Contemporary Aspects of Orthognathic Surgery

U proteklih pet godina ortognatska kirurgija je postala standardni postupak u kirurgiji glave, čeljusti i lica. Temeljen na radovima Obwegesera koji je uveo sagitalnu osteotomiju ramusa ranih 50-tih godina, danas je taj postupak postao zlatni standard u ortognatskoj kirurgiji donje čeljusti diljem svijeta. Uvođenjem naprava za osiguranje centrične pozicije kondila tijekom cijeloga kirurškog postupka Luhr je ranih 80-tih godina dao drugi doprinos modernom razumijevanju cijele funkcionalne rehabilitacije disgnatija. Premda je LeFort-ova osteotomija uvedena od Wassmunda 20-tih godina, trebalo je sljedećih 50 godina da ta metoda bude prihvaćena u kirurgiji, uglavnom zbog straha od mogućega krvarenja. Uvođenjem naprave za pozicioniranje kondila za vrijeme osteotomije gornje i donje čeljusti ili kombinirane bimaksilarne osteotomije, kao i upotrebom distrakcijskih naprava, danas smo u mogućnosti rije- πiti i najteže disgnacijske probleme. U Zavodu za kirurgiju glave, čeljusti i lica Sveučilišta u Würzburgu u zadnja dva desetljeća s više od 2000 ortognatskih kirurških zahvata želimo prikazati razvoj suvremenih kirurških tehnika i kliničke rezultate. Napredak ne bi bio moguć bez primarne i stalne pripreme od strane ortodonta i interdisciplinarno određenih indikacija za kirurško liječenje, ortognatsku obradu pacijenta kao i za postoperativni postupak. Posebna se pozornost daje ortognatskom liječenju i tehničkim preduvjetima za kirurški postupak.Orthognathic surgery within the past half decade has become a standard procedure in cranio-maxillo- facial surgery. Based upon the elementary works by Obwegeser introducing the sagittal split ramus osteotomy in the early 50is, today this procedure has become the gold standard in mandibular orthognathic procedures worldwide. The introduction of devices to ensure the centric condyle position throughout the entire surgery by Luhr in the early 80ies gives another impact to modern understanding on complete functional rehabilitation after dysgnathia. Even though the LeFort-I-Osteotomy was already introduced by Wassmund in the 20is it took almost another 50 years before this procedure became accepted in surgery, mainly based on the fear of severe bleeding that may occur during surgery. By introducing a compund condyle positioning device to ensure the exact condyle position throughout both procedures of maxillary and mandibular osteotomy respectively, during combined bimaxillary osteotomies, as well as the targeted use of distraction devices, today we are able to solve even the severest dysgnathia problems. At the Department of Cranio-Maxillo-Facial Surgery of the University of Würzburg, during the past two decades and far more than 2000 orthognathic surgery cases, we are trying to present a broad overview of the development of the latest surgical techniques and clinical results. This progress is not possible without the primary and consistent treatment by a specifically skilled orthodontist during primary treatment including the interdisciplinary indication for surgery, the orthognathic preparation of the patient as well as the postoperative treatment. Therefore special emphasis will be put on the orthognathic treatment, as well as on technical prerequisites for the surgical procedure

Impacted Maxillary Canines - Etiology, Diagnosis, Radiologic and Orthodontic Clinical

Canine maxillary teeth are aesthetically most dominant teeth which can present a smile as either holy or evi. They define the mouth’s corner, are involved in the aesthetic smile, maintain occlusal stability, and design the shape of the dental arch. As the position of the impacted canines is amidst vital anatomical structures like the nasal cavity and sinuses in the maxilla and mental nerve in the mandible, a thorough radiographic evaluation to determine the position of the impacted canines is of utmost importance prior to any treatment planning. By using a radiographic image, a clinician can clearly identify its location. The present paper aimed to determine the prevalence, etiology, and clinical diagnosis of impacted maxillary canines in orthodontic patients. Keywords: Canine impaction, Etiology, Inspection, Palpation, Radiographs, CT, CBCT, Transtomograph

