Treatment of severe maxillary cleft hypoplasia in a case with missing premaxilla with anterior maxillary distraction using tooth-borne hyrax appliance

Cleft orthodontics generally poses a challenge and a missing premaxilla adds to the difficulty in managing them. The lack of bone support and anterior teeth in a case with missing premaxilla accounts not only for difficulty in rehabilitation but also in increasing the maxillary hypoplasia. This article presents a case report where planned orthodontic and surgical management using distraction has helped treat a severe maxillary hypoplasia in a patient with missing premaxilla. The treatment plan and method can be used to treat severe maxillary hypoplasia and yield reasonably acceptable results for such patients.

Rinoplasti pada kelainan hidung kongenital

Latar belakang: Nasal bifida dan supernumerary nostril merupakan kelainan hidung kongenital yang sangat jarang. Nasal bifida disebut juga hidung ganda atau celah hidung, mempunyai manifestasi sangatberagam mulai dari lekukan minimal pada puncak hidung hingga celah maksila. Supernumerary nostrilmerupakan bagian dari kelainan duplikasi hidung. Tujuan: Sebagai ilustrasi kepada ahli THT-KL mengenaikasus kelainan hidung kongenital yang jarang ditemukan. Kasus: Dilaporkan tiga kasus anak dengankelainan hidung kongenital selama bulan Agustus-Desember 2012. Satu kasus dengan nasal bifida, satukasus dengan nasal bifida disertai atresia koana, dan satu kasus dengan triple nostril. Penatalaksanaan:Pada kasus nasal bifida dilakukan rekonstruksi hidung menggunakan tandur dermis dan pada kasustriple nostril dilakukan fistulektomi dan rekonstruksi alae. Kesimpulan: Nasal bifida dan triple nostrilmerupakan kelainan hidung kongenital yang jarang ditemukan. Kelainan ini membutuhkan rekonstruksiyang optimal. Indikasi waktu dari operasi pada kasus kelainan hidung kongenital ini berdasarkan ukuranhidung menyerupai ukuran dewasa dan perkembangan sosial anak. Kata kunci: kelainan hidung kongenital, nasal bifida, supernumerary nostril, duplikasi hidungABSTRACT Background: Bifid nose and supernumerary nostril are rare nasal congenital anomalies. The appearance of bifid nose, also called double nose or cleft nose, varies from a simple groove at thenasal apex to a maxillary cleft. Supernumerary nostril is a kind of nasal duplication. Purpose: Thiscase report is to forewarn general practitioners and ENT specialist about these rare nasal congenitalanomaly cases. Case: Reported three cases with congenital nasal anomaly, one case with bifid nose, onecase with bifid nose and choanal atresia, and one case with triple nostril. Management: The cases withbifid nose underwent nasal reconstruction using dermal graft and the case with triple nostril underwentfistulectomy and alae reconstruction. Conclusion: Bifid nose and triple nostril are rare nasal congenitalanomaly that need optimal reconstruction. Indication for the time of the operation for cases of congenitalnasal deformities is based on the size approaching the adult size and on the child’s social development. Keywords: congenital nasal anomaly, bifid nose, supernumerary nostril, nasal duplication

Bone Regeneration and Periosteoplasty: A 250-Year-Long History

Background: Since antiquity, many attempts have been carried out and a number of theories proposed to explain the process that leads to bone regeneration. Through manifold experiments, several authors tried to understand and subsequently to control the physiological events that enable bone healing. Between the 18th and 19th centuries something changed. Although the scientific world was initially skeptical, a new idea emerged in the field of bone surgery. It principally concerned the necessity to perform amputations and resections leaving intact the periosteum to obtain new bone formation. Materials and Methods: With this article we emphasize the contribution of many authors in the development of knowledge about the osteogenic properties of the periosteum. In particular we focus on the experiences of unknown Italian authors Michele Troja and Bernardino Larghi, consider well-recognized scientific personalities such as Leopold Ollier and Bernhard von Langenbeck, and reach a milestone of plastic surgery with Tord Skoog and his description of periosteoplasty. Conclusion: Various surgical approaches have been proposed to provide optimal care for patients with cleft lip and palate disorders. Among several treatment options, periosteoplasty is one of the choices to correct maxillary clefts. Highlighting difficulties and successes of many authors in demonstrating osteogenic properties of periosteum, this paper describes how periosteoplasty performed in maxillary cleft restoration capitalizes on what has been discovered during a 250-year-long history.