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THE CORRECTION OF CLASS III MANDIBULAR ASYMMETRY USING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY AND LATERAL ANGLE REDUCTION (외측 하악각 골절제술을 동반한 시상분할골절단술을 통한 골격성 3급 하악골 비대칭 환자의 치료)

  • Kang, Hee-Jea;Song, In-Woo;Kang, Yung-Ki;Kim, Jong-Ryoul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.132-140
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    • 2010
  • Purpose: The aim of this study is to identify the usefulness of unilateral mandibular angle ostectomy, so-called "Lateral Angle Reduction", in asymmetric prognathism patients by the assessment of postoperative stability and esthetic results Patients and methods: For the retrospective study, 10 skeletal class III mandibular asymmetry patients who were performed SSRO and unilateral mandibular angle ostectomy, Lateral Angle Reduction, was selected. Lateral and posterioanterior cephalogram was taken before surgery (T0), 1day after surgery (T1) and 6month after surgery (T2). To know the esthetic results the facial width and lateral facial contour were examined on posterioanterior cephalogram and to know the postoperative stability B point and Incisor inferius was examined on lateral cephalogram. Statistical analysis was performed. Results: From T0 to T1, Intergonial width was significantly decreased, dominantly at shortened side but no significant changes at lengthened side. Those were well-maintained during 6 months. Lateral facial angle and Ramus angle was significantly decreased on only shortened side from T0 to T1. As a result, after surgery, there were no significant differences in all measurements between shortened side and lengthened side. Ramus deviation angle in shortened side and ramus angle in lengthened side which reflect the angulation of ramus on frontal plane didn't show significant changes after surgery and during postsurgical periods. Lower dental midline showed no statistical changes during postsurgical period. The relapse rate on B-point was 11.92%. Conclusion: Unilateral "Lateral angle reduction" in the asymmetric mandible is valuable to obtain the narrow lower face and symmetric facial contour with a good stability.

A PHOTOELASTIC STUDY ON EFFECTS OF BONE REDUCTION FORCEPS ON MANDIBULAR FRACTURE REDUCTION (골절정복겸자가 하악골 골절정복에 미치는 효과에 관한 광탄성 연구)

  • Park, Jin-Hyoung;Choi, Byung-Ho;Yoo, Tae-Min;Huh, Jin-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.6
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    • pp.464-471
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    • 2002
  • The purpose of this study was to evaluate the stress patterns within fractured mandibles generated by reduction forceps and to determine the optimal position of the reduction forcep. Twenty-seven mandibular models were fabricated using a photoelastic resin. Each of the three sets of mandible models prepared was osteotomized according to one of three different fracture types(symphysis, parasymphysis and body fractures). After reducing the cut segments, a reduction forcep was placed into different engagement holes to compress the segments. Photoelastic stress analysis was used to visualize the stress patterns within the fractured mandiblular models generated by the reduction forcep. In the case of symphysis or parasymphysis fractures, an optimum distribution of stress over the fracture site was achieved when placing the reduction forcep more than 12.5mm on either side of the fracture line between the midway level bisecting the mandible and 5mm below the level. In the case of body fractures, optimum stress distribution was achieved when the reduction forcep was placed more than 15mm from the fracture line on the midway level. In conclusion, a correct use of reduction forceps helps to provide a precise threedimensional reduction for mandibular fractures.

MOUTHGUARD FOR PREVENTING ORAL INJURIES IN CHILDREN (소아환자에 있어서 외상방지를 위한 마우스가드의 치험례)

  • Kim, Kyoung-Hee;Kim, Jong-Soo;You, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.3
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    • pp.537-542
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    • 2005
  • Dentofacial trauma can result in tooth fracture, avulsion, facial bone fracture. The Unites states and Japan mandated the use of mouthguards for contact sports. But, Korean didn't. Mouthguards divided into ready-made type and custom-made type. Mouthguards protect the lips, intraoral soft tissues, teeth and provide the mandible with resilient support to prevent jaw fracture and dislocations. Sports-related accidents have been reported to be one of the most common causes of dentofacial trauma. Sports trauma of involving teeth with incomplete root formation cause long chair time, multiple visit, economic considerations, additional dental services. So, mouthguards can offer considerable protection against sports-related trauma.

