[Lengthening the mandibular ramus without external access].
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Bone Lengthening↗
Biomedical subjects
J Ferri
Publications and source records attributed to J Ferri.
[Verbal fluency tasks in a Spanish sample of young adults (20-49 years of age): normative data of clustering and switching strategies].
INTRODUCTION: The aim of this study is to establish normative data on phonological and semantic verbal fluency tests, measuring total production of words, clusters and switching of words in a healthy young adult Spanish population. MATERIAL AND METHODS: We assessed 53 healthy adults between 20-49 years old (32.8 +/- 9.5) with 8-18 years of formal education (9 +/- 3.3 years). The semantic fluency category included: animals, fruits, clothes and the initial letters F, A, S in 1 minute of time. Clustering and switching strategies were examined and scored according to a protocol elaborated ad hoc by the authors. Pearson correlations between number of "clusters", "switching" and total number of words was used and we evaluated the possible influence of age, years of schooling and gender in each one of the categories in 1 minute and in intervals of 15 seconds. RESULTS: The variable years of formal education was the only demographical factor that significantly influenced semantic verbal fluency (r = 0.43; p = 0.04). Switching and clustering were positively correlated with the number of words generated. Clustering was highly correlated with total number of words generated on semantic fluency (r = 0.846; p < 0.01). In contrast, switching was more highly correlated than clustering with total number of words generated on phonemic fluency (r = 0.864; p < 0.01). CONCLUSIONS: Rules for scoring switching and clustering in our population are provided. Optimal fluency performance requires some type of balance between clustering and switching strategies and should be taken into account in studies regarding verbal fluency.
Adult↗
Self-awareness after acquired brain injury--predictors and rehabilitation.
OBJECTIVE: To investigate the factors contributing to deficit in self-awareness following acquired brain injury and to study change in self-awareness during a group support program. METHODS: Sixty-two patients (mean age: 35.4 +/- 15.3 years) attending our Service (295 +/- 525 days after injury) were included in the study (41 of them had sustained a head injury). Thirty-six patients were admitted to a multidisciplinary rehabilitation program including a group support program designed to improve self-awareness deficits. All patients were assessed with the Patient Competency Rating Scale as a measure of self-awareness and with a broad range of neuropsychological tests, checklists of psychopathological symptoms, and several functional scales. RESULTS: Thirty patients showed high levels of self-awareness while 32 showed impaired self-awareness. Patients with appropriate perception of their deficits showed less psychopathological symptoms, better neuropsychological function and higher functional independence than those with impaired SA (Student's t test, p < 0.05). Both groups improved, but with different patterns, after rehabilitation (MANOVA, p < 0.05). Multiple regression analysis revealed that cognitive status was predictive of level of self-awareness. CONCLUSION: The level of self-awareness after acquired brain injury is a useful prognostic index of the neuropsychological, psychopathological and functional status of the patient. We recommend the evaluation of this symptom after acquired brain injury due to its clinical relevance.
Activities of Daily Living↗
[Entity, identity, speciality].
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Dentistry↗
[Dental avulsions and blood coagulation disorders].
INTRODUCTION: We performed a retrospective study of tooth removal for patients with coagulation disorders. MATERIAL AND METHOD: The study included 67 patients divided into 3 groups according to their coagulation disorder. The first group included 31 patients with a congenital disorder, the second 19 patients receiving anticoagulant therapy, and the third 16 patients with an acquired disorder. The same surgical procedure was used for all patients: alveoli regulation, socket preparation with resorbable oxycellulose dressing, and sutures with separate stitches. Biological glue and celluloid splints were not used. Depending on the severity of the coagulation disorder, factor VIII or concentrated von Willebrand factor or Desmopressine was administered for patients in the first group. If possible, low-molecular-weight heparin replaced oral anticoagulation for patients in the second group. Platelet concentrates were administered for 2 of the patients in the third group. RESULTS: Postoperative bleeding was noted in 4 patients in the first group, 2 in the second and 2 in the third. DISCUSSION: We have abandoned the use of biological glue and celluloid splints. The rate of bleeding in the first and second group was similar to that reported in the literature. We were unable to find any comparable report for the third group.
Anticoagulants↗
[Distraction osteogenesis in orthodontic surgery of the mandible].
