• Title/Summary/Keyword: Symphysis

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Reports of mandibular symphysis widening with distraction osteogenesis (견인 골 신장술을 이용한 하악 정중부 확대 치험례)

  • Tae, Ki-Chul;Oh, Sung-Whan;Min, Sung-Ki
    • The korean journal of orthodontics
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    • v.31 no.5 s.88
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    • pp.499-504
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    • 2001
  • Transverse skeletal deficiency is a common clincal problem associated with narrow basal and dentoalveolar bone. The clinical characteristics of transverse deficiency presents with anterior crowding and posterior buccal crossbite. Orthodontic expansion, using lip bumper and functional devices, was recommanded for younger ages. However, expansion of lower anterior area in older Patients is unstable and tends to relapse toward the original dimension. Distraction osteogenesis is a unique form of clincal tissue engineering and biologic process of new bone formation between bone segments that are gradually separately by incremental traction. Distraction osteogenesis was considered that great potential for correcting transverse mandibular deficiencies. In this Paper, a case of treated transverse deficiency patients with distraction osteogenesis using tooth-borne and tooth & bone-borne distractor is presented.

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The genial tubercle: A prospective novel landmark for the diagnosis of mandibular asymmetry

  • Lee, Seung-Youp;Choi, Dong-Soon;Jang, Insan;Song, Geun-Su;Cha, Bong-Kuen
    • The korean journal of orthodontics
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    • v.47 no.1
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    • pp.50-58
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    • 2017
  • Introduction: Identifying menton (Me) on posteroanterior cephalograms and three-dimensional (3D) cone-beam computed tomography (CBCT) images is difficult, because the midpoint of the symphyseal area is not identifiable after the mandibular symphysis fuses at an early age. The aim of this study was to evaluate the reliability of the identification of the genial tubercle (GT) in patients with mandibular asymmetry and to compare it with that of the traditional landmark, Me. Methods: The samples comprised 20 CBCT images of adults with mandibular asymmetry. Two examiners performed the identifications and measurements. Me and GT were marked, and the anteroposterior, vertical, and transverse distances to the three reference planes were measured on 3D-reconstructed CBCT images. The intra- and inter-examiner reliability of landmark identification of Me and GT were assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots. Results: The Me and GT landmarks showed excellent reliability ($ICC{\geq}0.993$) three-dimensionally. In the transverse evaluation, the ICC values of the GT (range, 0.997-0.999) tended to be slightly higher than those of Me (range, 0.993-0.996). In the Bland-Altman plots for the two separate assessments, Me showed a maximum error of 1.76 mm in the transverse direction, whereas the GT showed a maximum error of 0.96 mm in the 95% limit. Conclusions: Our results suggest that both Me and GT are clinically reliable and equally useful landmarks for the evaluation of mandibular asymmetry on CBCT images.

THE CLINICAL STUDY FOR AVAILABLE VOLUME OF ANTERIOR PART OF ASCENDING RAMUS AS A DONOR SITE IN ORAL AND MAXILLOFACIAL REGION (공여부로서의 하악 상행지 전방부의 가용 용적에 관한 임상적 연구)

  • Jung, Sung-Uk;Lee, Eui-Seok;Yun, Jung-Ju;Lee, Sung-Jae;Jang, Hyun-Seok;Kwon, Jong-Jin;Rim, Jae-Suk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.2
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    • pp.130-136
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    • 2005
  • Bone grafts are widely used in the reconstruction of osseous defects in the oral and maxillofacial region. Autogenous bone grafts are considered the gold standard in grafting of the oral and maxillofacial region, because of its osteoconductive and osteoinductive properties. Mandibular symphysis & ascending ramus bone graft have been used more frequently because of easy surgical access, reduced operative time, and following minimal morbidity. However, even though the frequent use of the anterior part of ascending ramus and the different regions of mandible, rare of the reports provide information about the quantity of bone available in this donor site. So this study was taken to evaluate & quantify the amount of bone graft material in the anterior ascending ramus regions. This study was made on 36 samples of CT image. In 3D volume image, imaginary osteotomy & segmentation were done and the dimensions and volume of the bone grafts were measured and evaluated. the average volume of the graft materials obtained from the ascending ramus was $3656.83{\pm}108.19mm^3$, and the average dimensions of graft materials were $(33.68{\pm}0.48){\times}(34.92{\pm}0.51){\times}(15.96{\pm}0.27){\times}(9.05{\pm}0.27)mm$.

