Dental inclusions are assessed on the basis of clinical and operating statistics relating to the ... more Dental inclusions are assessed on the basis of clinical and operating statistics relating to the years 1981-1985 and comprising 815 patients and 1445 treated teeth. The results confirm the predominance of inclusions among female patients and the prevalence of the mandibular site; the most frequently included teeth are the lower eighths followed by the upper eighths, the upper canines and the second lower premolars. Inclusions are bilateral in most cases. These findings are in substantial agreement with the epidemiological data recorded in the literature. The operating series shows that the type of surgical treatment varies with the localisation of the tooth (anterior or posterior), its relationship with contigous teeth and with the surrounding anatomical structures and the age of the patient. Teeth in the posterior sector are usually extracted. At young age, germectomy is carried out for orthodontic purposes; at mature age, teeth are extracted to prevent the formation of periodontal pockets and the aggravation of caries and their complications. On the other hand, for teeth in the anterior sector, surgery is usually merely the first stage in treatment and is followed by treatment of orthodontic type with traction, in view of the important aesthetic and functional role of the labial teeth.
Journal of Cranio-maxillofacial Surgery, Apr 1, 2016
Temporomandibular joint ankylosis is a joint disorder due to bone or fibrous adhesion of the join... more Temporomandibular joint ankylosis is a joint disorder due to bone or fibrous adhesion of the joint components that cause loss of function. There are many causes, such as trauma, infections and systemic diseases. To date, no uniform treatment protocol has been established. We enrolled in the study patients that underwent single stage alloplastic total joint replacement for complete bony ankylosis. The subjective and objective variables were as follow: TMJ pain, diet, jaw function, quality of life, maximum interincisal opening (MIO) and occlusion. The minimum follow-up was 12 months. 12 patients met the inclusion criteria. Six patients underwent bilateral or monolateral total joint reconstruction with stock prosthesis, six patients underwent bilateral total joint reconstruction with custom made prosthesis. The mean preoperative MIO was 7.9 mm. The mean MIO reordered at 12-month follow-up was 26.5 mm (P < 0,0001). The occlusion was unchanged in 9 patients out of 12. In two patients the occlusion was changed by means of custom prosthesis design. In one patient occlusion worsened with less stable functional contact. Quality of life and diet relevantly improved in all cases. Single stage resection and reconstruction with total alloplastic TMJ reconstruction is an effective and reliable method to reestablish stable long-term mandibular function in ankylotic patients.
Temporomandibular joint ankylosis is a joint disorder due to bone or fibrous adhesion of the join... more Temporomandibular joint ankylosis is a joint disorder due to bone or fibrous adhesion of the joint components that cause loss of function. There are many causes, such as trauma, infections and systemic diseases. To date, no uniform treatment protocol has been established. We enrolled in the study patients that underwent single stage alloplastic total joint replacement for complete bony ankylosis. The subjective and objective variables were as follow: TMJ pain, diet, jaw function, quality of life, maximum interincisal opening (MIO) and occlusion. The minimum follow-up was 12 months. 12 patients met the inclusion criteria. Six patients underwent bilateral or monolateral total joint reconstruction with stock prosthesis, six patients underwent bilateral total joint reconstruction with custom made prosthesis. The mean preoperative MIO was 7.9 mm. The mean MIO reordered at 12-month follow-up was 26.5 mm (P < 0,0001). The occlusion was unchanged in 9 patients out of 12. In two patients the occlusion was changed by means of custom prosthesis design. In one patient occlusion worsened with less stable functional contact. Quality of life and diet relevantly improved in all cases. Single stage resection and reconstruction with total alloplastic TMJ reconstruction is an effective and reliable method to reestablish stable long-term mandibular function in ankylotic patients.
Aesthetic requests of patients undergoing orthognatic surgery have increased over time and repres... more Aesthetic requests of patients undergoing orthognatic surgery have increased over time and represent nowadays the leading subjective motivation for the patient and a major aim of the treatment for the surgeon. In this regard, anthropometric evaluation has considerably improved the diagnostic capacity of the orthodontist and of the surgeon. Aim of the study is to provide the orthognatic surgeon with anthropometric normal values based on a sample of aesthetically pleasant Italian subjects and to discuss the use of a simplified aesthetical analysis in the set-up of the surgical plan and in the evaluation of treatment outcome. The present study analyses 94 Italian subjects, by means of anthropometric measurements on photographic images, considering 28 facial proportions and 33 angular values. These figures were compared with the aesthetic judgement provided by 3 common observers and 3 orthodontists. The aesthetic score was attributed on a subjective discrete scale (common observer: abov...
