• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.2
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• pp.91-96
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• 1998

Surgical resection of tumors in the maxillofacial region sometimes results in extended defects of soft and hard tissue that frequently causes aesthetic, functional and especially mental damages. It is essential for patients with such facial defects to reduce the scar and maxillofacial asymmetry. To attain esthetic facial appearance after hemimaxillectomy, we devise a new design, so called 'IOIO Incision' (InfraOrbital-IntraOral incision). The new approach is established on infraorbital region to expose maxillofacial skeleton in aspect of face. And the other incision is designed on intraoral region. The IOIO incision provide excellent aesthetic result after hemimaxillectomy, because of reduced minimal facial scar contraction. Maxillofacial surgeons are used to designing Weber-Fergusson incision in resection of maxillofacial tumors, but disadvantages of the incision were large scar and asymmetry of face. To improve theses problem, we attempted IOIO Incision.. For correct osteotomy of posterolateral wall of maxillary sinus, 1. Fenestra formation on zygomatic body for easily access of reciprocating saw to posterolateral wall of maxillary sinus. 2. To achieve better visual field in posterolateral aspect of maxilla, fat tissue is removed from infratemporal fossa. This new, versatile procedure can be used for benign and malignant lesions of the maxillary area. We introduce cases with review of literatures.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.43-51
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• 2022

Purpose: The aim of this study was to evaluate the reliability of the Vectra M3 (3D Imaging System; Canfield Scientific, Parsippany, NJ, USA) in detecting chin asymmetry, and to assess whether the automatic markerless tracking function is reliable compared to manually plotting landmarks. Materials and Methods: Twenty subjects (18 females and 2 males) with a mean age of 42.5±10.5 years were included. Three-dimensional image acquisition was carried out on all subjects with simulated chin deviation in 4 stages (1-4 mm). The images were analyzed by 2 independent observers through manually plotting landmarks and by Vectra software auto-tracking mode. Repeated-measures analysis of variance and the Tukey post-hoc test were performed to evaluate the differences in mean measurements between the 2 operators and the software for measuring chin deviation in 4 stages. The intraclass correlation coefficient (ICC) was calculated to estimate the intra- and inter-examiner reliability. Results: No significant difference was found between the accuracy of manually plotting landmarks between observers 1 and 2 and the auto-tracking mode (P=0.783 and P=0.999, respectively). The mean difference in detecting the degree of deviation according to the stage was <0.5 mm for all landmarks. Conclusion: The auto-tracking mode could be considered as reliable as manually plotted landmarks in detecting small chin deviations with the Vectra^® M3. The effect on the soft tissue when constructing a known dental movement yielded a small overestimation of the soft tissue movement compared to the dental movement (mean value<0.5 mm), which can be considered clinically non-significant.

• Archives of Plastic Surgery
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• v.39 no.6
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• pp.659-662
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• 2012

Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive and self-limited deformation of the subcutaneous tissue volume on one side of the face that creates craniofacial asymmetry. We present the case of a patient with a five-year history of progressive right facial hemiatrophy, who underwent facial volumetric restoration using cell-assisted lipotransfer (CAL), which consists of an autologous fat graft enriched with adipose-derived stem cells (ASCs) extracted from the same patient. ASCs have the capacity to differentiate into adipocytes. They also promote angiogenesis, release angiogenic growth factors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissue atrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome. Currently, CAL has showed promising results in the long term by decreasing the rate of fat reabsorption. The permanence and stability of the graft in all the injected areas has showed that autologous fat grafts enriched with stem cells could be a promising technique for the correction of defects caused by this syndrome.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.6
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• pp.379-384
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• 2020

Objectives: We sought to identify a clinically useful method of analyzing orbital dystopia to aid in diagnosis and treatment planning and to quantify vertical discrepancies in eye level and variations in canthal tilt in Koreans. Patients and Methods: In 76 Korean patients with a mean age of 23.12 years, mean differences in the level of the pupils, lateral canthi, medial canthi, and canthal tilt were measured. The difference in pupil level was calculated from the perpendicular lines drawn from the midpupil area of each eye to the midline of the face to determine the amount of skeletal discrepancy of the eye. Soft tissue discrepancies were determined according to the vertical difference between the lines drawn from the lateral or medial canthus of each eye perpendicular to the midline of the face. The canthal tilt was determined from the inclination of a line connecting the lateral and medial canthi, then classified as class I, II, or III. Results: Mean differences in pupil level, medial canthi, and lateral canthi were 1.57±1.10 mm, 1.14±1.07 mm, and 2.03±1.64 mm, respectively. The mean degree of canthal tilt were 8.45°±3.53° for the right side and 8.42°±3.81° for the left side. No study participants presented with class III canthal tilt. The mean canthal tilt values for those with class I tilt were 3.21°±1.68° for the right side and 3.18°±1.63° for the left side, while, for those who had class II tilt, the values were 9.60°±3.66° for the right side and 9.54°±2.99° for the left side. Conclusion: The presented diagnostic method of orbital dystopia can be used to effectively establish a treatment plan that takes into consideration the patient's skeletal and soft-tissue discrepancies.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.3
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• pp.207-216
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• 1992

