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An Investigation of Three-Dimensional Maxillary Arch Morphometry of Children With Unilateral Cleft Lip and Palate

Haque S, Khamis MF, Alam MK, Ahmad WMAW

J Craniofac Surg, 2021 May 01;32(3):964-966.
PMID: 33405460 DOI: 10.1097/SCS.0000000000007366

ABSTRACT: The aim of this study was to evaluate the effects of multiple factors (congenital and postnatal treatment factors) on the treatment outcome by assessing the maxillary arch dimension of children with unilateral cleft lip and palate (UCLP). Eighty-five Pakistani children with UCLP were taken who received cheiloplasty and palatoplasty. Laser scanned 3D digital models of UCLP subjects were prepared before any orthodontic treatment and bone grafting at 7.69 ± 2.46 (mean ± standard deviation) years of age. Inter-canine width (ICW), inter-molar width (IMW), and arch depth (AD) measurements of maxillary arch were measured with Mimics software. Multiple linear regression analyses were used to evaluate the association between congenital factors (age, gender, UCLP side, family history of cleft) and postnatal treatment factors (techniques of cheiloplasty and techniques of palatoplasty) with maxillary arch dimensions (ICW, IMW, and AD). P value was set at 5%. The mean (standard deviation) dimensions of ICW, IMW, and AD are 26.7 (5.70) mm, 43.3 (4.66) mm, and 27.1 (5.26) mm, respectively. There is no significant association found between multiple factors and maxillary arch dimensions. This regression analysis shows no significant association between multiple factors and MAD in this sample.

Matched MeSH terms: Maxilla/surgery
Fulltext Bilateral accessory central cusp of 2nd deciduous molar: an unusual occurrence

Sockalingam, S. Nagarajan M.P., Alida Mahyuddin

Archives of Orofacial Sciences, 2009;4(1):22-24.
MyJurnal

Presence of accessory cusp on the occlusal surface of a tooth may occasionally pose problems to dentists'. Although its presents may not be a cause for alarm in most instances, nevertheless it can lead to serious consequences if it is damaged. This report describes a rare finding of bilateral central accessory cusp seen on the occlusal surface of both the 2nd maxillary deciduous molars and the need for continuous dental surveillance and preventive measures have been highlighted.

Matched MeSH terms: Maxilla
Fulltext Multidisciplinary approach for management of a patient with fibrous dysplasia of maxilla

Eachempati P, Aggarwal H, Shenoy V, Baliga M

BMJ Case Rep, 2015 Aug 05;2015.
PMID: 26245286 DOI: 10.1136/bcr-2015-210330

Fibrous dysplasia is a non-neoplastic hamartomatous developmental fibro-osseous lesion of bone. Monostotic fibrous dysplasia is more common than the polyostotic form and usually involves jaw bones, ribs and femur. Maxillary lesions may extend to involve the maxillary sinus, zygoma, sphenoid bone and floor of the orbit and require surgical intervention resulting in an acquired defect of the involved site. A multidisciplinary team approach involving an oral pathologist, oral surgeon, oral medicine expert and maxillofacial prosthodontist is required for successful treatment and rehabilitation of such patients. This article describes a case of a patient with fibrous dysplasia of the left maxilla, which was successfully managed by integrating surgical intervention and postoperative rehabilitation, with a surgical obturator and an interim partial denture prosthesis that successfully limited the detrimental effects of surgery, and helped the patient in resocialisation, thereby improving her quality of life.

Matched MeSH terms: Maxilla/pathology*; Maxilla/surgery*
Fulltext Biomechanical Stress in Obturator Prostheses: A Systematic Review of Finite Element Studies

