• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권2호
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• pp.120-127
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• 2021

Primary intraosseous squamous cell carcinoma (PIOSCC) is very rare type of squamous cell carcinoma (SCC) that occurs within the jaw and arises from remnants of odontogenic epithelium with no connection to the oral mucosa. This study reports two cases of PIOSCC of the mandible. Reported in this article are two cases of PIOSCC of the mandible that were treated with resection and reconstruction using a fibular free flap. The first case was a 36-year-old male patient who complained of right mandibular pain. Computed tomography (CT) and panoramic radiograph revealed a large radiolucency in the mandibular ramus area. At first, an odontogenic keratocyst was tentatively diagnosed, and an excision procedure was carried out at another clinic. A final biopsy after cyst enucleation revealed well-differentiated SCC, so we proceeded with segmental mandibulectomy and reconstruction using a fibular free flap. The second case was a 48-year-old male patient with left mandibular pain. CT and panoramic radiograph revealed irregular radiolucency in the mandibular angle area near tooth #38. At first, osteomyelitis was tentatively diagnosed, and a curettage was carried out. A later biopsy revealed well-differentiated SCC, so segmental mandibulectomy and reconstruction with a fibular free flap were secondarily performed. Our two cases have had no recurrence. The facial appearance of both patients is satisfactory, and the neo-mandibular body created using a fibular bone transfer displays adequate bony volume.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권2호
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• pp.130-134
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• 1997

본 저자는 하악지시상분할법이 측두하악관절장애와 관련되어 교합의 개선과 과두의 위치적변화에 어떤영향을 미치는가에 관해 연구하고자하여 다음과 같은 결과를 얻었다. 측두하악관절증상은 약 80%에서 개선되었으며 이는 아마도 부정교합의 개선으로 일어난 것이 아닌가 생각된다. 하악지 시상분할술에 있어 측두하악관절의 구조적 변화가 야기되는데 이것이 관절의 기능에 어떤 변화를 주어 측두하악관절증상과 관련해서 발생되는 것으로 추정되고 단기 추적조사와 비교해 볼 때 장기추적조사 결과 하악두위치변화에도 불구하고 Range of adaptation이 환자 개개인에 존재하는 것이 아닐까 생각된다. 이와 같은 결과를 종합해볼 때 경미한 측두하악관절증상을 동반한 하악전돌증환자에서 악교정수술을 시행함에 있어 개인의 하악두의 위치를 지켜주어 부정교합의 개선과 정상적인 관절기능을 유지시켜주는 것이 회귀성향과 관련하여 중요한 요소가 아닌가 생각되며 회귀성향과 하악두의 위치관계 또 측두하악의 증상등을 연관하여 더 진행된 연구가 필요하리라 사려된다.

• 대한치과보철학회지
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• 제28권1호
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• pp.63-94
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• 1990

The purpose of this study was to analyze the displacement and the magnitude and the mode of distribution of the stresses in the lower overdenture, the mucous membrane, the abutment tooth and the mandibular supporting bone when various denture base materials, such as acrylic resin and 0.5mm metal base, and various denture base designs were subjected to different loading schemes. For this study, the two-dimensional finite element method was used. Mandibular arch models, with only canine remaining, were fabricated. In the first denture base design, a space, approximately 1mm thick, was prepared between the denture and the dome abutment. In the second denture base design, contact between the denture and the dome abutment was eliminated except the contact of the occlusal third of the abutment. In order to represent the same physiological condition as the fixed areas of the mandible under loading schemes, the eight nodes which lie at the mandibular angle region, the coronoid process and the mandibular condyle were assumed to be fixed. Each model was loaded with a magnitude of 10 kgs on the first molar region(P1) and 7 kgs on the central incisal region (P2) in a vertical direction. Then the force of 10 kgs was applied distributively from the first premolar to the second molar of each model in a vertical direction(P3). The results were as follows. : 1. When the testing vertical loads were given to the selected points of the overdenture, the overdenture showed the rotatory phenomenon, as well as sinking and the displacements of alveolar ridge, abutment and lower border of mandible under the metal base overdenture were less than those under the acrylic resin overdenture. 2. The maximum principal stresses(the maximum tensile stresses) being considered, high tensile stresses occured at the buccal shelf area, the posterior region of the ridge crest and the anterior border region of the mandibular ramus. 3. The minimum principal stresses(the maximum compressive stresses) being considered, high compressive stresses occured at the inferior and posterior border region of the mandible, the mandibular angle and the posterior border region of the mandibular ramus. 4. The vertical load on the central incisal region(P2) produced higher equivalent stress in the mandible than that on any other region(P1, P3) because of the long lever arm distance from the fixed points to the loading point. 5. Higher equivalent stresses were distributed throughout the metal base overdenture than the resin base overdenture under the same loading condition. 6. The case of occlusal third contact of the abutment to the denture produced higher equivalent stresses in the abutment, the mandibular area around the abutment and the overdenture than the case of a 1mm space between the denture and the abutment. 7. Without regard to overdenture base materials and designs, the amounts and distribution patterns of equivalent stresses under the same loading condition were similar in the mucous membrane.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권5호
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• pp.373-381
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• 2021

Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class III malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated. Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed. Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement. Conclusion: When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권2호
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• pp.126-131
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• 2002

Anatomical shape of the mandibular ramus, which includes the area from the rear of the mandibular second molar to the mandibular posterior border and from the mandibular sigmoid notch to the inferior mandibular border, must be carefully considered to perform orthognathic surgery. The locations of the lingula and mandibular foramen in medial side of mandibular ramus are one of the most important factors to decide the location of the horizontal medial osteotomy in sagittal split ramus osteotomy and to select the line of vertical osteotomy in intraoral vertical ramus osteotomy. Sixty-five different Korean human dry mandibles were surveyed. All mandible have permanent dentition including complete eruption of the mandibular second molar. The locations of the lingula and mandibular foramen in medial side of the ramus were identified and following results were obtained. Anterior ramal horizontal distance from lingula was $16.13{\pm}3.53mm(range:8.6{\sim}24.3mm)$, anterior ramal horizontal distance from mandibular foramen was $23.91{\pm}4.79mm(range: 14.1{\sim}39.7mm)$, horizontal width of mandibular foramen was $2.79{\pm}0.95mm(range:1.5{\sim}6.1mm)$, height of lingula was $10.51{\pm}3.84mm(range:3.1{\sim}22.4mm)$, vertical distance from sigmoid notch to lingula was $19.82{\pm}5.11mm(range:9.1{\sim}35.3mm)$. From this study, the result could be used to select the location of osteotomy lines and to decide amount of periosteal elevation to avoid injury of neurovascular bundle, and to accomplish the appropriate split in Korean patients in mandibular orthognathic surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권2호
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• pp.109-113
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• 2011

Introduction: To correct the facial asymmetry by mandibular jaw surgery, it is important to know the anatomy of the mandible including the mandibular canal positioning of patients with facial asymmetry. This study was performed to evaluate the differences in the cross-sectional surface in the body of the mandible between the deviated side and opposite side in patients with facial asymmetry. Materials and Methods: The study was conducted on 37 adult patients composed of 2 groups, the asymmetry group (n=20) and non-asymmetry group (n=17). Using the cross-sectional computed tomography (CT) images, the distance from the buccal aspect of the mandibular canal to the outer aspect of the buccal cortex, distance from the buccal aspect of the mandibular canal to the inner aspect of the buccal cortex, distance from the inferior aspect of the mandibular canal to the inferior border of the mandible, thickness of the mandible, and cross-sectional surface area of the mandible were measured in each side of the mandible Results: The cross-sectional area of the mandible including the mandibular canal positioning in the deviated side was not statistically different from the opposite side in the asymmetry group. Only the distance from the inferior aspect of the mandibular canal to the inferior border of the mandible in the ramus area of the deviated side was significantly longer than opposite side. On the other hand, the bucco-lingual width of the asymmetry group was thinner than the non-asymmetry group. Conclusion: The cross-sectional area including the mandibular canal of the mandible did not appear to be modified by the facial asymmetry.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.474-480
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• 2009

