单侧唇裂术后鼻畸形的二期整复

目的：观察单侧唇裂术后鼻畸形二期整复手术的效果。方法：选择自1997年3月－2001年2月在本科求医的单侧唇裂术后鼻畸形患者中的78例，全部采用鼻小柱基部的飞鸟形切口进路行鼻翼软骨内侧脚上移悬吊术，进行鼻畸形的二期整复，结果：所有病例术后鼻外形有明显改善，鼻小柱居中，双侧鼻孔大小基本相等，鼻翼鼻底丰满，鼻尖高挺。结论：鼻小柱基部飞鸟形切口进路的患侧鼻翼软骨内侧脚上移悬吊术是单侧唇裂术后鼻畸形的二期整复有效的手术方法之一。     

单侧完全性唇裂修复术同期矫正鼻畸形疗效观察

目的探讨婴幼儿单侧完全性唇裂I期修复术同期矫正鼻畸形的手术方法、可行性及其疗效。方法对5l例单侧完全性唇裂患儿采用Millard I或Ⅱ式手术方法修复唇裂,同期对其鼻畸形进行初步矫正,包括：恢复患侧鼻翼脚的水平高度,使之与健侧对称;重建患侧鼻底形态;延长患侧的鼻小柱长度;恢复患侧鼻嵴和鼻孔大小;鼻外形均得到改善。结果所有患儿均随访36～48个月,患侧鼻翼外侧脚上提内移,鼻小柱变长。所有患儿均未明昆增加术后瘢痕,随访期间均未出现患侧鼻翼发育障碍所致畸形加重。结论单侧完全性唇裂患儿均伴有较严晕的鼻畸形,在I期唇裂修复术同期矫正鼻畸形可以在不增加附加切口的情况下,获得更佳的畸形矫正疗效,患儿术后鼻部的美观和对称性可得到进一步改善,对患侧鼻部的发育未见明显影响。     

先天性唇裂整复理论与技术的现代走势

本文将现行的先天性唇裂整复理论与技术归纳总结为以功能基质学说为指导的整复理论与技术、以复位解剖标志为指导的整复理论与技术和以几何学解析结果为指导的整复理论与技术,并对各类方法的整复理论与技术要点作了介绍,为认识唇裂畸形的特点和整复方法提供了新的途径。     

应用双侧唇红黏膜滑行瓣修复双侧唇裂术后唇珠缺失5例报告

目的: 评价双侧唇裂术后唇珠缺失修复中应用双侧唇红黏膜滑行瓣再造唇珠的疗效。方法: 收集我科2015年3月—2017年5月收治的双侧唇裂术后唇珠缺失患者5例,男2例,女3例;年龄7~26岁,中位年龄13岁,平均14岁。于全麻下行双侧唇畸形矫正术,术中同期设计双侧唇红黏膜滑行瓣向下方滑行、转移再造唇珠,以达到再造唇珠、消灭口哨畸形的目的。结果: 术后切口均一期愈合,随访2~26个月,唇珠形态稳定,未再出现口哨畸形。整体上唇形态满意。结论: 双侧唇裂术后继发唇珠缺失、口哨畸形的修复方法较少,在唇红黏膜上保留原来需要被切除的瘢痕组织并通过适当修整、滑行、重建再造唇珠,消灭口哨畸形,可以得到稳定满意的效果,值得临床推广应用。     

唇缘红唇瓣在单侧唇裂红唇整复中的临床观察

目的:探求一种实用的修复单侧唇裂唇峰及唇珠的手术方法。方法:25例单侧唇裂患者应用旋转健侧唇缘红唇瓣重建唇峰唇珠。在术后第7天,由3名专科医师进行主观和客观评价。结果:所有患者健、患侧唇峰对称,唇红饱满,唇珠明显,干湿线(红线)恢复整齐。对称性的客观评价数值大多数在0.91～1.10之间,接近正常人群。结论:旋转健侧唇缘红唇瓣,能够较好地恢复单侧唇裂的红唇解剖结构。术式设计简单,定点明确具体,手术效果良好,是一种可靠实用的单侧唇裂红唇修复术式。     

Comparative Aesthetic Evaluation of Lip Reconstruction Using Abbe’s Flap in Secondary Cleft Lip Deformities: A Retrospective Study

AimTo objectively evaluate the surgical outcome of deformed cleft lip treated by Abbe’s flap using Digimizer image analysis software.MethodsFifteen Abbe’s flap (AF) reconstruction cases with satisfactory photographic records were acquired in Digimizer image analysis software. Anthropometric landmarks were marked on the lip. Bilateral lip lengths, height and width were measured preoperatively and postoperatively after AF reconstruction for comparison.ResultsIt was observed that by AF reconstruction, we could increase vermillion lip length and Cupid’s bow width, hence providing adequate bulk to the middle of the lip. In addition to it, in some cases we could achieve the acceptable anatomy of the centre of the Cupid’s bow with which it was sometimes disturbed during primary cheiloplasty. Lip length and lip height became proportionately equal bilaterally, leading to adequate lip symmetry in all cases.ConclusionComputer-assisted anthropometric analysis of photographs using Digimizer image analysis software (MedCalc Software, Belgium) demonstrates that AF lip reconstruction technique produces aesthetic lip consistently.     

