MyMedR

An Investigation of Three-Dimensional Maxillary Arch Morphometry of Children With Unilateral Cleft Lip and Palate

Haque S, Khamis MF, Alam MK, Ahmad WMAW

J Craniofac Surg, 2021 May 01;32(3):964-966.

PMID: 33405460 DOI: 10.1097/SCS.0000000000007366

ABSTRACT: The aim of this study was to evaluate the effects of multiple factors (congenital and postnatal treatment factors) on the treatment outcome by assessing the maxillary arch dimension of children with unilateral cleft lip and palate (UCLP). Eighty-five Pakistani children with UCLP were taken who received cheiloplasty and palatoplasty. Laser scanned 3D digital models of UCLP subjects were prepared before any orthodontic treatment and bone grafting at 7.69 ± 2.46 (mean ± standard deviation) years of age. Inter-canine width (ICW), inter-molar width (IMW), and arch depth (AD) measurements of maxillary arch were measured with Mimics software. Multiple linear regression analyses were used to evaluate the association between congenital factors (age, gender, UCLP side, family history of cleft) and postnatal treatment factors (techniques of cheiloplasty and techniques of palatoplasty) with maxillary arch dimensions (ICW, IMW, and AD). P value was set at 5%. The mean (standard deviation) dimensions of ICW, IMW, and AD are 26.7 (5.70) mm, 43.3 (4.66) mm, and 27.1 (5.26) mm, respectively. There is no significant association found between multiple factors and maxillary arch dimensions. This regression analysis shows no significant association between multiple factors and MAD in this sample.

Matched MeSH terms: Maxilla/surgery

The Impact of Facial Growth in Unilateral Cleft Lip and Palate Treated With 2 Different Protocols

Wong LS, Lu TC, Hang DTD, Chen PK

Ann Plast Surg, 2020 05;84(5):541-544.

PMID: 32091442 DOI: 10.1097/SAP.0000000000002232

BACKGROUND AND AIM: It is well known that palatoplasty can often cause disturbances in maxillary growth. The use of a single-layer vomer flap for the early closure of the hard palate is controversy among surgeons. The aim of this study is to compare the 10-year facial growth of 2 surgical protocols in the treatment of patients with unilateral cleft lip and palate performed by a single surgeon.

METHODS: This retrospective analysis includes 43 nonsyndromic patients with complete unilateral cleft lip with or without a vomer flap for the closure of the hard palate during cleft-lip repair. Lateral cephalograms were obtained at the age of 5, 7, and 9 years old, and angular measurements were used to assess patient's facial growth. The Mann-Whitney U test was used to compare 2 treatment protocol groups.

RESULT: A total of 23 patients in protocol 1 group (16 male, 7 female) and 20 patients in protocol 2 group (10 male, 10 female) were included. At the age of 5 and 7, there was no significant difference of maxillary and mandibular growth in both groups. At the age of 9 years, all the angular measurement revealed statistical significance with SNA (P = 0.02), SNB (P = 0.05), ANB (P < 0.01), and SNPg (P = 0.05).

CONCLUSIONS: The present study has shown that early anterior palate repair for 3-month-old cleft patients have better maxillary growth and less mandibular prognathism.

Matched MeSH terms: Maxilla/surgery

Fulltext Management of sinonasal inverted papillomas: endoscopic medial maxillectomy

Harvinder S, Rosalind S, Mallina S, Gurdeep S

Med J Malaysia, 2008 Mar;63(1):58-60.

PMID: 18935736

Inverted papillomas (IPs), although histologically benign, are aggressive lesions that may recur after excision. They usually present as unilateral firm, bulky, red and vascular masses. The objective of this case series is to discuss the surgical treatment options for IPs and to review the literature with a special emphasis on our experience with endoscopic medial maxillectomy. A retrospective review of the data of patients with IP treated by endoscopic medial maxillectomy was performed. This report describes the surgical experience with five patients with IP arising from various sites on the lateral nasal wall. Data points collected included age, sex, location(s) and histopathological diagnosis (benign IP vs IP with dysplasia or carcinoma). The surgical treatment strategy, need for adjunct approaches, complications, recurrence rates and length of follow-up were determined. The average age was 51.2 years (range, 35-62 years), with four males and one female. All cases were managed with endoscopic medial maxillectomy as the primary surgical modality. Adjunctive approaches included endoscopic dacryocystorhinostomy (EDCR) in two patients who presented with epiphora post-operatively. Intra-operative frozen section was performed in all cases to ensure complete tumor removal. No intra-operative complications were encountered. No recurrences were noted in these patients, with a mean follow-up period of 23 months.