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GARRE'S OSTEOMYELITIS IN CHILDREN (소아에서의 Garre 골수염)

  • Woo, Se-Eun;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.4
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    • pp.413-420
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    • 2011
  • Garre's osteomyelitis is associated with bacterial infection and bone necrosis resulting from obstruction of blood supply. The most common cause for Garre's osteomyelitis is odontogenic infection that originates from periodontal tissue or dental pulp. Subperiosteal abscess may also cause Garre's osteomyelitis in the progress of the infection. Mandible is more often affected than maxilla, most commonly in the permanent first molar region of mandible. Clinically, it results in a hard swelling over the jaw, producing facial asymmetry. Meanwhile, radiograph shows a characteristic feature of irregular pulpal cavity, showing new periosteal proliferation located in successive layers to the condensed cortical bone on stimulated site. The treatment method for Garre's osteomyelitis are removal of the infection source, root canal treatment, antibiotic medication, and incision and drainage. This report presents a case of Garre's osteomyelitis under 15 years old. The patient was successfully treated by antibiotic medication accompanied with root canal treatment. Since the symptom of pediatric patients is less severe than adult, careful diagnosis with history taking and clinical examination is necessary. Furthermore long-term follow-up examination is needed to prevent recurrence even after the symptom disapears.

GORHAM-STOUT DISEASE OF THE MANDIBLE: A CASE REPORT (하악골에 발생한 Gorham-Stout 증후군: 증례 보고)

  • Ji, Young-Min;Song, Gin-Ah;Shin, Jung-Hyun;Pang, Kang-Mi;Kim, Soung-Min;Myoung, Hoon;Seo, Byoung-Moo;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin;Hwang, Soon-Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.572-576
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    • 2008
  • Gorham-Stout disease is a rare skeletal disease which is progressive and spontaneous and idiopathic resorption of whole body bone. In the initial stage, the osteolytic site is replaced by histologically benign vascular proliferation without new bone formation and finally by dense fibrous tissues. We encountered with a patient involving the mandible with attention by the clinical, radiographic, scintigraphic, angiographic, and computed tomography. We resected the mandibular lesion which was reconstructed with a fibular free flap. We report literature review with a mandibular lesion involved with Gorham-Stout disease.

A study on Pre-and Post-surgical Patterns of Mandibular Movement and EMG in Skeletal Class III Prognathic Patients who underwent Intraoral Vertical Ramus Osteotomy (하악 전돌증 환자의 구내 하악골 상행지 골절단술전후의 하악골 운동양상 및 저작근 근전도 변화에 관한 연구)

  • Park, Young-Chel;Hwang, Chung-Ju;Yu, Hyung-Seog;Han, Hee-Kyung
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.283-296
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    • 1997
  • Stomatognathic system is a complex one that is composed of TMJ, neuromuscular system, teeth and connective tissue, and all its components are doing their parts to maintain their physiological relationships. Mandible, in particular, performs various functions such as mastication, speech, and deglutition, the muscular activities that determine such functions are signalled by numerous types of proprioceptors that exist in periodontal membrane, TMJ, and muscles to be controlled by complicated pathways and mechanics of peripheral and central nervous system. Orthodontic treatment, especially when accompanied by orthognathic surgery, brings dramatic changes of stornatognat is system such as intraoral proprioceptors and muscle activities and thus, changes in patterns of mandibular function result The author tried to analyze changes in patterns of mandibular movement and physiologic activities of surrounding muscles in Skeletal Class III ortlrognathic surgery patients who presently show a great increase in numbers. The purpose of this study was to draw some objective guidelines in evaluating funclierual aspects of orthognathic surgery patients. Mandibular functional analysis using Biopak was performed for skeletal Class III prognathic patients who underwent IVRO(lntraoral Vertical Ramus Osteotmy), and the following results were obtained: 1. Resting EMG was greater in pre-surgical group than the control group, and it showed gradual decrease after the surgery. Clenching EMG of masseter and anterior temporalis of pre-surgical group was smaller than those of control group, they also increased post-surgically, and significant difference was found between pre-surgical and post-surgical(6 months) groups. 2. Resting EMG of anterior ternporalis was greater than that of all the other muscles, but there was no significant difference. Clenching EMG of anterior temporalis and masseter were greater than those of the other muscles with statistical difference. In swallowing, digastric muscle showed the highest EMG with statistical significance. 3. Limited range of mandibular movement was shown in pre-surgical group. Significant increase in maximum mouth opening was observed six months post-surgically, and significant increase in protrusive movement was observed three months post-surgically.

