• Journal of Korean Dental Science
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• v.13 no.2
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• pp.67-72
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• 2020

Purpose: This clinical study presented the effectiveness of 2-stage posterior maxillary segmental osteotomy (PMSO) under local anesthesia in gaining interarch space to restore the posterior mandibular segment with dental implants. Materials and Methods: Nine patients who received two-stage PMSO for mandibular implant placement from 2003 to 2011 were included in the study. Of the 9 patients, 7 were female and 2 were male. Ages ranged form 28 to 72 (mean 46.6). Potential complications were investigated such as sinus infection, survival of bone segment, inflammatory root resorption of adjacent teeth, relapse of bone segment and timing of implant placement, delivery of implant prosthesis and stability of bone segment. Result: None of the patients showed relapse or complication. Bone segments were stabilized by opposed implant prosthesis. Conclusion: Office-based 2-stage PMSO under local anesthesia can be considered a stable and predictable procedure. Also pedicle damage can be avoided by allowing favor of blood supply to the bone segments. From these advantages, it can be concluded that this surgical procedure can decrease post-operative complications.

• The korean journal of orthodontics
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• v.37 no.5
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• pp.331-340
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• 2007

The aim of this study was to determine firstly the characteristics of esthetic lips in Korean females and secondly to measure the changes of the lips before and after anterior segmental osteotomy in bimaxillary protruded patients. Methods: Samples consisted of 30 models and 26 nonmodels, and 10 patients who had received anterior segmental osteotomy. Twelve linear measurements, 5 angular measurements, and the lip perimeter and area were measured. These results were compared for each group using unpaired and paired t-tests. Results: Full face width, nose to chin, upper vermilion height and angle, lateral heights at the point of the tips of Cupid's bow, central bow angle, and the lower lip to chin lengths were significantly greater in nonmodels than in models. However, overall lip width, lower vermilion height and angle, tip-to-tip of Cupid's bow lip perimeter, and lower vermilion area were greater in models than in nonmodels. Comparison of before and after anterior segmental osteotomy revealed that the values for the upper vermilion and lateral heights, the angle to Cupid's bow tip lengths, and upper vermilion area of post-operative patients had become similar to those of Korean female models. Our findings demonstrated that Korean female models have a fuller lower vermilion & thinner upper vermilion compared with nonmodel controls, as determined by the vermilion heights, angles, and areas. Conclusions: It will be helpful for clinicians to use these measurements as guidelines for improving patients' facial esthetics.

• 대한치과교정학회:학술대회논문집
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• 2003.10a
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• pp.103.1-103.1
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• 2003

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.274-278
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• 2005

Purpose : Prediction for soft tissue change after orthognathic surgery is very important for the final esthetics. In this study, we have tried to get the amount of upper lip movement relative to bony segment movement after anterior segmental osteotomy by cephalmetric analysis to predict final upper lip position after surgery. Material and Methods : 20 patients was studied on whom anterior segmental osteotmy as performed by Cupar method during the years 2002 to 2003. Cephalometric radiograph were taken at 1month before surgery and 6 month after surgery. Change of upper lip was measured on landmark Ls and Sto relative to hard tissue (landmark Ia) setback on these X-rays and analyzed. Results : 1. Upper lip setback movement. Setback of upper lip showed proportional relation to the hard tissue setback and the ratio was about 84%(p=0.001). 2. Upper lip downward movement. Downward movement of upper lip showed no proportional relation to hard tissue setback And the amount was mean 1.38 mm and SD 1.21mm (p=0.922). Conclusion : The posterior movement of upper lip is affected by hard tissue movement and shows good proportional change whereas downward movement is not so much influenced by hard tissue movement. And we think slight downward movement shown in this study could be explained by the V-Y closure performed during surgery.

• Journal of Periodontal and Implant Science
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• v.43 no.5
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• pp.243-247
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• 2013

Purpose: The aim of this work is to evaluate a surgical technique for mobilization of mal posed dental implant in anterior area. Methods: A 38-year-old patient consulted our unit for esthetic dissatisfaction with the implant treatment of a central incisor. An implant was observed in 11 and 21, where 11 was 3 mm above the ideal limit, with excessive vestibular angulation. The choice was made to perform a segmental osteotomy and mobilize the bone block and the implant down and forward; a bone block extracted from the mandibular ramus was installed between the implant block and the bed to stabilize the segment. Results: After 4 months, a conventional fixed prosthesis was created and the esthetic result achieved was close to what the patient wanted, with no need for further surgery. The surgical condition was stabilized and maintained for the long-time and no complications how necrosis, infection or bone defects was present. Conclusions: It was concluded that the procedure is efficient, and the biological arguments in favor of the procedure are discussed.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.584-587
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• 2014

