• Title/Summary/Keyword: Mandibular reconstructive surgery

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A Comparative Study of Intermaxillary Fixation and Manual Reduction at Open Reduction and Internal Fixation of Mandibular Fractures

  • Jin, Soo-Young;Kim, Su-Gwan;Oh, Ji-Su;Kim, Jeong-Sun;Jeong, Mi-Ae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.1
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    • pp.51-54
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    • 2013
  • Purpose: The purpose of this study is to evaluate the difference between open reduction and internal fixation (ORIF) and intermaxillary fixation (IMF) of mandibular fractures. Methods: A total of one hundred twenty-seven patients who were treated for mandibular fractures at Chosun University Dental Hospital, from January 2008 to December 2010, and analyzed their prognoses based on the use of IMF at the time of fracture reduction. The patients were divided into two groups; the manual reduction group without IMF and IMF group. Results: After reduction of the mandibular fracture, good results were obtained with majority patients. Nonetheless, seven patients (13.0%) in manual reduction method without arch bars or IMF, developed complications after surgery. Three patients underwent IMF due to occlusal instability after surgery, while one patient underwent re-operation. Thus, a significant difference was not observed between the IMF and manual reduction groups. Conclusion: Manual reduction and IMF at mandibular simple fracture could produce good results. In case of mandibular simple fracture, it was recommended with only manual reduction without IMF or IMF during a short period.

THE CASE OF TREATMENT OF OSTEOMYELITIS FOLLOWING THE OPEN REDUCTION OF MANDIBULAR FRACTURE (하악골 골절 환자에 있어 수술 후 합병증으로 발생한 골수염의 치험례)

  • Heo, Nam-Oh;Park, Jun-Ho;Shin, Yong-Gil;Pang, Seok-Joon;Jeon, In-Seong;Yoon, Kyu-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.712-717
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    • 1996
  • The term osteomyelitis literally means inflammation of bone marrow. It is described as an inflammatory condition of bone primarily engaging the medullary cavity extending to the periosteum. Following circulatory collapse and ischemia, the involved portions of the bone become necrotic. Cellulitis and osteomyelitis are the most frequent complications of fractures of the mandible and maxilla, because there is an abscessed tooth in the line of fracture. Since most fractures are compound fractures, infection may develop because of contact with oral secretions or outside air. The treatment of chronic osteomyelitis is still under debate. Some authors rely on antibiotics alone, while others advocate combination with surgery. But when infection occurs, establish proper drainage and administer antibiotics. Author treated a case of infected mandibular fracture with mandibular osteotomy, sequestrectomy, iliac bone graft and hyperbaric oxygen therapy, who had suffered suppurative osteomyelitis and mandibular nonunion following the open reduction of the mandibular fracture.

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C-Arm Fluoroscopy for Accurate Reduction of Facial Bone Fracture (C-Arm 유도하의 안면골 골절의 정복술)

  • Hwang, So-Min;Kim, Jang Hyuk;Kim, Hyung-Do;Jung, Yong-Hui;Kim, Hong-Il
    • Archives of Craniofacial Surgery
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    • v.14 no.2
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    • pp.96-101
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    • 2013
  • Background: Among facial fractures, nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture take a large portion. Among surgical operations for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture, closed reduction has been generally used but, unlike open reduction, there is a problem in evaluating its accuracy of reduction. Methods: An assessment was made from October 2011 until April 2013 prospectively on 37 patients. For all the operations, closed reductions were executed in a conventional way and simultaneously using C-Arm to verify the reduction of fractures. Two images of plain radiography, one taken before operation and another one taken one day after the operation, were compared. After obtaining images of plain radiography using C-Arm immediately after the correction upon operation, they were compared with the images of plain radiography taken one day after the operation. Results: The fracture reductions of 26 patients among 27 nasal fracture patients were satisfactory but one patient showed a marginal overcorrection of less than 1 mm. The fracture reductions of 7 patients among 8 zygomatic arch fracture patients were satisfactory but one patient showed a marginal undercorrection of less than 2 mm. All of two mandibular subcondyle fracture patients showed less than 2 mm undercorrection. Conclusion: Closed reduction guided by C-Arm for nasal bone fracture, zygomatic arch fracture and mandibular subcondyle fracture was clinically useful because it could make a real-time assessment on fractured areas and add immediate corrections during the operation.