Distraction osteogenesis is a bone creating procedure that can contribute materially to the treatment of Class II dento-skeletal disorders where the mandible is under-sized. Still, the serious commitments this treatment demands and the unpredictability of its occlusal results oblige practitioners to pinpoint precisely the indications for its use. We now believe that distraction osteogenesis can beneficially be employed for: 1--Adults with Class II malocclusions, a small mandible, and a lack of harmony between tooth and jaw size. This bone growing technique makes it possible to treat these patients without the extraction of premolars that would have been necessary in the traditional preparation for orthognathic surgery. 2--Patients whose mandibles are diminished in size in the area of the symphasis. Distraction osteogenesis of this anterior segment is the only way they can be treated without reduction of tooth structure or excessive labial tipping of teeth. 3--Some patients with short, or moderately short rami. We do not, at this time, believe that distraction osteogenesis is indicated for the treatment of any other kind of dento-facial deformity. But, in the future, improvement of surgical techniques and the miniaturization of appliances will doubtless extend its scope.
Adolescent↗
Retrospective study of 18 patients treated by maxillomandibular advancement with adjunctive procedures for obstructive sleep apnea syndrome.
A surgical protocol in the treatment of obstructive sleep apnea syndrome (OSAS) is presented. Eighteen patients with particular craniofacial characteristics consisting in maxillomandibular retroposition or retromandibulism underwent bimaxillary advancement by way of Lefort I and bilateral sagittal ramus osteotomies. Adjunctive procedures (genioplasty, uvuloplasty, and glossoplasty) were performed in the same surgical procedure. In all cases, the patients were evaluated before and 6 months after surgery by a physical examination, Delaire cephalometric analysis, and polysomnography. Surgery was considered successful when the postoperative apnea/hypopnea index (AHI) was less than 15/h and with at least a 50% reduction of the initial index. The surgical success rate was 84%. AHI decreased from 54/h (+/-20.7) to 9.66/h (+/-6.67). The results of this study indicate that successful surgical treatment by maxillomandibular advancement with adjunctive procedures at the same operative time is efficient with a high percentage of success when patients are clearly selected.
Body Mass Index↗
Iatrogenic pneumomediastinum and facial emphysema after endodontic treatment.
Subcutaneous emphysema is well known, but diffusion of gas into the mediastinum is not so common, particularly if it is caused by treatment of a root canal without apparent osseous fenestration or mucoperiostal lesions. We report a case of iatrogenic pneumomediastinum and facial emphysema after endodontic treatment. The diagnosis was confirmed by computed tomography, and the patient recovered after treatment with intravenous antibiotics and analgesia.
Adult↗
[Complutense Verbal Learning Test versus Wechsler Memory Scale-Revised].
INTRODUCTION: We present a comparative study (sensitivity and convergent validity) between a new verbal memory test Complutense Verbal Learning Test (TAVEC) and the Wechsler Memory Scale-Revised (WMSr) in a sample of patients with acquired brain injury. PATIENTS AND METHODS: Twenty-eight patients with acquired brain injury were included in this study. Twelve patients were reevaluated six months after their inclusion in a cognitive multidisciplinary rehabilitation program. All patients were assessed with the WMSr (verbal memory, general memory and long-term memory) and the TAVEC (verbal learning, immediate memory and delayed memory). Results obtained with both scales were compared (chi-square) and correlated (Pearson correlation). RESULTS: Globally, learning and memory deficits were detected with both scales. Initially 32.1 % of our sample showed general memory deficits, and 44.4 % long-term memory deficits when assessed with WMSr. These percentages were significantly lower compared to the 57.1 %, 75 % and 78.5 % of our sample who showed learning, recent memory and delayed memory difficulties when evaluated with the TAVEC. The results obtained by the 12 patients included in a cognitive rehabilitation program significantly improved. Numerous strong correlations between the TAVEC and the WMSr were found, suggesting a high degree of convergence between the two instruments. CONCLUSIONS: The TAVEC is a sensitive measure of learning and memory after acquired brain injury. Due to its sensitivity, ecological value and multifactorial structure we recommend this test for the evaluation of learning and memory of these patients.
Adolescent↗
[Our physiotherapy treatment of articular fractures of the mandibular condyle].
