Total Mandibular Subapical Osteotomy and Le Fort I Osteotomy Using Piezosurgery and Computer-Aided Designed and Manufactured Surgical Splints: A Favorable Combination of Three Techniques in the Management of Severe Mouth Asymmetry in Parry-Romberg Syndrome

被引:14
作者
Scolozzi, Paolo [1 ]
Herzog, Georges [1 ]
机构
[1] Univ Hosp Geneva, Fac Med, Dept Surg, Div Oral & Maxillofacial Surg, CH-1211 Geneva, Switzerland
关键词
HEMIFACIAL ATROPHY; ORTHOGNATHIC SURGERY; ORTHODONTIC TREATMENT; AESTHETIC TREATMENT; DISEASE; EXPERIENCE; RECONSTRUCTION; SOFT;
D O I
10.1016/j.joms.2013.09.044
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Although its pathogenesis remains obscure, Parry-Romberg syndrome (PRS) has been associated with the linear scleroderma en coup de sabre. PRS is characterized by unilateral facial atrophy of the skin, subcutaneous tissue, muscles, and bones with at least 1 dermatome supplied by the trigeminal nerve. Facial asymmetry represents the most common sequela and can involve the soft tissues, craniomaxillofacial skeleton, dentoalveolar area, and temporomandibular joint. Although orthognathic procedures have been reported for skeletal reconstruction, treatment of facial asymmetry has been directed to augmentation of the soft tissue volume on the atrophic side using different recontouring or volumetric augmentation techniques. Total mandibular subapical osteotomy has been used in the management of dentofacial deformities, such as open bite and mandibular dentoalveolar retrusion or protrusion associated with an imbalance between the lower lip and the chin. Management of orthognathic procedures has been improved by the recent introduction of stereolithographic surgical splints using computer-aided design (CAD) and computer-aided manufacturing (CAM) technology and piezosurgery. Piezosurgery has increased security during surgery, especially for delicate procedures associated with a high risk of nerve injury. The present report describes a combined total mandibular subapical osteotomy and Le Fort I osteotomy using piezosurgery and surgical splints fabricated using CAD and CAM for the correction of severe mouth asymmetry related to vertical dentoalveolar disharmony in a patient with PRS. (C) 2014 American Association of Oral and Maxillofacial Surgeons
引用
收藏
页码:991 / 999
页数:9
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