• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.36 no.5
• /
• pp.201-206
• /
• 2014

Purpose: To establish management protocol for mandibular angle fracture, we describe pertinent factors including cause, impacted third molar and recent treatment tendency. Methods: We examined the records of 62 patients who had unilateral mandibular angle fracture. Sixty patients who had open reduction surgery were examined at postoperative weeks 1, 4, 8, 12, and 28. Results: Left mandibular angle fracture is frequent in younger males. Presence of the mandibular third molar can increase fracture risk. Because of attached muscle, favorable fractures occurred primarily in the mandibular angle area. Conclusion: Extracting the mandibular third molar can prevent angle fractures, and open reduction with only one plate adaptation is generally the proper treatment method for mandibular angle fracture.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.5
• /
• pp.488-492
• /
• 2010

This review evaluates the literature on the relationship between mandibular condylar process fracture and temporomadibular joint (TMJ). The topic of condylar fracture generated more discussion and controversy than any other field of maxillofacial trauma associated with TMJ. Disturbance of occlusal function, devia-tion of mandible, internal derangements of TMJ, and ankylosis of the joint with resultant inability to move the jaw are sequelae of condylar process fracture. Thus it is necessary to understand how the masticatory system adapts to the structural alterations that accompany fractures of the mandibular condyle. Treatment of condylar process fracture include two methods ; closed treatment and open treatment. If one chooses totreat closed, one must understand that adaptations in the musculature, skeleton, and dentition will be necessary. Open treatment of condylar process fractures probably requires fewer adaptations within the masticatory system to provide a favorable functional outcome. However, one must weigh the risk of open surgery against the possible improvement in outcome. The risks are not just surgical risk, but biological risk as well, such as disruption of the blood supply to the condyle. This review presents relevant aspects of change of TMJ associated with condylar process fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.25 no.4
• /
• pp.361-366
• /
• 1999

Intermaxillary fixation is routine procedure to oral and maxillofacial area in jaw bone fracture, surgical correction of jaw deformity, osseus reconstruction of jaw. After transoral surgery, accompanied by intermaxillary fixation, dysphagia or airway obstruction may be followed due to blood clot, vomitus, or laryngeal spasm resulting from irritation by blood or secretions. Lingual or pharyngeal edema is other contributing factors of airway obstruction. In addition, intermaxillary fixation itself may cause obstruction of airway. In this study, pulmonary function test and arterial blood gas analysis were evaluated before and after intermaxillary fixation in 30 patients suffered from mandibular fractures. Comparative analysis was performed by estimated values. The results were as followed. 1. The spirometric values of FEV1, FEV1/FVC and FEF25-75% without intermaxillary fixation were reduced from 97.57%, 85.1%, 98.3,% to 71.7%, 66.5%, 61.2% with intermaxillary fixation, indicating the presence of obstructive pulmonary impairment. 2. Spirometric value of MVV, as the most influencing value of sensitive to extrapulmonary factors, was changed from 84.5% to 46.48%. 3. After intermaxillary fixation, the spirometric value of FVC, as indicator of restrictive pattern of pulmonary function, was not reduced significantly as measured from 94.47% to 89.97%. 4. $O_2$ saturation of arterial blood gas analysis without intermaxillary fixation was 97.86%. While intermaxillary fixation, $O_2$ saturation was 97.47%. The results indicate that careful airway management is mandatory undergoing intermaxillary fixation of various oral and maxillofacial surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.41 no.2
• /
• pp.74-77
• /
• 2015

Objectives: Transpositioning of the inferior alveolar nerve to prevent injury in lower jaw has been advocated for orthognathic, pre-prosthetic and for implant placement procedures. However, the concept of infra-orbital nerve repositioning in cases of mid-face fractures remains unexplored. The infraorbital nerve may be involved in trauma to the zygomatic complex which often results in sensory disturbance of the area innervated by it. Ten patients with infraorbital nerve entrapment were treated in similar way at our maxillofacial surgery centre. Materials and Methods: In this article we are reporting three cases of zygomatico-maxillary complex fracture in which intra-operative repositioning of infra-orbital nerve into the orbital floor was done. This was done to release the nerve from fractured segments and to reduce the postoperative neural complications, to gain better access to fracture site and ease in plate fixation. This procedure also decompresses the nerve which releases it off the soft tissue entrapment caused due to trauma and the organized clot at the fractured site. Results: There was no evidence of sensory disturbance during their three month follow-up in any of the patient. Conclusion: Infraorbital nerve transposition is very effective in preventing paresthesia in patients which fracture line involving the infraorbital nerve.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.43 no.1
• /
• pp.53-56
• /
• 2017

Malocclusion is a serious complication of open reduction surgery for facial fractures. It is often caused by the lack of adequate consideration for the occlusal relationship before the trauma and intermaxillary fixation during the operation. This is a case report of postoperative malocclusion that occurred in a patient with a midfacial complex fracture.

