• Imaging Science in Dentistry
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• 제46권1호
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• pp.25-31
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• 2016

Purpose: This study was performed to evaluate condylar surface changes and remodeling after orthognathic surgery using three-dimensional computed tomography (3D CT) imaging, including comparisons between the right and left sides and between the sexes. Materials and Methods: Forty patients (20 males and 20 females) who underwent multi-detector CT examinations before and after surgery were selected. Three-dimensional images comprising thousands of points on the condylar surface were obtained before and after surgery. For the quantitative assessment of condylar surface changes, point-to-point (preoperative-to-postoperative) distances were calculated using 3D processing software. These point-to-point distances were converted to a color map. In order to evaluate the types of condylar remodeling, the condylar head was divided into six areas (anteromedial, anteromiddle, anterolateral, posteromedial, posteromiddle, and posterolateral areas) and each area was classified into three types of condylar remodeling (bone formation, no change, and bone resorption) based on the color map. Additionally, comparative analyses were performed between the right and left sides and according to sex. Results: The mean of the average point-to-point distances on condylar surface was $0.11{\pm}0.03mm$. Bone resorption occurred more frequently than other types of condylar remodeling, especially in the lateral areas. However, bone formation in the anteromedial area was particularly prominent. No significant difference was found between the right and left condyles, but condylar surface changes in males were significantly larger than in females. Conclusion: This study revealed that condylar remodeling exhibited a tendency towards bone resorption, especially in the lateral areas. Condylar surface changes occurred, but were small.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.17.1-17.5
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• 2019

Background: Class II malocclusion patients with hyperdivergent facial types are characterized by short mandibular body lengths and anterior open bite. Accordingly, the treatment for hyperdivergent skeletal class II malocclusion is a lengthening of the mandibular body length and a counterclockwise rotation of the mandible. To prevent post-operative relapse, botulinum toxin-A (BTX-A) injection can be a retention modality. Case presentation: A class II open-bite patient received BTX-A injection to the anterior belly of her digastric muscle for the prevention of post-operative relapse. The relapse was evaluated via a clinical examination and a lateral cephalometric radiograph after the completion of post-surgical orthodontic treatment. The patient showed stable occlusion without any signs of relapse at 15 months post-operatively. Conclusion: In this case presentation, a single injection into the anterior belly of the digastric muscle was sufficient for the prevention of post-operative open bite.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.324-328
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• 2009

Submentovertex(SMV) projection shows the base of skull, positions of mandibular condyle and zygomatic arches. We would like to investigate how to use SMV and evaluate its availability for the construction of the plan for orthognathic surgery of mandible prognathism and asymmetry. Preoperative Surgical Treatment Objective(STO) using SMV was performed to 12 patients, who visited to Seoul National University Bundang Hospital with chief complaints like mandible prognathism or asymmetry from Dec 2007 to Feb 2009. Surgical splint was made of stone model repositioned according to STO using SMV. We estimate the change in skeletal midline and the stability of occlusion through superposition between preoperative and postoperative SMV. It was effective on the amount of mandible movement and the correction of mandibular asymmetry, while the facial asymmetry involved with maxilla was excluded. It was concluded that STO using SMV is available and predictable method for not only the setback of prognathic mandible but also the correction of mandible asymmetry accurately.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권1_2호
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• pp.54-64
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• 1992

The balance of facial sop tissue is important factor for the treatment of maxillofacial deformity patients. There are many cephalometric analysis of facial bone but a few soft tissue analysis of face for the orthognathic surgery, especially in the oriental people. This study aimed at examining the mean value of the soft tissue measurement of 120 Korean adult women with the linear and angular measurement and comparing with Caucasian. The results ere as follows. 1. In the frontal linear measurement, Korean women have larger interocular distant and width of nose, but the width of mouth appeared less than Caucasian. 2. In the frontal angular measurement, Korean women have larger inclination of the eye than Caucasian. 3. In the lateral linear measurement, Korean women have more prominent upper and lower lip position than Caucasian and have longer upper facial height comparing with lower facial height than Caucasian. 4. In the lateral angular measurement, Korean women have more convex facial profile and less nasolabial and geniolabial angle. 5. In the lateral facial ratio, Korean women have larger proportion in the lower department below the stomion.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.157-161
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• 1994

이상에서 저자들은 하악관절과두와 유사한 형태를 보이는 편측성과 양측성 오훼돌기 변형증의 가각의 원인, 성장형태, 발현연령과 성별 및 발생기전등에 대해서 문헌 고찰을 해보 았다. 본 증례에서도 정확한 원인은 알 수 없지만 환자의 과거 병력상 우축 악관절의 외상으로 추정된다. 외고작으로 exploration시 coronoidotemporal area에서 또 다른 관절의 양상을 보여 주어 이중관절을 이루고 있었으며 오훼돌기의 절제와 함께 물리치료 후 환자는 개구시 악골의 심한 우측 악관절의 관절잡음도 들리지 않았다. 현재 환자에게서 볼 수 있는 안면비대칭은 향후 주기적인 관찰과 성장 여력에 의해 개선이 기대되지만 추후 악교정 수술이 필요할 수도 있을 것으로 사료된다.

• 대한치과의사협회지
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• 제23권11호통권198호
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• pp.979-986
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• 1985

This is a case report of orthognathic surgery for the correction of maxillary retrusion and mandibular protrusion. The summary and results are as follows, 1. The maxillary retrusion was corrected by LeFort I osteotomy. 2. The mandibular protrusion was corrected by sagittal split osteotomies in the rami. 3. And, for the correction of the discrepancy between max8llary and mandibular arches, the mandibular arch was widened by the midsymphyseal step osteotomy. 4. The ratios of horizontal changes of soft tissue to hard tissue at the points, Subnasale (Sn), Labrale superius (Ls), Labrale inferius (L9), and Supramentale (B) were 67.6%, 43.2$, 70.2% and 87.7%, respectively.

