• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권6호
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• pp.272-277
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• 2014

Objectives: Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions. Materials and Methods: A retrospective review of medical records and patient case files from January 2012 to December 2013 was undertaken. All case files and other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed reconstruction were selected for review. Results: Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients' (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean $26.0{\pm}10.6years$). Indications for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmental resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients' postoperative reviews and radiographs revealed good facial profile and continued bone stability up to 1 year following NVIBG. Conclusion: NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권2호
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• pp.141-147
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• 2007

The purpose of this study was to evaluate the effects of maxillary occlusal plane angle to postoperative skeletal stability by comparative analysis after two-jaw surgery of patients with skeletal CIII malocclusion. This study was made with lateral cephalometric radiography of 52 patients with skeletal class III malocclusion that were performed to Le Fort I osteotomy and BSSRO. And 52 patients were divided to Group A(n=30) and B(n=22). Maxillary posterior impaction was not conducted in Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, and for Group B, which the pre-operative maxillary occlusal plane was low, the maxillary posterior impaction was conducted. The results were obtained as follows : 1. The relapse rate of Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, was relatively stable compared to Group B, which the pre-operative maxillary occlusal plane was low. 2. The relapse rate of each measurement of Group B, which had the maxillary occlusal plane altered during the operation, was somewhat high, and of those, the post-operative relapse rate of overjet, overbite, mandibular plane angle appeared to be significantly high in the statistics. The analyzed results above, was thought to be indicating that the pre-operative maxillary occlusal plane angle was closely related to the post-operative skeletal stability, and that obtaining post-operative skeletal stability only through operative normalization of occlusal plane angle may meet limitations.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권3호
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• pp.289-295
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• 1995

성인의 연조직에 발생하여 섬유아세포양세포 및 조직구양세포의 차륜형의 성장형태를 특징으로 하는 MFH는 주로 장년층의 남성에 호발되는 연조직 질환으로 두경부 영역에서의 발생률은 3% 정도이고, 특히 부비강 부위에 발생된 경우의 5년 생존률은 28% 정도이다. 저자들은 악골에 발생한 MFH 2례에서 항암화학요법과 방사선요법 및 광범위한 외과적 절제술을 시행하였다. 철저한 병리조직학적 검사에 의해 오진의 가능성을 줄일 수 있고, 치료시에는 병용요법을 사용함으로써 술후 재발이나 전이를 감소시킬 수 있으리라 생각된다.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.19-25
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• 2017

Background Numerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship. Methods We evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate. Results A 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits. Conclusions Our condylar repositioning method using a centric relation splint and miniplate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권6호
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• pp.490-496
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• 2011

Purpose: Dr. Marquardt made the facial 'phi' mask using golden ratio. Most class III patients have bulky faces and want a smaller face. Using a facial golden mask, this study estimated and compared frontal photographs before and after operation for soft tissue measurement. The golden mask can be considered as a reference tool for facial esthetic analyses especially in lower face. Methods: Forty patients who had undergone orthognathic surgery at Samsung Medical Center from January 2006 to December 2009 were included in this study. These patients had Class III malocclusion. Lateral cephalometric radiographs, frontal clinical photos of pre-op and 8~12 month later post-op, and the facial 'phi' mask using golden ratio, were used for analysis. Reduction of the lower face area, occlusal plane changes, amounts of mandible setback and amounts of maxilla posterior impaction were estimated. Results: Lower facial reduction ratio and mandibular setback amounts were significantly different between 1-jaw and 2-jaw groups. Average postoperative changes in the area of lower face between bilateral sagittal split ramus osteotomy (BSSRO) and BSSRO combined maxilla posterior impaction were compared by using an independent simple t-test and $P$ value was 0.016. Therefore, the lower facial reduction ratio and mandibular setback amount were significantly different in maxilla posterior impaction. Conclusion: The two-jaw surgery group showed more reduction of the lower facial area than the 1-jaw surgery group. The amount of lower facial reduction was more related with the amount of mandibular setback. There was no significant relation in lower facial reduction with amount of maxilla posterior impaction, pre-op occlusal plane, post-op occlusal plane and the mandibular angle. A relationship between the change in the lower facial area and the amount of maxilla posterior impaction or the change of mandibular angle occlusal plane at pre-op could not be found because of the difference in the amount of setback between two groups.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권4호
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• pp.300-304
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• 1998

Moderns have desire likely to be further good-looking concomitant with a qualitative advancement of the life. With one of this phenomenon, an orthognathic surgery performing at the dept. of oral and maxillofacial surgery have been becoming a more extensively. It's possible to occur many complications during the operations and especially, an excessive bleeding of those may be fatal and so a transfusion is performing for the prevention &management of that. But, because of the rate of increase of an blood-born infection like AIDS via transfusion, nowadays an autologous blood transfusion is interesting to us. We made a comparative study of an amount of blood loss &transfusion using hemoglobin value after classifying the orthognathic surgeries from Feb. '97 to Mar. '98 in single-jaw and doublejaw surgery. And we intended to set a standard against of a routine preoperative cross-matching deciding the amount of predictive homologous blood transfusion according to operative method. Simultaneously, we studied the realization &effectiveness of autologous blood transfusion with some cases, so would like to present. Results: 1. Single-jaw operation can be performed without blood transfusion or with homologous blood transfusion through only blood typing & screening. 2. We commonly transfuse two units of blood with double-jaw operation and an autologous blood transfusion has much more advantage than an homologous blood transfusion. 3. We can reduce charge associated with blood transfusion through precisely preoperative evaluation of patients and proper type of blood transfusion.