Mousa MA, Abdullah JY, Jamayet NB, Alam MK, Husein A

Biomed Res Int, 2021;2021:6419774.
PMID: 34447852 DOI: 10.1155/2021/6419774

Aim: This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to optimize it. Design and Methods. A literature survey was conducted for full-text English articles which used FEA to examine the stress developed in conventional and implant-assisted MFPs from January 2010 to December 2020.
Results: 87 articles were screened to get an update on the desired information. 74 were excluded based on a complete screening, and finally, 13 articles were recruited for complete reviewing. Discussion. The MFP is subjected to stress, which is reflected in the form of compressive and tensile strengths. The stress is mainly concentrated the resection line and around the apices of roots of teeth next to the defect. Diversity of designs and techniques were introduced to optimize the stress distribution, such as modification of the clasp design, using materials with different mechanical properties for dentures base and retainer, use of dental (DI) and/or zygomatic implants (ZI), and free flap reconstruction before prosthetic rehabilitation.
Conclusion: Using ZI in the defective side of the dentulous maxillary defect and defective and nondefective side of the edentulous maxillary defect was found more advantageous, in terms of compression and tensile stress and retention, when compared with DI and free flap reconstruction.

Matched MeSH terms: Maxilla/pathology*; Maxilla/surgery*
The Impact of Facial Growth in Unilateral Cleft Lip and Palate Treated With 2 Different Protocols

Wong LS, Lu TC, Hang DTD, Chen PK

Ann Plast Surg, 2020 05;84(5):541-544.
PMID: 32091442 DOI: 10.1097/SAP.0000000000002232

BACKGROUND AND AIM: It is well known that palatoplasty can often cause disturbances in maxillary growth. The use of a single-layer vomer flap for the early closure of the hard palate is controversy among surgeons. The aim of this study is to compare the 10-year facial growth of 2 surgical protocols in the treatment of patients with unilateral cleft lip and palate performed by a single surgeon.
METHODS: This retrospective analysis includes 43 nonsyndromic patients with complete unilateral cleft lip with or without a vomer flap for the closure of the hard palate during cleft-lip repair. Lateral cephalograms were obtained at the age of 5, 7, and 9 years old, and angular measurements were used to assess patient's facial growth. The Mann-Whitney U test was used to compare 2 treatment protocol groups.
RESULT: A total of 23 patients in protocol 1 group (16 male, 7 female) and 20 patients in protocol 2 group (10 male, 10 female) were included. At the age of 5 and 7, there was no significant difference of maxillary and mandibular growth in both groups. At the age of 9 years, all the angular measurement revealed statistical significance with SNA (P = 0.02), SNB (P = 0.05), ANB (P < 0.01), and SNPg (P = 0.05).
CONCLUSIONS: The present study has shown that early anterior palate repair for 3-month-old cleft patients have better maxillary growth and less mandibular prognathism.

Matched MeSH terms: Maxilla/surgery
Root canal morphology of primary maxillary second molars: a micro-computed tomography analysis

Mohd Ariffin S, Dalzell O, Hardiman R, Manton DJ, Parashos P, Rajan S

Eur Arch Paediatr Dent, 2020 Aug;21(4):519-525.
PMID: 32100200 DOI: 10.1007/s40368-020-00515-z

AIM: Successful endodontic treatment of primary teeth requires comprehensive knowledge and understanding of root canal morphology. The purpose of this study was to investigate the root canal configurations of primary maxillary second molars using micro-computed tomography.
METHODS: Extracted human primary maxillary second molars (n = 57) were scanned using micro-computed tomography and reconstructed to produce three-dimensional models. Each root canal system was analysed qualitatively according to Vertucci's classification.
RESULTS: 22.8% (n = 13) of the sample presented with the fusion of the disto-buccal and palatal roots; of these, Type V was the most prevalent classification. For teeth with three separate roots (n = 44), the most common root canal type was Type 1 for the palatal canal (100%) and disto-buccal canal (77.3%) and Type V for the mesio-buccal canal (36.4%). Overall, 7% (n = 4) of mesio-buccal canals were 'unclassifiable'.
CONCLUSION: The root canal systems of primary maxillary second molars were not only complex but had a range of configurations that may contribute to unfavourable clinical outcomes after endodontic treatment.

