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Biomedical subjects

P J Louis

Publications and source records attributed to P J Louis.

11 recordsLinked to original sources
PubMed2001

Soft tissue changes of the upper lip associated with maxillary advancement in obstructive sleep apnea patients.

PURPOSE: This retrospective study evaluated the horizontal and vertical soft tissue changes that occur with maxillary advancement surgery with a Le Fort I osteotomy with concomitant anatomic reorientation of the nasolabial musculature. SUBJECTS AND METHODS: Fifteen OSA patients who underwent maxillary advancement with a Le Fort I osteotomy without adjunctive nasal soft tissue procedures were studied after a minimum of 8 months of follow-up. The V-Y technique was used to close the maxillary vestibular incision. Only cases with minimal vertical movement (< 3.5 mm) in which no orthodontics were used were included. The average maxillary advancement was 8.0 +/- 2.5 mm, measured at the upper incisor (UPI) and the average vertical movement was 0.7 +/- 1.8 mm. The horizontal and vertical soft tissue change in subnasale (SN), labrale superiorus (LS), superior stomion (SS), nasal tip (NT), nasolabial angle (NLA), and lip length were measured in each patient and correlated with hard tissue measurements at anterior nasal spine (ANS) and UPI. The effect of lip thickness on these soft tissue changes also was evaluated. RESULTS: Using mean data, the horizontal soft-to-hard-tissue ratio for LS to UPI was 0.80:1, with a concomitant vertical (superior) soft tissue change to hard tissue advancement of 0.16:1. Lip length did not change significantly. All patients except 1 showed a slight decrease in nasolabial angle. The average decrease was 5 (range, -10 to +7 ). There was no statistically significant correlation between the degree of change in NLA and the amount of maxillary advancement. CONCLUSION: This study showed that advancement of the maxilla when controlling vertical movement resulted in the a hard-to-soft-tissue ratio of LS:UPI of 0.80:1. NLA did not change significantly.

Adult↗
PubMed2001

Inferior alveolar nerve repositioning.

Nerve repositioning is a viable alternative for patients with an atrophic edentulous posterior mandible. Patients, however, should be informed of the potential risks of neurosensory disturbance. Documentation of the patient's baseline neurosensory function should be performed with a two-point discrimination test or directional brush stroke test preoperatively and postoperatively. Recovery of nerve function should be expected in 3 to 6 months. The potential for mandibular fracture when combining nerve repositioning with implant placement also should be discussed with the patient. This can be avoided by minimizing the amount of buccal cortical plate removal during localization of the nerve and maintaining the integrity of the inferior cortex of the mandible. Additionally, avoid overseating the implant, thus avoiding stress along the inferior border of the mandible. The procedure does allow for the placement of longer implants, which should improve implant longevity. Patients undergoing this procedure have expressed overall satisfaction with the results. Nerve repositioning also can be used to preserve the inferior alveolar nerve during resection of benign tumors or cysts of the mandible. This procedure allows the surgeon to maintain nerve function in situations in which the nerve would otherwise have to be resected.

Atrophy↗
PubMed2000

Alloplastic augmentation of the face.

The previously presented facial augmentation techniques can be used in conjunction with orthognathic procedures or may be performed as separate procedures. When performed properly, they can enhance facial esthetics and improve patient satisfaction. Alloplastic augmentation, when properly planned and performed, is predictable, stable, and generally accepted by the patient.

Biocompatible Materials↗
PubMed1998

Problems and abnormalities found on routine clinical head and neck examination.

During the initial examination of a patient, the orthodontist may encounter various findings that will, for the most part, be normal or variants of normal. Most pathological conditions encountered will be derived from structures normally found in the anatomic locations examined. Knowledge of the anatomy and common pathological entities based on location can prove helpful when abnormalities are encountered. This article describes anatomic locations and their contents in and around the oral cavity and discusses pathological processes commonly encountered in these locations. Syndromes involved with various abnormalities also are briefly mentioned. The intent of this article is to give the clinician a working knowledge of commonly occurring pathological entities.

Diagnosis, Oral↗
PubMed1998

A case report. Chondromatosis of the temporomandibular joint.

Synovial chondromatosis is a rare pathological condition that usually affects large joints but can affect the temporomandibular joint. The disease typically manifests itself with signs and symptoms similar to internal derangement. The disease is characterized by free-floating or attached cartilaginous bodies in the joint space. In this article, the authors present a case of synovial chondromatosis and discuss its pathological process. They also discuss diagnostic approaches and current treatment.

Adult↗
PubMed1993

Secondary management of the nose in the cleft patient.

The management of the cleft lip and palate patient usually requires multiple primary and secondary surgical procedures to correct the deformity. This paper presents surgical methods in the secondary management of the cleft nose and presents three case reports to help illustrate these methods.

Adolescent↗
PubMed1993

Long-term skeletal stability after rigid fixation of Le Fort I osteotomies with advancements.

The purpose of this retrospective study was to evaluate relapse, comparing large and small maxillary advancements with four-plate rigid fixation and without bone grafting. All patients had obstructive sleep apnea, and underwent bimaxillary surgery. Standardized cephalometric analysis by two separate examiners was performed on serial radiographs of 20 patients immediately before surgery, and at 1 week and at least 6 months postoperatively (mean 18.5 months). The group was divided into three subsets to determine whether the magnitude of maxillary advancement correlated with the magnitude of relapse. In group 1 (< or = 6 mm, n = 4), the average advancement was 4.7 +/- 0.8 mm, with a mean relapse of 0 +/- 0.6 mm. In group 2 (7-9 mm, n = 9), the average advancement was 8.2 mm +/- 0.9, with a mean relapse of 0.7 +/- 1.5 mm. In group 3 (> or = 10 mm, n = 7), the mean advancement was 12.3 +/- 2.8 mm, with a mean relapse of 1.9 +/- 1.8 mm. There was no statistical difference in the measured relapse among the groups.

Adult↗