Radiographic evaluation of the symphysis menti as a donor site for an autologous bone graft in pre-implant surgery

  • Bari, Roberto Di;Coronelli, Roberto;Cicconetti, Andrea
    • Imaging Science in Dentistry
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    • v.43 no.3
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    • pp.135-143
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    • 2013
  • Purpose: This study was performed to obtain a quantitative evaluation of the cortical and cancellous bone graft harvestable from the mental and canine regions, and to evaluate the cortical vestibular thickness. Materials and Methods: This study collected cone-beam computed tomographic (CBCT) images of 100 Italian patients. The limits of the mental region were established: 5 mm in front of the medial margin of each mental foramen, 5 mm under the apex of each tooth present, and above the inferior mandibular cortex. Cortical and cancellous bone volumes were evaluated using SimPlant software (SimPlant 3-D Pro, Materialize, Leuven, Belgium) tools. In addition, the cortical vestibular thickness (minimal and maximal values) was evaluated in 3 cross-sections corresponding to the right canine tooth (3R), the median section (M), and the left canine tooth (3L). Results: The cortical volume was $0.71{\pm}0.23mL$ (0.27-1.96 mL) and the cancellous volume was $2.16{\pm}0.76mL$ (0.86-6.28 mL). The minimal cortical vestibular thickness was $1.54{\pm}0.41mm$ (0.61-3.25 mm), and the maximal cortical vestibular thickness was $3.14{\pm}0.75mm$ (1.01-5.83 mm). Conclusion: The use of the imaging software allowed a patient-specific assessment of mental and canine region bone availability. The proposed evaluation method might help the surgeon in the selection of the donor site by the comparison between bone availability in the donor site and the reconstructive exigency of the recipient site.

The Superficial Inferior Epigastric Artery Flap and its Relevant Vascular Anatomy in Korean Women

  • Kim, Byung Jun;Choi, Jun Ho;Kim, Tae Hoon;Jin, Ung Sik;Minn, Kyung Won;Chang, Hak
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.702-708
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    • 2014
  • Background Lower abdominal soft tissue transfer is the standard procedure for breast reconstruction. However, abdominal wall weakness and herniation commonly occur postoperatively at the donor site. To reduce the morbidities of the donor site, the superficial inferior epigastric artery (SIEA) flap was introduced, but inconsistent anatomy of the SIEA has reduced its utility. In the present study, the anatomy of the superficial inferior epigastric vessels in Korean women was determined with regards to breast reconstructive surgery. Methods The vascular anatomies of the SIEA and superficial inferior epigastric vein (SIEV) were evaluated on 32 breast cancer patients receiving free transverse rectus abdominis musculocutaneous flap reconstruction after mastectomy. The existence, pulsation, location, external diameter, and depth of the SIEA and SIEV were measured at the lower abdominal incision level. Results SIEA and SIEV were present in 48/64 (75.00%) and 63/64 (98.44%) hemi-abdomens, respectively. Pulsation of the SIEA was found in 44/48 (91.67%) cases. The mean locations of SIEA and SIEV were +5.79 (${\pm}12.87$) mm, and -8.14 (${\pm}15.24$) mm from the midpoint between the anterior superior iliac spine and symphysis pubis, respectively. The mean external diameters of SIEA and SIEV were 1.20 (${\pm}0.39$) mm and 1.37 (${\pm}0.33$) mm, and they were found at a mean depth of 9.75 (${\pm}2.67$) mm and 8.33 (${\pm}2.65$) mm, respectively. Conclusions The SIEA was absent in 25% of Korean women and had a relatively small caliber. Therefore, careful preoperative assessment of the lower abdominal vasculature is required to achieve successful breast reconstruction using SIEA flaps.

