• Title/Summary/Keyword: Mandibular symphysis

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A Clinical Review on the Transoral Approach to the Fractures of The Mandible (구내 접근법에 의한 하악골 골절 치료에 대한 임상적 고찰)

  • Park, Hyung-Sik;Kwon, Jun-Ho;Chung, Seong-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.79-86
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    • 1989
  • The is a retrospective study on the transoral approach to open reduction of the Mandibular fractures. Our study was based on a series of 64 patients with mandibular fractures among 99 patients of facial bone fractures who had been treated by transoral approach with or without extraoral approach at Department of Oral and Maxillofacial Surgery, Yonsei Medical Center, Yonsei University from January 1981 to October 1988. We studied favorite sites of open reduction, fixation methods, results and prognosis related to transoral approaches of Mandibular fractures, and which compared with extraoral approaches. The results obtained are as follows : 1. The transoral open reduction was used more frequently in Mandibular fractures(64.6%) than Midfacial bone fractures(35.4%). Among 64 patients of mandibular fractures, 47 patients(73.4%) were treated only by transoral approach and others(26.6%) were treated by both trans- and extra-oral approach. Among 92 sites of mandibular fractures, 75 sites(81.5%) were treated by transoral approach and 17(18.5%) were treated by extraoral approach. 2. The most favorite site for transoral approach compared with extraoral approach was Symphysis(100%), and Angle(62.5%) was next in order of frequency on Mandibular fractures. 3. Direct Interosseous Wiring(DIW) was most commonly used for fixation(64.6%) and Miniplate osteosynthesis was used next in 28.1%. 4. Simple(39.1%) and Compound(52.2%) fractures were frequently indicated for transoral approach, however comminuted fractures were rarely indicated. 5. The direction of fracture lines on Angle of the mandible did not influence to determine whether transoral approach should be selected or not. However this area seemed to be more difficult to reduce exactly by transoral procedure than other areas because simultaneous superior and inferior fixation was applied predominantly on this area. 6. The success rate of reduction and fixation analyzed from us was more excellent in Direct Interosseous Wiring(29/53=54.7%) than in Rigid Internal Fixation(9/29=31.0%). But it might be depended upon various factors as like as sugeon's skill. 7. The postoperative complication due to transoral open reduction of mandible was not high(12.0%) and this rate was similar with other published reports.

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A Design of Real Time Measurement System for EMG Silent Period Under Window Base (윈도우 환경하에서 근전도의 실시간 Silent Period 측정 시스템 설계)

  • 강병길;김태훈;이영석;김덕영;김세동;김성환
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.52 no.10
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    • pp.611-617
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    • 2003
  • A mechanical or electrical stimulation to the mandibular symphysis during a maximal voluntary clenching of the teeth always produces a jaw jerk followed by a silent period (transient stops) in the masseteric EMG (electromyogram). Generally, a mechanical stimulation is followed by a single silent period, and an electrical stimulation is followed by multiple silent periods. In this paper, we propose a new algorithm for determining the duration of the masseter silent period. The decision approach in essentially based upon a segmentation algorithm consisted of variance filter, median filter and gaussian filter. The new adaptive digital notch filter using R-CLMS(reverse constrained least mean-squared) algorithm is proposed for the elimination of powerline(60Hz) noise. At the same time, we design a real time measurement system for the EMG silent period under Window base.

Ridge Augmentation for Implant Placement Using Chin Graft;A Case Report (하악골 전방부 골이식술후 임프란트의 매식;증례보고)

  • Kim, Su-Gwan
    • Journal of Periodontal and Implant Science
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    • v.29 no.4
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    • pp.943-953
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    • 1999
  • Severe alveolar ridge deficiency can prevent ideal implant placement. Ridge augmentation procedures are necessary to regain lost alveolar structures. The corticocancellous block bone graft was harvested from the mandibular symphysis. This block bone was fixed to the lateral aspect of the ridge with titanium screws. Seven months later, the autogenous bone graft was reentered and sufficient bone volume was gained to allow implant placement. The fixation screws were removed and 3I implants were inserted. No complication and postoperative alteration in chin contour were observed. This report demonstrates that chin graft offers a predictable alternative in the reconstruction of ridge deficiency for implant placement.

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A CEPHALOMETRIC STUDY OF CRANIOFACIAL SKELETAL CHARACTERISTIC OF KOREAN ADOLESCENCES WITH NORMAL OCCLUSION (청소년기 정상교합자의 두개안면골격의 특성에 관한 연구)

