• Title/Summary/Keyword: Orthognathic Surgery

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RADIX AUGMENTATION USING TEMPORALIS FASCIA GRAFT (측두근막 이식을 이용한 비근증대술)

  • Ryu, Sun-Youl;Ryu, Jae-Young;Kim, Hyun-Syeob
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.2
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    • pp.167-173
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    • 2007
  • The temporalis fascia graft has been widely used in the correction of nasal deformities. The fascia can be used alone or combined for augmentation rhinoplasty. The fascia graft provides adequate coverage, contour, and bulk on the profile of the nose, as well as an inconspicuous donor site. A depressed radix area can be successfully corrected by the fascia graft. We present two cases of nasal radix augmentation by using temporalis fascia graft. Two male patients presented with the skeletal class III malocclusion and the depressed radix. A planned orthognathic surgery and the temporalis fascia graft to the radix were performed. The malocclusion and the profile of the patients were markedly improved after the operation. Not only the radix but also the nose was improved in its size and length. There was no noticeable resorption or displacement of the radix area at follow-up. The temporalis fascia graft could be an appropriate surgical technique in radix augmentation and nose lengthening.

RECONSTRUCTION OF UNILATERAL TMJ ANKYLOSIS WITH METALLIC CONDYLAR PROSTHESIS;REPORT OF A CASE (금속 이식물을 이용한 악관절 강직증의 치험례)

  • Lee, Dong-Keun;Yim, Chang-Joon;Kang, Moon-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.40-46
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    • 1989
  • Destruction of normal temporomandibular joint architechture may produce serious functional and cosmetic deficiencies. The literature is well documented as to the etiology and pathogenesis of temporomandibular joints. Numorous surgical procedure have been advocated for temporomandibular joint ankylosis from condylectomy to arthroplasty, cartilage transplant, metallic prosthesis, interpositional implant. These were to able reconstruct the normal mandibular function, and any even procedure could obtain the satisfactory results. In this paper, we reviewed young adult patient with TMJ ankylosis and facial asymmetry who was treated with metallic condylar prosthesis and orthognathic surgery.

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Correlation between skeletal and dental changes after mandibular setback surgery-first orthodontic treatment: Cone-beam computed tomography-generated half-cephalograms

  • Rhee, Chang-Hoon;Choi, Youn-Kyung;Kim, Yong-Il;Kim, Seong-Sik;Park, Soo-Byung;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.45 no.2
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    • pp.59-65
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    • 2015
  • Objective: To investigate skeletal and dental changes after application of a mandibular setback surgery-first orthodontic treatment approach in cases of skeletal Class III malocclusion. Methods: A retrospective study of 34 patients (23 men, 11 women; mean age, $26.2{\pm}6.6years$) with skeletal Class III deformities, who underwent surgery-first orthodontic treatment, was conducted. Skeletal landmarks in the maxilla and mandible at three time points, pre-treatment (T0), immediate-postoperative (T1), and post-treatment (T2), were analyzed using cone-beam computed tomography (CBCT)-generated half-cephalograms. Results: The significant T0 to T1 mandibular changes occurred $-9.24{\pm}3.97mm$ horizontally. From T1 to T2, the mandible tended to move forward $1.22{\pm}2.02mm$, while the condylar position (Cd to Po-perpendicular plane) shifted backward, and the coronoid process (Cp to FH plane) moved vertically. Between T1 and T2, the vertical dimension changed significantly (p < 0.05). Changes in the vertical dimension were significantly correlated to T1 to T2 changes in the Cd to Po-perpendicular plane (r = -0.671, p = 0.034), and in the Cp to FH plane (r = 0.733, p = 0.016), as well as to T0 to T1 changes in the Cp to Po-perpendicular plane (r = 0.758, p = 0.011). Conclusions: Greater alterations in the vertical dimension caused larger post-treatment (T2) stage skeletal changes. Studying the mandibular position in relation to the post-surgical vertical dimension emphasized the integral importance of vertical dimension control and proximal segment management to the success of surgery-first orthodontic treatment.

