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Secondary bone grafting of the cleft maxilla following reverse quad-helix expansion in 103 patients.

Emodi O, Noy D, Hazan-Molina H, Aizenbud D, Rachmiel A - Ann Maxillofac Surg (2015 Jan-Jun)

Bottom Line: Does RQH improve the surgical procedure before ABG?The following data were recorded for each of the patients: Unilateral/bilateral cleft, surgery time, hospital stay, success/failure, and follow-up.Presurgical orthodontic application of the RQH expander in the cleft area enabled improved anterior expansion rather than posterior expansion.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.

ABSTRACT

Introduction: The main points to consider in secondary alveolar bone grafting (ABG) of cleft patients are age at the time of surgery, the type of bone graft, and pre/postorthodontic expansion of the upper jaw.

Purpose: The aim of this study is to evaluate the reverse quad-helix (RQH) expander device. Does RQH improve the surgical procedure before ABG? We will evaluate the outcome of the procedure, duration of the operation, hospitalization time, satisfaction of the surgeon with this procedure and the success of the bone graft in the long-term.

Patients and methods: We reviewed the medical records of 103 cleft patients who underwent secondary bone grafting at our institution between 2001 and 2012. All patients were treated presurgically with a RQH appliance to expand the cleft area. The following data were recorded for each of the patients: Unilateral/bilateral cleft, surgery time, hospital stay, success/failure, and follow-up.

Conclusion: Presurgical orthodontic application of the RQH expander in the cleft area enabled improved anterior expansion rather than posterior expansion. This technique improves access for surgery and bone grafting, the use of RQH facilitates the improved manipulation of the nasal mucosa via direct view due to the wide separation of the alveolar segments in the cleft area. Furthermore, this gap enables improved access for the bone grafting procedure, shortens the surgery time and provides stable maxillary transverse correction.

No MeSH data available.


Related in: MedlinePlus

(a) Preparing the alveolar cleft area, raising two buccal advancement flaps, two palatal flaps and elevating the nasal floor to the same level as the unaffected side (b) Particulate cancellous bone marrow is packed in a routine fashion, elevating the nasal floor to the same level as the unaffected side. Bone is packed to the level of cement-enamel junction of adjacent teeth
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Figure 5: (a) Preparing the alveolar cleft area, raising two buccal advancement flaps, two palatal flaps and elevating the nasal floor to the same level as the unaffected side (b) Particulate cancellous bone marrow is packed in a routine fashion, elevating the nasal floor to the same level as the unaffected side. Bone is packed to the level of cement-enamel junction of adjacent teeth

Mentions: The buccal flaps are elevated above the piriform rim exposing the nasal floor of the affected side. It is important to expose the bone of the medial and lateral parts of the cleft in the alveolar area. Particulate cancellous bone marrow (PCMB) is then packed in a routine fashion, elevating the nasal floor to the same level as the unaffected side. Bone is packed to the level of cement-enamel junction of adjacent teeth. The buccal and palatal flaps are sutured to each other in the cleft area via horizontal mattress with 4.0 vicryl sutures. The area of the exposed alveolar bone is left for secondary healing [Figure 5a and b].


Secondary bone grafting of the cleft maxilla following reverse quad-helix expansion in 103 patients.

Emodi O, Noy D, Hazan-Molina H, Aizenbud D, Rachmiel A - Ann Maxillofac Surg (2015 Jan-Jun)

(a) Preparing the alveolar cleft area, raising two buccal advancement flaps, two palatal flaps and elevating the nasal floor to the same level as the unaffected side (b) Particulate cancellous bone marrow is packed in a routine fashion, elevating the nasal floor to the same level as the unaffected side. Bone is packed to the level of cement-enamel junction of adjacent teeth
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555945&req=5

Figure 5: (a) Preparing the alveolar cleft area, raising two buccal advancement flaps, two palatal flaps and elevating the nasal floor to the same level as the unaffected side (b) Particulate cancellous bone marrow is packed in a routine fashion, elevating the nasal floor to the same level as the unaffected side. Bone is packed to the level of cement-enamel junction of adjacent teeth
Mentions: The buccal flaps are elevated above the piriform rim exposing the nasal floor of the affected side. It is important to expose the bone of the medial and lateral parts of the cleft in the alveolar area. Particulate cancellous bone marrow (PCMB) is then packed in a routine fashion, elevating the nasal floor to the same level as the unaffected side. Bone is packed to the level of cement-enamel junction of adjacent teeth. The buccal and palatal flaps are sutured to each other in the cleft area via horizontal mattress with 4.0 vicryl sutures. The area of the exposed alveolar bone is left for secondary healing [Figure 5a and b].

Bottom Line: Does RQH improve the surgical procedure before ABG?The following data were recorded for each of the patients: Unilateral/bilateral cleft, surgery time, hospital stay, success/failure, and follow-up.Presurgical orthodontic application of the RQH expander in the cleft area enabled improved anterior expansion rather than posterior expansion.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.

ABSTRACT

Introduction: The main points to consider in secondary alveolar bone grafting (ABG) of cleft patients are age at the time of surgery, the type of bone graft, and pre/postorthodontic expansion of the upper jaw.

Purpose: The aim of this study is to evaluate the reverse quad-helix (RQH) expander device. Does RQH improve the surgical procedure before ABG? We will evaluate the outcome of the procedure, duration of the operation, hospitalization time, satisfaction of the surgeon with this procedure and the success of the bone graft in the long-term.

Patients and methods: We reviewed the medical records of 103 cleft patients who underwent secondary bone grafting at our institution between 2001 and 2012. All patients were treated presurgically with a RQH appliance to expand the cleft area. The following data were recorded for each of the patients: Unilateral/bilateral cleft, surgery time, hospital stay, success/failure, and follow-up.

Conclusion: Presurgical orthodontic application of the RQH expander in the cleft area enabled improved anterior expansion rather than posterior expansion. This technique improves access for surgery and bone grafting, the use of RQH facilitates the improved manipulation of the nasal mucosa via direct view due to the wide separation of the alveolar segments in the cleft area. Furthermore, this gap enables improved access for the bone grafting procedure, shortens the surgery time and provides stable maxillary transverse correction.

No MeSH data available.


Related in: MedlinePlus