• Title/Summary/Keyword: Mandibular position

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THE SHORT-TERM REMOVABLE INTERMAXILLARY FIXATION CARE BY USE OF AN ADDITIVE INCISION & DRAINAGE ON THE ORAL LACERATION WOUNDS ADJACENT WITH MANDIBULAR COMPOUND FRACTURES: REPORT OF A CASE (하악골 복합 골절시 구내 열창부 상에 추가 절개 배농술을 이용한 단기간 가변적 악간고정 관리: 증례보고)

  • Mo, Dong-Yub;Yoo, Jae-Ha;Choi, Byung-Ho;Kim, Ha-Rang;Lee, Chun-Ui;Ryu, Mi-Heon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.3
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    • pp.260-264
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    • 2010
  • Treatment of the mandibular fracture consists of reduction and fixation. The apparatus that is used to keep the jaws together during healing will often reduce the fracture as well. When the jaws are brought together and intermaxillary elastic rubber traction is placed, the occlusion of the teeth will help to orient the fractured parts into good position. Intermaxillary fixation, that is, fixation obtained by elastic bands between the upper & lower jaws to which suitable anchoring devices have been attached, will successfully treat most fractures of the mandible. Arch bars are perhaps the ideal method for intermaxillary fixation. Several types of ready-made arch bars are used. But, daily occupational life and oral hygiene is difficult to maintain during the period of longterm immobilized intermaxillary fixation (commonly 6-8 weeks), owing to malnutrition and emotional disorders in a position of the patient with mandibular fractures. Most mandibular fractures heal well enough to allow removal of fixation in about 6 weeks. Though there are many complications of mandibular fracture, such as infection, hemorrhage, trismus, paresthesia and nonunion, it is favorable to attain the short-term removable intermaxillary fixation care by use of an additive incision & drainage establishment on the oral lacerated wounds of adjacent mandibular compound fractures. The purpose of an additive incision & drainge establishment is the prevention of wound infection & nonunion by removing the hematoma & seroma in the fracture sites.

A STUDY ON THE MANDIBULAR MOMENTS ACCORDING TO ANTERO-POSTERIOR PLACEMENT OF PIVOT ON LOWER NATURAL DENTITION (자연치열에 설치한 pivot의 전후방 일치변화에 따른 하악의 moment에 관한 연구)

  • Lee Hyun-Shick;Park Nam-Soo;Choi Dae-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.31 no.3
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    • pp.394-410
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    • 1993
  • This study was accomplished for appreciation of the mandibular moments according to antero- posterior movement of pivot placed on the lower natural dentition. For this study, 20 subjects(male, $21\sim30$ yrs., average age 24) in the category of normal occlusion were selected, and the intraoral Vitallium clutches were cast and fabricated for each subjects. A 2-dimension PSD(Position Sensitive Detector, Hamamatsu Photonics Co., Japan) was attached to maxillary clutch in a mode of three dimensional control and LED (Light Emit Diode, Hamamatsu Photonics Co., Japan) was set up on mandibular clutch. Both clutches were set into oral cavity of each subjects and adjusted. Then the subjects were allowed to intercuspated with maximal bite force while the pivoting ball in the mid-line moving from anterior toward posterior position. The displacement scales were recorded by CCD camera(Sony, CCD-TR-705) and VCR, The conclusions were as follows : 1. When the subject was allowed to bite the metal pivoting ball in the midline of lower dentition with maximal bite force voluntarily while moving from lower central incisor to canine, 1st premolar, End premolar, 1st molar and 2nd molar. The lever actions on the pivot were revealed in all subjects. The equilibrium of moment were revealed on the pivots of 1st premolar(14 subjects), End premolar(4 subjects), and canine(2 subjects) areas. 2. The changes of loading on the TMJ according to antero-posterior positional changes of metal pivoting ball were able to recognize as follow. Compression on the TMJ was increased when the pivot moves anteriorly from the equilibrium point, and tension on the TMJ was increased when posteriorly. 3. 13 subjects were recognized their habitual chewing sides(Rights, Left8), and 7 subjects were not. During maximal biting, mandible was displaced toward their habitual chewing sides on the metal pivoting ball in the frontal plane. 4. In cephalometric analysis, the average genial angle of 20 subjects was $116.75^{\circ}$ and the average mandibular body length was 79.77mm. The equilibrium points of mandibular moment were positioned more posteriorly in the subjects having larger Genial angle than in the smaller(p<0.05). Relationships among the angle between FH plane and occlusal plane, the angle between occlusal plane and mandibular plane , and mandibular body length were not significant(p>0.05).

