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Mandible-first in bimaxillary orthognathic surgery: an accurate bimaxillary repositioning technique with straight locking miniplates
e230
E-Poster Presentation
Tumour protein D52 and D54 have opposite effects on terminal differentiation of chondrocytes C. Ito ∗ , Y. Mukudai, K. Kato, H. Motohashi, S. Kondo, T. Shirota Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, Tokyo, Japan Background: Tumour protein D (TPD) family consists of four members, TPD52, 53, 54 and 55, and expressed in various cancer cells, including testis and breast cancers. Objectives: Since testis and breast cancers are well known to metastasize to a bone. We hypothesized that TPD52 family might play an important role on proliferation and differentiation of chondrocytes, osteoblasts. Herein, we investigated the involvement of TPD family proteins in osteoblasts and chondrocytes in vitro. Methods: MC3T3-E1, ATDC5 and RAW264.7 were allowed to differentiate by growth factors, or not. Those cells were investigated for expression of TPD52, 53, 54 genes and proteins. Next, ATDC5 cells were subjected to over-expression and knocking-down of TPD52, 53, 54, in order to investigate a role for proliferation and differentiation of chondrocyte by cell-biological assay and RT-qPCR. Findings: In MC3T3E-1 cells, expressions of TPD52, 53, 54 were increased in a differentiation-dependent manner. To the contrary, in ATDC5 cells, those were decreased. In ATDC5 cells, over-expression of TPD52 decreased ALPase activity, Ca deposition, and expressions of Type X collagen and ALPase genes, whereas knocking-down of TPD52 showed less effect. On the other hands, over-expression of TPD54 enhanced ALPase activity, Ca deposition, and expressions of Type X collagen and ALPase genes, and of note, knocking-down of TPD54 reduced those phenotypes. Conclusions: Those results suggested that TPD52 family proteins might have little effects on proliferation and initial differentiation on chondrocytes, however, might play an important role on terminal differentiation. http://dx.doi.org/10.1016/j.ijom.2015.08.143 U-shaped osteotomy around the descending palatine artery to prevent posterior osseous interference for superior/posterior repositioning of the maxilla in Le Fort I osteotomy T. Iwai 1,∗ , S. Omura 2 , K. Honda 1 , N. Shibutani 2 , K. Fujita 2 , Y. Yamashita 2 , H. Takasu 2 , S. Murata 2 , I. Tohnai 1 1
Yokohama City University Graduate School of Medicine, Yokohama, Japan 2 Yokohama City University Medical Center, Yokohama, Japan Background: In maxillary orthognathic surgery, superior/posterior repositioning of the maxilla is sometimes difficult, and removal of bony interference, especially around the descending palatine artery (DPA), is very time-consuming in cases of severe maxillary impaction. Therefore, a simple and safe method for maxillary superior/posterior repositioning is required to remove osseous interference around the DPA. Objectives: We describe U-shaped osteotomy around the DPA to prevent posterior osseous interference for superior/posterior repositioning of the maxilla in Le Fort I osteotomy. Methods: A used 1.8-ml cartridge of dental local anaesthetic was then replaced with indigo carmine. After conventional Le Fort I osteotomy and downfracture, indigo carmine was injected with a dental syringe into the palatal soft tissue around the greater
palatine foramen. The neurovascular bundle of the DPA running through the maxillary bone could be clearly visualized by indigo blue. Then, U-shaped osteotomies around the DPA are made bilaterally through the nasal floor, the maxillary sinus and the maxillary tuberosity, extending into the oral cavity. During bone removal, the blue-dyed palatal soft tissue can be seen gradually through the thin residual bone. The complete osteotomy can be performed safely without palatal soft tissue injury using a round bur or piezoelectric bone device until the blue-dyed palatal soft tissue is completely exposed. Conclusions: When superior/posterior repositioning of the maxilla is needed, U-shaped osteotomy with staining by blue dye injection, bimaxillary orthognathic surgery can be simplified and performed safely and accurately even by a less experienced surgeon. http://dx.doi.org/10.1016/j.ijom.2015.08.144 Mandible-first in bimaxillary orthognathic surgery: an accurate bimaxillary repositioning technique with straight locking miniplates T. Iwai 1,∗ , S. Omura 2 , K. Honda 1 , N. Shibutani 2 , K. Fujita 2 , Y. Yamashita 2 , H. Takasu 2 , S. Murata 2 , I. Tohnai 1 1 Yokohama City University Graduate School of Medicine, Yokohama, Japan 2 Yokohama City University Medical Center, Yokohama, Japan
