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W A Borstlap

Publications and source records attributed to W A Borstlap.

At least 19 recordsLinked to original sources
PubMed2005

Stabilisation of sagittal split set-back osteotomies with miniplates: a prospective, multicentre study with 2-year follow-up.

The aim of this study was to assess post-operative stability of bilateral sagittal split set-back osteotomies using two miniplates and clinical parameters including nerve function, TMJ function, occlusal relapse and patient satisfaction. The stability was measured on cephalometric radiographs and possible condylar alterations on orthopantomograms. This prospective study implied a 2-year follow-up on a group of 24 patients. The same protocol was used at six participating institutions at which the patients were treated. A stable occlusion without appreciable relapse was seen in 91% after 2-year follow-up. Only two patients in this study had mild occlusal relapse. The mean skeletal horizontal relapse at pogonion of the whole group, after 2 years was 1.1mm and appeared to be directed backwards. At occlusal level, however, the mean relapse was 1.2mm forwards. The function of the inferior alveolar nerve 2 years post-operatively was reported to be normal in approximately 70% of the patients, yet 80% had no complaints about nerve dysaesthesia. In approximately 21% of the patients, signs and symptoms of TMJ dysfunction had disappeared. Another group (10%), however, without pre-operative signs and symptoms of TMJ dysfunction developed these signs or symptoms post-operatively. No condylar remodelling or resorption was seen in this group of patients. The sagittal split set-back osteotomy fixed with miniplates appeared to be a relatively save and reliable procedure giving rise to adequate results and a high degree of patients satisfaction.

Adolescent↗
PubMed2004

Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part II. Radiographic parameters.

This prospective study implied a two-year follow-up on a group of patients that underwent a Bilateral Sagittal Split Osteotomy (BSSO) for advancement (n=222) of the mandible that were treated in seven institutions following the same treatment protocol. The aim of Part II of this study was to correlate the clinical findings on stability and relapse as reported in Part I (clinical parameters) of this series of articles with the cephalometric findings. The mean skeletal relapse at pogonion of the whole group after two years was 0.9 mm. The clinically stable group, however, had only 0.4 mm relapse, whereas the clinical relapse group showed a mean relapse of 3.3 mm. The findings underline a relationship between the amount of advancement and relapse. The tendency for both, horizontal and vertical movement is the same, i.e., the larger the surgery effect, the larger the relapse. The angle post plane/mandibular plane showed the highest explained variance 9%. Patients with a high mandibular plane angle may be more prone to relapse. The explained variance of all considered prognostic factors together, however, is small (13%). The findings of this study express that patients with a clinical stable occlusion after a BSSO advancement, stabilised with miniplates, have a minimal to no skeletal relapse as measured on the cephalometric radiograms. The clinically non-stable group, however, appeared to have considerable skeletal relapse.

Bone Plates↗
PubMed2004

Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part III--condylar remodelling and resorption.

This prospective study implied a two-year follow-up in a group of patients that underwent a Bilateral Sagittal Split Osteotomy (BSSO) for advancement of the mandible that were treated in seven institutions following the same treatment protocol (using two miniplates). The aim of Part III of this study was to define a Condylar Morphology Scale (CMS) and to analyse radiological changes in the TMJ after BSSO in relation to postoperative relapse and to determine the incidence of morphologic changes and its risk factors. It was concluded that the used 3-point CMS served its purpose well. In eight patients (4%) resorption of the condyle developed postoperatively. The value of preoperative cephalograms to predict condylar alterations appeared to be limited (12% explained variance). Patients treated at a relative low age (< or = 14 years) appeared to be at risk for the occurrence of condylar alterations including resorption. A steep mandibular plane angle and the low facial height ratio (post:ant) were also significantly related to the occurrence of condylar alteration, but the multi variance regression showed that these parameters had only limited value. The occurrence of pain and TMJ sounds in the first few months postoperatively are highly suspicious for condylar changes to occur in the next months.

Adolescent↗
PubMed2004

Stabilisation of sagittal split advancement osteotomies with miniplates: a prospective, multicentre study with two-year follow-up. Part I. Clinical parameters.

