• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.356-360
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• 1999

PURPOSE : This is to review the complicated jaw fractures that had been referred for revision of the unsatisfactory results, and to provide proper managements for the easily complicated jaw fractures. MATERIALS & METHODS : Twenty-nine patients who had been revised due to malunion or complicated fractures of facial bones for last 3 years were reviewed. The main problems required for revision, type of fractures complicated, the primary managements to be reclaimed, the specialties to be involved, the management to be reclaimed, time elapsed to seek reoperation, type of revision surgeries, residual complication were analysed with medical records, radiographs and final examinations. RESULTS: The major complaints were malocclusion(79.3%), facial disfigurement(41.3%), TMJ problems (13.7%), neurologic problems(10.3%), non-union(10.3%), and infection(6.8%). Unsatisfactory results were occurred most frequently after improper management of the multiple fractures of the mandible (62.2%), combined fractures of maxilla and mandible (20.6%), fracture of zygomatico-maxillary complex and midpalate (17.2%). The complications to be corrected were widened or collapsed dental arches (79.3%), improperly reduced condyles (41.3%), painful TMJ (34.4%), limited jaw excursion (31.0%), over-reduction of zygoma (13.7%), and nonunion with infection(13.7%). and dysesthesia (10.3%). The primary managements were nendereet by plastic surgeons in 82.7%(24/29) and by oral surgeons in 7.6%(2/29). Main causes of malunion are inadequate ORIF in 76%, unawareness & delay in 17%, and delayed due to systemic cares in 17%. 76% of 29 patients had been in state of intermaxillary fixation for over 4 weeks. Revision were done by means of "refracture and ORIF"in 48.2%(14/29), orthognathic osteotomies with bone grafts in 55.1%(16/29), and camouflage countering & alloplastic implantations in 37.9%(11/29), TMJ surgeries in 17.2%, micro-neurosurgeries in 11.6%. Residual complications were limited mouth opening in 24.1% (7/29), paresthesia in 13.7%, resorption of reduced condyle in 10.3%. CONCLUSIONS : Failure of initial treatment of jaw fractures is due to improper diagnosis and inadequate treatment with lack of sufficient knowledge of stomatognathic system. It is crucial to judge jaw fracture and patients accurately, moreover, the best way of treatments has to be selected. Consideration of these factors in treatment could minimize the complication of jaw fractures.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.506-512
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• 2007

Traumatic injury of tooth in children is commonly occurred problem. It is classified into tooth, periodontal tissue, supporting bone, soft tissue injury by it's area and extent. Among the periodontal tissue injuries, traumatically intruded teeth are common in anterior maxillary area, though the occurrence rate is rather low, the pulp and supporting tissue injury is possible by vertical impact. The treatment method of traumatically intruded teeth is various. Observation on the spontaneous reeruption for 3-4 weeks is recommended if the traumatized teeth are deciduous teeth or slightly intruded immature permanent anterior teeth. If this did not occur because the extent of intrusion is severe or the traumatized teeth are mature permanent anterior teeth, orthodontic traction is applied by fixed/removable appliances. At this time, light and continuous force is applied for the extrusive movement of the intruded teeth. When above procedures are impossible, surgical repositioning and fixation is recommended. In these cases, we performed conventional endodontic therapy for pulp necrosis and orthodontic traction with fixed appliance. We obtained satisfactory results and will report that.

• Restorative Dentistry and Endodontics
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• v.24 no.1
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• pp.67-75
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• 1999

The use of composite restorative materials is established due to continuing improvements in the materials and restorative techniques. Composite resins are widely used for the restoration of cervical lesions because of esthetics, good physical properties and working time. There are several types of cavity design for class V composite resin filling, but inappropriate cavity form may affect bonding failure, microleakage and fracture during mastication. Cavity preparations for composite materials should be as conservative as possible. The extent of the preparation is usually determined by the size, shape, and location of the defect. The design of the cavity preparation to receive a composite restoration may vary depending on several factors. In this study, 5 types of class V cavity were prepared on each maxillary central incisor. The types are; 1) V-shape, 2) round(U) shape, 3) box form, 4) box form with incisal bevel and 5) box form with incisal bevel and grooves for axial line angles. After restoration, in order to observe the concentration of stress at bonding surfaces of teeth and restorations, developing a 2-dimensional finite element model of labiopalatal section in tooth, surrounding bone, periodontal ligament and gingiva, based on the measurements by Wheeler, loading force from direction of 45 degrees from lingual side near the incisal edge was applied. This study analysed Von Mises stress with SuperSap finite element analysis program(Algor Interactive System, Inc.). The results were as follows : 1. Stress concentration was prevalent at tooth-resin bonding surface of cervical side on each model. 2. In model 2 without line angle, stress was distributed evenly. 3. Preparing bevel eliminated stress concentration much or less at line angle. 4. Model with round-shape distributed stress concentration more evenly than box-type model with sharp line angle, therefore decreased possibility of fracture. 5. Adding grooves to line angles had no effect of decreasing stress concentration to the area.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.4
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• pp.427-435
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• 2017

