• Title/Summary/Keyword: Mandibular bone

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A RADIOGRAPHIC STUDY ON THE MANDIBULAR CANAL (하악관에 관한 방사선학적 연구)

  • Cho Seung-Eun;Kim Jae-Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.2
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    • pp.307-316
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    • 1991
  • The purpose of this study is to improve the availabilities of radiographic technics as diagnostic method related to mandibular canal in dental clinic. For this study 12 dry mandibles were used and 12 orthopantomograms were taken for measuring the gonial angle and the angle of mandibular canal to inferior border of mandible. 12 sites located between the 1st premolar to the 3rd molar region of 3dry mandibles were selected randomly, for measuring the vertical image magnification rates on three films; intraoral film, orthopantomogram, and computed tomogram, respectively and the thickness of cortical bone, and for observing bucco-lingually and supero-inferiorly location of the mandibular canal. The acquired results were as follows: 1. The means of the gonial angle and the angle of mandibular canal to inferior border of mandible were 123.9° and 143.5° And the two angles of dry mandible in alveolar crest stage were greater than in alveolar socket stage. 2. The vertical image length on intraoral film by paralleling technic was magnified by 3.07% on the average, the length on orthopantomogram by 18.49%, and the length on computed tomogram by 0.27%. 3. Observation of the bucco-lingually positional relationship of the mandibular canal was impossible by occlusal projection with the cross section technic and intraoral standard projection with the Clack's rule, however, possible by computed tomogram. 4. The thickness of the cortical bone of mandible was thickest in inferior border, and thicker by 6.59% at buccal side than at lingual side.

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STUDY ON THE RELATIONSHIP OF THE INFERIOR ALVEOLAR NERVE POSITION BETWEEN BUCCAL AND LINGUAL SIDE USING CT AND ORTHPANTOMOGRAM (컴퓨터단층촬영과 파노라마상을 이용한 한국인 하치조관의 하악에서의 협, 설측 위치 관계에 대한 연구)

  • Shin, Hong-Soo;Hwang, Soon-Jung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.1-6
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    • 2002
  • When bilateral sagittal split ramus osteotomy or mandibular angle reduction are carried out, we have to consider the position of inferior alveolar nerve. For bone splitting or resection using a saw or an osteotome, the bucco-lingual position of the inferior alveolar nerve plays an important role in the preventing perioperative complications such as paresthesia or anesthesia. Because it is rare to find literatures concerning the mean anatomic position of the inferior alveolar nerve in Koreans, we investigated 30 patients who underwent to take CT and orthopantomogram for implant surgery, and evaluated the bucco-lingual position and vertical relationship of the inferior alveolar nerve at the mandible. The results showed that the distance between inferior alveolar nerve and buccal plate was the farthest at mandibular second molar ($7.1{\sim}7.4mm$) and the nearest at mandibular angle area ($4.4{\sim}4.8mm$). But it was no statistical relationship between the bucco-lingual postion of inferior alveolar nerve on the CT and its vertical position on the OPT. In conclusion, the results suggest that a careful surgical procedure is needed at the mandibular angle area to avoid a nerve damage and there are sufficient bone materials at the mandibular second molar are for bilateral sagittal split ramus osteotomy or mandibular angle reduction or plate fixation. And OPT is not usefull for the evaluation of a relative bucco-lingual position of inferior alveolar nerve in relation to its vertical postion on the OPT.

Considerations and Protocols in Virtual Surgical Planning of Reconstructive Surgery for More Accurate and Esthetic Neomandible with Deep Circumflex Iliac Artery Free Flap

  • Kim, Nam-Kyoo;Kim, Hyun Young;Kim, Hyung Jun;Cha, In-Ho;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.4
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    • pp.161-167
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    • 2014
  • Purpose: The reconstruction of mandibular defects poses many difficulties due to the unique, complex shape of the mandible and the temporomandibular joints. With development of microvascular anastomosis, free tissue transplantation techniques, such as deep circumflex iliac artery (DCIA) flap and fibular free flap (FFF), were developed. The DCIA offers good quality and quantity of bone tissue for mandibular segmental defect and implant for dental rehabilitation. Virtual surgical planning (VSP) and stereolithography-guided osteotomy are currently successfully applied in three-dimensional mandibular reconstruction, but most use FFF. There are only a few articles on reconstruction with the DCIA that assess the postoperative results. Methods: Three patients admitted during a five month period (April of 2013 to August of 2013) underwent resection of mandible and DCIA musculo-osseous reconstruction using a VSP and stereolithographic modeling and assessment of outcomes included technical accuracy, esthetic contour, and functional outcomes. Results: This technique yielded iliac bone segment with excellent apposition and duplication of the preoperative plan. Flap survival was 100 percent and all patients maintained preoperative occlusion and contour. Conclusion: Based on our experience, we offer considerations and logically consistent protocols by classification of mandibular defects, and demonstrate the benefits in VSP and stereolithographic modeling of mandibular reconstructive surgery with DCIA flap.

