Postoperative neurosensory impairment perception using ultrasonic BoneScalpel and conventional rotary instruments after bilateral split sagittal osteotomy.

PURPOSE: Although bilateral sagittal split osteotomy (BSSO) is the most widely used surgical technique for the correction of mandibular dentofacial anomalies, it is associated with lesion of inferior alveolar nerve (IAN) and unwanted neurosensory disorders. The aim of this study was to document the perception of changes in sensitivity and mean recovery time after BSSO, using an ultrasonic BoneScalpel versus the conventional rotary instruments. PATIENTS AND METHODS: This retrospective observational study included all patients with diagnosis of skeletal anomaly who underwent advancement or setback BSSO of less than 10 mL, using the ultrasonic osteotome or conventional rotary instruments. The patients were operated on at the Hospital Universitario Clínica San Rafael, Bogotá Colombia, between 2017 and 2018. The primary predictor variable was the osteotomy technique. The primary outcome was the presence or absence of postoperative sensory alteration, whereas secondary outcomes were time of appearance and recovery, affected anatomical region, laterality, and disturbance in daily activities. Data were analyzed using Chi-square, Mann-Whitney U, and Fisher's exact test. RESULTS: Data of 38 patients were retrieved, of which 23 were operated with BoneScalpel and 13 with the conventional technique. Twenty patients were women and 18 were men. All patients reported experiencing at least one type of sensory disturbance immediately after the surgical procedure. There was a significant difference (p = 0.0001) in the time that the alteration was present between the two groups, in favor of the BoneScalpel group. The chin and the lower lip were the anatomical regions with the greatest alteration in sensitivity and persistence of it. CONCLUSIONS: The results of this study indicate that BoneScalpel is effective in performing BSSO. They also suggest that it may reduce the occurrence of nerve damage during BSSO, although more research on this topic is required.

Immediate total temporomandibular joint replacement with TMJ concepts prosthesis as an alternative for ameloblastoma cases.

Ameloblastoma is a common epithelial odontogenic tumor, representing 1 to 3% of all cysts and tumors of the oral and maxillomandibular region. It has been more commonly found in the mandible than in the maxilla. Treatment of ameloblastoma is essentially surgical, ranging from conservative therapy such as enucleation, marsupialization, and curettage, to more radical approaches, including marginal, segmental, or composite resection. It has a high tendency to recur and, in some instances, has shown malignant development when treated inadequately. When resection is indicated, reconstructive measures must be considered. The aim of the present study is to report on 2 cases of large ameloblastomas of the solid/multicystic type that were treated by hemimandibulectomy and reconstructed with a novel technique consisting of a custom-made TMJ Concepts prosthesis (TMJ Concepts, Ventura, CA). The role and outcomes of custom-made temporomandibular joint prostheses in these circumstances are discussed.

Temporomandibular joint meniscopexy with Mitek mini anchors.

PURPOSE: The purpose of this study is to show long-term results with the use of Mitek mini anchors (DePuy Mitek, Raynham, MA) in the surgical treatment (meniscopexy or discoplasty) of internal derangements that lead to a dysfunctional temporomandibular joint (TMJ). PATIENTS AND METHODS: We evaluated 50 patients, 32 women and 18 men, ranging in age from 19 to 53 years, with a mean age of 33.5 years. All patients included in the study were diagnosed with anterior disc displacement without reduction. Each patient underwent surgical meniscopexy and placement of Mitek mini anchors with No. 2-0 nylon monofilament sutures. The variables taken into account in this study include range of mouth opening, painful symptoms (evaluated with the visual analog verbal scale), and the presence of any clicks in the TMJ. RESULTS: Preoperative analysis showed painful symptoms in 100% of evaluated patients, the presence of clicks of the TMJ in 76%, and a mean mouth opening range of 23.5 mm. Postoperative analysis showed that 92% of the patients had no painful symptoms, 90% did not have any associated clicks in the TMJ, and the mean mouth opening range on postoperative evaluation was 38.3 mm, with a mean increase of 14.8 mm. CONCLUSIONS: We conclude that surgical placement of Mitek mini anchors represents an alternative that can be considered a tool of great utility for discoplasty procedures, showing evident clinical improvement.