The congenital condition referred as hemifacial microsomia is characterized by underdevelopment, malformation or abscence of certain soft and hard tissue derivatives of the first and second branchial arches and open also of structures which are not derived from the branchial arches, such as the zygoma, temporal bone. This is a report about a 14 years old male patient with the chief complaint of severe facial asymmetry, who was diagnosed as hemifacial microsomia having agenesis of the right mandibular condyle and zygomatic arch. Deformities and rib bone graft on the affected mandibular condyle and body, and LeFort I osteotomy in the maxilla. To correct contour-deficient chin, we performed the genioplasty, and the zygomatic arch was reconstructed with rib bone graft.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.346-351
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• 2011

Purpose: The purpose of this study was to measure the angular differences between the horizontal reference planes on the CBCT generated PA cephalogram and the modified interpupillary plane, which was usually used in the clinical examination, and to evaluate the validity of the horizontal reference planes. Methods: The CBCT generated PA cephalogram was used to measure the angles between the FH, Lo and IP planes. The subjects consisted of 42 patients with facial asymmetry (males: 21, females: 21, mean-age: 21.6 years). The control groups were also assessed (males: 10, females: 10, mean-age: 23.8 years). The distance of the interpupil was measured on the soft-tissue volume rendered image. The angular differences were statistically analyzed using the $Mann-Whitney$ $U$ $test$ for inter-group comparisons and the $Friedman$ $test$ for intra-group comparisions. Results: The angle between the FH plane and IP plane (the angle of the FH-IP line) showed a statistically significant difference between the two groups ($p$ <0.05). There was no statistical differences between each angle (angle of the FH-IP line, angle of the FH-Lo line, angle of the Lo-IP line) on the intra-group comparision ($p$ >0.05). Conclusion: The angle between the Lo line and IP line (angle of the Lo-IP line) showed no statistically significant difference in both the control and asymmetry groups. Therefore, the Lo line could be used as a horizontal reference plane in CBCT generated PA cephalograms.

• The korean journal of orthodontics
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• v.26 no.5 s.58
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• pp.637-645
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• 1996

In non-growing Class III malocclusion, the critical aspects which determine the need of orthognatic surgery are the severity of skeletal discrepancy, incisor inclination, overbile and soft tissue profile. Two-jaw surgery is more effective in correcting severe sagittal, vertical, transverse skeletal discrepancies and facial asymmetry. And more esthetic and stable profile can be achieved by two-jaw surgery Some midfacial deficiency Patients can be treated by Pyramidal Le Fort II osteotomy to maintain infraorbital rim and malar complex and to advance nasomaxillary complex. Others who require advancement of infraorbital rim and malar complex can be treated by quadrangular Le Fort II osteotomy. On the following cases, patients who had represented midfacial deficiency and mandibular prognathism were treated with combined orthodontic-surgical therapy by Le Fort II osteotomy and BSSRO.

• The korean journal of orthodontics
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• v.27 no.4 s.63
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• pp.643-659
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• 1997

For the total treatment of skeletal malocclusions, 3-dimensional evaluation and diagnosis are essential. Although anteroposterior discrepancies can be evaluated through various methods, the satisfactory methods for evaluations of facial asymmetry and transverse discrepancies are yet to be found. The adequate diagnosis and treatment of transverse discrepancies may be more important in the maintenance of functional occlusion as well as for the stability of results obtained from orthognathic surgery than the anteroposterior or vertical discrepancies. Since the soft tissue effects from the transverse discrepancies may not be pronounced, especially when combined with anteroposterior or vertical discrepancies which have prominent characteristics, the differentiation of their effects may be difficult from visual inspection alone. Therefore it is essential that the normal facial proportions would be established from the posteroanterior cephalometry as a reference for the accurate diagnosis and treatment. The present study evaluates 76 subjects from Yonsei University freshmen with normal facial symmetry and occlusion. Posteroanterior cephalograms were taken from the subjects and the normal values and facial proportions are obtained. The results are as follows. 1. The transverse and vortical values from posteroanterior cephalometry and their ratio, with means and standard deviations are calculated. 2. The ratio of vertical values to transverse values is 0.837 (male 0.836, female 0.841). 3. The Proportion of maxillary and mandibular widths is 0.747 (male 0.745, female 0.752), with statistically significant correlation. 4. Various degree of significant correlations are observed in the following craniofacial widths; (Cranial width, Bizygomaticofrontal suture width, Facial width, Maxillary width, Upper & Lower Intermolar width, Mandibular width). 5. Although the facial height as well as other line measurements increase as the facial widths increase, angle measurement ($Bj\ddot{o}rk$ Sum, Mandibular Plane Angle, Gonial Angle), decreases and posterior to anterior facial height ratio increases, therefore indicating the tendency for a brachycephalic facial type. These results may be used as references for the treatment planning in orthognathic and orthodontic treatments for the dentofacial deformity patients.

• The korean journal of orthodontics
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• v.30 no.1 s.78
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• pp.43-52
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• 2000

Hemifacial microsomia ( HFM ) is the second most common craniofacial abnormalies. HFM represnted a spectrum of clinical findings such as hypoplasia of the mandibular ramus and condyle, confinement of maxilla growth, external and/or middle ear defects, involvement of some cranial suture, buccal soft tissue, facial nerve, and muscles in the affected side. HFM often showed progressive facial asymmetry and occlusal plane slanting to the affected side with growth. There were several reports about asymmetry of tooth maturation, hypodontia, delayed eruption, enamel hypoplasia in HFM. Since teeth develope in close association with size and morphology of the maxillary and the mandible, it is highly likely that dental changes will be present in HFM. So the Purpose of this study was to investigate the differences of the primary and the permanent teeth dimensions in the maxillary and the mandibular dentition between the affected and the non-affected side of HFM.. The sample of this study consisted of 34 unilateral HFM Patients (18 males and 16 females, average age : 5 year 11 months old). The authors examined the mesiodistal and the faciolingual dimensions of the primary and the permanent teeth and performed statistical study by using paired t-test. The results were as follows 1. The mesiodistal dimensions of the mandibular second primary molar and the mandibular first permanent molar in the affected side of HFM were significantly smaller than those of non-affected side. But there were no significant differences in the anterior teeth and the mandibular first primary molar. It means that a gradient of severity from anterior teeth to posterior teeth was found in the mandibular dentition. 2. Although there were no significant differences in the faciolingual dimensions of the primary and the permanent teeth in the maxillary and the mandibular dentition between the affected and non-affected side of HFM, there were general trend of compensatory increase in faciolingual dimension of the mandibular primary and the permanent teeth in the affected side Therefore these results showed that HFM might affect on the abnormality of tooth dimension, especially the most posterior teeth, in the affected side of the mandible.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.6
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• pp.544-558
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• 2006

Trismus is a common problem to most people experiencing at once in his or her life and to most dental practitioners experiencing frequently. It has a number of potential causes which are single factor or complex factors. Its treatment will depend on the cause. The purpose of this study was to discuss the causes of trismus condition and the various treatments available. This study was made by reviewing of collected data from 86 patients complained of trismus among patients who were diagnosed by TMD, tumor, infection including tetanus, soft tissue anomalies, bony fracture and ankylosis from Jan 2002 to Dec 2004 on department of oral and maxillofacial surgery at Pusan National University Hospital, South Korea. The clinical reviews regarding chief complaints, clinical characteristics, diagnostic examination, treatments and the results on the patients were given as follows. 1. The etiology of trismus commonly were derived from temporomandibular joint(TMJ) disorder, TMJ ankylosis, TMJ tumor, odontogenic maxillofacial infection, mandibular condylar fracture, tetanus. 2. The chief complaints of trismus patients were progressive mouth opening limitation, TMJ pain, malocclusion, facial asymmetry, retrognathic state. 3. Especially, for the differential diagnosis between the fibrous ankylosis and true bony ankylosis, computed tomogram (CT) was useful. Surgical gap arthroplasty on bony ankylosis patients was applied and the gain of mouth opening after operation was average 35.8 mm during 19 months. 4. The tetanus, rarely, also induced the trismus with the range of mouth opening less than 10 mm. The average serum level of tetanus anti-toxin was 0.02-0.04 IU/mL. The limitation of mouth opening was improved into average 38 mm on 4 weeks after injection of 10,000 units of tetanus immune globulin. 5. In the treatment of osteochondroma, TMD, odontogenic infection and fracture, and the others inducing trismus, to obtian the maximum result and decreased inadequate time and effort, it is important to finding the causes from the exact clinical examination and diagnosis.