A conceptual framework for treating jaw deformities in patients with abnormal condyles: preservation versus replacement of the glenoid fossa-disc-condyle-ramus.

This article outlines a conceptual approach to the reconstruction of jaw deformities associated with abnormalities in the mandibular condyle. The authors describe a hierarchy of reconstruction, emphasizing use of the least invasive and progressing to the most complex and invasive techniques, depending on the nature and severity of the underlying deformity, prior operations, patient age, and stage of growth. Consider joint preservation orthognathic surgical correction, followed by biological techniques for replacement of the condyle, and avoid replacing a functional temporomandibular joint based only on radiographic remodeling and concerns about potential future flare-ups of disease based on anecdotal data.

Is a Final Splint Necessary in Bimaxillary Orthognathic Surgery?

For bimaxillary orthognathic surgery, a splint is commonly used to achieve the final occlusion and is then maintained through initial skeletal healing. The purpose of this study is to document how often a final splint is used to achieve the planned intraoperative occlusion, and how often is the final splint retained after surgery to maintain the occlusion during the initial skeletal healing phase.The investigators developed a retrospective case series.

Challenges in the Successful Reconstruction of Cleft Lip and Palate: Managing the Nasomaxillary Deformity in Adolescence.

The surgical techniques and execution of primary cleft lip and palate repair are no longer the greatest challenge to achieving successful rehabilitation for those born with facial clefting (i.e., bilateral and unilateral cleft lip and palate).

Short Face Dentofacial Deformities: Changes in Social Perceptions, Facial Esthetics, and Occlusion After Bimaxillary and Chin Orthognathic Correction.

The purpose of this study was to document changes in social perceptions and facial esthetics, and document occlusion outcomes in a series of short face (SF) dentofacial deformity (DFD) subjects. The investigators hypothesized that subjects would achieve positive change in social perceptions and facial esthetics, and maintain a long-term corrected occlusion after undergoing bimaxillary and chin osteotomies.A retrospective cohort study was implemented.

The Effect of Cleft Orthognathic and Nasal Reconstruction on Perceived Social Traits.

Background: The investigators hypothesized that a layperson's social perceptions of an adolescent cleft lip and palate (CL/P) patient are more favorable after orthognathic surgery and definitive nasal reconstruction.

Methods: The investigators implemented a survey comparing layperson's perception of specific social traits before and >6 months after jaw and nasal reconstruction in CL/P adolescent subjects by viewing standardized facial photographs. The sample was composed of 10 consecutive subjects treated by 1 surgeon from birth through completion of their staged reconstruction.

Orthognathic Surgery Has a Significant Positive Effect on Perceived Personality Traits and Perceived Emotional Facial Expressions in Subjects With Primary Mandibular Deficiency.

This study tested the hypothesis that a layperson's social perceptions of a dentofacial deformity (DFD) patient with primary mandibular deficiency (PMD) are more positive after bimaxillary orthognathic surgery.A survey was implemented comparing layperson's social perceptions of emotional expressions and personality traits before and >6 months after orthognathic surgery when viewing standardized facial photographs. The study sample comprised 20 patients selected randomly from a larger primary mandibular deficiency database, treated by 1 surgeon after orthognathic surgery.

Reconstruction of residual cleft nasal deformities in adolescents: Effects on social perceptions.

Purpose: The investigators hypothesized that a layperson's social perceptions of a primarily repaired adolescent cleft lip and palate (CL/P) patient is more favorable after definitive nasal reconstruction with regard to perceived social traits.

Methods: The investigators implemented a survey comparing layperson's social perceptions of 6 personality traits, 6 emotional expression traits, and 7 perceptions of interpersonal experiences before and >6 months after definitive nasal reconstruction in CL/P adolescent subjects by viewing standardized facial photographs. The sample was composed of consecutive CL/P subjects treated by one surgeon using a consistent technique involving a rib cartilage caudal strut graft through an open approach.

Orthognathic Surgery Has a Significant Positive Effect on Perceived Personality Traits and Perceived Emotional Facial Expressions in Subjects with Primary Maxillary Deficiency.

Background: Crowdsourcing is increasingly being used in medical research to obtain the opinion of laypeople. The investigators hypothesized that a layperson's perception of a primary maxillary deficiency (PMD) dentofacial deformity (DFD) patient is more favorable after orthognathic surgery with regard to perceived personality traits and emotional facial expressions.

