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At least 1,171 records · Page 65Linked to original sources
PubMed1989

Effects of sagittal split advancement osteotomy on facial profiles.

In 31 surgically treated Class II patients, several features were studied on cephalograms, before and after a mandibular lengthening osteotomy had been performed. After surgery, hardly any changes in the soft tissue thickness were recorded. In Class II patients, the upper part of the lower lip is situated at a larger distance from the skull, since its position is influenced by the antero-posterior position of the upper incisors and the overjet. The postoperative decrease of this distance was caused by the fact that the upper part of the lower lip failed to follow the total amount of forward mandibular displacement. This is due to the fact that the antero-posterior position of this part of the lip is touching the upper incisors and therefore does not follow the amount of mandibular advancement. The labiomental fold flattens, because the lower part of the lower lip completely follows the forward displacement of the mandible, whereas the upper part remains almost unchanged. This flattening can be favourable in Class II patients showing a very deep fold, as the surgical intervention tends to normalize the depth. In open bite profiles on the contrary, this effect could be unfavourable. The combination of the lengthening osteotomy with a genioplastic intervention, could mask this unfortunate result. Due probably to the presence of orthodontic retention devices and the intercuspidation of teeth, normal occlusal relations remained one year after surgery. A relapse of about 30 per cent was found in the mandibular bases. In order to anticipate this, some surgical overcorrection could be considered.

Adolescent↗
PubMedDate not supplied

Dense incisors (din): a new mouse mutation on chromosome 16 affecting tooth eruption and body size.

Dense incisors (din) is a new autosomal recessive mutation in the mouse that interferes with complete eruption of the incisors. The initial eruption of incisors through the gingiva does not differ in mutants and normal littermates, but subsequent further eruption of incisors is arrested in mutants. Radiographic examinations show that, because the incisors do not erupt, continued dentin formation gradually occludes the pulp chambers of these teeth creating as dense incisor. The arrested eruption of the incisor results in an anterior open bite. The pleiotropic phenotype of din/din mutant mice also includes small body size, reduced ear pinna size, and coat color dilution. The din mutation was mapped to Chr 16 near the pituitary transcription factor gene Pit1, but din is not a mutation in Pit1.

Animals↗
PubMed1982

The surgical correction of vertical maxillary excess (long face syndrome).

The surgical correction of vertical maxillary excess is a relatively new technique. Vertical maxillary excess (VME) may exist alone or in combination with a horizontal mandibular deficiency with or without an anterior open bite. The facial contour is characterized by a long, tapering face with anterior and posterior maxillary overgrowth, a narrow alar base, and lip in competence. Cephalometric analysis demonstrates steep mandibular and occlusal planes in relationship to the cranial base, and increase in facial height, and retroposition of the mandible. Evaluation of study models exhibits increased alveolar bone height, a high palatal vault, and a narrow maxillary arch. The dental relationship may be Class I, II, or III, with Class II being the most common. Orthodontic treatment before surgery consists of correct alignment of the teeth and removal of those dental compensations that preclude good dental interdigitation at surgery. Regardless of the surgical procedure, accurate preoperative planning based on careful evaluation of skeletal, dental, and soft tissue features in conjunction with correct orthodontic surgical sequencing is the key to a satisfactory result. The "downfracturing" or Le Fort I maxillary osteotomy for superior repositioning of the maxilla is the surgical procedure of choice for vertical maxillary excess. Two-, three-, or four-segment maxillary osteotomies can be done in conjunction with the Le Fort I osteotomy without jeopardizing healing capacity.

Adult↗
PubMed1983

Bronchoscopic intubation of patients with trismus.

Endotracheal intubation of patients with limited bite opening is a serious task for the caring physician. Blind intubation can be frustrating and, very often, unsuccessful. Tracheostomy, even under ideal conditions, can create serious complications. Fiberoptic bronchoscopy has opened up a new era in intubation of patients with trismus. In this article, we discuss an organized illustrated procedure for intubation of such patients. We have used this procedure successfully in 16 patients over the last sixteen months in our craniofacial unit, with no complications and no failures.

Bronchoscopy↗
PubMed2000

Extraoral vs. intraoral distraction osteogenesis in the treatment of hemifacial microsomia.

