Mandibular Dysmorphology in Unicoronal Synostosis and Plagiocephaly without Synostosis

1996 ◽  
Vol 33 (5) ◽  
pp. 418-423 ◽  
Author(s):  
Alex A. Kane ◽  
Lun-Jou, Lo ◽  
Michael W. Vannier ◽  
Jeffrey L. Marsh
Keyword(s):  
Body Length ◽  
Statistical Significance ◽  
Coronoid Process ◽  
Therapeutic Interventions ◽  
Lateral Side ◽  
Tertiary Referral Center ◽  
Gonial Angle ◽  
Affected Side ◽  
Mandibular Body ◽  
Ct Data

Patients with unicoronal synostosis (UCS) or plagiocephaly without synostosis (PWS) have distinctive skull dysmorphologies. Associated mandibular dymorphologies have been suspected but not quantified. This study was performed to test the hypothesis that discrete mandibular dysmorphology exists in both UCS and PWS. All patients at a tertiary referral center at a medical school-affiliated children's hospital with confirmed diagnosis of UCS or PWS with adequate pretreatment CT data were included in the study population, which population was comprised of 20 UCS, 23 PWS, and 8 normal infants. Each patient had a head CT scan using 2-mm slices. 3-D images were created using AnalyzeTM, a biomedical imaging program. The mandibles were isolated, and the coordinates of 8 landmarks were sampled from each mandible by a single investigator: a single volume value was measured, and 9 linear distances and 4 angles were calculated. Corresponding measurements from each hemimandible were expressed as ratios of ipsilateral/contra lateral side. In UCS, the affected side was defined as the side ipsilateral to the synostosis; in PWS, the affected side was defined as the side ipsilateral to the occipital flattening. The results from both groups were t tested for statistical significance. For UCS, statistically significant (p < .001) findings included: ipsilateral hemimandibular volume 5% smaller than contralateral; affected hemimandibular body length 1.9% shorter; affected gonial angle 2.6% more acute; affected coronoid process tilted anteriorly 2.5%; and distances from condylion and tip of the coronoid process to the chin landmarks 4% shorter on the affected side. For PWS, significant findings included: affected hemimandibular volume 3.8% larger; ramal height 3.5% shorter; mandibular body length 3% longer; and coronoid process tilted anteriorly by 2.3% on the affected side. In the UCS/PWS comparison, findings included: affected hemimandibular volume in UCS 8.7% less; affected gonial angle in UCS 3% more acute; affected mandibular corpus length in UCS 5% shorter; distances from the condylion and the tip of the coronoid process to the chin landmarks 4% shorter on the affected side in UCS. The hypothesized presence of diagnosis specific mandibular dysmorphology in UCS and PWS is confirmed. This analysis forms the baseline for study of the effects of unperturbed growth or therapeutic interventions upon the dentoskeletal dysmorphology of these anomalies.

scholarly journals Modelling growth curves of the normal infant’s mandible: 3D measurements using computed tomography

2021 ◽  
Author(s):  
Jan Aart M. Schipper ◽  
Manouk J. S. van Lieshout ◽  
Stefan Böhringer ◽  
Bonnie L. Padwa ◽  
Simon G. F. Robben ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Growth Models ◽  
Normal Growth ◽  
Growth Patterns ◽  
Ct Scans ◽  
Mandibular Ramus ◽  
Linear Measurements ◽  
Mandibular Growth ◽  
Gonial Angle ◽  
Mandibular Body

Abstract Objectives Data on normal mandibular development in the infant is lacking though essential to understand normal growth patterns and to discriminate abnormal growth. The aim of this study was to provide normal linear measurements of the mandible using computed tomography performed in infants from 0 to 2 years of age. Material and methods 3D voxel software was used to calculate mandibular body length, mandibular ramus length, bicondylar width, bigonial width and the gonial angle. Intra- and inter-rater reliability was assessed for these measurements. They were found to be sufficient for all distances; intra-class correlation coefficients were all above 0.9. Regression analysis for growth modelling was performed. Results In this multi-centre retrospective study, 109 CT scans were found eligible that were performed for various reasons (e.g. trauma, craniosynostosis, craniofacial abscesses). Craniosynostosis patients had larger mandibular measurements compared to non-craniosynostosis patients and were therefore excluded. Fifty-one CT scans were analysed. Conclusions Analysis showed that the mandible increases more in size vertically (the mandibular ramus) than horizontally (the mandibular body). Most of the mandibular growth occurs in the first 6 months. Clinical relevance These growth models provide insight into normal mandibular development in the first 2 years of life. This reference data facilitates discrimination between normal and abnormal mandibular growth.

