fort III DO treatment in all cases with an average posterior airway space increase from 3199 mm3 (+/? 229.6 mm3) to 8917,7 ml (+/?415.1 mm3) (T1 to T2).Surgical outcome was judged good to excellent both by patients and families and the craniofacial team.Conclusion
Le Fort III DO with a rigid external distraction device in patients with Crouzon syndrome is a powerful and reliable surgical procedure that reliably produces a more significant change of appearance than most other single procedures routinely performed by craniofacial surgeons. It effectively treated sleep apnea in the affected patients. In our collective, the maxilla remained stable after advancement without any relapse, but there was no subsequent anterior growth on one year follow-up. Careful vector planning was able to avoid frontal open bite in eight patients. Complication rates were acceptably low and patients’ functional and esthetic outcome was high. 相似文献5.
Kasper Stokbro Søren Wiatr Borg Morten Østergaard Andersen Torben Thygesen 《Journal of cranio-maxillo-facial surgery》2019,47(3):394-399
Purpose
Selective laser melting used to manufacture patient-specific 3D-printed (PSP) plates is a delicate process, which may introduce weakened areas in the plates, with risk of fracture. This in vitro study's purpose was to test the ability of PSP plates to stabilize Le Fort I osteotomies compared with manually adapted stock plates. The study's objectives were to measure the force needed to compress the osteotomy and evaluate whether the PSP plates would break during compression.Materials and methods
This controlled in vitro study evaluated the maxillary stability using the clinical data from 7 patients. The virtually planned maxillary reposition was 3D-printed in 2 copies, and the osteotomy gap was fixated by either PSP plates or stock plates. The models were compressed until the Le Fort I osteotomy gap was eliminated. The primary outcome was the force needed to compress the model. The primary predictor variable was a comparison between PSP and stock plates. Secondary outcome measurements were the slope of elastic modulus, yield point, and force needed for 2 mm compression. Statistical testing was performed by Wilcoxon signed-rank test with significance level at P ≤ 0.05.Results
The PSP plates performed better than stock plates in all outcome measurements. None of the plates broke during compression despite forces of more than 4000 N. The first point of failure in PSP plates was the first screw cranial to the osteotomy. In comparison, the first point of failure in stock plates was in the plates’ bend at the osteotomy.Conclusion
In this in vitro setup, the Le Fort I osteotomies fixated with PSP plates were more stable than the osteotomies fixated with conventional stock plates. No adverse effects occurred during testing of PSP plates; thus, PSP plates seem to be a safe alternative to stock plates and may even be preferable. 相似文献6.
Sarah A. Attia Hesham A. Helal Amir S. El Barabary Mostafa A. Awad Mahmoud M. Sherif 《Journal of cranio-maxillo-facial surgery》2019,47(2):255-262
Background
Although the role of nasalis muscle in the establishment of nasal deformity is well recognized; its abnormal anatomy and role in the correction of alar deformity in cleft lip patients have not been adequately studied. This work aimed to study the effect of nasalis muscle repair on the postoperative nasal symmetry.Patients and methods
A controlled prospective randomized study was conducted on 45 cases of unilateral complete pre-alveolar cleft. Patients were divided into two groups; Group 1 (repair of the Orbicularis muscle only), Group 2 was further divided into 2 subgroups: Subgroup A (repair of the orbicularis oris muscle and dissection and repair the origin of the nasalis muscle). Subgroup B (repair of the orbicularis oris muscle and dissection of both origin and abnormal insertion of the nasalis and repair of the origin). Evaluation was conducted both subjectively and objectively through cleft lip evaluation profile and nostril angles measurement.Results
Group 2B patients showed significantly better shape and symmetry of nasal tip, size and symmetry of nostrils and size, form and lateral displacement of the ala. Objective evaluation showed that group 2B had the closest results to the non-cleft side, with statistically significant difference, when compared to other groups.Conclusion
Dissection and repair of both origin and insertion of nasalis muscle produced a nasal width, columellar height, and nasal tip projection close to the normal population of the same age. 相似文献7.
