-
[show abstract]
[hide abstract]
ABSTRACT: This study was to describe the use of inverted-L osteotomy of ramus and iliac bone graft for the management of mandibular deficiency in adult patients. From 2008 to 2010, 11 patients (aged 19 to 29 years) with mandibular deficiency underwent intraoral or extraoral inverted-L osteotomy of ramus and iliac crest bone grafting. Data were collected from the patients' records, photographs and radiographs. The height and width of the ramus were successfully expanded by inverted-L osteotomy and iliac crest bone grafting with minimal complications in all patients, resulting in significant improvement in occlusion and facial appearance. Our early results showed that the inverted-L osteotomy of ramus and iliac crest bone grafting is safe and effective, and should be considered as a good alternative for the patients with mandibular deficiency.International Journal of Oral Science advance online publication, 21 December 2012; doi:10.1038/ijos.2012.75.
International Journal of Oral Science 12/2012; · 1.41 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the the feasiblility and effectiveness of narrowing and sliding genioplasty combined with mandibular outer cortex ostectomy technique to reshape a square jaw in short face.
From July 2005 to October 2009, a total of 57 patients received narrowing and sliding genioplasty combined with mandibular outer cortex ostectomy procedure to correct square jaw in short face. All the patients had standard frontal and lateral cephalometric radiographs, panoramic radiographs, and were photographed preoperatively and postoperatively to assess their face contour. The alteration of mandibular angle, mental contour and width of lower face was observed for 6 to 24 months postoperatively. Questionnaires were used to assess the patients' satisfactory.
It showed that the postoperative lower face had narrowed and become softer, slender and oval, with a slick mental region. The final aesthetic outcomes were quite satisfactory in all cases from both the view of surgeons and patients.
Narrowing and sliding genioplasty combined with mandibular outer cortex ostectomy procedure could efficiently adjust the shape and position of chin to obtain a good proportion of the lower face, and to change square and short face to slender oval one by single operation in accordance with the fashionable aesthetics in orientals.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 01/2011; 27(1):15-8.
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the feasibility of mandibular "V-Line" osteotomy combined with mandibular outer cortex osteotomy for correction of low angle-square jaw.
From Jul. 2005 to Nov. 2007, 31 patients with low angle-square jaw were corrected with mandibular "V-Line" osteotomy combined with mandibular outer cortex osteotomy. The patients were followed up for 6-24 months. Pre- and Post-operative standard images and X-ray cephalometric examination were used to assess the therapeutic effect.
The wounds were healed primarily in all the 31 cases with no severe complication. The lower labial numbness was happened in 13 cases, which was recovered within 4 months. All the patients achieved esthetic improvement at the frontal and lateral view. The mandibular angle and the mandibular plane angle reached 110 degrees - 120 degrees and 25 degrees - 30 degrees after operation. The distance between the angles was decreased.
The low angle-square jaw can be corrected satisfactorily with mandibular "V-Line" osteotomy combined with mandibular outer cortex osteotomy.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 03/2010; 26(2):89-92.
-
[show abstract]
[hide abstract]
ABSTRACT: This article describes the clinical effects of condylar reconstruction by free grafting of autogenous coronoid process in patients with temporomandibular joint (TMJ) ankylosis.
Fifteen cases of uni- or bilateral TMJ ankylosis during a 3-year period from March 2004 to March 2007 were surgically treated, and the average observation period was 22 months. All patients were treated by condylar reconstruction of immediate autogenous coronoid process grafts. Temporal muscle myofascial flaps or native articular disc was used as an interpositional tissue. Clinical examination, radiographs, and photographs were used postoperatively to evaluate the grafts and TMJ function.
Satisfactory mouth opening was achieved in 14 cases, and 1 patient showed signs of reankylosis of the joint (20 mm mouth opening). Radiographic examination showed that bone union occurred between the grafts and the ramus in all cases. Some bony resorption of the grafted coronoid process was observed in all patients, but no occlusal changes were noted.
Satisfactory clinical outcomes are obtained after the condylar reconstruction by free grafting of autogenous coronoid process. Therefore, autogenous coronoid process may be a suitable bone resource for condylar reconstruction in patients with TMJ ankylosis.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 08/2008; 106(5):662-7. · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Mandibular condyle damage during childhood disturbs mandibular growth and facial skeletal development. Transport distraction osteogenesis provides a new treatment for condyle reconstruction, but there are no data available on mandibular growth in growing individuals following surgery. The authors investigated the effect of condylar reconstruction by transport distraction osteogenesis on mandibular growth in goats.
