• 대한구순구개열학회지
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• 제6권2호
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• pp.131-135
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• 2003

Severe maxilla1y deficiency can be caused by cleft lip and palate(CLP), other craniofacial deformities, atrophy in the edentulous maxilla, and trauma. Patients with maxillary deficiency present a difficult treatment challenge. Traditionally, this skeletal deformity has been treated by Le Fort osteotomy, skeletal repositioning, and fixation with mini-plates and screws. The drawbacks of this method include a limited amount of anterior maxillary advancement often requiring simultaneous mandibular setback, the inability to create new bone, and minimal soft tissue adaptation to the new position, all of which increase the potential of relapse in case of large advancement. The alternative method of maxillary distraction osteogenesis offers promising results for successfully treatment of these patients while potentially minimizing the risk of relapse.

• 대한구순구개열학회지
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• 제5권2호
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• pp.109-112
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• 2002

구순 구개열 환자의 악교정 성형수술로 구강내 Le Fort II 골절단술이나 비중격 성형술이 많이 이용되는데, 이때 비골의 외측골절단술을 요하며, 이에 대한 술 후 합병증으로 비루관의 폐쇄나 비골의 분쇄골절 등이 발생할 수 있어, 악안면기형 환자를 다루는 구강악안면외과의사에게 비루관의 웅용해부학적 연구는 중요하다. 본 연구의 목적은 교합면을 기준으로 촬영된 컴퓨터 단충 촬영에서 비루관의 위치와 크기를 조사하는데 있다. 2000년 7월부터 2003년 2월까지 서울대학교병원 구강악안면방사선과에서 컴퓨터 단층촬영을 시행한 환자 62명을 대상으로 비상악봉합선에서 비루관까지의 최단거리와 비루관의 최대반경과 최소반경을 측정하였다. 우측비상악 봉합선에서 비루관까지의 거리는 5.68mm이고, 좌측은 5.67mm였다. 좌우 및 성별간의 차이는 없었다. 이의 해부학적 지견은 악기형 수술시의 비루관 폐쇄라는 합병증의 예방책으로 기여하리라 생각된다.

• 대한구순구개열학회지
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• 제12권2호
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• pp.95-100
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• 2009

In spite of all fine methods developed for treating cleft lip, a certain percentage of cases might still need secondary correction. Generally, secondary revision of cleft lip is much difficult to produce esthetic outcome, because the cleft lip scar gives a variable symmetrical and anatomic defect that may not be possible to make inconspicuous of this scar and rebuild good esthetics. In this case report, a five year-old girl was underwent secondary cleft lip repair using straight line technique to correct unfavorable postoperative scar, peaking of Cupid's bow, notching of vermillion and shortened lip on cleft side with simultaneous repairing cleft palatal fistula. After operation, the secondary deformity was much improved, but, long term follow up is needed to evaluate the additional postoperative deformity might be happen during growth.

• 대한구순구개열학회지
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• 제14권1_2호
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• pp.19-28
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• 2011

Maxillary anterior segmental distraction osteogenesis (DO) has been the alternative treatment option for patients with midfacial retrusion. The patient showed unilateral cleft lip and palate, and premaxillary distraction with rigid external device (RED) was planned to solve midface deficiency and to create alveolar space. Significant advancement of A point was observed, but relapse of A point was detected during consolidation period. The vertical position of the ANS was found to have moved downward. Axis of upper incisor decreased after DO. Maxillary anterior segmental DO is effective for treatment of patient with cleft lip and palate. The alveolar space is regained successfully, and the facial profile is improved without velopharyngeal problems.

• 대한구순구개열학회지
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• 제16권1호
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• pp.1-8
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• 2013

Purpose : To introduce a more effective and efficient protocol for protraction of maxillary complex in CLP patient and demonstrate it by case presentation. Methods : Miniplates are placed on zygomatic buttress and anterior part of mandible, at the time of secondary alveolar bone graft. During the night time, the orthopedic force is applied by wearing elastics from maxillary miniplates to facemask (500 g per side). During the day time, the intermaxillary elastics connecting maxillary miniplates to mandibular miniplates are applied (200 g per side). During the orthopedic treatment, dental alignment is possible. Results and conclusion : By the new protocol, the intermaxillary relation and occlusion are improved due to the stable intraoral anchorage and better cooperation of patients.

