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The aim of this study was the evaluation and prediction of profile changes after Le Fort I osteotomy including maxillary impaction and subsequent autorotation of the mandible. A group of 42 patients (32 female, 10 male) underwent a Le Fort I osteotomy with posterior impaction after preoperative orthodontic treatment. No surgical intervention in the mandible was performed. Pre- and postoperative lateral cephalograms of each patient were analyzed in two steps using the Wilcoxon and Mann-Whitney U test. All patients were evaluated for vertical and sagittal skeletal and soft tissue changes. These results led to further classification into three groups according to the type and extent of maxillary impaction. These groups included parallel impaction, posterior impaction with additional anterior subsidence, and posterior impaction only. The results of the first evaluation step revealed that the chin had advanced on average by 79%, while the lower face was shortened by as much as 70% in the pogonion point. However, the second evaluation showed that the type and extent of maxillary impaction led to significant changes in these parameters. Parallel maxillary impaction resulted in 100%, posterior impaction in 80% and posterior impaction with anterior subsidence in 50% advancement of the mandible in the pogonion point in relation to the distance covered during impaction. This study showed that the change in the facial profile caused by autorotation of the mandible after Le Fort I osteotomy and maxillary impaction can be predicted in relation to the dimensions of maxillary impaction.

Summary Treatment of mandibular condylar process fractures may be conservative or surgical. Both treatment approaches aim to reconstruct the articulating joint surfaces in a physiological position to the discoligamentary structures. The study comprised 1812 patients of Wuerzburg University who presented with a fracture of the mandibular condylar process between 1981 and 2001. Besides conservative management options, surgical interventions using mini-plate osteosynthesis and the Wuerzburg lag screw plate were studied for post-treatment changes. Statistical analysis revealed that surgical osteosynthesis is superior to merely conservative therapy in terms of post-treatment dysgnathic severity. Hence, surgical osteosynthesis is advocated especially in patients with high condylar fractures or dislocated fractures in order to ideally achieve ‘restitutio ad integrum’.

The aim o f the present study was (i) to evaluate the gain and maintenance of new clinical attachment following GTR therapy of deep intrabony defects and (ii) to analyse the significant factors associated with the clinical outcome. Twenty-four defects in 19 patients were treated by GTR with ePTFE membranes. Clinical measurements were recorded at baseline and at 6 and 12 months post-surgically. GTR treatment resulted in a probing depth reduction (x = 3.8 ± 1.5 mm, p=.0001) and a gain clinical attachment (x = 2.6 ± 1.5 mm, p=.0001) after 6 months. The amount of probing attachment gain was explained in terms o f a series of patient, defect morphology and surgical factors. Clinical attachment gain was significantly associated with the intrabony depth of defect, the defect configuration, and the level o f oral hygiene., Cilj ovog ispitivanja bio je utvrditi postojanje pričvrstka dobivenog GTR terapijom dubokih koštanih defekata i analizirati utjecaje različitih čimbenika na kliničke rezultate. 24 defekta kod 19 pacijenata tretirana su GTR terapijom pomoću ePTFE membrane. Klinička su mjerenja provedena na početku, 6, te 12 mjeseci nakon zahvata. GTR tretmanom se nakon 6 mjeseci postiže smanjenje dubine defekta (x-3.8 ± 1.5 mm, p=.0001) i stvaranje pričvrstka (x=2.6 ± 1.5 mm, p=.001). Uspjeh stvaranja pričvrstka promatran je ovisno o pacijentu, morfologiji defekta i kirurškim čimbenicima. Stvaranje pričvrstka značajno je povezano s dubinom koštanog defekta, konfiguracijom defekta i stupnjem oralne higijene.

One-mm CT or spiral CT scans were performed in 48 patients and processed with Siemens Dental-CT software. Data manipulation with this software, the so-called multiplanar reformation (MPR), creates panoramic sections and sections perpendicular to the mandibular and maxillary arch. Advanced preimplantological diagnostic radiography with Dental-CT software was used to observe important anatomical structures, such as sinus maxillaris or n. alveolaris inf., or to get an insight into the hard tissue morphology in case of severe atrophy, post-traumatic states or in tumor patients with free or microvascular graft reconstruction. The position and angulation of implants could be visualized using radioopaque pins. Simultaneously performed orthopantomography and tomography of the molar region of the upper and lower jaws were clearly inferior to Dental-CT scans according to the information produced. With the use of Dental-CT scans, the implantological treatment could be properly planned and damage to important anatomical structures avoided., U 48 bolesnika učinjene su CT snimke s razmakom od jednoga milimetra ili spiralni CT, a podaci su obrađeni Siemens Dental-CT programom. Manipulacija podataka ovim programom, tzv. multiplanar reformation (MPR), stvara panoramske sekcije i poprečne prereze kroz mandibulni i maksilni luk. Predimplantološka dijagnostička radio grafija Dental-CT programom rabljena je kako bi se pozornost usredotočila na važne anatomske strukture, npr. sinus maxillaris ili n. alveolaris inf., kako bismo dobili uvid u morfologiju koštanih tkiva u slučaju teške atrofije, posttraumatskih situacija ili u bolesnika s tumorima u kojih je provedena rekonstrukcija čeljusti slobodnim ili mikrovaskularnim transplantatima. Položaj i angulaciju implantata moguće je predvidjeti uz pomoć radio-neprozirnih indikatora. Istodobno provedene ortopantomografija i tomografija molarnoga područja gornje i donje čeljusti bitno su siromašnije informacijama koje pružaju u usporedbi s Dental-CT snimkama. Pomoću Dental-CT snimaka moguće je uspješno planirati implantološku terapiju. Također smo pomoću ove metode uspjeli očuvati od povrede važne anatomske strukture.

Stereolithography (SLA) is used for treatment planning in reconstruction of severe defects after tumor resection, trauma, malformations of the skull, and for planning of dental implantology after mandibular reconstruction. In 16 patients, 1-mm CT scans and spiral CT scans of the reconstructed mandible were performed with image processing and stereolithography modeling of the mandible. Usual surgical drilling templates were manufactured for insertion o f endosseous BONE-LOCK dental implants. After osseous integration, the supraconstruction was designed and prosthetic treatment completed with excellent functional and esthetic results. The accuracy of stereolitho graphy models was very high, with a deviation of ± 0 .5 mm. The method was found very reliable in severe implantological cases after bone reconstruction of the mandible., Stereolito grafija (SLA) se rabi kao pomagalo pri rekonstrukciji teških defekata nakon operacije tumora, traume, malformacije lubanje te za planiranje implantoloških zahvata u bolesnika nakon mandibulne rekonstrukcije. U 16 bolesnika provedeno je CT snimanje rekonstruirane donje čeljusti s debljinom sloja od 1 mm ili tehnikom spiralne CT, kompjutorska obrada podataka slojevnih snimaka i konstrukcija stereolito grafsko ga modela mandibule. Zatim je po modelu stvorena individualna šablona za umetanje BONE—LOCK implantata. Nakon oseointegracije konstruirana je suprakonstrukcija i završen protetski tretman s odličnim funkcijskim i estetskim rezultatima. Točnost dimenzija stereolitografskih modela izrazito je visoka, s odstupanjem od ±0,5 mm. Metoda se pokazala veoma pouzdana u teškim implantološkim slučajevima nakon koštane rekonstrukcije donje čeljusti.