scholarly journals Deliberate Hypotensive Anesthesia With the Rapidly Acting, Vascular-Selective, L-Type Calcium Channel Antagonist—Clevidipine: A Case Report

2014 ◽  
Vol 61 (1) ◽  
pp. 18-20 ◽  
Author(s):  
Kevin Croft ◽  
Stephen Probst

Abstract Deliberate hypotension is an important technique for use in select anesthetics for procedures such as orthognathic surgery, specifically LeFort I maxillary osteotomy. We present a case report of an anesthetic involving deliberate hypotension for a 17-year-old female patient who presented for a LeFort I osteotomy, bilateral sagittal split of the mandible, and a genioplasty in order to correct a skeletal class III malocclusion. After reaching a steady-state general anesthetic, deliberate hypotension was induced solely with a bolus and subsequent continuous infusion of the ultrashort acting calcium channel blocker, clevidipine. The preoperative, intraoperative, and postoperative course and anesthetic management are discussed.

Author(s):  
Vo Truong Nhu Ngoc ◽  
Nguyen Thi Thu Phuong ◽  
Nguyen Viet Anh

A skeletal Class III malocclusion with open bite tendency is considered very difficult to treat orthodontically without surgery. This case report describes the lingual orthodontic treatment of an adult skeletal Class III patient with mandibular deviation to the left side, lateral open bite, unilateral posterior crossbite, zero overbite and negative overjet. The lower incisors were already retroclined to compensate with the skeletal discrepancy. The patient was treated by asymmetric molar extraction in the mandibular arch to retract the lower incisors and correct the dental midline, with the help of intermaxillary elastics. Lingual appliance was used with over-torqued lower anterior teeth’s brackets to control the torque of mandibular incisors. After a 30-month treatment, satisfactory smile and facial esthetics and good occlusion was achieved. A 12-month follow-up confirmed that the outcome was stable. Asymmetric molar extraction could be a viable option to retract mandibular incisors in Class III malocclusion with lower dental midline deviation.


2021 ◽  
Vol 10 (34) ◽  
pp. 2954-2959
Author(s):  
Shilpa Venkatesh Pharande

The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-Ramec (alternate rapid maxillary expansion and contraction) protocol is an efficient method for early treatment of skeletal Class III malocclusion. This case report shows the results of using a hyrax bonded maxillary expander with the Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 12-year-old patient with skeletal class III malocclusion with anterior as well as the unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analysing the skeletal changes that have occurred after using the AltRamec protocol. The objective of this case report is to assess skeletal changes after using the Alt-RAMEC protocol.


2020 ◽  
Vol 54 (2) ◽  
pp. 150-156
Author(s):  
Sanjeev Verma

VG, 25-year-old male, presented with c/c of forwardly placed lower jaw and history of unsatisfactory previous orthodontic treatment. Extraorally, the patient had asymmetrical face and concave profile, competent lips, positive lip step, and chin deviated toward left side by 2 mm. Intraorally, the patient had Angle’s class III type 3 malocclusion with an overjet of (–1) mm, overbite of 0%, and cross-bite wrt 12, 21. The patient was skeletal class III due to macrognathic and prognathic mandible with hypodivergent growth pattern, and proclined upper and retroclined lower incisors. The patient was managed orthosurgically with bimaxillary surgery (maxillary advancement 3 mm + mandibular setback 7 mm) after presurgical decompensation. The case report discusses in detail the diagnosis and comprehensive management of the skeletal class III case.


2018 ◽  
Vol 6 (02/03) ◽  
pp. 118-121
Author(s):  
Suruchi Jatol-Tekade ◽  
Satyajit Tekade ◽  
Sachin Sarode ◽  
Vishal Patni ◽  
Vihang Naphde

AbstractTandem appliance is preferred over face mask mainly because of compliance reasons. In the given case report, clinicians have used tandem appliance for correcting skeletal class III malocclusion patient in later stage of growth. Operators utilized residual growth. Facial harmony was achieved by gaining positive overjet. Adolescent class III malocclusion is challenging to treat. Occurrence of class III malocclusion is just 5% in India. If patient reports in growing stage, clinicians get many relevant treatment options. Lack of knowledge about growth modulation therapy causes loss of growing stage of patients. This situation reduces available treatment modalities. Here is a case of female patient with class III malocclusion who is near completion of her growth; maxillary growth was stimulated in forward direction taking anchorage from overgrown mandible with the help of tandem appliance.


2016 ◽  
Vol 53 (3) ◽  
pp. 424-429
Author(s):  
Patrycja Downarowicz ◽  
Beata Kawala ◽  
Rafał Nowak

Author(s):  
Mahmoud Serag ◽  
Heba Ismail ◽  
Joseph Zichella

This case report describes the correction of a skeletal Class III malocclusion by performing alveoloplasty and All-on-four styletitanium/acrylic (hybrid) fixed/detachable implant supported prosthesis.  A 76-year-old Hispanic,female patient with a noncontributory medical history presented to the clinic with a chief complaint of “I cannot wear my upper partial denture, it keeps on breaking”. Intraoral examination revealed significant inter-arch Class III relation, supra-erupted mandibular dentition, and significant loss of the vertical dimension of occlusion. Surgical treatment included edentulation of the patient in addition to a significant mandibular alveoloplasty in order to correct the patient’s malocclusion prosthetically. Through proper planning and execution, a skeletal Class III relationship was corrected with an implant supported All-on-four maxillary/mandibular prostheses. An edge-to-edge incisal relationship was achieved along with an appropriate vertical dimension of occlusion. The preplanning protocol allowed determination of the required alveoloplasty in order to obtain sufficient restorative space to allow for the correction of the skeletal malocclusion prosthetically.


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