Autologous versus prosthetic nasal and auricular reconstruction - patient, professional and layperson perceptions.

The aim of this study was to retrospectively evaluate the perceptions of aesthetic outcome following the autologous and prosthetic reconstruction of nasal and auricular defects among patients, professionals (oral and maxillofacial surgeons and ear, nose and throat surgeons) and people unfamiliar with reconstructive surgery. The influence of anatomical subunits on the overall perception of nasal and auricular reconstructions was also determined. A total of 119 patients treated for nasal and auricular defects between 1997 and 2016, with a minimum follow-up period of 6 months, were selected, and photographs of 77 of these patients (65%) were presented in a digital survey and reviewed using a standardized questionnaire. No clinically relevant correlations were found between the age or gender of patients (as well as those of the respondents) and their scores. Prosthetic reconstructions of nasal and auricular defects were considered advantageous over autologous reconstructions in terms of the subjective aesthetic outcome in the view of the professionals, in particular oral and maxillofacial surgeons; however, the patients judged both techniques to be equally effective in terms of aesthetics. No anatomical subunits were found to have a significant impact on the overall match of a nasal or auricular reconstruction with the patient's face.

3D evaluation of the lingual fracture line after a bilateral sagittal split osteotomy of the mandible.

The purpose of this prospective observational study was to evaluate whether cone beam CT (CBCT) is a useful tool for analyzing the fracture line in a bilateral sagittal split osteotomy (BSSO). The patient group consisted of 40 consecutive patients (9 males and 31 females) with a mandibular hypoplasia who underwent a BSSO advancement (Hunsuck modification; n=80 splits) between September 2006 and July 2008. The mean age at the time of surgery was 34 years (range 17-61 years). A newly developed lingual split scale was used to categorize the path of the fracture line on the lingual side of the ramus based on one-day postoperative data sets reconstructed from CBCT data. Although all splits (n=80) were performed according to the standardized protocol, only 51% of the fracture lines run according to the Hunsuck's description, whereas 33% ran through the mandibular canal and 16% split otherwise. The split pattern was influenced by the length of the medial osteotomy (p=0.01). In conclusion, 3D imaging is a useful tool for analyzing the surgical outcome of a BSSO and has the potential to provide substantial data on the position of the proximal segments as a result of the lingual fracture line.

[Clinical results of bone anchors for orthodontic anchorage; the indications and surgical complications]. / Zygoma-ankers voor orthodontische verankering. Indicaties en chirurgische complicaties.

In order to make teeth-movement possible, orthodontic anchorage is necessary. Neighbouring teeth, a headgear, dental implants and bone anchors can be used. During the period 2002-2007 158 bone anchors have been placed in 84 patients by an oral surgeon after referral by an orthodontist in order to achieve anchorage for orthodontic treatment. The bone anchor consists of a titanium osteosynthesis-plate ending in a round neck perforating the soft tissue and a cylinder attached to it. The indications for placement, results and complications were registered. 15 anchors (9,5%) were lost prematurely and in 13 cases (8,2%) complications needing surgical intervention were reported. It is concluded that zygoma-bone anchor is a good alternative for orthodontic anchorage and the number of complications is acceptable, though there is room for improvement.

[Diagnosis of occlusal caries lesions using laser fluorescence measurements]. / Diagnostiek van occlusale cariëslaesies met behulp van laserfluorescentiemetingen.

Recently, a device for detecting occlusal caries lesions (DIAGNOdent) has been introduced. The reproducibility and validity of this laser-fluorescence device were investigated. In the in vivo part of the study, 45 sites at the occlusal surfaces of permanent molar teeth in 13 patients were measured by 2 observers using 2 DIAGNOdent devices, one produced in 1998 and one in 1999. The interobserver reliability between both devices and both observers was established. In the in vitro part of the study, 49 permanent molars were measured by 2 observers using 2 DIAGNOdent devices. In addition, visual inspection was performed. The teeth were sectioned to measure the histological depth and area of the caries lesions. The reproducibility of both DIAGNOdent devices was high, and so was the interobserver reliability. The correlation between DIAGNOdent measurements and the actual depth of the caries lesions was lower than that of visual inspection. The correlation with the enamel part of the lesion exceeded that of the dentine part. It was concluded that the validity of the DIAGNOdent, expressed as the area under the Receiver Operating Characteristic (ROC) curve, was not statistically significantly different from that of visual inspection. Because of the high reproducibility, dental practitioners who wish to use the DIAGNOdent for monitoring caries lesions, this investigation indicates that an old device may be replaced by a new one, provided that the same tip will be used.