• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.6
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• pp.526-531
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• 2005

Distraction osteogenesis is a technique of bone lengthening by gradual movement and subsequent remodeling. Distraction forces applied to bone also create tension in the surrounding soft tissues, distraction histiogenesis. Distraction osteogenesis is used to correct facial asymmetry, such as patients with hemifacial microsomia, maxillary or mandibular retrusion, cleft lip & palate, alveolar defect and craniofacial deficiency. Hemifacial microsomia is characterized by unilateral facial hypoplasia, often with unilateral shortening of the mandible and subsequent malocclusion. This report describes two cases of hemifacial microsomia(type IIB). In these two cases, distraction osteogenesis was used to correct a facial asymmetry. Two patients underwent unilateral mandibular distraction osteogenesis of ascending ramus of the mandible with extraoral devices. Successful distraction osteogenesis was achieved in the patients with hemifacial microsomia.

• Imaging Science in Dentistry
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• v.44 no.1
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• pp.15-20
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• 2014

Purpose: This study aimed to assess the three-dimensional (3D) facial changes after orthognathic surgery by evaluating the spherical coordinates of facial lines using 3D computed tomography (CT). Materials and Methods: A 19-year-old girl was diagnosed with class III malocclusion and facial asymmetry. Orthognathic surgery was performed after orthodontic treatment. Facial CT scans were taken before and after orthognathic surgery. The patient had a menton deviation of 12.72 mm before surgery and 0.83 mm after surgery. The spherical coordinates of four bilateral facial lines (ramal height, ramal lateral, ramal posterior and mandibular body) were estimated from CT scans before and after surgery on the deviated and opposite side. Results: The spherical coordinates of all facial lines changed after orthognathic surgery. Moreover, the bilateral differences of all facial lines changed after surgery, and no bilateral differences were zero. Conclusion: The spherical coordinate system was useful to compare differences between the presurgical and postsurgical changes to facial lines.

• The korean journal of orthodontics
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• v.24 no.1 s.44
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• pp.161-180
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• 1994

This study was performed to investigate the midline having the least difference between the right and left structure among the lines that had been used in the submentovertex analysis and secondarily to know the distribution of asymmetry and it's degree existed normal persons and asymmetric patients. The subjects consisted of 40 normal adult patients and 40 asymmetric adult patients. The computerized analyses from submentovertex cepholometric radiograph were carried out. The results were as follows : 1. The right and left difference of the perpendicular bisecting line between right and left foramen spinosum was larger than the other midlines in the anterior area and it was decreased gradually as it progressed posteriorly. Specially the difference of this line was the smallest in the area where there was foramen spinosum. 2. The right and left difference of the perpendicular line through crista gali to the line between right and left foramen spinosum was smaller than the other midlines in the anterior area and it was increased gradually as it progressed posteriorly. 3. The right and left difference of the line between crista gali and anterior process of atlas was constant and smaller than the other midlines. 4. Asymmetry was a common finding in both normal and asymmetry group and left or right dominance of asymmetry was not statistically singnificant. 5. When the analyses were undertaken after submentovertex radiogram was divided into cranial base, upper face and lower face, the more inferior part showed relative asymmetry than the more superior part.

• Journal of Oral Medicine and Pain
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• v.31 no.2
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• pp.167-176
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• 2006

Recent studies have shown that there are significant increasing facial asymmetry using 3-dimensional imaging. This study use panorama view and PA cephalograph that were low in price and make good use in dentistry. For this study, 35 persons without remarkable malocclusion were selected, they had panorama view and PA cephalograph, make written questionnaire about facial asymmetry cognition and masticatory pattern. Data obtained were statistically processed by the SPSS Windows program and the results of this study were as follows: 1. There were significant difference between Rt and Lt. on Co-Go, Co-Ag, Co-Go-Ag, Go-Me- Ag. 2. In panorama view, There were significant difference between Rt. and Lt Co-Ag that chewing right side, Rt. and Lt. Co-Go that chewing left side, 3. In PA cephalograph view, There were significant difference in Rt. and Lt. Cg-Go, Rt. and Lt. Co-Ag that chewing right side, Rt. and Lt. Cg-Go that chewing left side 4. There were significant difference in Rt. and Lt. Co-Go, CO-si-CR, go-ME-Ag that cogniting facial asymmetry.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.13.1-13.8
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• 2018

