• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제17권4호
• /
• pp.429-437
• /
• 1995

Of all facial fractures in children, condylar fractures have the greatest propensity to produce a growth disturbance. This risk appears to be greatest when the injury is during the first 3 years of during adolescence. Yet, the ability of a child to undergo compensatory growth that decrease the effects of the injury is also the greatest. Fracture dislocation of the condyle in the preadolescent often results in excellent remodeling and function. Because of this factor and the higher risRs of avascular necrosis and ankylosis open reduction of a condylar fracture in a child is not widely recommended. This retrospective study analyzed mandibular condyle fractures in the children who admitted in dept. of Oral and Maxillofacial Surgery, Pusan paik hospital from 1984 to 1993 clinically and radiologically.

• 대한두개안면성형외과학회지
• /
• 제19권2호
• /
• pp.157-161
• /
• 2018

A sialocele is a subcutaneous cavity containing saliva, most often caused by facial trauma or iatrogenic complications. In subcondylar fractures, most surgeons are conscious of facial nerve injury; however, they usually pay little attention to the parotid duct injury. We report the case of a 41-year-old man with a sialocele, approximately $5{\times}3cm$ in size, which developed 1 week after subcondylar fracture reduction. The sialocele became progressively enlarged despite conservative management. Computed tomography showed a thin-walled cyst between the body and tail of the parotid gland. Fluid leakage outside the cyst was noted where the skin was thin. Sialography showed a cutting edge of the inferior interlobular major duct before forming the common major duct that seemed to be injured during the subcondylar fracture reduction process. We decided on prompt surgical treatment, and the sialocele was completely excised. A duct from the parotid tail, secreting salivary secretion into the cyst, was ligated. Botulinum toxin was administrated to block the salivary secretion and preventing recurrence. Treatment was successful. In addition, we found that parotid major ducts are enveloped by the deep lobe and extensive dissection during the subcondylar fracture reduction may cause parotid major duct injury.

• 대한치과기공학회지
• /
• 제42권2호
• /
• pp.129-137
• /
• 2020

Purpose: The aim of this study is to observe the compressive fracture strength of the crown according to the direction of the occlusal force of the mandibular canine and carnassial of the small dog. Methods: The abutment models of mandibular canine and carnassial were prepared, specimens of zirconia, PMMA and Ni-Cr alloy were produced. The experimental jig was fabricated with Co-Cr alloy and buried in acrylic resin after make tilt to specified angle. The specimen was attached to a jig and loaded using a universal testing machine until the specimen fractured. Results: The compressive fracture strengths of CXZ and CXP specimens were found to be 999.21 ± 31.15 N on average and 731.42 ± 59.13 N on average. And CZZ and CZP specimens were 730.48 ± 70.14 N on average and 377.65 ± 11.87 N on average. CXN and CZN specimens were not fractured. In addition, MZZ and MZP specimens were 746.46 ± 50.75 N and 258.64 ± 31.86 N on average. The MZN specimens were not fractured. Conclusion: Zirconia has compressive fracture strength that can be applied to small dog's canine and Carnassial prosthetics, while PMMA has inadequate strength to small dog's carnassial prosthesis.

• 대한두개안면성형외과학회지
• /
• 제22권2호
• /
• pp.105-109
• /
• 2021

The use of a fibula osteocutaneous flap is currently the mainstay of segmental mandibular reconstruction. This type of flap is used to treat tumors, trauma, or osteoradionecrosis of the mandible. However, a fibula osteocutaneous flap may also be a good option for reconstructing the mandible to preserve oropharyngeal function and facial appearance in cases of pathological fracture requiring extensive segmental bone resection. Chronic osteomyelitis is one of the various causes of subsequent pathologic mandibular fractures; however, it is rare, and there have been few reports using free flaps in osteomyelitis of the mandible. We share our experience with a 76-year-old patient who presented with a pathologic fracture following osteomyelitis of the mandible that was reconstructed using a fibula osteocutaneous flap after wide segmental resection.

• 대한두개안면성형외과학회지
• /
• 제21권6호
• /
• pp.384-386
• /
• 2020

This report describes osteotomy and iliac bone graft for malunion caused by failed mandibular fracture reduction. A 27-year-old man was referred 3 months after a motor vehicle accident. At another hospital, two operations had been performed for symphyseal fracture using two resorbable plates. Malocclusion was noted, and panoramic radiography and computed tomography revealed a misaligned dental arch, with a 9.37-mm gap between the central and the lateral incisor of the left mandible. A wafer was made from the patient's dental model, and a maxillary arch bar was applied. Through a lower gingivolabial incision, osteotomy was performed between the malunited symphyseal fracture segments. Both segments were reduced to their original position using the wafer and fixed with titanium miniplates via intermaxillary fixation (IMF). The intersegmental gap was filled with cancellous bone from the iliac crest. The gingival defect was covered with a mucosal transposition flap from the gingivolabial sulcus. IMF and the wafer were maintained for 5 and 9 weeks, respectively. At postoperative week 13, the screws were removed from the mandible and satisfactory occlusion was noted. His mouth opening improved from 2.5 to 3 finger breadths (40 mm). This case demonstrates the need for sufficient IMF when using resorbable plates.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제18권3호
• /
• pp.470-487
• /
• 1996

