• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.520-526
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• 2007

The accuracy of model surgery is one of important factors which can influence the outcome of orthognathic surgery. To evaluate the accuracy of digitalized model surgery, we tried the model surgery on a software after transferring the mounted model block into a digital model, and compared the results with that of classical manual model surgery. We could get the following results, which can be used as good baseline analysis for the clinical application. 1. We made the 3D scanning of dental model blocks, and mounted on a software. And we performed the model surgery according to the previously arranged surgical plans, and let the rapid prototyping machine produce the surgical wafer. All through these process, we could confirm that the digital model surgery is feasible without difficulties. 2. The digital model surgery group (Group 2) showed a mean error of $0.0{\sim}0.1mm$ for moving the maxillary model block to the target position. And Group 1, which was done by manual model surgery, presented a mean error of $0.1{\sim}1.2mm$, which is definitely greater than those of Group 2. 3. Remounted maxillary model block with the wafers produced by digital model surgery from Group 2 showed the less mean error (0.2 to 0.4 mm) than that produced by manual model surgery in Group 1 (0.3 to 1.4 mm). From these results, we could confirm that the digital model surgery in Group 2 presented less error than manual model surgery of Group 1. And the model surgery by digital manipulation is expected to have less influence from the individual variation or degree of expertness. So the increased accuracy and enhanced manipulability will serve the digital model surgery as the good candidate for the improvement and replacement of the classical model surgery, if careful preparation works for the clinical adjustment is accompanied.

• Journal of Chest Surgery
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• v.54 no.2
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• pp.88-98
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• 2021

Background: This study aimed to develop a new risk prediction model for operative mortality in a Korean cohort undergoing heart valve surgery using the Korea Heart Valve Surgery Registry (KHVSR) database. Methods: We analyzed data from 4,742 patients registered in the KHVSR who underwent heart valve surgery at 9 institutions between 2017 and 2018. A risk prediction model was developed for operative mortality, defined as death within 30 days after surgery or during the same hospitalization. A statistical model was generated with a scoring system by multiple logistic regression analyses. The performance of the model was evaluated by its discrimination and calibration abilities. Results: Operative mortality occurred in 142 patients. The final regression models identified 13 risk variables. The risk prediction model showed good discrimination, with a c-statistic of 0.805 and calibration with Hosmer-Lemeshow goodness-of-fit p-value of 0.630. The risk scores ranged from -1 to 15, and were associated with an increase in predicted mortality. The predicted mortality across the risk scores ranged from 0.3% to 80.6%. Conclusion: This risk prediction model using a scoring system specific to heart valve surgery was developed from the KHVSR database. The risk prediction model showed that operative mortality could be predicted well in a Korean cohort.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.323-330
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• 2011

Purpose: The present study examined the reproducibility of an operation plan by comparing the jaw position of STO with the postoperative mandibular set back measurement in sagittal split ramus osteotomy. Methods: Thirty patients with class III dental and skeletal malocclusion and who were treated with BSSRO were reviewed. Three plain radiographs such as the panoramic view, the lateral cephalogram and the submentovertex view were taken before and after operation. Also, paper surgery for STO and model surgery were used to evaluate the amount of mandibular set back. Results: On the panoramic view, the amount of mandibular set back in STO was similar to the postoperative results of model surgery, but the amount of mandibular set back on the lateral cephalogram was smaller than the postoperative result of model surgery and then the amount of set back on submentovertex view was similar to the postoperative result of model surgery. Conclusion: Precise tracing and paper surgery should be performed for a combined expected STO in order to predict the exact amount of preoperative mandibular set back.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.3
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• pp.254-261
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• 2006

