• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권1호
• /
• pp.99-103
• /
• 1994

Various extraoral and intraoral approaches to reduction and fixation of zygomatic complex fractures were used. The method for exposure of inferior orbital area include the subciliary, inferior eyelid, infraorbital rim and conjunctions incisions. For exposure of frontozygomatic suture, lateral brow, coronal and b'ephaloplasty incisions were used. It is necessary that the usual approaches to the inferior and lateral orbit have two incisions. However, lateral canthotomy-conjunctival approach presented on this paper provide optimal exposure to lateral and inferior orbit.

• The korean journal of orthodontics
• /
• 제50권1호
• /
• pp.33-41
• /
• 2020

Objective: To investigate the distribution and phenotypes of hemifacial microsomia (HFM) and its association with other anomalies. Methods: This study included 249 Korean patients with HFM, whose charts, photographs, radiographs, and/or computed tomography scans acquired during 1998-2018 were available from Seoul National University Hospital and Dental Hospital. Prevalence according to sex, side involvement, degree of mandibular deformity, compensatory growth of the mandibular body, and Angle's classification, and its association with other anomalies were statistically analyzed. Results: Prevalence was not different between male and female patients (55.0% vs. 45.0%, p > 0.05). Unilateral HFM (UHFM) was more prevalent than bilateral HFM (BHFM) (86.3% vs. 13.7%, p < 0.001). Although distribution of the Pruzansky-Kaban types differed significantly in patients with UHFM (I, 53.0%; IIa, 18.6%; IIb, 24.7%; III, 3.7%; p < 0.001), no difference was observed in occurrence between the right and left sides (52.6% vs. 47.4%, p > 0.05). Among patients with BHFM, prevalence of different Pruzansky-Kaban types on the right and left sides was greater than that of the same type on both sides (67.6% vs. 32.4%, p < 0.05). Despite hypoplasia of the condyle/ramus complex, compensatory growth of the mandibular body on the ipsilateral side occurred in 35 patients (14.1%). Class I and II molar relationships were more prevalent than Class III molar relationships (93.2% vs. 6.8%, p < 0.001). Forty-eight patients (19.3%) had other anomalies, with 50.0% and 14.4% in the BHFM and UHFM groups (p < 0.001). Conclusions: Patients with HFM require individualized diagnosis and treatment planning because of diverse phenotypes and associations with other anomalies.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제14권1_2호
• /
• pp.135-142
• /
• 1992

This study was performed to define the anatomical position of the mandibular canal and the findings during the sagittal split ramus osteotomy of the mandible. The mandibles of 20 adult Korean were used. The dimension of mandibular canal from the mandibular foramen to the 1st molar was measured at 4 specific coronal-sectional location by CT scan. The results were as follows ; 1. The distance from the mandibular canal to the medial aspect of the buccal cortical plate was greatest($4.5{\pm}1.1mm$) at 2nd molar area and was not significantly greater than at any other section. 2. Buccal cortex was thickest($3.8{\pm}0.9mm$) at 2nd molar and thinnest ($2.5{\pm}0.3mm$) mandibular foramen um 3. The distance from the mandibular canal to the medial aspect of the lingual cortical plate was not significant at any sections. 4. The distance from the mandible canal to the inferior border of mandible was greatest at the mandibular foramen($20.7{\pm}3.9mm$). The canal was located more closely to the inferior border at 1st, 2nd molar area 5. The diameter of the mandibular canal was between $2.5{\pm}0.3mm$ and $2.8{\pm}0.6mm$. 6. The total mandibular thickness was greatest($21.1{\pm}2.6mm$) at 2nd molar area and narrowest($17.2{\pm}3.2mm$) at mandibular foramen area.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제27권4호
• /
• pp.350-359
• /
• 2005

