• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권2호
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• pp.150-154
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• 2020

We present a case of osteoradionecrosis treated with leukocyte- and platelet-rich fibrin (LPRF) and surgery and followed up with clinical and tomographic investigations. A 65-year-old woman presented with pain in the posterior region of the right palate. Her medical history included cardiovascular disease and squamous cell carcinoma in the anterior region of the floor of the mouth that had been treated with intensity-modulated radiation therapy. Measurements of isodose curves showed a full dosage of 6,462.6 cGy in the anterior mandibular region, whereas that in the posterior region on the right side of the maxilla reached 5,708.1 cGy. Osteotomy was performed using rotary instruments, and debridement and placement of two LPRF membranes were also carried out. New gum tissue with no bone exposure was noted 14 days postoperatively. Tissue repair was complete, and the patient had no further complaints. During a 39-month follow-up period, the oral mucosa remained intact, and the patient was rehabilitated with a new upper denture. Since there is no consensus regarding the best protocol to treat osteoradionecrosis, LPRF might be an interesting adjuvant to a surgical approach. The use of LPRF is simple and reduces operational costs, time of handling, probability of technical failure, and associated morbidities for patients with osteoradionecrosis.

• Archives of Plastic Surgery
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• 제40권4호
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• pp.433-439
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• 2013

Background Facial beauty depends on the form, proportion, and position of various units of the face. In terms of the frontal view and facial profile, the chin is the most prominent aesthetic element of the lower third of the face. Many methods have been implemented to obtain good proportions of the lower face. In this study, we applied the T-shaped genioplasty method to correcting chin deformities. Methods All of the procedures in 9 cases were performed under general anesthesia. For genioplasty, a horizontal cutting line and 1 or 2 vertical cutting lines were drawn 5 mm below the mental foramen. Osteotomed bone segments of the chin were used for horizontal widening using bone grafts or for horizontal shortening. Likewise, they were used as bone grafts for vertical lengthening or vertical shortening. The bone segments were approximated in the midline and held in place using miniplates. Results The postoperative appearance of the 9 cases showed that the lower third of the face had been naturally changed. At the same time, vertical lengthening or shortening, and horizontal widening or shortening could be implemented during the operation. Satisfactory results were obtained based on reviews of the patients' preoperative and postoperative photographs. The patients were also satisfied with the outcomes. Conclusions Using T-shaped genioplasty, we efficiently adjusted the shape and position of the chin to obtain good proportions of the lower face and change its contour to obtain an aesthetically appealing oval face in accordance with East Asians' aesthetic preferences.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권2호
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• pp.40-46
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• 1989

출생 전${\cdot}$후 악관절의 외상 또는 감염은 과두 성장을 방해하며 편측으로 발생하는 경우 하악골의 비대칭 성장을 초래하여 심한 안모 변형과 부정교합을 유발하거나 악관절 유착의 주된 원인이 된다. 역사적으로 관절 유착은 과두절단술에서부터 연골이식, 진피이식, 금속과두 이식, 관절 성형술, 관절과 이식물 삽입에 이르기까지 매우 다양한 방법에 의해 치료되어 왔으며 하악운동이 보장되고 정상적인 기능을 회복하는데는 어떤 술식이라도 만족스런 결과를 가져다줄 수 있다. 이에 저자는 편측성 악관절 강직증 및 비대칭 안모를 가진 환자에서 과두절제술 후 금속 과두이식을 이용한 악관절 재건과 하악 골체부 절단술 및 C-sliding 절단술, 하악지 수직 골절단술, Medpor를 이용한 증식술로 개구기능과 비대칭 안모를 개선하여 비교적 만족할 만한 결과를 얻었기에 그 치험례를 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권2호
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• pp.182-190
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• 2008

본 증례에서는 자기강화 흡수성 고정판을 사용하여 하악골 골절을 정복하였다. 하악각 부위와 정중부, 부정중부, 하악지 부위의 골절이 발생하여 직경 2.0mm의 4-hole plate와 직경 2.4mm의 6-hole plate를 1개 혹은 2개를 사용하였다. 발생한 합병증에는 4명의 환자에 있어서 감각저하 이외에는 어떠한 합병증도 관찰되지 않았다. 본 연구의 추적 조사 기간이 너무 짧고 환자 수가 너무 적어 생체 흡수성 고정판을 사용한 골절 정복의 장기간의 효과를 결정할 수 없지만 하악골 골절의 초기 골 치유를 가능하게 하는 적절한 견고성과 안정성을 보여주었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권2호
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• pp.133-136
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• 2011

Cystic lesions on the jaws with expansion can invade the adjacent anatomical structure, infiltrate and expand the jaws, cause facial deformity, etc. There is great potential for pathologic fractures after cyst enucleation, and damage to the major structures like the nerve, artery. For these reasons, marsupialization and decompression are commonly used to reduce the cystic size. In 1947, Thomas first mentioned decompression that reduces the osmotic pressure in a cyst by making a hole in the cyst and insert a drain. In our cases, a large sized cystic lesion was treated with a specific device made from an orthodontic band and spinal needle. This device is easy and effective for applications and self irrigation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권4호
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• pp.240-247
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• 2009

Purpose: The purpose of this study was to evaluate marginal bone loss to the bone crest functionally loaded for up to eighteen months and also with regard to other variables of interest. Material and Methods: 135 endosseous implants(GS II, Osstem, South Korea) were placed in 35 patients. The design of GS II implant is straight with the microthread. Radiographic examinations were conducted at baseline (implant loading) and 3, 6, 9, 12 and 18 months after loading. Marginal bone level measurement was made from the reference point to the lowest observed point of contact of the marginal bone with the fixture. The reference point of the fixture was the border between the blasted surface and machined surface of the fixture. Results: Implants were on function for a mean 12.7 months(range, 3?18 months). For the 56 maxillary and 79 mandibular implants, mean marginal bone loss was 0.68 mm and 0.70 mm. Implants placed maxillary posterior area displayed more crestal bone loss than the other position. The difference between mesial and distal bone levels was statistically significant (p<0.05) with respective means of 0.51 mm and 0.62 mm. Also, The difference between bone graft group and no-bone graft group was statistically significant(p<0.05) with respective means of 0.38 mm and 0.66 mm. But no statistically significant influence of sex, type of surgery(one or two stage surgery), the implant length was observed(p>0.05). Conclusion: This study indicates the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods.