These is a cases of chronic suppurative osteomyelitis occurred in the mandibular body to condyle of 48-year-old male patient. Extensive bone destruction was noted on the right mandibular body, angle, ascending ramus, mandibular notch and condylar region. We made a treatment plan that radicular mandibular resection from body to condyle and mandibular reconstruction with vascularized fibular flap at first time. But, we could observe marked bone regeneration with only mild curettage, local wound care and massive antibiotic therapy. So we preserved the anterior ramus portion of mandible. Defected mandibular condyle was reconstructed with costochondral graft. In this paper we present the case of a patient who has chronic osteomyelitis in mandibular area.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권2호
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• pp.173-180
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• 2007

According to the increase in use of implants in clinical dentistry, new kinds of complications happen. Complications that can happen during implant placement are bleeding, nerve injury, jaw fracture, fenestration of maxillary sinus or nasal cavity, dehiscence, fenestration, injury of adjacent tooth. And complications that can happen after implant operation are infection, bleeding, hematoma, chronic sinusitis, peri-implantitis. Problems that are confronted during implant placement happen by inadequate preoperative treatment plan, inadequate consideration about individual anatomic difference, inadequate operation process and lack of experience of clinician. It is important that clinicians consider possible complications in advance and make a comprehensive treatment plan. We report the patient who was happened ramus fracture during block bone harvesting from ramus of severely atrophic mandible, the patient who came to emergency ward due to postoperative swelling and bleeding and the patient whose implant was migrated to maxillary sinus with a review of literature.

• 치과방사선
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• 제17권1호
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• pp.163-171
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• 1987

The author has clinically and radiologically investigated 57 cases of odontogenic keratocyst in 47 patients consisted of 26 males and 21 females aged from.2 to 63 years, who were pathologically diagnosed as odontogenic keratocyst at infirmaries of dental colleges, Yonsei University and Seoul national university during 1965-1986. The results were as follows: 1. The peak incidence of the disease was on their teenagers (29.8%). The ratio of Male/Female was 1.23:1 and incidence rate of males showed higher than their counterpart. 2. The most frequent complaints were swelling in (65.9%) followed by pus discharge, unknown mass, pain, residual root. 3. The most common site was mandibular third molar and mandibular ramus region (15.8%) followed by mandibular body and ramus, mandibular third molar, mandibular anterior teeth. Incidence of this disease in mandible was higher than in maxilla. 4. The lesions not associated with adjacent teeth were (14.0%) and in the lesions associated with adjacent teeth (35.1%) showed root resorption, (50.9%) were without root resorption, (35.1%) showed tooth migration and (50.9%) were without tooth migration. 5. The border types of the lesions were scalloped type in (52.6%), smooth type in (47.4%) and morphological type were unilocular in (50.9%), multilocular in (49.1%). 6. The radiologic cyst type of the lesions were follicular type (42.1%) followed by primordial, unclassified odontogenic, residual, lateral periodontal, median mandibular, globulomaxillary type.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.8.1-8.6
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• 2019

Background: Resorbable devices have recently been adopted in the field of orthognathic surgery with controversies about their postoperative skeletal stability. Hence, we determined the long-term skeletal stability of unsintered hydroxyapatite/poly-ʟ-lactic acid (HA/PLLA) mesh for osteofixation of mandibular sagittal split ramus osteotomy (SSRO), and compared it with that of titanium miniplate. Methods: Patients were divided into resorbable mesh and titanium miniplate fixation groups. A comparative study of the change in the mandibular position was performed with preoperative, 1-day, 6-month, and 2-year postoperative lateral cephalograms. Results: At postoperative 6 months-compared with postoperative 1 day, point B (supra-mentale) was significantly displaced anteriorly in the titanium-fixation group. Moreover, at postoperative 2 years-compared with postoperative 6 months, point B was significantly displaced inferiorly in the titanium-fixation. However, the HA/PLLA mesh-fixation group did not show any significant change with respect to point B postoperatively. Conclusions: The HA/PLLA mesh-fixation group demonstrated superior long-term skeletal stability with respect to the position of mandible, when compared with the titanium-fixation group.