A condylar defect was created unilaterally in 44 growing goats. The animals were divided randomly into group A (n = 22) and group B (n = 22). Transport distraction was used to reconstruct the condyles in group A, whereas group B served as sham controls. Three-dimensional computed tomographic imaging was performed at different intervals. Ten animals from each group were used for mandibular growth measurements at 48 weeks after the end of distraction. Four animals from each group were euthanized at 12, 24, and 48 weeks after surgery. Their transport disks were harvested and processed for histologic evaluation.
In group A, the hemimandible of the distracted side exhibited similarities to the contralateral side except for the larger neocondyles. In group B, ramus height and width were significantly shorter on the undistracted side than on the contralateral side; concomitantly, there was mandibular deviation to the operated side. Well-organized fibrocartilage was seen at the neocondylar surface over time in group A but not in group B.
This study suggests that a neocondyle reconstructed by means of transport distraction has the potential to grow under functional stimuli of the temporomandibular joint. Therefore, this technique may serve as an alternative method for condylar reconstruction in growing individuals.
Plastic and reconstructive surgery 06/2008; 121(5):1760-7. · 2.74 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the applicability and effectiveness of reconstruction of mandibular condyle by transport distraction osteogenesis in an animal model of rhesus monkeys.
Six adult rhesus monkeys were used in this study. Bilateral condyles and articular discs were extirpated, and the technique of transport distraction osteogenesis was performed to reconstruct the condyle. X-ray and CT scanning films were taken at various intervals. Two monkeys selected at random were sacrificed respectively at 4, 12 and 24 weeks after completion of distraction, and the newly formed condyles resulted from bony transport disc were harvested and processed for histologic examination. The removed condyles at surgery were used as normal control and prepared in the same manner.
Open bite was seen in all animals postoperatively, and disappeared at the end of distraction. The shape and appearance of the bony transport disc was similar to original condyles at sacrifice. The articular cavity was filled with fibrous connective tissue and considerable cartilage cells were observed in the surface of the condyle stump. Bone regeneration was perfect in the distraction gap.
A neocondyle with functional shape can be created by transport distraction osteogenesis, which suggested that this technique might be an alternative method in reconstruction of the condyle.
Hua xi kou qiang yi xue za zhi = Huaxi kouqiang yixue zazhi = West China journal of stomatology 03/2007; 25(1):86-9.
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the feasibility and effectiveness of autogenous coronoid process grafts for reconstruction of the mandibular condyle.
Two groups of 9 goats each were used. Each animal underwent unilateral total condyle and disk removal and was treated by grafting an autogeneous coronoid process. The animals in group A were sacrificed at 4, 12, and 24 weeks after surgical procedure, and their grafted coronoid processes were harvested for histological observation. All animals in group B received 3-dimensional CT scanning examination at different times and were sacrificed at 24 weeks after surgical procedure. The items of ramus height (RH), transverse dimension of the condyle (CT), and posteroanterior dimension of the condyle (CP) were measured for comparison with the operated and nonoperated sides.
Despite the differences in the measurements of RH, CT, and CP between the operated and nonoperated sides, the grafted coronoid process had a similar shape and histological structures to the normal condyle at 24 weeks after surgical procedure. The head of the neocondyle was covered by a cap of fibrous tissue, which might play the role of the articular disc.
Under the mechanical stimuli of the temporomandibular joint site, the grafted coronoid process could gradually remodel to a neocondyle with functional shape and structure in goats. This animal study suggests that autogenous coronoid process could be considered as a new donor source for reconstruction of the mandibular condyle.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 06/2006; 101(5):572-80. · 1.50 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the regenerating bone during mandibular distraction osteogenesis by bone histomorphometry combining tetracycline bone labeling fluorescence microscopy.
Osteotomy was performed on bilateral mandibles in ten goats. A custom-made distractor was applied to lengthen the mandible at a rate of 1 mm/d (0.5 mm/12 hrs) for ten days. Every two animals were sacrificed at 10 d, 15 d, 25 d, 35 d and 45 d postoperatively. Two additional goats were used as normal control. The bony specimens were collected and prepared for bone histomorphometry and tetracycline bone labeling fluorescence microscopy with analysis of variance.
From 10 days subgroup to 45 days subgroup, bone volume fraction,trabecular thickness,trabecular number and volume density were gradually increased (P<0.05), while trabecular separation distance and surface density were gradually decreased (P<0.05). Between 15 days subgroup and 45 days subgroup,the index of osteoblast was significantly higher than normal control (P<0.05) and index of osteoclast was increased gradually (P<0.05). Compared with normal control, bone formation rate was accelerated by thousand times between 15 days subgroup and 45 days subgroup (P<0.05).
During the process of mandibular distraction osteogenesis, the bone formation is active, the newly formed bone trabecula gradually become mature, and the remodeling activities of regenerated bone are enhanced gradually. The rate of bone formation within distraction period is faster than consolidation period.
Shanghai kou qiang yi xue = Shanghai journal of stomatology 09/2005; 14(4):382-6.
