• The korean journal of orthodontics
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• v.43 no.3
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• pp.113-119
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• 2013

Objective: To compare three-dimensionally the midfacial hard- and soft-tissue asymmetries between the affected and the unaffected sides and determine the relationship between the hard tissue and the overlying soft tissue in patients with nonsyndromic complete unilateral cleft lip and palate (UCLP) by cone-beam computed tomography (CBCT) analysis. Methods: The maxillofacial regions of 26 adults (18 men, 8 women) with nonsyndromic UCLP were scanned by CBCT and reconstructed by three-dimensional dental imaging. The frontal-view midfacial analysis was based on a $3{\times}3$ grid of vertical and horizontal lines and their intersecting points. Two additional points were used for assessing the dentoalveolar area. Linear and surface measurements from three reference planes (Basion-perpendicular, midsagittal reference, and Frankfurt horizontal planes) to the intersecting points were used to evaluate the anteroposterior, transverse, and vertical asymmetries as well as convexity or concavity. Results: Anteroposteriorly, the soft tissue in the nasolabial and dentoalveolar regions was significantly thicker and positioned more anteriorly on the affected side than on the unaffected side (p < 0.05). The hard tissue in the dentoalveolar region was significantly retruded on the affected side compared with the unaffected side (p < 0.05). The other midfacial regions showed no significant differences. Conclusions: With the exception of the nasolabial and dentoalveolar regions, no distinctive midfacial hard- and soft-tissue asymmetries exist between the affected and the unaffected sides in patients with nonsyndromic UCLP.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.759-764
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• 2007

Purpose: Various types of flaps, with their own advantages and disadvantages, have been described for reconstruction of soft tissue defect with exposure of tendons, bones, or joints in the hand or foot. Local flaps with random vascularity have a limitation by their length. Free flaps are time-consuming procedure that may require the sacrifice of some major vessels. The ideal flap for covering soft tissue defects of the hand or foot must provide subcutaneous tissue that tendons can glide through which, supply enough subcutaneous tissue for cover of vital neural, bony, vascular and joint structures, and it has to be aesthetically pleasing. The adipofascial flap fulfills these criteria. It allows immediate or early closure of difficult wound of hand and foot in an easy way, and is especially indicated for small to medium-sized defects. Methods: From October 2005 to December 2006, seven cases underwent this procedure to reconstruct soft tissue defect on hand or foot. Results: All flaps survived completely, and no complications were observed. Conclusion: The adipofascial flap is a convenient flap for coverage of soft tissue with exposure of vital structure in the hand or foot, and provide several advantages, as following; easy and safe, short operating time, one stage procedure, thinness and good pliability of the flap, preservation of the major vascular pedicles, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar.

• Proceedings of the KSME Conference
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• 2007.05a
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• pp.372-377
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• 2007

For more than 2,500 years, surgical teaching has been based on the so called "see one, do one, teach one" paradigm, in which the surgical trainee learns by operating on patients under close supervision of peers and superiors. However, higher demands on the quality of patient care and rising malpractice costs have made it increasingly risky to train on patients. Minimally invasive surgery, in particular, has made it more difficult for an instructor to demonstrate the required manual skills. It has been recognized that, similar to flight simulators for pilots, virtual reality (VR) based surgical simulators promise a safer and more comprehensive way to train manual skills of medical personnel in general and surgeons in particular. One of the major challenges in the development of VR-based surgical trainers is the real-time and realistic simulation of interactions between surgical instruments and biological tissues. It involves multi-disciplinary research areas including soft tissue mechanical behavior, tool-tissue contact mechanics, computer haptics, computer graphics and robotics integrated into VR-based training systems. The research described in this paper addresses the problem of characterizing soft tissue properties for medical virtual environments. A system to measure in vivo mechanical properties of soft tissues was designed, and eleven sets of animal experiments were performed to measure in vivo and in vitro biomechanical properties of porcine intra-abdominal organs. Viscoelastic tissue parameters were then extracted by matching finite element model predictions with the empirical data. Finally, the tissue parameters were combined with geometric organ models segmented from the Visible Human Dataset and integrated into a minimally invasive surgical simulation system consisting of haptic interface devices and a graphic display.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.24 no.1
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• pp.13-24
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• 2015

