• 제목/요약/키워드: Mandibular angle

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The postoperative trismus, nerve injury and secondary angle formation after partial masseter muscle resection combined with mandibular angle reduction: a case report

  • Kim, Jeong-Hwan;Lim, Seong-Un;Jin, Ki-Su;Lee, Ho;Han, Yoon-Sic
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제43권1호
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    • pp.46-48
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    • 2017
  • A patient, who underwent partial masseter muscle resection and mandibular angle reduction at a plastic surgery clinic, visited this hospital with major complaints of trismus and dysesthesia. A secondary angle formation due to a wrong surgical method was observed via clinical and radiological examinations, and the patient complained of trismus due to the postoperative scars and muscular atrophy caused by the masseter muscle resection. The need for a masseter muscle resection in square jaw patients must be approached with caution. In addition, surgical techniques must be carefully selected in order to prevent complications, and obtain effective and satisfactory surgery results.

안면골격 유형에 따른 하악 전치 치조골의 형태 차이: Cone-beam CT를 이용한 정량적 평가 (Morphological difference of symphysis according to various skeletal types using cone-beam computed tomography)

  • 권현진;전윤식;김민지
    • 구강회복응용과학지
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    • 제30권3호
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    • pp.215-222
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    • 2014
  • 본 연구는 수평적, 수직적 안면 골격 유형에 따른 하악 전치부 치조골의 형태학적 차이를 알아보기 위하여 시행 하였다. 연구 재료 및 방법: 40명의 Cone-beam computed tomography (Cone-beam CT)를 선별하여, 4개 군으로 분류하였다. Cone-beam CT 자료를 이용하여 하악 전치부 치조골의 부피($mm^3$), 하악 4절치 치축 기준 시상단면의 단면적(총 단면적, 해면골 단면적: $mm^2$), 백악법랑경계(cemento-enamel junction: CEJ) 2 mm, 3 mm 아래 순, 설측 치조골 두께를 측정하였다. 통계분석은 GLM, Kruskal-Wallis test and Tukey HSD를 사용하였다. 결과: 측절치의 백악법랑경계 2 mm, 3 mm 하방 설측 치조골 두께가, Class I low angle군이 나머지 3군 보다 두꺼웠다 (P < 0.05). 하악 전치 치조골의 부피, 전체 치조골 및 해면골의 단면에서의 통계적으로 유의한 차이는 없었다. 결론: Class I low angle군은 Class II high angle군에 비해 하악 전치 치조골의 설측 부위가 더 두껍다.

하악(下顎) 전돌증(前突症)에 관(關)한 방사선(放射線) 두부계측학적(頭部計測學的) 연구(硏究) (A ROENTGENOCEPHALOMETRIC STUDY ON MANDIBULAR PROGNATHISM)

  • 이기수
    • 대한치과교정학회지
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    • 제9권1호
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    • pp.85-98
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    • 1979
  • This investigation was designed to compare the craniofacial and dental morphology of class III malocclusion with that of normal occlusin in children, and to determine the incidence of various class III craniofacial skeletal patterns. The material selected for this study consisted in standard lateral cephalograms of eighty two Korean children, forty one boys and forty one girls, aged 10 through 12 years, having class III malocclusion, and forty two Korean children, twenty boys and twenty two girls, with normal occlusion in the same age. Using the tracings of the standard lateral cephalograms, various angular and linear measurements were recorded, tabulated and statistically analyzed, and then the class III craniofacial skeletal morphology was divided into various patterns by the degree of SNA and SNB, which respectively were below, within or beyond the normal range of those of normal occlusion. The following characteristics of the craniofacial and dental morphology of class III malocclusion were observed. 1. The cranial base length of class III malocclusion was smaller than that of normal occlusion, and the small saddle angle was a characteristic figure of class III malocclucion. 2. Maxillary length of class III malocclusion was smaller than that of normal occlusion, and point A was retropositioned relative to cranial base but not PNS in class III malocclusion. Maxillary base inclination was not significantly different between the two, but occlusal plane to palatal plane was small in class III malocciusion. 3. The mandibular body length shown no difference between the two, but the mandibular body positioned anteriorly relative to cranial base in class III malocclusion. Ramus height, gonial angle, and mandibular effective length were large in class III malocclusion. Mandibular plane angle and joint angle had no difference between the two, and occlusal plane to mandibular plane angle was large in class III malocclusion. 4. Maxillary incisor inclination was not significantly different between class III malocclusion and normal occlusion, but mandibular incisors positioned and inclined lingually and consequently interincisal angle was large in class III malocclusion. 5. Class III malocclusion was divided into six categories of craniofacial skeletal pattern. The most common class III pattern was found to be one in which the maxilla was within the normal range of prognathism while the mandible extended beyond this range. The pattern in which the maxilla was below the normal range of prognathism while the mandible was within this range was approximately one fifth of the class III sample.

