Surgical Ciliated Cysts in Orthognathic Surgery.

ABSTRACT: Surgical ciliated cysts (SCC) are rare entities that were first described in the Japanese literature after treatment for chronic maxillary sinusitis. Classically associated with surgery to the maxillary sinus, they have also been reported in association with orthognathic surgery, bone grafting, and trauma. These lesions can develop from a few months up to several years after the surgical procedure. The authors report 2 new cases of SCC after a LeFort I osteotomy for class III dentofacial deformity correction. One of them presented with bilateral lesions and suffered from a recurrence after 5 years, 2 rare events associated with SCC.A review of the literature of the past 5 years was undertaken, in order to ascertain the reported time of follow-up and recurrence. A PubMed search retrieved a total of 15 articles with 17 cases reported. Nine cases were associated with orthognathic surgery, 4 with Caldwell-Luc procedures, 2 with sinus lift and 2 with trauma. The mean follow-up after removal of the SCC was of 8.6 months. Four cases did not specify the follow up time; 1 case was lost to follow-up. No relapses were reported.Like what happens with the primary lesion, a recurrence can take place several years after removal. It is the authors' opinion that adequate long-term follow-up must be granted for a timely diagnosis and treatment of relapsed SCC.

Transverse maxillary distraction in patients with periodontal pathology or insufficient tooth anchorage using custom-made devices.

PURPOSE: We present our experience using modified Hyrax devices for treating transverse deficiencies of the maxilla in adult patients with periodontal pathology or insufficient tooth anchorage. The surgical technique, clinical indications, and results are discussed. MATERIALS AND METHODS: Eight adult patients (6 females, 2 males) requiring maxillary expansion were studied prospectively between July 2002 and July 2007. All the patients had periodontal pathology or insufficient tooth anchorage preventing the use of conventional Hyrax devices. Patients underwent surgically assisted rapid maxillary expansion with the use of custom-made modified Hyrax devices (bone-borne or tooth-bone-borne devices). Patients received preoperatively (T1), at the end of distraction (T2), at removal of the expansion device (T3), and 12 months after surgery (T4) lateral and posterior anterior cephalograms and study models to measure the width of the anterior and posterior dental arches with a digital sliding calliper. RESULTS: Mean age was 28.5 years (range, 18-45 years). A significant widening of the anterior (6.3 +/- 1.6 mm) and posterior (7.1 +/- 1.2 mm) dental arches was demonstrated. No significant differences were found when comparing T3 with T4 measures. No significant complications were found. CONCLUSION: The results indicated that maxillary expansion with custom-made devices in adults was an easy, affordable, predictable and stable technique without significant complications in patients who suffer periodontal pathology or patients without enough dental support.