Physical therapy greatly contributes to improved function of the injured temporomandibular joint, particularly after trauma. In our unit, we use the Delaire rehabilitation method for patients presenting a fracture of the mandibular condyles. This method involves active mobilization, first with assistance, then with facilitation, and finally against resistance. A rehabilitation session starts with a preparation of the teguments and muscles associated with relaxation exercises. The joint is first mobilized by assisted movements if needed. When unassisted motion becomes possible, propulsion, diduction and open-close exercises are then performed with neuromuscular facilitation. When sufficient amplitudes have been achieved, the program proceeds with opposed exercises. By inducing propulsion and diduction (lateral pterygoid muscle) movements, physical therapy stimulates regeneration of the condylar unit, thus facilitating optimal functional rehabilitation. Posture and passive motion methods, which in our opinion are poorly adapted to the temporomandibular joint, are used little in our unit. Since condylar regeneration is controlled by functional factors, the lateral pterygoid muscle is an important element. Good functional outcome, and the absence of ankylosis, depends directly on the quality of active rehabilitation.
Humans↗
[Radiographic anomalies and obstructive sleep apnea syndrome].
BACKGROUND: The purpose of this study was to identify the particular cranio-facial pattern observed in patients with obstructive sleep apnea syndrome and to search for possible correlations between morphological anomalies and disease severity. MATERIAL AND METHODS: The study group included 49 dentate patients, mean age 47.7 years suffering from obstructive sleep apnea syndrome. Most of the patients were overweight. RESULTS: Typical features observed in these patients were a short craniospinal field, a retro-maxillary, a retro-mandibula, antero-inferior vertical excess of the face, and class II malocclusion. No correlation between severity of obstructive sleep apnea syndrome and craniofacial morphology could be identified. DISCUSSION: These results are in agreement with data in the literature. The absence of a morphological correlation appears to be related to the type of patients studied (overweight). Indeed, two categories of sleep apnea patients have been identified: obese patients who have few or no anomalies of the facial skeleton and thin patients with characteristic open bite class II malocclusion.
Adult↗
[Retrospective study of two years of surgery for temporomandibular joint pain dysfunction syndrome].
BACKGROUND: Assessment of temporomandibular joint (TMJ) surgery is a controversial topic. We analyzed our long-term surgical results in a set of patients who underwent TMJ surgery in our unit from January 1995 through December 1996. We used a simple methodology based on 4 criteria: pain, mouth opening, type of feeding and patient satisfaction. MATERIAL AND METHODS: We reviewed 21 operated patients who had been managed by an orthodontist after surgery. The post-surgical follow-up was 4 years. Patient age at surgery ranged from 14 to 51 years; the sex ratio was 1/9 M/F. Seventeen patients suffered a closed-lock, 2 had fibrous ankylosis of the disc. Fifteen patients underwent bilateral TMJ arthrotomy with joint fixation and, very often, mandibulo-condylar-plasty to counteract the bony compression inside the joint. We rated outcome as "very good" if four factors were found: resolution or improvement of pain, more than 40 mm post-surgery mouth opening or at least 10 mm improvement for patients with less than 40 mm post-surgical mouth opening, normal feeding, subjective satisfaction rated as very or quite good. Outcome was thus rated as very good (4 factors), quite good (3 factors), good (2 factors), poor (1 factor), failure (0 factors). RESULTS: Resolution of pain was achieved in 55% of the patients with an improvement in the others. All patients recovered normal feeding. Mouth opening remained limited for two patients. Subjective patient satisfaction was very or quite good in 80% of the cases. Outcome was rated very good in 9 patients, quite good in 7, and good in 5. There were no patients with poor outcome or failure. Analysis of the good outcome group showed that 3 had experience a post-surgery trauma, one had not complied with rehabilitation therapy, and one suffered from undiagnosed rheumatoid polyarthritis. CONCLUSION: According to the literature, TMJ surgery is an effective means of treating pain and reducing dysfunction. We obtained good and stable outcome in patients who participated in our postoperative follow-up. The TMJ is a fragile joint particularly susceptible to trauma.
Adolescent↗
[The management of anterior transversal mandibular deficiencies by distraction osteogenesis. Preliminary results and report of 3 cases].