Background: We evaluated change in the mandibular condyle after orthognathic surgery using cone-beam computed tomography (CBCT) in patients with facial asymmetry. Methods: Thirty patients with skeletal class III malocclusion and mandibular prognathism or facial asymmetry were classified into two groups according to the amount of menton deviation (MD) from the facial midline on anteroposterior (AP) cephalogram: group A (asymmetry, MD ≥ 4 mm; n = 15) and group B (symmetry, MD < 4 mm; n = 15). Position and angle of condylar heads on the axial, sagittal, and coronal views were measured within 1 month preoperatively (T0) and postoperatively (T1) and 6 months (T2) postoperatively. Results: On axial view, both groups showed inward rotation of condylar heads at T1, but at T2, the change was gradually removed and the condylar head returned to its original position. At T1, both groups showed no AP condylar head changes on sagittal view, although downward movement of the condylar heads occurred. Then, at T2, the condylar heads tended to return to their original position. The change in distance between the two condylar heads showed that they had moved outward in both groups, causing an increase in the width between the two heads postoperatively. Analysis of all three-dimensional changes of the condylar head positions demonstrated statistically significant changes in the three different CBCT views in group B and no statistically significant changes in group A. Conclusions: There was no significant difference between the two groups in condylar head position. Because sagittal split ramus osteotomy can be performed without significant change in symmetrical and asymmetrical cases, it can be regarded as an effective method to stabilize the condylar head position in patients with skeletal class III malocclusion and mandibular prognathism or facial asymmetry.

• The korean journal of orthodontics
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• v.31 no.5 s.88
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• pp.489-498
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• 2001

This study was aimed at how posteroanterior cephalometric measurements affect the perception of the patient about his/her facial asymmetry. One hundred orthodontic patients, over the age of 12, who required a posteroanterior cep-halogram in the Department of Orthodontics of Chonnam National University Hospital were used as the subjects. They were asked if they thought their faces were asymmetrical. Their responses were classified into 5 groups based on the level of asymmetry as follows : Definitely No, Probably No, Don't Know, Probably Yes, and Definitely Yes. Nine linear and low angular measurements from each posteroanterior cephalometric radiographs were analysed on the standard of the line between crista galli and anterior nasal spine to show the extent of asymmetry. Through this comparative study, the following results were obtained. 1. As the deviation of menton and the midline discrepancy of the upper and lower jaws were greater, the perception of patients about their facial asymmetry was higher. 2. All the measurements from the group 'Don't Know' showed no statistical difference from those of the groups 'Definitely No' or 'Probably No.' 3. All the measurements from the group 'Probably Yes' showed no statistical difference from those of the group 'Definitely yes.' .

• The Journal of the Korean dental association
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• v.17 no.1 s.116
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• pp.19-23
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• 1979

An instance of facial asymmetry due to fibrous dysplasia occurred on left maxilla in 18-year-old girl was observed. After operation by partial resection and curettage, she gained good facial profile and had no complication.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.12.1-12.6
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• 2016

Background: Temporomandibular joint (TMJ) ankylosis can be accompanied by various degrees of functional and esthetic problems. Adequate mouth opening, occlusal stability, and harmonious facial form are the main goals of treatment for ankylosis. Distraction osteogenesis has proven to be an excellent treatment for lengthening the ramus-condyle unit. However, various timings for distraction have been suggested, and there is no consensus on selection criteria for performing the procedure in stages or simultaneously with other treatments. Case presentation: In this case report, concomitant intraoral distraction and gap arthroplasty was planned to treat TMJ ankylosis and associated facial asymmetry. After gap arthroplasty and 23 mm of distraction, the ramus-condyle segment was successfully lengthened and mouth opening range was significantly increased. The resultant interocclusal space was stably maintained with an occlusal splint for 4 months after distraction. Finally, good occlusion was achieved after prosthetic treatment. The remaining mandibular asymmetry was corrected with osseous contouring and augmentation surgery. The mouth-opening range was maintained at 35 mm 24 months after treatment. Conclusion: Gap arthroplasty with intraoral distraction as a one-stage treatment and subsequent contouring surgery can be applied to correct ankylosis with moderate malocclusion and facial asymmetry.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.3
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• pp.156-164
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• 2015

Bilateral sagittal split ramus osteotomy is considered a standard technique in mandibular orthognathic surgeries to reduce unexpected bilateral stress in the temporomandibular joints. Unilateral sagittal split ramus osteotomy (USSO) was recently introduced to correct facial asymmetry caused by asymmetric mandibular prognathism and has shown favorable outcomes. If unilateral surgery could guarantee long-term postoperative stability as well as favorable results, operation time and the incidence of postoperative complications could be reduced compared to those in bilateral surgery. This report highlights three consecutive cases with long-term follow-up in which USSO was used to correct asymmetric mandibular prognathism. Long-term postoperative changes in the condylar contour and ramus and condylar head length were analyzed using routine radiography and computed tomography. In addition, prior USSO studies were reviewed to outline clear criteria for applying this technique. In conclusion, patients showing functional-type asymmetry with predicted unilateral mandibular movement of less than 7 mm can be considered suitable candidates for USSO-based correction of asymmetric mandibular prognathism with or without maxillary arch surgeries.