Effect of Presurgical Nasoalveolar Molding on Nasal Symmetry in Unilateral Complete Cleft Lip/Palate Patients after Primary Cheiloplasty without Concomitant Nasal Cartilage Dissection: Early Childhood Evaluation.

OBJECTIVE: The objective of this study was to assess the efficacy of presurgical nasoalveolar molding (PNAM) on long-term nasal symmetry and shaping after primary cheiloplasty in patients with unilateral complete cleft lip/palate (UCL/P). DESIGN: This was a two-group, parallel, retrospective, randomized clinical trial. SETTING: The setting for this study was the Chang Gung Craniofacial Center in Taoyuan, Taiwan. PATIENTS: Patients were divided into one of the following two groups: infants with UCL/P who underwent PNAM (PNAM group, n = 42) and infants with UCL/P who did not undergo PNAM (non-PNAM group, n = 42). INTERVENTIONS: Interventions included PNAM and primary cheiloplasty without nasal cartilage dissection. MAIN OUTCOME MEASURES: In this study, 4- to 5-year postoperative full-face and submental oblique photographs were taken of all patients and scored from 1 to 5 points by 10 medical evaluators. The scores were statistically analyzed using repeated-measures analysis of variance, and P < .05 was considered to represent statistical significance. RESULTS: After 1 to 3 months of PNAM but before primary cheiloplasty, the displaced nasal and alveolar cartilage showed obvious improvement. However, the scores in the PNAM and non-PNAM groups at 4 to 5 years postoperatively were 66.62 ± 14.25 and 66.31 ± 15.08, respectively. There was no significant difference between the two groups ( F = 0.009, P = .923). CONCLUSION: PNAM as an early-stage adjunctive therapy for nasal deformity correction is beneficial before primary cheiloplasty, but it is insufficient to maintain long-term nostril symmetry after primary cheiloplasty without nasal cartilage dissection.

[Investigation of related risk factors of temporomandibular disorders in 109 patients].

PURPOSE: To investigate the related risk factors of temporomandibular disorders(TMD), and to provide evidences for clinical prevention. METHODS: One hundred and nine TMD patients were included in the study as case group, while 109 people with no TMJ symptoms and signs were selected randomly as control group. All subjects fulfilled questionaires. Logistics regression analysis was used to analyze the data with SPSS 22.0 software package. RESULTS: Females patients were more common than males, with 20~29 age group accounting for 44%. The proportions of patients with habits of bruxism or clenching, unilateral mastication and maxillofacial injure history were significantly greater than those of control group (P<0.05). The proportions of patients with life stress and habits of stay-up late, chewing hard food and orthodontic treatment history showed no significant difference compared with the control group (P>0.05). CONCLUSIONS: TMD has a higher prevalence in female than in male, with a peak incidence in 20-29 age group. Habits of bruxism or clenching, unilateral mastication and maxillofacial injury history may be risk factors of TMD, while life stress, habits of stay-up late, chewing hard food and orthodontic treatments show no significant correlation with TMD.

[Treatment of Class II malocclusion using Herbst appliance with headgear and rapid palatal expansion and straight wire appliance with implant anchorage].

PURPOSE: To investigate the effects of early treatment of Class II malocclusion with Herbst appliance with headgear and rapid palatal expansion and straight wire appliance with implant anchorage. METHODS: Twenty-five Chinese children (14 males, 11 females, aged from 10-12 years with an average age of 10.5 years) were treated with Herbst appliance with headgear and rapid palatal expansion for 6 months. Then they were further treated with straight wire appliance with implant anchorage. Cephalometric data pre- and post-treatment were measured and analysed. Multiple correlation analysis was performed with SPSS13.0 software package. RESULTS: Compared with pretreatment, as angle SNB (4.2800±1.4000)° and as angle NP-FH (3.5600±1.0440)° increased posttreatment. as angle SNA (0.5600±0.8206)°, as angle ANB (4.7600±1.2000)°, as angle U1-NA (11.9200±1.4411)° and as angle U1-SN (13.1600±1.7720)° decreased posttreatment (P<0.05). CONCLUSIONS: Maxillary growth is successfully inhibited and mandibular growth is significantly promoted by Herbst appliance with headgear and rapid palatal expansion. The maxillary dentition is significantly retracted by fixed appliance with implant anchorage and the skeletal pattern of patients is significantly improved.

Application of buccal fat pads in pack palate relaxing incisions on maxillary growth: a clinical study.

OBJECTIVE: To observe the impact on maxillary growth of the use of buccal fat pads to pack palate relaxing incisions. METHODS: We recruited 30 patients aged 3-4 years with a complete cleft palate. Half (15) of the patients underwent reparative surgery that entailed packing buccal fat pads into the bilateral raw bony surfaces and served as the experimental group. The remaining 15 patients underwent reparative surgery that entailed packing and fixing relaxing incisions with iodoform gauze and served as the control group. After a 5-year follow-up, the differences in data from X-ray cephalometry and upper dental models in the two groups were analyzed using the T test. RESULTS: A significant difference (P < 0.05) in maxillary growth was observed between the two groups of children with cleft palate. CONCLUSION: The results supported the use of buccal fat pads to pack relaxing incisions which led to improved maxillary development in patients with cleft palate.

Arthroscopic surgery for removal of 112 loose bodies of synovial chondromatosis of the temporomandibular joint.