Sagittal split ramus osteotomy(SSRO) has been commonly performed in the mandibular prognathism. The previous studies of the mandibular anatomy for SSRO have mostly been used in dry skull without consideration of age, sex or jaw relationship of patients. This study was performed to evaluate the location of mandibular canal and the anatomy of ramus, such as the location of mandibular lingula and the ramal bone marrow, which were associated with SSRO procedures, in the patients with mandibular prognathism and normal young adults by using computerized tomographs(CT) and 3D images. The young adults at their twenties, who were considered to complete their skeletal growth, and seen in the Department of Orthodontics and Oral and Maxillofacial Surgery in Chonnam National University Hospital between March 2000 and May 2003, were selected. This study was performed in 30 patients (15men, 15women) who were diagnosed as skeletal class I normal relationship, and another 30 patients (15men, 15women) who were diagnosed as skeletal class III relationship upon clinical examination and lateral cephalometric radiographs. The patients were divided into 2 groups : Class I group, the patients who had skeletal class Ⅰ normal relationship(n=30, 15men, 15women), and Class III group, the patients who had skeletal class III relationship(n=30, 15men, 15women). Facial CT was taken in all patients, and pure 3D mandibular model was constructed by V-works version 4.0. The occlusal plane was designed by three points, such as the mesiobuccal cusp of both mandibular 1st molar and the incisal edge of the right mandibular central incisor, and used as a reference plane. Distances between the tip of mandibular lingula and the occlusal plane, the sigmoid notch, the anterior and the posterior borders of ramus were measured. The height of ramal bone marrow from the occlusal plane and the distance between mid-point of mandibular canal and the buccal or lingual cortex of the mandible in the 1st and 2nd molars were measured by V-works version 4.0. Distance(Li-OP) between the occlusal plane and the tip of mandibular lingula of Class III Group was longer than that of Class I Group in men(p<0.01), but there was no significant difference in women between both groups. Distance(Li-SN) between the sigmoid notch and the tip of mandibular ligula of Class III group was longer than that of Class I Group in men(p<0.05), but there was no significant difference in women between both groups. Distance(Li-RA) between the anterior border of ramus and the tip of mandibular lingula of Class III Group was shorter than that of Class I Group in men and women(p<0.01). Distance(Li-RP) between the posterior border of ramus and the tip of mandibular lingula of Class III Group was slightly shorter than that of Class I Group in men(p<0.05), but there was no significant difference in women between both groups. Distance(RA-RP) between the anterior and the posterior borders of ramus of Class III Group was shorter than that of Class I Group in men and women(p<0.01). Longer the distance(SN-AN) between the sigmoid notch and the antegonial notch was, longer the vertical ramal length above occlusal plane, higher the location of mandibular lingula, and shorter the antero-posterior ramal length were observed(p<0.01). Height of ramal bone marrow of Class III Group was higher than that of Class I Group in men and women(p<0.01). Distance between mandibular canal and buccal cortex of Class III Group in 1st and 2nd lower molars was shorter than that of Class I Group in men and women (p<0.05 in 1st lower molar in men, p<0.01 in others). These results indicate that there are some anatomical differences between the normal occlusal patients and the mandibular prognathic patients, such as the anterior-posterior length of ramus, the height of ramal bone marrow, and the location of mandibular canal.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제28권5호
• /
• pp.375-395
• /
• 2006

