• Title/Summary/Keyword: Le Fort I osteotomy

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LATE TREATMENT OF MALUNITED MAXILLARY FRACTURE (부정유합된 상악골 골절의 처치)

  • Chang, Se-Hong;Ann, Jye-Jynn;Kim, Doe-Gyeun;Jeong, Min-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.255-260
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    • 1989
  • Unfavorable healing of maxillary fractures may impose functional and esthetic burdens upon the trauma victim. Malunited maxillary fractures are generally a result of treatment delay, incomplete or inaccurate immobilization of the fracture fragments, or infection. Dysfunctions of mastication, distortions in speech, gross defects in facial contour, and related psychic changes are problems which may require secondary correction. When it is necessary to delay definitive treatment or when inadequate maxillary fracture reduction is recognized within the first week following injury, the maxilla can be mobilized by heavy handed dental manipulation under anesthesia or by elastic traction to an external fixation appliance attached to the maxilla by arch bars or an acrylic splint. But malunited maxillary fracture that have progressed to bony malunion require osteotomy procedure in order to establish normal anatomic relationships. This report parents two cases of malunited unilateral maxillary fracture surgically corrected by unilateral Le Fort I osteotomy.

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STABILITY OF TWO-JAW SURGERY FOR MANDIBULAR PROGNATHISM (하악전돌증 환자에 대한 양악 수술의 안정성)

  • Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.4
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    • pp.348-356
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    • 2001
  • The factors related to relapse in 20 skeletal class III patients who performed two-jaw surgery with Le Fort I maxillary osteotomy and bilateral sagittal split ramus osteotomy was investigated. All patients were fixed with miniplate on the maxilla and three screws at each mandible. Cephalograms taken at preoperative, immediate postoperative and 8 months postoperative after surgery were traced and digitized. 1.The horizontal and vertical relapse of maxilla and mandibular chin points was within 1mm postoperatively. Compare to the preceding report concerning the mandibular set-back surgery only group, this reveals two-jaw surgery for mandibular prognathism using rigid fixation is more stable. 2.Although there was no significant relapse tendancy was observed at chin points, the screw tip land-marks moves anterio-superiorly and each side of the screws moved as a one unit. The screw tip points moved similar direction to the masticatory force and this movements might be influenced by the muscular tension to the distal segment of the mandible. 3.According to the regression analysis, the amount of horizontal and vertical movement of mandibular set-back influenced the mandibular relapse. However, direction and amount of maxillary surgical movement did not inf1uenced the maxillary and mandibular relapse.

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Correction of Facial Asymmetry Using Costochondral Graft and Orthognathic Surgery in Hemifacial Microsomia Patient: Case Report (반안면왜소증 환자의 안면비대칭 해소를 위한 늑연골 이식 및 악교정 수술의 동시 이용: 증례보고)

  • Park, Sung-Soo;Suh, Jin-Won;Choi, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.4
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    • pp.351-358
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    • 2010
  • A 31-year-old woman with hemifacial microsomia presented to the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The patient was previously treated with distraction osteogenesis device to elongate right maxilla and mandibular ramus. But, the result was not satisfactory, to correct residual facial asymmetry due to hemifacial microsomia we planned costochondral graft for reconstruction of ramus and condyle, Le Fort I osteotomy and sagittal split ramus osteotomy for facial asymmetry. The right mandibular condyle and ramus was reconstructed with right eleventh costochondral graft via submandibular approach. Using costochondral graft and orthognathic surgery the facial asymmetry in hemifacial microsomia patient was corrected. 1-stage treatment consists of costochondral graft and orthognathic surgery can achieve function and esthetics at the same time, is timesaving to both patient and surgeon.

Surgery-first approach using a three-dimensional virtual setup and surgical simulation for skeletal Class III correction

  • Im, Joon;Kang, Sang Hoon;Lee, Ji Yeon;Kim, Moon Key;Kim, Jung Hoon
    • The korean journal of orthodontics
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    • v.44 no.6
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    • pp.330-341
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    • 2014
  • A 19-year-old woman presented to our dental clinic with anterior crossbite and mandibular prognathism. She had a concave profile, long face, and Angle Class III molar relationship. She showed disharmony in the crowding of the maxillomandibular dentition and midline deviation. The diagnosis and treatment plan were established by a three-dimensional (3D) virtual setup and 3D surgical simulation, and a surgical wafer was produced using the stereolithography technique. No presurgical orthodontic treatment was performed. Using the surgery-first approach, Le Fort I maxillary osteotomy and mandibular bilateral intraoral vertical ramus osteotomy setback were carried out. Treatment was completed with postorthodontic treatment. Thus, symmetrical and balanced facial soft tissue and facial form as well as stabilized and well-balanced occlusion were achieved.

