The Surgical Predictability of Maxillary Advancement and Impaction in Le Fort I Osteotomy

Objective:The aim of this study was to evaluate and compare the amount of preoperatively planned surgical movement of the maxilla and postoperatively obtained maxillary repositioning.Materials and Method:Thirty-one patients (16 female and 15 male) were included in this study. Fifteen combined maxillary advancement and impaction, 5 isolated maxillary impaction, and 11 isolated maxillary advancement surgeries were performed by the same surgical team. The 31 patients were divided into 2 groups: group 1 (GoGnSN≤38°) and group 2 (GoGnSN>38°). Various measurements from the horizontal and vertical reference lines were used to compare the predicted maxillary movement and the postoperatively obtained maxillary position. All variables were evaluated by Student's 2-tailed paired t tests.Results:There were statistically significant differences between the preoperatively planned and surgically obtained impaction movements of all evaluated landmarks, but no significant difference was seen between the planned and obtained advancement movement. For the differences between the planned and acquired maxillary advancement movements, 51% were within 2 mm of prediction. For the differences between the planned and the acquired maxillary anterior impaction movements, 51% were within 1 mm of the prediction. The difference was 35% for the impaction of posterior maxilla.Conclusion:The predictability of vertical movement of the maxilla via Le Fort I osteotomy was lower than that for sagittal movement. The difference between planned surgical movement and actual surgical outcome should be taken into consideration during treatment planning

A rare complication following maxillary third molar extraction: infratemporal fossa abscess

<p>Infratemporal fossa abscess formation is a very rare and life threatening condition and also its differential diagnosis is a very difficult process. Infratemporal fossa abscess following the non-infected, asymptomatic, erupted maxillary third molar extraction in a young and healthy patient is an unexpected and unusual complication.</p> <p>A 25 years old, male patient with a significant infratemporal fossa abscess and his treatment protocol was presented in this case report.</p&gt

The effect of conventional surgery and piezoelectric surgery bone harvesting techniques on the donor site morbidity of the mandibular ramus and symphysis

WOS: 000360419000012PubMed ID: 25979191The aim of this study was to evaluate the morbidity following bone harvesting at two different intraoral donor sites, mandibular symphysis and ramus, and to determine the effects of piezoelectric. and conventional surgical graft harvesting techniques on donor site morbidity. Intraoral block bone grafts were harvested from the symphysis (n = 44) and ramus (n = 31). The two donor site groups were divided into two subgroups according to the surgical graft harvesting method used (conventional or piezoelectric surgery). Intraoperative and postoperative pain was assessed using a visual analogue scale (VAS). Donor site morbidity and the harvesting techniques were compared statistically. Of 290 teeth evaluated in the symphysis group, four needed root canal treatment after surgery. The incidence of transient paresthesia in the mucosa was significantly higher in the symphysis group than in the ramus group (P = 0.004). In the symphysis group, the incidence of temporary skin and mucosa paresthesia was lower in the piezoelectric surgery subgroup than in the conventional surgery subgroup (P = 0.006 and P = 0.001, respectively). No permanent anaesthesia of any region of the skin was reported in either donor site group. VAS scores did not differ between the ramus and symphysis harvesting groups, or between the piezoelectric and conventional surgery subgroups. When the. symphysis was chosen as the donor site, minor sensory disturbances of the mucosa and teeth were recorded. The use of piezoelectric surgery during intraoral harvesting of bone blocks, especially from the symphysis, can reduce these complications

The influence of bilateral sagittal split ramus osteotomy on submental-cervical aesthetics

WOS: 000343861000004PubMed ID: 24946129The effect of orthodontic-surgical treatment on submental-cervical region was evaluated in a very limited number of studies. The aim of this study was to evaluate submental-cervical soft tissue contour changes following mandibular advancement and set-back procedures via bilateral sagittal split ramus osteotomy. Sixty-seven patients were included in this study. Group 1 consisted of 27 skeletal Class II patients who underwent mandibular advancement surgery, whereas Group 2 consisted of 40 skeletal Class III patients who underwent mandibular set-back surgery. Various linear and angular measurements were performed on pre-operative and sixth month post-operative cephalometric radiographs. A new method was used to evaluate the amount of sagging at submental region. The submental length did not change in Group 1; however, it decreased significantly in Group 2 (P005). Mandibular set-back and advancement procedures do not remarkably change the submental sag following approximately 6mm jaw movement. Although mandibular advancement did not significantly effect submental length, soft tissue followed mandibular set-back with a ratio of 1:1 at C-point to projection of soft tissue pogonion and 1:07 at C-point to soft tissue menton distances.Baskent University Institutional Review Board and Ethical Committee [D-KA 12/02]This study has been approved by Baskent University Institutional Review Board and Ethical Committee with Project no: D-KA 12/02. This research was carried out without funding. No conflicts of interest declared

Changes in difficult airway predictors following mandibular setback surgery

WOS: 000363826000005PubMed ID: 26206397The aim of this study was to determine the effect of surgical mandibular backward movements on the predictors of a difficult airway. Thirty-seven skeletal class III patients were included in this study. The Mallampati score, body mass index (BMI), maximal inter-incisal distance, and thyromental and sternomental distances of these patients were evaluated preoperatively and at 6 months and 2 years postoperatively. A sagittal split ramus osteotomy (SSRO) without genioplasty was performed in all patients by the same surgical team, and anaesthesia was provided by the same anaesthesiologist using nasotracheal intubation. The paired samples t-test and Wilcoxon signed-rank test were used for statistical comparisons of the data. There were no statistically significant changes in BMI or sternomental and thyromental distances after SSRO. The maximal inter-incisal distance was significantly reduced at 6 months postoperatively (P < 0.05), but no statistical difference was found between the values obtained preoperatively and at 2 years postoperative. A statistically significant increase in Mallampati score was observed postoperatively (P < 0.05). Both the patient and practitioner should be aware of the risks associated with an increased postoperative Mallampati score in mandibular setback patients. The amount of mandibular setback in skeletal class III patients with a high preoperative Mallampati score should be limited to prevent potential postoperative airway problems