• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.4
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• pp.386-394
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• 2008

Osteosarcoma of the jaw is a rare malignant bone tumor which usually leads to a poor prognosis. It commonly occurs in young patients, especially in male. The tumor can involve mandible or maxilla with same frequency. The swelling in the involved area and facial deformity are common clinical findings. The pain and sensory changes are also complained by the patients. Although radical surgery plays an important role in the management of this tumor, the adjuvant chemotherapy or radiotherapy is used to enhance local control and to prevent distant metastases. We treated a 22-year-old male patient who had osteosarcoma in the left condylar region. The radical surgery which consisted of hemimandibulectomy and total parotidectomy, was done and an immediate mandibular reconstruction was performed with a vascularized free iliac osteomuscular flap. The obtained results, both esthetic and functional, were satisfactory. The patient was received postoperative chemotherapy. This is a case with reviews of the literatures.

• Korean Journal of Cleft Lip And Palate
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• v.3 no.2
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• pp.41-50
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• 2000

The alar base on the cleft side in unilateral complete cleft lip, alveolus and palate is markedly displaced laterally, caudally and dorsally, By incising the pyriform margin from the cleft margin of the alveolar process, including mucosa of the anterior part of the inferior turbinate, to the upper end of the postnasal vestibular fold, the alar base is released from the maxilla, A physiological correction of nasal deformity can be accomplished by careful reconstruction of nasolabial muscle integrity, functional repair of the orbicular muscle, raising and rotating the displaced alar cartilage, and finally by lining the lateral nasal vestibule, The inferior maxillary head of the nasal muscle complex is identified as the deeper muscle just below the web of the nostril, The muscle is repositioned inframedially, so that it is sutured to the periosteum that overlies the facial aspect of the premaxilla in the region of the developing lateral incisor tooth, And then, the deep superior part of the orbicular muscle is sutured to the periosteum and the fibrous tissue at the base of the septum, just in front of the anterior nasal spine, The nasal floor is surgically created by insertions of the nasal muscle complex in deep plane and of the orbicular muscle in superficial one, The upper part of the lateral nasal vestibular defect is sutured by shifting the alar flap cephalically, The middle and lower parts of this defect are closed by use of cleft margin flaps of the philtral and lateral segments, respectively, Authors stress the importance of nasal floor reconstruction at primary surgery and report the technique and postoperative results.

• The korean journal of orthodontics
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• v.49 no.6
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• pp.413-426
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• 2019

This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

• Archives of Craniofacial Surgery
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• v.22 no.5
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• pp.268-275
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• 2021

Background: The study aimed to evaluate nasal reconstruction techniques customized for Asians. The currently available nasal reconstruction guidelines are based on Caucasian patients, and their applicability is limited in Asian patients due to differences in anatomical and structural features. Methods: A retrospective analysis was performed of the medical records of 76 patients who underwent nasal reconstruction at a single center between January 2010 and June 2020. A comprehensive evaluation was conducted of patients' baseline demographics and clinical characteristics, including age, sex, medical history, defect size and location, reconstructive procedure, pathological diagnosis, postoperative complications, and recurrence. Results: In 59 cases (77%), nasal defects resulted from tumor ablation, and the remaining 17 cases involved post-traumatic (20%) and infection-induced (3%) tissue damage. The most common defect location was the alae, followed by the sidewalls, tip, and dorsum. Forehead flaps were the most commonly used reconstructive technique, followed by nasolabial advancement flaps, rotation flaps, and skin grafts. Each procedure was applied considering aspects of structural anatomy and healing physiology specific to Asians. Complications included nasal deformity, hypertrophic scarring, secondary infection, and partial flap necrosis, but no cases required additional surgical procedures. Tumors recurred in two cases, but tumor recurrence did not significantly affect flap integrity. Conclusion: Nasal reconstruction techniques applied considering Asians' facial features resulted in fewer postoperative complications and higher patient satisfaction than the approaches that are currently in widespread use. Therefore, this study is expected to serve as an essential reference for establishing treatment guidelines for nasal reconstruction in Asians.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.2
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• pp.112-119
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• 2021

