- Email: [email protected]
The effect of maxillary advancement on speech outcomes in patients with cleft lip and palate
ARTICLE IN PRESS 8
Abstracts / British Journal of Oral and Maxillofacial Surgery xxx (2014) xxx–xxx
donor tooth. The purpose of this study was to evaluate success of immediate autotransplantation of third molars when piezosurgery was used for surgical extraction of embedded or impacted donor teeth. Material and methods: An institutional review board approved prospective study was designed wherein 20 consecutive patients with non-restorable 1st or 2nd molar and a caries free retrievable third molar were enrolled. Third molars not requiring bone removal for extraction were excluded. Piezosurgery was used for removing inter-radicular bone at the recipient socket as well as for bone removal around the donor teeth so as to facilitate extraction as atraumatically as possible. Results: Of 20 patients enrolled, 1 was lost to follow up and excluded. The age range of patients was between 16-25 years. After an average follow-up of 12.8 months (SD 1), 18 cases were successful with formation of PDL around the teeth and good clinical outcome. 1 tooth was lost due to infection at 1 month. There was no root resorption or ankylosis in any of our cases. In 6 donor teeth with complete root formation, root canal treatment was carried out 2weeks following transplantation. All the remaining teeth responded positively with vitality testing at the end of follow-up period. Conclusion: Piezosurgery is an effective device if embedded or impacted third molars are to be harvested for successful autogenous transplantation. http://dx.doi.org/10.1016/j.bjoms.2014.07.025 20 The effect of maxillary advancement on speech outcomes in patients with cleft lip and palate Serryth Colbert ∗ , Joanne McDaid, Shirley Williams, Helen Extence, Adrian Sugar, David Drake South West and South Wales Cleft Units Introduction/Aims: Orthognathic surgery can alter symptoms of velopharyngeal insufficiency in cleft patients. The goal of this study was to evaluate how advancing the maxilla would affect the speech and articulation disorders of these patients. Materials/Methods: This was a retrospective study in which we evaluated the speech scores on 50 cleft lip and palate patients who underwent maxillary advancement at our unit. The following variables were recorded from both preoperative and postoperative speech evaluations: presence of a pharyngoplasty, nasality, velopharyngeal function assessment, and overall speech score. Preoperative and postoperative changes in the data were analyzed. Results/Statistics: we report on the competency of velopharyngeal function mechanisms postoperatively in patients with pharyngoplasties and in cases of borderline incompetence preoperatively. Speech scores after surgery are reported using the CAPS - A scoring system in patients with preoperative hypernasality.
Conclusions/Clinical Relevance: our study is compared to previous findings that patients with clefts of the lip and palate or palate alone are predisposed to velopharyngeal function alteration after maxillary advancement, particularly patients with borderline function and/or pharyngoplasty preoperatively. http://dx.doi.org/10.1016/j.bjoms.2014.07.026 21 Outcome of incompletely excised Non-Melanoma Head and Neck skin cancer from one Unit Paraneetharan, Ahmed N.N. Baheerathan ∗ , Sath Abouserwel, Guzin Bostanci, V. Ilankovan Poole General Hospital Introduction: Complete surgical excision is the gold standard for the treatment of Basal and Squamous cell Carcinomatas. Macroscopically, tumour extension is not always visible. The Head and Neck region due to the anatomical restrictions poses further difficulties. The available guidelines are arbitrary and Moh’s surgery resulting in wider area of normal tissue sacrifice. Our Unit has a defined excision guidelines using loupes magnification. We retrospectively studied the one year outcome. Patient- methods: 571 non-Melanotic skin cancers in 350 patients underwent treatment in a 12 months period. 77% were males and 23% were females. Results: 28 (5%) patients report was of incomplete margins, 24 being BCC and 4 SCC. 80% of the incomplete margins were periphery and the rest was deep. Cheek and Temporal regions (29&25% respectively) were the highest incidence sites for incompletely excised BCC margins and Scalp (30%) for the Squamous cell carcinomata. All 28 patients underwent re-excision after MDT decision. Only 9 (8 BCC &1 SCC) (25%) patients were positive for residual tumour. The commonest sites were medial eyebrow, supraorbital ridge and Nasal sill. 3 patients were subjected to Moh’s surgery and only one patient needed flap reconstruction and other two were closed primarily. Conclusion: With defined technique and loupe magnification our incomplete margins of Head and neck Non-Melanoma skin cancers were below the published figure. Further Excision and tumour clearance without anatomical mutilation was feasible in more than 98% of patients. The need for Moh’s surgery in every unit is questioned http://dx.doi.org/10.1016/j.bjoms.2014.07.027
