Ultrasonic aesthetic cranioplasty.

The management of frontal bone injury is an important issue, and inappropriate management of such injuries may give rise to serious complications. Piezosurgery is a technique used to perform safe and effective osteotomies using piezoelectric ultrasonic vibrations. This instrument allows a safe method for osteotomy of the cranial vault in close proximity to extremely injury-sensitive tissue such as the brain. After a wide review of the literature, the authors present this technical report, introduce the use of piezosurgery to perform a safe "slim-osteotomies" for treatment of posttraumatic frontal bone deformities, and suggest the use of this instrument for aesthetic recontouring of the craniofacial skeleton.

Immediate socket restoration after orbital trauma with globe loss: principles, timing, and our experience.

The literature-reported incidence of ophthalmic injuries occurring with facial fracture ranges widely from 0.8% to 30%. Ocular trauma necessitating enucleation or evisceration is less common, but it is not rare. The trauma and physical disability related to removal of the eye are extreme. Moreover, the loss of an eye causes severe changes to the anatomy and physiology of the orbit, resulting in deformities that affect the relationship between the socket and the prosthesis. Here, the authors present their own experience of 8 consecutive cases of trauma injuries with globe loss and emphasize the importance of accurate, early bone reconstruction involving evisceration and immediate socket restoration.

Evaluations of sagittal and vertical changes induced by surgically assisted rapid palatal expansion.

INTRODUCTION: Class II, anterior open bite and/or a steep mandibular plane angle are frequently considered a contraindication to the use of surgically assisted rapid palatal expansion (SARPE). Nevertheless, few studies have investigated the maxillary and mandibular effects after SARPE on the sagittal and vertical planes, with dissimilar results and small samples of patients.The aim of the current study was to evaluate the sagittal and vertical effects after SARPE. METHODS: Twenty-one consecutive adult patients (7 males, 14 females; mean age, 25.6 ± 6.3 years) who required SARPE were included in this study. All patients were subjected to subtotal LeFort I osteotomy with pterygomaxillary disjunction. Lateral cephalometric radiographs were taken during the preoperative assessment (T0) and 6 months after the end of the expansion (T1). Cephalometric measurements were realized at T0 and T1 for all the patients. Independent-sample t test and analysis of variance were used. RESULTS: Statistically significant changes were observed only in upper incisor^NA (P = 0.04). No skeletal sagittal or vertical variation was found after SARPE. CONCLUSIONS: Class II, anterior open bite and/or a steep mandibular plane angle cannot be considered an outright contraindication to its use. Upper incisor palatal inclination could result after SARPE.

Minimally invasive surgery for coronoid hyperplasia: endoscopically assisted intraoral coronoidectomy.

The term hyperplasia of the coronoid process of the mandible defines an abnormal elongation of the coronoid process consisting of histologically normal bone. The main clinical finding of hyperplasia of the coronoid process is a progressive painless difficulty in opening the mouth owing to the contact with the temporal surface of the zygomatic bone or medial surface of the zygomatic arch. Computed tomography with three-dimensional reconstruction is essential and is the gold standard for an accurate diagnosis. The etiology remains unknown, although several theories have been suggested. The main aim of treatment was to restore mouth opening, and this article introduces and illustrates the advantages of endoscopic assistance for coronoidectomy through the classic "intraoral" approach and emphasize this minimally invasive approach.