• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권4호
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• pp.331-336
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• 2011

Purpose: McNamara and Delaire analyses are two commonly used analytic methods, yet, they differ in their theoretic concepts and different reference lines are used for ideal surgical prediction. Therefore, the use of different analytic methods may result in different surgical plans. The purpose of this study was to compare the anterior and posterior relationship of the maxilla and mandible by using McNamara and Delaire analysis. Methods: 30 Korean patients (15 male and 15 female) who had visited the Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, for dentofacial evaluation were studied by using McNamara's and Delaire's analyses. Results: On the maxillary analysis, 26 out of 30 patients (86.7%) were in accordance. On the mandibular analysis, 20 out of 30 patients (66.7%) were in accordance. On the maxillary analysis, McNamara's analysis showed an average of 0.36 mm greater amount of prognathism compared to Delaire's analysis, and this was not statistically significant. On the mandibular analysis, McNamara's analysis showed an average of 6.03 mm greater amount of prognathism compared to Delaire's analysis, and this was statistically significant. On the mandibular analysis, 26 out of 30 patients (86.7%) showed a greater amount of prognathism on McNamara's analysis compared to that of Delaire's analysis. The remaining 4 patients (13.3%) showed the same amount of prognathism on both analyses. Conclusion: These results may serve as a reference for surgeons when determining which analytic method is to be used for optimal surgical results.

• 대한구순구개열학회지
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• 제16권1호
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• pp.37-49
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• 2013

Cleft lip is a common congenital facial deformity which might cause speech, hearing, appearance, and psychological disorder. For the purpose of appropriate management for the cleft lip patients according to their individual situations, reviews of the historical evolution for the cleft lip treatment were summarized. More than 15 English written articles with 4 related historical books were reviewed, and the chronology of the cleft lip management from ancient to recent twenty first century, via middle ages and Renaissance, were summarized. Multifactorial causes of cleft lip, before the modern understanding of embryological background of it, most management of cleft lip has been explained under the basis of religions and/or superstitions. As the anatomic and embryologic knowledges were known and revealed, various misconceptions were corrected continously, and the simple closure of the lip defect was also evoluted to the applications of plastic concept. Recently, cosmetic outcomes with functional results, such as speech, hearing, psychological status, have been considered importantly, under the multidiciplinary care system. For the better understanding of cleft lip management as a routine esthtetic and funtional reconstructive procedure, the various historical treatment trends were reviewed and summarized as time goes on. This review presentation will discuss the appropriate management for cleft lip patients.

• Archives of Plastic Surgery
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• 제33권4호
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• pp.499-502
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• 2006

Purpose: Grave's disease is an autoimmune disease with chronic and systemic features. It affects the orbital fat and muscle bringing about defect in extrinsic eye motility, diplopia, optic nerve defect and lid retraction. In patients with lagopthalmos and resulting facial deformity, treatment can be done by rectus muscle recession or filling with various material. Autogenous auricular cartilage graft is often used and synthetic material such as synthetic acellular dermis, polyethylene meshs are also used for filling of the depressed area. Nevertheless, autogenous auricular cartilage grafts are difficult to utilize and synthetic materials sometimes result in protrusion or infection. Therefore, hard palate mucosa was considered as an alternative. We report two cases of patients with lower eyelid retraction corrected with autogenous hard palate mucosa. Methods: We performed this operation in two patients of Graves' ophthalmopathy. The capsulopalpebral fascia was incised and elevated through an incision on the conjunctiva. Then, the harvested hard palate mucosa was sutured to the inferior border of the tarsus and covered with the conjunctiva. Results: The lower eyelid retraction was corrected successfully. No hypertrophy or deformation of the transplanted hard palate mucosa was noted 6 months after the surgery. Conclusions: From the results above, we may conclude that the hard palate mucosa serves as an ideal spacer for the curvature and the inner lining in lower lid retraction. Hard palate mucosa is as sturdy as the autogenous cartilage but is much easier to utilize. It can be also used for lid retraction after lower lid aesthetic surgeries or traumas.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.251-256
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• 2011