• 대한구순구개열학회지
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• 제10권2호
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• pp.75-80
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• 2007

For the treatment of cleft palate patients, orthognathic surgery has been used by standard protocol. Predictable results have been achieved with standard techniques in slight to moderate maxillary hypoplasia. However, limited advancement and high relapse rate was reported in severe cases. The purpose of the present study was to review the clinical results of distraction osteogenesis in the patients with cleft lip and palate. Distraction osteogenesis has improved results in these patients by allowing soft tissue relaxation and gradual bone generation. Therefore, greater movement of the craniofacial skeleton is possible in severe cases of maxillary retrusion with lower relapse rates. In conclusion, distraction osteogenesis for the advancement of hypoplastic maxilla of cleft patients has shown successful treatment method.

• 대한구순구개열학회지
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• 제12권2호
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• pp.85-94
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• 2009

Cleft lip and palate patients show midface hypoplasia, maxillary hypoplasia due to scar of previous surgery, and manifest as a class III malocclusion, retruded midface and shallow palate. These deformities have been treated with traditional orthognathic surgery. Although conventional Le Fort I osteotomy was performed on most cleft patinets with midface hypoplasia, it showed limited amount of maxillary advancement and high relapse tendency. Recently, when great amount of advancement are required in severe maxillary hypoplasia, distraction osteogenesis using RED system is widely used. But, several months of consolidation period is needed after distraction osteogenesis, occlusal relationship is not stable until mandibular setback surgery has done in mandibular hyperplasia cases and during these period, patients may feel discomfort. We present clinical cases of immediate rigid internal fixation after completion of maxillary distraction using RED system and simultaneous mandibular setback procedure in adult cleft and lip patients who show both maxillary hypoplasia and mandibular prognathism.

• 치위생과학회지
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• 제21권4호
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• pp.275-281
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• 2021

Background: The aim of this study was to understand the importance of professional oral care for inpatients by examining the type and frequency of surgery and hospital discharge period at dental hospitals, and identify the types of professional oral care actually in progress. Methods: In this study, the type of surgery and length of hospitalization were investigated among patients admitted to the dental hospital for oral and maxillofacial surgery, and the professional oral care status of inpatients who had difficulty self-managing their oral care was retrospectively identified by collecting data on oral care before and after surgery, including the type and frequency. Results: The majority of inpatients at dental hospitals were male (57.6%), elderly patients over 60 years accounted for 20% of patients, and the average length of hospitalization was 4 days. In the 20s (aged 20~29 y), the number of orthognathic surgery patients (73.1%) was high, and the incidence of cysts was high in middle-aged patients. Regarding the oral care of hospitalized patients, scaling was performed once by a dentist before surgery. After surgery, surgical dressings using H₂O₂ balls were applied and oral care education was introduced before discharge. Conclusion: Based on the results of this study, professional oral care is essential to prevent infection and complications caused by oral bacteria among inpatients at dental hospitals. It is necessary to use various oral hygiene aids for inpatients and to conduct effective oral care instruction according to each patient's situation. In addition, it is necessary to raise awareness and the role of dental hygienists in professional oral care.

• 대한치과교정학회지
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• 제28권3호
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• pp.461-477
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• 1998

하악 전돌증의 치료를 위해 외과적인 술식이 교정임상분야에 도입된 이래로 많은 임상적인 성공사례가 보고되어 왔으며 최근에 와서는 하악골 후퇴술의 대표적 술식으로 구내 시상 분할 골절단술(SSRO)과 구내 상행지 수직 골절단술(IVRO)이 주로 시행되고 있다. 물론 이 두가지 술식 모두 만족스러운 술후 결과를 얻을 수 있으나 술후 안정성과 재발의 양상과 정도가 다르게 나타나고 있다. 그러나 하악 후퇴술후 시간경과에 따른 재발의 정도에 관한 국내의 연구는 국외에 비해 다소 부족한 상황이며, 특히 시상 분할 골절단술과 상행지 수직 골절단술후의 재발양상에 관한 비교 연구는 아직 없는 실정이다. 이에 저자는 골격성 III 급 부정교합자의 악교정 수술 후 수술방법에 따른 재발 양상과 장기적 안정성을 알아보고자 구내 시상 분할 골절단술로 시행받은 24명(남자 10명, 여자 14명)과 구내 상행지 수직골절단술로 시행받은 26명 (남자 10명, 여자 16명)의 수술 직전(T1), 수술 직후 48시간 이내(T2), 수술 후 4-8주(T3), 수술후 6개월 이상(T4)등 4장의 측모두부방사선 사진을 계측하여 두 군간의 기간별 재발 양상과 각 군내의 타 변수들과의 상관성에 관해 검증하여 다음과 같은 결과를 얻었다. 1. 하악골의 수평적인 초기 재발은 시상 분할 골절단술군에서는 전방 이동, 상행지 수직 골절단술군에서는 후방 이동양상을 보였다. 2. 두 군 모두에서 하악골의 수직적인 초기 재발과 후기 재발은 전안면고경이 감소하는 쪽으로 일어났으며 두 군간의 유의차는 없었다. 3. 시상 분할 골절단술군에서 수술시 근심절편의 후방회전이 많을수록 하악골의 수평적인 후기 재발이 더 전방으로 일어났다. 4. 두 군 모두에서 수술시 하악골 후퇴량이 많을수록 하악골의 수평적인 초기 재발이 더 전방으로 일어났다.