• Archives of Craniofacial Surgery
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• v.20 no.2
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• pp.76-83
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• 2019

Background: The mental V-Y advancement flap method is useful for reconstruction of lower lip defect because of its many advantages. However, it is not easy to select the optimal reconstructive method for the vermilion defect that remains after application of the mental V-Y advancement flap. In choosing the representative surgical method for vermilion mucosal reconstruction including mucosal V-Y advancement flap, buccal mucosal flap, and buccal mucosal graft. We describe an efficient technique to large lower lip defects combining mental V-Y advancement flap and buccal mucosal graft Methods: This study included 16 patients who underwent reconstructive surgery for full-thickness and large defect (> half the entire width) of the lower lip from October 2006 to September 2017. The operation was conducted using mental V-Y advancement flap with various vermilion mucosal reconstruction methods considering the location of the defect and the amount of residual tissue of the lip coloboma after excision. Results: All patients underwent mental V-Y advancement flap. In vermilion mucosal reconstruction, five patients underwent mucosal V-Y advancement flap, three underwent buccal mucosal flap, and eight underwent buccal mucosal graft. There were good aesthetic and functional results in all patients who underwent buccal mucosal graft. However, two patients who underwent mucosal V-Y advancement flap complained of oral incompetence, and all patients who underwent buccal mucosal flap had oral commissure deformity. Conclusion: Buccal mucosal graft combined with mental V-Y advancement flap can produce suitable functional and aesthetic outcomes in near total lower lip reconstruction in patient with large mucosal defect including vermilion portion.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.3
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• pp.207-214
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• 2015

Due to the limitations of conventional removable partial denture prostheses to treat a cleft lip & palate patient who shows scar tissue on upper lip, excessive absorption of the maxillary residual alveolar ridge, and class III malocclusion with narrow palate and undergrowth of the maxilla, 4 implants were placed on the maxillary edentulous region and a maxillary removable implant-supported partial denture was planned using a CAD/CAM milled titanium bar. Unlike metal or gold casting technique which has shrinkage after the molding, CAD/CAM milled titanium bar is highly-precise, economical and lightweight. In practice, however, it is very hard to obtain accurate friction-fit from the milled bar and reduction in retention can occur due to repetitive insertion and removal of the denture. Various auxiliary retention systems (e.g. $ERA^{(R)}$, $CEKA^{(R)}$, magnetics, $Locator^{(R)}$ attachment), in order to deal with these problems, can be used to obtain additional retention, cost-effectiveness and ease of replacement. Out of diverse auxiliary attachments, $Locator^{(R)}$ has characteristics that are dual retentive, minimal in vertical height and convenient of attachment replacement. Drill and tapping method is simple and the replacement of the metal female part of $Locator^{(R)}$ attachment is convenient. In this case, the $Locator^{(R)}$ attachment is connected to the milled titanium bar fabricated by CAD/CAM, using the drill and tapping technique. Afterward, screw holes were formed and 3 $Locator^{(R)}$ attachments were secured with 20 Ncm holding force for additional retention. Following this procedure, satisfactory results were obtained in terms of aesthetic facial form, masticatory function and denture retention, and I hereby report this case.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.6 no.2
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• pp.105-111
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• 2010

Objective : To report eruption of maxillary canine through Bio-$Oss^{(R)}$ graft in patients with secondary bone-grafted alveolar clefts. Methods : Secondary alveolar bone grafts placed in the cleft alveolar defect have been shown to support dental eruption through the graft and may further affect the prevalence of impacted teeth. As the case may be, it could be difficult to do secondary alveolar bone graft with autologous bone. In particular, few reports have been shown the secondary bone graft with heterogenous bone(Bio-$Oss^{(R)}$). In this report, the eruption of canine into bone-grafted alveolar clefts was recorded as panoramic, occlusal radiographs, in 3 patients grafted with Bio-$Oss^{(R)}$ Results : Like autologous bone graft, the canine was erupted and developed into the cleft alveolar defect through Bio-$Oss^{(R)}$ graft. Conclusion : In some cases that autologous bone graft is not available, we can consider heterogenous bone graft into the cleft alveolar defect for dental development and eruption of impacted teeth.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.105-111
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• 2017

