RESUMO
The purpose of this study was to check the feasibility of botulinum toxin efficacy to eliminate the residual soft tissue defects following Lefort 1 osteotomy. Severe skeletal discrepancies treated by orthognathic surgery is not satisfactory at times. Moreover, soft tissue changes following orthognathic surgey are minimal. Injection of botulinum as an adjunctive to orthognathic surgery produces desirable outcome in soft tissue changes.Five cases of maxillary excess were treated with Lefort 1 osteotomy followed by administration of botulinum toxin. Botulinum was injected in the muscles around the lip and the nose. The injection sites were determined by muscle animation[smiling] and palpation on contraction to ensure precise muscle location before injection.Five patients were included in the present study of which 4 were females and one was male.This study was done in Adiparasakthi dental college and hospital between 2009 and 2011. The results were markedly noticeable at 2 weeks following administration of botulinum toxin. Pre surgical and post surgical soft tissue cephalometric analysis performed on the patients showed satisfactory changes. The results were consistent for six months. This study revealed botulinum toxin to be a minimally invasive ,effective alternate for the correction of gummy smile caused by upper lip elevator muscles. Therefore, it can be used as an adjunct to enhance esthetics and improve patient satisfaction where orthognathic surgery alone may have proved inadequate
RESUMO
Maxillary central incisors with large periapical cystic lesions have been treated by conventional endodontic therapy combined with surgical decompression.Electing surgical enucleation may some-times lead to inadvertent injury to adjacent teeth or structures. This retreatment case presented here was treated successfully using Mineral Trioxide Aggregate and surgical decompression
RESUMO
The aim of this study was to determine the efficiency of extraoral bone anchored appliances to distract human mandible using the principles of distraction osteogenesis without orthognathic surgery, and to induce mandibular lengthening with minimal injury to soft tissues and neuro-vascular bundle. Distraction osteogenesis is an alternative treatment method for the correction of mandibular hypoplasia. In this study, distraction with a unidirectional extra oral device was performed to gradually lengthen the corpus and ramus of patients who had hypo-plastic mandible. Ten patients, six females and four males underwent unilateral and bilateral extra oral ramus and corpus distraction osteogenesis. After five days of latency period distraction was performed 0.5 mm twice a day. Subsequent consolidation period was twelve weeks. This study was conducted in Adiparasakthi Dental College and Hospital in Tamilnadu, India. from 2004 to 2010. In all the patients desired mandibular length [in 4 patients 10mm and in 6 patients 14mm] was achieved. Ultrasound examination was performed during the first, third, fifth, seventh, ninth and eleventh week, which showed echolucent area followed by hyperechoic spicules in a echolucent window and increasing echogenic material in distraction gap respectively. Posterior airway space [PAS] also increased due to advancement of mandible. Parasthesia was noticed in all the patients during activation but sensory function eventually regained during consolidation. Satisfactory results from both aesthetic and functional standpoints were obtained by distraction osteogenesis of the ramus and corpus