Purpose: Lingual nerve (LN) damage may be caused by either tumor resection or injury such as wisdom tooth extraction, Although autologous nerve graft is sometimes used to repair the damaged nerve, it has the disadvantage of necessity of another operation for nerve harvesting. Moreover, the results of nerve grafting is not satisfactory. The nerve growth factor (NGF) is well-known to play a critical role in peripheral nerve regeneration and its local delivery to the injured nerve has been continuously tried to enhance nerve regeneration. However, its application has limitations like repeated administration due to short half life of 30 minutes and an in vivo delivery model must allow for direct and local delivery. The aim of this study was to construct a well-functioning $rhNGF-{\beta}$ adenovirus for the ultimate development of improved method to promote peripheral nerve regeneration with enhanced and extended secretion of hNGF from the injured nerve by injecting $rhNGF-{\beta}$ gene directly into crush-injured LN in rat model. Materials and Methods: $hNGF-{\beta}$ gene was prepared from fetal brain cDNA library and cloned into E1/E3 deleted adenoviral vector which contains green fluorescence protein (GFP) gene as a reporter. After large scale production and purification of $rhNGF-{\beta}$ adenovirus, transfection efficiency and its expression at various cells (primary cultured Schwann cells, HEK293 cells, Schwann cell lines, NIH3T3 and CRH cells) were evaluated by fluorescent microscopy, RT-PCR, ELISA, immunocytochemistry. Furthermore, the function of rhNGF-beta, which was secreted from various cells infected with $rhNGF-{\beta}$ adenovirus, was evaluated using neuritogenesis of PC-12 cells. For in vivo evaluation of efficacy of $rhNGF-{\beta}$ adenovirus, the LNs of 8-week old rats were exposed and crush-injured with a small hemostat for 10 seconds. After the injury, $rhNGF-{\beta}$ adenovirus($2{\mu}l,\;1.5{\times}10^{11}pfu$) or saline was administered into the crushed site in the experimental (n=24) and the control group (n=24), respectively. Sham operation of another group of rats (n=9) was performed without administration of either saline or adenovirus. The taste recovery and the change of fungiform papilla were studied at 1, 2, 3 and 4 weeks. Each of the 6 animals was tested with different solutions (0.1M NaCl, 0.1M sucrose, 0.01M QHCl, or 0.01M HCl) by two-bottle test paradigm and the number of papilla was counted using SEM picture of tongue dorsum. LN was explored at the same interval as taste study and evaluated electro-physiologically (peak voltage and nerve conduction velocity) and histomorphometrically (axon count, myelin thickness). Results: The recombinant adenovirus vector carrying $rhNGF-{\beta}$ was constructed and confirmed by restriction endonuclease analysis and DNA sequence analysis. GFP expression was observed in 90% of $rhNGF-{\beta}$ adenovirus infected cells compared with uninfected cells. Total mRNA isolated from $rhNGF-{\beta}$ adenovirus infected cells showed strong RT-PCR band, however uninfected or LacZ recombinant adenovirus infected cells did not. NGF quantification by ELISA showed a maximal release of $18865.4{\pm}310.9pg/ml$ NGF at the 4th day and stably continued till 14 days by $rhNGF-{\beta}$ adenovirus infected Schwann cells. PC-12 cells exposed to media with $rhNGF-{\beta}$ adenovirus infected Schwann cell revealed at the same level of neurite-extension as the commercial NGF did. $rhNGF-{\beta}$ adenovirus injected experimental groups in comparison to the control group exhibited different taste preference ratio. Salty, sweet and sour taste preference ratio were significantly different after 2 weeks from the beginning of the experiment, which were similar to the sham group, but not to the control group.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제13권3호
• /
• pp.278-290
• /
• 1991

