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

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.12-20
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• 1989

This is a retrospective study on 452 patients with maxillofacial bone fracture. The patients were treated at the Dept. of Oral and Maxillofacial Surgery, WON KWANG UNIV. HOSPITAL from Aug. 1, 1984 to Sept. 30, 1988. The results were as follows. 1. The facial bone fractures occured most frequently in the twenties (35.3%)and male were predominant(75%) than female. 2. The most frequent etiologic factor was traffic accident. 3. The most common location of facial bone fracture was mandible(57%). Zygomatic bone & arch(39.9%) were most common on middle 1/3 of the face and symphysis(37.1%) were most common on the mandible. 4. The time from injury to treatment was variable from under the 1 week (65%) to over the 1 week(35%). In most case of the patients were treated beyond the 3 days(51.5%). 5. The relationship of intermaxillary fixation period and treatment method was an intimate relationship. The IMF period was reduced by the use of plate and screw osteosynthesis. 6. The weight loss was proportioned to intermaxillary fixation period.

• Journal of Veterinary Clinics
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• v.25 no.6
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• pp.545-548
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• 2008

A 3-year-old castrated male Siberian husky was presented for evaluation after being hit by a car. On physical examination, the dog showed open-mouth, displacement of mandible and hypersalivation with blood ting. The base of tongue was transected almost 80% on the bias from right dorsal side to the left ventral side. Radiography demonstrated separation of mandible symphysis, and fracture of right condyle and vertical ramus. After debridement of the necrotic tissue, tongue apposition with simple interrupted suture was performed. Mandibular symphysis, condyle and mandibular vertical ramus fractures were fixed using pin, cerclage wire, T-plate, and K-wires. The mouth was irrigated daily using chlorhexidine after surgery. The sutures that were loose here or untied at tongue were re-sutured under sedation. The transected tongue was healed and recovered its normal movement after 6 weeks.

• The Journal of the Korean dental association
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• v.50 no.9
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• pp.566-573
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• 2012

Purpose : This study evaluated the impact of the presence and aspect of mandibular third molars to the mandible angle fracture or condyle fractures in Korean. Materials and Methods : A retrospective study was designed for patients attending the division of Oral and Maxillofacial Surgery, Kang-dong sacred heart hospital for treatment of mandibular fracture from January 2006 to September 2010. The primary variable was the presence of mandibular third molar and the secondary variable was the aspects of third molar impaction. Mandibular third molars were classified by the impaction depth and the available space as Pell & Gregory system. Outcome variables were the presence of mandibular angle fracture or condyle fracture. Also the source of trauma, age, sex were studied. Hospital charts, radiographs were used for study. Statistic analysis was done with descriptive statistics, the X2-test, linear-by-linear association. P value under 0.05 was considered significant statistically. Results : The number of involved patients was 86. The ratio of male to female patients was about 9:1 for angle fracture and 7:3 for condyle fracture. The most common source of trauma was assault for angle fracture and fall down for condyle fracture. The presence of mandibular third molar increased frequency of angle fracture and decreased condyle fracture with larger impaction depth. But available space of mandibular third molar did not show high association with angle or condyle fractures. Conclusion: Preventive extraction of mandibular third molar is recommended for patients with high risk of angle fracture. Male patients at their third decade or martial artists, police officer could be the case. But it is not recommended for patients with low risk of angle fracture and high risk of condyle fracture relatively. Elder female patients without any symptom on their third molar could be the case.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.5
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• pp.207-213
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• 2014

Fractures of the mandible occur with a greater frequency in the elderly. This study reports three cases of edentulous atrophic mandible fracture in elderly patients treated with open reduction technique. Three patients who presented with edentulous atrophic mandible fractures underwent surgical management using open reduction and internal fixation. After treatment, clinical evaluations and postoperative complications were examined with postoperative x-ray. Patients were followed with clinical and radiographic examinations. In the postoperative clinical evaluation, two male patients healed well, but one female patient complained of pain and swelling. In radiographic examinations, no union delay or lack of fusion was observed in the edentulous area. Open reduction technique is a viable treatment option for the edentulous atrophic mandible fractures in geriatric patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.435-446
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• 1997

Overall study was carried out for the patients visiting Department of Oral & Maxillofacial Surgery through Emergency Room in Chonnam University Hospital, from Jan. 1, 1992 to Dec. 31, 1996. Result obtained were as follows ; Male predilection was shown, the male to female ratio being 2.5 to 1. The frequently developing age group were the first 3rd and 4th decade and under the age of 9 was followed. The number of patients for emergency was peak in September and October to 11%. About the causes for emergency, traffic accident was the most, and fall down injury and assault were followed. About the injury lists, facial laceration was preceded and the next facial bone fracture and the tooth injury followed. In the facial bone fracture, fracture in the mandible only was the most, and zygomaticomaxillary complex fracture, and mandible-maxilla complex fracture were followed. when the case of the mandible fracture, symphysis, condyle, angle were marked in succession. 57% was predomunatly ranged in the timea of 18 : 00 to 03 : 00 for the emergency. From injury onset to visiting emergency room, the range of 8 hours to 12 hours was predominant. Above results suggest that urgent patients of oral and maxillofacial area were relatively so high that division of oral and maxillofacial surgery should be established immediately.