• Imaging Science in Dentistry
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• 제53권1호
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• pp.21-26
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• 2023

Purpose: A fully digital approach to oral prosthodontic rehabilitation requires the possibility of combining (i.e., registering) digital documentation from different sources. This becomes more complex in an edentulous jaw, as fixed dental markers to perform reliable registration are lacking. This validation study aimed to evaluate the reproducibility of 1) intraoral scanning and 2) soft tissue-based registration of an intraoral scan with a cone-beam computed tomography (CBCT) scan for a fully edentulous upper jaw. Materials and Methods: Two observers independently performed intraoral scans of the upper jaw in 14 fully edentulous patients. The palatal vault of both surface models was aligned, and the inter-observer variability was assessed by calculating the mean inter-surface distance at the level of the alveolar crest. Additionally, a CBCT scan of all patients was obtained and a soft tissue surface model was generated using patient-specific gray values. This CBCT soft tissue model was registered with the intraoral scans of both observers, and the intraclass correlation coefficient(ICC) was calculated to evaluate the reproducibility of the registration method. Results: The mean inter-observer deviation when performing an intraoral scan of the fully edentulous upper jaw was 0.10±0.09 mm. The inter-observer agreement for the soft tissue-based registration method was excellent(ICC=0.94; 95% confidence interval, 0.81-0.98). Conclusion: Even when teeth are lacking, intraoral scanning of the jaw and soft tissue-based registration of an intraoral scan with a CBCT scan can be performed with a high degree of precision.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.7.1-7.8
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• 2020

Maxillomandibular advancement (MMA) is effective for the treatment of obstructive sleep apnea (OSA). In previous studies, the airway was increased in the anteroposterior and transverse dimensions after MMA. However, the effect of the opposite of mandibular movement (mandibular setback) on the airway is still controversial. Mandibular setback surgery has been suggested to be one of the risk factors in the development of sleep apnea. Previous studies have found that mandibular setback surgery could reduce the total airway volume and posterior airway space significantly in both the one-jaw and two-jaw surgery groups. However, a direct cause-and-effect relationship between the mandibular setback and development of sleep apnea has not been clearly established. Moreover, there are only a few reported cases of postoperative OSA development after mandibular setback surgery. These findings may be attributed to a fundamental difference in demographic variables such as age, sex, and body mass index (BMI) between patients with mandibular prognathism and patients with OSA. Another possibility is that the site of obstruction or pattern of obstruction may be different between the awake and sleep status in patients with OSA and mandibular prognathism. In a case-controlled study, information including the BMI and other presurgical conditions potentially related to OSA should be considered when evaluating the airway. In conclusion, the preoperative evaluation and management of co-morbid conditions would be essential for the prevention of OSA after mandibular setback surgery despite its low incidence.

• Journal of Multimedia Information System
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• 제6권2호
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• pp.67-74
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• 2019

Bone density is one of the factors in the early failure of dental implants and doctors should make a preoperative assessment of jaw bone density using patient's CT data before dental implant surgery in order to find out whether the patient has osteoporosis and osteopenia. The main goal of this study was to propose a method that based on image processing techniques in order to provide accurate information about where to drill and place an abutment screw of implants in the jaw bone for doctors and reduce human activity for the estimation of the local cancellous bone density of mandible using CT data. The experiment was performed on a computed tomography data of the jaw bone of two different individuals. We assumed that the result of the estimation of jaw bone density depends on the angle of drilling and average HU (Hounsfield Unit) values were used to evaluate the quality of local cancellous bone density of mandible. As a result of this study, we have been developed a toolbox that can be used to estimate jaw bone density automatically and found a positive correlation between the angle of the drill and time complexity but a negative correlation between the diameter of the drill and time complexity.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권5호
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• pp.428-434
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• 2001

Few topics in operative and perioperative patient management generate more controversy than that of appropriate fluid and electrolyte therapy. especially, controversy has swirled around colloid vs crystalloid therapy and the composition of administered fluids, agreement among clinicians as to what fluid therapy is appropriate, and in what amount, is rare. This controversy likely will be enhanced by Arieff' s provocative article. He described 11 adults and 2 pediatric patients. All developed fatal postoperative pulmonary edema, seemingly caused solely by excessive postoperative fluid administration. From January 1999 to December 1999, we investigated 24 patients, which were operated by orthognathic surgery, about the intraoperative fluid therapy and the associated effect in orthognathic surgery, which is regarded as one of the major surgery of oral and maxillofacial surgery. First, They were devided into two groups, that is one-jaw surgery and two-jaw surgery, and each groups were devided by intraoperative fluid volume of 8ml/kg/hr. Subjective assesment was collected through use of a series of 3 questionnaries. In each questionnaire, a 5-point Liekert scale was used far assessment of following parameters of recovery from anesthesia: headache, dizziness, drowsiness, nausea/vomiting, thirst. The patient completed questionnaire 1 at 4 hour after surgery, questionnaire 2 was completed at 24 hours after surgery, and questionnaire 3 was completed at 48 hours after surgery. This study demonstrated that appropriated perioperative rehydration decreases postoperative adverse outcomes and improved the patient's perception of the postoperative period.