• Title/Summary/Keyword: Symphysis widening

Search Result 9, Processing Time 0.024 seconds

Mandibular Symphysis Transverse Widening (임상가를 위한 특집 2 - 하악골의 외과적 확장)

  • Oh, Sung-Hwan
    • The Journal of the Korean dental association
    • /
    • v.51 no.6
    • /
    • pp.313-321
    • /
    • 2013
  • The most common orthodontic methods of treating mandibular transverse deficiencies is extractions, interdental stripping, and other dento-alveolar compensation but it can not addressesd about skeletal problem This study assessed the treatment outcomes after surgically assisted rapid tooth orthodontics using the symphysis osteotomy and dentoalveolar distraction osteogenesis technique. The applications of distraction osteogenesis in mandibular widening, by symphysis osteotomy, has emerged as a definitive, predictable and better stability. The most important factors in mandibular widening is performed with simple surgical technique and devices. As a results, these techniques are very useful and effective in cases of difficult tooth movement in adult orthodontics transverse problems There were few intraoperative or postoperative complications and were not clinically significant.

DISTRACTION OSTEOGENESIS ON MANDIBLE SYMPHYSIS WIDENING WITH A BONE-BORNE TYPE DISTRACTOR (Bone-borne type distractor를 사용한 하악골 정중부 골신장술)

  • Cho, Jin-Hyoung;Chee, Young-Deok
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.28 no.4
    • /
    • pp.356-364
    • /
    • 2006
  • Transverse mandibular deficiency has a many problem in growing patients. Therefore, Mandible symphysis widening is recommended. A new surgical technique has been developed to widen the mandible. The purpose of this study is to report the effect of mandibluar symphyseal distraction osteogenesis by use of bone-borne type distractor. The surgical procedure was accomplished under general anaesthesia with step-line osteotomy. Bone-borne type distractor was used to generally widen the mandible. The expansion achieved in the mandible was 8.31mm at the device, 6.32mm at the canines, 4.06mm at the first molars. The symphyseal distraction gaps were bridged by new bony regeneration. Mandibular symphseal distraction osteogenesis increased mandibular arch width, stabilized occlusion, and corrected dental crowding.

A CASE REPORT OF COMPLICATIONS DURING MANDIBULAR TRANSVERSE SYMPHYSIS WIDENING (하악 이부 확장술 시 나타나는 합병증의 치험례)

  • Suh, Chung-Whan;Kang, Kyung-Hwa;Choi, Moon-Gi
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.30 no.5
    • /
    • pp.480-488
    • /
    • 2008
  • Orthodontists often treat cases which are difficult to treat with conventional orthodontics. In such cases, it could be treated with surgical procedures with the help of an oral surgeon. Especially, transverse deficiency of the mandible can be corrected by widening the transverse width of mandibular symphysis, using distraction osteogenesis. Transverse widening of mandibular sympysis is known as a safe treatment but still complications could occur during the treatment. We are reporting some complications of cases that mandibular symphysis transverse widening were applied. Some cases showed complications because of the inappropriate osteotomy line. Since straight vertical osteotomy line was inclined to the left, only the left bony segment was likely to expand. According to bio-mechanical considerations, it will be better to perform a step osteotomy, cutting the eccentric area of the alveolar crest and the centric area of the basal symphyseal area. Complications could also occur by the failure of the distraction device. The tooth borne distraction device was attached on the lingual side of the tooth with composite resin. During the distraction period, it was impossible to obtain appropriate distraction speed and rhythm because of frequent fall off of the distraction device. Therefore, distraction device should be attached firmly with orthodontic band or bone screw, etc. Tooth mobility increasement could also occur as a complication. 'Walking teeth phenomenon' was observed during the distraction period, showing severe teeth mobility and pain during mastication. These symptoms fade out during the consolidation period. Since the patient could feel insecure and uncomfortable, it should be notified to the patient before the procedure. Finally, alveolar crestal bone loss could occur. Alveolar crestal bone loss occurred because of lack of distraction device firmness and teeth trauma caused by lower lip biting habit. Therefore, adequate firmness of the distraction device and habit control will be needed.