SOFT TISSUE CHANGES AFTER DOUBLE JAW ROTATION SURGERY IN SKELETAL CLASS III MALOCCLUSION (골격성 III 급 부정 교합자에서 양악 회전 수술 후 연조직 변화에 대한 연구)

  • Jeong, Mi-Hyang;Choi, Jeong-Ho;Kim, Byuong-Ho;Kim, Seong-Gon;Nahm, Dong-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.6
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    • pp.559-565
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    • 2006
  • The aim of this study was to evaluate the amount and interrelationship of the soft and hard tissue changes after simultaneous maxillary clockwise rotation and mandibular setback surgery in skeletal class III malocclusion. The sample comprised of 16 adult patients who had anteroposterior skeletal discrepancy. These patients had received presurgical orthodontic treatment and surgical treatment which consisted of Le fort I Osteotomy and bilateral saggital split ramus osteotomy. The presurgical (T1) and postsurgical (T2) lateral cephalograms were evaluated. The computerized statistical analysis was carried out with SPSS/PC program. The results demonstrated a decrease in the vertical dimension in the soft and hard tissue. The nasolabial angle was increased and the mentolabial angle was decreased. The results showed also many statistically significant correlations(p<0.05). The lower lip closely followed the skeletal movement of the B- point in the horizontal plane. The double jaw rotation surgery can afford a good solution to solve the problems of class III malocclusion cases.

The orthopedic relapse after orthognathic surgery of unilateral cleft lip and palate patient : A case report (구순구개열 환자 양악교정술 후 회귀 증례)

  • Seok, Min;Lee, Tae-Hyung;Lee, Jong-Kuk;Baek, Jin-Woo;Lee, Eui-Seok;Rim, Jae-Suk
    • Korean Journal of Cleft Lip And Palate
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    • v.10 no.1
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    • pp.57-65
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    • 2007
  • It is well known that the main factor which contributes to the relapse of orthognathic surgery for Cleft Lip and Palate (CLP) patients is post-operative scar on hard and soft palate of maxilla. Therefore, to compensate the amount of relapse, though it cannot be the perfect way to prevent orthodontic, orthopedic relapse, the Le-fort I osteotomy of maxilla and set-back osteotomy of mandible are generally carried-out simultaneously. We are to review the factors contribute to the relapse of CLP patients after orthognathic surgery through this clinical case : The relapse of Skeletal Class III tendency immediately after orthognathic surgery for grown up CLP patients.

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The treatment of malocclusion after open reduction of maxillofacial fracture: a report of three cases

  • Lee, Sung-Suk;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su;You, Jae-Seek
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.2
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    • pp.91-95
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    • 2014
  • The posttraumatic complications of jaw fractures related to jaw function and facial deformity include nonunion, malunion, malocclusion, temporomandibular joint dysfunction and facial asymmetry. This report presents cases referred to our department for revision of malunion and malocclusion following inadequate reduction of jaw fractures. Three patients with posttraumatic malocclusions caused by malunion were treated with a LeFort I osteotomy in one case and re-fracture in two cases. All of the patients exhibited stable results without further complications (e.g., malunion or malocclusion). Accurate preoperative diagnosis and proper anatomical reduction of the fracture segments are essential to preventing post-surgical malunion and malocclusion.

The Evaluation of TMJ Status after Orthognathic Surgery for Skeletal Class III Malocclusion (악교정 수술을 받은 골격성 III급 부정교합 환자의 악관절 상태에 관한 연구)

  • Son, Woo-Sung;Jung, Choong-Bo;Kim, Jong-Ryoul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.22 no.4
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    • pp.289-300
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    • 2006
  • This study was performed to investigate the influence of orthognathic surgery on the temporomandibular dysfunction in skeletal class III malocclusion. The temporomandibular joint status in 22 patients(mean age: 23.7 years) who received orthognathic surgery such as mandibular BSSRO(14 patients), maxillary Le Fort I osteotomy with mandibular BSSRO(8 patients) was evaluated by craniomandibular index. All these patients received orthognathic surgery at least 6 months ago. The mean score and standard deviation was obtained and compared with that of 22 normal individuals(mean age: 24.8years) by Student's t-test. In mandibular movement, the score of orthognathic surgery group was higher than that of the normal group. All the items except mandibular movement did not show any differences between the two groups.

Unilateral Segmental Palatal Distraction in Unilateral Cleft Lip and Palate Patient (편측성 구순구개열 환자에서의 편측성 분절 구개골 신장술)

  • Baek Seung-Hak;Kim Na-Young;Choi Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.1
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    • pp.43-51
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    • 2003
  • Patients with unilateral cleft lip and palate (UCLP) usually present unilateral cross bite due to collapse of the maxillary minor segment. Unequal expansion of the palate is needed to resolve this problem in UCLP patient. Unilateral segmental palatal distraction (USPD) after Le Fort I osteotomy and the oblique placed orthodontic expansion screw (Hyrax) can be used to correct the unilateral cross bite. 1his case report describes the effects of USPD of the collapsed maxillary minor segment on patient with unilateral cleft lip and palate.

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Surgery-first Approach for Facial Asymmetry with Transverse Discrepancy Using Hyrax-type Palatal Expansion Appliance

  • Youn-Kyung Choi;Sung-Hun Kim;Yong-Il Kim
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.87-98
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    • 2023
  • This report presents a case of successful treatment of skeletal Class III malocclusion with transverse discrepancy in adult by surgery-first approach. Traditionally dental decompensation is necessary prior to surgery in 2-jaw surgery to correct transverse and rotational discrepancy. However, the hyrax-type palatal expansion appliance was used to improve maxillary expansion accuracy and postoperative stability in this surgery-first approach (segmental Le Fort I osteotomy and mandibular setback surgery). It was established to be an effective means of precisely predicting postoperative occlusion and achieving stable retention after surgery of skeletal Class III malocclusion with maxillary transverse discrepancy.