Early Orthognathic Surgery: A Review

2017 ◽  
Vol 18 (3) ◽  
pp. 250-256
Author(s):  
Saleh Alwadei
Keyword(s):  
Surgical Procedures ◽  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Surgical Intervention ◽  
Well Being ◽  
Facial Growth ◽  
Subsequent Growth ◽  
Congenital Deformities ◽  
Jaw Abnormalities ◽  
Early Surgical Intervention

ABSTRACT Introduction Management of growing patients with severe developmental jaw abnormalities can be very difficult. Early surgical intervention may be warranted in situations where function (e.g., mastication, swallowing, breathing, or speech) and/or psychological well-being could be negatively affected. Many surgeons and orthodontists are reluctant to recommend a surgical treatment option for growing patients with severe developmental jaw abnormalities because of their age. Specific surgical procedures can be performed during growth to correct developmental jaw abnormalities with predictable results. A sound understanding of the facial growth and the effects of the surgical procedures on subsequent growth is essential when managing growing patients with severe developmental jaw abnormalities. Children with severely progressive congenital deficiencies affecting function/health should be distinguished from ones with severe developmental jaw abnormalities that can be managed later in life. In this review, we will focus on the management of growing patients with developmental jaw abnormalities who seek orthodontic treatment, rather than patients with progressive congenital deformities affecting function and/or health. How to cite this article Alwadei S. Early Orthognathic Surgery: A Review. J Contemp Dent Pract 2017;18(3):250-256.

scholarly journals Mandibular distractions in jaws deformations - as a sufficient method or in combination with orthognatic surgery

2017 ◽  
Vol 21 (1) ◽  
pp. 14-21
Author(s):  
Alexandr L. Ivanov ◽  
G. Yu Chikurov ◽  
N. V Starikova ◽  
A. G Nadtochiy ◽  
P. I Agapov
Keyword(s):  
Distraction Osteogenesis ◽  
Surgical Procedures ◽  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Treatment Results ◽  
Retention Period ◽  
Mandibular Distraction ◽  
Mandibular Distraction Osteogenesis ◽  
Surgical Methods ◽  
Computer Planning

Aim: improvement of mandibular distraction osteogenesis and rehabilitation algorithm of patients with combined jaws deformities caused by mandible hypoplasia. Matherial and methods: we report treatment results of 6 patients with the combined jaws deformities and mandible hypoplasia (developmental and congenital). All of the patients have undergone Steiner cephalometric analysis on the presurgical stage, after mandible distraction osteogenesis (DO) and after orthognathic surgery. The assessment of callus formation was done by ultrasound. All patients have undergone orthodontic treatment during retention period after distraction. The need of orthognathic surgery was defined at the end of retention period. Final evaluation was provided accordingly to functional and esthetic results. Results. Distration speed adjustments were the case in 5 patients to get normotrophic type of bone regeneration. Mean allongation was 175 mm. All of the patients had fully matured bony regenerate after mandibular distraction. That gave the opportunity to provide bimaxillary ortognathic surgery and genioplasty simultaneously with distractors removement in 3 patients. In 2 patients was performed only genioplasty with distractors removement. In 1 case with preoperative distraction computer planning there was no need of any additional surgical procedures. Acceptable functional and esthetic results were achieved after DO and orthodontic treatment. Conclusion. The combination of surgical methods (DO and ortognathic surgery) and early orthodontic treatment allow complete recovery. Use of sophisticated algorithm of DO, including computer planning, conservative surgical methods and curvilinear distractors as well as the ultrasonic assessment of distraction, allow to get fully matured bone regenerate and predictable treatment results in all cases. Sometimes the DO alone permits to avoid additional surgical procedures.

Longitudinal Follow-Up of Facial Growth of Patients With Unilateral Cleft Lip and Palate Following Modified Veau–Wardill–Kilner Palatoplasty

2021 ◽  
pp. 105566562110048
Author(s):  
Konomi Iwasaki ◽  
Yuki Sato Yamamoto ◽  
Marina Masuda ◽  
Prasad Nalabothu ◽  
Fumio Ohkubo ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Phase 1 ◽  
Phase 2 ◽  
Facial Growth ◽  
Phase 3 ◽  
Skeletal Class ◽  
Second Stage

