• Title/Summary/Keyword: Functional facial asymmetry

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Full mouth rehabilitation of a panfacial fracture patient with bilateral condylar fracture (다발성 안면골절환자의 교합회복 증례)

  • Park, Go-Woon;Cha, Min-Sang;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.2
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    • pp.159-169
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    • 2014
  • Panfacial fractures require complex multidisciplinary approaches for treatment. Functional stability of bilateral condylar-disc complex should be the goal of the treatment. A patient with complex clinical panfacial fractures, including a bilateral condylar fractures visited our clinic. Facial asymmetry, insufficient vertical space and multiple missing teeth of the patient were major problems. Closed reduction and splint treatment were tried for stable condylar position. A functional and esthetic rehabilitation was accomplished by using implants and full mouth rehabilitaion. Potential possibilities of unstable occlusion should be prevented with night guard and periodic occlusal adjustment.

A RETROSPECTIVE STUDY ON THE CLINICAL MANEFESTATIONS, ETIOLOGIC FACTORS OR SURGICAL CORRECTION METHODS OF THE MAXILLOFACIAL DEFORMITY PATIENTS (악안면 기형 환자들의 발현 양상, 원인 요소 및 외과적 교정 방법에 관한 역학적연구)

  • Hyeon, Chung-Hwan;Yim, Chang-Joon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.3
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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%).

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A Posteroanterior Cephalometric Study on Craniofacial Proportions of Koreans with Normal Occlusion (한국인 정상 교합자의 정모 두부 방사선 사진을 이용한 안모비율에 관한 연구)

  • Baik, Hyoung-Seon;Yu, Hyung Seog;Lee, Kie-Joo
    • The korean journal of orthodontics
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    • v.27 no.4 s.63
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    • pp.643-659
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    • 1997
  • For the total treatment of skeletal malocclusions, 3-dimensional evaluation and diagnosis are essential. Although anteroposterior discrepancies can be evaluated through various methods, the satisfactory methods for evaluations of facial asymmetry and transverse discrepancies are yet to be found. The adequate diagnosis and treatment of transverse discrepancies may be more important in the maintenance of functional occlusion as well as for the stability of results obtained from orthognathic surgery than the anteroposterior or vertical discrepancies. Since the soft tissue effects from the transverse discrepancies may not be pronounced, especially when combined with anteroposterior or vertical discrepancies which have prominent characteristics, the differentiation of their effects may be difficult from visual inspection alone. Therefore it is essential that the normal facial proportions would be established from the posteroanterior cephalometry as a reference for the accurate diagnosis and treatment. The present study evaluates 76 subjects from Yonsei University freshmen with normal facial symmetry and occlusion. Posteroanterior cephalograms were taken from the subjects and the normal values and facial proportions are obtained. The results are as follows. 1. The transverse and vortical values from posteroanterior cephalometry and their ratio, with means and standard deviations are calculated. 2. The ratio of vertical values to transverse values is 0.837 (male 0.836, female 0.841). 3. The Proportion of maxillary and mandibular widths is 0.747 (male 0.745, female 0.752), with statistically significant correlation. 4. Various degree of significant correlations are observed in the following craniofacial widths; (Cranial width, Bizygomaticofrontal suture width, Facial width, Maxillary width, Upper & Lower Intermolar width, Mandibular width). 5. Although the facial height as well as other line measurements increase as the facial widths increase, angle measurement ($Bj\ddot{o}rk$ Sum, Mandibular Plane Angle, Gonial Angle), decreases and posterior to anterior facial height ratio increases, therefore indicating the tendency for a brachycephalic facial type. These results may be used as references for the treatment planning in orthognathic and orthodontic treatments for the dentofacial deformity patients.

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Surgical and Orthodontic Treatment of Unicystic Ameloblastoma Related to an Impacted Molar Tooth in the Mandible: Case Report (낭종성 법랑모세포종으로 인하여 매복된 하악 구치의 교정-외과 치료: 증례보고)

  • Moon, Cheol-Hyun;Kim, Hyeon-Min;Park, Dae-Song;Kim, Dong-Woo;Lee, Sang-Chil;Kim, Sung-Yong;Lim, Ho-Yong;Yeom, Hak-Yeol
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.5
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    • pp.435-439
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    • 2011
  • Ameloblastoma is an aggressive benign odontogenic epithelial tumour that may arise from the enamel organ, remnants of dental lamina, or the lining of an odontogenic cyst. It is usually categorized into solid or multicystic, unicystic, and peripheral types. Treatment ofameloblastomas include conservative methods such as marsupialisation, enucleation, and curettage; and radical treatments such as marginal or segmental resection. Radical treatments have resulted in lower recurrence rates; however, may also encounter esthetic, functional, and reconstructive problems. Unicystic ameloblastoma has been considered less aggressive and a lower recurrence tendency. Thus, many authors have recommended conservative treatment in cases of unicystic ameloblastoma. An 11 year-old boy presented with displaced second and third molars by luminal unicystic ameloblastoma in the mandible. Cyst enucleation, curettage, and third molar extraction were done. No signs of recurrence or esthetic problems such as facial asymmetry were seen radiologically and clinically, up to 8 years 2 months postoperatively.