Matched MeSH terms: Maxilla/surgery*

Fulltext Multidisciplinary approach for management of a patient with fibrous dysplasia of maxilla

Eachempati P, Aggarwal H, Shenoy V, Baliga M

BMJ Case Rep, 2015 Aug 05;2015.

PMID: 26245286 DOI: 10.1136/bcr-2015-210330

Fibrous dysplasia is a non-neoplastic hamartomatous developmental fibro-osseous lesion of bone. Monostotic fibrous dysplasia is more common than the polyostotic form and usually involves jaw bones, ribs and femur. Maxillary lesions may extend to involve the maxillary sinus, zygoma, sphenoid bone and floor of the orbit and require surgical intervention resulting in an acquired defect of the involved site. A multidisciplinary team approach involving an oral pathologist, oral surgeon, oral medicine expert and maxillofacial prosthodontist is required for successful treatment and rehabilitation of such patients. This article describes a case of a patient with fibrous dysplasia of the left maxilla, which was successfully managed by integrating surgical intervention and postoperative rehabilitation, with a surgical obturator and an interim partial denture prosthesis that successfully limited the detrimental effects of surgery, and helped the patient in resocialisation, thereby improving her quality of life.

Matched MeSH terms: Maxilla/surgery*

A denture replication technique following partial maxillectomy: a case report

Haider KG, Lewis GR

Quintessence Int, 1994 Jan;25(1):23-6.

PMID: 8190877

A variety of problems faces the prosthodontist attempting reconstruction of maxillary defects. There are various treatment options for patients requiring a partial maxillectomy and an obturator prosthesis. Reduced adaptability makes it difficult for the patient to learn to use a new appliance, unless existing skills can be employed. It is therefore helpful to reproduce familiar features of a patient's existing obturator, especially if this has been used successfully over a transition period.

Matched MeSH terms: Maxilla/surgery*

Fulltext Biomechanical Stress in Obturator Prostheses: A Systematic Review of Finite Element Studies

Mousa MA, Abdullah JY, Jamayet NB, Alam MK, Husein A

Biomed Res Int, 2021;2021:6419774.

PMID: 34447852 DOI: 10.1155/2021/6419774

Aim: This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to optimize it. Design and Methods. A literature survey was conducted for full-text English articles which used FEA to examine the stress developed in conventional and implant-assisted MFPs from January 2010 to December 2020.

Results: 87 articles were screened to get an update on the desired information. 74 were excluded based on a complete screening, and finally, 13 articles were recruited for complete reviewing. Discussion. The MFP is subjected to stress, which is reflected in the form of compressive and tensile strengths. The stress is mainly concentrated the resection line and around the apices of roots of teeth next to the defect. Diversity of designs and techniques were introduced to optimize the stress distribution, such as modification of the clasp design, using materials with different mechanical properties for dentures base and retainer, use of dental (DI) and/or zygomatic implants (ZI), and free flap reconstruction before prosthetic rehabilitation.

Conclusion: Using ZI in the defective side of the dentulous maxillary defect and defective and nondefective side of the edentulous maxillary defect was found more advantageous, in terms of compression and tensile stress and retention, when compared with DI and free flap reconstruction.

Matched MeSH terms: Maxilla/surgery*

Fulltext How does mandibular advancement with or without maxillary procedures affect pharyngeal airways? An overview of systematic reviews

Tan SK, Leung WK, Tang ATH, Zwahlen RA

PLoS One, 2017;12(7):e0181146.

