• Archives of Plastic Surgery
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• v.40 no.4
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• pp.348-352
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• 2013

Background Temporalis muscle transfer produces prompt surgical results with a one-stage operation in facial palsy patients. The orthodromic method is surgically simple, and the vector of muscle action is similar to the temporalis muscle action direction. This article describes transferring temporalis muscle insertion to reconstruct incomplete facial nerve palsy patients. Methods Between August 2009 and November 2011, 6 unilateral incomplete facial nerve palsy patients underwent surgery for orthodromic temporalis muscle transfer. A preauricular incision was performed to expose the mandibular coronoid process. Using a saw, the coronoid process was transected. Three strips of the fascia lata were anchored to the muscle of the nasolabial fold through subcutaneous tunneling. The tension of the strips was adjusted by observing the shape of the nasolabial fold. When optimal tension was achieved, the temporalis muscle was sutured to the strips. The surgical results were assessed by comparing pre- and postoperative photographs. Three independent observers evaluated the photographs. Results The symmetry of the mouth corner was improved in the resting state, and movement of the oral commissure was enhanced in facial animation after surgery. Conclusions The orthodromic transfer of temporalis muscle technique can produce prompt results by applying the natural temporalis muscle vector. This technique preserves residual facial nerve function in incomplete facial nerve palsy patients and produces satisfying cosmetic outcomes without malar muscle bulging, which often occurs in the turn-over technique.

• Journal of Oral Medicine and Pain
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• v.38 no.1
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• pp.53-67
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• 2013

This study was aimed to evaluate the masticatory efficiency after botulinum toxin type A (BTX-A) injection during 12 weeks using objective and subjective test. Also, we compared the difference of masticatory efficiency between group that injected into the masseter muscle only (M-group) and group that injected into the masseter and temporalis muscle (M-T group). The mixing ability index (MAI) was used as the objective indicator, and visual analogue scale (VAS) and food intake ability (FIA) index were used as the subjective indicators. It was concluded that masticatory efficiency was significantly lowered after a BTX-A injection into the masticatory muscle, but it gradually recovered in a predictable pattern by the 12 weeks. The disturbance of subjective masticatory efficiency was lasted longer than objective masticatory efficiency. The masticatory efficiency was lower in M-T group than M group. It was statistically significant in the VAS and FIA at 4 weeks, but the MAI showed no significancy. After 4weeks, there was rapid recovery of muscle function in M-T group, and the difference between two groups was not significant. It could be concluded that there will be no serious disturbance of mastication compared to injection is done only into the masseter muscle, even if injection is done into the masseter and temporalis muscle in dose of this study. According to the food properties, it was confirmed that people feel more discomfort on taking hard and tough foods after BTX-A injection and not only hard foods, but also intake of soft and runny foods were influenced by botulinum toxin injection.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.12.1-12.5
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• 2017

Background: Rehabilitation of normal function and form is essential in cleft lip repair. In 2005, Dr. David M. Fisher introduced an innovative method, named "an anatomical subunit approximation technique" in unilateral cleft lip repair. According to this method, circumferential incision along the columella on cleft side of the medial flap is continued to the planned top of the Cupid's bow in straight manner, which runs parallel to the unaffected philtral ridge. Usually, small inlet incision is needed to lengthen the medial flap. On lateral flap, small triangle just above the cutaneous roll is used to prevent unesthetic shortening of upper lip. This allows better continuity of the Cupid's bow and ideal distribution of tension. Case presentation: As a modification to original method, orbicularis oris muscle overlapping suture is applied to make the elevated philtral ridge. Concomitant primary rhinoplasty also results in good esthetic outcome with symmetric nostrils and correction of alar web. As satisfactory results were obtained in three incomplete and one complete unilateral cleft lip patients, indicating Fisher's method can be useful in cleft lip surgery with functional and esthetic outcome. Conclusions: Clinically applied Fisher's method in unilateral cleft lip patients proved the effectiveness in improving the esthetic results with good symmetry. This method also applied with primary rhinoplasty.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.50-54
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• 2019