Moderate to severe dentofacial deformities usually require combined orthodontic treatment and orthognathic surgery to obtain the most stable result with optimal function and facial esthetics. Accordingly, the orthodontist and oral maxillofacial surgeon must be able to exactly diagnose existing deformities, establish an appropriate treatment plan, and execute the recommended treatment. Especially, to obtain optimal result of the maxillary surgery, model surgery is essential. But, the preoperatively planned position of the maxillary dental arch often cannot be sufficiently achieved during actual surgery, and deviations in the sagittal and vertical dimensions are common. To achieve three dimensional repositioning of the maxilla exactly, several methods have been introduced so far. Recently Model Repositioning Instrument (MRI, SAM, Inc., $M\ddot{u}nchen$, Germany), one of these methods, has been introduced and applied clinically, which is reported as accurate, effective and prompt method for three dimensional repositioning of the maxilla. This article describes an introduction and a clinical application of this MRI.

• Journal of International Society for Simulation Surgery
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• v.4 no.1
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• pp.9-12
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• 2017

Purpose Surgery for separating craniopagus twins involves many critical issues owing to complex anatomical features. We demonstrate a 3D printed model and virtual reality (VR) technologies that could provide valuable benefits for surgical planning and simulation, which would improve the visualization and perception during craniopagus surgery. Material & Methods We printed a 3D model extracted from CT images of craniopagus patients using segmentation software developed in-house. Then, we imported the 3D model to create the VR environment using 3D simulation software (Unity, Unity Technologies, CA). We utilized the HTC Vive (HTC & Valve Corp) head-mount-display for the VR simulation. Results We obtained the 3D printed model of craniopagus patients and imported the model to a VR environment. Manipulating the model in VR was possible, and the 3D model in the VR environment enhanced the application of user-friendly 3D modeling in surgery for craniopagus twins. Conclusion The use of the 3D printed model and VR has helped understand complicated anatomical structures of craniopagus patients and has made communicating with other medical surgeons in the field much easier. Further, interacting with the 3D model is possible in VR, which enhances the understanding of the craniopagus surgery as well as the success rate of separation surgery while providing useful information on diagnosing and surgery planning.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.37-45
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• 2001

The errors in orthognathic surgery can occur during the preoperative preparations including the model surgery, but till now there's been some lack of reserches about them. So we wanted to verify the accuracies in measurements used in model surgery. We compared the accuracy of measurements by vernier calipers, which has been the main measurement tool for conventional model surgery, and that by height gauge, which is recently claimed to be more accurate, with 3 dimensional coordinate analyzer. We could have following results and have a plan to use them for the invention of new model surgery techniques. 1. The measurement errors in Group 1, which mean the difference between "the measurements by 3-D analyzer"and "the measurements by height gauge", were small enough with the range of $0.1{\sim}0.2mm$ in all planes. 2. The mean error in Group 2, which is the differences between the measurements of 3-D analyzer and those of vernier calipers, was 1.1mm. 3. The measurement errors in Group 2 were variable according to the factors including the differences of individuality and expertness of each measurers. But in case of Group 1, they were small and not variable by the expertness. 4. The measurements were more accurate at the points in anterior teeth than in molar teeth in Group 1 and 2. 5. The errors after model surgery increased remarkably, compared with those before surgery in Group 2. And the situation was different in Group 1 in that errors decreased after surgery. According to these results, it assumed that the measurements with height gauge during the model surgery for orthognathic surgery are accurate enough and can be maintained, regardless of complexity of models, individuality, or expertness of measurers.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.2
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• pp.128-136
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• 2011

Purpose: Errors in orthognathic model surgery occur during the planning, measuring and/or moving of the models. However, there has been little effort to find ways to reduce these errors. In this study, we introduce a new orthognathic model surgery technique (Yonsei method) which adopts the tooth point as the reference and the occlusal index as a moving vehicle for the model. Methods: The technique consists mainly of: 1) measuring the three-dimensional lengths of model points, 2) fabricating and moving the occlusal index and 3) verifying the movement. Then we compared the accuracy of the Yonsei method to conventional methods, with special reference made to influencing factors. Results: Errors for the Yonsei method with the occlusal index were reduced to the range of 0.61~1.04 mm in three-dimension, providing a more accurate model surgery technique than conventional methods which have errors ranging from 0.77~3.11 mm. Conclusion: It provided us a more accurate model surgery technique based on the reference points onto the teeth and the use of occlusal index.

