• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.1
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• pp.32-36
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• 2014

Preoperative surgical simulation in orthognathic surgery has progressed in recent years; the movement of the mandible can be anticipated through three-dimensional (3D) simulation surgery before the actual procedure. In this case report, the mandible was moved to the intended postoperative occlusion through preoperative surgical 3D simulation. Right-side condylar movement change was very slight in the surgical simulation, suggesting the possibility of mandibular surgery that included only left-side ramal osteotomy. This case report describes a patient with a mild asymmetric facial profile in which the mandibular menton had been deviated to the right and the lips canted down to the left. Before surgery, three-dimensional surgical simulation was used to evaluate and confirm a position for the condyle as well as the symmetrical postoperative state of the face. Facial asymmetry was resolved with minimal surgical treatment through unilateral intraoral vertical ramus osteotomy on the left side of the mandible. It would be a valuable complement for the reduction of the surgical treatment if one could decide with good predictability when an isolated intraoral vertical ramus osteotomy can be done without a compensatory osteotomy on the contralateral side.

• Archives of Plastic Surgery
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• v.45 no.4
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• pp.325-332
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• 2018

Background Zygomaticomaxillary complex (ZMC) fractures mostly occur in the form of tripod fractures. The surgical field is accessed using a combination of three classic approaches. However, the subciliary incision may have unfavorable aesthetic results. Herein, the authors report the advantages of the extended transconjunctival approach (ETA) combined with T-bar screw reduction in minimizing scarring and complications for the treatment of ZMC fractures. Methods A total of 26 patients underwent ZMC reduction through the ETA and intraoral approach. A skin incision measuring roughly 5 to 8 mm in length was placed following the lateral canthal skin crease. After releasing the inferior crus of the lateral canthal tendon for canthotomy, the medial periosteum of the lateral orbital rim was preserved for canthal reattachment. A limited subperiosteal dissection and partial relaxing incision of the orbicularis oculi were performed to expose the fracture line of the inferior orbital rim and zygomaticofrontal suture. Reduction was performed using a T-bar screw through the transconjunctival incision and an elevator through the intraoral incision. Results The aesthetic and functional results were excellent. Successful reduction was achieved and the skin incision was less than 8 mm in 20 cases (76.9%). Only six patients had an additional skin incision (less than 5 mm) to achieve reduction. No cases of ectropion, entropion, or excessive scarring were noted. Conclusions The ETA using a T-bar screw is a useful method for maximizing aesthetic results in ZMC fractures, with the advantages of minimal scarring, faster recovery, and maintenance of pretarsal fullness.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.187-194
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• 2020

Background: The aim of the present systematic review was to evaluate and compare the efficacy of warmed and unwarmed local anesthesia solutions in reduction of pain during intraoral injection administration. Methods: PubMed, Ovid SP, and Cochrane Central Register of Controlled Trials were searched from publication years 1990 to 2020 with relevant MeSH terms. Studies were screened by titles and abstracts, followed by full-texts evaluation of the included studies. Results: A total of four studies were included in the systematic review. Outcomes evaluated were subjective and objective pain during administration of the warmed local anesthesia solution in comparison with the unwarmed local anesthesia solution. Among the four studies that evaluated the self-reported pain score, three studies showed significantly lower pain scores associated with warmed local anesthesia. Only two studies evaluated the observed pain score, and both of them reported a significantly lower pain reaction with the warmed local anesthesia solution. Conclusion: Within the limits of this systematic review, warming the local anesthesia solution to body temperature (37℃) before administration seemed to reduce the discomfort during intraoral local anaesthesia administration, and more high-quality studies should be carried out to validate the same.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.215-219
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• 1999

This article discusses the diagnosis, anatomic consideration, and surgical management of masseter muscle hypertrophy. Surgical correction is advised for patients who have esthetic complaints. Esthetic improvement can be achieved by surgery and not by conservative treatment. Recently, the intraoral method, which leaves no scar on the face and minimizes the possibility of injury to the marginal branch of the facial nerve, has been supported by many surgeons. Patients who complained of marked swelling of unilateral or bilateral mandibular angle area and showed abnormal bony growth at the mandibular angle area and enlarged masseter muscle received mandibular angle shaving and excision of the inner layer of masseter muscle with intraoral approach. After operation, physiotherapy was done with EAST(eletrical acupuncture stimulation therapy) for encouraging the mouth opening and reducing the swelling. They showed early maximum mouth opening and reduction of swelling.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.2
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• pp.297-308
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• 1995

