• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권4호
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• pp.407-413
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• 2000

To evaluate the stability after orthognathic surgery in cleft lip and palate patients using rigid fixation, 20 patients underwent primary repair in childhood and later developed a jaw deformity and malocclusion that required orthognathic surgery were reviewed. Two groups, one of 10 patients performed Le Fort I osteotomy with sagittal split ramus osteotomy and one of 10 patients with sagittal split ramus osteotomy of the mandible, were evaluated. Each group had unilateral cleft only and all alveolar cleft sites had been grafted with autogeneous bone before the orthognathic surgery. The amount of surgical movement and relapse were compared in both horizontal and vertical dimensions. Two-jaw surgery group was more stable than mandibular surgery only group in mandibular position (p< 0.05). Statistically significant relapse was observed in mandibular skeletal point in mandibular surgery group (p<0.05). There was no statistically significant relapse in the skeletal point of two-jaw surgery group. However, the correlation between the horizontal surgical movement and relapse was detected (r = 0.88). This correlation indicates the need of overcorrection. The presence of scar tissues and relatively deficient maxillary bone could be attributed to this close relation between the surgical change and relapse.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권1호
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• pp.1-6
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• 2002

When bilateral sagittal split ramus osteotomy or mandibular angle reduction are carried out, we have to consider the position of inferior alveolar nerve. For bone splitting or resection using a saw or an osteotome, the bucco-lingual position of the inferior alveolar nerve plays an important role in the preventing perioperative complications such as paresthesia or anesthesia. Because it is rare to find literatures concerning the mean anatomic position of the inferior alveolar nerve in Koreans, we investigated 30 patients who underwent to take CT and orthopantomogram for implant surgery, and evaluated the bucco-lingual position and vertical relationship of the inferior alveolar nerve at the mandible. The results showed that the distance between inferior alveolar nerve and buccal plate was the farthest at mandibular second molar ($7.1{\sim}7.4mm$) and the nearest at mandibular angle area ($4.4{\sim}4.8mm$). But it was no statistical relationship between the bucco-lingual postion of inferior alveolar nerve on the CT and its vertical position on the OPT. In conclusion, the results suggest that a careful surgical procedure is needed at the mandibular angle area to avoid a nerve damage and there are sufficient bone materials at the mandibular second molar are for bilateral sagittal split ramus osteotomy or mandibular angle reduction or plate fixation. And OPT is not usefull for the evaluation of a relative bucco-lingual position of inferior alveolar nerve in relation to its vertical postion on the OPT.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.19.1-19.6
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• 2018

Background: Calcium pyrophosphate dihydrate deposition disease (CPDD) is a rare disease in the temporomandibular joint (TMJ) space. It forms a calcified crystal mass and induces a limitation of joint movement. Case presentation: The calcified mass in our case was occupied in the left TMJ area and extended to the infratemporal and middle cranial fossa. For a complete excision of this mass, we performed a vertical ramus osteotomy and resected the mass around the mandibular condyle. The calcified mass in the infratemporal fossa was carefully excised, and the segmented mandible was anatomically repositioned. Scanning electronic microscopy (SEM)/energy-dispersive X-ray spectroscopy (EDS) microanalysis was performed to evaluate the calcified mass. The result of SEM/EDS showed that the crystal mass was completely composed of calcium pyrophosphate dihydrate. This result strongly suggested that the calcified mass was CPDD in the TMJ area. Conclusions: CPDD in the TMJ is a rare disease and is difficult to differentially diagnose from other neoplasms. A histological examination and quantitative microanalysis are required to confirm the diagnosis. In our patient, CPDD in the TMJ was successfully removed via the extracorporeal approach. SEM/EDS microanalysis was used for the differential diagnosis.

• 대한소아치과학회지
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• 제25권2호
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• pp.430-440
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• 1998

This study was performed to establish the cephalometric standards and to compare measurement of Korean children in the Field I, II, III, IV, V, VI to Japanese and Caucasians by the Ricketts' analysis. Lateral cephalograms of 24 males and 27 females with normal occlusion and acceptable profile 9 years of age were obtained and statistically analyzed. 1. Norms of Korean males, females and both sexes at 9 years old were established. 2. Significant differences between male and female exist in incisor overjet, maxillary incisor protrusion, mandibular incisor inclination, cranial deflection, corpus length. Maxillary incisor of male was more protrude and overjet was larger than female 3. Korean was similar to Japanese but different from Caucasian. Compare with facial axis and facial depth, chin was retruded dolichofacial pattern and due to large mandibular plane angle and small corpus length, mandibular plane was inclined and mandible body was short. Compare with porion location, ramus position and posterior facial height, ramus was long and located posterior. Compare with maxillary depth and maxillary height, maxilla was located posterior and inferior. The distance between the upper molar and PTV was short, the amount of distalization is limited. Maxillary and mandibular incisor were more protruded and also lower lip was more protruded to esthetic line 4. In comparison between 9 and 11 years old, growth changes of facial depth, mandibular plane angle, corpus length and upper molar position were larger than that of Japanese and Caucasians.

