• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.6
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• pp.474-480
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• 2009

These is a cases of chronic suppurative osteomyelitis occurred in the mandibular body to condyle of 48-year-old male patient. Extensive bone destruction was noted on the right mandibular body, angle, ascending ramus, mandibular notch and condylar region. We made a treatment plan that radicular mandibular resection from body to condyle and mandibular reconstruction with vascularized fibular flap at first time. But, we could observe marked bone regeneration with only mild curettage, local wound care and massive antibiotic therapy. So we preserved the anterior ramus portion of mandible. Defected mandibular condyle was reconstructed with costochondral graft. In this paper we present the case of a patient who has chronic osteomyelitis in mandibular area.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.161-168
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• 2010

Purpose: Surgical approaches to the condylar neck and subcondyle area can cause some morbidity such as, facial nerve injury, time-consuming nature and external scar etc. So many surgeons hesitate using open reduction and internal fixation for the treatment of subcondylar fractures. We report open reduction and internal fixation of subcondylar fractures in 13 adult patients via transmasseteric approach. Methods: From 2007 to 2009, 13 adults with subcondylar fracture of mandible were treated with open reduction and internal fixation via transmasseteric approach. A preauricular incision was extended downwards in a curvilinear fashion in the cervicomastoid skin crease. Skin flap was elevated above the SMAS layer. Masseter muscle was splitted at the anteroinferior edge of the parotid gland. After the fracture was reduced, fixed with appropriate plates and screws. All operation were performed under general anesthesia. Results: Mean follow-up period was 13.3 months. There were no signs and symptoms of facial nerve injury, difficulty in mouth opening, or malocclusion. Dissection time was roughly within 30 minutes. Conclusion: Transmasseteric open reduction and internal fixation of mandible subcondylar fracture can be performed with excellent visualization, and inconspicuous scar. It also offers swift access to the subcondylar area while substatially reducing the risk to the facial nerve and eliminating the complications associated with transparotid approaches.

• The korean journal of orthodontics
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• v.32 no.5 s.94
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• pp.313-325
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• 2002

Three-dimensional CT imaging is efficient in examining specific structures in the craniofacial area by reproducing actual measurements through minimization of errors from patient movement and image magnification. Due to the rapid development of digital image technology and the expansion of treatment range a need for developing three -dimensional analysis has become urgent. Therefore the purpose of this study was to evaluate the percentage of error and magnification of three-dimensional CT using a dried skull and Vworks $program^{TM}$ (Cybermed Inc., Seoul, Korea) and also to obtain landmarks that are easy to designate and reproduce in three-dimensional images using the Vmorph-proto $program^{TM}$ (Cybermed Inc., Seoul, Korea). The following conclusions were obtained, 1. In the comparison of actual measurements from the dried skull and the three-dimensional image obtained from the Vworks program, the mean error was 0.99mm and the magnification was 1.04%. 2. Clinically useful hard tissue landmarks from three-dimensional images were Supraorbitale, Lateral orbital margin, Infraorbitale, Nasion, ANS, A point, Zygomaticomaxilla, Upper incisor, Lower incisor, B point, pogonion, Menton, PNS, Condylar inner margin, Condylar outer margin, Porion, Condylion, Gonionl, Gonion2, Gonion3, Sigmoid notch and Basion. 3. Clinically useful soft tissue landmarks from three-dimensional images were Endocanthion, Exocanthion, Soft tissue Nasion, Pronasale, Alare lateralis, Upper nostril point, Lower nostril point, Subnasale, Upper lip point, Cheilion, Stomion, Lower lip center, Soft tissue B, Pogonion, Menton and Preaurale. The Vworks program can be considered a clinically efficient tool to produce and measure three-dimensional images. Most of the hard and soft tissue landmarks proposed above are anatomically important points which are also easily reproducible and designated. These landmarks can be beneficial in three-dimensional diagnosis and the prediction of changes before and after surgery.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.2
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• pp.109-118
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• 2011