• The korean journal of orthodontics
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• v.43 no.1
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• pp.42-52
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• 2013

The aim of this paper was to propose a new method of bimaxillary orthognathic surgery planning and model surgery based on the concept of 6 degrees of freedom (DOF). A 22-year-old man with Class III malocclusion was referred to our clinic with complaints of facial deformity and chewing difficulty. To correct a prognathic mandible, facial asymmetry, flat occlusal plane angle, labioversion of the maxillary central incisors, and concavity of the facial profile, bimaxillary orthognathic surgery was planned. After preoperative orthodontic treatment, surgical planning based on the concept of 6 DOF was performed on a surgical treatment objective drawing, and a Jeon's model surgery chart (JMSC) was prepared. Model surgery was performed with Jeon's orthognathic surgery simulator (JOSS) using the JMSC, and an interim wafer was fabricated. Le Fort I osteotomy, bilateral sagittal split ramus osteotomy, and malar augmentation were performed. The patient received lateral cephalometric and posteroanterior cephalometric analysis in postretention for 1 year. The follow-up results were determined to be satisfactory, and skeletal relapse did not occur after 1.5 years of surgery. When maxillary and mandibular models are considered as rigid bodies, and their state of motion is described in a quantitative manner based on 6 DOF, sharing of exact information on locational movement in 3-dimensional space is possible. The use of JMSC and JOSS will actualize accurate communication and performance of model surgery among clinicians based on objective measurements.

• Journal of Chest Surgery
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• v.57 no.3
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• pp.302-311
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• 2024

Background: Unexpected conversion to thoracotomy during planned video-assisted thoracoscopic surgery (VATS) can lead to poor outcomes and comparatively high morbidity. This study was conducted to assess preoperative risk factors associated with unexpected thoracotomy conversion and to develop a risk scoring model for preoperative use, aimed at identifying patients with an elevated risk of conversion. Methods: A retrospective analysis was conducted of 1,506 patients who underwent surgical resection for non-small cell lung cancer. To evaluate the risk factors, univariate analysis and logistic regression were performed. A risk scoring model was established to predict unexpected thoracotomy conversion during VATS of the lung, based on preoperative factors. To validate the model, an additional cohort of 878 patients was analyzed. Results: Among the potentially significant clinical variables, male sex, previous ipsilateral lung surgery, preoperative detection of calcified lymph nodes, and clinical T stage were identified as independent risk factors for unplanned conversion to thoracotomy. A 6-point risk scoring model was developed to predict conversion based on the assessed risk, with patients categorized into 4 groups. The results indicated an area under the receiver operating characteristic curve of 0.747, with a sensitivity of 80.5%, specificity of 56.4%, positive predictive value of 1.8%, and negative predictive value of 91.0%. When applied to the validation cohort, the model exhibited good predictive accuracy. Conclusion: We successfully developed and validated a risk scoring model for preoperative use that can predict the likelihood of unplanned conversion to thoracotomy during VATS of the lung.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.3
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• pp.163-168
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• 2003

Three-dimensional solid model has not been widely used in surgical prediction of orthognathic surgery because frequent artifacts from occlusal restorations or prosthesis limited the usefulness of simulated surgery involving occlusion. We prepared three-dimensional(3D) solid model from CT data and integrated the 3D solid model with dental cast using a face-bow transfer technique combined with skeletal reference measurement and confirmation with cephalometric radiographs. With this simple and easy method, it was possible to predict bony interference between the proximal and distal segment of the mandible so that we can prevent condylar displacement after sagittal split ramus osteotomy of the mandible with prominent asymmetry. The method error was within 2mm and it seemed to be useful in preoperative planning for maxillofacial surgery with maxillo-mandibular occlusal change.