提高双侧唇裂整复效果的理论与技术要点

为了改善双侧唇裂的初期整复效果,笔者在观察双侧唇裂术前、术后畸形特点的基础上,有针对性地建立了双侧唇裂整复基本准则,形成了新的整复理论与手术设计方法,并对手术技术等作了较大的改进,初步形成具有一定特色的理论与技术方法．实现了提高双侧唇裂整复效果的目的．     

单侧唇裂鼻翼软骨组织学观察

目的:探讨单侧唇裂鼻畸形的形成机制,为唇裂鼻整形提供理论基础。方法:单侧唇裂流产胎儿标本1具,解剖双侧鼻翼软骨,并于鼻翼软骨内1/2处、穹隆角、外1/2处、外1/4处垂直于软骨长轴切开,水平包埋,常规组织学处理,HE染色,进行图像分析。结果:内侧角1/2处与穹隆脚处膜边和中央细胞面积、周长、等效圆直径等测量值,健患侧间无显著性差异。外侧角1/2处与1/4处膜边和中央细胞的上述指标健患侧间有差异,患侧各项均小于健侧。健侧软骨4个部位间发育无差异,而患侧间有差异。结论:单侧唇裂患侧鼻翼软骨的外侧脚细胞发育差于内侧脚及中间脚处。     

Assessment of Deformities of the Lip and Nose in Cleft Lip Alveolus and Palate Patients by a Rating Scale

Introduction  

Labial and nasal deformities have always been a fundamental problem in the treatment of cleft lip, alveolus and palate patients. The primary surgical treatment of nasolabial area is of paramount importance in order to obtain both an esthetical correction of the deformity and a progressive and a balanced development of mid-face. In this study the nasal deformities in patients with cleft lip, alveolus and palate (CLAP) were analyzed and the relevant role of the perinasal, perioral muscular balance and the inborn dislocation of the alar cartilages are presented.     

A determination of occlusal plane comparing different levels of the tragus to form ala-tragal line or Camper's line: A photographic study

PURPOSE

The purpose of this study was to determine accurately the part of the tragus to be used to form the Ala-Tragal line or Camper''s line in orthognathic profile patients.

MATERIALS AND METHODS

150 dentate subjects with age of 18-40 years with orthognathic profile were sampled. Life-size lateral digital photographs of the face with fox plane were taken in natural head position. Different angles between Eye-Ear plane and occlusal plane (OT₁-OP), Eye-Ear plane and ala-superior border of tragus (OT₁-AT₁), Eye-Ear plane and ala-middle border of tragus (OT₁-AT₂) and Eye-Ear plane and ala-inferior border of tragus (OT₁-AT₃) were calculated using computer software package, AutoCAD 2004. From the three angles formed by the Eye-ear plane (OT₁ or FH plane) and the ala-tragal lines, the one closest to the angle formed between Eye-Ear plane (OT₁) and occlusal plane (OP) was used to determine the occlusal plane of orientation. The obtained results were subjected to ANOVA F test, Tukey''s Honestly significant difference test, followed by Karl Pearson coefficient of correlation test. P values of less than 0.05 were taken as statistically significant.

RESULTS

The mean of base line angle i.e. OT₁-OP angle (11.96 ± 4.36) was found to be close to OT₁-AT₂ angle (13.67 ± 1.93) and OT₁-AT₃ angle (10.31 ± 2.03), but OT₁-OP angle was found to be more closer to OT₁-AT₃ angle. Comparison of mean angles showed that OT₁-OP angle in both males (11.68) and females (12.51) is close to OT₁-AT₃ angle (males- 11.01, females- 11.95).

CONCLUSION

The line joining from ala to the lower border of the tragus was parallel to the occlusal plane in 53.3% of the subjects. There was no influence of the sex on the level of occlusal plane.     