The aims of this study were analyze the amount of stress condition when the traction force was applied to the condyle head from the chin area of mandible and amount of distortion condition when intended 0.5 mm distraction distance from surface or one point of dissected midline of mandible. For this study, 3D finite element analysis were performed. The following results were obtained : 1. When traction force of 500 g was applied to the condyle head from the chin area, condylar neck area showed the greatest amount of stress and coronoid process was the least amount of stress area. For the amount of distortion condition, infra dental area showed the greatest. 2. When 0.5 mm of intended surface distortion was applied after dissection of mid-mandible area, base anterior area showed the greatest amount of stress but the least stress area was coronoid process. For the amount of distortion, infra dental, menton area showed the greatest amount. 3. One point distortion was applied after dissection of mid-mandible area, ramus posterior area showed the greatest amount of stress and menton area were the least stress condition. For the amount of distortion, menton area showed the greatest amount of distortion condition.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.4
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• pp.209-214
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• 2016

Traumatic bone cyst (TBC) occurs preferentially on the mandibular symphysis and body, but rarely on the mandibular condyle. When TBC occurs in the condylar area, it can usually be related with or misdiagnosed as a temporomandibular joint disorder. A 15-year-old female patient visited the Temporomandibular Joint Clinic with a 5-year history of pain and noise localized in the left temporomandibular joint. On imaging, a well demarked oval-shaped radiolucent lesion was observed on the left condyle head. The patient underwent cyst enucleation and repositioning of the bony window on the lateral cortex of the affected condyle head under the impression of subchondral cyst or TBC; however, no cystic membrane was found. The bone defect resolved and showed no recurrence on the serial radiographic postoperative follow-up for 43 months after surgery.

• Journal of Korean Dental Science
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• v.6 no.2
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• pp.87-95
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• 2013

Synovial chondromatosis (SC) is a rare, benign disease found in metaplastic cartilaginous nodules within the synovial membrane. The etiology of SC is not well-known, but it may be associated with trauma, chronic abnormal loading, or inflammatory joint disease. It is often found in knee, elbow, ankle, and shoulder joint but rarely in the temporomandibular joint (TMJ) area. SC of TMJ frequently appears in middle age and more often in females. Clinical symptoms include periarticular swelling, pain, crepitus, and limitation of joint motion. The most common feature is a radiographic finding of loose bodies in the joint. Irregularity of joint space and condylar head is also observed. Treatment involves the surgical removal of synovium and loose bodies. The prognosis is good, with low postsurgical recurrence rate. Functional improvement of the joint and pain relief are noted in many patients. Malignant transformation of SC has not been recorded. In this study, we report a 54-year-old female patient who experienced discomfort on the right TMJ with SC on the area but made a satisfactory recovery after surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.4
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• pp.397-410
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• 2000

Skeletal class III had been classified by the position of the maxilla, the mandible, the maxillary alveolus, the mandibular alveolus and vertical development. This morphologic approach is simple and useful for clinical use, but it is insufficient to permit understanding of the pathophysiology of dysmorphoses. The author hypothesizes that there are different patterns of mutual relation of the skeletal components which have contributed pathologic equilibrium of skeletal class III. The purpose of this study are threefold: 1) to classify skeletal class III in subgroups, which can show the architectural characteristics of the deformity, 2) to analyse the craniofacial architecture of each subgroup on etio-pathogenic basis, and 3) to characterize and visualize the pattern as a prototype. Materials used in this study were lateral cephalograms of 106 skeletal class III adults, which were analysed with modified Delaire's architectural and structural analysis. Linear and angular measurements of the individual subject were obtained and cluster analysis was used for the subgrouping. Data were evaluated for verification of the statistical significances. The following results were obtained. 1. By the modified Delaire's architectural and structural analysis and cluster analysis, skeletal class III adults were classified into 7 clusters and presented as prototypes, which could show the pathophysiology of the skeletal architecture 2. There was significant relationship in measurement variables of each cluster, which could reflect characteristics of the skeletal pattern of growth. 3. The flexure of cranial base had a close relationship to the anterior rotational growth of the maxilla and contributes to understand the etio-pathology of skeletal class III. 4. The proportion of craniospinal area in cranial depth, craniocervical angle and vertical position of point Om had a close relationship to rotational growth of the mandible and direction of condylar growth. They contribute to understand the etio-pathology of skeletal class III. In summary, the cranium and the craniocervical area must be considered in diagnosis and treatment planning of dentofacial deformity. And the occlusal plane can be considered as a representative which shows the mutual relationships of the skeletal components.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.345-352
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• 1999

