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Biomedical subjects

S A Schendel

Publications and source records attributed to S A Schendel.

At least 55 records · Page 3Linked to original sources
PubMed1981

An architectural and structural craniofacial analysis: a new lateral cephalometric analysis.

The architectural and structural craniofacial analysis is based upon mutual balance of the cranial and facial bony structures. With this technique, the bases and calvaria of the cranium and then the face can be studied successively in relation to the cranium and craniospinal articulation. Statistical averages are avoided, and individual proportions influenced by the unique features of each skeleton are relied upon. The dentition is placed within the cephalic context, and therapy etiologic factors of dentofacial dysmorphoses which would not otherwise be demonstrated by conventional analysis are made obvious. This technique is particularly useful to the maxillofacial surgeon, as it clearly demonstrates all of the maxillofacial deformities and the pathologic balances that need to be corrected. In severe craniofacial malformations, it offers better possibilities than other cephalometric analysis methods of detecting the various cranial and facial anomalies which characterize these conditions.

Cephalometry↗
PubMed1981

Functional musculoskeletal correction of secondary unilateral cleft lip deformities: combined lip-nose correction and Le Fort I osteotomy.

Secondary cleft lip-palate deformities frequently involve a combination of skeletal, cartilagenous, dental and muscular deformities. Correction of these deformities should be based on normalization of function by restoring normal anatomy as much as possible. Functional correction of the lip musculature is best done at the same time as surgical correction of the skeletal-dental deformities. In this article, we outline a fundamental technique for secondary lip-nose correction based on muscle reorientation and a concomitant Le Fort I maxillary osteotomy.

Adult↗
PubMed1981

[Surgical removal of surplus vertical bone in the maxilla (author's transl)].

Excess length of the anterior part of the face secondary to maxillary vertical excess is called the Long Face Syndrome. It consists of a combination of neuromuscular, skeletal, occlusal, and functional characteristics. This syndrome is best corrected functionally and esthetically by surgical superior repositioning of the maxilla. Complete mobilisation of the maxilla is easily achieved by the surgical technique of downfracture. The results using this technique are excellent and very stable.

Facial Muscles↗
PubMed1980

Hawaiian craniofacial morphometrics: average Mokapuan skull, artificial cranial deformation, and the "rocker" mandible.

Craniofacial morphology and cultural cranial deformation were analyzed by the computer morphometric system in 79 adult Hawaiian skulls from Mokapu, Oahu. The average Hawaiian male was large, but similar in shape to the female. Both were larger than the present Caucasian, showed a greater dental protrusion, and possessed a larger ANB angle, flatter cranial base, and larger facial heights. Correlations in Hawaiian craniofacial structure were found between an increasing mandibular plane angle and 1) shorter posterior facial height, 2) larger gonial angle, 3) larger cranial base angle, and 4) smaller SNA and SNB angles. Of the 79 skulls studied, 8.9% were found to have severe head molding or intentional cranial deformation. Significant statistical differences between the molded group and the nonmolded group are, in decreasing significance: 1) larger upper face height, 2) smaller glabella to occiput distance, and 3) increased lower face height with deformation. The morphometric differences were readily seen by graphic comparison between groups. It is postulated that external forces to the neurocranium result in redirection of the growth vectors in the neurocranial functional matrix, including the cranial base, and secondarily, to the orofacial functional matrix. There is a possibility that the cranial deformation is a retention of the normal birth molding changes. The Polynesian "rocker jaw" was found in 81% to 95% of this populace. This mandibular form occurs only with attainment of adult stature and craniofacial form. This data agrees with the hypothesis that mandibular form is modified by the physical forces present and their direction in the orofacial functional matrix.

Adult↗
PubMed1980

Total maxillary surgery.