Objective: To evaluate facial growth after modified Veau–Wardill–Kilner/pushback (PB) palatoplasty from childhood to adulthood in patients with unilateral cleft lip and palate (UCLP). Design: Retrospective longitudinal study. Setting: Single center. Patients: Sixty-two (29 males and 33 females) consecutive patients with nonsyndromic UCLP. Interventions: Pushback palatoplasty and subsequent cleft palate treatment. Main Outcome Measures: Lateral and posterior–anterior cephalograms were taken at 3 different phases: phase 1 (before first-stage orthodontic treatment; N = 58; average age, 4.9 ± 1.1 years), phase 2 (before second-stage orthodontic treatment; N = 58; 15.9 ± 1.1 years), and phase 3 (after orthodontic retention; N = 51; 22.1 ± 3.2 years). Results: The majority of patients had skeletal class III morphology in all 3 phases due to retrognathic maxilla. Maxillary growth did not improve in phase 2 despite first-stage orthodontic treatment in phase 1. Maxillary morphology improved in phase 3 but retardation occurred, although 77.42% of patients received orthognathic surgery during second-stage orthodontic treatment. Mandibular growth was slightly reduced in phases 1 and 2 and the mandible remained retrognathic in phase 3, following mandibular setback orthognathic surgery. The horizontal occlusal cant was slightly upward and toward the cleft side with respect to the reference plane, and the upper midline was deviated to the cleft side in phases 1 and 3. Conclusions: Patients with UCLP who undergo phased PB palatoplasty, orthodontic treatment, and orthognathic surgeries do not maintain skeletal class I facial morphology.

Microporous Polysaccharide Hemosphere Absorbable Hemostat (AristaAH®) in Re-Operative Cardiac Surgical Procedures

2012 ◽  
Vol 9 (2) ◽  
pp. 96-98
Author(s):  
Brian A Bruckner ◽  
Matthias Loebe
Keyword(s):  
Patient Outcomes ◽  
Surgical Procedures ◽  
Systematic Approach ◽  
Surgical Intervention ◽  
Transfusion Requirement ◽  
Cardiac Surgical Procedures ◽  
Platelet Inhibitors ◽  
Hemostatic Agents ◽  
Surgical Field ◽  
Improve Patient

Patients undergoing re-operative cardiac surgical procedures present a great challenge with regard to obtaining hemostasis in the surgical field. Adhesions are ever-present and these patients are often on oral anti-coagulants and platelet inhibitors. As part of a well-planned surgical intervention, a systematic approach to hemostasis should be employed to decrease blood transfusion requirement and improve patient outcomes. Topical hemostatic agents can be a great help to the surgeon in achieving surgical field hemostasis and are increasingly being employed. Our approach, to these difficult patients, includes the systematic and planned use of AristaAH, which is a novel hemostatic agent whose use has proven safe and efficacious in our patient population.

scholarly journals Early surgical intervention for active thoracic spinal tuberculosis patients with paraparesis and paraplegia

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Weiwei Li ◽  
Zheng Liu ◽  
Xiao Xiao ◽  
Zhenchao Xu ◽  
Zhicheng Sun ◽  
...  
Keyword(s):  
Blood Loss ◽  
Surgical Intervention ◽  
Spinal Tuberculosis ◽  
Thoracic Spinal ◽  
Cobb’S Angle ◽  
Perioperative Complication ◽  
The Mean ◽  
Early Surgical Intervention ◽  
Thoracic Spinal Tuberculosis

Abstract Background To explore the therapeutic effect of early surgical intervention for active thoracic spinal tuberculosis (TB) patients with paraparesis and paraplegia. Methods Data on 118 active thoracic spinal TB patients with paraparesis and paraplegia who had undergone surgery at an early stage (within three weeks of paraparesis and paraplegia) from January 2008 to December 2014 were retrospectively analyzed. The operation duration, blood loss, perioperative complication rate, VAS score, ASIA grade and NASCIS score of neurological status rating, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb’s angle, and duration of bone graft fusion were analyzed to evaluate the therapeutic effects of surgery. Results The mean operating time was 194.2 minutes, and the mean blood loss was 871.2 ml. The perioperative complication rate was 5.9 %. The mean preoperative VAS score was 5.3, which significantly decreased to 3.2 after the operation and continued decreasing to 1.1 at follow up (P<0.05). All cases achieved an increase of at least one ASIA grade after operation. The rate of full neurological recovery for paraplegia (ASIA grade A and B) was 18.0 % and was significantly lower than the rate (100 %) for paraparesis (ASIA grade C and D) (P<0.05). On the NASCIS scale, the difference in the neurological improvement rate between paraplegia (22.2 % ± 14.1 % in sensation and 52.2 % ± 25.8 % in movement) and paraparesis (26.7 % ± 7.5 % in sensation and 59.4 % ± 7.3 % in movement) was remarkable (P<0.05). Mean preoperative ESR and CRP were 73.1 mm /h and 82.4 mg/L, respectively, which showed a significant increase after operation (P>0.05), then gradually decreased to 11.5 ± 1.8 mm/h and 2.6 ± 0.82 mg/L, respectively, at final follow up (P<0.05). The mean preoperative kyphotic Cobb’s angle was 21.9º, which significantly decreased to 6.5º after operation (P<0.05) while kyphotic correction was not lost during follow up (P>0.05). The mean duration of bone graft fusion was 8.6 ± 1.3 months. Conclusions Early surgical intervention may be beneficial for active thoracic spinal TB patients with paraparesis and paraplegia, with surgical intervention being more beneficial for recovery from paraparesis than paraplegia.