In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

• The korean journal of orthodontics
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• v.40 no.6
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• pp.383-397
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• 2010

Objective: The objective of this study was to compare maxillary soft tissue changes and their relative ratios to hard tissue changes after anterior segmental osteotomy (ASO)/bilateral sagittal split ramus osteotomy (BSSRO) and Le Fort I/BSSRO in skeletal Class III malocclusion with upper lip protrusion. Methods: The study sample comprised the ASO/BSSRO group (n = 14) and the Le Fort I/BSSRO group (n = 15). The Le Fort I/BSSRO group included cases of maxillary posterior impaction only. Lateral cephalograms were taken 2 months before and 6 months after surgery. Linear and angular measurements were performed. Results: The anterior maxilla moved backward in both groups after surgery, however the amount of change was significantly larger in the ASO/BSSRO group (p < 0.01). The ratios of hard to soft tissue change were 79% (SLS to A point), 80% (LS to A point) in the ASO/BSSRO group, and 15% (SLS to A point), 68% (LS to A point) in the Le fort I/BSSRO group. In addition, there was a $3.23^{\circ}$ increase of the occlusal plane in the Le Fort I/BSSRO group. Conclusions: When two-jaw surgery is indicated in skeletal Class III patients with protrusive lips, ASO may be a treatment of choice for cases with more severe upper lip protrusion, while Le Fort I with posterior impaction may be considered if an increase of occlusal plane angle is required.

• 대한치과보철학회:학술대회논문집
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• 2006.04a
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• pp.108-108
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• 2006

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.4
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• pp.338-347
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• 2001

Purpose: This is to review the cases of posterior maxillary segmental osteotomies to regain the interarch spaces for dental implants in the posterior mandible. Materials & Methods: Seven patients who presented with alveolar extrusion of upper posterior molars underwent segmental osteotomies by single-stage Kufner's buccal approach under the intravenous sedation and local anesthesia. The posterior maxillary cento-alveolar segments were repositioned upward using pre-fabricated palato-occlusal resin splints and immobilized with osteosynthesis microplates and screws. Dental implants were installated simultaneously. The regained spaces, tooth vitality, periodontal healing, relapse, tenderness on function, and complications including maxillary sinus involvements were evaluated periodically for over one year after the surgeries. Results: The single-tage procedures were completed within 80 minutes without any surgical complications. The posterior maxillary segments were repositioned upward to regain the interarch spaces ranging from 2.5 to 5.5mm. All teeth involved in the procedures keep their vitalities. The repositioned segments were maintained showing neither evidence of periodontal break-down nor tenderness to function. One patient whose segments had not been immobilized by osteosynthesis plate resulted in 2mm down-ward relapse in post-operative 8 months. A case of postoperative nasal bleeding from the posterior-lateral wall resulted in oroantral fistula and chronic maxillary sinusitis later. Conclusion: The extruded dento-alveolar segments of the posterior maxilla were repositioned properly by Kufner's one-stage segmental osteotomies. One microplate can be of help to keep the position until the osseous healing enough to support the masticatory force.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.3
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• pp.355-364
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• 2008

Skeletal anterior open bite is a difficult problem to correct in orthodontic treatment. To treat adult patients who have skeletal anterior open bite, we considered two methods. Combination treatment of orthodontics & surgery and camouflage orthodontic treatment. In adults, treatment of severe skeletal anterior open bite consists mainly of surgically repositioning the maxilla or the mandible. However, camouflage therapy is often the treatment of choice for skeletal open bite patients who have mild to moderate skeletal discrepancies when growth modification is no longer possible. But excellent results generally require careful coordination of the orthodontic and surgical phases of treatment. This is a case report of a skeletal anterior open bite patients who were treated with orthodontic treatment and orthognathic surgery. First case was diagnosed as skeletal class I malocclusion & bimaxillary protrusion with anterior open bite, and finally treatment ended for removal of open bite with orthodontic procedure and bimaxillary anterior segmental osteotomy surgery. Second case was diagnosed as skeletal class II malocclusion with open bite & mandibular retrusion, and was treated with only camouflage orthodontics because she feared to have a surgery. In a regular follow up visit after debonding we proposed to the patient advanced genioplasty, and in her agreement her facial esthetics was improved through the surgery.