Face Deformity

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Veronica Tomasello - One of the best experts on this subject based on the ideXlab platform.

  • Specific Aspects of Anaesthesiology in Face Transplantation
    Face Transplantation, 2014
    Co-Authors: Juan P. Barret, Veronica Tomasello
    Abstract:

    Face transplantation is a novel experimental treatment that aims to reconstruct Face Deformity by the replacement of Face anatomy with donor tissues. However, the anaesthetic act does not differ much from common surgical interventions in plastic and reconstructive surgery. In general terms, massive bleeding (burns, head and neck tumours, neurofibromatosis, etc.) is common to some operations, and autotransplantation (free flaps, microsurgery) is performed on a daily basis.

  • Face Transplantation: Surgical Aspects
    Face Transplantation, 2014
    Co-Authors: Juan P. Barret, Veronica Tomasello
    Abstract:

    Reconstructive allotransplantation has emerged as the ultimate restorative technique for treating Face Deformity, hand amputations and others. With the development of novel, more effective, immunosuppressant regimens, which shall decrease the advent of toxic side effects, the indication for this new technique may widen. In fact, the achievement of such a regimen that minimised side effects and counterbalanced the ethical issues in reconstructive allotransplantation would allow for the transplantation and restoration of any anatomical and functional unit of the human body. Cell therapy, tissue engineering and new synthetic polymers will help for the development of a true restorative surgery in the future, combining the knowledge and expertise of transplantation medicine with the advent and development of biological and synthetic tissue engineering.

  • Indications for Face Transplantation
    Face Transplantation, 2014
    Co-Authors: Juan P. Barret, Veronica Tomasello
    Abstract:

    Severe Face Deformity is one of the most devastating disabilities of human beings. In the majority of cases, this disability produces a myriad of symptoms, including depression, social isolation and suicide ideation. In comparison to other extreme disabilities, such as amputations, spinal cord injuries or cerebrovascular disease, where compassion and sympathy are common reactions in those that relate with the patients and in society in general, catastrophic Face deformities produce anxiety, rejection and fear in those that are confronted with them. Physicians that care for this people ordinarily listen to histories of rejection and isolation feelings, fear to expose oneself to society for being “ugly” or “anger gazes” and even increpations such as “how one dares to walk on the street with such a Face” or “you are scaring my children”.

Juan P. Barret - One of the best experts on this subject based on the ideXlab platform.

  • Specific Aspects of Anaesthesiology in Face Transplantation
    Face Transplantation, 2014
    Co-Authors: Juan P. Barret, Veronica Tomasello
    Abstract:

    Face transplantation is a novel experimental treatment that aims to reconstruct Face Deformity by the replacement of Face anatomy with donor tissues. However, the anaesthetic act does not differ much from common surgical interventions in plastic and reconstructive surgery. In general terms, massive bleeding (burns, head and neck tumours, neurofibromatosis, etc.) is common to some operations, and autotransplantation (free flaps, microsurgery) is performed on a daily basis.

  • Face Transplantation: Surgical Aspects
    Face Transplantation, 2014
    Co-Authors: Juan P. Barret, Veronica Tomasello
    Abstract:

    Reconstructive allotransplantation has emerged as the ultimate restorative technique for treating Face Deformity, hand amputations and others. With the development of novel, more effective, immunosuppressant regimens, which shall decrease the advent of toxic side effects, the indication for this new technique may widen. In fact, the achievement of such a regimen that minimised side effects and counterbalanced the ethical issues in reconstructive allotransplantation would allow for the transplantation and restoration of any anatomical and functional unit of the human body. Cell therapy, tissue engineering and new synthetic polymers will help for the development of a true restorative surgery in the future, combining the knowledge and expertise of transplantation medicine with the advent and development of biological and synthetic tissue engineering.

