1,721,002 research outputs found
Does functional appliance treatment truly improve stability of mandibular vertical distraction osteogenesis in hemifacial microsomia?
No full textAim:
After mandibular unilateral distraction osteogenesis (DO) a gradual reappearance of the vertical asymmetry during growth is observed. A pre- and post-surgical functional-orthodontic treatment was added to our distraction protocol in the attempt to increase long-term stability. In order to evaluate the actual efficacy of such a combined treatment, two samples of children affected by hemifacial microsomia were compared long-term.
Material:
Ten children were treated by a combined orthodontic–distraction treatment, seven by distraction only.
Method:
Only the vertical changes in the mandible and maxilla in the panoramic and postero-anterior cephalometric X-rays were measured.
Results:
All of the patients showed a gradual return of the asymmetry with growth. Occlusal plane correction and, to a much lesser extent, mandibular vertical ramus height correction were better maintained over 5 years post-DO in the orthopaedic group.
Conclusion:
Although orthopaedic treatment allows for a more stable occlusal plane and for a slower return of the mandibular vertical asymmetry, it has mainly a dento-alveolar effect. Therefore, the decision of applying an orthopaedic treatment associated with distraction, should be taken by surgeon and orthodontist together, considering both the advantages and the disadvantages of this treatment
Photometric evaluation of bilateral cleft lip and palate patients after primary columella lengthening
No full textOBJECTIVE: To evaluate the results in terms of nasal esthetics of children with bilateral cleft lip and palate, operated with the Cutting primary columella lengthening technique, associated with Grayson orthopedic nasoalveolar molding, and to compare them with the nasal aspects of children with bilateral cleft lip and palate operated with a traditional approach and to an age-matched sample of normal Caucasian children. DESIGN: Normalized photogrammetry. SETTING: Regional Center for CLP, Department of Maxillo-Facial Surgery, San Paolo Hospital, Milan. PATIENTS: Three groups of patients 5 years of age. Cutting group: 18 patients treated with the Grayson-Cutting technique. Delaire group: 18 patients treated with the traditional Delaire technique. Normal children: 40 normal preschool children. RESULTS: With the Cutting-Grayson technique, the columella length, nasal tip angle, and protrusion are greatly improved compared with the previous protocol and are close to normal. On the other hand, the nasolabial angle and interalar distances are still excessively wide in both samples. CONCLUSIONS: Although this is not a long-term study, at this time none of the patients operated with this technique have needed secondary columella lengthening. On the other hand, although certainly improved, the nasal anatomy obtained is far from norma
Alveolar bone formation in patients with unilateral and bilateral cleft lip and palate after early secondary gingivoalveoloplasty : long-term results
No full textThe Milan surgical protocol includes the use of an early secondary gingivoalveoloplasty together with hard palate closure at 18 to 36 months, to avoid later bone grafting. The goal of this study was to evaluate the long-term quality of ossification in patients who have undergone early secondary gingivoalveoloplasty. METHODS: The samples consisted of panoramic radiographs of 87 unilateral cleft lip-cleft palate and 29 bilateral cleft lip-cleft palate patients. The records available allowed for a longitudinal and a cross-sectional evaluation of the ossification in the cleft area. Alveolar bridging was assessed using a modified Bergland's scoring system. Nasal area ossification and canine inclination were each given three different qualitative scores. RESULTS: The alveolar bridging noted was type I (71.7 percent), type II (23.5 percent), and type III (4.8 percent) in the whole sample of unilateral and bilateral cleft lip-cleft palate patients. No type IV ossification was found. Longitudinal analysis showed that approximately one-fourth of the cleft sites improved after permanent tooth eruption, and very few worsened. An evaluation of permanent dentition in a group of 27 unilateral and nine bilateral cleft lip-cleft palate patients (mean age, 14.8 +/- 2.0 years) showed that 15.5 percent of the whole sample had canine retention and 4.4 percent of the whole sample had to be surgically exposed. CONCLUSIONS: Early secondary gingivoalveoloplasty seems to allow for adequate ossification in both the alveolar and the nasal regions. Permanent tooth eruption occurs at a normal rate. None of the patients has required a secondary alveolar bone graf
Orthopedic palatal expansion in the treatment of bilateral congenital choanal atresia : an additional tool in the long term follow up of patients?
No full textObjective
Rapid Palatal Expansion (RPE) is an orthodontic procedure commonly used to widen the maxilla. Aim of this study is the description of the effects produced by RPE in two patients affected by Bilateral Congenital Choanal Atresia (BCCA) operated in infancy and who were scheduled for a secondary endoscopical surgical correction.
Methods
The two cases presented were studied through Postero Anterior and Submental Vertex cephalometric x-rays, and TC-Scans pre and 12 months post expansion.
Results
Both nasal and choanal widths were increased 12 months post expansion of an amount which was equivalent to 30% of the defective bony whidth. Endoscopically the expansion of the lumen was more evident given the associated soft tissue improvement. In both cases secondary surgery was avoided.
Conclusion
The cooperation between ENT surgeon and orthodontist may allow for an reduction in the burden of treatment of children affected by BCCA
FACTORS AFFECTING VARIABILITY IN MAXILLARY GROWTH IMPAIRMENT IN CLEFT AND LIP AND PALATE PATIENTS TREATED WITH THE SAME SURGICAL PROTOCOL
No full textEarly Secondary Gingivo-Alveolo-Plasty in the treatment of unilateral cleft lip and palate patients: 20 years experience
No full textSince 1988, the Milano surgical protocol has included lip, nose and soft palate repair at 6-9 months of age and closure of the hard palate at 18-36 months together with an Early Secondary Gingivo-Alveolo-Plasty (ESGAP). Prior to 1988 the alveolar cleft was repaired in a third step by bone grafting at 9-11 years of age. The goal of this study was to evaluate the long-term maxillary growth in unilateral cleft lip and palate (UCLP) patients who have undergone ESGAP. Alveolar ossification after ESGAP was also studied in the permanent dentition. Growth assessment was carried out comparing lateral X-ray cephalograms of a UCLP ESGAP sample (15 consecutive patients with a mean age of 18.2 ±1.2 years) and of the UCLP bone graft sample (10 consecutive patients with a mean age of 18.7 ±1.1 years) and a sample from the Oslo cleft lip and palate (CLP) centre sample (15 patients with a mean age of 18.1 ±0.8 years). Alveolar ossification in the sample which had undergone ESGAP was evaluated through a sample of panoramic X-rays of UCLP in the permanent dentition. Alveolar bridging was assessed using a modified Bergland's scoring system. From the results it seems that ESGAP allows for an excellent alveolar ossification, but patients show an inhibition of maxillary growth compared with the secondary bone graft group and with the Oslo group. Although ESGAP allows for early repair of the alveolus together with palate repair, thus eliminating in all patients the need for secondary bone grafting, it seems to have an inhibiting influence on maxillary growth which increases the need for Le Fort I osteotomies. It is however fair to recall, that, even with an adjunctive Le Fort I osteotomy, ESGAP enables the total number of operations to be reduced to three, instead of most European protocols (4-5 procedures). © 2009 European Association for Cranio-Maxillo-Facial Surgery
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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