Fabio Ritto

Comparative analysis of two different alar base sutures after Le Fort I osteotomy: randomized double-blind controlled trial

OBJECTIVE The aim of this prospective study was to analyze the efficacy of a new alar base cinch suture by comparing it with the commonly used cinch suture described by Schendel and Delaire in Dr. William Bells book. STUDY DESIGN Thirty-five patients submitted to maxillary impaction and/or advancements of ≥ 3 mm were randomly divided into 2 groups. Group 1 received an extra oral alar base cinch suture, and patients from group 2 received the classic intraoral suture. Alar and alar base width were measured before and after surgery in digital photographs, with the patients head in a submental oblique view. Data were reported as means and standard deviations, and difference between groups were determined using Welch t test. A P value of <.05 was considered to be statistically significant. RESULTS Mean alar base widening was 1.38 mm in group 1 and 2.5 mm in group 2, and mean alar widening was 1.40 mm in group 1 and 2.31 mm in group 2. The difference was statistically significant (P < .05). CONCLUSION Extraoral alar base cinch suture was more effective in maintaining preoperative Alar and alar base width compared with classic intraoral nasal suture.

Rehabilitation of an adolescent with ectodermal dysplasia. Two-stage orthognathic, graft, and implant surgery: case report.

A 16-year-old girl presenting with ectodermal dysplasia has undergone double jaw orthognathic surgery to correct mandibular prognathism and maxillary anteroposterior deficiency. Ten months later the patient had a second surgery that included the placement of 11 implants along with bone grafting to the maxilla and mandible. Fourteen months after the second surgery, the definitive ceramic work was fabricated and screw retained. Even though the patient was still an adolescent at the time of the first surgery, psychological effects of the deformity may require an early solution for this kind of patient.

Avoiding condylar displacement after intraoral vertical ramus osteotomy.

The intraoral vertical osteotomy is a versatile and simple technique usually applied to correct mandibular prognathism. Its greatest advantages include ease of performance and minimum neurosensory disturbances, whereas maxillomandibular fixation is pointed as its major disadvantage. Another important concern about this technique is condylar displacement, which may lead to temporomandibular dysfunction. Technical notes to avoid condylar luxation are discussed after 15 years of experience using this osteotomy as the technique of choice to correct mandibular prognathism. Three similar cases are presented, where 1 condyle was displaced from the glenoid fossa, resulting in mandibular deviation during function in patients requiring small mandibular setback.