• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권5호
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• pp.325-330
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• 2013

The patient's appearance can be dramatically enhanced as a result of orthognathic surgery. However, esthetic contouring of the mandibular body portion is often overlooked in the surgery. Restoring a more beautiful jaw line is important and directly affects surgical results. From December 2010 to February 2012, we performed mandibular body contouring for the slimming of the third lower part of the face in 37 patients who had undergone either 1-jaw surgery or 2-jaw surgery. The third lower part of the facial contour was improved in all the patients after at least 3 months follow-up. Mandibular body contouring is a simple method that can be additionally used for the slimming of the third lower part of the face in patients who require orthognathic surgeries. It makes the lower face look more attractive from both the anterior and lateral perspectives.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권6호
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• pp.444-449
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• 2003

Distraction osteogenesis is a biologic process in which new bone is formed between bone fragments being separated by a tractional force. This technique has the advantage of initiating new bone growth without bone transplantation and promoting the growth of soft tissue. Mandibular distraction osteogenesis has shown to be effective to treat congenital or acquired mandibular hypoplasias. On the basis of positive results with implant-supported prostheses, the use of implants in the distracted site can significantly help stabilize the prosthesis. We obtained good result in the patient with mandibular deficiency due to trauma, who have been reconstructed with distraction osteogenesis and implant. We report our experiences with literature view.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권6호
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• pp.565-569
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• 2006

The purpose of this study was to assess the influence of the presence and impacted state of the mandibular third molars on the incidence of mandibular condyle fracture. A retrospective study was designed for patients presenting to the Department of Oral and Maxillofacial Surgery, Kyungpook National University Hospital and Tae-gu Fatima Hospital for treatment of mandibular fractures from January 2003 to January 2006. The independent variables in this study were the presence, degree of impaction of third molars, and the outcome variables were the incidence of mandibular condyle fractures. Hospital charts and panoramic radiographs were used to determine and classify these variables. The demographic data included age, sex, mechanisms of injuries and number of mandibular condyle fractures. The study sample comprised 136 mandibular condyle fractures in 105 patients. Result of this study demonstrated a statistically significant difference in ipsilateral condyle fractures and mandibular third molar absence(P=0.032) and bilateral condyle fractures without another fracture and mandibular third molar absence(P=0.028).

• Archives of Plastic Surgery
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• 제39권4호
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• pp.301-308
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• 2012

In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.291-300
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• 2012

The incidence of condylar fractures is high,but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권4호
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• pp.351-361
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• 1997

This study was performed to evaluate the change of the soft tissue facial profile after mandibular set back surgery during time intervals. For this study, 33 patient, 8 males and 25 females, were selected and their lateral cephalograms were taken and analyzed periodically. Hard and soft tissue changes during postoperative time intervals, correlation between surgical skeletal changes and postoperative soft tissue changes, and prediction for long-term soft tissue changes were established through varying statistical methods. The results were as follow : 1. There were meaningful changes of anteroposterior skeletal position at 6 months and 2 years after mandibular set back by mandibular ramus osteotomy. Two years postoperatively, there was 30%, 32%, 29% relapse on B point, pogonion, menton each. 2. Two years after the mandibular ramus osteotomy, the relative changes of the soft tissue to their osseous counterparts showed 76% on the lower lip and 91% on the pogonion. 3. The movements of the mandibular landmarks in correlation to anteroposterior position of the lower lip and soft tissue of the chin showed to be effective on a long-term basis. 4. Using surgical changes of pogonion, prediction of changes in soft and hard tissue pogonion was useful and the coefficient of determination was 0.46 each and their reliability decreased 2 years postoperatively. 5. The upper lip position after the mandibular set back surgery was somewhat anterior 2 years postoperatively, but that has no statistical meanings.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권1호
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• pp.21-30
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• 2001

