• Archives of Plastic Surgery
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• v.49 no.4
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• pp.510-516
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• 2022

Background Surgical correction of bilateral cleft lip deformities remains one of the most challenging areas in facial plastic surgery. Many surgical techniques and conservative devices have been offered for the early management of bilateral cleft lip in infants. The purpose of this study was to evaluate the effect of lip adhesion on the lip and nose of patients with bilateral cleft lip. Methods A retrospective review of 13 patients with bilateral cleft lip was performed and compared with age-matched noncleft children. Patients underwent lip adhesion at a mean age of 2.8 months, and cheiloplasty at 6.6 months of age using a modification the Mulliken method. Secondary rhinoplasty was performed at the age of 6 in 13 patients. The surgical results were analyzed using photographic records obtained at the age of 1 and 7 years. Twelve length measurements and one angle measurement were obtained. Results All measurements were not statistically different from those of the noncleft age-matched control group at the age of 1. At 7 years of age, upper lip height and vermilion mucosal height were shorter (p < 0.05) than in the control group. Nasal tip protrusion and the nasolabial angle were greater (p < 0.05) than in the control group. Conclusion Lip adhesion followed by secondary rhinoplasty resulted in an acceptable lip and nasal appearance. Although nasoalveolar molding is now widely used, lip adhesion can be an appropriate alternative if an orthodontist is not available due to geographical or economic constraints.

• Archives of Craniofacial Surgery
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• v.24 no.6
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• pp.266-272
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• 2023

Background: In recent years, there has been an increase in reports of perioral vascular complications resulting from filler injections, such as necrosis of the lip or alar rim, occlusion, and in severe cases, blindness. Conversely, the use of perioral arterial flaps is becoming more prevalent in the treatment of cleft lips, cancer, and trauma. A thorough understanding of perioral arteries is essential to minimize complications and maximize the success of these flaps. However, the course of the facial artery (FA) in the perioral region remains incompletely understood. The aim of this study was to describe the variations of the FA in the perioral region. Methods: We dissected 52 embalmed and formaldehyde-fixed Vietnamese cadavers. We then studied the size and distribution of perioral arteries in 102 specimens. Results: The superior labial artery (SLA) was the most common branch, occurring in 87.25% of cadavers, followed by the inferior labial artery (ILA) at 78.43%. The SLA primarily originated above the mouth corner (cheilion), accounting for 91.01% of cases, and predominantly exhibited a tortuous course within the submucosa (78.65%). The ILA's branching pattern varied, but it was primarily located below the cheilion (91.25%). The ILA also followed a twisted path, generally within the submucosa. The ILA exhibited two patterns: the typical pattern, distributed at the vermilion border of the lower lip (8.82%), and the horizontal labiomental artery pattern, which ran horizontally in the middle of the lower lip area (69.61%). At their origin, the SLA and ILA had average external diameters of 1.29 mm and 1.28 mm, respectively. Conclusion: Numerous anatomical variations in the FA in the perioral region were found. A detailed anatomic description, suggested landmarks, and angiography before the procedure will be useful to help doctors avoid complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.38.1-38.10
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• 2016

