Orthognathic surgery and aligners. A comparative assessment of periodontal health and quality of life in postsurgical orthodontic treatment with aligners versus traditional fixed appliances:a randomized controlled trial

Removable clear aligners have become very popular in the last few decades, but they are still little used in the field of orthognathic surgery (OS). The objective of this study was to compare periodontal health and quality of life (QoL) associated to postsurgical orthodontic treatment. Patients with dentofacial deformities undergoing OS were randomly allocated to receive postsurgical orthodontic treatment with either fixed orthodontic appliances or Invisalign. The main outcomes were periodontal health and QoL. Plaque index, probing depth and bleeding on probing were assessed as periodontal health indicators. QoL was assessed through the Orthognathic Quality of Life Questionnaire (OQLQ-22) and the Oral Health Impact Profile (OHIP-14). Data were analyzed before surgery and end of treatment. Total duration of treatment was also recorded. Twenty-eight patients were randomized, (16 women, 12 men). Periodontal assessment showed better outcomes for the Invisalign group: bleeding on probing (p=0.013), plaque index (p=0.001) and probing depth (p<0.001). The QoL questionnaires showed significant differences in favor of the Invisalign group: OHIP-14 (p=0.004) and OQLQ-22 (p=0.002). Total duration of treatment was similar in both groups (p=0.575). Compared to traditional orthodontics with fixed appliances, patients managed with clear aligners after OS (surgery-first approach) had better periodontal health and QoL outcomes

Desarrollo de una placa de osteosíntesis personalizada como técnica de fijación y posicionamiento simultáneo del maxilar superior en osteotomías tipo Lefort I en cirugía ortognática

En este estudio se desarrolla una técnica de posicionamiento y fijación para osteotomías tipo Lefort I en cirugía ortognática. En concreto, se lleva a cabo una prueba de concepto de diseño de una placa de osteosíntesis multifunción customizada. Inicialmente se han analizado parámetros influyentes en la morfología y situación de la placa, según lo cual se ha diseñado la placa. Este diseño se ha validado mediante la impresión 3D de prototipos plásticos y ha sido validado por un cirujano maxilofacial especialista en cirugía ortognática. El resultado del diseño CAD (Computer-Aided Design) de la placa de osteosíntesis ha sido exitoso y se ha completado en un tiempo aceptable para una cirugía electiva. Gracias a las características de la placa se prevé que aumente la precisión del procedimiento y que, por tanto, se obtengan mejores resultados clínicos

Desarrollo de una placa de osteosíntesis personalizada como técnica de fijación y posicionamiento simultáneo del maxilar superior en osteotomías tipo Lefort I en cirugía ortognática

En este estudio se desarrolla una técnica de posicionamiento y fijación para osteotomías tipo Lefort I en cirugía ortognática. En concreto, se lleva a cabo una prueba de concepto de diseño de una placa de osteosíntesis multifunción customizada. Inicialmente se han analizado parámetros influyentes en la morfología y situación de la placa, según lo cual se ha diseñado la placa. Este diseño se ha validado mediante la impresión 3D de prototipos plásticos y ha sido validado por un cirujano maxilofacial especialista en cirugía ortognática. El resultado del diseño CAD (Computer-Aided Design) de la placa de osteosíntesis ha sido exitoso y se ha completado en un tiempo aceptable para una cirugía electiva. Gracias a las características de la placa se prevé que aumente la precisión del procedimiento y que, por tanto, se obtengan mejores resultados clínicos

Giant aneurysmal bone cyst of the mandible with unusual presentation

Aneurysmal bone cysts are rare benign lesions of bone tissue, infrequent in craneofacial skeleton with regard to other structures like long bones or the spine. They are composed of sinusoidal and vascular spaces blood-filled and surrounded by fibrous tissue septa. We present a case of a 29-year-old Caucasian male with a big swelling in the left mandible associated to pain and rapid growth. He referred previous extraction of the left inferior third molar. On the X-ray study, an expansive multilocular and high vascularized bony lesion within the mandibular angle was observed. It produced expansion and destruction of lingual and buccal cortex. An incisional biopsy was performed showing a fibrous tissue with blood-filled spaces lesion suggestive of an aneurysmal bone cyst. After selective embolization of the tumour, surgical resection was done with curettage and immediate reconstruction of the defect with an anterior iliac crest graft. Aneurysmal bone cysts are non-neoplastic but locally aggressive tumours with occasional rapid growth that may be differenciated from other multilocular process like ameloblastoma, ossifying fibroma, epithelial cyst, giant cell granuloma and sarcomas. Treatment of choice consists on conservative surgical excision of the mass with curettage or enucleation. When resection creates a big defect, primary surgical reconstruction is recommended

Jacob's disease secondary to coronoid process osteochondroma. A case report

The formation of a new joint between a pathologically elongated coronoid process and the body of the malar homolateral bone is known as Jacob's disease. Coronoid process hyperplasia was first described in 1853 by Von Langenbeck, and it was not until 1899 when Oscar Jacob described the disease that it was named after him. Jacobs's disease is an uncommon entity with only a few documented cases in the literature. The condition first manifests with progressive limitation of mouth opening and facial asymmetry. Pain is uncommon and it mainly affects young patients. Different factors have been postulated as possible causes, including temporal muscle hyperactivity, previous trauma, chronic disc displacement of the ipsilateral temporomandibular joint, endocrine stimuli, and genetic alterations. Definitive diagnosis is by histopathology and it is necessary to confirm bone hyperplasia, the presence of cartilage and synovial capsule forming the new joint between the malar bone and the coronoid process. We report a 52-year-old woman patient with a history of childhood trauma in the right preauricular region. She came to our department with a 2-year history of progressive limitation of mouth opening. Computed tomography (CT) revealed a right coronoid process elongation, in contact with the homolateral malar bone, causing it to deform. Surgery with general anesthesia was performed using an intraoral vestibular approach. Histopathology confirmed the diagnoses of Jacob's disease. © Medicina Oral S. L

El titanio como material de fijación en cirugía ósea facial: análisis clínico y anatomopatológico

Tesis doctoral inédita leida en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Cirugía. Fecha de lectura: 25-3-199

El titanio como material de fijacion en cirugia osea facial Analisis clinico y anatomopatologico

Centro de Informacion y Documentacion Cientifica (CINDOC). C/Joaquin Costa, 22. 28002 Madrid. SPAIN / CINDOC - Centro de Informaciòn y Documentaciòn CientìficaSIGLEESSpai