  • Indications for Face Transplantation
    Face Transplantation, 2014
    Co-Authors: Juan P. Barret, Veronica Tomasello
    Abstract:

    Severe Face Deformity is one of the most devastating disabilities of human beings. In the majority of cases, this disability produces a myriad of symptoms, including depression, social isolation and suicide ideation. In comparison to other extreme disabilities, such as amputations, spinal cord injuries or cerebrovascular disease, where compassion and sympathy are common reactions in those that relate with the patients and in society in general, catastrophic Face deformities produce anxiety, rejection and fear in those that are confronted with them. Physicians that care for this people ordinarily listen to histories of rejection and isolation feelings, fear to expose oneself to society for being “ugly” or “anger gazes” and even increpations such as “how one dares to walk on the street with such a Face” or “you are scaring my children”.

Timothy A Turvey - One of the best experts on this subject based on the ideXlab platform.

  • long term stability of surgical open bite correction by le fort i osteotomy
    Angle Orthodontist, 2009
    Co-Authors: William R Proffit, Ltanya J Bailey, Ceib Phillips, Timothy A Turvey
    Abstract:

    Abstract Skeletal changes greater than those observed in untreated adults have been noted beyond 1 year post-surgery in adult patients who had surgical correction of a long Face Deformity. The stability of skeletal landmarks and dental relationships from 1 to >3 years post-surgery was examined in 28 patients who had undergone surgery of the maxilla only, and in 26 patients who had undergone 2-jaw surgery to correct >2 mm anterior open bite. Although the average changes in almost all landmark positions and skeletal dimensions were less than 1 mm, point B moved down >2 mm and Face height increased >2 mm in one-third of the maxilla-only group and in 40% of the 2-jaw group (>4 mm in 10% and 22% respectively). Overbite decreased 2–4 mm in only 7% of the maxilla-only and 12% of the 2 groups, with no changes >4 mm, because in three-fourths of the patients with an increase in anterior Face height, further eruption of the incisors maintained the overbite relationship. In the maxilla-only group, mandibular length (...

  • long term stability of surgical open bite correction by le fort i osteotomy
    Angle Orthodontist, 2009
    Co-Authors: William R Proffit, Ltanya J Bailey, Ceib Phillips, Timothy A Turvey
    Abstract:

    Skeletal changes greater than those observed in untreated adults have been noted beyond 1 year post-surgery in adult patients who had surgical correction of a long Face Deformity. The stability of skeletal landmarks and dental relationships from 1 to >3 years post-surgery was examined in 28 patients who had undergone surgery of the maxilla only, and in 26 patients who had undergone 2-jaw surgery to correct >2 mm anterior open bite. Although the average changes in almost all landmark positions and skeletal dimensions were less than 1 mm, point B moved down >2 mm and Face height increased >2 mm in one-third of the maxilla-only group and in 40% of the 2-jaw group (>4 mm in 10% and 22% respectively). Overbite decreased 2-4 mm in only 7% of the maxilla-only and 12% of the 2 groups, with no changes >4 mm, because in three-fourths of the patients with an increase in anterior Face height, further eruption of the incisors maintained the overbite relationship. In the maxilla-only group, mandibular length (Co-Pg) showed >2 mm long-term change in 45% of the patients, two-thirds of whom showed an increase rather than a decrease in length. In the 2-jaw group, no patients showed a decrease in Co-Pg length and one-third had an increase. For both groups, changes in overjet were smaller and less frequent than changes in mandibular length.

  • Long-Term Stability of Surgical Open-Bite Correction by Le
    2000
    Co-Authors: William R Proffit, Ceib Phillips, Timothy A Turvey
    Abstract:

