• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.5
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• pp.353-357
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• 2020

Fractures of the orbital floor and walls are among the most frequent maxillofacial fractures. Virtual three-dimensional (3D) planning and use of patient-specific implants (PSIs) could improve anatomic and functional outcomes in orbital reconstruction surgery. The presented case was a victim of a terrorist attack involving improvised explosive devices. This 58-year-old female suffered severe wounds caused by a single piece of metal from a bomb, shattering the left orbital floor and lateral orbital wall. Due to remaining hypotropia of the left eye compared to the right eye, late orbital floor reconstruction was carried out with a personalised 3D printed titanium implant. We concluded that this technique with PSI appears to be a viable method to correct complex orbital floor defects. Our research group noted good aesthetic and functional results one year after surgery. Due to the complexity of the surgery for a major bony defect of the orbital floor, it is important that the surgery be executed by experienced surgeons in the field of maxillofacial traumatology.

• Imaging Science in Dentistry
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• v.33 no.2
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• pp.71-77
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• 2003

Purpose : To evaluate and compare the efficacy of digital radiographic images in the detection of bone loss at the bifurcation area of the mandibular first molar with traditional film-based periapical radiographs, Materials and Methods : One dried human mandible with minimal periodontal bone loss around the first molar was selected and an artificial alveolar bone defect at the bifurcation area was serially prepared over 18 steps. Images were taken using a direct CCD-based system and with F-speed periapical films. The images were evaluated by seven interpreters (3 radiologists, 3 periodontologists, and 1 general dentist) using a 5-point confidence rating scale. Results : The readability of both periapical radiographs and digital image increased as the size of the artificial lesion and exposure time increased (p < 0.05). Periapical radiographs offered greater readability of smaller bone defects than digital images, and the coefficient of variation of mean score between periapical radiographs and digital images showed a significant difference. Conclusion : The experimental results indicate that a significant difference in the coefficient of variation of mean score exists between periapical radiographs and digital images, and that traditional film-based periapical images offer greater readability of smaller bone defects than digital images can presently offer.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.1_2
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• pp.22-39
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• 1992

The purpose of this study was to evaluate hypernasality, nasal air emission, glottal stop, articulation disorder in patients with velopharyngeal incompetency(V.P.I.) and to analyze speech improvement after pharyngoplasty. In this study 61 patients with velopharyngeal incompetency were tested, and in patents with pharyngoplasty speech problems before pharyngoplasty were compared with those after pharyngoplasty. The results obtained are as follows : 1. There are few speech problems in pronouncing the vowel sounds. 2. There are many speech problems in pronouncing the pressure sounds and few speech problems in non-pressure sounds. 3. Speech problems in patients with cleft palate are influenced not by anatomical defect but by severity of velopharyngeal incompetence after palatorrhaphy. 4. Operation methods which decrease the velopharygeal incompetence must be considered for reducing the speech problems. 5. Among the 61 cases with V.P.I. 19 cases(31%) showed nasal air emission and 24 cases(39%) showed glottal stop. 6. Pharyngoplasty is of benefit to primary precipitating components such as hypernasality, nasal air emission but of no benefit to secondary compensating component such as glottal stop. 7. There as no significant difference in speech improvement between pre-and post-pharyngoplasty(p<0.05).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.3
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• pp.253-263
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• 1995

Microsurgical vascularized bone transfer has the disadvantages of limitation of available donor sites, loss of donor function, and the possibility of donor site defects or deformity. To overcome these shortage of current microsurgical tissue transfer, the method of creating the neovascularized free flap has been introduced. Potentially, this technique must be an innovation in providing the free vascularized bone grafts that are not limited by natural vascular anatomy. But, as could be imagined technique resulted in unavoidable donor bone defect and additional operation for harvesting the autologous bone. The purpose of this study was to evaluate the efficacy of demineralized allogeneic bone as a possible substitute for autologous bone in fabricating the neo-osseous flap. By histologic, microangiographic and radioisotope method, the viability and vascularity of neo-osseous flap, which has been fabricated using allogeneic bone or autologous bone, was assessed in rat model. After 6 weeks, demineralized allogeneic bone showed consistent bone formation and neovascularization. The clinical and microscopic findings of demineralized allogeneic bone group were inferior to those of autogenous bone with regard to bone regeneration. The amount of bone blood floow per dry weight of demineralized allogeneic bone group was significantly higher than that of autogenous bone, even higher that of control intact iliac bone. In conclusion, findings supported that allogeneic bone could be the potential substitute for autologous bone source in creating a prefabricated neo-osseous flap.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.167-172
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• 2009

The maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary necrosis can occur due to bacterial infections such as osteomyelitis. viral infections such as herpes zoster and fungal infections such as mucormycosis, aspergillosis etc. Herpes zoster is a common viral infection, the oral soft tissue manifestations of which are widely known and recognized. Extremely rare complications such as osteonecrosis, and secondary osteomyelitis in maxilla were observed. But, reports of spontaneous tooth exfoliation and jaw osteonecrosis following herpes zoster infection in the distribution of the trigeminal nerve are extremely rare in the literature. We report a case of maxillary necrosis by herpes zoster in an uncontrolled diabetic patient. There was extensive necrosis of the buccal and palatal mucoperiosteum and exposure of the alveolar bone. This patient was successfully treated using a removal of necrotic bone and nasolabial flap. We briefly discuss different diseases which can lead to maxillary necrosis and a review. Analysis of the pathogenesis of herpes zoster and bone necrosis are discussed.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.26 no.2
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• pp.153-163
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• 1996

The purpose of this study was to evaluate the ability of radiographs in detecting experimental bony defect in the posterior wall of the maxillary sinus. For this study, experimentally five skulls were used, the bony defects with a diameter of 5mm were created at different locations in the posterior wall of the right maxillary sinus and the bony defects of 10mm were created at different locations in the posterior wall of th maxillary sinus. Panoramic view, panoramic sinus view, water's view, and computed tomogram were taken and the results analyzed. The obtanined results were as follows: 1. The panoramic view was superior to the panoramic sinus view in detecting the bony defects in the posterior wall of the maxillary sinus. 2. Panoramic view, panoramic sinus view, and waters's view were limitation to the detection of the bony defects in the posterior wall of the maillary sinus. 3. All the bony defects in the posterior wall of the maxillary sinus were excellently visualized on the computed tomogram.

• Korean Journal of Cleft Lip And Palate
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• v.10 no.1
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• pp.17-22
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• 2007

The vertebrate upper lip forms from initially freely projecting maxillary, medial nasal, and lateral nasal prominences at the rostral and lateral boundaries of the primitive oral cavity. These facial prominences arise during early embryogenesis from ventrally migrating neural crest cells in combination with the head ectoderm and mesoderm and undergo directed growth and expansion around the nasal pits to actively fuse with each other. Initial fusion is between lateral and medial nasal processes and is followed by fusion between maxillary and medial nasal processes. Fusion between these prominences involves active epithelial filopodial and adhering interactions as well as programmed cell death. Slight defects in growth and patterning of the facial mesenchyme or epithelial fusion result in cleft lip with or without cleft palate, the most common and disfiguring craniofacial birth defect. This review will summarize the current understanding of the basic morphogenetic processes and molecular mechanisms underlying upper lip development.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.3
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• pp.68-73
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• 1990

Fibrous dysplasia is an idiopathic skeletal disorder in which medullary bone is replaced and disturbed by poorly organized, structually unsound fibroosseous tissue, which may produce cortical expansion. When facial bones are involed, considerable esthetic deformity may result. The term monostotic fibrous dysplasia has been applied when one bone is involved : when more than one bone is affected, the term polyostotic used. The polyostotic form may be accomplished by pigmented skin lesion (Jaffe type), or by pigmented skin lesions with endocrine disturbance (Albright syndrome). No general agreement exists on the cause of fibrous dysplasia. A few authors have suggested that fibrous dysplasia arises as a resujlt of trauma. It occurs predominantly in infant, adolescent females and runs a variable clinical course. When several bones are involed, it tends to be unilateral. Involements of alveolar bone may produce displacement of teeth with malocclusion, or loss of teeth, or both. Radiographycally, it shows an indistinctly delimited osteolytic defect with a bubble - like pattern, but without a sclerotic rim. The preferred treatment is almost always surgery. If the lesion is extensive, surgical intervention with use of recontouring procedures aimed at the correction of esthetic or funtional disturbances is preferred treatment. Now, we present a case of fibrous dysplasia on the left maxilla and the zygoma treated by bony contourign via hemicoronal flap and intraoral approach with good results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.6
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• pp.431-436
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• 2009

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.6
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• pp.298-302
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• 2014

The radial forearm free flap (RFFF) is a thin and pliable tissue with many advantages for tongue reconstruction. However, tongues reconstructed with RFFF occasionally need revision surgery because inadequate defect measurement at primary surgery can lead to bulkiness and limited movement of reconstructed tongue. In this case, the patient underwent partial glossectomy and RFFF reconstruction for treatment of tongue cancer five years prior. We could not make a lower denture for the patient, because the alveolo-lingual sulcus of tongue was almost lost. So we performed vestibuloplasty with a modified Kazanjian method on the lingual vestibule of the mandibular right posterior area, and defatting surgery to debulk the flap. After surgery, we observed that the color and texture of the revised tongue changed to become similar with adjacent tissue. The patient obtained a more functional and esthetic outcome. Accordingly, we present a case report with a review of relevant literature.