The use of total maxillary surgery in the correction of various dentofacial and craniofacial deformities has become commonplace. Indeed, with current surgical techniques it is possible independently or simultaneously to reposition the maxilla in a superior, transverse, anterior, or posterior direction. By segmentalization of the maxilla under direct vision it is further possible to independently and simultaneously reposition portions of it in different planes of spaces. This paper will not attempt a detailed historical review, rather it will emphasize the current state of the art of total maxillary surgery.

Bone Transplantation↗
PubMed1980

Modified maxillary submucosal vestibuloplasty.

The literature during the past few decades is replete with methods to improve denture retention and stability. The maxillary submucosal vestibuloplasty is a relatively simple, yet effective method of increasing the functional alveolar ridge with a minimum of postoperative morbidity. This article presents a modification of the maxillary submucosal vestibuloplasty originally described by OBWEGESER. The procedure is indicated for edentulous patients who experience unsatisfactory denture retention and stability due to muscle and mucosal attachments located near the maxillary alveolar crest, have adequate bone height, and healthy vestibular mucosa. The modifications presented herein provide improved surgical exposure, improved vestibular depth, and a comfortable, hygienic and esthetic removable interim prosthesis.

Denture Design↗
PubMed1980

Results after mandibular advancement surgery: an analysis of 87 cases.

Clinical results and stability after mandibular advancement surgery were evaluated in a multi-institutional study of 87 individuals. Skeletal and dental stability were evaluated by a computer morphometric technique and clinical results were determined by recall of patients. Analyses of multiple variables were performed to determine factors that contributed to optimum treatment results or relapse, or both, after mandibular advancement. It was found that the mandible can be advanced successfully in all types of mandibular deficiency. Problems primarily related to surgical technique, such as postoperative condylar distraction, were consistently associated with relapse. Position of the proximal segment and the use of skeletal fixation were important in preventing relapse, but the value of suprahyoid myotomies and cervical collars was not proved. Significant postural changes of the head and cervical spine were observed after surgery.

Adult↗
PubMed1979

Velopharyngeal anatomy and maxillary advancement.

This study was undertaken to evaluate the radiographic changes in the static velopharyngeal mechanism following total maxillary advancement. Records of 21 patients treated for maxillary retrusion were evaluated. Two groups were present: 13 non-cleft patients and 8 cleft-lip patients. The findings demonstrate an anatomical change in the velopharyngeal mechanism following total maxillary advancement. A similar change occurred in both groups; however, the magnitude is differed. The angle of the soft palate to hard palate increased with surgery (2 degrees per mm. advancement noncleft and 1 degree per mm. cleft). An increase in soft palate length was also seen (.5mm. per mm. advancement non-cleft and .4 mm. per mm. cleft). A pharyngeal need ratio prediction method was established (pharyngeal depth/soft palate length). A ratio of .68--.84 in this study was observed. A ratio greater than one was found to indicate probable velopharyngeal incompetence.

Adolescent↗
PubMed1979

Monophase extraskeletal fixation.

The monophase appliance for extraskeletal fixation of facial fractures is discussed. The technique for its implementation is presented with a discussion of its indications and considerations. Reports of three cases demonstrate clinical applications of this one-step method of extraskeletal fixation.

Adult↗
PubMed1978

Mandibular deficiency syndrome. III. Surgical advancement of the deficient mandible in growing children: treatment results in twelve patients.

The surgical-orthodontic correction of mandibular deficiency in growing children (8 to 16 years of age) can be employed to achieve excellent results. Mandibular advancement by a modified sagittal osteotomy proves to be an acceptable procedure with good skeletal stability. Dentofacial growth following surgery will be harmonious and not adversely affected. Direction of growth varies, with the mandibular plane angle becoming more vertical with an increasing mandibular plane angle.

Adolescent↗
PubMed1978

Revascularization after surgical repositioning of one-tooth dento-osseous segments.

