RESUMEN
RESUMEN Introducción: El síndrome de apnea obstructiva del sueño provoca somnolencia diurna; incide negativamente sobre el sistema cardiovascular y disminuye la calidad de vida. La cirugía ortognática provoca cambios en el espacio aéreo faríngeo, por lo que ha sido empleada en el tratamiento de dicho síndrome. Objetivo: Caracterizar las técnicas en cirugía ortognática más empleadas en el tratamiento del síndrome de apnea obstructiva del sueño, sus influencias sobre la vía aérea faríngea y efectividad terapéutica. Métodos: Se realizó una revisión de la literatura científica desde diciembre del 2016 a junio del 2017 a través de los buscadores de información y plataformas SciELO, Medline, Pubmed y Hinari. Los descriptores empleados para la búsqueda fueron cirugía ortognática, síndrome de apnea obstructiva del sueño, vía aérea faríngea, avance máxilo mandibular y sus combinaciones. Se obtuvieron 127 artículos de los que se seleccionaron 28 por su contenido, actualidad y objetividad. Análisis e integración de la información: El adelanto quirúrgico del maxilar, mandíbula, mentón o sus combinaciones minimiza los efectos del síndrome de apnea obstructiva del sueño. Es recomendable la cirugía bimaxilar en la corrección de las clases III esqueletales para atenuar posibles efectos perjudiciales sobre la vía aérea por la retroposición mandibular aislada. Conclusiones: La cirugía ortognática de avance, incrementa el espacio faríngeo y mejora la calidad del sueño. Los movimientos de retroposición pueden tener efecto inverso, aspecto importante en la corrección de las clases III esqueletales(AU)
ABSTRACT Introduction: Obstructive sleep apnea syndrome causes daytime sleepiness, affects the cardiovascular system and reduces the quality of life. Since orthognathic surgery brings about changes in the pharyngeal airway space, it has been used to treat this syndrome. Objective: Characterize the orthognathic surgery techniques most commonly used to treat obstructive sleep apnea syndrome, their impact on the pharyngeal airway and their therapeutic effectiveness. Methods: A bibliographic review was conducted from December 2016 to June 2017 using the search engines and platforms SciELO, Medline, Pubmed and Hinari. The search words used were orthognathic surgery, obstructive sleep apnea syndrome, pharyngeal airway, maxillomandibular advancement, and combinations thereof. Of the 127 papers obtained, 28 were selected based on their content, topicality and objectivity. Data analysis and integration: Surgical advancement of the maxilla, mandible, chin or combinations thereof minimizes the effects of obstructive sleep apnea syndrome. Bimaxillary surgery is recommended to correct skeletal class III malocclusion so as to lessen potential damaging effects on the airway caused by isolated mandibular retroposition. Conclusions: Advancement orthognathic surgery broadens the pharyngeal airway space and improves the quality of sleep. The fact that retroposition movements may have an opposite effect is an important aspect to be considered in the correction of skeletal class III malocclusions(AU)
Asunto(s)
Humanos , Retrognatismo/etiología , Apnea Obstructiva del Sueño/diagnóstico , Cirugía Ortognática/métodos , Calidad de Vida , Literatura de Revisión como AsuntoRESUMEN
PURPOSE: Maxillary retrognathism appears in 14.3% of patients exhibiting malocclusion after trauma treatment. This report describes the application of alveolar distraction osteogenesis (ADO) for treating the severely deficient anterior maxilla after trauma injuries in the vertical and anteroposterior planes. MATERIALS AND METHODS: This is a retrospective study of patients exhibiting severe vertical and anteroposterior maxillary bone deficiency after trauma injuries and treated by ADO as a first stage with additional Le Fort I advancement when required. Predictor variables included ADO for alveolar augmentation and Le Fort I advancement for anteroposterior discrepancy after ADO. Outcome variables included dental implant failure and anteroposterior maxillary relations. RESULTS: Twelve patients with severe atrophic anterior maxilla secondary to trauma injuries were included and treated using ADO. In accordance to the size of the horizontal deficiency, 1 or 2 distractors were used. Vertical alveolar distraction was performed and the transported segments were elongated at a rate of 0.5 mm/day to a mean total of 13.9 mm (12 to 15 mm). In 4 of 12 cases, there was a severe anteroposterior discrepancy larger than 8 mm that could not be fully corrected using an anterior inclination during the vertical elongation. Therefore, a second stage of conventional Le Fort I advancement was performed. Thirty-eight dental implants were inserted, with a survival rate of 97.37% (median follow-up, 6.2 yr). CONCLUSIONS: This report describes treatment of the deficient anterior maxilla after trauma injuries in the vertical and anteroposterior planes, including implant-based dental rehabilitation. The main advantages include simultaneous bone and mucosa augmentation, no donor site morbidity, considerably higher vertical augmentation compared with other methods, and minimal relapse. Using an additional Le Fort I advancement in severe cases permits a useful method for proper repositioning of the maxilla, thus resulting in superior intermaxillary relations.
