• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.4
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• pp.296-299
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• 1998

After orthognathic surgery, postoperative complications are studied by many clinician. The complications include sensory disturbance, jaw fracture, excessive bleeding, condylar positional changes and loss of pulp vitality. Few surgical procedures are as satisfying for the surgeon and patient as a well-done orthognathic surgery. On the other hand, the patient is more satisfied with the result than who are treated with only orthodontic treatment especially in severe deformity case. There are problems that patient overcome but it is not serious complications. One of these, the problem about loss of pulp vitality can't influence function but give a lot of discomfort to the patient. From September 1997 to January 1998, 7 patients who are treated for dentofacial deformity via Le Fort I osteotomy or anterior segmental osteotomy were examined pulp sensitivity using digital pulp tester. This preliminary study have a focus on the investigation of recovery of pulp vitality. The electric pulpal test were used at preoperative, postoperative, at intervals. And we report some results acquired from this study. Follwing result are obtained 1. In anterior segmental ostetomy case (1 case), total 12 teeth were examined. Postoperative 8 weeks, 1 tooth are positive reaction 2. In Le Fort I osteotomy case (6 case), total 71 teeth were examined. Postoperative 8 weeks, 5 teeth are positive reaction

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.4
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• pp.476-490
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• 1991

Although various technical details of the surgical procedures have been improved, Skeletal relapse is the most noteworthy complication of orthognathic surgery. It seems to be an imbalance of the perioral muscular groups resulting from changes in the cavitas oris propria after surgery. Among other factors, it is widely known with the changes of tongue posture, as indicated by the hyoid position. Ten patients that had undergone mandibular setbacks by way of Modified Obwegeser method were evaluated retrospectively. The serial cephalometric films were taken preoperatively, immediately postoperatively, after removal of IMF, and at a subsequent long-term follow-up period. The cephalometric evaluation of tongue posture were based on stable craniofacial landmarks. The relation between the 2-dimensional changes of tongue posture and hyoid position and the relapse of mandibular setback are discussed. Anatomic changes that were found to accompany such setback are as follows. 1.There are 2 cases of relapse in 10 patients at long-term follow-up(20%) 2.The tongue was moved posteriorly and its size was reduced anteriorly and posteriorly at immediate postoperative change and then the mandible shifted slightly toward the preoperative position, but the long was adapted to its new environment due to changing the position of its posterior part, and also the hyoid that moved posterioly and inferiorly was stabilized sightly posteriorly than its original position. 3.On the distance change of the suprahyoid muscle, the distance of P-H, ST-H was increased at immediate postoperative change(p<0.01) and decreased at IMF period(p<0.001), but the distance of H-Me, H-Ge was slightly decreased at IMF and long-term period(p<0.05). 4.On the width change of the pharyngeal air way, the width of the upper part of the pharyngeal space was lightly contracted at IMF and long-term period(p<0.05). 5.On the relation between mandibular setback and tongue posture and hyoid position, the significant correlation was found between the changes of some parts of mandibular setback and those of tongue posture, and not found those of hyoid position.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.2
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• pp.124-129
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• 2013

Multiple segment osteotomy orthognathic surgery serves to combine the total or segmental maxillary and mandibular correction of the dentofacial deformities with concurrent procedures to provide immediate repositioning to the dento-osseous elements. In addition, splitting the palate may often be necessary to correct a functionally poor relationship of the maxilla to the mandible or the facial skeleton by realigning the maxillary arch. In this case, the discrepancy in a bimaxillary horizontal relationship and the space between the 2nd premolar and 2nd molar was retained after lengthy preoperative orthodontic treatment. However, we could correct these dento-osseous discrepancies immediately by performing midpalatal expansion, anterior segmental osteotomy and symphyseal osteotomy with bimaxillary osteotomies. If the blood supply to each segment segments was maintained and primary closure of the operation site was feasible, multiple segment osteotomy was considered as a very effective technique for treating dentofacial deformities in vertical, transverse, and sagittal dimensions with differential repositioning of all segments.

• Archives of Plastic Surgery
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• v.40 no.3
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• pp.192-197
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• 2013

Background To construct a sophisticated three-dimensional framework, numerous modifications have been reported in the literature. However, most surgeons have paid little attention to the anatomical configuration of the concha and more to its deepness and hollowness, leading to unsatisfactory outcomes. Methods For a configuration of the concha that is definitely anatomical, the author further developed and employed the conchal bowl element, which has been used by several surgeons although the results have not been published elsewhere. The author constructed the conchal bowl element in one of three patterns according to the amount of available cartilages: one block, two-pieces, or a cymba bowl element only. A total of 20 patients underwent auricular reconstruction using a costal cartilage framework between 2009 and 2012. The 8 earliest reconstructions were performed without a conchal bowl element and the latter 12 with a conchal bowl element. The patients were followed up for more than 1 year. The aesthetic results were scored by evaluating characteristics involving the stability of the crus helicis, the conchal definition, and the smoothness of the helical curve. Results The ears reconstructed early without a conchal bowl element showed a shallow and one or two incompletely separated concha with an obliterated cymba conchal space. They also did not have a realistic or smooth curve of the helix because of an unstable crus helicis. However, ears reconstructed later with the concha bowl element showed a definite crus helicis, deep cymba conchal space, and smooth helical curve. Conclusions The construction of the conchal bowl element is simple, not time-consuming procedure. It is suggested that the conchal bowl element must be constructed and attached to the main framework for natural configuration of the reconstructed ear.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.2
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• pp.185-189
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• 2007