Prediction of the sop tissue changes following hard tissue movements is very important in the preoperative analysis of surgical changes of the patient who have orthognathic surgery. This study examined post operative changes of the mid-facial sop tissues in Koreans depending upon two major positional changes of the maxilla following Le Fort - I type osteotomy for orthognathic purposes. Sixty patients(41 males and 19 females) of Koreans were selected and divided into two groups according to directional change of movement of anterior bony structures of the Maxilla as follows : Group I (44 patients) was mooed anteriorly and/or inferiorly, and Group II (16 patients) was mooed posteriorly and/or superioly. Postoperative changes of the sop tissue measurements following hard tissue changes were examined on pre - and post - operative cephalometrics by means of computerized digitation methods and the ratios of changes were analysed. The results were obtained as follows : 1. In Group I, all of the sop tissue measures except the Pn was closely followed by the changes of the hard tissue measures in the horizontal plane, but the Sn and the Cm were only correlated to the vertical changes(p<0.001). In group II, all of the sop tissue measures excluding of the N' and the Pn were significantly correlated to the hard tissue measures in horizontal plane(p<0.001), but the Ls and Stm were only correlated relatively to the vertical changes of the ANS(p<0.01). 2. Predictable ratio of the Sn was 66% of the ANS or 56% of the A in the horizontal plane and 89% of the A in the vertical plane in Group I. In Group II, the Sn was predictable as 85% of the ANS or 70% of the A in the horizontal plane but was not predictable in vertical plane. 3. Predictable ratio of the Cm was 28% of the ANS or 50% of the A in the horizontal plane and 56% of the ANS or 36% of the A in the vertical plane in Group I. In Group II, the Cm was predictable horizontally as 74% of the A. Predictable ratio of the Pn was 30% of the ANS or 38% of the A in horizontal plane in Group I, but it was not predictable both horizontally and vertically in Group II. 4. Predictable ratio of the Ls was 52% of the Pr in Group I and 77% in Group II in the horizontal plane. The Stm was predictable as 34% of the pr or 22% of the I in the horizontal plane in Group I, and was also predictable as 55% of the pr or 68% of the I horizontally and 21% of the pr or 65% of the I vertically in Group II. 5. All ratios of change in the thickness. length and area of the upper lip following maxillary movement were statiscally correlated, however, mangitudes of them were meaningful clinically.

• Journal of the Korean Society of Visualization
• /
• 제22권2호
• /
• pp.90-95
• /
• 2024

This study examined changes in airway airflow characteristics before and after extensive surgery for tongue cancer, which includes neck dissection and reconstruction. Pre- and post-operative CBCT scans were used to model 3D upper airways. Computational fluid dynamics (CFD) simulations analyzed airflow and pressure variations. Results showed a significant reduction in airway volume post-surgery, especially in the posterior tongue and epiglottis areas, leading to increased airflow velocity and complex vortex formations. Pressure drop analysis revealed that post-surgery, higher negative pressure is required for inhalation, indicating increased breathing effort. This suggests that the surgical removal of cancerous tissues and lymph nodes, along with reconstruction, alters airway geometry significantly, potentially impacting respiratory function. The findings highlight the clinical importance of assessing airway changes in tongue cancer surgery to anticipate and mitigate postoperative respiratory complications.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제18권2호
• /
• pp.323-336
• /
• 1996

This is a retrospective study on the patients with infection of the oral and maxillofacial region with the purpose of obtaining some useful data for diagnosis and treatment plan of that relatively common disease in dentistry. The used materials of study were 87 in total, including 52 male patients, 35 female patients who diagnosed and treated at the Department of the Dentistry in Hanyang Medical College Hospital for the period of Jan. 1990 to Dec. 1994. The author analyzed the distribution and incidence of sex, age, admission period, etiologic factors, etiologic teeth, treatment method of infections, pus culture, antibiotics sensibilities and medication. The result obtained as follows : 1. The developmental incidences by sex was superior in male by the ratio of 1.5 : 1 and the infection was most frequently occurred during the third decades(35.6%). 2. The number of admitted patients elevated in February, March, and April, and average of admission period was 9.8 days. 3. Main etiologic teeth showed on lower molar region in adult(63%) and upper molar region in primary dentition(46.1%). 4. Medications were administrated in all of the cases, and surgical incision and drainage were performed in 53% and extraction of the causative teeth were performed in 63.6% of all cases. 5. The most common involved fascial spaces were Buccal space(41.4%), Infraorbital space(27.6%), Submandibular space(16.1%),in order, and 9 cases(10.3%) were Ludwig's Angina. In 68.2% of the patients, and infection involved only one fascial space and in 21.8% of the patients, it involved to more fascial spaces. 6. The most causative organisms isolated from pus culture were Gram-positive facultative cocci(55.5%), and antibiotics sensitivities on the total isolated bacterial strains were exposed chloramphenicol(88.6%), Cephalothin(88.6%), Erythromycin(81.5%), Lincomycin(77.8%) in order, but it showed resistant on Gentamycin(58.3%), Tetracycline(56.5%), Methicillin(38.5%).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제42권2호
• /
• pp.77-83
• /
• 2016