Objectives: Myxomatous odontogenic tumors (MOTs) are the third most common odontogenic tumors in the oral and maxillofacial region. Due to its slow-growing, but locally invasive nature, the tumor is usually detected by accident or only when it becomes a large mass, which causes facial deformity. Materials and Methods: Current study reports three unusual cases of MOT including huge myxoma involve the mandible in middle-aged man, MOT with ossifying fibroma pattern in mandible, and MOT in maxilla of young female patient. The diagnosis and treatment strategy of MOTs was also summarized and updated. Results: In reported three cases of patients with large MOTs, surgical treatment was indicated with fibular free flap reconstruction in the mandible and plate reconstruction in the maxilla. The tumors were successfully treated with radical resection and did not show signs of recurrence during the follow-up period. Conclusion: Surgical treatment indication depends on size, the position of the lesion, patient systemic condition and surgeon individual experience. In the case of a large tumor, radical resection and reconstruction is the standard surgical strategy. The conservative surgical treatment including enucleation with wide curettage is still under controversy. The recurrence rate for MOTs is significantly high, up to 30%, therefore long-term follow-up is essential.

• Korean Journal of Head & Neck Oncology
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• v.37 no.1
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• pp.33-37
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• 2021

Intraosseous hemangioma is a rare, benign vascular tumor of endothelial origin. It accounts for fewer than 1% of all hemangiomas, and very rarely occurs in the face. Intraosseous hemangioma usually presents as an asymptomatic lesion, but symptoms can occur due to the mass effect. The authors describe a case of intraosseous hemangioma of the zygoma with a review of the relevant literature. A 44-year-old man presented with a chief complaint of painless swelling on the left zygomatic region that had been slowly growing for the past year. On physical examination, a hard, non-movable mass in a deep layer was palpated. On computed tomography performed to evaluate its layers and extent, trabeculation was found inside the mass, but the lack of destruction of the surrounding bone suggested that the mass was benign. Complete surgical excision was performed under local anesthesia. After complete excision of the mass, slight erosions remained on the cortical bone of the zygoma, but because it was small enough not to cause a facial deformity such as depression or asymmetry, no additional reconstructive procedure was performed. There were no symptoms or recurrence during a 8-month follow-up period.

• Archives of Craniofacial Surgery
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• v.24 no.2
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• pp.59-65
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• 2023

Background: Fibrous dysplasia (FD) is a localized bone disorder in which fibro-osseous tissue replaces the normal bone structure. Patients with craniofacial FD often present with gradual swelling, deformity, and compromised vision or hearing. We previously introduced "the core extirpation method," a novel surgical technique that is minimally invasive like traditional bone shaving but has longer-lasting effects. This study presents the long-term outcomes of our core extirpation method. Methods: We conducted a retrospective analysis of patients who underwent core extirpation for FD of the zygomaticomaxillary region from 2012 through 2021. Computed tomography (CT) scans were performed 6 to 12 months before the operation, immediately before and after the operation, and during follow-up visits. We performed all operations using the upper gingivobuccal approach, and we extirpated the core of the lesion while preserving the cortical structures of the zygoma and the maxilla to maintain symmetrical facial contour. Results: In 12 patients with lesions in the growth phase, anteroposterior/mediolateral (AP/ML) length discrepancies and the volume increased between preoperative and immediate postoperative CT scans. All patients' immediate postoperative AP/ML discrepancies were stable up to 12-17 months postoperatively. Postoperative volume showed continuous lesion growth; the median volume growth rate was 0.61 cc per month. Conclusion: In this article, we present our experiences managing FD using the minimally invasive core extirpation technique, which entails small expected blood loss and can be performed as day surgery. It provides similar cosmetic outcomes as traditional bone shaving but with longer-lasting results. Although there are some limitations with the study's retrospective nature and small sample size, our 4-year follow-up results show promising results of the core extirpation method in well-indicated patients.