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A study on the perimandibular tissues before and after orthodontic treatment with orthognathic surgery in mandandibular prognathic patients (하악골 전돌자의 악교정 수술을 동반한 교정치료 전후 하악골 주위조직의 변화에 관한 연구)

  • Yang, Byung-Ho;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.261-272
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    • 2000
  • Severe skeletal anteroposterior and vertical discrepancy is difficult to obtain satisfactory result by only orthodontic treatment, and much anteroposterior movement and treatment stability require orthodontic treatment with orthognathic surgery. The treatment goal of mandibular prognathic patients is to promote the function of stomatognathic system including mastication and phonetics, to improve the esthetics of facial profile and to maintain stability. Positional changes of hyoid bone, pharynx and tongue were seen with mandibular movement after orthognathic surgery. This study was performed to observe the changes of perimandibular tissues of orthodontic patients with skeletal mandibular prognathism who treated with orthodontic treatment, and the changes of hyoid bone, pharyx and tongue by relapse or recurrance after before and after orthognathic surgery and retention. The 22 patients who had mandibular prognathism were selected. They treated with orthodontic treatment with sagittal split ramus osteotomy as orthognathic surgery. And lateral cephalometric radiographs were taken 3 times : pre-surgery (T1), immediate post-surgery (T2) and 2 years alter retention (T3). The results were as follows : 1. The hyoid bone returned back after clockwise rotation to maxilla and occlusal plane during retention (P<0.01). 2. The hyoid bone moved posterior-inferiorly by mandibular surgery and returned back anterior-superior after retention. (P<0.01) 3. The changes of pharyngeal depth showed a little decrease at upper area in post- surgery, but it was not a significant difference generally through before, after and retention. 4. In relating to tongue base, the angle of tongue base was decreased and the dorsal area of tongue base moved to inferior-posterior direction and to superior direction again after retention (P<0.01). 5. Related to the thickness of upper and lower lip, the thickness of upper lip decreased after surgery, and the soft tissues below lower lip increased after surgery and decreased after retention.

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EVALUATION OF CONDYLAR POSITION USING COMPUTED TOMOGRAPH FOLLOWING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY (전산화단층촬영법을 이용한 하악 전돌증 환자의 하악지 시상 골절단술후 하악과두 위치변화 분석)