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EFFICACY OF ENaP(ESTHETIC NaP)-LINE FOR ORTHOGNATHIC SURGERY OF KOREAN MANDIBULAR PROGNATHISM (한국인 하악골 전돌증 환자의 악교정수술을 위한 ENaP(Esthetic NaP)선의 유효성에 관한 연구)

  • Kim, Jong-Kook;Park, Hyung-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.5
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    • pp.372-382
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    • 2002
  • As the most of dentofacial deformity patients indicated to orthognathic surgery have strong desire for esthetic improvement as well as functional improvement, ideal esthetic evaluation should be made at surgical prediction. Lateral cephalographs has been commonly used for surgical prediction, however, remarkable discrepancy between esthetic viewpoint by simple looking and analysis on lateral cephalographs often found on evaluation of sagittal position of the upper and lower jaws especially in cases of mandibular prognathism of Koreans. In these cases, we have been employed Esthetic NaP(ENaP)-line for corrective evaluation and ideal surgical prediction on lateral cephalographs, but the efficacy of ENaP-line has not been evaluated. This is a study on efficacy of ENaP-line for orthognathic surgery of Korean mandibular prognathism. 170 Korean patients who had been diagnosed as mandibular prognathism and planned for orthognathic surgery at Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University during last 10 years are studied. The obtained results are as followings; among 170 patients of mandibular prognathism, 132 patients(77.6%) had not discrepancy in evaluation of sagittal position of the maxilla between cephalometric and esthetic evaluation(they are classified as Group I), however, 38 patients(22.4%) had definite discrepancy(they are classified as Group II). ENaP-line was employed in all cephalometric analysis of Group II. The proportions of male and female were similar in both Groups. Sixteen vertical reference lines perpendicular to 16 horizontal reference lines were obtained as followings; Each of the representative degree of ${\angle}SN/AFH$, ${\angle}SN/CFH$ and ${\angle}AFH/CFH$ obtained at Group I was applied to SN plane, AFH plane and CFH plane of Group II each other, and so 16 horizontal reference lines could be obtained individually according to each of the applied degree to each plane. And then their reliability to coincide with ENaP-line of Group II was evaluated. A vertical reference line perpendicular to a horizontal line made by application of the representative degree of ${\angle}$AFH/CFH in Group I to AFH line in Group II had the most highest coincidence with ENaP-line of Group II, however, its agreement was 42% in male and 47% in female. From this results, the rest of them should be determined their corrective jaw position definitely depend on

Evaluation of craniofacial growth prediction method on Class III malocclusion patients (골격성 III급 부정교합자의 두개안모 성장예측에 대한 평가)

  • Son, Woo-Sung;Kang, Eun-Hee;Jung, Mi-Ra;Sung, Ji-Hyun
    • The korean journal of orthodontics
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    • v.33 no.1 s.96
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    • pp.31-39
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    • 2003
  • This study was performed to evaluate whether growth Prediction method can be used to diagnose and make treatment plan in skeletal Class III malocclusion patients or not. The sample was consisted of 25 patients(13 males, 12 females) who had been diagnosed with skeletal Class III malocclusion at first visit and after that had returned to take ortognathic surgery. Growth prediction performed with Ricketts' growth prediction method from first cephaogram. was compared with actual growth of the second cephalogram. The findings of this study were as follows ; 1. There was significant difference between actual growth and growth prediction in Porion Location, Ramus Position, Facial Depth, Facial Axis, Mandibular Plane angle, Maxillary Convexity. So, for these items Ricketts' growth prediction method is not proper to predict growth. 2. Although the growth amount of mandibular body was similar to normal growth amount, mandible was positioned anteriorly because of Porion Location and Ramus Position. 3. In skeletal Class III malocclusion patients, the tendency of mandibular prognathism might be aggreviated because of anterior placement of ramus and anterosuperior rotation of Pogonion.

Full mouth rehabilitation in partially edentulous patient with an unstable mandibular position (불안정한 하악위를 가진 부분 무치악 환자에서 전악 수복 증례)

  • Donghwi Yook;Younghoo Lee;Seoung-Jin Hong;Ahran Pae;Kwantae Noh;Hyeong-Seob Kim;Kung-Rock Kwon;Janghyun Paek
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.308-315
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    • 2023
  • In the case of a patients who have lost the centric stop and have a staggered occlusion of the residual teeth, various movements occur when the denture is loaded. Implant placement is necessary to reinforce the retention, support, and stabilization elements to reduce denture movement. However, in this case, considering the patient's age, aversion to surgery, and bone loss, implants were not placed and restoration was performed with a removable partial denture. In this case, it is important to set the correct mandibular position for restoration because the patient has a habit of chewing with the remaining teeth. In this case, a stable mandibular position was established using a gothic arch tracing, and good results were obtained by restoring with partial dentures, so this is reported.