Muscular dystrophy (MD) is a heterogeneous group of inherited neuromuscular disorders, characterized by progressive muscle weakness. Severity of the disease ranges from mild to severe, and the disease is mostly caused by mutations in a number of genes. These genetic mutations cause lack of proteins which are essential for muscle cell stability. Muscle fibers are gradually replaced by fat and fibrous tissue. The muscles of the head and neck are affected in several types of MD that manifest as altered craniofacial morphology and dental malocclusion. A 3-year-10-month old, 15.0 kg boy with MD presented to Seoul National University Dental Hospital, Seoul, South Korea because of extensive carious teeth. A number of dental caries in primary dentition were identified during clinical oral examination. Due to dental anxiety and underlying systemic disease, general anesthesia was considered. General anesthesia was induced and maintained with intravenous anesthetics, propofol and remifentanil. Caries treatments - resin restoration, pulpectomy, zirconia crown restoration, stainless steel crown restoration - were performed. Under general anesthesia, successful dental procedure was done. Total intravenous anesthesia (TIVA) was performed instead of inhalation anesthesia in order to avoid risk of complications such as malignant hyperthermia and life-threatening rhabdomyolysis. With decreasing muscle function, plaque control becomes more difficult and leads to gingivitis. Especially, the open-mouth posture worsens gingivitis and can leads to malocclusions and problems in swallowing. Regular and periodic dental care is essential for maintaining oral health for patients with MD.

• Journal of Korean society of Dental Hygiene
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• v.15 no.4
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• pp.679-685
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• 2015

Objectives: The purpose of the study is to investigate the change of the salivary flow rate, xerostomia, and oral health-related quality of life in the elderly people after the application of oral massage. Methods: The subjects were 101 elderly people at two senior welfare centers in Mokpo from November, 2012 to January, 2013 by the application of oral massage. The final subjects were 56 elderly people who participated in the massage more than 15 times of 20. They were measured for saliva flow rate, xerostomia, and OHIP. On the first and the last day, a self-reported questionnaire was completed by the elderly people. The questionnaire consisted of general characteristics of the subjects, oral health related knowledge, symptoms and behavior of xerostomia, and OHIP. OHIP included functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap, and was measured by Likert 5 point scale. Results: The salivary flow rate of the elderly people increased after the implementation of the program. There was a significant improvement in xerostomia, functional limitation, physical pain, psychological discomfort, and social efficacy (p<0.001). Conclusions : The oral massage program enhanced the oral function of the elderly people, and had an influence on the improvement of oral health-related quality of life.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.247-251
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• 2011

Botulinum toxin type A (BoNT-A) is used for treating bilateral masseter hypertrophy since 1994. Recently there have been more clinical studies in this area, with some authors reporting that BoNT-A can reduce the size of the masseter muscle, as documented by photography, ultrasonography, computed tomography, and 3D(three dimensional) laser scan. However, earlier studies were only for bilateral masseter hypertrophy cases, not for unilateral masseter hypertrophy cases. The aim of this study was to use 3D laser scanning to evaluate changes in the external facial contour induced by unilateral BoNT-A injection. BoNT-A was injected into hypertrophic masseter muscle unilaterally in 10 patients with asymmetric masseter hypertrophy. The clinical effects of unilaterally injected BoNT-A were evaluated before the injection and 4, 8, and 12weeks after the injection using 3D laser scan. And the mean values of both sides (injection and non-injection sides) were compared with. At injection side, mean values of the volume and the bulkiest height at each time point diminished significantly between pre-injection and 4, 8, and 12weeks post-injection. At non-injection side, in contrast, mean values of the volume and the bulkiest height diminished also but less than that of injected side, and there was no statistical significance. In this limited study, we concluded that the unilaterally BoNT-A injection side showed greater mean values of the reduction of muscle volume than non-injection side at 4, 8, and 12 weeks after the injection.

• Journal of Oral Medicine and Pain
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• v.16 no.1
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• pp.85-93
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• 1991

In this study, 88 dental students were examined to evaluate the relationship between occlusal states and TM disorders for the epidemiologic study of TM disorders. The clinical evaluation were composed of mandibular movement, TMJ noise, occlusal states and muscle palpation. The following results were disclosed. 1. The frequencies of pain on mandibular movement were 3.4% on maximum opening, 1.13% on protrusion and no pain on laterotrusion. 2. The frequencies on TMJ sound were 21.6% in click, 1.13% in crepitus. 3. The frequency of tenderness on palpation was 12.5% on extra oral, intraoral and neck muscles, tenderness on palpation of TMJ capsule were reported 5 cases, and 4 of them were female. 4. The distribution of Angle's classification was found 79.5% in class I, 4.5% in clasII-div.1 and 15.9% in class III. There was no significant differences on TM disorders between Angles classifications. 5. There was no significant differences on TM disorders between the subjects of canine guided occlusion and group function occlusion, and also for the differences between the subjects of nonworking side interferences and no interferences on laterotrusion. 6. There was no significant differences on TM disorders between the subjects of anterior teeth trauma in C.C. and no anterior teeth trauma, but there were significant differences between the subjects of posterior protrusive contact and no posterior protrusive contact.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.3
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• pp.175-181
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• 2002

