• Archives of Plastic Surgery
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• v.43 no.2
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• pp.197-203
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• 2016

Background The aim of unilateral breast reconstruction after mastectomy is to craft a natural-looking breast with symmetry. The latissimus dorsi (LD) flap with implant is an established technique for this purpose. However, it is challenging to obtain adequate volume and satisfactory aesthetic results using a one-stage operation when considering factors such as muscle atrophy, wound dehiscence and excessive scarring. The two-stage reconstruction addresses these difficulties by using a tissue expander to gradually enlarge the skin pocket which eventually holds an appropriately sized implant. Methods We analyzed nine patients who underwent unilateral two-stage LD reconstruction. In the first stage, an expander was placed along with the LD flap to reconstruct the mastectomy defect, followed by gradual tissue expansion to achieve overexpansion of the skin pocket. The final implant volume was determined by measuring the residual expander volume after aspirating the excess saline. Finally, the expander was replaced with the chosen implant. Results The average volume of tissue expansion was 460 mL. The resultant expansion allowed an implant ranging in volume from 255 to 420 mL to be placed alongside the LD muscle. Seven patients scored less than six on the relative breast retraction assessment formula for breast symmetry, indicating excellent breast symmetry. The remaining two patients scored between six and eight, indicating good symmetry. Conclusions This approach allows the size of the eventual implant to be estimated after the skin pocket has healed completely and the LD muscle has undergone natural atrophy. Optimal reconstruction results were achieved using this approach.

• The korean journal of orthodontics
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• v.17 no.1
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• pp.93-106
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• 1987

The purpose of this study was to investigate the fittness of Golden relation items was advocated by Ricketts whether or not it is applicable to the young adult Korean dentitions and also to evaluate the several new Golden relation items conducted by the author. The material was consisted of 81 dental casts (34 male, 47 female) with ideal occlusion, which never undergone orthodontic, prosthodontic procedures. Measurements were made on the arch dimensions using sliding caliper (Mitutoyo. Co) and data were computerized and analyzed. The findings of this study were as follows, 1. The Golden proportion advocated by Ricketts dose not seem to directly applicable to the Korean normal dentition, however, the modification from the Ricketts' original shows the Golden proportion as follow: A first series of progressive Golden relations was found on the Golden ratio among the lower central incisors width, the inter mesioincisal width of the upper lateral incisors, and the upper first premolars width. A second series was found on the Golden ratio among the lower lateral incisors width, lower inter canine tips width and theupper first molar distal cusp tips width. A third series was found on the Golden ratio between the inter distal aspect width of e lower canine and the mesial cusp tips width of the lower second molars or inter cusp tips width of upper second premolars. 2. In addition to Ricketts' original, 4 new Golden proportions were found in young adult Korean dentition, these are as follows; The tips of lower canine width had Golden relation with the width of the upper first premolar buccal cusp tips or the width of the lower first molar central fossae. The distal aspect of the lower first premolars had Golden relation with the buccal surface widths of the lower or upper second molars. The width of upper lateral incisors had Golden relation with the upper second molar height. The width of the lower canine tips had Golden relation with the lower second molar height.

• 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

• Journal of Periodontal and Implant Science
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• v.39 no.sup2
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• pp.261-268
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• 2009

Purpose: To estimate the prevalence of periodontitis in Korean adults and to examine the associations between periodontitis and known risk factors. Methods: Using Korean National Oral Health Survey 2006 data, a total of 4,263 people who had taken oral examination, interviewed by questionnaire, and aged 18 or older were sampled. The prevalence of periodontitis measured by Community Periodontal Index (CPI) was calculated and the differences in prevalence according to known risk factors (age, sex, monthly income, education, residential area, tooth-brushing frequency, regular dental visit, smoking, and diabetes) were examined with chi-square test. Logistic regression analysis was performed to see the effects of each risk factor on the risk of having periodontitis. All statistical approaches were reflected national sampling design using Survey procedures in SAS 9.1. Results: The overall prevalence of periodontitis in Korean adults was 10.3%. There existed statistically significant differences in crude prevalence for periodontitis according to the all risk factors. In logistic regression, older age groups (O.R.:2.94-3.71), people living in rural area (O.R.:1.87), and current smokers (O.R.:1.77) were significantly prone to have periodontitis. People who earned monthly income of more than 2 million Korean won (O.R.:0.64) and brushed their teeth two or more times per day (O.R.:0.60-0.62) had significantly lower risk of having periodontitis. Conclusions: About 10% of Korean adults had periodontitis in 2006. People who were older, living in rural region, in lower income status, smoking, less tooth brushing were more likely to have periodontitis.

