• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.319-324
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• 2009

Kole's Anterior segmental osteotomy of the mandible is commonly used to close an anterior open bite, to depress an elevated anterior dentoalveolar segment, or to retrude or advance a dentoalveolar segment. The procedure is often combined with an anterior maxillary segmental osteotomy to correct bimaxillary protrusion. We report 53-year-old woman who the extruded state of mandibular anterior alveolar segment was corrected using an mandibular anterior alveolar segmental osteotomy and dental implantation of the anterior maxilla. We planned to remove the old prosthesis, and then perform an anterior mandibular segmental osteotomy and implant restoration of the anterior maxilla. We suggest that anterior segmental osteotomy is very useful for rehabilitating edentulous patients with malaligned alveolar segment.

• Archives of Craniofacial Surgery
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• v.19 no.2
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• pp.152-156
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• 2018

Mandibular defects lead to severe deformation and functional deficiency. Vascularized osteocutaneous tissue has been widely used to reconstruct the mandible. However, it is technically challenging to shape this type of grafts in such a manner that they resemble the configuration of the mandible. A 48-year-old female patient who underwent anterolateral thigh (ALT) flap coverage after a tongue cancer excision was diagnosed with a tumor recurrence during the follow-up. A wide excision mandibulectomy and mandibular reconstruction with an ALT flap and a titanium implant were performed. The prefabricated titanium implant was fixed to the condyle. Then, an ALT flap was harvested from the ipsilateral thigh and anastomosed. After confirming that the circulation of the flap was intact, the implant was fixed to the parasymphysis. On the radiograph taken after the surgery, the prosthesis was well positioned and overall facial shape was acceptable. There was no postoperative complication during the follow-up period, 1 year and 2 months. The prefabricated implant allows the restoration of facial symmetry without harvesting autologous bone and it is a safe and effective surgical option for mandibular reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.3
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• pp.128-135
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• 2018

Objectives: The role of alloplastic materials in maxillofacial reconstruction is still controversial. Determining the utility of porous, high-density, polyethylene implants as a highly stable and flexible, porous alloplast, with properties such as rapid vascularization and tissue ingrowth, is crucial in cases of maxillofacial deformities and aesthetic surgery. Materials and Methods: Thirty high-density porous polyethylene implants were implanted in 16 patients that had been referred to a private office over a three-year period. These implants were used for correcting congenital deformities, posttraumatic defects and improving the aesthetic in nasal, paranasal, malar, chin, mandibular angle, body and orbital areas. Results: The outcomes of the cases in this study showed good aesthetic and functional results. The majority of patients had no signs of discomfort, rejection or exposure. Two implants suffered complications: a complicated malar implant was managed by antibiotic therapy, and an infected mandibular angle implant was removed despite antibiotic therapy. Conclusion: Based on the results, the Medpor implant seems to be an excellent biomaterial for correcting various facial deformities. Advantages include its versatility and relatively ideal pore size that allows for excellent soft tissue ingrowth and coverage. It is strong, flexible and easy to shape.

• The Journal of the Korean dental association
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• v.56 no.5
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• pp.263-276
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• 2018

Long-term survival and prognosis of narrow-diameter implants have been reported to be adequate to consider them a safe method for treating a deficient alveolar ridge. The objective of this study was to perform case report of narrow-diameter implants with a trapezoid-shape in anterior teeth alveolar bone. A 50-year-old male patient presented with discomfort due to mobility of all of the maxillary teeth and mandibular incisors. Due to destruction of alveolar bone, four anterior mandibular teeth were extracted. Soft tissue healing was allowed for approximately 3 months after the extraction, and a new design of implant placement was planned for the mandibular incisor area, followed by clinical and radiological evaluation. Implant placement was determined using an R2GATE surgical stent. The stability of the implants was assessed by ISQ measurements at the first and second implant surgery and after prosthetic placement. At 1 and 3 months and 1 year after implantation of the prosthesis, clinical and radiological examinations were performed. Another 50-year-old male patient presented with discomfort due to mobility of the mandibular central incisors. For the same reason as in the first patient, implant placement was carried out in the same way after extraction. ISQ measurements and clinical and radiological examinations were performed as in the previous case. In these two clinical cases, 12 months of follow-up revealed that the implant remained stable without inflammation or additional bone loss, and there was no discomfort to the patient. In conclusion, computer-guided implant surgery was used to place an implant in an optimal position considering the upper prosthesis. A new design of a narrow-diameter implant with a trapezoid-shape into anterior mandibular alveolar bone is a less invasive treatment method and is based on the contour of the deficient alveolar ridge. Through all of these procedures, we were able to reduce the number of traumas during surgery, reduce the operation time and total treatment period, and provide patients with more comfortable treatment.

• Journal of Korean Dental Science
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• v.10 no.1
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• pp.35-44
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• 2017

In case of loss of many teeth due to dental caries or periodontal disease, improvement of masticatory function and aesthetics can be obtained through implant treatment. However, if the patient does not have a normal intercondylar relationship, it is difficult to achieve an ideal occlusal relationship with only prosthetic treatment. In particular, oral reconstruction with orthodontic treatment or orthognathic surgery is necessary for patients with mandibular prognathism. However, if the posterior occlusion collapses due to severe caries or periodontal disease, orthognathic surgery may be difficult. The occlusal vertical stop is very important for the stability of the mandibular position during occlusal reconstruction through orthognathic surgery. The patient in this case had posterior occlusion collapsed due to the caries of a large number of posterior teeth, and showed mandibular prognathism and long face. We planned a full arch restoration with orthognathic surgery and extracted the hopeless teeth. To secure the vertical stop required for orthognathic surgery, the implant was placed before surgery. After the orthognathic surgery and the final prosthesis application, the results were satisfactory for the improvement of the aesthetics and the restoration of the masticatory function.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.1
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• pp.108-115
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• 2017

Numerous therapeutic approaches are available for impacted teeth, including orthodontic retraction, implantation, and autogenous tooth transplantation. Autotransplantation is a promising method, especially for juvenile patients, as it enables preservation of the function of the periodontal tissues, as well as continued alveolar bone growth. This report describes autotransplantation in two cases in which the tooth was fully-ectopically impacted. With case 1, an ectopically impacted premolar was extracted and transplanted in an upright position, and regenerative endodontic treatment was performed using a platelet-rich fibrin clot and mineral trioxide aggregate (MTA). With case 2, a calcifying odontogenic cyst with an impacted left mandibular second molar was treated by enucleation. The tooth was transplanted into the proper position 3 months after enucleation, and endodontic treatment was performed using MTA. In both cases, autotransplantation appeared to provide a simple and rapid treatment option for patients with ectopically impacted teeth. These cases demonstrate that autotransplantation of ectopically impacted teeth is a viable treatment option rather than implant placement or prosthesis, especially in juvenile patients.