• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권3호
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• pp.217-227
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• 1992

The purpose of this paper is to investigate changes in soft tissue in 22 patients treated by vertical ramus osteotomy and sagittal split ramus osteotomy for the correction of mandibular prognathism. 22 individuals, 12 males and 10 females, were selected from the patients with mandibular prognathism at the Department of Oral and Maxillofacial Surgery, Colledge of Dentistry, Kyung Hee University. Patient were analyzed with cephalogram taken 1 week before and at least 6 weeks after surgery under the same condition. Measurements were made constructed hard tissue and sop tissue points located on each before-and-after film tracing. Comparision were made of these figures to estimate the amount that the soft tissue followed the hard tissue structures in each surgical procedure : ratio of sop and hard tissue changes were formulated. The results were as follows. 1. The horizontal changes of Pogs and Bs as a ratio of the horizontal changes of Pog and B point were 1.02 and 1.16 respectively. 2. One millimeter of posterior changes at Pog resulted in 0.86mm of posterior change at Li and 0.09mm of posterior change at Ls. The greatest amount of sop tissue change occurred at Pogs, with substantially less posterior displacement at Bs, even less at Li and at least at Ls. 3. The ratio of LI to Li was 1:0.81 and the ratio of LI to Ls was not significant.(1 : 0.17) 4. The ULA(Cm-Sn-Ls) and the relative lower lip projection (LLP) was incnease4 but the relative upper lip projection (ULP) was slightly decreased 5. The angular change of the upper lip inclined angle (Ls-Sn/ANS-PNS) and lower lip inclined angle(Li-Pogs/Me-Go) expressed as a ratio of the posterior change of Pog were 0.57 and 0.20 respectively. 6. The ratio of the lower anterior facial height change of the soft tissue(Sn-Mes) to the hard tissue(ANS-Gn) were 0.78 and and the ratio of vertical height changes of the hard tissue and sop tissue to the posterior change of the Pog were 0.18 and 0.19 respectively. 7. The sop tissue angular change of facial convexity(G-Sn-Pogs) expressed as a ratio of the angular change of the hard tissue angle of facial convexity(N-A-Pog) was 1.24.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권3호
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• pp.319-329
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• 2000

Prediction of the soft tissue changes following hard tissue movement is very important from the esthetic view point for patients who have orthognathic surgery. There are many cephalometric analysis of facial bone and soft tissue on the lower lip and chin region but few soft tissue analysis on the midface after mandibular setback surgery. This study was performed to obtain whether the mandibular posterior movement has influence on the midface and the predictable ratio of post-operative measurement values of the soft tissue changes following mandibular setback surgery. Fifteen patients (8 males and 7 females) who had undergone mandibular setback surgery were selected and analyzed the soft tissue movement on the upper lip and the cheek region. Post-operative changes of the soft tissue measurements after mandibular surgery were examined on pre- and post-operative cephalometrics and the ratio of changes were analyzed after drawing the reference line on the face with the barium sulfate solution. The reference lines were perpendicular to the intercanthal line from infraorbital foramen and lateral canthus. The results obtained were as follows : 1. There were tendancy of anterior movement of soft tissue adjacent the nose after mandibular surgery 2. There were incerased tendancy of the amount of anterior movement from the nasal crease to the cheek region. 3. The amount of anterior movement of the soft tissue was larger below the palatal plane compared with above the palatal plane in the cheek region. 4. The upper lip length was increased and moved posterior direction after mandibular setback surgery 5. The lower lip was moved posterior direction by posterior movement of the mandibular structure 6. Soft tissue of the midface around the nose moved anterior direction after mandibular setback surgery but there was no correlation between the amount of mandibular setback and the amount of the soft tissue changes

• Clinical and Experimental Pediatrics
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• 제61권2호
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• pp.43-48
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• 2018