Vascularization, revascularization, and bone healing were studied after two different surgical techniques for surgical repositioning of single-tooth dento-osseous segments in adult mongrel dogs. Microangiographic and histologic studies of both one-stage and two-stage techniques for immediate surgical repositioning of single-tooth dento-osseous segments showed early but transient vascular ischemia, minimal osteonecrosis, and osseous union between most of the osteotomized segments. The attached soft tissue provided an adequate vascular pedicle for immediate repositioning of small dento-osseous segments by interdental and subapical osteotomies. The results of these clinically analogues studies support the clinical use of techniques that maximize the attachment of the gingiva to the mobilized dento-osseous segment.

Alveolar Process↗
PubMed1978

Total maxillary advancement with and without bone grafting.

Computer morphometrics was used to analyze 21 adult patients who underwent total maxillary advancement; ten had bone grafting behind the tuberosity and 11 did not. Each group was subclassified as those with idiopathic maxillary deficiency and those with cleft lip and cleft palate; all patients were treated by the same basic operative technique. The results of the study indicate that those patients who had bone grafts had optimum stability. However, individuals with maxillary deficiency who undergo minimal advancements (less than 0.5 mm) can have overcorrections at surgery and, therefore, do not require bone grafts for good stability.

Adolescent↗
PubMed1977

Biologic basis for modification of the sagittal ramus split operation.

Ten adult rhesus monkeys were used as experimental models to investigate revascularization and bone healing associated with sagittal splitting of the mandibular rami by two different techniques. Microangiographic and histologic studies showed intraosseous ischemia in the margins of the osteotomized segments and areas where the pterygomasseteric sling had been detached. When the mucoperiosteum and pterygomasseteric sling were minimally detached from the proximal segment, intraosseous ischemia and necrosis were significantly reduced. The results support the use of a clinical technique of sagittally splitting the mandibular ramus, which maximizes attachment of the pterygomasseteric sling and mucoperiosteum.

Animals↗
PubMed1976

The long face syndrome: vertical maxillary excess.

There is a clinically recognizable facial morphology, the long face syndrome, which has been incompletely described in the literature. On the basis of the clinical summary in thirty-one adults with this syndrome, an analysis of esthetics, skeletal morphology, and occlusion was undertaken. Herein we report on these findings, which confirm that this basic dentofacial deformity is associated with excessive vertical growth of the maxilla. Dental open and closed bite are two variants of the syndrome. An increased mandibular ramus height is associated with the closed-bite group.

Adolescent↗
PubMed1976

Superior repositioning of the maxilla: stability and soft tissue osseous relations.

The skeletal stability and soft-tissue changes associated with superior repositioning of the maxilla by Le Fort I osteotomy or simultaneous anterior and posterior maxillary osteotomies was studied in thirty patients by means of a computerized craniofacial model. Excellent skeletal stability was demonstrated 14 months postoperatively. Postsurgically, the reduction in lower face height and amount of maxillary incisor exposure resulted in improved facial balance. The use of a computerized osseous and soft-tissue craniofacial model has added a new dimension to evaluation of surgical changes associated with correction of dentofacial and craniofacial deformities.

Adolescent↗
PubMedDate not supplied

Familial osteodysplasia.

A family with characteristics that have striking similarities to the syndrome of familial osteodysplasia is reported. The inheritance pattern appears to be autosomal dominant. The typical facies has a lack of vertical facial development and a functional prognathism caused by overclosure of the mandible and opening of the gonial angle. Midfacial hypoplasia and a pointed chin are characteristic. Alveolar and sutural bone growth in the face is diminished and associated with partial dental agenesis. Variable cranial digital markings and possible synostosis are also seen. These typical facial changes are associated with other bony and systemic abnormalities. The long bones have a flask shape and occasionally have increased cortical thickness. The superior pubic ramus is often thin and scoliosis is common. The dermatoglyphic pattern demostrates a distal triradius and small whorl abnormalities. The most significant laboratory values are an increased erythrocyte sedimentation rate and C3 complement found on the erythrocytes. The plasma fibrinogen level was low in all family members.

Adult↗