Infraorbital nerve transpositioning into orbital floor: a modified technique to minimize nerve injury following zygomaticomaxillary complex fractures

  • Kotrashetti, Sharadindu Mahadevappa;Kale, Tejraj Pundalik;Bhandage, Supriya;Kumar, Anuj
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.2
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    • pp.74-77
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    • 2015
  • Objectives: Transpositioning of the inferior alveolar nerve to prevent injury in lower jaw has been advocated for orthognathic, pre-prosthetic and for implant placement procedures. However, the concept of infra-orbital nerve repositioning in cases of mid-face fractures remains unexplored. The infraorbital nerve may be involved in trauma to the zygomatic complex which often results in sensory disturbance of the area innervated by it. Ten patients with infraorbital nerve entrapment were treated in similar way at our maxillofacial surgery centre. Materials and Methods: In this article we are reporting three cases of zygomatico-maxillary complex fracture in which intra-operative repositioning of infra-orbital nerve into the orbital floor was done. This was done to release the nerve from fractured segments and to reduce the postoperative neural complications, to gain better access to fracture site and ease in plate fixation. This procedure also decompresses the nerve which releases it off the soft tissue entrapment caused due to trauma and the organized clot at the fractured site. Results: There was no evidence of sensory disturbance during their three month follow-up in any of the patient. Conclusion: Infraorbital nerve transposition is very effective in preventing paresthesia in patients which fracture line involving the infraorbital nerve.

A CASE OF DERMIS-FAT AUTOTRANSPLANTATION FOR CORRECTION OF SOFT TISSUE DEFICIT IN HEMIFACIAL MICROSOMIA (반안면왜소증환자에 있어서 자가지방이식을 이용한 연부조직결손의 수복예)

  • Park, Young-Wook;Lee, Jin-Gew;Min, Byoung-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.82-87
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    • 1991
  • Hemifacial microsomia is a term used to describe a facial anomalies caused by the defect of anatomic structures originated from the first and the second branchial arches. The defect area encompasses some facial areas including mandible, facial muscles, masticatory muscles, cranial nerves, auricles, etc., and the degree of manifestations of the anomalies is extmely diverse. A 20-year-old man complaining of facial asymmetry and malocclusion visited our hospital. An orthognathic surgery was performed for the correction of hard tissue anomalies and then autogenous dermis-fat autotransplantation was done for the improvement of remaining soft tissue defect. The result was esthetically good and the case was presented here.

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Accuracy of simulation surgery of Le Fort I osteotomy using optoelectronic tracking navigation system (광학추적항법장치를 이용한 르포씨 제1형 골절단 가상 수술의 정확성에 대한 연구)

  • Bu, Yeon-Ji;Kim, Soung-Min;Kim, Ji-Youn;Park, Jung-Min;Myoung, Hoon;Lee, Jong-Ho;Kim, Myung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.2
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    • pp.114-121
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    • 2011
  • Introduction: The aim of this study was to demonstrate that the simulation surgery on rapid prototype (RP) model, which is based on the 3-dimensional computed tomography (3D CT) data taken before surgery, has the same accuracy as traditional orthograthic surgery with an intermediate splint, using an optoelectronic tracking navigation system. Materials and Methods: Simulation surgery with the same treatment plan as the Le Fort I osteotomy on the patient was done on a RP model based on the 3D CT data of 12 patients who had undergone a Le Fort I osteotomy in the department of oral and maxillofacial surgery, Seoul National University Dental Hospital. The 12 distances between 4 points on the skull, such as both infraorbital foramen and both supraorbital foramen, and 3 points on maxilla, such as the contact point of both maxillary central incisors and mesiobuccal cuspal tip of both maxillary first molars, were tracked using an optoelectronic tracking navigation system. The distances before surgery were compared to evaluate the accuracy of the RP model and the distance changes of 3D CT image after surgery were compared with those of the RP model after simulation surgery. Results: A paired t-test revealed a significant difference between the distances in the 3D CT image and RP model before surgery.(P<0.0001) On the other hand, Pearson's correlation coefficient, 0.995, revealed a significant positive correlation between the distances.(P<0.0001) There was a significant difference between the change in the distance of the 3D CT image and RP model in before and after surgery.(P<0.05) The Pearson's correlation coefficient was 0.13844, indicating positive correlation.(P<0.1) Conclusion: Theses results suggest that the simulation surgery of a Le Fort I osteotomy using an optoelectronic tracking navigation system I s relatively accurate in comparing the pre-, and post-operative 3D CT data. Furthermore, the application of an optoelectronic tracking navigation system may be a predictable and efficient method in Le Fort I orthognathic surgery.

