Introduction Because the standards of facial beauty are changed, indications for maxillary expansion procedures are increasing. Also symmetry is an important element of facial harmony, because it is related to the expression of a correct genetic asset of each individual. Moreover a wide smile without black lateral corridors, small amount of gingival exposure of upper dental arch is accepted as young nice appearance. Also a bi-protrusive cephalometric pattern with a good skin tension is important to obtain a young and nice appearance .Distraction techniques are the main procedures for facial skeleton expansion gaining bone volume stable over time and similar to the native patient bone for histological features. Also histiodistraction is achieved by distractions techniques gaining soft tissue amount when needed. Aim The purpose of this work is to report about some orthognathic cases showing maxillary or mandible insufficiency respectively treated by a new palatal distraction device and a mandible distractor to correct facial deformities in relation with the new concept of facial beauty. Methods and patients Four case with maxillary constriction were treated by LFI-DO bone-rigid (Cortese), a new procedure to perform a Le Fort I osteotomy with down fracture, three-dimensional maxillary repositioning and distraction osteogenesis by a rigid bone borne device in one surgical step. Palatal distractor had an intrinsic rigidity by a jack-screw and 8 anchor points on the horizontal plane: 4 on the hard palate in the paramedian area at the septum foot and 4 other points on the teeth. In the reported case with madibular isufficiency, mandibular distraction was performed by an intraoral three-dimensional distractor device. Results By the LFI-DO bone-rigid technique bodily maxillary expansion is achieved with good comfort for patients, easy removal of the device and without any bone defect of the palate anchorage site Other advantages are no need of a second surgery for maxillary repositioning, improvement in orthodontic treatment by bone anchorage, possibility of further expansion in case of lower molars buccal torque. Mandibular distraction with intraoral three-dimensional distractor allowed large mandibular advancement (15mm.) preserving condylar safety and obtaining a nice lower border contour for impressive enhancement of facial beauty.

Distraction techniques in maxillofacial surgery in relation with the new concept of facial beauty

CORTESE, ANTONIO;SAVASTANO, Germano;Pantaleo, G;AMATO, Massimo
2014

Abstract

Introduction Because the standards of facial beauty are changed, indications for maxillary expansion procedures are increasing. Also symmetry is an important element of facial harmony, because it is related to the expression of a correct genetic asset of each individual. Moreover a wide smile without black lateral corridors, small amount of gingival exposure of upper dental arch is accepted as young nice appearance. Also a bi-protrusive cephalometric pattern with a good skin tension is important to obtain a young and nice appearance .Distraction techniques are the main procedures for facial skeleton expansion gaining bone volume stable over time and similar to the native patient bone for histological features. Also histiodistraction is achieved by distractions techniques gaining soft tissue amount when needed. Aim The purpose of this work is to report about some orthognathic cases showing maxillary or mandible insufficiency respectively treated by a new palatal distraction device and a mandible distractor to correct facial deformities in relation with the new concept of facial beauty. Methods and patients Four case with maxillary constriction were treated by LFI-DO bone-rigid (Cortese), a new procedure to perform a Le Fort I osteotomy with down fracture, three-dimensional maxillary repositioning and distraction osteogenesis by a rigid bone borne device in one surgical step. Palatal distractor had an intrinsic rigidity by a jack-screw and 8 anchor points on the horizontal plane: 4 on the hard palate in the paramedian area at the septum foot and 4 other points on the teeth. In the reported case with madibular isufficiency, mandibular distraction was performed by an intraoral three-dimensional distractor device. Results By the LFI-DO bone-rigid technique bodily maxillary expansion is achieved with good comfort for patients, easy removal of the device and without any bone defect of the palate anchorage site Other advantages are no need of a second surgery for maxillary repositioning, improvement in orthodontic treatment by bone anchorage, possibility of further expansion in case of lower molars buccal torque. Mandibular distraction with intraoral three-dimensional distractor allowed large mandibular advancement (15mm.) preserving condylar safety and obtaining a nice lower border contour for impressive enhancement of facial beauty.
9788026067818
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11386/4649115
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