Background: The aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology. Methods: The samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program $Ondemand^{TM}$. Paired and independent t tests were performed for statistical analysis. Results: Landmarks in the mouth corner (cheilion, Ch) moved backward and downward (p < .005, p < .01). However, cheilion width was not statistically significantly changed. Landmark in labrale superius (Ls) was not altered significantly. Upper lip prominence angle (ChRt-Ls-$ChLt^{\circ}$) became acute. Landmarks in stomion (Stm), labrale inferius (Li) moved backward (p < .005, p < .001). Lower lip prominence angle (ChRt-Li-$ChLt^{\circ}$) became obtuse (p < .001). Height of the upper and lower lips was not altered significantly. Length of the upper lip vermilion was increased (p =< 0.01), and length of the lower lip vermilion was decreased (p < .05). Lip area on frontal view was not statistically significantly changed, but the upper lip area on lateral view was increased and change of the lower lip area decreased (p > .05, p < .005). On lateral view, upper lip prominent point (UP) moved downward and stomion moved backward and upward and the angle of Ls-UP-Stm ($^{\circ}$) was decreased. Lower lip prominent point (LP) moved backward and downward, and the angle of Stm-LP-Li ($^{\circ}$) was increased. Li moved backward. Finally, landmarks in the lower incisor tip (L1) moved backward and upward, but stomion moved downward. After surgery, lower incisor tip (L1) was positioned more superiorly than stomion (p < .05). There were significant associations between horizontal soft tissue and corresponding hard tissue. The posterior movement of L1 was related to statistically significantly about backward and downward movement of cheilion. Conclusions: The lip morphology of patients with dento-skeletal class III malocclusion shows a significant improvement after orthognathic surgery. Three-dimensional lip morphology changes in class III patients after MSS exhibited that cheilion moved backward and downward, upper lip projection angle became acute, lower lip projection angle became obtuse, change of upper lip area on lateral view was increased, change of lower lip area decreased, and morphology of lower lip was protruding. L1 was concerned with the lip tissue change in statistically significant way.

• Journal of Conservation Science
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• v.20
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• pp.9-22
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• 2007

Three kinds of natural pesticides extracted from plants which are being sold in the Korean markets, were estimated effects on materials of art of museum. Tested samples were 1) silk fabrics : undyed, dyed(amur cork tree, gallut, gallut(alum post mordancy), gallut(copperas post mordancy), gardenia, turmeric, acorn, acorn(copperas post mordancy), gromwell, madder, madder(alum post mordancy), safflower, sappanwood, sappanwood(alum pre mordancy, post mordancy), indigo, indigo+amur cork tree, indigo+sappanwood) 2) cotton fabrics : undyed, dyed(amur cork tree, gallut, gallut(alum post mordancy), gardenia, acorn, acorn(copperas post mordancy), gromwell, madder, madder(alum post mordancy), safflower, sappanwood, sappanwood(alum pre mordancy, post mordancy), indigo, indigo+sappanwood) 3) undyed ramie fabric 4) Korean papers : undyed, dyed(sappanwood, indigo, gardenia, amur cork tree, safflower) 5) pigments : azurite, malachite, red lead, litharge, orpiment, hematite, iron oxide, cinnabar, vermilion, indigo, lake indigo, kaolin, lead white, oyster shell white 6) painted plates : azurite, malachite, red lead, litharge, orpiment, hematite, iron oxide, cinnabar, vermilion, indigo, lake indigo, kaolin, lead white, oyster shell white. Conditions of tests were that after samples were exposed to 10 times of promoted concentration for 9 months in relative humidity $55{\pm}1%$ and temperature $20{\pm}2^{\circ}C$, they were compared with standards. Items of estimation were color difference(${\Delta}E^*$) and tenacity. After exposure to pesticides, undyed silk cotton ramie fabrics and Korean papers were not nearly changed in their colors, but colors of most of dyed samples were clearly changed by pesticides except for partial samples(acorn- and madder-dyed fabrics etc, gardenia-dyed samples). Especially changes of colors of turmeric-dyed silk fabrics were most distinct. And colors of pigments and painted plates containing lead, copper, arsenic, mercury and vegetable pigments, were clearly changed. Tenacities of yams of undyed silk fabrics were not nearly changed and undyed cotton fabrics were a little reduced as compared with standards. But tenacities of yams of dyed silk and cotton fabrics were clearly reduced or increased as compared with standards. Especially, madder-dyed silk fabrics were increased 10% or more and indigo-dyed silk fabrics were reduced 10% or less in all pesticides. Also madder- and sappanwood(alum post mordancy)-dyed cotton fabrics were increased 10% or more in all pesticides.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.4
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• pp.348-355
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• 2006