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

  • Ahn, Byoung-Keun;Rhee, Gun-Ju;Han, Ho-Jin;Park, Hyoung-Tae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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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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Mandibular Posterior Rehabilitation Case after Occlusal Plane Correction using Micro-Implant Anchorage (Micro-Implant를 이용한 교정치료로 교합평면 개선 후 하악 구치부 수복증례)

  • Park, Ju-Mi
    • Journal of Dental Rehabilitation and Applied Science
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    • v.20 no.2
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    • pp.143-150
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    • 2004
  • Endosseous implants have been used to provide anchorage control in orthodontic treatment without the need for special patient cooperation. However these implants have limitation like space requirement, cost, equipments. Recently titanium micro-implant for orthodontic anchorage was introduced. Micro-implants are small enough to place in any area of the alveolar bone, easy to implant and remove, and inexpensive. In addition, orthodontic force application can begin almost immediately after implantation. The mandibular first, maxillary first, mandibula second, and maxillary second molars were the four most commonly missing teeth in adult sample. In case of posterior molar teeth missing, deflective contacts in any position, over time, has produced pathologic change of occlusal scheme because of extrusion of opposing teeth. This case had interocclusal space deficiency by mandibular right molars missing over time. The micro-implants had been used for intrusion of maxillary right molars for interocclusal space. The micro-implant would be absolute anchorage for orthodontic movement. Therefore, the micro-implant would be effective method for correction of occlusal plane.

A CASE REPORT OF REMOVAL OF FOREIGN BODY AND REDUCTION OF CONDYLE FRACTURE, SEQUELAE OF GUN SHOT WOUND. (안면부 총상으로 인한 하악과두 골절 환자의 치험 예)

  • Kim, Hyoun-Tae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.1
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    • pp.55-59
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    • 1995
  • Today, with the development of modern civilization, the change of industrial structure and the increase of traffic volume and population make the number of maxillofacial injury patients also increase. Especially, the fracture possibilities of mandibular condyle have been increased because of mandibular position and shape. I experienced the case that mandibular condyle fracture caused by gun-shot injury(Bullet had been packed at the opposite condyle of input site) was treated by foreign body removal and condyle open reduction. I will represent that case with the journal review.

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MORPHOLOGY OF MANDIBULAR SYMPHYSIS AND POSITIONING OF LOWER INCISORS IN THE SKELETAL CLASS III MALOCCLUSIONS (골격성하악전돌증의 하악결합의 형태 및 절치의 위치에 관한 연구)

  • Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.15 no.1
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    • pp.149-153
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    • 1985
  • The purpose of this study was to pursue the morphology and position of mandibular symphysis and the positioning of lower incisors in 36 male and female adults with severe skeletal Class III malocclusion indicated for surgical orthodontic treatment. The following results were obtained. 1. Skeletal Class III malocclusion samples had thinner labio-lingual depth and more lingual inclination of mandibular symphysis than that of normal occlusion in both sexes. 2. Male and female with the skeletal Class III malocclusion showed marked lingual tipping of lower incisors. 3. In skeletal Class III malocclusion samples, lingual basal bone was thinner than that of normal occlusion in both sexes.

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RETROSPECTIVE STUDY FOR PROGNOSIS AFTER OPEN AND CLOSED REDUCTION OF THE MANDIBULAR CONDYLE FRACTURES (하악골 과두 골절의 관혈적 정복술과 비관혈적 정복술의 예후에 관한 후향적 연구)

  • Kim, Byoung-Soo;Lee, Jae-Hoon;Kim, Chul-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.4
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    • pp.372-380
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    • 2005
  • Condylar process of mandible, has the specialized anatomic structure compared with any other body structure, acts directly in connection with mastication and speech and so on. In general, mandibular condyle fractures have been managed by two methods as open and closed reduction. But, there are no reasonable consensus about the proper management of this injury. This study was designed for analysis of the prognosis of two methods of treatment, open and closed reduction, with positional change of fractured condyle and complications within 6 months post-intermaxillary fixation period. We conducted a retrospective analysis of 154 patients whose unilateral mandibular condyle fractures were treated by open or closed reduction in our department. The horizontal, sagittal, and coronal change of the condyle was examined using modified Towne's and panoramic radiographs before intermaxillary fixation(IMF), immediately after IMF, and at 6 months after IMF. Patients, whose mandibular condyle fractures were treated by closed reduction, had significantly shorter ramus height on the side of injury(P<0.05). But, fractured condylar fragments were displaced insignificantly with aspect to sagittal and coronal plane(P>0.05). The level of the fracture influenced the ramus length and the degree of coronal change in the closed reduction group(P<0.05). There was no significant correlation among the level of the fracture, treatment methods and complications(P>0.05). From the results obtained in this study, fractured mandibular condyles, were treated by closed reduction, had a tendency that continuous condylar displacement was occurred with aspect to horozontal and coronal plane in treatment period including intermaxillary fixation. And then there was a correlation between the level of the fracture and the position change in close reduction group statistically. These result suggested that care must be taken in basing treatment decisions on the degree of displacement of the condyle and in treating the mandibular condyle fractures for a long time.