Background: Although BSSO is generally performed after Le Fort I osteotomy, BSSO should be performed first in several situations. Although we have been applied straight locking miniplate (SLM) technique which enables accurate superior maxillary repositioning without any intraoperative measurements, this technique enables accurate bimaxillary repositioning in mandible-first procedure because SLMs can also play role as a condylar positioning device. Objectives: We describe an accurate bimaxillary repositioning technique with SLMs for mandible-first procedure in bimaxillary orthognathic surgery. Methods: Before down-fracture of the maxilla and complete bilateral mandibular ramus osteotomy, MMF was performed with interocclusal wafer guiding CR position and the maxillomandibular complex is fixed by SLMs bilaterally. SLMs are fixed to the zygomatic buttress above the Le Fort I osteotomy line and the proximal segment of the mandible, and secured with two screws on each side. BSSO is performed completely after removal of SLMs and MMF. The mandible is placed in the planned position after MMF using an intermediate splint, and SLMs are fixed bilaterally only on the proximal segment of the mandible. When SLMs are secured with two screws on the zygomatic buttress bilaterally and both condyles are set in CR position, the mandible can be accurately moved into the planned position as in the model surgery and is fixed with locking miniplates. Conclusions: Using SLM technique, the complex procedure of bimaxillary orthognathic surgery including mandible-first as well as maxilla-first can be simplified and the outcome of surgery will be more predictable even if performed by a less-experienced surgeon. http://dx.doi.org/10.1016/j.ijom.2015.08.145
E-Poster Presentation
Tumour protein D52 and D54 have opposite effects on terminal differentiation of chondrocytes C. Ito ∗ , Y. Mukudai, K. Kato, H. Motohashi, S. Kondo, T. Shirota Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, Tokyo, Japan Background: Tumour protein D (TPD) family consists of four members, TPD52, 53, 54 and 55, and expressed in various cancer cells, including testis and breast cancers. Objectives: Since testis and breast cancers are well known to metastasize to a bone. We hypothesized that TPD52 family might play an important role on proliferation and differentiation of chondrocytes, osteoblasts. Herein, we investigated the involvement of TPD family proteins in osteoblasts and chondrocytes in vitro. Methods: MC3T3-E1, ATDC5 and RAW264.7 were allowed to differentiate by growth factors, or not. Those cells were investigated for expression of TPD52, 53, 54 genes and proteins. Next, ATDC5 cells were subjected to over-expression and knocking-down of TPD52, 53, 54, in order to investigate a role for proliferation and differentiation of chondrocyte by cell-biological assay and RT-qPCR. Findings: In MC3T3E-1 cells, expressions of TPD52, 53, 54 were increased in a differentiation-dependent manner. To the contrary, in ATDC5 cells, those were decreased. In ATDC5 cells, over-expression of TPD52 decreased ALPase activity, Ca deposition, and expressions of Type X collagen and ALPase genes, whereas knocking-down of TPD52 showed less effect. On the other hands, over-expression of TPD54 enhanced ALPase activity, Ca deposition, and expressions of Type X collagen and ALPase genes, and of note, knocking-down of TPD54 reduced those phenotypes. Conclusions: Those results suggested that TPD52 family proteins might have little effects on proliferation and initial differentiation on chondrocytes, however, might play an important role on terminal differentiation. http://dx.doi.org/10.1016/j.ijom.2015.08.143 U-shaped osteotomy around the descending palatine artery to prevent posterior osseous interference for superior/posterior repositioning of the maxilla in Le Fort I osteotomy T. Iwai 1,∗ , S. Omura 2 , K. Honda 1 , N. Shibutani 2 , K. Fujita 2 , Y. Yamashita 2 , H. Takasu 2 , S. Murata 2 , I. Tohnai 1 1