  • Chol, Kang-Young;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.570-593
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    • 1996
  • This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after BSSRO in 20 patients(males 9, females 11) using computed tomogram that were taken in centric occlusion before, immediate, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period intermaxillary fixation, 24hour after removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.45{\pm}4.01mm$ and horizontal long axis of condylar angle was $11.89{\pm}5.19^{\circ}$on right, $11.65{\pm}2.09^{\circ}$on left side and condylar lateral poles were located about 12mm and medial poles about 7mm from reference line(AA') on the axial tomograph. Mean intercondylar distance was $84.43{\pm}3.96mm$ and vertical axis angle of condylar angle was $78.72{\pm}3.43^{\circ}$on right, $78.09{\pm}6.12^{\circ}$on left. 2. No statistical significance was found on the condylar change(T2C-T1C) but it had definitive increasing tendency. There was significant decreasing of the distance between both condylar pole and the AA'(p<0.05) during the long term(TLC-T2C). 3. On the lateral cephalogram, no statistical significance was found between immediate after surgery and 24 hours after the removing of intermaxillary fixation but only the lower incisor tip moved forward about 0.33mm(p<0.05). Considering individual relapse rate, mean relapse rate was 1.2% on L1, 5.0% on B, 2.0% on Pog, 9.1% on Gn, 10.3% on Me(p<0.05). 4. There was statistical significance on the influence of the mandibular set-back to the total mandibular relapse(p<0.05). 5. There was no statistical significance on the influence of the mandibular set-back(T2-T1) to the condylar change(T2C-T1C), the condylar change(T2C-T1C, TLC-T2C) to the mandibular total relapse, the pre-operative condylar position to the condylar change(T2C-T1C, TLC-T2C), the pre-operative mandibular posture to the condylar change(T2C-T1C, TLC-T2C)(p>0.05). 6. The result of multiple regression analysis on the influence of the pre-operative condylar position to the total mandibular relapse revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condyalr head long axis angle, the more increasing of mandibular horizontal relapse(L1,B,Pog,Gn,Me) on the right side condyle. The same result was founded in the case of horizontal relapse(L1,Me) on the left side condyle.(p<0.05). 7. The result of multiple regression analysis on the influence of the pre-operative condylar position to the pre-operative mandibular posture revealed that the more increasing of intercondylar distance and condylar vertical axis angle and decreasing of condylar head long axis angle, the more increasing of mandibular vertical length on the right side condyle. and increasing of vertical lengh & prognathism on the left side condyle(p<0.05). 8. The result of simple regression analysis on the influence of the pre-operative mandibular posture to the mandibular total relapse revealed that the more increasing of prognathism, the more increasing of mandibular total relapse in B and the more increasing of over-jet the more increasing of mandibular total relapse(p<0.05). Consequently, surgical mandibular repositioning was not significantly influenced to the change of condylar position with condylar reposition method.

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OSTEOPETROSIS WITH MAXILLARY OSTEOMYELITIS (상악골 골수염을 수반한 골화석증)

  • Lee Won-Shik;You Dong-Soo;Park Tae-Won;Choi Soon-Chul
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.2
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    • pp.405-413
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    • 1991
  • The authors observed a 33-year-old male patient who had suffered from osteopetrosis with maxillary osteomyelitis. The obtained results were as follows: 1. Physical examination revealed hepatosplenomegaly and bowing legs. 2. Nearly all bones of the entire skeleton showed unusual increased radiodensity and the paranasal sinuses were markedly obliterated. 3. There were seveal old fractured sites in the femur and hip bones and subluxation of hip joint. 4. The radiodensity of both jaws were prominently increased and there were many malformed teeth and impacted teeth. 5. Bone scan revealed multiple, irregularly increased uptakes in large joints and long bones.

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A CLINICAL STUDY ON MANDIBULAR FRACTURE (하악골 골절의 임상적 연구)

  • Jang, Hyun-Seok;You, Jun-Young;Kim, Yong-Kwan;Yang, Byeong-Eun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.181-189
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    • 1997
  • The mandible plays a crucial role in the vital human functions of breathing, eating, and speaking. No other bone in the body has such a distinctive shape and function. Because of its prominence in the facial structure, the mandible is highly prone to fracture. A clinical study on 122 patients with mandibular fracture who visited Kangnam General Hospital during 4 year(1992-1995) was done by analysing sex, age, cause, fracture site, teeth involvement, treatment method, complication and involvement of other body part. The results obtained were as follows : 1. The occurrence was more frequent in male than in female with the ratio of 5.4 : 1 and most frequently in twenties. 2. Violence was the most common cause of facial mandibular fracture. 3. In mandibular fracure, fracture site was average 1.5 sites, most frequently in symphysis and simple fracture was 86.1%. 4. As treatment methods, open reduction(78.6%) was used more frequently than closed reduction(21.4%). 5. Post-operational complication occurred in 27.0% of the cases. 6. Other injuries that were related to maxillofacial fracture occurred in 25.4%.

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