During hemifacial microsomia (HMF), an important phase of the treatment is elongation of the hypoplastic mandible, mainly the ramus, at an early stage. Twenty-two patients with HFM were treated with distraction osteogenesis: 12 with an extraoral device (10 unidirectional and 2 multidirectional) and 10 with an intraoral device. The mean elongation with the extraoral device was 21 mm, and with the intraoral device was 17 mm, resulting in a more symmetrical facial appearance. The advantages and disadvantages of both methods are presented, based on the authors' experience and a review of the literature. The extraoral device permits elongation of a greater distance, enables extraoral control of the vector of elongation, and conserves the gonial angle by working in many directions. The main disadvantages of the extraoral device are the social inconvenience to the patient and the extraoral cutaneous scars. Conversely, the intraoral device is much more socially convenient to the patient and avoids residual scarring. However, in 2 patients treated with an intraoral device, an undesired contralateral open bite appeared as a result of reduced vector control. The intraoral method should always be considered first because of its previously mentioned advantages. However, in severely hypoplastic patients, when three-dimensional correction and gonial angle control are necessary, or when there is a limited space along the planned distracted bone, the extraoral device has an advantage over the intraoral device.

Adolescent↗
PubMed1978

Advancement of the orbits and the midface in one piece, combined with frontal repositioning, for the correction of Crouzon's deformities.

We describe the use of radical craniofacial osteotomies, to improve the correction of exorbitism and to obtain better esthetic results in children with Crouzon's syndrome. We suggest some minor modifications to improve the fixation and the mechanical stability of the mobilized segments of the skull. Our procedure consists, essentially, of advancement of both orbits and the midface in one piece, plus advancement and reshaping of the frontal area. The results obtained by this technique, in children with a Crouzon's deformity without open bite, have been most satisfactory. We believe the satisfactory resultant appearance will be maintained during and after growth of the face, although these children have not been followed long enough yet to ascertain this with certainty.

Adult↗
PubMed1988

Facial deformity of juvenile rheumatoid arthritis.

Arthritis of the temporomandibular joint and resulting deficient mandibular growth are seen in as many as 25 percent of patients with juvenile rheumatoid arthritis. The magnitude of joint involvement and resulting growth deficiency varies significantly. These patients typically develop a "birdface" deformity with retruding mandible, alteration of the cervicofacial angle, and class II occlusion with limitation of the bite opening. A multidisciplinary approach, including the surgeon, a dentist, an orthodontist, and a rheumatologist, is necessary to ensure a safe and successful surgical outcome. The side effects of pharmacologic agents used to control the disease on coagulation, healing, and bone density should be considered seriously.

Adult↗
PubMed1990

Geometrical planning for the correction of orbital hypertelorism.

Orbital hypertelorism may be associated with a variety of deformities affecting several elements of the craniofacial skeleton. Shortness of the central portion of the face represented by a wide, short nose and anterior open bite is frequently combined with the exaggerated interorbital distance. With the mobilization of the two halves of the face it is possible to approximate the orbits, simultaneously elongating the center of the face and normalizing the maxillary alveolar ridge. A technique is described to plan the operation geometrically in order to predict accurately the skeletal correction, the change of the inclination of the eye slant, and the modification of the axis of the teeth.

Adolescent↗
PubMed1988

Adenotonsillectomy in children: indications and contraindications.

Adenoidectomy and tonsillectomy are the most common major operations done on children. The indications for tonsillectomy in certain clinical situations are constantly being debated in the literature and among professionals. We studied the efficacy (or lack of it) of adenotonsillectomy for chronic tonsillitis (recurrent throat infections), oral nasal obstruction, peritonsillar abscess, elimination of a bacterial carrier state, biopsy, and prevention of tongue thrusting with resultant anterior open bite. Adenoidectomy has been advocated in the literature for the treatment of nasal obstruction, sinusitis, and chronic serous otitis media. Complications of tonsillectomy and adenoidectomy include hemorrhage, anesthetic death, infection, nasopharyngeal stenosis, patulous eustachian tube, and hypernasality. Children at risk for hypernasality are those with mental retardation, cerebral palsy, neuromuscular disorders, and submucous cleft of the soft palate. Because of the severity of the complications that can be encountered in any child, medical and conservative therapy should be attempted before operation is done. Proper antibiotic therapy will often control chronic serous otitis, sinusitis, and chronic, recurrent tonsillitis. Bacterial synergy is important to consider when selecting antibiotic therapy, since beta-lactamase production may protect pathogens commonly considered susceptible to standard antibiotic therapy.

Adenoidectomy↗
PubMed2003

Molding of the regenerate in mandibular distraction: clinical experience.

