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A case of hemifacial microsomia with unilateral vertical shortening of maxilla and mandibular ramus
Poster given to the analysis of morbidity issues related to each technique. Conclusion: Facial translocation approaches are based on sound anatomical and embryological principles and are functionally and cosmetically acceptable in treating tumours of the anterior and lateral skull base. The possible complications related to each approach and their management are discussed.
tation includes a series of patients who have under gone unifocal distraction osteogenesis, vector planning with stereolithography, polysomonography, etc. The complications including undesirable soft tissue changes, difficulty in vector control, etc. A 3-year follow up of these patients is presented in detail in this paper presentation.
1091
Through a triradain extended pre-auricular approach all the three flaps were raised in subcuticular plane to expose a measured length of galea. Adequate length of galea temporalis flap was raised and tunneled through subplatysmal plane and sutured to the opposite side facial musculature. doi:10.1016/j.ijom.2007.09.038
doi:10.1016/j.ijom.2007.09.036 doi:10.1016/j.ijom.2007.09.034
P38 P36
Distraction Osteogenesis P34 Role of distraction osteogenesis in temporomandibular joint ankylosis: a case report N. Sagar*, S. M. Kotrashetti, T. Kale, S. Balaiga, M. Umarani K.L.E.’s institute of Dental Sciences, Belgaum, India Cranio-mandibular ankylosis is characterized by the formation of a bony mass which replaces the normal articulation. For this reason, excision of this mass is not necessary for the release of ankylosis. In recent studies, mandibular distraction has been used to lengthen the retrognathic mandible of patients with TMJ ankylosis. The vertical ramal height is corrected and a pseudo joint is created. The aims of this poster are to show the use of distraction osteogenesis in ankylosis and to present a therapeutic option for the treatment of mandibular hypoplasia with unilateral ankylosis in the childhood to treat the ankylosis. doi:10.1016/j.ijom.2007.09.035
P35 Retrospective outcomes in distraction osteogenesis for mandibular problems N. Nanda Kumar*, S. Ramkumar, C. Ravindran Krishnadevaraya College of Dental Sciences and Hospital, Yelahanka, Bangalore, India Distraction osteogenesis is an exciting new technique which has been applied in various centers world wide with varying results. Our experience with distraction for various applications like obstructive sleep apnoea, TMJ ankylosis, mandibular agenesis and tumors, have met with some element of success and its share of problems. This paper presen-
Distraction osteogenesis – the AFMC experience M. G. Venugopal*, R. Sinha, S. Menon Department of Dental Surgery, AFMC, Pune, India Distraction Osteogenesis has established itself as a definite treatment modality of treating severe Craniofacial Defects and atrophic alveoalar ridges. It produces better post treatment results as compared to conventional orthognathic and pre-prosthetic surgical procedures. Retrospective review of various such cases involving maxilla and mandible treated by Distraction Osteogenesis using various intraoral and extraoral distractors in the past 2-yearperiod at AFMC are presented. Craniofacial Defects when treated by Distraction Osteogenesis was effective in improving both function and aesthetics by soft tissue and bone regeneration. doi:10.1016/j.ijom.2007.09.037
P37 A case of hemifacial microsomia with unilateral vertical shortening of maxilla and mandibular ramus S. Sachdeva*, M. Kohli, R.S. Neelakandan, P. Wadhwani, N. Sharma Saraswati Dental College, Lucknow 233, Tewariganj, Faizabad Road, Lucknow, U.P., India A 23-year-male patient with hemifacial microsomia and unilateral vertical shortening of maxilla and mandibular ramus was treated with an extraoral monofocal distractor. Maxillomandibular vertical distraction with facial reamination with galeal temporal flap was done. A differential LeFort 1 osteotomy cut was made through an intraoral approach and the maxilla was down fractured. An extraoral Risdons incision was made and osteotomy line was made on ramus parallel to occlusal plane.
Reconstruction of partial maxillectomy defect by transport distraction osteogenesis M. R. Hendricks*, M. Hallund, S. Singh Private Practice, Cape Town, South Africa Reconstruction of large maxillectomy defects following intra-oral tumour resection presents a formidable challenge. In addition to hermetic obturation of the oronasal-antral defect, rehabilitation has to take into account the demands for aesthetics, function, deglutition and speech. To this end, it would be desirable to recreate a palatal vault, alveolar ridge and vestibule. Due to the complexity of maxillectomy defects, the structural and functional restoration requires composite tissue replacement involving autogenous grafting of bone and soft tissue usually in the form of local free vascularised flaps and skin grafts. These procedures demand long and skillful surgical techniques and though often highly successful, are not always predictable and cause donor site morbidity. Distraction osteogenesis is a biological process of generating new bone and soft tissue by gradual traction of the clinical bone segments (ILIZAROV, 1989). Based on a successful prototype private model developed by CHEUNG et al. (2003), the authors have successfully obturated a large maxillectomy defect, Okay Class II, measuring 40 20 mm in a 42-year-old male following resection of a maxillary tumour (aggressive cemento-ossifying fibroma). The patient wore a tissue-borne obturator for 2 years. A Herford plateguided distraction device (KLS Martin) was modified for use in the maxilla. The defect was closed within 27 days at a rate of 1.5 mm/day to prevent premature ossification of the transport segment. The distractor was removed after a consolidation period of 3 months and small interface bone grafts were placed at the docking site for future implant-borne fixed prosthetic rehabilitation. doi:10.1016/j.ijom.2007.09.039
tation includes a series of patients who have under gone unifocal distraction osteogenesis, vector planning with stereolithography, polysomonography, etc. The complications including undesirable soft tissue changes, difficulty in vector control, etc. A 3-year follow up of these patients is presented in detail in this paper presentation.