The Role of Systemic Condition in the Management of Maxillofacial Infections

Ludwig’s Angina is a rare type of facial infection which formerly invariably was fatal but now with adequate surgical and antibiotic treatment has a much reduced mortality. In spite of the recent advances in therapy, rare and potentially life threatening complications may still arise from time to time and as a result account for significant morbidity and mortality. A case of Ludwig’s angina reported at A.B Shetty Memorial Institute of Dental Sciences, Mangalore, India resulting in fatality, in spite of surgical and antibiotic treatment, due to underlying systemic condition and involvement of multiple resistant organisms. The condition was worsened by subsequent esophageal rupture and death occurred due to multiple organ failure.     

Adequate Reporting of Dental Diagnostic Accuracy Studies is Lacking: An Assessment of Reporting in Relation to the Standards for Reporting of Diagnostic Accuracy Studies Statement

ObjectiveThe objective of this study was to assess the quality of reporting of full-text articles of dental diagnostic accuracy studies published in eight leading speciality dental journals in relation to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement.MethodsThe full articles of all included studies were assessed for their adherence to the 30-item STARD checklist by two researchers independently. A score of 0-2 was attributed to each item. Inter-rater agreement was assessed. Univariate and multivariate linear regression analyses were carried out to evaluate differences in reporting qualities between journals and whether certain variables influenced reporting qualities.ResultsA total of 145 articles were identified. Full-article STARD checklist items relating to methodology and results were poorly reported. The overall mean quality score for full articles was 28.75. Articles published in the Journal of Cranio-Maxillofacial Surgery obtained the highest quality score. In the multivariate analysis, articles published in the Journal of Cranio-Maxillofacial Surgery had significantly higher reporting quality scores than those published in the European Journal of Orthodontics (β = ?6.97, 95% confidence interval [CI]: ?11.62, ?2.30, P < .05), the Journal of Prosthetic Dentistry (β = ?8.01, 95% CI: ?14.60, ?1.41, P < .05) and Oral Diseases (β = ?6.72, 95% CI: ?11.57, ?1.86, P < .05). Reporting quality improved each year (P < .028).ConclusionAdherence of full articles to the STARD is suboptimal in dental journals.     

Analysing chin prominence in relation to the lower lip: The lower lip-chin prominence angle

The purpose of this investigation is to describe a potentially useful analysis in assessing the required extent of sagittal chin augmentation or set-back, by relating chin prominence to lower lip position using the ‘lower lip-chin prominence angle’. The secondary aim was to quantitatively evaluate the influence of this angle on perceived attractiveness and desire for surgery. Having described this angular analysis, a quantitative evaluation was undertaken by incrementally altering the angle on an idealised profile image to create a range of images that were rated on a 7-point Likert scale by a pre-selected group of pre-treatment orthognathic patients, clinicians and laypeople. In treatment planning alterations in chin prominence, an ‘ideal’ sagittal position with soft tissue pogonion on or just behind a true vertical line through the most prominent point of the lower lip may be used. Chin retrusion or prominence up to an angle of 15° retrusion to ?5° prominence is deemed acceptable. Surgery is desired from chin prominence of greater than ?15° and retrusions greater than 25°. The greater the retrusion or prominence of the chin from an angle of 0°, the less the perceived attractiveness and the greater the desire for surgical correction.     

A Study to assess the awareness and use of Silver Diammine Fluoride and Hall Technique among dental professionals and dental students in the Eastern Province

BackgroundA major shift has occured in the trend of dealing with dental caries from primary to secondary prevention, specially after SDF approval off-label by US FDA in recent years and Hall Technique (HT) in the last decade.ObjectivesTo determine the frequency of awareness and use of Silver Diammine Fluoride (SDF) and Hall technique among dental professionals in the Eastern province of Saudi Arabia.MethodsThis cross-sectional study was conducted in a public hospital, metropolitan city of Middle Eastern region between March 15, 2019 & January 31, 2020. Dental practitioners were requested, with their consent, to fill up a digitally designed survey. Chi-square test on SPSS-20.0 was applied to compare frequency of awareness and use of SDF and HALL Technique among the survey participants.ResultsThe awareness of SDF was found to be 73.6% among specialists, 54.9% among graduates and 29.6% among students whereas awareness of HALL technique for stainless steel crown in pediatric dentistry was found statistically similar in all participants groups i.e. 42.7% in students, 55.5% in graduates and 54.9% in specialist group (p = 0.125).ConclusionThe results show potential with regards to awareness of dental specialists & postgraduate residents but inadequate among general dentists and students though all were keen advocates and found committed to its use to help the community. It points towards a further need of the of education for all groups. Those non- invasive techniques are very useful tools in general but specifically during Covid-19 pandemic where they can play a major role in preventing the spread of infection, arresting decay, alleviating pain and anxiety without resorting to aggressive treatment like pulp treatment/extraction. Low response rate may be improved in future through the respondents’ counselling and regular follow up.