• 대한치과교정학회지
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• 제33권5호
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• pp.391-398
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• 2003

견인골 신장술은 막내골화를 유도하는 조직공학으로, 두개안면기형 영역에서 치료는 지난 10년간 지속되었다. 본 연구는 하악지를 절단한 후 구강내 견인장치를 사용하여 안모 비대칭을 치료한 증례이다. 안모 비대칭 환자를 치료하는데 섬세하게 견인골 신장술을 이용하면 성장기와 성장이 끝난 환자에게서 효율적인 치료방법으로 생각된다.

• 한국융합학회논문지
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• 제7권6호
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• pp.75-80
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• 2016

악골기형에 따른 외과적 치료방법은 상악골 또는 하악골을 직접 늘리거나 줄이는 방식을 이용한다. 골신장술(distraction osteogenesis)은 열성장한 악골에 치밀뼈절단술(corticotomy)을 시행한 후, 골신장기(jaw bone distractor)를 사용하여 간헐적인 힘을 골에 부과하며 골의 길이를 늘여주는 대표적인 방법이다. 그러나 이러한 골신장기는 피부를 관통한 채 골에 고정되기 때문에, 비심미적이며 감염이나 흉터 등의 많은 문제점이 발생한다. 이 연구에서는 구내형 골신장기(intraoral jaw bone distractor) 개발을 위해 유한요소분석을 시행하여 핵심구동부의 안정성을 시뮬레이션한 후, 골신장기를 제작하였다. 융합연구를 통하여 향후 무선형 골신장기를 제작하기 위한 기반 자료를 구축하였으며, 관련 자료는 골신장술의 근본적인 문제점을 해결할 수 있는 가능성을 제시하며, 제반 기술은 다양한 의료기기 개발 기술에 활용될 수 있다

• Archives of Plastic Surgery
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• 제38권3호
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• pp.279-286
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• 2011

Purpose: Chin is located in a prominent position, and is important to balance and harmony of the face. Genioplasty is widely performed with patients' high satisfaction, yet being relatively simple procedure. Recently in analysis of dentofacial trait, three rotational variables of yaw, pith, and roll are considered with three translational variables (forward/backward, up/down, right/left). And we could correct chin deformity effectively by applying the three rotational variables with three translational variables in genioplasty. Methods: Twenty-eight patients who have chin deformity underwent osseous genioplasty. Preoperative photography, facial three dimensional computed tomography, and cephalography were taken while chin deformities were accessed. The chin deformity was classified into four categories; macrogenia, microgenia, asymmetric chin deformity, and combined chin deformity groups. According to the nature of chin deformities and the patients' desire, preoperative plans were formulated, in consideration of three rotational variables and translational variables. Through intraoral approach, anterior mandible was exposed in the subperiosteal plane between the mental foramens and beneath the mental foramens. In the anterior mandible, vertical and horizontal grid lines with 5 mm intervals were marked to confirm the spatial location of osteomized bone segment after osteotomy. Chin repositioning was done in consideration of axial rotation and planar translation. Results: Most of the patients had achieved satisfactory results with few complications. By considering the three rotational variables, it was possible to make the chin repositioning effectively. One of the patients complained about insufficient chin correction. In other case, persistent sensory impairment around chin was observed. Conclusion: In conclusion, it is worthwhile to apply preoperative analysis and operative procedures in consideration of a three rotational variables with three translational variables in genioplasty.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권3호
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• pp.233-242
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• 1997

