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Find video protocols related to scientific articles indexed in Pubmed.
Attachment Rate of the Inferior Alveolar Nerve to Buccal Plate During Bilateral Sagittal Split Osteotomy Influences Self-Reported Sensory Impairment.
J Craniofac Surg
PUBLISHED: 07-11-2014
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This study was aimed to investigate a modified buccal osteotomy technique and whether the integrity of the lingual part of the lower border influences the attachment of the neurovascular bundle to the proximal segment of the mandible during a sagittal split osteotomy without increasing the number of bad splits. The presence of self-reported sensibility disturbance in the lower lip at the last follow-up visit was assessed. This study included 220 and 133 patients with bilateral sagittal split osteotomy undergoing the classical and the new modified buccal osteotomy techniques, respectively. In the new technique, the lower border is divided into a lingual fragment that remains incorporated in the tooth-bearing fragment and a buccal fragment that comes with the proximal fragment (buccal plate). In the classical technique, the inferior alveolar nerve was attached to the proximal segment of the mandible in more than one third of operation sites (36.36% on the right and 40.91% on the left) compared with less than one fourth of the operation sites using the new technique (9.73% on the right and 23.01% on the left). The overall figure of self-reported changed sensibility was 09.40% (12/128) in the new technique compared to 15.12% in the classical technique. We present a suitable improvement to the classical buccal osteotomy technique that allows less manipulation and injury of the inferior alveolar nerve with consequent reduction in self-reported postoperative changes in lower lip sensation.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
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Safe surgical access to the mandibular nerve at the infratemporal fossae.
J Craniofac Surg
PUBLISHED: 06-10-2014
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Some anatomic patterns formed by the anterior border of the ascending ramus relative to the mandibular canal can cause nerve complications during surgery. We determined the frequency of obstructive anatomy in patients undergoing jaw surgery, and we described a perioperative method for a bilateral sagittal split osteotomy that ensured inferior alveolar nerve (IAN) protection. The anatomy of the anterior border of the ascending ramus of the mandible was examined on axial and cross-sectional cone beam computed tomographic images of 114 consecutive patients undergoing bilateral sagittal split osteotomies. The thickness of the anterior border of the ascending ramus determined whether the mandibular foramen could be visualized (pattern A) or was obscured (pattern B). Patients with pattern B anatomy received a perioperative procedure. Direct visualization of the mandibular foramen was achieved in 100% of patients with pattern A anatomy. We examined 228 anterior borders of the ascending ramus of the mandible relative to the mandibular foramen in 114 patients. Pattern A was observed in 146 cases (64%); pattern B, in 82 (36%) cases. The use of the nerve hook resulted in no injuries to the IAN in all cases. The described procedure ensured direct visualization of the IAN, which prevented inadvertent damage to the IAN during instrumentation and surgical procedures at the mandibular foramen.
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Osseous reconstruction using an occlusive titanium membrane following marginal mandibulectomy: proof of principle.
J Craniofac Surg
PUBLISHED: 04-18-2014
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Guided bone regeneration using barrier membranes is useful in bone augmentation. In contrast to flexible membranes, stiff membranes such as titanium membranes are capable of maintaining sufficient space underneath them. We report a case of bone regeneration under an occlusive titanium membrane following marginal mandibulectomy in a 50-year-old patient with odontogenic keratocyst. Preoperative analysis of the anatomical conditions was evaluated with panoramic radiographs and spiral computer tomography (CT) scan. The digital data from the CT scan were transferred to a personal computer. Using Simplant software, a mirror image of the right mandible was constructed from which a custom-made titanium membrane was made. The cyst with the remaining inferior alveolar nerve was removed and curettage of the lesion was performed under general anesthesia. The definitive titanium plate was inserted and fixated with osteosynthesis screws, and then removed 5 years later. Postoperative CT scanning showed good healing, bone growth under the titanium plate, and no evidence of residual cyst The titanium plate reinforced the mandibular skeleton and restored the shape of the mandible and facial symmetry; it also promoted new bone formation to fill in the mandibular defects.
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The accuracy of image-guided navigation for maxillary positioning in bimaxillary surgery.
J Craniofac Surg
PUBLISHED: 04-11-2014
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The aim of our study was to evaluate the accuracy of image-guided maxillary positioning in sagittal, vertical, and mediolateral direction. Between May 2011 and July 2012, 17 patients (11 males, 6 females) underwent bimaxillary surgery with the use of intraoperative surgical navigation. During Le Fort I osteotomy, the Kolibri navigation system was used to measure movement of the maxilla at the edge of the upper central upper incisor in sagittal (buccal surface), vertical (incisor edge), and mediolateral (dental midline) direction. Six weeks after surgery, a postoperative CBCT scan was taken and registered to the preoperative cone-beam computed tomography scan to identify the actual surgical movement of the maxilla. Student 2-tailed paired t test was used to evaluate differences between the measured result from navigation system and actual surgical movement of the maxilla, which were 0.44 ± 0.35 mm (P = 0.82) in the sagittal, 0.50 ± 0.35 mm (P = 0.85) in the vertical, and 0.56 ± 0.36 mm (P = 0.81) in the mediolateral direction. Our finding demonstrates that intraoperative computer navigation is a promising tool for measuring the surgical change of the maxilla in bimaxillary surgery.