• 대한구순구개열학회지
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• 제15권2호
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• pp.89-96
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• 2012

Le Fort 1 osteotomy or maxillary advancement with distraction osteogenesis (DO) is main treatment strategy for cleft palate patients with maxillary hypoplasia. Maxillary DO allows greater maxillary advancement within physiological limit than Le Fort 1 osteotomy. Moreover, it is better for velopharyngeal function. However, there is a greater tendency for an increase in nasal sound when maxilla is advanced excessively. Therefore, the advancement of anterior maxillary segment using DO has been utilized. It offers advantages such as an increase in the length of the palate, a prevention of the change in palatopharyngeal depth, and a preservation of the velopharyngeal function. Moreover, it will obliterate the necessity of bone graft, and it prevents the occurrence of oronasal or oroantral fistula. Finally, it stimulates the regeneration of the soft and hard tissue of alveolus, and subsequently makes possible to place implant.

• 대한구순구개열학회지
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• 제12권1호
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• pp.41-46
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• 2009

Historically, various techniques to correct the deformity of lip and nose in functional and esthetic ways were developed and applied in dealing the patients with cleft lip. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation-advancement method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, triangular flap technique has its advantage in designing the flap using the patient's anatomic landmarks. It enables less skillful operator to perform this technique relatively easily and produce reasonable results. In this report we present 8 cases of unilateral complete cleft lip and 3 casesof unilateral incomplete cleft lip. They all underwent primary cheiloplasty based on triangular flap technique, and functional, esthetic outcomes were favorable.

• 대한구순구개열학회지
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• 제12권1호
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• pp.7-20
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• 2009

Orthodontic treatment planning of cleft lip and palate requires consideration of the characteristic features, growth pattern and functional disorders related to cleft lip and palate patients. Tissue deficiencies and constriction of the scar tissue in surgically treated cleft lip and palate results in disturbance of maxillary growth and deficiency of midfacial region with anterior and posterior crossbite. These patients often present congenital missing of teeth, supernumerary teeth, malformed teeth, or ectopic position of teeth, which should be treated by orthodontic treatment by expanding upper arch followed by fixed appliance. Proper use of retainer and continuous follow-up is needed to prevent relapse after orthodontic treatment has finished. Also we have to pay attention to correct speech disorder which is caused by the velopharyngeal insufficiency.

• 대한구순구개열학회지
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• 제11권1호
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• pp.23-30
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• 2008

From 2001 year, our department has been participated medical charity for cleft lip and palate patients with Japanese team, on general hospital of Quang Nam Province in Tamky, Vietnam. Also we started medical service with student volunteer in Hue University Hospital, sisterhood relationship with Chonbuk National University, from 2006. The central area of Vietnam is a hard fought-field during the Vietnam war, many chemical weapons (defoliant etc.) were used during war. As the mountain region lose currency, this area was still retarded. We would like to introduce the medical charity service of our department and the classification of operated patients and performed operation.

• 대한구순구개열학회지
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• 제7권1호
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• pp.47-61
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• 2004

The closure of a wide alveolar cleft and fistula in cleft patients and the reconstruction of a maxillary dentoalveolar defect in bilateral cleft lip and palate (BCLP) patients are challenging for both orthodontists and oromaxillofacial surgeons. It is due to the difficulty in achieving complete closure by using local attached gingiva (palatal flap) and the great volume of bone required for the graft. In this article, the authors used bifocal distraction-compression osteosynthesis(BDCO) to create a segment of new alveolar bone and attached gingiva for the complete approximation of a wide alveolar cleft/fistula and the reconstruction of a maxillary dentoalveolar defect. Since the alveoli and gingivae on both ends of the cleft were approximated after BDCO, the need for extensive alveolar bone grafting was eliminated. It also could create new alveolar bone and gingiva for orthodontic tooth movement and implant.