Intermaxillary fixation and occusal splint are routine procedure for maxillofacial fracture and orthognathic surgery. When these methods could obstruct oral airway the patients who kept intermaxillary fixation and occusal splint in their mouth, are very difficult to breath after surgery. Nasal bleeding and pharyngeal edema due to nasotracheal intubation, residual effect of muscle relaxants, and anesthetic agent could be contributing factor of airway obstruction. In this study, pulmonary function test was evaluated before and after intermaxillary fixation, and intermaxillary fixation with occusal splint in 22 volunteers. The results were as follows 1. FVC, %FVC, $FEV_1$, $FEV_1%$, PEF, $PEF_{50}$, MVV without intermaxillary fixtion were 4.45L, 88%, 4.03L, 90.9%, 10.26L/s, 5.53L/s, and 136.14L/min, and with intermaxillary fixation were 3.51L, 68.67%, 3.06L, 69.39L, 6.52L/s, 3.94L/s, and 69.39L/min. The results with intermaxillary fixation and occusal splint were 2.15L, 42.41%, 1.71L, 38.81%, 2.83L/s, 1.74L/s, and 37.14L/min. 2. Compared with before and after intermaxillary fixation, all values of pulmonary function test were decreased and after intermaxillary fixation and intermaixillary fixation with occulasal splint, the results were decreased. 3. MVV and PEF were decreased significantly with interaxillary fixtion and occusal splint, and FVC was less decreased. It meant that intermaxillary fixation and occluasal splint induced reduction of respiratory flow significantly, but less reduction of respiratory volume. 4. Intermaxillary fixation and occulsal splint induced increase of airway resistance, decrease of expiratory volume and air flow. So severe respiratory difficulty could be seen to all volunteers who kept intermaxillary fixtion and occusal splint. 5. In classification of respiratory difficulty, intermaxillary fixation with occulsal splint induced complex respiratory difficulty more than intermaxillary fixation only did. From the above results, doctors who care patients kept intermaxillary fixation and occusal splint should be aware of respiratory depression caused by these treatment.

• Journal of Oral Medicine and Pain
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• v.12 no.1
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• pp.53-61
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• 1987

In order to evaluate the effect of unilateral tooth clenching, the author observed a feature of producing the symptom complex related to pain and discomfort by the isometric unilateral canine biting under force of 5kg(FS) in Korean 31 adult females within normal masticatory function who were divided into the bilateral, the right and the left group according to their habitual sides of mastication, and analyzed the observed data statistically. The obtained results were as follows: 1. The duration of the isometric unilateral canine biting maintained before the occurrence of symptom complex related to pain and discomfort 66.72 seconds at right side and 39.50 seconds at left side in a group of subjects with bilateral habitual mastication. And the difference of the duration between of unilateral biting side was almost significant (P<0.05). 2. The most frequent region of occurrence of symptom complex related to pain and discomfort by the isometric unilateral canine biting was the contralateral superficial masseter muscle in a group of subjects with bilateral habitual mastication.

• Speech Sciences
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• v.3
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• pp.57-69
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• 1998

Velopharyngeal function refers to the combined activity of the soft palate and pharynx in closing and opening the velopharyngeal port to the required degree. In normal speech, during the production of oral consonant sounds elevation of the soft palate, along with the superior constrictor muscle, occludes the oropharynx from the nasopharynx. Inadequate velopharyngeal function caused by congenital or acquired insufficiency or incompetency may result in abnormal speech characterized by hypernasality, nasal emission and decreased intelligibility of speech due to weak consonant production. The speech aid is often helpful in improving the speech of individuals with velopharyngeal incompetency. In this article, the pathogenesis and treatment of velopharyngeal incompetence are discussed and a speech aid appliance that was constructed for the patient is described.