Congenitally Missing Bilateral Incisors with Single-Tooth Implants: Clinical Case

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Anterior Open Bite Malocclusion: From Clinical Treatment Strategies towards the Dissection of the Genetic Bases of the Disease Using Human and Collaborative Cross Mice Cohorts

Anterior open bite malocclusion is a complex dental condition characterized by a lack of contact or overlap between the upper and lower front teeth. It can lead to difficulties with speech, chewing, and biting. Its etiology is multifactorial, involving a combination of genetic, environmental, and developmental factors. Genetic studies have identified specific genes and signaling pathways involved in jaw growth, tooth eruption, and dental occlusion that may contribute to open bite development. Understanding the genetic and epigenetic factors contributing to skeletal open bite is crucial for developing effective prevention and treatment strategies. A thorough manual search was undertaken along with searches on PubMed, Scopus, Science Direct, and Web of Science for relevant studies published before June 2022. RCTs (clinical trials) and subsequent observational studies comprised the included studies. Orthodontic treatment is the primary approach for managing open bites, often involving braces, clear aligners, or other orthodontic appliances. In addition to orthodontic interventions, adjuvant therapies such as speech therapy and/or physiotherapy may be necessary. In some cases, surgical interventions may be necessary to correct underlying skeletal issues. Advancements in technology, such as 3D printing and computer-assisted design and manufacturing, have improved treatment precision and efficiency. Genetic research using animal models, such as the Collaborative Cross mouse population, offers insights into the genetic components of open bite and potential therapeutic targets. Identifying the underlying genetic factors and understanding their mechanisms can lead to the development of more precise treatments and preventive strategies for open bite. Here, we propose to perform human research using mouse models to generate debatable results. We anticipate that a genome-wide association study (GWAS) search for significant genes and their modifiers, an epigenetics-wide association study (EWAS), RNA-seq analysis, the integration of GWAS and expression-quantitative trait loci (eQTL), and micro-, small-, and long noncoding RNA analysis in tissues associated with open bite in humans and mice will uncover novel genes and genetic factors influencing this phenotype

RESEARCH AND REVIEWS: JOURNAL OF DENTAL SCIENCES Miniscrews: Clinical Application of Orthodontic

ABSTRACT The incorporation of miniscrews into orthodontic treatment planning has allowed for predictable anchorage control and has increased the ability to correct severe skeletal and dental discrepancies. Various minicsrews systems are now available for clinical use and abundant reports and studies are being published, dealing with different aspects of their applications (biology, surgical procedures, placement sites, complications, success rate). The aim of this article is to review the actual considerations regarding their mechanical properties, surgical considerations, risks and complications as well as their success rate and failure reasons

A Retrospective Study of the AL Technology Implant System used for Single-Tooth Replacement

Objective: The objective of this retrospective study was to evaluate the success rate of AL Technology implants used for single tooth replacement after a minimum of three years of loading at Center for Dentistry, Research &amp; Aesthetics, Jatt, Almothalat, Israel.Method: Dental records for 43patients who underwent single tooth replacement using ALTechnology implant system at Center for Dentistry, Research &amp; Aesthetics, Jatt, Almothalath, Israel during a three years period (2010-2012) were retrospectively analyzed. Only implants that were functioning for at least three years were included.Results: 152 AL-Technology implants were used for the replacement of single teeth in 43patients, 114(75%) implants were placed in the posterior regions, and 38 (25%) implants were placed in the anterior regions. All implants were restored with cement-retained crowns and have been in function for at least three years. Out of the total 152implants, two (1,3%) were considered failures as a result of significant radiographic bone loss. Therefore, the survival rate at three years was 98,7%.Conclusion: The results of this study suggested that AL-Technology implants could be a satisfactory choice for anterior and posterior single tooth restorations.</p