• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.438-446
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• 1994

Eighty-nine patients with mandibular fracture were treated by open reduction and internal fixation using the monocortical titanium miniplate(Leibinger Co.). Postsurgical intermaxillary fixation was carried out for 2 to 18 days according to the patient's status. Seven patients developed infections postoperatively(7.9%). Five patients were favorably treated by incision and drainage and/or saucerization. But two patients were not controlled by early surgical intervention and should have been followed by plate removal, saucerization and secondary reconstruction including the bone graft. This article reports the postoperative infection associated with miniplate fixation of mandibular fractures and discuss the incidence, cause, treatment and prognosis with careful case analyses.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.735-742
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• 2009

Purpose: The management of fractures of mandibular subcondyle continues to be controversial between open and closed treatment. The purpose of this article is to explain the endoscopic assisted open reduction and internal fixation and minimize the controversy. Methods: Nine patients of mandibular subcondylar fracture were reduced and fixed by using intraoral endoscopic - assisted open reduction and internal fixation and were followed up for 14 ~ 24 months after surgery. Results: Eight patients of mandibular subcondylar fracture had been treated without significant complications. One patient, whose malocclusion had been remained, was recovered normal occlusion by maxillomandibular fixation using intermaxillary screws for 3 weeks. Conclusion: The advantages of endoscopic - assisted open reduction and internal fixation are direct visualization, accurate fracture repair, minimized scar, decreased morbidity. And maxillomandibular fixation is not needed when it is done by accurate reduction and rigid fixation with one miniplate in the region of subcondylar fracture. With the above consideration, endoscopic - assisted open reduction and internal fixation can be considered as one of the best treament for subcondylar fracture of the mandible.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.12-20
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• 1989

This is a retrospective study on 452 patients with maxillofacial bone fracture. The patients were treated at the Dept. of Oral and Maxillofacial Surgery, WON KWANG UNIV. HOSPITAL from Aug. 1, 1984 to Sept. 30, 1988. The results were as follows. 1. The facial bone fractures occured most frequently in the twenties (35.3%)and male were predominant(75%) than female. 2. The most frequent etiologic factor was traffic accident. 3. The most common location of facial bone fracture was mandible(57%). Zygomatic bone & arch(39.9%) were most common on middle 1/3 of the face and symphysis(37.1%) were most common on the mandible. 4. The time from injury to treatment was variable from under the 1 week (65%) to over the 1 week(35%). In most case of the patients were treated beyond the 3 days(51.5%). 5. The relationship of intermaxillary fixation period and treatment method was an intimate relationship. The IMF period was reduced by the use of plate and screw osteosynthesis. 6. The weight loss was proportioned to intermaxillary fixation period.

• 대한치과마취과학회지
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• 제4권2호
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• pp.96-99
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• 2004

구강저를 통한 기관내 삽관은 1986년 Altemir에 의해 처음 소개된 바 있는데 그 후 1993년 Hoenig와 Braun 및 같은 해 Stoll 등에 의해서나, 또는 1996년 Prochno 등에 의해 계속 변형된 방법으로 문헌에서 기술되어 왔다. 이 방법은 치과 영역 특히 구강악안면외과의 외상수술시 이상적인 교합을 얻기 위해 임시 상하악간 고정(intermaxillary fixation)을 할 수 있고 중안모 골절(midface fracture)의 회복을 위한 비관 삽관의 불편함을 피할 수 있는 유리한 점이 있으며, 또한, 정복 및 고정술이 필요한 비골 골절(nasal bone fracture)에서나 두개기저골 골절(skull base fracture)에서 여러 감염 등 합병증을 피하기 위해 추천될 수 있다. 또한, 목 부위에 비심미적인 반흔을 만들게 되며 여러 합병증을 초래할 수 있는 기관절개술(tracheostomy)보다 유용할 수 있다. 본 증례보고에서는 교통사고로 두개기저부 골절을 동반한 심한 중안모 골절 환자에서 적용시킨 경우를 알아보고, 아울러 이러한 악하부 삽관의 장, 단점 및 시술 과정 등에 대해 고찰해보고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권2호
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• pp.48-54
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• 1990

This is a report of 4 cases of the surgical correction of mandibular prognathism with chief complaint of mastication difficulty, facial asymmetry and protrusive chin. We performed sagittal spit ramus osteotomy for the prognathism, we used the repositioning plate for conserving the condylar segment into its original position and fixed the osteotomized bone segments rigidly with adjustable monocortical plate. Intermaxillary fixation was performed during 2 weeks. As a results, we found the following advantage. 1. Rigid fixation effect like the fixation by the tandem screw. 2. Decreased postoprative swelling. 3. It is needless to do the stab incision for the transbuccal set instrument. 4. It is more convenient to perform the rigid fixation in the monocortical plate method than screw technique.

• 대한장애인치과학회지
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• 제11권2호
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• pp.62-66
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• 2015

Temporomandibular joint dislocation causes considerable pain, discomfort, and swelling. The anatomic construction of the articular fossa and the eminentia articularis may predispose to dislocation, and weakness of the connective tissue forming the capsule is believed to be a predisposing factor. The capsule may be stretched and, more rarely, torn. Dislocation may be unilateral or bilateral and may occur spontaneously after stretching of the mouth to its extreme open position, such as during a yawn or during a routine dental operation. Manual reduction with the patient under muscle-relaxing condition or anesthesia is recommended method. After the reduction of an acute dislocation, immobilization of the jaw is recommended to allow the stretched and sometimes torn capsule to heal, thus preventing recurrence. A Barton's bandage may be applied for 2 to 3 weeks to prevent the patient from opening the jaw too wide. But, it results in recurrent dislocation in the neurologically disabled patient, because of loose intermaxillary fixation. This is a case report about management of recurrent temporomandibular joint dislocation by multiple loop wirings and intermaxillary elastics in cerebrovascular accident patient.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권2호
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• pp.125-130
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• 2009