Advancement of imaging and surgical technique makes the internal hemipelvectomy one of the routine procedures of pelvis sarcoma. However, optimal reconstructive option for skeletal defect is still controversial. Pasteurized autogenous bone-total hip composite is a biologic method and its anatomical appropriateness gives good indication for selected cases. Nevertheless, in case of complication such as infection or mechanical breakage, removal of hardware including graft is inevitable. In those cases, marked limb length discrepancy induce marked functional deficit. To overcome this problem, the authors report 1 case, refining previous technique, saving the femoral head and reinsertion of osteoarticularly pasteurized host bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.2
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• pp.140-147
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• 2012

Microvascular reconstruction, in the oral and maxillofacial regions, is a widely accepted as the best way to overcome the complex oral cavity defects. Many patients requiring composite reconstructions have been treated previously with radiation therapy, chemotherapy, selective and/or functional neck dissection or any of these combinations. In many cases of these patients, inadequate neck vessels for the microanastomosis of free flap are available, due to a lack of recipient vessels in the neck, poor vessel quality or vessel caliber mismatch. To achieve a tension-free anastomosis, vein grafting must be considered to span the vessel gap between the free flap pedicle and the recipient neck vessels. Although most microsurgeons believed that interpositional grafts are to be avoided due to vessel thrombosis and increased number of necessary microanastomosis, we, authors have some confidence of equivalency between reconstruction with and without interpositional saphenous vein graft. The great saphenous vein, also known as the long saphenous vein, is the large subcutaneous superficial vein of the leg and thigh. It joins with the femoral vein in the region of femoral triangle at the saphenofemoral junction, and coursed medially to lie on the anterior surface of the thigh before entering an opening in the fascia lata, called the saphenous opening. For a better understanding of the great saphenous vein graft for the interpositional vessel graft in the oral cavity reconstructions, and an avoidance of any uneventful complications during these procedures, the related surgical anatomies with their harvesting tips are summarized in this review article in the Korean language.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.6
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• pp.513-519
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• 2007

Typical surgical methods for the treatment of mandibular fractures include intermaxillary-fixation (IMF) for obtaining temporary intraoperative occlusion. Traditionally IMF has been achieved with arch-bars or interdental eyelet wiring. However, these techniques are time-consuming procedures, can produce periodontal damage, and are not well tolerated by the patient even under local anesthesia. Moreover, daily maintenance of oral hygiene is difficult for patients with an arch bar. Recently, intermaxillary fixation using intraoral skeletal anchorage screws (SAS) has been introduced for the treatment of mandibular fractures. This method solves the problems above, but they have the potential for tooth damage, screw fractures and intraoperative occlusal instability. In this study, patients with mandiblular fractures were divided into three groups. Group 1 was treated by IMF using archbars(both maxilla and mandible), Group 2 was treated with SAS(maxilla) and arch-bar (mandible), Group 3 was treated with SAS(both maxilla and mandible). The aim of this study was to evaluate the influence of the different IMF methods on periodontal tissue health and intraoperative occlusal rehabilitation about each groups, and to discuss the most favorable IMF method.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.1
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• pp.69-77
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• 1996

The midfacial deficiency is usually accompanied with congenital craniofacial synostosis, such as Crouzon, Apert, Pfeiffer, Carpenter, Saethre-Chotzen syndrome, and so on. But sometimes isolated midfacial deficiency without cranial malformations may appeared, the cause of which is congenital, hereditary, or secondary to developmental factors, such as infection and trauma to middle face. Since Sir Harold Gillies reposted the first high maxillary osteotomy that alleviated the problems of total midfacial deficiency, the various operative methods were developed by many clinicians, such as Longacre and Tessier. These procedures can enlarge the orbital volume and decreases exorbitism. As middle face was moved forward, these functional, esthetic, and psychologic advantages were resulted from this. This is a case of midfacial deficiency corrected by the subcranial Le Fort Ⅲ osteotomy through only coronal approach.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.35-40
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• 2009

Dental emergency varies from toothache to trauma of oromaxillofacial area. Recently, the number of emergency cases after dental treatment is increasing because surgical treatments such as implant installation rise. Dental emergency patients have been looking for emergency room of general hospital and they could be treated only when the dentist of night duty exists. Although there are many analyses on the dental emergency patients visiting general hospitals, research on the dental treatment only has not been provided enough. We anticipated different aspects between the dental emergency patients visiting independent dental hospital and general hospitals. We analyzed dental emergency patients' chief complaints and received procedures for almost 1-year period in Won-Kwang dental hospital in Dae-jeon where there had been no dental emergency settings. With this 1574 patients' result, we tried to find appropriate treatment plans regarding dental emergency patients occurring at night and holidays.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.22.1-22.9
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• 2017

Background: Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery. Methods: A prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring. Results: Among 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers. Conclusions: This study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.