Maurice Y. Mommaerts Karsten KH. Gundlach Ana Tache 《Journal of cranio-maxillo-facial surgery》2019,47(1):143-148
Purpose
This study served to evaluate a two-stage concept in cleft palate repair, including key use of a triangular hinge (“flip-over”) flap, in order to prevent palatal fistulae. It uses data from a prospective registry established in 1991.Materials and methods
The concept entails Furlow soft palate repair (at 1 year of age) and hard palate closure (at 4 years) by a three-pronged approach [paring of the edges with or without postero-lateral relaxing incisions, peninsula (Veau) flap(s)], plus a triangular hinge flap. The latter is elevated from the oral layer of the already-repaired soft palate, stays based anteriorly, and is flipped over to close the posterior nasal layer defect. The case series is compared with data from the literature.Results
The palatal fistula rate for Veau II to IV types (two-stage surgeries) was 4.3%. The overall fistula rate in the cleft population (Veau I–IV) was 2.9%. Meta-analyses describe 4.9 and 8.6% on average. There was no difference between sample A in which the flip-over flaps were used only when modified Veau flaps were indicated (until 2006) and sample B in which it was used regardless of the technique of hard palate closure applied (2006–2018). The fistula rate decreased to zero after 2010, which may reflect also an influence of other factors such as the interpositioning of a collagen membrane and also of improved surgical judgment.Conclusions
Using a flip-over flap in two-stage cleft palate repair may contribute to prevent fistula formation at the hard/soft palate junction.Level of evidence
III. 相似文献8.
Amin Norouzi Gerald Chi Shahrooz Shafaee Fard Mehdi Sezavar Farzin Sarkarat Vahid Rakhshan Farima Kahe 《Journal of cranio-maxillo-facial surgery》2018,46(9):1480-1483
Purpose
Exposure of sclera below the iris in natural head positions is aesthetically undesirable. Studies on post-surgical changes in inferior scleral exposure following orthognathic surgery are scarce and mostly retrospective. The aim of this clinical trial is to examine the effect of Le Fort I osteotomy, a procedure for correction of malocclusion and maxillo-mandibular deformities, on the inferior scleral exposure and overall scleral surface area in skeletal class III patients.Materials and methods
This trial was performed on 40 eyes of 20 skeletal class III patients undergoing Le Fort I osteotomy without impaction (n = 20 eyes) and with impaction (n = 20 eyes). Standard true-size frontal photography was performed pre-operatively and post-operatively at 6 months. After measuring the overall eye height and the height of visible inferior sclera, the ratio of inferior sclera to overall eye height (S:E) was calculated three times. Also, overall surface area of the sclera was measured three times. The average of three attempts was considered the main measurement. Changes in the sclera after the surgery and between both methods were compared.Results
The average age of patients (9 men, 11 women) was 24.5 years. Age and gender were balanced between the two groups (P > 0.05). S:E ratios decreased in both groups after surgery (P < 0.05, Wilcoxon test). The decrease was greater in the impaction group (P < 0.05, Mann–Whitney test). Similar results were observed for overall sclera surface areas.Conclusion
Maxillary advancement, with or without impaction, reduced the inferior scleral exposure and overall scleral surface area. The effect was more pronounced in the impaction group. 相似文献9.
Shajidan Kelimu Mariko Hattori Shataer Awuti Mahmoud E. Elbashti Yuka I. Sumita Hisashi Taniguchi 《The Journal of prosthetic dentistry》2019,121(4):671-675
Statement of problem
A palatogram aids prosthodontists and speech pathologists in evaluating the precise prosthetic treatment needed and the effectiveness of such treatment to improve speech intelligibility. Powder is commonly used to visualize tongue-palate contact, where wetted areas of powder in the oral cavity reveal such contact during palatography. However, discomfort and the risk of aspiration are among the shortcomings of this method, and an improved method is needed.Purpose
The purpose of this in vitro study was to examine the feasibility of a new method of palatography that uses airborne-particle–abraded acrylic resin so that wet areas can be easily distinguished from dry areas.Material and methods
Seventy-two specimens of heat-polymerized acrylic resin were prepared in 6 different resin colors. After the specimens had been airborne-particle abraded, CIELab color values for each specimen were measured using a colorimeter under dry and wet conditions and recorded. Color difference (ΔE) was then computed, and a paired Student t test, 1-way analysis of variance, and multiple comparison using the Tukey post hoc analysis were applied (α=.05).Results
A significant color difference was found between the 2 conditions in all acrylic resin specimens examined. Mean ΔE ranged from 5.58 to 6.76.Conclusions
The results indicated that an airborne-particle–abraded acrylic resin surface can show color differences made by wetting on palatograms. 相似文献10.