Matched MeSH terms: Maxilla*
A comparative study of evolutionary trends in the upper molar pattern of recent Kodiak Island inhabitants and subrecent Javanese Malayans

Korenhof CA

J Dent Res, 1966 Nov-Dec;45(6):1687-95.
PMID: 5226535
Matched MeSH terms: Maxilla*
Unusual clinical presentation of a severely protruding premaxilla in patient with bilateral clefts

Burezq H, Bang RL, George A, Mukhtar A

J Craniofac Surg, 2007 Jul;18(4):971-4.
PMID: 17667698

Prominent premaxilla is one of the problems encountered when dealing with bilateral complete cleft lip and palate patients. Secondary alveolar bone grafting with these patients would achieve filling of the osseous defect, supports the alar base, eliminate the oro-nasal fistula and enhance the maxillary instability. This article describes the management of a bilateral cleft lip and palate patient with an extremely protruding premaxilla done in one stage surgery. To our knowledge, this is the first report of such degree of severity in the English literature.

Matched MeSH terms: Maxilla/abnormalities*; Maxilla/pathology; Maxilla/surgery
Fulltext Aneurysmal Bone Cyst - A Case Report And

Abdul Rahman, Z.A., Jalaludin, M.A., Hussaini, N.Z., Zain, R.B.

Ann Dent, 1998;5(1):-.
MyJurnal

Aneurysmal bone cyst is a rare non-epithelialized pseudocyst of the jaws. Jaffe and Lichtenstein in 1942 were the first to recognize aneurysmal bone cyst as a distinct clinical and pathological entity while Bernier and Bhaskar in 1958 were the first to describe the presence of this lesion in the jaws. A case of aneursymal bone cyst in the maxilla is presented and the literature reviewed.

Matched MeSH terms: Maxilla
Fulltext A case of osteosarcoma of the maxilla - challenges in diagnosis and management

Abdul Rahim, N.I.H., Ngah, N.A., Ramanathan, A., George, T., Ismail, S.M.

Ann Dent, 2011;18(1):24-29.
MyJurnal

Osteosarcoma is a primary malignant neoplasm of the bone. Osteosarcoma of the jaws especially those of maxilla is rare. The diagnosis of osteosarcomas is difficult and challenging. In this case report we highlight a rare case of osteosarcoma of the maxilla in a 29 year old male patient which was highly aggressive and was initially diagnosed as rhabdomyosarcoma. This case highlights the difficulty in diagnosing osteosarcoma merely from incisional biopsy specimens which may not be representative of the whole tumour. Limited clinical information at incisional biopsy also adds to the difficulty in arriving at the definitive diagnosis. We further discuss the treatment modalities followed in this case.

Matched MeSH terms: Maxilla
Fulltext Orthodontic management of an erupted mesiodens: a case report

Noraini Abu Bakar

International Medical Journal Malaysia, 2017;16(21):65-65.
MyJurnal

Hyperdontia is the condition of having supernumerary tooth, or teeth, which appear
in addition to the regular number of teeth. It is a developmental anomaly and has been argued to
arise from multiple aetiologies. It may remain embedded in the alveolar bone or can erupt into the
oral cavity. Mesiodens is a supernumerary tooth located in the anterior maxilla, placed palatally or
in between the maxillary central incisors. (Copied from article).

Matched MeSH terms: Maxilla
Fulltext Technical issues in craniomaxillofacial distraction osteogenesis: a case series

Khairul Bariah Chi Adam, Firdaus Hariri, Lim, Kwong Cheung, Syed Nabil, Aung, Lwin Oo, Zainal Ariff Abdul Rahman

International Medical Journal Malaysia, 2018;17(101):109-114.
MyJurnal

Distraction osteogenesis allows superior skeletal advancement compared to conventional surgical osteotomy. It can be considered as a reliable and predictable surgical procedure and is widely used to correct the craniomaxillofacial bone discrepancy. Nevertheless, the outcome is technically dependent and requires comprehensive peri-operative assessment, preparation, and precision in application. The objective of this study is to highlight some important technical issues in distraction osteogenesis when the technique is indicated in various craniomaxillofacial regions and at the same time to discuss the options of preventing and overcoming these technical complications based on our experience and relevant literature. Important technical issues on the application of distraction osteogenesis in 5 different craniomaxillofacial regions were selectively highlighted based on the completed cases in one centre. Potential complications and its prevention methods were documented and discussed. The 5 highlighted regions of craniomaxillofacial distraction osteogenesis were alveolar, mandibular, cleft maxilla, craniofacial and facial cleft. Technical issues and complications were mostly device related and associated with anatomical limitations and surgical technique. Nevertheless, these complications are preventable and can be appropriately managed. From the literature and our experience, the technical aspects vary according to its application in different craniomaxillofacial regions. Preventing the potential complications contribute to the success of its application. This article also discussed the concept of Ihsan application in the medical field, to achieve the best of treatment in terms of delivery and technical preparation for the patients.