Initial clinical experience with distraction osteogenesis has demonstrated the risk of developing postdistraction malocclusion that requires secondary orthodontic correction. In addition, optimal mandibular form is not always achieved. Both animal studies and preliminary clinical investigations have suggested that the regenerate can be successfully "molded" during active mandibular distraction. The authors have applied this concept clinically to obtain a more desirable occlusal relationship in a group of mandibular distraction patients. Eleven patients are described in whom angulation of the distraction device or intermaxillary/interdental elastics were employed to mold the regenerate. Two representative case studies are provided to illustrate the principles. When using elastic traction to close an anterior open bite, care must be taken that extrusion of individual teeth is minimized by distributing the force over the entire dental arch, especially the basilar portions of the jaws. The authors demonstrate that molding of the regenerate can be successfully accomplished not only during device activation but also early in the consolidation period. The outer limit of the time window in which molding is effective remains to be defined.

Adolescent↗
PubMed2005

Lymphatic malformation of the lingual base and oral floor.

BACKGROUND: Lymphatic malformation of the tongue and floor of the mouth is associated with chronic airway problems, recurrent infection, and functional issues related to speech, oral hygiene, and malocclusion. There are no accepted anatomic guidelines or treatment protocols. METHODS: This retrospective review focused on anatomic extent, treatment, complications, and airway management in 31 patients with lymphatic malformation of the lingual base and oral floor. RESULTS: Involved adjacent structures included the neck (77 percent), mandible (41 percent), face (42 percent), lips (10 percent), pharynx (45 percent), and larynx (26 percent). Fifty-eight percent of patients required tracheostomy during infancy; decannulation was possible in two-thirds of these patients. Management included resection alone (42 percent), resection and sclerotherapy (26 percent), resection and laser coagulation (16 percent), sclerotherapy and laser coagulation (16 percent), and resection and radiofrequency ablation (3 percent). Resection involved the neck (58 percent), floor of the mouth (52 percent), and tongue (42 percent); there were often multiple procedures. Aspiration was tried with little success in 10 percent of patients. Virtually all patients had residual abnormal lymphatic tissue. Complications and posttherapeutic problems included infection (81 percent), neural damage (27 percent), difficulty in speech (23 percent), feeding problems (10 percent), and seroma or hematoma (6 percent). Associated dental/orthognathic conditions, particularly prognathism and anterior open bite, were documented in one-third of patients. CONCLUSIONS: The initial step in the protocol is control of the neonatal airway. Staged cervical resection is undertaken in late infancy to early childhood; resection should also include abnormal tissue in the oral floor. Sclerotherapy is primarily for macrocystic disease or secondarily for recurrent cysts following partial extirpation. Vesicles of the mucous membranes and dorsal tongue are treated either by sclerotherapy, laser (carbon dioxide, yttrium-aluminum-garnet, or potassium-titanyl-phosphate), or radiofrequency ablation. Reduction for macroglossia is indicated for persistent protrusion or to allow correction of malocclusion. Embolization controls lingual bleeding. Orthognathic procedures are undertaken at the appropriate age, only after lingual size and position are acceptable.

Catheter Ablation↗
PubMed2006

Synchronous palatal closure and premaxillary setback in older children with bilateral complete cleft of lip and palate.

BACKGROUND: Achieving good results after primary repair in older children with complete bilateral cleft lip and palate is a Herculean task, particularly when the premaxilla is protruding and twisted. The authors faced the problems of protruding premaxilla in children older than 5 years of age with bilateral complete cleft lip and palate who presented late for primary repairs. Due to financial constraints and the distances traveled, these patients prefer to come for fewer procedures with maximum benefits. These factors encouraged the authors to carry out synchronous palatal closure and premaxillary setback in older children with bilateral complete cleft of the lip and palate. METHODS: Synchronous palatal repair and premaxillary setback were carried out in 14 patients. During palate repair, good exposure of the vomer made premaxillary setback easy without compromising the blood supply to it. The premaxilla, after osteotomy, was immobilized in all patients using the simple technique of Kirschner wire fixation; an additional gingivoperioplasty was performed in a few patients. Palatal closure was achieved with two flap techniques with intravelar veloplasty. RESULTS: Proper positioning of the premaxilla was achieved in all patients, with good labial repair 6 months after the primary palate closure. There were no major complications, such as loss of the premaxilla or vascular compromise. Two patients had an anterior open bite and one patient had a postalveolar fistula. CONCLUSIONS: This technique had a few minor complications, but the overall surgical outcome was satisfactory. This protocol proved advantageous in achieving good results with fewer procedures and in reducing the total expenditures and the length of the patient's hospital stay.

Adolescent↗
PubMed1994

Oral findings in a group of newborn Swedish children.

