• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.35.1-35.7
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• 2019

Background: The purpose of this study was to measure the time of the conventional surgical planning (CSP) and virtual surgical planning (VSP) in orthognathic surgery and to compare them in terms of cost. Material and method: This is a retrospective study of the patients who underwent orthognathic surgery at the Pusan National University Dental Hospital from December 2017 to August 2018. All the patients were analyzed through both CSP and VSP, and all the surgical stents were fabricated through manual and three-dimensional (3D) printing. The predictor variables were the planning method (CSP vs. VSP) and the surgery type (group I: Le Fort I osteotomy + bilateral sagittal split osteotomy [LFI+BSSO] or group II: only bilateral sagittal split osteotomy [BSSO]), and the outcomes were the time and cost. The results were analyzed using the paired t test. Results: Thirty patients (12 females, 18 males) met the inclusion criteria, and 17 patients were excluded from the study due to missing or incomplete data. There were 20 group I patients (LFI+BSSO regardless of genioplasty) and 10 group II patients (BSSO regardless of genioplasty). The average time of CSP for group I was 385 ± 7.8 min, and that for group II was 195 ± 8.33 min. The time reduction rate of VSP compared with CSP was 62.8% in group I and 41.5% in group II. On the other hand, there was no statistically significant cost reduction. Conclusions: The time investment in VSP in this study was significantly smaller than that in CSP, and the difference was greater in group I than in group II.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.4
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• pp.239-246
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• 2017

Objectives: This paper proposes Han's ratio as an objective and quantitative comparative result obtained from pre and postoperative data in patients with a mandibular angle reduction. Materials and Methods: Thirty patients, 12 men and 18 women, who visited the Department of Oral and Maxillofacial Surgery with the chief complaints of skeletal mandibular prognathism and prominent mandibular angle were selected. The subjects were classified into 3 groups according to the types of surgical procedures involved. Group A consisted of patients who underwent mandibular angle resection and mandibular setback. Group B was comprised of patients with mandibular angle resection, mandibular setback and genioplasty. Group C consisted of patients with mandibular angle resection, mandibular setback, Le Fort I osteotomy, and genioplasty. The landmarks placed in pre and postoperative frontal photographs were used to obtain the Han's ratio in each group. The Han's ratios were compared pre- and postoperation and according to the surgical techniques applied. Results: Of the 3 groups who had undergone a mandibular angle resection, all showed a statistically significant increase in Han's ratio. On the other hand, there was no statistically significant difference based on the surgical techniques used. Conclusion: The ratio of the lateral lower face proposed in this study is a potential indicator of postoperative esthetic enhancement in mandibular angle reduction surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.2
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• pp.184-188
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• 2001

Horner's syndrome as a complication of orthognathic surgery is given little attention of head and neck surgery and is a relatively benign and transient condition. A 18-year-old male referred to our department with long and anteriorly projected chin. The cephalometric evaluation revealed a skeletal Class III relationship. A 10-mm setback of the mandible to eliminate Class III relationship and 4-mm vertical reduction genioplasty were performed. Three weeks after operation, the patient was recognized anhidrosis in left face and the head, and ptosis of left eye. The trauma to cervical sympathetic nerve during left sagittal split ramus osteotomy was thought to be the cause of Horner's syndrome. Patient was treated by dermatologic and opthalmologic care. Follow-up examination 8 months later, he was recovery of horner's symptom.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.3
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• pp.173-176
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• 2012

Certain oral procedures require a sedated patient who is responsive to allow for the mouth opening and position change. Dexmedetomidine is a relatively selective alpha2-adrenoceptor agonist with sedative, analgesic, amnestic, and anesthetic-sparing effects. Large dose dexmedetomidine is suitable as a single agent for sedation and anxiolysis for plate removal in a patient with bilateral sagittal split osteotomy and Lefort 1 osteotomy with genioplasty.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.1
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• pp.105-109
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• 2000

The zygoma is protruded on both sides of the midface and plays an important part in determining the impression of face. There are much different esthetic consideration of zygomatic prominence between the oriental and western. Because slight prominent zygoma is thought to be esthetic in the western, there has been done many augmentation therapy. But, in the oriental, prominent zygoma, especially in the female, is thought to be aggresive and manlike image, there has been done many zygoma reduction therapy. There are two methods to reduce the prominent zygoma, one is shaving method and the other is zygoma repositioning with ostectomy. The approach to zygoma and zygomatic arch without surgical morbidity is very difficult, so this problem has been difficult subject to oral & maxillofacial surgeon in a long period. We report the treatment case of facial asymmetry with the unilateral zygoma reduction & genioplasty using only intraoral approach with the retrospective study.

• Archives of Craniofacial Surgery
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• v.17 no.2
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• pp.82-85
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• 2016

We report two cases of cleidocranial dysplasia, which was managed without significant craniofacial osteotomy. A mother and daughter, both of normal intelligence, presented with central forehead depression, mid-face hypoplasia, and blepharoptosis. The fact that they have an identically deformed face implied a genetic basis. In both patients, radiologic evaluation revealed the underdeveloped maxilla, persistent fontanelle opening, and cleidal aplasia. Clinical findings and radiologic studies were consistent with the diagnosis of cleidocranial dysplasia. Both patients underwent forehead plasty via bicoronal approach, augmentation rhinoplasty using tip plasty, and epicanthoplasty. In addition, the mother underwent malar augmentation using Medpor implantation and reduction genioplasty. The patients did not experience any postoperative complication and remained satisfied with the operation at 6-year follow-up.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.3
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• pp.319-323
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• 1991

This is a case report and review of literature that deal with a surgical correction of mandibular deficiency. Patient, 38 years old male, had visited to treat mandibular deficiency. On the basis of clinical and radiographic examination, he was diagnosed as a micrognathia. Surgical method. 1. Intraoral Bilateral sagittal split osteotomy 2. Augmentation of genioplasty - double step. Patient was satisfied with final esthetics by gnathosurgery.

• Archives of Plastic Surgery
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• v.45 no.1
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• pp.74-79
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• 2018

The aim of this study was to present a case series of the orthognathic treatment of facial asymmetry due to temporomandibular joint (TMJ) ankylosis and to characterize the current treatment modalities through a literature review. Four patients who presented with facial asymmetry due to TMJ ankylosis between 2010 and 2014 were included in this study. TMJ ankylosis was surgically treated before bimaxillary surgery with advancement genioplasty in some of the cases. In 2 cases, 3-dimensional (3D) models were used for diagnosis and treatment planning, as 3D models are very important tools for planning surgical maneuvers. Aesthetically pleasant facial symmetry and a good facial profile were obtained in all the cases.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.5
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• pp.307-312
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• 2019

Klippel-Feil syndrome is characterized by congenital fusion of two or more cervical vertebrae, a low hair line at the back of the head, restricted neck mobility, and other congenital anomalies. We report a 16-year-old young man with Klippel-Feil syndrome, Sprengel deformity of the right scapula, thoracic kyphoscoliosis, and mandibular prognathism with an anterior open bite. He was treated with orthodontic treatment and maxillofacial surgery. An anticipated difficult airway due to a short neck with restricted neck movements and extrinsic restrictive lung disease due to severe thoracic kyphoscoliosis increased his anesthesia risk. Due to his deviated nasal septum and contralateral inferior turbinate hypertrophy, we chose awake fiber optic orotracheal intubation followed by submental intubation. Considering the cervical vertebral fusion, he was carefully positioned during surgery to avoid potential spinal injury. He recovered well and his postoperative course was uneventful.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.3
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• pp.359-371
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• 2010

Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.