Birth Weight, Body Length, and Cranial Circumference in Newborns with Cleft Lip or Palate

1998 ◽  
Vol 35 (3) ◽  
pp. 255-261 ◽  
Author(s):  
Magnus Becker ◽  
Henry Svensson ◽  
Bengt Källén
Keyword(s):  
Birth Weight ◽  
Body Length ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Statistical Significance ◽  
The Body ◽  
Control Subjects ◽  
Study Population ◽  
Isolated Cleft Palate ◽  
Pierre Robin

Objective This paper reports on birth weight, body length, body mass index, and cranial circumference at birth of infants with cleft lip and/or palate born between 1973 and 1992. Methods Data were obtained from two nationwide swedish health registries. Infants with syndromes, twins, and infants with immigrant parentage were excluded from the study. Comparisons were made with all singleton births with the same exclusion criteria (n = 2,031,140). Results The body dimensions of infants with isolated cleft lip (n = 865) were found not to differ from those of control subjects, but infants with isolated cleft palate (n = 811) or cleft lip and palate (n = 1139) were found to be lighter and shorter than control subjects. Also, infants with the Pierre Robin sequence (n = 121) had a tendency to be lighter and shorter than control subjects, but these differences did not reach statistical significance despite the large study population.

Correction of Facial Asymmetry with Multiplanar Mandible Distraction: A One-Year Follow-Up Study

2004 ◽  
Vol 41 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Ellen W. Ko ◽  
Kai-Fong Hung ◽  
Chiung Shing Huang ◽  
Philip K. T. Chen
Keyword(s):  
Body Length ◽  
Facial Asymmetry ◽  
Mandibular Advancement ◽  
Occlusal Plane ◽  
Mandibular Distraction ◽  
Mandibular Body ◽  
One Year ◽  
Ramus Height ◽  
Oral Commissure

Objective To assess the effectiveness of multiplanar mandibular distraction by evaluating the treatment effect and 1-year stability, measuring changes on the affected and nonaffected sides, and evaluating correction of the occlusal plane and oral commissure cant. Patients and Method Eleven patients aged 5 to 9.4 years (mean 6.7 years) who underwent unilateral multiplanar mandibular distraction were included, 10 with hemifacial microsomia and one temporomandibular joint ankylosis. Intermaxillary elastics were applied to intraoral dental devices during and after distraction until bony consolidation and occlusal interdigitation were achieved. Radiographs were taken and measured before distraction, after vertical distraction, after completion of distraction, and 1 year after treatment. Frontal facial photographs were obtained to analyze the changes in the position of the oral commissure. Results The facial profile was improved by sagittal mandibular advancement. Although the facial height increased 6.6 mm during vertical distraction, with a net gain of 5.8 mm in follow-up, the mandibular plane angle was maintained. The affected mandibular length increased 8.3 mm after distraction and remained unchanged after 1 year. Ramus height increased 12.7 mm after distraction and relapsed 3.8 mm at follow-up (30%). The affected body length demonstrated postoperative growth of 3.1 mm. Correction of the chin deviation was 9.8 mm after distraction and relapsed 1.6 mm (16.3%) after 1 year. Canting of the occlusal plane and oral commissure was corrected and remained stable. Conclusion Multiplanar mandibular distraction is an effective treatment for correcting facial asymmetry in young children. The 1-year follow-up revealed that the new sagittal jaw relation and mandibular body length were stable, and the achieved occlusal interdigitation was well maintained. However, the ramus height and chin deviation demonstrated some relapse.

scholarly journals Correlation between the size of the maxillary sinus and vertical growth patterns: a 3-dimensional cone-beam computed tomographic study

2020 ◽  
Author(s):  
Xu Yili ◽  
Huang Yingyi ◽  
Fan Jiaqian ◽  
Liu Fan ◽  
Yonghua Lei
Keyword(s):  
Maxillary Sinus ◽  
Body Length ◽  
Growth Patterns ◽  
3 Dimensional ◽  
Vertical Growth ◽  
Computed Tomographic ◽  
Maxillary Sinus Volume ◽  
Skeletal Malocclusion ◽  
Mandibular Plane ◽  
Mandibular Body

