• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제35권5호
• /
• pp.316-324
• /
• 2013

This case report describes the treatment of a 23-year-old woman who had lip protrusion with gummy smile and mentalis muscle strain. Orthognathic surgery was performed in conjunction with orthodontics. Minimum dental decompensation was performed with presurgical orthodontics followed by an anterior segmental osteotomy for the majority of dental decompensation. Counterclockwise rotation of the maxillomandibular complex was applied by LeFort I osteotomy, and bilateral sagittal split ramus osteotomies with anterior segmental osteotomy to achieve overall facial balance. The active treatment period was 15 months. Stable occlusion and skeletal relationship were observed after a 10-month follow-up period.

• 대한치과교정학회지
• /
• 제26권5호
• /
• pp.637-645
• /
• 1996

성장이 완료된 골격성 III급 부정교합의 치료는 골격 부조화의 심도, 절치 치축, overbite와 연조직 측모의 심미성 등을 고려하여 필요한 경우 교정치료와 악교정수술을 병행하여 골격과 치아관계 개선에 따른 기능의 증진외에도 안모의 심미성을 증진시킬 수 있다. 특히 전후방적, 수직적, 횡적인 골격 부조화가 크거나 안면비대칭이 있는 경우, 또한 악교정수술후의 안정성이나 보다 이상적인 안모를 위하여 양악수술을 시행한다. 중안면부 함몰환자에서 안와하연과 관골부는 보존하며 비상악체를 전방이동하는 pyramidal Le Fort II osteotomy 를 시행할 수 있으며, 안와하연과 관골부치 전방이동을 필요로 할 때는 quadrangular Le Fort II osteotomy 를 시행할 수 있다. 이 수술법은 안와하연의 위치를 변화시켜 안와체적에 영향을 미치므로 상악골의 횡적, 수직적 이동량이 5 mm 이상일 때는 시행할 수 없다. 서울대학교병원 치과진료부 교정과에 내원하여 중안면부 함몰과 하악전돌을 동반한 골격성 III급 부정교합으로 진단되어 교정-악교정수술 (Le Fort II osteotomy 와 BSSRO) 복합치료를 받은 2명의 환자에 대해 살펴보고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제35권5호
• /
• pp.302-309
• /
• 2013

Purpose: This study evaluated the prognosis of conservative and surgical treatment according to the staging of bisphosphonate-related osteonecrosis of jaw (BRONJ) by American Association of Oral and Maxillofacial Surgeons and American Society for Bone and Mineral Research. Methods: We evaluated 53 patients of BRONJ who visited Department of Dentistry, Ajou University School of Medicine from May 2007 to February 2013. Twenty eight patients in stage 2, were divided into surgical and conservative groups with cessation of bisphosphonate therapy. Fifteen patients belonged to the conservative treatment group, in which mouth rinsing and antibiotics medication were done. Thirteen patients were treated with debridement or sequestrectomy, in the surgical treatment group. Each study list was analyzed by SPSS ver. 14.0 (SPSS Inc., USA) software and the favorable rate was verified by the Fisher exact test. P-values less than 0.05% were deemed significant. Results: Clinical outcome was evaluated on the basis of both clinical and radiographic findings. Of all the 28 patients of stage 2, 15 patients underwent conservative treatment and 13 patients received surgical treatment. In the surgical group, 9 of 13 (69.2%) showed good prognosis, 4 of 13 (30.7%) showed recurrence. In the conservative group, 13 of 15 (86.6%) showed no change duting the follow-up period. Two of 15 patients even showed a bad prognosis, such as pain and pus discharge, which are criteria for stage 3. P-value was 0.067 (>0.05). Conclusion: The results of the present study suggests that surgical intervention is good choice against the conservative treatment, after proper drug holidays period, while further investigation is needed for a definite solution to BRONJ.