Recently the goal of orthognathic surgery has been focused on esthetic improvement of the patients. Also early corrective surgery was favorable selected by most of the oral and maxillofacial surgeons. We should consider the etiologic factor of the patient's dentofacial deformities when treatment is planned, because this is the major factor in estimating the predictability or stability of result. The more researches were carried on the etiologic factors of the dentofacical deformities, The more possibility of the early surgical correction will be increased. The authors analyzed about etiologic factors and epidemiologic studies of the forth patients who had received the orthognathic surgery. The analyzed results were as follows: 1. The predilection ration between male and female was 17:23, and 32 patients (80%) of 40 patients were aged twenties. 2. 26patients(65%) complained estetic problems as well as functional problems. 10 patients(25%) complained only esthetic problems, and 4 of 40 patients complained only functional problems. 3. Mandibular prognathism was found to be done most frequently(25, 39%). Facial asymmetry (13, 20%) and angle hypertrophy were found to be next in sequence. 4. Sagittal split ramus ostetomy was done most frequently(27, 35%). Lefort I osteotomy(13, 17%), angle reduction (12,16%), and genioplasty(11, 15%) were done also. 5. The number of the cases due to nonspecific etiologic factor was 22(55%), that of cases due to inhertied tendency was 12(30%), that of cases due to congenital anomaly was 3(7.5%), and that of cases due to trauma was 3(7.5%). 6. The number of patients who got only maxilliary surgery was 2(5%), that of patients who got only mandibular surgery was 23(57.5%), and that of patients who got simultaneous two jaw surgery was 15(37.5%).

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권2호
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• pp.126-131
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• 2010

Objectives: This study is aimed to determine any differences in the postoperative stability between absorbable and titanium plate systems for fixation in orthognathic surgery with simultaneous maxillomandibular procedures especially including maxillary posterior impaction and advancement. Study Design: Forty patients with dentofacial deformities were randomly assigned into titanium (4 males and 6 females) and absorbable (17 males and 13 females) fixation group. All patients had undergone surgical alterations of maxilla with posterior impaction and advancement. A comparison study of the change in the maxillary position after the simultaneous surgery was performed with 1-day, 6-months postoperative lateral cephalograms compared to preoperative lateral cephalogram by tracing. Wilcoxon rank sum test was used for statistical analysis. Result: The position of the maxilla was stable after surgery and was not changed significantly from 1 day to 6 month after the simultaneous maxillomandibular surgery both in the experimental (absorbable plates) and control (titanium plates). Conclusion: This study suggests that application of absorable plating system in the fixation of maxillary segment in the simultaneous maxillomandibular procedures, leads to a predictable short-term postoperative skeletal stability comparable to the titanium plating system. Long term follow-up and further studies will be needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권2호
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• pp.169-173
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• 2001

본 교실에서는 조선대학교 구강악안면외과에 내원한 중안면성장부전을 동반한 하악전돌증소견을 보이는 22세 여자 환자의 치료에 있어서 변형 LeFort III 골절단술과 양측 하악지 시상분할골절단술 그리고 자가 장골 이식술을 동시에 시행하여 기능적 심미적으로 만족할 만한 결과를 얻었기에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.21.1-21.6
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• 2016

Background: The Le Fort I osteotomy is one of the most widely used and useful procedure to correct the dentofacial deformities of the midface. The changes of the maxilla position affect to overlying soft tissue including the nasal structure. Postoperative nasal septum deviation is a rare and unpredicted outcome after the surgery. There are only a few reports reporting the management of this complication. Case Presentation: In our department, three cases of the postoperative nasal septum deviation after the Le Fort I osteotomy had been experienced. Via limited intraoral circumvestibular incision, anterior maxilla, the nasal floor, and the anterior aspect of the septum were exposed. The cartilaginous part of the nasal septum was resected and repositioned to the midline and the anterior nasal spine was recontoured. Alar cinch suture performed again to prevent the sides of nostrils from flaring outwards. After the procedure, nasal septum deviation was corrected and the esthetic outcomes were favorable. Conclusion: Careful extubation, intraoperative management of nasal septum, and meticulous examination of preexisting nasal septum deviation is important to avoid postoperative nasal septum deviation. If it existed after the maxillary osteotomy, septum repositioning technique of the current report can successfully correct the postoperative septal deviation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권3호
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• pp.310-318
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• 2000

