Mund Kiefer GesichtsChir 2001 · 5 : 326–327 © Springer-Verlag 2001
Summaries
British Journal of Oral and Maxillofacial Surgery
Positional changes and stability of bone segments during simultaneous bilateral mandibular lengthening and widening by distraction
Audit of a multidisciplinary approach to the care of children with unilateral and bilateral cleft lip and palate
Costochondral grafts in reconstruction of the temporomandibular joint after condylectomy: an experimental study in sheep
M. Gonzalez · W. H. Bell · C. A. Guerrero · P. H. Buschang · M. L. Samchukov
A. A. C.Webb · R.Watts · E. Read-Ward · J. Hodgkins · A. F. Markus
H. Matsuura · H. Miyamoto · J.-I. Ishimaru · K. Kurita · A. N. Goss
Br J Oral Maxillofac Surg (2001) 39:169–178
Br J Oral Maxillofac Surg (2001) 39:182–188
Br J Oral Maxillofac Surg (2001) 39:189–195
The purpose of this study was to analyse the skeletal changes and stability of the distracted segments during and after simultaneous widening and bilateral lengthening of the mandible in baboons with a miniaturized intraoral bone-borne osteodistractor. Distraction appliances were activated 5 days after vertical posterior body and midsymphyseal osteotomies at a rate of 0.9 mm/day for 10 days. The appliances were then stabilized for a period of 8 weeks, after which the animals were killed. The distraction gaps and gingival tissues were studied clinically and on standardized radiographs. The proportional movement of the distracted segments that we found supports the clinical use of the miniaturized intraoral bone-borne distraction appliance to widen and lengthen the mandible selectively. It also supports the concept of positioning the mandibular osteodistractors parallel to the common vector of distraction, which should parallel the corrected maxillary occlusal plane.
Cleft lip and palate affects the child in many ways, particularly appearance, dental arch relationships, growth of the face, and speech development. The key to successful care is management in a multidisciplinary team adhering to a well-designed protocol, and careful audit of results. We present the intermediate outcome audit of 15 patients with complete bilateral and unilateral cleft lip and palate whose condition was managed in a multidisciplinary team according to a strict protocol.We give the results observations of operations of a single surgeon’s functional primary surgery over a 6-year period in terms of dental arch relationships, cephalometric analyses, aesthetic assessments, and speech analysis. The results show good early facial growth, with dental arch relationships appropriate for the age and group; we found only minor speech discrepancies, with no patients requiring pharyngoplasty. The results show the importance of multidisciplinary management, the value of keeping to sound surgical protocols, and functional techniques in cleft lip and palate surgery. Our study includes the neglected group of children who have bilateral cleft lip and palate, and it conforms to the style of pan-European projects.
The purpose of this study was to investigate the effect of costochondral grafts in the temporomandibular joint (TMJ) in sheep. Five pure-bred adult Merino sheep were used. The condyle alone was resected and replaced with a costochondral graft from the 13th rib. The sheep were killed 3 months after operation. The range of jaw movements before and after operation and at death were recorded. The joints were examined radiologically, macroscopically, and histologically. A new condylar head with normal configuration and function developed. Histologically, the chondrocytes were arranged in a fashion similar to that of a normal joint. All inferior joint spaces showed fibrous adhesions between the condylar head and disc. This study showed that, when such grafts are used to replace the condyle in an otherwise normal sheep TMJ, they fused to the ramus and reconstituted a nearly normal, fully functional joint.