Namiko Kimura Etsuro Nozoe Takako Okawachi Kiyohide Ishihata Takao Fuchigami Norifumi Nakamura 《Journal of cranio-maxillo-facial surgery》2019,47(2):245-254
Purpose
To analyze three-dimensional (3D) nasolabial forms and upper lip surface symmetry after primary lip repair in children with unilateral cleft lip and palate (UCLP).Methods
Subjects were 22 Japanese children with complete UCLP who underwent primary lip repair and were followed-up for 4–6 years. The 3D coordinates of facial landmarks and the angle and radius of the approximate nasal alar circle were calculated. Upper lip surface symmetry was analyzed using histogram intersection.Results
The nasal tip and columella base were slightly dislocated to the cleft side, and the midpoint of Cupid's bow shifted to the non-cleft side. The nasal alar and the top of Cupid's bow were reconstructed at the same height, while the approximate nasal alar circle was smaller on the cleft side. The mean value of similarity for upper lip surface symmetry was 0.82; a subject with a higher value had more symmetrical contour lines in the visualized surface image.Conclusions
Postoperative nasolabial forms were almost restored to symmetrical levels, while retaining a small nasal alar. Histogram intersection is applicable as a method for the quantitative evaluation of upper lip surface symmetry in UCLP. 相似文献11.
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Eriko Matsunaka Shingo Ueki Kiyoko Makimoto 《Journal of cranio-maxillo-facial surgery》2019,47(4):570-577
Background
Immediately after cleft lip repair, breastfeeding and bottle-feeding are generally restricted to avoid placing tension on the surgical incision. However, no consensus about feeding methods after cleft lip repair has been reached. The objective of this systematic review was to examine the impact of breastfeeding and/or bottle-feeding on surgical wound dehiscence after cleft lip repair in infants.Material and methods
We searched PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Mednar from October to November 2017. Two reviewers independently assessed eligibility for inclusion and checked critical appraisal of the study quality.Results
Three randomized controlled trials and two cohort studies involving 342 infants were included in this review. Two cases of surgical wound dehiscence occurred in the control group of alternative feeding. In three of five studies, surgical wound dehiscence did not occur in either the intervention or control group within the first week postoperatively.Conclusions
This review showed no increased risk of surgical wound dehiscence in infants with breastfeeding and/or bottle-feeding after cleft lip repair compared with infants with alternative feeding methods. It may not be necessary to restrict breastfeeding and/or bottle-feeding immediately after cleft lip repair. 相似文献13.
Nabil Ben Bouhjar Johannes Kleinheinz Dieter Dirksen Philipp Berssenbrügge Christoph Runte Kai Wermker 《Journal of cranio-maxillo-facial surgery》2019,47(5):741-749
Purpose
Patients with cleft lip, alveolus and palate (CLAP) may suffer from marked asymmetry with an impact on attractiveness and psychosocial aspects. The aim of this study was to assess symmetry in CLAP patients compared to non-cleft controls of similar age with regard to cleft type and treatment concept.Materials and methods
In CLAP patients with different cleft forms and in healthy non-cleft subjects (control group) a three-dimensional stereophotogrammetric face scan was performed and an objective 3D asymmetry index (AI) was calculated for the whole face, the midface, the upper lip and the nose.Results
In total, 305 patients were included: 140 CLAP patients (90 male, 50 female, mean age 9.9 ± 3.6 years) and 165 controls (87 male, 78 female, mean age 8.7 ± 2.1 years). In general, CLAP patients showed significantly higher asymmetry than controls, with the most severe asymmetry found in unilateral complete CLAP. Patients treated according to an actual concept considering reconstruction of all affected muscular systems had a significant lower and more favourable AI than patients not treated according to this concept (p < 0.05).Conclusion
An adequate treatment concept is essential to achieve better results concerning symmetry in CLAP, but symmetry values of healthy non-cleft controls are not reached. 相似文献14.
Afisu A. Oladega Olutayo James Wasiu L. Adeyemo 《Journal of cranio-maxillo-facial surgery》2019,47(1):93-98
Aim
The aim of the study was to compare postoperative sequelae and wound healing outcome following closure of surgical wound with either cyanoacrylate tissue adhesive or silk suture.Methods
Subjects with mesio-angularly impacted mandibular third molar were allocated randomly into 2 equal groups. The control group had wound closure with silk suture and study group with cyanoacrylate tissue adhesive. Subjects were followed up for 7 postoperative days. Postoperative pain, swelling, trismus, bleeding, wound dehiscence and wound infection were evaluated.Results
Sixty subjects in each group completed the study. No significant difference was observed in the mean postoperative pain, swelling, trismus, wound dehiscence and infection between the 2 groups. There was a statistically significant difference in postoperative bleeding between the 2 groups on postoperative day 1, with more bleeding in the control group.Conclusions
This study shows that cyanoacrylate tissue adhesive compares favourably with silk suture as a wound closure material. In addition, cyanoacrylate tissue adhesive seems to have beneficial haemostatic effect on postoperative bleeding. 相似文献15.
