Surgical Protocol for Pierre Robin Sequence

Oral Abstract Session 3 tissue between the superimposed pre- and postoperative surfaces on both left and right sides were then individually computed by the 3D editing software. Methods of Data Analysis: Non-parametric statistical analysis was performed. Within each patient’s 3D photograph set, left or right volume changes were assigned to either “larger expansion group” or “smaller expansion group” based on the magnitude of expansion. Mann-Whitney U test was used to determine if the volume change of nasolabial soft tissue was significantly symmetrical. Results of Investigation: The range of volume change of nasolabial soft tissue due to SARPE ranged from ⫹0.15 to ⫹4.49 mm3. The mean volume changes in “larger expansion group” and “smaller expansion group” were 2.29 mm3 (SD 1.06 mm3) and 1.61 mm3 (SD 0.91 mm3), respectively. Mann-Whitney U test demonstrated that the volume change of nasolabial soft tissue was asymmetrical (U⫽77; P ⫽ .028). Conclusion: There was an asymmetrical volumetric expansion of nasolabial soft tissue following SARPE. Asymmetrical expansion of nasolabial soft tissue might be secondary to asymmetrical osteotomies, soft tissue management or palatal distractor placement. 3D stereophotogrammetry is a non-invasive, safe, and sensitive technique for evaluation of subtle surgically-induced facial volume changes. References: Ramieri GA, Nasi A, Dell’Acqua A, et al. Facial soft tissue changes after transverse palatal distraction in adult patients. Int. J. Oral Maxillofac. Surg. 2008; 37(9): 810-18 Plooij JM, Swennen GRJ, Rangel FA, et al. Evaluation of reproducibility and reliability of 3D soft tissue analysis using 3D stereophotogrammetry. Int. J. Oral Maxillofac. Surg. 2009; 38(3): 267-73

Surgical Protocol for Pierre Robin Sequence P. Cascone: Sapienza university of Rome Policlinico Umberto I, P. Cascone, A. Silvestri, V. Ramieri Pierre Robin Sequence is a defined chain of events of the fetal development leading to an acquired malformation characterized by micrognathia, glossoptosis and upper airway obstruction. Cleft palate is present in the majority of patients, and is commonly U-shaped. These patients at birth may present mild to severe obstructive sleep apnea with respiratory distress. Sometimes feeding represents a pathologic issue to, mainly due to gastroesophageal reflux. International literature provides different treatment options. At the present time there are no recognized international guidelines. Our protocol is based upon the following elements: at birth if the micrognathia is relevant and there is airways narrowing we used to schedule the patient for a sleep report and CT scan (low dose) to collect data on obstructive sleep e-28

apnea and airway actual volume. At first there are a few rules that we teach the parents such as: sideling or prone positioning to improve the airways space. Feeding should be fractioned to minimize the effort. An appliance is realized to seal the palate and to reposition the tongue in order to stimulate mandibular protrusion. Sometimes due to the severity of the respiratory distress, orotracheal intubation is needed. When necessary, we perform surgical lengthening of the mandible as soon as possible. Our treatment is based on mandibular external distraction. The authors present their experience in the management of Pierre Robin Sequence.

Rehabilitation of Atrophic Maxillas Using Zygomatic Fixation in an Immediate Loading System: Prospective 1-to-6-Year Clinical Study on 20 Cases C. Correa: S. Lobo Jr, N. Uzun Statement of the Problem: Few long-term follow-up and prospective studies are available using zygomatic implants for the rehabilitation of atrophic maxillas in an immediate loading system. The aim of this study was to evaluate prospectively 20 cases of atrophic edentulous upper jaw rehabilitated with zygomatic implants associated with 2 or 4 anterior conventional implants in immediate loading. Materials and Methods: Twenty edentulous patients with atrophic maxilla, provided with 40 machined Zygomatic implants and 66 MKIV TiUnite implants (Nobel Biocare, Yorba Linda, CA), were followed up clinically and radiographically during a minimum period of 1 year and maximum of 6 years regarding success rate and complications. Methods of Data Analysis: The data were analyzed descriptively. The Fisher test was used to compare the success rates between the conventional MK IV Ti Unite implants (Nobel Biocare, Yorba Linda, CA) and the zygomatic fixations (Nobel Biocare). Results of Investigation: Twenty patients were included in this study (ten males and 10 females). The patients’ ages ranged from 42 to 71 years, with a mean of 56 years (mean ⫾ standard deviation). Only three patients presented loss of a zygomatic fixation, and in one of these cases, the patient also lost a conventional implant. In the present study, 66 conventional MK IV Ti Unite implants were installed, and one of them was lost, thus resulting in a success rate of 98.5%. Forty zygomatic fixations were also installed, and three of them were lost during the period of postoperative follow-up, thereby achieving a success rate of 92.5% for this type of fixation. Conclusion: Rehabilitation of atrophic maxillas using zygomatic fixation in an immediate loading system is a predictable technique and is sensitive to the surgeon’s learning curve. AAOMS • 2011