Changes in the Complexity of Orthodontic Treatment for Patients Referred to a Teaching Hospital

1988 ◽  
Vol 15 (1) ◽  
pp. 27-32 ◽  
Author(s):  
C. D. Stephens ◽  
N. W. Harradine
Keyword(s):  
General Practitioner ◽  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Further Training ◽  
Fixed Appliance ◽  
Dental Hospital ◽  
Orthodontic Patients ◽  
Specialist Treatment ◽  
Fixed Appliances ◽  
Removable Appliance

The records of 200 orthodontic patients accepted for treatment by the Orthodontic Department of the Bristol Dental Hospital in 1977 were compared with 200 taken on in 1985 in order to determine whether there had been any change in the proportion of referred cases requiring more complex procedures. Within each sample, cases were categorized as follows: (a) suitable for removable appliance treatment by an undergraduate or general practitioner; (b) requiring simple one arch fixed appliance treatment such as might he attempted by a general practitioner after a period of further training; (c) needing specialist treatment such as full multibracketed fixed appliances or orthognathic surgery. It was found that there had been no change in the proportions of simple and complex cases referred during the 8-year period although the proportion of patients now receiving complex treatment had increased greatly. Possible explanations and implications are discussed.

Early Surgical Intervention for Infective Endocarditis

2002 ◽  
Vol 10 (4) ◽  
pp. 298-301 ◽  
Author(s):  
Hong Sheng Zhu ◽  
Pei Yan Yao ◽  
Jia Hao Zheng ◽  
A Thomas Pezzella
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Complex Disease ◽  
Surgical Intervention ◽  
Elective Surgery ◽  
Postoperative Bleeding ◽  
Arterial Embolization ◽  
Early Surgical Intervention

Infective endocarditis remains a serious and complex disease with significant morbidity and mortality. Sixty cases of infective endocarditis were retrospectively reviewed, consisting of 41 males and 19 females aged 7 to 50 years (mean, 30 years). Congenital heart disease was diagnosed in 19 of the patients and rheumatic heart disease in 41. Congestive heart failure occurred in 36 and systemic embolism in 8 cases. Blood cultures were positive in only 21.7% of the cases, while vegetations were detected by 2-dimensional echocardiography in 70%. Elective surgery was performed in 57 patients and emergent operation for systemic arterial embolization and/or intractable congestive heart failure in 3 patients. Two patients required reoperation for postoperative bleeding. All but 2 patients had been followed up for 6 to 160 months with no evidence of reinfection. Three patients with mechanical valve implantation later died of intracranial bleeding due to over-anticoagulation. The remaining 55 resumed normal activity. The encouraging outcomes were the result of an aggressive diagnostic approach and early surgical intervention.

scholarly journals Correction to: Early surgical intervention for structural infantile spasms in two patients under 6 months old: a case report

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Haiyan Yang ◽  
Zhiquan Yang ◽  
Jing Peng ◽  
Yehong Huang ◽  
Zhuanyi Yang ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Infantile Spasms ◽  
Early Surgical Intervention

Mycobacterium mageritense infection following mastectomy and breast reconstruction requiring triple antibiotic therapy and surgical debridement

2021 ◽  
Vol 14 (2) ◽  
pp. e237618 ◽  
Author(s):  
Christie Alyce Joya ◽  
Cara Deegan ◽  
Todd D Gleeson
Keyword(s):  
Antibiotic Therapy ◽  
Surgical Intervention ◽  
Treatment Guidelines ◽  
Perforator Flap ◽  
Published Data ◽  
Gastrointestinal Distress ◽  
Deep Inferior Epigastric Perforator ◽  
Infectious Disease Specialists ◽  
Systemic Symptoms ◽  
Early Surgical Intervention

A 40-year-old woman was referred to infectious disease specialists for a Mycobacterium mageritense skin infection following mastectomy and bilateral reconstruction with deep inferior epigastric perforator flap. Her case demonstrates the difficulty in treating non-tuberculosis mycobacterial infections, especially the rarely seen species. She failed to respond to dual antibiotic therapy containing imipenem-cilastin despite reported sensitivity. Additionally, her course was complicated by intolerance to various regimens, including gastrointestinal distress, a drug rash with eosinophilia and systemic symptoms, and tendinopathy. With few published data, no treatment guidelines, and limited medications from which to choose for M. mageritense, her treatment posed a challenge. She ultimately required aggressive surgical intervention and a triple therapy antibiotic regimen. The duration of our patient’s treatment and the extent of her complications suggest a potential need for early surgical intervention in postsurgical wounds infected with M. mageritense that do not respond to conventional treatment.

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