The principal aim of this study was to assess the postoperative stability of bilateral sagittal split osteotomies (BSSO) using two miniplates. Part I reports on the clinical results including treatment characteristics, nerve functions, TMJ function, occlusional relapse and patient satisfaction. This prospective study evaluated a group of 222 patients who underwent a BSSO for mandibular advancement. The same treatment protocol was used at seven participating institutions at which the patients were treated. A stable occlusion without appreciable relapse was seen in 84% after 2 years of follow-up. A considerable minority (16%) had occlusal relapse. There were no clinical parameters that pointed towards a high risk for relapse except age. The mean operation age of the relapse group was 20.7 years (SD 6.7) and in the stable group 26.1 years (SD 8.2). The function of the inferior alveolar nerve 2 years postoperatively was reported to be normal in approximately 88% of the patients, while 94% had no complaints about nerve dysaesthesia. In approximately 56% of the patients with pre-existing TMJ-dysfunction these signs and symptoms had disappeared. Another group of patients, however, without TMJ-dysfunction preoperatively (22%) developed signs or symptoms of TMJ-dysfunction postoperatively. The sagittal split osteotomy fixed with miniplates appeared to be a relatively safe and reliable procedure giving rise to a high degree of patient satisfaction, despite the fact that some occlusal relapse was seen.

Adolescent↗
PubMed2000

[Team management of orofacial clefts].

In the Netherlands 15 centres provide multidisciplinary care for cleft lip and palate patients. Usually the following disciplines participate in such teams: paediatrics, plastic and reconstructive surgery, orthodontics, genetics, social work or nursing, ENT, speech therapy, maxillofacial surgery, prosthetic dentistry, psychology and oral hygiene. An overview is given of the treatment protocol from birth until 20 years of age for a child with a complete UCLP or BCLP. It is concluded that properly designed prospective clinical trials are rare, resulting in a lack of evidence based care in the field of cleft lip and palate. Furthermore it should be investigated whether it is preferable to centralise the cleft care in less centres than the present 15 ones.

Adolescent↗
PubMed1999

[Syndromes 10. Beckwith-Wiedemann syndrome].

Beckwith-Wiedemann syndrome is characterised by variable clinical combinations of exomphalos, macroglossia, gigantism, hypoglycemia and an increased incidence of tumors. This article briefly describes its clinical symptomatology. Recently, hemangiomatous lesions in tongues have been determined.

Beckwith-Wiedemann Syndrome↗
PubMed1998

Reproducibility of aimed-at profiles.

Would a surgeon always draw the same aimed-at profile when planning the correction of a face with evidently malpositioned jaws? The same 10 profile lines were given to seven maxillofacial surgeons on two occasions at intervals of 6 months. The differences in absolute and proportional vertical measurements were compared. It is shown that the variations between first and second drawing were quite large for individual values. However, even the mean differences per measurement vary between surgeons from 0 to 10%. The drawings for the whole group corresponded reasonably well with the ratios given by Farkas and Munro (1987) but were rather divergent from the 'golden dimensions' proposed by Brons and Mulié (1993). Considering the sometimes significant differences, one is advised not to draw profiles 'off the cuff' but to use a construction system for planning osteotomies.

Cephalometry↗
PubMed1996

[Skull roof reconstruction in infants].

In this article an introduction into craniofacial surgery in children is given based on the case histories of two patients (cleido-cranial dysplasia and cranio-synostosis).

Child↗
PubMed1995

Effectiveness of primary correction of traumatic telecanthus.

To assess the aesthetic and functional results of primary treatment of telecanthus in patients with naso-orbito-ethmoidal fractures, the results in 36 patients were evaluated in a retrospective study. Twenty had double-sided telecanthus: 13 required an indirect technique of canthopexy and seven a direct technique. Sixteen had unilateral telecanthus, of whom six were treated by the indirect and 10 by the direct technique. The intercanthal distance (ICD) was measured directly postoperatively and more than 12 months after reconstruction. The late ICD after application of the direct technique was nearly 3 mm smaller (ANOVA, P < or = 0.02, mean 34.3 mm) and yielded 2 mm less relapse (ANOVA, P < or = 0.02) as compared with the indirect technique. Delayed or late-primary treatment showed a significantly higher frequency of epiphora (chi-square test, P < or = 0.05). Early primary treatment of traumatic telecanthus produced the best aesthetic and functional result.

Analysis of Variance↗
PubMed1994

[Corrections after facial trauma. Experiences with secondary periorbital corrections].

Corrective surgery after primary treatment of periorbital trauma is indicated for functional as well as aesthetical reasons. These indications and the over-all results will be discussed, based on 56 cases. Surgical techniques such as osteotomy of the malar bone or correction of the nose will be presented. It is concluded that 60% of the cases achieve a good, final result. In another 30% considerable improvements have been realized.

