Purpose: Chin is located in a prominent position, and is important to balance and harmony of the face. Genioplasty is widely performed with patients' high satisfaction, yet being relatively simple procedure. Recently in analysis of dentofacial trait, three rotational variables of yaw, pith, and roll are considered with three translational variables (forward/backward, up/down, right/left). And we could correct chin deformity effectively by applying the three rotational variables with three translational variables in genioplasty. Methods: Twenty-eight patients who have chin deformity underwent osseous genioplasty. Preoperative photography, facial three dimensional computed tomography, and cephalography were taken while chin deformities were accessed. The chin deformity was classified into four categories; macrogenia, microgenia, asymmetric chin deformity, and combined chin deformity groups. According to the nature of chin deformities and the patients' desire, preoperative plans were formulated, in consideration of three rotational variables and translational variables. Through intraoral approach, anterior mandible was exposed in the subperiosteal plane between the mental foramens and beneath the mental foramens. In the anterior mandible, vertical and horizontal grid lines with 5 mm intervals were marked to confirm the spatial location of osteomized bone segment after osteotomy. Chin repositioning was done in consideration of axial rotation and planar translation. Results: Most of the patients had achieved satisfactory results with few complications. By considering the three rotational variables, it was possible to make the chin repositioning effectively. One of the patients complained about insufficient chin correction. In other case, persistent sensory impairment around chin was observed. Conclusion: In conclusion, it is worthwhile to apply preoperative analysis and operative procedures in consideration of a three rotational variables with three translational variables in genioplasty.
Purpose: A cost effective tool for the clinical measurement of trunk reposition sense is clearly needed. This study was to analyze intrarater and interrater Reliability of trunk repositioning error (TRE) test which assesses trunk position sense using a portable digital inclinometer. Methods: Twenty four normal healthy subjects were recruited. TRE was measured using a portable digital inclinometer. A digital inclinometer (Acumar-ACU360; Lafayetter Instrument) with precision to $1^{\circ}$ was placed on skin over the spinous process from first to second thoracic vertebra (T1-T2) and secured with double-sided tape. TRE test during sitting forward and lateral flexion movement was assessed. When they reached a point approximately 50% of full trunk flexion range, the examiner instructed the subjects to stop and told them. This was the target position that they should try to reproduce exactly. Each subject performed six trials. Results: ICC (2,1) for intrarater reliability (with-day and between-day) of TRE test in sagittal and frontal plane of movement was 0.75 and 0.78 (excellent reliability). Interrater reliability was 0.66 in sagittal and 0.64, frontal plane (fair to good reliability). However, there were poor correlations between an average of TRE test in sagittal and frontal plane. Conclusion: TRE test using a portable digital inclinometer demonstrated good to excellent reliability. The device may be a cost effective clinical measurement for trunk reposition sense measurement.
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.
This case report demonstrates two different uprighting mechanics separately applied to mesially tipped mandibular first and second molars. The biomechanical considerations for application of these mechanisms are also discussed. For repositioning of the first molar, which was severely tipped and deeply impacted, a novel cantilever mechanics was used. The molar tube was bonded in the buccolingual direction to facilitate insertion of a cantilever from the buccal side. By twisting the distal end of the cantilever, sufficient uprighting moment was generated. The mesial end of the cantilever was hooked over the miniscrew placed between the canine and first premolar, which could prevent exertion of an intrusive force to the anterior portion of the dentition as a side effect. For repositioning of the second molar, an uprighting mechanics using a compression force with two step bends incorporated into a nickel-titanium archwire was employed. This generated an uprighting moment as well as a distal force acting on the tipped second molar to regain the lost space for the first molar and bring it into its normal position. This epoch-making uprighting mechanics could also minimize the extrusion of the molar, thereby preventing occlusal interference by increasing interocclusal clearance between the inferiorly placed two step bends and the antagonist tooth. Consequently, the two step bends could help prevent occlusal interference. After 2 years and 11 months of active treatment, a desirable Class I occlusion was successfully achieved without permanent tooth extraction.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.41
no.2
/
pp.74-77
/
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.
Purpose - This study proposes a strategic model for the late mover to effectively penetrate an industry that is dominated by a leading company. Thus, this study presents strategic implications for several late movers in overcoming the advantages of the leading company. Research design, data, and methodology - This study begins with a literature review followed by the formation of a strategic model that consists of: Repositioning, Utilization of Competence, Strategic Leadership, and Innovation. Specifically, this research analyzes LG Electronics (LG) as an example and investigates how LG infiltrates and grows in the water purifier market, overcoming the advantages of the powerful leading company. Results - The major steps taken by LG are summarized into four. First, LG studied the market, which had been conventionally treated as a single market. To penetrate the market, LG founded a new, special market segment. Subsequently, LG further segmented the market, executing a marketing strategy for each segment. Second, the unbending will of top managers was a key factor that addressed the challenge persistently. Third, even though LG was the late mover in the water purifier market, it had several technology competences such as compressor, refrigeration cycles, and algorithms. LG had profound knowledge in technology and used it effectively. Fourth, LG created a premium market through three innovative and distinguished factors such as the stainless water tank, sterilization service, and luxury design. Conclusions - This research draws four key findings from the example of the late mover in the water purifier industry: the reestablishment of a strategic position based on environmental change is an effective strategy for the late mover; strategic leadership is an important motive to generate late mover performance; and the late mover can utilize its existing knowledge and resources to overcome the first mover, such as presenting new added value compared to existing products as an effective catch-up strategy. Consequentially, through the study of performance determinants and the market penetration strategy of the late mover, this research has significance in providing basic material for companies trying to penetrate the market.