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.94-99
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• 2014

Purpose: Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the longterm outcome of this grafted gingiva. Methods: A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap. Results: At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue. Conclusions: Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.3
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• pp.265-271
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• 2010

One of the most important aspect of esthetic dentistry is shade selection. Alterations to perception of color can occur as a result of numerous factors, including light source, tooth surface texture, observer's ability, surrounding colors, the angle of observation, light and dark adaptation and others. During the clinical procedures, tooth might be in dry or semi-dry condition. The purpose of this study was to compare the shade changes in wet and dry conditions of natural tooth. Groups of measurement are an initial wet condition as control, dry in 10seconds, 1 minute, 5minutes and 30seconds air dry. Using Shadeeye, color difference(${\Delta}E$) between measurements were analyzed and there were significant differences between groups. But most of the differneces were <3.7 ${\Delta}E$ unit. Such differences are below the threshold for perceivable color mismathces in intraoral condition. Shade selection with an intraoral colorimeter could be changes in dry and wet condition but there might be no significant differences in visual color mathing.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.4
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• pp.391-396
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• 2007

The aim of this study was to evaluate implant stability placed in the maxillary sinus which was augmented with bovine bone mineral(Bio-$Oss^{(R)}$) mixed with autogenous bone from the maxillary tuberosity. Maxillary sinus floor augmentation with the mixture of bovine bone mineral and autogenous maxillary tuberosity bone was performed in 30 maxillary sinuses, and 68 implants were placed at the time of sinus graft. After 6 months of implant placement abutments were connected and implant stability quotient(ISQ) was measured by radio frequency analysis(RFA). In addition, bone level changes was evaluated by taking periapical radiograph. During surgical procedures, no complication was observed, and all patients healed uneventfully. At 6 months the implant showed stable ISQ values. The marginal bone level changes around the fixtures was stably maintained through out the follow up period. This study confirmed that maxillary sinus floor augmentation with mixture of bovine bone mineral and maxillary tuberosity bone could be reliable for bone regeneration in subantral space.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.208-213
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• 2013

The spectrum of physically challenged patients who visit to a dental clinic for treatments are diverse: from ones of mild disabilities, who lead their lives in a similar way of ordinary people, to others who suffer from diseases that are difficult to be diagnosed, and need medical expertise due to systemic care or special techniques and instruments because of behavior management and difficulty of treatments. The patient in this case was 25-year-old autistic male patient who visited the clinic on account of overall treatment for multiple carious lesions. He could perform normal daily life to some degree under the care of a guardian. This case report describes predicaments of making a treatment plan resulted from lack of information about disabled patients, and difficulties of proceeding treatment procedures under general anesthesia. It is considered that sufficient consultation and history taking are needed before treatment for disabled patients.

• Korean Journal of Cleft Lip And Palate
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• v.12 no.2
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• pp.73-84
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• 2009

The treatment of cleft lip and palate must be based on a complete knowledge of the anatomy, physiology and growth of the involved deformity, because of not only the appearance but also impaired functions such as phonation, mastication, respiration and lingual posture of the maxillomandibular complex. Delaire has long studied all these aspects, and has published many numbers of articles and constructed a philosophy concerning the significance and interrelationship of the various structures. The results obtained from its application seem to be particularly valid from a clinical point of view, although it has not all been scientifically supported by experimental data. For these reasons, Delaire's primary unilateral and bilateral cheilorhinoplasty procedures are particulary good, as is his secondary gingivoalveoloplsty procedure during the course of the surgical repair of the hard palate. In order to understand Delaire's philosophy, it is necessary to consider the normal and pathologic anatomy of the structures involved in the deformity, the role of some structures, such as nasal septum, musculature, and tongue, and some functions, such as dental occlusion or nasal respiration, which play important roles in maxillary and particularly premaxillary growth. Despite of important concept and meanings, Delaire's philosophy has not been introduced widely to our Korean cleft surgeons yet. So authors will summarize the basic concepts of Delaire's philosophy according to already published literatures and lectures based on our previous treatment outcomes.

• Journal of Periodontal and Implant Science
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• v.48 no.5
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• pp.274-283
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• 2018

Purpose: Numerous indices have been proposed to analyse wound healing in oral soft tissues, but each has specific shortcomings. A new method of analysis, the Early Wound Healing Score (EHS), was evaluated in the present study. The aim was to assess more accurately early healing by primary intention of surgical incisions in periodontal soft tissues. Methods: Twenty-one patients were treated with different surgical procedures comprising 1 or 2 vertical releasing incisions as part of a surgical access flap. Twenty-four hours after surgery, early wound healing at the vertical releasing incisions was assessed using the EHS. This score assessed clinical signs of re-epithelialization (CSR), clinical signs of haemostasis (CSH), and clinical signs of inflammation (CSI). Since complete wound epithelialization was the main outcome, the CSR score was weighted to be 60% of the total final score. Accordingly, a score of 0, 3, or 6 points was possible for the assessment of CSR, whereas scores of 0, 1, or 2 points were possible for CSH and CSI. Higher values indicated better healing. Accordingly, the score for ideal early wound healing was 10. Results: Thirty vertical releasing incisions were assessed in 21 patients. At 24 hours after incision, 16 vertical releasing incisions (53.33%) received the maximum score of CSR, while 6 cases (20%) received an EHS of 10. None of the cases received 0 points. Conclusion: The EHS system may be a useful tool for assessing early wound healing in periodontal soft tissue by primary intention after surgery.