The visual three-dimensional (3D) reconstruction of CT findings has been used since the Seventies... more The visual three-dimensional (3D) reconstruction of CT findings has been used since the Seventies to design and plan complex surgical procedures. The availability of such models and the development of computer science have permitted, since the mid-Eighties, the medical use of rapid prototyping for anatomical modelling. We studied the technical steps of CT data processing for rapid prototyping and the dimensional and structural accuracy of replicas of skeletal components relative to the originals. A dried mandible and an arthrotic hip joint were compared with their stereolithographic replicas using the measurements made on CT images. The 3D graphic models were processed with a commercially available software and replicated with an SLA 250 stereolithographer (3D System Inc, Valencia CA, USA). Satisfactory morphologic agreement was found between the original and its replica. The mandibular replica exhibited dimensional errors ranging 0 to 4.03%, z-axis shortening and an increase in gon...
The paper examine 40 cases of bone graft from the iliac crest used in maxillo-facial surgery. The... more The paper examine 40 cases of bone graft from the iliac crest used in maxillo-facial surgery. The immediate and late complications included pain with resulting difficulty of walking and, less frequently, hematoma, sensitivity disorders and dehiscence of the wound. Late complications were most frequently related to esthetic problems as well as a negligible number of persistent cases of difficult walking and neurological deficiencies. The results obtained were comparable to those most recently reported in the literature. The low incidence of immediate and late sequelae at the donor site and the characteristics of the bone graft confirm the suitability of iliac crest bone graft, in particular for use in reconstructive maxillo-facial surgery.
International Journal of Oral and Maxillofacial Surgery, 2005
In 29 adult patients presenting with maxillary deficiency, a bone-anchored palatal distractor (Su... more In 29 adult patients presenting with maxillary deficiency, a bone-anchored palatal distractor (Surgi-Tec NV, Brugge, Belgium) was applied after osteotomy of the anterolateral walls of the maxillary sinuses, midpalatal suture, and, eventually, separation of the pterygomaxillary sutures. Expansion proceeded at a rate of 0.33-0.66 mm per day and the device was retained for 4-6 months for consolidation. Active orthodontic therapy was started after 8-10 weeks. The increment of arch width and the perimeter were evaluated using dental casts. Tooth thermal sensitivity and the periodontal side effects of treatment were monitored clinically after distraction, at device removal, and after 1 year. Bone healing was also investigated during the procedure using conventional radiological techniques. This experience confirms that transverse maxillary distraction is an effective technique in adult patients, leading to the formation of new bone. There were no noticeable intraoperative complications, but postsurgical periodontal side effects were documented. The procedure offers advantages over traditional teeth-borne appliances in terms of rapidity of treatment and the absence of mechanical forces acting on the teeth. Further evaluation is required to assess the long-term stability and periodontal consequences of this technique.
Dental inclusions are assessed on the basis of clinical and operating statistics relating to the ... more Dental inclusions are assessed on the basis of clinical and operating statistics relating to the years 1981-1985 and comprising 815 patients and 1445 treated teeth. The results confirm the predominance of inclusions among female patients and the prevalence of the mandibular site; the most frequently included teeth are the lower eighths followed by the upper eighths, the upper canines and the second lower premolars. Inclusions are bilateral in most cases. These findings are in substantial agreement with the epidemiological data recorded in the literature. The operating series shows that the type of surgical treatment varies with the localisation of the tooth (anterior or posterior), its relationship with contigous teeth and with the surrounding anatomical structures and the age of the patient. Teeth in the posterior sector are usually extracted. At young age, germectomy is carried out for orthodontic purposes; at mature age, teeth are extracted to prevent the formation of periodontal pockets and the aggravation of caries and their complications. On the other hand, for teeth in the anterior sector, surgery is usually merely the first stage in treatment and is followed by treatment of orthodontic type with traction, in view of the important aesthetic and functional role of the labial teeth.
Journal of Cranio-maxillofacial Surgery, Apr 1, 2016
Temporomandibular joint ankylosis is a joint disorder due to bone or fibrous adhesion of the join... more Temporomandibular joint ankylosis is a joint disorder due to bone or fibrous adhesion of the joint components that cause loss of function. There are many causes, such as trauma, infections and systemic diseases. To date, no uniform treatment protocol has been established. We enrolled in the study patients that underwent single stage alloplastic total joint replacement for complete bony ankylosis. The subjective and objective variables were as follow: TMJ pain, diet, jaw function, quality of life, maximum interincisal opening (MIO) and occlusion. The minimum follow-up was 12 months. 12 patients met the inclusion criteria. Six patients underwent bilateral or monolateral total joint reconstruction with stock prosthesis, six patients underwent bilateral total joint reconstruction with custom made prosthesis. The mean preoperative MIO was 7.9 mm. The mean MIO reordered at 12-month follow-up was 26.5 mm (P < 0,0001). The occlusion was unchanged in 9 patients out of 12. In two patients the occlusion was changed by means of custom prosthesis design. In one patient occlusion worsened with less stable functional contact. Quality of life and diet relevantly improved in all cases. Single stage resection and reconstruction with total alloplastic TMJ reconstruction is an effective and reliable method to reestablish stable long-term mandibular function in ankylotic patients.