Asunto(s)
Implantación Dental Endoósea , Maxilar/lesiones , Traumatismos Maxilofaciales/cirugía , Osteogénesis por Distracción/métodos , Osteotomía Le Fort , Complicaciones Posoperatorias/cirugía , Retrognatismo/cirugía , Estudios de Seguimiento , Humanos , Imagenología Tridimensional , Maxilar/cirugía , Retrognatismo/etiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Mandibular hypoplasia is very common clinically. Studies have reported that temporomandibular joint internal derangement (TMJID) might manifest as mandibular retrusion, and whether there is a direct correlation between them remains controversial in academia. On the other hand, for adolescent patients with skeletal class â ¡ malocclusion, the growth of mandible could be motivated by orthopedic force, and then the mandibular retrusion corrected. However, if TMJID is the direct cause of mandibular retrusion, orthopedic treatment will not have a significant effect on it. Base on literature review and analysis as well as our own research, this article will review the distribution of structural abnormalities of the temporomandibular joint in adolescents with mandibular hypoplasia and its association with skeletal class â ¡ malocclusion, as well as the effect of TMJID on the treatment of skeletal class â ¡ malocclusion in adolescents.
Asunto(s)
Maloclusión Clase II de Angle/terapia , Mandíbula/anomalías , Retrognatismo/terapia , Trastornos de la Articulación Temporomandibular/complicaciones , Articulación Temporomandibular/anomalías , Adolescente , Humanos , Mandíbula/crecimiento & desarrollo , Retrognatismo/etiologíaRESUMEN
Anterior disc displacement is a common subtype seen in temporomandibular disorders (TMD) patients. It may cause mandibular movement disorders, such as clicking of joint, intermittent closed lock, limitation of mouth opening, etc. These disorders may affect the life qualities of patients. Anterior disc displacement may also cause mandibular malformations, especially among adolescents, which may affect the growth of condyle, therefore may have a correlation with mandibular retrusion or mandibular deviation when grown up. This paper going to review the influences of anterior disc displacement on oral mandibular function and morphology and their biological mechanisms.
Asunto(s)
Trastornos de la Articulación Temporomandibular/fisiopatología , Adolescente , Humanos , Mandíbula/anomalías , Mandíbula/patología , Cóndilo Mandibular/crecimiento & desarrollo , Enfermedades Mandibulares/etiología , Movimiento , Retrognatismo/etiología , Trastornos de la Articulación Temporomandibular/etiologíaRESUMEN
The purpose of this study was to investigate the effect of secondary alveolar bone grafting (SABG) on the maxillary growth in patients with unilateral (UCLP) and bilateral cleft lip and palate (BCLP). The samples consisted of 40 Korean boy cleft patients who had the similar initial skeletal characteristics and were treated with the identical treatment protocol. They were divided into UCLP group (N = 25; mean SABG age, 9.9 years; mean follow-up duration, 42.3 months) and BCLP group (N = 15; mean SABG age, 10.2 years; mean follow-up duration, 40.6 months). In the lateral cephalograms taken 1 month before (T1) and at least 2 years after SABG (T2), cephalometric variables were measured. At T1 stage, the 2 groups did not exhibit significant differences in the cephalometric variables except posterior maxillary height (P-HRP) (P < 0.05). At T2 stage, both groups exhibited the reduced sagittal growth (UCLP, ANB, P < 0.001; AB to facial plane angle (AB-FPA), P < 0.01; BCLP, A to N perpendicular, P < 0.05; ANB and AB-FPA, P < 0.001) and the undisturbed vertical growth (A-HRP and P-HRP, all P < 0.001) of the maxilla. During T1 to T2, BCLP group experienced more aggravation of Class III skeletal pattern than UCLP group (ΔAB-FPA, P < 0.05). There, however, were no differences in the amounts of changes in the maxillary vertical position and mandibular plane angulation between the 2 groups. Two-stage SABG procedure subgroup in patients with BCLP demonstrated a more retrusive maxilla compared with 1-stage SABG procedure subgroup (ΔSNA, P < 0.05). Patients with BCLP, especially who underwent 2-stage SABG procedure, might have a possibility of poor sagittal growth of the maxilla compared with patients having UCLP.
