Comparative Study of Mandible Ramus Morphology Using 3-dimensional CT in Sagittal Split Ramus Osteotomy.

The purpose of the present study was to investigate the relevance of the external morphology of the mandibular ramus, internal bone tissue structure, and maxillofacial morphology at the site for sagittal split ramus osteotomy among different facial skeletal patterns. A total of 80 patients with jaw deformities who underwent sagittal split ramus osteotomy were included in the study. The patients were divided into two groups based on facial skeletal type (skeletal Class II or skeletal Class III). A further 7 patients with no skeletal abnormalities were established as the control group (skeletal Class I). Computed tomography images obtained from these patients were 3-dimensionally reconstructed and the morphology of the mandibular ramus determined. Thickness at the mandibular foramen in Class II was greater than that in Class III, and showed the lowest value at the midpoint of the mandibular foramen and mandibular notch in Class I. Mandibular morphology showed change according to facial skeletal type. Correlations were also observed between the cephalometric analysis values and mandibular morphology.

Growth of Palate in Unilateral Cleft Lip and Palate Patients Undergoing Two-stage Palatoplasty and Orthodontic Treatment.

The purpose of this study was to investigate the long-term effects of two-stage palatoplasty on the morphology of the maxillary alveolar arch and occlusion using plaster models of the maxilla and mandible obtained from patients with unilateral complete cleft lip and palate who also underwent orthodontic treatment. A total of 20 patients undergoing two-stage palatoplasty by Perko's method (Group T) were enrolled. Plaster models of the maxilla and mandible were obtained from each patient at Time 1, on commencement of orthodontic treatment in the mixed dentition period; at Time 2, on that of orthodontic treatment in the permanent dentition period; and at Time 3, on completion of active orthodontic treatment. Analysis of occlusion and morphological analysis were performed using a 3-dimensional measuring system. The results were compared with 15 patients who underwent one-stage palatoplasty by the push-back method using a mucoperiosteal flap (Group P). Alveolar morphology and the relationship between the maxilla and mandible were satisfactory in Group T. The palates in Group T were deeper and larger than those in Group P. Alveolar collapse in Group T was milder, and impairment of the alveolar morphology less notable than in Group P, as surgical invasion to the anterior alveolar region was avoided during the palatal growth period. These results suggest that two-stage palatoplasty is advantageous for jaw development.

[Determination of the Effect of Aprepitant and Fosaprepitant for Nausea in Patients with Oral Cancer Receiving Combination Chemotherapy with TPF].

The objective of this study was to determine the effect of aprepitant(from days 1 to 3, po)and fosaprepitant(day 1, iv) for nausea in patients with oral cancer receiving combination chemotherapy with docetaxel, nedaplatin, or cisplatin(divided doses for 5 days), and 5-fluorouracil(TPF).The incidence rate of nausea in the aprepitant group was 60%(6/10), and that in the fosaprepitant group was 90%(9/10).The incidence rate of continuous nausea for more than 2 days was significantly lower in the aprepitant group than in the fosaprepitant group(40%[4/10]vs 90%[9/10], p=0.02; c 2 test).In addition, the mean area under the curve of the chronological changes in the grade of nausea tended to be lower in the aprepitant group than in the fosaprepitant group.In both groups, 3 cases(30%)of vomiting were observed.However, the incidence of continued daily vomiting tended to be lower in the aprepitant group than in the fosaprepitant group.These results suggest that aprepitant is more effective than fosaprepitant for nausea induced by TPF.

Application of interdental distraction osteogenesis to unilateral cleft lip and palate patients.

Distraction osteogenesis is widely used for the treatment of craniofacial deformities. In patients with cleft lip and palate, distraction osteogenesis can be employed to repair the alveolar cleft. In this report, we describe the management of three cases of unilateral cleft lip and palate by interdental distraction osteogenesis. Interdental distraction osteogenesis of the maxillary bone was performed to reduce the width of the alveolar cleft in these patients in conjunction with orthodontic treatment. Tooth-tooth type distraction devices were fabricated and delivered at the same time as osteotomy. Distraction was continued until the midline of the dentition coincided with the facial midline, and until the width of the alveolar cleft was reduced to the width of lateral incisor or had closed. One month after distraction was complete, orthodontic treatment with an edgewise appliance was initiated, and neighboring teeth were moved into the newly created bone. A favorable treatment outcome was achieved in all three cases.