Matched MeSH terms: Maxilla
Fulltext Management of sinonasal inverted papillomas: endoscopic medial maxillectomy

Harvinder S, Rosalind S, Mallina S, Gurdeep S

Med J Malaysia, 2008 Mar;63(1):58-60.
PMID: 18935736

Inverted papillomas (IPs), although histologically benign, are aggressive lesions that may recur after excision. They usually present as unilateral firm, bulky, red and vascular masses. The objective of this case series is to discuss the surgical treatment options for IPs and to review the literature with a special emphasis on our experience with endoscopic medial maxillectomy. A retrospective review of the data of patients with IP treated by endoscopic medial maxillectomy was performed. This report describes the surgical experience with five patients with IP arising from various sites on the lateral nasal wall. Data points collected included age, sex, location(s) and histopathological diagnosis (benign IP vs IP with dysplasia or carcinoma). The surgical treatment strategy, need for adjunct approaches, complications, recurrence rates and length of follow-up were determined. The average age was 51.2 years (range, 35-62 years), with four males and one female. All cases were managed with endoscopic medial maxillectomy as the primary surgical modality. Adjunctive approaches included endoscopic dacryocystorhinostomy (EDCR) in two patients who presented with epiphora post-operatively. Intra-operative frozen section was performed in all cases to ensure complete tumor removal. No intra-operative complications were encountered. No recurrences were noted in these patients, with a mean follow-up period of 23 months.

Matched MeSH terms: Maxilla/surgery*
A probability distribution of shape for the dental maxillary arch using digital images

Rijal OM, Abdullah NA, Isa ZM, Noor NM, Tawfiq OF

Annu Int Conf IEEE Eng Med Biol Soc, 2012;2012:5420-3.
PMID: 23367155 DOI: 10.1109/EMBC.2012.6347220

Selected landmarks from each of 47 maxillary dental casts were used to define a Cartesian-coordinate system from which the positions of selected teeth were determined on standardized digital images. The position of the i-th tooth was defined by a line of length (l(i)) joining the tooth to the origin, and the angle (θ(i)) of this line to the horizontal Cartesian axis. Four teeth, the central incisor, lateral incisor, canine and first molar were selected and their position were collectively used to represent the shape of the dental arch. A pilot study using clustering and principal component analysis strongly suggest the existence of 3 groups of arch shape. In this study, the homogeneity of the 3 groups was further investigated and confirmed by the Dunn and Davies-Bouldein validity indices. This is followed by an investigation of the probability distribution of these 3 groups. The main result of this study suggests 3 groups of multivariate (MV) normal distribution. The MV normal probability distribution of these groups may be used in further studies to investigate the issues of variation of arch shape, which is fundamental to the practice of prosthodontics and orthodontics.

Matched MeSH terms: Maxilla/anatomy & histology*
A denture replication technique following partial maxillectomy: a case report

Haider KG, Lewis GR

Quintessence Int, 1994 Jan;25(1):23-6.
PMID: 8190877

A variety of problems faces the prosthodontist attempting reconstruction of maxillary defects. There are various treatment options for patients requiring a partial maxillectomy and an obturator prosthesis. Reduced adaptability makes it difficult for the patient to learn to use a new appliance, unless existing skills can be employed. It is therefore helpful to reproduce familiar features of a patient's existing obturator, especially if this has been used successfully over a transition period.

