[Comparison of osteoplasty of the maxillary cleft with and without simultaneous osteotomy in patients with maxillary clefts].
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Biomedical subjects
Publications and source records attributed to N Samman.
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Three rare variants of the adenomatoid odontogenic tumor (AOT) are described. A follicular AOT associated with an impacted and displaced 28, an extra-follicular variant mimicking a radicular cyst around the apex of 23 and a peripheral (epulis-like) variant exhibiting a periodontal bone defect palatal to 21. On reappraisal of the origin and pathogenesis of the AOT, it would seem that this tumor or hamartomatous lesion is derived from odontogenic epithelium of the dental lamina complex or its remnants.
The records of 300 consecutive Chinese patients with a dentofacial deformity were reviewed to determine the spectrum and characteristics of deformities presenting to a university joint orthognathic clinic. Twenty-six percent of the patients had cleft lip and palate with maxillary hypoplasia; within this group, 26% had double jaw deformity and 5% had nasomaxillary hypoplasia. Of the noncleft group, 47% were Class III facial types, of which 59% were due to mandibular hyperplasia. Of the noncleft group, facial asymmetry accounted for 21%, long face for 18%, bimaxillary protrusion for 14%, Class II types for 11%, and short face for 4%. Overall, there was a high incidence of two-jaw deformity, suggesting that severity may be a major factor in the decision by patients to seek treatment. Findings from this study are thought to be generally applicable to overseas Chinese.
Two examples are presented of osteotomies performed simultaneously with surgical recontouring in cases of fibrous dysplasia of the jaws. Osteotomies are necessary when a coexistent discrepancy in jaw relationship is present. This provides a functional as well as aesthetic result. Rigid miniplate fixation was utilised, and dysplastic bone healing was uneventful, and found clinically not to differ from that of normal bone. Osteotomy is thus feasible in dysplastic bone, and may complement recontouring in achieving a better result.
A severe case of disseminated intravascular coagulation secondary to a road traffic accident in a pregnant woman is presented. The nature of this recognised complication of pregnancy is noted, and the problems encountered when it occurs together with facial trauma, are described. The importance of awareness and recognition of this condition is emphasised.
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