• Archives of Plastic Surgery
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• v.39 no.4
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• pp.284-290
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• 2012

Open reduction and anatomic reduction can create better function for the temporomandibular joint, compared with closed treatment in mandible fracture surgery. Therefore, the double miniplate fixation technique via mini-retromandibular incision was used in order to make the most stable fixation when performing subcondylar fracture surgery. Those approaches provide good visualization of the subcondyle from the posterior edge of the ramus, allow the surgeon to work perpendicularly to the fracture, and enable direct fracture management. Understanding the biomechanical load in the fixation of subcondylar fractures is also necessary in order to optimize fixation methods. Therefore, we measured the biomechanical loads of four different plate fixation techniques in the experimental model regarding mandibular subcondylar fractures. It was found that the loads measured in the two-plate fixation group with one dynamic compression plate (DCP) and one adaption plate showed the highest deformation and failure loads among the four fixation groups. The loads measured in the one DCP plate fixation group showed higher deformation and failure loads than the loads measured in the two adaption plate fixation group. Therefore, we conclude that the selection of the high profile plate (DCP) is also important in order to create a stable load in the subcondylar fracture.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.26 no.2
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• pp.7-17
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• 1996

This study was performed to determine the postitional relationships of two lobes of parenchyma and to analysis the anatomical feature and its variations of duct on the panoramic views of the normal parotid glands in adults. Materials included 66 panoramic views and anterioposterior views of sialograms of selected persons and the radiograms of the gland experimentally reproduced on dry skull with lead foil and the reference images of computed tomograms of normal persons. Results were as follows : 1. On panoramic view of sialogram, the superficial lobe was revealed with totally being superimposed with the mandibular ramus and condyle and its tail portion superimposed with mandibular angle area, the deep lobe was revealed between the posterior border of the ramus and the mastoid process, and the isthmus was begin from the marked furcation off main duct and superimposed partially with the medial part of the deep lobe. 2, The mean length and the lateral extension of parenchyma was 63.18±8.05mm and 21.78±4.87mm respectively on panoramic view and showed no statistical relationship between them. 3. The main duct was generally perpendicular to the posterior border of ramus at middle portion and its configurations revealed 57,58％ of curvilinear type, 21.21％ sigmoid type, 15.15％ reverse sigmoid type. 4, The interlobular ducts of the deep lobe showed relatively well defined features between the mandibular ramus and the mastoid process.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.3
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• pp.214-216
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• 2010

An osteochondroma is an osseous protuberance with cartilaginous growth potential, usually arising in skeletal bone and relatively uncommon in the craniofacial bone. Osteochondroma of the craniofacial region usually occurs at the condyle or the tip of the coronoid process, and rarely arises in the mandibular body, symphysis, ramus, and similar areas. Excision of the lesion including the periosteum is curative, and recurrence or malignant change (usually to a chondrosarcoma) after treatment is rare. We present an atypical case of osteochondroma in the left mandibular inferior border with review of literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.3
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• pp.166-169
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• 2024

Ankylosis of the temporomandibular joint (TMJ) is a condition in which the mandibular condyle fuses with the mandibular fossa through fibrous or bone tissue. It is a debilitating pathology that interferes with chewing, speaking, and oral hygiene. Currently, alloplastic reconstruction is considered the gold standard for treating severely compromised TMJs, such as in ankylosis. The article describes a patient with a history of facial trauma, with bilateral ankylosis of the TMJs, inability to open his mouth, and poor dental condition. Due to a long period of immobilization of approximately 40 years, the initial treatment plan was to remove the ankylosis bilaterally and install customized PMMA (polymethylmethacrylate) spacers. The patient gained mouth opening and improved chewing quality with one year of customized spacer use prior to definitive alloplastic replacement with stock-type TMJ prostheses. Customized joint spacers are a provisional treatment option when definitive alloplastic reconstruction is not indicated. Spacers provide the patient with progressive jaw function and mobility gains.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.130-134
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• 1997

The sagittal split ramus osteotomy(SSRO) of the mandible has used one of the most popula methods for the correction of various dentofacial deformities, especially mandibular prognathism. In SSRO, there are produced bony gap following mandible setback because of mandibular flaring. For this reason, the condylar axis may be changed due to bony approximation both segment in three dimension more mesio-laterally. According to change of condylar position, the condition of TMJ structure are changed and change of TMJ symptoms are suggested theoretically, and the correction of malocclusion by SSRO may improve the TMJ symptoms by improvement of feeding difficulties. The pupose of this study was to determine relationship between expected alterations in condylar position and suggested TMJ symptoms produced by change of condylar position. TMJ symptoms of 15patients who had operated SSRO are checked at about postoperative 6 month ranging $5{\sim}11$ month. Anterior-posterior position of condyle which was comparison preoperative with postoperative position, was classified 5 groups. The author tried to identify relationship between positional change of condyle and TMJ discomfort.

