Daniel Perez

Corporacion Universitaria Minuto de Dios · Agroecologia

The treatment of patients with severe temporomandibular joint (TMJ) disorders and associated skeletal discrepancies presents a complex challenge for oral and maxillofacial surgeons. It is widely recognized that TMDs can impact the stability and outcomes of surgical treatments for dentofacial deformities. Consequently, addressing TMDs prior to or in...

Objective This project aimed to analyze the proximity of orthognathic surgical fixation to specific anatomical landmarks and to assess postoperative symptoms. Study Design The data consisted of an available pool of CT scans from the oral surgery department at the University of Texas Health at San Antonio from 2015 to 2020. We investigated the prox...

Bimaxillary orthognathic surgery has many indications when correcting dentofacial deformities. There is added complexity in achieving clinically accurate results when simultaneously operating on both the maxilla and the mandible. It is crucial to have precision in clinical evaluation, presurgical planning, and execution of surgery to ensure ideal c...

Primary xanthomas of the mandible and maxilla, or primary intraosseous xanthomas of the jaw are exceptionally rare with only 36 cases previously reported. We present another case of a primary xanthoma of the mandible in where a novel approach was used. A conventional sagittal split osteotomy was performed for wide access and a complete enucleation...

Mandible fractures are the second most common facial fracture after fractures of the nose. The treatment of mandibular fractures has evolved greatly over time but has been constantly guided by the principles of immobilization and repositioning. The early Egyptians relied on closed reduction through the use of bandages. Hippocrates, and his successo...

Patient-specific TMJ prostheses are increasingly being used to correct end-stage skeletal facial deformities in patients with mandibular malformations and syndromes like Treacher Collins or the spectrum of cases suffering from craniofacial microsomia (CFM). Both of these congenital craniofacial anomalies are frequently seen with hypoplastic growth...

PURPOSE The purpose of this study was to evaluate subjective and objective outcomes in patients with temporomandibular joint (TMJ) ankylosis treated with TMJ alloplastic reconstruction (TMJR). STUDY DESIGN All patients diagnosed with TMJ ankylosis that underwent TMJR at our institution between 2010 and 2019 were retrospectively reviewed. Patients...

Purpose Temporomandibular joint replacement (TJR) with an alloplastic (metal/ultra-high-molecular-weight polyethylene (UHMWP)) device has proven to be a successful and predictable procedure. This paper describes a novel technique for performing TJR with an endaural incision alone. Materials and Methods The technique we are describing uses only an...

Purpose This article describes a novel technique for replacing the temporomandibular joint (TMJ) with a prosthesis. The technique applies a simple endaural incision to approach the temporomandibular joint in order to place a total joint prosthesis. This is followed by small trochar site incisions for plating of the prosthesis. The technique was per...

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder in the USA that predisposes patients to multisystemic health complications. Typically, patients have nocturnal airway collapse and disruption of sleep due to redundant tissue or a retrognathic mandible; however, some patients develop OSA due to severe, destructive end...

Maxillomandibular advancement (MMA) is a highly successful surgical treatment for patients with obstructive sleep apnea (OSA). The bilateral sagittal split osteotomy in conjunction with a Le Fort I osteotomy allows the surgeon to advance the patient’s skeletal framework to decrease nocturnal airway collapse and disruption of sleep. The patient demo...

Mandibular fractures are common facial injuries. Their treatment varies as do postoperative complications. This paper discusses the common complications that are associated with the treatment of mandibular fractures and presents management strategies.

Purpose The purpose of this study was to assess the efficacy of alloplastic temporomandibular joint (TMJ) total joint replacement (TJR) in patients with juvenile idiopathic arthritis (JIA). Materials and Methods All patients formally diagnosed with JIA requiring a TMJ patient-specific TJR between 2010-2018 at the University of Texas – Health at Sa...

Purpose To compare complication rates and functional outcomes in patients with bilateral mandibular fractures treated with different degrees of internal fixation rigidity. Patients and Methods This international multicenter randomized controlled trial included adults with bilateral mandibular fractures located at the angle and body, or angle and s...

Purpose The purpose of this study was to report temporomandibular joint alloplastic reconstruction (TMJR) revision and/or replacement rates and its associated complication outcome data gathered from experienced TMJ surgeons, and to review the recent relevant literature. Materials and Methods A 21-question anonymous on-line survey was sent to all C...

Purpose: The purpose of the present study was to identify the perceived barriers to full-text journal publication (JP) from abstracts presented at the 2010-2013 American Association of Oral and Maxillofacial Surgeons (AAOMS) meetings. Methods and materials: In the present cross-sectional study, all unpublished AAOMS abstracts (n = 473) from the...

Fractures of the condylar process of the mandible are common injuries. The treatment is controversial because they can be treated closed or open. This chapter will discuss these fractures and the methods by which they can be successfully treated.

As orthodontic treatment has advanced in complexity and in frequency, more recent techniques, using temporary skeletal anchorage, were developed to help correct more severe occlusal and dentofacial discrepancies that were treated with orthognathic surgery alone previously. These techniques have allowed the orthodontist to move teeth against a rigid...

Objective: Evaluate the outcomes of using Class III elastic mechanics to correct the postsurgical malocclusion produced after temporomandibular joint (TMJ) disc repositioning with the Mitek anchor technique. Materials and methods: Retrospective study of 42 patients (72 TMJs) with a Wilkes class II or III internal derangement (ID) that were corre...

