• Title/Summary/Keyword: Mandibular fracture

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Orthognathic surgery with removal of lipoma in the asymmetric mandibular prognathism of a patient with a mandibular bone defect due to intramuscular lipoma on the medial aspect of the ramus: a case report

  • Yoon Ju Nam;Min Seong Kang;Jung Han Lee;Bok Joo Kim;Jung Han Kim;Chul Hoon Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.4
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    • pp.235-240
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    • 2024
  • Lipomas, the most common soft-tissue mesenchymal neoplasms in adults, are characterized by the proliferation of mature white adipocytes without cytologic atypia. Lipomas are rarely observed in the head and neck region. We present a case of resection and orthognathic surgical removal of an intramuscular lipoma of the mandible with involvement of the mandibular ramus and condylar head and neck. An 18-year-old female patient was referred to our hospital for orthognathic surgery for the management of facial asymmetry and mandibular prognathism. The patient did not present with facial swelling, pain, or temporomandibular dysfunction; however, on radiographic examination, including cone-beam computed tomography and magnetic resonance imaging, an infiltrative fatty lesion was observed in the masticator space inside the right mandible, and the adjacent mandible exhibited bone thinning and deformity. Resection of the lipoma was performed along with orthognathic surgery, including a Le Fort I osteotomy for the maxilla and bilateral sagittal split ramus osteotomy (BSSRO). In this case, because the ramus was split using BSSRO, accessing the lipoma intraorally was easy. Consequently, aesthetic scarring was avoided, and no complications, such as unfavorable splitting or pathologic fracture, occurred. Although recurrence has not been observed about 1 year, long-term follow-up should be performed.

TREATMENT OF MANDIBLE FRACTURES USING BIOABSORBABLE PLATES: PRELIMINARY STUDY (생흡수성판을 이용한 하악골 골절의 치료 : 일차보고)

  • Kim, Young-Kyun;Kim, Su-Gwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.6
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    • pp.570-575
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    • 2001
  • This study evaluated the short-term outcome of treating fractures of the mandible with bioabsorbable plates. Thirty-four fractures of the mandible in 27 patients were treated by open reduction and internal fixation using bioabsorbable plates and 2.4-mm, 2.0-mm, and 1.5-mm pre-tapped screws. The duration of intermaxillary fixation ranged from 0 to 23 days, with a mean of 5.3 days. Patients were evaluated for complications during the follow-up period, which ranged from 2 to 18 months. Five patients(18.5%) experienced complications. These included infection (four patients), and premature occlusal contact(one patient). Except for one case, all complications were minor and adequately managed with incision and drainage, elastic traction, and medication. Delayed infection (osteomyelitis) developed in a symphysis fracture and was treated by saucerization and antibiotics. The fracture line subsequently showed complete consolidation. Bioabsorbable plates can be selectively used for internal fixation in mandibular fractures with the advantage that they do not need to be removed.

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Treatment of pathologic fracture following postoperative radiation therapy: clinical study

  • Kim, Chul-Man;Park, Min-Hyeog;Yun, Seong-Won;Kim, Jin-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.31.1-31.5
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    • 2015
  • Background: Pathologic fractures are caused by diseases that lead to weakness of the bone structure. This process sometimes occurs owing to bony change after radiation therapy. Treatment of pathologic fractures may be difficult because of previous radiation therapy. Methods: In this study, we analyzed clinical and radiographic data and progress of five patients with mandibular pathological fractures who had received postoperative radiation therapy following cancer surgery. Result: Patients received an average radiation dose of 59.2 (SD, 7.2) Gy. Four of five patients exhibited bone union regardless of whether open reduction and internal fixation (OR/IF) was performed. Patients have the potential to heal after postoperative radiation therapy. Treatment of a pathologic fracture following postoperative radiation therapy, such as traditional treatment for other types of fractures, may be performed using OR/IF or CR. OR/IF may be selected in cases of significant bone deviation, small remaining bone volume, or occlusive change. Conclusion: Patients have the potential to heal after postoperative radiation therapy.

