• Title/Summary/Keyword: Maxillofacial defect

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A MODIFIED "GULL-WING" TYPE INCISION FOR MINIMIZING POSTOPERATIVE COMPLICATIONS IN THE CHIN BONE GRAFT (하악정중부 골채취시 술후 합병증을 최소화하기 위한 변형"gull-wing"형 절개법)

  • Kim, Ji-Hyuck;Lee, Jong-Ho;Lee, Suk-Keun;Kim, Soung-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.2
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    • pp.161-163
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    • 2005
  • In the reconstruction of the hard tissue defect of the oral cavity, the usefulness of the chin bone graft, one of the intraoral donor site, is gradually increased. The advantages include reduced resorption rate after graft due to its membranous bone nature, relatively ease to harvest under local anesthesia, reduced operative time because of the same operative field, decreased morbidity, and relatively large amount of bone can be harvested compared to other intraoral donor site. It has also postoperative complications including paresthesia of the lip or chin area, discomfort of lower anterior teeth, and facial swelling around chin area. Of these complications, facial swelling occurs more frequently, is more severe as a early postoperative discomfort, and prevents fast recover of patient's social activity since this procedure is generally accomplished in the outpatient base under local anesthesia. So we applied a modified " gull-wing" type incision to minimize this complication, and now we report this simple but effective surgical technique with clinically favorable result.

COMPARATIVE STUDY OF WOUND HEALING FOLLOWING PARTIAL GLOSSECTOMY OF RAT TONGUE USING CO2 LASER AND SCALPEL ($CO_2$ 레이저와 일반 수술도를 이용한 백서의 부분적설 절제술 후의 창상치유에 관한 비교연구)

  • Jang, Jae-Pil;Kim, Kyung-Wook;Lee, Jae-Hoon;Kim, Chang-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.437-445
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    • 2000
  • Object This study is focused on the comparison between $CO_2$ laser and scalpel by examining the overal process of wound healing after partial glossectomy of rats so that the result from the research could be easily applied to actual clinical environment. Method and Material In this research, 2mm defect was formed on both lateral borders of the tongue of rats by using $CO_2$ laser and scalpel respectively. 4rats were sacrified each time on the 1st, 2nd, 4th, 7th, 14th and 21th day according to a general method. After fabricating $5{\mu}m$ paraffin specimen, H&E staining and MT staining were performed. Results Compared to scalpel, wound healing by $CO_2$ laser leads to a earlier initiation of vascular proliferation and re-epithelization. Therefore, some influence is exerted on the early stage of wound healing. However, the two methods seem to undergo the similar healing process.

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Bony window approach for a traumatic bone cyst on the mandibular condyle: a case report with long-term follow-up

  • Kim, Hyoung Keun;Lim, Jae-Hyung;Jeon, Kug-Jin;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.4
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    • pp.209-214
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    • 2016
  • Traumatic bone cyst (TBC) occurs preferentially on the mandibular symphysis and body, but rarely on the mandibular condyle. When TBC occurs in the condylar area, it can usually be related with or misdiagnosed as a temporomandibular joint disorder. A 15-year-old female patient visited the Temporomandibular Joint Clinic with a 5-year history of pain and noise localized in the left temporomandibular joint. On imaging, a well demarked oval-shaped radiolucent lesion was observed on the left condyle head. The patient underwent cyst enucleation and repositioning of the bony window on the lateral cortex of the affected condyle head under the impression of subchondral cyst or TBC; however, no cystic membrane was found. The bone defect resolved and showed no recurrence on the serial radiographic postoperative follow-up for 43 months after surgery.

ORO-FACIAL RECONSTRUCTION WITH ANTEROLATERAL THIGH(ALT) FREE FLAP (전외측대퇴유리피판 (Anterolateral Thigh Free Flap)을 이용한 구강안면부 결손의 재건)

  • Kim, Chul-Hwan;Bhang, Dae-Yeon;Hwang, Seung-Yeon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.6
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    • pp.526-530
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    • 2009
  • Recently, the anterolateral thigh(ALT) flap, based on the septocutaneous vessels or musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery has gained popularity in head and neck soft-tissue reconstruction. It has some advantages in free-flap surgery with respect to the radial forearm free flap, such as low donor site morbidity, availability of different tissues with large amounts of skin, adaptability as a sensate or flow-through flap (with the possibility of harvesting a long pedicle with a suitable vessel diameter). Moreover, the thickness of the flap is adjustable until the subdermal fat level, allowing it to be used as a thin or ultrathin flap. This clinical cases are ALT free flap reconstructions without functional impairment of the donor limbs (transitory and permanent) based on anastomosis with superficial temporal arteries and veins in patient of huge resection defect on face, lip and tongue.