Evaluation of the effects of mandibular angle sagittal ostectomy and botulinum toxin type A treatment using facial golden mask (황금마스크를 이용한 하악각시상골절제술과 보툴리눔독소 치료법의 평가)

  • Shin, Seung-Kyu;Kim, Yong-Ha;Kim, Tae-Gon;Lee, Jun-Ho;Ahn, Ki-Young
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.469-474
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    • 2009
  • Purpose: A lower facial contouring surgery has become a commonly performed procedure in Asia. Currently, mandibular angle sagittal ostectomy and botulinum toxin type A treatment are main procedures for aesthetic correction of a broad lower face. There are a few date to show the differences in the mandibular contouring changes between mandibular angle splitting ostectomy and botulinum toxin type A treatment. Facial golden mask is easy to apply, inexpensive, and relatively objective for evaluation of facial contour analysis. This study was designed specifically to compare the changes in lower face width after two different forms of lower facial contouring procedure using facial golden mask. Methods: Seventeen patients, aged 18 to 55 years (mean, 28.6 years), 15 women and 2 men, consented to the study and receive a contouring procedure of lower face. The patients were classified in to 2 groups. In group A, the sample consisted of 10 patients with a prominent squared mandibular angle and mandibular angle splitting ostectomy was performed. In group B, the sample consisted of 7 patients with masseteric hypertrophy and botulinum toxin type A treatment was performed. Photographs of the face were taken to record the facial change at preoperative and postoperative. The postoperative photographs were taken to considered maximal effect at 2 years after surgery in group A and 4.8 months after treatment in group B. The authors applied the facial golden mask to preoperative and postoperative photographs and horizontal ratio, which compares facial width with golden mask width, were calculated. We made an analysis of the result of horizontal ratio using SPSS. Results: Overall average horizontal ratio of pre- and postoperative photos of group A were 1.24 and 1.11, whereas overall average horizontal ratio of pre- and postoperative photos of group B were 1.19 and 1.12. The horizontal ratio decreased 10.24% in group A and 5.93% in group B. There was a statistically significant change in before and after treatment, but there was no significant change in comparing the group A and group B. Conclusions: The result from this study suggest that mandibular angle sagittal ostectomy and botulinum toxin type A treatment showed relatively satisfactory clinical effects on lower facial contouring treatment. There was no statistical significant difference within two lower facial contouring treatment. Facial golden mask is easy to apply, inexpensive, and relatively objective, so we think that facial golden mask is a good method for evaluation of lower facial contouring treatment.

SOFT HARD TISSUE CHANGES FOLLOWING ANTERIOR SEGMENTAL SURGERY IN BIMAXILLARY PROTRUSION (상하악 치조전돌증의 양악 분절골절단 수술후 경, 연조직 변화에 관한 연구)

  • Song, Jae-Chul;Chin, Byung-Rho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.3
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    • pp.250-259
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    • 1997
  • The purpose of this study was to evaluate the interrelationship of the soft and hard tissue changes after both maxillary and mandibular anterior segmental surgery in bimaxillary protrusion patients. 11 patients had received both maxillary and mandibular anterior segmental surgery and were investigated radiologically with lateral cephalogram. The results were as follows : 1. The correlation of maxillary hard and soft tissue horizontal changes were relative high. : Coefficient between UIE and Stms was 0.89 (p<0.001). 2. The correlation of mandibular hard and soft tissue horizontal changes were very high, especially at the chin. : Coefficients were over 0.90 (p<0.001) 3. All points were moved superiorly except SLS, LS, Stms. 4. Upper and lower lip convexity to the E-Line were decreased (p<0.001) and postsurgical facial profiles were changed very esthetically.