Correspondence: Professor W.H.Bell, 4100 15th Street Suite 104, Plano,TX 75093, USA. Tel: + 1 972 596 8767; Fax: + 1 972 867 7041; E-mail: [email protected]
Correspondence: Mr A.F.Markus,The Dorset Cleft Centre, Poole Hospital NHS Trust, Longfleet Road, Poole BH15 2JB, UK. Tel: + 44 (0) 1202 442080
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Mund Kiefer GesichtsChir 5 · 2001
Correspondence: Dr H.Matsuura,The First Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan. Tel: + 81 52 759 2157; Fax: + 81 52 759 2157; E-mail: [email protected]
Effect of partial immobilization on reconstruction of ankylosis of the temporomandibular joint with an autogenous costochondral graft: an experimental study in sheep H. Matsuura · H. Miyamoto · J.-I. Ishimaru · K. Kurita · A. N. Goss
Death certification in patients whose primary treatment for oral and oropharyngeal carcinoma was operation: 1992–1997
S. Iida · M. Kogo · G.Tominaga · T. Matsuya C. Leitner · S. N. Rogers · D. Lowe · P. Magennis Br J Oral Maxillofac Surg (2001) 39:204–209
Br J Oral Maxillofac Surg (2001) 39:196–203 The purpose of this study was to show the effect of partial immobilization of a costochondral graft reconstruction of an ankylosed temporomandibular joint (TMJ) in five adult sheep. Ankylosis was induced in all rigth TMJs. At three months, a graft was inserted and partially immobilized. Three months after the second operation, four sheep were killed by an overdose with pentothal. One sheep was killed at one month because of infection. Functionally, the body weight, which decreases with ankylosis, did not recover after insertion of the graft and the range of jaw movements got worse. Histologically, the grafts were well attached to the mandibular rami in three of four joints. In one joint, the graft showed signs of resorption and a foreign body reaction. We conclude that, if the reconstructed joint is partially immobilized, then there will be a degree of reankylosis. There was also a high failure rate. Correspondence: Dr H.Matsuura,The First Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan. Tel: + 81 52 759 2157; Fax: + 81 52 759 2157; E-mail: [email protected]
Plunging ranula as a complication of intraoral removal of a submandibular sialolith
The aim of this study was to report the cause and place of death of patients with oral cancer as recorded by death certification and their survival with regard to comorbidity and age. From the departmental head and neck oncology database, 322 patients were identified with previously untreated oral and oropharyngeal squamous cell carcinoma diagnosed between 1992 and 1997 inclusive. Three-hundred were matched with the Office for National Statistics (ONS) and copies of death certificates generated on 6 March 1999. Of the 286 patients primarily treated by operation, 203 were alive and 83 had died. In 56 (68%), oral cancer was a contributory factor to the patient’s death. Patients with a medical history recorded on their admission for operation had similar survival curves compared to those having no problems recorded. Although most patients (n = 46 55%) died in hospital, only 13 (16%) died in the Regional Maxillofacial Unit. Almost half of those patients who died were not recorded as dead on the departmental oncology database. This study shows that it is useful to link with the ONS to obtain accurate data on date and place of death. The death certificate also gives a useful indication of the cause of death and this seems unrelated to preoperative comorbidity. Correspondence: Simon Rogers FDSRCS, FRCS, Consultant and Honorary Reader, Regional Maxillofacial Unit, University Aintree, Lower Lane, Liverpool L9 1AL. Tel: + 44 (0) 151 529 5287; Fax: + 44 (0) 151 529 5288; E-mail: [email protected]
Br J Oral Maxillofac Surg (2001) 39:214–216 Mucous cysts in the submandibular region – so-called ‘plunging’ ranula – are relatively uncommon. We report a case of a plunging ranula that complicated excision of an intraductal sialolith of the submandibular gland. Correspondence: Seiji Iida DDS, PhD,The First Department of Oral and Maxillofacial Surgery, Osaka University Faculty of Dentistry, 108, Yamadaoka, Suita City, Osaka 565-0871, Japan. Tel: + 81 6 6879 2936; Fax: + 81 6 6876 5298