PMID: 28749983 DOI: 10.1371/journal.pone.0181146

BACKGROUND: Mandibular advancement surgery may positively affect pharyngeal airways and therefore potentially beneficial to obstructive sleep apnea (OSA).

OBJECTIVE: To collect evidence from published systematic reviews that have evaluated pharyngeal airway changes related to mandibular advancement with or without maxillary procedures.

METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library were searched without limiting language or timeline. Eligible systematic reviews evaluating changes in pharyngeal airway dimensions and respiratory parameters after mandibular advancement with or without maxillary surgery were identified and included.

RESULTS: This overview has included eleven systematic reviews. Maxillomandibular advancement (MMA) increases linear, cross-sectional plane and volumetric measurements of pharyngeal airways significantly (p<0.0001), while reducing the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI) significantly (p<0.0001). Two systematic reviews included primary studies that have evaluated single-jaw mandibular advancement, but did not discuss their effect onto pharyngeal airways. Based on the included primary studies of those systematic reviews, single-jaw mandibular advancement was reported to significantly increase pharyngeal airway dimensions (p<0.05); however, conclusive long-term results were lacking.

CONCLUSION: MMA increases pharyngeal airway dimensions and is beneficial to patients suffering from OSA. However, more evidence is still needed to draw definite conclusion related to the effect of single-jaw mandibular advancement osteotomies on pharyngeal airways.

Matched MeSH terms: Maxilla/surgery*

Management of unfavorable implant positions and angulations in edentulous maxillae with different complete-arch fixed prosthetic designs: A case series and clinical guidelines

Kher U, Tunkiwala A, Patil PG

J Prosthet Dent, 2022 Jan;127(1):6-14.

PMID: 33243475 DOI: 10.1016/j.prosdent.2020.09.023

Implant-supported fixed prostheses in the edentulous maxilla can be difficult because of anatomic limitations and high esthetic demand. The choice between cement and screw retention depends on factors such as esthetics, occlusion, retrievability, and passivity. The choice is also often governed by the ability to manage technical or biologic complications. In the edentulous maxilla, because of the bone trajectory and resorption pattern, unfavorable implant angulations may be encountered. In such situations, a conventional screw-retained prosthesis is difficult to design. This article describes the restoration of edentulous maxillae for a series of patients with different complete-arch fixed prosthesis designs. The clinical guidelines, including indications, advantages, and limitations of each design, were discussed.

Matched MeSH terms: Maxilla/surgery

Autotransplantation of maxillary canine following removal of compound odontome: a case report

Zaman JQ, Yahaya N, Razali M, Ibrahim N, Nor GM, Ramli R

Singapore Dent J, 2007 Dec;29(1):41-5.

PMID: 18472529

Obstruction remains as an important cause of failure in the eruption of a tooth. In this article, a 15-year-old girl was presented with retained upper left primary canine (63) and first primary molar (64), while the contralateral permanent canine (13) and premolars (14 and 15) have erupted. Upon radiographic examination, a mass which was diagnosed later to be compound odontome was detected. The treatment consisted of surgical removal of the odontome, extraction of the primary canine (63) and left permanent canine (23), and transplantation of the permanent canine (23). The management of this case and the literature related to autotransplantation are discussed.

Matched MeSH terms: Maxilla/surgery*

Fulltext Maxillary sinus tumours--a review of twenty-nine patients treated by maxillectomy approach

Mazlina S, Putra SH, Shiraz MA, Hazim MY, Roszalina R, Abdul AR

Med J Malaysia, 2006 Aug;61(3):284-7.

PMID: 17240576

A retrospective data of 29 patients who underwent various types of maxillectomy from January 1998 till January 2004 in UKM hospital were reviewed. There were 21 males (72%) and 8 females (28%) with mean age of 42 years. Malays were the majority of patients 17 (59%), Chinese 11 (38%) and Indian 1 (3%). Seventeen patients (59%) presented with malignant tumours while 12 patients (41%) with benign tumours. Inverted papilloma (50%) was the commonest benign tumour and squamous cell carcinoma (36%) was the commonest malignancy. Medial maxillectomy was performed in ten patients (35%), total maxillectomy in seven patients (24%), three patients (10%) had near total, three patients (10%) had partial maxillectomy and six patients (21%) underwent inferior maxillectomy.