With the development of treatment of hard and soft tissue around the implants, the implant restoration is increasingly used in the maxillary anterior region which is very important aesthetically. However, the aesthetic reconstruction of the maxillary anterior region is still challenged. Three following conditions should be fully satisfied for aesthetic prosthesis restoration; reconstruction of hard tissue, soft tissue and harmonic prosthesis. In this case report, hard and soft tissue augmentations were performed at atrophied maxillary incisor. Additionally, customized impression coping and provisional restoration were used to make the final restoration.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.3
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• pp.241-251
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• 1991

During the condylar shaving procedure, the articular soft tissue cover can be removed. Author compaired the histological healing process of the articular soft tissue cover between the preservative and unpreservative group group with 45 New Zealand rabbits(Average wt. : about 2.5kg). In unpreservative group, the usual high condylar shave with the removal of soft tissue cover was performed. In the preservative group, the underlying bone, replaced in its original position and sutured. The animals were sacrified 1, 2, 3, 4, 6 weeks interval after operation. The specimens were fixed in 10% neutral formalin and decalcified, paraffin embedded and stained by Hematoxylin & Eosin, and Masson's trichrome. The obtained results were as follows. 1. The condyles of the both group were covered with an articular sop tissue layer. 2. The cartilage cells in subarticular layer has regular continuous patterns in the preservative group but frequently interrupted in the unpreservative group. 3. The incision made in the posterior part of the articular surface for the elevation of the articular soft tissue frequently caused a deformity such as the interruption of the subarticular layer of cartilage. 4. By the above findings, the preservation of articular sop tissue cover may be the effective operation method on concept of bone remodelling.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.21-26
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• 2006

Considering the skeletal class III malocclusion that complains of mandibular prognathism, there have been some studies of the mandibular change for comparing the changes of pre operative with post operative state. Nowadays it is common to do the orthognathic 2-jaw surgery for the correction of the maxillary deficiency, the post operative stability and the esthetics. We compare and analyze the changes of soft tissue around the nose and the lip with the changes in the direction and the amount of maxilla. Patients who were diagnosed as maxillofacial deformity and received orthognathic surgery of both jaws at Yongdong Severance hospital from 2001 through 2003 were included in this study. Their lateral cephalograms were analyzed, and the post operative change of hard tissue and soft tissue were studied. Upon analyzing the preoperative cephalograms and 6 month post operative cephalograms, there were significant in the vertical change of Labialis superius(Ls) and Stomion(Stm) in soft tissue in relation to the vertical change of skeletal landmarks (Anterior Nasal Spine, Subspinale, Prosthion, Incision Superious). In addition, there were no significance in horizontal movement of the skeletal landmarks among groups. In terms of hard tissue landmarks, group 3(maxillary posterior impaction and advancement surgery group) showed significantly greater change in the vertical movement of Anterior Nasal Spine(ANS), Subspinale(A), Prosthion(Pr), and Incision Superious(Is) compared with other groups. In terms of soft tissue change, group 3 showed more significant change in the vertical movement of Ls and Stm. This study calculated the changes of the skeletal and soft tissue landmarks in order to act as a guide in planning and performing the surgery and as a reference in predicting the postoperative change of facial appearance.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.86-92
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• 2001

Failure of replantation is inevitable in finger replantation surgery, around 10% of failure rate are reported in many authors. Management of the failed finger replantation is one of big dilemma to microsurgeons. We report 5 cases of thumb reconstruction after failure of replantation. The reconstructive surgery composed with early debridement of soft tissue that are under gangrenous processing, extract the phalangeal bone without any soft tissues. Osteosynthesis of the extracted phalangeal bone with host phalangeal bone. The exposed bony portion covered with vascularized flaps such as revered radial forearm pedicled flap, free radial forearm flap and neurovascular island finger flap. This procedure underwent within a week after vascular insufficiency developed. All of the flaps are survived, bone union achieved within 3 months. The function and external appearance of the reconstructed thumb were encouraging; Pinch Power was average 1.2 Pounds. Early removal of necrotizing soft tissue followed by covering none vascular phalangeal bone which extracted from the dead phalanx with vascularized flap is one of the useful alterative solutions in failed replantation surgery in hand.