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Partial Necrosis of the Mandibular Proximal Segment Following Transoral Vertical Ramus Osteotomy

  • Kim, Somi;Kim, Sang Yoon;Kim, Gi-Jung;Jung, Hwi-Dong;Jung, Young-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.3
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    • pp.131-134
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    • 2014
  • Transoral vertical ramus osteotomy (TOVRO) procedure can result in a variety of complications. Complications commonly reported include extensive bleeding due to major blood vessel injury, unpredictable fracture, postoperative infection, neurosensory deficit related Inferior alveolar nerve, insufficient osteosynthesis, and temporomandibular joint problem. The authors describe a case of partial necrosis of the mandibular proximal segment following TOVRO, a rarely reported complication. A 37-year-old otherwise healthy woman underwent Lefort l osteotomy and TOVRO to correct mandibular prognathism. Postoperatively, she developed pain and swelling in the right submandibular region and was found to have a partial necrosis of proximal segment.

THE INFLUENCE OF MANDIBULAR THIRD MOLAR ON MANDIBULAR ANGLE FRACTURE (하악 제3대구치가 하악 우각부 골절에 미치는 영향)

  • Cho, Sung-Pil;Lee, Jae-Hoon;Kim, Chul-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.49-57
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    • 2006
  • Mandibular fractures have higher incidence rate compared to facial bone fractures because of relatively prominent form. Specially, mandibular angle fractures were known as common fracture site because of morphological anatomic structure. The mandibular third molar appears to be the most frequent impacted tooth. The mandibular third molar have influence on mandibular angle fractures according to it's eruption state. Also, the mandibular angle fracture including the third molar may influence on post operative infection whether the third molar is in impacted or extracted state when reduction of fracture site is operated. The presence or absence and degree of impaction of the mandibular third molar were assessed for each patient and were related to the occurrence of the mandibular angle fracture. The extraction or non extraction of the mandibular third molar were related to the occurrence of the post operative infection in the reduction of mandibular angle fractures. In the presence of mandibular third molar, the possibility of mandibular angle fractures were relatively common. When viewing the mandibular third molar at occlusal plane, the possibility of mandibular angle fractures were high in the class C group. The possibility of mandibular angle fractures were high in the mesial angulation and partial impaction. There was a statistically significant difference(P<0.05). In complete erupted mandibular third molar, the possibility of post operative infection occurs quite often, but there was no statistical significant difference(P>0.05). In the extracted or non extracted of mandibular third molar, the post operative infection showed no statistical significant difference(P>0.05). With the results mentioned above, mandibular third molar was significantly more susceptible to mandibular angle fracture. In the reduction of mandibular angle fracture, it was recommended that mandibular third molar should be extracted especially in case of pericoronitis, periodontitis and other infections.

POSITIONAL RELATIONSHIP OF THE MANDIBULAR CANAL AND IMPACTED THIRD MOLARS BY USING DENTAL CONE BEAM COMPUTED TOMOGRAPHY (제3대구치와 하악관과의 위치 관계에서 치과용 Cone beam CT의 유용성)

  • Chu, Yeon-Gyu;Park, Young-In;Kim, Jin-Wook;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.492-498
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    • 2009
  • We sought to evaluate the relationship between the mandibular canal and impacted mandibular third molars by using dental cone beam computed tomograph(CBCT) for third molar surgery. A total of 111 patients(177 teeth) offered the images through CBCT and panoramic radiography for the extraction of the mandibular third molars. In CBCT, the accurate relationship between the third molar and the mandibular canal were evaluated. In panoramic radiographies, we evaluated the impacted level and superimposition sign of the mandibular third molar with the mandibular canal, and also, the radiopacity of the white line in the canal. Data were statistically analyzed and estimated by $X^2$-test. In CBCT finding, high prevalence of contact between the mandibular canal and roots occured in the deep impacted third molars, narrowing mandibular canals, bending mandibular canals and cases where the radiopacity of white line of canals were "absence" on panoramic images. It showed statistical significance (P<0.05). When evaluating the mandibular canal and the roots through the panoramic radiography for third molar extraction, it could be difficult to diagnosis accurately. Thus, it is required to have an accurate diagnostic approach through CBCT that could evaluated the location between mandibular canal and root.