• Archives of Craniofacial Surgery
• /
• v.16 no.2
• /
• pp.96-98
• /
• 2015

Maxillomandibular fractures usually require intermaxillary fixation as a means to immobilize and stabilize the fracture and to re-establish proper occlusion. Arch bars or intermaxillary fixation screws cannot be used for edentulous patients or for patients who have poor dental health. Here, we present a case of repeated intermaxillary fixation failure in a patient weak alveolar rigidity secondary to multiple dental implants. Because single-point fixation screws were not strong enough to maintain proper occlusion, we have used Y-shaped plates to provide more rigid anchoring points for the intermaxillary wires. We suggest that this method should be considered for patients in whom conventional fixation methods are inappropriate or have failed.

• The Journal of Advanced Prosthodontics
• /
• v.8 no.3
• /
• pp.194-200
• /
• 2016

PURPOSE. The prospective follow-up aimed to assess the performance of lithium disilicate crowns and clinical reasons of adverse events compromising survival and quality. MATERIALS AND METHODS. 58 patients were treated with 375 heat-pressed monolithic crowns, which were bonded with resin cement. Annual recalls up to five years included a complete dental examination as well as quality assessment using CDA-criteria. Any need for clinical intervention led to higher complication rate and any failure compromised the survival rate. Kaplan-Meier-method was applied to all crowns and a dataset containing one randomly selected crown from each patient. RESULTS. Due to drop-outs, 45 patients (31 females, 14 males) with the average age of 43 years (range = 17-73) who had 327 crowns (176 anterior, 151 posterior; 203 upper jaw, 124 lower jaw) were observed and evaluated for between 4 and 51 months (median = 28). Observation revealed 4 chippings, 3 losses of retention, 3 fractures, 3 secondary caries, 1 endodontic problem, and 1 tooth fracture. Four crowns had to be removed. Survival and complication rate was estimated 98.2% and 5.4% at 24 months, and 96.8% and 7.1% at 48 months. The complication rate was significantly higher for root canal treated teeth (12%, P<.01) at 24 months. At the last observation, over 90% of all crowns showed excellent ratings (CDA-rating Alfa) for color, marginal fit, and caries. CONCLUSION. Heat pressed lithium disilicate crowns showed an excellent performance. Besides a careful luting, dentists should be aware of patients' biological prerequisites (grade of caries, oral hygiene) to reach full success with these crowns.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.1
• /
• pp.50-54
• /
• 2012

According to Luhr's classification, a fracture in the mandible with a width of less than 15-20 mm is considered to be an atrophic mandibular fracture and its incidence is very rare. Because of the reduced cross-sectional area and smaller contact area of the fractured ends as well as the poorly vascularized bony structure and delayed bone healing, an atrophic mandibular fracture is a great challenge for oral and maxillofacial surgeons. Surgeons tend to perform closed reduction, because open reduction is considered a non-life-saving surgery among elderly patients. Thus, most of them have limited experience in surgical management. According to recent reports, open reduction yields a good result, and the Association for Osteosynthesis (AO) group has recommended open reduction. This is a case report of our two experiences of open reduction and rigid fixation of atrophic mandibular fractures by the AO principle. Articles were also reviewed here.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.30 no.3
• /
• pp.477-482
• /
• 2003

The pediatric condylar fracture occurs very frequently in the mandible, but this injury is occasionally ignored due to difficulty of diagnosis and no cooperation of patient. The adequate initial diagnosis and active treatment must be performed because delayed and improper treatment lead to possible severe complication such as TMJ ankylosis and reta rdation of mandibular development. Most pediatric condylar fracture is mainly performed by the conservative or functional treatment, but it may be required open reduction according to cases. In this study, activator is applied for functional treatment of pediatric condylar fracture and fair recovery of jaw function is acquired.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.31 no.6
• /
• pp.532-535
• /
• 2005

The objective of this study is assessment of the efficacy of upper joint space arthrocentesis on prevention of TMJ injury from patient with mantibular fractures. We divided the patients into two groups, one which consist of 24 patients who are taken arthrocentesis while open reduction of mandibular fracture, the other which consist of 27 patients without arthrocentesis from Jan 1999 to Dec 2001. We measured maximum mouth opening, excursive movement range respectively one week, one month, three months later after operation. The patients were instructed to mark on 10 cm VAS for evaluation of TMJ pain during resting, mouth opening, and mastication. We evaluated the signs and symptoms of temporomandibular disorder clinically and radiographically 6 months later. The result of this study is that there is a reduction of pain and increase of range of mandibular motion in both groups but in patients with arthrocentesis there is relatively reduction of pain and increase of range of mandibular motion compared with control group. On the points of 6 months later, temporomandibular disorder occurred in 4 patients (16.7%) in group with arthrocentesis and 13 patients (47.1%) in control group. In conclusion, we think that supplemental therapy such as arthrocentesis is helpful for the recovery of jaw function and prevention of the development of temporomandibular disorder after facial trauma.