• The korean journal of orthodontics
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• v.40 no.1
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• pp.16-26
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• 2010

Objective: The purposes of this study were to evaluate the force and stress depending on the type, deflection and thickness of the materials and to evaluate the mechanical properties of thermoplastic materials after repeated loading. Methods: Four types of thermoplastic products were tested. Force until the deflections of 2.0 mm and the stress when the materials were restoring to its resting position were evaluated. The mechanical properties of thermoplastic materials evaluated after 5 repeated loading cycles. Results: The interaction was observed between the thickness and the deflection (p < 0.05) from the regression equation. Thickness and amount of deflection rather than products and materials showed the largest effect on force and stress. In all products, at least 159 gf of force was required for more than 1.0 mm deflection or when materials with 1.0 mm thickness were deflected. The stress recorded was more than 19 gf/$mm^2$. During repeated loading, each group showed significant difference on the force and the stress (p < 0.01), 10 - 17% reduction of force and 4 - 7% reduction of stress in average. Conclusions: Proper thickness of thermoplastic materials and deflection level of tooth movement should be decided for the physiologic tooth movement. Force decay after repeated loading should be considered for the efficient tooth movement.

• The korean journal of orthodontics
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• v.29 no.2 s.73
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• pp.197-207
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• 1999

Although there is a severe underlying skeletal deformity, the dentition has often maintained some occlusal contact and interdigitation by the teeth compensating in their positions for the skeletal problem, and these dental compensations are manifested in all three planes of space. The purposes of present investigation were 1) to study the pattern of dentoalveolar compensation of hyperdivergent skeletal pattern , and 2) to compare the dentoalveolar compensations of hyperdivergent skeletal pattern in children with adults. The samples selected for this study were consisted of 60 subjects in normal group, 60 subjects in hyperdivergent group. Each was divided into two subgroups by age ; child groups($8\~12yr$ old) and adult groups(17yr old over). The findings of this study were as follows; 1. In child, hyperdivergent subjects had smaller posterior lower facial height(p<0.01) and slightly longer anterior lower facial height than normal ones. In adults, they still expressed smaller posterior lower facial height and much longer anterior lower facial height than normal ones(p<0.01). 2. Hyperdivergent subjects had larger amount of upper and lower incisor relative eruption to their basal bone length than normal ones(p<0.05). In adult, relative eruption of upper incisor was increasing(p<0.05), although relative eruption of lower incisor remained the same as the child. 3. In child, there was no difference between hyperdivergent group and nomal one in the upper and lower molar relative eruption to their basal bone length. In adult, hyperdivergent group had target amount of upper molar relative eruption than normal ones(p<0.01), but relative eruption of lower molar was similar to normal ones. 4. Hyperdivergent group had larger angle between lower occlusal plane and mandibular plane than normal group(p<0.01). Upper occlusal plane of adult groups rotated more antero-superiorly than child groups, and adult hyperdivergent group had sleeper upper occlusal plane than normal group(p<0.05).

• The korean journal of orthodontics
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• v.30 no.2 s.79
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• pp.235-243
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• 2000

Magnetic resonance imaging(MRI) of the temporomandibular joint(TMJ) is very useful method to diagnose internal derangement of the TMJ because of its high specificity foy identification of condyle-disc relationships. The purpose of this study was to evaluate the existence, incidence and severity o』 internal derangement o』 the TMJ by the MRI of Patients who are suspected to have TMJ disorder. MRI sample was composed of 50 subjects(10 males, 40 females) and the mean age was 22.9 years. 43 subjects of the sample were found to have positive findings. $56\%$ of the subjects with positive findings had ADD(anterior disc displacement) without reduction, and $65\%$ had internal derangement of bilateral joints. Distributions in the types of malocclusion in patients with positive findings, the Angle's classification had shown : the largest $41.9\%$ for Cl II ($39.6\%$ for Cl II div 1 and $2.3\%$ for Cl II div 2), $37.2\%$ for Cl I, $18.6\%$ for Cl III, and $2.3\%$ for the unidentified. $8.6\%$ of the subjects with positive findings had facial asymmetry and $55.8\%$ had openbite. We can conclude that the percentage of Cl II is the highest in patients with internal derangement of the TMJ. Openbite or facial asymmetry is considered to be uncompensated or compensated deformity which results from facial skeleton remodeling in the process of degenerative joint disease(DJD) due to TMJ degeneration. Therefore it is recommended to screen the patients with facial asymmetry or openbite by MRI before the beginning of orthodontic treatment. Differential diagnosis is essential because the tendency of relapse is high after the orthodontic treatment and continuous observation of TMJ is needed in patients with TMJ disorder.