  • Lee, Jeong-Min;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.19 no.1 s.27
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    • pp.187-200
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    • 1989
  • The purpose of this study was to find out the craniofacial skeletal characteristics and to establish standards in facial patterns of Korean adolescences with normal occlusion. The subjects consisted of 54 males and 71 females ranging in age from 12 to 16 years. To classify facial patrons, number the clinical deviations from the normal five key measurements: the facial axis, facial angle, mandibular plane angle, lower face height, mandibular arc, are added and averaged with the proper sign to divide subjects into three groups ; brachyfacial, mesofacial dolichofacial groups. For the comparison of each group, a total of 43 morphologic variables were employed and the data were analyzed by statistical methods. The findings of this study can be summerized as follows; 1. The mesofacial group was $54.4\%$, the brachyfacial group was $29.6\%$ and the dolichofacial group was $16.0\%$ in this subjects. 2. There were no significant differences in size and shape of cranial base among each groups. 3. The brachyfacial group manifested the forward positioned maxilla and mandible to anterior cranial base, smaller cant of the mandibular plane, square shaped mandible, and prominent symphysis as compared with dolichofacial group. 4. There were no significant differences in the cant of the maxilla to the anterior cranial base among each groups. 5. Ramal height and madibular body length of brachyfacial group were larger than those of dolichofacial group. 6. Brachyfacial group indicated the smallest degree in divergency of maxilla and mandible while dolichofacial group showed the largest degree.

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A CLINICO-RADIOLOGIC STUDY OF BONY REMODELING OF THE FRACTURED CONDYLES IN CHILDREN (소아에서 골절된 하악과두의 골개조 양상에 관한 임상 및 방사선학적 연구)

  • Cho Jeong-Shin;Park Chang-Seo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.2
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    • pp.471-482
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    • 1995
  • Bony remodeling pattern of condyle fractures in children are different from in adult for growing of condyle, also might affect treatment and prognosis of the condyle fracture. Subjects of this clinical and radiologic study were 26 temporomandibular joints diagnosed as condyle fracture in 23 patients under 15 years old age. They were treated with conservative method at Dental Hospital of Yonsei University from Jan., 1986 to Oct., 1994. Bony remodeling related with fracture pattern was evaluated. The results obtained are as follows: 1. The ratio of male to female in patients with condyle fracture was 1 : 0.9 and the difference of sex ratio was not noted. Comparing with preschool-age group and school-age group, age frequency was higher in preschool-age group(83%). 2. Fallen down(54%) was the most frequent cause of condyle fractures. Traffic accident and slip down were followed. 3. The most common clinical sign of condyle fractures was tenderness to paipation09 cases). Mouth opening limitation07 cases), swelling(7 cases), malocclusion(3 cases) were next in order. 4. According to sites of condyle fractures, unilateral fractures were in 20 patients and bilateral fractures in 3 patients, therefore total 23 patients-26 cases of condyle fracture were observed. According to fracture distribution, condyle fractures were in 10 patients(44%). Condyle fractures with symphysis fracture(9 patients, 39%), condyle fractures with ascending ramus fracture(2 patients, 9%), condyle fracture with mandibular body fracture(1 patient, 4%), and condyle fractures with mandibular angle fracture(1 patient, 4%) were followed. 5. In displacement pattern of fractured fragment of mandibular condyle, dispiacement(17 cases, 66%) was most common. Dislocation(5 cases, 19%) and deviation (4 cases, 15%) were next in order. 6. During the observation period of fractured condyles, remodeling patterns of fracture sites related with articular fossa were observed with usual condylar shape in 23 cases and with prominently different shape in 3 cases.

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FUNCTIONAL RECONSTRUCTION OF MANDIBULAR DEFECTS WITH FREE BONE GRAFT (유리골 이식을 통한 하악골 결손부의 기능적 재건술)

  • Kim, Jong-Won;Nam, II-Woo;Kim, Myung-Jin;Choung, Pill-Hoon;Seo, Byung-Moo;You, Jun-Young;Nam, Ki-Weon;Song, Min-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.4
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    • pp.338-345
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    • 1993
  • Mandibular discontinuity defect due to benign tumor, malignant tumor, infection, or truma results in major esthetic and biologic compromise. The primary goal of reconstruction is full restitution of function, which secondarily lead to normalization of the cosmetic deformity. The authors make a clinical study of 61 consecutive bone graft cases for mandibular reconstruction of discontinuity defect which were studied retrospectively using clinical data and radiographic findings. The cases were reviewed to evaluate the clinical success in the period from 1981 to 1990 in the Dept. of Oral & maxillofacial Surgery, Seoul National University Hospital. The criteria of the success in bone graft, are no residual infection, graft in with maintain its integrity, and remain over a half of its original size of graft in the radiographic features. The purpose of this clinical survey is to study of the mandibular discontinuity defects and success rate of free bone graft in mandibular defects. To summarize the clinical study of free bone graft, the main type of autogenous bone graft is iliac bone and corticocancellous type. Overall success rate is 80.3% in 61 followup cases over 6 months. Wire fixation and Extraoral approach has realtively better prognosis than other methods. It showed relatively poor prognosis in symphysis defects than other recipient site.

