• Korean Journal of Cleft Lip And Palate
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• v.4 no.2
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• pp.69-78
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• 2001

Alveolar cleft exists in 75% of cleft patients, In alveolar cleft patients, alar base is widening, palatal fistular formation, maxillary growth disturbance & tooth loss of adjacent area is raised, Alveolar bone grafting, especially iliac bone grafting, is a general treatment method. As operation timing, bone grafting is classified with primary, early secondary, secondary, & late secondary, Here we report cleft width, marginal bone height, bone resorption rate, grafted shape & bone densities after secondary iliac bone grafting was done in the Dept. of oral and maxillofacial surgery of chonbuk national university hospital. We compared cleft width to bone resorption rate and grafted shape. Also, alveolar bone densities of grafted and contralateral site was compared with Emago 3 package? (Oral Diagonostic System, The Netherlands), The data obtained were analyzed using Spearman's rho coefficients and sign test with SPSS for window, The results were obtained as follows. 1. As alveolar cleft width is increase, bone resorption rate is, too. This relation showed significant difference(P<.01). 2, In proximal & distal area, alvolar cleft width and bone graft contour after bone grafting had a reverse proportional difference. It was not significant difference(P>.05). 3. After 3 month, in bone density results by using Emago 3 package? with periapical standard view, occlusal view & panoramic view, differences between grafted bone and alveolar bone of contralateral site didn't show a significant difference(P>.05). Thus, differences of bone densities in the alveolar bones didn't exist.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.666-671
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• 2000

Objectives: This study evaluated the availability of mandibular symphysis corticocancellous block grafts in patients treated for reconstruction of intraoral jaw defects. Materials & Methods: 8 patients with mandibular and maxillary bony defects were treated with corticocancellous block of symphysis. The types of defects included 4 pathologic jaw defects and 4 vertical and/or horizontal alveolar deficiencies. The age ranged from 13 to 45 years. Additional treatments such as plate fixation, alloplastic bony substitutes, and/or barrier membrane application were perfomred. They were evaluated for complications and healing of defects. Follow-up period ranged from 6 to 15 months. Results: 2 patients experienced complications such as wound dehiscence and mild resorption of exposed bone. None of the patients needed secondary operation. Paresthesia of lip, chin, and teeth were recovered completely by 6 months postoperatively. Reconstructed wound showed favorable healing and bony consolidation. Conclusion: Corticocancellous block of mandibular symphysis can be used for the reconstruction of a variety of intraoral local jaw defects selectively. Advantages were easy fixation of graft, possibility of restoration of original alveolar contour, and decreased donor site morbidity.

• The Journal of Korean Academy of Prosthodontics
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• v.52 no.3
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• pp.252-257
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• 2014

It is important to produce a provisional restoration reflecting the patient's jaw relation, occlusal plane, lip support, shape of teeth, and occlusion type for fully edentulous patients before making a definite prosthesis. The patient introduced in this study showed bad prognosis of remained tooth after severe periodontal diseases. Therefore, remaining teeth were extracted and replaced with dental implants. Provisional restorations were fabricated and the the patient's vertical and horizontal jaw relationship, occlusal plane, amount of overjet and overbite, size of teeth, and length of anterior tooth were recorded. Provisional restorations were scanned and CAD/CAM techniques were used to fabricate a monolithic zirconia bridge, which contour is identical with the provisional restorations. The patient was satisfied with the treatment results on functional, esthetic aspects and the prosthesis retained stable during the four-month clinical observation period.

• Journal of Dental Rehabilitation and Applied Science
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• v.17 no.2
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• pp.107-112
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• 2001

The prosthodontic treatment of severely resorbed edentulous patients has been one of the frustrating areas due to extensive loss of tissues. The integrated neuromuscular balance among tongue, lip, and cheek is compromised. The retention, stability, and support are the three major factors to influence the clinical outcome. Fish described a denture as having three surface, with each surface playing an independent and important role in the over all fit, stability, and comfort of the denture. He recommended that the polished surface should be a series of inclines so that pressure from muscular activity will retain dentures. Within the denture space there is an area that has been termed the neutral zone. The neutral zone is that area in the mouth where, during function, the forces of the tongue pressing outward are neutralized by the forces of the cheeks and lips pressing inward. According to Jacobson and Krol, neuromuscular control interacts to provide retention and the relationship of polished surface of denture base to the surrounding muscular structure of orofacial capsule facilitates the stability and retention. This neutral zone concept has been demonstrated with various modification by a number of authors. The theory used to develop the denture base contours is based on the belief that the muscle should functionally mold not only the border but the entire polished surface. Lott and Walsh reported the clinical success on complete mandibular dentures with application of neutral zone concept. A number of studies demonstrated that denture stability and retention are more dependent on correct position of the teeth and correct contour of external surfaces of the denture in a severely resorbed alveolar ridge. This article presents a prosthodontic approach to treatment of a edentulous patient using neutral zone technique to improve the retention and stability of the prosthesis.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.4
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• pp.766-770
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• 2008

