• Title/Summary/Keyword: Soft tissue deviation

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Horizontal change of philtrum after orthognathic surgery in patients with facial asymmetry

  • Joh, Yewon;Park, Hyun Soo;Yang, Hoon Joo;Hwang, Soon Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.48.1-48.7
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    • 2019
  • Background: Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods: Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results: Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values. Conclusion: The horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.

THE STDUY OF THE RELAPSE OF HARD AND SOFT TISSUE AFTER MAXILLARY PROTRACTION (상악골 전방견인 후 경조직과 연조직의 재발에 관한 연구)

  • Yang, Jun-Ho;Park, Soo-Byung;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.27 no.3 s.62
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    • pp.373-389
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    • 1997
  • The purpose of this stdudy was to evaluate the effect of maxillary protraction and the relapse of hard and soft tissue after maxillary protraction. For this study 29 patients who were treated with maxillary protractor and labiolingual archwire were selected. Their mean age was 9 years 4 months and mean treatment period was 8.5 months. Lateral cephalograms were taken at pretreatment, immediately after treatment and one to three months after removal of the maxillary protractor. They were traced on skeletodental and soft tissue structures based on Burstone's analysis and analyzed by Quick-Ceph Image Digitizing System(ORTHODONTIC PROCESSING). The mean and standard deviation between pretreatment and posttreatment and between posttreatment and retention period for each cephalometric variable were calculated. Student t-test was used to determine the statistical significance of the changes in each variable. Correlation coefficients between hard tissue and soft tissue were used to determine interrelationship. The results were as follows. 1. After maxillayy protraction, the maxilla and maxillary dentition moved antero-inferiorly, the mandibld and mandibular dentition moved postero-interiorly and palatal plane rotated antero-superiorly by $0.59^{\circ}$. 2. After maxillary protraction, the soft tissue of upper lip moved antero-interiorly with the movement of hard tissue but the antero-posterior position of lower lip was stable in spite of the change of hard tissue. The thickness of upper lip was decreased and that of lower lip was increased after maxillary Protraction. 3. During the retention period, the position of jaws was relatively stable but upper and lower anterior teeth and antero-superiorly rotated palatal plane relapsed to original position. 4. During the retention period, the soft tissue of lips was stable antero-posteriorly and moved mote inferiorly than posttreatment. 5. The correlation coefficients between the postion of upper and lower incisal edge and that position of lips were high, especially in horizontal change.

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Corrective Osteotomies in Hallux Valgus (무지외반증에서의 절골술)

  • Ko, Kyung Rae;Sung, Ki-Sun
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.2
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    • pp.43-49
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    • 2017
  • Hallux valgus is a deformity characterized by lateral deviation of the great toe and medial deviation of the first metatarsal. When planning an operative treatment, it is important to realize that the deformity is tridimensional and diverse. Operative techniques include medial eminence resection, distal soft tissue procedure, first metatarsal osteotomy (distal, diaphyseal, proximal, or multiple), proximal phalanx osteotomy, arthrodesis (first metatarsophalangeal or metatarsocuneiform joint), and so on. Among these techniques, osteotomy is the main procedure for correcting the hallux valgus. The objective of this article is to describe the characteristics and recent advancements made for corrective osteotomies in the hallux valgus. The pathophysiology of the hallux valgus is also described.

CEPHALOMETRIC NORMS OF THE SOFT TISSUES OF KOREAN FOR ORTHOGNATHIC SURGERY (악교정 수술을 위한 한국 성인 정상교합자의 연조직 기준치)

  • Kim, Kyung-Ho;Choy, Kwang-Chul;Kim, Gin-Kap;Park, Kwang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.231-238
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    • 2001
  • This study was performed to evaluate soft tissue cephalometric norms for Korean adults which can be implemented in surgical orthodontic treatment planning using selected horizontal reference plane especially for Koreans (Male: $SN-7.5^{\circ}$, Female: $SN-9.0^{\circ}$) and a simplified analytical method. 70 males and 70 females consisting of freshmen of Yonsei University from 1996 to 1997 and students from the Dental College of Yonsei University were chosen according to clinical examination and cephalometric analysis. The samples had normal profiles, normal anteroposterior skeletal relationship(ANB angle of $0^{\circ}\;to\;4^{\circ}$ and Wits appraisal of -4.0mm to 0mm), and Class I molar and canine relationship. They had no missing or supernumerary teeth and had no experience of orthodontic or prosthetic treatment. After the selection of 15 soft tissue landmarks and the construction of horizontal and vertical reference lines, 25 measurements were taken. These consisted of vertical and horizontal linear measurements and angular measurements. The results were as follows. 1. Mean and standard deviation of the measurements were calculated in males and females. 2. Vertical measurements were comparably bigger in males than females whereas anterior facial height ratio(sN-Sn/Sn-sMe) and lower anterior facial height ratio(Sn-Stms/Stmi-sMe) showed no significant difference between sexes. 3. Most of the horizontal measurements in relation to the vertical reference line(G-perpendicular) showed no significant difference between sexes. 4. Nasofacial angle, columellar angle, nasolabial angle and facial contour angle showed no significant difference between sexes. 5. The upper and lower lip were positioned about $-1.0{\pm}2.0mm$ and $+1.0{\pm}2.0mm$ in relation to the Ricketts' esthetic line in both sexes. In this study, soft tissue cephalometric norms of Korean adults for orthognathic surgery were obtained.

