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Presurgical orthodontics for dentofacial deformities
SurgicalRoundtable Clinics
Adwmges overotherAutologousandAlloplastic Grafts Disadvantagesover other Autologous and Alloplastic Grafts Complications Results References Jackson, LT., et ak Skull bone grafts in maxiUofacial and craniofaeid surgery. J Oral Maxillofac Surg 44949~955,1986 Tessier, T.: Autogenous bone grafts taken from the cahwium for facial and cranial appkations. Clin Plast Surg 9531,1982 Jackson, LT., et al: The skull as a bone graft donor site. Ann Plast Surg 11:527,1983 Harsha, B.C., et al: Use of autogenous cranial bone grafts in maxilbfacial surgety. J Oral Maxillofac Surg till-15,1986 hfarkowitz, N.R., Allan, P.G.: Cranial bone graft harvesting--A modified technique. J Oral Maxillofac Sutg 47~11%11151989
SRC 144 Pre Orthodonticsfor Den@f& DefiwtSes Daniel Dugan,DDS, MS, Hurst, TX An essentialkey to achievinglong-termstability and function of patients with den&&&l deformities is appropriatepresurgicalorthodontictreatment.Practical ~~l~r~~orth~~~p~~plesandmechanits will be presentedasthey relate to surgicalplan&g and treatmentof patientswith dentofacialdeformities. (No abstractprovided)
still consideredto be a better choice becauseof the potentialfor growthof the graft. MRI is curratly the best imaging technique for evaluationof bony condylar degeneration.Progressive reduction in condylar medullary MRI signal intensity seemsto correspondto progressivedegenerativechanges. Thesefindingscanbe utilized to selectirreparablejoints that areappropriatefor total joint reconstruction. A prospective study was performed on 141 joints reconstructedwith Vitek-Kent implants in 86 patients. The preoperativeaveragejoint pain level was 4, on a scale of 0 to 10, with a range of 0 to 10, and the postoperativeaveragepain level was2,with a rangeof 0 to 5. The averagepreoperativeheadachelevel was 6, with a rangeof 1 to 10, and the averagepostoperative headachepain level was 2, with a rangeof 0 to 5. The averagepreoperativeinterincisal opening was 35 mm, with a rangeof 4 to 55, and the postoperativeopening was36 mm, with a rangeof 24to 45mm. The averagepostoperativefollow-up was 10 months, with a rangeof 1 to 60 months. Reoperationhas only beenrequiredon 14joints: 11joints were reoperatedfor recurrentadhesionsor bonyspurswhich prc&ed pain and limitation of motion, 1 joint had a foreign body reaction to residualProplast-Tefloninterpositionalimplant material, 1 joint was removed for an infection, anotherjoint wasremovedfor persistentpain 18months postoperatively,and two FEP fossa implants were removed, due to slight articular surface wear, during reoperationfor bonespurs. A similar study was performedwith 14joints reconstructedwith the Christensensystemin 8 patients.The resultsof this studywill be presented. References
SRC 145 To&alTWRecxawtn&n Kevin L. McBride, DDS, Dallas,TX
Kent, J.N., et al: Partial and total joint reconstruction. J Oral MaxilIofac surg 44?520,1986 Christensen, R.W.: Mandibular joint arthrosis corrected by the insertion of a cast vitaMum gknoid fossa prosthesis, a new technique. Oral Surg 17:712,1964
Total temporomandibularjoint reconstruction has been performed for more than 20 years with good results.Severalimplant systemshavebeenused exten- SRC 146 sively during the past 6 years.As our understandingof temporomandibularjoint degenerationimproves and LeFwt I Chteatomy new materials and implant systemsbecom.eavailable, William H. Bell, DDS, Dallas,TX total joint reconstructionwill becomethe treatment of choicefor severedegenerativedisease. An overviewis presentedof new and modified techExperiencewith total joint implant systemsindicates niquesof repositioningand stabilizingthe maxillaby the that it is appropriateto perform total joint reconstruc- LeFort I downfracturetechniqueand skeletaltitian. tion at earlier stagesof degenerativejoint diseasethan Gsteotomydesign,anatomicalconsiderations,sectionpreviouslyaccepted.Current indications include bony ing of the maxilla, treatmentof mandibulardysfunction ankyhxis, recurrentfibrous ankylosis,severedegenera- andsoft tissueclosuretechniquesaredescribed. tive joint disease,aseptic necrosisof the mandibular condyle,costochondralgraft failure, advancedrheuma- Foundationfor SurgicallyRepositioningthe Maxilla toid arthritis and loss of the condyle from trauma or Clinical pathology.In growingpatients,a costochondralgraft is Functional AAOMS
.
