Frank Moloney

Mandibular advancement surgery: A study of the lower border wiring technique for osteosynthesis

A study was undertaken to evaluate the effectiveness of osteosynthesis achieved by a lower border wire technique. Fifty patients who underwent mandibular advancement surgery were examined cephalometrically during 6 weeks of maxillomandibular fixation. A detailed analysis was made of spatial changes in the proximal and distal segments following bilateral sagittal-split osteotomies.

Surgical correction of vertical maxillary excess: A re-evaluation

Correction of vertical maxillary excess by Le Fort I osteotomy has become a widely accepted practice. Although the downfracture method is used almost exclusively in most major centres, the total maxillary alveolar osteotomy still has its advocates. Two patients surgically treated by total maxillary alveolar osteotomy and presented in this journal are re-evaluated with respect to the long-term stability of maxillary intrusion. Literature pertaining to the stability of the maxilla following intrusion by Le Fort I osteotomy and after various combinations of anterior and posterior maxillary ostectomy is reviewed. The advantages of the downfracture method are discussed. An alternative method of achieving the desired degree of intrusion is presented, which ensures more intimate bone contact.

Recent developments in interpositional bone-grafting of the atrophic mandible

A clinical study on 54 patients, who underwent augmentation of the atrophic mandible by interposed bone-grafts, but in whom routine follow-up vestibuloplasty was deliberately avoided, is presented. The results show a reduced rate of bone resorption in the anterior region and less interference with lip and chin sensibility. An additional study is included concerning the fate of the elevated ridge and associated bone-graft in the body region posterior to the mental foramen. Results suggest that the resorption pattern in this area is very similar to that of a subperiosteal bone-graft. Modification of surgical technique in this regard has produced encouraging results.