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Face asymmetry caused by the mandibular coronoid process hypertrophy: Report of two cases
Posters 137
Augmentation Techniques with Autogenous Bone Chips Haessler 1).
Privatpraxis, Mund-Kiefer-Gesichtschirurg, Oppenheim, Germany Results and clinical use with a new developed bone-chipcollecter will be described. Shavings of implant preparations or alveolar ridge plastics are safely collected with the bone-chip-collecter. Secondary interventions for autogenous bone grafts, e.g. from the chin or the mandibular angle, can be avoided. A separate aspiration system for saliva allows nearly sterile aspiration of bone chips with a second aspiration system. Collected bone shavings can be used as autogenous transplantation material for alveolar ridge augmentations or extension plastics. In case of insufficient periost placement, bone chip transplantation in combination with membrane techniques allows safe osseointegration of enosseous implants. In the period from February 1994 to January 1995, 284 implantation procedures with simultaneous bone chip augmentation were performed: 284 IMZ® implants and 76 FrialitIl®-implants were inserted. The results will be discussed with consideration of membrane techniques. Differential therapeutical considerations in respect of further augmentation procedures will be mentioned.
or trauma. Surprisingly, a relatively uncomplicated procedure capable of achieving very satisfactory results has been generally neglected: the perioral mucomyocutaneous flap according to Karapandzic. The goal of the presented investigation was to compare the advantages and disadvantages of the above mentioned procedure with others for lip reconstruction. Follow-up was conducted in 13 of 19 patients whose lips were reconstructed using the Karapandzic procedure. Size of mouth opening, motoric function, sensibility and aesthetic aspects were reviewed and evaluated. Our results demonstrated: (i) the procedure should always be performed bilaterally; (ii) it is effective for defects up to 70% of the original lip length, including commissural defects; and (iii) better functional and aesthetic outcome is achievable than with many other more complicated surgicalprocedures.
Outcome after Surgical Treatment of Habitual Dislocation of the Mandibular Articulation by the Method of Leclerc/Girard Herzmann K., Eckelt U.
Department of Maxillo Facial Surgery, Universityof Dresden, Dresden, Germany
In 1994 and 1995 we noticed two cases of facial asymmetry in adult patients which were characterized by slowly increasing volume of the zygomatic bone unilaterally. Difficulties with opening movements of the mandible were the main functional symptoms. Following clinical investigation including X-ray and computed tomography scan the diagnosis of Osteoma osteoides corporis ossis zygomatici was assessed. Only during the operation the expanded mandibular coronoid process with the cartilage surface was found in the infratemporal space just behind the body of zygomatic bone. This joint-like formation pushed itself from the posterior aspect of zygomatic bone and acted like a hammer causing the bulge of zygomatic bone. Histologic examination of these formations revealed the diagnosis: osteochondroma of coronoid process. Both patients stated in their medical history some unspecified trauma of mandible in the past. Therefore, we can not point out precisely the exact cause of these findings (i.e. postraumatic or tumourous lesions). The patients were restored without any functional limitations after their operations, i.e. resection of pathological coronoid process The aesthetic correction of facial asymmetry will be done eventually. On radiological documents, we are trying to present the possibilities of false reading on X-ray and CT scan in particular, for the above mentioned cases.
A habitual dislocation of the mandibular articulation means a condition in which the condyle is fixed at the ventral surface of the tuberculum articulare. That condition occurs particularly frequent when the mouth is opened in yawning or for a dental treatment. Patients generally succeed in resetting the mandible on their own by certain manipulations, which are, for the most part, only slightly painful. Surgical therapy for habitual dislocation of the mandibular articulation is only indicated if conservative treatment has been unsuccessful. It is the aim of most methods of operation cited in the literature to restrict the excursion of the capitulum and discus. The method of surgery used in those patients at our clinic is attributed to Leclerc and Girard. In the period of 1975-1994, a total of 15 patients were operated on for habitual dislocation of the mandibular articulation by that method. Surgery was performed bilaterally in all cases, no postoperative intermaxillary immobilization was performed. Long-term results obtained after a follow-up period of 2-15 years are satisfactory, both from a clinical point of view and in the subjective evaluation by patients. In no case, was opening of the mouth restricted in such a way that mastication or speech function was impaired. Though forward and lateral mobility of the mandible was reduced, no patient found this fact bothersome. Two patients complained of occasional pain when masticating. In one case, dislocation recurred immediately after operation but did not recur later on. Operation by the method of Leclerc and Girard is performed only in the lateral part of the tuberculum articulare extending far in the medial direction. Therefore, scars forming periarticularly seem to be of primary importance to restricted movement and to success of treatment. It is our experience that surgery for the treatment of habitual dislocation of the mandibular articulation, which is easy to perform and adversely affects patients only slightly, can thus be recommended.
Lip Reconstruction with the Mucomyocutaneous Flap According to Karapandzic Hartmann N., Riesemann U., Miirker R.
Cryoepilation of Tissue-Pedicle Myocutaneous Grafts after Plastic Reconstruction in the Region of the Oral Cavity Hlawitschka M., Eckelt U.
Department or Oral and Maxillofacial Surgery, Universityof Witten-Herdecke, Witten-Herdecke, Germany
Department of Maxillo Facial Surgery, University of Dresden, Dresden, Germany
The literature describes a confusing multitude of surgical methods for reconstruction of lip defects following tumour
Oral cavity grafts after tumour operations with tissue-pedicle skin grafts (e.g. radial flap, pectoralis major island flap,
Face Asymmetry Caused by the Mandibular Coronoid Process Hypertrophy: Report of Two Cases Hajek P., Hanek P., Povysil C., Vyhnanek L.