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Accuracy of Dental Implant Placement Using CBCT-Derived Mucosa-Supported Stereolithographic Template.
Clin Implant Dent Relat Res
PUBLISHED: 12-18-2013
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The aim of the present in vivo study was to evaluate whether a difference exists between the maxilla and the mandible regarding the precision of implant placement utilizing a cone beam computed tomography (CBCT)-derived mucosa-supported stereolithographic (SLA) template.
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Accuracy of upper jaw positioning with intermediate splint fabrication after virtual planning in bimaxillary orthognathic surgery.
J Craniofac Surg
PUBLISHED: 11-14-2013
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The purpose of the study is to present and discuss a workflow regarding computer-assisted surgical planning for bimaxillary surgery and intermediate splint fabrication. This study describes a protocol starting from wax bite registration to fabrication of the necessary intermediate splint. The procedure is a proof of concept to replace not only the model surgery but also facebow registration and transfer from facebow to articulator. Three different modalities were utilized to obtain this goal: cone beam computed tomography (CBCT), optical dental scanning, and 3-dimensional printing. A universal registration block was designed to register the optical scan of the wax bite to the CBCT data set. Integration of the wax bite avoided problems related to artifacts caused by dental fillings in the occlusal plane of the CBCT scan. Fifteen patients underwent bimaxillary orthognathic surgery. The printed intermediate splint was used during the operation for each patient. A postoperative CBCT scan was taken and registered to the preoperative CBCT scan. The difference between the planned and the actual bony surgical movement at the edge of the upper central incisor was 0.50 ± 0.22 mm in sagittal, 0.57 ± 0.35 mm in vertical, and 0.38 ± 0.35 mm in horizontal direction (midlines). There was no significant difference between the planned and the actual surgical movement in 3 dimensions: sagittal (P = 0.10), vertical (P = 0.69), and horizontal (P = 0.83). In conclusion, under clinical circumstances, the accuracy of the designed intermediate splint satisfied the requirements for bimaxillary surgery.
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Evaluation of 3 different registration techniques in image-guided bimaxillary surgery.
J Craniofac Surg
PUBLISHED: 07-16-2013
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Perioperative navigation is an upcoming tool in orthognathic surgery. This study aimed to access the feasibility of the technique and to evaluate the success rate of 3 different registration methods--facial surface registration, anatomic landmark-based registration, and template-based registration. The BrainLab navigation system (BrainLab AG, Feldkirchen, Germany) was used as an additional precision tool for 85 patients who underwent bimaxillary orthognathic surgery from February 2010 to June 2012. Eighteen cases of facial surface-based registration, 63 cases of anatomic landmark-based registration, and 8 cases of template-based registration were analyzed. The overall success rate of facial surface-based registration was 39%, which was significant lower than template-based (100%, P = 0.013) and anatomic landmark-based registration (95%, P < 0.0001). In all cases with successful registration, the further procedure of surgical navigation was performed. The concept of navigation of the maxilla during bimaxillary orthognathic surgery has been proved to be feasible. The registration process is the critical point regarding success of intraoperative navigation. Anatomic landmark-based registration is a reliable technique for image-guided bimaxillary surgery. In contrast, facial surface-based registration is highly unreliable.
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Problems during orthognathic surgery resulting from errors in diagnostic wax bite.
J Craniofac Surg
PUBLISHED: 05-30-2013
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There are many problems associated with model surgery and splint fabrication, and they can directly affect the results of surgery. An erroneous diagnostic wax bite can lead to improper positioning of the upper jaw during bimaxillary surgery. In addition, postoperative malocclusions that are out of orthodontic range often are initiated perioperatively by insufficient surgical control over interdigitation, overjet, overbite, and control of the midlines. The objectives of this study were to investigate whether wax bites can be used effectively in patients undergoing bimaxillary operations. In 5 (10%) of 50 patients, the wax bite did not fit properly. Based on these preliminary results, we believe it would be prudent to build safety measures into the treatment of patients who require bimaxillary surgery. If the wax bite does not fit properly at the beginning of surgery, navigation tools could be used to overcome inaccuracies resulting from the wax bite.
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Neuropathic pain after orthognathic surgery.
Oral Surg Oral Med Oral Pathol Oral Radiol
PUBLISHED: 04-30-2013
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This study assesses the incidence of neuropathic pain after orthognathic surgery at our center and briefly reports the cases found.
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Examiner performance in calibration exercises compared with field conditions when scoring caries experience.