Asunto(s)
Injerto de Hueso Alveolar/métodos , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Maxilar/crecimiento & desarrollo , Puntos Anatómicos de Referencia/patología , Cefalometría/métodos , Niño , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Maloclusión de Angle Clase III/etiología , Maloclusión de Angle Clase III/patología , Mandíbula/crecimiento & desarrollo , Mandíbula/patología , Maxilar/patología , Hueso Nasal/patología , Retrognatismo/etiología , Retrognatismo/patología , Estudios Retrospectivos , Silla Turca/patología , Dimensión VerticalRESUMEN
Dentofacial deformities involve deviations from the normal facial proportions and dental relationships and can range from mild to being severe enough to be severely handicapping.The term handicapping malocclusions though not a term commonly used, involves a fortunately small section (2-4%) of patients who can suffer from esthetic,psychological and functional problems. Craniofacial Orthodontics is the area of orthodontics that treats patients with congenital and acquired deformities of the integument and it's underlying musculoskeletal system within the craniofacial area and associated structures.This case report of a young woman with severe mandibular deficiency and facial asymmetry due to condylar ankylosis highlights the importance of team work in rehabilitation of such severe craniofacial deformities.
Asunto(s)
Anquilosis/complicaciones , Deformidades Dentofaciales/terapia , Asimetría Facial/terapia , Mandíbula/anomalías , Trastornos de la Articulación Temporomandibular/complicaciones , Diente Premolar/cirugía , Cefalometría/métodos , Deformidades Dentofaciales/etiología , Deformidades Dentofaciales/cirugía , Asimetría Facial/etiología , Asimetría Facial/cirugía , Femenino , Humanos , Mandíbula/cirugía , Diente Molar/cirugía , Osteogénesis por Distracción/métodos , Técnica de Expansión Palatina , Planificación de Atención al Paciente , Retrognatismo/etiología , Retrognatismo/terapia , Extracción Dental , Técnicas de Movimiento Dental/métodos , Diente Impactado/cirugía , Adulto JovenRESUMEN
A hypotonic newborn or infant with pale skin and sparse, friable, hypopigmented, or depigmented hair should have his copper and ceruloplasmin plasma levels evaluated because this is the usual clinical presentation of Menkes disease. Menkes disease is an X-linked recessive disease caused by a defect in the ATP7A gene, identified in 95% to 98% of the cases. Identifying the mutation confirms the diagnosis and allows for prenatal counseling and diagnosis in a future pregnancy. When administered within the first few months of life, copper histidinate, given subcutaneously in a dose of 50 to 150 mg/kg per day, appears to be effective not only by increasing life expectancy from 3 to 13 years but also by improving neurologic symptoms and neurodevelopmental outcomes in approximately 30% of the patients.
Asunto(s)
Alopecia/etiología , Síndrome del Pelo Ensortijado/diagnóstico , Hipotonía Muscular/etiología , Adenosina Trifosfatasas/genética , Encéfalo/irrigación sanguínea , Encéfalo/patología , Proteínas de Transporte de Catión/genética , ATPasas Transportadoras de Cobre , Humanos , Recién Nacido , Angiografía por Resonancia Magnética , Masculino , Síndrome del Pelo Ensortijado/genética , Micrognatismo/etiología , Mutación , Retrognatismo/etiologíaRESUMEN
Congenital craniofacial malformations such as Pierre Robin sequence or Treacher Collins syndrome are associated with mandibular micrognathia, resulting in obstructive sleep apnea (OSA) due to a decreased pharyngeal airway; in severe cases this leads to tracheostomy dependence. We present a series of 18 patients in whom we performed mandibular lengthening using internal distraction devices to relieve airway obstruction. Seven were tracheostomy-dependent and 11 were respiratory distressed without tracheostomy. The mandible was distracted at a rate of 1mm per day. Following 3 months of consolidation for bony maturation, the distraction devices were removed. Results demonstrated forward mandibular elongation of a mean 22mm (range 20-25mm) and an increase in SNB angle and in pharyngeal airway. All patients with tracheostomies were decannulated, and there was an improved airway with resolution of signs and symptoms of OSA and elimination of oxygen requirement in all patients. We conclude that mandibular distraction using internal devices is a useful and comfortable method for younger children to expand the mandible forward and increase the pharyngeal airway.
