• 치과방사선
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• 제25권2호
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• pp.569-578
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• 1995

Condylar hyperplasia is a self-limiting condition characterized by a slowly progressing, enlargement of the mandible that results in facial asymmetry and a crossbite malocclusion. The facial asymmetry, open bite or crossbite, and radiographic evidence of an enlarged condyle confirm the diagnosis of condylar hyperplasia. The etiology of the condition is unknown. This condition usually first becomes apparent during the second decade of life, when one condyle continues to grow while the other is no longer active. Radiographically, the condyle may appear enlarged or the neck of the condyle maybe elongated or both may occur, Sometimes, however, no radiographically demonstrable condylar abnormality will be noted. Surgical correction with subcondylar osteotomy is the treatment of choice. We have observed two cases of condylar hyperplasia occurred in the left mandibular condyle of 24-year-old and 35-year-old women. We obtained that two cases were shown the followed results; 1. Clinically, both cases was unilaterally developed on C/C area, with temporomandibular disorders and pain, facial asymetry and malocclusion. 2. Radiographically, hyperplastic mass confined to the condyle. 3. Histopathologically, these cases shown increased hypertrophic region in parts, and lamellated bone with irregular trabeculae.

• 구강회복응용과학지
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• 제26권1호
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• pp.77-87
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• 2010

비대칭은 두개안면증후군 같은 선천적 요인과 외상과 같은 환경적 요인에 의해 발생할 수 있으며 심한 골격성 비대칭에서부터 경미한 치열 비대칭에 이르기까지 그 정도는 매우 다양하며 이에 대한 환자의 인지 또한 주관적이다. 심한 비대칭의 경우 악교정 수술이 필요할 수도 있으나 비대칭이 심하지 않고 환자가 수술을 원하지 않을 경우 교정치료 만으로 비대칭의 개선을 도모할 수 있다. 하지만 비대칭 고무줄을 사용한 통상적인 방법으로 장기간 치료하면 교합평면이 기울어지거나 치아가 경사이동이 되는 등의 부작용이 발생하여 만족스럽지 못한 결과를 초래할 수 있다. 이를 예방하기 위해 초진 시부터 주의 깊은 진단과 충분한 역학적 고려를 포함한 철저한 치료 계획이 필요하다. 이에 하악의 편위가 발생한 안면 비대칭 환자에서 수술 없이 비대칭을 악화시키지 않는 조절된 교정력을 적용하여 만족스런 비대칭 절충 치료 결과를 얻었기에 이를 보고하고자 한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.324-328
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• 2009

Submentovertex(SMV) projection shows the base of skull, positions of mandibular condyle and zygomatic arches. We would like to investigate how to use SMV and evaluate its availability for the construction of the plan for orthognathic surgery of mandible prognathism and asymmetry. Preoperative Surgical Treatment Objective(STO) using SMV was performed to 12 patients, who visited to Seoul National University Bundang Hospital with chief complaints like mandible prognathism or asymmetry from Dec 2007 to Feb 2009. Surgical splint was made of stone model repositioned according to STO using SMV. We estimate the change in skeletal midline and the stability of occlusion through superposition between preoperative and postoperative SMV. It was effective on the amount of mandible movement and the correction of mandibular asymmetry, while the facial asymmetry involved with maxilla was excluded. It was concluded that STO using SMV is available and predictable method for not only the setback of prognathic mandible but also the correction of mandible asymmetry accurately.

• Korean Journal of Acupuncture
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• 제39권4호
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• pp.191-198
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• 2022

Peripheral facial palsy generally results from damage to the facial nerve. As facial asymmetry is observed, it accompanies not only functional problems but also psychological and social difficulties. Medical institutions treat most patients, however, there are still patients who rely on invasive methods by unqualified practitioners for fear of sequelae. This case describes a 61-year-old woman who experienced facial palsy twice. She visited our hospital with skin damage after folk patch therapy for her facial palsy. Combined Korean medicine treatment was administered during treatment period. After treatments, the symptoms of facial palsy and skin lesions improved. This case showed that Korean Medicine was efficacious in improving symptoms of facial palsy with damaged skin caused by folk patch therapy. Education and awareness of uncontrolled invasive treatments for facial palsy are needed.

