Orthognathic Surgery in the Young Cleft Patient: Preliminary Study on Subsequent Facial Growth

Purpose: This study evaluated the long-term effects of orthognathic surgery on subsequent growth of the maxillomandibular complex in the young cleft patient. Patients and Methods: We evaluated 12 young cleft patients (9 male and 3 female patients), with a mean age of 12 years 6 months (range, 9 years 8 months to 15 years 4 months), who underwent Le Fort I osteotomies, with maxillary advancement, expansion, and/or downgrafting, by use of autogenous bone or hydroxyapatite grafts, when indicated, for maxillary stabilization. Five patients had concomitant osteotomies of the mandibular ramus. All patients had presurgical and postsurgical orthodontic treatment to control the occlusion. Radiographs taken at initial evaluation (T1) and presurgery (T2) were compared to establish the facial growth vector before surgery, whereas radiographs taken immediately postsurgery (T3) and at longest follow-up (T4) were used to determine postsurgical growth. Each patient's lateral cephalograms were traced, and 16 landmarks were identified and used to compute 11 measurements describing presurgical and postsurgical growth. Results: Before surgery, all patients had relatively normal growth. After surgery, cephalograms showed statistically significant growth changes from T3 to T4, with the maxillary depth decreasing by -3.3° ± 1.8°, Sella-nasion-point A by -3.3° ± 1.8°, and point A-nasion-point B by -3.6° ± 2.8°. The angulation of the maxillary incisors increased by 9.2° ± 11.7°. Of 12 patients, 11 showed disproportionate postsurgical jaw growth. Maxillary growth occurred predominantly in a vertical vector with no anteroposterior growth, even though most patients had shown anteroposterior growth before surgery. The distance increased in the linear measurement from nasion to gnathion by 10.3 ± 7.9 mm. Four of 5 patients operated on during the mixed dentition phase had teeth that erupted through the cleft area. A variable impairment of postoperative growth was seen with the 2 types of grafting material used. No significant difference was noted in the effect on growth in patients with unilateral clefts versus those with bilateral clefts. The presence of a pharyngeal flap was noted to adversely affect growth, whereas simultaneous mandibular surgery did not. After surgery, 11 of 12 patients tended toward a Class III end-on occlusal relation. Conclusions: Orthognathic surgery may be performed on growing cleft patients when mandated by psychological and/or functional concerns. The surgeon must be cognizant of the adverse postsurgical growth outcomes when performing orthognathic surgery on growing cleft patients with the possibility for further surgery requirements. Performing maxillary osteotomies on cleft patients would be more predictable after completion of facial growth. © 2008 American Association of Oral and Maxillofacial Surgeons.

A logical approach to the management of object identifiers in non-conventional database management systems

Non-conventional database management systems are used to achieve a better performance when dealing with complex data. One fundamental concept of these systems is object identity (OID), because each object in the database has a unique identifier that is used to access and reference it in relationships to other objects. Two approaches can be used for the implementation of OIDs: physical or logical OIDs. In order to manage complex data, was proposed the Multimedia Data Manager Kernel (NuGeM) that uses a logical technique, named Indirect Mapping. This paper proposes an improvement to the technique used by NuGeM, whose original contribution is management of OIDs with a fewer number of disc accesses and less processing, thus reducing management time from the pages and eliminating the problem with exhaustion of OIDs. Also, the technique presented here can be applied to others OODBMSs. © 2011 IEEE.

Uso de meio a base de esterco suíno no cultivo de Ankistrodesmus gracilis (Chlorophyta) em laboratório

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Desenvolvimento e avaliação de um protocolo de atenção farmacêutica intensiva com metodologia educacional de empoderamento para adultos com Diabetes mellitus tipo 2 - estudo translacional fase 1

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Preparação de espumas cerâmicas de 'TIO IND. 2' a partir do processo sol-emulsão-gel

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Síntese, estrutura e propriedades de complexos de molibdênio, prata e chumbo com ácido 'alfa'-hidroxicarboxílicos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência da queima da palha de cana de açúcar na constituição do material particulado atmosférico (MP2,5 e MP10) e as suas implicações potenciais sobre a saúde humana

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Tratamento endovascular de angiomiolipoma renal por embolização arterial seletiva

Relata-se um caso de um paciente com queixa principal de dor lombar à esquerda, portador de angiomiolipomas renais (AMLRs) bilaterais, com a lesão mais volumosa de 6,2 cm em seu maior diâmetro, submetido a tratamento endovascular por embolização arterial superseletiva com microesferas. Os AMLRs são tumores benignos raros. A maioria é esporádica, enquanto uma minoria está associada à Esclerose Tuberosa Complexa (ETC). Os AMLRs maiores do que 4 cm devem ser tratados devido ao maior risco de complicações, principalmente hemorrágicas. A embolização arterial seletiva (EAS) é um tratamento efetivo e seguro para os AMLRs.

Avalição comparativa das intercorrências dialíticas de pacientes com lesão ranal aguda submetidos a sessões de hemodiálise prolongada de 6 e 10 horas

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Estudo de aspectos químicos, biológicos e biossintéticos em Piper fuligineum Kunth(Piperaceae)

Pós-graduação em Química - IQ

Sistemas anfifílicos derivados de megiumina: uma nova abaordagtem no desenvolvimento de biomateriais supramoleculares

Pós-graduação em Química - IQ

Estrógenos na bacia hidrográfica Tietê-Jacaré: ocorrência e avaliação do impacto ambiental

Pós-graduação em Química - IQ

Plasma anti-mullerian hormone: an endocrine marker for in vitro embryo production from Bos taurus and Bos indicus donors

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mechanisms of SnO2 Nanoparticles Formation and Growth in Acid Ethanol Solution Derived from SAXS and Combined Raman-XAS Time-Resolved Studies

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Estudo eletroquímico do sistema microestruturado montmorilonita-8- hidroxiquinolina na presença de íons metálicos

Pós-graduação em Química - IBILCE