Hemifacial microsomia: oral, clinical, genetic and dermatoglyphic findings.
Oral, clinical, genetic and dermatoglyphic findings of a female patient with hemifacial microsomia are described and compared with those cited in the literature.
Child↗
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Simultaneous maxillary and mandibular distraction osteogenesis with a semiburied device.
Distraction osteogenesis is a technique utilizing natural healing mechanisms to generate new bone; it is commonly used to lengthen the hypoplastic mandible. Distraction of the maxilla and mandible as a unit is an obvious extension of the technique. We describe the application of a semiburied distractor to simultaneously lengthen the mandible and maxilla and level a canted occlusal plane in three cases. The indications for bimaxillary distraction are reviewed, including its advantages, disadvantages and limitations.
Adolescent↗
Structural goals in craniofacial surgery.
Major craniofacial abnormalities can be considered as a group for purposes of operative planning. Known normal relations define what is abnormal and indicate goals to be achieved with the craniofacial operative procedures. The principle syndromes with significant facial structural changes amenable to such surgical corrective procedures are craniofacial stenoses, hypertelorism, mandibulofacial dysostoses, median facial clefts, residua of encephaloceles, and trauma. Deformities primarily involve the middle and upper thirds of the face. In planning, abnormal relations and structures must be clearly defined utilizing patient examination, x-rays, dental study models, and photography. Standards of norm indicating goals for the corrective procedure are also based on studies using these tools, data from previous publications, and measurements directly from skulls. Precise measurements about the orbits and maxillary-mandibular relation are the keystone for planning. Soft tissue, nose, and ear alterations are based on already widely known concepts of norm and symmetry. Bony interocular distance, medial intercanthal distance, height and width at the orbital rim of the bony orbits, orbital shape, orbital axis, and orbital volume as determined by measurement with an exophthalmometer are useful in determining what is to be done about the orbits. Cribiform plate level, anterior cranial base, length and contour, and size of the zygomatic arches are important dimension considerations. Paranasal sinus size and location is important. These considerations are essential prior to any major facial structural changes.
Adult↗
Habilitation of severe craniofacial anomalies--the challenge of new surgical procedures: an NIDR workshop.
Three NIDR-sponsored workshops were conducted with the goal of identifying research needs in treatment and basic sciences relating to a group of severe craniofacial anomalies that are now correctable by new radical surgical procedures. Experts in the fields of developmental biology, neurosurgery and reconstructive craniofacial surgery discussed areas of investigation dealing with etiology, prevention and treatment that are most likely to result in clincally-useful information. In addition the establishment of craniofacial anomalies centers for data collection, treatment and research was examined.
Acrocephalosyndactylia↗
Centric relation. A study of pressure and tension systems in bone modeling and mandibular positioning.
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Animals↗
[Mouth opening limitations due to soft tissue lesions].
Mouth opening limitations following on soft tissue lesions are subdivided according to aetiology into collagen disease connectival lesions, cutaneous and mucosa lesions consequent on the action of physical agents and, finally, cicatricial lesions of the cheeks and lips as a result of surgery for cancer or trauma. The commonest forms of plastic surgery used to correct such lesions are reviewed.
Burns↗
Morphometry of the mandible in prepubertal craniofacial microsomia patients following an inverted L osteotomy.
The aim of this study was to undertake finite element modeling of craniofacial microsomia (CFM) patients who exhibited a unilateral mandibular deformity that was surgically corrected by an inverted L osteotomy and autogenous bone graft. Preoperative, 1-year, and 3-year postoperative anteroposterior cephalographs of 14 consecutive children (mean age, about 9 years) with CFM were employed. All cephalographs were scanned, and 8 homologous mandibular landmarks were digitized in triplicate (digitization error < 1%; P > 0.05). Average mandibular geometries, scaled to an equivalent size, were generated using Procrustes superimposition and subjected to analysis of variance. Results showed that while the mean pre- and early postoperative mandibular configurations marginally failed to differ statistically, finite element modeling of the affected mandibular ramus showed a positive allometry (a lengthening by about 10% to 12%) and marked anisotropy, presumably reflecting the surgical procedure carried out in that region. For the preoperative and late postoperative means, the configurations were statistically different (P < 0.002), showing a lengthening of the ramus (about 14%) while the unoperated side had a high degree of isotropy. The early and late postoperative configurations were also statistically different (P < 0.002). The operated ramus showed an increase in length (about 15%), but the corpus showed a decrease in size (about 10%) and marked anisotropy that reflected remodeling associated with the surgical procedure. Although mandibular morphology is improved in CFM patients who are surgically treated by an inverted L osteotomy, some relapse is evident due to deficient growth, localized in the mandibular ramus and body of the affected side.
Analysis of Variance↗
Scleroderma: what the general dentist should know.
Scleroderma is characterized by fibrotic changes of the skin and organ systems. The disease presents in a variety of forms, ranging from the most aggressive progressive systemic sclerosis (PSS), to the three less aggressive, CREST syndrome, morphea, and the more localized form, linear scleroderma. The oral manifestations of the disease result from deposits of collagen in the tissues or as a result of collagen deposition around nerves and vessels. All oral tissues are affected. In scleroderma patients, the oral manifestation most commonly recognized is wide periodontal ligament spaces. Limited function, impaired healing, and neurologic symptoms all may be present to varying degrees, depending on the form and progression of the disease.
DMF Index↗
The role of the orthodontist in the treatment of craniofacial anomalies.
