A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Anand, S. C.
- Role of Lag and Position Screws for Osteosynthesis in Various Oral and Maxillofacial Operative Procedures
Authors
1 Department of Oral and Maxillofacial Surgery Postgraduate Institute of Dental Sciences Rohtak - 124001 (Haryana), IN
2 Department of Oral and Maxillofacial Surgery Postgraduate Institute of Dental Sciences Rohtak - 124001 (Haryana), IN
Source
Journal of Dento-Medical Science and Research, Vol 1, No 1 (2013), Pagination: 31-38Abstract
Aim: The aim of this study was to portray lag screw and position screw utility and accuracy in various situations in bony fractures, osteotomy fragments, placement of costochondral and sternoclavicular split grafts and also in reconstruction with bone grafts. Material and Methods: This prospective study includes 30 numbers of patients of mandibular fractures, jaw deformity and TMJ ankylosis. All cases were treated by using lag screws except in two cases in which positional screws were used to stabilize osteotomized fragments. These cases were selected randomly from patients attending the outdoor patient department of oral and maxillofacial surgery at PGIDS, Rohtak, irrespective of age, sex and caste and socioeconomic status. Results: This study comprised 30 numbers of cases which were evaluated clinically as well as radiologically. The measured parameters were further analyzed statistically. The number of cases and its distribution shows that major part of the use of lag screws were in the body of mandibular fracture which are 10 out of 30 while the immobilization of CCG/ SCG are eleven in number. It was observed that use of lag screw with definite protocol give the maximum compressive osteosynthesis. In spite of careful use of the laid down technique the complication of various types were encountered. Conclusion: It is apparent that a lag screw osteosynthesis with its ability of compression is a versatile internal rigid fixation and can be utilized in various surgical procedures for fixation of bony fragments. It is extremely technique sensitive procedure in spite of minimal requirement of armamentarium.Keywords
Lag and Position Screw, Internal Fixation, OsteosynthesisReferences
- Alan Schwimmer et al. The effect of screw size and insertion technique on the stability of the mandibular sagittal split osteotomy. J of Maxillofac Surg 1994; 52: 45-48.
- Aune Raustia et al. Clinical and computed tomographic finding in CCG replacing the mandibular condyle 1996; 54: 1393-1400.
- Brons R, Boering G. Fracture of the mandibular body treated by stable internal fixation: A preliminary report. J Oral Surg 1970; 28: 407-15.3.
- Christopher RF. Application of minimal-access techniques in lag screws fixation of fractures of the anterior mandible. J Plastic Recons Surg 1999; 104: 2127-34.
- Eberhard Kruger. Results of bone grafting after rigid fixation. J of Maxillofac Surg 491-496.
- Edward Ellis E, Ghali G. Lag screw fixation of mandibular angle fractures. J Oral Maxillofac Surg 1991; 49; 234-43.
- Edward Ellis 3. Use of lag screws for fractures of the mandibular body. J Oral Maxillofac Surg 1996; 54: 1314-1316.
- Ellen Wenching. TMJ reconstruction in children using CCG 1999; 7:789-98.
- Francois S. Sagittal splitting and bicortical screw fixation of the ascending ramus. J Maxillofac Surg 1978; 6: 198-200.
- Hendrik Terheysen. The self adapting washer for lag screw fixation of mandibular fractures: Finite element analysis and preclinical evaluation. J of Cranio-Maxillofacial Surg 1999; 27: 58-67.
- Hyoun Chull Kim. Compression of screw placement patterns on the rigidity of the sagittal split ramus osteotomy: Technical note. J of Cranio-Maxillo-Faci Surg 1995; 23: 54-56.
- Llkka K. Lag screw fixation of mandibular parasymphyseal and angle fractures. Oral Surg Oral Med Oral Patho Oral Radio Endo 1996; 81: 510-16.
- Llkka K et al. Fixation of mandibular body osteotomies using biodegradable amorphous self reinforced polylactide or metal lag screws: An experimental study in sheep. J of Cranio-Maxillofacial Surg 1999; 27:124-133.
- Llkka K. Lag screw osteosynthesis of mandibular condyle fractures. J of Maxillofacial Surg 1995;53: 1397-1404.
- Joha A Ellis. Analysis of seating and fracturing torque of bicortical screws. J of Maxillofac Surg 1994;52: 483-486.
- Kaban LB. A Protocol for management of TMJ ankylosis. J of Maxillofac Surg 1990;48: 1134-51.
- Kenneth S. TMJ ankylosis. The rationale for grafting in young patient. J of Maxillofac Surg 1973; 31:744.
- Kenneth K. Transoral technique for rigid internal fixation of sagittal ramus osteotomies. J of Maxillofac Surg 1987, 1077-79.
- Kitayama S. A new method of intraoral open reduction using a screw applied through the mandibular crest of condylar fractures. J of Cranio-Maxillofac Surg 1989; 17:16-23.