Esthetic restoration in mandibular anterior region with one-piece implant and immediate loading (하악 전치부에서의 일체형 임플란트 식립 후 즉시부하)

  • Yoon, Sena
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.27 no.2
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    • pp.97-104
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    • 2018
  • Mandibular anterior region has high implant survival rates and better accessibility compared with any other region. Even if there are possibilities for perforation on lingual cortical bone due to improper drilling and bleeding caused by lingual artery damage, mandibular anterior region is a safe region because less amount of major anatomical structures exist compared with other regions. However, because of narrow bucco-lingual width of alveolar ridge, it is challengeable to obtain esthetic implant prosthesis. Although patients are less sensitive subjectively, mandibular anterior region is as difficult as maxillary anterior region in that implant placement location plays a critical role on the prognosis of implant prosthesis. One-piece implant is a very useful option for mandibular anterior region. Considering the narrow roots and thin alveolar bone of mandible, it is clinically difficult for implant diameter to be greater than 3mm In this case, we could approach the esthetic restoration in mandibular anterior region with one-piece implant and immediate loading.

Evaluation of the course of the inferior alveolar canal in the mandibular ramus using cone beam computed tomography

  • Kwon, Kyung-Hwan;Sim, Kyu-Bong;Lee, Jae-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.4
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    • pp.231-239
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    • 2012
  • Objectives: This study sought to provide guidelines in order to decrease the incidence of nerve injury during mandibular ramus bone harvesting, and to improve understanding of the anatomical structure of the inferior alveolar canal (IAC) to include its distance from the exterior buccal cortex. Materials and Methods: In January and February 2009, 20 patients who visited the Wonkwang University Department of Oral and Maxillofacial Surgery reporting various conditions underwent cone beam computed tomography and were included in this study. Patients with missing left or right mandibular first molars or incisors, or who had jaw fracture or bone pathologies, were excluded. The reference point (R point) was defined as the point where the occlusal plane reached the anterior ramus of the mandible. The position of the IAC in relation to the R point, the buccal bone width (BW), the alveolar crest distance (ACD), the distance from the alveolar crest to the occlusal plane (COD), and the distance from the IAC to the sagittal plane (CS) were determined using proprietary image analysis software which produced cross-sectional coronal and axial images. Results: The distance medially from the R point to the IAC along the axial plane was $6.19{\pm}1.21mm$. The HD from the R point, posteriorly to IAC, in the lateral view was $13.07{\pm}2.45mm$, the VD from the R point was $14.24{\pm}2.41mm$, and the ND from the R point was $10.12{\pm}1.76mm$. The pathway of the IAC was positioned almost in a straight line along a sagittal plane within $0.56{\pm}0.70mm$. The distance from the buccal bone surface to the IAC increased anteriorly from the R point. Conclusion: Marking osteotomy lines in the retromolar area in procedures involving bone harvesting should be discouraged due to the risk of damage to IAC structures. Our measurements indicated that the area from the R point in the ramus of the mandible to 10 mm anterior can be safely harvested for bone grafting purposes.

The study on success rate of single implant replacing the mandibular first and second molars (하악 제1, 2대구치 단일 임플란트의 생존율에 관한 연구)

  • Jung, Taek-Gyun;Paeng, Joon-Young;Cho, Jin-Hyun;Lee, Sang-Han
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.252-260
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    • 2013
  • Purpose: After the introduction of concept of osteointegration, dental implantology have been successful procedure in the dental field. Recently, it has shown successful results when used to restore single tooth missing. Considering the difference in bone quality of the mandible and maxilla, and the increased occlusal force in the posterior region, the success rates in each region may be different. In this study, success rates of single implants placed in the mandibular first and second molar areas were analyzed. Materials and methods: The subjects were patients (284 patients, 308 implants) who had been operated with single implant installation from 2002 to 2009 in seven dental clinics in Daegu city. One hundred sixty eight implants were placed in the mandibular 1st molar and 140 implants were placed in the mandibular 2nd molar. They were analyzed according to implant site, age, sex, length and diameter. Results: The survival rates of single implant of this study were 97.6% in the mandibular 1st molar and 92.9% in the mandibular 2nd molar. In the mandibular 1st molar, 4 implants were failed. In the mandibular, 2nd molar, 10 implants were failed. Conclusion: The restoration of the mandibular 1st molar using single implant was found to be clinically acceptable treatment and showed higher survival rate than mandibular 2nd molar single implant. Single implant in mandibular 2nd molar needs careful consideration of poor bone quality, risk of overloading and anatomical structure of the mandible.

Protraction of mandibular molars through a severely atrophic edentulous space in a case of juvenile periodontitis

  • Wu, Jian-chao;Zheng, Yu-ting;Dai, Yi-jun
    • The korean journal of orthodontics
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    • v.50 no.2
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    • pp.145-154
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    • 2020
  • Moving the mandibular posterior teeth into a severely atrophic edentulous space is a challenge. A carefully designed force-and-moment system that results in bodily protraction of the posterior teeth with balanced bone resorption and apposition is needed in such cases. This report describes the treatment of a 19-year-old woman with missing mandibular first molars due to juvenile periodontitis. Miniscrews were used as absolute anchorage during protraction of the mandibular second and third molars. Bodily mesial movement of the mandibular second and third molars was achieved over a distance of 11 to 17 mm after 39 months of orthodontic treatment.

Mandibular Reconstruction using Simulation Surgery after Segmental Mandibulectomy

  • Hwang, Jong-Hyun;Kim, Ji-Wan;Ahn, Kang-Min
    • 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.