Purpose: A nasolabial cyst is a rare non-odontogenic, soft-tissue, developmental cyst arising anywhere on the face inferior to the nasoalar region. It is thought to arise from either epithelial remnants trapped along the lines of fusion during the development of face or the remnants of the developing nasolacrimal duct. This study examines various features of nasolabial cysts with bony involvement to provide a basis for correct diagnosis and treatment. Methods: Eight cases of nasolabial cyst treated in Soonchunhyang Hospital between March 2002 and July 2010 were examined in terms of their clinical features and radiological and histological findings. Seven patients underwent surgical excision of the cyst via an intraoral, sublabial approach. One underwent incision and drainage. Results: Our eight patients were seven women and one man. The most frequent symptoms and signs were facial deformity and swelling of the nasolabial fold. Computed tomography (CT) showed a well-circumscribed cystic mass lateral to the pyriform aperture. Seven cases had erosive lesions on CT, and the intraoperative findings were consistent with a nasolabial cyst with a bony defect. Typical histopathological findings showed that these cysts were most frequently lined with respiratory epithelium with ciliated columnar cells and cuboid cells. No patient developed complications or recurrences. Conclusion: A nasolabial cyst is often unrecognized or confused with other intranasal masses, including fissural and odontogenic cysts, midface infections, or swelling in the nasolabial area. Therefore, a careful clinical and radiological evaluation should be preformed when considering the differential diagnosis. We present eight patients with nasolabial cysts treated via a gingivobuccal approach with excellent functional and cosmetic results.

• Archives of Plastic Surgery
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• 제35권6호
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• pp.735-738
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• 2008

Purpose: Intraosseous hemangiomas are rare and account for fewer than 1% of all bone tumors. The site that is most commonly involved are the vertebral column and the skull. Within the facial skeleton, hemangiomas can occur in the mandible, maxilla, the nasal bones, and rarely the zygoma. Methods: We report a case of an intraosseous hemangioma of the zygoma in a 49-year-old male. The patient had a slow growing hard mass in the left zygoma, which had been present for 8 years. Other than the cosmetic deformity, the patient experienced no pain and did not have any problem. He had no history of trauma in that area and no ocular symptoms. Preoperative computed tomography showed a trabeculated mass arising from the body of the left zygoma. The mass was surgically removed without having to reconstruct the bone defect by spairing the inner cortex. Results: Histopatholgical examination indicated a cavernous hemangioma. After 4 months of follow up, no functional and cosmetic impairment was identified. The patient was satisfied with the result. Conclusion: An intraosseous hemangioma of the zygoma can be treated with total surgical excision with preservation of the inner cortex, thus eliminating the need for reconstruction of bone defect.

• 대한치과보철학회지
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• 제54권2호
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• pp.126-131
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• 2016

구강암에 의해 하악골 절제술을 받은 환자들은 저작 및 연하 기능의 저하와 같은 문제가 발생하며 동반된 안모의 변화와 발음의 문제로 인하여 사회적, 심리적인 영향을 받게 된다. 따라서 보철적인 수복을 통해 하악골 변연절제술 환자의 문제를 개선해 나아가는 것이 무엇보다 중요하다. 본 증례는 편평세포암으로 인하여 하악골 변연절제술을 받은 환자에서 골결손이 일어나지 않은 후방부위에 전략적으로 임플란트를 식립하였고 임플란트를 통해 의치의 유지와 지지를 담당할 수 있도록 보철물을 설계하였다. 이를 바탕으로 Kennedy class IV 국소의치를 제작하여 만족스런 심미적, 기능적 결과를 얻었으며, 8개월 간의 임상 관찰 동안 임플란트 주변 골의 안정적인 유지가 관찰되는 바 이를 보고하고자 한다.

• 대한치과교정학회지
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• 제50권2호
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• pp.98-107
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• 2020

Objective: The aim of this study was to compare posterior tooth inclinations, occlusal force, and contact area of adults with different sagittal malocclusions. Methods: Transverse skeletal parameters and posterior tooth inclinations were evaluated using cone beam computed tomography images, and occlusal force as well as contact area were assessed using pressure-sensitive films in 124 normodivergent adults. A linear mixed model was used to cluster posterior teeth into maxillary premolar, maxillary molar, mandibular premolar, and mandibular molar groups. Differences among Class I, II, and III groups were compared using an analysis of variance test and least significant difference post-hoc test. Correlations of posterior dental inclinations to occlusal function were analyzed using Pearson's correlation analysis. Results: In male subjects, maxillary premolars and molars had the smallest inclinations in the Class II group while maxillary molars had the greatest inclinations in the Class III group. In female subjects, maxillary molars had the smallest inclinations in the Class II group, while maxillary premolars and molars had the greatest inclinations in the Class III group. Occlusal force and contact area were not significantly different among Class I, II, and III groups. Conclusions: Premolar and molar inclinations showed compensatory inclinations to overcome anteroposterior skeletal discrepancy in the Class II and III groups; however, their occlusal force and contact area were similar to those of Class I group. In subjects with normodivergent facial patterns, although posterior tooth inclinations may vary, difference in occlusal function may be clinically insignificant in adults with Class I, II, and III malocclusions.