Matched MeSH terms: Maxilla/surgery*
Relationship between the loss of maxillary anterior alveolar bone and the duration of untreated lepromatous leprosy in Malaysia

Nah SH, Marks SC, Subramaniam K

Lepr Rev, 1985 Mar;56(1):51-5.
PMID: 3990507
Matched MeSH terms: Maxilla/pathology*
Haemangioma on the palate next to a maxillary tori in an edentulous patient: a challenge to the prosthodontist

Mayya A, Eachempati P, Nagraj SK, Kumar K

BMJ Case Rep, 2020 Jun 09;13(6).
PMID: 32522723 DOI: 10.1136/bcr-2020-234297
Matched MeSH terms: Maxilla/pathology
Fulltext How does mandibular advancement with or without maxillary procedures affect pharyngeal airways? An overview of systematic reviews

Tan SK, Leung WK, Tang ATH, Zwahlen RA

PLoS One, 2017;12(7):e0181146.
PMID: 28749983 DOI: 10.1371/journal.pone.0181146

BACKGROUND: Mandibular advancement surgery may positively affect pharyngeal airways and therefore potentially beneficial to obstructive sleep apnea (OSA).
OBJECTIVE: To collect evidence from published systematic reviews that have evaluated pharyngeal airway changes related to mandibular advancement with or without maxillary procedures.
METHODOLOGY: PubMed, EMBASE, Web of Science, and Cochrane Library were searched without limiting language or timeline. Eligible systematic reviews evaluating changes in pharyngeal airway dimensions and respiratory parameters after mandibular advancement with or without maxillary surgery were identified and included.
RESULTS: This overview has included eleven systematic reviews. Maxillomandibular advancement (MMA) increases linear, cross-sectional plane and volumetric measurements of pharyngeal airways significantly (p<0.0001), while reducing the apnea-hypopnea index (AHI) and the respiratory disturbance index (RDI) significantly (p<0.0001). Two systematic reviews included primary studies that have evaluated single-jaw mandibular advancement, but did not discuss their effect onto pharyngeal airways. Based on the included primary studies of those systematic reviews, single-jaw mandibular advancement was reported to significantly increase pharyngeal airway dimensions (p<0.05); however, conclusive long-term results were lacking.
CONCLUSION: MMA increases pharyngeal airway dimensions and is beneficial to patients suffering from OSA. However, more evidence is still needed to draw definite conclusion related to the effect of single-jaw mandibular advancement osteotomies on pharyngeal airways.

Matched MeSH terms: Maxilla/surgery*
Management of unfavorable implant positions and angulations in edentulous maxillae with different complete-arch fixed prosthetic designs: A case series and clinical guidelines

Kher U, Tunkiwala A, Patil PG

J Prosthet Dent, 2022 Jan;127(1):6-14.
PMID: 33243475 DOI: 10.1016/j.prosdent.2020.09.023

Implant-supported fixed prostheses in the edentulous maxilla can be difficult because of anatomic limitations and high esthetic demand. The choice between cement and screw retention depends on factors such as esthetics, occlusion, retrievability, and passivity. The choice is also often governed by the ability to manage technical or biologic complications. In the edentulous maxilla, because of the bone trajectory and resorption pattern, unfavorable implant angulations may be encountered. In such situations, a conventional screw-retained prosthesis is difficult to design. This article describes the restoration of edentulous maxillae for a series of patients with different complete-arch fixed prosthesis designs. The clinical guidelines, including indications, advantages, and limitations of each design, were discussed.

Matched MeSH terms: Maxilla/surgery
Fulltext The radiographic appearance of ameloblastoma in Malaysians

Yaacob H

Singapore Med J, 1991 Feb;32(1):70-2.
PMID: 2017711

The radiographs of fifteen Malaysian patients with presenting ameloblastoma aged between 20-55 years (average 35 years) were studied for any peculiar local features. The most common features were cortical plate expansion (80%), corticated scalloped margin (67%), multiloculation (87%), and resorption of tooth roots (47%). The latter two features are constantly found in advanced tumour stage. As pain was not a frequent complaint, many Malaysian patients seek treatment only at a very late stage after the tumours have reached large dimensions. Although ameloblastomas may be diagnosed often through radiographs, it should not be relied upon solely.

Matched MeSH terms: Maxilla/radiography*

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