Evaluation of Stability Following Two-Jaw Surgery (양악 수술 후 안정성 평가)

  • Lee, Sung-Yong;Kim, Su-Gwan;Kim, Seo-Yoon;Oh, Ji-Su;Moon, Kyung-Nam;Yoon, Dae-Woong;Kim, Hoon;Kim, Jeong-Sun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.2
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    • pp.137-143
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    • 2011
  • Purpose: Orthognathic surgery is required in patients with severe skeletal disharmony and facial asymmetry, which results in functional and esthetic improvement. Recently, bimaxillary surgery has become generalized. Establishment of the occlusal plane among several other factors included in the surgery plan is a major consideration for the diagnosis and treatment plan and it is also an important factor for postoperative stability. Methods: In this study, we assessed postoperative stability of occlusal plane, B-point, and pogonion point on 20 patients who underwent two-jaw surgery in the Chosun Dental Hospital from 2000 to 2007. Preoperative and postoperative states and at least a one year postoperative follow-up were compared. Results: The postsurgical relapse volume of the occlusal plane to the SN plane and the FH plane was $-0.26{\pm}2.8^{\circ}$ and $-0.44{\pm}3.29^{\circ}$, respectively and after two-jaw surgery, the stability of occlusal plane was maintained. The horizontal relapse degree was $0.85{\pm}0.46$ mm and $0.76{\pm}0.48$ mm, respectively, and the vertical relapse degree was $1.16{\pm}0.36$ mm and $1.13{\pm}0.71$ mm of the B point and the Pogonion point at the time after minimal 1 year. Conclusion: The vertical relapse amount was shown to be slightly larger than the horizontal relapse amount.

CONSERVATIVE TREATMENT OF DENTIGEROUS CYSTS ; 5 CASES (소아에서 발생한 함치성 낭종의 보존적 치료의 치험례 ; 5 례)

  • Jun, Chang-Hun;Jeong, Jong-Cheol;Song, Min-Seok;Seo, Ji-Hoon;Kim, Sung-Beom;Choi, Se-Hoon;Kim, Hyeon-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.2
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    • pp.135-139
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    • 2003
  • A dentigerous cyst is an epithelium-lined sac that surrounds the crown of an unerupted tooth or odontoma. And the most common sites of this cyst are the mandibular and maxillary third molar and maxillary cuspid a areas. Clinically, expansion of bone with subsequent facial asymmetry, extreme displacement of teeth, severe root resorption of adjacent teeth and pain are all possible sequelae of this cyst. The standard treatment for a dentigerous cyst is enucleation and extraction of the involved tooth. But in large cysts, this can lead to functional, cosmetic and psychologic consequences to the patients. So recently, more conservative methods are used. We report 5 cases of dentigerous cysts in pediatric patient which were treated by a conservative approach, By this methods, we can preserve teeth and guide eruption of the teeth which are involved in cystic area.

RECONSTRUCTION OF UNILATERAL TMJ ANKYLOSIS WITH METALLIC CONDYLAR PROSTHESIS;REPORT OF A CASE (금속 이식물을 이용한 악관절 강직증의 치험례)

  • Lee, Dong-Keun;Yim, Chang-Joon;Kang, Moon-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.40-46
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    • 1989
  • Destruction of normal temporomandibular joint architechture may produce serious functional and cosmetic deficiencies. The literature is well documented as to the etiology and pathogenesis of temporomandibular joints. Numorous surgical procedure have been advocated for temporomandibular joint ankylosis from condylectomy to arthroplasty, cartilage transplant, metallic prosthesis, interpositional implant. These were to able reconstruct the normal mandibular function, and any even procedure could obtain the satisfactory results. In this paper, we reviewed young adult patient with TMJ ankylosis and facial asymmetry who was treated with metallic condylar prosthesis and orthognathic surgery.

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Clinical Follow-up on Sagittal Fracture at the Temporal Root of the Zygomatic Arch: Does It Need Open Reduction?