- Larry M Wolford, Christopher. Modification of the mandible ramus sagittal split osteotomy. Oral Surg, Oral Med, Oral Patho 1987. 21. Leonard MS et al. The sagittal split osteotomy of the mandible. Oral Surg, Oral Med, Oral Patho 1985; 60:459-66.
- Lindorf HH, Stenhauser EW. Correction of jaw deformities involving simultaneous osteotomy of the mandible and maxilla. J of Maxillofac Surg 1978;6: 239-44.
- Macintosh RB. A spectrum of application of autogenous CCG. J of Maxillofac Surg 1977; 5: 257.
- Nelson. CCG for post-traumatic TMJ reconstruction. A review
- of 6 cases. J of Maxillofac Surg 1977; 47: 1030. 25. Niederdellmann H. Lag screw osteosynthesis : A new procedure for treating fractures of the mandibular angle. J Oral Surg 1981; 39; 938.
- Niederdellmann H. Osteosynthesis of mandibular fracture using lag screws. Int J of Oral Surg 1976; 5:117.
- Nicholas Zachariades et al. Use of lag screws for the management of mandibular trauma. Oral Surg Oral Med Oral Patho Oral Radio 1996; 81: 164-167.
- Peter ILG, Edward E. A comparison of two methods for inserting lag screws. J of Maxillofac Surg 1992; 50: 119-23.
- Roche. The use of position screws as an alternative to plating in segmental Le fort 1 osteotomies. J of Maxillofac Surg 1994; 52: 640-41.
- Shetty V, Caputo A. Biomechanical validation of the solitary lag screw technique for reducing mandibular angle fracture. J of Maxillofac Surg 1992; 50:603-07. 631.
- Spiessl B. In: Internal fixation of the mandible a manual of AO/ ASIF Principles 1976; p.45.
- Synder CC. Trial of SC whole joint graft as a substitute for the TMJ. Plastic Reconst Surg 1971; 48: 447.
- Tharanon W. Comparison between the rigidity of bicortical screws and a miniplates for fixation of a mandibular setback after a stimulated bilateral sagittal split osteotomy. J of Maxillofac Surg 1998; 58: 1055-58.
- Thomas S Jeter. Modified technique for internal fixation of sagittal split osteotomies. J of Maxillofac Surg 1984; 42: 270-72.
- Vivek Shetty et al. Functional stability of sagittal split ramus osteotomies: Effect of positional screw, size and placement configuration. J of Maxillofac Surg 1996; 54: 601-09.
- William C Ardary. Comparative evaluation of screw configuration on the stability of the sagitally split osteotomy. Oral Surg Oral Med Oral Patho 1989; 68: 125-129.
- Role of Le Fort I Osteotomy in Orthosurgical Management of Maxillary Deformities in North Indian Population
Authors
1 Department of Dental surgery, BPS Govt. Medical College and Hospital for women, Khanpur kalan, Sonepat, Haryana, IN
2 Post Graduate Institute of Dental Sciences, Rohtak, Haryana, IN
3 BPS Govt. Medical College and Hospital for women, Khanpur kalan, Sonepat, Haryana, IN
Source
International Journal of Medical and Dental Sciences, Vol 3, No 2 (2014), Pagination: 471-483Abstract
Background: Le Fort I osteotomy is one of the most commonly performed procedure, either alone or in conjunction with other orthognathic procedures for maxillary deformities.
Objective: The present prospective study pertains to definite diagnosis, orthosurgical planning with cephalometric predictions of dento-osseus deformities of maxilla and their correction by LeFort I osteotomy.
Material and Methods: Fourteen patients with skeletal deformity along with malocclusion which was too severe to be corrected orthodontically alone were selected. Parameters were selected on the basis of clinical findings, cephalometrically hard and soft tissue landmarks [COGS (Burstone and Legan) and Steiners analysis]. Parameters were observed and compared preoperatively prediction values, postoperatively and on follow-up.
Results: There were obvious improvement in various linear and angular readings of hard and soft tissues.In linear measurements,NANS ⊥ HP decreased from 57.62 ± 3.3 to 52.4 ± 2.9; ANS-Gn ⊥ HP decreased from 75.8 ± 8.1 to 69.3 ± 6.1; NA || HP reduced by approximately 5mm; N-Pg || HP decreased from -12.07 ± 9.6 to -3.78 ± 8.8 and PNS-N ⊥ HP decreased from 55.28 ± 5.08 to 58.07 ± 4.4. On analysis of angular hard tissue measurements, N-A-Pg angle decreased from 5.14 ± 5.75 to 4.17 ± 2.73 (superior repositioning of maxilla) and increased from 3.0 ± 1.4 to 4.5 ± 0.7 (inferior repositioning of maxilla);MP-HP angle, Ar-Go-Gn angle decreased following superior repositioning and increased following inferior repositioning of maxilla and SNA angle decreased from mean 80.8 to 79.5.
