1114 Abstracts and fixation of zygoma fractures. The sam- ple was 10 patients were divided into two groups. The experimental group received the technique of closed reduction with Kirschner wire fixation, while the con- trol group, received the open reduction technique with titanium plate fixation. In both groups, the zygoma fractures were of the Knith and North type III, IV, and V. Furthermore, the both groups were submit- ted to a subjective evaluation through the patients perception, where they could eval- uate the deformity regions, the paresthesia, the mouth opening, and the pain during mouth opening. During this study, we con- sider that t(0) is the preoperative period, while the t(1) is the postoperative. The quality assessment of the bone reduction was performed using quantifiable point measured from the tomographic images, i.e., it was used as points: the lateral orbit wall; the zygoma anteroposterior projec- tion; the orbital globe volume; and the orbital globe projection. As results, during t(1), 70% of the patients showed paresthe- sia, while 20% retained the complaint of deformity. Also it was observed that the mouth opening amplitude in both groups was increased. Considering the experimen- tal and the control group, the means of (a) the lateral orbit wall disjunction and (b) the difference of the anteroposterior zygoma projection were decreased. Regarding the orbital globe projection, it was observed a reduction in both groups. Finally, we concluded that both techniques achieved a good reduction of zygoma fractures in postoperative period. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.294 32 Sub-mental intubation in maxillofacial trauma M. León 1 , C. Ulloa 2,* , C. Nú ˜ nez 2 , H. Begazo 3 , G. Gazitúa 4 , P. Cerda 4 1 Cirugia, Chile 2 Cirugía, Universidad de Chile, Facultad de Odontología, Chile 3 Anestesiología, Chile 4 CMF, Instituto Traumatológico Dr. Teodoro Gebauer Weisser, Santiago, Chile The presences of fractures that com- promise the midface and inferior thirds of the face either hurdle or impede the use of conventional methods of endotracheal intubation. The airway is traditionally pro- tected by means of tracheostomy and cricothyroidotomy, techniques that are frequently associated with significant mor- bidity. Sub-mental intubation is a widely accepted option to attend a number or surgery situations, maxillary trauma being one of them. Objective: Present our experience as well as the results of a bibliographic revision about the use of the sub-mental intubation technique in the airway manage- ment of maxillofacial trauma patients. Method: From September 2009 to February 2011, four maxillofacial trauma patients were submitted to surgery under general anesthesia and sub-mental intuba- tion was used. The clinical record of each patient was studied and a bibliographic revision was carried out. Results: The use of submental intu- bation permitted a simultaneous reduction and fixation of all fractures as well as intraoperative control of the dental occlu- sion without interference from the tube during the operation. There were no peri- opertative complications. Conclusions: Submental intubation is a simple and rapid technique for the atten- tion of maxillofacial fractures. It has shown low morbidity associated to its use in maxillary trauma operations. It may be used as an alternative to temporal tra- cheostomy when conventional methods of endotracheal intubation cannot be utilized. However, it should not be considered as a routine procedure in primary service atten- tion of poly-traumatised patients. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.295 33 Topic: Distraction Osteogenesis Distraction Osteogenesis with complimentary Herbst Appliance and Activator therapy to produce significant mandibular lengthening in bilateral Tessier 7 clefts L.P. Ylikontiola 1,* , G.K. Sándor 1,2 , V.H. Harila 3 , P.M. Pirttiniemi 3 1 Oral and Maxillofacial Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland 2 Regea Institute for Tissue Engineering, University of Tampere, Tampere, Finland 3 Orthodontics, Oulu University Hospital, University of Oulu, Oulu, Finland Introduction: Distraction Osteogene- sis (DO) in patients with lower facial clefts is rarely reported. Standard osteotomies are difficult and prone to significant relapse in such patients. Aim: This presentation introduces novel techniques in the management of severe malocclusion in a patient with bilateral Tessier meridian 7 facial clefts requiring DO. Methods: A 15-year old male with severe mandibular retrognathia due to amniotic bands with necessary macrosto- mia repair was treated with DO of the mandible at two ages. The first attempted DO at another centre at 6 years of age failed totally because of a lack of patient and family compliance. At age 14 the mandible was distracted in three planes of space using two SYNTHES multiplanar extraoral mandibular distraction devices at a rate of 1 mm per day guided by intraoral splints. The distractors were maintained for 9 months following distraction for consol- idation purposes. Results: The mandible was length- ened by 35 mm using DO. The external pins retaining the distractors loosened just before their planned removal. The occlusal plane discrepancies were treated with vertical elastics. The downward and forward vectors of the Herbst Appliance and Activator provided active retention in complementary directions. Conclusions: Significant distraction of the mandible is a safe approach for the treatment for a patient with facial clefting and severe antero-posterior discrepancies. A unique role for Herbst Appliances and Activator in the retention of such cases is introduced. Parental and patient co- operation is an important key to the success of labour intensive procedures such as DO. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.296 34 Bone molding for post-distraction mandibular open-bite closure G. Gocmen * , B. Karatas, A. Varol, S. Basa Oral and Maxillofacial Surgery, Marmara University, Istanbul, Turkey Distraction osteogenesis has evolved as a mainstream surgical technique for length- ening and augmentation of the hypoplastic mandible. However, one of the unfavor- able results of mandibular distraction is development of postdistraction open-bite and malocclusion. The latter needs imme- diate or secondary management with the help of guiding elastic traction, inter- maxillary fixation, vector re-alignment or re-osteotomies of ossified regenerate to close the lower jaw.