What is the impact of lateral nasal wall osteotomy depth on pterygomaxillary separation during a Le Fort I downfracture?

The study aimed to investigate the effect of customized lateral nasal wall osteotomy (LNO) on the lateral nasal wall (LNW) and pterygomaxillary junction (PMJ) separation during Le Fort I. We hypothesized that customized LNO on the LNW affect the PMJ separation type. This prospective, controlled, randomized study included forty-three patients were randomly assigned to either the conventional or customized (study) osteotomy groups. In the study group, LNW depth was measured before surgery in the axial section of the CT scan, and LNO was performed at a depth of 2 mm less than the measured distance. In the conventional osteotomy group, LNO was performed at 30 mm for females and 35 mm for males. Patients with cleft lip and palate, previous orthognathic surgery, or rhinoplasty were excluded. Separation types were classified as follows: LNW types; Type1-from the osteotomy line; Type2- 2-4 mm above the osteotomy line; Type3- 4 mm or more above the osteotomy line. PMJ types; Type1-including the tuber maxilla; Type2-from the pterygomaxillary junction; Type3-including the pterygoid plates. Chi-square tests were conducted to determine whether there was a significant correlation between groups and LNW separation types, groups and PMJ separation types and groups, and LNW separation type and PMJ separation type. A P value of < .05 was considered statistically significant. In both the conventional (P=0.052) and the study groups (p=0.828), there was no significant difference between LNW depth. Type 1 (P=0.0003) and Type 2 (P=0.0051) LNW separation types presented a significant difference between groups. A chi-square test showed a significant correlation between the surgical groups and PMJ separation patterns (P<0.05). Customized LNO optimizes the LNW and PMJ separation. Facilitates the Le Fort I surgery and decrease unintentional fracture of the PMJ

Dysaesthesia in the mental nerve distribution triggered by a foreign body: a case report

INTRODUCTION: Foreign bodies' entrapments in the mandibular and submandibular regions are quite common. CASE PRESENTATION: We report an unusual case of foreign body (amalgam filling) entrapment over the mental foramen causing dysaesthesia in the distribution of the mental nerve. An interesting sign was blue discoloration of the overlaying oral mucosa which was interpreted as amalgam tattooing. CONCLUSION: Surgical removal of the foreign object eliminated the reported symptoms

Treatment of cherubism with salmon calcitonin: A case report

Cherubism is a familial disease of the jaws which is inherited via autosomal dominant manner. Typical features of cherubism include a painless bilateral, symmetrical enlargement of the jaws, misalignment of teeth, and intra-osseous central giant cell granuloma-like lesions, which are usually evident in early childhood. Treatment of cherubism consists of local curettage of the lesions, jaw contouring, intralesional steroid injections, and systemic calcitonin administration as well. Calcitonin therapy for central giant cell granuloma of the jaws is well documented, and favorable results have been achieved. However, fewer reports have been presented in regard to calcitonin administration for cherubism. In the present report, a 14-year-old boy with cherubism who had intra-osseous cherubic lesions in his mandible was treated with an administration of 200 IU systemic calcitonin every other day via his nasal passage for duration of more than two years. After 30 months of calcitonin therapy, the lesions in the mandible were significantly regressed, and calcitonin application was ceased. Despite some drawbacks, such as unpredictable efficient absorption and patient tolerability, nasal administration is the easiest way to use calcitonin therapy on children. In this report, every-other-day applications of calcitonin increased patient tolerability and might be considered as an effective treatment for mild cherubic lesions

Biomechanical evaluation of two miniplate fixations applied in the anterior region after Le Fort I osteotomy: an experimental study

© 2021 The British Association of Oral and Maxillofacial SurgeonsThe aim of this experimental study was to evaluate the reliability of two-plate fixations applied to the anterior region of the maxilla after Le Fort I osteotomy in terms of stability. Twenty polyurethane-based skull models were used to evaluate two fixation techniques. Two groups consisting of four and two L-shaped titanium miniplates were tested. Each group was tested with the application of vertical forces in the anteroposterior direction using a servohydraulic testing unit. The displacement values in each group at each stage (from 10 N - 120 N) were compared using the Mann-Whitney U test. The displacement values for the two groups were not statistically significant up to 20 N, but differed significantly between 20 N and 120 N (p < 0.05). The results showed that the biomechanical behaviour of fixation with four miniplates was better than that of two after a load of 20 N. It can be concluded that when the amount of maxillary advancement is increased to 10 mm or more, fixation with only two plates does not provide sufficient stability experimentally

Reconstruction of an unusual orocutaneous fistula by using a bilobed flap.

Orocutaneous fistulas or cutaneous sinus tracts of dental origin are pathologic communications between the cutaneous surface of the face and the oral cavity. They are relatively uncommon and may be easily misdiagnosed. In this report, management of an orocutaneous fistula of dental origin, which endured for 20 years, by using an extraoral bilobed skin flap, an intraoral buccal rotational mucosal flap and allogenic bone graft, is presented