• Journal of Periodontal and Implant Science
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• 제39권1호
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• pp.53-58
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• 2009

Purpose: The resective treatment in mandibular Degree III furcation areas includes root resection and tunnel preparation. The purpose of this retrospective study is to evaluate which treatment procedure(root resection vs tunnel preparation) has more favorable prognosis in mandibular Degree III furcation involvement. Materials and methods: The subjects of this study were patients who were treated their mandibular posteriors with either root resection(22 teeth on 22 patients) or tunnel preparation(24 teeth on 22 patients) and have participated in periodic recall check program for at least 2 years. Failure rate, plaque index, bleeding on probing and probing pocket depth were measured and the results were compared and statistically analysed. Results: Failure rates of root resection and tunnel praparation were 13.6% and 16.7%, respectively, and showed no significant difference between two procedures. No significant differences were observed between two procedures with respect to plaque index, bleeding on probing and probing pocket depth. Conclusion: root resection and tunnel preparation are both effective procedures to treat mandibular posterior furcation involvement, if adequate treatment of choice is made and patient's cooperation is accompanied. However, tunnel preparation is more preservative procedure in mandibular posterior furcation involvement since root canal treatment and prosthetic restoration are needed additionally, in case of root resection.

• Archives of Plastic Surgery
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• 제45권6호
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• pp.572-577
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• 2018

Background Mandibular contouring surgery to produce a more slender and small face has become popular, especially in East Asia. Narrowing genioplasty should be simultaneously performed with mandibular angle resection to achieve satisfactory results. In Korea, T-genioplasty has been frequently performed for chin narrowing. The authors developed a new, safe, and reliable method, termed M-genioplasty, that can provide a more slender and attractive lower face. Methods From June 2013 to December 2017, 36 patients underwent M-genioplasty with mandibular angle resection for lower facial contouring. Horizontal and vertical osteotomies were performed obliquely. The resected bone segments were wedge-shaped. The remaining two bone segments were rotated and approximated centrally. The lateral mandible bony step-off was trimmed off for mandibular angle resection. Results In all patients, the facial contour sufficiently improved, and most patients were satisfied with the outcome. No severe complications took place during postoperative follow-up. Conclusions M-genioplasty can provide more mandibular angle resection and can create a more acute chin angle without bone resorption than other methods, including T-genioplasty. M-genioplasty with mandibular angle resection is a safer, more accurate, and more reliable method for lower facial contouring.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권4호
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• pp.239-246
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• 2017

Objectives: This paper proposes Han's ratio as an objective and quantitative comparative result obtained from pre and postoperative data in patients with a mandibular angle reduction. Materials and Methods: Thirty patients, 12 men and 18 women, who visited the Department of Oral and Maxillofacial Surgery with the chief complaints of skeletal mandibular prognathism and prominent mandibular angle were selected. The subjects were classified into 3 groups according to the types of surgical procedures involved. Group A consisted of patients who underwent mandibular angle resection and mandibular setback. Group B was comprised of patients with mandibular angle resection, mandibular setback and genioplasty. Group C consisted of patients with mandibular angle resection, mandibular setback, Le Fort I osteotomy, and genioplasty. The landmarks placed in pre and postoperative frontal photographs were used to obtain the Han's ratio in each group. The Han's ratios were compared pre- and postoperation and according to the surgical techniques applied. Results: Of the 3 groups who had undergone a mandibular angle resection, all showed a statistically significant increase in Han's ratio. On the other hand, there was no statistically significant difference based on the surgical techniques used. Conclusion: The ratio of the lateral lower face proposed in this study is a potential indicator of postoperative esthetic enhancement in mandibular angle reduction surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권6호
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• pp.272-277
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• 2014

Objectives: Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions. Materials and Methods: A retrospective review of medical records and patient case files from January 2012 to December 2013 was undertaken. All case files and other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed reconstruction were selected for review. Results: Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients' (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean $26.0{\pm}10.6years$). Indications for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmental resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients' postoperative reviews and radiographs revealed good facial profile and continued bone stability up to 1 year following NVIBG. Conclusion: NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.

• Archives of Plastic Surgery
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• 제46권5호
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• pp.426-432
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• 2019

Background The mandible is an important structure that is located in the lower third of the face. Large mandibular defects after tumor resection cause loss of its function. This study assessed the outcomes and tumor recurrence after immediate mandibular reconstruction using a free fibula osteocutaneous flap following radical resection of ameloblastoma. Methods This is a retrospective non-randomized study of outcomes and tumor recurrence of all patients diagnosed with mandibular ameloblastoma from August 1997 until August 2017 (20 years) requiring free fibula osteocutaneous flap reconstruction at a single institution. The patients were identified through an electronic operative database; subsequently, their medical records and photo documentation were retrieved. Results Twenty-seven patients were included in this study. Eighteen patients were male, while nine were female. The majority of the patients (48.1%) were in their third decade of life when they were diagnosed with ameloblastoma. All of them underwent radical resection of the tumor with a surgical margin of 2 cm (hemimandibulectomy in cases with a large tumor) and immediate mandibular reconstruction with a free fibula osteocutaneous flap. Two patients required revision of a vascular anastomosis due to venous thrombosis postoperatively, while one patient developed a flap recipient site infection. The flap success rate was 100%. There was no tumor recurrence during a mean follow-up period of 5.6 years. Conclusions Mandibular ameloblastoma should be treated with segmental mandibulectomy (with a surgical margin of 2 cm) to reduce the risk of recurrence. Subsequent mandibular and adjacent soft tissue defects should be reconstructed immediately with a free fibula osteocutaneous flap.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.508-514
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• 1994