Objectives: To evaluate the effectiveness of regenerative tissue matrix (Alloderm) as an oral layer for difficult anterior palatal fistula closure. Materials and Methods: The authors have tested the feasibility of a novel surgical technique of adding a regenerative tissue matrix (Alloderm) as an oral layer for closure of recalcitrant large anterior palatal fistulae and report the outcome of the first 12 patients in this pilot study. Patients with recurrent large fistula who otherwise would require either a local pedicled flap, free flap, or an obturator were treated with this technique and followed up for at least 6 months to monitor the progress of healing. Results: Of the 12 patients, 8 patients (66.7%) had complete closure of the fistula, and 2 patients (16.7%) showed reduction in size of the fistula to the extent that symptoms were eliminated, for an overall success rate of 83.3% (10/12 patients). Premature graft loss and recurrence of the fistula were noted in 2 patients (16.7%). Conclusion: Alloderm provided an adequate barrier allowing healing to occur unimpeded and allowed closure of the palatal fistula. In our experience, this new technique using regenerative tissue matrix as an adjunct to the oral layer in large anterior palatal fistula has an advantage compared to other more invasive complex procedures and has been shown to provide satisfactory results.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제40권
• /
• pp.44.1-44.17
• /
• 2018

Background: Coffee extract has been investigated by many authors, and many minor components of coffee are known, such as polyphenols, diterpenes (kahweol and cafestol), melanoidins, and trigonelline, to have anti-inflammatory, anti-oxidant, anti-angiogenic, anticancer, chemoprotective, and hepatoprotective effects. Therefore, it is necessary to know its pharmacological effect on hepatocytes which show the most active cellular regeneration in body. Methods: In order to determine whether coffee extract has a beneficial effect on the liver, 20 C57BL/6J mice were intraperitoneally injected once with dialyzed coffee extract (DCE)-2.5 (equivalent to 2.5 cups of coffee a day in man), DCE-5, or DCE-10, or normal saline (control), and then followed by histological observation and IP-HPLC (immunoprecipitation high performance liquid chromatography) over 24 h. Results: Mice treated with DCE-2.5 or DCE-5 showed markedly hypertrophic hepatocytes with eosinophilic cytoplasms, while those treated with DCE-10 showed slightly hypertrophic hepatocytes, which were well aligned in hepatic cords with increased sinusoidal spaces. DCE induced the upregulations of cellular proliferation, growth factor/RAS signaling, cellular protection, p53-mediated apoptosis, angiogenesis, and antioxidant and protection-related proteins, and the downregulations of NFkB signaling proteins, inflammatory proteins, and oncogenic proteins in mouse livers. These protein expression changes induced by DCE were usually limited to the range ± 10%, suggesting murine hepatocytes were safely reactive to DCE within the threshold of physiological homeostasis. DCE-2.5 and DCE-5 induced relatively mild dose-dependent changes in protein expressions for cellular regeneration and de novo angiogenesis as compared with non-treated controls, whereas DCE-10 induced fluctuations in protein expressions. Conclusion: These observations suggested that DCE-2.5 and DCE-5 were safer and more beneficial to murine hepatocytes than DCE-10. It was also found that murine hepatocytes treated with DCE showed mild p53-mediated apoptosis, followed by cellular proliferation and growth devoid of fibrosis signaling (as determined by IP-HPLC), and subsequently progressed to rapid cellular regeneration and wound healing in the absence of any inflammatory reaction based on histologic observations.