• Archives of Plastic Surgery
• /
• 제49권5호
• /
• pp.652-655
• /
• 2022

Patients with advanced malignant tumors, including both jaws, is a challenging task for a head and neck surgeon. Current treatment landscape demonstrates good functional, anatomical, and aesthetic results in patients who could previously receive only palliative care. The extensive tissue defects resulting from oncological resections in the head and neck region require immediate reconstruction due to the exposure of vital structures and their contact with the external environment. A patient was operated using a three-team multidisciplinary approach involving simultaneous work of three specialized teams of maxillofacial and reconstructive microsurgeons, as well as an implantologist and a prosthodontist. This approach allowed simultaneous tumor resection with subsequent reconstruction of the intraoperative defect involving bilateral harvesting of two revascularized free fibular osteomusculocutaneous flaps with dental implantation and simultaneous rehabilitation of dentition with crowns.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제38권1호
• /
• pp.50-54
• /
• 2012

According to Luhr's classification, a fracture in the mandible with a width of less than 15-20 mm is considered to be an atrophic mandibular fracture and its incidence is very rare. Because of the reduced cross-sectional area and smaller contact area of the fractured ends as well as the poorly vascularized bony structure and delayed bone healing, an atrophic mandibular fracture is a great challenge for oral and maxillofacial surgeons. Surgeons tend to perform closed reduction, because open reduction is considered a non-life-saving surgery among elderly patients. Thus, most of them have limited experience in surgical management. According to recent reports, open reduction yields a good result, and the Association for Osteosynthesis (AO) group has recommended open reduction. This is a case report of our two experiences of open reduction and rigid fixation of atrophic mandibular fractures by the AO principle. Articles were also reviewed here.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제47권3호
• /
• pp.229-232
• /
• 2021

Cancer of the oral cavity and pharynx represents the 7th most diagnosed malignancy in Spain. Mucoepidermoid carcinomas are the most frequent malignancies of the minor salivary glands of oral cavities. The purpose of this report is to describe the very rare case of an alveolar ridge high-grade mucoepidermoid carcinoma presenting as an inside socket radiolucent lesion, simulating an apical cyst. The patient was diagnosed in our unit for oral and maxillofacial surgery and treated with surgery and adjuvant radiotherapy. The patient continues to be free of recurrent/persistent, local/regional disease after two years of follow up. Non-healed tooth related lesions present for more than one year are strongly recommended to be biopsied and evaluated histopathologically.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제42권
• /
• pp.24.1-24.7
• /
• 2020

Background: In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the "in-house" fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes. Review: We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups. Conclusions: In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제36권5호
• /
• pp.207-213
• /
• 2014

Fractures of the mandible occur with a greater frequency in the elderly. This study reports three cases of edentulous atrophic mandible fracture in elderly patients treated with open reduction technique. Three patients who presented with edentulous atrophic mandible fractures underwent surgical management using open reduction and internal fixation. After treatment, clinical evaluations and postoperative complications were examined with postoperative x-ray. Patients were followed with clinical and radiographic examinations. In the postoperative clinical evaluation, two male patients healed well, but one female patient complained of pain and swelling. In radiographic examinations, no union delay or lack of fusion was observed in the edentulous area. Open reduction technique is a viable treatment option for the edentulous atrophic mandible fractures in geriatric patients.

• 대한두개안면성형외과학회지
• /
• 제9권1호
• /
• pp.41-44
• /
• 2008

Cleft palate and congenital alveolar synechia is a rare syndrome. Only eight cases have been previously reported. It consists of a spectrum of facial anomalies always including cleft palate and congenital alveolar synechiae without other abnormalities. This report described an unusual case of congenital alveolar synechial band spanning posterior alveolar of the two jaws with cleft palate. Previously reported cases showed bilaterally or anteriorly located fibrous band. In our department, a new born revealed unilateral posterior synechia. Under brief intravenous sedation, synechium was divided using bipolar diathermy in the nursery at 3 days of age because of poor feeding. This division allowed full jaw opening after brief passive exercise. The patient is growing and maturing as expected with no complications. This patient is supposed to be the first reported case of isolated unilateral alveolar synechium combined with cleft palate in the worldwide.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제33권4호
• /
• pp.346-351
• /
• 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.