Departments of Oral and Maxillofacial Surgery, Pathology and Radiology, Charles University, Prague, Czech Republic
Augmentation Techniques with Autogenous Bone Chips Haessler 1).
Privatpraxis, Mund-Kiefer-Gesichtschirurg, Oppenheim, Germany Results and clinical use with a new developed bone-chipcollecter will be described. Shavings of implant preparations or alveolar ridge plastics are safely collected with the bone-chip-collecter. Secondary interventions for autogenous bone grafts, e.g. from the chin or the mandibular angle, can be avoided. A separate aspiration system for saliva allows nearly sterile aspiration of bone chips with a second aspiration system. Collected bone shavings can be used as autogenous transplantation material for alveolar ridge augmentations or extension plastics. In case of insufficient periost placement, bone chip transplantation in combination with membrane techniques allows safe osseointegration of enosseous implants. In the period from February 1994 to January 1995, 284 implantation procedures with simultaneous bone chip augmentation were performed: 284 IMZ® implants and 76 FrialitIl®-implants were inserted. The results will be discussed with consideration of membrane techniques. Differential therapeutical considerations in respect of further augmentation procedures will be mentioned.
or trauma. Surprisingly, a relatively uncomplicated procedure capable of achieving very satisfactory results has been generally neglected: the perioral mucomyocutaneous flap according to Karapandzic. The goal of the presented investigation was to compare the advantages and disadvantages of the above mentioned procedure with others for lip reconstruction. Follow-up was conducted in 13 of 19 patients whose lips were reconstructed using the Karapandzic procedure. Size of mouth opening, motoric function, sensibility and aesthetic aspects were reviewed and evaluated. Our results demonstrated: (i) the procedure should always be performed bilaterally; (ii) it is effective for defects up to 70% of the original lip length, including commissural defects; and (iii) better functional and aesthetic outcome is achievable than with many other more complicated surgicalprocedures.
Outcome after Surgical Treatment of Habitual Dislocation of the Mandibular Articulation by the Method of Leclerc/Girard Herzmann K., Eckelt U.
Department of Maxillo Facial Surgery, Universityof Dresden, Dresden, Germany
In 1994 and 1995 we noticed two cases of facial asymmetry in adult patients which were characterized by slowly increasing volume of the zygomatic bone unilaterally. Difficulties with opening movements of the mandible were the main functional symptoms. Following clinical investigation including X-ray and computed tomography scan the diagnosis of Osteoma osteoides corporis ossis zygomatici was assessed. Only during the operation the expanded mandibular coronoid process with the cartilage surface was found in the infratemporal space just behind the body of zygomatic bone. This joint-like formation pushed itself from the posterior aspect of zygomatic bone and acted like a hammer causing the bulge of zygomatic bone. Histologic examination of these formations revealed the diagnosis: osteochondroma of coronoid process. Both patients stated in their medical history some unspecified trauma of mandible in the past. Therefore, we can not point out precisely the exact cause of these findings (i.e. postraumatic or tumourous lesions). The patients were restored without any functional limitations after their operations, i.e. resection of pathological coronoid process The aesthetic correction of facial asymmetry will be done eventually. On radiological documents, we are trying to present the possibilities of false reading on X-ray and CT scan in particular, for the above mentioned cases.
A habitual dislocation of the mandibular articulation means a condition in which the condyle is fixed at the ventral surface of the tuberculum articulare. That condition occurs particularly frequent when the mouth is opened in yawning or for a dental treatment. Patients generally succeed in resetting the mandible on their own by certain manipulations, which are, for the most part, only slightly painful. Surgical therapy for habitual dislocation of the mandibular articulation is only indicated if conservative treatment has been unsuccessful. It is the aim of most methods of operation cited in the literature to restrict the excursion of the capitulum and discus. The method of surgery used in those patients at our clinic is attributed to Leclerc and Girard. In the period of 1975-1994, a total of 15 patients were operated on for habitual dislocation of the mandibular articulation by that method. Surgery was performed bilaterally in all cases, no postoperative intermaxillary immobilization was performed. Long-term results obtained after a follow-up period of 2-15 years are satisfactory, both from a clinical point of view and in the subjective evaluation by patients. In no case, was opening of the mouth restricted in such a way that mastication or speech function was impaired. Though forward and lateral mobility of the mandible was reduced, no patient found this fact bothersome. Two patients complained of occasional pain when masticating. In one case, dislocation recurred immediately after operation but did not recur later on. Operation by the method of Leclerc and Girard is performed only in the lateral part of the tuberculum articulare extending far in the medial direction. Therefore, scars forming periarticularly seem to be of primary importance to restricted movement and to success of treatment. It is our experience that surgery for the treatment of habitual dislocation of the mandibular articulation, which is easy to perform and adversely affects patients only slightly, can thus be recommended.
Lip Reconstruction with the Mucomyocutaneous Flap According to Karapandzic Hartmann N., Riesemann U., Miirker R.
Cryoepilation of Tissue-Pedicle Myocutaneous Grafts after Plastic Reconstruction in the Region of the Oral Cavity Hlawitschka M., Eckelt U.
Department or Oral and Maxillofacial Surgery, Universityof Witten-Herdecke, Witten-Herdecke, Germany
Department of Maxillo Facial Surgery, University of Dresden, Dresden, Germany
The literature describes a confusing multitude of surgical methods for reconstruction of lip defects following tumour
Oral cavity grafts after tumour operations with tissue-pedicle skin grafts (e.g. radial flap, pectoralis major island flap,
Face Asymmetry Caused by the Mandibular Coronoid Process Hypertrophy: Report of Two Cases Hajek P., Hanek P., Povysil C., Vyhnanek L.
Departments of Oral and Maxillofacial Surgery, Pathology and Radiology, Charles University, Prague, Czech Republic