1
Abstracts 1185 from this is make supplementary tests to confirm it. The location of metastases in the region molar and premolar mandibu- lar, may be due to a greater amount of medullar bone and vascularization. Kid- ney tumors in clear cell from the bark, neoplasms are morphologically similar to the hypernephromas, clear cell carcino- mas, carcinomas of glandular cells and cell carcinomas sarcomatoid, therefore, the distinction between benign neoplasms and malignant, primary tumors and metastases require expertise on the part of the pathol- ogist and the clinician. Treatment and prognosis vary depending on the primary lesion. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.537 275 Topic: orthognathic and aesthetic surgery Correction of maxillary vertical excess with guided revert bone transport. A case report of a new surgical technique A.A. Hernandez 1,, J. Gonzalez Lugo 2 , V. Baralt 3 , E. Manduca 2 1 Oral Surgery, Centro Nacional de Cirugia Bucomaxilofacial CIBUMAXI, Venezuela 2 Ortodoncista CIBUMAXI, Venezuela 3 Residente CIBUMAXI, Centro Nacional de Cirugia Buco Maxilo Facial e Implantes, Caracas, Venezuela Introduction: 30 percent of craniofa- cial abnormalities on patients have vertical maxillary excess. This condition is usually accompanied with great teeth exposure, gummy smile and mandible clock rotation. The following technique is an alternative of a conventional osteotomy Le fort I and is based on the turnover of hard and soft tis- sues through a corticotomy with light and continues forces by Niti coils and microim- plants. Materials and methods: The selec- tion criterion of the patients was that all individuals had a dental class I and verti- cal maxillary excess between 5 and 7 mm. To determine these parameters, all patients had extra and intra oral photos, X ray films. After the initial selection of patients, they were treated by an orthodontist who did the initial aligning and leveling of teeth prior to the surgery. The procedure was done under sedation at an ambulatory care unit. Results and conclusions: Because of the simplicity and low mortality rate of this procedure, it can be done with sedation and at an ambulatory care unit. The success rate of this technique has been successful on all cases treated. Furthermore, it has sev- eral advantages compared to conventional osteotomies such as, reduced operatory time, general anesthesia is not necessary needed, less bleeding and therefore the postoperative discomfort is quite reduced as well as the high medical cost. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.538 276 3D analysis and surgical orientation of severe antero-posterior disharmonies: determinant parameters and threshold values J.H. Faure 1,, A. Oueiss 1 , J. Braga 2 1 Dento-Facial Orthopedics, France 2 Laboratoire CNRS Anthropobiologie FR 2960, University of Toulouse 3, Toulouse, France Severe maxilla-facial disharmonies need a complete three dimensional analysis. This conference describes results of a social program financed by the French National Medical Insurance aimed at improving identification, diagnosis, follow-up and treatment of surgical cases. Participating orthodontists selected a group of 312 “border line surgery” patients who profited of CT scan exams. This work compared two sub-samples of patients with severe antero-posterior disharmonies evoking surgical direction (40 Class II and 34 Class III) with a reference sample (40 patients). Patient’s CT scan data are treated by specific softwares elaborated in Toulouse using 14 maxillo-facial landmarks associ- ated with trigeminal anatomy, and inertia matrices calculus to localize dental ele- ments. This cephalometric analysis is able to describe the anatomy with three lev- els: alveolo-dental level/basic bones/global architecture or envelop. The most determinant parameters and the threshold values are determined by sta- tistical methods. The importance of different kinds of parameters for surgical orientation can be classified: 1. Alveolo-dental parameters are more important than basic bone or architec- tural parameters. 2. Upper/lower gaps parameters are more important than position of whatever anatomical element. 3. Anterior landmarks are always more important than medium or posterior ones. Beyond orthodontist’s comportment analysis, this work proposes an help for parameters selection and can give warning lights for surgical orientation. The long term target was to define good practice behavior and to encourage orthodontists to avoid therapeutic relent- lessness by not focusing too narrowly on orthodontic solutions. to the exclusion of other modalities such as surgery or to overuse orthodontic camouflage tech- niques: Alveolo-dental parameters are more important than basic bone or architec- tural parameters. Upper/lower gaps parameters are more important than position of whatever anatomical element. Anterior landmarks are always more important than medium or posterior ones. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.539 277 Fistula rate for modified “Mongolian technique” for congenital cleft palate repair G. Ayanga , J. Erdenetsogt, R. Bayasgalan, D. Tserendulam, M. Erdenesaikhan Maxillo-Facial Surgery, Mongolian Maternal and Child Health Research Center, Ulaanbaatar, Mongolia Background: The timing and tech- nique for palatoplasty is very controversial, recent literature advocates for early repair, between six and eighteen months of age. It is using three kinds of techniques of palato- plasty mainly, two flap technique, Furlow double opposing z-plasty, and two-step palatoplasty. Oro-nasal fistula formation is an one of most documented postoper- ative complication, and it’s rate is reported between 6–42.3% in the literature. In Mongolia patients often present in older than recommended age for palatoplasty, it provides surgeons with the challenge of managing wider defects, which have higher rates of fistula formation and wound dehiscence. These complications forced us to modify palatoplasty techniques for improved outcomes. Objective: The objective is to compare the efficacy of three established palato-

3D analysis and surgical orientation of severe antero-posterior disharmonies: determinant parameters and threshold values

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Page 1: 3D analysis and surgical orientation of severe antero-posterior disharmonies: determinant parameters and threshold values

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rom this is make supplementary tests toonfirm it. The location of metastases inhe region molar and premolar mandibu-ar, may be due to a greater amount ofedullar bone and vascularization. Kid-

ey tumors in clear cell from the bark,eoplasms are morphologically similar tohe hypernephromas, clear cell carcino-

as, carcinomas of glandular cells andell carcinomas sarcomatoid, therefore, theistinction between benign neoplasms andalignant, primary tumors and metastases

equire expertise on the part of the pathol-gist and the clinician. Treatment andrognosis vary depending on the primaryesion.