This study was conducted for the purpose of suggestion of the new technique of sagittal split ramus osteotomy pararell to the true sagittal plane. This pararellism is the important concept of the sagittal split ramus osteotomy to reduce the condylar sagging including mandibular hypomobility, temporomandibular disorder, occlusal relapse and other complications. We used 26 adult dry manibles(52 rami), and obtained the computed tomographs through the sagittal, horizontal and coronal sections. The results were obtained as follows. 1. On sagittal section, mean area of S1 was $8.63{\pm}2.10cm^2$, S2 was $8.93{\pm}1.94cm^2$, S3 was $9.49{\pm}2.15cm^2$, S6 was $10.72{\pm}2.22cm^2$. The wider area of sagittal section, the more lateral section, But, no significant differency between the areas of the sagittal sections(P>0.05). 2. On horizontal section, The distance between the inferior alveolar canal and the lateral cortical plate of the mandibular ramus were $6.73{\pm}1.24mm$ minum, $7.70{\pm}1.44mm$ maximum. 3. On coronal section, Outer mandibular angle were $4.84{\pm}2.37^{\circ}$ right side, $4.93{\pm}2.12^{\circ}$ left side. 4. The design of the ideal true sagittal split ramus osteotomy is that posterior border of osteotomy must be limited vertically, at the right posterior point of lingula mandibularis and anterior of osteotomy must be extended to mandibular body, anteroinferiorly.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.207-217
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• 2010

The purpose of this study was to evaluate the effects of the stress distribution and displacement in mandible according to treatment modalities of mandibular angle fractures, using a three dimensional finite element analysis. A mechanical model of an edentulous mandible was generated from 3D scan. A 100-N axial load and four masticatory muscular supporting system were applied to this model. According to the number, location and materials of titanium and biodegradable polymer plates, the experimental groups were divided into five types. Type I had a single titanium plate in the superior border of mandibular angle, type II had two titanium plates in the superior tension border and in the inferior compression border of mandibular angle, type III had a single titanium plate in the ventral area of mandibular angle, type IV had a single biodegradable polymer plate in the superior border of mandibular angle, type V had a single biodegradable polymer plate in the ventral area of mandibular angle. The results obtained from this study were follows: 1. Stress was concentrated on the condylar neck of the fractured side except Type III. 2. The values of von-Mises stress of the screws were the highest in the just-posterior screw of the fracture line, and in the just-anterior screw of Type III. 3. The displacement of mandible in Type III was 0.04 mm, and in Type I, II, IV, and V were 0.10 mm. 4. The plates were the most stable in the ventral area of mandibular angle (Type III, V). In conclusion, the ventral area of mandibular angle is the most stable location in the fixation of mandibular angle fractures, and the just- posterior and/or the just-anterior screws of the fracture line must be longer than the other, and surgeons have to fix accurately these screws, and the biodegradable polymer plate also was suitable for the treatment of mandible angle fracture.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.21 no.2
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• pp.165-179
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• 1991

This study was performed to understand the irradiation effects on the mandibular condyle and mandibular growth in developing white rats. Forty eight white male rats of the Sprague-Dawley strain aged 4 weeks, were devided into two groups; control group and experimental group. A single target dose of l0Gy of radiation was given to the mandibular condylar area and the observations of the photo analysis, radiologic, histopathologic and immunohistochemical study revealed as follows; 1. Animals killed one week after irradiation showed lesser increase in body weights, no difference in photo analysis and decreased thickness of cartilagenous layers of the condyle than the control group. 2. Two weeks after irradiation the weight increases were almost same in both irradiated and control groups and in photo analysis, the distance from Mental Foramen to Incisal tip (Mf-It) was longer than the controls. Repair processes were taken place in irradiated group, but the cartilagenous layers were thinner than the controls. 3. By the third week after exposure further repair was seen in the trabeculae and the distance from Condylion to Mandibular plane (Cd-Cd') was longer than the controls and the weight increases were almost same as the controls. 4. At 4 weeks after irradiation the cells of proliferating zone repaired to almost normal findings, but the cartilagenous cell layers were still thinner than the control animals. In photo analysis, the distances from Menton to Anterior Notch (Me-An), from First Molar to Mandibular plane (Fm-Fm') were shorter and the weight increases were lesser than the controls. 5. In the S-100 antibody, the positive cells were increased in number, but decreased reactivities were seen at the proliferating zone of the irradiated groups. In the Monoclonal Anti-Proteoglycan antibody and Type Ⅰ collagen antibody, the irradiated groups showed little decreased number of positive cells and in the Type Ⅱ collagen antibody, the differences between irradiated and control groups were undetectable in immunohistochemical study.