Journal of Dental Rehabilitation and Applied Science
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v.23
no.4
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pp.313-326
/
2007
With rising prevalency of mouth breathing children caused by developing civilization and increasing pollution, there are many maxillary transverse discrepancy patients with undergrowth of maxilla. For improving this, maxillary mid-palatal suture splitting was often performed. The purpose of this study was to analyse the stress distribution on the craniofacial suture and cranium after rapid maxillary expansion by finite element model. The boy(13Y6M) was chosen for taking computed-tomography for finite element model. Three-dimensional model of maxilla, first premolar, first molar, buccal and lingual part of rapid maxillary expansion were constructed. 1. The alveolar bone adjacent to the first molar and the first premolar that was affected directly by rapid maxillary expansion was displaced laterally approximately 4.04mm at maximum. The force decreased toward anterior region and frontal alveolar bone displaced laterally about 3.18mm. 2. A forward maximum displacement was exhibited at zygomatic process middle region. 3. At maximum, maxillary median part experienced 0.973mm downward repositioning and 0.65mm upward repositioning at lateral alveolar bone. 4. Von mises stress was observed the largest stress distribution around teeth and zygomatic buttress. 5. The largest tensile force was observed around alveolar bone of teeth, while compression force was observed at zygomatic buttress.
Patients with unilateral cleft lip and palate (UCLP) generally demonstrate the asymmetries in the lip, nose and the naso-maxillary complex. And their skeletal asymmetries are known to be derived from the displacement of nasal septum, anterior nasal spine (ANS) and the pre-maxilla toward the non-affected side during the developmental and growth period. Due to the interruption of the important facial muscles, which are critical for the symmetric growth of premaxilla, functional matrix system fails to develop and results in the displacement of the ANS toward the non-affected side and nasal asymmetry. Therefore the rhinoplasty for CLP patients is required to have inter-skeletal and muscular rearrangement in the naso-maxillary complex in order to let them recover from esthetic and physiologic imbalances. And functional cheilorhinoplasty (FCR) has been a representative treatment of choice for this concept of treatment modality. The outcome and prognosis of primary or repair FCR have been known to be definitely affected by timing of the operation as well as adequate reconstruction of naso-labial muscles. However, sometimes FCR has an ineffective treatment results for patients after the facial growth period, and the limited rhinoplasty around the nose often fails to bring satisfying results. In order to circumvent this limitation, we performed ANS osteotomy for patients with unilateral CLP showing asymmetric nose, as an alternative way for corrective rhinoplasty. We could observe that the nose was rearranged along the facial mid-line by this osteotomy design and asymmetries were evidently improved postoperatively. Here we present this osteotomy method in CLP patients.
Journal of the korean academy of Pediatric Dentistry
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v.30
no.4
/
pp.654-659
/
2003
Intrusive luxation that takes approximately three percent of permanent teeth commonly occures at anterior teeth. This intrusion frequently leads to pulp necrosis, root resorption, marginal bone loss and these complications are influenced by depth of intrusion and stage of root development. Various treatment approaches have been suggested to manage of intrusive luxation. Techniques aiming to reposition the intruded tooth include an observation for spontaneous re-eruption, surgical or orthodontic repositioning. We report two cases with clinically satisfactory results for traumatically intruded maxillary central incisor. In one case which has a large open apex and mild intrusion depth, we observed for spontaneous eruption and then repositioning by forced eruption method. In other case, which has been completely intruded, was repositioned by surgical extrusion and followed by apexification.
Seo, Yun-Jin;Lee, Kwang-Hee;La, Ji-Young;An, So-Youn;Kim, Yun-Hee;Keum, Ki-Seok;Lee, Sang-Bong
Journal of the korean academy of Pediatric Dentistry
/
v.39
no.2
/
pp.166-173
/
2012
Dilaceration is a developmental disturbance in shape of teeth. It refers to an angulation, or a sharp bend or curve, in the root or crown of a formed tooth. Dilacerations are estimated to occur in 3% of all permanent dentitions. However, the etiology of dilaceration is not yet fully understood. Traumatic injury to the deciduous predecessors and ectopic development of the tooth germ are the two commonly cited causes of this anomaly. The involved tooth is usually the maxillary central incisor and it also shows high prevalence of impaction. At first, We tried to do surgical exposure with orthodontic traction but to no avail. After then surgical repositioning of the dilacerated tooth was performed. Finally, Satisfactory results were obtained at the end of treatment, with improvement in dental esthetics and functional aspects.
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