In medicine, classifications are designed to describe accurately and reliably all anatomic and structural components, establish a prognosis, and guide a given treatment. Classifications should be useful in a universal way to facilitate communication between health professionals and to formulate management protocols. In many situations and particularly with craniofacial microsomia, there have been many different classifications that do not achieve this goal. In fact, when there are so many classifications, one can conclude that there is not a clear one that accomplishes all these ends and defines a treatment protocol. It is our intent to present a new classification based on the Pruzansky's classification, later modified by Kaban, to determine treatment protocols based on the degree of osseous deficiency present in the body, ramus, and temporomandibular joint. Different mandibular defects are presented in two patients with craniofacial microsomia type III and IV according to our classification with the corresponding management proposed for each type and adequate functional results.
When comparing the apnea-hypopnea index (i.e., respiratory disturbance index) of patients treated for velopharyngeal insufficiency with palatoplasty versus pharyngoplasty, we observed an important difference between the groups, with the highest indices in the pharyngoplasty group.
The aim of this article is to describe the results of the use of demineralized bone matrix putty in alveolar cleft of patients with cleft lip and palate. We performed a prospective, descriptive case series study, in which we evaluated the results of the management of alveolar clefts with demineralized bone matrix. Surgery was performed in 10 patients aged between 7 and 26 years (mean 13 years), involving a total of 13 clefts in the 10 patients. A preoperative cone beam computed tomography (CBCT) was taken to the patients in whom the width of the cleft was measured from each edge of the cleft reporting values between 5.76 and 16.93 mm (average, 11.18 mm). The densities of the clefts were measured with a CBCT, 6 months postoperative to assess bone formation. The results showed a register of gray values of 1,148 to 1,396 (mean, 1,270). The follow-up was conducted for 15 to 33 months (mean, 28.2 months). The results did not show satisfactory bone formation in the cleft of patients with the use of demineralized bone matrix.
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