    Skeletal changes greater than those observed in untreated adults have been noted beyond 1 year post-surgery in adult patients who had surgical correction of a long Face Deformity. The stability of skeletal landmarks and dental relationships from 1 to .3 years post-surgery was examined in 28 patients who had undergone surgery of the maxilla only, and in 26 patients who had undergone 2-jaw surgery to correct .2 mm anterior open bite. Although the average changes in almost all landmark positions and skeletal dimensions were less than 1 mm, point B moved down .2 mm and Face height increased .2 mm in one-third of the maxilla-only group and in 40% of the 2-jaw group (.4 mm in 10% and 22% respectively). Overbite decreased 2-4 mm in only 7% of the maxilla-only and 12% of the 2 groups, with no changes .4 mm, because in three-fourths of the patients with an increase in anterior Face height, further eruption of the incisors maintained the overbite relationship. In the maxilla-only group, mandibular length (Co-Pg) showed .2 mm long-term change in 45% of the patients, two-thirds of whom showed an increase rather than a decrease in length. In the 2-jaw group, no patients showed a decrease in Co-Pg length and one-third had an increase. For both groups, changes in overjet were smaller and less frequent than changes in mandibular length. (Angle Orthod 2000;70:112-117.)

William R Proffit - One of the best experts on this subject based on the ideXlab platform.

  • long term stability of surgical open bite correction by le fort i osteotomy
    Angle Orthodontist, 2009
    Co-Authors: William R Proffit, Ltanya J Bailey, Ceib Phillips, Timothy A Turvey
    Abstract:

    Abstract Skeletal changes greater than those observed in untreated adults have been noted beyond 1 year post-surgery in adult patients who had surgical correction of a long Face Deformity. The stability of skeletal landmarks and dental relationships from 1 to >3 years post-surgery was examined in 28 patients who had undergone surgery of the maxilla only, and in 26 patients who had undergone 2-jaw surgery to correct >2 mm anterior open bite. Although the average changes in almost all landmark positions and skeletal dimensions were less than 1 mm, point B moved down >2 mm and Face height increased >2 mm in one-third of the maxilla-only group and in 40% of the 2-jaw group (>4 mm in 10% and 22% respectively). Overbite decreased 2–4 mm in only 7% of the maxilla-only and 12% of the 2 groups, with no changes >4 mm, because in three-fourths of the patients with an increase in anterior Face height, further eruption of the incisors maintained the overbite relationship. In the maxilla-only group, mandibular length (...

  • long term stability of surgical open bite correction by le fort i osteotomy
    Angle Orthodontist, 2009
    Co-Authors: William R Proffit, Ltanya J Bailey, Ceib Phillips, Timothy A Turvey
    Abstract:

    Skeletal changes greater than those observed in untreated adults have been noted beyond 1 year post-surgery in adult patients who had surgical correction of a long Face Deformity. The stability of skeletal landmarks and dental relationships from 1 to >3 years post-surgery was examined in 28 patients who had undergone surgery of the maxilla only, and in 26 patients who had undergone 2-jaw surgery to correct >2 mm anterior open bite. Although the average changes in almost all landmark positions and skeletal dimensions were less than 1 mm, point B moved down >2 mm and Face height increased >2 mm in one-third of the maxilla-only group and in 40% of the 2-jaw group (>4 mm in 10% and 22% respectively). Overbite decreased 2-4 mm in only 7% of the maxilla-only and 12% of the 2 groups, with no changes >4 mm, because in three-fourths of the patients with an increase in anterior Face height, further eruption of the incisors maintained the overbite relationship. In the maxilla-only group, mandibular length (Co-Pg) showed >2 mm long-term change in 45% of the patients, two-thirds of whom showed an increase rather than a decrease in length. In the 2-jaw group, no patients showed a decrease in Co-Pg length and one-third had an increase. For both groups, changes in overjet were smaller and less frequent than changes in mandibular length.

