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This study aimed to describe the condylar layer and cartilage island in subjects with unilateral condylar hyperplasia (UCH). Five individuals (15-18 years old) with a diagnosis of UCH, treated in a university hospital in Temuco, Chile, were included. The analysis examined the presence, extension, and thickness of the layers on the condylar surface, the number, depth, and area of the cartilage islands, and the argyrophilic proteins of the nucleolar organizer region (AgNOR) score. Statistical significance was set at P<0.05. The fibrocartilaginous layer was thickest (0.13±0.05mm) and the joint layer was thinnest (0.07±0.01mm) (P<0.05). With respect to the number, depth, and area of the islands, case 1 presented the highest values, followed by case 2; the cartilage island was related to the fibrocartilaginous layer (P<0.05). All cases had AgNOR proteins in the proliferative and fibrocartilaginous layers, as well as the islands with the greatest presence of chondrocytes (P=0.245). A relationship was observed between the histopathological alterations in the different layers on the condylar surface and the thickness of the fibrocartilaginous layer, as well as the thickness of the latter and the number, depth, and area of the cartilage islands in the trabecular bone., (Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Clinicians are accustomed to viewing conventional two-dimensional (2D) photographs and assume that viewing three-dimensional (3D) images is similar. Facial images captured in 3D are not viewed in true 3D; this may alter clinical judgement. The aim of this study was to evaluate the reliability of using conventional photographs, 3D images, and stereoscopic projected 3D images to rate the severity of the deformity in pre-surgical class III patients. Forty adult patients were recruited. Eight raters assessed facial height, symmetry, and profile using the three different viewing media and a 100-mm visual analogue scale (VAS), and appraised the most informative viewing medium. Inter-rater consistency was above good for all three media. Intra-rater reliability was not significantly different for rating facial height using 2D (P=0.704), symmetry using 3D (P=0.056), and profile using projected 3D (P=0.749). Using projected 3D for rating profile and symmetry resulted in significantly lower median VAS scores than either 3D or 2D images (all P<0.05). For 75% of the raters, stereoscopic 3D projection was the preferred method for rating. The reliability of assessing specific characteristics was dependent on the viewing medium. Clinicians should be aware that the visual information provided when viewing 3D images is not the same as when viewing 2D photographs, especially for facial depth, and this may change the clinical impression., (Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.)

The purpose of this study was to clarify the correlation between pre-treatment anterior disc displacement and mandibular stability after orthognathic and orthodontic treatment among patients with a skeletal class II malocclusion and without pre-treatment condylar resorption. Thirty-seven patients were included (7 male, 30 female). The mean length of follow-up was 6.76±3.06 years. Patients with condylar resorption before treatment were excluded. Magnetic resonance images and lateral cephalometric radiographs were taken before treatment (T0), after treatment (T1), and at follow-up (T2). Patients were classified according to the degree of disc displacement: -10-10° 'normal', 11-50° 'slight to mild', ≥51° 'moderate to severe'. Results showed the condyle moved posterosuperiorly after treatment, and then moved anteriorly to a more concentric location during the long follow-up period. Condylar movement was found not to correlate with disc displacement. The degree of disc displacement before treatment did not correlate with the post-surgical mandibular positional change in either the sagittal or vertical direction. To conclude, the mandibular bilateral sagittal split ramus osteotomy was stable in the long-term after orthognathic and orthodontic treatment. In the absence of pre-treatment condylar resorption, the degree of initial anterior disc displacement did not have a significant influence on the stability of mandibular advancement., (Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