• 치과방사선
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• 제21권2호
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• pp.341-351
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• 1991

The purpose of this study was to aid in the evaluation of prognosis of temporomandibular joint after open reduction of fractured mandible. The author studied the bony changes (remodelling) of 116 temporomandibular joints and facial asymmetry in 58 patients. Subjects were divided into 4 Groups according to the follow up periods after open reduction of fractured mandible. The bony changes and facial asymmetry were observed on lateral tomograms and cephalometric posteroanterior skull radiograms. The results were as follows: 1. The bony changes of condyles were observed in 56 cases (38 flattening, 14 osteophyte, 3 erosion, 1 sclerosis). Flattening was observed in 32.8% (Group Ⅰ 27.8%, Group Ⅱ 37.5%, Group Ⅲ 35.7%, Group Ⅳ 32.1%). Osteophyte was observed in 12.1% (Group Ⅰ 11.1%, Group Ⅱ 8.3%, Group Ⅲ 7.1%, Group Ⅳ 21.4%). Erosion and sclerosis were observed in 2.6%, 0.9%, respectively. 2. The bony changes of articular fossa were observed in 18 cases (15.5%). Flattening was observed in 12.1% (Group Ⅰ 2.8%, Group Ⅱ 4.2%, Group Ⅲ 10.7%, Group Ⅳ 17.9%). Sclerosis was observed in 3.4% (Group Ⅰ 5.6%, Group Ⅲ 3.6%, Group Ⅳ 3.6%). 3. The amount of facial asymmetry was 2.81±2.20㎜ (Group Ⅰ 3.06±1.93㎜, Group Ⅱ 2.38±2.44㎜, Group Ⅲ 2.74±1.19㎜, Group Ⅳ 2.93±2.93㎜). There was no significant difference between all groups according to bony changes of temporomandibular joints after open reduction of fractured mandibles (x²-Test, P>0.05).

• 대한장애인치과학회지
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• 제10권1호
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• pp.22-25
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• 2014

본 증례는 연세대학교 치과대학병원 소아치과에 하악 좌측 구치부 잇몸의 팽융을 주소로 내원하여 파노라마, 컴퓨터 단층촬영 결과 두개 악안면 부위에 이환된 섬유성이형성증으로 진단되었으며, 하악 좌측골의 팽윤과 안모 비대칭 및 좌우 안와 비대칭 소견을 보이고 있었다. 섬유성이형성증의 두개 안면부 병소는 안면기형, 두개 비대칭 뿐만 아니라 안구돌출, 시각 손상, 안면 마비, 삼차 신경통, 청각 손실, 치아 변위 및 부정교합, 맹출지연 등을 유발할 수 있다. 따라서 환아에게 증상이 발생할 수 있음을 보호자에게 설명하고, 검진 및 치료를 위해 구강악안면외과와 협진을 시행하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.13.1-13.12
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• 2016

Background: Mandibular motion tracking system (ManMoS) has been developed for orthognathic surgery. This article aimed to introduce the ManMoS and to examine the accuracy of this system. Methods: Skeletal and dental models are reconstructed in a virtual space from the DICOM data of three-dimensional computed tomography (3D-CT) recording and the STL data of 3D scanning, respectively. The ManMoS uniquely integrates the virtual dento-skeletal model with the real motion of the dental cast mounted on the simulator, using the reference splint. Positional change of the dental cast is tracked by using the 3D motion tracking equipment and reflects on the jaw position of the virtual model in real time, generating the mixed-reality surgical simulation. ManMoS was applied for two clinical cases having a facial asymmetry. In order to assess the accuracy of the ManMoS, the positional change of the lower dental arch was compared between the virtual and real models. Results: With the measurement data of the real lower dental cast as a reference, measurement error for the whole simulation system was less than 0.32 mm. In ManMoS, the skeletal and dental asymmetries were adequately diagnosed in three dimensions. Jaw repositioning was simulated with priority given to the skeletal correction rather than the occlusal correction. In two cases, facial asymmetry was successfully improved while a normal occlusal relationship was reconstructed. Positional change measured in the virtual model did not differ significantly from that in the real model. Conclusions: It was suggested that the accuracy of the ManMoS was good enough for a clinical use. This surgical simulation system appears to meet clinical demands well and is an important facilitator of communication between orthodontists and surgeons.

