• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.29 no.2
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• pp.533-547
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• 1999

Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life. but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area. the lateral wall of the maxillary sinus. and the ascending ramus of mandible. MRI demonstrated a well defined mass of intermediate signal intensitiy in Tl weighted images but T2 weighted images showed two distinctive regions of different characteristics. Upper portion of the lesion was of hyperintense signal but (at) lower portion, the signal intensity decreased clearly, which might mean that this lesion(mass) is composed of two different subtypes though it couldn't be confirmed by histopathological examination. Biopsy was taken the lesion as only in the soft tissue of the maxillary posterior alveolar region and confirmed the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.

• Imaging Science in Dentistry
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• v.43 no.4
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• pp.261-266
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• 2013

Purpose: This study was performed to investigate the bone thickness of the infrazygomatic crest area by computed tomography (CT) for placement of a miniplate as skeletal anchorage for maxillary protraction in skeletal Class III children. Materials and Methods: CT images of skeletal Class III children (7 boys, 9 girls, mean age: 11.4 years) were taken parallel to the Frankfurt horizontal plane. The bone thickness of the infrazygomatic crest area was measured at 35 locations on the right and left sides, perpendicular to the bone surface. Results: The bone was thickest (5.0 mm) in the upper zygomatic bone and thinnest (1.1 mm) in the anterior wall of the maxillary sinus. Generally, there was a tendency for the bone to be thicker at the superior and lateral area of the zygomatic process of the maxilla. There was no clinically significant difference in bone thickness between the right and left sides; however, it was thicker in male than in female subjects. Conclusion: In the infrazygomatic crest area, the superior and lateral area of the zygomatic process of the maxilla had the most appropriate thickness for placement of a miniplate in growing skeletal Class III children with a retruded maxilla.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.2
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• pp.545-553
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• 1995

The subjects of this study consisted of 58 patients with Le Fort fractures, who were admitted to Chonbuk National University Hospital from Jan. 1988 to Oct. 1995. The author classified the maxillofacial fractures by Le Fort classification and examined the. incidence of Le Fort fractures by age, sex and etiology. The purpose of this study was to compare the imagings of conventional radiograms with those of computed tomograms and to aid in the diagnosis of patients with Le Fort fractures. The obtained results were as follows: 1. The Le Fort fractures occured mainly in 3rd and 4th decades, but there was no significant difference between decades. A ratio of men to women was 5.5 : 1. The major etiologic factors were traffic accident(69％), assault(14％) and fall-down(12％). 2. The most common type of Le Fort fracture was type I(49.3％). The numbers of Le Fort II, ill fractures were 41.3％, 9.4％ respectively. And 8.6％ were midsagittal splitting fractures. 3. The discontinuity and haziness of the maxillary sinus were easily detected by Waters' view. In skull PI A view, it was difficult to observe fractures due to overlapping of the other structures, but the haziness of the maxillary sinus was sometimes observed. 4. In Le Fort fracture, the fracture pattern of orbit, the wall of maxillary sinus, nasal bone and pterygoid plate were more easily detected in computed tomograms than in conventional radiograms.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.13.1-13.8
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• 2017

Background: Oronasal/antral communication, loss of teeth and/or tooth-supporting bone, and facial contour deformity may occur as a consequence of maxillectomy for cancer. As a result, speaking, chewing, swallowing, and appearance are variably affected. The restoration is focused on rebuilding the oronasal wall, using either flaps (local or free) for primary closure, either prosthetic obturator. Postoperative radiotherapy surely postpones every dental procedure aimed to set fixed devices, often makes it difficult and risky, even unfeasible. Regular prosthesis, tooth-bearing obturator, and endosseous implants (in native and/or transplanted bone) are used in order to complete dental rehabilitation. Zygomatic implantology (ZI) is a valid, usually delayed, multi-staged procedure, either after having primarily closed the oronasal/antral communication or after left it untreated or amended with obturator. The present paper is an early report of a relatively new, one-stage approach for rehabilitation of patients after tumour resection, with palatal repair with loco-regional flaps and zygomatic implant insertion: supposed advantages are concentration of surgical procedures, reduced time of rehabilitation, and lowered patient discomfort. Cases presentation: We report three patients who underwent alveolo-maxillary resection for cancer and had the resulting oroantral communication directly closed with loco-regional flaps. Simultaneous zygomatic implant insertion was added, in view of granting the optimal dental rehabilitation. Conclusions: All surgical procedures were successful in terms of oroantral separation and implant survival. One patient had the fixed dental restoration just after 3 months, and the others had to receive postoperative radiotherapy; thus, rehabilitation timing was longer, as expected. We think this approach could improve the outcome in selected patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.29-39
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• 1989