Comparison of postoperative changes in the distal and proximal segments between conventional and sliding mini-plate fixation following mandibular setback

  • Kim, Seong-Sik;Kwak, Kyoung-Ho;Ko, Ching-Chang;Park, Soo-Byung;Son, Woo-Sung;Kim, Yong-Il
    • The korean journal of orthodontics
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    • v.46 no.6
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    • pp.372-378
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    • 2016
  • Objective: The purpose of the present study was to evaluate the postoperative three-dimensional (3D) changes in the proximal segments after mandibular setback sagittal split ramus osteotomy and to compare the changes between the conventional mini-plate fixation and semi-rigid sliding plate fixation. Methods: Cone-beam computed tomography (CBCT) images were used to evaluate the postoperative 3D changes in the proximal segments during the healing process. CBCT images were superimposed using the symphysis and the lower anterior mandible as references. Results: There were no statistically significant differences between the conventional mini-plate and semi-rigid sliding plate groups (p > 0.05). With respect to the distribution of changes greater than 2 mm in the landmarks, the right condylion, right coronoid process, and left condylion showed ratios of 55.6%, 50.0%, and 44.4%, respectively, in the semi-rigid sliding plate group; however, none of the landmarks showed ratios greater than 30% in the conventional mini-plate group. Conclusions: There were no statistically significant differences in postoperative changes in the segments between the conventional mini-plate and semi-rigid sliding plate groups. Nevertheless, while selecting the type of fixation technique, clinicians should consider that landmarks with greater than 2 mm changes were higher in the semi-rigid sliding plate group than in the conventional mini-plate group.

A CLINICAL STUDY ON FACIAL BONE FRACTURE (악안면 손상에 관한 임상적 연구)

  • Jang, Ki-Young;Shin, Mi-Jeung;Kim, Do-Gyeun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.379-388
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    • 1995
  • This study was based on a series of 369 patients with Oral and Maxillofacial injuries treated at Kumi Hospital, College of Medicine, Soon-Chun-Hyang University from Jan. 1992 to Dec. 1994. The results obtained were as follows : 1. The number of male patient was 310 and that of female was 59, leading to 5.3 : 1 of male-female ratio, and the 3rd decade was the highest age group in incidence. 2. Weekly incidence was the highest in Sun. & Sat. and monthly incidence was the highest in Nov.& Oct. 3. Causes as follows : traffic accident 41.9%, slip& fall down 25.4%, human trouble 16.5%, industrial accident 7.5%, sports 6.7%, etc. 4. Site distribution as follows : mandible fracture 32.3%, maxilla fracture 4.8%, zygoma fracture 21.4%, nasal bone fracture 34.1%, orbital& ethmoidal fracture 4.6%. 5. The most common site of mandible was symphysis & angle, and the ratio of OR & CR was 1.3 : 1. 6. The most common site of maxilla was Le Fort 1, 2, and the ratio of OR & CR was 3 : 1. 7. The most common site of zygoma was body, the ratio of OR & CR was 3.3 : 1. 8 . The mean period of intermaxillary fixation was 4.33weeks. 9. Combined injury in facial fracture was 35.8% : The facial fracture were most frequently combind with head & neck(47.0%), upper extremities and abdomen(9.8%). 10. The mean elapsed time from injury to hospital was 1.9days, and that to operation was 5.1days. 11. The mean number of combined teeth injury was 0.6, and percent of combined soft tissue injury of face was 51.3%. 12. Post-operative complication occurred in 4 out of 323 cases. all of that was infection.

