Advantages and disadvantages of mandibular distraction in Robin sequence

Robin sequence (RS) is diagnosed in infants born with micrognathia, glossoptosis and varying degrees of upper airway obstruction (UAO). Due to the variable levels of hypoxia, severe breathing and feeding problems can occur. Treatment is determined by clinical severity, ranging from conservative interventions for mild cases to surgical interventions for severe cases. Mandibular distraction osteogenesis (MDO) is a surgical technique that gradually lengthens the mandible after an osteotomy by using an internal or external distraction device, directly correcting the micrognathia. This review will focus on advantages and disadvantages of mandibular distraction in infants with RS

Management of Asymmetry

Orthognathic surgery in asymmetric cases is challenging because of diversity and individuality. Clinical observations are of paramount importance and need to be systemically thorough. Three-dimensional diagnosis and virtual planning have been proven extremely helpful in facilitating treatment toward symmetry in difficult cases with increasing precision. Compared with orthognathic surgery in symmetric situations, asymmetries produce numerous pitfalls and provide opportunities for out-of-the-box procedures

Quality of Life After Orthognathic Surgery in Patients with Cleft: An Overview of Available Patient-Reported Outcome Measures

Objective : Measuring the impact of orthognathic surgery on quality of life is of significant importance in patients with cleft deformities. Standardized tools such as patient-reported outcome measures (PROMs) are needed to fully comprehend patients’ needs and perceptions. Therefore, the availability of reliable, valid, and comprehensive questionnaires for patients is essential. The aim of this study is to identify PROMs measuring the impact of orthognathic surgery on quality of life in patients with cleft deformities and to evaluate the identified PROMs. Methods : A systematic search of the literature was performed according to the preferred reporting items for systematic reviews and meta-analysis guidelines. All validated PROMs, regarding the impact of orthognathic surgery on quality of life in patients with cleft deformities, were identified and assessed according to the quality criteria proposed for measurement properties of health status questionnaires. Results : An electronic search yielded 577 articles. After a full-text review of 87 articles, 4 articles met the inclusion criteria, comprising 58 PROMs. Of these 58 PROMs, 1 PROM (the CLEFT-Q) has been validated to measure the impact of orthognathic surgery on patients with a facial cleft. Evaluation of methodological quality of the included articles and assessment of the measurement properties of the CLEFT-Q show that the CLEFT-Q scores relatively good for all available measurement properties, making it suitable for immediate use. Conclusion: The CLEFT-Q was found to be the only valid instrument so far to measure the impact of orthognathic surgery on the quality of life in patients with cleft deformities

The Orthognathic Quality of Life Questionnaire: Translation and Validation into Dutch

Objective:The aim of this study is to translate and validate the Orthognathic Quality of Life Questionnaire (OQLQ) in the Dutch language (OQLQ-NL).Methods:The translation of the OQLQ into the Dutch language was performed following the guidelines for the Process of Cross-Cultural Adaption of Self-Report Measures. Sixty-two patients who received orthognathic surgery in the past 10 years were included for participation. Internal reliabilities of the OQLQ-NL were evaluated for multiple item scales with the use of the Cronbach alpha coefficient. For the establishment of the test-retest reliability, the OQLQ-NL was repeated with a 2-week interval and the intraclass correlation coefficient was calculated. Spearman correlation was used to test the correlation with the OHIP-49NL and the FACE-Q, to be able to evaluate the construct validity of the OQLQ-NL.Results:Thirty-five patients filled in the OQLQ-NL, OHIP49NL, and FACE-Q upon arrival and 22 patients returned the OQLQ-NL after 2 weeks (response rate of 56.6% and 62.9%, respectively). The OQLQ-NL showed excellent results in internal reliability and test-retest reliability. The vast majority of the correlations between the domains of the questionnaires were as expected. Data from this study and previous studies confirm the construct validity of the OQLQ-NLConclusion:The OQLQ-NL appears to be a valid and reliable instrument to measure quality of life for patients receiving orthognathic surgery in the Netherlands

Temporomandibular Joint Prosthesis in a Patient with Congenital Infiltrating Lipomatosis of the Face with Bony Ankylosis of the Temporomandibular Joint:A Case Report

