• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권1호
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• pp.29-34
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• 1999

Special attention should be directed toward the preservation of preoperative condylar position during orthognathic surgery because their positional change may leads to postoperative skeletal relapse as well as TM joint problem. Various condylar positioning devices, therefore, have been introduced and utilized in orthognathic surgery. Even though most of them provided us with improvement of surgical results, we also found some problems including limited indication, etc. For more accurately repositioning the maxilla and the mandible and its wide versatility, a newly designed maxilla and condylar positioning device based on the fixed part of cranium is introduced.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.563-569
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• 1996

Skeletal and dental changes were examined in 38 patients of mandibular prognathism who been treated by a bilateral sagittal split osteotomy(SSRO) and internal fixation using titanium mini-screws. All patients were followed up for over 8 months after the surgeries, and postoperative cephalometric measurements were compared at 2 months and at 8 months. Linear measurements of the "Pog-most posterior screws" and angular measurementsts of "SN-Pog'were compared to figure out the change of bony fragments. The significancy of data were tested by unpaired T-test. The results were as follows : 1. The fixation screws were changed in cephalometric position as little as $0.32{\pm}2.51mm$ in SSRO and $0.15{\pm}1.00mm$ in SSRO & Le Fort I Osteotomy.(P<0.05) 2. Mandibular set-back over 5mm resulted in less stability of the fixation screws and higher relapse tendency. 3. The internal fixation using two screws along the inferior border and one on the superior ridge is considered to be very resistant to postoperative relapse of the repositioned bony segments.

• 대한치과교정학회지
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• 제52권5호
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• pp.362-371
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• 2022

Orthognathic surgery is the primary treatment option for severe skeletal discrepancy. However, orthodontic camouflage should be considered as an alternative treatment option, considering the risks of surgery. A 19.5-yearold man presented with a severe prognathic mandible with a Class III molar relationship and an anterior crossbite. Orthognathic surgery could be considered because of his severe skeletal discrepancy and mandibular prognathism. However, the anesthetist for orthognathic surgery did not recommend surgery under general anesthesia because of risk factors associated with the patient's aplastic anemia, including bleeding and infections. Thus, a camouflage treatment to promote backward rotation of the mandible via orthodontic extrusion of the posterior teeth was planned. An anterior bite plate, intermaxillary elastics, and fixed orthodontic appliances were used to extrude the posterior teeth and to align the dentition. After 17 months of nonsurgical orthodontic treatment, normal occlusion was achieved, and the facial profile was dramatically improved. This case report describes the dentoskeletal and soft-tissue effects of mandibular rotation and its long-term stability.

• 대한치과의사협회지
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• 제47권11호
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• pp.750-757
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• 2009

Purpose : The purpose of this study is to evaluate the clinical availability of submentoplasty for esthethic improvement of the cervico-facial region of patients with obtuse chin-neck angle. Materials and methods : Case 1. We evaluate the changes of submental line length and chin-neck angle of 35-year-old woman with skeletal Class III and mandibular excess with excessive submental fat before and after surgery: Bilateral sagittal split ramus osteotomy(BSSRO) setback(5mm), Mandibular Angle Reduction, Reduction Malarplasty and Submentoplasty. In this case, It was done simultaneously with orthognathic surgery. Case 2. The changes of submental line length and chin-neck angle of 20-year-old man with skeletal class III and maxillary defiency were evaluated before surgery, at first surgery : Lefort I osteotomy(6mm posterior Impaction), BSSRO setback(9mm), Paranasal Augmentation and at second surgery: genioplasty(6mm advanced) with submentoplasty. In this case, submentoplasty and advancement genioplasty were done after 2 months post-operative periods. Results : Case 1. In case of the Skeletal Class III mandibular excess with submental fat deposit, It showed the improvement of submental angle and length of submental line after simultaneous submentoplasty. Submental angle is changed from $177^{\circ}$ (pre-op) to $151^{\circ}$ (post-op) and submental line length is changed from 8mm(pre-op) to 36mm(post-op). Case 2. The improvement of submental angle and length of submental line after delayed submentoplasty was aquired in case of the skeletal class III maxillary defiency. Submental angle is changed from $154^{\circ}$ (pre-op) to $161^{\circ}$ (first surgery) and to $153^{\circ}$ (second surgery) and submental line length is changed from 25mm(pre-op) to 19mm(first surgery) and to 23mm(second surgery). Conclusion : The results suggest that Submentoplasty is useful surgical procedure for esthethic improvement of the cervicofacial region of patients with obtuse chin-neck angle.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권1호
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• pp.9-13
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• 2012

