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European Respiratory Review : An... Dec 2021Treatment of obstructive sleep apnoea (OSA) in adults is evolving, as new therapies have been explored and introduced in clinical practice, while other approaches have... (Review)
Review
Treatment of obstructive sleep apnoea (OSA) in adults is evolving, as new therapies have been explored and introduced in clinical practice, while other approaches have been refined or reconsidered. In this European Respiratory Society (ERS) guideline on non-continuous positive airway pressure (CPAP) therapies for OSA, we present recommendations determined by a systematic review of the literature. It is an update of the 2011 ERS statement on non-CPAP therapies, advanced into a clinical guideline. A multidisciplinary group of experts, including pulmonary, surgical, dentistry and ear-nose-throat specialists, methodologists and patient representatives considered the most relevant clinical questions (for both clinicians and patients) relating to the management of OSA. Eight key clinical questions were generated and a systematic review was conducted to identify published randomised clinical trials that answered these questions. We used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to assess the quality of the evidence and the strength of recommendations. The resulting guideline addresses gastric bypass surgery, custom-made dual-block mandibular advancement devices, hypoglossal nerve stimulation, myofunctional therapy, maxillo-mandibular osteotomy, carbonic anhydrase inhibitors and positional therapy. These recommendations can be used to benchmark quality of care for people with OSA across Europe and to improve outcomes.
Topics: Adult; Continuous Positive Airway Pressure; Humans; Mandibular Advancement; Occlusal Splints; Respiratory System; Sleep Apnea, Obstructive
PubMed: 34853097
DOI: 10.1183/16000617.0200-2021 -
BMJ Case Reports Feb 2019Unilateral condylar hyperplasia is characterised by slow progressive growth of the different parts of mandible, the aetiology of which is still unclear. It is a... (Review)
Review
Unilateral condylar hyperplasia is characterised by slow progressive growth of the different parts of mandible, the aetiology of which is still unclear. It is a self-limiting condition mostly seen between the age of 11-30 years causing facial asymmetry and its progression ceases after a certain time. In literature until now very few cases have been reported and every case that is being reported adds to its features or the aetiology. Previously, it has been classified into two types that is, hemimandibular hyperplasia and hemimandibular elongation. Here, we report a similar case with a few features distinct from those reported earlier.
Topics: Adult; Facial Asymmetry; Humans; Hyperplasia; Male; Malocclusion; Mandible; Mandibular Condyle; Oral Surgical Procedures; Osteotomy; Treatment Outcome
PubMed: 30737324
DOI: 10.1136/bcr-2018-227569 -
Biomedical Journal 2014The surgery-first approach in orthognathic surgery has recently created a broader interest in completely eliminating time-consuming preoperative orthodontic treatment.... (Review)
Review
The surgery-first approach in orthognathic surgery has recently created a broader interest in completely eliminating time-consuming preoperative orthodontic treatment. Available evidence on the surgery-first approach should be appraised to support its use in orthognathic surgery. A MEDLINE search using the keywords "surgery first" and "orthognathic surgery" was conducted to select studies using the surgery-first approach. We also manually searched the reference list of the selected keywords to include articles not selected by the MEDLINE search. The search identified 18 articles related to the surgery-first approach. There was no randomized controlled clinical trial. Four papers were excluded as the content was only personal opinion or basic scientific research. Three studies were retrospective cohort studies in nature. The other 11 studies were case reports. For skeletal Class III surgical correction, the final long-term outcomes for maxillofacial and dental relationship were not significantly different between the surgery-first approach and the orthodontics-first approach in transverse (e.g., intercanine or intermolar width) dimension, vertical (e.g., anterior open bite, lower anterior facial height) dimension, and sagittal (e.g., anterior-posterior position of pogonion and lower incisors) dimension. Total treatment duration was substantially shorter in cases of surgery-first approach use. In conclusion, most published studies related to the surgery-first approach were mainly on orthognathic correction of skeletal Class III malocclusion. Both the surgery-first approach and orthodontics-first approach had similar long-term outcomes in dentofacial relationship. However, the surgery-first approach had shorter treatment time.
Topics: Humans; Malocclusion, Angle Class III; Mandibular Osteotomy; Orthodontics, Corrective; Orthognathic Surgery; Orthognathic Surgical Procedures; Treatment Outcome
PubMed: 25116713
DOI: 10.4103/2319-4170.126863 -
The American Journal of Case Reports Jul 2015Ameloblastic carcinoma secondary type is an extremely rare and aggressive odontogenic neoplasm that exhibits histological features of malignancy in primary and...
BACKGROUND
Ameloblastic carcinoma secondary type is an extremely rare and aggressive odontogenic neoplasm that exhibits histological features of malignancy in primary and metastatic sites. It arises through carcinomatous de-differentiation of a pre-existing ameloblastoma or odontogenic cyst, typically following repeated treatments and recurrences of the benign precursor neoplasm. Identification of an ameloblastic carcinoma, secondary type presenting with histologic features of malignant transformation from an earlier untreated benign lesion remains a rarity. Herein, we report 1 such case.
CASE REPORT
A 66-year-old man was referred for management of a newly diagnosed ameloblastic carcinoma. He underwent radical surgical intervention comprising hemimandibulectomy, supraomohyoid neck dissection, and free-flap reconstruction. Final histologic analysis demonstrated features suggestive of carcinomatous de-differentiation for a consensus diagnosis of ameloblastic carcinoma, secondary type (de-differentiated) intraosseous.
