Bilateral aplasia of the mandibular ramus and condyle in Klinefelter syndrome.
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Child↗
Biomedical subjects
J H Schoenaers
Publications and source records attributed to J H Schoenaers.
Late management of secondarily grafted clefts.
34 patients (40 sides) received alveolo-palatal bone grafts for closure of the residual cleft, thus guiding a lateral incisor or canine into the arch. Long-term follow-up shows that in 41% of the patients uninterrupted arches were achieved with a normal relationship by orthodontic treatment only. 38% needed segmental osteotomies to eliminate the edentulous space, and in only 20% were bridges made to restore the dental arch. 9 (25%) patients still required a Le Fort I advancement osteotomy, despite optimal orthodontic treatment. The use of segmental osteotomies for eliminating edentulous spaces in cleft palate patients is discussed, and their advantage in relation to nasal base support is emphasized. It should be the aim to achieve in every cleft palate patient a complete archform without the need for bridges or removable prostheses. A rational orthodontic-surgical approach to the cleft, lip and palate patient is suggested with respect to naso-maxillary growth and development.
Alveolar Process↗
[The role of the dentist in the prevention and early detection of oral carcinoma].
Based on data derived from the Arnhem Regional Health area, the number of patients with a primary oral squamous cell carcinoma in the Dutch population has been estimated to be approximately 400 per year. Given the population of almost 15 million, the incidence can be estimated to be 2.8 per 100,000. The role of the dentist in the prevention and early detection of cancer of the mouth is discussed. The need for regular check-ups on the target group of patients, being heavy alcohol consumers and smokers, is emphasized. Simple methods for elimination of local irritating factors are recommended.
Adult↗
Reconstruction of the severely resorbed mandible with interposed bone grafts and hydroxylapatite. A 2-3 year follow-up.
A follow-up study on 55 patients, who underwent an augmentation of their severely resorbed mandible, using a mixture of autogenous bone and HA-granules, is discussed. The method combines an interposed bone graft technique in the symphyseal area with a subperiosteal tunneling in the region posterior to the mental foramina. The results show a maximum height loss of approximately 30% in both the symphysis and the bicuspid-molar region after 2 to 3 years, from which most occurred in the first 6 months. The method is relatively safe with regard to potential nerve damage and provides excellent aesthetic results. The option for subsequent placement of implants is entirely possible.
Adult↗
Skeletal stability following sagittal split osteotomy using monocortical miniplate internal fixation.
Skeletal stability was evaluated in 20 patients with mandibular hypoplasia, treated with bilateral sagittal split osteotomies to advance the mandible. Stable internal fixation was obtained using osseous miniplates and monocortical screws. Intermaxillary fixation was released after 5.15 days (range 1 to 11 days). The average B-point advancement was 6.07 mm (range 2.25 to 17.5 mm) and the average Pogonion-point advancement was 5.39 mm (range 1.75 to 14 mm). Mandibular range of motion, TMJ dysfunction and neurosensory deficits were also evaluated. The follow-up period averaged 8.85 months (range 6 to 14 months) and final evaluations were made after completion of orthodontics. Relapse measured at B-point was 10.7% and at Pogonion was 18.7%. Maximal opening decreased an average of 0.47 mm. Symptoms in 8 patients with TMJ dysfunction resolved, while 3 others developed TMJ dysfunction following surgery. Neurosensory deficits were subjectively identified in 9 patients (10 sides) and were objectively measured in 5 patients (5 sides).
Bone Plates↗
The prevention of relapse after maxillary osteotomies in cleft palate patients.
The use of segmental osteotomies to treat surgically severe malocclusion in cleft patients is discussed. The coordinated approach by orthodontist and surgeon is advocated and the advantage of such an approach is stressed. The method allows for the simultaneous correction of the skeletal deformity and closure of residual oro-nasal perforation. The relapse tendency in both antero-posterior and transverse dimensions appeared to be minimal as found in this study of 18 patients.
Adolescent↗