COMPLICATIONS ASSOCIATED WITH DENTAL IMPLANT SURGERY; CASE REPORT (임플란트 수술 시의 합병증; 증례 보고)

  • Lee, Hyun-Jin;Yeo, Duck-Sung;Lim, So-Yeon;An, Kyung-Mi;Sohn, Dong-Seok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.173-180
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    • 2007
  • According to the increase in use of implants in clinical dentistry, new kinds of complications happen. Complications that can happen during implant placement are bleeding, nerve injury, jaw fracture, fenestration of maxillary sinus or nasal cavity, dehiscence, fenestration, injury of adjacent tooth. And complications that can happen after implant operation are infection, bleeding, hematoma, chronic sinusitis, peri-implantitis. Problems that are confronted during implant placement happen by inadequate preoperative treatment plan, inadequate consideration about individual anatomic difference, inadequate operation process and lack of experience of clinician. It is important that clinicians consider possible complications in advance and make a comprehensive treatment plan. We report the patient who was happened ramus fracture during block bone harvesting from ramus of severely atrophic mandible, the patient who came to emergency ward due to postoperative swelling and bleeding and the patient whose implant was migrated to maxillary sinus with a review of literature.

A Clinical Review on the Transoral Approach to the Fractures of The Mandible (구내 접근법에 의한 하악골 골절 치료에 대한 임상적 고찰)

  • Park, Hyung-Sik;Kwon, Jun-Ho;Chung, Seong-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.79-86
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    • 1989
  • The is a retrospective study on the transoral approach to open reduction of the Mandibular fractures. Our study was based on a series of 64 patients with mandibular fractures among 99 patients of facial bone fractures who had been treated by transoral approach with or without extraoral approach at Department of Oral and Maxillofacial Surgery, Yonsei Medical Center, Yonsei University from January 1981 to October 1988. We studied favorite sites of open reduction, fixation methods, results and prognosis related to transoral approaches of Mandibular fractures, and which compared with extraoral approaches. The results obtained are as follows : 1. The transoral open reduction was used more frequently in Mandibular fractures(64.6%) than Midfacial bone fractures(35.4%). Among 64 patients of mandibular fractures, 47 patients(73.4%) were treated only by transoral approach and others(26.6%) were treated by both trans- and extra-oral approach. Among 92 sites of mandibular fractures, 75 sites(81.5%) were treated by transoral approach and 17(18.5%) were treated by extraoral approach. 2. The most favorite site for transoral approach compared with extraoral approach was Symphysis(100%), and Angle(62.5%) was next in order of frequency on Mandibular fractures. 3. Direct Interosseous Wiring(DIW) was most commonly used for fixation(64.6%) and Miniplate osteosynthesis was used next in 28.1%. 4. Simple(39.1%) and Compound(52.2%) fractures were frequently indicated for transoral approach, however comminuted fractures were rarely indicated. 5. The direction of fracture lines on Angle of the mandible did not influence to determine whether transoral approach should be selected or not. However this area seemed to be more difficult to reduce exactly by transoral procedure than other areas because simultaneous superior and inferior fixation was applied predominantly on this area. 6. The success rate of reduction and fixation analyzed from us was more excellent in Direct Interosseous Wiring(29/53=54.7%) than in Rigid Internal Fixation(9/29=31.0%). But it might be depended upon various factors as like as sugeon's skill. 7. The postoperative complication due to transoral open reduction of mandible was not high(12.0%) and this rate was similar with other published reports.

