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Biomedical subjects

T A Turvey

Publications and source records attributed to T A Turvey.

At least 55 records · Page 3Linked to original sources
PubMed1986

Use of autogenous cranial bone grafts in maxillofacial surgery: a preliminary report.

In conventional reconstruction of the facial skeleton, bone grafts are usually harvested from distant sites such as the ilium or ribs. Because of the morbidity associated with the use of these sites, the calvarium was studied as an alternate donor site. Twenty-three patients underwent bone grafting using autogenous calvarial bone. Reconstructive procedures included alveolar cleft grafts, Le Fort I osteotomies, midface onlay grafts, and grafting of a mandibular continuity defect. Intraoperative and postoperative morbidity associated with the bone donor site was minimal, and there was good incorporation of all the grafts. Long-term follow up is necessary before definitive conclusions about the response of the grafted bone can be made, but short-term results were promising.

Adolescent↗
PubMed1985

Maxillary expansion: a surgical technique based on surgical-orthodontic treatment objectives and anatomical considerations.

Maxillary transverse expansion is usually done as an ancillary, not primary surgical movement in the surgical-orthodontic correction of dentofacial deformities. A maxillary osteotomy technique is described which permits combinations of movements, including expansion. Releasing the palatal soft tissue to disperse the resulting soft tissue tension, bone grafting and adequate stabilization and retention of the segments are stressed to achieve success. Also described is the use of local bone grafts and the rotation of soft tissues to cover surgical defects. Results are encouraging and the complication rate has been low in this series of 104 patients.

Adolescent↗
PubMed1985

Orthodontic-surgical interaction in the management of cleft lip and palate.

The orthodontist's role in the cleft palate team requires close collaboration with the surgeons and other team members. The rationale of timing and sequencing of orthodontic treatment have been discussed in the various time frames, which for convenience have been considered as follows: (1) neonatal or infant maxillary orthopedics; (2) orthodontic considerations in the primary dentition; (3) mixed dentition orthodontics to include presurgical recommendations before an alveolar bone graft and its rationale for use in selected patients; and (4) orthognathic surgery combining an orthodontic and surgical approach to the correction of dental and skeletal components of malocclusion in the permanent dentition. Speech considerations and the communicative skills of the patient with a cleft are important aspects in planning orthognathic surgery for this group of patients. Also, subsequent nose and lip revisions for cosmetic improvement must not be underestimated in the enhancement of the final result following correction of the skeletal and dental discrepancies. Provided the timing and sequencing of appropriate treatment modalities are planned in a closely coordinated, problem-oriented approach by the team members, cleft patients should currently have optimal functional and esthetic results.

Adolescent↗
PubMed1984

Alterations in nasal airway resistance following superior repositioning of the maxilla.

Superior repositioning of the maxilla is a contemporary surgical procedure used to correct a variety of dentofacial deformities, including vertical maxillary excess. Concern for the effect of this procedure on nasal respiration is warranted, since superior repositioning of the maxilla may decrease the volume of the nasal cavity. In this study pre- and postoperative nasal-resistance values were obtained for 52 patients who underwent superior repositioning of the maxilla by the LeFort I downfracture procedure. Of these 52 patients, 24 underwent segmental osteotomies and 28 underwent one-piece superior repositioning. Results indicate that the long-faced persons for whom superior repositioning of the maxilla is recommended usually have pretreatment nasal-resistance values within previously reported normal ranges. Superior repositioning of the maxilla, with or without involvement of the nasal floor, usually results in decreased nasal resistance.

Adolescent↗
PubMed1984

Delayed bone grafting in the cleft maxilla and palate: a retrospective multidisciplinary analysis.

The results of delayed bone-grafting procedures in a group of twenty-four cleft patients are reported. All patients benefitted from closure of their fistulas. The need for a prosthesis was eliminated in twelve patients, and eight of the remaining twelve patients required only a three-unit bridge. Residual movement of the premaxilla in two of the nine bilateral cases included in this study was detectable. The esthetic benefits were difficult to assess since sixteen of the patients simultaneously underwent lip and nasal revisions. In seventeen patients, the graft was placed prior to canine eruption, and in sixteen of these patients, the canine erupted passively into the arch. Not every patient with a cleft is a candidate for delayed bone grafting, but the procedure has been found to be beneficial in selected persons.

Adolescent↗
PubMed1982

Simultaneous mobilization of the maxilla and mandible: surgical technique and results.