An alternative treatment option for a bony defect from large odontoma using recycled demineralization at chairside

  • Lee, JuHyon;Lee, Eun-Young;Park, Eun-Jin;Kim, Eun-Suk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.2
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    • pp.109-115
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    • 2015
  • Odontoma is the most common odontogenic benign tumor, and the treatment of choice is generally surgical removal. After excision, bone grafts may be necessary depending on the need for further treatment, or the size and location of the odontoma. Although the osteogenic capacity of a demineralized tooth was verified as early as 1967 by Urist and many other investigators, the cumbersome procedure, including a long demineralization time, may be less than comfortable for clinicians. A modified ultrasonic technology, with periodic negative pressure and temperature control, facilitated rapid and aseptic preparation of demineralized teeth for bone grafts. This approach reduces the demineralization time dramatically (${\leq}80$ minutes), so that the graft material can be prepared chairside on the same day as the extraction. The purpose of this article is to describe two cases of large compound odonotomas used as graft material prepared chairside for enucleation-induced bony defects. These two clinical cases showed favorable wound healing without complications, and good bony support for future dental implants or orthodontic treatment. Finally, this report will suggest the possibility of recycling the benign pathologic hard tissue as an alternative treatment option for conventional bone grafts in clinics.

Reconstruction of large oroantral defects using a pedicled buccal fat pad

  • Yang, Sunin;Jee, Yu-Jin;Ryu, Dong-mok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.7.1-7.5
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    • 2018
  • Background: Oroantral communicating defects, characterized by a connection between the maxillary sinus and the oral cavity, are often induced by tooth extraction, removal of cysts and benign tumors, and resection of malignant tumors. The surgical defect may develop into an oroantral fistula, with resultant patient discomfort and chronic maxillary sinusitis. Small defects may close spontaneously; however, large oroantral defects generally require reconstruction. These large defects can be reconstructed with skin grafts and vascularized free flaps with or without bone graft. However, such surgical techniques are complex and technically difficult. A buccal fat pad is an effective, reliable, and straightforward material for reconstruction. Case presentation: This report describes three cases of reconstruction of large oroantral defects, all of which were covered by a pedicled buccal fat pad. Follow-up photography and radiologic imaging showed successful closure of the oroantral defects. Furthermore, there were no operative site complications, and no patient reported postsurgical discomfort. Conclusion: In conclusion, the use of the pedicled buccal fat pad is a reliable, safe, and successful method for the reconstruction of large oroantral defects.

3D-printed titanium implant with pre-mounted dental implants for mandible reconstruction: a case report

  • Park, Jung-Hyun;Odkhuu, Michidgerel;Cho, Sura;Li, Jingwen;Park, Bo-Young;Kim, Jin-Woo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.28.1-28.4
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    • 2020
  • Background: This clinical case presented a novel method of segmental mandible reconstruction using 3D-printed titanium implant with pre-mounted dental implants that was planned to rehabilitate occlusion. Case presentation: A 53-year-old male who suffered osteoradionecrosis due to the radiation after squamous cell carcinoma resection. The 3D-printed titanium implant with pre-mounted dental implant fixtures was simulated and fabricated with selective laser melting method. The implant was successfully inserted, and the discontinuous mandible defect was rehabilitated without postoperative infection or foreign body reaction during follow-ups, until a year. Conclusions: The 3D-printed titanium implant would be the one of the suitable treatment modalities for mandible reconstruction considering all the aspect of mandibular functions.