The purpose of this study was to assess the soft tissue changes of upper lip & nose using 38 patients who treated with Le Fort I osteotomy for the correction of dentofacial deformities. Patients were devided into three groups. One was advancement group of maxilla(Group I, N=14), another was impaction group of maxilla(Group II, N=12) and the other was combination group(advancement & impaction)(Group III, N=12). Preop. and 1 month postop. (T1), preop. and 6 months postop.(T2) were analyzed and compared. The results obtained were as follows : 1. The upper lip thickness(UL-VP) moved anteriorly approximately 62% of the horizontal maxillary change and this was significant in the advancement group(Group I) 2. The upper lip length(Stm-Sn) and the lower border of upper lip(Stm) moved superiorly 25%, 40% of the maxillary impaction group(Group II) (P<0.05) 3. There was significancy in the upper lip thicness(UL-VP) approximately 56% of the combination group(Group III) (P<0.05) 4. The nasolabial angle decreased in all groups, but there were no significancy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권5호
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• pp.413-419
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• 2011

Purpose: Reposition of the maxilla is a common technique for correction of midfacial deformities. To achieve the goal of the surgery, the maxilla should be repositioned based on the precisely planned position during surgery. The internal reference points (IRPs) and the external reference points (ERPs) are usually used to determine vertical dimension of maxilla, which is an important factor for confirming maxillary position. However, the IRPs are known to be inaccurate in determining the vertical dimension. In this study, we investigated the correlation of positional change of the modified IRPs with repositioned maxilla. Methods: The study group consisted of 26 patients with dentofacial deformities. For the simulation of the surgery, patient maxillary CT data and 3-D virtual surgery programs (V-$Works^{(R)}$ and V-$Surgery^{(R)}$) were used. IRPs of this study were set on both the lateral wall of piriform aperture, inferior margin of both infraorbital foramen, and the labial surfaces of the canine and first molar. The distance from the point on lateral wall of the piriform aperture to the point on the buccal surface of the canine was defined as IRP-C, and the distance from the point on the inferior margin of the infraorbital foramen to the point on the buccal surface of the $1^{st}$ molar was defined as IRP-M. After the virtual simulation of Le Fort I osteotomy, the changes in IRP-C and IRP-M were compared with the maxillary movement. All measures were analyzed statistically. Results: With respect to vertical movements, the IRP-C (approximately 98%) and the IRP-M (approximately 96%) represented the movement of the canine and the $1^{st}$ molar. Regarding rotating movement, the IRPs changed according to the movement of the canine and the $1^{st}$ molar. In particular, the IRP-C was changed in accordance with the canine. Conclusion: IRPs could be good indicators for predicting vertical movements of the maxilla during surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권2호
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• pp.130-134
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• 1997

본 저자는 하악지시상분할법이 측두하악관절장애와 관련되어 교합의 개선과 과두의 위치적변화에 어떤영향을 미치는가에 관해 연구하고자하여 다음과 같은 결과를 얻었다. 측두하악관절증상은 약 80%에서 개선되었으며 이는 아마도 부정교합의 개선으로 일어난 것이 아닌가 생각된다. 하악지 시상분할술에 있어 측두하악관절의 구조적 변화가 야기되는데 이것이 관절의 기능에 어떤 변화를 주어 측두하악관절증상과 관련해서 발생되는 것으로 추정되고 단기 추적조사와 비교해 볼 때 장기추적조사 결과 하악두위치변화에도 불구하고 Range of adaptation이 환자 개개인에 존재하는 것이 아닐까 생각된다. 이와 같은 결과를 종합해볼 때 경미한 측두하악관절증상을 동반한 하악전돌증환자에서 악교정수술을 시행함에 있어 개인의 하악두의 위치를 지켜주어 부정교합의 개선과 정상적인 관절기능을 유지시켜주는 것이 회귀성향과 관련하여 중요한 요소가 아닌가 생각되며 회귀성향과 하악두의 위치관계 또 측두하악의 증상등을 연관하여 더 진행된 연구가 필요하리라 사려된다.