Three-Dimensional Virtual Treatment Planning: Presurgical Evaluation.

OBJECTIVE: This article describes a virtual protocol designed to optimize surgical orthodontic diagnosis and treatment plan. METHODS: A total of 15 patients undergoing orthodontic-surgical treatment have been analyzed with a presurgical virtual three-dimensional (3D) treatment planning, which involves 9 steps. All the patients have been treated with the use of occlusal splint guides projected on the basis of the surgical and orthodontic visualized treatment objective . RESULTS: In all the analyzed patients, a precise and optimal orthodontic presurgical preparation has been obtained. CONCLUSIONS: The 3D analysis seems more precise to interpret than two-dimensional; it provides information and images of craniofacial structures free from perspective distortion and it reduces the steps of the presurgical diagnosis. The simplicity of the protocol described in this paper makes possible to apply it in everyday practice.The study described here allows high-precision planning of orthodontic-surgical therapy and optimization of each treatment phase, with consequent advantages in clinical practice: a more accurate orthognathic surgery with predictable results.

Evaluation of patients' compliance in different age groups: preventive methodology.

BACKGROUND: The aim of this work was to evaluate the effectiveness of the SSRD Department of University of Milan PREVENTION PROGRAM between subjects of different sex and ages. METHODS: Prevention Program is divided into six stages, in which specific and standardized procedures are effected on patient; then checkups are planned after three months. Ninety patients (48 females, 42 males) were included. Subjects were divided into three ages groups: 6-9, 10-12 and over 12 years old. Plaque Index, Bleeding Index, and quantitative and qualitative variations of bacterial plaque were considered. RESULTS: Remarkable results were obtained regarding both the effective reduction of bacterial oral flora and patient's compliance and learning, especially in the group of patients older than 10 years. The new values of parameters recorded at the end of the study showed that all the subjects included in the sample had an improvement of compliance in oral hygiene, in particular: 1) P.I. level 3, 10-12 age, female; 2) B.I. level 4, males over 10, female 6-9 age; 3) quantitative and qualitative variations of bacterial plaque, level 4, all groups. CONCLUSIONS: Patient instruction and motivation allow to obtain optimal results in particular in patients aged more than 10 years.

Orthodontic-surgical treatment: electromyographic and kinesiographic evaluation in follow up period. Experimental study.

INTRODUCTION: The aim of this study was to investigate muscular function and mandibular kinesiology of patients undergoing orthodontic-surgical treatment by electromyography and kinesiography. Electromyographic evaluation is essential to estimate masticatory forces in patients undergoing combined surgical-orthodontic treatment. MATERIALS AND METHODS: 60 patients referred for orthodontic surgical treatment were included in the study, 43 patients presented a class III while 17 presented a class II. The patients underwent electromyographic and kinesiographic examinations during all the therapeutic orthodontic-surgical phases. RESULTS: The relationship between fundamental electromyographic values and age, weight, asymmetry and activation was weak. A strong and positive relationship was observed between the relaxation percentage after TENS (transcutaneous electrical neuromuscular stimulation), the steepness of the post-surgery rehabilitation curve, the initial POC (percentage overlapping coefficient), and for the values in microvolts of the right and left temporal and masseters at the beginning of treatment. CONCLUSIONS: Patients with dentofacial deformities corrected by surgical treatment, have a significant positive treatment outcome in respect of masticatory activity and performance electromyographic evaluation on, before, during and follow up period of the analized patients permit to underline that this examination can predict long term stability.

Orthodontic--surgical treatment and respiratory function: rhinomanometric assessment.

BACKGROUND: Several correlations between morphological and/or positional alterations of the jaws and respiratory functional impairments have been reported. Nasal airway obstruction represents a critical issue with no clearly defined gold standard as for its measurement. Rhinomanometry was adopted by multiple Authors to evaluate whether patients with malocclusion developed respiratory functional changes after an orthodontic-surgical treatment. However, there are contrasting findings in the literature regarding the possibility of improving the respiratory function by means of surgically-assisted rapid palatal expansion (SARPE) or bimaxillary repositioning of the bony bases. METHODS: Ten patients aged from 18 to 30 years and scheduled for orthodontic-surgical treatment of maxillary constriction volunteered as participants for this study. Orthognathic surgery consisted in: 1) SARPE in 4 patients; 2) Le Fort I down fracture combined with a bilateral sagittal split osteotomy (BSSO) in 6 patients. All patients underwent a computerized rhinomanometric test before treatment (T0) and 40 days after surgery, at the time of the inter-maxillary splint removal (T1). Specifically, all 10 patients received AAR evaluations, while 6 patients received both active anterior (AAR) and active posterior rhinomanometry (APR). RESULTS: Both AAR and APR tests showed a decrease in mean nasal resistance following the intervention. As for the AAR, a difference of 0.19 Pa/s/cm3 was found. The difference found for APR at a reference pressure of 75 Pa was 0.24 Pascal/s/cm3, while for APR at 150 Pa it was 0.20 Pa/s/cm3. CONCLUSIONS: This study helps to confirm respiratory benefits obtainable after mono and bi-maxillary orthognathic surgery.