• Imaging Science in Dentistry
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• 제39권3호
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• pp.163-168
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• 2009

Purpose : To assess the clinical findings and hard tissue changes of osteomyelitis of the jaws using computed tomographic (CT) image analysis. Materials and Methods : We reviewed and interpreted the CT images of 163 patients (64 males and 99 females, age range from 10 to 87 years) who visited the Seoul National University Dental Hospital from April 23, 2006 to December 31, 2008 and were diagnosed as osteomyelitis of the jaws through clinical, radiologic, and histopathologic examination. Each CT findings was investigated for frequency, correlation with age and gender. Results : Of the 163 patients, 31 (19.0%) were affected on the maxilla, 135 (82.8%) were affected on the mandible, and 3 (1.8%) were affected on the both jaws simultaneously. The mean age of the patients who were affected on the maxilla was 61.0 years and that of the patients who were affected on the mandible was 56.2 years. On the maxilla, the most frequent site of disease was the posterior area (83.9%) and on the mandible, mandibular body (83.0%), followed by angle (48.1%), ramus (38.5%), condyle (13.3%), incisal area (9.6%), and coronoid process (3.0%). Among the 31 maxillary osteomyelitis, defect in the trabecular bone was observed in 28 (90.3%), osteosclerosis 20 (64.5%), defect in the cortical bone 27 (87.1%), sequestrum 17 (54.8%), and periosteal reaction 2 (6.5%). Among the 135 mandibular osteomyelitis, defect in the trabecular bone was observed in 100 (74.1%), osteosclerosis 104 (77.0%), defect in the cortical bone 116 (85.9%), sequestrum 36 (26.7%), and periosteal reaction 67 (49.6%). Conclusion : Of our cases, the maxillary osteomyelitis was visibly observed more frequently in females than males. The incidence is the highest in seventies (28.8%) and the lowest in teens (3.1%). The osteomyelitis of the jaws was observed more frequently in males than females before the age of 50, and observed more frequently in females after the age of 50. The most noticeable point was that the sequestrum was observed more often on maxillary osteomyelitis and the periosteal reaction was observed more often on mandibular osteomyelitis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권4호
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• pp.337-345
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• 2011

Purpose: The purpose of this study was to define the relation of the degree of menton deviation and 3-D CT (computerized tomography) measurements of the glenoid fossa and the mandible, which are considered to have an influence on menton deviation. Methods: The CT images were obtained in 60 adults and these were transmitted to a computer and reconstructed using computer software. According to the degree of the menton deviation, which was measured on the posteroanterior cephalogram, the subjects were divided into the menton deviated group (30 adults) and the symmetry group (30 adults). A total of 11 measurements that might have an effect on menton deviation were determined and these were measured in the right and left sides using the function of 3-D measurement in the computer program. The 11 measurements consist of 6 measurements in the glenoid fossa (vertical position of the glenoid fossa and articular eminence, the sagittal position of the glenoid fossa and articular eminence, the depth of the glenoid fossa, and the anterior angle of the glenoid fossa), and 5 measurements in the mandible (ramus length, frontal ramal inclination, lateral ramal inclination, body length, body height). Results: The comparison of the differences between the menton deviated and symmetry groups and correlation analysis on the degree of menton deviation were carried out. The results of comparison of the right and the left difference between the menton deviated and symmetry groups showed that the vertical position and depth of the glenoid fossa were significantly increased in the menton deviated group. Conclusion: The results of the present study show that consideration of the shape and position of the glenoid fossa is necessary for making the diagnosis and administering proper treatment in facial asymmetry patients and especially growing patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.38.1-38.6
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• 2015

Background: The posterior movement of mandible was known as the main cause of the changes in the pharyngeal airway space (PAS) and the postoperative obstructive sleep apnea (OSA). The purpose of this study was to know the changes of PAS and position of hyoid bone. Methods: Lateral cephalographies of 13 patients who had undergone sagittal split ramus osteotomy (SSRO) setback surgery were taken preoperatively (T1), postoperatively within 2 months (T2), and follow-up after 6 months or more (T3). On the basis of F-H plane, diameters of nasopharynx, oropharynx, and hypopharynx were measured. The movements of the soft palate, tongue, and hyoid bone were also measured. Results: The amount of mandible setback was $7.5{\pm}3.8mm$. In the measurements of PAS, there was a statistically significant decrease of $2.8{\pm}2.5mm$ in nasopharynx (P < 0.01), and $1.7{\pm}2.4mm$ in oropharynx (P < 0.01) were observed after surgery. The hypopharynx decreased $1.0{\pm}2.1mm$ after surgery and continuously decreased $1.0{\pm}2.8mm$ at follow-up. The changes in hyoid bone position showed the posterior movement only after surgery and posteroinferior movement at follow-up. Conclusions: The PAS such as nasopharynx, oropharynx, and hypopharynx showed relatively high correlation with the amount of mandibular setback. The change of resistance in upper airway may be important for the prevention of OSA after mandibular setback surgery.