Ossifying fibroma is a relatively slow growing tumor, and likely to have presented for some years before its clinical diognosis. The usually well circumscribed nature of ossifying fibroma in jaws lends itself to relative ease of excision and hence the favorable therapeutic results. On occasion, however, particulary in juvenile patient, if maxilla the tumor assumes an aggressive behavior. In that case, because the tumor grows invasively, resection with a margin of healthy tissue is indicated. The case presented is 34 - year old female. The patient had noticed a gradual swelling of the right side of the face approximately 2 months in duration correlation with a intermittent pain on the right maxillary molar area. Palpation disclosed firm swelling on the right anterior and lateral walls of the maxillary sinus extended to the maxillary tuberosity area. The radiographic examination revealed soft tissue mass with multiple dense round calcifications with destruction of anterior and posterolateral wall of the right maxillary sinus and right alveolar process, and hard palate. The mass totally obliterated maxillary sinus and extended to the pterygopalatine fossa. The histologic diagnosis from the biopsied specimen revealed ossifying fibroma. The tumor mass was resected by subtotal maxillectomy procedure due to a recent rapid infiltrative growth. In 5 months of postoperative follow - up period, the patient has favorable prognosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.5
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• pp.413-419
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• 2011

Purpose: Reposition of the maxilla is a common technique for correction of midfacial deformities. To achieve the goal of the surgery, the maxilla should be repositioned based on the precisely planned position during surgery. The internal reference points (IRPs) and the external reference points (ERPs) are usually used to determine vertical dimension of maxilla, which is an important factor for confirming maxillary position. However, the IRPs are known to be inaccurate in determining the vertical dimension. In this study, we investigated the correlation of positional change of the modified IRPs with repositioned maxilla. Methods: The study group consisted of 26 patients with dentofacial deformities. For the simulation of the surgery, patient maxillary CT data and 3-D virtual surgery programs (V-$Works^{(R)}$ and V-$Surgery^{(R)}$) were used. IRPs of this study were set on both the lateral wall of piriform aperture, inferior margin of both infraorbital foramen, and the labial surfaces of the canine and first molar. The distance from the point on lateral wall of the piriform aperture to the point on the buccal surface of the canine was defined as IRP-C, and the distance from the point on the inferior margin of the infraorbital foramen to the point on the buccal surface of the $1^{st}$ molar was defined as IRP-M. After the virtual simulation of Le Fort I osteotomy, the changes in IRP-C and IRP-M were compared with the maxillary movement. All measures were analyzed statistically. Results: With respect to vertical movements, the IRP-C (approximately 98%) and the IRP-M (approximately 96%) represented the movement of the canine and the $1^{st}$ molar. Regarding rotating movement, the IRPs changed according to the movement of the canine and the $1^{st}$ molar. In particular, the IRP-C was changed in accordance with the canine. Conclusion: IRPs could be good indicators for predicting vertical movements of the maxilla during surgery.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.2
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• pp.171-181
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• 2009

The objective of this study was to analyse stress distribution of maxillary complex by use of face mask. The construction of the three-dimensional FEM model was based on the computed tomography(CT) scans of 13.5 years-old male subject. The CT image were digitized and converted to the finite element model by using the mimics program, with PATRAN. An anteriorly directed force of 500g was applied at the first premolar 45 degrees downwards to the FH plane and at the first molar 20 degrees downwards to the FH plane. When 45 degrees force was applied at maxillary first premolar, there were observed expansion at molar part and constriction at premolar part. The largest displacement was 0.00011mm in the x-axis. In the y-axis, anterior displacement observed generally 0.00030mm at maximum. In the z-axis, maxillary complex was displaced 0.00036 mm forward and downward. When 20 degrees force was applied at maxilla first molar, there were observed expansion at lateral nasal wall and constriction at molar part. The largest displacement was 0.001mm in the X-axis. In the Y-axis, anterior displacement observed generally 0.004mm at maximum. In the Z-axis, ANS was displaced upward and pterygoid complex was displaced downward. The largest displacement was 0.002mm.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.4
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• pp.349-357
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• 2012

