Anterior segmental distraction osteogenesis in the hypoplastic cleft maxilla: report of five cases

Orthognathic surgery and distraction osteogenesis play a prime role in the correction of maxillary hypoplasia in patients with cleft lip and palate [CLP]. Advancement of the anterior maxilla alone without interfering with the velopharyngeal sphincter may be advantageous in cleft patients, who more commonly have speech deficits and dental crowding. We present a case series of anterior maxillary segmental distraction for maxillary hypoplasia in 5 CLP patients with a one-year follow-up. A custom-made tooth-borne distraction device with a hyrax screw positioned anteroposteriorly was used. The evaluation comprised of hard and soft tissue analysis and speech assessment. A stable occlusion with positive overjet and correction of dental-crowding without extraction was achieved at one year post-distraction. Facial profile and lip support improved. There was no deterioration in speech

Effectiveness of HemCon Dental Dressing versus conventional method of haemostasis in 40 patients on oral antiplatelet drugs

The purpose of the study was to evaluate the effectiveness of the HemCon Dental Dressing [HDD] in controlling post extraction bleeding and to ascertain its role in healing of extraction wounds, as compared to control. The 40 participants in the study were all receiving oral antiplatelet therapy [OAT]. A total of 80 extractions were conducted without altering the patients' drug therapy. The extraction sites were divided into 2 groups: one group received a HDD, and the control group where the conventional method of pressure pack with sterile gauze under biting pressure [followed by suturing if required] was used to achieve haemostasis. All HemCon treated sites achieved haemostasis sooner [mean = 53 seconds] than the control sites [mean = 918 seconds] which was statistically significant [P <0.001]. Postoperative pain in the HDD group [1.74] was also significantly lower than in the control group [5.26] [P <0.001]. Approximately 72.5% of HDD-treated sites showed significantly better postoperative healing when compared to the control site [P <0.001]. HDD proved to be an excellent haemostatic agent that significantly shortened the bleeding time following dental extraction in patients on OAT. Additionally, HDD offered significantly improved post-operative healing of the extraction socket and less postoperative pain