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A clinical study on the dental emergency patients visiting an University Hospital emergency room (대학병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구)

  • Jang, Chang-Su;Lee, Chang-Yeon;Kim, Ju-Won;Yim, Jin-Hyuk;Kim, Jwa-Young;Kim, Young-Hee;Yang, Byoung-Eun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.6
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    • pp.439-447
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    • 2011
  • Introduction: In today's society, the rapid and appropriate care of the dental emergency patients is much more important. So, a retrospective study on the characteristics of emergency dental injuries and diseases will be very meaningful. Materials and Methods: This retrospective clinical study was carried by reviewing the radiographic films and emergency chart of 11,493 patients who had visited the emergency room of Hallym Sacred heart Hospital and were treated in the Department of Oral and Maxillofacial Surgery from January 2006 to December 2010. Results: The male to female ratio was 1.9:1. The highest monthly incidence was observed in May (10.4%) and June (8.9%) and the peak age distribution was the first decade (56.0%), followed by the second decade (16.0%). Trauma was the most common cause in dental emergency patients, followed in order by toothache, odontogenic infection, temporomandibular joint (TMJ) disorder and oral hemorrhage. Soft tissue injury was most prevalent in the trauma group, followed by tooth injury and facial bone fractures. In the tooth injury group, tooth fracture (56.7%) showed the highest incidence followed in order by tooth subluxation (18.2%), tooth concussion (16.9%), tooth avulsion (11.5%) and alveolar bone fractures (3.7%). In the facial bone fracture group, mandibular fractures (81.8%) showed the highest incidence followed in order by maxilla fractures (15.7%), nasal bone fractures (9.0%), zygomaticomaxillary complex fractures (5.4%), orbital bone fractures (2.5%). In mandibular bone fractures, the most common location was the symphysis (70.1%), followed in order by the mandibular angle (33.0%), mandibular condyle (22.8%) and mandibular body (13.6%). In the infection group, a submandibular space abscess (46.2%) was most common followed in order by a buccal space abscess (17.4%), canine space abscess (16.9%) and submental space abscess (12.3%). TMJ dislocation (89.3%) showed the highest incidence in the TMJ disorder group, followed by TMJ derangement (10.7%). In the other group, a range of specific symptoms due to post operation complications, trigeminal neuralgia, chemical burns and foreign body aspiration were reported. Conclusion: For the rapid and appropriate care of the dental emergency patients, well-organized system should be presented in oral and maxillofacial surgery. And it is possible under analysis of pattern and the variation of the dental emergency patients.

Retrospective clinical study of mandible fractures

  • Jung, Hai-Won;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Jun;Lee, Jung-Woo;Lee, Hyun-Woo;Moon, Chang-Sig;Ohe, Joo-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.1
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    • pp.21-26
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    • 2014
  • Objectives: The purpose of this article is to analyze the incidence, demographic distribution, type, and etiology of mandible fractures that were treated by the Department of Oral and Maxillofacial Surgery in Kyung Hee University Dental Hospital from January 2002 to December 2012. Materials and Methods: This was a descriptive and analytic retrospective study that evaluated 735 patients that were treated for mandible fracture. Results: This study included 1,172 fractures in 735 patients. The ratio of male to female patients was 5.45 : 1; the maximum value was in patients between 20 and 29 years (38.1%) and the minimum in patients over 70 years old. The monthly distribution of facial fractures peaked in the fall and was lower during winter. No specific correlation was identified based on the annual fracture distribution. Among the 735 fracture patients, 1.59 fracture lines were observed per patient. The most frequent site was the symphysis, which accounted for a total of 431 fractures, followed by the angle (348), condyle (279), and body (95). The symphysis with angle was the most common site identified in combination with fracture and accounted for 22.4%, followed by symphysis with condyle (19.8%). The angle was the most frequent site of single fractures (20.8%). The major cause of injury was accidental trauma (43.4%), which was followed by other causes such as violence (33.9%), sports-related accidents (10.5%), and traffic accidents (10.1%). Fracture incidents correlated with alcohol consumption were reported between 10.0%-26.9% annually. Conclusion: Although mandible fracture pattern is similar to the previous researches, there is some changes in the etiologic factors.

Reports of mandibular symphysis widening with distraction osteogenesis (견인 골 신장술을 이용한 하악 정중부 확대 치험례)

  • Tae, Ki-Chul;Oh, Sung-Whan;Min, Sung-Ki
    • The korean journal of orthodontics
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    • v.31 no.5 s.88
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    • pp.499-504
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    • 2001
  • Transverse skeletal deficiency is a common clincal problem associated with narrow basal and dentoalveolar bone. The clinical characteristics of transverse deficiency presents with anterior crowding and posterior buccal crossbite. Orthodontic expansion, using lip bumper and functional devices, was recommanded for younger ages. However, expansion of lower anterior area in older Patients is unstable and tends to relapse toward the original dimension. Distraction osteogenesis is a unique form of clincal tissue engineering and biologic process of new bone formation between bone segments that are gradually separately by incremental traction. Distraction osteogenesis was considered that great potential for correcting transverse mandibular deficiencies. In this Paper, a case of treated transverse deficiency patients with distraction osteogenesis using tooth-borne and tooth & bone-borne distractor is presented.

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