A Case of Separation of the Symphysis Pubis in Association with Delivery (분만과 연관된 치골결합부 분리 치험례)

  • Kim, Se-Dong;Ihn, Joo-Chul;Lee, Jae-Chang
    • Journal of Yeungnam Medical Science
    • /
    • v.5 no.2
    • /
    • pp.201-203
    • /
    • 1988
  • Separation of the pubic symphysis in association with delivery is very rare. The Korean orthopedic and obstetrical literature pertaining to this syndrome is absent. The physiological widening is small and asymptomatic, but a separation of more than one centimeter may occur and is usually symptomatic. A twenty-six-year-old woman of separation of symphysis pubis associated with delivery was treated successfully with the treatment of reduction and pelvic band, with absolute bed rest in the lateral decubitus position.

  • PDF

CLINICAL STUDY OF MANDIBLE SYMPHYSIS WIDENING (외과적 하악 정중부 골신장술)

  • Kwon, Kyung-Hwan;Min, Seung-Ki;Oh, Sung-Hwan;Lee, Jun;Cha, Jae-Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.30 no.6
    • /
    • pp.516-525
    • /
    • 2004
  • Mandibular symphyseal distraction osteogenesis is an alternative approach for correcting mandibular transverse deficiencies and dental crowding. The traditional approaches for these are extraction of teeth and arch expansion with traditional orthodontic treatment. Also extractions are usually unavoidable in patients with severe crowding. The purpose of this study is to evaluate the effect of mandibular symphyseal distraction osteogenesis by use of tooth-borne expansion appliance. All of 12 patients had been performed distraction osteogenesis. The surgical procedures were accomplished under local anesthesia and intravenous sedation in an ambulatory surgical setting using a routine distraction protocol. The latency period was 5 days or 7 days after symphyseal osteotomies. The rate & rhyth is a intermittent, 0.75mm or 1.0 mm per day and stabilized for 6, 8 weeks after distraction. The time of orthodontic tooth movement after distraction was variable from 2 weeks to 8 weeks (mean 3 weeks). All patients had been evaluated with study casts, plain periapical films, panorama radiograms before & after surgery. Mandibular symphyseal distraction osteogenesis increased mandibular arch width and corrected dental crowding, with paralleling tooth-borne movement, without proclination of the mandibular incisors.

COMPLEX DISTRACTION OSTEOGENESIS ON HEMIMANDIBULAR HYPOPLASIA : A CASE REPORT (하악과두 골절후 발생한 편측성 하악골 형성부전의 치료로서 복합적 악골 신장술의 임상증례)

  • Oh, Sung-Hwan;Min, Seung-Gi;Kwon, Kyong-Hwan;Koh, Se-Wook;Lee, Kyong-Seuk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.30 no.3
    • /
    • pp.246-250
    • /
    • 2004
  • Uni- or bilateral mandibular hypoplasia can be associated with various syndromes or is acquired after early traumatic or inflammatory disease in the temporomandibular joint(TMJ). Early treatment is necessary to avoid consequent impairment of midfacial growth. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth, but the new procedure of bone lengthening which was presented by McCarthy et al. represents a limited surgical intervention and therefore open up a new perspective of treatment, especially in younger children with severe deformities. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, a tilted occlusal plane, and a short mandible. A 14-years-old boy with facial asymmetry, who was fractured on both condyle and mandibular symphysis before 8 years ago, was treated by mandibular ramus lengthening, symphysial widening and surgically assisted rapid palatal expansion with corticotomy. After allowing 1 week for the healing of the periosteum, the distraction was performed at the rate of 0.5-1.0mm per day for 7 days on maxilla and 14 days on mandible. The device was maintained on maxilla and mandible for 12 weeks following distraction. The difference in ramus and mandibular transverse deficiency were corrected and facial asymmetry was improved with complex distraction osteogenesis.

