• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.1
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• pp.16-29
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• 1991

The occurrence of thrombotic occlusion & endothelial injuries at the site of anastomosis have been considered as major problems in microvascular surgery. The purpose of this study was to ascertain whether a end-in-end(sleeve, telescope) anastomosis compared favorably with end-to-end anastomosis in healing procedures on the endothelium and to study the possibility of clinical application in end-in-end method. The microvascular anastomoses have been performed with end-in-end method in the femoral arteries of 20 rats group, also with end-to-end method on the same arteries of another 20 rats group, and then the four anastomosed vessels in subdivided groups on each group were taken after period of 1, 3, 7, 14, 21 days following by anastomoses for scanning electron microscope observation. The results were as following: 1. The patency rate was 90% in the end-in-end group and 85%in the end-to-end group and late thrombus occurred at 7, 14 days on both groups, which suggested -consistent monitoring of patency was required for two weeks at least. 2. Platelet aggregates at the site of anastomosis began to organize on post-operation 3 days and in the end-in-end group, the initially decreased lumen of inserted vessel was gradually increasing on 7 days due to atrophy of the medial layers. 3. Re-endothelialization was completed between 7 and 14 days in end-in-end group, whereas between 14 and 21 days in end-to-end group.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.53-60
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• 2002

Neurosensory dysfunction of the injured inferior alveolarnerve(IAN) is a common and distrssing consequence of traumatic or iatrogenic injury. Conventional neurosensory testing has been used to detect and monitor sensory impairments of the injured IAN. However, these tests had low reliability and are not qualitative at best because they are based on solely on the patient's subjective assesment of symptoms. Consequently, there is need for more reliable, sensitive, and objective test measures to document and to monitor sensory dysfunction of the trigeminal nerve. This study was to investigate DITI's (digital infrared thermographic imaging) potential as a diagnostic alternative for evaluating of the nerve injures and sensory disturbance. Subjects were 30 patients who had been referred to Ewha Medical Center due to sensory disturbance of the lower lip and chin followed after unobserved inferior alveolar nerve injuries. The patients were examined by clinical neurosensory tests as SLTD (static light touch discrimination), MDD (moving direction discrimination), PPN (pin prick nociception) and DITI (digital infrared thermographic imaging). The correlation between clinical sensory dysfunction scores(Sum of SLTD, MDD, PPN, NP, Tinel sign) and DITI were tested by Spearman nonparametric rank correlation anaylsis & Kruskal-Wallis test, Wilcoxon 2-sample test. This study resulted in as follows; (1) The difference of thermal difference between normal side and affected side was as ${\Delta}-3.2{\pm}0.13$. (2) The DITI differences of the subjects presenting dysesthesia of the lip and chin were correlated significantly with the neurosensory dysfunction scores(r=0.419, p=0.021)and SLTD (r=0.429, p<0.05). (3) The MDD, PPN, NP, Tinel sign, duration, gender were not correlated with DITI(p> 0.05). Therefore, the DITI(digital infrared thermographic imaging) can be an option of the useful objective diagnostic methods to evaluate the injured inferior alveolar nerve and sensory dysfunction of trigerminal nerve.

• Archives of Plastic Surgery
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• v.40 no.1
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• pp.44-50
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• 2013

Background The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. Methods A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis. Results From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed. Conclusions Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.6
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• pp.339-346
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• 2023

Objectives: This analysis details the characteristics of dental trauma in South Korea during the coronavirus disease 2019 (COVID-19) (DC) pandemic and compares them in patients before and after COVID-19 (BC and AC, respectively). Materials and Methods: Data were collected from medical records of patients who visited Seoul National University Bundang Hospital's Emergency Dental Care Center during three 12-month periods: BC, DC, and AC (BC from March 1, 2019 to February 29, 2020; DC from March 1, 2020 to February 28, 2021; AC from March 1, 2022 to February 28, 2023). A retrospective review was conducted to investigate patient age, sex, time of visit, cause, and diagnosis. The study included 1,544 patients: 660 BC, 374 DC, and 510 AC. Results: Significant difference in age and sex was not observed among the three periods; 1-9 years of age was the largest group (38.3% in BC, 29.6% in DC, and 27.8% in AC), and the percentage of male patients was greater than of female patients (male proportion as 63.5% in BC, 67.4% in DC, and 64.9% in AC). The number of patients generally peaked at a Saturday night in spring (for BC: May, Saturday, 18:00-19:59; for DC: March, Saturday, 18:00-19:59; for AC: April as the second most (October as the most peaked), Saturday, 20:00-21:59). The primary etiology of the dental trauma was identical in the three periods: falls, followed by sports. The most frequent diagnosis was laceration, followed by tooth avulsion and jaw fracture. Conclusion: Significant differences were not found between the characteristics and patterns of dental trauma in the BC, DC, and AC periods. However, due to the pandemic and social distancing, activities decreased and associated dental trauma-related incidents declined.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.365-370
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• 2007