Introduction: To evaluate the 3-dimensional changes in the pharyngeal airway of skeletal class III patients after bimaxillary surgery. Materials and Methods: The study sample consisted of 18 Korean patients that had undergone maxillary setback or posterosuperior movement and mandibular bilateral sagittal split osteotomy setback surgery due to skeletal class III malocclusion (8 males, 10 females; mean age of 28.7). Cone beam computed tomography was taken 1 month before and 6 months after orthognathic surgery. Preoperative and postoperative volumes of the nasopharyngeal, oropharyngeal, and laryngopharyngeal airways and minimum axial areas of the oropharyngeal and laryngopharyngeal spaces were measured. Moreover, the pharyngeal airway volume of the patient group that had received genioplasty advancement was compared with the other group that had not. Results: The nasopharyngeal and laryngopharyngeal spaces did not show significant differences before or after surgery. However, the oropharyngeal space volume and total volume of pharyngeal airway decreased significantly (P<0.05). The minimum axial area of the oropharynx also decreased significantly. Conclusion: The results indicate that bimaxillary surgery decreased the volume and the minimum axial area of the oropharyngeal space. Advanced genioplasty did not seem to have a significant effect on the volumes of the oropharyngeal and laryngopharyngeal spaces.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권2호
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• pp.148-156
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• 2007

Purpose: The aim of this study is the changes of upper respiratory airway space in patients with mandibular prognathism after 2-jaw orthognathic surgery in patients with skeletal classs III malocclusion. Method: We measured the lines between selected upper airway landmarks on lateral cephalometric x-ray films of skeletal class III 64 persons who had not been operated yet, were 6 months after operation. The test subjects were divided into 3 groups according to maxillary movement, as follows; maxillary advancement (MA) group, maxillary posterior impaction (MPI) group, maxillary posterior impaction and superior repositioning (MPI+MSR) group. Result: In this study, nasopharyngeal airway space in MPI+MSR group was significantly increased after operation (p<0.05). Oropharygeal and hypopharyngeal airway space in MA group and MPI group were significantly decreased after operation (p<0.05). From hyoid bone to anterior mandible point distance in MA group and MPI group were significantly decreased after operation (p<0.05). Conclusion: Oropharygeal and hypopharyngeal airway space were influenced more by mandibular set-back than maxillary movement. Maxillary movement surgery as well as mandibular setback surgery should be taken into consideration in order to minimize symptoms related to obstructive sleep apnea syndrome after operation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권4호
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• pp.370-379
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• 2008

Objective: This study was carried out to evaluated the psychologic changes of skeletal Class III malocclusion individuals by orthognathic surgery. Methods: One hundred and thirty seven adults skeletal Class III malocclusion individuals were selected for this study. Fifty two for pre-surgery group, forty two for 2-months after orthognathic surgery group and forty three for 6-months after orthognathic surgery group. Each group was investigated by questionnaires related to self-concept standard developed by Dr. Lee. The questionnaires included physical self-concept, ethic self-concept, characteristic self-concept, domestic self-concept, the social self-concept and capable self-concept. Each group was compared by one-way ANOVA. Results: Only the physical self-concept showed significant changes after orthognathic surgery, however it did not showed differences between after 2-months and after 6-months. But other self-concept did not show significant changes by orthognathic surgery. Conclusion: At first, it is expected that many variables related to self-concept were influenced by orthognathic surgery. But only physical self-concept showed significant change by orthognathic surgery.

