• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.4
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• pp.397-410
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• 2000

Skeletal class III had been classified by the position of the maxilla, the mandible, the maxillary alveolus, the mandibular alveolus and vertical development. This morphologic approach is simple and useful for clinical use, but it is insufficient to permit understanding of the pathophysiology of dysmorphoses. The author hypothesizes that there are different patterns of mutual relation of the skeletal components which have contributed pathologic equilibrium of skeletal class III. The purpose of this study are threefold: 1) to classify skeletal class III in subgroups, which can show the architectural characteristics of the deformity, 2) to analyse the craniofacial architecture of each subgroup on etio-pathogenic basis, and 3) to characterize and visualize the pattern as a prototype. Materials used in this study were lateral cephalograms of 106 skeletal class III adults, which were analysed with modified Delaire's architectural and structural analysis. Linear and angular measurements of the individual subject were obtained and cluster analysis was used for the subgrouping. Data were evaluated for verification of the statistical significances. The following results were obtained. 1. By the modified Delaire's architectural and structural analysis and cluster analysis, skeletal class III adults were classified into 7 clusters and presented as prototypes, which could show the pathophysiology of the skeletal architecture 2. There was significant relationship in measurement variables of each cluster, which could reflect characteristics of the skeletal pattern of growth. 3. The flexure of cranial base had a close relationship to the anterior rotational growth of the maxilla and contributes to understand the etio-pathology of skeletal class III. 4. The proportion of craniospinal area in cranial depth, craniocervical angle and vertical position of point Om had a close relationship to rotational growth of the mandible and direction of condylar growth. They contribute to understand the etio-pathology of skeletal class III. In summary, the cranium and the craniocervical area must be considered in diagnosis and treatment planning of dentofacial deformity. And the occlusal plane can be considered as a representative which shows the mutual relationships of the skeletal components.

• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.361-366
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• 1999

Intermaxillary fixation is routine procedure to oral and maxillofacial area in jaw bone fracture, surgical correction of jaw deformity, osseus reconstruction of jaw. After transoral surgery, accompanied by intermaxillary fixation, dysphagia or airway obstruction may be followed due to blood clot, vomitus, or laryngeal spasm resulting from irritation by blood or secretions. Lingual or pharyngeal edema is other contributing factors of airway obstruction. In addition, intermaxillary fixation itself may cause obstruction of airway. In this study, pulmonary function test and arterial blood gas analysis were evaluated before and after intermaxillary fixation in 30 patients suffered from mandibular fractures. Comparative analysis was performed by estimated values. The results were as followed. 1. The spirometric values of FEV1, FEV1/FVC and FEF25-75% without intermaxillary fixation were reduced from 97.57%, 85.1%, 98.3,% to 71.7%, 66.5%, 61.2% with intermaxillary fixation, indicating the presence of obstructive pulmonary impairment. 2. Spirometric value of MVV, as the most influencing value of sensitive to extrapulmonary factors, was changed from 84.5% to 46.48%. 3. After intermaxillary fixation, the spirometric value of FVC, as indicator of restrictive pattern of pulmonary function, was not reduced significantly as measured from 94.47% to 89.97%. 4. $O_2$ saturation of arterial blood gas analysis without intermaxillary fixation was 97.86%. While intermaxillary fixation, $O_2$ saturation was 97.47%. The results indicate that careful airway management is mandatory undergoing intermaxillary fixation of various oral and maxillofacial surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.4
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• pp.415-428
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• 1995