For many years, intermaxillary fixation using arch bar has been operated in treatment of mandibular fracture patients. But it has many complications including injury of operators and assistants cause by wire, inflammation of periodontium. For that reasons alternatives are required; osteosynthesis technique using mini plate, intermaxillary fixation using IMF screws have been available. Treatment by arch bar fixation, however, is still valuable to treat craniomaxillary fracture patients. The purpose of this study is to know effect arch bar on periodontium and influence gingival gel on periodontium applied by arch bar. 40 mandibular fracture patients are monitored. 30 patients were applied by arch bar, 10 patients were not. And the former were classified by 3 categories; Nano vitamin and Mastic gel were applied to 10 patients respectively and any gingival gel was not used to 10 patients. Clinical attachment level, bleeding on probing and periodontal depth of each group were measured and compared before operation and on 2 weeks and 6 weeks after operation. Mann-Whitney U test was used to analyze result which leads to this conclusion. 1. Whether arch bar is applied or not, treatment of mandlbular fracture gave rise to gingivitis, but 6 weeks after operation, gingivitis is restored to the same level as the state before operation. 2. More severe gingivitis appeared when arch bar is applied to mandibular fracture than when it is not. 3. Both gingival gel used in this study can reduce gingivitis which can be caused by arch bar. 4. In this study, Mastic gel is more effective for prevent gingival inflammation cause by arch bar than nano vitamin. In regard to this result, gingivitis is considered to be available because it is reversible and does not induce periodontal disease. Gingival gel is regarded to be helpful for patients applied by arch bar to feel less discomfort.

• Journal of Yeungnam Medical Science
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• 제7권1호
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• pp.203-210
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• 1990

저자들은 영남대학교 영남의료원 치과로 교통 사고후 부정유합으로 인한 부정교합으로 저작 곤란을 호소하며 내원한 환자를 상악골 수평 및 후방 분절 골절단술을 시행해 다음과 같은 결과를 얻었다. 1. 교통 사고후 부정유합된 상악골을 수평 및 후방 분절 골절단술을 이용하여 전방 치열의 반대 교합과 구치부의 개교 및 scissor's bite를 해소했다. 2. 술후 감염등 특기할 만한 합병증은 발생하지 않았으며 술후의 종창은 48시간이 지나면서 서서히 감소했다. 3. 수술후 악간고정은 8주간 시행했으며 악간 고정 제거 1주후 정상적인 개구가 가능했다. 4. 절단된 상악골 고정시 확고한 고정과 회귀성향을 줄이기 위해 miniplates로 고정했다.

• 대한두개안면성형외과학회지
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• 제23권1호
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• pp.23-28
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• 2022

Background: Intermaxillary fixation (IMF) is a technique that allows for the reduction and stabilization of mandibular fractures. Several methods of IMF, such as self-tapping screws or arch bars, have been developed. This study aimed to validate the usefulness of IMF with a self-tapping screw compared to IMF with arch bars with focus on the patients' perspective. Methods: We retrospectively reviewed the medical records of all patients who were treated for mandibular fractures at our hospital between August 2014 and February 2021. A total of 57 patients were enrolled in this study. Thirteen patients were excluded from the analysis: three patients were lost to follow-up, and 10 patients did not undergo IMF. Finally, 44 patients were analyzed, of which 31 belonged to the arch bar group, and 13 belonged to the screw group. Patient discomfort and pain during IMF application and removal were analyzed using a patient self-assessment questionnaire. The surgeon also assessed oral hygiene, IMF stability, and occlusion. Results: We applied IMF to 34 men (77%) and 10 women (23%). The mean age of the patients was 37.3 years. The most common fracture site was the angle (30%), followed by the parasymphysis (25%), the body (23%), the condyle (11%), and the ramus (11%). Patient discomfort and oral hygiene were statistically favorable in the screw group. The IMF application time was statistically shorter in the screw group (p< 0.001). IMF stability was not statistically different between the two groups. The pain score during IMF removal was lower in the screw group (p< 0.001). Conclusion: Compared to arch bars, IMF screws provide more comfort during the IMF period, help maintain favorable oral hygiene, and have a shorter application time. From the patient's perspective, IMF screws are an excellent alternative to conventional arch bars when applicable.

• Journal of Yeungnam Medical Science
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• 제6권2호
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• pp.183-194
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• 1989

저자들은 2명의 하악 전돌증 환자에게 수술전 치열교정후 구내 하악지 경사 분열 골절단술을 시행하고 술후 치열교정을 계속 시행중이며 이 술식으로 다음과 같은 결과를 얻었다. 1. 전돌된 하악골의 후방이동으로 환자의 안모 추형과 심리적 열등감을 해소했으며 교합관계는 Angle 1급으로 회복하였으며 전반적인 부정교합을 치열교정과 더불어 해소했다. 2. 술후 감염과 골편 파절, 안면 지각이상, 측두하악 장애는 나타나지 않았으며 48시간 지난후 안면부 종창은 서서히 해소되었다. 3. 수술후 약간 고정은 8주간 시행했으며 악간 고정 제거 1주후 정상적인 개구가 가능했다. 4. 경조직의 후방이동에 따른 연조직의 하순과 하악 이부에서의 이동량은 본 증례에서는 거의 1:1로 나타났다. 5. 악간 고정 기관과 술후 치열고정 기간중의 회귀현상은 약간 관찰되었으나 이에 대하여는 더 오랜 기간의 연구 관찰이 필요하고 관찰중이다.