Pharyngeal airway changes five years after bimaxillary surgery - A retrospective study.

The aim of this study was to retrospectively evaluate pharyngeal airway (PA) changes after bimaxillary surgery (BMS). Preoperative, immediate- and 5-year postoperative cone-beam computed tomography images of subjects who underwent BMS were assessed. The primary outcome variable was the PA volume.

Virtual Analysis of Segmental Bimaxillary Surgery: A Validation Study.

Purpose: Three-dimensional (3D) assessment of orthognathic surgery is often time consuming, relies on manual re-identification of anatomical landmarks or is limited to non-segmental osteotomies. The purpose of the present study was to propose and validate an automated approach for 3D assessment of the accuracy and postoperative outcome of segmental bimaxillary surgery.

Methods: A semi-automatic approach was developed and validated for virtual surgical analysis (VSA) of segmental bimaxillary surgery using a pair of pre- and postoperative (2 weeks) cone-beam computerized tomography (CBCT) scans.

[Treatment of patients with obstructive sleep apnoea syndrome].

Continuous positive airway pressure (CPAP) is an effective treatment modality for patients with obstructive sleep apnoea syndrome (OSAS). Surgical treatment of OSAS can include functional nasal surgery, uvulopalatopharyngoplasty, transoral robotic surgery, maxillo-mandibular advancement (MMA) and bariatric surgery. MMA should be considered in patients with moderate to severe OSAS, if CPAP treatment is ineffective or not tolerated, as well in patients with failure of previous sleep surgery or in patients with severe dentofacial anomalies.

Orthognathic Surgery-Induced Fibrinolytic Shutdown Is Amplified by Tranexamic Acid.

Purpose: Little is known of the systemic effects of oral and maxillofacial surgery on the hemostatic balance, including the biochemical effects of tranexamic acid (TXA), on fibrin clot lysis. The present study investigated the effects of orthognathic surgery on fibrin lysis, fibrin structure, and D-dimer and evaluated the effect of TXA on these fibrinolytic measures.

Materials And Methods: The present double-blind, controlled, and randomized, placebo study included patients referred to the Department of Oral and Maxillofacial Surgery at the University Hospital of Southern Denmark-Esbjerg from August 2014 through September 2016.

The effect of altered head and tongue posture on upper airway volume based on a validated upper airway analysis-An MRI pilot study.

Objective: To determine the influence of altered head or tongue posture on upper airway (UA) volumes using MRI imaging based on a new objective and validated UA evaluation protocol.

Setting And Sample Population: One supine CBCT and five sagittal MRI scans were obtained from ten subjects in different head and tongue positions: (a) supine neutral head position (NHP) with the tongue in a natural resting position with the tip of the tongue in contact with the lingual aspect of the lower incisors (TRP); (b) head extension with TRP; (c) head flexion with TRP; (d) NHP with the tip of the tongue in contact with the posterior edge of the hard palate (THP); and (e) NHP with the tip of the tongue in contact with the floor of the mouth in contact with the caruncula sublingualis.

Material And Methods: Based on a validated CBCT UA analysis, the retropalatal, oropharyngeal and the corresponding total volumes were measured from each MRI scan.

Long-term radiographic assessment of titanium implants installed in maxillary areas grafted with autogenous bone blocks using two predefined sets of success criteria.

Purpose: Assess the radiographic peri-implant bone loss of implants installed in maxillary areas grafted with autogenous bone and classify the long-term (at least >4 ≤ 6 years) implant success according to two predefined sets of criteria.

Material And Methods: Sixty patients had full maxillary alveolar reconstructions using autogenous bone grafts (iliac crest), and 369 titanium implants were installed. The follow-up protocol was 5 (>4 ≤ 6) years; thereafter only patients who presented significant peri-implant bone loss were followed up to 12 years.

Two-Year Postoperative Upper Airway Cone-Beam Computed Tomographic Outcomes Based on a Verified Upper Airway Analysis Following Bimaxillary Orthognathic Surgery.