The purpose of this study was to investigate the dynamic response of the mandible to impact and provide insight into the fracture mechanism of the mandible, by 3-dimensional finite element method. The finite element model of the mandible was developed and calculated using NASTRAN/XL (MSC co. U.S.A.) and the linear dynamic transient analysis was performed according to the impulsive force direction, force type and impulse time to the mandible. At first, the load was applied on the mandibular symphysis, body, angle and subcondylar area in the horizontal mandibular plane and the computed stress-time histories at 14 locations of the mandible were obtained. Secondly, the impulsive force was directed to the symphyseal area with changing the force magnitude and impulse time, and calculated the node displacement at 8 locations of mandible. The conclusions from from this study were as follows. 1. The appearance of impulsive energy transmission was different to the direction of impulse to the mandible. 2. The impulsive stress and deformation were larger in lingual or medial side than buccal or lateral in the mandible. 3. The velocity, appearance of energy transmission and the fracture pattern in mandible were affected rather impulse time than force. 4. The horizontal impact to the one side of mandible did not have effect on the stress and displacement of contralateral mandible. From the above results, fracture pattern in symphysis can be showed as simple or comminuted, multiple or associated in body and angle and solitary in subcondyle area.

• Journal of Korean Dental Science
• /
• 제1권1호
• /
• pp.10-14
• /
• 2008

The fracture of facial bone usually accompanies alveolar bone fracture and dislocation or fracture of teeth. Thus, aside from the reduction of fracture, the reconstruction of occlusion through the rehabilitation of lost teeth should be considered. The dislocation of tooth after trauma accompanying alveolar bone fracture needs bone grafting in case of implant treatment. Although autogenous bone graft shows good prognosis, it has the disadvantage of requiring a secondary surgery. This is a case of a mandibular condyle head fracture accompanied by alveolar bone fracture. The condylar head fragment removed during open reduction was grafted to the alveolar bone fracture site, thereby foregoing the need for secondary surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제32권3호
• /
• pp.250-261
• /
• 2006

Diabetes mellitus, as a major health problem for the elderly, is associated with an extensive list of complications involving nearly every tissue in the body and has been shown to alter the properties of bone and impair fracture healing in both human and animals. The objective of this study was to examine the healing process of a mandibular fracture in the streptozotocin-induced rats histomorphometrically and histologically. A standardized fracture model was chosen and based on blood-glucose value at the time of surgery. A total of 11-weeks old 36 rats were divided into 2 groups; One is a streptozotocin-induced diabetic group and the other is a non-diabetic group. All was fractured experimentally. Three animals from each group were killed 1, 2, 4, 6, 8 and 12 weeks after fracture and specimens were processed undecalcified for quantitative bone histomorphometric and histologic studies. The diabetic group showed a significant decrease of histomorphometry-based parameter including trabecular bone volume, trabecular thickness in comparison to the non-diabetic rat. This was confirmed histologically. In conclusion, this study suggests that in streptozotocin-induced diabetics, the healing process of bone fracture was impaired and delayed about 2-3 weeks comparing to non-diabetics.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제14권4호
• /
• pp.283-294
• /
• 1992

Functional recovery associated with mouth opening after mandibular condyle fracture was a contradictory result of many authors. The treatment goal of condyle fracture has been not only the good reduction and fixation but also the rapid functional recovery with mouth opening capacity. The purpose of this study is to evaluate the mouth opening capacity after surgical or non-surgical treatment of condyle fracture according to the site, level, maxillomandibular fixation(MMF) and operation method based on 39 patents with condyle fracture who were admitted to the department of oral and maxillofacial surgery, Wonkwang University Hospital from May.1, 1990 to Aug.31, 1992. The results were as follows. 1. The most common fracture site was level IV (17 cases : 42.2%) and level I (14 cases : 36.8%), level II (5 cases: 13.2%) and level III(3 cases : 7.9%) were in decreasing order of frequency. Compound fracture with symphysis was more frequent (69.2%) than simple fracture(30.8%). 2. The mouth opening capacity was increased in the level I compared with level IV. 3. The mouth opening capacity was increased in the group of segment removal. 4. The mouth opening capacity was increased in the MMF period was decreased. 5. Better mouth opening capacity was recorded in the physical therapy group of more than 3-4 weeks of treatment period.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제41권6호
• /
• pp.306-316
• /
• 2015

Objectives: The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods: A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results: The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion: This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures.