Journal - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

Journal - Orthodontics : the art and practice of dentofacial enhancement (United States )

Abstract :

This report presents a multidisciplinary approach to the treatment of a rare case of a distally impacted mandibular second premolar indicating a 90-degree tilt of the long axis in a healthy, 15-year-old girl. It also describes the clinical and radiologic findings after a 10-year longitudinal follow-up period. The horizontally impacted mandibular second premolar was positioned behind the roots of the first molar and in close proximity to the root of the second molar, toward the lingual cortex of the mandibular body. Treatment methods required 2 years of cooperation among an orthodontist, an oral and maxillofacial surgeon, a periodontist, and an endodontist to achieve a leveled and aligned position in a properly healed condition. Finally, the horizontally impacted mandibular second premolar was correctly positioned in the arch surrounded by healed periodontal ligament tissue. Root resorption of the adjacent orthodontic anchorage units was recorded. The 10-year postoperative follow-up presented a stable, functional, and symptom-free permanent mandibular second premolar. The multidisciplinary dental team's considerations and cooperation account for the successful repositioning of the compromised mandibular second premolar with minimal damage to the surrounding hard and soft tissue following 10 years of longitudinal follow-up.

Journal - International journal of oral and maxillofacial surgery

Abstract :

This report describes a combined orthodontic surgical technique involving vertical alveolar distraction using temporary anchorage devices (TADs) in cases of massive alveolar ridge bone and teeth loss. A combined surgical orthodontic protocol included presurgical orthodontic preparation and a preimplantation surgical augmentation stage for insertion of a vertical distractor. During the active vertical alveolar distraction process TADs were inserted. Intraoral orthodontic elastics were attached to the main orthodontic archwire exerting multidirectional forces to control the vertical distraction vector. After 3 months of vector controlling and active bone moulding, the TADs were removed. Anterior alveolar ridge augmentation using distraction osteogenesis was achieved. The application of TADs for better anterior segment curvature enabled dental implant insertion, better positioning and restoration. A combined surgical orthodontic management protocol involving vertical alveolar distraction osteogenesis for augmentation purposes is an efficient treatment method to improve alveolar ridge volume for the preimplantation stage.Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Journal - Ann R Australas Coll Dent Surg (Australia )

Abstract :

Three-dimensional Le Fort I DO can be used to selectively widen, lengthen, and vertically reposition the maxilla, without bone grafts and with a good adaptation of the surrounding soft tissues. Therefore DO is a complementary tool for conventional orthodontics and orthognathic surgical techniques that address maxillary deficiency. It is the technique of choice for patients who require significant maxillary repositioning and have significant soft tissue limitations, such as scarring secondary to previous surgical procedures. The procedure can be performed in children prior to reaching skeletal maturity and also in adult patients. Finally, three-dimensional maxillary reconstruction by distraction of the Le Fort I segment offers an improved aesthetic outcome and less risk of deterioration of speech in comparison with traditional orthognathic techniques.

Journal - Oral diseases

Abstract :

Oral Diseases (2010) doi: 10.1111/j.1601-0825.2010.01729.x Objectives: The aim of this investigation was to study the epidemiology of the isolated soft tissue cleft lip (ICL) population and to evaluate the dental anomalies associated with permanent dentition. Methods: The study included 19 children aged 9-13 years presenting ICL selected from 657 cleft lip-affected patients treated during the last 10 years in two craniofacial centers. Only 17 patients could be included for dental anomaly evaluation: Hyperdontia, Hypodontia, Gemination, Talon tooth, Microdontia, and Macrodontia. These were compared with cleft lip and palate (CLP) and cleft lip and alveolus (CLA)-affected populations and with normal populations. Results: The prevalence of ICL was 2.8%. All types of tooth abnormalities were found to be higher and mainly significant for the cleft side of ICL compared with the normal population. On the side opposite the cleft, the prevalence of dental anomalies reduced toward the normal individuals and was not significantly different. The significant differences found between CLP, CLA, and ICL-affected populations were mostly depicted by lower incisors and second pre-molar hypodontia. Conclusions: Isolated cleft lip is a rare phenomenon among the spectrum of the cleft-affected population. The prevalence of the dental anomalies in ICL maintains the proportional trend according to clefting severity.

Journal - American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics (United States )

Abstract :

The purpose of this article is to present a long-term follow-up of the growth of the face and the nasomaxillary complex in a pair of identical twins, one of whom had suffered severe midfacial trauma at age 2 years. Growth of the face and the nasomaxillary complex was longitudinally assessed and compared by means of facial photographs and cephalometric x-rays. Twin A suffered Le Fort II and III fractures with an associated frontal bone injury in early childhood and subsequently developed significant midface hypoplasia; twin B had no trauma and normal facial growth and development. Facial profile difference between the twins gradually became more pronounced until age 19. Twin A had obvious retrusion of the midfacial region, including the nasal bones on visual examination and radiographic study. At age 20, she underwent orthognathic surgical correction of the traumatic deformity. Her unaffected sibling, twin B, provided the genetic facial phenotype for the surgical orthognathic reconstruction.Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Journal - The Journal of clinical pediatric dentistry (United States )

Abstract :

An odontoma is usually found in the surrounding area of the unerupted permanent tooth bud and rarely adjacent to the primary central incisor This report presents a case of an unerupted malformed primary central incisor, histologically diagnosed as a compound odontoma. A 5.5 year-old healthy boy presented with an unerupted maxillary left primary central incisor and mild gingival buccal swelling. No history of traumatic injury was recorded. Radiological examination revealed a tooth-like mass with a partially developed root and a malformed crown in the area of the left primary central incisor Delayed development of the successor left permanent incisor in comparison to the right one was noted. The rational for early surgical intervention to enable normal development and eruption of permanent incisors is described. Clinical and radiographic diagnoses as well as several etiological factors and a differential diagnosis are considered and reviewed.

Journal - Plastic and reconstructive surgery (United States )

Journal - Dental traumatology : official publication of International Association for Dental Traumatology

Abstract :

Abstract - This article reviews the management of mandibular body fractures in young children. Treatment principles of this fracture type differ from that of adults due to concerns regarding mandibular growth processes and dentition development. The goal of this fracture treatment is to restore the underlying bony architecture to its preinjury position in a stable fashion as non-invasively as possible and with minimal residual esthetic and functional impairment. The management of mandibular body fractures in children depends on the fracture type and the stage of skeletal and dental development; treatment modalities range from conservative non-invasive, through closed reduction and immobilization methods to open reduction with internal fixation. Disruption of the periosteal envelope of the mandibular body may have an unpredictable effect on growth. Thus, if intervention is required closed reduction is favored.

Journal - Plastic and reconstructive surgery (United States )

Journal - Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics (United States )

Abstract :

In this review we describe the advantages, complications, and preventive considerations encountered as a result of the use of a halo for distraction of a retrusive nasomaxillary complex. Distraction osteogenesis is a well accepted combined orthodontic-surgical technique used in the treatment of patients with hypoplastic craniofacial components. The rigid external distraction (RED) system is a useful external distraction device for the advancement of severe retrusive maxilla especially in cleft palate patients. However, the addition of this new technique to the surgeon's armamentarium is accompanied by new complications and risks. Review of the literature on complications of the use of halo revealed that most complications are pin related. Complications with the use of RED have mainly included the penetration of intracranial pins. Risk management and preventive considerations propose several procedures to minimize the side effects when using RED: preoperative skull computerized tomography, pediatric neurosurgical consultation, proper pin care during distraction, frequent monitoring of the patient's general condition, proper pin and torque design, and special attention to the removal process of the RED.

Journal - Archives of oral biology (England )

Abstract :

OBJECTIVE: To investigate the sialometry, sialochemistry and antioxidants in cleft patients prior to alveolar closure procedures. DESIGN: Saliva was collected from 21 children with unilateral and bilateral cleft lip and palate (UCLP and BCLP) with overt oronasal alveolar communication and with recurrent licking of fluids and soft diet complaints (the study group) and in 22 normal individuals (the control group). Salivary flow rate was measured, and calcium (Ca), phosphate (P), magnesium (Mg), total protein, albumin, amylase, lactate dehydrogenase (LDH), and secretory IgA were analysed. Salivary total antioxidant status (TAS), peroxidase activity, superoxide dismutase (SOD) activity, uric acid (UA), was also determined. RESULTS: The sialometry and sialochemistry analyses did not reveal significant difference between the two groups. Salivary median uric acid concentration was 6-fold lower in the cleft group (p<0.05). The median total antioxidant status (TAS) of the cleft group however, was significantly higher by 58% (p<0.005) than that of the control group. Median SOD activity was also higher in the cleft group, by 42%, though these differences did not reach statistical significance. CONCLUSIONS: Our findings suggest that the oral biology system of cleft patients in their prealveolar closure stage does not differ significantly from normal controls. Low UA found in the saliva of cleft patients may suggest that some genetic alteration of the UA transport occurs simultaneously when cleft lip and palate occur. TAS reduction may also reveal an increased oxidative stress burden in the oral cavities of cleft children which has never been shown before.

Journal - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (United States )

Journal - Plastic and reconstructive surgery (United States )

Journal - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (United States )

Journal - The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association (United States )

Abstract :

OBJECTIVE: The purpose of the study was to determine the prevalence of congenitally missing teeth in a group of Israeli children with various types of clefts. DESIGN: Prevalence of congenitally missing teeth was determined for 179 children with cleft lip, cleft lip and alveolar ridge, cleft lip and palate, and cleft palate. Subgroupings were assessed according to patient sex, origin, cleft type, tooth type, and the side of hypodontia. The diagnosis of congenitally missing teeth (CMT) was based on initial and follow-up panoramic roentgenograms. In case of doubt, occlusal or periapical roentgenograms as well as clinical dental photographs were also used. SETTING: Data collection was conducted at the Rambam Medical Center, Orthodontic and Craniofacial Unit, Haifa, Israel. RESULTS: In the total cleft group, 67.6% of the patients presented with hypodontia, totaling 246 missing teeth. A statistically significant difference was found in the distribution of patients with CMT of Jewish and minority origin according to sex. Cleft lip and palate was the most frequently affected group in which 195 teeth were missing. The most frequently missing tooth among the cleft population was the maxillary incisor. The order of frequency of the other missing teeth was the same as in the normal population. Hypodontia and malformations of permanent teeth were most common on the cleft side. CONCLUSION: The frequency of CMT in the Israeli cleft population studied was higher than in the intact population. This confirms findings in other populations worldwide.