Purpose: Upper airway (UA) assessment after orthognathic surgery should rely on a verified method of UA analysis. Therefore, the authors applied a new validated UA evaluation method to determine the effect of bimaxillary surgery (BMS) on UA parameters and hyoid bone and epiglottis displacement evaluated immediately and 2 years after surgery.

Materials And Methods: A retrospective cohort study was implemented of patients without obstructive sleep apnea who had undergone BMS for maxillomandibular deficiencies.

Long term follow-up of titanium implants installed in block-grafted areas: A systematic review.

Background: An enduring clinical question concerns the outcome (ie, success) of implants placed in areas grafted with block-grafts.

Objective: To undertake a systematic review of the literature on the long term results (≥5 years) of implants placed in maxillofacial areas grafted with any type of osseous block-grafts in two-stage surgeries. Further, the review addresses how available success criteria were used within the studies.

The Effect of Tranexamic Acid and Gender on Intraoperative Bleeding in Orthognathic Surgery-A Randomized Controlled Trial.

Purpose: The purpose of this randomized trial was to measure the effect of intravenously administered tranexamic acid (TXA) on intraoperative blood loss (IOB) in patients undergoing bimaxillary orthognathic surgery (OS).

Materials And Methods: The authors designed and implemented a double-blinded placebo-controlled trial composed of patients eligible for OS at the Hospital of South West Denmark (Esbjerg, Denmark) from August 2014 through September 2016. The primary predictor variable was a single intravenous dose of TXA 1 g administered preoperatively or an equivalent saline placebo.

Effect of Head and Tongue Posture on the Pharyngeal Airway Dimensions and Morphology in Three-Dimensional Imaging: a Systematic Review.

Objectives: Natural head position is recommended to be optimal at cone-beam computed tomography acquisition. For standardization purposes in control of treatment outcome, it is clinically relevant to discuss, if a change of posture from natural head position may have an effect on the pharyngeal airway dimensions and morphology, during computed tomography, cone-beam computed tomography or magnetic resonance imaging acquisition. This was the aim of the present literature review study for purposes of valid evidence, which was hypothesized, to be present.

Can Preoperative Sex-Related Differences in Hemostatic Parameters Predict Bleeding in Orthognathic Surgery?

Purpose: Bleeding volume in orthognathic surgery (OS) varies considerably, although OS comprises standardized procedures and the patient population consists of young healthy individuals. The aim of this prospective cohort study was to investigate the influence of preoperative sex-related differences in hemostatic parameters on intraoperative bleeding (IOB) volume in OS.

Materials And Methods: Patients scheduled for routine OS in our department in Esbjerg, Denmark, were included as study patients in this short-term cohort study.

Prevention of Bleeding in Orthognathic Surgery--A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Purpose: The objective of the present study was to evaluate the efficacy of hemostatic adjuncts on intraoperative blood loss (IOB) in orthognathic surgery (OS) detected by randomized controlled trials (RCTs) of the highest quality.

Materials And Methods: A search of the Medline, Cochrane, Embase, and Web of Science databases was performed in January 2015, and the risk of bias was assessed using the Jadad and Delphi scales. The predictor variable was the hemostatic measures, and the main outcome variable was the total IOB volume.

Reconstruction of irradiated mandible after segmental resection of osteoradionecrosis-a technique employing a microvascular latissimus dorsi flap and subsequent particulate iliac bone grafting.

The fibula osteocutaneous flap has revolutionized the options of mandibular segmental defect bridging in osteoradionecrosis (ORN). In selected cases, however, the fibula flap is not an option because of atherosclerosis or other features that compromise the vascularity of the lower leg and foot. The aim of this study is to present an alternative method of mandibular segmental reconstruction employing a latissimus dorsi (LD) flap and subsequent particulate iliac free bone graft reconstruction.

Intraoperative blood loss during orthognathic surgery is predicted by thromboelastography.

Purpose: The aim of this prospective study was to evaluate the predictive value of the viscoelastic properties of whole blood samples collected preoperatively in relation to intraoperative blood loss in patients subjected to orthognathic surgery.

Materials And Methods: Forty-one consecutive patients underwent simultaneous mandibular and maxillary osteotomy. Whole blood samples were collected preoperatively.