Tennison was the first to recognize and to preserve the Cupid's bow by lowering the peak in the margin of the cleft. Randall had modified the Tennison's repair based on accurate measurements. Bardach's technique evolved from the basic concept of triangular flap cleft lip repair described by Tennison-Randall method. Precise measurements are used to define the dimensions of the equilateral triangular flap, which is created on the cleft side and is inserted into an equilateral triangular defect on the noncleft side. Two symmetrical vertical distances on either side of the cleft are thus formed. It is essential that the incisions in the skin correspond precisely with those on the muscles and mucosa, and that all layers are sutured with the use of the triangular flap, thus preventing vertical scar contracture. This procedure produces a symmetric, balance lip with a well-defined Cupid's bow, a symmetric vermilion, and a properly aligned orbicularis oris muscle. We had treated three patients with unilateral incomplete cleft lip by using Bardach's triangular flap method. The operation scars could be reduced comparing to Millard method because Bardach's method did not use the columella base and the alar base incision. And the flap design was more simple and accurate comparing to Tennison-Randall method. On the other hand, the postoperative scars on the philtrum pointed as a disadvantage of triangular flap method were cosmetically acceptable because the three patients had incomplete cleft lip. We have experienced that Bardach's triangular flap is a recommendable technique for the repair of unilateral incomplete cleft lip.

• Journal of Conservation Science
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• v.30 no.4
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• pp.457-466
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• 2014

Rigorous analysis was performed to identify the structure and materials of the murals to study techniques used on mural tombs of ancient Daegaya era(6th century). The murals were painted by applying mortar on the walls and the ceiling after building a stone chamber and creating ground layers on mortar layers. Mud was applied on most of the mortar layers on four sides of the walls except the ceiling. Sand was not used in mortar but was made of materials with pure calcium substances. In addition, shells in irregular sizes with incomplete calcination were mixed; and the mortar's white powder was inferred as lime obtained by calcination of oyster shells. Kaolinite($Al_2Si_2O_5(OH)_4$) was used in the ground layer, Cinnabar(HgS) was used for red pigment, Malachite($Cu_2CO_3(OH)_2$) for green and Lead white($PbCO_3{\cdot}Pb(OH)_2$) for white. Mud plaster was applied on the mortar and was composed thinly and densely using clayey of particle size smaller than that of medium sand. It was assumed that the finishing was for repair after long time had passed since the mortar layer came off. Using lime made with oyster shells as mortar is unprecedented in ancient Korean mural tombs and its durability was very poor, suggesting that Gaya's mortar production technique was relatively behind compared to that of Koguryo's in the same era.

• Journal of Conservation Science
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• v.33 no.2
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• pp.85-95
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• 2017

Oil paints are mixtures of pigments, drying oils and additives. In the past, oil paints were mainly composed of inorganic pigments. However, recently color matching techniques vary depending on manufacturers due to the development of various kinds of synthetic pigments. Despite this, most studies of oil paints in South Korea are about durability tests, and there is no comparative study on the characteristics of commercial oil paint components. This study aims to compare the properties of four different kinds of oil paints from four manufacturers, which are the most popularity used. Extender pigments in oil paint from C brand differed from that of other manufacturers and various kinds of coloring pigments were differently used depending on the oil paints and the manufacturers. The mixing ratios and the pigment types differed even for oil paints having the same product name. It is assumed that these differences could affect the colors. The result of this study is expected to contribute to the analysis of artworks through the accumulation of scientific data of oil paints. In addition, it can be utilized as a scientific basis for art history studies, including the characteristics of artists or production year.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.526-534
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• 2001