Asunto(s)
Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/cirugía , Disostosis Mandibulofacial/complicaciones , Osteogénesis por Distracción/métodos , Síndrome de Pierre Robin/complicaciones , Retrognatismo/etiología , Retrognatismo/cirugía , Apnea Obstructiva del Sueño/etiología , Apnea Obstructiva del Sueño/cirugía , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , TraqueostomíaRESUMEN
BACKGROUND: Larsen syndrome (LS) is a rare bone dysplasia characterized by multiple dislocations affecting large and small joints, progressive scoliosis, accessory and early ossifying carpal/tarsal bones, and characteristic craniofacial features. CASE PRESENTATION: A newborn with a clinical diagnosis of LS is presented. Shortly after birth, she had respiratory distress due to retrognathia. Such a life-threatening complication was resolved by mandibular distraction osteogenesis at 24 days of age. CONCLUSION: Fast and early mandibular osteogenetic distraction could represent an optimal tool to avoid tracheostomy and to improve oral feeding in patients with rare conditions, such as LS.
Asunto(s)
Mandíbula/cirugía , Osteogénesis por Distracción/métodos , Retrognatismo/cirugía , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/cirugía , Femenino , Humanos , Recién Nacido , Osteocondrodisplasias/complicaciones , Osteocondrodisplasias/cirugía , Polisomnografía/métodos , Síndrome de Dificultad Respiratoria del Recién Nacido/etiología , Síndrome de Dificultad Respiratoria del Recién Nacido/cirugía , Retrognatismo/etiologíaRESUMEN
AIM: To evaluate the effects of distraction osteogenesis in management of obstructive sleep apnoea patients secondary to temporomandibular joints ankylosis. METHODS: Fifteen patients were included in study. Preoperatively the patients were worked up for polysomnography and CT scans. Only those patients with Apnoea-hypopnoea index >15 events/h denoting moderate to severe obstructive sleep apnoea were included in the study. Distraction osteogenesis was followed with 5 days latency period in adult patients and 0 days for children. Rate of distraction was 1 mm/day for adults and 2 mm/day for children till the mandibular incisors were in reverse overjet. After 3 months post distraction assessment was done using polysomnography and CT scan. TMJ ankylosis was released by doing gap arthroplasty after distraction osteogenesis. RESULTS: Post distraction improvement was seen in clinical features of OSA like daytime sleepiness and snoring. Epworth sleepiness scale improved from a mean of 10.25 to 2.25. Polysomnographic analysis also showed improvement in all cases with apnoea-hypopnoea index from 57.03 to 6.67 per hour. Lowest oxygen saturation improved from 64.47% to 81.20% and average minimum oxygen saturation improved from 92.17% to 98.19%. Body mass index improved from a mean of 18.26 to 21.39 kg/m2. CONCLUSION: Distraction osteogenesis is a stable and beneficial treatment option for temporomandibular joint ankylosis patients with obstructive sleep apnoea.
Asunto(s)
Anquilosis/complicaciones , Mandíbula/cirugía , Osteogénesis por Distracción/métodos , Apnea Obstructiva del Sueño/cirugía , Trastornos de la Articulación Temporomandibular/complicaciones , Adolescente , Adulto , Anquilosis/cirugía , Artroplastia/métodos , Índice de Masa Corporal , Cefalometría/métodos , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Masculino , Avance Mandibular/métodos , Persona de Mediana Edad , Oxígeno/sangre , Polisomnografía/métodos , Estudios Prospectivos , Retrognatismo/etiología , Retrognatismo/cirugía , Apnea Obstructiva del Sueño/etiología , Fases del Sueño/fisiología , Ronquido/terapia , Infección de la Herida Quirúrgica/etiología , Trastornos de la Articulación Temporomandibular/cirugía , Tomografía Computarizada por Rayos X/métodos , Adulto JovenRESUMEN
The aim of this study was to investigate the influence of the pharyngeal flap procedure on the frequency of Le Fort I osteotomies in full-grown nonsyndromic cleft patients. A retrospective review of 508 full-grown cleft patients born between 1 January 1983 and 31 December 1992 was performed. Following data analysis, 140 males older than 18 years and 111 females over the age of 16 years were included. 69 of the 251 included cleft patients required pharyngeal flap surgery (27.5%). Revision flap surgery was performed in 17.4% of the cases. A significantly lower age at time of the initial pharyngeal flap procedure was found in patients requiring revision surgery (5.6 years versus 6.8 years). The frequency of Le Fort I osteotomies was significantly higher in the patients with a pharyngeal flap (19%) compared to those without (8%) (p<0.05). The results of this study point towards the pharyngeal flap procedure being one of the possible limiting factors for maxillary antero-posterior growth in cleft patients.
Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Maxilar/crecimiento & desarrollo , Faringe/cirugía , Retrognatismo/etiología , Colgajos Quirúrgicos/efectos adversos , Insuficiencia Velofaríngea/cirugía , Adolescente , Femenino , Humanos , Enfermedad Iatrogénica , Masculino , Maxilar/patología , Desarrollo Maxilofacial , Osteotomía Le Fort , Reoperación , Estudios RetrospectivosRESUMEN
In this article, we report successful orthodontic treatment combined with segmental distraction osteogenesis after a modified LeFort II osteotomy in a patient with craniosynostosis. An 8-year-old boy diagnosed with craniosynostosis had a dished-in face, an anterior crossbite, and a skeletal Class III jaw relationship because of midfacial hypoplasia. At the age of 13 years 6 months, the maxillary second and mandibular first premolars were extracted, and leveling and alignment of both arches was started with preadjusted edgewise appliances. At age 14 years 11 months, the patient had a modified LeFort II osteotomy, and the maxillary segment was advanced 7 mm and fixed to the zygomatic bone. At the same time, segmental distraction osteogenesis was started with a rigid external distraction system, and the nasal segment was advanced for 20 days at a rate of 1.0 mm per day. The total active treatment period was 40 months. As a result of the modified segmental distraction osteogenesis, significant improvement of his severe midfacial hypoplasia was achieved without excessive advancement of the maxillary dentition. Both the facial profile and the occlusion were stable after 1 year of retention. However, the nasal segment relapsed 1.4 mm during the 1.5 years after the segmental distraction osteogenesis. Evaluation of the stability and retention suggests that some overcorrection in midfacial advancement is recommended.
Asunto(s)
Craneosinostosis/cirugía , Maloclusión de Angle Clase III/cirugía , Maxilar/cirugía , Osteogénesis por Distracción/métodos , Osteotomía Le Fort/métodos , Retrognatismo/cirugía , Cefalometría , Niño , Craneosinostosis/complicaciones , Humanos , Masculino , Maloclusión de Angle Clase III/etiología , Maloclusión de Angle Clase III/terapia , Ortodoncia Correctiva/métodos , Retrognatismo/etiología , Extracción DentalAsunto(s)
Artritis Infecciosa/complicaciones , Mandíbula/cirugía , Osteogénesis por Distracción/métodos , Retrognatismo/cirugía , Apnea Obstructiva del Sueño/cirugía , Trastornos de la Articulación Temporomandibular/complicaciones , Anquilosis/complicaciones , Anquilosis/microbiología , Resorción Ósea/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Lactante , Cóndilo Mandibular/diagnóstico por imagen , Mordida Abierta/etiología , Osteogénesis/fisiología , Planificación de Atención al Paciente , Rango del Movimiento Articular/fisiología , Retrognatismo/etiología , Sepsis/complicaciones , Apnea Obstructiva del Sueño/etiología , Infecciones Estafilocócicas/complicaciones , Cirugía Asistida por Computador , Trastornos de la Articulación Temporomandibular/microbiología , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: Conventional maxillary distraction osteogenesis and anterior maxillary segmental distraction were applied in the treatment of severe maxillary hypoplasia secondary to cleft clip and palate. The aim of the present study was to compare the difference between these 2 osteotomy modalities used for rigid external distraction. PATIENTS AND METHODS: Ten patients with severe maxillary hypoplasia secondary to CLP were enrolled in our study. They were randomly divided into 2 groups. Conventional maxillary distraction osteogenesis was performed in 5 patients and anterior maxillary segmental distraction in 5 patients. The preoperative and postoperative lateral cephalograms were compared, and cephalometric analysis was performed. The independent sample t test was used to evaluate the differences between the 2 groups. RESULTS: All patients healed uneventfully, and the maxillae moved forward satisfactorily. The sella-nasion-point A angles, nasion-point A-Frankfort horizontal plane angles, overjets, and 0-meridian to subnasale distances had increased significantly after distraction osteogenesis. Significant differences were found in the changes in palatal length between the 2 groups (P < .05). A mean increase of 7.50 mm in palatal length was found in the anterior maxillary segmental distraction group. No significant difference in the changes in palatopharyngeal depth or soft palatal length was found. CONCLUSIONS: With the ability of increasing the palatal and arch length, avoiding changes in palatopharyngeal depth, and preserving palatopharyngeal closure function, anterior maxillary segmental distraction has great value in the treatment of maxillary hypoplasia secondary to CLP. It is a promising and valuable technique in this potentially complicated procedure.