Simultaneous mobilization of the entire maxilla and mandible is a versatile procedure that can be used to correct multiple dentofacial deformities. The procedure is especially useful in correcting open bite deformities, as well as sagittal, vertical, and transverse dysplasias of the maxilla and mandible, and cases of asymmetry involving both the maxilla and mandible. Mock surgery performed on cephalometric tracings and study models provide a blueprint for the planned surgery. The use of an interim splint, constructed from sectioned models mounted on a semiadjustable articulator from a face bow transfer, is advocated to aid in accurate placement of the maxilla. The correct position of the maxilla is required to determine the ultimate position of the mandible; there is no room for error with this step if the procedure is to be accurate. Stabilization of the mobilized segments by direct osseous fixation, suspension wires, and maxillomandibular fixation is suggested. Maintenance of rigid maxillomandibular fixation for six weeks combined with an additional four weeks of guided mandibular function with skeletal elastics assures proper healing and position of segments.

Adult↗
PubMed1981

Augmentation genioplasty as an adjunct to conservative orthodontic treatment.

Augmentation genioplasty can serve as a valuable adjunct to orthodontic treatment. The borderline extraction patient with a good nasolabial angle, protruding lower incisors and a deficient chin often can be treated better by nonextraction orthodontics followed by advancement of the chin than by any regimen involving orthodontic extraction. Genioplasty also can be used to improve facial esthetics in the patient with a short mandibular ramus in whom mandibular advancement might well lead to unstable results. In some instances, genioplasty may be a way to overcome the appearance of facial asymmetry without requiring jaw surgery which would complicate a pre-existing adequate occlusion. As a relatively straightforward and predictable procedure, augmentation genioplasty should be used more often in conjunction with orthodontic treatment than it has been in the past.

Adolescent↗
PubMed1980

Early fracture of the mandibular condyles: frequently an unsuspected cause of growth disturbances.

Experience with patients referred to the Dentofacial Clinic at the University of North Carolina indicates that previous fracture of the mandibular condylar process may be involved in 5 to 10 percent of all severe mandibular deficiency or asymmetry problems. Since these fractures often go undiagnosed and since three fourths of the children with fractures have no growth deficits, the incidence of condylar fractures probably is much higher than commonly thought. Management of fracture patients immediately following the accident, during the postinjury stages of mandibular growth, and at completion or near-completion of growth is discussed.

Adolescent↗
PubMed1980

Cephalometric diagnosis and surgical-orthodontic correction of apertognathia.

Nineteen postadolescent white woman with uncorrected Class I molar and/or canine occlusion were compared cephalometrically to thirteen postadolescent white women with skeletal apertognathia that was later corrected by a combination of surgical procedures, the common denominator being maxillary posterior superior repositioning. The cephalometric tracings were compared statistically by evaluating the study group preoperatively, immediately postoperatively, and at a long-term follow-up appointment. The results indicate that there is a statistical difference in certain important measurements between normal persons and preoperative apertognathic patients with the deformity identified in the dentoalveolar complex of the maxilla. Posterior maxillary superior repositioning tends to correct this skeletal deformity, with postoperative measurements approaching the normal values. The correction proved to be stable over a mean follow-up period of 19 months (range, 7 to 30 months).

Adolescent↗
PubMed1980

Management of the nasal apparatus in maxillary surgery.

Many patients requiring maxillary surgery for the correction of dentofacial deformities have pre-existing nasal airway obstructions. In addition, some of the movements accomplished during surgery may reduce the volume of the nasal cavity or may result in nasal airway obstructions. Techniques for eliminating pre-existing nasal obstructions and of avoiding adverse effects on the nasal airway resistance after maxillary surgery are presented.

Airway Obstruction↗
PubMed1980

Speech considerations with maxillary advancement procedures.

Advancement of the maxilla has the potential to cause hypernasal speech, especially in patients with repaired cleft palates. Findings in three patients whose speech was at risk with maxillary advancement procedures are discussed, as well as their management. Diagnostic guidelines for identifying patients whose speech may be adversely affected by maxillary advancement are also presented.

Adolescent↗
PubMed1979

Alterations in osseous crestal height following interdental osteotomies.

A study was performed to evaluate the osseous crestal changes following maxillary and mandibular segmental osteotomies. Ten patients with 22 osteotomy sites were evaluated prior to surgery and 6 months postsurgery. Periodontal sounding measurements along with plaque and gingival indices were used as parameters. Except for two patients whose osteotomies were carried out between closely approximated teeth, no patients experienced significant osseous crestal level changes during the investigation period. This leads the authors to believe that segmental osteotomies may be performed without significantly modifying the height of interproximal bone.

Adolescent↗
PubMed1979

Multidisciplinary management of Crouzon syndrome.

The comprehensive management of Crouzon syndrome in a 14-year-old girl has been presented. Because of the complexity of the facial and associated problems, a multidisciplinary approach is necessary to provide maximum functional and esthetic results; however, with such a cooperative interdisciplinary effort, the improvement and benefits derived for these patients are rewarding to all concerned.

Adolescent↗