Matched MeSH terms: Maxilla/surgery*

Unusual clinical presentation of a severely protruding premaxilla in patient with bilateral clefts

Burezq H, Bang RL, George A, Mukhtar A

J Craniofac Surg, 2007 Jul;18(4):971-4.

PMID: 17667698

Prominent premaxilla is one of the problems encountered when dealing with bilateral complete cleft lip and palate patients. Secondary alveolar bone grafting with these patients would achieve filling of the osseous defect, supports the alar base, eliminate the oro-nasal fistula and enhance the maxillary instability. This article describes the management of a bilateral cleft lip and palate patient with an extremely protruding premaxilla done in one stage surgery. To our knowledge, this is the first report of such degree of severity in the English literature.

Matched MeSH terms: Maxilla/surgery

Hypoglossia congenita with anterior maxillo-mandibular fusion

Arshad AR, Goh CS

Br J Plast Surg, 1994 Mar;47(2):139-41.

PMID: 8149059

Two cases of hypoglossia congenita with anterior maxillo-mandibular fusion are reported. One is a case of hypoglossia with anterior maxillo-mandibular fusion and the other is a case of hypoglossia-hypodactylia with anterior maxillo-mandibular fusion. This condition presents the anaesthetist with the problem of airway management during the surgery. A simple technique using a nasopharyngeal tube was used for these two cases, with satisfactory results.

Matched MeSH terms: Maxilla/surgery

Application of Functional Impression Technique and Use of Silicone as Bulb for Maxillary Obturator

Rahman AM, Nizami MMUI, Jamayet NB, Husein A

J Coll Physicians Surg Pak, 2017 May;27(5):319-320.

PMID: 28599699 DOI: 2623

Matched MeSH terms: Maxilla/surgery*

Fulltext Aneurysmal bone cyst of the maxilla

Tang IP, Shashinder S, Loganathan A, Anura MM, Zakarya S, Mun KS

Singapore Med J, 2009 Sep;50(9):e326-8.

PMID: 19787162

An aneurysmal bone cyst is a rare bone lesion. Its origin and precise nature remain unknown. It is seen as a locally-destructive, rapidly expandable, benign multicystic mass. We report a 17-year-old boy with an aneurysmal bone cyst of the maxilla, with extensive local involvement and bony destruction that was treated surgically. There was no recurrence noted after four years of follow-up.

Matched MeSH terms: Maxilla/surgery

Fulltext 3D mapping of safe and danger zones in the maxilla and mandible for the placement of intermaxillary fixation screws

Purmal K, Alam MK, Pohchi A, Abdul Razak NH

PLoS One, 2013;8(12):e84202.

PMID: 24367643 DOI: 10.1371/journal.pone.0084202

Intermaxillary (IMF) screws feature several advantages over other devices used for intermaxillary fixation, but using cone beam computed tomography (CBCT) scans to determine the safe and danger zones to place these devices for all patients can be expensive. This study aimed to determine the optimal interradicular and buccopalatal/buccolingual spaces for IMF screw placement in the maxilla and mandible. The CBCT volumetric data of 193 patients was used to generate transaxial slices between the second molar on the right to the second molar on the left in both arches. The mean interradicular and buccopalatal/buccolingual distances and standard deviation values were obtained at heights of 2, 5, 8 and 11 mm from the alveolar bone crest. An IMF screw with a diameter of 1.0 mm and length of 7 mm can be placed distal to the canines (2 - 11 mm from the alveolar crest) and less than 8 mm between the molars in the maxilla. In the mandible, the safest position is distal to the first premolar (more than 5 mm) and distal to the second premolar (more than 2 mm). There was a significant difference (p<0.05) between the right and left quadrants. The colour coding 3D template showed the safe and danger zones based on the mesiodistal, buccopalatal and buccolingual distances in the maxilla and mandible.The safest sites for IMF screw insertion in the maxilla were between the canines and first premolars and between the first and second molars. In the mandible, the safest sites were between the first and second premolars and between the second premolar and first molar. However, the IMF screw should not exceed 1.0 mm in diameter and 7 mm in length.