Abstract Background The maxillary sinus has been considered as an important factor that affects the development of craniomaxillofacial bone. However, the correlation between the maxillary sinus and skeletal malocclusion is controversial. This study aimed to compare the dimensions of the maxillary sinus in patients with different vertical growth patterns and investigated the correlation between the maxillary sinus and craniofacial parameters.Methods This descriptive study included 90 patients from age 15 to 20 years old. According to the vertical growth patterns that were classified by MP-FH (angle between the mandibular plane and Frankfort horizontal plane), they were equally divided into three groups: high-, low- and normal-angle, and the gender ratio was 1:1. Cephalometric tracings were conducted from CBCT images, which were also used to measure the dimensions and volume of the maxillary sinus. Data were analyzed with one-way ANOVA, Pearson’s correlation coefficient, and multiple comparison LSD.Results The variables of the maxillary sinus, including the volume, length, and width, among different groups, were significant(p<0.05). The variables of mandibular body length were significantly correlated with the volume of the maxillary sinus (p<0.01), and the coefficient was 0.425.Conclusions The maxillary sinus volume, length, and width were larger in low-angle patients. The mandibular body length had a significantly positive correlation with the maxillary sinus volume.

scholarly journals Is the Mandibular Condyle Involved in Medication-Related Osteonecrosis of the Jaw? Audit of a Single Tertiary Referral Center and Literature Review

2021 ◽  
Vol 15 (1) ◽  
pp. 769-777
Author(s):  
Giorgio Lo Giudice ◽  
Antonio Troiano ◽  
Carmelo Lo Faro ◽  
Mario Santagata ◽  
Marco Montella ◽  
...  
Keyword(s):  
Literature Review ◽  
Mandibular Condyle ◽  
Osteonecrosis Of The Jaw ◽  
Tertiary Referral Center ◽  
Site Distribution ◽  
Underlying Malignancy ◽  
Pubmed Database ◽  
Mandibular Body ◽  
Maxilla And Mandible ◽  
Surgery Department

Background: Medication-related osteonecrosis of the jaw (MRONJ) may manifest as exposed mandible bone. Recent reviews of the incidence of MRONJ report primarily as exposed cortical bone of the mandibular body, ramus, and symphysis with no reports of condylar involvement. Objective: The aim of this study is to analyze the topographical incidence of MRONJ, comorbidities, demographics data, and clinical characteristics of patients diagnosed with MRONJ between 2014 and 2019 in the Maxillo-Facial Surgery Department University of Campania “Luigi Vanvitelli”, and compare these results with published reports. Methods: Data on 179 patients were collected for the study, including gender, age, underlying malignancy, medical history, and specific lesion location-identifying premaxilla and posterior sectors area involvement for the maxilla and symphysis, body, ramus, and condyle area for the mandible. A literature review was performed in order to compare our results with similar or higher sample sizes and find if any condylar involvement was ever reported. The research was carried out on PubMed database identifying articles from January 2003 to November 2020, where MRONJ site distribution was discussed, and data were examined to scan for condylar localization reports. Results: 30 patients had maxillary MRONJ, 136 patients had mandibular MRONJ, and 13 patients had lesions located in both maxilla and mandible. None of the patients reported condylar involvement, neither as a single site nor as an additional localization. Literature review results were coherent to our findings showing no mention of condylar MRONJ. Conclusion: Results do not show reports of condylar involvement in MRONJ. Although the pathophysiology of the disease has not been fully elucidated, two possible explanations were developed: the first one based on the condyle embryogenetic origin; the second one based on the bisphosphonate and anti-resorptive medications effects on the different vascular patterns of the mandible areas.

scholarly journals Correction of Mandibular Retrognathia and Laterognathia by Distraction Osteogenesis: Follow up of 5 cases

2009 ◽  
Vol 03 (04) ◽  
pp. 335-342 ◽  
Author(s):  
Dogan Dolanmaz ◽  
Ali Ihya Karaman ◽  
Hakan Gurcan Gurel ◽  
Abdullah Kalayci ◽  
Hasan Kucukkolbasi ◽  
...  
Keyword(s):  
Distraction Osteogenesis ◽  
Clinical Success ◽  
Term Treatment ◽  
Mandibular Distraction ◽  
Gonial Angle ◽  
Affected Side ◽  
Long Term Treatment ◽  
Mandibular Retrognathia ◽  
Ramus Height