Purpose: Human adenovirus infection mimics Kawasaki disease (KD) but can be detected in KD patients. The aim of this study was to determine the clinical differences between KD with adenovirus infection and only adenoviral infection and to identify biomarkers for prediction of adenovirus-positive KD from isolated adenoviral infection. Methods: A total of 147 patients with isolated adenovirus were identified by quantitative polymerase chain reaction. In addition, 11 patients having KD with adenovirus, who were treated with intravenous immunoglobulin therapy during the acute phase of KD were also evaluated. Results: Compared with the adenoviral infection group, the KD with adenovirus group was significantly associated with frequent lip and tongue changes, skin rash and changes in the extremities. In the laboratory parameters, higher C-reactive protein (CRP) level and presence of hypoalbuminemia and sterile pyuria were significantly associated with the KD group. In the multivariate analysis, lip and tongue changes (odds ratio [OR], 1.416; 95% confidence interval [CI], 1.151-1.741; P=0.001), high CRP level (OR, 1.039; 95% CI 1.743-1.454; P= 0.021) and sterile pyuria (OR 1.052; 95% CI 0.861-1.286; P=0.041) were the significant predictive factors of KD. In addition, the cutoff CRP level related to KD with adenoviral detection was 56 mg/L, with a sensitivity of 81.8% and a specificity of 75.9%. Conclusion: Lip and tongue changes, higher serum CRP level and sterile pyuria were significantly correlated with adenovirus-positive KD.

• 대한치과교정학회지
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• 제29권5호
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• pp.627-635
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• 1999

하안면의 장경이 길고 웃을 때 치은이 과다 노출되거나 전치부 개방교합을 나타내는 상악골의 수직적 과성장 환자의 치료법으로 상악골의 수술적 상방이동이 고려되어질 수 있다. 이 방법에 의하여 기능적으로 만족스러운 결과를 가져오더라도 심미적 개선이 중요한 부분인 만큼 장기간에 걸친 연조직 변화를 관찰하여 임상적으로 중요하다고 생각되어지는 상악골 상방이동에 대한 상, 하순의 수직적 변화 특히 안정위시의 상악전치와 상순간의 관계의 변화와 상하순간의 이개 거리의 장기간에 걸친 변화를 관찰하는 것이 수술계획 시 치료결과에 대한 심미적 만족도를 높여 줄 수 있다. 따라서 이번연구를 통하여 상악골의 수직적 상방이동 후의 장기간에 걸친 연조직 변화를 관찰하여 상악골의 수술적 상방이동에 의한 치료계획 시 도움을 주고자 하였다. 이를 위해 술 후 최소한 5년이 경과되고 2mm 이상의 수술적 상방이동이 이루어진 49명의 환자의 술 전, 술 후 1년, 술 후 5년의 측모 두부방사선 규격사진을 이용하여 다음과 같은 결론을 얻었다. 1) 코의 하부와 상순의 연조직 계측점의 술 전과 술 후5년의 비교 시 superior labial sulcus의 상방이동과 pronasale의 전방이동만이 유의성있는 변화를 보였다. 2) 술 후 1년까지 하순의 전상방으로의 이동이 그 후 후하방으로 변화되는 경향을 보였으나 술 전과 술 후 5년의 비교시 전상방으로의 전위가 유지되었고 이부성형술을 한 군에서 변화가 더욱 뚜렷하였다. 3)상순의 길이와 홍순(upper vermilion)의 수직적 변화는 술 후 1년까지 감소되었다가 그 후 증가되어 술 전과 비교시 유의성있는 변화가 없었으나 하순의 길이의 증가와 홍순(lower vermilion)의 수직적 감소는 술 후 1년과 5년에서 계속 지속되었다. 4) 안정위시 상악전치의 노출이 지속적으로 유의성있는 감소를 나타냈고, 상하순간의 거리도 지속적 감소를 보였는데 이는 수술에 의한 상악골 상방 이동양보다 큰 감소였다. 5) 술 후 1년 이후에 나타나는 연조직의 하방 이동이 악골의 하방 이동 보다 크게 나타나는 경향을 보였다.