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MRI Evaluation for the Histologic Components of Soft-tissue Tumors: Comparison of MEDIC and Fast SE T2-weighted Imaging (연조직종양의 조직 성분 평가를 위한 자기공명영상: MEDIC 과 지방억제 T2 영상의 비교)

  • Moon, Tae-Yong;Lee, In-Sook;Lee, Jun-Woo;Choi, Kyung-Un;Kim, Jeung-Il;Kim, E. Edmund
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.1
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    • pp.1-7
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    • 2008
  • Purpose : To compare Multi Echo Data Image Combination (MEDIC) and fast SE T2-weighted images with fat saturation (T2FS) to suggest more accurate evaluation of the histologic components of soft-tissue tumors. Materials and Methods : The experimental group included 25 histologic tissues (5 vascular, 4 neural, 4 fibrous, 4 hypercellular, 2 hemorrhagic necroses, 2 cystic, 2 lipoid, 1 myxoid stroma, and 1 thrombus) in 10 patients who had pathologically confirmed schwannoma (n = 3), hemangioma (n = 2), lipoma (n = 1), angiokeratoma (n = 1), synovial sarcoma (n = 1), liposarcoma (n = 1), and malignant fibrous histiocytoma (n = 1). The inhomogeneity values were measured using the standard deviation value (SD) divided by the mean value as SD presents an error amount similar to that of imaging heterogeneity. Results : The inhomogeneity values of 25 histologic components were lower on MEDIC than those on T2FS (p < .001). Conclusion : We conclude that MEDIC is more accurate than T2FS for evaluating the tissue components of soft-tissue tumors using digitalized data because MEDIC images have far lower inhomogeneity.

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The measurement of nose dimensions through the three-dimensional reformation images after nasal bone fracture

  • Jang, Seung Bin;Han, Dong Gil
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.31-36
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    • 2019
  • Background: After closed reduction, patients are sometimes concerned that their external nasal shapes have changed. The aim of this study was to investigate and explain changes in nasal shape after surgery through objective photogrammetric anthropometry measurements taken through three-dimensional (3D) reformed computed tomography (CT) images. Methods: Our study included 100 Korean patients who underwent closed reduction of isolated nasal bone fracture from January 2016 to June 2017. Using the ruler tool in Adobe Photoshop CS3, we measured preoperative and postoperative nasal base heights, long nostril axis lengths, both nasal alar angles, and amount of nasal deviation through the 3D reformation of soft tissue via CT scans. We then compared the dimension of nose. Results: The amount of postoperative correction for nasal base height was 1.192 mm. The differences in nostril length between each side were found to be 0.333 mm preoperatively and 0.323 mm postoperatively. The differences in the nasal alar angle between each side was $1.382^{\circ}$ preoperatively and $1.043^{\circ}$ postoperatively. The amount of nasal deviation was found to be 5.248 mm preoperatively and 1.024 mm in postoperatively. Conclusion: After the reduction of nasal bone fractures, changes in nasal dimensions were noticeable in terms of nasal deviation but less significant in nasal tips, except for changes in nasal alar angles, which were notable.

A LONGITUDINAL ROENTGENO-CEPHALOMETRIC STUDY ON THE INTERMAXILLARY SPACE OF NORMAL KOREAN CHILDREN AGED FROM 6 TO 11 YEARS (두부방사선 계측사진에 의한 6세에서 11세 사이의 악간 공간에 관한 누년적 연구)

  • Ryu, Young-Kyu
    • The korean journal of orthodontics
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    • v.15 no.1
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    • pp.141-148
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    • 1985
  • It has been a long time since the cephalometrics was introduced to orthodontic field for diagnosis and treatment planning, but it's main concern was limited to hard, skeletodental tissue. It is well known that perioral and facial soft tissue determine the position of individual teeth and that the abnormality in size and shape of the soft tissue are able to cause malformed occlusion. Because of our lack of knowledge about resultant morphologic changes in the relationship between skeletal pattern and specific pattern of lingual and facial muscles, we can't help setting greater value on only abnormalities of teeth in the skeletal interrelationship. In a point of view that the orthodontist is dealing primarily with muscular structures around the dentition, the tongue, lips, and cheeks, therefore it may be desirable to estimate these structure and their potential influence on the dentition on developmental and time base. The author hit upon on idea of the aspect above, so studied on the intermaxillary space and tongue space and this study used the data from cephalometric films of 33 male and 40 female subject aged from 6 to 11 years of normal Korean children following results were obtained: 1. Means and standard deviation of Korean children were obtained. 2. Yearly increment of each variables were obtained. 3. There is the correlationship more than average among the variables except posterior intermaxillary height item. 4. There are differences between male children and female children in all variables except posterior intermaxillary space item. 5. All variables increased as the age increased except posterior intermaxillary height item of male children.

