• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.4
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• pp.264-271
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• 2011

Purpose: This study evaluated retrospectively the postsurgical facial hard tissue profile of a Le Fort I osteotomy with/without posterior impaction and rigid internal fixation to correct mandibular prognathism. After observing a difference between the two groups, this measurement was used to prepare a treatment plan for 2-jaw surgery. Patients and Methods: Thirty patients who had undergone orthognathic surgery in Pusan National University Dental Hospital were enrolled in this study. Fifteen patients were treated using a Le Fort I osteotomy with posterior impaction and mandibular setback bilateral sagittal split ramus osteotomy, and the other fifteen patients were treated without posterior impaction. The preoperative (T0), immediate postoperative (T1) and six-month follow-up period (T2) cephalograms were taken and difference between T1-T0 and T2-T2 was analyzed. Results: Both groups was FH-ABp, SNB and ANB showed significant changes in the measurement, whereas only the posterior impaction group showed a change in the SN-U1, occlusal plane, posterior facial height, surgical movement difference from the L1 and B-point. There was no significant statistical change between the immediate postoperative (T1) and six-month follow-up (T2) hard tissue analysis in the two groups. Conclusion: A Le Fort I osteotomy with posterior impaction is considerable for patients with a flat occlusal plane angle, large posterior facial height, prominent B-point, pogonion and labioversed incisal inclination if the indications are well chosen.

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

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.3
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• pp.247-253
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• 2006

Pleomorphic adenoma of the parotid gland typically presents as painless, mobile mass of long duration, and originate in the superficial lobe but, more rarely these tumors may involve the deep lobe of the parotid gland. The average size of a parotid neoplasm is 2 to 4 cm. The effective treatment of parotid pleomorphic adenoma is surgical excision. The simple excision or enucleation resulted in recurrence rate of 45% in benign tumor. Therefore, the superficial parotidectomy with identification and preservation of the facial nerve is now the most widely accepted surgery. We report a case of the huge pleomorphic adenoma of the left parotid gland in a 67-year-old man who complained the large mass, measured about $10\times7\times5$cm-sized, in front of the left ear and on the mandibular ascending ramus. The diagnosis was confirmed by the clinical examination, computed tomographic scan, fine needle aspiration, and incisional biopsy. Superficial parotidectomy including the tumor and preservation of the facial nerve using the modified Blair approach was performed. And satisfactory results have been obtained cosmetically and functionally.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.3
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• pp.254-261
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• 2009

The maxillary sinus bone graft procedure is one of the predictable and successful treatments for the rehabilitation of atrophic and pneumatized edentulous posterior maxilla. Materials used for maxillary sinus floor augmentation include autogenous bone, allogenic bone, xenogenic bone and alloplastic materials. Among them, autogenous bone grafts still represents 'gold standard'for bone augmentation procedures. We selected the mandibular ramus area as a donor site for the autogenous bone graft because of low donor site morbidity. We performed maxillary sinus bone graft procedures with implant placement using particulated ramal autobone and bovine bone mixture, and got good results. This is a preliminary report of the maxillary sinus bone graft using particulated ramal autobone and bovine bone, requires more long-term follow up and further studies.

• The korean journal of orthodontics
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• v.22 no.3 s.38
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• pp.657-673
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• 1992

Orthodontic treatment of cleft patients is difficult as the growth is different from that of normal ones. So it is very important to know the characteristic features of the craniofacial morphology and growth pattern in unilateral cleft lip and palate patients. The materials for this study consisted of 55 normal males and 50 unilateral cleft lip and palate ones who received cheiloplasty and palatoplasty previously. The cleft subjects were divided into 4 groups according to their ages kto find out the growth pattern of hard and soft tissue, and to compare the features with those of normal ones. Each cephalogram analysed by McNamara method and others. The obtained results were as follows 1. In the unilateral cleft lip and palate subjects, forward growth of the maxilla was smaller than that of normal ones from 9 years old. So the maxilla was retruded. The maxillary incisors were severely retruded in all age groups. 2. The mandibular overall length and its anteroposterior position did not show any significant differences between two groups. But the height of ramus was very short and the mandible had vertical growth tendency to compensate for undergrowth of the maxilla in cleft subjects after 12 years of age. 3. Horizontal growth of the soft tissue in middle face was smaller than that of any other facial region from 9 years old. The vertical growth rate of upper lip was decreased as growing old. 4. In cleft subjects, the upper and lower facial component angle and the facial convexity angle were large. So their facial profile changed to straight or concave as growing old.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.2
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• pp.197-200
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• 2001

We described two cases of odontogenic keratocysts of the maxilla. Odontogenic keratocysts (OKCs) are jaw cysts with a proclivity for local invasion and recurrence. Clinically, OKCs are characterized by aggressive, local growth. The diagnosis of mandibular OKC is based on physical examination and plain film radiographic findings. However, histopathological confirmation is required to make the diagnosis with certainty. The molar regions of the mandible and maxilla are the principal primary locations. The maxillary antrum is also a common site. Initial therapy is typically enucleation with or without extraction of the associated teeth. Long-term follow-up is necessary because of the aggressive nature and recurrence rate of OKCs.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.2
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• pp.144-154
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• 2001