Clin Oral Investig
PUBLISHED: 02-04-2011
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The objective of this study was to verify how valid misclassification measurements obtained from a pre-survey calibration exercise are by comparing them to validation scores obtained in field conditions. Validation data were collected from the Smile for Life project, an oral health intervention study in Flemish children. A calibration exercise was organized under pre-survey conditions (32 age-matched children examined by eight examiners and the benchmark scorer). In addition, using a pre-determined sampling scheme blinded to the examiners, the benchmark scorer re-examined between six and 11 children screened by each of the dentists during the survey. Factors influencing sensitivity and specificity for scoring caries experience (CE) were investigated, including examiner, tooth type, surface type, tooth position (upper/lower jaw, right/left side) and validation setting (pre-survey versus field). In order to account for the clustering effect in the data, a generalized estimating equations approach was applied. Sensitivity scores were influenced not only by the calibration setting (lower sensitivity in field conditions, p?
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Measurement, analysis and interpretation of examiner reliability in caries experience surveys: some methodological thoughts.
Clin Oral Investig
PUBLISHED: 09-28-2010
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Data obtained from calibration exercises are used to assess the level of agreement between examiners (and the benchmark examiner) and/or between repeated examinations by the same examiner in epidemiological surveys or large-scale clinical studies. Agreement can be measured using different techniques: kappa statistic, percentage agreement, dice coefficient, sensitivity and specificity. Each of these methods shows specific characteristics and has its own shortcomings. The aim of this contribution is to critically review techniques for the measurement and analysis of examiner agreement and to illustrate this using data from a recent survey in young children, the Smile for Life project. The above-mentioned agreement measures are influenced (in differing ways and extents) by the unit of analysis (subject, tooth, surface level) and the disease level in the validation sample. These effects are more pronounced for percentage agreement and kappa than for sensitivity and specificity. It is, therefore, important to include information on unit of analysis and disease level (in validation sample) when reporting agreement measures. Also, confidence intervals need to be included since they indicate the reliability of the estimate. When dependency among observations is present [as is the case in caries experience data sets with typical hierarchical structure (surface-tooth-subject)], this will influence the width of the confidence interval and should therefore not be ignored. In this situation, the use of multilevel modelling is necessary. This review clearly shows that there is a need for the development of guidelines for the measurement, interpretation and reporting of examiner reliability in caries experience surveys.
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Bone healing after dental extractions in irradiated patients: a pilot study on a novel technique for volume assessment of healing tooth sockets.
Clin Oral Investig
PUBLISHED: 11-17-2009
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The aim of this study was to evaluate longitudinally the bone-healing process by measuring volumetric changes of the extraction sockets in head and neck cancer patients undergoing radiotherapy after tooth extraction. A total group of 15 patients (nine males, six females) undergoing tooth extraction at the Department of Periodontology (University Hospital KULeuven) were enrolled after giving informed consent. In seven patients, teeth presenting a risk for complications and eventual radionecrosis were extracted prior to the radiotherapeutical procedure. Monitoring of bone healing was performed by evaluating the volumetric changes of the alveoli by cone beam CT scanning (CBCT) at extraction and after 3 and 6 months. In parallel, a similar longitudinal evaluation of extraction sites was done in a control group of eight patients. Within this pilot-study, a total of 15 healing extraction sockets were evaluated and followed up. There was a significant difference in volumetric fill up of extraction sockets in test group vs. control group at three (37.1 +/- 7.9%) vs. (54.6 +/- 4.0%) and 6 months (47.2 +/- 8.8%) vs. (70.0 +/- 7.3%), respectively. The present pilot study demonstrated the clinical usefulness of CBCT for evaluation of extraction socket healing. The study objectively demonstrates the delayed bone healing after tooth extraction in irradiated head and neck cancer patients. Considering the limitations of this pilot study, a potential effect of radiotherapy on further jaw bone healing after pre-therapeutic tooth extractions should be further explored.
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Validation of anatomical landmarks-based registration for image-guided surgery: an in-vitro study.
J Craniomaxillofac Surg
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Perioperative navigation is a recent addition to orthognathic surgery. This study aimed to evaluate the accuracy of anatomical landmarks-based registration.
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Visibility of mandibular canal on panoramic radiograph after bilateral sagittal split osteotomy (BSSO).
Surg Radiol Anat
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This study aimed to assess the visibility of the mandibular canal (MC) on panoramic radiographs after bilateral sagittal split osteotomy (BSSO), and to investigate what factors affect this MC visibility.
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Risk factors for the development of lower border defects after bilateral sagittal split osteotomy.
J. Oral Maxillofac. Surg.
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Defects at the lower border of the mandible may persist after bilateral sagittal split osteotomy (BSSO). The purpose of this study was to estimate the frequency of lower border defects after BSSO and to identify factors associated with the development of these defects.
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JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.