Purpose: There are many reports about facial bone fractures, but limited to retrospective data of a single hospital. Etiology and severity of the facial bone fracture have been changed and treatment method and materials have been advanced. In order to reflect those changes and provide up-to-date data of the facial bone fractures in Daegu, we gathered the data and analyzed the epidemiologic study. Methods: The medical records of 1058 fractures in 895 patients were gathered from 5 general hospitals in Daegu during last year and these data were analyzed by following parameters: age, sex, place of residence, occupation, cause of injury, time of injury, location of fracture, length of in-hospital stay, time of operation, treatment method, associated injury, complication. Statistical analysis was performed using the Chi-square test. Results: Most commonly involved age group was 20s(26%) and the sex ratio was 3.4:1(male predominance). Fractures were occurred more in unban and white-color workers. Among variable etiology of injury, traffic accident was the most common cause. Time of injury was heighest at 6 to 7 P.M., on Sunday, in July. Locations of fractures were following sequence: nasal, zygoma, mandible, orbit, maxilla. Mean length of in-hospital stay and time of operation after injury were 6.3 and 3.2 days, respectively. In treatment methods, operative methods were dominant than conservative management and general anesthesia were favored than local anesthesia. Associated injuries were noticed in 188 cases(21.2%) and complications were in 94 cases(8.9%) and among them, ocular problem were common. Conclusion: Compared to previous studies, mean age of occurrence was lowered and the etiologies showed age-specific pattern and reflected the change of lifestyle. In young age groups, sports injury, violence were more dominant and the other hand, traffic accident and fall were dominant in older groups.

• Archives of Craniofacial Surgery
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• v.17 no.4
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• pp.206-210
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• 2016

Background: Zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. Zygoma fractures are classified according to Knight and North based on the direction of anatomic displacement and the pattern created by the fracture. In zygomaticomaxillary complex (ZMC) fracture many incisions (lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary, subtarsal, intraoral, direct percutaneous approach) are useful. We reviewed various approaches for the treatment of ZMC fractures and discussed about incisions and fixation methods. Methods: A retrospective review was conducted of patients with ZMC fracture at a single institution from January 2005 to December 2014. Patients with single zygomatic arch fracture were excluded. Results: The identified 694 patients who were admitted for zygomatic fractures from which 192 patients with simple arch fractures were excluded. The remaining 502 patients consisted of 439 males and 63 females, and total 532 zygomatic bone was operated. Orbital fracture was the most common associated fracture. According to the Knight and North classification the most frequent fracture was Group IV. Most fractures were fixated at two points (73%). Conclusion: We reviewed our cases over 10 years according to fracture type and fixation methods. In conclusion, minimal incision, familiar approach and fixation methods of the surgeon are recommended.

• Imaging Science in Dentistry
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• v.42 no.2
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• pp.71-75
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• 2012

Purpose : Dental trauma is frequently unpredictable. The initial assessment and urgent treatment are essential for dentists to save the patient's teeth. Mobile-phone-assisted teleconsultation and telediagnosis for dental trauma could be an aid when a dentist is not available. In the present in-vitro study, we evaluated the success rate and time to transfer images under various conditions. Materials and Methods : We analyzed the image quality of cameras built into mobile phones based on their resolution, autofocus, white-balance, and anti-movement functions. Results : The image quality of most built-in cameras was acceptable to perform the initial assessment, with the autofocus function being essential to obtain high-quality images. The transmission failure rate increased markedly when the image size exceeded 500 kB and the additional text messaging did not improve the success rate or the transmission time. Conclusion : Our optimal protocol could be useful for emergency programs running on the mobile phones.

• Journal of Korean society of Dental Hygiene
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• v.11 no.1
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• pp.127-136
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• 2011

