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Biomedical subjects

A M Medra

Publications and source records attributed to A M Medra.

4 recordsLinked to original sources

Management of unilateral temporomandibular ankylosis associated with facial asymmetry.

Longstanding unilateral temporomandibular joint ankylosis, which starts during the active growth period in early childhood, results in facial asymmetry. Three problems are encountered: the ankylosed joint; the asymmetric face and, occasionally, upper airway obstruction. Simultaneous surgery was performed on 27 patients to release the joint ankylosis and to correct the facial deformity. Bimaxillary surgery was done for adult patients with occlusal canting, and mandibular surgery alone for adult patients without occlusal canting and for young children. Very satisfactory results were obtained during a follow-up period ranging from 2 to 6 years, regarding the restoration of joint function, improvement in aesthetic appearance and relief of respiratory obstruction.

Adolescent↗

Bird face deformity secondary to bilateral temporomandibular joint ankylosis.

This paper describes our experience in the treatment of 10 patients with bilateral longstanding temporomandibular joint ankylosis occurring during the active growth period and causing severe bird face deformity. The clinical manifestations were: (1) upper airway obstruction in the form of either severe night snoring or obstructive sleep apnoea; (2) inability to open the mouth and (3) severely convex facial profile. Surgery consists of simultaneous release of the ankylosed joints, advancement of the mandible and insertion of posterior mandibular costochondral graft struts. A Le Fort I osteotomy was performed concomitantly in marked deformities to help in the restoration of the posterior facial height. Dramatic improvement in the airway, facial profile and jaw function were obtained by this programme.

Adolescent↗

Vascular malformations of the jaw bones. Report on nine patients.

Nine patients with vascular malformations of the jaw bones, 4 affecting the mandible, 2 affecting both jaws and 3 affecting the maxilla only. Four lesions were of the high flow type and 5 were of low flow type. Our experience in the management of these lesions is presented together with the possible complications.

Adolescent↗

The split rib bundle graft in mandibular reconstruction.

This article describes a modified technique for the use of free non-vascularized split ribs (bound together in the form of a tight bundle), to reconstruct different types of mandibular defects. Experience gained over the last 4 years in treating 38 patients with different pathological lesions is presented. The procedure, carried out simultaneously with bone resection proved to be highly effective in providing mesio-distal spanning of the defect, adequate mandibular height as well as bucco-lingual thickness. This technique utilizes the different theories of osteogenesis: (a) from the periosteal cells, (b) from the transplanted living osteocytes and from (c) stimulating host mesenchymal cells to form new bone by bone induction. The surgical technique, results and conclusions are presented in this report.

Adolescent↗