• 대한두경부종양학회:학술대회논문집
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• 1991.11a
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• pp.14.2-16
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• 1991

• 대한두경부종양학회:학술대회논문집
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• 2004.11a
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• pp.233-233
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• 2004

• Archives of Craniofacial Surgery
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• v.19 no.2
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• pp.152-156
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• 2018

Mandibular defects lead to severe deformation and functional deficiency. Vascularized osteocutaneous tissue has been widely used to reconstruct the mandible. However, it is technically challenging to shape this type of grafts in such a manner that they resemble the configuration of the mandible. A 48-year-old female patient who underwent anterolateral thigh (ALT) flap coverage after a tongue cancer excision was diagnosed with a tumor recurrence during the follow-up. A wide excision mandibulectomy and mandibular reconstruction with an ALT flap and a titanium implant were performed. The prefabricated titanium implant was fixed to the condyle. Then, an ALT flap was harvested from the ipsilateral thigh and anastomosed. After confirming that the circulation of the flap was intact, the implant was fixed to the parasymphysis. On the radiograph taken after the surgery, the prosthesis was well positioned and overall facial shape was acceptable. There was no postoperative complication during the follow-up period, 1 year and 2 months. The prefabricated implant allows the restoration of facial symmetry without harvesting autologous bone and it is a safe and effective surgical option for mandibular reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.2
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• pp.112-119
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• 2021

Objectives: Myxomatous odontogenic tumors (MOTs) are the third most common odontogenic tumors in the oral and maxillofacial region. Due to its slow-growing, but locally invasive nature, the tumor is usually detected by accident or only when it becomes a large mass, which causes facial deformity. Materials and Methods: Current study reports three unusual cases of MOT including huge myxoma involve the mandible in middle-aged man, MOT with ossifying fibroma pattern in mandible, and MOT in maxilla of young female patient. The diagnosis and treatment strategy of MOTs was also summarized and updated. Results: In reported three cases of patients with large MOTs, surgical treatment was indicated with fibular free flap reconstruction in the mandible and plate reconstruction in the maxilla. The tumors were successfully treated with radical resection and did not show signs of recurrence during the follow-up period. Conclusion: Surgical treatment indication depends on size, the position of the lesion, patient systemic condition and surgeon individual experience. In the case of a large tumor, radical resection and reconstruction is the standard surgical strategy. The conservative surgical treatment including enucleation with wide curettage is still under controversy. The recurrence rate for MOTs is significantly high, up to 30%, therefore long-term follow-up is essential.

• Journal of International Society for Simulation Surgery
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• v.3 no.1
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• pp.12-15
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• 2016

Functional and esthetic reconstruction after segmental mandibulectomy is one of the most challenging surgeries in microsurgical reconstruction field. Simulation surgery before free flap reconstruction has been performed for efficient surgery and successful results. Fibula free flap is the flap of the choice for reconstruction of the segmental mandibular defect. Straight nature of the fibula bone requires multiple segmentations to fit into mandible. 3D rapid prototype (RP) model gives a lot of information for mandibular reconstruction. The purpose of this study was to report mandibular reconstruction with free fibular flap using simulation surgery. A total of 30 consecutive patients were included for functional and esthetic evaluation. Among 30 patients, two flaps showed necrosis after radiotherapy. The other flaps were all survived and showed successful reconstruction in both function and esthetics.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.223-226
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• 2002

The segmental mandibulectomy should be performed, if mandiblie invasion is suspected clinically and radiologically. And if tumor is located to mandible very closely or when microinvasion to mandible is suspected, marginal mandibulectomy is recommended. But in segmental mandibulectomy, reconstruction is difficult and cosmetic problem remains. In this case, we performed modified segmental resection of mandible, preserving the inferior margin of mandible, and maintains the continuity of the bone, in mucoepidermoid carcinoma of parapharynx, invading mandible. We reviewed the diagnosis, pathology, and treatment, and report the case with reviews of literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.5
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• pp.429-438
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• 2007

Transport distraction osteogenesis has been introduced recently to correct skeletal malformations and discrepancies in the maxillofacial area. To reconstruct 3-dimensitonal mandibular shape, this transport distraction can be considered with the use of reconstruction plate. A 23-years-old male having unilateral mandibular body and angle defects, who had been operated of partial mandibular resection due to unicystic ameloblastoma, was treated by transport distraction procedures with ThreadLock transport $distractor^{(R)}$ (KLS Martin Co., Germany) through the rail of reconstruction plate (Osteomed Co., USA). After being distracted 35 mm defect from mandibular angle to body, and consolidated for 16 weeks, allogenic bone graft on docking site was performed with removal of transgingival pin. For more than 13 weeks follow up period after consolidation period, gradual increase of radiopacity in the radiographic examination was shown, and the curved mandibular continuity according to the reconstruction plate was made firmly. These transport distraction osteogenesis in the mandible was able to be considered as the good and minimally invasive technique for the reconstruction of mandibular discontinuity. Young patient was also very satisfactory for these results.