The purpose of this study was to evaluate the skeletal relapse pattern of the mandibular prognathic patients after mandibular set back surgery by sagittal split ramus osteotomy. The horizontal and vertical position of the cephalometric points were measured before, after surgery and after one-year follow up period. The next, the positional change of the proximal and distal mandibular segment were evaluated respectively. The obtained results were as follows; 1. The horizontal and vertical position of Cd was not changed before and after surgery, and it was maintained its original position during the observation periods. 2. As the mandibular prognathism of the patients was severe before surgery, the more skeletal relapse tendency was observed during follow-up period(p<0.05). 3. As the horizontal positional change of the mandible which was obtained by mandibular set-back surgery was large, the more horizontal relapse tendency was observed during follow-up period(p<0.05). 4. The corpus axis angle decreased by sagittal split ramus osteotomy(p<0.01), but it was kept its reoriented position during follow-up period. 5. During the follow-up period after mandibular set-back by sagittal split ramus osteotomy, the forward relapse of mandible correlated with not only the forward rotation of the proximal segment but also the forward movement of the distal segment(p<0.05).

• 대한두개안면성형외과학회지
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• 제21권5호
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• pp.294-300
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• 2020

Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p< 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.101-105
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• 1998

Compound comminuted mandibular fracture is defined as the presence of multiple fracture lines with open wound resulting in many small pieces within the same area. The incidence of mandibular comminution is difficult to determine but reported as 2.7~18.6 % incidence among mandibular fractures. There are controversies in the treatment of mandibular comminuted fractures. Treatment of comminuted mandibular fracture has traditionally involved closed reduction in an effort to avoid stripping periostcum from the bony segments, but rigid internal rigid fixation is used more popular at present. The extent of comminution, displacement of bony fragments and patient general conditions are important factors in decision of the treatment methods. When significant bone displacement is present, it is necessary to reduce these comminuted fragments to an anatomic, pretraumatic relationship to restore facial form and function. In these cases, ORIF allows anantomic reduction of comminuted segments as well as pretraumatic occlusion. Gentle handling of the soft tissue, rigid fixation of bony fragments and adequate immobilization are essential for reducing the complications. This is the report the incidence, causes, complications and treatment of the patients who visited our department for compound comminuted mandibular fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권2호
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• pp.9-20
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• 1990

A series of 19 cases with maxillary hyperplasia and mandibular retrognathia were operated on by simultaneous superior repositioning of the maxilla after Le Fort I osteotomy and anterior repositioning of the mandible after bilateral sagittal split ramus osteotomies with or without osteotomy of the inferior border of the mandible. These were evaluated by retrospective cephalometric and computer analysis for the longitudinal skeletal and dental changes for an average of 17.1 months after surgery. For stabilization of the osteotomized segments, the authors used wire osteosynthesis by means of bilateral infraorbital and zygomatic buttress suspension wire at the maxilla, and direct interosseous wire at the split segments of the mandibular rami. Results show generally good stability after simultaneous maxillary and mandibular surgery with wire osteosynthesis, and a minimal to moderate tendency toward skeletal and dental relapse. This article is a preliminary study to defy the efficiency of the wire osteosynthesis (wo)compared with rigid internal fixation (RIF) for simultaneous maxillary and mandibular surgery. 1. The vertical relapse rate of the A point after superior repositioning of the maxilla is 2.2%. 2. The horizontal relapse rate of the B point after advancement of the mandible is 18.3%. 3. The condyle is distracted inferiorly and slightly posteriorly at the immediate postoperative period. 4. At the long term follow up examination, the condyle presents tendency of return to the preoperative position. 5. Condylar segment angle is decreased at the immediate postoperative period, and at the long term follow up evaluation, the angle is increased. 6. Gonial angle is increased at the immediate postoperative period, and then is decreased at the long term follow up evaluation. 7. The dentition is satisfactory with acceptable movement at the long term follow up evaluation. 8. At the mandibular free body analysis, genioplasty shows good stability. 9. Wire osteosynthesis provides excellent stabilization for the simultaneous maxillary and mandibular surgery.