Purpose: Idiopathic condylar resorption (ICR) is a relatively uncommon condition. Its diagnosis, etiology, and management options are controversial. Furthermore, it is difficult for 1 provider to collect a large cohort of ICR patients to develop a statistically significant study of these concerns. Therefore, the purpose of this study was to survey...

Purpose Reconstruction of orbital wall fractures is demanding and has improved dramatically with the implementation of new technologies. True-to-original accuracy of reconstruction has been deemed essential for good clinical outcome, and reasons for unfavorable clinical outcome have been researched extensively. However, no detailed analysis on the...

Controversy has accompanied orthognathic surgery since its adaptation for the correction of dentofacial deformities. With the development of less invasive and less morbid osteotomy designs, questions regarding overall osteotomy stability have abounded. The transition from prolonged intermaxillary fixation and wire osteosynthesis to rigid internal f...

Purpose: The aim of this study was to identify, through meta-analysis, whether patients who require orthognathic surgery have a higher prevalence of temporomandibular disorders (TMDs) than controls, both before treatment and after. Material and methods: A systematic review and meta-analysis were conducted based on PRISMA guidelines, to address t...

With the incidence of melanoma increasing yearly, there is a need for heightened awareness of its metastatic potential and for screening with appropriate referral for identification of pre-metastatic lesions. Melanoma has a 16-25 month time to metastasize from a localized disease to one with a median survival of only 12 months or less once metastas...

Purpose: There is still controversy about whether orthognathic surgery negatively or positively affects temporomandibular disorders (TMDs). The purpose of this study was to determine whether orthognathic surgery has a beneficial or deleterious effect on pre-existing TMDs. Materials and methods: A systematic review and meta-analysis were conducte...

Purpose: A variety of implants are available for orbital reconstruction. Titanium orbital mesh plates are available either as standard preformed implants or able to be individualized for the patient. The aim of this study was to analyze whether individualized orbital implants allow a more precise reconstruction of the orbit than standard preformed...

Purpose: The purpose of this study was to evaluate patients requiring unilateral total temporomandibular joint (TMJ) reconstruction and the risk for development of postsurgical contralateral TMJ pain and dysfunction over time requiring subsequent contralateral total joint reconstruction. Long-term subjective and objective outcomes of unilateral TM...

Dislocation of the temporomandibular joint is one of many pathophysiologic joint conditions that the oral and maxillofacial surgeon is challenged with managing. Managing a dislocated joint will inevitably be the challenge of most surgeons or physicians, whether in private or academic practice. Accordingly, this article addresses the pathophysiology...

This article discusses hemifacial microsomia and Treacher Collins syndrome relative to the nature of these congenital deformities as well as the clinical, radiographic, and diagnostic characteristics. These patients often have severe facial deformities with hypoplasia or aplasia of the temporomandibular joints (TMJs) and mandible. The surgical trea...

Purpose To present algorithms for the treatment of zygomatico-orbital (ZMO) fractures and to review how many of our patients were treated using each. Two algorithms are presented: one when intraoperative CT scans are not available, another for when intraoperative CT scans are available. Materials and Methods All patients treated by the authors for...

A classification system was developed to place patients with condylar hyperplasia (CH) into categories based on histology, clinical and imaging characteristics, effects on the jaws and facial structures, and rate of occurrence. Four major categories were defined. CH type 1 is an accelerated and prolonged growth aberration of the "normal" mandibular...

PURPOSE: Traditionally, patients with hemifacial microsomia (HFM) and significant ipsilateral hypoplasia or absence of the condyle and ramus undergo reconstruction on the ipsilateral side with autogenous tissues such as rib grafts, often with compromised results. This study analyzed the surgical treatment outcomes of nongrowing patients with HFM an...

Distraction osteogenesis (DO) is a biological process involving the formation of new bone between viable bone segments that are gradually separated by incremental traction. This technology has proved useful in several craniomaxillofacial applications where conventional techniques were previously used. This article describes DO and demonstrates thre...

The purpose of the present study was to evaluate the nasopharyngeal airway changes after transnasal adenoidectomy and to determine whether a specific facial morphologic type is associated with hypertrophied nasopharyngeal adenoids. The nasopharyngeal adenoid tissues are present during childhood but usually spontaneously atrophy by 12 to 14 years of...

We present a retrospective review of a new technique for the transportation of alveolar bone using a Hyrax device modified by the principal author (O.A.V.). There were seven patients (five males and two females), including five patients with cleft palate and lip diagnosis, one patient with a high-speed gunshot wound, and one patient with facial tra...

Bimaxillary surgery is often indicated to correct a wide range of maxillomandibular malrelationships. The traditional method of performing bimaxillary surgery has always been to reposition the maxilla first, stabilize it, and then reposition the mandible. However, rigid internal fixation has allowed a change in this classical sequencing 1-3 whereby...

There is frequently lack of understanding and apprehension among dental practitioners treating patients with vascular lesions of the oral and maxillofacial region. Arteriovenous malformations are rare lesions which can easily be misdiagnosed yet produce the very dramatic clinical presentation of severe life threatening oral bleeding. Much of this a...

This study compared outcomes of two surgical methods for patients diagnosed with active condylar hyperplasia type 1. Group 1 (n = 12) was treated with orthognathic surgery only, while group 2 (n = 42) was treated with high condylectomies, articular disc repositioning, and orthognathic surgery. There was no statistically significant difference betwe...