International journal of oral and maxillofacial surgery
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Int J Oral Maxillofac Surg · Jul 2011
Additional orthognathic surgery following Le Fort III and monobloc advancement.
Severe midface hypoplasia in patients with various craniofacial anomalies can be corrected with Le Fort III or monobloc advancement. Often additional corrective orthognathic surgery is indicated to achieve Class I occlusion and a normal inter-jaw relationship. This study evaluated the incidence of, and the surgical indications for, secondary orthognathic surgery following Le Fort III/monobloc advancement. ⋯ Le Fort III and monobloc advancement aim to correct skeletal deformities on the level of zygoma, orbits, nasal area and forehead, but Class I occlusion is frequently not achieved. Additional orthognathic surgery is often indicated in patients undergoing Le Fort III or monobloc advancement. Naso-endoscopic analysis of the upper airway and the outcomes of sleep studies may influence the orthognathic treatment plan.
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Int J Oral Maxillofac Surg · Jul 2011
Effects of lidocaine and adrenaline combination on postoperative edema and ecchymosis in rhinoplasty.
Nasal osteotomies are the most important cause of periorbital edema and ecchymosis. Injection of lidocaine and adrenaline is recommended to reduce bleeding. Whilst the lidocaine and adrenaline combination (LAC) is claimed to reduce postoperative ecchymosis and edema, this effect remains to be proven conclusively. ⋯ The degrees of edema/ecchymosis increased with increases in the duration of operation and the systolic blood pressure on the first postoperative day for the LAC-applied side (p<0.05). This correlation was not observed on the opposite side (p>0.05). Application of LAC reduces bleeding during rhinoplasty and pain control postoperatively but reduced edema and ecchymosis should not be expected following LAC application.
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Int J Oral Maxillofac Surg · Jul 2011
Randomized Controlled Trial Comparative Study3D evaluation of postoperative swelling using two different cooling methods following orthognathic surgery: a randomised observer blind prospective pilot study.
Orthognathic surgery is associated with side effects including severe postoperative swelling, pain, neurological dysfunction and trismus. The beneficial effects of localised cold treatment on postoperative swelling have been described. Topographical considerations make it difficult to quantify facial swelling. ⋯ No differences were observed concerning neurological score and outcome. In conclusion, 3D optical scanning is a simple and precise method of quantifying face swelling after orthognathic surgery. Hilotherm significantly reduces swelling and duration of hospital stay compared with conventional cooling.
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Int J Oral Maxillofac Surg · Jul 2011
Comparative StudyTemporomandibular joint involvement in rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis.
The aim of the present study was to estimate the prevalence of temporomandibular joint (TMJ) symptoms and clinical findings in Albanian patients with rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis. The authors examined 124 consecutive hospitalized patients (88 with rheumatoid arthritis, 22 with systemic lupus erythematosus and 14 with systemic sclerosis) and 124 age- and gender-matched healthy controls using a questionnaire and an oro-facial clinical examination for assessing the presence of TMJ sounds, pain in the TMJ area, tenderness of masticatory muscles and limited mouth opening. Significantly more patients (67%) reported TMJ symptoms than controls (19%). ⋯ Pain was found in a significantly higher proportion in patients with systemic lupus erythematosus compared with controls. Difficulty and limitation in mouth opening were observed in the majority of systemic sclerosis patients, and in only a minority of rheumatoid arthritis patients. This study supports the notion that TMJ examination should be encouraged in the rheumatology setting and clinicians should be able to provide pain management and patient support.