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Survival analysis of dental implants in maxillary and mandibular molar regions; A 4$\sim$5 year report ($\cdot$하악 대구치 부위에 식립된 임플란트의 생존율에 대한 후향적 연구)

  • Jang, Jin-Wha;Ryoo, Gyeong-Ho;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.37 no.2
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    • pp.165-180
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    • 2007
  • Dental Implants have been proved to be successful prosthetic modality in edentulous patients for 10 years. However, there are few reports on the survival of implant according to location in molar regions. The purpose of this study was to evaluate the $4{\sim}5$ years' cumulative survival rate and the cause of failure of dental implants in different locations for maxillary and mandibular molars. Among the implants placed in molar regions in Gwangju Mir Dental Hospital from Jan. 2001 to Jun. 2002, 473 implants from 166 patients(age range; $26{\sim}75$) were followed and evaluated retrospectively for the causes of failure. We included 417 implants in 126 periodontally compromised patients, 56 implants in 40 periodontal healthy patients, and 205 maxillary and 268 mandibular molar implants. Implant survival rates by various subject factors, surgical factors, fixture factors, and prosthetic factors at each location were compared using Chi-square test and Kaplan-Meier cumulative survival analysis was done for follow-up(FU) periods. The overall failure rate at 5 years was 1O.2%(subject level) and 5.5%(implant level). The overall survival rates of implants during the FU periods were 94.5% with 91.3% in maxillary first molar, 91.1% in maxillary second molar, 99.2% in mandibular first molar and 94,8% in mandibular second molar regions. The survival rates differed significantly between both jaws and among different implant locations(p<0.05), whereas the survival rates of functionally loaded implants were similar in different locations. The survival rates were not different according to gender, age, previous periodontal status, surgery stage, bone graft type, or the prosthetic type. The overall survival rate was low in dental implant of too wide diameter(${\geq}5.75$ mm) and the survival rate was significantly lower for wider implant diameter(p

Comparison of fatigue fracture strength by fixture diameter of mini implants (미니 임플란트 직경에 따른 피로파절강도의 비교 연구)

  • Heo, Yu-Ri;Son, Mee-Kyoung;Kim, Hee-Jung;Choe, Han-Cheol;Chung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.3
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    • pp.156-161
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    • 2012
  • Purpose: This study was conducted to obtain difference in fracture strength according to the diameter of one-body O-ring-type of mini implant fixture, to determine the resistance of mini implant to masticatory pressure, and to examine whether overdenture using O-ring type mini implant is clinically usable to maxillary and mandibular edentulous patients. Materials and methods: For this study, 13 mm long one body O-ring-type mini implants of different diameters (2.0 mm, 2.5 mm and 3.0 mm) (Dentis, Daegu, Korea) were prepared, 5 for each diameter. The sample was placed at $30^{\circ}$ from the horizontal surface on the universal testing machine, and off-axis loading was applied until permanent deformation occurred and the load was taken as maximum compressive strength. The mean value of the 5 samples was calculated, and the compressive strength of implant fixture was compared according to diameter. In addition, we prepared 3 samples for each diameter, and applied loading equal to 80%, 60% and 40% of the compressive strength until fracture occurred. Then, we measured the cycle number on fracture and analyzed fatigue fracture for each diameter. Additionally, we measured the cycle number on fracture that occurred when a load of 43 N, which is the average masticatory force of complete denture, was applied. The difference on compressive strength between each group was tested statistically using one-way ANOVA test. Results: Compressive strength according to the diameter of mini implant was $101.5{\pm}14.6N$, $149{\pm}6.1N$ and $276.0{\pm}13.4N$, respectively, for diameters 2.0 mm, 2.5 mm and 3.0 mm. In the results of fatigue fracture test at 43 N, fracture did not occur until $2{\times}10^6$ cycles at diameter 2.0 mm, and until $5{\times}10^6$ cycles at 2.5 mm and 3.0 mm. Conclusion: Compressive strength increased significantly with increasing diameter of mini implant. In the results of fatigue fracture test conducted under the average masticatory force of complete denture, fracture did not occur at any of the three diameters. All of the three diameters are usable for supporting overdenture in maxillary and mandibular edentulous patients, but considering that the highest masticatory force of complete denture is 157 N, caution should be used in case diameter 2.0 mm or 2.5 mm is used.

