• Title/Summary/Keyword: Maxilla

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An Adult Cleft Lip and Plate Patient Using a Maxillary Distractor by $Synthes^{(R)}$ : Report of a case ($Synthes^{(R)}$상악골 신장기를 이용한 성인 구개구순열 환자의 치험례)

  • Kim, Jun-Yeong;Lee, Bu-Gyu
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.1
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    • pp.21-32
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    • 2009
  • Generally, an adult cleft lip or/and palate patient shows some amount of maxillary deficiency due to limitation of bony growth caused by heavy scars resulted from previous operations such as a cheiloplasty and/or a palatoplasty at an early child age. To solve the problem, advancement of the maxilla is usually required during orthognathic surgery. However, severe tensional force resulted from heavy scars on the palate and/or the lip, as well as the bony defect at the cleft area limited sufficient advancement of the maxillary segment and finally caused relapse of the reposed maxilla. Therefore, distraction osteogenesis of the maxilla was introduced for the successful maxillary advancement inthose kinds of patients. As both hard and soft tissues can be simultaneously and gradually extended with this technique, tensional force caused by heavy scars opposed to forward movement of the maxilla can be reduced to an extent not to develop severe relapse of the advanced maxilla. Since distraction osteogenesis of the maxilla was applied as one of standard protocols for the treatment of the patients with severe maxillary hypoplasia dueto cleft lip and/or palate, the devices for the distraction was improved to control the vectors of distraction with better and more stable. We have treated a 23-year-old male cleft patient with a severe maxillary hypoplasia using a newly developed a maxillary distraction device and a RP model for a pre-operative simulation surgery. As a result, we could successfully move the maxilla as we designed pre-operatively and also reduce much of operation time. Therefore, we report of the case to share our experience with colleagues.

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Short dental implants in the posterior maxilla: a review of the literature

  • Esfahrood, Zeinab Rezaei;Ahmadi, Loghman;Karami, Elahe;Asghari, Shima
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.2
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    • pp.70-76
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    • 2017
  • The purpose of this study was to perform a literature review of short implants in the posterior maxilla and to assess the influence of different factors on implant success rate. A comprehensive search was conducted to retrieve articles published from 2004 to 2015 using short dental implants with lengths less than 10 mm in the posterior maxilla with at least one year of follow-up. Twenty-four of 253 papers were selected, reviewed, and produced the following results. (1) The initial survival rate of short implants in the posterior maxilla was not related to implant width, surface, or design; however, the cumulative success rate of rough-surface short implants was higher than that of machined-surface implants especially in performance of edentulous dental implants of length <7 mm. (2) While bone augmentation can be used for rehabilitation of the atrophic posterior maxilla, short dental implants may be an alternative approach with fewer biological complications. (3) The increased crown-to-implant (C/I) ratio and occlusal table (OT) values in short dental implants with favorable occlusal loading do not seem to cause peri-implant bone loss. Higher C/I ratio does not produce any negative influence on implant success. (4) Some approaches that decrease the stress in posterior short implants use an implant designed to increase bone-implant contact surface area, providing the patient with a mutually protected or canine guidance occlusion and splinting implants together with no cantilever load. The survival rate of short implants in the posterior edentulous maxilla is high, and applying short implants under strict clinical protocols seems to be a safe and predictable technique.

The factors that influence postoperative stability of the dental implants in posterior edentulous maxilla

  • Kim, Yun-Ho;Choi, Na-Rae;Kim, Yong-Deok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.2.1-2.6
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    • 2017
  • Background: All clinicians are aware of the difficulty of installing a dental implant in posterior maxilla because of proximate position of maxillary sinus, insufficient bone width, and lower bone density. This study is to examine which factors will make the implantation in the posterior maxilla more difficult, and which factors will affect the postoperative implant stability in this region. Methods: Five hundred seventy-three fixtures on the maxilla posterior were included for this study from all the patients who underwent an installation of the dental implant fixture from January 2010 to December 2014 at the Department of Oral and Maxillofacial Surgery in Pusan National University Dental Hospital (Yangsan, Korea). The postoperative implant stability quotient (ISQ) value, fixture diameter and length, presence of either bone graft or sinus lift, and graft material were included in the reviewed factors. The width and height of the bone bed was assessed via preoperative cone beam CT image analysis. The postoperative ISQ value was taken just before loading by using the OsstellTM $mentor^{(R)}$ (Integration Diagnostics AB, Gothenburg, Sweden). The t test and ANOVA methods were used in the statistical analysis of the data. Results: Mean ISQ of all the included data was 79.22. Higher initial bone height, larger fixture diameter, and longer fixture length were factors that influence the implant stability on the posterior edentulous maxilla. On the other hand, the initial bone width, bone graft and sinus elevation procedure, graft material, and approach method for sinus elevation showed no significant impact associated with the implant stability on the posterior edentulous maxilla. Conclusions: It is recommended to install the fixtures accurately in a larger diameter and longer length by performing bone graft and sinus elevation.