• 대한치과교정학회지
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• 제51권1호
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• pp.43-54
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• 2021

Objective: To investigate the cephalometric predictors of the future need for orthognathic surgery in Korean patients with unilateral cleft lip and palate (UCLP) despite long-term use of facemask with miniplate (FMMP). Methods: The sample consisted of 53 UCLP patients treated by a single orthodontist using an identical protocol. Lateral cephalograms were taken before commencement of FMMP therapy (T0; mean age, 10.45 years), after FMMP therapy (T1; mean age, 14.72 years), and at follow-up (T2; mean age, 18.68 years). Twenty-eight cephalometric variables were measured. At T2 stage, the subjects were divided into FMMP-Nonsurgery (n = 33, 62.3%) and FMMP-Surgery (n = 20, 37.7%) groups according to cephalometric criteria (point A-nasion-point B [ANB] < -3°; Wits-appraisal < -5 mm; and Harvold unit difference [HUD] > 34 mm for FMMP-Surgery group). Statistical analyses including discrimination analysis were performed. Results: In FMMP-Surgery group, the forward position of the mandible at T0 stage was maintained throughout the whole stages and Class III relationship worsened with significant growth of the mandibular body and ramus and counterclockwise rotation of the maxilla and mandible at the T1 and T2 stages. Six cephalometric variables at T0 stage including ANB, anteroposterior dysplasia indicator, Wits-appraisal, mandibular body length, HUD, and overjet were selected as effective predictors of the future need for surgical intervention to correct sagittal skeletal discrepancies. Conclusions: Despite long-term use of FMMP therapy, 37.7% of UCLP patients became candidates for orthognathic surgery. Therefore, differential diagnosis is necessary to predict the future need for orthognathic surgery at early age.

• Imaging Science in Dentistry
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• 제40권2호
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• pp.75-81
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• 2010

Purpose : This study is aimed to evaluate the position of mandibular foramen of mandibula prognathism patients using 3-dimensional CT images in order to reduce the chance of an anesthetic failure of the mandibular nerve and to prevent the damage to the inferior alveolar nerve during the orthognathic surgery. Materials and Methods : The control group consist of 30 patients with class I occlusion. The experimental group consist of 44 patients with class III malocclusion. Three-dimensional computed tomography was used to evaluate the position of the mandibular foramina. Results : The distance between mandibular plane and mandibular foramen, class I was 25.385 mm, class III was 23.628 mm. About the distance between occlusal plane and mandibular foramen, class I was 1.478 mm, class III was 5.144 mm. The distance between posterior border plan of mandibular ramus and mandibular foramen had not statistically significant. About the distance between sagittal plane of mandible and mandibular foramen did not also showed statistically significant. Conclusion : The result of this study could help the clinicians to apprehend more accurate anatomical locations of the foramina on the mandible with various facial skeletal types. thereby to perform more accurate block anesthesia of the mandibular nerve and osteotomy with minimal nerve damage. In addition, this study could provide fundamental data for any related researches about the location of the mandibular foramina for other purposes.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권6호
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• pp.510-518
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• 2009

Purpose: In this study, we analyzed and compared the anatomical position of the mandibular canal in normal occlusion and mandibular prognathism patients. Patients and Methods: Computed tomography image from 58 patients were divided into normal occlusion group and mandibular prognathism group, and each measurement were taken in the each measuring points(2nd premolar, 1st molar, 2nd molar, 3rd molar, ramus). Measurements were statistically analyzed by student's t-test. Results: BC (Thickness of the buccal cortex) value was 2.3~2.7 mm, CB (Distance from the canal to the lingual aspect of the buccal cortex) value was 1.3~4.3 mm, MC (Diameter of the canal) value was 3.2~3.8 mm, LI (Distance from the canal to the lingual aspect of the lingual cortex) value was 2.0~3.7 mm, TM (Thickness of the total mandible) value was 9.5~12.9 mm and CM (Distance from the canal to the inferior border of the mandible) value was 6.9~17.5 mm. Conclusion: In the comparison between two groups, there was statistically significant difference in CB value of 2nd, 3rd molar between normal occlusion and mandibular prognathism, and other value in the rest of the measuring points didn't show statistically significant difference.