The purpose of this study was to measure the thickness of the sinus lateral wall using cone-beam computed tomography (CBCT), and to find the most suitable vertical position for lateral window opening prior to sinus elevation. Fifty three patients requiring sinus elevation had CBCT scans acquired by CB MercuRay (Hitachi, Medico, Tokyo, Japan) from July, 2010 to June, 2012. The thickness of the sinus lateral wall was measured according to its vertical position against the sinus inferior border (SIB), and its mean was calculated through two repeated measurements. The thickness of the sinus lateral wall was more than 2 mm at 2 mm above the sinus inferior border (SIB+2), however, it was less than 2 mm at 3 mm above the sinus inferior border (SIB+3). In conclusion, it is recommended that the inferior border of lateral wall window be made 3 mm above the sinus inferior border during sinus elevation using the lateral approach considering the thickness of the sinus lateral wall.

• Journal of Periodontal and Implant Science
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• v.26 no.1
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• pp.47-67
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• 1996

The purpose of this study was to observe the effect of $Biocoral^R$ graft and bioglass 45S5 graft in combination with ePTFE membrane in periodontal osseous defects for new bone formation. Nine healthy dogs were used. Under general anesthesia, 3-wall defects were created on the mesial and distal surfaces of the maxillary right canines, the mesials of the maxillary right second premolars, the distals of the mandibular right canines and the mesials of the mandibular right third premolars. To induce periodontitis, a silicone rubber, $Provil^R$ light body, was injected under pressure into the defects. Ninety days later, $Provil^R$was removed and followed by thorough root planing. The followings were then applied in the mesial and distal defects of the maxillary right canines, the mesials of the maxillary right second premolars, the distals of the mandibular right canines and the mesials of the mandibular right third premolars by random selections : 1) ePTFE membrane only application, 2) $Biocoral^R$ graft, 3) $Biocoral^R$ graft and ePTFE membrane application, 4)Bioglass 45S5 graft, 5) Bioglass 45S5 graft and ePTFE membrane application. The membranes were removed 1 month later. The dogs were sacrified at 1, 2 and 3 months following the graft, and block sections were made, demineralized, embedded, stained and examined by light microscope and transmission electron microscope. On the sections from teeth treated with ePTFE membrane only, the defect demonstrated extensive connnective tissue and alveolar bone regeneration. The $Biocoral^R$ graft group demonstrated extensive bone regeneration compared with ePTFE membrane only group. In the $Biocoral^R$ graft plus ePTFE membrane group, regeneration of new alveolus and crest occurred within the defect. As the experimental period lengthened, bone regeneration was increased and bone bridge was formed among the graft particles. The but bioglass 45S5 graft group demonstrated extensive bone regeneration but the amount of new bone was less than that of the $Biocoral^R$ graft group. For the bioglass 45S5 graft plus ePTFE membrane group, the amount of new bone was also increased. As the experimental period lengthened, bone regeneration was increased. Multinucleated giant cells, fibroblasts and macrophages were observed. As the bone formation was increased, the number of such cells was decreased. In conclusion, the $Biocoral^R$ was found better than the bioglass 45S5 for new bone formation, and the use of ePTFE membrane alone or with $Biocoral^R$/bioglass 45S5 can be supported as potential methods of promoting bone formation.

• Archives of Craniofacial Surgery
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• v.10 no.1
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• pp.1-6
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• 2009

Purpose: This study presents a classification of pure medial and inferior blow-out fracture, and confirms the relationship between the types of fractures, postoperative complications and operative methods. Methods: Sixty patients were treated by transnasal endoscopic reduction with $Medpor^{(R)}$ implantation through subciliary incision and foley catheter insertion into maxillary sinus was done if there was extensive orbital floor fracture. Fractures were classified by number of coronal sections from posterior margin of fossa for lacrimal sac to orbital apex in CT. Type I is defined when the medial wall fracture is over 50% and inferior wall fracture below 50%. Type II, when below 50% medial wall fracture and over 50% floor fracture were present. If there were both over 50%, it was classified as Type III and both below 50% for Type IV. Extreme fracture involving orbital buttress was Type V and postoperative findings in all patients were examined. Results: Type I and V were most common and preoperative findings were more likely to present according to extent of inferior fracture. Diplopia remained in 2 cases after additional insertion of foley catheter, but enophthalmos over 2 mm were presented in 3 cases and diplopia in 3 cases were observed who were not treated with foley catheter. Conclusion: Postoperative complications were increased according to extent of fracture, especially buttress involvement. Additional insertion of foley catheter proved its effectiveness in decreasing postoperative complications.