Conclusion: LeFort I osteotomy is really a workhouse of orthognathic surgery in which maxilla can be mobilized in vertical and saggital planes to correct various dento-osseous deformities.
Keywords
Lefort I Osteotomy, Orthosurgical Planning, Cephalometric Analysis, the Dento-Osseous Deformity.References
- Langenbeck B von. Die Uranoplastik. Arch Klin Chir 1861;2:252.
- Cheever DW. Nasopharyngeal polypus attached to the basilar process of the occipital and body of the sphenoid bone successfully removed by section displacement and subsequent replacement and reunion of the superior maxillary bone. Boston Med Surg Journal 1867;8:162.
- Sailer HF, Haers PE, Gratz KW. The Le Fort I osteotomy as surgical approach for removal of tumours of the midface. J Cranio Maxillofac Surg 1999;27:1.
- Moloney F, Worthington P. The origin of Le Fort I maxillary osteotomy: Cheever's operation. J Oral Surg 1981;39:731.
- Hedemark A, Freihofer HP Jr. The behaviour of the maxilla in vertical movements afte Le Fort I osteotomy. J Oral Maxillofac Surg 1978;6:244.
- Schuchardt K. Experience with the surgical treatment of deformities of the jaws; prognathia, micrognathia and open bite. In Wallace AB, editor. Second Congress of International Society of Plastic Surgeons. London: E & SS Livingstone;1959.
- Dingman RO, Harding RL. Treatment of malunion of facial bones. Plast Reconstr Surg 1951;7:505.
- Drammer RB. The history of the "Le Fort Iosteotomy, J Oral Maxillofac Surg 1986;14:119.
- Bell WH. Revascularization and bone healing after anterior maxllary osteotomy: a study using adult rhesus monkeys. J Oral Surg 1969;27:249.
- Bell WH, Mannai C, Luhr HG. Art and science of the Le Fort I down fracture. Int J Adult orthod orthognath Sur 1988;3:23.
- Bell WH. Modern practice in orthognathic and Reconstructive Surgery. Philadelphia: WB Saunders; 1992.p.2211-2223.
- Obwegeser HL. Surgical correction of small or retrodisplaced maxillae: The "dish-face" deformity. Plast Reconst Surg 1969;43:35.
- Wilmer K. On LeFort I osteotomy; A follow up study of 106 operated patients with maxillofacial deformities. Scand J Plast Reconstr Surg 1974;Supple 12:1-68.
- Wolford LW. Effects of orthognathic surgery on nasal form and function in the cleft palate patient. Cleft palate Craniofac J 1992;29:546.
- Al-Waheidi EMH, Harradine NWT, Orth M. Soft tissue profile charges in patients with cleft lip and palate folowing maxillary osteotomies. Cleft palate Craniof J 1998;35:535.
- Legan HL, Burstone CJ. Soft tissue cephalometric analysis for orthognathic surgery. J Oral Surg 1980;38:744.
- Obwegeser H. Chirugia dell “mordex apparatus.” Rev Asoc Odontol Argent. 1962;50:429.
- Parula K, Finn, Oli Karinen K. Incidence of complications and problems related to orthognathic surgery. J Oral Maxillofac Surg 2001;59:1128.
- Wolford L, Hellerd FW, Dugan DJ. Surgical treatment objective. St.Louis: CV Mosby Co; 1985.
- Nordenram A, Walker A. Oral surgical correction of mandibular protrusion. Br J Oral Surg 1968;64:75.
- McNeil, Proffit WR and White RP. Cephalometric prediction for orthognathic surgery. Angle Orthod 1972;42:154.
- Burstone CJ, James RB, Legan HC. Cepahlometrics for Orthognathic Surgery. Journal of Oral Surgery 1978;36:269-77.
- Kent, Hinds. Management of dental facial deformities by anterior alveolar surgery. J Oral Surg 1971;29:13-25.
- Ewing M, Ross RB. Soft tissue response to the osthognathic surgery in persons with unilateral cleft, lip and palate. Cleft Palate Craniofac J 1993;30:320-329.
- Schendel SA, Carlotti AE. Nasal considerations in orthognathic surgery. Am J Orthod Dentofac Orthop 1991;100:197.
- Moshiri F, Jung ST, Sclaroff A, Marsh JL, Gay DW. Orthognathic and craniofacial surgical diagnosis and treatment planning: A visual approach. J Clin Orthod 1982;16:37–59.
- Bell WH, Dann. Correction of dentofacial deformities by surgery in the anterior part of jaws: A study of stability and soft tissue changes. Am J Orthod, 1973;64: 162-186.
- Henderson D. A color atlas and textbook of orthognathic surgery-the surgery of facial skeletal deformity. Weert Netherland: Wolfe Medical Publications Ltd; 1985.p.224-225.
- Kole H. Surgical operations on the alveolar ridge to correct occlusal abnormalities. J Oral Surg 1959;12:227.