Treatment of severe obstructive sleep apnea syndrome with a chinstrap.
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A chinstrap alone improved severe obstructive sleep apnea as well as or better than the use of CPAP. (+info)
Submental intubation in oral maxillofacial surgery: review of the literature and analysis of 13 cases.
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OBJECTIVES: Various different methods of intubation are suitable for facial trauma cases. A choice often has to be made between orotracheal and nasotracheal when surgical access to the nasal or oral cavity is necessary. This work presents our current experience using submental intubation in the airway management of facial trauma patients. STUDY DESIGN: From July 2003 to February 2005, 13 sufferers from facial trauma benefited from submental intubation. All the patients were males and the ages ranged from 19 to 35 years (mean, 27 years). RESULTS: In all the patients, the submental intubation permitted simultaneous reduction and fixation of all fractures and intraoperative control of the dental occlusion without interference from the tube during the operation. There was only one intra-operative complication, when the tracheal pressure increased as a result of deviation and compression of the tube. No post-operative complications were reported. CONCLUSION: Submental intubation is a simple, secure and effective procedure for operative airway control in major maxillofacial traumas. (+info)
Tooth axis and skeletal structures in mandibular molar vertical sections in jaw deformity with facial asymmetry using MPR images.
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The objective of the present study was to investigate frontal morphological asymmetry in the mandibular molar region in terms of tooth axis and skeletal structures using vertical MPR sections in jaw deformity accompanied by facial asymmetry. Subjects consisted of 15 patients with jaw deformity accompanied by facial asymmetry aged 17.4 years to 37.8 years. There were four men and eleven women. Based on X-ray computed tomography (CT) scans, DICOM viewer software was used to prepare multiplanar reconstruction (MPR) sections. The mandible was then positioned on a reference plane based on the menton and left and right gonions, and a vertical MPR section passing through the mesial root of the first mandibular molar was prepared. The following measurements were made on both the shifted and non-shifted sides: maximum buccolingual width of the mandibular body; height of the mandibular body; inclination angle of the mandibular body; degree of buccal protrusion of the mandibular body; and inclination angle of the buccolingual tooth axis of the first molar. Furthermore, degree of median deviation in the menton was measured using frontal cephalograms. Differences in morphological parameters between the shifted and non-shifted sides were assessed. Furthermore, the relationship between median deviation and asymmetry were statistically analyzed. There was no significant asymmetry in the maximum buccolingual width of the mandibular body, the height of the mandibular body or the degree of buccal protrusion of the mandibular body. However, when compared to the shifted side, the inclination angle of the buccolingual tooth axis of the first molar for the non-shifted side was significantly greater. There was a relatively strong correlation between median deviation and inclination angle of the mandibular body. The above findings clarified that, in orthognathic surgery for jaw deformity accompanied by facial asymmetry, actively improving asymmetry in the buccolingual inclination of the tooth axis of the molar region during presurgical orthodontic treatment is important in achieving favorable post-treatment occlusal stability and facial symmetry. (+info)
The effects of PNF training on the facial profile.
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Although orthodontic treatment improves dentoalveolar problems, the facial profile seldom changes because the perioral muscles do not easily adapt to the new morphological circumstances. We employed proprioceptive neuromuscular facilitation (PNF), which is training with added resisted movement to motions such as lifting the upper lip, lowering the lower lip, and sticking out the tongue, to adapt the perioral muscles to the new morphological circumstances. The subjects were 40 adults with an average age of 29.6 years. A series of PNF exercises was performed three times per day for 1 month. Lateral facial photographs were taken using a digital camera before training (T(0)), after training (T(1)), and 1 month after the end of training (T(2)). The nasolabial (NL), mentolabial (ML), and mentocervical (MC) angles were measured, and linear measurements were taken to verify the change of each measurement point. In the test group, the NL and ML angles significantly increased (P < 0.05), and the MC angle significantly decreased after the PNF exercise. From T(1) to T(2), the NL and ML angles decreased significantly, while the MC angle increased significantly. No significant differences were observed in these angles when the values measured at T(0) and T(2) were compared. Although the training appeared to be effective for sharpening the mouth and submandibular region, continued training is necessary to avoid relapse. (+info)
Greenstick fracture of the mandible: a case report.