FREE JEJUNAL FLAP FOR INTRAORAL RECONSTRUCTION CASES REPORT & LITERATURE REVIEW (유리 소장이식을 이용한 구강내 결손부위의 수복 증례보고 및 문헌 고찰)

  • Kang, Bo-Won;Kim, Sung-Moon;Lim, Jae-Suk;Kwon, Jong-Jin;Choi, Sung-Weon;Lee, Dong-Keun;Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.113-121
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    • 1994
  • Large oral defects following tumor resection pose formidable challenge for the reconstructive surgeon. Ideally, wound closure should utilize like tissue in providing expedient, single-stage closure, returning maximum function while minimizing deformity. Recent methods have reported and utilize variable mucocutaneous flaps. However, the ideal reconstruction has yet to defined. The small bowel serves as a readily available donor site for satisfying reconstructive needs in oropharyngeoesophageal defects. Segments of jejunum may be opened along the antimesenteric border and transferred to oral defect as free tissue transfers. Some of the benefits of this technique have included a one-stage procedure, abundant donor tissue with characteristics similar to oral mucosa, near normal facial appearance, preservation of maximum tongue function and relief of annoying xerostomia by jejunal mucous secretion. Three cases re presented in which two cases show successful use of this flap. The other one patient developed total necrosis of this flap. We report cases of reconstruction using free jejunal flap transfer in oral reconstruction.

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RESTORATION OF MANDIBULAR CONTINUITY USING MANDIBULAR TRANSPORT DISTRACTOR GUIDED BY RECONSTRUCTION PLATE (재건용금속판을 따라 하악골편 전이 골신장기를 이용한 하악골 연속성의 회복)

  • Kim, Soung-Min;Chung, Ji-Hun;Kim, Han-Seok;Kim, Ji-Hyuck;Park, Young-Wook;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.5
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    • pp.429-438
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    • 2007
  • Transport distraction osteogenesis has been introduced recently to correct skeletal malformations and discrepancies in the maxillofacial area. To reconstruct 3-dimensitonal mandibular shape, this transport distraction can be considered with the use of reconstruction plate. A 23-years-old male having unilateral mandibular body and angle defects, who had been operated of partial mandibular resection due to unicystic ameloblastoma, was treated by transport distraction procedures with ThreadLock transport $distractor^{(R)}$ (KLS Martin Co., Germany) through the rail of reconstruction plate (Osteomed Co., USA). After being distracted 35 mm defect from mandibular angle to body, and consolidated for 16 weeks, allogenic bone graft on docking site was performed with removal of transgingival pin. For more than 13 weeks follow up period after consolidation period, gradual increase of radiopacity in the radiographic examination was shown, and the curved mandibular continuity according to the reconstruction plate was made firmly. These transport distraction osteogenesis in the mandible was able to be considered as the good and minimally invasive technique for the reconstruction of mandibular discontinuity. Young patient was also very satisfactory for these results.

AVAILABILITY OF RADIAL FOREARM FREE FLAP IN RECONSTRUCTION OF INTRAORAL SOFT TISSUE DEFECTS : REVIEW OF 50 CASES (구강내 연조직 결손부 재건시 유리 전완 피판(Radial Forearm Free Flap)의 유용성)

  • Kim, Nam-Kyun;Seo, Dong-Jun;Park, Se-Hyun;Kim, Hyung-Jun;Cha, In-Ho;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.353-358
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    • 2008
  • Purpose: The purpose of this clinical retrospective study was to evaluate our experience of radial forearm free flap for reconstruction of the oral cavity. Material and methods: From 1997 to 2006, 50 radial forearm free flaps were employed for head and neck reconstruction in 50 patients at department of oral and maxillofacial surgery, Yonsei University, Korea. Data were obtained from chart review, and clinical follow-up. Results: Patients' age ranged from 26 to 82 years (mean 53.2). There were 39 men and 11 women. 43 of the 50(86%) patients had squamous cell carcinoma. The total flap survival were 47(94%), complication rate were revealed for 15(30%). Conclusion: In the reconstruction of soft tissue within the oral cavity, several free flaps have been used. Because of its constant anatomy, long pedicle allows a hypothetic vascular anastomosis in the contralateral neck, contourability for various type of oral defects, pliability and can be used simultaneous reconstruction in intraoral and extra oral defects, the radial forearm free flap constitutes one of the best choice of intraoral soft tissue reconstruction.