• 대한치과의사협회지
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• 제52권10호
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• pp.623-632
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• 2014

안면비대칭의 주원인은 하악골이며, 하악골의 비대칭 성장에 대한 상악골의 보상성장에 따라 교합면 경사 등이 초래된다. 디지털 사진과 삼차원 CT 등 다양한 방법으로 정확한 진단을 하고 수술을 포함한 치료계획을 세운다. 술전 교정 치료는 상악골과 하악골 치열의 치성 보상(dental compensation)을 제거하면서 상악 치열의 중심은 상악골의 정중선에, 하악 치열의 중심은 하악골 정중선에 맞게 이동하여 술후 상하악 치열궁이 일치하면서 동시에 안모 정중선에 일치하게 맞추어야 한다. 악교정 수술은 일반적으로 상하악 동시 수술을 하게 되며 우각부 풍융도 교정과 이부 성형술(genioplasty) 등을 부가적으로 할 수 있으며, 교합면 경사 교정과 수평 회전 등의 이동이 상하악 위치에 서로 영향을 주면서 수술 후 안모 변화에 대한 예측을 어렵게 만들기 때문에, 다양한 분석을 통해 정확한 예측으로 최선의 결과를 얻는 것이 가장 중요하다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권3호
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• pp.246-250
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• 2004

Uni- or bilateral mandibular hypoplasia can be associated with various syndromes or is acquired after early traumatic or inflammatory disease in the temporomandibular joint(TMJ). Early treatment is necessary to avoid consequent impairment of midfacial growth. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth, but the new procedure of bone lengthening which was presented by McCarthy et al. represents a limited surgical intervention and therefore open up a new perspective of treatment, especially in younger children with severe deformities. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, a tilted occlusal plane, and a short mandible. A 14-years-old boy with facial asymmetry, who was fractured on both condyle and mandibular symphysis before 8 years ago, was treated by mandibular ramus lengthening, symphysial widening and surgically assisted rapid palatal expansion with corticotomy. After allowing 1 week for the healing of the periosteum, the distraction was performed at the rate of 0.5-1.0mm per day for 7 days on maxilla and 14 days on mandible. The device was maintained on maxilla and mandible for 12 weeks following distraction. The difference in ramus and mandibular transverse deficiency were corrected and facial asymmetry was improved with complex distraction osteogenesis.

• 대한두개안면성형외과학회지
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• 제12권2호
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• pp.125-128
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• 2011

Purpose: Asymmetric crying facies is caused by agenesis or hypoplasia of the depressor anguli oris muscle and is often associated various anomalies. Several static and dynamic surgical interventions have been reported, but their effects are unreliable. We report on the successful use of botulinum toxin A in an asymmetric crying facies patient. Methods: A 4-year-old girl presented with a facial asymmetry on crying or smiling. Physical examination revealed that her face had no asymmetry at rest. However, the patient showed characteristic asymmetry when smiling, crying, and with other normal facial movements. Asymmetric crying facies was clinically suspected and the weakness of left depressor anguli oris was present on electrophysiology study. Fifteen units of botulinum toxin type A were injected to the right depressor anguli oris muscle. Results: The patient showed the prominent improvement in the facial symmetry without significant complication and the effect persisted until 3 months post injection. Conclusion: Asymmetric crying facies was treated successfully with botulinum toxin A and this method was easy and noninvasive.