For the complete cure of oral cancer suspected to have invaded the mandible in clinical & radiological evaluation, the mandible resection in planned. The aim of this clinical study was to help in decision making in the method & the extent of the mandibular resection surgery. This study was conducted on 46 oral cancer patients, who received cancer surgery including mandibulectomy. And we evaluated the relationship between the pathologic results of resected mandible and the location, size and clinical newk node involvement, tumor cell differentiation. The results are that ; (1) Hiher incidence of bone invasion patterns were observed in tumor of mouth floor & gingiva compared to those of tongue & tonsil, and (2) No significant relationship was found between bone invasion of tumor and tumor size, neck node involvement tumor cell differentiation. The approximation between tumor and bone seems to be the most reliable factor among the other factors in decision making of mandibular resection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권1호
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• pp.46-48
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• 2017

A patient, who underwent partial masseter muscle resection and mandibular angle reduction at a plastic surgery clinic, visited this hospital with major complaints of trismus and dysesthesia. A secondary angle formation due to a wrong surgical method was observed via clinical and radiological examinations, and the patient complained of trismus due to the postoperative scars and muscular atrophy caused by the masseter muscle resection. The need for a masseter muscle resection in square jaw patients must be approached with caution. In addition, surgical techniques must be carefully selected in order to prevent complications, and obtain effective and satisfactory surgery results.

• 대한치과교정학회지
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• 제16권1호
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• pp.119-131
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• 1986

The purpose of the study is to note the effects of the resection of the lateral pterygoid muscle on the mandibular growth in the growing rats. Twenty four female Wistar rats were used in the experiment. They were divided into three groups: group 1 ; bilateral sham operation group 2 ; bilateral resenction of the lateral pterygoid muscle group 3 ; unilateral resection of the lateral pterygoid muscle (The right lateral pterygoid muscle was resected and the left one was sham-operated.) Groups 1&2 were sacrificed eight weeks lateral and group 3, four weeks later. All specimens were measured with calipers, and stained with hematoxylin and eosin. Groups 1 & 2 were compared with each other. In group 3, the right side was compared with the left. The results were as follows: 1. In the growing rats, the resection of the lateral pterygoid muscle was followed by a decrease of the mandibular growth. After eight weeks, the condyle-mental foramen distance, the angular process-mental foramen distance, the size of the condylar head, the supradentale-first molar distance, and the diameter of the symphysis were significantly smaller than the control. 2. Resection of the lateral pterygoid muscle resulted in decrease of the thickness of the cartilage layer and the prechondroblastic-chondroblastic layer after four weeks. 3. After eight weeks, group 1 and group 2 were not different significantly in the histologic sections. 4. The condylar cartilage was stabilized eight weeks after the experiment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권3호
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• pp.231-233
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• 2002

Temporary reconstruction of the mandibular continuity defect resulting from the ablative tumor surgery with a reconstruction plate can be used for the preservation of normal facial contour and oral function and for periodic follow up of recurrence. Reconstruction plates are adapted to the bone before the resection and provisionally fixated with some screws. Accurate contouring and adaptation are very important for the prevention of displacement of bony stumps and decubituous skin ulcer. However, if there is large expanding buccal tumor mass in mandible, it is very difficult or even impossible to contour the plate before resection. I, therefore, introduce the reconstruction plate application technique using a simple condylar repositioning miniplate after segmental mandibular resection.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.35.1-35.7
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• 2018

Background: After the resection at the mandibular site involving oral cancer, free vascularized fibular graft, a type of vascularized autograft, is often used for the mandibular reconstruction. Titanium mesh (T-mesh) and particulate cancellous bone and marrow (PCBM), however, a type of non-vascularized autograft, can also be used for the reconstruction. With the T-mesh applied even in the chin and angle areas, an aesthetic contour with adequate strength and stable fixation can be achieved, and the pores of the mesh will allow the rapid revascularization of the bone graft site. Especially, this technique does not require microvascular training; as such, the surgery time can be shortened. This advantage allows older patients to undergo the reconstructive surgery. Case presentation: Reported in this article are two cases of mandibular reconstruction using the ready-made type and custom-made type T-mesh, respectively, after mandibular resection. We had operated double blind peer-review process. A 79-year-old female patient visited the authors' clinic with gingival swelling and pain on the left mandibular region. After wide excision and segmental mandibulectomy, a pectoralis major myocutaneous flap was used to cover the intraoral defect. Fourteen months postoperatively, reconstruction using a ready-made type T-mesh (Striker-Leibinger, Freibrug, Germany) and iliac PCBM was done to repair the mandible left body defect. Another 62-year-old female patient visited the authors' clinic with pain on the right mandibular region. After wide excision and segmental mandibulectomy on the mandibular squamous cell carcinoma (SCC), reconstruction was done with a reconstruction plate and a right fibula free flap. Sixteen months postoperatively, reconstruction using a custom-made type T-mesh and iliac PCBM was done to repair the mandibular defect after the failure of the fibula free flap. The CAD-CAM T-mesh was made prior to the operation. Conclusions: In both cases, sufficient new-bone formation was observed in terms of volume and strength. In the CAD-CAM custom-made type T-mesh case, especially, it was much easier to fix screws onto the adjacent mandible, and after the removal of the mesh, the appearance of both patients improved, and the neo-mandibular body showed adequate bony volume for implant or prosthetic restoration.