The most important factor in the treatment of fully edentulous patients using implants is the shape of the definitive prosthesis. After the shape of the definitive prosthesis is determined, residual bone analysis and selection of the implant type, number and position should be followed. In this case, for restoration of an edentulous patient fully implanted (except the maxillary right lateral incisor) without considering definitive prosthesis, facial esthetics and possibility of fixed type prosthesis were evaluated using complete denture. It was determined that the fixed type prosthesis was possible. Implants that could not be used for the definitive prosthesis were excluded from the treatment plan and fixed type provisional restorations were fabricated. After four months of provisional restorations, the patient showed stable occlusion and esthetic satisfaction. Definitive prosthesis was made of zirconia using CAD/CAM (computer aided design and computer aided manufacturing). The results were satisfactory during the 3 months of follow-up period after termination of treatment.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.3
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• pp.253-268
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• 2012

Full-mouth reconstruction of a patient using dental implants is a challenge if there is vertical and horizontal bone resorption, since this includes the gingival area and restricts the position of the implants. however, hard- and soft-tissue grafting may allow the implants to be placed into the desired position. Although it is possible to regenerate lost tissues, an alternative is to use fixed detachable prostheses that restore the function and the esthetics of the gingiva and teeth. Various material combinations including metal/acrylic, metal/ceramic, and zirconia/ceramic have been used for constructing this type of restoration. Other problems include wear, separation or fracture of the resin teeth from the metal/acrylic prosthesis, chipping or fracture of porcelain from the metal/ceramic or zirconia/ceramic prosthesis, and fracture of the framework in some free-end prostheses. With virtually unbreakable, chip-proof, life-like nature, monolithic zirconia frameworks can prospectively replace other framework materials. This clinical report describes the restoration of a patient with complete fixed detachable maxillary and mandibular prostheses made of monolithic zirconia with dental implants. The occluding surfaces were made of monolithic zirconia, to decrease the risk of chipping or fracture. The prostheses were esthetically pleasing, and no clinical complications have been reported after two years.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.1
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• pp.41-52
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• 2012

Purpose: Triangulation is the process of determining the location of a point by measuring angles to it from known points at either end of a fixed baseline. This point can be fixed as the third point of a triangle with one known side and two known angles. The aim of this study was to find a clinically adaptable method for applying an optical tracking navigation system to orthognathic surgery and to estimate its accuracy of measuring the bone displacement by use of triangulation methods. Methods: In orthognathic surgery, the head position is not fixed as in neurosurgery, so that a head tracker is needed to establish the reference point on the head surface byusing an optical tracking system. However, the operation field is interfered by its bulkiness that makes its clinical use difficult. To solve this problem, we designed a method using an Aquaplast splinting material and a mini-screw in applying a head tracker on a patient's forehead. After that, we estimated the accuracy of measuring displacements of the ball marker by an optical tracking system with a conventional head tracker (Group A) and with a newly designed head tracker (Group B). Measured values of ball markers' displacements by each optical tracking system were compared with values obtained from fusion CT images for an estimation of accuracy. Results: The accuracy of the optical tracking system with a conventional head tracker (Group A) is not suitable for clinical usage. Measured and predictable errors are larger than 10 mm. The optical tracking system with a newly designed head tracker (Group B) shows 1.59 mm, 6.34 mm, and 9.52 mm errorsin threeclinical cases. Conclusion: Most errors were brought on mainly from a lack of reproducibility of the head tracker position. The accuracy of the optical tracking system with a newly designed head tracker can be a useful method in further orthognathic navigation surgery even though the average error is higher than 2.0 mm.

• The korean journal of orthodontics
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• v.30 no.6 s.83
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• pp.677-685
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• 2000

Anchorage plays an important role in orthodontic treatment. Because of limited anchorage Potential and acceptance problems of intra- or extraoral anchorage aids, endosseous implants have been suggested and used. However, clinicians have hesitated to use endosseous implants as orthodontic anchorage because of limited implantation space, high cost, and long waiting period for osseointegration. Titanium miniscrews and microscrews were introduced as orthodontic anchorage due to their many advantages such as ease of insertion and removal, low cost, immediate loading, and their ability to be placed in any area of the alveolar bone. In this study, a skeletal Class II Patient was treated with sliding mechanics using M.I.A.(micro-implant anchorage). The maxillary micro-implants provide anchorage for retraction of the upper anterior teeth. The mandibular micro-implants induced uprighting and intrusion of the lower molars. The upward and forward movement of the chin followed. This resulted in an increase of the SNB angle, and a decrease of the ANB angle. The micro-implants remained firm and stable throughout treatment. This new approach to the treatment of skeletal Class II malocclusion has the following characteristics . Independent of Patient cooperation. . Shorter treatment time due to the simultaneous retraction of the six anterior teeth . Early change of facial Profile motivating greater cooperation from patients These results indicate that the M.I.A. can be used as anchorage for orthodontic treatment. The use of M.I.A. with sliding mechanics in the treatment of skeletal Class II malocclusion increases the treatment simplicity and efficiency.