Gingival fibromatosis is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. It usually appears at the time of eruption of permanent dentition but, can develop at the time of eruption of the primary dentition and rarely at birth. It may deform palatal contour and subsequently restrict the tongue movement, resulting in interference during speech and mastication. In addition, it incapacitates maintenance of normal lip closure. A 14-month-old girl visited the department of pediatric dentistry, Yonsei University Dental Hospital, for the congenital gingival overgrowth. There was no one in the family, who showed similar pattern of gingival growth. The intraoral clinical examination revealed generalized severe gingival enlargement throughout the maxillary and the mandibular arches. Enlarged gingival tissue was pink and had firm consistency. She was referred for chromosomal analysis, which confirmed absence of any known syndrome. Under local anesthesia, "Punch-biopsy" was performed on the labial area, and the specimen was histologically diagnosed as gingival fibromatosis. For she did not have any medical problem nor familiar history, she was diagnosed as having idiopathic gingival fibromatosis. Regarding her age and behavior, close follow-up was decided.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.3
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• pp.231-238
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• 2001

This study was performed to evaluate soft tissue cephalometric norms for Korean adults which can be implemented in surgical orthodontic treatment planning using selected horizontal reference plane especially for Koreans (Male: $SN-7.5^{\circ}$, Female: $SN-9.0^{\circ}$) and a simplified analytical method. 70 males and 70 females consisting of freshmen of Yonsei University from 1996 to 1997 and students from the Dental College of Yonsei University were chosen according to clinical examination and cephalometric analysis. The samples had normal profiles, normal anteroposterior skeletal relationship(ANB angle of $0^{\circ}\;to\;4^{\circ}$ and Wits appraisal of -4.0mm to 0mm), and Class I molar and canine relationship. They had no missing or supernumerary teeth and had no experience of orthodontic or prosthetic treatment. After the selection of 15 soft tissue landmarks and the construction of horizontal and vertical reference lines, 25 measurements were taken. These consisted of vertical and horizontal linear measurements and angular measurements. The results were as follows. 1. Mean and standard deviation of the measurements were calculated in males and females. 2. Vertical measurements were comparably bigger in males than females whereas anterior facial height ratio(sN-Sn/Sn-sMe) and lower anterior facial height ratio(Sn-Stms/Stmi-sMe) showed no significant difference between sexes. 3. Most of the horizontal measurements in relation to the vertical reference line(G-perpendicular) showed no significant difference between sexes. 4. Nasofacial angle, columellar angle, nasolabial angle and facial contour angle showed no significant difference between sexes. 5. The upper and lower lip were positioned about $-1.0{\pm}2.0mm$ and $+1.0{\pm}2.0mm$ in relation to the Ricketts' esthetic line in both sexes. In this study, soft tissue cephalometric norms of Korean adults for orthognathic surgery were obtained.

• Korean Journal of Cleft Lip And Palate
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• v.3 no.1
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• pp.23-31
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• 2000

Objective: When an alveolar cleft is too large to close with adjacent mucobuccal flaps or large secondary fistula following a primary bilateral palatoplasty exists, a one-stage procedure for bone grafting becomes challenging. In such a case, we used the tongue flap to repair the fistula and cleft alveolus in the first stage, and bone grafting to the cleft defect was performed in the second stage several months later. The purpose of this paper is to report our experiences with the use of an anteriorly-based Y-shaped tongue flap to fit the palatal and labial alveolar defects and the ultimate result of the bone graft. Patients: A series of 14 patients underwent surgery of this type from January 1994 to December 1998.The average age of the patients was 15.8 years old (range: 5 to 28 years old). The mean period of follow-up following the 2nd stage bone raft operation was 45.9 months (range: 9 to 68 months). In nine of the 14 cases, the long-fork type of a Yshaped tongue flap was used for extended coverage of the labial side alveolar defects with the palatal fistula in the remaining cases the short-forked design was used. Results: All cases demonstrated a good clinical result after the initial repair of cleft alveolus and palatal fistula. There was no fistula recurrence, although Partial necrosis of distal margin in long-forked tongue flap was occurred in one case. Furthermore, the bone graft, which was performed an average of 8 months after the tongue flap repair, was always successful. Occasionally, the transferred tongue tissue was bulging and interfering with the hygienic care of nearby teeth; however, these problems were able to be solved with proper contour-pasty performed afterwards. No donor site complications such as sensory disturbance, change in taste, limitations in tongue movement, normal speech impairments or tongue disfigurement were encountered. Conclusion: This two-stage reconstruction of a bilateral cleft alveolus using a Y-shaped tongue flap and iliac bone graft was very successful. It may be indicated for a bilateral cleft alveolus patient where the direct closure of the cleft defect with adjacent tissue or the buccal flap is not easy due to scarred fibrotic mucosa and/or accompanied residual palatal fistula.