Asunto(s)
Fisura del Paladar/cirugía , Osteotomía Maxilar/métodos , Osteogénesis por Distracción/métodos , Adolescente , Adulto , Cefalometría , Niño , Labio Leporino/complicaciones , Labio Leporino/cirugía , Fisura del Paladar/complicaciones , Femenino , Humanos , Masculino , Maxilar/anomalías , Maxilar/cirugía , Retrognatismo/etiología , Retrognatismo/cirugía , Adulto JovenRESUMEN
Ectodermal dysplasia (ED) is a hereditary disorder that affects ectodermal structures. The main clinical oral manifestations of ED include oligodontia and deficient alveolar ridges. This case report presents the oral rehabilitation of a 15-year-old female patient who never received an accurate diagnosis or appropriate dental care. Treatment included a combination of surgical intervention, a maxillary tooth-supported fixed detachable telescopic prosthesis, and an implant-supported mandibular fixed partial denture. The results showed a significant improvement in the esthetics, function, and psychological status of the patient. This article stresses the importance of appropriate care in providing an acceptable quality of life for patients with ED.
Asunto(s)
Anodoncia/rehabilitación , Coronas , Atención Dental para Enfermos Crónicos , Prótesis Dental de Soporte Implantado , Displasia Ectodérmica/complicaciones , Mandíbula/cirugía , Adolescente , Aumento de la Cresta Alveolar/métodos , Anodoncia/etiología , Mentón/cirugía , Implantación Dental Endoósea , Dentadura Parcial Fija , Femenino , Humanos , Maxilar/cirugía , Osteotomía Le Fort , Retrognatismo/etiología , Retrognatismo/cirugíaRESUMEN
OBJECTIVE: To test the null hypothesis that no differences exist in craniofacial morphology between patients with familial Mediterranean fever (FMF) and the healthy population. MATERIALS AND METHODS: Standardized lateral cephalograms of 32 FMF patients (mean age, 11.50 ± 2.72 years) and 32 healthy controls (mean age, 11.86 ± 2.19 years) were obtained. Cranial and dentofacial parameters were measured using a cephalometric analysis program (Nemoceph Imaging Cephalometric and Tracing Software S.L., Spain). All statistical analyses were conducted using SPSS version 17.0.0 (SPSS Inc., Chicago, Ill). Descriptive statistics were calculated for all measurements, and the independent t-test was used to evaluate intergroup differences. RESULTS: The ANB angle was significantly greater in the FMF group (P < .05). Differences in SNA and SNB angles were insignificant. Anterior (P < .001) and posterior (P < .05) face heights were significantly shorter in the FMF group. Mandibular body length (P < .001) and condylion to gnathion (P < .05) measurements were significantly shorter in the FMF group. The upper lip was more protrusive in the FMF group (P < .05). U1-NA (mm; P < .001) and L1-NB (mm; P < .05) measurements were significantly shorter in the FMF group. CONCLUSION: The hypothesis is rejected. Significant differences exist between the craniofacial morphology of patients with FMF and the healthy population.