Malignant Fibrous Histiocytoma of the Maxilla - Report of A Case - (상악골의 악성 섬유성 조직구종 - 증례보고 -)

  • Oh, Yoon-Kyeong;Yeo, Hwan-Ho
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.225-231
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    • 1995
  • Malignant fibrous histiocytoma(MFH) of the maxilla is a rare malignant bone tumor Seven percents of all MFH occur in the head and neck. Approximately $12{\%}$ of these tumors occur in the maxilla. Local recurrence or distant metastasis was reported in $55{\%}$ of cases of maxillary MFH. The mean survival time of 30 months was reported from a review of 14 MFHs in the maxilla, mandible and oral soft tissues. MFH of the maxilla is best treated surgically but radical neck dissection does not appear to be indicated unless there is clinical evidence of lymph node metastases Although the use of radiation therapy for head and neck MFH has not been studied for a series of cases, individual cases of regression or histological change have been reported. Other authors have reported numbers of cases who received radiation therapy without benefit. Response to combination chemotherapy has been reported in $33{\%}$ of 23 patients with recurrent or metastatic MFH. We report here a case of MFH occurring in the maxilla with a review of literature about the clinical behavior and treatment of these lesions.

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USING OF THE TEMPORALIS MUSCLE AND FASCIA FLAP FOR MAXILLA RECONSTURCTION (상악 결손부 수복을 위한 측두피판의 이용)

  • Kim, Young-Jo;Lee, Dong-Keun;Kim, Kui-Hee;Yoon, Sung-Phil;Chung, Chang-Joo;Jin, Kook-Bum
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.1-11
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    • 1994
  • The functional deformity following removal of the maxilla is considerable, especially following maxilla cancer excision. Rehabilitation of oral and maxillofacial region used to be very difficult with prosthesis or traditional flaps. Temporal muscle and fascia flaps have been described for immediate reconstruction following hemi-maxillectomy, but not total maxillectomy. The muscle and superficial fascia of the temporal area differ in their physical characteristics, vascular supply and clinical applications. Both can be employed independently or simultaneously as regional flaps in the reconstruction of a variety of complex craniofacial defects. Four case is presented in which 3 case maxilla cancer, one case non-union after maxilla fracture, and all case showed successful use of this flap. Only one patient developed partial necrosis of the flap ; significant necrosis did not occur in any other patient. This present paper reviews the anatomy, surgical technique and utilisation of temporal muscle and fascia flaps.

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SIMULTANEOUS SURGICAL REPOSITIONING OF THE MAXILLA, MANDIBLE, AND CHIN (상악골, 하악골 및 이부의 외과적 동시 이동술)

  • Lee, Jae-Hwy;Lee, Ho-Jun;Hwang, Byung-Nam;Lee, Jeong-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.2
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    • pp.184-199
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    • 1996
  • The challenges to achieve three dimensional facial proportionality and occusal stability in many patients with complex dentofacial deformity have been met by the development and use of the maxilla, mandible, and chin surgery techniques in combination with efficient orthodontic treatment. There is a clinical, biological, and biomechanical foundation for simultaneous surgical repositioning of the maxilla, mandible, and chin in a significant proportion of adult and adolescent patients. A combination of the surgical and orthodontic approach may provide increased treatment efficiencies and optimal esthetic results. Art and science to determine the treatment objectives, specifically, the desired soft tissue changes are firstly established by using the clinician's "esthetic sense" of the facial beauty and proportion aided to a few cephalometric guidelines. In this sense, the dependence on the clinician's "esthetic eye" by Dr. Bell is more important in analyzing the facial proportion than the satisfaction of rigid cephalometric norms. The purpose of this article was to elucidate the indication for simultaneous surgical repositioning of the maxilla, mandible, and chin, and to describe the clinical cephalometric analysis for orthognathic surgery. Representative 6 case reports were presented and discussed to illustrate the esthetic, orthodontic, and surgical treatment objectives with long-term follow-up.

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The correlation between physique and dental arch size

  • Lee, Seung-Hun;Park, In-Suk
    • Journal of Korean society of Dental Hygiene
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    • v.20 no.1
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    • pp.11-18
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    • 2020
  • Objectives: We analyzed the correlation between physique and size of the dental arch of college students with normal occlusion. Methods: Ninety-nine college students filled out the prepared questionnaire. The length and width of the dental arch of the students was measured using a plaster model after taking an impression. The data were analyzed using the t-test and correlational analysis. Results: The maxilla arch length was 3.70 mm longer and the inter-molar width of the maxilla was 3.06 mm longer in men (both p<0.01) than in women. Additionally, the mandible was 3.66 mm longer in men as compared to those in the women (p<0.01). As height increased, there was increase in the body weight (α=0.683, p<0.01), maxilla arch length (α=0.373, p<0.01), molar width of the maxilla (α=0.214, p<0.05), and the mandible (α=0.280, p<0.01). The greater the weight increase, the greater the maxillary arch length increase (α=0.392, p<0.01), and the greater the molar width of the maxilla (α=0.336, p<0.01) and mandible (α=0.502, p<0.01) increase. Conclusions: As physical size (both height and weight) increased, the maxillary length and molar width also increased. Based on the results of this study, the cause of malocclusion, form and size of the dental arch, and stable occlusion can be used as basic data.