Rodrigo Fariña Salvador Valladares Araceli Raposo Francisco Silva 《Journal of cranio-maxillo-facial surgery》2018,46(5):837-843
Purpose
There are multiple conditions that may affect the development of the middle third of the face and with varying degrees of severity. The surgical treatment alternatives for major midfacial sagittal deficiencies consist in Le Fort I, II, or III with conventional osteotomies or with distraction osteogenesis (DO). Both techniques have advantages and disadvantages that should be evaluated specifically in each case. The aim of this report is to present a group of patients with severe hypoplasia of the middle third of the face, with different origins, and their treatment with a Modified Le Fort III osteotomy and distraction osteogenesis, using a minimally invasive surgical approach.Materials and methods
The surgical technique was performed in a group of patients with severe hypoplasia of the middle third of the face, through a transconjunctival approach with lateral canthotomy and a trans-oral approach. The osteotomy consisted of a Le Fort III without the nasofrontal component. A rigid external distractor (RED) type II or internal distractor was installed. The amount of distraction, surgical time, blood loss, and complications were evaluated.Results
A total of 7 patients underwent operation, 5 men and 2 women with an average age of 20.8 (range 11–41) years; 3 patients with Crouzon syndrome, 2 with Pfeiffer syndrome, 1 patient with cleft lip and palate sequel, and 1 with a severe non-syndromic class III. The average follow-up was 3.14 years. All patients achieved stable occlusion without postoperative changes, positive overbite and overjet, without relapse in the skeletal position. The average advancement was 14.7 (±4.07) mm, in 1.1 incisors, and 15.2 (±3.19) in point A. The average time of surgery was 2.78 (±0.64) hours, with an average blood loss of 240 (±48.6) ml. Four patients required a rhinoplasty in a secondary surgery.Conclusion
This technique shows a surgical approach with low morbidity, short surgery time, and low blood loss. It allows optimal resolution of severe hypoplasia of the middle third of the face with long-term stability. It avoids the use of grafts and osteosynthesis material. By not including the nasal pyramid in the osteotomy design, the size, position, and nasofrontal angle in patients with adequate facial balance is maintained. If nasal correction is necessary, a second surgery may be done. In cases of asymmetrical hypoplasia of the middle third, this osteotomy shows great versatility and can be done unilaterally and/or simultaneously combined with other distractions. 相似文献16.
Na-Rae Choi Sang-Hun Shin Seong-Sik Kim George Sandor Yong-Deok Kim 《Journal of cranio-maxillo-facial surgery》2018,46(10):1828-1833
Background
To evaluate maxillary stability following Le Fort I osteotomy using postero-superior movement after pterygoid plate fracture. Additionally the authors sought to analyze the postoperative changes at the intentional pterygoid plate fracture site.Materials and methods
Thirty-six patients with class III deformities treated with total maxillary setback at the Lefort I level were enrolled in a retrospective cohort study. Relative changes in measurement points were identified on cone-beam computed tomographic scans (CBCT) as well as lateral cephalograms. The outcome variables were determined as changes at measurement points obtained preoperatively, immediately postoperatively, and 6 months after surgery.Results
The average posterior repositioning of ANS in the 36 patients was 1.78 mm and the mean superior repositioning at PNS was 2.78 mm. The maximal recurrence rate was less than 10% at the 6 months postoperative time point. The intentional fracture site of the pterygoid plates healed with a linear pattern. There were no major complications such as airway edema, hemorrhage and nerve damage reported over the 6-month follow-up period.Conclusions
Intentional fracture of the pterygoid plates has a role in the retropositioning of the maxilla with good healing at the fracture site, little relapse and satisfactory postoperative stability. 相似文献17.