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하악골 골절의 원인과 양상에 관한 연구 (ETIOLOGY AND PATTERNS OF MANDIBULAR FRACTURES)

  • 정일혁;한기덕;서제덕;황경균
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권5호
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    • pp.472-477
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    • 2005
  • 저자 등은 1996년 1월부터 2004년 12월까지 서울대학교 보라매병원 구강악안면외과에서 치료받은 141명의 하악골 골절 환자의 임상적 연구를 통하여 다음을 알 수 있었다. 1. 전체 환자에서 남,녀 성별 발생빈도는 5.13대 1로 남자에서 호발 하였으며, 연령대별로는 20대에서 가장 빈발하였고 (30.5%), 그 다음 30대, 40대 (22.7%) 순이었다. 2. 하악골 골절의 원인으로 폭행 (45.4%), 낙상, 추락 및 충돌 (40.4%), 교통사고 (11.3%) 순이었다. 3. 골절부의 위치는 하악 정중부 (41.2%), 우각부(32.2%), 과두부 골절(18.5%)의 순으로 나타났으며, 단일 골절의 경우 하악 우각부 골절이 (46.7%)로 가장 많았고, 두 군데 이상의 골절의 하악 정중부 및 우각부 동시 골절이 가장 많았다 (45.5%). 4. 교통사고로 인한 하악 골절은 정중부, 과두부, 우각부 골절의 순으로 발생 빈도를 보였고, 폭력과 낙상, 추락 및 충돌 등으로 인한 골절의 경우 정중부, 우각부, 과두부 골절 순으로 발생빈도를 보였다.

하악과두 잘림과 경추의 하악지 겹침을 야기하는 파노라마방사선촬영 오류 (Experimental panoramic positioning errors for inducing condylar cutoff and superimposition of cervical vertebrae on the mandibular ramus)

  • 강병철;김민종;박혜선;황슬애;윤숙자;이재서
    • 대한치과의사협회지
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    • 제56권3호
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    • pp.134-141
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    • 2018
  • Purpose: To measure the head tilting angle creating initial condylar cut-off and to find the head position inducing the superimposition of the cervical vertebrae over the mandibular ramus on panoramic radiograph. Materials and Methods: The panoramic radiographs were taken with Didactic skull on cervical spine model (Scientific GmbH, Hamburg, Germany) using Kodak 8000c Digital Panoramic radiography. For the inherent radiolucency of the plastic skull model, radiopaque 1 mm diameter lead wires were attached along the margin of the mandibular condyle, ramus, mandibular body, cervical vertebrae, and FH plane of the skull model. For measuring the head tilting angle creating the condylar head cutoff, panoramic radiographs were taken by tilting the FH plane downward in 5 degree increments. For finding the distance between transverse process of the third cervical vertebra and gonion inducing superimposition of cervical vertebrae on the mandibular ramus, panoramic radiographs were taken by decreasing the distance in 0.5 cm increments. Result and Conclusion: The condylar cutoff began to appear when the head of skull model was tilted downward by 15o. As the head tilting angle increasing, the condylar cutoff became more prominent. The superimposition of cervical vertebrae over the mandibular ramus began to appear when the distance between the gonion and third cervical vertebra was 1.0 cm. As the distance decreasing, the superimpostion became more prominent.