Temporomandibular joint ankylosis is a joint disorder due to bone or fibrous adhesion of the join... more Temporomandibular joint ankylosis is a joint disorder due to bone or fibrous adhesion of the joint components that cause loss of function. There are many causes, such as trauma, infections and systemic diseases. To date, no uniform treatment protocol has been established. We enrolled in the study patients that underwent single stage alloplastic total joint replacement for complete bony ankylosis. The subjective and objective variables were as follow: TMJ pain, diet, jaw function, quality of life, maximum interincisal opening (MIO) and occlusion. The minimum follow-up was 12 months. 12 patients met the inclusion criteria. Six patients underwent bilateral or monolateral total joint reconstruction with stock prosthesis, six patients underwent bilateral total joint reconstruction with custom made prosthesis. The mean preoperative MIO was 7.9 mm. The mean MIO reordered at 12-month follow-up was 26.5 mm (P < 0,0001). The occlusion was unchanged in 9 patients out of 12. In two patients the occlusion was changed by means of custom prosthesis design. In one patient occlusion worsened with less stable functional contact. Quality of life and diet relevantly improved in all cases. Single stage resection and reconstruction with total alloplastic TMJ reconstruction is an effective and reliable method to reestablish stable long-term mandibular function in ankylotic patients.
Aesthetic requests of patients undergoing orthognatic surgery have increased over time and repres... more Aesthetic requests of patients undergoing orthognatic surgery have increased over time and represent nowadays the leading subjective motivation for the patient and a major aim of the treatment for the surgeon. In this regard, anthropometric evaluation has considerably improved the diagnostic capacity of the orthodontist and of the surgeon. Aim of the study is to provide the orthognatic surgeon with anthropometric normal values based on a sample of aesthetically pleasant Italian subjects and to discuss the use of a simplified aesthetical analysis in the set-up of the surgical plan and in the evaluation of treatment outcome. The present study analyses 94 Italian subjects, by means of anthropometric measurements on photographic images, considering 28 facial proportions and 33 angular values. These figures were compared with the aesthetic judgement provided by 3 common observers and 3 orthodontists. The aesthetic score was attributed on a subjective discrete scale (common observer: abov...
The visual three-dimensional (3D) reconstruction of CT findings has been used since the Seventies... more The visual three-dimensional (3D) reconstruction of CT findings has been used since the Seventies to design and plan complex surgical procedures. The availability of such models and the development of computer science have permitted, since the mid-Eighties, the medical use of rapid prototyping for anatomical modelling. We studied the technical steps of CT data processing for rapid prototyping and the dimensional and structural accuracy of replicas of skeletal components relative to the originals. A dried mandible and an arthrotic hip joint were compared with their stereolithographic replicas using the measurements made on CT images. The 3D graphic models were processed with a commercially available software and replicated with an SLA 250 stereolithographer (3D System Inc, Valencia CA, USA). Satisfactory morphologic agreement was found between the original and its replica. The mandibular replica exhibited dimensional errors ranging 0 to 4.03%, z-axis shortening and an increase in gon...
The paper examine 40 cases of bone graft from the iliac crest used in maxillo-facial surgery. The... more The paper examine 40 cases of bone graft from the iliac crest used in maxillo-facial surgery. The immediate and late complications included pain with resulting difficulty of walking and, less frequently, hematoma, sensitivity disorders and dehiscence of the wound. Late complications were most frequently related to esthetic problems as well as a negligible number of persistent cases of difficult walking and neurological deficiencies. The results obtained were comparable to those most recently reported in the literature. The low incidence of immediate and late sequelae at the donor site and the characteristics of the bone graft confirm the suitability of iliac crest bone graft, in particular for use in reconstructive maxillo-facial surgery.
International Journal of Oral and Maxillofacial Surgery, 2005
In 29 adult patients presenting with maxillary deficiency, a bone-anchored palatal distractor (Su... more In 29 adult patients presenting with maxillary deficiency, a bone-anchored palatal distractor (Surgi-Tec NV, Brugge, Belgium) was applied after osteotomy of the anterolateral walls of the maxillary sinuses, midpalatal suture, and, eventually, separation of the pterygomaxillary sutures. Expansion proceeded at a rate of 0.33-0.66 mm per day and the device was retained for 4-6 months for consolidation. Active orthodontic therapy was started after 8-10 weeks. The increment of arch width and the perimeter were evaluated using dental casts. Tooth thermal sensitivity and the periodontal side effects of treatment were monitored clinically after distraction, at device removal, and after 1 year. Bone healing was also investigated during the procedure using conventional radiological techniques. This experience confirms that transverse maxillary distraction is an effective technique in adult patients, leading to the formation of new bone. There were no noticeable intraoperative complications, but postsurgical periodontal side effects were documented. The procedure offers advantages over traditional teeth-borne appliances in terms of rapidity of treatment and the absence of mechanical forces acting on the teeth. Further evaluation is required to assess the long-term stability and periodontal consequences of this technique.
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