ABSTRACTThis article evaluates the use of distraction osteogenesis in the treatment of mandibular retrognathia and laterognathia and the long term treatment results of the patients treated with this technique. The procedure was carried out in 5 subjects (3 males and 2 females, mean age 18.4 years) aged between 14 years and 27 years. In patients treated with bilateral mandibular distraction, it was observed that the ANB angle decreased by a mean of 5°, the mandibular corpus length increased by a mean of 14.5 mm and the overjet decreased by a mean of 12.2 mm after treatment. In patients treated with unilateral mandibular distraction, a mean of 3.5° reduction was achieved in ANB angle, the mandibular corpus length increased by a mean of 5.5 mm and a mean of 7 mm correction was achieved in relation to craniofacial midline with treatment. One of these patients showed an increase of 10 mm in ramus height on the affected side and a decrease of 5° in gonial angle whereas the other one showed an increase of 12.5° in gonial angle and an increase of 11 mm in ramus height on the affected side after treatment. The most significant long term relapse was observed in one of the patients treated with bilateral mandibular distraction. Long term relapse seen in the rest of the patients was within clinically acceptable limits. It can be concluded that distraction of the deformed mandible is a feasible and effective technique for treating mandibular retrognathia and laterognathia. However, it must be borne in mind that accurate placement of the distractors and determining the correct distraction vector are crucial factors that have an influence on long term clinical success. (Eur J Dent 2009;3:335-342)

Joint angle, moment and power compensations in dogs with fragmented medial coronoid process

2008 ◽  
Vol 21 (02) ◽  
pp. 110-118 ◽  
Author(s):  
J. A. Dobney ◽  
M. R. Owen ◽  
G. R. Colborne ◽  
N. J. Burton
Keyword(s):  
Dynamic Analysis ◽  
Stance Phase ◽  
Coronoid Process ◽  
Joint Moments ◽  
Inverse Dynamic ◽  
Inverse Dynamic Analysis ◽  
Affected Side ◽  
Custom Software ◽  
Stance Time ◽  
Force Data

SummaryFragmented medial coronoid process (FMCP) is the most common cause of forelimb lameness in juvenile medium and large breed dogs; however methods of assessing the disruption to their gait remain subjective. The purpose of this study was to objectively quantify the mechanical disruptions to gait in dogs with arthroscopically confirmed unilateral FMCP. Seven dogs underwent full inverse dynamic analysis at the time of diagnosis. Kinematic and force data were collected from both forelimbs at trot. Stance phase joint angles, net joint moments and net joint powers were calculated using custom software. There were gross differences in kinetic and kinematic patterns between FMCP affected and compensating forelimbs. Stance time was 0.24 sec on the lame side and 0.26 sec on the compensating side. The shoulder and the elbow were more flexed at ground contact, and elbow, carpal and MCP joints had smaller ranges of motion on the lame side. Net joint moments were significantly reduced (P<0.05) in the elbow, carpal and MCP joints of the FMCP affected limb. Net joint powers were likewise significantly smaller (P<0.05). However, the overall moment and power patterns persisted. Total limb support moment was significantly smaller on the affected side (P<0.05). Total limb power was significantly reduced on the affected side (P<0.05) being most affected in its propulsive phase in the second half of stance. Inverse dynamic analysis of this clinical condition is an objective means by which to assess the mechanical disruption to gait.

Office-Based Cholesterol Testing: Impact on Process-of-Care in Patients with Hypercholesterolemia a Pilot Study

1997 ◽  
Vol 13 (2) ◽  
pp. 75-79 ◽  
Author(s):  
David M Ruffin ◽  
James M McKenney
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Statistical Significance ◽  
Intervention Group ◽  
Office Visit ◽  
Therapeutic Interventions ◽  
Control Group ◽  
Process Of Care ◽  
Physician Office ◽  
Significant Difference

Objective: To determine whether providing cholesterol results during a patient-physician office encounter would affect the process-of-care in patients with hypercholesterolemia. Methods: We used a randomized, parallel-group, control design to conduct the study. Thirty-five participants had a lipoprotein analysis performed using the L.D.X. cholesterol analyzer. Patients randomly assigned to the intervention group (n = 19) had their results provided to the physician during the office visit; the results of those in the control group (n = 16) were not made available to the physician. Each participant's medical record was reviewed to determine the physican's process-of-care with respect to cholesterol management. The indicators of the process-of-care for which we sought documentation included therapeutic interventions and the physician's assessment of risk for coronary heart disease. We used Fisher's exact test to determine statistical significance of the intervention. Descriptive analysis was also performed. Results: We were unable to detect a statistically significant difference in therapeutic interventions (p = 0.183). However, we did observe a statistically significant difference in the physician's assessment of risk for coronary heart disease (p = 0.0001). Conclusions: Our data suggest that providing a cholesterol test result during a patient-physician office encounter positively affects the process-of-care in patients with hypercholesterolemia. Future studies should include larger numbers of patients and longer follow-up periods.

scholarly journals Clinical and Radiographic Outcomes of Tibiotalocalcaneal or Pantalar Arthrodesis Using a Novel Lateral Locking Plate