During the last ten years, osteodistraction genesis appeared as being a treatment of some maxillo-facial transversal deficiencies. A new technique have been develop in Lille Maxillo-Facial Department (Pr Ferri, France). This new technique is used in cases of mandibular hyposymphysis, which induce most of the time a mandibular incisor crowding. This distraction osteogenesis performed after sagittal osteotomy of the mandibular symphysis and associated with orthodontic treatment is a solution to avoid teeth extractions. Other treatments could be used to solve anterior mandibular teeth crowding but they have disadvantages: teeth slicing, teeth extraction or orthodontic teeth tilting. This new technique is performed with intra oral-device, small enough to be placed under mandibular periosteum. Three patients have been treated by this technique, they got a stable result. In these three cases, alveolar and basal bone is present. So for us, symphysis osteogenesis distraction appears to be an alternative treatments to mandibular incisor crowding.
Adolescent↗
Pure ectodermal dysplasia: retrospective study of 16 cases and literature review.
OBJECTIVE: To review the possible craniomaxillofacial deformative consequences associated with ectodermal dysplasias and embryonic malformations, which include dental ageneses. SETTING: Oral and Maxillofacial Surgery Department, University Hospital, Lille, France. PATIENTS: Sixteen patients (seven boys and nine girls, aged 4 to 34 years) with pure ectodermal dysplasia (no ectodermal dysplasia syndromes). INTERVENTIONS: All patients had a clinical examination. Seven (two boys and five girls, aged 4 to 25 years) had undergone plaster casts and radiographic and Delaire's cephalometric studies before being treated. MAIN OUTCOME MEASURES: All patients had tooth ageneses (from hypodontia to anodontia), associated with cutaneous dyshidrosis and hair and nail dystrophy. Most of them had a short face, with an unusual facial concavity, a maxillary retrusion, and a relative mandibular protrusion. MANAGEMENT RESULTS AND DISCUSSION: Depending on their ages and their orthopedic abnormalities, patients underwent either dental or prosthodontic, orthodontic, orthopedic, orthognathic, or implant treatment. So as not to interfere with the growth pattern, we preferred to reserve implant and orthognathic surgery for full-grown cases. CONCLUSIONS: Oral and maxillofacial surgeons must undertake a comprehensive approach to these patients to improve their dental, masticatory, growing, and orthognathic conditions.
Adolescent↗
[Permanent percutaneous connections and osteointegration].
Passage through the skin of an abutment anchored on an implant fixed on the underlying one constitutes a Permanent Percutaneous Connection of which the principal applications are stabilization of maxillofacial prosthesis (MFP) or bone anchored hearing aid (BAHA) support. The long-term outcome of a PPC depends on a variety of different parameters. We analyzed the influence of the most important factor: osseointegration.
Biocompatible Materials↗
[Growth: responses to pathology. Preliminary study].
Many pathologies involve face. Among them, many have craniofacial growth consequences. The authors' aims are to analyze some of these pathologies, where clinical observations emphasize the role of the different craniofacial growth patterns. Despite a complex relation between the malformative part and the deformative one, untreated observations provide a better understanding of some craniofacial growth defects. Syndromes can be classified in 4 categories, involving the primitive causes of the clinical finding: 1. organic abnormalities of one or many functional matrix, 2. localized abnormalities of the anatomical structures, 3. general abnormalities of the conjunctive tissue, 4. mixed syndromes. Many observations will presented.
Cephalometry↗
[Progressive hemifacial atrophy in the young patient: physiopathologic hypotheses, diagnosis and therapy].
Parry-Romberg syndrome is characterized by a limited progressive hemifacial atrophy. Since its first description in 1825, this syndrome has aroused interrogation and reflection about is pathophysiology, its variable clinical expression and its progression. The first part of this focuses on the different hypotheses advanced to date to explain this type of atrophy. We then recall the different steps for clinical diagnosis and treatment. Management of such an unpredictable disorder is particularly difficult. Because of the uncertain pathophysiology, medical therapy has not been very successful. Palliative reconstruction surgery remains the only possibility. We present three cases illustrating this review of progressive hemifacial atrophy.
Adolescent↗
[Progressive hemifacial atrophy in the young patient: surgical problems in children].
Parry-Romberg syndrome is characterized by a limited progressive hemifacial atrophy. For young patients, the surgeon has to deal with two tendencies: the patient's growth and the course of the syndrome. When managing such an unpredictable disease, the surgeon has to make a guess about the future course of the structural movements. We reviewed our experience and analyzed the different surgical possibilities for reconstructive surgery for Parry-Romberg syndrome.
Adipocytes↗