Background: The author analyse the impact of extracapsular lymph node spread and bone engagement in the ipsilateral neck of patients suffering squamous cell carcinoma (SCC) of the lower lip. Methods: The data of 56 neck dissections performed in patients suffering SCC of the lower lip between January 2000 and December 2008 were retrospectively analysed. Statistical analysis was performed with the Kaplan-Meier life table method, and the survival rate was investigated with the log rank statistic and significance test. The values were considered statistically significant at p<0.05. Results: Nine patients took advantage from simultaneous treatment of tumor and prophylactic neck dissection (level I-III), reaching 100% survival rate. Patients suffering metastasized disease, who received radical neck dissection at the time of tumor treatment, presented 83.3% survival rate. Patients who underwent previous surgery and radiotherapy presented worse prognosis although radical neck dissection in case of extra-capsular spread only (24.7%) and osseous engagement (22.2%). Conclusion: Prophylactic neck dissection (level I-III) is recommended in T3-T4 N0 SCC. Simultaneous treatment of tumor and cervical lymph nodes provides a better prognosis as respect to delayed nodal management. Extra-capsular spread with or without bone engagement represents independent risk factor responsible for high mortality rate of SCC of the lower lip.

• Journal of Animal Reproduction and Biotechnology
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• v.34 no.3
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• pp.253-258
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• 2019

A female English bulldog was gave birth two neonates by cesarean section on the sixty one days after mating, but both neonates were died soon after birth. The bodies of neonates were diagnosed using radiography, ultrasonography, computed tomography and necropsy immediately after death. Both neonates had caudal regression syndrome, butterfly vertebra, hydrocephalus, umbilical hernia, cleft palate and bow-legged hind-limb. At necropsy, neonates had mild fetal anasarca, cleft lip and the skull was remained non-union. At thoracic cavity, only three ribs and thoracic spines were existed and patent ductus arteriosus was found. At abnormal cavity, the renal ectopia was found with abnormal morphology. In the present case, those English bulldog neonates with multiple congenital malformation syndromes seriously suffered vertebral column anomalies and that may induced by neural tube defects in during embryonic period. To prevent congenital malformation occurring in English bulldog, further in depth studies are needed for the breed specific genetic diversity and for the reason of behind genetic abnormality in these breed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.3
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• pp.237-245
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• 2004

The deformities of micrognathia and glossoptosis in the newborn are frequently associated with a cleft palate, which is known as Pierre Robin sequence. Upper airway obstruction is the most serious problem in these patients. Treatment of Pierre Robin sequence includes either positional or surgical intervention. Mild cases are often managed in the prone position. However, when the patient fails to thrive due to chronic upper airway obstruction, or severe respiratory distress ensures despite positional treatment, surgical intervention is mandatory to relieve the obstruction. We experienced three infants with Pierre Robin sequence who showed a symptom triad of micrognathia, glossoptosis, and cleft palate. Intermittent cyanosis, depression of the chest, respiratory difficulty and feeding problems were also observed. To relieve severe upper airway obstruction caused by micrognathia and glossoptosis, we simultaneously performed modified tongue lip adhesion (TLA) and a subperiosteal release of the floor of the mouth (SRFM). Respiratory and feeding difficulties were relieved, the tongue positioned anteriorly, body weight increased, and mandibular growth improved. Simultaneous TLA and SRFM may constitute a simple and reliable method for surgical treatment of airway obstruction in patients with Pierre Robin sequence.

• Korean Journal of Cleft Lip And Palate
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• v.4 no.1
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• pp.39-43
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• 2001

The design of osteotomy plane in orthognathic surgery has been developed to diminish the nerve injury. Intraoral Vertico-Sagittal Ramus Osteotomy (IVSRO) is the one of the best way to minimize untoward results, which is designed not to expose the lingula. We evaluated the nerve damage before and after with current perception threshold (CPT) test which is modem and numerically expressible way of nerve damages. Sixty patients underwent IVSRO since 1998 were evaluated. They were divided into 2 groups; one group underwent IVSRO only, and the other underwent IVSRO plus genioplasty. The both groups were evaluated with CPT test 1 week before surgery, and 1, 3 and 6 months after surgery. The CPT test was performed on A-beta, A-delta and C fiber respectively. 111e result showed that the recovery of sensory function of damaged nerve fibers was observed at the period of three to six months after surgery. There was no impairment of nerve function after only the IVSRO . But there were sensory disturbances in cases of additional genioplasty group. We thought that one of major factors on nerve damages were exposure of nerve and traction injury during genioplasty.