• 대한치과교정학회지
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• 제50권4호
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• pp.258-267
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• 2020

Objective: This study aimed to analyze the correlation of horizontal and sagittal planes used in two-dimensional diagnosis with lip canting by using three-dimensional (3D) analysis. Methods: Fifty-two patients (25 men, 27 women; average age: 24 years) undergoing treatment for dentofacial deformity were enrolled. Computed tomography images were acquired, and digital imaging and communication in medicine files were reconstructed into a 3D virtual model wherein horizontal and sagittal craniofacial planes were measured. Subsequently, the correlations of lip canting with these horizontal and sagittal planes were investigated. Results: The mandibular symmetry plane, the occlusal plane, Camper's plane, the mandibular plane, Broadbent's plane, and the nasal axis plane were correlated with the amount of lip canting (Pearson's correlation coefficients: 0.761, 0.648, 0.556, 0.526, 0.438, and 0.406, respectively). Planes associated with the lower part of the face showed the strongest correlations; the strength of the correlations decreased in the midfacial and cranial regions. None of the planes showed statistically significant differences between patients with clinical lip canting (> 3°) and those without prominent lip canting. Conclusions: The findings of this study suggest that lip canting is strongly correlated with the mandibular symmetry plane, which includes menton deviation. This finding may have clinical implications with regard to the treatment of patients requiring correction of lip canting. Further studies are necessary for evaluating changes in lip canting after orthognathic surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권3호
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• pp.258-265
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• 2001

A prognathic mandible and prominent gonial angle are considered to be unattractive in the Orient because it gives the face a square and muscular appearance. Requests for contouring of the mandibular angle are rare in the other race but are much more common in Korea and, through out the Orient. So, we often encounter a patient with a prognathic mandible and squarish or broad face who wishes to have his or her facial size reduced minimally or to acquire a round or slender appearance. But, mandibular angle is located in the deepest part of the operative field and the strong tension of the lateral soft tissue makes retraction difficult. It is extremely difficult to reduce the gonial angle with sagittal split ramus osteotomy by intraoral approach at the same time. We apply the method of gonial angle reduction during SSRO and had satisfactory results. We will present our results and hope to give some useful information for management of mandibular deformity.

• Journal of Genetic Medicine
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• 제13권1호
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• pp.31-35
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• 2016

Antley-Bixler syndrome (ABS) is a rare form of syndromic craniosynostosis with additional systemic synostosis, including radiohumeral or radioulnar synostosis. Another characteristic feature of ABS is mid-facial hypoplasia that leads to airway narrowing after birth. ABS is associated with mutations in the FGFR2 and POR genes. Patients with POR mutations present with either skeletal manifestations or congenital adrenal hyperplasia with ambiguous genitalia. We report here two cases of ABS caused by mutations in FGFR2 and POR. Although the patients had craniosynostosis and radiohumeral synostosis in common and cranioplasty was performed in both cases, the male with POR mutations showed an elevated level of $17{\alpha}$-hydroxyprogesterone during newborn screening and was diagnosed with congenital adrenal hyperplasia by adrenocorticotropic hormone stimulation. This patient has been treated with hydrocortisone and fludrocortisone. He had no ambiguous genitalia but had bilateral cryptorchidism. On the other hand, the female with the FGFR2 mutation showed severe clinical manifestations: upper airway narrowing leading to tracheostomy, kyphosis of the cervical spine, and coccyx deformity. ABS shows locus heterogeneity, and mutations in two different genes can cause similar craniofacial and skeletal phenotypes. Because the long-term outcomes and inheritance patterns of the disease differ markedly, depending on the causative mutation, early molecular genetic testing is helpful.