Methods: The investigators implemented a survey, distributed through Amazon.

Redo orthognathic surgery: a report of 10 cases.

Objective: The purpose of this study was to compare a cohort of patients who had a developmental dentofacial deformity (DFD) and then underwent redo orthognathic surgery (OGS) to a similar cohort who underwent primary OGS. We hypothesized that there would be no difference in operative time, blood replacement, perioperative airway risks, length of hospital stay, or complication rates.

Study Design: We implemented a retrospective study of patients with a DFD initially treated with orthodontics and jaw osteotomies and later with redo OGS.

Orthognathic surgery in "older" adults with Hemi-Mandibular Elongation: Long-term occlusion outcomes.

Purpose: The purpose of this study was to describe a consecutive series of subjects with HME who underwent orthognathic correction after 26 years of age. The investigators hypothesized that for this group of HME subjects, bimaxillary orthognathic correction would result in a favorable initial and long-term occlusion.

Materials And Methods: A retrospective cohort study was implemented.

Orthognathic Surgery Has a Significant Positive Effect on Perceived Personality Traits and Perceived Emotional Expressions in Long Face Patients.

Purpose: Crowdsourcing is increasingly being used in medical research to obtain the opinion and perception of laypeople. We hypothesized that a layperson's perception of a patient with long face dentofacial deformity is more favorable after orthognathic surgery than before surgery regarding perceived personality traits and emotional facial expressions.

Materials And Methods: We implemented a survey, distributed through Amazon.

Primary Mandibular Deficiency Dentofacial Deformities: Occlusion and Facial Aesthetic Surgical Outcomes.

Purpose: The purpose of the present study was to document the malocclusion and facial dysmorphology in primary mandibular deficiency (PMD) subjects with chronic obstructive nasal breathing before treatment and the outcomes after bimaxillary orthognathic, genioplasty, and intranasal surgery.

Patients And Methods: A retrospective cohort study of PMD subjects undergoing bimaxillary, chin, and intranasal surgery was implemented. The predictor variables were grouped into demographic, anatomic, operative, and longitudinal categories.

Primary Maxillary Deficiency Dentofacial Deformities: Occlusion and Facial Esthetic Surgical Outcomes.

Purpose: The purpose of this study was to document the malocclusion and facial dysmorphology in patients with primary maxillary deficiency (PMD) and chronic obstructive nasal breathing before treatment and the outcomes after bimaxillary orthognathic, genioplasty, and intranasal surgery.

Materials And Methods: A retrospective cohort study of patients with PMD undergoing bimaxillary orthognathic, chin, and intranasal surgery was implemented. The predictor variables were grouped into demographic, anatomic, operative, and longitudinal follow-up categories.

"Silent" Sleep Apnea in Dentofacial Deformities and Prevalence of Daytime Sleepiness After Orthognathic and Intranasal Surgery.

Purpose: The purposes of this study were to determine the occurrence of undiagnosed "silent" obstructive sleep apnea (OSA) in dentofacial deformity (DFD) patients at initial surgical presentation and to report on the level of daytime sleepiness in DFD patients with OSA and chronic obstructive nasal breathing (CONB) after undergoing bimaxillary, chin, and intranasal surgery.

Materials And Methods: A retrospective cohort study of patients with a bimaxillary DFD and CONB was implemented. Patients were divided into those with no OSA (group I) and those with OSA (group II).

Method of osteotomy fixation and need for removal following bimaxillary orthognathic, osseous genioplasty, and intranasal surgery: a retrospective cohort study.

The purpose of this study was to determine the incidence and causes of fixation hardware removal after bimaxillary orthognathic, osseous genioplasty, and intranasal surgery. A retrospective study was performed, involving subjects with a bimaxillary developmental dentofacial deformity (DFD) and symptomatic chronic obstructive nasal breathing. At a minimum, subjects underwent Le Fort I osteotomy, bilateral sagittal ramus osteotomies (SROs), septoplasty, inferior turbinate reduction, and osseous genioplasty.

Hemimandibular Elongation: Is the Corrected Occlusion Maintained Long-Term? Does the Mandible Continue to Grow?