Purpose : The objective of this study is to ascertain whether the positive exists among the frenum length, the tongue movement and the speech and to present the normal range of tongue movement and guidelines for the choice of surgery, observation if necessary. Materials and Methods : 180 patients were evaluated. We divided 180 patients into 6 group by age. Each group was separated as follows; the age of 2.5-4, 5-6, 7-9, 10-12, 16-18. We measured the frenal length, the range of tongue motion and evaluated the speech so that we really questioned about the positive relationship between the tongue-tie and speech. We let the patient exercise the protrusive both(right, left) laterotrusive superior movement of the tongue. During these movements, we measured the distance between the vermilion border and the tongue tip. We also measured the distance from the tongue tip to the point contacting the upper lip with dorsum of the tongue during the maximal protrusive movement of the tongue. Three linear measurement of the anterior, inferior segment of the tongue including the lingual frenum, are made. These measurements are as follows: 1. Distance A. Free anterior portion of the tongue from the point of frenular insertion to the tongue tip. 2. Distance B. The distance from the initiating point of the lingual frenum to the point connecting the two sublingual carundcles to the lingual frenum perpendicularly. 3. Distance C. The distance from the point contacting the line crossing the sublingual caruncles with the lingual frenum to the terminating point of the lingual frenum. We transform three linear measures into a statistical ratio, A/(A-B+C), representing the length of the free portion of the tongue compared with the total sublingual dimensions. In addition, we assessed the speech through Picture Consonant Articulation Test(PCAT) and tried to find out the relationship between the length of the lingual frenum and speech. Conclusion : As people are born, they have small and restricted tongue. As people grow old, tongue motions are more liberate, and unrestricted and they can speak so freely. Therefore we suggest that until age 5, oral and maxillofacial surgeons postpone the surgery if not urgent, evaluate the maximal lingual motions and PCAT according to this article and observe their changes.

• Korean Journal of Cleft Lip And Palate
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• v.3 no.1
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• pp.11-16
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• 2000

Many efforts are made to achieve satisfactory cosmetic and functional result in the repair of cleft lip. However, repair may be complicated in many cases by distortion of the vermilion border, obliteration of the normal contour of the philtrum, and eclabium in spite of many methods used in these days. To achieve better results in cleft lip repair, thorough understandings of the relationship between the surface morphology of the upper and lower lip and the underlying musculature is necessary but reports about this topic is rare. So, our studies were performed on the full-thickness upper lips containing both philtral ridge up to columelar base and lower lip, 4 post-mortem specimens of 2 females and 2 males aged from 16 to 42, using serial histological sections taken in the transverse and vertical planes under light microscopy. Thorough understanding of the anatomical relationships is established and on the basis of our findings, we can postulate some criteria to create a normal and natural philtrum in a patient with a cleft lip, it would be necessary to restore the normal deep muscle attachments and superficial dermal attachments of the orbicularis muscle, to close the lip without tension, to restore thickness of the philtral ridge, and to minimise nonelastic scar tissue.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.3
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• pp.263-269
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• 2001

Median cleft of the lower lip and/or mandible is a rare congenital anomaly, first mentioned by Couronne in 1819. Monroe(1966), Fujino(1970), Ranta(1984) and Oostrom(1996) conducted comprehensive reviews and list cases in literature. Median cleft varies greatly, from a simple vermilion notch to a complete cleft of the lip involving the tongue, the chin, the mandible, the supporting structures of the median of the neck, and the manubrium sterni. The associated anomalies include ankyloglossia, cleft tongue, neck contraction, heart lesion, absence of hyoid bone, and so on. The etiology of median cleft is unknown. Various possibilities, such as failure of mesodermal penetration into the midline, failure of fusion of mandibular processes, external factors apart from the embryogenic pattern such as pressure, position in utero, circulatory failure caused placental adhesion, diseases in pregnancy, and so on, have been discussed. A 8-year-old girl was referred to the Dept. of Oral & Maxillofacial Surgery, Kyungpook National University Hospital and had been aware of the fact that at birth "she had something wrong with her mouth." Shortly after birth she had been examined by a plastic surgeon and at that time surgical procedure had been performed to release the tongue from the lower jaw and lip at local hospital. On admission, she had a slight notching of lower lip and two fibrous frenum ran from the lip along the ventral surface of the tongue, diastema between her mandibular central incisors, and slightly constricted bifid mandible associated independent movement of the two halves of mandible. The patient had autogenous iliac bone graft to reconstruct the mandibular midline defect. The postoperative result was uneventful. In future, the correction of the soft tissue deformities such as notching of the lower lip and partial ankyloglossia will be required for the esthetic and functional improvement.