Objectives : The writer aimed to examine the dynamic aspect on damage and to be conducive to the swift cure according to right treatment to educate prevention of injury through surveying on the number of the damaged teeth given injury, tooth kind, type in damage, place and cause for being damaged, frequency by month and by time level, and location of the damaged tooth. Methods : Targeting 343 teeth of receiving injury in 201 patients who visited the department of pediatric dentistry, the department of preservation, and the oral and maxillofacial surgery in a dental hospital in Cheonan city from April 2007 to April 2009, by having the dental injury as the main reason, the following conclusions were obtained. Results : 1. Deciduous teeth were indicated to be the highest in imperfect luxation with 60.7%, and were indicated to be in order of crown fracture with 25.5%, root fracture with 12.4%, and perfect luxation with 1.4%. The permanent teeth were indicated to be the highest in crown with 58.1%, and were indicated to be in order of imperfect luxation with 27.3%, root fracture with 13.1%, and perfect luxation with 1.5%(p<0.001). 2. In case of deciduous teeth for a place with damage, the home was indicated to be the highest with 31.7%. The permanent teeth were indicated to be the highest(p<0.001) in the road and stairs with 40.4%. As to a cause for damage, both deciduous and permanent teeth were indicated to be the highest(p<0.001) in a cause for falling with 53.1% and 30.8%, respectively. 3. As for a treatment method, in case of deciduous teeth, the close observation was indicated to be the highest with 46.9%. In permanent teeth, the resin restoration was indicated to be the highest(p<0.001) with 22.2%. Dental injuries in deciduous teeth and permanent teeth are showing diverse aspects. Conclusions : It is important to arrange guidelines on cure of the damaged teeth by injury through continuing a dynamic research on these aspects. Also, the damage in deciduous teeth may have direct and indirect influence upon growth in successional permanent teeth. Thus, through careful treatment, the injury needs to be minimized. It is considered to be likely necessary for a right coping method when injury occurs, and above all, for enough prior education so that injury cannot occur.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.1
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• pp.117-127
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• 1991

When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.3
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• pp.193-203
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• 2001

Orthognathic surgery of the mandibular prognathism and the retrognathism is tend to be performed on the mandibular ramus to prevent inferor alveolar nerve injuries. The purpose of this study is to find a safe and accurate reference point on mandibular ramus for orthognathic surgery by comparative anatomical study of dentofacial deformity patients. We use 38 Korean Cadavers with normal occlusion(Group 1), 3-dimensional simulation of computerized tomogram of 23 patients with retrognathism (Group 2), 27 patients with mandibular prognathism (Group 3). Following results are obtained : 1. The maximum thickness of the mandibular ramus is $8.78{\pm}1.15mm$ for Group 2, $7.61{\pm}1.26mm$ for Group 1, $6.95{\pm}0.82mm$ for Group3 respectively (P=0001). The minimum thickness is $5.51{\pm}1.08mm$ for Group 1, $5.06{\pm}0.40mm$ for Group 2, $4.56{\pm}0.78mm$ for Group3, respectively (p=0.0001). But, the thickness at the level of 5mm above the lingular is $0.78{\pm}0.65mm$ for Group 2, $5.63{\pm}1.28mm$ for Group 1, $5.32{\pm}0.91mm$ for Group 3, respectively. There is no significant difference between these groups(P=0.0510). 2. The horizontal location from the midwaist point to lingular is $0.18{\pm}1.57mm$ for Group 1, $0.69{\pm}1.33mm$ for Group 2, $0.66{\pm}1.66mm$ for Group 3, and there is no significant difference between these groups(p=0.0835). But the vertical location from the midwaist point to lingular is $1.45{\pm}2.64mm$ for Group 1, $0.63{\pm}1.44mm$ for Group 2, $0.34{\pm}1.81mm$ for Group 3, and there is significant difference between these groups(p=0.0030). 3. The horizontal location from the midwaist point to mandibular foramen is $0.29{\pm}1.75mm$ for Group 1, $0.63{\pm}1.44mm$ for Group 2, $0.34{\pm}1.81mm$ for Group 3, and there is no significant difference between these groups(p=0.5403). But the vertical location from the midwaist point to mandibular foramen is $-3.33{\pm}4.43mm$ for Group1, $-4.79{\pm}2.26mm$ for Group 2, $-6.06{\pm}2.99mm$ for Group 3, and there is significant difference between these groups(P=0.0001). 4. The horizontal length from the disto-buccal cusp tip of mandibular second molar to lingula is $30.97{\pm}4.17mm$ for Group 3, $28.29{\pm}2.65mm$ for Group 1, $25.48{\pm}0.77mm$ for Group 2 (p=0.0000), and also vertical length is $7.72{\pm}3.22mm$ for Group 3, $6.38{\pm}1.83mm$ for Group 1, $5.89{\pm}2.30mm$ for Group 2 (P=0.0014). 5. The location of lingular is 0.50 from anterior border of mandibular ramus in all groups, if it assumed the length from anterior border to posterior border is 1. And it is almost 0.33 from the sigmoid notch, if it assumed the length from sigmoid notch to antegonial notch is 1. 6. In Group 1, Antilingular prominence is located on ($1.12{\pm}1.43mm,\;4.01{\pm}2.36mm$) from the midwaist point, and there is no correlation between antilingular prominence and lingular, mandibular foramen.