ABSTRACT
Over the last decade, the accuracy of three-dimensional computer-assisted orthognathic surgery has been investigated extensively. The absence of high-quality controlled trials, limited number of studies overall, and methodological flaws have hindered its use in general clinical practice. The aim of this study was to assess the accuracy of computer-assisted orthognathic surgery compared to the classic occlusal wafers. Eighteen patients were randomly allocated to two groups: CAD/CAM splints and patient-specific osteosynthesis were used for maxillary positioning in group 1; occlusal wafers fabricated on a semi-adjustable articulator were used in group 2. Patients were assessed for linear and angular deviations of maxillary position from the virtual plan using cone beam computed tomography scans. The CAD/CAM group showed mean deviations of 0.26mm vertically, 0.17mm anteroposteriorly, and 0.07mm mediolaterally, while the classic wafer group showed mean deviations of 1.45mm vertically, 1.31mm anteroposteriorly, and 0.71mm mediolaterally. Statistical analysis showed that the proposed workflow provided a significantly more accurate plan transfer compared to classic occlusal wafers. Despite the statistical significance, the clinical significance was less appreciated. However, this new technology facilitated cases with skeletal asymmetry, reduced operating times, and allowed a trainee surgeon to perform the procedure with great accuracy and minimal time. The main limitation was the high cost.
Subject(s)
Orthognathic Surgical Procedures , Surgery, Computer-Assisted , Computer-Aided Design , Cone-Beam Computed Tomography , Humans , Imaging, Three-Dimensional , Maxilla , Patient Care PlanningABSTRACT
Ten patients suffered from chronic oroantral fistula had been closed with Zenoderm (lyophilized porcine dermis) covering the bony defects by 1-2 mm. The Zenoderm was covered by buccal sliding and rotating pedicle palatal flaps after complete resolution of sinusitis and/or infection of the fistula. In nine patients, competent closure of the fistula had been achieved also Zenoderm supported the flaps against negative or positive pressure from the sinus and supported the bony contour. In only one case the Zenoderm was expelled from the tissues due to infection which prevented healing of the flaps; this patient was controlled diabetic. The current study showed that Zenoderm had promising results in closing the chronic oroantral fistula.
Subject(s)
Collagen/therapeutic use , Oroantral Fistula/surgery , Skin Transplantation/methods , Adolescent , Adult , Aged , Animals , Chronic Disease , Female , Follow-Up Studies , Freeze Drying , Humans , Male , Middle Aged , Oroantral Fistula/diagnostic imaging , Radiography , Surgical Flaps , SwineSubject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Arthralgia/drug therapy , Arthralgia/radiotherapy , Laser Therapy , Temporomandibular Joint Disorders/drug therapy , Temporomandibular Joint Disorders/radiotherapy , Tolmetin/therapeutic use , Adult , Arthralgia/diagnosis , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pain Measurement , Palliative Care/methods , Palliative Care/statistics & numerical data , Temporomandibular Joint Disorders/diagnosisABSTRACT
Carcinogenesis of 35 ddy male mice submandibular salivary glands were attempted; using implants of a 1 mg (2 mm) prepared pellets of the potent chemical carcinogen 9, 10-dimethyl-1, 2-benzanthracene (DMBA) dry powder without a vehicle or carrier. This method appeared to be easy, fast and effective. Within a period ranging from 7-14 weeks; twenty animals developed epidermoid carcinoma (two of them developed squamous cell carcinoma of covering skin as well), and two animals developed mixed tumors (pleomorphic adenoma like tumor) but neither adenocystic carcinoma nor sarcoma were found, the results were adequately discussed.
Subject(s)
Adenoma, Pleomorphic/chemically induced , Carcinoma, Squamous Cell/chemically induced , Submandibular Gland Neoplasms/chemically induced , 9,10-Dimethyl-1,2-benzanthracene , Adenoma, Pleomorphic/pathology , Animals , Carcinogens , Carcinoma, Squamous Cell/pathology , Disease Models, Animal , Drug Implants , Male , Mice , Submandibular Gland/pathology , Submandibular Gland Neoplasms/pathology , Time FactorsABSTRACT
Twelve adult mongrel dogs were divided into two groups and were used in this study; to compare and to evaluate histologically in 3 months period; unilateral replacement of the dogs meniscus of temporomandibular joint with either autogenous cartilage of their external ears or with Zenoderm heterogeneous graft. Autogenous cartilage of the dogs ear was progressively replaced by fibrous tissue and its attachment to the lateral pterygoid muscle was started at the third month postoperatively. On the other hand, Zenoderm was replaced by vascular fibrous tissue and begun to attach to the lateral pterygoid muscle from the first month postoperatively and showed also good functional adaptation to the bony surfaces. In both grafts there were no changes of the bone architecture.
Subject(s)
Ear Cartilage/transplantation , Membranes, Artificial , Skin Transplantation/methods , Temporomandibular Joint Disc/surgery , Animals , Dogs , Ear Cartilage/pathology , Fibrosis , Skin Transplantation/pathology , Swine , Temporomandibular Joint Disc/pathology , Time Factors , Transplantation, AutologousABSTRACT
Nine cases of unilateral internal derangement of TMJ indicated for surgical intervention, were selected for this study. The affected joints were imaged by MRI presurgically. The non-affected joints were also imaged as controls. MRI findings were correlated with intraoperative surgical findings. The results were absolutely accurate as regards degenerative joint pathosis and capsular rupture, and with high degree of accuracy (85.7%) in detection of disc displacement. Two cases of disc perforation were not detected by MRI. The results were promising and encouraging the use of this noninvasive imaging technique as presurgical aid in TMJ disorders.