• The Journal of the Korean dental association
• /
• v.57 no.2
• /
• pp.93-99
• /
• 2019

Ectodermal dysplasia is a genetic disorder in which various clinical manifestations involve two or more of the differentiated tissues of the ectoderm. Facial deformity, which is frequently associated with ectodermal dysplasia, appears in the form of cleft lip or cleft palate, especially in the middle facial area.Cleft and tooth defects result in decreased alveolar bone development.This leads to severe skeletal incongruity. Facial features include frontal protrusion, malar bone hypoplasia, flat nose, mandibular prominence and long lower facial height. This clinical report presents treatment including orthognathic surgery of a patient with Hypohidrotic Ectodermal dysplasia with cleft palate.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.25 no.2
• /
• pp.409-422
• /
• 1995

The purpose of this study was to investigate the effects of radiation on the formation of rat molar enamel at the developmental stage. The experimental animals were divided into five groups and were irradiated single dose of 396cGy ; 1 st group on 14th day of gestation, 2nd group on 19th day of gestation, 3rd group on 3 days after birth, 4th group on 8 days after birth, 5th group on 28 days after birth. The control and 1, 2, 3, and 4th experimental groups were sacrificed on 2, 4, and 6 weeks and the 5th groups were sacrificed on 1 day and 2 weeks after irradiation. Distal 1/2 and occlusal 1/3 enamel surface of lingual side of lingual cusp, and fractured surface of lingual side of lingual cusp in a longitudinal direction of the mandibular first molar were examined using scanning electron microscope. The following results were obtained. 1. The roughness of enamel surface and enamel hypoplasia were increased in a sequence of 4th, 1st, 2nd, and 3rd experimental group, and the enamel cracks were increased in the 1st and 2nd experimental group. 2. The pattern of enamel hypoplasia had a network form on the 1st and 2nd experimental group, and appeared a linear shape on the 3rd experimental group, and then the crator-like enamel defects were observed in all experimental groups (especially 1st and 2nd experimental group) except 5th. 3. Dentinoenamel junction showed the clear-cut and straight appearance except 5th experimental group. 4. There was no significant difference between 5th experimental and control group.

• Korean Journal of Cleft Lip And Palate
• /
• v.8 no.2
• /
• pp.71-79
• /
• 2005

Purpose: Maxillary hypoplasia is a common developmental problem of cleft lip and palate. Fair results with distraction osteogenesis have been reported especially when these patients need a large amount of maxillary advancement, instead of orthognathic surgery. The purpose of this study is to evaluate the clinical results with a relatively new distractor, $TS-MD^{(R)}$ (Trans-sinusoidal maxillary distractor, KLS Martin, Tuttlingen, Germany) which was used for the advancement of the maxilla in the cleft patients. Patients and Method: Distraction osteogenesis using $TS-MD^{(R)}$ was performed for four CLP patients (three males and one female) who had maxillary hypoplasia. All patients were over 16 years old. As three patients showed mandibular prognathism as well, bilateral sagittal split ramus osteotomy for mandibular setback was performed at the same time. After consolidation periods of 4 to 12 weeks, the distraction devices were removed and miniplates were placed for simultaneous internal fixation. Results: Three patients showed a large amount of incisal overbite but one patient did not have sufficient maxillary advancement. Le Fort I osteotomy, maxillary advancement and internal fixation should have been performed for the patient when removing the distraction devices. Different from the $clinician{\box}s$ expectation, the amount of maxillary advancement using $TS-MD^{(R)}$ was not sufficient, although the device has rigid mechanical property. Rotation of maxilla during distraction forward and downward was also observed. Conclusion: Even though the maxillary advancement with $TS-MD^{(R)}$ device could be achieved, the clinical control of some characteristics related with the device was necessary. More clinical studies on $TS-MD^{(R)}$ should be performed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.33 no.5
• /
• pp.559-566
• /
• 2007

Distraction osteogenesis(DO) is a surgical method of bone formation that involves an osteotomy and sequential stretching of the healing callus by gradual movement and subsequent remodeling. DO is used to correct facial asymmetry, such as in patients with hemifacial microsomia, maxillary or mandibular retrusion, cleft lip and palate, alveolar defects, and craniofacial deficiency. It is accomplished with the aid of a distraction device, which is secured with screws placed directly into bone, for a predetermined length of time. Hemifacial microsomia is characterized by unilateral facial hypoplasia, often with unilateral shortening of the mandible and subsequent malocclusion. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, tilted occlusal plane, and short mandible. Early treatment is necessary to avoid subsequent impaired midfacial growth. The standard treatment of these malformations consists of the application of bone grafts, which can lead to unpredictable growth. The new bone-lengthening procedure represents a limited surgical intervention and opens up a new perspective for treatment, especially in younger children with severe deformities. This report describes a case of hemifacial microsomia(Type-II left-sided hemifacial microsomia). The patient, a 10-year-old child, visited our clinic for facial asymmetry correction. He had a hypoplastic mandible, displaced ear lobe, 10 mm canting on the right side, and malocclusion. We planned DO to lengthen the left mandible in conjunction with a Le Fort I osteotomy for decanting and then perform a right intraoral vertical ramus osteotomy(IVRO). Progressive distraction at a rate of 0.5 mm/12 hours was initiated 7 days postoperatively. The duration of DO was 17 days. The consolidation period was 3 months. Satisfactory results were obtained in our case, indicating that DO can be used successfully for functional, aesthetic reconstruction of the mandible. We report a case involving DO in conjunction with orthognathic surgery for correcting mandibular hypoplasia with a review of the literature.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.31 no.2
• /
• pp.262-266
• /
• 2004