• 대한치과교정학회지
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• 제32권3호
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• pp.155-163
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• 2002

치조성 양악 전돌 증례에서 컴퓨터 시뮬레이션을 이용한 연조직 측모의 치료 결과 예측의 객관적 정확성을 상, 하악 제 1소구치 발거를 통해 교정치료를 받은 21명의 성인 여성을 대상으로 $Quick\;Ceph\;Image\;Pro^{TM}\;&\;Quick Eeph\;2000^{TM}$ 을 이용하여 조사, 평가하였다. 치료 전 측모 두부방사선 규격사진 투사도에서 경조직 이동량을 계측하고 Quick Ceph system 상에서 경조직을 동일한 양 이동시켜 컴퓨터시뮬레이 션을 위한 기준으로 삼았다. 이후 프로그램을 통해 연조직 변화를 시뮬레이션하고, 이 자료와 실제 치료 결과로 얻어진 연조직 계측 값을 측정하여 비교해 봄으로써 치료 결과 예측에 대한 정확도를 확인하고 임상에의 적용시 고려할 사항을 알아보았다. 시뮬레이션 결과 계측 항목의 수평 성분은 실제 치료 결과보다 작게, 수직 성분은 치료 결과보다 크게 예측하는 것으로 나타났으며 치료시 의 후방 견인은 실제보다 확대되어 나타나는 경 향을 보였다. 상악에서는 항목간 예측 오차의 방향이 일정하여 예측치가 실제보다 더 후방 이동되어 나타났으나, 하악에서는 증례간 차이가 컸다 Upper Lip Length는 짧게, Upper Vermilion Length는 길게 예측하여 시뮬레이션시 상순이 말려 보이는(rolling)효과를 확인할 수 있었으며 하순에서도 유사한 성향이 나타났으나 상순에 비해서 약하게 나타났다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.457-463
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• 2011

Introduction: This study evaluate the soft tissue changes to the upper lip and nose after Le Fort I maxillary posterosuperior rotational movement. Materials and Methods: Twenty Skeletal class III patients, who had undergone bimaxillary surgery with a maxillary Le Fort I osteotomy and bilateral sagittal split ramus osteotomy, were included in the study. The surgical plan for maxilla was posterosuperior rotational movement, with the rotation center in the anterior nasal spine (ANS) of maxilla. Soft and hard tissue changes were measured by evaluating the lateral cephalograms obtained prior to surgery and at least 6 months after surgery. For cephalometric analysis, four hard tissue landmarks ANS, posterior nasal spine [PNS], A point, U1 tip), and five soft tissue landmarks (pronasale [Pn], subnasale [Sn], A' Point, upper lip [UL], stomion superius [StmS]) were marked. A paired t test, Pearson's correlation analysis and linear regression analysis were used to evaluate the soft and hard tissue changes and assess the correlation. A P value <0.05 was considered significant. Results: The U1 tip moved $2.52{\pm}1.54$ mm posteriorly in the horizontal plane (P<0.05). Among the soft tissue landmarks, Pn moved $0.97{\pm}1.1$ mm downward (P<0.05), UL moved $1.98{\pm}1.58$ mm posteriorly (P<0.05) and $1.18{\pm}1.85$ mm inferiorly (P<0.05), and StmS moved $1.68{\pm}1.48$ mm posteriorly (P<0.05) and $1.06{\pm}1.29$ mm inferiorly (P<0.05). The ratios of horizontal soft tissue movement to the hard tissue were 1:0.47 for the A point and A' point, and 1:0.74 for the U1 tip and UL. Vertically, the movement ratio between the A point and A' point was 1:0.38, between U1 tip and UL was 1:0.83, and between U1 tip and StmS was 1:0.79. Conclusion: Posterosuperior rotational movement of the maxilla in Le Fort I osteotomy results in posterior and inferior movement of UL. In addition, nasolabial angle was increased. Nasal tip and base of the nose showed a tendency to move downward and showed significant horizontal movement. The soft tissue changes in the upper lip and nasal area are believed to be induced by posterior movement at the UL area.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권2호
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• pp.217-223
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• 1996

In order to evaluate the changes before and after secondary operations in the patients with cleft lip objectively using full face photographs, the author analyzed results of improvement on nasal width and mouth width and asymmetry of nostril. 1. The ration of asymmetry of thenostril is changed from average 1.24 preoperatively to average 1.08 postoperaively : 61.2% is improved postoperatively. 2. The ratio of nasal width compared with intermedial canthal distance is changed from average 1.15 preoperatively to average 1.10 postoperatively : 3.8% is reduced posteroperatively. 3. The ratio of mouth width compared with intermedial canthal distance is changed from average 1.08 preoperatively to average 1.03 postoperathvely : 4.1% is reduced posteroperatively.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권2호
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• pp.173-178
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• 2021