1091
Through a triradain extended pre-auricular approach all the three flaps were raised in subcuticular plane to expose a measured length of galea. Adequate length of galea temporalis flap was raised and tunneled through subplatysmal plane and sutured to the opposite side facial musculature. doi:10.1016/j.ijom.2007.09.038
doi:10.1016/j.ijom.2007.09.036 doi:10.1016/j.ijom.2007.09.034
P38 P36
Distraction Osteogenesis P34 Role of distraction osteogenesis in temporomandibular joint ankylosis: a case report N. Sagar*, S. M. Kotrashetti, T. Kale, S. Balaiga, M. Umarani K.L.E.’s institute of Dental Sciences, Belgaum, India Cranio-mandibular ankylosis is characterized by the formation of a bony mass which replaces the normal articulation. For this reason, excision of this mass is not necessary for the release of ankylosis. In recent studies, mandibular distraction has been used to lengthen the retrognathic mandible of patients with TMJ ankylosis. The vertical ramal height is corrected and a pseudo joint is created. The aims of this poster are to show the use of distraction osteogenesis in ankylosis and to present a therapeutic option for the treatment of mandibular hypoplasia with unilateral ankylosis in the childhood to treat the ankylosis. doi:10.1016/j.ijom.2007.09.035
P35 Retrospective outcomes in distraction osteogenesis for mandibular problems N. Nanda Kumar*, S. Ramkumar, C. Ravindran Krishnadevaraya College of Dental Sciences and Hospital, Yelahanka, Bangalore, India Distraction osteogenesis is an exciting new technique which has been applied in various centers world wide with varying results. Our experience with distraction for various applications like obstructive sleep apnoea, TMJ ankylosis, mandibular agenesis and tumors, have met with some element of success and its share of problems. This paper presen-
Distraction osteogenesis – the AFMC experience M. G. Venugopal*, R. Sinha, S. Menon Department of Dental Surgery, AFMC, Pune, India Distraction Osteogenesis has established itself as a definite treatment modality of treating severe Craniofacial Defects and atrophic alveoalar ridges. It produces better post treatment results as compared to conventional orthognathic and pre-prosthetic surgical procedures. Retrospective review of various such cases involving maxilla and mandible treated by Distraction Osteogenesis using various intraoral and extraoral distractors in the past 2-yearperiod at AFMC are presented. Craniofacial Defects when treated by Distraction Osteogenesis was effective in improving both function and aesthetics by soft tissue and bone regeneration. doi:10.1016/j.ijom.2007.09.037
P37 A case of hemifacial microsomia with unilateral vertical shortening of maxilla and mandibular ramus S. Sachdeva*, M. Kohli, R.S. Neelakandan, P. Wadhwani, N. Sharma Saraswati Dental College, Lucknow 233, Tewariganj, Faizabad Road, Lucknow, U.P., India A 23-year-male patient with hemifacial microsomia and unilateral vertical shortening of maxilla and mandibular ramus was treated with an extraoral monofocal distractor. Maxillomandibular vertical distraction with facial reamination with galeal temporal flap was done. A differential LeFort 1 osteotomy cut was made through an intraoral approach and the maxilla was down fractured. An extraoral Risdons incision was made and osteotomy line was made on ramus parallel to occlusal plane.
Reconstruction of partial maxillectomy defect by transport distraction osteogenesis M. R. Hendricks*, M. Hallund, S. Singh Private Practice, Cape Town, South Africa Reconstruction of large maxillectomy defects following intra-oral tumour resection presents a formidable challenge. In addition to hermetic obturation of the oronasal-antral defect, rehabilitation has to take into account the demands for aesthetics, function, deglutition and speech. To this end, it would be desirable to recreate a palatal vault, alveolar ridge and vestibule. Due to the complexity of maxillectomy defects, the structural and functional restoration requires composite tissue replacement involving autogenous grafting of bone and soft tissue usually in the form of local free vascularised flaps and skin grafts. These procedures demand long and skillful surgical techniques and though often highly successful, are not always predictable and cause donor site morbidity. Distraction osteogenesis is a biological process of generating new bone and soft tissue by gradual traction of the clinical bone segments (ILIZAROV, 1989). Based on a successful prototype private model developed by CHEUNG et al. (2003), the authors have successfully obturated a large maxillectomy defect, Okay Class II, measuring 40 20 mm in a 42-year-old male following resection of a maxillary tumour (aggressive cemento-ossifying fibroma). The patient wore a tissue-borne obturator for 2 years. A Herford plateguided distraction device (KLS Martin) was modified for use in the maxilla. The defect was closed within 27 days at a rate of 1.5 mm/day to prevent premature ossification of the transport segment. The distractor was removed after a consolidation period of 3 months and small interface bone grafts were placed at the docking site for future implant-borne fixed prosthetic rehabilitation. doi:10.1016/j.ijom.2007.09.039