Esthetics↗
PubMed1993

Timing and transplant materials for closure of alveolar clefts. A clinical comparison of 296 cases.

A retrospective study of bone grafting of 296 clefts (165 unilateral and 131 bilateral was required) to answer questions about the most favourable timing and the most appropriate bone graft material. The results as such are not exceptional in comparison with earlier publications by the same or other authors, but it is of special interest that operations with different graft materials applied at different times in development, in (usually) a sufficient number of cases, can be compared together. The patients have been operated on during a period of 11 years, by the same surgeons, applying the same principles and techniques. It is shown that early secondary grafting, before the eruption of the canine, results in by far, the highest success rate. Similarly, chin bone is considerably better than any other type of transplant. Aspects of general planning, timing, technique and failures are extensively discussed. Besides the afore-mentioned most significant findings, it is also concluded that the results of grafting during osteotomies are better than they appear; that tertiary grafting is extremely difficult, and requires special surgical skill; that rib grafts score as high as iliac crest grafts and that materials other than these three types of bone should be avoided.

Alveolar Process↗
PubMed1992

[Orthodontic and surgical aspects of cleft palate treatment].

The growth pattern of the face in cleft lip and palate patients is determined by intrinsic, functional and iatrogenic factors. Probably the iatrogenic factors are the most important. Orthodontic and orthognatic aspects of cleft palate treatment are described, being divided in five stages: 1. presurgical orthopedic treatment prior to lipclosure; 2. early orthopedic treatment of maxillary hypoplasia; 3. reconstruction of the alveolar cleft with bonegrafting and/or orthodontic treatment; 4. orthodontic treatment and 5. combined surgical/orthodontic treatment.

Adult↗
PubMed1991

Diagnostic and prognostic value of quantitative immunohistological examination of lip biopsy in Sjögren's syndrome.

Three patients are presented to illustrate the diagnostic and prognostic value of quantitative immunohistological examination of labial salivary gland biopsy in Sjögren's syndrome. In an obvious case of primary Sjögren's syndrome and in a case of rheumatoid arthritis without clinical and serological evidence of secondary Sjögren's syndrome, quantitative immunohistological examination of the labial salivary gland biopsy gave more appropriate information than the widely accepted lymphocytic focus score criterion for Sjögren's syndrome. In the third case quantitative immunohistological examination disclosed monoclonal B-cell expansion in the labial salivary gland biopsy six months before evidence of systemic monoclonal gammopathy appeared.

Adult↗
PubMed1990

Early secondary bone grafting of alveolar cleft defects. A comparison between chin and rib grafts.

Since 1981 in cleft lip and palate patients a combined surgical-orthodontic procedure has been performed to eliminate the residual alveolar cleft. For early secondary bone grafting (before the eruption of the canine tooth) initially the graft tissue of choice was rib. Since 1984 chin bone has also been used. Sixty one patients with complete unilateral clefts were reviewed (mean age 9.5 years). 15.7% of the rib graft cases showed resorption of the graft of 50% and more. Such resorption was not found in any of the chin graft cases. No complications such as wound dehiscence, sequestration, excessive resorption of bone or recurrence of an oro-nasal fistula were found in the chin graft group. This leads to the conclusion that if enough bone is available in the chin region to bridge the defect, this graft is preferable to a rib graft.

Adolescent↗
PubMed1989

Reconstruction of the zygomatic area. A comparison between osteotomy and onlay techniques.

The contour of the hypoplastic or displaced zygoma can be corrected by two basically different techniques. For reconstruction, onlays with alloplastic or autologous material are advocated. In post-traumatic cases an osteotomy may be considered. The two techniques are compared. It appears that the longterm results achieved in 7 cases with the onlay technique are aesthetically inferior to those of the 20 cases treated by osteotomy. Since the osteotomy also has technical advantages, it should also be preferred in cases of marked hypoplasia, if need be in combination with onlays.

Adolescent↗
PubMed1983

Apicoectomy on molars: a clinical and radiographical study.

Apicoectomies on molars are not performed frequently, although their success rate can reach that obtained by apicoectomies on front teeth and premolars. 86 patients were operated on between January 1976 and December 1980 at St. Radboud Hospital. Clinical and radiological re-examination could be carried out on 70 of them. In 73% of the cases, healing was complete, in 21% incomplete, and in 6% the teeth were extracted. Certain factors which possibly influenced healing and the methods of root filling are discussed.

Adolescent↗