Bing Guo Yu-an Cao Xingjun Qin Chunyue Ma 《Journal of cranio-maxillo-facial surgery》2019,47(5):826-831
Purpose
Cystadenocarcinoma (CAC) is an extremely rare disease in parotid gland. This study aimed to identify the clinical characteristics of CAC, and the therapeutic options for its treatment. An attempt was also made to identify postoperative recurrence-related risk factors.Material and methods
A retrospective study was conducted of CAC patients treated between 2008 and 2018. Predictive factors for postoperative recurrence (5-year RFS rate) were preliminarily filtered by Kaplan–Meier analysis and then further confirmed by a Cox regression model. Postoperative recurrence was defined as the primary outcome variable and was measured using both univariate and multivariate analysis.Results
A total of 27 patients were analyzed, and the total incidence of postoperative recurrence was 33.3% (9/27). In the Cox regression analysis, patients who received a superficial parotidectomy were 0.046 times more likely to develop tumor relapse than those who only underwent enucleation (p = 0.032; 95% CI: 0.003–0.070). The chances of tumor recurrence in patients with the cribriform subtype were 9.701 times that for cases with a papillary pattern (p = 0.016; 95% CI: 1.517–62.030). The risk of postoperative recurrence increased abruptly, with an OR of 6.373 (p = 0.042; 95% CI: 1.070–37.965), when LN metastasis was found in patients.Conclusion
Preoperative diagnosis of CAC in parotid gland is extremely important for allowing surgeons to apply appropriate therapeutic strategies (enucleation or superficial parotidectomy). Patients with LN metastasis, cribriform pattern, and Ki-67 positivity should be treated further to avoid tumor relapse. 相似文献18.
Sameh Attia Jörg Wiltfang Philipp Streckbein Jan-Falco Wilbrand Thaqif El Khassawna Katharina Mausbach Hans-Peter Howaldt Heidrun Schaaf 《Journal of cranio-maxillo-facial surgery》2019,47(5):786-791
Purpose
Microvascular fibula flap surgery is a reliable and effective procedure for reconstructing the jaws after tumour surgery. This procedure allows the placement of dental implants after bone consolidation. This study was designed to evaluate the oral, functional, and aesthetic rehabilitation of tumour patients with immediate fibula transfer and dental implants and included assessment of diet, speech, and aesthetics.Materials and methods
The study included 34 patients who underwent ablative tumour surgery and immediate jaw reconstruction using a fibula free flap with consecutive rehabilitation by dental implants. In total, 134 implants were inserted into the transferred fibula. The functional and aesthetic results were assessed using a questionnaire. Implant loss and oral excursion were compared with diet type, speech ability, functionality, and patient satisfaction.Results
Of the 34 patients included in this study, 33 completed the questionnaire. Twenty-six patients (76%) could eat normally without the limitation of a hard or soft diet, 73% could speak intelligibly, and 31 rated the aesthetic result from good to excellent.Conclusion
The fibula flap with the early application of endosseous implants allowed primary immediate reconstruction of the jaw, significantly leading to functional and aesthetic satisfaction in patients who underwent ablative tumour surgery. 相似文献19.
Peter Balon Aleš Vesnaver Andrej Kansky Miha Kočar Luka Prodnik 《Journal of cranio-maxillo-facial surgery》2019,47(1):60-65
Purpose
The aim of this study was to analyse treatment results after alloplastic temporomandibular joint replacement surgery.Materials and methods
Twelve patients who met the inclusion criteria underwent operation between the years 2012 and 2016 at the Department of Maxillofacial and Oral Surgery of the University Medical Centre Ljubljana, Slovenia. Seven patients had posttraumatic sequelae, 4 osteoarthritis and 1 psoriatic arthritis. We inserted 12 temporomandibular joint prostheses (Biomet- Lorenz). A retrograde analysis of the patients, subjective assessment of the pre- and postoperative temporomandibular pain, opening the mouth, the ability to chew food, and quality of life (VAS scale, 0–10) was performed. Additionally, we evaluated the inter-incisal distance pre- and postoperatively. Complications that occurred were also included in our evaluation.Results
During final examinations, at least 15 months after the surgery (on average 39.5 months), we observed an improved ability to open the mouth in all patients. The average preoperative inter-incisal distance was 22 mm (15–30 mm); the average postoperative distance was 37.5 mm (32.3–1.8 mm), (p < 0.001). The analysis of pain and other subjective variables (opening the mouth, the ability to chew, quality of life) showed a statistically significant improvement (p < 0.001).Conclusion
According to our initial experience, replacement of the temporomandibular joint with a total prosthesis is a safe and effective treatment method. 相似文献20.
Niyazi Aizezi Tomohisa Nagasao Tadaaki Morotomi Motoki Tamai Koji Imajo 《Journal of cranio-maxillo-facial surgery》2018,46(5):795-801