Faculty Bibliography

Vascular malformations affect the craniofacial skeleton in many ways, depending on the type of the lesion and its location. The lesions may exert a mass effect and cause thinning or thickening of the bone or cause expansion from direct bony infiltration. Orthognathic surgery can be used to correct any malocclusion or open bite deformities after the soft tissues are addressed.

Distraction osteogenesis (DO) is a major surgical technique that promotes new bone formation. It was first developed in the long bones and has now been applied to the facial bones. McCarthy et al. were the first to apply the procedure to the human mandible. The early uses in craniofacial surgery and orthognathic surgery were with extraoral appliances and therefore had limited appeal to many patients other than those with severe craniofacial anomalies, such as hemifacial microsomia. This changed with the introduction of intraoral appliances. Since that time, the use of DO has expanded to applications beyond those in jaw and craniofacial abnormalities to include its use in the treatment of cleft palate patients, condylar regeneration, discontinuity defects of the mandible, and for ridge augmentation before the placement of implants. Moreover, as experience in treating severe dentofacial deformities increased, surgeons were encouraged to intercede at an earlier age to minimize the extent of the deformity and to minimize relapse after surgery. This article describes some of the newer concepts in using DO to treat maxillary and mandibular deformities and growth discrepancies that are not amenable to routine orthognathic surgery.

Distraction osteogenesis is an alternative treatment method for correction of mandibular hypoplasia. This paper outlines the use of mandibular distraction in a patient with mandibular hypoplasia and a history of a mandibular cleft

Accuracy of cephalometric tracings and model surgeries is of utmost importance in planning for orthognathic surgery. The technique described allows surgeons to verify position of the models by superimposing a cephalogram of the mounted models over that of the patient. It also reduces the chance of error during actual surgery by placing models in centric relation. Therefore, the possibility of intraoperative complications, and thus longer operating times, is minimized.

Electrical burns of the oral cavity are relatively rare; a case is reported here. An acrylic splint fabricated for the patient helped prevent microstomia and the subsequent development of a deformity.

There are many causes of limitation of mandibular function. The use of CT scanning has enhanced our ability to look beyond the more obvious anatomic areas of mandibular ankylosis. An interesting case of pseudoankylosis of the pterygoid plate and mandible is presented. This case clearly demonstrates the importance of CT scanning in the diagnosis and treatment planning for such an unusual anomaly