orthognathic surgery
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2022 ◽  
Vol 11 (2) ◽  
pp. 428
Author(s):  
Krzysztof Dowgierd ◽  
Rafał Pokrowiecki ◽  
Małgorzata Kulesa Kulesa Mrowiecka ◽  
Martyna Dowgierd ◽  
Jan Woś ◽  
...  

Treatment of temporomandibular ankylosis is challenging and frequently leads to re-ankylosis, relapse, dangerous complications and, in turn, the need for multiple operations. In this article, we present a protocol for the treatment of ankylosis of the temporomandibular joints that assumes earlier intervention with the assistance of 3D virtual surgical planning (3DVSP) and custom biomaterials for better and safer surgical outcomes. Thirty-three patients were treated due to either uni- or bilateral temporomandibular ankylosis. Twenty individuals received temporomandibular prosthesis, whereas seventeen required simultaneous 3D virtual surgical/planned orthognathic surgery as the final correction of the malocclusion. All patients exhibited statistically significant improvements in mouth opening (from 1.21 ± 0.74 cm to 3.77 ± 0.46 cm) and increased physiological functioning of the mandible. Gap arthroplasty and aggressive rehabilitation prior to temporomandibular prosthesis (TMJP) placement were preferred over costochondral autografts. The use of 3DVSP and custom biomaterials enables more precise, efficient and safe procedures to be performed in the paediatric and adolescent population requiring treatment for temporomandibular ankylosis.


2022 ◽  
Vol 2022 ◽  
pp. 1-15
Author(s):  
Moonhwan Kim ◽  
Chung-Ju Hwang ◽  
Jung-Yul Cha ◽  
Sang-Hwy Lee ◽  
Young Joon Kim ◽  
...  

Introduction. Studies on the pharyngeal airway space (PAS) changes using three-dimensional computed tomography (CT) have shed more light on patients with Class III than Class II malocclusion. This paper focuses on analyzing the long-term changes in the PAS and evaluating the postoperative association between these PAS and skeletal changes in patients with skeletal Class II malocclusion who have undergone orthognathic surgery. Methods. The records of 21 patients with skeletal Class II malocclusion who had undergone orthognathic surgery were included. The anatomical modifications in both jaws, changes in volume, sectional area (SA), minimum sectional area (MSA), and anterior-posterior (AP) and transverse (TV) width in the airway at one month before surgery ( T 0 ), and one month ( T 1 ) and one year ( T 2 ) after surgery were analyzed using CT images. The association between the skeletal and airway changes was evaluated between T 0 , T 1 , and T 2 . Results. After surgery, the ANS, A point, and PNS demonstrated significant posterior and superior movement. The B point and the pogonion exhibited substantial anterior and superior movement. The total and inferior oropharyngeal volumes (vol 3, vol 4) notably increased, while the nasopharyngeal volume (vol 1) decreased. The anterior-posterior movement at the ANS and PNS after surgery was significantly associated with the total volume, vol 2, vol 3, SA 1, MSA, and TV width 1, while substantial association with the total volume was found at the pogonion. Conclusion. Thus, an ideal treatment plan can be formulated for patients with skeletal Class II malocclusion by considering the postoperative PAS changes.


FACE ◽  
2022 ◽  
pp. 273250162110696
Author(s):  
Sultan Z. Al-Shaqsi ◽  
Senthujan Senkaiahliyan ◽  
Christopher R. Forrest ◽  
Tara D. Der ◽  
John H. Phillips

Craniofacial and orthognathic surgery are high risk procedures for surgical blood loss. Significant blood loss leads to increased rates of blood product transfusion which may be associated with increased morbidity to the patient. The use of anti-fibrinolytics such as tranexamic acid has become popular in these procedures. However, the evidence to support its use in pediatric craniofacial and orthognathic surgery is sparse. This review analyzes the current randomized control trials assessing the use of tranexamic acid in craniofacial and orthognathic surgery. The study reviewed published literature up until December 20th, 2020. Six trials were included in this analysis. Pooled data showed that patients who received tranexamic acid during craniofacial or orthognathic surgery have less blood loss compared to those in control groups (mean difference—5.47 ml/kg [CI -7.02-3.82], P value <.05). Hence, rate of blood product transfusion in patients who received tranexamic acid is lower than control group by 2.01 ml/kg (CI 95%, 1.27-2.74, P value <.05). In summary, this review showed that craniofacial and orthognathic surgery patients who receive tranexamic acid might have lower estimated blood loss and receive less volume of blood products transfusion.


2022 ◽  
pp. 172-181
Author(s):  
Peter J. Taub ◽  
Anand R. Kumar ◽  
Navid Pourtaheri ◽  
Pravin K. Patel
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