Treating oral ranula: another case against blanket removal of the sublingual gland H. D. Baurmash Br J Oral Maxillofac Surg (2001) 39:217–220 There are a number of occasions when ranula-like lesions of the oral floor can develop that do not originate from the sublingual gland, or that arise from the gland with no tendency towards recurrence. The author advises that the unconditional removal of the sublingual gland should not be the standard treatment for all ranulas, and presents four case reports to illustrate these and describes how they should be treated. All the patients were treated successfully with conservative management and retained normal functioning sublingual glands. Except for the management of plunging ranulas, caution and a close examination of the origin of the lesion are prudent before considering excision of sublingual glands for all ranula-like lesions. Correspondence: H.D.Baurmash, 4666 Hazleton Lane, Lake Worth, FL 33467, Florida, USA. Tel: + 1 561 969 0394; Fax: + 1 561 968 2038
Mund Kiefer GesichtsChir 5 · 2001
327
Summaries
British Journal of Oral and Maxillofacial Surgery
Positional changes and stability of bone segments during simultaneous bilateral mandibular lengthening and widening by distraction
Audit of a multidisciplinary approach to the care of children with unilateral and bilateral cleft lip and palate
Costochondral grafts in reconstruction of the temporomandibular joint after condylectomy: an experimental study in sheep
M. Gonzalez · W. H. Bell · C. A. Guerrero · P. H. Buschang · M. L. Samchukov
A. A. C.Webb · R.Watts · E. Read-Ward · J. Hodgkins · A. F. Markus
H. Matsuura · H. Miyamoto · J.-I. Ishimaru · K. Kurita · A. N. Goss
Br J Oral Maxillofac Surg (2001) 39:169–178
Br J Oral Maxillofac Surg (2001) 39:182–188
Br J Oral Maxillofac Surg (2001) 39:189–195
The purpose of this study was to analyse the skeletal changes and stability of the distracted segments during and after simultaneous widening and bilateral lengthening of the mandible in baboons with a miniaturized intraoral bone-borne osteodistractor. Distraction appliances were activated 5 days after vertical posterior body and midsymphyseal osteotomies at a rate of 0.9 mm/day for 10 days. The appliances were then stabilized for a period of 8 weeks, after which the animals were killed. The distraction gaps and gingival tissues were studied clinically and on standardized radiographs. The proportional movement of the distracted segments that we found supports the clinical use of the miniaturized intraoral bone-borne distraction appliance to widen and lengthen the mandible selectively. It also supports the concept of positioning the mandibular osteodistractors parallel to the common vector of distraction, which should parallel the corrected maxillary occlusal plane.
Cleft lip and palate affects the child in many ways, particularly appearance, dental arch relationships, growth of the face, and speech development. The key to successful care is management in a multidisciplinary team adhering to a well-designed protocol, and careful audit of results. We present the intermediate outcome audit of 15 patients with complete bilateral and unilateral cleft lip and palate whose condition was managed in a multidisciplinary team according to a strict protocol.We give the results observations of operations of a single surgeon’s functional primary surgery over a 6-year period in terms of dental arch relationships, cephalometric analyses, aesthetic assessments, and speech analysis. The results show good early facial growth, with dental arch relationships appropriate for the age and group; we found only minor speech discrepancies, with no patients requiring pharyngoplasty. The results show the importance of multidisciplinary management, the value of keeping to sound surgical protocols, and functional techniques in cleft lip and palate surgery. Our study includes the neglected group of children who have bilateral cleft lip and palate, and it conforms to the style of pan-European projects.
The purpose of this study was to investigate the effect of costochondral grafts in the temporomandibular joint (TMJ) in sheep. Five pure-bred adult Merino sheep were used. The condyle alone was resected and replaced with a costochondral graft from the 13th rib. The sheep were killed 3 months after operation. The range of jaw movements before and after operation and at death were recorded. The joints were examined radiologically, macroscopically, and histologically. A new condylar head with normal configuration and function developed. Histologically, the chondrocytes were arranged in a fashion similar to that of a normal joint. All inferior joint spaces showed fibrous adhesions between the condylar head and disc. This study showed that, when such grafts are used to replace the condyle in an otherwise normal sheep TMJ, they fused to the ramus and reconstituted a nearly normal, fully functional joint.