• The korean journal of orthodontics
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• v.26 no.3
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• pp.267-279
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• 1996

This study was investigated the changes during treatment and retention period in the Class III malocclusion patients and explored the correlationship between factors that showed relapse tendencies and pre-treatment skeletal pattern and the changes during treatment period. Numbers of total sample were 24 and their Hellman's dental age at the start of treatment was over III B and were retained at least over 1 year 6 months. The following conclusion were obtained by comparing the differences between treatment period and retention period, and after analysing the correlationship of factors that manifested relapse tendencies. 1. The angles formed by FH plane and occlusal plane, FH plane and mandibular plane, and mandibular incisor and mandibular plane changes showed rebound effect during retention period and among them occlusal plane angle and IMPA show reverse correlationship. 2. Upward displacement of the occlusal plane at the end of treatment has returning tendency, is proportional to the displacement during treatment period, but the angle between maxillary and mandibular 1st molar to its basal bone have been constantlsy maintained during the retention period. 3. Mandibular plane decrease during retention period and downward backward rotation during treatment period show correlationship.

• Restorative Dentistry and Endodontics
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• v.19 no.2
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• pp.345-371
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• 1994

Restorative procedures can lead to weakening tooth due to reduction and alteraton of tooth structure. It is essential to prevent fractures to conserve tooth. Among the several parameters in cavity designs, cavity isthmus and depth are very important. In this study, MO amalgam cavity was prepared on maxillary first premolar. Three dimensional. finite element models were made by serial photographic method and cavity depth(1.7mm, 2.4mm) and isthmus (11 4, 1/3, 1/2 of intercuspal distance) were varied. linear, eight and six-nodal, isoparametric brick elements were used for the three dimensional finite element model. The periodontal ligament and alveolar bone surrounding the tooth were excluded in these models. Three types model(B, G and R model) were developed. B model was assumed perfect bonding between the restoration and cavity wall. Both compressive and tensile forces were distributed directly to the adjacent regions. G model(Gap Distance: 0.000001mm) was assumed the possibility of play at the interface simulated the lack of real bonding between the amalgam and cavity wall (enamel and dentin). When compression occurred along the interface, the forces were transferred to the adjacent regions. However, tensile forces perpendicular to the interface were excluded. R model was assumed non-connection between the restoration and cavity wall. No force was transferred to the adjacent regions. A load of 500N was applied vertically at the first node from the lingual slope of the buccal cusp tip. This study analysed the displacement, von Mises stress, 1 and 2 direction normal stress and strain with FEM software ABAQUS Version 5.2 and hardware IRIS 4D/310 VGX Work-station. The results were as follows: 1. G model showed stress and strain patterns between Band R model. 2. B model and G model showed the bending phenomenon in the displacement. 3. R model showed the greatest amount of the displacement of the buccal cusp followed by G and B model in descending order. G model showed the greatest amount of the displacement of the lingual cusp followed by B and R model in descending order. 4. B model showed no change of the displacement as increasing depth and width of the cavity. G and R model showed greater displacement of the buccal cusp as increasing depth and width of the cavity, but no change in the displacement of the lingual cusp. 5. As increasing of the width of the cavity, stress and strain were not changed in B model. Stress and strain were increased on the distal marginal ridge and buccopulpal line angle in G and R model. The possibility of the tooth fracture was increased. 6. As increasing of the depth of the cavity, stress and strain were not changed in B and G model. Stress and strain were increased on the distal marginal ridge and buccopulpal line angle in R model. The possibility of the tooth fracture was increased.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.247-256
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• 2009

The purpose of this study was to investigate the changes of the pharyngeal space when the following appliances were inserted: the mandibular advancement appliance (MAA), tongue retaining appliance (TRA), and mandibular advancement-tongue retaining appliance (MATRA). Nine male dental students exhibiting Class I occlusion, normal body mass index (BMI), and no signs and symptoms of snoring were selected for this study. The three kinds of snoring appliances (MAA, TRA and MATRA) were fabricated for each subject. The mandibular advancement of the MAA and MATRA was set at a distance of 5 mm, and the TRA and MATRA were made to hold the tongue in front of the maxillary incisors by 10 to 20 mm. Lateral cephalometric radiographs of the following four states - with no appliance, MAA, TRA, and MATRA - were taken to examine any anatomical changes resulting from the application of the appliances. All four radiographs were traced and analyzed for twenty selected variables related to the pharyngeal space, cranio-cervical posture, and position of the soft palate and hyoid bone. According to the results of this study, there were significant increases in both the upper and lower oropharyngeal spaces when the mandible and tongue were protruded simultaneously, although there was a significant increase only in upper oropharyngeal space when the mandible or tongue was advanced separately. In conclusion, it is suggested that the MATRA may result in more positive effect on the control of snoring and OSA compared to a single use of the MAA or TRA, especially for the patients whose upper airway obstruction occurs in the lower oropharynx.