Asunto(s)
Fiebre Mediterránea Familiar/complicaciones , Anomalías Maxilomandibulares/etiología , Adolescente , Estudios de Casos y Controles , Cefalometría , Niño , Cara/anatomía & histología , Femenino , Humanos , Masculino , Mandíbula/anomalías , Retrognatismo/etiología , Estudios Retrospectivos , Dimensión VerticalRESUMEN
OBJECTIVE: To obtain a deeper insight into the difficulties individuals with cri-du-chat syndrome experience by means of the analysis of the most common features and oral pathology observed in the subjects enrolled in the study. SUBJECTS AND METHODS: Intra-oral and extra-oral features of a total of 33 patients with cri-du-chat syndrome (the larger sample so far analyzed) through their clinical and photographic examination. Models, orthopantomographies, and teleradiographies have been collected to establish a pattern as accurate as possible of the oral pathology associated with these patients. RESULTS: The present descriptive study shows that patients with cri-du-chat syndrome present with a series of orofacial features such as mandibular retrognathism, high palate, and variable malocclusion, more commonly anterior open-bite. Most patients also present with perioral muscle relaxation with labial incompetence and short philtrum. As regards oral pathology, these patients suffer dental erosions provoked by gastroesophageal reflux and attritions because of intense day-and-night bruxism. CONCLUSION: The odontologists' familiarity with the orofacial pathology associated with cri-du-chat syndrome and with the specific needs such disorder conveys should improve the quality of the buccodental treatment these professionals may offer to these patients.
Asunto(s)
Síndrome del Maullido del Gato/complicaciones , Síndrome del Maullido del Gato/patología , Mordida Abierta/etiología , Retrognatismo/etiología , Anomalías Dentarias/etiología , Adolescente , Adulto , Análisis de Varianza , Bruxismo/complicaciones , Bruxismo/etiología , Distribución de Chi-Cuadrado , Niño , Preescolar , Caries Dental/etiología , Músculos Faciales/fisiopatología , Facies , Femenino , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/etiología , Humanos , Masculino , Mandíbula/anomalías , Hipotonía Muscular , Higiene Bucal/estadística & datos numéricos , Paladar Duro/anomalías , Índice Periodontal , Atrición Dental/etiología , Erosión de los Dientes/etiología , Adulto JovenRESUMEN
Dubowitz syndrome is a rare genetic condition characterized by microcephaly, dysmorphic facial features and delayed general growth. It is transmitted through autosomal recessive inheritance. The purpose of this report is to describe the oral, craniofacial and systemic characteristics of a 7-year 11-month-old boy with Dubowitz syndrome and the dental management provided. The pediatric dentist should possess the ability to recognize this rare alteration, to provide dental treatment and to refer for the necessary medical and multidisciplinary treatment.
Asunto(s)
Caries Dental/terapia , Restauración Dental Permanente/métodos , Eccema/complicaciones , Trastornos del Crecimiento/complicaciones , Discapacidad Intelectual/complicaciones , Microcefalia/complicaciones , Obstrucción de las Vías Aéreas/etiología , Cefalometría , Niño , Caries Dental/etiología , Huesos Faciales/anomalías , Facies , Humanos , Hipertelorismo/etiología , Masculino , Maloclusión/etiología , Micrognatismo/etiología , Mordida Abierta/etiología , Selladores de Fosas y Fisuras/uso terapéutico , Retrognatismo/etiología , SíndromeRESUMEN
PURPOSE: The management of maxillary retrusion in a patient with cleft lip and palate is performed using Le Fort I advancement or distraction osteogenesis using an external or an internal device. Distraction mostly involves movement of the entire maxilla at the Le Fort I level and is characterized by a higher relapse rate and a hampering of speech. Hence, distraction of the anterior maxilla was performed using a tooth-borne palatal distractor similar to the one proposed by Gunaseelan et al (J Oral Maxillofac Surg 65:1044, 2007). However, the technique was modified by placing the distractor preoperatively before performing the osteotomy cut. The main advantage of this modification is that more control over the vector can be achieved and chances of cement failure caused by contamination and an inability to achieve isolation is drastically decreased. This study investigated the efficacy and stability of anterior maxillary distraction in the management of cleft maxillary retrognathia and any resulting complications. MATERIALS AND METHODS: Fourteen patients older than 12 years with cleft maxillary retrognathia were included in the study irrespective of gender, type of cleft lip and palate, and the amount of advancement needed. The patients were evaluated using Orthopantomogram and lateral cephalograms preoperatively and at 3 months postoperatively (ie, before appliance removal) and at 6 months postoperatively. The distractor was fabricated extraorally on a cast and cemented into the patient's mouth the day before surgery. The initial deficiency, amount of advancement achieved, and relapses at 6 months, if any, were studied. The data were tabulated and analyzed. RESULTS: Only 1 of the 14 patients showed a relapse, of 2 mm, because this patient was lost to follow-up and thus delayed tooth replacement. CONCLUSIONS: Anterior maxillary distraction with a tooth-borne device is a feasible modality for the management of cleft maxillary retrognathia, with stable results.