Purpose: The purpose of this study was to assess for the maintenance of a corrected occlusion and ongoing mandibular growth in a group of patients younger than 26 years with hemimandibular elongation (HME) who underwent bimaxillary orthognathic reconstruction.

Materials And Methods: We conducted a retrospective cohort study of HME patients operated on by a single surgeon at 1 institution between 1999 and 2013. At a minimum, all patients underwent Le Fort I and bilateral sagittal ramus osteotomies.

Surgical Site Infections Following Bimaxillary Orthognathic, Osseous Genioplasty, and Intranasal Surgery: A Retrospective Cohort Study.

Purpose: Frequency estimates of surgical site infection (SSI) after orthognathic surgery vary considerably. The purpose of this study was to determine the incidence and site of SSIs and associated risk factors after bimaxillary orthognathic, osseous genioplasty, and intranasal surgery.

Materials And Methods: The authors executed a retrospective cohort study of patients with a bimaxillary developmental dentofacial deformity (DFD) and symptomatic chronic obstructive nasal breathing.

Lingual nerve injury in association with sagittal ramus osteotomy and bicortical screw fixation: a review of 523 procedures in 262 subjects.

The purpose of this study was to assess the frequency of irreversible lingual nerve (LN) injury in patients undergoing sagittal ramus osteotomies (SRO) with bicortical screw fixation. A retrospective cohort study of patients treated by a single surgeon was performed (follow-up 2-11 years). The sample consisted of a series of subjects with a bimaxillary dentofacial deformity (DFD).

Occurrence of a 'bad' split and success of initial mandibular healing: a review of 524 sagittal ramus osteotomies in 262 patients.

The purpose of this study was to assess the prevalence of a 'bad' split after sagittal ramus osteotomies (SRO) and report the results of initial mandibular healing. A retrospective cohort study derived from patients treated by a single surgeon at one institution between 2004 and 2013 was performed. An index group consisting of a series of subjects with a spectrum of bimaxillary dentofacial deformities also involving the chin and symptomatic chronic obstructive nasal breathing was identified.

Osseous genioplasty in conjunction with bimaxillary orthognathic surgery: a review of 262 consecutive cases.

The purpose of this study was to evaluate the results of osseous genioplasty with bimaxillary orthognathic surgery. A retrospective consecutive case series of patients treated by a single surgeon between 2004 and 2013 was studied. All underwent Le Fort I, sagittal ramus osteotomies, septoplasty, inferior turbinate reduction, and osseous genioplasty.

Segmental Maxillary Osteotomies in Conjunction With Bimaxillary Orthognathic Surgery: Indications - Safety - Outcome.

Purpose: The purpose of the present study was to evaluate the indications, safety, and treating orthodontists' assessment of outcomes after bimaxillary orthognathic surgery that included segmental osteotomies.

Materials And Methods: We performed a retrospective cohort study of patients treated by a single surgeon from 2004 to 2013. The index group consisted of a consecutive series of subjects with a bimaxillary dentofacial deformity (DFD) involving the chin and symptomatic chronic obstructive nasal breathing.

Correction of Symptomatic Chronic Nasal Airway Obstruction in Conjunction With Bimaxillary Orthognathic Surgery: Does It Complicate Recovery and Is It Effective?

Purpose: The purpose of this study was to assess the safety and efficacy of intranasal procedures carried out simultaneously with bimaxillary orthognathic surgery.

Materials And Methods: The authors executed a retrospective cohort study derived from patients treated by a single surgeon at 1 institution from 2004 through 2013 with a minimum follow-up of 1 year (range, 1 to 10 yr). An index study group consisting of a consecutive series of patients with symptomatic chronic obstructive nasal breathing (CONB) and a bimaxillary developmental dentofacial deformity (DFD) also involving the chin were identified.

Is It Safe to Re-Harvest the Anterior Iliac Crest to Manage Le Fort I Interpositional Defects in Young Adults With a Repaired Cleft?

Purpose: Re-harvesting the anterior iliac crest to obtain autogenous bone grafts is a controversial practice. The purpose of this study was to assess the feasibility and associated disability of re-harvesting the anterior iliac crest.

Material And Methods: To address the research purpose, the authors executed a retrospective case series study.