Hemifacial hyperplasia (HFH) is a rare congenital disorder characterized by marked unilateral overgrowth of the facial tissues. A subtype of HFH is congenital infiltrating lipomatosis of the face (CIL-F). This disease is characterized by unilateral diffuse infiltration of mature adipose cells in the facial soft tissue and is associated with skeletal hypertrophy. This work aims to report a case of a CIL-F patient with right facial asymmetry and progressive growth at adolescent age, causing mandibular asymmetry due to signs of concomitant unilateral condylar hyperplasia. At the age of seventeen, a condylectomy was performed to stop the progression of asymmetric mandibular growth. Five years later, the patient developed CIL-F-associated temporomandibular joint ankylosis, manifesting as progressive restricted mouth opening along with temporal facial pain. In this CIL-F patient, a TMJ reconstruction with an alloplastic total joint prosthesis was successfully performed with optimal maximal mouth opening, complete alleviation of temporal facial pain, and stable dental occlusion one year postoperatively. A TMJ reconstruction with a complete alloplastic total joint prosthesis proved to be a predictable, stable, and safe treatment option in a patient with CIL-F-associated TMJ ankylosis who was previously treated with condylectomy due to progressive mandibular asymmetry.</p

Quality of Life After Orthognathic Surgery in Patients with Cleft: An Overview of Available Patient-Reported Outcome Measures

Objective : Measuring the impact of orthognathic surgery on quality of life is of significant importance in patients with cleft deformities. Standardized tools such as patient-reported outcome measures (PROMs) are needed to fully comprehend patients’ needs and perceptions. Therefore, the availability of reliable, valid, and comprehensive questionnaires for patients is essential. The aim of this study is to identify PROMs measuring the impact of orthognathic surgery on quality of life in patients with cleft deformities and to evaluate the identified PROMs. Methods : A systematic search of the literature was performed according to the preferred reporting items for systematic reviews and meta-analysis guidelines. All validated PROMs, regarding the impact of orthognathic surgery on quality of life in patients with cleft deformities, were identified and assessed according to the quality criteria proposed for measurement properties of health status questionnaires. Results : An electronic search yielded 577 articles. After a full-text review of 87 articles, 4 articles met the inclusion criteria, comprising 58 PROMs. Of these 58 PROMs, 1 PROM (the CLEFT-Q) has been validated to measure the impact of orthognathic surgery on patients with a facial cleft. Evaluation of methodological quality of the included articles and assessment of the measurement properties of the CLEFT-Q show that the CLEFT-Q scores relatively good for all available measurement properties, making it suitable for immediate use. Conclusion: The CLEFT-Q was found to be the only valid instrument so far to measure the impact of orthognathic surgery on the quality of life in patients with cleft deformities

Impact of Bone Volume Upon Condylar Activity in Patients With Unilateral Condylar Hyperplasia

Purpose: Unilateral condylar hyperplasia or hyperactivity (UCH) is a bone overgrowth disorder affecting the mandible. The purpose of this study was to determine the relations among age, condylar bone structure, condylar bone volume, and condylar bone activity on single-photon emission computed tomographic (SPECT) scans in patients with UCH. Materials and Methods: This study included 20 patients with a clinical presentation of progressive mandibular asymmetry and a positive bone SPECT scan. A bone SPECT-derived standardized uptake value (bSUV) for the condylar region was determined. All patients underwent condylectomy to arrest further progression of the disease. The resected condyles were scanned with a micro-computed tomographic scanner (18-μm resolution). Bone architectural parameters were calculated with routine morphometric software. Results: The mean bSUV of the condyle on the affected side was 15.32 (standard deviation [SD], 8.98) compared with 9.85 (SD, 4.40) on the nonaffected side (P =.0007). For trabecular bone structure, there was a nonsignificant correlation between the SUV of the affected condyle and the measured bone volume fraction (r = 0.13; P =.58) and trabecular thickness (r = 0.03; P =.90). Conclusion: No meaningful relation was found between condylar bone volume fraction and condylar activity on bone scan; therefore, the impact of bone volume fraction on the results of bone scans is limited. The measured condylar activity on SPECT scan seems to be primarily a reflection of the remodeling rate of bone

Intra- and inter-observer performances of the lower face method.

<p>The results for the absolute mean and the 95^th percentile are shown. The difference in means (Mean) (95% CI) (mm), standard error (SE) (mm) and the measurement error (ME) (mm).</p

Illustrating step 5.

<p>A reference frame is set up. The subnasal landmark (Sn) is indicated through which a plane, perpendicular to the horizontal plane of the reference frame, is computed. The new plane is used to split the (in step 4 computed) distance map. (The individual in this photograph has given written informed consent (as outlined in PLOS consent form) to publish this picture).</p