• The korean journal of orthodontics
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• v.4 no.1
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• pp.21-29
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• 1974

The purpose of the present study is to evaluate changes of the soft tissue relative to underlying skeletal elements during orthodontic treatment, and the influence of orthodontic treatment quantitatively on various regions of the facial profile. 59 Korean young women were selected, whose Hellman dental age was IV A, IV C and V A. Lateral cephalometric head films were taken before and after orthodontic treatment. From tracings, landmarks on skeletal and soft tissue profile were located, and then their linear and angular measurements were made directly. The results were obtained as follow: 1) Soft tissues of the facial profile were closely related and dependent on the underlying dentoskeletal frameworks. Orthodontic treament resulted in the reduction of dentofacial protrusion with both upper and lower lips becoming less procumbent during treament. 2) Thickness of the upper lip increased considerably during orthodontic treatment, and this change was related to maxillary incisor retraction. The ratio between the amount of maxillary incisor retraction and that of increment of upper lip thickness was approximately 5:3. 3) Soft tissue thickness overlying Downs' point A, point B and pogonion was not modified by orthodontic treatment. 4) Holdaway's H line, relating facial profile to the underlying dentoskeletal framework, seemed to be the most practical approach to soft tissue analysis.

• Journal of Periodontal and Implant Science
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• v.48 no.3
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• pp.152-163
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• 2018

Purpose: To determine whether the swelling and mechanical properties of osmotic self-inflating expanders allow or not the induction of intraoral soft tissue expansion in dogs. Methods: Three different volumes (0.15, 0.25, and 0.42 mL; referred to respectively as the S, M, and L groups) of soft tissue expanders (STEs) consisting of a hydrogel core coated with a silicone-perforated membrane were investigated in vitro to assess their swelling behavior (volume swelling ratio) and mechanical properties (tensile strength, tensile strain). For in vivo investigations, the STEs were subperiosteally inserted for 4 weeks in dogs (n=5). Soft tissue expansion was clinically monitored. Histological analyses included the examination of alveolar bone underneath the expanders and thickness measurements of the surrounding fibrous capsule. Results: The volume swelling ratio of all STEs did not exceed 5.2. In tensile mode, the highest mean strain was registered for the L group ($98.03{\pm}0.3g/cm$), whereas the lowest mean value was obtained in the S group ($81.3{\pm}0.1g/cm$), which was a statistically significant difference (P<0.05). In addition, the S and L groups were significantly different in terms of tensile strength ($1.5{\pm}0.1g/cm$ for the S group and $2.2{\pm}0.1g/cm$ for the L group, P<0.05). Clinical monitoring showed successful dilatation of the soft tissues without signs of inflammation up to 28 days. The STEs remained volumetrically stable, with a mean diameter in vivo of 6.98 mm, close to the in vitro post-expansion findings (6.69 mm). Significant histological effects included highly vascularized collagen-rich fibrous encapsulation of the STEs, with a mean thickness of $0.67{\pm}0.12mm$. The bone reaction consisted of resorption underneath the STEs, while apposition was observed at their edges. Conclusions: The swelling and mechanical properties of the STEs enabled clinically successful soft tissue expansion. A tissue reaction consisting of fibrous capsule formation and bone loss were the main histological events.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.94-99
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• 2010

The purpose of this study was to examine the soft tissue changes in skeletal class II patients after mandibular advancement by bilateral sagittal split ramus osteotomy (BSSRO). In Asian population, the incidence of skeletal class II malocclusion is lower than that of skeletal class III malocclusion unlike the caucasians. This study was conducted to figure out the ratio at which hard tissue and soft tissue changes after mandibular advancement by analyzing cephalograms of 13 patients that have undergone the mandibular advancement surgery. As a result, change ratios of Li, B', Pog' according to the movement of li, B, Pog were found to be 0.59, 1.06, 0.82. Also, vertical height of vermilion zone (Si-Vb) and lower lip and chin (Si-Me') were measured to evaluate vertical changes. Vermilion zone showed tendency to decrease by 1.02 mm on the average postoperatively, whereas vertical length of lower lip and chin showed tendency to increase by 3.57 mm on the average.