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Acrocephalosyndactylia↗
Behçet's disease: dental and oral soft tissue complications.
Behçet's disease is a chronic, multisystem disorder. It has 3 primary components: recurrent inflammations of the eye, ulcerations of the oral mucous membranes, and ulcerations of the genitalia. Diagnosis of Behçet's disease relies mainly on history taking and clinical manifestations. This article describes the oral soft tissue and dental complications and the prosthetic problems encountered in a young patient. If dentists encounter patients with chronic ocular inflammations and recurrent oral mucous membrane ulcers, the index of suspicion should increase.
Adult↗
Oro-dental and craniofacial anomalies in LEOPARD syndrome.
'LEOPARD syndrome' is a syndrome affecting many systems or organs. The main anomalies are summarized in the acronym LEOPARD in which each letter corresponds to the damage of a given organ. In the presented case, there are oro-dental and craniofacial anomalies. The relationship between the LEOPARD syndrome and the given anomalies and the possibilities of the management and the follow-up of the diseased are studied. The clinical case presented is a 4-year-old boy with LEOPARD syndrome showing retardation of dental development, delayed development and possible agenesis of permanent teeth, and craniofacial anomalies (osseous hypodevelopment). The bibliographical study shows that LEOPARD syndrome is due to damage of the neural crest cells. Thus, the dental and craniofacial anomalies arise since neural crest cells participate in the formation of the teeth and some craniofacial bones. Therefore, dental and craniofacial anomalies might be expected in some cases of the disease. The therapeutic management of the lesions, and the follow-up of the patient would be done by a multidisciplinary team.
Abnormalities, Multiple↗
Changes in soft tissue facial profile of craniofacial microsomia patients: geometric morphometrics.
To analyze changes in the soft tissue profile associated with an inverted L osteotomy, preoperative, early postoperative, and late postoperative lateral cephalographs of 13 children with craniofacial microsomia (mean age 9 +/- 2 years) were scanned, and 11 soft tissue landmarks were digitized (digitization errors insignificant; P > 0.05). Cephalometry, Euclidean distance matrix analysis (EDMA), and thin-plate spline (TPS) analysis were carried out on the mean soft tissue landmark configurations. Cephalometry indicated that there were very few statistically significant differences in mean measurements pre- and postoperatively. In contrast, EDMA determined that there were significant differences (P < 0.05) between mean preoperative, early postoperative, and late postoperative soft tissue configurations, particularly in the labiomental region. Transformation grids obtained from TPS analysis indicated clockwise rotation of the soft tissue configurations with anteroinferior elongation in the labiomental region. Geometric morphometrics indicated that the soft tissue lower facial height increased secondary to the associated underlying skeletal change, improving the profile of patients treated with an inverted L osteotomy of the mandible for the correction of craniofacial microsomia.
Cephalometry↗
Facial asymmetries in hemifacial microsomia, Goldenhar syndrome, and Treacher Collins syndrome.
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Adolescent↗
[Problems posed by difficult intubations].
The difficulties of tracheal intubation are mainly encountered in facial surgery and E.N.T. surgery, but they may nevertheless, occur in any form of surgery. The indications for nasal intubation, without visible glottis, the problems raised and the means of solving them, whilst respecting safety precautions, are briefly recalled.
Cicatrix↗
Systemic sclerosis: description and diagnostic role of the oral phenomena.
This study was designed to describe and evaluate the eventual prodromic role of the orofacial phenomena encountered in patients suffering from systemic sclerosis. Phenomena preceding the diagnosis and events that occured at the onset of systemic sclerosis were considered. Sclerodermic patients were monitored to implement a secondary preventive plan for controlling oral injuries caused by developing systemic sclerosis.
Autoimmune Diseases↗
Reconstructing the burned face.
The priorities, timing, techniques, and philosophies of reconstruction of the burned face are outlined in this article. Each anatomic area is analyzed, and the appropriate procedure is described.
Adult↗
Splints and accessories following burn reconstruction.
Splints, exercise, traction, and compression garments are commonly accepted methods to minimize disabling scar formation. Although burn rehabilitation treatment has improved over the past 10 years, there is still no overnight cure for scars and contracture. The extent and depth of the burn injury, emotional strength and patience of the burn victim, and support systems available play an important role in scar treatment. Scar contracture is a frustrating complication for the recovering patient and burn team. Surgical reconstruction to correct functional impairment is often needed before wound maturation is complete. Splints are usually part of the postoperative treatment plan. When this is the case, patient understanding, compliance, motivation, and comfort are important to assure splint effectiveness. The treatments reviewed are specific for scar contracture limiting function of the upper body. Although they were presented as treatment of neck, mouth, axilla, and hand contractures, many of the principles and materials can be used after burn reconstruction of the lower extremities. Regardless of the area treated, assessment of patients is important to determine their specific needs in splint design.
Axilla↗
Whistling face syndrome. A case report and literature review.
The cranio-carpo-tarsal or "whistling face" syndrome was first described by Freeman and Sheldon in 1938. More than 60 cases with great variability of expression are known till now and autosomal dominant as well as recessive inheritance and sporadic cases suggest a genetic heterogeneity. We review 60 well-documented cases of the literature and present a patient with a severe form, who died of bronchopneumonia at the age of 9 months. The facial stigmata of his mother and the ulnar deviations of his maternal grandfather support the autosomal inheritance of the syndrome.
Abnormalities, Multiple↗