Biomedical subjects

F B Moloney

Publications and source records attributed to F B Moloney.

12 recordsLinked to original sources

PubMed1996

The stability of facial osteotomies. Part 6. Chin setback.

Isolated horizontal osteotomy of the anterior mandible (genioplasty) to move the chin posteriorly can be used to improve facial profile. There has been an increasing tendency in practice to carry out this procedure in combination with maxillary and/or mandibular surgery. This is most appropriately undertaken when pre-operative prediction techniques indicate that chin prominence will remain excessive following maxillary and/or mandibular advancement surgery. This paper reviews surgical techniques applicable to posterior movement of the chin ("the setback genioplasty') and illustrates the clinical results achieved with its use.

Adolescent↗

PubMed1996

The stability of facial osteotomies. Part 5. Maxillary advancement with miniplate and screw fixation.

Surgical repositioning of the dento-skeletal components of the middle-third of the face, combined with appropriate orthodontic treatment, can be used to improve function and aesthetics. However, the attainment of three-dimensional stability following corrective jaw surgery continues to be a major problem in the postsurgical period. This paper examines the short-term (six weeks postoperative) and long-term (12 months postoperative) horizontal skeletal stability of Le Fort I maxillary advancement in 15 patients. The mean horizontal advancement of the maxilla was 8.76 +/- 0.99 mm. Six weeks later, a mean relapse of 0.22 +/- 0.19 mm was identified. The mean relapse at long-term follow-up was 0.61 +/- 0.26 mm (6.96%). These results indicate that rigid miniplate and screw fixation of Le Fort I osteotomy undertaken to correct horizontal mid-dentofacial deficiency is both statistically and surgically predictable and stable when reviewed up to twelve months after surgery.

Adolescent↗

PubMed1995

Collagen type in dysfunctional temporomandibular joint disks.

Controlled studies were undertaken to ascertain the nature of the fibrous tissue component of surgically removed dysfunctional human temporomandibular joint disks. Each disk was divided into several parts and dissociative methods were used to extract collagenous residues. The resultant residues were digested with cyanogen bromide and the obtained soluble peptides were characterized by their electrophoretic mobility on polyacrylamide slab gels. The separated peptides were then scanned on a laser densitometer. Type III collagen was identified in samples taken from both the women's and the men's posterior disk attachment tissues. The amount of type III collagen in the women's attachments was approximately twice that found in the men's and both of these quantities were greater than those previously found in nondysfunctional tissues. The finding that there was more type III collagen in the posterior attachments of the women's chronically damaged disks may indicate that these tissues in women are less able to withstand functional loading.

Cartilage, Articular↗

PubMed1995

The stability of facial osteotomies. 2. Mandibular advancement with bicortical screw fixation.

Surgical repositioning of the dento-skeletal components of the lower third of face, combined with appropriate orthodontic treatment, can be used to improve function and aesthetics. However, the attainment of three-dimensional stability following corrective jaw surgery continues to be a major problem in the post-surgical period. This paper examines the short-term (6 week post-operative) and long-term (12 months postoperative) horizontal skeletal stability of bilateral sagittal split mandibular advancement in 15 patients. The mean horizontal advancement of the mandible was 6.1 mm. Six weeks later, a mean continued forward movement of 0.16 mm was identified. The mean relapse at long-term follow-up was 0.46 mm (7.5%). Results indicate that rigid bicortical screw fixation of bilateral sagittal split osteotomies undertaken to correct horizontal lower dentofacial deficiency is both statistically and surgically predictable and stable when reviewed up to twelve months after surgery.

Adolescent↗

PubMed1995

The stability of facial osteotomies. 3. Chin advancement.

Surgical repositioning of the chin can be used to improve function and aesthetics. The most commonly employed technique involves a sectioning of the lower border of the anterior mandible, thus allowing a sliding movement of the chin. It is generally accepted that the maintenance of a soft tissue attachment provides a clinically stable skeletal and predictable soft tissue change with minimal postoperative osseous resorption. Part 3 of this series of papers addresses the issues of treatment planning, surgical technique and clinical indications for undertaking advancement genioplasty. These, combined with the surgeon's artistic sense of facial harmony, are pre-conditions necessary for successful chin surgery.

Adolescent↗

PubMed1995

The stability of facial osteotomies. 4. Maxillary and mandibular (with or without chin) advancement with rigid internal fixation.

The short-term (6 weeks postoperative) and long-term (12 months postoperative) horizontal skeletal stability of combined maxillary and mandibular advancement was evaluated by cephalometric analysis of 15 patients. The mean horizontal advancement of the maxilla was 5.84 mm. Six weeks later a mean horizontal relapse of 0.03 mm (0.05%) was identified. The mean horizontal relapse at long-term follow-up was 0.59 mm (10.1%). The mean horizontal advancement of the mandible was 12.35 mm at menton and 12.65 mm at pogonion. At 6 weeks, mean horizontal relapse, respectively at the above landmarks, was 0.11 mm and 0.21 mm (1.3%). The mean horizontal relapse at long-term follow-up was 2.19 mm and 1.98 mm (16.6%) respectively for the same landmarks. Subjectively and objectively, improvements were seen in facial aesthetics and dental occlusion. The results indicate that rigid fixation of osteotomies undertaken to correct 'horizontal facial deficiency' is a surgically predictable and relatively stable procedure when reviewed up to 12 months after surgery.