The aim of this research was to compare the condylar morphology of patients with unilateral condylar hyperplasia (UCH) and patients with a class III skeletal relationship using cone beam computed tomography (CBCT). A prospective study was conducted on patients with facial asymmetry attending the division of oral and maxillofacial surgery of the study university in Chile. Fifteen patients with UCH and 15 with a class III skeletal relationship were selected. Linear measurements of the condylar processes were obtained at a scale of 1:1 using the software Ez3D Viewer Plus. Analysis of variance (ANOVA) and the paired t-test were used, considering P<0.05. Patients with UCH presented statistical differences between the hyperplastic condyle and non-hyperplastic condyle for anteroposterior and mediolateral diameters, condylar neck length, and ramus height. Patients with a class III skeletal relationship showed no differences between the right and left sides; the morphology of their condyles was similar to the condyles with hyperplasia and presented statistical differences when compared with the non-hyperplastic condyles (one-way ANOVA, P<0.05). The condylar morphology of UCH patients could be related to the development of a class III skeletal relationship. These findings provide an insight into the possibility of some class III patients presenting bilateral condylar hyperplasia., (Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Our aim was to evaluate cephalometrically the preoperative inclination of the incisors in a group of 50 patients with Class III dentofacial deformities whose immediate preoperative lateral cephalometric radiographs were analysed after they had been treated by maxillary advancement. The radiographs were hand-traced by the same operator who made the cephalometric analysis. Mean values for each measurement were compared with the normal values using Student's t-test (p<0.05). Results showed significantly increased inclination of the upper incisors, with a mean U1-NA angle of 27.58° and a mean U1-PP angle of 116°. The lower incisors were also inclined lingually, with a mean L1-NB angle of 22.53° and a mean IMPA of 83.13°. Thirty-five of the patients had labial inclination of the upper, and 28 lingual inclination of the lower, incisors. Mean inclinations of upper and lower incisors differed from the normal values, and the inclination of the lower incisors was more likely to be decompensated than that of the upper incisors., (Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Macroglossia is observed in the majority of paediatric patients diagnosed with Beckwith-Wiedemann syndrome and surgical treatment may be indicated. A 20-year retrospective study was performed to evaluate all patients with Beckwith-Wiedemann syndrome who underwent tongue reduction surgery at the authors' institution. A literature review was performed. Surgical treatment was indicated and carried out in 23 patients with a yearly average varying from 0 to 3 subjects. The mean follow-up time was 7 years. Primary indications for surgical treatment of macroglossia included significant tongue protrusion in 30% (n=7), and a combination of clinical problems in 70% (n=16). In all cases, the procedure was performed by the same surgeon using an anterior, V-shaped, wedge resection technique. Two patients had direct postoperative complications. No recurrence of macroglossia was observed in this study. Reported clinical outcome during follow-up demonstrated a satisfactory resting tongue position in all patients. Review of the literature demonstrated variability in surgical indications and techniques, and postoperative outcome. The results of this study indicate that the anterior wedge resection is a simple, effective and safe technique in the surgical treatment of paediatric patients, diagnosed with Beckwith-Wiedemann syndrome, suffering from macroglossia., (Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Nine patients aged between 18 and 35 years who had severe skeletal Class III malocclusion and moderate-to-severe mandibular asymmetry, were assessed by a non-invasive, landmark-based, three-dimensional system before and after mandibular reduction by sagittal split osteotomy and LeFort I maxillary advancement. The three-dimensional coordinates of 50 facial soft tissue landmarks were collected, and a series of anthropometric measurements was calculated and compared with reference values from 240 healthy subjects of similar sex, age, and ethnic group. Patients were more asymmetrical than normal subjects before the operations, particularly in the gonion. Postoperatively, total and lateral asymmetry was considerably reduced. The three-dimensional approach was a valuable complementary diagnostic aid that enabled quantitative evaluation of the final soft-tissue results without invasive procedures.