  • Long-Term Stability of Surgical Open-Bite Correction by Le
    2000
    Co-Authors: William R Proffit, Ceib Phillips, Timothy A Turvey
    Abstract:

    Skeletal changes greater than those observed in untreated adults have been noted beyond 1 year post-surgery in adult patients who had surgical correction of a long Face Deformity. The stability of skeletal landmarks and dental relationships from 1 to .3 years post-surgery was examined in 28 patients who had undergone surgery of the maxilla only, and in 26 patients who had undergone 2-jaw surgery to correct .2 mm anterior open bite. Although the average changes in almost all landmark positions and skeletal dimensions were less than 1 mm, point B moved down .2 mm and Face height increased .2 mm in one-third of the maxilla-only group and in 40% of the 2-jaw group (.4 mm in 10% and 22% respectively). Overbite decreased 2-4 mm in only 7% of the maxilla-only and 12% of the 2 groups, with no changes .4 mm, because in three-fourths of the patients with an increase in anterior Face height, further eruption of the incisors maintained the overbite relationship. In the maxilla-only group, mandibular length (Co-Pg) showed .2 mm long-term change in 45% of the patients, two-thirds of whom showed an increase rather than a decrease in length. In the 2-jaw group, no patients showed a decrease in Co-Pg length and one-third had an increase. For both groups, changes in overjet were smaller and less frequent than changes in mandibular length. (Angle Orthod 2000;70:112-117.)

Jeremy Collyer - One of the best experts on this subject based on the ideXlab platform.

  • Reinventing the wheel: a modern perspective on the bilateral inverted ‘L’ osteotomy
    International journal of oral and maxillofacial surgery, 2015
    Co-Authors: L. Greaney, Gurprit Bhamrah, Ken Sneddon, Jeremy Collyer
    Abstract:

    The bird-Face Deformity of a severe class II, high Frankfort-mandibular plane angle with significant retrogenia, often associated with diminutive condyles and reduced posterior Face height, poses many challenges to the orthognathic surgeon. Of greatest concern in these patients is the degree of mandibular advancement required and the potential for relapse. The sagittal split osteotomy is the workhorse of mandibular surgery but does not allow significant lengthening of the ramus, which is desirable in this group of patients. An inverted 'L' osteotomy of the mandible to facilitate ramus lengthening is therefore indicated in the management of this group, but is a procedure that has largely fallen out of favour due to the need for an extraoral approach and intermaxillary fixation. The advent of distraction osteogenesis promised to be the answer for these cases, but with nearly 20 years of experience with these techniques, it is clear that it does not represent the panacea that was hoped for. We present a series of four cases of bimaxillary surgery consisting of maxillary osteotomy and bilateral inverted 'L' osteotomy of the mandible carried out via an intraoral approach (average advancement 10.5mm), where internal semi-rigid fixation was employed to obviate the need for intermaxillary fixation. We highlight the indications for this procedure and why it is ideally suited to this group of patients and argue that the procedure should be re-introduced to the armamentarium of the orthognathic surgeon.

  • Reinventing the wheel: a modern perspective on the
    2015
    Co-Authors: L. Greaney, Gurprit Bhamrah, Ken Sneddon, Jeremy Collyer
    Abstract:

    The bird-Face Deformity of a severe class II, high Frankfort-mandibular plane angle with significant retrogenia, often associated with diminutive condyles and reduced posterior Face height, poses many challenges to the orthognathic surgeon. Of greatest concern in these patients is the degree of mandibular advancement required and the potential for relapse. The sagittal split osteotomy is the workhorse of mandibular surgery but does not allow significant lengthening of the ramus, which is desirable in this group of patients. An inverted 'L' osteotomy of the mandible to facilitate ramus lengthening is therefore indicated in the management of this group, but is a procedure that has largely fallen out of favour due to the need for an extraoral approach and intermaxillary fixation. The advent of distraction osteogenesis promised to be the answer for these cases, but with nearly 20 years of experience with these techniques, it is clear that it does not represent the panacea that was hoped for. We present a series of four cases of bimaxillary surgery consisting of maxillary osteotomy and bilateral inverted 'L' osteotomy of the mandible carried out via an intraoral approach (average advancement 10.5 mm), where internal semi-rigid fixation was employed to obviate the need for intermaxillary fixation. We highlight the indications for this procedure and why it is ideally suited to this group of patients and argue that the procedure should be re- introduced to the armamentarium of the orthognathic surgeon.