A Clinical Study of Soft Tissue Changes of the Midface after Mandibular Setback Surgery (하악골 후방이동시 중안면부 연조직의 변화양상에 대한 임상통계학적 연구)

  • Han, Dae-Hee;Kim, Soo-Nam;Min, Seung-Ki;Kim, Tae-Seong;Sung, Hun-Mo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.3
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    • pp.319-329
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    • 2000
  • Prediction of the soft tissue changes following hard tissue movement is very important from the esthetic view point for patients who have orthognathic surgery. There are many cephalometric analysis of facial bone and soft tissue on the lower lip and chin region but few soft tissue analysis on the midface after mandibular setback surgery. This study was performed to obtain whether the mandibular posterior movement has influence on the midface and the predictable ratio of post-operative measurement values of the soft tissue changes following mandibular setback surgery. Fifteen patients (8 males and 7 females) who had undergone mandibular setback surgery were selected and analyzed the soft tissue movement on the upper lip and the cheek region. Post-operative changes of the soft tissue measurements after mandibular surgery were examined on pre- and post-operative cephalometrics and the ratio of changes were analyzed after drawing the reference line on the face with the barium sulfate solution. The reference lines were perpendicular to the intercanthal line from infraorbital foramen and lateral canthus. The results obtained were as follows : 1. There were tendancy of anterior movement of soft tissue adjacent the nose after mandibular surgery 2. There were incerased tendancy of the amount of anterior movement from the nasal crease to the cheek region. 3. The amount of anterior movement of the soft tissue was larger below the palatal plane compared with above the palatal plane in the cheek region. 4. The upper lip length was increased and moved posterior direction after mandibular setback surgery 5. The lower lip was moved posterior direction by posterior movement of the mandibular structure 6. Soft tissue of the midface around the nose moved anterior direction after mandibular setback surgery but there was no correlation between the amount of mandibular setback and the amount of the soft tissue changes

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Factors Associated with the Stability of Two-part Mini-implants for Intermaxillary Fixation

  • Kim, Seong-Hun;Seo, Woon-Kyung;Lee, Won;Kim, In-Soo;Chung, Kyu-Rhim;Kook, Yoon-Ah
    • Journal of Korean Dental Science
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    • v.2 no.2
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    • pp.24-30
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    • 2009
  • Two component orthodontic C-implants have been introduced as intermaxillary fixation (IMF) screws in cases of periodontal problems with bone loss, severely damaged teeth, or short roots. This retrospective research sought to investigate the complications and risk factors associated with the failure of two-part C-implants for IMF cases and to show the possible indications compared to one-component mini-implants. The study sample consisted of 46 randomly selected patients who had a total of 203 implants. Pearson chi-square tests of independence were used to test for associations among categorical variables. At least 19 of the total 203 implants failed (9.3%). There was no significant difference in implant failure due to gender, oral hygiene, and placement, although a significant difference due to soft tissue characteristics and root contact was observed. The two-component design of the mini-implant is reliable for difficult IMF cases. Note, however, that the factors influencing implant failure were found to be age, root damage, and condition of soft tissues.

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Chair side measuring instrument for quantification of the extent of a transverse maxillary occlusal plane cant

  • Naini, Farhad B.;Messiha, Ashraf;Gill, Daljit S.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.21.1-21.3
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    • 2019
  • Background: Treatment planning the correction of a transverse maxillary occlusal plane cant often involves a degree of qualitative "eyeballing", with the attendant possibility of error in the estimated judgement. A simple chair side technique permits quantification of the extent of asymmetry and thereby quantitative measurements for the correction of the occlusal plane cant. Methods: A measuring instrument may be constructed by soldering the edge of a stainless steel dental ruler at 90° to the flat surface of a similar ruler. With the patient either standing in natural head position, or alternatively seated upright in the dental chair, and a dental photographic retractor in situ, the flat under-surface of the horizontal part of this measuring instrument is placed on a unilateral segment of a bilateral structure, e.g. the higher maxillary canine orthodontic bracket hook. The vertical ruler is held next to the contralateral canine tooth, and the vertical distance measured directly from the canine bracket to the flat under-surface of the horizontal part of the measuring instrument. Results: This vertical distance quantifies the overall extent of movement required to level the maxillary occlusal plane. Conclusions: This measuring instrument and simple chair side technique helps to quantify the overall extent of surgical levelling required and may be a useful additional technique in our clinical diagnostic armamentarium.

Midfacial distraction osteogenesis of Crouzon syndrome with RED(Rigid External Distraction) system (RED(Rigid External Distraction) system을 이용한 Crouzon syndrome환자의 distraction osteogenesis)

  • Lee, Yang-Ku;Choi, Jeong-Ho;Kim, Seok-Hwa;Baek, Seung-Hak;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.32 no.3 s.92
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    • pp.175-183
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    • 2002
  • Crouzon syndrome Is one of the craniofacial syndromes characterized by craniosynostosis, midfacial hypolpasia and ocular proptosis. Distraction osteogenesis is becoming Important technique to treat craniofacial dyplaisa. It has nuy advantages compared with standard orthognathic surgery. Maxillary distraction osteogenesis after Le Fort III osteotomy with the RED system presents successful maxillary protraction to Crouzon syndrome patient with severe maxillary deficiency. It also allows remarkable improvement of facial esthetics and respiratory functions.