Yokohama City University Graduate School of Medicine, Yokohama, Japan 2 Yokohama City University Medical Center, Yokohama, Japan Background: In maxillary orthognathic surgery, superior/posterior repositioning of the maxilla is sometimes difficult, and removal of bony interference, especially around the descending palatine artery (DPA), is very time-consuming in cases of severe maxillary impaction. Therefore, a simple and safe method for maxillary superior/posterior repositioning is required to remove osseous interference around the DPA. Objectives: We describe U-shaped osteotomy around the DPA to prevent posterior osseous interference for superior/posterior repositioning of the maxilla in Le Fort I osteotomy. Methods: A used 1.8-ml cartridge of dental local anaesthetic was then replaced with indigo carmine. After conventional Le Fort I osteotomy and downfracture, indigo carmine was injected with a dental syringe into the palatal soft tissue around the greater
palatine foramen. The neurovascular bundle of the DPA running through the maxillary bone could be clearly visualized by indigo blue. Then, U-shaped osteotomies around the DPA are made bilaterally through the nasal floor, the maxillary sinus and the maxillary tuberosity, extending into the oral cavity. During bone removal, the blue-dyed palatal soft tissue can be seen gradually through the thin residual bone. The complete osteotomy can be performed safely without palatal soft tissue injury using a round bur or piezoelectric bone device until the blue-dyed palatal soft tissue is completely exposed. Conclusions: When superior/posterior repositioning of the maxilla is needed, U-shaped osteotomy with staining by blue dye injection, bimaxillary orthognathic surgery can be simplified and performed safely and accurately even by a less experienced surgeon. http://dx.doi.org/10.1016/j.ijom.2015.08.144 Mandible-first in bimaxillary orthognathic surgery: an accurate bimaxillary repositioning technique with straight locking miniplates T. Iwai 1,∗ , S. Omura 2 , K. Honda 1 , N. Shibutani 2 , K. Fujita 2 , Y. Yamashita 2 , H. Takasu 2 , S. Murata 2 , I. Tohnai 1 1 Yokohama City University Graduate School of Medicine, Yokohama, Japan 2 Yokohama City University Medical Center, Yokohama, Japan
Background: Although BSSO is generally performed after Le Fort I osteotomy, BSSO should be performed first in several situations. Although we have been applied straight locking miniplate (SLM) technique which enables accurate superior maxillary repositioning without any intraoperative measurements, this technique enables accurate bimaxillary repositioning in mandible-first procedure because SLMs can also play role as a condylar positioning device. Objectives: We describe an accurate bimaxillary repositioning technique with SLMs for mandible-first procedure in bimaxillary orthognathic surgery. Methods: Before down-fracture of the maxilla and complete bilateral mandibular ramus osteotomy, MMF was performed with interocclusal wafer guiding CR position and the maxillomandibular complex is fixed by SLMs bilaterally. SLMs are fixed to the zygomatic buttress above the Le Fort I osteotomy line and the proximal segment of the mandible, and secured with two screws on each side. BSSO is performed completely after removal of SLMs and MMF. The mandible is placed in the planned position after MMF using an intermediate splint, and SLMs are fixed bilaterally only on the proximal segment of the mandible. When SLMs are secured with two screws on the zygomatic buttress bilaterally and both condyles are set in CR position, the mandible can be accurately moved into the planned position as in the model surgery and is fixed with locking miniplates. Conclusions: Using SLM technique, the complex procedure of bimaxillary orthognathic surgery including mandible-first as well as maxilla-first can be simplified and the outcome of surgery will be more predictable even if performed by a less-experienced surgeon. http://dx.doi.org/10.1016/j.ijom.2015.08.145