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Abdominal-based adipocutaneous advancement flap for reconstructing inguinal defects with contraindications to standard reconstructive approaches: a simple and safe salvage reconstructive option

  • Schaffer, Clara;Haselbach, Daniel;Schiraldi, Luigi;Sorelius, Karl;Kalbermatten, Daniel F.;Raffoul, Wassim;di Summa, Pietro G.
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.395-403
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    • 2021
  • Background Groin wounds occurring after vascular surgical site infection, oncologic resection, or occasionally orthopedic surgery and trauma may represent a surgical challenge. Reconstruction of these defects by the usual workhorse flaps may be contraindicated following previous surgery and in patients with lower limb lymphedema or extreme morbidity. Methods This study included 15 consecutive patients presenting with inguinal wounds after vascular or general surgery that required debridement and soft tissue coverage. All cases had absolute or relative contraindications to conventional reconstructive techniques, including a compromised deep femoral artery network, limb lymphedema, scarring of potential flap harvesting sites, or poor overall condition. Abdominal adipocutaneous excess enabled the performance of adipocutaneous advancement flaps in an abdominoplasty-like fashion. Immediate and long-term outcomes were analyzed. Results Soft tissue coverage was effective in all cases. Two patients required re-intervention due to flap-related complications (venous congestion and partial flap necrosis). All patients fully recovered over a mean±standard deviation follow-up of 2.4±1.5 years. Conclusions Abdominal flaps can be an effective and simple alternative technique for inguinal coverage with reproducible outcomes. In our experience, the main indications are a compromised deep femoral artery network and poor thigh tissue quality. Relative contraindications, such as previous open abdominal surgery, should be considered.

A LATERAL CEPHALOMETRIC ANALYSIS OF MIDFACE FOCUSING ON ZYGOMATIC BONE IN KOREAN ADULTS (정상 한국인 성인 남녀에서 협골을 중심으로 한 중안모의 측모 두부방사선 규격사진 분석법)

  • Lee, Eui-Hoon;Chung, In-Kyo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.4
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    • pp.353-359
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    • 1999
  • Purpose : A new method of lateral cephalometric analysis for midface, focusing on zygomatic bone, was created in this study, and measured in Korean adults. The purposes of this study are understanding about new approach for midfacial depression, especially zygomatic bone, and using to make adequate diagnosis and treatment plan. Materials and methods : In this study, esthetic Korean adults, 25 males and 25 females who were between $0^{\circ}$ and $4^{\circ}$ in ${\angle}ANB$, and between 62% and 70% in P/A facial height ratio, and had normal overbite and overjet, were used. Orbitale(Or) and Soft tissue orbitale(Or') were used for indicators of anteroposterior position of zygomatic area. And, mean value and standard deviation of linear and angular measurements, and ratio about each linear measurements, were obtained. then, standard deviation diagram - wiggle diagram - was made for visualization of results. Results : Mean values, standard deviations and ranges of 19 measurements were obtained, and among them, 5 linear measurements that had large standard deviation were excluded and the others were used for making standard deviation diagram. In standard deviation diagram, the following results were obtained. 1. If the measurements are located on more left side of mean-value-vertical -line, the potential of midfacial hypoplasia are stronger, especially zygomatic area. 2. If the measurements are located on more right side of mean-value-vertical-line, the potential of midfacial hypoplasia are decreased. Conclusion : This study presented a new method of lateral cephalometric analysis focusing on zygomatic bone in Korean adults. We expect that the results of this study can be used as parameter when clinicians make decisions about diagnosis and treatment plan for rehabilitation of esthetics and function. But, it is necessary to prove its usefulness, and to further evaluate the results.

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Diagnosis and Pathophysiology of Hallux Valgus (무지 외반증의 진단 및 병태생리)

  • Jang, Kyu-Sun;Kim, Tae Wan;Kim, Hak Jun
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.43-47
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    • 2014
  • Hallux valgus is a lateral deviation of the first phalanx and medial deviation of the first metatarsal at the first metatarsophalangeal (MP) joint. Its incidence has increased due to developing footwear. The etiologies include fashion footwear, genetic causes, anatomical abnormality around the foot, rheumatoid arthritis, and neuromuscular disorders. Physiologic alignment of the first MP joint is maintained by congruent and symmetric alignment of the articular surface of the first proximal phalanx and first metatarsal head, physiologic relationship of the distal first metatarsal articular surface and the first metatarsal shaft axis, and stable balance of soft tissue around the first MP joint and stable tarsometatarsal joint. Several factors have been associated with hallux valgus, including pes planus, hypermobility of the first tarsometatarsal joint, flattened shape of the first metatarsal head, increased distal metatarsal articular angle, and deformation of the medial capsular integrity. History and physical examination are very important to diagnosis of hallux valgus. Simple radiography provides information on deformity, particularly in weight-bearing anteroposterior and lateral radiographs. Understanding the etiologies and pathophysiology is very important for success in treatment of patients with hallux valgus.