The parathyroid hormone plays a major role in the metabolism of calcium and phosphorus. In hypoparathyroidism the parathyroid glands are atrophied or absent associated with autoantibodies against parathyroid tissue. Pseudohypoparathyroidism is a metabolic disease caused by the disturbance in peripheral action of parathormone, but parathormone level is normal. In general, patients with pseudohypoparathyroidism have short stature, round face, brachydactylia, obesity, mental retardation, cataracts & ectopic calcifications on soft tissues. Dental manifestations are enamel hypoplasia, delayed eruption, blunting of root apex, hypodontia, pulp calcification, thickened lamina dura, excessive caries & malocclusion. In this case, intraoral examination showed enamel hypoplasia on the erupted permanent teeth & hypermobility on the remaining deciduous teeth. From the radiographic view severe dental anomalies were observed on canines and shortening and blunting of root apex was observed on mandibular incisors. Pathologic root resorption was also observed on deciduous teeth.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.11 no.1
• /
• pp.5-8
• /
• 2015

Neuroblastoma is a common malignant tumor of the sympathetic nervous system in childhood, arises from embryonic neural crest cells. The period of tooth development is matched with peak times of diagnosis and treatment of neuroblastoma. The intensive multimodality treatment including radiotherapy and chemotherapy is used in patients with neuroblastoma has been shown to have late adverse effects and disturbances in dental development like tooth agenesis, microdontia, enamel hypoplasia and short roots. A 8-year old girl had been on medication and radiotherapy for neuroblastoma since she was 15 months old at Department Pediatrics, Chonnam National University Hospital. Oligodontia, microdontia, and short root formation was notable in clinical and radiological examination. Mobility of lower permanent incisor was detected and measured at about degree 2. Resin wire splint using mini-screw implantation on buccal alveolar bone was conducted for maintenance of mandibular incisors and alveolar bone. Excessive mobility has been eliminated and maintained well so far. Further treatment is planned for re-evaluation of mobility, preventing dental caries and regular oral hygiene management. Although we need further evaluation, this treatment could be one of alternative therapy for those who have similar dental anomalies.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.34 no.2
• /
• pp.335-340
• /
• 2007

Primary teeth and the permanent successor must be understood as interdependent units, where each one of them interacts with and depends upon the other. The spread of pulpal inflammation in primary teeth to the periradicular tissues can lead to early eruption, enamel hypoplasia or hypocalcification, developmental arrest of permanent successor. Also the periapical inflammation cause permanent tooth displacement in various direction. We describe here two clinical cases of displaced permanent successor caused by periapical lesion of mandibular primary molar in children.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.1
• /
• pp.1-4
• /
• 2000

True midfacial deficiency is defined as a hypoplasia of various components of midface such as maxilla, orbit, zygoma and nasal bone. For treatment of these anomalies Le Fort III osteotomy and its modifications have been used traditionally. Le Fort III osteotomy is the method which advances maxilla with nasal bone and zygomatic bone at a time. At first midfacial osteotomy was introduced by Gillies to treatment of dentofacial deformity in 1950. In 1967 Tessier designed Le Fort III osteotomy according to Le Fort III midfacial fracture line and popularized to treat midfacial deficiency using coronal incision to appoach osteotomy sites. This is a case of patient who had mandibular prognathism with midfacial deficiency with severe discrepancy in maxillomandibular interrelation. First we performed Le Fort III osteomomy for zygomaticomaxillary advancement, and then carried out simultaneous two jaw surgery with Le Fort I osteotomy and BSSRO three months after first surgery.

• The korean journal of orthodontics
• /
• v.49 no.1
• /
• pp.59-69
• /
• 2019

In this report, we describe a case involving a 34-year-old woman who showed good treatment outcomes with long-term stability after multidisciplinary treatment for unilateral cleft lip and palate (CLP), maxillary hypoplasia, severe maxillary arch constriction, severe occlusal collapse, and gingival recession. A comprehensive treatment approach was developed with maximum consideration of strong scar constriction and gingival recession; it included minimum maxillary arch expansion, maxillary advancement by distraction osteogenesis using an internal distraction device, and mandibular setback using sagittal split ramus osteotomy. Her post-treatment records demonstrated a balanced facial profile and occlusion with improved facial symmetry. The patient's profile was dramatically improved, with reduced upper lip retrusion and lower lip protrusion as a result of the maxillary advancement and mandibular setback, respectively. Although gingival recession showed a slight increase, tooth mobility was within the normal physiological range. No tooth hyperesthesia was observed after treatment. There was negligible osseous relapse, and the occlusion remained stable after 5 years of post-treatment retention. Our findings suggest that such multidisciplinary approaches for the treatment of CLP with gingival recession and occlusal collapse help in improving occlusion and facial esthetics without the need for prostheses such as dental implants or bridges; in addition, the results show long-term post-treatment stability.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.12 no.2
• /
• pp.69-81
• /
• 1990

Classification of facial asymmetry has not been yet well-organized because of their variety on etiologic factors, involved sites and clinical expressions. And surgical treatments are also variable and depend upon their causes and clinical abnormalities. This is a case report on surgical experiences of two patients who had severe facial asymmetry and could not treated pre-surgical orthodontics before surgery. One patient was belong to hemifacial microsomia and another was a very unusual complex type related to unilateral condylar hyperplasia, unilateral macrognathia and unilateral mandibular hypoplasia. The authors used a simultaneous two-jaw surgery, bone shaving and onlay-type bone graft in former case, and a simultaneous two-jaw surgery, condylectomy, bone shaving and only-type bone graft in latter case. In two cases, immediate post-operative results in function and esthetics were excellent, however, progressive resorption of onlay-type bone grafts have been noticed.