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This case report is an insight in to pediatric traumatology whereby bilateral greenstick fracture of condyle is used as a means to discuss the incidence and anatomic considerations for the management of the same, highlighting the fact that dental surgeons require a unique understanding of the anatomy, growth considerations, healing pattern and operative management involving minimal manipulation while managing pediatric facial fractures. (+info)
Elevated PEM (phasic electromyographic metric) rates identify rapid eye movement behavior disorder patients on nights without behavioral abnormalities.
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OBJECTIVE: To determine the validity of the phasic electromyographic metric (PEM) to differentiate patients with a history suggestive of rapid eye movement behavior disorder (REMBD) on laboratory nights without overt dream-enactment behavior. METHODS: PEM was quantified as the % of 2.5-sec intervals with phasic muscle activity of 100-msec duration with an amplitude of at least 4 times background activity in 11 patients and 31 elderly controls. Data were derived from both REM and NREM sleep from 5 muscle groups (mentalis, left/right anterior tibialis, left/right brachioradialis). RESULTS: Relative to controls, REMBD patients had significantly higher levels of PEM activity in all recordings. The largest differences occurred during REM sleep for the mentalis and brachioradialis channels. Similar results were obtained by limiting quantification of PEM to the final REM period of the night and could be accomplished by individuals with no previous familiarity with polysomnography. DISCUSSION: PEM may be a useful metric to characterize the REM related phasic muscle activity on patients with a history of REMBD, even when no overt dream-enactment behaviors are detected on a laboratory night. (+info)
Malignant mental neuropathy (MMN) is a neurological manifestation of cancer, characterized by the presence of hypoesthesia or anesthesia restricted to the territory of the mental branch of the mandibular nerve. A systematic review of the literature has been made on MMN, analyzing the etiology, pathogeny, clinical characteristics, complementary tests and the prognosis. Sixteen studies, providing 136 cases were selected. Breast cancer and lymphomas were the most frequently associated malignant diseases. The most frequent pathogenic mechanisms producing neurological involvement were: peripherally, mandibular lesions; and centrally, tumors at the base of the cranium. Regarding clinical characteristics, manifestation of MMN was the primary symptom of malignant disease in 27.7% of cases, and a first symptom of recurrence in 37.7%. The group of selected studies included 50 orthopantomographs, 9 mandibular computed tomographies and 50 radiographic examinations of the cranial region. The most affected region was the mandible. The appearance of MMN is an ominous prognosis for the progression of the disease, with a mortality of 78.5% within a mean of 6.9 months. (+info)
A study of cephalometric appraisal of the inheritance of craniofacial pattern in Gorkhas.
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The phenotypic expression of biologic variability expressed in the craniofacial complex is influenced by constant interplay of heredity and environmental factors. The aim of this study was to observe the pattern of inheritance of cranio-facial complex in Gorkhas. Gorkhas are the original inhabitants of NEPAL in the slopes of HIMALAYAS and they generally marry strictly in their race. 76 individuals from 19 Gorkha families (son, daughter and both parents); were selected. Eight angular (saddle angle, articular angle, gonial angle, N-S-Gn, N-S-Go, SNA, SNB and ANB angles) and four linear (anterior facial height, posterior facial height, overjet and overbite) variables were measured from lateral head cephalograms and the values of the variables were evaluated and compared. It was found that the Inheritance of cranio facial pattern has shown significant coefficient of correlation from mother to offsprings for jarabak ratio, father to son for NS-Gn and NS-Go angle, father to daughter for articular and ANB angles. Different parts of craniofacial complex represents the resultant of morphology and size variation. Each one of these components are in turn influenced by many genetic and environmental factors. (+info)