Successful Surgical Treatment of Severe Lower Lip Avulsion in Two Cats

  • Jang, Kwangsik;Chae, Yangwon;Yang, Euisin;Jo, Hyun Min;Shim, Kyung Mi;Bae, Chunsik;Kang, Seong Soo;Kim, Se Eun
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.264-271
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    • 2022
  • Two Korean short-haired cats were admitted to the Veterinary Medical Teaching Hospital, Chonnam National University, with severe lower lip avulsion. In the first case, the treatment was performed using the tension-free suture technique with rubber tube stents. The second case was treated using the tension-free suture technique with rubber tube stents for lip avulsion and using the cerclage wiring technique for alveolar fracture. The teeth around the alveolar fracture were extracted and bone graft and collagen membrane were applied at the alveolar fracture site to stabilize the mandibular alveolar fracture. Thereafter, the cerclage wire was placed circumferentially around the mandible. In both cases, normal function of the oral cavity was successfully recovered by repairing the anatomic abnormality. In conclusion, tension-free suture technique can be a treatment option for bilateral lower lip avulsion in cats.

ANTIBIOTIC PROPHYLAXIS IN THE OPERATION OF THE CLOSED MANDIBULAR FRACTURES AND THE EFFICACY OF POSTOPERATIVE ANTIBIOTICS (하악골 골절에 대한 수술 시 예방적 항생제 사용과 술후 항생제 투여의 효율성)

  • Kang, Sang-Hoon;Choi, Young-Su;Byun, In-Young;Kim, Moon-Key
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.1
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    • pp.31-34
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    • 2009
  • Purpose: This study compared the frequency of postoperative infections in patients for a closed mandibular fracture with that without the postoperative antibiotic prophylaxis. Patients and Methods: 48 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The 24 patients in group 1 received only a second-generation cephalosporin ($Cefotetan^{(R)}$) intravenously from admission to immediate after the surgery. Likewise, 24 patients in group 2 received 1.0g of $Cefotetan^{(R)}$ twice daily longer than the third day after surgery. The mean (SD) duration of antibiotics administration after surgery was 6.9 (${\pm}3.56$). The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. Results: Postoperative infections were encountered in 2 out of 24 patients in group 1, who received antibiotic medication until shortly after surgery, and in 3 out of the 24 patients in group 2, in whom the medication was continued even after the surgery. There was no sig nificant difference in the incidence of postoperative infections between the two groups. Conclusion: From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

A CLINICAL STUDY ON THE CONDYLRAR FRACTURES OF MANDIBLE (하악과두 골절에 대한 임상적 연구)

  • Yeo, Hwan-Ho;Yoon, Chang-Lyuk;Hwang, Ho-Keel;Lee, Hyo-Bin;Son, Bo-Hyung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.4
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    • pp.295-304
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    • 1992
  • The author investigated the 162 patients with the condylar fractres of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Hospital of Chosun Dental School from January 1985 to September 1992 clinically, including fracture incidennce, age and sex of the patients, causes of injures, associated injures, treatments and complications and obtained the following results. 1. Of the 449 patients with mandibular fractures, 162patients suffered condylar fractures(36.1%). 2. Of the 162 patients, males with condylar fractures were 128 patients, by a ratio of 3.8 : 1. 3. The most frequently affected age group was the third decade(32.7%). 4. Falls were ranked as the predominant cause(50.6%), followed by traffic accident(27.8%) and violence (16.0%). 5. The incidence of single condylar fractures was 28% and symphysis fractures were the most commomest of the concomittant injuries(60%). 6. The subcondylar fractures occurred most frequently(41.6%) and anteromedial displacement of the condylar fragments occurred most frequently(45.4%) 7. Of the all condylar fracture patients, children under 15 of age comprized 31 patients(19.1%) and condylar head fractures occurred most frequently at those children. 8. Of the managetments in condylar fractures, open reduction was 52.5% and remainder were closed reduction(47.5%). 9. Complications ensured such as TMJ ankylosis, limitation of mouth opening and mandibular movements, TMJ dysfunction, and anterior open bite.

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