• Imaging Science in Dentistry
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• v.36 no.1
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• pp.41-48
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• 2006

Purpose : To evaluate the reliability and clinical usefulness of ultrasonography in the temporomandibular joint (TMJ). Materials and Methods : Parasagittal and paracoronal 1.5 T MR images and 7.5 MHz ultrasonographs of 40 TMJs in 20 asymptomatic volunteers were obtained. Disc position using MR imaging was evaluated and the distance between the lateral surface of mandibular condyle and the articular capsule using MR image and ultrasonograph of 27 TMJs with normal disc position was measured and compared. Intraobserver and interobserver measurements reliability was evaluated by using interclass correlation coefficients (ICC) and measurement error. Also, the distance measured on ultrasonographs was compared, according to mouth position and disc postion. Results : The normal disc position was found in 27 of 40 asymptomatic joints. At the intraobserver reliability of measurement, ICC at the closed and open mouth position were 0.89 and 0.91. The measurement error was 0.4% and 0.5%. At the interobserver reliability, ICC at the closed and open mouth position were 0.92 and 0.81. The measurement error was 0.4% and 0.7%. At the TMJ with normal disc position, the distances between the lateral surface of mandibular condyle and the articular capsule measured on MR images and ultrasonographs were $2.0{\pm}0.7mm,\;1.8{\pm}0.5mm$, respectively (p<0.05). On the ultrasonographs, the distances at open mouth position were $1.2{\pm}0.5mm$ (p<0.05). At the TMJ with medially displaced disc, the distances at the closed and open mouth position were $1.3{\pm}0.3\;mm\;and\;0.9{\pm}0.2\;mm$ (p<0.05). Conclusion : The results suggest ultrasonography of TMJ is a reliable imaging technique for assessment of normal disc position.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.1
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• pp.70-79
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• 2016

Patients who lost posterior teeth due to periodontitis or dental caries have collapsed vertical dimension, unstable occlusion and change of the mandibular position. In particular, patients in orthognathic surgery, clinician should re-establish the pre-operative stable position of mandibular condyle in articular fossa and favorable vertical dimension for high post-operative stability of mandible. Therefore, interdisciplinary approach and co-operation, including prosthetics, orthodontics, oral and maxillofacial surgeon, from diagnosis and treatment plan is important to get a good outcome. This case report was patients who had collapsed occlusal plane due to severe dental caries on maxillary molars with skeletal Class III malocclusion. Before orthognathic surgery, resetting of maxillary occlusal plane with temporary removable denture was performed. Then successful multidisciplinary approach was done and lead to acceptable clinical outcome.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.5
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• pp.331-335
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• 2017

Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.287-296
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• 1989

Fractures of the mandibular condyle are among the most frequently occuring facial bone fractures. Anatomical structures around the joint inhibit the ideal reposition of the fragments, so variable treatment modalities have been tried selectivly. There can be functional disturbances postoperatively, and normalization of joint function must be considered primarily in treatment planning. Secondly, the possible joint ankylosis and facial deformity following developmental disturbance of facial skeleton must be considered. The authors reviewed 73 patients treated in Dept. of Oral and Maxillofacial Surgery. Inje College of medicine Pusan Paik Hospital from 1981 to 1987. Also literatures were reviewed, and we obtained some reference points concerning the selection of the treatment modality and prevention of the possible complication.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.21 no.1
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• pp.73-81
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• 1991

The purpose of this study was to analyze the position of mandibular condyle on the submentovertex radiograph, thereafter to evaluate the usefulness of submentovertex radiograph in diagnosis of temporomandibular joint dysfunction, and to check the best method of tomographic techniques. Submentovertex radiographs which were taken in 75 temporomandibular joint dysfunction patients and 75 normal persons were used as the sample for this study. The obtained results were as follows: The submentovertex radiograph was a improper method in diagnosis of temporomandibular joint dysfunction and discrimination of affected side. The selective tomography was a better method than any other tomographic techniques in diagnosis of temporomandibular joint dysfunction.