[Retrospective view of the development of malocclusion surgery and prospects]. / Rückblick auf die Entwicklung der Dysgnathiechirurgie und Ausblick.

DEVELOPMENT: The history of the correction of the jaw deformities began in the US more than 100 years ago with a bilateral osteotomy in a case of mandibular prognathism performed by Vilray Blair. This operation was the starting point for Blair's interest in jaw surgery. In 1907 he already described three different operative techniques for the correction of malpositions of the lower jaw. Between the First and the Second World War no major progress in corrective jaw surgery occurred, until in the fifties of the 20th century a rapid development started off. Mainly in Germany and in Austria new operative techniques not only for the mandible, but also for maxilla and midface were established. Finally, this development reached its height in the simultaneous total osteotomy of upper and lower jaw that was published by Obwegeser in 1970. OUTLOOK: Innovations first of all in regard to technical improvements especially in four fields could be realized within the past 20 years. For planning of a procedure mostly computer-assisted systems combined with video- or laser technique were utilized. The improvement of resorbable materials such as plates and screws can be considered as a major progress. With regard to new operative techniques not only first results with navigation systems but also the introduction of endoscopic osteotomies were reported. Distraction osteogenesis was successfully performed on developmental deformities of the mandible, the maxilla, and the midface, while technical devices are being improved continuously. As in all fields mentioned above development is not yet completed further improvements can be expected.

Mandibular reconstruction with cancellous bone, hydroxylapatite and titanium mesh.

Over the past 20 years, titanium mesh combined with autologous iliac crest spongiosa and hydroxylapatite has performed well in the restoration of mandibular discontinuity defects in 79 patients. In 14 irradiated patients with a transplant bed of inferior quality, however, complications and failures occurred more often than in the 65 non irradiated patients. The results of our investigation clearly show that the success of mandibular reconstruction mainly depends on a well vascularized transplant bed.

[Reconstruction of the orbital walls by autologous calvarial transplants]. / Rekonstruktion der Orbitawandungen durch autogene Kalottentransplantate.

This article reports on the experience gained with outer table calvarial bone grafts used for the reconstruction of the bony orbital walls in 43 patients. The transplants were harvested in the parietal area above the non-dominant hemisphere. Morbidity and complication rate at the harvest site were extremely low. In all patients the grafts became uneventfully incorporated.

[Surgical and orthodontic treatment approach for cleidocranial dysostosis]. / Kieferchirurgische und kieferorthopadische Behandlungsmoglichkeiten bei der Dysostosis cleidocranialis.

Developmental deformities of the permanent dentition are of primary concern in the treatment of patients suffering from cleidocranial dysostosis. The therapeutic approach should be based on interdisciplinary cooperation between orthodontists as well as oral and maxillofacial surgeons. Therapy may include surgical exposure of impacted teeth in combination with removal of supernumerary teeth. Already during the surgical procedure orthodontic bands and brackets may be attached. The next step in treatment should consist of orthodontic alignment of the teeth and correction of the jaw relations. In most cases, midfacial hypoplasia and corresponding abnormal jaw relations are also present. This deformity is best treated with midfacial osteotomy. Following this second surgical intervention, orthodontic treatment is completed in order to establish an optimal result regarding function and esthetics.

[Time-tested procedures for the surgical closure of palatal perforations]. / Bewährte Verfahren zum operativen Verschluss von Gaumenperforationen.

Time-tested procedures for the surgical closure of palatal perforations are reported. Apart from local flap procedures emphasis is being placed on the possible applications of lingual flaps and temporal muscle flaps in the closure of a perforated palate.

[Technique and results of a one-stage procedure combining endosseous implantation (TPS) and classical preprosthetic surgery in the mandible]. / Technik und Ergebnisse der einzeitigen Kombination von enossalen Implantaten (TPS) mit klassisch praprothetischen Operationen im Unterkiefer.

Relative ridge augmentation procedures often provide a limited improvement in denture retention, due to advanced resorption of the alveolar ridge and loss of vertical bone height. The alternative treatment, i.e. integration of endosseous implants, leaves the mobile soft tissues uncapable of bearing a denture; this requires additional mucosal procedures. To avoid multiple operations we have combined the integration of frontal endosseous implants with the classical relative ridge augmentation procedure in one stage. While implantation, on the one hand, improves multidimensional denture retention, total sulcoplasty with split skin and mucosal grafts, on the other, provides a firm and strong covering of the ridge and a wider soft tissue area for denture support.