• 대한치과교정학회지
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• 제54권2호
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• pp.89-107
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• 2024

Objective: This systematic review aimed to provide a comparative analysis of the treatment outcomes, including hard and soft tissues, postoperative stability, temporomandibular disorders (TMD), and quality of life (QoL), in patients with facial asymmetry who underwent orthognathic surgery. Methods: The primary objective was to address the question, "How do different factors related to surgery affect the outcomes and stability of orthognathic surgery in the correction of facial asymmetry?" A meta-analysis was conducted on the outcome parameters, such as skeletal, dental, and soft tissue symmetry, TMD, QoL, and relapse, using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Subgroup analyses were conducted considering surgery-related factors such as surgical techniques (one-jaw vs. two-jaw), use of the surgery-first approach, utilization of computer simulation, and analytical methods employed to evaluate asymmetry (2D vs. 3D). Results: Forty-nine articles met the inclusion criteria. The metaanalysis demonstrated a significant improvement in the symmetry of hard and soft tissues. The subgroup analysis indicated that the treatment outcomes showed significant improvement, regardless of the factors related to surgery. Changes in TMD signs and symptoms varied according to the surgical technique used. Quality of life improved in the facial, oral, and social domains. Skeletal relapse was observed during the follow-up. Conclusions: Our findings support the positive outcomes of orthognathic surgery in the treatment of facial asymmetry in terms of skeletal and soft tissue improvements, stability, relief of TMD symptoms, and enhancement of QoL. However, most of the included studies showed a low certainty of evidence and high heterogeneity.

• Clinical and Experimental Pediatrics
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• 제51권4호
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• pp.435-438
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• 2008

Cerebro-Oculo-Facio-Skeletal (COFS) syndrome은 뇌, 안면, 안구 및 사지의 기형을 특징으로 하는 상염색체 열성 유전 질환이다. COFS 증후군은 DNA-repair gene의 돌연변이로 인한 뇌와 척수의 퇴행성 질환으로 여겨지며, 대뇌, 안구, 안면 및 사지의 복합 기형을 보인다. 국내에서는 신생아기에 진단되어 생후 1개월에 사망한 1례만이 보고 되어 있다. 저자들은 뇌, 안면, 안구, 그리고 사지의 복합 기형을 보여 COFS 증후군으로 진단된 환아를 경험하였으며, 이를 문헌 고찰과 함께 보고한다.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.31-38
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• 2006

The effect of melatonin on morphological changes after ischemia-reperfusion injury was investigated in rat skeletal muscle. Dimethyl-sulfoxide(DMSO) was also tested for comparison. Muscle injury was evaluated in 4 groups as a single laparotomy group(control), ischemia-reperfusion group, DMSO group, melatonin group. Left hind limb ischemia was induced for 4 hours by vascular clamping of the common femoral artery and followed by 24 hours of reperfusion. The midportion of gastrocnemius muscle was taken for histological evaluation. In light microscopic study, ischemia-reperfusion group showed severe neutrophil infiltration, interstitial edema, and partial loss or degeneration of muscle fibers. The muscle tissue of melatonin group showed relatively normal architecture with mild inflammatory cell infiltration. In electron microscopic study, dilated cisternae of sarcoplasmic reticulum, dilated mitochondria with electron loose matrix and dilated cristae, disordered or loss of myofilament, indistinct A-band and I-band, intracytoplasmic vacuoles, and markedly decreased glycogen granules were observed in ischemia-reperfusion group. But relatively well maintained A-band, I-band, Z-line, M-line, and mildly dilated mitochondria with well preserved cristae were observed in melatonin group. The DMSO group showed intermediately attenuated ultrastructural changes. The results show that melatonin improves morphologically ischemia-reperfusion injury more effectively than DMSO. In conclusion, melatonin seems to be a promising agent that can salvage the skeletal muscle from severe ischemia-reperfusion injury.