• Journal of Periodontal and Implant Science
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• 제27권1호
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• pp.45-59
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• 1997

Platelet-derived growth factor(PDGF) has been shown to play an important role in periodontal regeneration. The purpose of the present study was to examine the distribution of PDGF in experimentally created periodontal intrabony defects after flap surgery with various bone graft materials. Six healthy mongrel dogs were used in this study. Three-wall bony defects were created in maxillary and mandibular premolars, inflammation induced by wire ligation and injection of impression material into the defects. Eight weeks later, the experimental lesions thus obtained were treated by plain flap surgery(control group), flap surgery plus autogenous bone graft(autogenous bone group), flap surgery plus Biocoral graft(Biocoral group), or flap surgery plus bioglass graft(bioglass group), which were randomly assigned to the defects. After 4, H, and 12 weeks postoperatively, 2 dogs were sacrificed at each time and 1he specimens were taken for histological examinations and immunohistochemical examinations for PDGF. In the control defects the amount of new bone formation was minimal. In the autogenous bone and Biocoral group new bone was deposited around implanted particles and the amount of new bone was increased with time. A large number of bioglass particles exibited a central excabation and bone formation could be observed in the central excabation as well as around the particles. The expression of PDGF was low in the control group. The expression of PDGF in Biocoral group was increased at 1, H week, but decreased at 12 week. The increased PDGF expression in autogenous bone and bioglass group was maintained to the end of the experiment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권6호
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• pp.297-300
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• 2014

Objectives: To compare the clinical and radiological outcomes after closed reduction (CR) and open reduction and internal fixation (ORIF) in the management of subcondylar fractures. Materials and Methods: Forty-eight patients presenting with subcondylar fracture between January 2010 and March 2013 were evaluated retrospectively. Fifteen patients were treated with CR and 33 patients with ORIF. The clinical and radiologic parameters were evaluated during follow-up (mean, 7.06 months; range, 3 to 36 months). Results: In the CR group, no patients had any problems with regard to the clinical parameters. The average period of maxillomandibular fixation (MMF) was 5.47 days. The preoperative average tangential angulation of the fractured fragment was $3.67^{\circ}$, and loss of ramus height was 2.44 mm. In the ORIF group, no clinical problems were observed, and the average period of MMF was 6.33 days. The preoperative average tangential angulation of the subcondylar fragment was $8.66^{\circ}$, and loss of ramus height was 3.61 mm. Conclusion: CR provided satisfactory clinical results, though ORIF provided more accurate reduction of the fractured fragment. So there is no distinct displacement of fractured fragment, CR should be selected than ORIF because of no need for surgery.

• 대한두개안면성형외과학회지
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• 제15권2호
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• pp.82-88
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• 2014

Background: The chin shape and position is important in determining the general shape of the face, and augmentation genioplasty is performed alone or in combination with other aesthetic procedures. However, augmentation genioplasty using osteotomy is an invasive and complex procedure with the potential to damage mentalis muscle and mental nerve, to affect chin growth, and prolonged recovery. Our aim was to present our experience with a modified augmentation genioplasty procedure for hypoplastic chins using a Gore-Tex implant. Methods: Two vertical slit incisions were made at the canine level to create a supra-periosteal pocket between the incisions, preserving the periosteum and mentalis muscle. Minimal sub-periosteal dissection was performed lateral to the incisions along the mandibular border. The both wings of implant were inserted under the periosteum to achieve a stable dual plane implantation. Results: In total, 47 patients underwent dual plane chin augmentation using a Gore- Tex implant between January 2008 and May 2013. The mean age at operation was 25.77 years (range, 15-55 years). There were 3 cases of infection; one patient was treated with antibiotics, the others underwent implant removal. Additionally, two patients complained of postoperative parasthesia that spontaneously improved without any additional treatment. Most patients were satisfied with the postoperative outcomes, and no chin growth problems were observed among the younger patients. Conclusion: Dual plane Gore-Tex chin augmentation is a minimally-invasive operation that is simple and safe. All implants yielded satisfactory results with no significant complications such as mental nerve injury, lower lip incompetence, or chin growth limitation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권4호
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• pp.414-417
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• 1999

The congenital epulis of newborn is a rare benign tumor that occurs on the gingiva of the anterior alveolar ridge of the jaws, also known as a congenital granular cell tumor. Females are affected 8 - 10 times more often than males. The typical location is the alveolar ridge of the maxilla near the canine but the mandibular region can also be involved. The lesion may be sessile or pedunculated with red or normal color. The size of tumor varies from several millimeters to a few centimeters in diameter. Surgical excision is generally indicated and no recurrences have been noticed. Spontaneous regression is rare. It is histologically similar to the granular cell tumor, although pseudoepitheliomatous hyperplasia does not occur in the former lesion. Thus sheets of large, closely packed cells showing fine, granular, eosinophilic cytoplasm comprise the tumor mass. This is a case report of congenital epulis in the fetus. The lesion was detected in ultrasonogram, its size is 3cm in diameter. The infant showed nursing disturbance and respiratory obstruction after birth, so the tumor was surgically excised under local anesthesia.