We present a new case of unilateral synovial chondromatosis of the temporomandibular joint, including diagnostic images, the treatment performed, and histologic analysis. In this report, we describe a case of temporomandibular joint synovial chondromatosis treated only through arthroscopy to remove 112 loose bodies completely.

[Factorial analysis of microleakage at the fixation screw pores of implant denture].

PURPOSE: The purpose of this study was to evaluate closure of the fixation screw pores of implant denture by using 4 different light-cured composite resins (LCRs), and to observe the effects of organosilane and thermocycling on microleakage. METHODS: A total of 80 hollow semi-cylinders were fabricated with titanic alloy, with the upper half of the specimens was porcelain, and the internal surfaces were sandblasted and etched. All specimens were divided into 2 groups: treated and not treated with organosilane. After bonding with 4 kinds of LCRs, the testing samples were assigned into 2 subgroups for different thermocycles. Then the degree of microleakage were measured by glucose oxidase-peroxidase(GOD-POD) methods. The results were statistically analyzed with one-way ANOVA by using SAS 11.10 software. RESULTS: Statistical analysis revealed that the microleakage associated with LCRs were significantly different, and the microleakage associated with organosilane or thermocycles were also significantly different (P<0.01). Interactive analysis showed that there was interaction between the organosilane disposal (factor B) and thermocycling disposal (factor C) (P<0.01), whereas no interaction was found between the other factors (P>0.05). CONCLUSIONS: The results suggest that the type of bonding materials would affect the degree of microleakage, and the microleakage can be reduced if the specimens are treated with organosilane. The tolerance of specimens under thermocycling are very poor.

Arthroscopic surgery for treatment of anterior displacement of the disc without reduction of the temporomandibular joint.

The aim of this study was to investigate the clinical results and efficacy of an arthroscopic approach to correct anterior displacement of the disc without reduction of the temporomandibular joint (TMJ) with limitation of mouth opening. We studied 28 joints with internal derangement in 23 patients, all of whom had had arthroscopic surgery (lavage, lysis of adhesions in the superior compartment, incision parallel to the disc-synovial crease of the upper joint compartment, and pull back of the anteriorly located disc). Objective and subjective data (increase in maximal interincisal opening, magnetic resonance imaging, and visual analogue pain score, VAS) were collected preoperatively and at 7, 30, 60 days, and 6 months or more postoperatively. Maximal interincisal opening improved from a mean (SD) of 20.4 (±4.5) mm preoperative measurement to 38.9 (±3.2) mm by 6 months postoperatively where indicated in previous line. The VAS showed a significant improvement in pain score (p=0.0023). Sixty days postoperatively the positions of the discs in 14 of the TMJs had improved considerably. In 13 of the TMJs the positions had improved slightly. Only 1 of the TMJs had not improved at all. There were no complications in any patient. Our arthroscopic procedure is safe, minimally invasive, and effective for the treatment of patients with displacement of the disc anteriorly without reduction of the TMJ.

[Nursing of root canal therapy with nickel titanium mechanical instruments].

PURPOSE: To discuss the related problems of nursing during root canal preparation with nickel titanium mechanical instruments. METHODS: 206 cases were nursed who underwent root canal preparation, after which the dentists and patients were surveyed on their satisfactory extents, in order to assess the effect of nursing. RESULTS: The results of root canal preparation of 206 cases were good without any accidents such as break of instruments, while 100% dentists and 97.58% patients were satisfied with the nursing. CONCLUSION: Proper and skilled nursing could shorten treatment time, enhance patients' compliableness and decrease the unnecessary injuries. Thus it raised the efficiency and therapeutic effect.

[Summary of 2004 Chinese National Conference on oral and maxillofacial vascular anomalies].

Congenital vascular anomalies have been the subject of much controversy and confusion over the years, many remain to be investigated and resolved. Authorized by the Managing Director Board of Chinese Stomatological Association (CSA), 2004 Chinese National Conference on Oral and Maxillofacial Vascular Anomalies was successfully held on July 15 to 18, 2004 in Shenzhen Grand Hotel. The conference was sponsored by Chinese Society of Oral and Maxillofacial Surgery (CSOMS), and undertaken by the Second People's Hospital of Shenzhen city. Professor ZHANG Zhen-kang, president of CSA, Professor QIU Wei-liu, president of CSOMS and academician of Chinese Academy of Engineers, and Professor LIU Bao-lin, vice president of CSOMS were present and made important speech at the meeting. More than 120 delegates nationwide attended this conference. Through a 3-day of oral presentation and discussion, the terminology, classification, treatment selection and outcome measurement of oral and maxillofacial hemangioma and vascular malformations were concerted among the delegates. Hemangiomas and vascular malformations have been recognized as distinct diseases that exhibit unique properties and behavior that demand an appropriately tailored treatment plan. The classification of Waner and Suen was adopted and different treatment modalities were reviewed and advocated for different lesions. Delegates were most interested in intralesional injection of Pingyangmycin for venous malformations, Krypton laser photodynamic therapy of venular malformations, Nd:YAG laser therapy for deep head and neck venous malformations after surgical exposure of the lesions, as well as "double" embolization of large venous malformations reported by Professor QIN Zhong-ping. The conference witnessed the foundation of the Division of Vascular Anomalies, Chinese Society of Oral and Maxillofacial Surgery.