[The determination of the level of the external osteotomy line in Le Fort I interventions for pure maxillary advancement]. / Determinazione del livello della linea osteotomica esterna negli interventi secondo Le Fort I di puro avanzamento del mascellare.

BACKGROUND: Therapy of severe malocclusions needs a cooperation between orthodontist and maxillo-facial surgeon. The aim of this study is to evaluate how the ortho-surgical team can get a common base of programmation to transfer on split-casts osteotomic simulation reaching a more exact surgical result. METHODS: In this paper were considered patients operated by orthognathic surgery from January 1994 to June 1997 have been studied. ENVIRONMENT: Patients were operated in the Institute in which authors work. PATIENTS: Patients included were 120, 65 female and 55 male between 20 and 42 (mean 31). OPERATIONS: Patients were operated, for the most part, by combined operation at maxilla and mandible. RECORDINGS: The mean of values noticed was calculated adding all values and dividing for the number of values. RESULTS: The mean calculated is 33 mm (DS 2,22) of distance from canine cusp and 29 mm (DS 2,19) from mesio-vestibular cusp of the first upper molar. CONCLUSIONS: This study demonstrates that it is possible, with a statistically significant precision, to transfer osteotomic reference lines from clinical practice to a planning more pertinent to surgical performance. In this study we tried to standardize a value to increase precision of surgery, transferring easily feasible surgical measurements to split-casts.

[Evaluation of tegumental changes after skeletal repositioning in orthodontic surgery]. / Valutazione della modificazione dei tegumenti dopo riposizionamento scheletrico negli interventi di chirurgia ortognatodontica.

One of the main problems of orthognathodontic surgery is to evaluate the effects on soft tissue of bone positioning performed following surgical programming. A method which is of particular interest, easy to perform and reproduce was proposed by Jensen in 1992. It evaluates the correspondence of soft tissues on the basis of surgical programming and allows percentage values of soft tissue movement to be calculated in relation to bone tissue, thus performing a surgical VTO which corresponds as closely as possible to the postoperative result. It is important to remember that surgical programming is essentially based on the aesthetic and clinical analysis of the patient, the evaluation of the records collected, the surgeon's sensitivity dictated by his experience and his aesthetic sense which may result in an increasingly reliable VTO.

[Evaluation of the posture of patients before and after orthodontic surgery]. / Valutazione della postura in soggetti disgnatici prima e dopo intervento ortochirurgico.

INTRODUCTION AND AIMS: The term "craniomandibular disorder" is used to describe a series of symptoms and signs that directly affect the stomatognathic apparatus with possible repercussions on the otovestibular and oculomotor apparatus and on the cervical spine that may condition the entire body posture. The aim of this study was to evaluate a series of parameters correlated to the occlusal situation and to verify how these factors are affected by a change following the correction of occulusal ratios. METHODS: The paper reports a series of 15 patients suffering from facial dysmorphia treated surgically in the Division of Maxillofacial Surgery of S. Giovanni Battista Hospital in Turin in which an evaluation was made of posture and symptoms linked to craniomandibular disorders before surgery and six months after. At the preoperative evaluation a high incidence of this type of symptoms and signs was observed, and in particular a high percentage of patients with postural imbalance and asymmetry of the frontal body segments. RESULTS AND CONCLUSIONS: From the results obtained it emerges that the surgical re-adaptation of occlusion is followed by esthetic improvement and also by a good recovery of frontal postural symmetry in conformity with the reduced frequency and intensity of symptoms classified as craniomandibular disorders.

[Adenophlegmons of the neck area. A case report and review of the literature]. / Adenoflemmoni della regione cervicale. Presentazione di un caso e revisione della letteratura.

Adenopathies in general and cervicofacial adenopathies in particular are a pathology that can affect both medical and surgical disciplines. They may be found in both acute and chronic disorders, in children and in adults, and in local or systemic forms with benign or malignant pathogenesis. It is clear that the differential diagnosis and consequently the therapeutic approach may be complicated at times by the variety of pathological processes. Interest in the case reported her is, in our opinion, justified by the rare finding in the age of antibiotics of such striking symptoms. The severity of local symptoms and the general conditions of the patient resulted in the need for surgery under anesthesia in order to enable the extensive collection of purulent matter to be drained. The postoperative course showed a marked and progressive improvement of the patient's general and local conditions, even a few hours after surgery. Given that several factors contribute to determining the evolution of septic conditions (patient's general and in particular immunological status) and given that, owing to the aspecific nature of symptoms, the diagnosis and relative specific therapy may be delayed, it can be seen that the clinical picture may evolve and be complicated by massive general manifestations, sufficient in extreme cases to endanger the patient's life, in the form of acute and sudden respiratory disorders and or more gradually with generalised septic conditions (encephalitis, mediastinitis and generalised sepsis). The objective to be attained is therefore a careful diagnosis and the immediate implementation of medical procedures in order to remove the cause that has triggered off the pathology.

[Dermoid cysts of the oral floor. A clinical case report and review of the literature]. / Cisti dermoidi del pavimento orale. Presentazione di una casistica clinica e revisione della letteratura.

The authors report two cases of dermoid cysts of the oral floor. The incidence of this pathology in this region is difficult to assess due to the rarity of reported cases. In particular, dermoid cysts appear to derive from the inclusion of epithelial cells on the median line in the fusion point between the first and second branchial arch. Other pathogenetic causes are however reported in the literature, namely traumatic epidermal implants during fetal development in utero. Dermoid cysts are most frequently manifested between the second and sixth decade of life, although cases of younger and older patients have been reported. All the authors agree that there is no sex-related preference. In general, the patient becomes aware of the pathology due to the gradual deterioration of locoregional functional signals: difficulties related to speech, chewing and swallowing. These symptoms are closely correlated to the size of the lesion. The development of the cyst is usually slow and does not involve painful symptoms, but it may become rapid and painful in the presence of concomitant phlogistic processes. In the first case an 18-year-old patient reported the appearance some 4 years earlier of a swelling measuring approximately 4 x 2 cm, involving the entire front portion of the oral floor; the swelling was spontaneously painful. Having been referred to the authors'attention the patient showed a swelling which was localized on the mid oral floor, the size of a tangerine and with a hard elastic consistency and taut, shiny mucous covering; the swelling was apparently normotrophic.(ABSTRACT TRUNCATED AT 250 WORDS)

[The orthosurgical correction of 2 cases of Angle class II div I]. / Correzione ortochirurgica di due casi di II classe di Angle div I.

An orthosurgical technique comprising maxillary expansion using Burstone screws associated with multiple corticotomy, repositioning of the bone basis and pre- and postoperative orthodontics was used to correct two cases of Angle's class dysgnathia with involvement of both the bone basis and alveolodental component. The outcome was satisfactory in that a good esthetic result was achieved together with normal and functional occlusion which was stable over time.