Short term profile changes after mandibular set back surgery [cephalometric analysis]

This retrospective study analyzed lateral profile soft and hard tissue changes that occurred shortly two months after bilateral sagittal split ramus osteotomy [BSSRO] and set back mandibular surgery in both horizontal and vertical planes, it also assessed the significance and correlations between the soft tissue changes and the dentoskeletal changes. The subjects enrolled were six patients suffering from mandibular prognathism [4 males and 2 femals] operated with BSSRO and rigid fixation. This study was conducted using digitized lateral profile cephalometric radiographs immediate presurgical and 2 months after surgery. Soft and hard tissues were traced and landmarks located in relation to an X and Y coordinate system. Variables corresponding to the horizontal and vertical relationships of the skeletal and soft tissue profiles and incisal relationships were measured. The statistical elaboration of the data made by means of paired t-test and Pearson's coefficient of correlation to examine relationships between tissue and hard tissue changes. The assessment of the results showed changes of the lower anterior 1/3 of the facial profile characterized by significant decrease in height as a result of cranial movement of soft landmarks of the lip [subnasale and superior sulcus] and chin landmarks [gnathion and pogonion]. On the other hand significant cranial movement was found including bony landmarks A point B, pogonion and menton. Also facial profile changed as a result of significant posterior movement of bony tissues and soft tissues below the stomion with increase in the lower facial 1/3 convexity. Both incisors showed upward movement and retroclination which was more significant in lower incisors. A strong correlation was found between both soft and hard tissue changes. In conclusion, lateral cephalometric analysis in this study proved that there was short term lateral profile soft and hard tissue changes after BSSRO and set back surgery with significant correlation between changes. Cephalometry is a valuable method used for assessment of these changes in spite of the existent limitations

Digital and cephalometric radiographic assessment after reconstruction of alveolar cleft with mandibular bone graft

This study was designed to assess radiographic changes during healing of symphyseal bone graft used in reconstruction of alveolar cleft with direct digital radiography [DDR] and to evaluate soft tissues profile changes of the midface that may occurs after treatment using cephalometric analysis. Plain and direct digital radiographs of ten patients [nine unilateral alveolar cleft patients and one bilateral] were taken before and after 1, 3, 6 and 9 months of treatment to assess changes in radiographic bone morphology and density, Interdental alveolar bone height and eruption status of the teeth related to the cleft site. Lateral cephalometric radiographs were taken before and after 6 months of treatment to assess lateral soft tissues profile changes. The results of this study showed that the sequences of changes in radiographic morphology and density in the postoperative follow-up periods were corresponding to histologic phases of bone graft healing in most cases. The mean of linear and angular cephalometric measurements showed an improvement in the nasal soft tissue, labrale superior and the nasolabial angle. In conclusion Symphyseal bone graft provides adequate bone to reconstruct alveolar cleft, to support the teeth and alar base, DDR is considered a sensitive indicator of bone graft healing through assessment of bone morphology and density changes. Cephalometry is an accepted method for assessing postoperative soft tissue profile changes accompanying alveolar cleft reconstruction and reported in this study

Long term evaluation of unilateral displaced condylar fracture after open reducion and rigid internal fixation using computerized tomography

This study was designed to evaluate long term structural and positional changes of the fractured condyles after open reduction and rigid internal fixation by mini dynamic compression plates [mini-DCP] using computerized tomography [CT] through assessment of the different radiographic variables including condylar angles, distances and measurements of superior joint spaces. Six patients were included in the study [6 males] with age ranged from 19 to 39 years. Assessment of the unilateral displaced condylar fractures is done after 13 years of follow up. The results of this study showed negative structural changes and insignificant differences between the various linear and angular measurements of the fractured and non-fractured joints, which indicates proper repositioning of the fractured condyles. In conclusion, the use of maxillomandibular fixation [MMF] before and during placement of the plates, surgical approach, proper reduction using mini dynamic plates with compression were all factors contributed to the proper three-dimensional repositioning of the fractured condyles. Computerized tomography is an acceptable method for assessment of the structure and position of the condyles as it allows accurate linear and angular measurements from different scans in different planes without superimnosing structures projecting over them

Concho - meatoplasty technique in tympanoplasty

A Concho-meatoplasty technique is described which has proved successful in creation of a wide meatus when it is used in tympanoplasty with open mastoidectomy. The technique is described in details and the results are mentioned with a discussion of the technique in accordance to the otologic surgery literature