Matched MeSH terms: Maxilla/surgery

Fulltext Immediate placement and loading of implants in anterior maxilla using an altered screw-retained implant fixed prosthesis

Baig MR, Rajan G

Indian J Dent Res, 2010 Apr-Jun;21(2):311-3.

PMID: 20657109 DOI: 10.4103/0970-9290.66635

This article describes the immediate placement and loading of implants in the aesthetic zone using an implant-retained, fixed prosthesis with a modified design. One section of the implant prosthesis has cemented crowns and the other section is the conventional screw-retained. This combined approach significantly offsets the unsuitable implant position, alignment or angulation, while ensuring the easy retrievability, repair and maintenance of the prosthesis at the same time.

Matched MeSH terms: Maxilla/surgery

Evaluation of bone healing following immediate and delayed dental implant placement

Younis L, Taher A, Abu-Hassan MI, Tin O

J Contemp Dent Pract, 2009;10(4):35-42.

PMID: 19575052

The purpose of this study was to compare bone healing and coronal bone remodeling following both immediate and delayed placement of titanium dental implants in extraction sockets.

Matched MeSH terms: Maxilla/surgery

Stress distributions in maxillary central incisors restored with various types of post materials and designs

Madfa AA, Kadir MR, Kashani J, Saidin S, Sulaiman E, Marhazlinda J, et al.

Med Eng Phys, 2014 Jul;36(7):962-7.

PMID: 24834856 DOI: 10.1016/j.medengphy.2014.03.018

Different dental post designs and materials affect the stability of restoration of a tooth. This study aimed to analyse and compare the stability of two shapes of dental posts (parallel-sided and tapered) made of five different materials (titanium, zirconia, carbon fibre and glass fibre) by investigating their stress transfer through the finite element (FE) method. Ten three-dimensional (3D) FE models of a maxillary central incisor restored with two different designs and five different materials were constructed. An oblique loading of 100 N was applied to each 3D model. Analyses along the centre of the post, the crown-cement/core and the post-cement/dentine interfaces were computed, and the means were calculated. One-way ANOVAs followed by post hoc tests were used to evaluate the effectiveness of the post materials and designs (p=0.05). For post designs, the tapered posts introduced significantly higher stress compared with the parallel-sided post (p<0.05), especially along the centre of the post. Of the materials, the highest level of stress was found for stainless steel, followed by zirconia, titanium, glass fibre and carbon fibre posts (p<0.05). The carbon and glass fibre posts reduced the stress distribution at the middle and apical part of the posts compared with the stainless steel, zirconia and titanium posts. The opposite results were observed at the crown-cement/core interface.

Matched MeSH terms: Maxilla/surgery

Treatment of a maxillary dento-alveolar defect using an immediately loaded definitive zygoma implant-retained prosthesis with 11-month follow-up: a clinical report

Baig MR, Rajan G

J Oral Implantol, 2010;36(1):31-5.

PMID: 20218868 DOI: 10.1563/AAID-JOI-D-09-00062

This article describes the dental implant-based rehabilitation of a partially edentulous patient with a unilateral maxillary dento-alveolar defect. A screw-retained prosthesis with a modified design was fabricated on zygomatic and regular dental implants. One section of the implant prosthesis has cemented crowns and the other section is conventional screw-retained. The design of the prosthesis overcame the hard and soft tissue deficit and provided the desired esthetics.

Matched MeSH terms: Maxilla/surgery

The correlation between crestal bone resorption and implant stability during healing period using resonance frequency analysis

Al-Juboori MJ, AbdulRahaman SB, Hassan A

Implant Dent, 2013 Aug;22(4):351-5.

PMID: 23811720 DOI: 10.1097/ID.0b013e318296583d

To detect the correlation between crestal bone resorption and implant stability during healing period using resonance frequency analysis (RFA).

Matched MeSH terms: Maxilla/surgery

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