A 3-D finite element analysis on the mandibular movement pattern and stress distribution during symphyseal widening (하악 이부확장 시 하악골 이동 양상과 응력 분포에 관한 삼차원 유한요소법적 연구)

  • Lee, Do-Hoon;Hong, Hyun-Sil;Chae, Jong-Moon;Jo, Jin-Hyung;Kim, Sang-Cheol
    • The korean journal of orthodontics
    • /
    • v.38 no.1
    • /
    • pp.13-30
    • /
    • 2008
  • Objective: The objective of this study was to evaluate the displacement pattern and the stress distribution of the finite element model 3-D visualization during symphyseal widening according to the osteotomy position, osteotomy type, and distraction device. Methods: The kinds of distraction devices used were tooth-borne type, hybrid type, bone-borne type and tooth-borne type $30^{\circ}$ angulated, and the kinds of osteotomy design were vertical osteotomy line between the central incisors and step osteotomy line through the symphysis. Results: All reference points of the mandible including the condyles were displaced laterally irrespective of the osteotomy position, osteotomy method and distraction device. The anteroposterior or vertical displacements showed small differences between the groups. The widening pattern of the osteotomy line in the tooth-borne type of device was v shaped, and that of bone-borne type was a reverse v shape. However, the pattern in the hybrid type was parallel. The lateral displacement of the mandibular angle by the bone-borne device was more remarkable than the other types of devices. The displacement by the $30^{\circ}$ angulated tooth-borne type was different between the left and right sides in both the transverse and anteroposterior aspects. Conclusion: The design of the distraction devices and osteotomy line can influence the displacement pattern and the stress distribution during mandibular symphyseal distraction osteogenesis procedures.

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
    • /
    • v.31 no.5 s.88
    • /
    • pp.499-504
    • /
    • 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.

  • PDF

Percutaneous two unilateral iliosacral S1 screw fixation for pelvic ring injuries: a retrospective review of 38 patients

  • Son, Whee Sung;Cho, Jae-Woo;Kim, Nam-Ryeol;Cho, Jun-Min;Choi, Nak-Jun;Oh, Jong-Keon;Kim, HanJu
    • Journal of Trauma and Injury
    • /
    • v.35 no.1
    • /
    • pp.34-42
    • /
    • 2022
  • Purpose: Percutaneous iliosacral (IS) screw fixation for pelvic ring injuries is a minimally invasive technique that reduces the amount of blood loss and shortens the procedure time. Moreover, two unilateral IS S1 screws exhibit superior stability to a single IS screw and are also safer for neurological injuries than an S2 screw. Therefore, this study aimed to evaluate fixation using percutaneous two unilateral IS S1 screws for pelvic ring injuries and its subsequent clinical outcomes. Methods: We retrospectively reviewed 38 patients who underwent percutaneous two unilateral IS S1 screw fixation for pelvic ring injuries. The procedure time, blood loss, achievement of bone union, radiological outcomes (Matta and Tornetta grade), and postoperative complications were evaluated. Results: The mean procedure time, hemoglobin loss, bone union rate, and time to union were 40.1 minutes (range, 18-102 minutes), 0.6 g/dL (range, 0.3-1.0 g/dL), 100%, and 153.2 days (range, 61-327 days), respectively. The Matta and Tornetta grades were excellent, good, and fair in 24 (63.1%), 11 (28.9%), and three patients (7.9%), respectively, and the postoperative complications were S1 screw loosening, widening of the symphysis pubis (2.3 and 2.5 mm), lumbosacral plexopathy, and S1 radiculopathy in one (2.6%), two (5.3%), one (2.6%), and one patient (2.6%), respectively. However, all neurological complications recovered spontaneously. Conclusions: Percutaneous two unilateral IS S1 screw fixation was useful for treating pelvic ring injuries. In particular, it involved a short procedure time with little blood loss and also led to 100% bone union and good radiological outcomes.