Correspondence: Professor W.H.Bell, 4100 15th Street Suite 104, Plano,TX 75093, USA. Tel: + 1 972 596 8767; Fax: + 1 972 867 7041; E-mail: [email protected]
Correspondence: Mr A.F.Markus,The Dorset Cleft Centre, Poole Hospital NHS Trust, Longfleet Road, Poole BH15 2JB, UK. Tel: + 44 (0) 1202 442080
326
Mund Kiefer GesichtsChir 5 · 2001
Correspondence: Dr H.Matsuura,The First Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan. Tel: + 81 52 759 2157; Fax: + 81 52 759 2157; E-mail: [email protected]
Effect of partial immobilization on reconstruction of ankylosis of the temporomandibular joint with an autogenous costochondral graft: an experimental study in sheep H. Matsuura · H. Miyamoto · J.-I. Ishimaru · K. Kurita · A. N. Goss
Death certification in patients whose primary treatment for oral and oropharyngeal carcinoma was operation: 1992–1997
S. Iida · M. Kogo · G.Tominaga · T. Matsuya C. Leitner · S. N. Rogers · D. Lowe · P. Magennis Br J Oral Maxillofac Surg (2001) 39:204–209
Br J Oral Maxillofac Surg (2001) 39:196–203 The purpose of this study was to show the effect of partial immobilization of a costochondral graft reconstruction of an ankylosed temporomandibular joint (TMJ) in five adult sheep. Ankylosis was induced in all rigth TMJs. At three months, a graft was inserted and partially immobilized. Three months after the second operation, four sheep were killed by an overdose with pentothal. One sheep was killed at one month because of infection. Functionally, the body weight, which decreases with ankylosis, did not recover after insertion of the graft and the range of jaw movements got worse. Histologically, the grafts were well attached to the mandibular rami in three of four joints. In one joint, the graft showed signs of resorption and a foreign body reaction. We conclude that, if the reconstructed joint is partially immobilized, then there will be a degree of reankylosis. There was also a high failure rate. Correspondence: Dr H.Matsuura,The First Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan. Tel: + 81 52 759 2157; Fax: + 81 52 759 2157; E-mail: [email protected]
Plunging ranula as a complication of intraoral removal of a submandibular sialolith
The aim of this study was to report the cause and place of death of patients with oral cancer as recorded by death certification and their survival with regard to comorbidity and age. From the departmental head and neck oncology database, 322 patients were identified with previously untreated oral and oropharyngeal squamous cell carcinoma diagnosed between 1992 and 1997 inclusive. Three-hundred were matched with the Office for National Statistics (ONS) and copies of death certificates generated on 6 March 1999. Of the 286 patients primarily treated by operation, 203 were alive and 83 had died. In 56 (68%), oral cancer was a contributory factor to the patient’s death. Patients with a medical history recorded on their admission for operation had similar survival curves compared to those having no problems recorded. Although most patients (n = 46 55%) died in hospital, only 13 (16%) died in the Regional Maxillofacial Unit. Almost half of those patients who died were not recorded as dead on the departmental oncology database. This study shows that it is useful to link with the ONS to obtain accurate data on date and place of death. The death certificate also gives a useful indication of the cause of death and this seems unrelated to preoperative comorbidity. Correspondence: Simon Rogers FDSRCS, FRCS, Consultant and Honorary Reader, Regional Maxillofacial Unit, University Aintree, Lower Lane, Liverpool L9 1AL. Tel: + 44 (0) 151 529 5287; Fax: + 44 (0) 151 529 5288; E-mail: [email protected]
Br J Oral Maxillofac Surg (2001) 39:214–216 Mucous cysts in the submandibular region – so-called ‘plunging’ ranula – are relatively uncommon. We report a case of a plunging ranula that complicated excision of an intraductal sialolith of the submandibular gland. Correspondence: Seiji Iida DDS, PhD,The First Department of Oral and Maxillofacial Surgery, Osaka University Faculty of Dentistry, 108, Yamadaoka, Suita City, Osaka 565-0871, Japan. Tel: + 81 6 6879 2936; Fax: + 81 6 6876 5298
Treating oral ranula: another case against blanket removal of the sublingual gland H. D. Baurmash Br J Oral Maxillofac Surg (2001) 39:217–220 There are a number of occasions when ranula-like lesions of the oral floor can develop that do not originate from the sublingual gland, or that arise from the gland with no tendency towards recurrence. The author advises that the unconditional removal of the sublingual gland should not be the standard treatment for all ranulas, and presents four case reports to illustrate these and describes how they should be treated. All the patients were treated successfully with conservative management and retained normal functioning sublingual glands. Except for the management of plunging ranulas, caution and a close examination of the origin of the lesion are prudent before considering excision of sublingual glands for all ranula-like lesions. Correspondence: H.D.Baurmash, 4666 Hazleton Lane, Lake Worth, FL 33467, Florida, USA. Tel: + 1 561 969 0394; Fax: + 1 561 968 2038
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