• Journal of Korean Dental Science
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• v.2 no.1
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• pp.31-38
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• 2009

With today's social and cultural personal interactions, greater leisure time and participation in sports activities, and growing traffic volume, the risk of physical trauma has increased markedly. This is a clinical and retrospective study of patients exposed to oral and maxillofacial trauma. We clinically observed 72 patients with trauma in the Department of Oral and Maxillofacial Surgery, Kyunghee University Dental Hospital, from June 2006 through November 2007. The following data was obtained: 1. The male:female ratio of patients having experienced physical trauma was 6.2:1, with most patients in their twenties. 2. Traffic accident (37.5%) was the most common cause of trauma. 3. The highest incidence of fracture occurred to the zygomatic arch(22.1%) among mid-facial fractures and angle(37.5%), symphysis(35.4%) in mandible fractures. 4. Open reduction (88.9%) was the most frequently used form of treatment. Closed reduction was performed on the remaining 11.1% of cases. 5. Teeth and alveolar bone damage occurred in 23.6% of all cases. 6. Other injuries that were related to mid-face fracture occurred in 27.8% of all cases. 7. Post-operative complications occurred in 31.9% of cases, and the highest complication was the nerve injury.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.145-148
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• 2010

Maxillofacial injuries are less common in children than in adolescents and adults. This lower incidence is a result of the relatively small size of mandible, the resilient nature of the bones, and a relatively protected environment, which distinguish the treatment principles of pediatric mandibular fractures from those of the adult. The bone of child is malleable, so pediatric fractures tend to be less displaced and rarely comminuted. Moreover, high regeneration potential of the wound allows more conservative treatment modalities for the pediatric mandibular fracture. High risk of damaging unerupted tooth bud renders many clinicians to resort to more conservative treatment modality for the reduction of displaced segments. This case report describes two successful treatment cases using the circummandibular wiring which was applicated to the fracture on parasymphysis of mandible. Circummandibular wiring can protect the tooth buds, and there is no need for intermaxillary fixation so that it prevents the possible complications of intermaxillary fixation such as the temporomandibular joint ankylosis and the facial growth disturbances. The acrylic splint was removed after 3 weeks, which showed clinically good union across the fracture line without complications. They showed complete clinical and radiological bone healing with an optimum occlusion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.121-130
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• 2004

The purpose of this study was the long-term clinical and radiological evaluation of conservatively treated condylar fractures in children. This study was therefore undertaken to analyze the long-term effects of treating condylar fractures in children with conservative therapy in order to resolve the controversial question of whether complete remodeling occurs in this age or, if not, whether it is more likely to be associated with certain types of fracture or with other factors. This study was based on a series of 11 consecutive children and adolescents, aged between 3 and 15 years, with fractures of the condylar process who had been treated with conservative therapy at the Department of Oral & Maxillofacial surgery, Inha University Hospital, Inchon, Korea. All patients underwent a clinical investigation with special emphasis on Temporomandibular joint function and facial asymmetry. The patients also underwent a radiologic investigation, focusing on fracture remodeling and symmetry of mandible. It consists of panoramic radiograph, PA & lateral cephalogram and 3-D CT. No patient described impaired temporomandibular joint(TMJ) function or pain on the affected side. 2 of 8 (25%) unilateral and 1 bilateral fractures show slight facial asymmetry. Despite apparently excellent recovery of function, there were marked remodeling changes evident on the CT scan. Such changes are not usually evident on panoramic radiograph. Radiologic investigation showed incomplete remodelling(54.5%) and asymmetry of the mandible (27.3%) in some patients. Conservative treatment of condyle fracture in children results in satisfactory long-term outcome of jaw function despite a relative high frequency of radiologically noted aberrations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.6
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• pp.464-471
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• 2002

The purpose of this study was to evaluate the stress patterns within fractured mandibles generated by reduction forceps and to determine the optimal position of the reduction forcep. Twenty-seven mandibular models were fabricated using a photoelastic resin. Each of the three sets of mandible models prepared was osteotomized according to one of three different fracture types(symphysis, parasymphysis and body fractures). After reducing the cut segments, a reduction forcep was placed into different engagement holes to compress the segments. Photoelastic stress analysis was used to visualize the stress patterns within the fractured mandiblular models generated by the reduction forcep. In the case of symphysis or parasymphysis fractures, an optimum distribution of stress over the fracture site was achieved when placing the reduction forcep more than 12.5mm on either side of the fracture line between the midway level bisecting the mandible and 5mm below the level. In the case of body fractures, optimum stress distribution was achieved when the reduction forcep was placed more than 15mm from the fracture line on the midway level. In conclusion, a correct use of reduction forceps helps to provide a precise threedimensional reduction for mandibular fractures.