Inferior alveolar nerve (IAN) injury is usually caused by stretching or crushing of the neurovascular structures and postoperative intra-alveolar hematoma or edema after dental procedures. This results in paresthesia in the ipsilateral chin, lip (vermilion border, skin, and mucosa), and labial or buccal alveolar mucosa of the mandibular anterior teeth. However, there are no reports of sensory alterations in the teeth, especially tooth hypersensitivity, after IAN injury. I report a case in which paresthesia of the lower lip and hypersensitivity of the lower anterior teeth occurred simultaneously after the removal of the third molar that was located close to the IAN. In addition, I discuss the reasons for the different sensory changes between the tooth and chin (skin) after nerve injury from a neurophysiological point of view. Since the dental pulp and periodontal apparatus are highly innervated by the inferior alveolar sensory neurons, it seems necessary to pay attention to the changes in tooth sensitivity if IAN injury occurs during dental procedures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권1호
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• pp.49-56
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• 2010

Objective: To evaluate nasal and upper lip changes after Le Fort I surgery by means of images taken with a three-dimensional computed tomography (3D-CT). Methods: Fifteen patients (9 female and 6 male, mean age 21.9 years) with preoperative and postoperative 3D-CT were studied. The patients underwent maxillary movement with impaction or elongation, and advancement or setback. With the 3D-CT which presents reconstructive soft tissue images, preoperative and postoperative measurement and analysis were performed for nasal tip projection angle, columellar angle, supratip break angle, nasolabial angle, interalar width, internostril width, columella length and nasal tip projection. Results: Postoperative interalar and internostril widening was significant for all categories of maxillary movement. However, there was little significant relation in all parameters between the amount and direction of maxillary movement. Interestingly, movement of the maxilla with upward did show a little decrease in the columellar angle, supra tip break angle and nasolabial angle. Also movement of the maxilla with forward did show a little advancement in the upper lip position. Conclusion: Changes to the nose clearly occur after orthognathic surgery. There was a significant increase in postoperative interalar width and internostril width with maxillary movement. However, no clear correlation could be determined between amount of change and maxillary movement. Interestingly, maxillary impaction did show a little decrease in the columellar angle, supra tip break angle and nasolabial angle. In addition, we used 3D-CT for more precise analysis as a useful tool.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.73-76
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• 2011

Purpose: Congenital midline upper lip sinus is a rare lesion. There are two postulates that can account for the formation of the upper lip sinus based on two major theories of the development of the face: the fusion theory and the merging theory. However, congenital midline lower lip sinus is very rarely reported and described. We report a case of a congenital midline sinus of the lower lip in a 6-year-old female. Methods: A 6-year-old girl presented with a nipple like swelling on the midline lower lip. Physical examination revealed about $5{\times}5$ mm protruding round mass with a just small opening that was non-tender to palpation. The mass was not associated with any skin changes. It umbilicated at the apex and contains a fistulous tract, discharging clear fluid. Only, simple radiologic finding shows bony spur on the lower one third of mandibular symphsis. Results: A small transverse ellipse is made around the opening and elevated mass with sharpe dissection. The tract is excised using the probe and dye as the guide. The tract was extended to periosteum of the lower one third of the mandible. The tract and involved periosteum were excised en bloc, and removed protrusion of the mandibular bone using diamond burr. Microscopic examination of the resected sinus revealed the fistulous tract itself, consisting of fibrous connective tissue covered with cornified stratified squamous epithelium, was observed in the center of the sample. In 6 months follow-up, This patient had a good result was obtained by the method of fistulectomy alone. Conclusion: Midline cranoifacial fistulas represent rare lesions resulting from abnormal fusion of embryologic structures. Our case report describes the excision of a congenital midline sinus of the lower lip in a 6-year-old female. This case represents the first report of a lower lip sinus presenting in a girl as a mass in the skin of the chin with extension to the midline of the mandible. However, the etiology of this rare congenital sinus remains obscure.