The author studied on the 115 cases of the ameloblastoma which had been diagnosed with biopsy during the period of 1962 to 1994 at the Kyungpook National University Hospital, Pusan National University Hospital, Youngnam University Hospital, Keimyung University Hospital, Catholic Medical School Hospital, and Maryknol Hospital. This study contains the statistical analysis of the clinico-pathological findings such as sex, age, location, chief complaint, duration,treatment method, size, recurrence and impacted teeth in relation to radiographic findings. The results were as follows : 1. The incidence rate was 60% in male and 40% in female. 2. At the time of diagnosis, the age of the patients ranged from 9 to 69 years old (average 31.4 years old). The cases of 73% were in the 2nd, 3rd and 4th decades of life. 3. The majority of cases, 88.7% occurred in the mandible, especially 59% in the mandibular angle area. 4. The most prevalent chief complaint of swelling was 56.5%. 5. As regards duration, the cases less than 12 months appeared 49.5%, and average duration is 30.45months. 6. Unilocular radiographic findings showed 43.5%, Multilocular radiographic findings appeared 56.5%. 7. Conservative treatment was performed 40.0%, and radical treatment was employed 60.0%. 8. There was the variation of lesional sizes between 2.0cm and 15cm, average size 6.19cm. 9. Recurrent cases were 28.7%, and impacted teeth were shown 30.43%. 10. The radiographic finding has no relationship with the factors of age, location, chief complaint, recurrence and impacted teeth, however there is slight indication that the below 30-year-old patient tend to be related to the multilocular type. 11. The multilocular radiographic findings were shown more frequently in the groups of females, over average of 30.45 months, over average size of 6.19cm and radical treatment.

• Journal of Korean Dental Science
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• v.7 no.1
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• pp.38-42
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• 2014

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is defined as exposed necrotic bone without evidence of healing for at least 8 weeks in the maxillofacial area in a patient with history of bisphosphonate use. Obtaining complete coverage of the hard tissue by soft tissue in BRONJ patients is especially important. Therefore, managing the mucosa is one of the key factors in a successful outcome, but this is especially hard to achieve in BRONJ patients. Various applications of buccal fat pad in oral reconstruction-including the closure of surgical defects following tumor excision, repair of surgical defects following the excision of leukoplakia and submucous fibrosis, closure of primary and secondary palatal clefts, coverage of maxillary and mandibular bone grafts, and lining of sinus surface of maxillary sinus bone graft in sinus lift procedures for maxillary augmentation-have been studied. Eliminating all potential sites of infection and post-operative infection control is crucial in BRONJ. We present a case using the buccal fat pad pedicle for a stage 3 BRONJ defect. Uneventful total epithelialization of the buccal fat pad regardless of size was noted. In summary, the buccal fat pad has versatile application and various recipient sites for surgical utilization. It is an easy technique, with promising overall success rates. With careful selection and handling, buccal fat graft can resolve problems with soft tissue coverage in stage 2 or 3 BRONJ patients.

• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.167-171
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• 2004

Background and Objectives: Squamous cell carcinoma of retromolar tringone (RMT) is an uncommon head and neck tumor. RMT cancer has unique clinical feature and specific considerations for surgical treatment are needed but, reports on the treatment of RMT cancer are still lacking. Patients and Methods: From May 1997 to July 2004, 8 patients with histologically proven squamous cell carcinoma of the RMT were treated in Severance Hospital. Surgical excision of the primary lesion and neck dissection were performed in all patients. Reconstruction was accomplishing using several methods. Charts and other medical records were reviewed. Results: In early cases, lower cheek flap was appropriate but, mandibular swing or madibulectomy approach was appropriate in advanced cases. Reconstruction was needed in all patients and excision of mandible was needed in majority of patients. 6 patients were disease free status and one died from recurrence and one was lost to follow up. Conclusion: In treatment of RMT cancer, several surgical approach methods and reconstruction should be considered before treatment. Surgical treatment of RMT cancer may be one of a useful primary treatment modality.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.3
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• pp.237-245
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• 2004

The deformities of micrognathia and glossoptosis in the newborn are frequently associated with a cleft palate, which is known as Pierre Robin sequence. Upper airway obstruction is the most serious problem in these patients. Treatment of Pierre Robin sequence includes either positional or surgical intervention. Mild cases are often managed in the prone position. However, when the patient fails to thrive due to chronic upper airway obstruction, or severe respiratory distress ensures despite positional treatment, surgical intervention is mandatory to relieve the obstruction. We experienced three infants with Pierre Robin sequence who showed a symptom triad of micrognathia, glossoptosis, and cleft palate. Intermittent cyanosis, depression of the chest, respiratory difficulty and feeding problems were also observed. To relieve severe upper airway obstruction caused by micrognathia and glossoptosis, we simultaneously performed modified tongue lip adhesion (TLA) and a subperiosteal release of the floor of the mouth (SRFM). Respiratory and feeding difficulties were relieved, the tongue positioned anteriorly, body weight increased, and mandibular growth improved. Simultaneous TLA and SRFM may constitute a simple and reliable method for surgical treatment of airway obstruction in patients with Pierre Robin sequence.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.1
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• pp.11-16
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• 2014