Conflict of interest: None declared.

oi:10.1016/j.ijom.2011.07.537

75

opic: orthognathic andesthetic surgery

orrection of maxillary verticalxcess with guided revert boneransport. A case report of a newurgical technique

.A. Hernandez 1,∗, J. Gonzalez Lugo 2,. Baralt 3, E. Manduca 2

Oral Surgery, Centro Nacional de Cirugiaucomaxilofacial CIBUMAXI, VenezuelaOrtodoncista CIBUMAXI, VenezuelaResidente CIBUMAXI, Centro Nacionale Cirugia Buco Maxilo Facial emplantes, Caracas, Venezuela

Introduction: 30 percent of craniofa-ial abnormalities on patients have verticalaxillary excess. This condition is usually

ccompanied with great teeth exposure,ummy smile and mandible clock rotation.he following technique is an alternative ofconventional osteotomy Le fort I and is

ased on the turnover of hard and soft tis-ues through a corticotomy with light andontinues forces by Niti coils and microim-lants.

Materials and methods: The selec-ion criterion of the patients was that allndividuals had a dental class I and verti-al maxillary excess between 5 and 7 mm.o determine these parameters, all patientsad extra and intra oral photos, X ray films.

After the initial selection of patients,hey were treated by an orthodontist whoid the initial aligning and leveling of teethrior to the surgery. The procedure was

one under sedation at an ambulatory carenit.

Results and conclusions: Because ofhe simplicity and low mortality rate of this

procedure, it can be done with sedation andat an ambulatory care unit. The success rateof this technique has been successful onall cases treated. Furthermore, it has sev-eral advantages compared to conventionalosteotomies such as, reduced operatorytime, general anesthesia is not necessaryneeded, less bleeding and therefore thepostoperative discomfort is quite reducedas well as the high medical cost.

Conflict of interest: None declared.

doi:10.1016/j.ijom.2011.07.538

2763D analysis and surgicalorientation of severeantero-posterior disharmonies:determinant parameters andthreshold valuesJ.H. Faure 1,∗, A. Oueiss 1, J. Braga 2

1 Dento-Facial Orthopedics, France2 Laboratoire CNRS Anthropobiologie FR2960, University of Toulouse 3, Toulouse,France

Severe maxilla-facial disharmoniesneed a complete three dimensionalanalysis.

This conference describes resultsof a social program financed by theFrench National Medical Insurance aimedat improving identification, diagnosis,follow-up and treatment of surgicalcases. Participating orthodontists selecteda group of 312 “border line surgery”patients who profited of CT scan exams.This work compared two sub-samplesof patients with severe antero-posteriordisharmonies evoking surgical direction(40 Class II and 34 Class III) with areference sample (40 patients).

Patient’s CT scan data are treated byspecific softwares elaborated in Toulouseusing 14 maxillo-facial landmarks associ-ated with trigeminal anatomy, and inertiamatrices calculus to localize dental ele-ments. This cephalometric analysis is ableto describe the anatomy with three lev-els: alveolo-dental level/basic bones/globalarchitecture or envelop.

The most determinant parameters andthe threshold values are determined by sta-tistical methods.

The importance of different kinds ofparameters for surgical orientation can beclassified:1. Alveolo-dental parameters are more

important than basic bone or architec-

tural parameters.

2. Upper/lower gaps parameters are moreimportant than position of whateveranatomical element.

Abstracts 1185

3. Anterior landmarks are always moreimportant than medium or posteriorones.

Beyond orthodontist’s comportmentanalysis, this work proposes an help forparameters selection and can give warninglights for surgical orientation.

The long term target was to definegood practice behavior and to encourageorthodontists to avoid therapeutic relent-lessness by not focusing too narrowlyon orthodontic solutions. to the exclusionof other modalities such as surgery orto overuse orthodontic camouflage tech-niques:

• Alveolo-dental parameters are moreimportant than basic bone or architec-tural parameters.

• Upper/lower gaps parameters are moreimportant than position of whateveranatomical element.

• Anterior landmarks are always moreimportant than medium or posteriorones.

Conflict of interest: None declared.

doi:10.1016/j.ijom.2011.07.539

277Fistula rate for modified“Mongolian technique” forcongenital cleft palate repairG. Ayanga ∗, J. Erdenetsogt,R. Bayasgalan, D. Tserendulam,M. ErdenesaikhanMaxillo-Facial Surgery, MongolianMaternal and Child Health ResearchCenter, Ulaanbaatar, Mongolia

Background: The timing and tech-nique for palatoplasty is very controversial,recent literature advocates for early repair,between six and eighteen months of age. Itis using three kinds of techniques of palato-plasty mainly, two flap technique, Furlowdouble opposing z-plasty, and two-steppalatoplasty. Oro-nasal fistula formationis an one of most documented postoper-ative complication, and it’s rate is reportedbetween 6–42.3% in the literature. InMongolia patients often present in olderthan recommended age for palatoplasty,it provides surgeons with the challengeof managing wider defects, which havehigher rates of fistula formation and wounddehiscence. These complications forced

us to modify palatoplasty techniques forimproved outcomes.

Objective: The objective is to comparethe efficacy of three established palato-