Journal of Craniofacial Surgery 

About: Journal of Craniofacial Surgery is an academic journal published by Lippincott Williams & Wilkins. The journal publishes majorly in the area(s): Medicine & Craniofacial. It has an ISSN identifier of 1049-2275. Over the lifetime, 13565 publications have been published receiving 157240 citations.

International anthropometric study of facial morphology in various ethnic groups/races.

Abstract: When anthropometric methods were introduced into clinical practice to quantify changes in the craniofacial framework, features distinguishing various races/ethnic groups were discovered. To treat congenital or post-traumatic facial disfigurements in members of these groups successfully, surgeons require access to craniofacial databases based on accurate anthropometric measurements. Normative data of facial measurements are indispensable to precise determination of the degree of deviations from the normal. The set of anthropometric measurements of the face in the population studied was gathered by an international team of scientists. Investigators in the country of the given ethnic group, experienced and/or specially trained in anthropometric methods, carried out the measurements. The normal range in each resultant database was then established, providing valuable information about major facial characteristics. Comparison of the ethnic groups' databases with the established norms of the North America whites (NAW) offered the most suitable way to select a method for successful treatment. The study group consisted of 1470 healthy subjects (18 to 30 years), 750 males and 720 females. The largest group (780 subjects, 53.1%) came from Europe, all of them Caucasians. Three were drawn from the Middle-East (180 subjects, 12.2%), five from Asia (300 subjects, 20.4%) and four from peoples of African origin (210 subjects, 14.3%). Their morphological characteristics were determined by 14 anthropometric measurements, 10 of them used already by classic facial artists, Leonardo da Vinci and Albrecht Durer, complemented by four measurements from the nasal, labio-oral and ear regions. In the regions with single measurements, identical values to NAW in forehead height, mouth width, and ear height were found in 99.7% in both sexes, while in those with multiple measurements, vertical measurements revealed a higher frequency of identical values than horizontal ones. The orbital regions exhibited the greatest variations in identical and contrasting measurements in comparison to NAW. Nose heights and widths contrasted sharply: in relation to NAW the nose was very or extremely significantly wide in both sexes of Asian and Black ethnic groups. Among Caucasians, nose height significantly differed from NAW in three ethnic groups, with one shorter and two greater. In the Middle Eastern groups nose width was identical to those of NAW but the height was significantly greater. The present study, conducted by investigators working separately across the world and with small samples of the population, is clearly preliminary in nature and extent. Yet it may fulfill its mission if medical and anthropological investigators continue the work of establishing normative data of the face. These data are urgently needed by medical professionals but have been lacking up till now in western and northern Europe, Asia, and Africa.

The critical size defect as an experimental model to test bone repair materials.

Abstract: Accuracy and reproducibility are the hallmarks of the scientific method. Too frequently, the scientific method is abandoned and short circuited. The development and eventual clinical application of dental and medical materials and devices requires strict adherence to scientific methodology. The development of new bone repair materials is no exception. A reliable, convenient, and scientifically sound evaluation system is available for testing new bone repair materials. Animal models that fulfill stringent testing criteria and analytical methodology for assessment are described in this review. Experimental design, surgical protocols, tissue preparation for quantitative histology and x-rays, and biochemical assessments are reviewed.

Management of Severe Maxillary Deficiency in Childhood and Adolescence Through Distraction Osteogenesis With an External, Adjustable, Rigid Distraction Device

Abstract: We present our technique for maxillary distraction osteogenesis in patients with severe maxillary hypoplasia. With the use of an external, adjustable, rigid distraction device, we can now treat patients with severe maxillary hypoplasia with a precise and controlled distraction process, obtaining predictable results. This technique has allowed us to treat patients in all age groups. In this report we review our indications for maxillary distraction and describe our technique using an external, adjustable, rigid midface distraction device.

Clinical Outcome in Cranioplasty: Critical Review in Long-Term Follow-Up

Abstract: Various materials have been proposed for cranial reconstruction. Bone autograft and alloplasts such as polymethylmethacrylate (PMMA) and hydroxyapatite (HA) cement are most commonly used at the present time. Patients submitted for cranioplasty were evaluated. The prognostic factors influencing the results and the outcome were analyzed. Three hundred twelve patients who had 449 procedures performed by a single surgeon to reconstruct a calvarial deformity between 1981 and 2001 were studied. Post-tumor resection deformity was the main reason for cranioplasty (32.4%). Bone graft was the material of choice (69.5%). The main surgical site was the frontal bone (53.2%). Complications were observed in 23.6% of cases and were responsible for the least satisfactory results (P > 0.001), with infection and material exposure being the most critical complications. The eventual outcome was considered good in 91.8% of cases. The use of HA cement was associated with the worst results (P > 0.001). Bone grafts showed a high grade of partial resorption and required further surgery for correction. Multiple surgical procedures were correlated with a high rate of complications and an unsatisfactory outcome. Bone graft and PMMA are still the best materials in calvarial reconstruction. Even though HA cement is an osteoconductive material, it seems to induce what appears to be an immunoguided delayed inflammatory reaction that leads to thinning of the skin and exposure of the material, making secondary repair difficult. Before deciding which reconstructive option to use, a careful evaluation of the patient in terms of diagnosis, number of previous surgeries, and surgical site should be undertaken. If this is adopted, good results and a satisfactory outcome can be achieved on long-term follow-up.