Oral examinations were performed of 1021 newborn Swedish children, of whom 101 were re-examined after 2-3 or 4-5 months. The most common findings, registered in 74.9% of the children, were of oral mucosal cysts situated either palatally or on the alveolar ridges. The majority of the palatal cysts disappeared shortly after birth, and some alveolar cysts appeared after birth. Ankyloglossia was found in 2.5% of the children, and Fordyce spots in 1.0%. No natal teeth were found. The upper labial frenum was attached to the crest of the alveolar ridge in 76.7% of the children, palatally in 16.7% and buccally in 6.7%. The relationship of the alveolar ridges was recorded: the anterior segment of the mandibular ridge was distal to the maxillary in 99% of cases, and, posteriorly, the mandibular ridges were lingual to the maxillary in 97.6%. An open bite was found in 39.8% of the children.

Female↗
PubMed1995

Dental caries, tooth trauma, malocclusion, fluoride usage, toothbrushing and dietary habits in 4-year-old Swedish children: changes between 1967 and 1992.

The dental health of 4-year-old children in the city of Umeå, northern Sweden, has been followed in cross-sectional studies conducted in 1967, 1971, 1976, 1980, 1987 and 1992. Similar methods and criteria were used. Dental caries and background factors (fluoride usage, toothbrushing frequency and diet) were recorded. In 1971, 1987 and 1992 signs of tooth trauma and presence of malocclusion were also recorded, the latter also in 1976. The present paper summarizes the results of these studies. Between 1967 and 1992 the mean dmfs values declined from 7-8 to 1-8. The decline was greatest between 1967 and 1980 and then levelled off. Toothbrushing frequency was similar over the years, but parental help with brushing was more common in the more recent studies. The use of fluoride toothpaste increased. About 30% of the children had experienced tooth trauma. A unilateral crossbite was recorded in 18% and 16% of the children in 1971 and 1992, respectively, and an anterior open bite in about 35% and 41%, respectively; both types of malocclusion were related to a dummy- or finger-sucking habit.

Child, Preschool↗
PubMed1995

Oral myiasis: report of two cases.

Case reports are presented of two patients from Oman who developed myiasis in the palate. Both suffered from cerebral palsy and had incompetent lips, anterior open bite and very poor oral hygiene. Both patients had denuded areas of hard palate anteriorly. In both cases large numbers of maggots were found under the surrounding mucoperiosteam. Removal of the maggots and debridement resulted in resolution of the condition.

Adult↗
PubMed1996

The oro-facial manifestations of trisomy 8 mosaicism: a case report.

Trisomy 8 mosaicism is a relatively common autosomal chromosomal disorder characterized by features such as mental retardation, characteristic facies, skeletal abnormalities and congenital heart disease. The case of a 4-year-old boy is described with particular reference to the oro-facial manifestations, which included cleft palate, pronounced anterior open bite, complete reserved unilateral buccal cross-bite, slightly increased width of alveolar processes, and gingival enlargement.

Child, Preschool↗
PubMed2006

Apert syndrome with glucose-6-phosphate dehydrogenase deficiency: a case report.

Apert syndrome is characterized by midface hypoplasia, syndactyly of the hands and feet, proptosis of eyes, steep and flat frontal bones, and premature union of cranial sutures. Maxillary hypoplasia, deep palatal vault, anterior open bite, crowding of the dental arch, severely delayed tooth eruption, and dental malocclusion are the main oral manifestations of this syndrome. In this report, a case of Apert syndrome with glucose-6-phosphate dehydrogenase (G(6)PD) deficiency is presented. The patient, a 4-year-old male and the fourth child of healthy parents, was admitted to our department because of delayed tooth eruption. He had all the cardinal symptoms of the Apert syndrome. Clinical examination revealed that primary centrals, canines and first molars erupted; however, primary second molars and laterals had not erupted. The patient had no dental caries. Preventive treatments were applied, and subsequently, the patient was taken to long-term follow up.

Acrocephalosyndactylia↗
PubMed1987

Investigations on the relation of dysgnathias and S-sound pronunciation.

A registration-form phonetic test has been developed which incorporates an established method for checking fine motor skills. Using an objective measuring and computing technique (electro-acoustic sound analysis according to the sound-seeking method), the author studied the pronunciation of the S-sound of one group of eugnathic and three groups of dysgnathic test persons. There were significant differences in sound characteristics between the normal group and all groups with dysgnathia (P = 0.001). Therefore it is considered that not every patient with an anomaly of the tooth position must have a disturbance of the S-sound. In contrast to the relatively narrow variations in the normal group, in all groups with dysgnathia considerable dispersions were registered. The anterior open bite occupies first place with regard to its susceptibility to disturbances of the S-sound. The statistical analysis of the partial energy values of all the S-sound spectra revealed typical normal behaviour on the one hand, and characteristic differences between the groups with dysgnathia and the group with eugnathia on the other. The information which is most important for the valuation of the S-sound are contained in the frequency area up to 9 kHz.

Adolescent↗