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상하악 동시 악교정술시 안정성에 관한 연구;[Ⅰ] 강선 고정에 의한 방법 (STABILITY OF SIMULTANEOUS MAXILLARY AND MANDIBULAR SURGERY;[Ⅰ]Wire osteosynthesis)

  • 김여갑
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권2호
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    • pp.9-20
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    • 1990
  • A series of 19 cases with maxillary hyperplasia and mandibular retrognathia were operated on by simultaneous superior repositioning of the maxilla after Le Fort I osteotomy and anterior repositioning of the mandible after bilateral sagittal split ramus osteotomies with or without osteotomy of the inferior border of the mandible. These were evaluated by retrospective cephalometric and computer analysis for the longitudinal skeletal and dental changes for an average of 17.1 months after surgery. For stabilization of the osteotomized segments, the authors used wire osteosynthesis by means of bilateral infraorbital and zygomatic buttress suspension wire at the maxilla, and direct interosseous wire at the split segments of the mandibular rami. Results show generally good stability after simultaneous maxillary and mandibular surgery with wire osteosynthesis, and a minimal to moderate tendency toward skeletal and dental relapse. This article is a preliminary study to defy the efficiency of the wire osteosynthesis (wo)compared with rigid internal fixation (RIF) for simultaneous maxillary and mandibular surgery. 1. The vertical relapse rate of the A point after superior repositioning of the maxilla is 2.2%. 2. The horizontal relapse rate of the B point after advancement of the mandible is 18.3%. 3. The condyle is distracted inferiorly and slightly posteriorly at the immediate postoperative period. 4. At the long term follow up examination, the condyle presents tendency of return to the preoperative position. 5. Condylar segment angle is decreased at the immediate postoperative period, and at the long term follow up evaluation, the angle is increased. 6. Gonial angle is increased at the immediate postoperative period, and then is decreased at the long term follow up evaluation. 7. The dentition is satisfactory with acceptable movement at the long term follow up evaluation. 8. At the mandibular free body analysis, genioplasty shows good stability. 9. Wire osteosynthesis provides excellent stabilization for the simultaneous maxillary and mandibular surgery.

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하악운동 회전량과 과로의 형태에 관한 연구 (A Study on the Amount of Mandibular Rotation and Pattern of Condylar Path)

  • Kyung-Soo Han;You-Me Lee
    • Journal of Oral Medicine and Pain
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    • 제21권2호
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    • pp.369-382
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    • 1996
  • The author performed this study to investige the relationship between condylar movements recorded with Pantronicⓡ and mandibular rotational torque movements with BioEGNⓡ. For this study 56 patients with Temporomandibular disorders(TMD) and 30 dental students without any masticatory signs and symptoms were selected as patients group and control group, respectively. The items recorded with Pantronicⓡ(Denar Corp., USA) were immediate side-shift, progressive side-shift, angle of orbiting path, protrusive path and PRI. BioEGNⓡ(Bioelectric gnathography, Bioresearch Inc., USA) were used to measure the amounts of mandibular rotational torque movements in frontal and horizontal plane, and the distance of mandibular translation at incisal area. Amount of mandibular rotational torque movement depicted between the condyles was automatically analysed by angle and difference in frontal and horizontal plane. The obtained data were processed with SAS program and the conclusion of this study were as follows : 1. Mean values of items between patients group and control group in Pantronic measurements were not significantly different except in left protrusive path and in Pantronic Reproducibility Index(PRI). There were no significant difference of condylar paths by preferred chewing side and affected side between the two groups. 2. The amount of mandibular rotational torque movements were differed in frontal angle and difference on protrusion, and in frontal and in horizontal difference on left excursion between the two groups. But the amounts of translatory movements were actually same on all eccentric movements. 3. The amount of mandibular rotational torque movements with splint mere almost not changed from those without splint, with the exception of in horizontal measurements on protrusion. 4. The correlations of items between in Pantronic measurements and in BioEGN measurements wert not consistently, significant, however, generally the ISS related significantly with horizontal torque movement positively, and with frontal torque movement negatively on the contrary, the PSS showed positive correlation with frontal torque movement, and negative correlation with horizontal torque movement.

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단면 CT 영상을 이용한 무치악 하악 대구치부 잔존골의 형태 분석 (Morphological analysis of mandibular posterior edentulous bones using cross-sectional CT images)

  • 이설미;허경회;이원진;허민석;이삼선;강태인;최순철
    • Imaging Science in Dentistry
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    • 제37권3호
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    • pp.133-138
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    • 2007
  • Purpose: The purpose of this study was to evaluate the morphologic features of posterior edentulous mandible for Korean patients using cross-sectional CT images. Materials and Methods: Computed tomographic cross-sectional views taken in 2004 and 2005 at Seoul National University Dental Hospital were analyzed by an oral and maxillofacial radiologist. Four indices were measured to meet the purpose of this study: 1) the horizontal distance between the alveolar crest and mandibular canal (Type), 2) the angle of the mandibular long axis (Angle), 3) the bucco-lingual location of mandibular canal, and 4) the depth of the submandibular fossa. The averages and standard deviations of the measurements were compared according to the location (the first and second molar area) and sex of the patients. Results: Statistically significant difference was found in Type, Angle, and submandibular fossa depth between the first and second molar area (p<0.05). However, there was no significant difference between men and women in any of the measured indices. Most of the mandibular canals were located in lingual side of posterior mandible. Conclusion: More care should be taken when an implant is installed on the mandibular second molar area.