• Korean Journal of Cleft Lip And Palate
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• v.4 no.1
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• pp.45-53
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• 2001

Congenital craniofacial disorders represent approximately 20% of all birth defects, One of these disorders is syngnathia, Congenital fusion of the maxilla and mandible is rare and can present in a wide range of severity from single mucosal band(synechiae) to complete bony fusion(syngnathia), Syngnathia, congenital bony fusion of the mandible and maxilla, is even less common than synechiae, with only 25 cases reported in the literature, Most of them have presented as an incomplete, unilateral fusion, We report a case of unilateral bony fusion of the maxilla, mandible, and zygomatic arch, Details of operative management and follow-up data are presented with review of literature.

• Korean Journal of Cleft Lip And Palate
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• v.6 no.2
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• pp.91-105
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• 2003

There are significant limitations in the precision of mandibular distraction in setting a desired occlusal and facial esthetic outcome. The purpose of this study is to present the simulation method for the distraction osteogenesis treatment planning. 3-D surgery simulation software programs V-works and V-Surgery(Cybermed, Seoul, Korea) were used from the 3D CT data in addition to the conventional data facial photography, panorama and cephalogram, dental cast model. We have utilized already for the various surgical procedures to get information preoperatively for the maxillofacial surgery like cancer localization and reconstructive surgery, orthognathic surgery and implant surgery in the department of Oral and Maxillofacial surgery, Seoul National University Hospital. On the software, bone cutting can be done at any place and any direction. Separated bone segment can be mobilized in all 3 dimensional direction. After the 3D simulation on the software program, mock surgery on the RP model can be performed. This planning method was applied to two hemifacial microsomia patients. With this protocol, we could simulate the movement of bony segment after maxillofacial distraction osteogenesis

• Korean Journal of Cleft Lip And Palate
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• v.7 no.2
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• pp.77-91
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• 2004

본 연구의 목적은 반안면왜소증 환자의 하악골 신장술시 초기 치아골격 특성들 중에서 치료결과의 차이에 기여하는 인자를 찾는 것이다. 치료전의 치아골격 특성, 골신장술의 효과와 그 유지상태를 관찰하기 위하여 골신장술 직전(T0), 직후(T1), 추적 2년후(T2)에 측모와 정모 두부방사선 계측사진을 촬영하여 전후방, 수직치아, 비대칭 항목들을 계측하였다. T2 시기의 계측 결과에 따라서 환자들을 1군(양호군, 10명)과 2군(불량군, 9명)으로 분류하였다. 두 군에서 각 시기와 T0-T1, T1-T2 동안의 변화량의 차이를 Mann-Whitney U test, Wilcoxon signed independent t-test, rank test, ANOVA test를 사용하여 분석하였다. pruzansky type이 골신 장술의 성공과 실패 여부와 관계가 깊게 나타났다. T0 시기에 2군은 1군에 비하여 하악골이 후방위치되었고, 하악지 고경(ramus height)이 짧았고, 하악각(gonial angle)이 컸으며, 이환측 하악지가 내측경사되었고, 이환측으로의 이부변위(chin point deviation)가 크게 나타났다. 1군에서 골신장술의 주요한 효과는 하악지 고경의 증가, 하악골의 전방위치, 하악각의 증가, articular angle의 감소에 따른 하약골의 반시계방향 회전, 이환측의 하악지 경사의 증가, 교합면경사와 이부변위의 개선으로 나타났다. 그러나 2군에서는 골신장술을 시행했을 때 1군에 비하여 하악골이 시계방향으로 회전되었고 하악지 고경의 증가량이 작게 나타났다. T2 시기에 2군에서는 하악골의 반시계방향 회전이 나타났고, 하악지 성장이 일어나지 않았으나, 1군은 반대의 경향을 보였다. 이러한 인자들이 골신장술 결과의 차이에 기여하는 것으로 생각된다.