Dysfunction of the inferior alveolar nerve indicated by various degree of numbness of the lower lip and chin is one of the few drawbacks of mandibular osteotomy, especially Bilateral Sagittal Split Ramus Osteotomy(BSSRO) and genioplasty. Although it has been recorded throughout the history of this techniques, it is true etiology poorly understood. In this study, 22 consecutive patients under class III malocclusiion impression and undergoing orthognathic surgery(BSSRO only 11 case, BSSRO with genioplasty 11 case) were studied using 4 neurosensory test(static light touch, directional discrimination, two-point discrimination, pin pressure nociception) with post OP 1 week, 2 weeks, 4 weeks, 8 weeks, 12 weeks, 24 weeks, On control group, 10 members without trauma and nerve damage history, nerve test was accomplished. We concluded majority of patients return of sensation during post operative 24 weeks. Althought immediate nerve deficit are 92.2%, 97.2% 88.9% these are recovered to 25%, 35.72%, 10.71% at 24 weeks. Nerve recovery rate increased prominently between post 4 weeks and 8 weeks. There is no statistically difference about neurosensory deficit among the chin area. Neurosensory deficit more severe when the BSSRO with genioplasty group than the only BSSRO group. Immediate neurosensory deficit is larger left side than right side but after 6 months, there is no significantly difference between left side and right side. Static light touch and pin pressure nociception are more sensitive method of neurosensory deficit than two point discrimination.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.431-436
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• 2010

Purpose: It is estimated that the odontogenic keratocyst (OKC) makes up 10% to 12% of all developmen-tal odontogenic cysts. The lesion has been of particular interest because of its specific histopathologic fea-ture, high recurrence rate, and aggressive behavior. Materials and Methods: We investigated 266 OKCs of Korean patients for the sex of patient, the age of the patient, the location of OKC, the recurrence rate related to radiographic impression. Results: The male-to-female ratio was 1.47:1, showing a slight male predilection. Odontogenic keratocysts had a peak of occurrence in the third decade of life. The mandibular angle and ascending ramus area (49.6%) is the most frequent site of OKCs in the jaws. Fourteen cases of unilocular (12%) and 5 cases of multilocular (20%) OKCs recurred. Thirteen cases of smooth (12.9%) and 6 cases of lobulated (14.6%) OKCs recurred. Seventeen cases of OKCs without perforation of cortical bone (12.5%) and 2 cases of OKCs with perforation of cortical bone (33.3%) recurred. Fifteen people of patients with single lesion (12.2%) and 4 people of patients with multiple lesions (66.7%) recurred. Conclusion: In this resul, we consider multiple odontogenic keratocysts can recur more easily. So we have to treat them more carefully and need long-time follow-ups.

• Imaging Science in Dentistry
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• v.33 no.4
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• pp.239-244
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• 2003

Malignant fibrous histiocytoma (MFH) is a pleomorphic soft tissue sarcoma. Three cases of MFH were reported in our study. The first case involved in the right infratemporal fossa of a 32-year-old female was presented. MR imaging revealed a 5.0 × 3.3 cm soft tissue mass of inhomogeneous high signal intensity. The second case was found in the right hard palate of a 66-year-old male. CT demonstrated bone destruction and MR imaging showed a 4 × 4 cm sized soft tissue mass of heterogeneous high signal intensity. The final case was found in the left masticator space of a 37-year-old male. The CT image showed a large mass with massive bone destruction of the left mandibular ramus, while the MRI displayed a soft tissue mass, 8 cm diameter. Our cases exhibited the general features of MFH. MRI is essential in the imaging of MFH, namely to depict tumor borders and demonstrate relationships with adjacent structures.

• The korean journal of orthodontics
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• v.17 no.1
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• pp.135-148
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• 1987

To investigate the relationship between craniofacial growth and bone maturity of the hand wrist in normal occlusion, the author took cephalogram and handwrist radiogram of 391 students (male 192, female 199) and assessed the measurements of cephalogram according to skeletal maturity stages of the hand and wrist. In this study, four skeketal stages and 36 linear, angular measurements of the cephalometrics were selected. In hand-wrist X-ray the bones used to determine skeletal maturity were the middle phalanges of the third finger, and distal epiphysis of the radius. In cephalogram, the landmark used to measure the angle and length were N, S, Po., Ar., Go., Me., Gn., Pog., Point B, Point A, ANS, PNS, Or., U1, L1, U6, L6 etc.. The results were as follows, 1. The table of mean, standard deviation, p-value from measurements were made in each group and both sex. 2. The increased measurements according to skeletal maturity were anterior cranial bese length, posterior cranial base length, ramus height, anterior facial height, posterior facial height, L1 to mandibular plane (mm), facial plane angle. In contrast to, decreased measurements were genial angle, facial cnvexity and facial plane angle. 3. Denture pattern measurements (IMPA, FMIA, occlusal plane to Go-Gn, interincisal angle, U1 to SN plane, U1 to SN plane, U1 to facial plane, L1 to facial plane etc.) .had nothing to do with skeletal maturity. 4. Skeletal maturity had close relationship with craniofacial growth, but had little to do with tooth development.