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골격성 III급 부정교합자의 두개안면형태에 대한 하악이부의 형태 및 하악절치의 위치에 대한 연구 (A study of morphology of mandibular symphysis and location of lower incisor under the influence of the craniofacial skeleton in skeletal Class III malocclusion)

  • 김성식;박재억;손우성
    • 대한치과교정학회지
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    • 제28권5호
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    • pp.763-774
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    • 1998
  • 골격성 III급 부정교합자의 두개안면골격형태가 하악이부형태와 하악전치의 위치에 미치는 영향을 알아보고자 연구를 시행하였다. 전후방적인 악골부조화가 나타나지 않고 교정치료의 경험이 없는 만 20세 이상의 성인남녀(정상군)와, 하악전돌의 악골부조화를 보이며 교정치료의 경험이 없 만 20세 이상의 성인남녀(하악전돌군)를 비교하여, 두개안면골격형태에 따른 하악이부형태와 하악전치의 위치에 관하여 다음과 같은 결론을 얻었다. 1. 두개안면골격형태의 비교에서 하악에 관련된 ${\angle}SN-Mn,\;{\angle}FMA,\;{\angle}Pal-Mn,\;{\angle}LFH$은 하악전돌군이 정상군에 비하여 크게 나타났지만,(p<0.05) 상악에 관련된 항목은 차이를 나타내지 아니하였다(p>0.n). 2. 하악전치를 둘러 싸고 있는 치조돌기는 하악전돌군이 정상군에 비해서 수평적으로 좁고,수직적으로 긴 형태를 나타내었다(p<0.05). 하악이부의 형태에서도 수평적으로는 하악전돌군이 정상군에 비해서 좁게 나타났으나, 수직적으로는 차이를 나타내지 아니하였다(p>0.05). 3. 하악전돌군의 두개안면골격형태와 이부계측항목과의 상관관계에서 두개저와 하악하연에 기인하는 수직적인 악골부조화가 증가할수록 LaABH, LiACBW, LaACBW, LiABBW, SW, ${\angle}LISA$가 감소하는 역상관관계를 나타냈지만 (p<0.05), 전후방적인 악골부조화와는 별다른 상관관계가 나타나지 않았다(p>0.05). 4. 하악전돌군에서 수직적인 두개안면골격형태를 나타내는 ${\angle}SN-Mn,\;{\angle}FMA,\;{\angle}Pal-Mn,\;{\angle}LFH$ 와 하악이부의 계측 항목인 LiACBW, LiABBW, SW, ${\angle}LISA$ 사이에 높은 상관관계가 존재하여, 수직적인 악골부조화로 하악이부의 형태와 하악전치의 경사도를 예측할 수 있었다(p<0.001).

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하악골 골절시 사용되는 TRANSBUCCAL TROCAR TIP의 새로운 고안 (DESIGN OF TRANSBUCCAL TROCAR TIP USED IN MANDIBULAR ANGLE FRACTURES)

  • 안병근;이건주;한호진;박형태
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제11권1호
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    • pp.87-92
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    • 1989
  • Transbuccal trocar has been an established method of fixation for the bone plate in the case of mandibular angle fracture. Other than extraoral approaches, this transbuccal approach has many advantages in the treatment of the fracture of mandibular angle. These advantages are as follows ; (1) Damage to the facial nerve branches is minimal. (2) Less postoperative scar is formed. (3) Good vision of occlusion can be easily obtained on the entire operation. (4) Shorter operation time is needed. But, in the clinical procedure of plate fixation, it is has a difficulty in manipulation of the plate and correction of position. To solve these problems, we designed and used a trocar tip which can be easily attached to the trocar, and could make an improvement in the clinical procedures.

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