  • Cheon, Ji Seon;Seo, Bin Na;Yang, Jeong Yeol;Son, Kyung Min
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.546-552
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    • 2013
  • Background The zygoma is a major portion of the midfacial contour. When deformity occurs in this area, a reduction should be conducted to correct it. If a sagittal fracture at the temporal root of the zygomatic arch occurs, this also requires reduction, but it is difficult to approach due to its anatomical location, and the possibility of fixation is also limited. Thus, the authors attempted the reduction of sagittal fracture by two- or three-point fixation and the Gillies approach without direct manipulation. The preoperative and postoperative results of the patients were evaluated. Follow-up was performed to establish a treatment guideline. Methods A retrospective study was done with 40 patients who had sagittal fractures at the temporal root of the zygomatic arch from March 2009 to June 2012. Only two- or three-point fixation was performed for the accompanying zygomatic-orbital-maxillary fracture. The Gillies approach was used for complex fractures of the zygomatic arch, while the temporal root of the zygomatic arch was only observed without reduction. Preoperative and postoperative computed tomography and X-ray scans were performed to examine the results. Results The result of the paired t-test on preoperative and postoperative bone gap differences, the depression level, and the degree of temporal protrusion showed a marked decrease in the mean difference at a 95% confidence interval. The results were acceptable. Conclusions In the treatment of sagittal fractures at the temporal root of the zygomatic arch, it is acceptable to use indirect reduction and non-fixation methods. This leads to a satisfactory aesthetic and functional outcome.

OLIGODONTIA : CASE REPORT (부분 무치증 환아의 증례보고)

  • Son, Jeong-Min;Choi, Nam-Ki;Kim, Seon-Mi;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.4
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    • pp.658-665
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    • 2007
  • Oligodontia is defined as the congenital absence of six or more teeth in dentition, excluding the third molars. The prevalence of congenital missing teeth is about 1.6 to 9.6% of population and the prevalence of oligidontia is about 0.08 to 1.1%. The mandibular second premolar is the most frequently absent after the third molar, followed by the maxillary lateral incisor and upper second premolar. Females seem to be affected slightly more than males. Oligodontia may occur either in isolation, or as a part of a syndrome such as ectodermal dysplasia. Different causes are possible for oligodontia: physical obstruction or distruction of the dental lamina, space limitation, functional abnormalities of the dental epithelium, failure of induction of the underlying mesenchyme, chemotherapy, radiotherapy or genetic factor. Because oligodontia would result in esthetic and functional problems, such as facial asymmetry or occlusal disharmony, early diagnosis from clinical and radiographic examination was necessary. And appropriate treatment plan should be followed. This case report was about oral conditions and treatment of the oligodontia patients who have no specific systemic disease.

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Treatment modalities for Korean patients with unilateral hemifacial microsomia according to Pruzansky-Kaban types and growth stages

  • Yang, Il-Hyung;Chung, Jee Hyeok;Yim, Sunjin;Cho, Il-Sik;Kim, Sukwha;Choi, Jin-Young;Lee, Jong-Ho;Kim, Myung-Jin;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.50 no.5
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    • pp.336-345
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    • 2020
  • Objective: To investigate the treatment modalities (Tx-Mods) for patients with unilateral hemifacial microsomia (UHFM) according to Pruzansky-Kaban types and growth stages. Methods: The samples consisted of 82 Korean UHFM patients. Tx-Mods were defined as follows: Tx-Mod-1, growth observation due to mild facial asymmetry; Tx-Mod-2, unilateral functional appliance; Tx-Mod-3, fixed orthodontic treatment; Tx-Mod-4, growth observation due to a definite need for surgical intervention; Tx-Mod-5, unilateral mandibular or bimaxillary distraction osteogenesis (DO); Tx-Mod-6, maxillary fixation using LeFort I osteotomy and mandibular DO/sagittal split ramus osteotomy; Tx-Mod-7, orthognathic surgery; and Tx-Mod-8, costochondral grafting. The type and frequency of Tx-Mod, the number of patients who underwent surgical procedures, and the number of surgeries that each patient underwent, were investigated. Results: The degree of invasiveness and complexity of Tx-Mod increased, with an increase in treatment stage and Pruzansky-Kaban type (initial < final; [I, IIa] < [IIb, III], all p < 0.001). The percentage of patients who underwent surgical procedures increased up to 4.2 times, with an increase in the Pruzansky-Kaban type (I, 24.1%; IIa, 47.1%; IIb, 84.4%; III, 100%; p < 0.001). However, the mean number of surgical procedures that each patient underwent showed a tendency of increase according to the Pruzansky-Kaban types (I, n = 1.1; IIa, n = 1.5; IIb, n = 1.6; III, n = 2.3; p > 0.05). Conclusions: These findings might be used as basic guidelines for successful treatment planning and prognosis prediction in UHFM patients.