This study was designed to measure the absorbed dose to organs of special interest from full mouth with intraoral film(l4 films) and to compare the five periapical techniques. Thermoluminescent crystals(TLD-100 chip) were located in brain, orbit, bone marrow of mandibular ramus, bone marrow of mandibular body, bone marrow of 4th cervical spine, parotid gland, submandibular gland and thyroid gland. X -ray machine was operated at 70kVp and round collimating film holding device(XCP) and rectangular collimating film holding device(Precision Instrument) were used. The distance from the X-ray focus to the open end of the collimator was 8 inch, 12 inch and 16 inch. The results were as follows : 1. The absorbed dose was the highest in bone marrow of mandibular body(5.656mGy) and the lowest in brain (0.050mGy). 2. Generally, the lowest absorbed dose was measured from 16 inch cylinder, rectangular collimating film holding device with paralleling technique. But, in bone marrow of mandibular body and the floor of mouth, the highest absorbed dose was measured from 12 inch cylinder, rectangular collimating film holding device with paralleling techniques. 3. Comparing of five intraoral radiographic techniques, it was appeared statistically significant reduction of the absorbed doses measured with rectangular collimating film holding device compared to XCP film holding device (P<0.05). 4. No statistically significant reduction in the absorbed dose was found as cylinder length was changed(P>0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.3
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• pp.149-155
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• 2015

Surgical approaches to the condylar fracture include intraoral, preauricular, submandibular, and retromandibular approaches. Each approach has its own advantages and disadvantages. When a patient needs esthetic results and an intraoral approach is not feasible, the transmasseteric antero-parotid facelift approach is considered. This approach permits direct exposure and allow the surgeon to fixate the fractured unit tangentially. Tangential fixation is critical to osteosynthesis. Disadvantages of the transmasseteric antero-parotid facelift approach include damage to the facial nerve and a longer operation time. However, after the initial learning curve, facial nerve damage can be avoided and operation time may decrease. We report three cases of subcondylar fractures that were treated with a transmasseteric antero-parotid facelift approach. Among these, two cases had trivial complications that were easily overcome. Instead of dissecting through the parotid gland parenchyma, the transmasseteric antero-parotid facelift approach uses transmasseteric dissection and reduces facial nerve damage more than the retromandibular transparotid approach. The esthetic result is superior to that of other approaches.

• Archives of Plastic Surgery
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• v.36 no.6
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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.

• The Journal of the Korean dental association
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• v.58 no.2
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• pp.103-113
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• 2020

Background: Reduction malarplasty is one of the most popular facial contouring surgeries in east Asia for making patients' faces smaller. Currently in Korea, reduction malarplasty surgeries are performed mostly at plastic surgery clinics, but few cases are done at oral and maxillofacial surgery clinics. The reason might be because of post-operative complications after reduction malarplasty, such as undercorrection, overcorrection, asymmetry, cheek drooping, malunion, pain and noise. Those complications should be uneasy to be handled by oral and maxillofacial surgeons, however, they can be prevented by knowing the effective and safe reduction malarplasty techniques. Therefore, in this article the author as an oral and maxillofacial surgeon, would like to suggest safe and effective surgical methods for reduction malarplasty customized for Korean patients. Method: L- shape osteotomy of zygomatic body was performed with intraoral approach via vestibular incision, and the zygomatic arch was osteotomized with extraoral approach via sideburn incision. Then zygomatic complex was separated and rotated mesio-superiorly without removal of a bony strip and fixed with miniplates and microplates without making a bony gap. Conclusion: Surgical results were favorable and satisfied by the patients without cheek drooping, malunion, undercorrection and asymmetry.

• Journal of the Korean Society of Radiology
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• v.15 no.4
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• pp.491-498
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• 2021

In this study, the effective dose was measured using the PCXMC v2.0 program by examining the conditions used to set the diagnostic reference level for intraoral imaging recommended by the government, and the effect of the Al additive filter was confirmed. In oral imaging, the largest effective dose was calculated from the oral mucosa among 11 organs. The effect of the Al additive filter showed an excellent radiation reduction effect at 2mm rather than 1mm. In the case of children aged 5 years, the overall effective dose was calculated to be high in all 11 organs because they are more sensitive to radiation than adults. And as a result of evaluating the image quality according to the use of an additional filter during intraoral imaging, there was no significant difference in SNR and CNR changes compared to before the additional filter was used. Based on this study, it is thought that additional filter settings can be recommended for intraoral imaging.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.373-377
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• 2010

Vascular anomalies are common birthmarks. A eight-month-old male infant had a small size, bright red swelling on the lower lip since birth. On cutaneous examination there was a small brightly erythematous, lobulated, soft plaque on the left side of the lower lip of $10{\times}8{\times}5$ mm. Ultrasonogram examination revealed the lesion and confirmed the diagnosis of capillary hemangioma. The decision to initiate treatment is based on many factors, including size, location and risks and benefits of the proposal therapy. Systemic corticosteroids are decided to prevent the scarring and deforming. Prednisolone was given at a dose of 2 mg/kg/day for 2 weeks followed by tapering for 6 weeks for treatment. After eight weeks there was 80% reduction in the size of the lesion and the left lower lip almost completely cleared without intraoral bleeding. Furthermore, intervention by way of systemic steroids, laser therapy or surgical debulking is appropriate and safe in a select group of patients presenting with a proliferating hemangioma. This report describes a case that was sucessfully treated by systemic steroid therapy for hemangima in intraoral region.