Three-Dimensional Analysis of the Skull Base of Individuals With Cleft Lip and Palate.

AIMS: Identify variations of skull base measurements in individuals with dentofacial deformities associated or not with cleft lip and palate and compare the results with individuals without dentofacial deformities. METHODS AND RESULTS: The individuals were categorized into three different groups: dentofacial deformity without cleft malformation, dentofacial deformity associated with cleft lip and palate, and without facial deformity. The inclusion criteria were individuals over 18 years of age, without any intervention involving facial bones or structures of interest for the study and field of view encompassing from the glabella to the hyoid bone. Poor quality CT scans or lack of adequate medical records were considered exclusion criteria. In the analysis by computerized tomography using the Dolphin Imaging Software, the length determined by the Ba-S and S-N lines was evaluated, as well as the Ba-S-N angle formed by landmarks. RESULTS: The length of S-N was not statistically different between the groups, the Ba-S length and the Ba-S-N angle demonstrated statistical difference. CONCLUSION: There was statistically significant difference in the morphometry of the (Ba-S) between groups (FS) and (C). This suggests that the standard values for cephalometric analyzes involving these structures, especially to determine the treatment planning, should be used with caution.

The Usefulness of a Facial Digital Biobank for Ameloblastoma Resection and Fracture Fixation - A Case Report.

Rationale: Ameloblastoma often requires complex facial treatments such as resection and reconstruction, which can be aided using three-dimensional resources towards improved surgical planning, reduction of surgical time, and customization. Patient Concerns: A 51-year-old patient, concerned about submandibular volumetric increase discovered performing imaging exams to install dental implants. Diagnosis and Treatment: Diagnosed with ameloblastoma, he underwent uneventful partial mandibular resection and placement of prebent mandibular reconstruction plate. Four months later, following a motorcycle accident, a deflection of the plate and mandibular fracture was observed. Using the initial prototyping, a new reconstruction plate was customized and surgically placed to reduce the mandibular fracture, with adequate titanium plate adaptation to the remaining bone and maintenance of aesthetic mandibular contour. Outcomes and Take-away Lessons: The current digital dentistry resources, such as computed tomography and intraoral scan, can be recovered and used as a backup of recorded anatomy anytime in future, providing a long-lasting facial digital biobank.

Predictors of complication for alveolar cleft bone graft.

We have analysed the predictors of postoperative complications and the need for reoperation after grafting of the alveolar cleft from one specialised cleft centre. The data were obtained from hospital casenotes of patients operated on from December 2004 to April 2010, with a minimum one-year follow-up from the final operation. Independent variables included postoperative complications and the need for reoperation. Conditional variables were sex, age, type of cleft, sides affected, donor area, type of graft material, and the presence of an erupted tooth in contact with the cleft. A total of 71 patients had bone grafted on to the alveolar cleft. The following associations were found to be significant: postoperative complications and need for reoperation (p=0.003); age and complications (p=0.002); affected side and complications (p=0.006); age and reoperation (p=0.000); sex and reoperation (p=0.001); and type of cleft and reoperation (p=0.001). Proper attention should be given to all the variables and risk factors to overcome the many obstacles that might have an adverse influence on a successful outcome of alveolar bone grafting for patients with clefts.