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0041
Author(s):  
Tyler Rutherford ◽  
John Campbell ◽  
Rebecca Cerrato ◽  
Clifford Jeng
Keyword(s):  
Plate Fixation ◽  
Large Diameter ◽  
Lateral Side ◽  
Study Group ◽  
X Rays ◽  
Lateral Plate ◽  
Side Plate ◽  
Tertiary Referral Center ◽  
Number Of Patients

Category: Ankle Introduction/Purpose: For patients suffering from severe ankle and hindfoot arthritis or deformity, tibiotalocalcaneal (TTC) or pantalar arthrodesis may be the best option to achieve a plantigrade and painless foot. These fusions are typically fixed with a retrograde intramedullary nail, a lateral side plate, or screws alone. Theoretically, the advantages of a lateral side plate applied via a trans-fibular approach include the use and the multiple points of fixation available in the tibia, talus, and calcaneus. The results of a novel side plate construct with a unique screw hole that extends underneath the calcaneus are presented in this study. A large diameter screw can be inserted retrograde through this inferior hole to engage the medial tibial cortex and provide axial compression across the ankle and subtalar joints. Methods: This study retrospectively evaluated 39 patients that underwent a tibiotalocalcaneal (TTC) or pantalar arthrodesis using this novel lateral plate fixation technique by one of three fellowship trained surgeons at a tertiary referral center. Patients with less than a one year follow up were excluded. Thirty-nine patients were identified between 2012 and 2016. Two patients were deceased from other causes, 2 had a below the knee amputation due to chronic pain, and 9 were lost to follow up. Pre- and postoperative General Health and Wellness (SF-12) and Revised Foot Function Index scores were obtained. Study subjects were seen for a clinical evaluation and final post-operative x-rays. The Shapiro-Wilk test was used to test for normality. The paired student’s t-test was used to compare pre- and post-surgical outcome measures. Results: Twenty-six patients were included in the study group. Mean follow up time was 34.42 ± 12.94 months. The SF-12 score was 32.2 ± 10.22 (physical) and 54.8 ± 10.7 (mental) before surgery, and 41.35 ± 9.21 (p < 0.01) and 56.5 ± 7.47 (p = 0.73) at final follow-up, respectively. The FFI score was 106 ± 32.69 before surgery and 53.94 ± 24.14 after surgery (p = 0.06). Eighteen patients were satisfied or very satisfied with the outcome of the surgery (70%). CT confirmation of joint fusion was obtained in all 26 patients. Twenty out of the 26 patients demonstrated fusion of all joints (77%). There were 2 ankle, 1 subtalar, and 1 talonavicular nonunions. In total, 44 of 48 total joints were fused (91%). Conclusion: Tibiotalocalcanceal and pantalar arthrodesis using a novel lateral plate for the treatment of complex deformity and severe osteoarthritis demonstrated acceptable fusion rates considering the number of patients with high risk factors for nonunion in this study group. Complications included fractures at the proximal end of the plate construct and persistent neurapraxia which was well tolerated. Patients reported significant improvements in SF-12 clinical scores at final 34 month follow-up.

Divided Renal and Peripheral Venous Renin as a Means of Predicting Operative Curability of Renal Hypertension

1973 ◽  
Vol 45 (s1) ◽  
pp. 311s-314s ◽  
Author(s):  
Kikuo Arakawa ◽  
Zenziro Masaki ◽  
Yukio Osada ◽  
Junko Yamada ◽  
Shunro Momose
Keyword(s):  
Plasma Renin Activity ◽  
Similar Pattern ◽  
Renal Vein ◽  
Renal Hypertension ◽  
Plasma Renin ◽  
Arterial Stenosis ◽  
Lateral Side ◽  
Corrective Surgery ◽  
Parenchymal Lesion ◽  
Affected Side

1. Eighteen patients with unilateral arterial stenosis or renal parenchymal lesion underwent corrective surgery for hypertension. Operative curability of hypertension was compared with pre-operative plasma renin activity (PRA) determined in three different veins; affected side renal (A), contralateral renal (C), and peripheral veins (P). 2. Those with renal arterial stenosis in whom the PRA in the affected side renal vein was significantly higher (more than 14 ng/ml) than that in both the contra-lateral side and peripheral veins, i.e. those with PRA values showing a pattern of A > C=P were found surgically curable without exception. 3. Patients with unilateral renoparenchymal lesions showed either A, C > P or A = C=P pattern and these were all found not curable. A similar pattern was found in four controls.

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