1991
29
Adwmges overotherAutologousandAlloplastic Grafts Disadvantagesover other Autologous and Alloplastic Grafts Complications Results References Jackson, LT., et ak Skull bone grafts in maxiUofacial and craniofaeid surgery. J Oral Maxillofac Surg 44949~955,1986 Tessier, T.: Autogenous bone grafts taken from the cahwium for facial and cranial appkations. Clin Plast Surg 9531,1982 Jackson, LT., et al: The skull as a bone graft donor site. Ann Plast Surg 11:527,1983 Harsha, B.C., et al: Use of autogenous cranial bone grafts in maxilbfacial surgety. J Oral Maxillofac Surg till-15,1986 hfarkowitz, N.R., Allan, P.G.: Cranial bone graft harvesting--A modified technique. J Oral Maxillofac Sutg 47~11%11151989
SRC 144 Pre Orthodonticsfor Den@f& DefiwtSes Daniel Dugan,DDS, MS, Hurst, TX An essentialkey to achievinglong-termstability and function of patients with den&&&l deformities is appropriatepresurgicalorthodontictreatment.Practical ~~l~r~~orth~~~p~~plesandmechanits will be presentedasthey relate to surgicalplan&g and treatmentof patientswith dentofacialdeformities. (No abstractprovided)
still consideredto be a better choice becauseof the potentialfor growthof the graft. MRI is curratly the best imaging technique for evaluationof bony condylar degeneration.Progressive reduction in condylar medullary MRI signal intensity seemsto correspondto progressivedegenerativechanges. Thesefindingscanbe utilized to selectirreparablejoints that areappropriatefor total joint reconstruction. A prospective study was performed on 141 joints reconstructedwith Vitek-Kent implants in 86 patients. The preoperativeaveragejoint pain level was 4, on a scale of 0 to 10, with a range of 0 to 10, and the postoperativeaveragepain level was2,with a rangeof 0 to 5. The averagepreoperativeheadachelevel was 6, with a rangeof 1 to 10, and the averagepostoperative headachepain level was 2, with a rangeof 0 to 5. The averagepreoperativeinterincisal opening was 35 mm, with a rangeof 4 to 55, and the postoperativeopening was36 mm, with a rangeof 24to 45mm. The averagepostoperativefollow-up was 10 months, with a rangeof 1 to 60 months. Reoperationhas only beenrequiredon 14joints: 11joints were reoperatedfor recurrentadhesionsor bonyspurswhich prc&ed pain and limitation of motion, 1 joint had a foreign body reaction to residualProplast-Tefloninterpositionalimplant material, 1 joint was removed for an infection, anotherjoint wasremovedfor persistentpain 18months postoperatively,and two FEP fossa implants were removed, due to slight articular surface wear, during reoperationfor bonespurs. A similar study was performedwith 14joints reconstructedwith the Christensensystemin 8 patients.The resultsof this studywill be presented. References
SRC 145 To&alTWRecxawtn&n Kevin L. McBride, DDS, Dallas,TX
Kent, J.N., et al: Partial and total joint reconstruction. J Oral MaxilIofac surg 44?520,1986 Christensen, R.W.: Mandibular joint arthrosis corrected by the insertion of a cast vitaMum gknoid fossa prosthesis, a new technique. Oral Surg 17:712,1964
Total temporomandibularjoint reconstruction has been performed for more than 20 years with good results.Severalimplant systemshavebeenused exten- SRC 146 sively during the past 6 years.As our understandingof temporomandibularjoint degenerationimproves and LeFwt I Chteatomy new materials and implant systemsbecom.eavailable, William H. Bell, DDS, Dallas,TX total joint reconstructionwill becomethe treatment of choicefor severedegenerativedisease. An overviewis presentedof new and modified techExperiencewith total joint implant systemsindicates niquesof repositioningand stabilizingthe maxillaby the that it is appropriateto perform total joint reconstruc- LeFort I downfracturetechniqueand skeletaltitian. tion at earlier stagesof degenerativejoint diseasethan Gsteotomydesign,anatomicalconsiderations,sectionpreviouslyaccepted.Current indications include bony ing of the maxilla, treatmentof mandibulardysfunction ankyhxis, recurrentfibrous ankylosis,severedegenera- andsoft tissueclosuretechniquesaredescribed. tive joint disease,aseptic necrosisof the mandibular condyle,costochondralgraft failure, advancedrheuma- Foundationfor SurgicallyRepositioningthe Maxilla toid arthritis and loss of the condyle from trauma or Clinical pathology.In growingpatients,a costochondralgraft is Functional AAOMS
.
1991
29