CONCLUSIONS
Ameloblastic carcinoma, secondary type represents a rare and challenging histologic diagnosis. Radical surgical resection with adequate hard and soft tissue margins is essential for curative management of localized disease.
Topics: Aged; Ameloblastoma; Biopsy; Diagnosis, Differential; Humans; Lymphatic Metastasis; Male; Mandibular Neoplasms; Mandibular Osteotomy; Neck Dissection; Radiography, Panoramic
PubMed: 26126621
DOI: 10.12659/AJCR.893918 -
L' Orthodontie Francaise Jun 2016
Topics: Dental Research; Esthetics; Face; Genioplasty; Humans; Malocclusion; Mandible; Mandibular Advancement; Mandibular Osteotomy; Orthodontics, Corrective; Orthognathic Surgical Procedures; Osteogenesis, Distraction; Patient Care Planning
PubMed: 27358002
DOI: 10.1051/orthodfr/2016021 -
Australian Dental Journal Mar 2018Facial Osteotomy techniques have evolved enormously over the past 20 years providing significant and often life-changing benefits to our dental patients with skeletal...
Facial Osteotomy techniques have evolved enormously over the past 20 years providing significant and often life-changing benefits to our dental patients with skeletal malocclusions. Advancements in technology and refined surgical techniques have resulted in improvements in surgical outcomes, a reduction in post-operative complications and a quicker recovery for today's patients undergoing orthognathic surgery. This paper aims to an update on the contemporary approach to the correction of skeletal malocclusions with facial osteotomies.
Topics: Adolescent; Adult; Dentistry; Face; Facial Bones; Female; Humans; Male; Malocclusion; Mandible; Maxilla; Orthognathic Surgical Procedures; Osteotomy; Osteotomy, Le Fort; Postoperative Period; Plastic Surgery Procedures; Young Adult
PubMed: 29574821
DOI: 10.1111/adj.12590 -
Maxillofacial Plastic and... Dec 2015The aim of this article is to review temporomandibular joint symptoms as well as the effects of orthognathic surgery(OGS) on temporomandibular joint(TMJ). The causes of... (Review)
Review
The aim of this article is to review temporomandibular joint symptoms as well as the effects of orthognathic surgery(OGS) on temporomandibular joint(TMJ). The causes of temporomandibular joint disease(TMD) are multifactorial, and the symptoms of TMD manifest as a limited range of motion of mandible, pain in masticatory muscles and TMJ, Joint noise (clicking, popping, or crepitus), myofascial pain, and other functional limitations. Treatment must be started based on the proper diagnosis, and almost symptoms could be subsided by reversible options. Minimally invasive options and open arthroplasty are also available following reversible treatment when indicated. TMD manifesting in a variety of symptoms, also can apply abnormal stress to mandibular condyles and affect its growth pattern of mandible. Thus, adaptive developmental changes on mandibular condyles and post-developmental degenerative changes of mandibular condyles can create alteration on facial skeleton and occlusion. The changes of facial skeleton in DFD patients following OGS have an impact on TMJ, masticatory musculature, and surrounding soft tissues, and the changes of TMJ symptoms. Maxillofacial surgeons must remind that any surgical procedures involving mandibular osteotomy can directly affect TMJ symptoms, thus pre-existing TMJ symptoms and diagnoses should be considered prior to treatment planning and OGS.
PubMed: 26029683
DOI: 10.1186/s40902-015-0014-4 -
Seminars in Plastic Surgery Aug 2013The LeFort I osteotomy is one of the most commonly used procedures to correct midface deformities. It allows for correction in three dimensions including advancement,...
The LeFort I osteotomy is one of the most commonly used procedures to correct midface deformities. It allows for correction in three dimensions including advancement, retrusion, elongation, and shortening. It is indicated, often in conjunction with mandibular surgery, for class II and III malocclusion, facial asymmetry, obstructive sleep apnea, and maxillary atrophy. Before surgery, proper orthodontics and surgical planning should be undertaken to ensure adequate outcomes. Overall, the surgery is widely used due to its low complication profile and reliable long-term results.
PubMed: 24872761
DOI: 10.1055/s-0033-1357112 -
Journal of Oral and Maxillofacial... May 1993
Review
Topics: Bone Nails; Bone Plates; Bone Transplantation; Dental Implantation, Endosseous; Humans; Mandible; Osteotomy; Surgery, Oral; Surgical Flaps
PubMed: 8478754
DOI: 10.1016/s0278-2391(10)80501-4 -
Swiss Dental Journal 2016Dental aplasia of heterogenous etiology may cause jaw growth disturbance, malocclusion, esthetic discontent and psychosocial impairment. By a case report of a young...
Dental aplasia of heterogenous etiology may cause jaw growth disturbance, malocclusion, esthetic discontent and psychosocial impairment. By a case report of a young patient suffering from hypodontia, class II malocclusion and a deep bite the intricate interdisciplinary diagnosis- and treatment-protocol targeting the functional and esthetic rehabilitation is illustrated.
Topics: Adolescent; Anodontia; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Interdisciplinary Communication; Intersectoral Collaboration; Malocclusion, Angle Class II; Mandibular Osteotomy; Orthodontics, Corrective; Overbite; Radiography, Panoramic
PubMed: 27874918
DOI: No ID Found