• Imaging Science in Dentistry
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• v.33 no.3
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• pp.187-193
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• 2003

Purpose: To compare the measurements of the mandible and the detectability of the mandibular canal on reformatted images using a newly developed 3-dimensional implant simulation program with traditionally used CT multiplanar reconstruction program and true measurements. Materials and Methods: Ten dry dog mandibles were used in this study. Occlusal templates for CT examination were fabricated and marked with gutta perch a at ten sites. Axial CT scans were taken and reconstructed using DentaScan (D group) and Vimplant program (V group), and each mandible was sectioned at the previously marked sites (R group). Maximum vertical height (H) and maximum width (W) of the mandible, the distances from buccal border of the mandibular canal to the most buccal aspect of the mandible (X), and the distance from the superior border of the mandibular canal to the alveolar crest (Y) were measured, and the mandibular measurements in each group were compared. Detectability of mandibular canal was evaluated using a 3-point scale in both V and D groups by three oral radiologists and compared. Results: H in the V group was slightly greater than that in the D group, and Wand X in the V group was slightly less than those in the D group. H in the V group was less than that in the R group, and Wand X in the V group was larger than those in the R group. The detectability of the mandibular canal did not show statistically significant differences between V and D groups. Conclusion: The results of the experiment show that the newly developed, inexpensive Vimplant/TM/ simulation program can be used as an alternative to the traditionally used, and more expensive CT multiplanar reconstruction program.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.475-480
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• 2009

Purpose: To correct the facial asymmetry and to achieve symmetry and balance, not only the soft tissue restoration of deficits but also creation and facial contour line such as mandible border and angle is important. Micro fat graft has limitation such as high resorption rate and somewhat limited ability to emphasize the rigid bony characteristics of the mandible angle due to its innate soft consistency. We have investigated the advantages of dermal fat graft over micro fat graft to correct asymmetry of the lower face in patients who had undergone mandibular reconstruction or distraction, using comparative analysis. Methods: Total of 12 patients were enrolled in our study: 6 micro fat graft and 6 dermal fat graft. Postoperative results were compared and analyzed at immediate postoperative period and more than 1 year later in each group with photographs, and analysised with image J program. Result: No complications were noted both in the micro fat type and the dermal fat type of procedures such as fat necrosis or micro calcifications. All of the patients who received micro fat graft, however had considerable amount of fat resorption after the procedure which led to two additional fat graft procedures. Although minor contour obliteration due to contracture was seen in patients who had undergone dermal fat graft procedure, no definite resorption was found even after more than one year follow-up. Results of dermal fat graft patients were satisfactory in terms of mandible angle symmetry. Secondary revision was necessary in one case due to overcorrection using dermal fat graft. Conclusion: The dermal fat graft has many advantages over the conventionally more popular micro fat graft to correct asymmetry of the lower face following mandible reconstruction owing to its lower resoption rate, more effective in emphasizing the natural curvilinear anatomical contours of the mandible angle and body and lower complication rates such as fat necrosis or micro calcifications.

• Imaging Science in Dentistry
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• v.32 no.3
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• pp.153-157
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• 2002

Purpose : This study was performed to determine the proper reference line for taking axial computed tomograms from which the good cross-sectional views can be reformatted by multiplanar reconstruction. Methods : Three dry mandibles with implanted gutta percha cones in the extracted socket were scanned axially according to 6 reference lines of 2 mandibular positions with computed tomogram Hitachi W550. The accuracy of measurements of the lengths of implanted gutta perch a cones in the each cross-sectional view reformatted from axial computed tomogram by multiplanar reconstruction was evaluated. Results: The difference between the measurements and the real length of implant was smallest in the bucco-lingual views reformatted from the axial views scanned according to the reference line of group V-a. The smaller the angle difference between reference line and occlusal line was, the smaller the difference between the measurements in the bucco-lingual views reformatted from axial views and the real length of implant. The majority of measured widths of implants in the bucco-lingually reformatted views were larger than the actual values. Conclusions : When the mandible is inclined within the limitation of gantry angle and scanned with the reference line coincident with occlusal plane, the bucco-lingual view can be reformatted without deformation of images from the axially scanned images.