Skeletal Class III malocclusion has been classified by the position of the maxilla, the mandible, the maxillary alveolus, the mandibular alveolus and vertical development. This morphologic approach is simple and useful for clinical use, but it is insufficient to permit understanding of the pathophysiology of dysmorphoses. The authors hypothesized that there were different patterns of mutual relation of the skeletal components contributed to pathologic equilibrium of skeletal Class III malocclusion. The purpose of this study is 3-fold; (1) to classify skeletal Class III malocclusion in subgroups that can show the architectural characteristics of the deformity, (2) to analyze the craniofacial architecture of each subgroup on etio-pathogenic basis, and (3) to characterize and visualize the pattern as a prototype. Materials used in this study were lateral cephalograms of 106 untreated skeletal Class III malocclusion adults, which were analyzed with modified Delaire's analysis. Linear and angular measurements of each subject were obtained and cluster analysis was used for grouping. In the results, seven groups were identified and presented as prototypes, which could show the etio-pathology of the skeletal architecture. The classification and description presented in this study is thought to be biologic and helpful in the understanding of skeletal Class III malocclusion and treatment planning.

Surgery for cleft lip and palate is known to have an effect on growth and development of the mid-face. This paper studies the outcomes in 34 consecutive 10-year-old patients with unilateral cleft lip and palate. Clinical observations of the importance of both surgical technique and the influence of cranial base morphology on maxillo-mandibular position are discussed.

The relative reproducibility of two widely used arbitrary face-bow transfer systems, the Denar Slidematic and the Dentatus type AEB, was assessed for use in orthognathic surgery planning. A novel method was also developed to determine any variation in three-dimensional spatial position and orientation of the maxillary cast. This envelope of movement enabled realistic comparisons to be made for each face-bow system, operator, and skeletal type. The overall face-bow/articulator procedure showed poor reproducibility. However, the Denar Slidematic face-bow was better (P < 0.001) than the Dentatus type AEB standard face-bow, and the errors were higher in the anteroposterior and lateral directions than the vertical direction. There was no significant difference between operators for each system.

The Kabuki make-up syndrome is characterized by peculiar cranio-facial abnormalities, including cleft lip and palate. A case with velopharyngeal incompetence in a 7-year-old boy is reported. The significance of a possible association of this syndrome with congenital velopharyngeal incompetence is also discussed.

The planned preoperative maxillary movements for five groups of patients requiring orthognathic surgery were prospectively compared to the actual surgical movements achieved in the operating theatre. There was a very poor success rate in achieving predicted movements in all the patient groups. There is a need to test and implement a reliable method of assisting the surgeon in spatially orientating the jaws on the operating table.

The three dimensional changes in the bone and the ratio of soft tissue to bone movement were investigated in a group of 16 Skeletal III patients following orthognathic surgery. Computerised tomogram scans were taken for each patient pre-operatively and 1 year postoperatively. The scans were superimposed, radial measurements calculated, and the changes illustrated by two separate colour scales. There was no constant pattern of movement in the maxilla or mandible in these patients. However, following a Le Fort 1 osteotomy there was commonly a 1:1 ratio in the midline which increased to 1.25:1 at the alar bases and over the canine regions bilaterally. There was also a 1.25:1 ratio or greater over the chin and mentalis regions following mandibular set back.

A three-dimensional soft tissue study of the results of surgery in a group of 16 skeletal Class III adult patients following orthognathic surgery was carried out using laser scans (Arridge et al., 1985). The patient group was compared to a control group of the same population. Laser scans were taken prior to surgery, 3 months post-surgery, and at least 1 year after retention. Preoperative comparison to the control groups revealed that the facial disproportion related to both the maxilla and the mandible. Le Fort I advancements resulted in broadening of the lateral aspects of the nose, advancement of the dorsum, and overcorrection of the alar bases. There was a degree of change over the cheeks bilaterally, because of alterations in the general drape of the soft tissues. There was a degree of overcorrection in the female group following mandibular set back but the male group were still more prognathic, when compared to the control group. There was a marked degree of relapse in the mandible from 3 months to 1 year postoperatively, with a resultant anterior movement of the maxillary arch. Laser scanning has proved to be a simple non-invasive method of measuring three-dimensionally, and is a very useful tool in auditing surgical outcome and measuring surgical relapse.