Aim: To evaluate the effectiveness of various internal fixation hardware used for treatment of symphyseal and parasymphyseal mandibular fractures based on a single institution`s experience. Materials and Methods: In this retrospective clinical study, one hundred patients with fractures of the anterior region of the mandible involving both the symphysis and parasymphysis areas were included. All cases were selected from the patients` records who were treated in the oral and maxillofacial surgery department in a 4 years period extended from May 2013 to May 2017. Surgical admission notes, x-ray reports, operation records, outpatient notes, and complications were recorded. The patients were followed up periodically until a minimum of 6 weeks. Results: The distribution of fracture pattern was as follows; 53 patients with anterior mandible associated with subcondylar/ condylar fractures, 31 with anterior mandible in association with mandibular angle fractures, and only 16 patients with isolated anterior mandible fracture. The majority of the fractures (40%) were treated by 2 miniplates, followed by the 3-D miniplates (17%), equal use (12% each) of (2 lag screws, 1 lag plus 1 miniplate and 1 reconstruction plate), then 1 lag screw (4%), and the least was the use of only 1 miniplate (3%). Conclusion: Proper selection of the fixation method for anterior mandibular fractures is essential to guarantee a successful treament and early restoration of function. Each method has its own advantages and disadvantages, and each case should be treated individually based on proper diagnosis and planning.
Alveolar cleft repair is well established, with bone grafting in mixed dentition phase. Mesenchymal derived stem cells were applied to different kinds of bone substitute and compared in different animal models..This study aimed to evaluate the bone quality and quantity at the alveolar cleft sites that were repaired with autogenous mesenchymal stem cell and its effect on orthodontic dental arch expansion and compare these results with cases treated with autogenous chin bone graft. Patients and methods:16 patients (14 left and 2 right, 9 males and 7 females)with unilateral alveolar cleft were included in this study. The age range was 7-12 yearswithmean age was 9.5 years. The alveolar cleft was repaired surgically and the patients were divided into 2 groups (8 patients in each one)according to surgical technique of repair. Group I (5 males and 3 females) : surgical repair was done by using autogenous bone marrow derived mesenchymal stem cells. Group II (4 males and 4 females): surgical repair was done by using autogenous chin bone grafting. The patients were undergo to orthodontic dental arch expansion and followed up to 18 months clinically and radiographically to evaluate and compare the effect of grafting types on arch expansion. Results: The results of this study revealed that the patients in group I who treated by stem cell technology have a clinical results superior than the patients in group II who treated with chin bone grafting. Radiographic results revealed that in group I the bone quality and quantity were superior than that in group II. Conclusion: The autogenous bone marrow derived mesenchymal stem cells is a good technique in repair of alveolar cleft as it promote the bone healing capacity with high quantity and quality as well as enhance orthodontic arch expansion.
This study was aimed to evaluate and compare the posterior pharyngeal wall augmentation using muscular flap versus musculomucosal flap for correction of velopharyngeal incompetence (VPI).Patients and methods: this study was conducted on twenty children (13 males and 7females) complaining from VPI with age ranging between 6.5 and 13 years with a mean of age 8.7 years. All patients were treated surgically using posterior pharyngeal wall augmentation. Patients were classified into two equal groups according to the type of flap technique used for posterior pharyngeal wall augmentation. Group I included10 patients (7 males and 3 females) were treated by muscular flap. Group II included10 patients (6 males and 4 females) were treated by musculomucosal flap. The preoperative and postoperative assessments for patients with VPI included clinical examination of the voice, nasopharyngoscopy and computed tomography (CT) scans.
Results:Regarding clinical presentation (hypernasality and nasal regurgitation of fluid), all patients in both groups had no nasal regurgitation of fluid or food which represents 100%. As regard the overall nasalance results (Nasal sentence) measured by nasometry in both groups there was noticeable improvement. But when comparing overall nasalance results between both groups there was no significant difference .Competence and borderline closure was achieved in 65% for patients of both groups. The VP gap size reduction was achieved in both groups, however there was no significant difference regarding reduction of median VP gap size.
Conclusion:At the end, as there no significant difference in the results of both groups: the myomucosal flap technique for posterior pharyngeal wall augmentation is simple and easier than the muscular flap technique and the posterior pharyngeal wall augmentation is a good technique for treatment of VPI KEY WORDS: VPI, Posterior pharyngeal wall augmentation, nasometer.(1230) Mahmoud E. Khalifa, et al.
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