Objectives: The aim of this study was to evaluate the pattern of lingual split line when performing a bilateral sagittal split osteotomy (BSSO) for asymmetric prognathism. This was accomplished with the use of cone-beam computed tomography (CBCT) and three-dimensional (3D) software program. Materials and Methods: The study group was comprised of 40 patients (20 males and 20 females) with asymmetric prognathism, who underwent BSSO (80 splits; n=80) from January 2012 through June 2013. We observed the pattern of lingual split line using CBCT data and image analysis program. The deviated side was compared to the contralateral side in each patient. To analyze the contributing factors to the split pattern, we observed the position of the lateral cortical bone cut end and measured the thickness of the ramus that surrounds the mandibular lingula. Results: The lingual split patterns were classified into five types. The true "Hunsuck" line was 60.00% (n=48), and the bad split was 7.50% (n=6). Ramal thickness surrounding the lingual was $5.55{\pm}1.07$ mm (deviated) and $5.66{\pm}1.34$ mm (contralateral) (P =0.409). The position of the lateral cortical bone cut end was classified into three types: A, lingual; B, inferior; C, buccal. Type A comprised 66.25% (n=53), Type B comprised 22.50% (n=18), and Type C comprised 11.25% (n=9). Conclusion: In asymmetric prognathism patients, there were no differences in the ramal thickness between the deviated side and the contralateral side. Furthermore, no differences were found in the lingual split pattern. The lingual split pattern correlated with the position of the lateral cortical bone cut end. In addition, the 3D-CT reformation was a useful tool for evaluating the surgical results of BSSO of the mandible.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.2
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• pp.170-175
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• 2014

The growth disorder influences craniofacial development and early loss of permanent teeth. This case reports the importance of computerized tomography (CT) and surgical guide to identify horizontal bone loss, adjacent teeth and to guide drills when placing implants in a short stature patient. The patient has idiopathic short stature and the 3rd grade of intellectual disability. To recover posterior mandibular teeth, implant treatment was planned. CT images showed that the adjacent teeth were located markedly to the buccal side. A CT-based surgical guide was fabricated and implants was placed using flapless surgery. Bone dehiscence and fenestration may happen when the surgical guide was fabricated just based on adjacent clinical crowns. Thus, it is essential to analysis bone and teeth and to make surgical guide through CT, especially in atrophied bone on grow disorder patients. Furthermore, systematic researches are recommended to elucidate the relationship between growth disorder and tooth malposition.

• Imaging Science in Dentistry
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• v.32 no.4
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• pp.201-206
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• 2002

Purpose : To evaluate the radiographic change of operation sites after orthognathic surgery using the digital image processing and fractal analysis. Materials and Methods : A series of panoramic radiographs of thirty-five randomly selected patients who had undergone mandibular orthognathic surgery (bilateral sagittal split ramus osteotomy) without clinical complication for osseous healing, were taken. The panoramic radiographs of each selected patient were taken at pre-operation (stage 0), 1 or 2 days after operation (stage 1), 1 month after operation (stage 2), 6 months after operation (stage 3), and 12 months after operation (stage 4). The radiographs were digitized at 600 dpi, 8 bit, and 256 gray levels. The region of interest, centered on the bony gap area of the operation site, was selected and the fractal dimension was calculated by using the tile-counting method. The mean values and standard deviations of fractal dimension for each stage were calculated and the differences among stage 0, 1, 2, 3, and 4 were evaluated through repeated measures of the ANOVA and paired t-test. Results : The mean values and standard deviations of the fractal dimensions obtained from stage 0, 1, 2, 3, and 4 were 1.658±0.048, 1.580±0.050, 1.607±0.046, 1.624±0.049, and 1.641 ±0.061, respectively. The fractal dimensions from stage 1 to stage 4 were shown to have a tendency to increase (p < 0.05). Conclusion: The tendency of the fractal dimesion to increase relative to healing time may be a useful means of evaluating post-operative bony healing of the osteotomy site.