A COMPARATIVE STUDY ON THE POSITIONAL CHANCES OF CRANIOFACIAL STRUCTURES BETWEEN MIXED AND PERMANENT DENTITION IN CLASS III MALOCCLUSION BY MESH DIAGRAM (혼합치열 및 영구치열기에서 mesh diagram을 이용한 3급 부정교합자 악안면구조의 위치변화에 관한 비교 연구)

  • Lee, Young-Mi;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.23 no.1 s.40
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    • pp.101-113
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    • 1993
  • For the purpose of interpretation of positional changes of craniofacial structures in Class III malocclusion between mixed and permanent dentition, 73 normal samples and 103 Class III samples of mixed dentition and 125 normal samples and 168 Class III samples of permanent dentition were selected. Comparative cephalometric analysis was undertaken between them respectively by mesh diagram method to evaluate the positional changes of maxilla and mandible in anteroposterior direction and vertical direction and also the inclination changes of maxillary and mandibular incisors in labio-lingual direction. The following results were obtained : 1. The antero-posterior positional changes of the maxilla and mandible were posterior direction of maxilla and anterior direction of mandible. 2. The vertical positional changes of the maxilla and mandible were superior direction of both maxilla and mandible. 3. The labio-lingual inclination changes of the maxillary and mandibular incisors were lingual direction of both maxillary and mandibular incisors.

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THE MANAGEMENT OF A COMPLEX IMPLANT CASE USING CAD-CAM TECHNOLOGY: A CLINICAL REPORT

  • Park, Eun-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.6
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    • pp.634-638
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    • 2008
  • PURPOSE: The application of computer-aided technology to implant dentistry has created new opportunities for treatment planning, surgery and prosthodontic treatment, but the correct selection and combination of available methods may be challenging in times. Hence, the purpose of this case report is to present a combination of several computer-aided tools as approaches to manage complicated implant case. MATERIAL AND METHODS: A 47 year-old female patient with severe dental anxiety, high expectations, financial restrictions and poor compliance presented for a fixed rehabilitation. A CT scan with a radiographic template obtained with software (SimPlant, Materialize, Leuven, Belgium) was used for treatment planning. The surgical plan was created and converted into a stereolithographic model of the maxilla with bone-supported surgical templates (SurgiGuide, Materialise, Leuven, Belgium), that allowed for the precise placement of 7 implants in a severely resorbed edentulous maxilla. After successful osseointegration, an accurate scan model served as the basis for the fabrication of a one-piece milled titanium framework using the Procera (Nobel Biocare, Gothenburg, Sweden) technology. The final rehabilitation of the edentulous maxilla was rendered in the form of a screw-retained maxillary metal-reinforced resin-based complete prosthesis. RESULTS: Despite challenging circumstances, 7 implants could be placed without bone augmentation in a severely resorbed maxilla using the SimPlant software for pre-implant analysis and the SurgiGuide-system as the surgical template. The patient was successfully restored with a fixed full arch restoration, utilizing the Procera system for the fabrication of a milled titanium framework.

Case report of bilateral facial cleft and duplicated maxilla (양측성 안면열과 중복 상악골:증례보고)

  • Eom Min-Yong;Song Min-Seok;Kim Hyeon-Min;Koo Hyun-Mo;Yi Jun-Kyu;Jeong Jong-Sun;Na Joo-Il
    • Korean Journal of Cleft Lip And Palate
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    • v.8 no.1
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    • pp.23-29
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    • 2005
  • The facial cleft and duplicated maxilla are lire congenital anomaly. After Rushton and Walker had reported a unilateral facial cleft with excess tooth and bone formation in 1937, few authors described similar cases. The etiology of this anomaly is not well understood, but considered embryologically as a neurocristopathy. A neurocristopathy is defined as a condition arising from aberrations in early migration, growth and differentiation of neural crest cells. This aberrations result in facial malformation such as facial clefts and loss or duplication of facial structures. We experienced a male newborn baby with bilateral facial cleft and duplicated maxilla. The cleft was surgically corrected when he was 5 months old. The function and appearance of lip are improved. Duplicated maxilla will be surgically removed. We report this case with review of literatures.

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