Relaciones anatómicas intraóseas en rama y cuerpo mandibular en la técnica de osteotomía sagital mandibular modificada / Intraosseous anatomical relations in ramus and mandibular body in modified sagittal mandibular osteotomy techniques

Se han realizado varias mofificaciones a la osteotomía digital mandibular (OSM) intraoral para disminuir sus complicaciones, que siguen presentándose posiblemente por desconocimiento de la anatomía.

Reconstrucción de maxilar superior con injerto autólogo de mentón y micromalla de titanio: reporte de dos casos / Autogenous mandibular bone graft with titanium micromesh for reconstruction of the maxillary alveolar ridge: a report of two cases

Existen ciertas condiciones que pueden alterar la anatomía del reborde alveolar de los maxilares, tales como osteorradionecrosis, tumores, enfermedad periodontal y secuelas de trauma o de labio y paladar hendido, comprometiendo el patrón oclusal, la fonética y el aspecto estético y funcinal de los pacientes. En procedimientos convencionales de reconstrucción, usualmente son utilizados injertos óseos autólogos de cresta ilíaca, arcos costales, calota y tibia. Debido a la morbilidad asociada con la toma de injertos de estos lugares, se han estudiado diferentes zonas alternas de donación. El presente artículo describe una técnica de reconstrucción del reborde alveolar del maxilar superior mediante la combinación de injerto óseo autólogo de mentón más micromalla de titanio en dos casos de diferente etiología

Abordaje intraoral único para el manejo de fracturas del complejo cigomático. Informe de un caso / Intraoral approach for zygomatic complex fractures management. A case report

Las fracturas del complejo cigomático son lesiones comunes asociadas al trauma maxilofacial. la mayoría de estas fracturas son tratadas a menudo utilizando diferentes tipos de abordajes en conjunto, que permitan una amplia exposición del esqueleto facial. A partir de estos abordajes se han estandarizado diferentes técnicas para el manejo del trauma maxilofacial; sin embargo, cada uno tiene indicaciones y características precisas que requieren ser tenidas en cuenta para asegurar el éxito en el tratamiento. El presente informe describe la técnica para el manejo de las fracturas del complejo cigomático a través de un abordaje intraoral único.

Respuesta tisular y expresión de fibronectina a nivel de la cápsula articular de la ATM / Tissue response and expression of fibronectin in the temporomandibular joint capsule

Se realizó un estudio de tipo descriptivo no experimental, con el fin de identificar las característícas histológicas de la respuesta tisular a nivel de la cápsula articular de pacientes con subluxación crónica sintomática de la articulación tempomandibular. Para esto se seleccionaron, mediante muestreo no probabilístico intencional, 15 pacientes con un rango de edad entre 18 y 50 años, con historia de al menos un episodio de luxación de la articulación temporomandibular sintomatología dolorosa asociada.

Palatorrafia de Pusch back en paladar hendido unilateral. Revisión de la técnica quirúrgica / Push back palatorraphy in unilateral cleft palate. A review of the surgical technique

Las fisuras palatinas han sido tratadas a través de los años por medio de diferentees procedimientos, los cuales han ido evolucionando hasta el perfeccionamiento de nuevas técnicas quirúrgicas. El presente artículo describe paso a paso la técnica de Push Back en el cierre de una fisura palatina completa unilateral. Se hace una revisión de la literatura teniendo en cuenta los antecedentes históricos que dieron origen a las técnicas quirúrgicas utilizadas actualmente

Fractura horizontal parasinfisiaria / Horizontal parasymphyseal fracture

Las fracturas de la parte anterior del maxilar inferior están clasificadas como fracturas sinfisiarias o parasinfisiarias de acuerdo con el área anatómicamente comprometida. Este artículo presenta el reporte de un caso en un paciente con una fractura horizontal parasinfisiaria, la cual fue manejada mediante fijación interna rígida. Este tipo de fractura no se encuentra frecuentemente reportada dentro de la literatura y asimismo, es muy poco reconocida como tal dentro de las clasificaciones actualmente aceptadas