Surgical treatment of double mandibular fracture

Surgical treatment of double mandibular fracture

146 Journal of Cranio-Maxillofacial Surgery Five Cases using Membrane Technique on Apicectomy Stiff Fixation in Orbito-Malar-Zygomatic Complex Recon...

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146 Journal of Cranio-Maxillofacial Surgery

Five Cases using Membrane Technique on Apicectomy

Stiff Fixation in Orbito-Malar-Zygomatic Complex Reconstruction

Nakanishi T., Nagamine K., Shimada J., Yamamoto If..

First Department of Oral and Maxillofacial Surgery, Meikai University School of Dentistry, Saitama, Japan Cyst-like cavities in the jaw bone often heal incompletely because of ingrowth of connective tissue. Thus osteogenesis does not occur. In the present study, a new membrane technique has been utilized in order to improve bone healing. An inert, porous membrane was placed in close contact with the bone surface and a secluded space was created which could only be repopulated by cells from the adjacent bone. Therefore, osteogenesis is able to occur without interference from other tissue types. A front tooth of the upper or lower jaw was treated in a male and female group (31-51years-old) and the membrane used in the 5 cases was PTEF membrane of the Japan Goretex company. The size of membrane was 2-3 mm larger than the bone defect to cover the entire defect and the root canal filling was orthograde filling. Membrane was extracted after 3-4 months. All membranes were well accepted by the host tissue and no inflammatory cells or signs of foreign body reaction were seen. The bone was regenerated in all cases of apicectomy. In one case, where apicectomy was operated 2 years ago and showed favourable clinical results, it showed only scar tissue histologically. 'The results clearly confirmed that new bone tissue was regenerated histologically.

Natale F., Caramanna 11., Nocera G.

Division of Maxillofacial Surgery and Odontostomatology, Ospedale Civico e Benfratelli, Palermo, Italy In large maxillofacial trauma both functional and aesthetic problems rise. We often meet serious loss of skeletal support which makes indispensable complicated and necessary reconstruction to solve the above mentioned problems. In particular, the orbitomalas-zygomatic region presents a large aesthetic deficit in the case of malar and zygomatic arch fracture, or interruption of the continuity of the orbital contour and loss of eyelid tissues. At the same time, functional problems may occur due to orbital floor fractures with periocular tissue herniation and ocular ptosis with consequent diplopia and, sometimes, with inferior muscle imprisonment.

Surgical Treatment of Double Mandibular Fracture

Natale F., Nocera G., Polizzi V.

Div&ione di Chirurgia Maxillo-Facc&le, Ospedale Civico Palermo, Palermo, Italy

Mechanical Study on the Stability of Osteosynthesis with Leibinger Titanium Microplate Two Cases of Oral Synechia

Namiki L, Takeshima H., Shimada J., Yamamoto Y.

First Department of Oral and Maxillofacial Surgery, Meikai University School of Dentistry, Saitama, Japan Facial/jaw bone fracture occurs rather frequently. Treatment of the composite fracture of cheek and upper jaw bone is especially difficult because of the nature of involved area with anatomical complexity, presence of facial nerves, aesthetic effects on the face. Various institutions have tried various conventional methods for reposition and retention surgery. In cases with greater displacement, surgical suturing to secure reposition and firm retention have been performed with titanium miniplates which have better biological compatibility. Such plates, however, can not satisfy all-round cases. Some patients feel and express uneasiness because the hypodermal tissue is thin-layered and the plates may be perceived by touch. In some cases, the plates must be surgically removed which requires re-hospitalization becoming the main obstacle of this remedy. These plates are thinner and more manageable than most conventional plates but they still are not adequate enough for the parts where the jaw bones are delicately curved, narrow, and/or thin. Microplates compensate such faults. They are thinner, more manageable, and with better compatibility. These plates probably will be utilized more and more in the treatment of jaw/face fractures in future. However, the factors influencing benefit of clinical application of the titanium microplates have not been examined thoroughly, especially in dynamic movement of the plates when loaded with external force/ stress to secure reposition and retention. The presenters will report the observation and verification obtained as a result of experiments and research to clarify this point.

Negishi A., Yoshimasu H., Amagasa T. First Department of Oral and Maxillofacial Surgery, Medical and Dental University, Tokyo, Japan Oral synechia is a rare congenital anomaly accompanied by cleft palate. Because of congenital limitation of the mouth opening, there are many problems, e.g. feeding incompetence. A few case reports described the oral synechia. Two cases of babies with oral synechia and cleft palate are presented.

Case 1: A newborn girl, suffering from oral synechia and cleft palate, was referred to our hospital 8 days after birth. The maximal mouth opening was 5 mm. At the age of 4 months, the bands between the upper and lower alveolar ridge were surgically divided under general anaesthesia following fibreoptic intubation. Postoperatively, the maximal mouth opening was 9 mm. This was further improved by daily manipulation, until a maximal mouth opening of 22 mm was reached. At this stage, the palatoplasty was performed at the age of 24 months. Case 2: A newborn boy, suffering from oral synechia, bilateral congenital fistulae of the lower lip, bilateral cleft lip and palate, was referred to our hospital 11 days after birth. Initially, the mouth opening was 22 mm. The bands between the upper and lower alveolar ridge, the buccal mucosa and the gingiva of the mandible were surgically divided under general anaesthesia at the age of 1 month. Bilateral cleft repair and excision of the fistulae of the lower lip were performed at the age of 3 months, 8 months and 1t months, respectively. The palatoplasty is planned at 18 months of age.