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Anatomical Review of Rectus Abdominis Muscle Free Flap for the Oral and Maxillofacial Reconstruction (구강악안면재건을 위한 복직근 유리피판의 해부학적 고찰)

  • Park, Jung Min;Seo, Mi Hyun;Kim, Soung Min;Kang, Ji Young;Myoung, Hoon;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.367-375
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    • 2012
  • Midfacial reconstruction following resection of extensive malignant oral cavity tumors constitutes a challenging problems for reconstructive surgeons. Rectus abdominis muscle free flap (RAMFF) can be considered as the optimal reconstructive option in this case, because this flap has some advantages including consistent deep inferior epigastric artery anatomy, easy to dissect with well defined skin boundaries, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with oral cancer ablation surgery. The rectus abdominis muscle forms an important part of the anterior abdominal wall and flexes the vertebral column, which is a long strap-like muscle divided transversely by three tendinous intersections, fibrous bands which are adherent to the anterior rectus sheath, which is thickly enclosed by the rectus sheath, except for the posterior part below the arcuate line that is usually located midway between the umbilicus and symphysis pubis. Below the arcuate line, this muscle lies in direct contact with the transversalis fascia and parietal peritoneum. For the better understanding of RAMFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings muse be learned and memorized by the young doctors in the course of the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article will discuss the anatomical basis of RAMFF with Korean language.

Predictors of favorable soft tissue profile outcomes following Class II Twin-block treatment

  • Kim, Ji-Eun;Mah, Su-Jung;Kim, Tae-Woo;Kim, Su-Jung;Park, Ki-Ho;Kang, Yoon-Goo
    • The korean journal of orthodontics
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    • v.48 no.1
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    • pp.11-22
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    • 2018
  • Objective: The aim of this study was to determine cephalometric factors that help predict favorable soft-tissue profile outcomes following treatment with the Class II Twin-block appliance. Methods: Pre- and post-treatment lateral cephalograms of 45 patients treated with the Class II Twin-block appliance were retrospectively analyzed. Profile silhouettes were drawn from the cephalograms and evaluated by three orthodontists in order to determine the extent of improvement. Samples were divided into a favorable group (upper 30% of visual analogue scale [VAS] scores, n = 14) and an unfavorable group (lower 30% of VAS scores, n = 14). Skeletal and soft-tissue measurements were performed on the cephalograms and an intergroup comparison was conducted. Results: An independent t-test revealed that the following pre-treatment values were lower in the favorable group compared to the unfavorable group: lower incisor to mandibular plane angle, lower incisor to pogonion distance, point A-nasion-point B angle, sella-nasion line (SN) to maxillary plane angle, SN to mandibular plane angle, gonial angle, and symphysis inclination. The favorable group had a larger incisor inclination to occlusal plane. Moreover, the favorable group showed larger post-treatment changes in gonial angle, B point projection, and pogonion projection than did the unfavorable group. Conclusions: Class II malocclusion patients with a low divergent skeletal pattern and reduced lower incisor protrusions are likely to show more improvement in soft-tissue profile outcomes following Class II Twin-block treatment.

Redescription of the Hawaiian Ladyfish Elops hawaiensis from Korea (한국산 당멸치, Elops hawaiensis의 재기재)

  • Kwun, Hyuck-Joon;Kang, Chung-Bae;Kim, Jin-Koo
    • Korean Journal of Ichthyology
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    • v.23 no.1
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    • pp.80-84
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    • 2011
  • Redescription of the Hawaiian ladyfish Elops hawaiensis was carried out based on four specimens collected from Busan and Gwangyang between 2008 and 2010. This species has a gular plate between the symphysis and isthmus, and the entire premaxillary tooth band is exposed when the mouth is closed. Our Korean specimens of E. hawaiensis are characterized by having 65~67 vertebrae, 14 anal fin rays and 95~101 lateral line scales, which values differed slightly from those given in previous studies. Molecular analysis using 4S0 base pairs of mitochondrial DNA cytochrome b sequences showed that our four specimens corresponded well with E. hawaiensis (99.8~100.0%). Therefore, our results suggest that there may exist regional differences in vertebrae and anal fin ray counts for E. hawaiensis.