• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.16 no.1
• /
• pp.51-62
• /
• 1994

The sagittal split osteotomy of the mandibular ramus is a common procedure which has been used in the correction of mandibular deformities for a few decades. Although the technical improvements have increased the reliability and stability of SSRO procedure, the postoperative relapse is imperative and clinically more significant than any other complication. One of the major causes of the relapse is due to the displacement of the proximal segment during SSRO procedure, which is well documented in the literature. Therefore it is important to preserve the original position of the proximal segment during SSRO proced and maxillofacial fixation period. In the case of mandibular asymmetry, if one side of mandible is advanced and the other side of mandible is setback during SSRO procedure, the proximal segment in the advancement site will rotate laterally and the proximal segment in the setback site will rotate medially. For the prevention of the lateral rotation or flaring of the proximal segment in the advancment site. we deliberately fracture the posterior protion of the distal segment in green-stick fashion during SSRO procedure, and there is no need to fix the fractured lingual segment. We fix the two osteotomized bony segments in the buccal cortex area rigidly with adjustable monocortical plates and screws. During SSRO procedure the lingual fracture technique was applied to nine patients with severe mandibular asymmetry who underwent orthognathic surgery in our hospital since march, 1992. These clinical experiencies enable us to find the lingual fracture technique has the following advantages. 1. The proximal segment is displaced minimally. 2. The osteotomized bony segments are contacted intimately. 3. The postoperative relapse and the healing period are decreased.

• Restorative Dentistry and Endodontics
• /
• v.19 no.1
• /
• pp.231-254
• /
• 1994

Fracture of cusp, on posterior teeth, especially those carious or restored, is major cause of tooth loss. Inappropriate treatments, such as unnecessarily wide cavity preparations, increase the potential of further trauma and possible fracture of the remaining tooth structures. Fracture potential may be directly related to the stresses exerted upon the tooth during masticatory function. The purpose of this study is to evaluate the fracture resistance of tooth, restored with composite resin inlay. In this study, MOD inlay cavity prepared on maxillary first premolar and restored with composite resin inlay. Three dimensional finite element models with eight nodes isoparametric solid element, developed by serial grinding-photographing technique. These models have various occlusal isthmus and depth of cavity, 1/2, 1/3 and 1/4 of isthmus width and 0.7, 0.85 and 1.0 of depth of cavity. The magnitude of load was 474 N and 172 N as presented to maximal biting force and normal chewing force. These loads applied onto ridges of buccal and lingual cusp. These models analyzed with three dimensional finite element method. The results of this study were as follows : 1. There is no difference of displacement between width of occlusal isthmus and depth of cavity. 2. The stress concentrated at bucco-mesial comer, bucco-disal comer, pulpal line angle and the interface area between internal slopes of cusp and resin inlay. 3. The vector of stress direct to buccal and lingual side from center of cavity, to tooth surface going on to enamel. The magnitude of vector increase from occlusal surface to cervix. 4. The crack of tooth start interface area, between internal slop of buccal cusp and resin inlay. It progresses through buccopulpal line angle to cervix at buccomesial and buccodistal comer. 5. The influence with depth of cavity to fracture of tooth was more than width of isthmus. 6. It would be favorable to make the isthmus width narrower than a third of the intercuspal distance and depth of cavity is below 1 : 0.7.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.2
• /
• pp.137-143
• /
• 1991

The bulging of mandibular angle area, frequently, make some difficulties in social life due to its reckless appearence, especially in oriental nations. So, many authors had reported its causes and surgical techniques for correction since late 19th century with diagnosis of masseter hypertrophy. But in spite of its muscular origin, major surgical techniques, in general, should aim complete bony reduction or osteotomy and supplemental myotomy as in hemimandibular hypertrophy or mandibular elongation. We used ultrasonogram for soft tissue depth estimation and expearenced some complications such as incomplete lingual cortical bony reduction, condylar fracture in mandibular angle reduction via intraoral circumvestibular approach. So we reported our surgical technique for angle reduction with possible complications.

• Restorative Dentistry and Endodontics
• /
• v.15 no.2
• /
• pp.104-114
• /
• 1990

The purpose of this study was to evaluate the adaptation of root canal filling material to the dentinal wall of root canal and to compare the sealing ability of the root canal filling materials using ultrasonic endodontic instrument with injection-molded thermoplasticized gutta-percha filling method and lateral condensation method. Fifty fresh human single root exlracted for orthodontic treatment, were randomly selected, and instrumented by step-back technique. And then, the teeth were divided into 5 groups according to each root canal filling methods. In the experimental group 1 and group 2, the root canals were filled with gutta perdia cases using ultrasonic instrument with and without sealer. In the experimental group 3 and 4, using jection-moldeed thermoplasticized gutta-percha method by obtul$^{(R)}$ canals were filled with and without sealer. In the control group, the canals were filled with sealer by lateral candensation. And then, 5 teeth of each group were immersed in black Indian ink, decalcified and cleared. The depth of dye penetration into the root canal were evaluated with stereoscope (Reichert Ltd., USA). Among the 5 teeth remaining in each group, the single longituding grooves were made on the labial and lingual root surfaces and then immersed in the liquid nitrogen to fracture the teeth spontaneously without any distortions of gutta-percha. Each specimens were examined with X-650 Scanning Electron Microscope(Hitachi ltd, Japan) to show the adaptation to the canal wall, void, homogenicity of filling material and location of gutta-percha or sealer in the dentinal tubules of the root canal. The observations were as follows : 1. The experimental group 1 showed smaller mean dye penetration than control group, and showed the penetraton of sealer in the dentinal tubules of apical third of the root canal. 2. The experimental group 2 and group 4 showed the penetration of gutta-percha in the dentinal tubules of root canals. 3. The experimental group 1 and group 3 showed less mean dye penetration than the experimental group 2 and group 4. 4. The experimental group 1 and group 2 showed better adaptation of filling materials than control group.