Adolescent↗

PubMed1995

The stability of facial osteotomies. 1. The evolution of maxillary, mandibular and chin osteotomies.

Surgical repositioning of the dento-skeletal components of the face, combined with appropriate orthodontic treatment, can be used to improve function and aesthetics. An extensive number of osteotomies are performed within the maxillofacial region. The most common of these are the Le Fort I osteotomy of the maxilla, the bilateral sagittal split osteotomy of the mandibular ramus, and the horizontal osteotomy of the anterior mandible. The attainment of three dimensional stability following corrective jaw surgery continues to be a major problem in the post-surgical period, in spite of the widespread adoption of rigid internal osteosynthesis. The evolution of these osteotomies to advance dento-skeletal components is traced from their inception to the present day and the concept of stability is explained (Part I). This serves as a prelude to an investigation into the stability of these procedures, undertaken in isolation or combination, to advance selected segments of the mid- and lower face (Parts 2, 3, 4, 5).

Chin↗

PubMed1994

The stability of facial advancement surgery (in the management of combined mid and lower dento-facial deficiency).

The short-term (6 weeks postoperative) and long-term (12 months postoperative) skeletal stability of combined maxillary and mandibular advancement was evaluated by cephalometric analysis in 15 patients. The mean horizontal advancement of the maxilla was 5.84 mm. 6 weeks later a mean relapse of 0.03 mm (0.5%) was identified. The mean relapse at long-term follow-up was 0.59 mm (10.1%). The mean horizontal advancement of the mandible was 12.35 mm at menton and 12.65 mm at pogonion. At 6 weeks, mean horizontal relapse, respectively at the above landmarks, was 0.11 mm and 0.21 mm (1.3%). The mean relapse at long-term follow-up was respectively 2.19 mm and 1.98 mm (16.9%). Subjectively and objectively improvements were seen in facial aesthetics and dental occlusion. The results indicated that rigid fixation of osteotomies undertaken to correct 'horizontal facial deficiency' is a surgically predictable and relatively stable procedure when reviewed up to 12 months after surgery.

Adolescent↗

PubMed1994

Cephalometric alterations following facial advancement surgery. 2. Clinical and computerised evaluation.

Part 1 of this investigation identified an established patient cohort whose treatment is best suited to combined surgical-orthodontic correction of dento-facial deformity. This is as opposed to the attempted correction of the problem by an orthodontics-only or a surgery-only approach. Experienced surgeons will subjectively assess facial aesthetics and devise surgical treatment objectives in terms of the beneficial soft tissue improvements derived from dento-skeletal manipulation. None the less, traditional and soft tissue cephalometric parameters remain a guideline in the diagnostic phase of treatment. Part 2 of this investigation compared pre and postoperative clinical and computerised evaluations of patients diagnosed as having combined mid and lower dento-facial deficiency with Class 1 dento-skeletal parameters.

Cephalometry↗

PubMed1994

Cephalometric alterations following facial advancement surgery: 1. Statistical evaluation. A review of aesthetic evaluation of the face and an attempt to assess treatment validity.

Simultaneous maxillary and mandibular advancement surgery, with or without chin advancement, was performed to correct combined mid and lower dento-facial deficiency, the diagnosis of the deformity in this study being based purely on a clinical analysis. The purpose of this investigation was to test the validity of the diagnosis, surgical treatment objective, and subsequent surgical result, by comparing pre- and postoperative cephalometric data with 'Class I dento-skeletal parameters', derived from three different analyses. Lateral cephalometric radiographs were obtained from patients who had undergone 'facial advancement surgery'. The radiographs were subjected to cephalometric analysis in an attempt both to quantify and qualify the skeletal and dental changes that had taken place, following surgical correction of 'horizontal facial deficiency'. A statistical analysis was then used to assess postoperative change to normal, and how the proportion of patients so defined varied by method. All patients had optimal improvements in aesthetics, and in dental occlusion. Dento-skeletal changes remained stable at 12 months post surgery. In spite of these successes, the results of this investigation showed that no greater than 50% of preoperative abnormal measurements per patient were normalised by surgery.

Adolescent↗

PubMed1985

Mandibular advancement surgery. A study of the lower border wiring technique for osteosynthesis.

A study was undertaken to evaluate the effectiveness of osteosynthesis achieved by a lower border wire technique. Fifty patients who underwent mandibular advancement surgery were examined cephalometrically during 6 weeks of maxillomandibular fixation. A detailed analysis was made of spatial changes in the proximal and distal segments following bilateral sagittal-split osteotomies.

Adolescent↗

PubMed1983

Occlusal splints.

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Dental Occlusion↗