Abstracts / British Journal of Oral and Maxillofacial Surgery xxx (2014) xxx–xxx
donor tooth. The purpose of this study was to evaluate success of immediate autotransplantation of third molars when piezosurgery was used for surgical extraction of embedded or impacted donor teeth. Material and methods: An institutional review board approved prospective study was designed wherein 20 consecutive patients with non-restorable 1st or 2nd molar and a caries free retrievable third molar were enrolled. Third molars not requiring bone removal for extraction were excluded. Piezosurgery was used for removing inter-radicular bone at the recipient socket as well as for bone removal around the donor teeth so as to facilitate extraction as atraumatically as possible. Results: Of 20 patients enrolled, 1 was lost to follow up and excluded. The age range of patients was between 16-25 years. After an average follow-up of 12.8 months (SD 1), 18 cases were successful with formation of PDL around the teeth and good clinical outcome. 1 tooth was lost due to infection at 1 month. There was no root resorption or ankylosis in any of our cases. In 6 donor teeth with complete root formation, root canal treatment was carried out 2weeks following transplantation. All the remaining teeth responded positively with vitality testing at the end of follow-up period. Conclusion: Piezosurgery is an effective device if embedded or impacted third molars are to be harvested for successful autogenous transplantation. http://dx.doi.org/10.1016/j.bjoms.2014.07.025 20 The effect of maxillary advancement on speech outcomes in patients with cleft lip and palate Serryth Colbert ∗ , Joanne McDaid, Shirley Williams, Helen Extence, Adrian Sugar, David Drake South West and South Wales Cleft Units Introduction/Aims: Orthognathic surgery can alter symptoms of velopharyngeal insufficiency in cleft patients. The goal of this study was to evaluate how advancing the maxilla would affect the speech and articulation disorders of these patients. Materials/Methods: This was a retrospective study in which we evaluated the speech scores on 50 cleft lip and palate patients who underwent maxillary advancement at our unit. The following variables were recorded from both preoperative and postoperative speech evaluations: presence of a pharyngoplasty, nasality, velopharyngeal function assessment, and overall speech score. Preoperative and postoperative changes in the data were analyzed. Results/Statistics: we report on the competency of velopharyngeal function mechanisms postoperatively in patients with pharyngoplasties and in cases of borderline incompetence preoperatively. Speech scores after surgery are reported using the CAPS - A scoring system in patients with preoperative hypernasality.
Conclusions/Clinical Relevance: our study is compared to previous findings that patients with clefts of the lip and palate or palate alone are predisposed to velopharyngeal function alteration after maxillary advancement, particularly patients with borderline function and/or pharyngoplasty preoperatively. http://dx.doi.org/10.1016/j.bjoms.2014.07.026 21 Outcome of incompletely excised Non-Melanoma Head and Neck skin cancer from one Unit Paraneetharan, Ahmed N.N. Baheerathan ∗ , Sath Abouserwel, Guzin Bostanci, V. Ilankovan Poole General Hospital Introduction: Complete surgical excision is the gold standard for the treatment of Basal and Squamous cell Carcinomatas. Macroscopically, tumour extension is not always visible. The Head and Neck region due to the anatomical restrictions poses further difficulties. The available guidelines are arbitrary and Moh’s surgery resulting in wider area of normal tissue sacrifice. Our Unit has a defined excision guidelines using loupes magnification. We retrospectively studied the one year outcome. Patient- methods: 571 non-Melanotic skin cancers in 350 patients underwent treatment in a 12 months period. 77% were males and 23% were females. Results: 28 (5%) patients report was of incomplete margins, 24 being BCC and 4 SCC. 80% of the incomplete margins were periphery and the rest was deep. Cheek and Temporal regions (29&25% respectively) were the highest incidence sites for incompletely excised BCC margins and Scalp (30%) for the Squamous cell carcinomata. All 28 patients underwent re-excision after MDT decision. Only 9 (8 BCC &1 SCC) (25%) patients were positive for residual tumour. The commonest sites were medial eyebrow, supraorbital ridge and Nasal sill. 3 patients were subjected to Moh’s surgery and only one patient needed flap reconstruction and other two were closed primarily. Conclusion: With defined technique and loupe magnification our incomplete margins of Head and neck Non-Melanoma skin cancers were below the published figure. Further Excision and tumour clearance without anatomical mutilation was feasible in more than 98% of patients. The need for Moh’s surgery in every unit is questioned http://dx.doi.org/10.1016/j.bjoms.2014.07.027