Interdisciplinary orthognathic treatment of high angle class III malocclusion

For Class III adult patients, combined treatment strategy must be followed which includes either further dentoalveolar compensation or orthognathic surgery following decompensation of the teeth. This case report presents the interdisciplinary approach of a skeletal Class III malocclusion with increased vertical facial dimension, occlusal cant, extracted posterior teeth on the right upper and left lower segments, extensive restorations, and total circular crossbite. The orthodontic alignment took 10 months. LeFort 1 osteotomy with 7 mm advancement, 5 mm impaction on the left side, 3 mm impaction on the right side and 2 mm rotation for midline correction toward the left side, 3 mm set.back of mandible with bilateral sagittal split osteotomy were done. The surgery simulation, postoperative and 2 year follow up records were compatible. The treatment was finalized in a straight profile with stable occlusion and good smile characteristics without airway disturbance.Key words: Interdisciplinary treatment, orthognathic surgery, skeletal Class II

Prevalence of vitamin D deficiency among Turkish, Moroccan, Indian and sub-Sahara African populations in Europe and their countries of origin: an overview

Public Health and primary carePrevention and community carePrevention, Population and Disease management (PrePoD

One-stage approach to the correction of facial skeletal deformity with malocclusion

A total of 40 patients with varying degrees of facial skeletal deformity and Class III malocclusion were treated by bimaxillary osteotomy combining maxillo-malar augmentation and/or osseous genioplasty at the same sitting by the author. In all patients, the maxillary advancement and mandibular set back were performed, using Le Fort I maxillary osteotomy and bilateral sagittal split osteotomy of the mandibular rami. In additional bimaxillary osteotomy, simultaneous maxillo-malar augmentation and genioplasty in 20 patients, genioplasty in 12 patients, maxillo-malar augmentation in eight patients, were performed to improve facial harmony. All patients were followed clinically and radiographically for at least 1 year and as much as 5 years after undergoing surgical correction. No cases with relapse or other major complications have been encountered up to now. There were, however, persisting unilateral inferior alveolar nerve damage in two patients, prolonged nerve anesthesia or hypoesthesia in four patients, and short period anesthesia or hypoesthesia in 11 patients, wide alar base in three patients and slight deviation of cartilage septum in two patients. There were no other complications encountered and an unexpected result. The facial skeletal deformity and malocclusion were always treated satisfactorily as patient and plastic surgeon's expectations in one-stage operation, without significant complications and morbiditiy

Repair of large, anterior palatal fistulas using thin tongue flaps: Long-term follow-up of 10 patients

Anteriorly based, thin tongue flaps were used in 10 patients to close large, anterior palatal fistulas, All 10 flaps (100%) survived, and complete closure was obtained in all patients, with the exception of a recurrent fistula that occurred in 1 patient during maxillary expansion (10%), Another patient (10%) demonstrated postoperative bleeding that required formal hemostasis under general anesthesia. No other complications were encountered, The results of this series indicate that the tongue flap is a safe technique for closure of large, anterior palatal fistulas, This thin, long flap is also reliable for orthodontic maxillary expansion

A SIMPLE METHOD TO HARVEST DURAL GRAFTS

A small rectangular wire loop was designed to harvest dural graft from rats. This loop was used successfully to take 40 dural grafts from 20 infant and 20 adult rats. The technique is presented in detail

Z-plasty and microvascular anastomosis

An experimental study in rats was designed to determine the effects of z-plasty on the patency of microvascular anastomosis. Eighty Sprague-Dawley rats of mixed sex were divided into two groups. In all animals, the left carotid arteries were used. In the first group (n=40), a single z-plasty was done at the anterior side of the carotid artery before end-to-end anastomosis was performed. In the second group (n=40), end-to-end anastomosis with interrupted sutures was done. Patency and the appearance of the anastomosis were evaluated 1 hr later, on the seventh postoperative day, and at the end of the third postoperative week. There was no vasospasm demonstrated in the first group. Patency rates were 100 percent for both groups after 1 hr. On the seventh postoperative day, one anastomosis in the first group (patency rate, 97.5 percent) and two anastomoses in the second group had failed (patency rate, 95 percent). Patency rates were similar at the third week. The difference was not statistically significant (p=0.5). Histologic examinations demonstrated that z-plasty did not cause any adverse effects at the vessel wall or at the anastomosis

Reconstruction of shallow upper buccal sulcus deformity secondary to cleft lip and palate repair

Shallow upper buccal sulcus deformity, one of the secondary deformities after cleft lip-palate repair, causes both aesthetic and functional problems. This deformity also prevents or makes difficult orthodontic and prosthodontic procedures. An upper buccal sulcus deepening procedure was performed in 14 patients during the last 5 years. In 12 cases, premaxillary-based mucosal flaps were combined with one of the following: lip re-repair, Abbe flap, or bilateral buccal mucosal advancement flaps; in two cases, premaxilla was grafted wit buccal mucosal graft together with bilateral buccal mucosal advancement flaps. The follow-up period was 2 to 5 years. Results were satisfactory for the surgeon, orthodontist, prosthodontist, and the patient. Upper buccal sulcus reconstruction with premaxillary thin mucosal flap or full-thickness mucosal graft combined with tissue-sparing techniques provides successful and durable results

OSTEOGENIC POTENTIAL OF INFANT DURAL GRAFTS IN DIFFERENT RECIPIENT BEDS

An experimental study in adult rats was designed to test whether infant dura, when transplanted as an isograft to different recipient beds, can maintain its osteogenic potential. There was bone regeneration in more than 50% of the defects in all animals in which infant dura was present. There was minimal bone regeneration in defects in which adult dura remained alone and in which the dural defect repaired with adult dural graft. Ectopic bone did not form on the abdominal fascia or in the abdominal muscles from either infant or adult dural transplantation

RECONSTRUCTION OF THE TOTAL LOWER EYELID DEFECT - USEFUL MODIFICATIONS

Various techniques have been used for reconstruction of extensive lower eyelid defects, but it is difficult to achieve results which are satisfactory, both from a functional and cosmetic viewpoint. In the past three years, ten patients have been reconstructed using a cheek flap over a chondromucosal graft, after extensive resection of lower eyelid tumors. As a modification of the classic method, the dermal layer of the cheek flap was sutured to the inferior orbital rim to prevent late sagging and ectropion. In addition, a tie-over pressure dressing on the inner aspect of the lid was used to give good contact between the chondromucosal graft and the flap. At a one year follow-up, the results were judged to be good, both aesthetically and functionally