• Journal of International Society for Simulation Surgery
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• v.2 no.2
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• pp.90-93
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• 2015

The fibula free flap has now become the most reliable and frequently used option for mandible reconstruction. Recently, three dimensional images and printing technologies are applied to mandibular reconstruction. We introduce our recent experience of mandibular reconstruction using three dimensionally planned fibula free flap in a patient with gunshot injury. The defect was virtually reconstructed with three-dimensional image. Because bone fragments are dislocated from original position, relocation was necessary. Fragments are virtually relocated to original position using mirror image of unaffected right side of the mandible. A medical rapid prototyping (MRP) model and cutting guide was made with 3D printer. Titanium reconstruction plate was adapted to the MRP model manually. 7 cm-sized fibula bone flap was designed on left lower leg. After dissection, proximal and distal margin of fibula flap was osteotomized by using three dimensional cutting guide. Segmentation was also done as planned. The fibula bone flap was attached to the inner side of the prebent reconstruction plate and fixed with screws. Postoperative evaluation was done by comparison between preoperative planning and surgical outcome. Although dislocated condyle is still not in ideal position, we can see that reconstruction was done as planned.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.2.1-2.7
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• 2018

With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.

• Journal of the Korean Society of Clothing and Textiles
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• v.35 no.9
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• pp.1085-1098
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• 2011

In the $21^{st}$ century, technology is a tool for the expansion of the five senses and physical ability that works as an element for posthuman identity. This study analyzes and theorizes on the characteristics of the posthuman body in fashion illustration. The method of this study analyzes documentaries about posthuman and fashion illustration. The results are as follow. Posthuman body types are classed as hybrid body, plastic surgery body, and digital body. The characteristics of the posthuman body are categorized as ultra- functional prosthetic, mythical undifferentiated, radical plastic surgery type and post-physical digitization type. The ultra-functional prosthetic type shows a restored body and upgraded functional body through a machine hybrid, cyborg suit and mannequin hybrid. It is a break from classical gender identity to form a nerve sense extension that displays physical and abstract power. The mythical undifferentiated type shows a therianthropic form, parts of an animal body, radical skin and gender bending. It represents the return to an undifferentiated world, the desire of a powerful being and the possibility of radical transformation. The radical plastic surgery type shows a photomontage of an ideal body, transgendered body, grotesque body marking, absence of partial or overall face organ and the expansion of abnormal body organs. It represents the expression of narcissism, unconscious desire, fantasy, fear and suggests an alternative ideality, sexual attachment and ambiguous gender identity. The post-physical digitization type shows an imperfect form or duplicated ego image through the omission of the body silhouette or detailed form, fragmented image using net, representative self like optical illusion using typography, an imperfect vague silhouette and immaterial body outline through the use of virtual light. It represents the lack of desire, narcissism, fluidity in a virtual space, the continued creation of a new self, ambiguous gender identity and the liberation of environment, sex, and race. Likewise, the posthuman in fashion illustration shows the absence of a species boundary, destruction of classical gender identity, a new personality and virtual self image.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.5
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• pp.413-419
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• 2011

Purpose: Reposition of the maxilla is a common technique for correction of midfacial deformities. To achieve the goal of the surgery, the maxilla should be repositioned based on the precisely planned position during surgery. The internal reference points (IRPs) and the external reference points (ERPs) are usually used to determine vertical dimension of maxilla, which is an important factor for confirming maxillary position. However, the IRPs are known to be inaccurate in determining the vertical dimension. In this study, we investigated the correlation of positional change of the modified IRPs with repositioned maxilla. Methods: The study group consisted of 26 patients with dentofacial deformities. For the simulation of the surgery, patient maxillary CT data and 3-D virtual surgery programs (V-$Works^{(R)}$ and V-$Surgery^{(R)}$) were used. IRPs of this study were set on both the lateral wall of piriform aperture, inferior margin of both infraorbital foramen, and the labial surfaces of the canine and first molar. The distance from the point on lateral wall of the piriform aperture to the point on the buccal surface of the canine was defined as IRP-C, and the distance from the point on the inferior margin of the infraorbital foramen to the point on the buccal surface of the $1^{st}$ molar was defined as IRP-M. After the virtual simulation of Le Fort I osteotomy, the changes in IRP-C and IRP-M were compared with the maxillary movement. All measures were analyzed statistically. Results: With respect to vertical movements, the IRP-C (approximately 98%) and the IRP-M (approximately 96%) represented the movement of the canine and the $1^{st}$ molar. Regarding rotating movement, the IRPs changed according to the movement of the canine and the $1^{st}$ molar. In particular, the IRP-C was changed in accordance with the canine. Conclusion: IRPs could be good indicators for predicting vertical movements of the maxilla during surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.5
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• pp.337-342
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• 2012

The osseous or osteocutaneous free fibula flap has become the gold standard for most mandibular reconstructions because of its favorable osseous characteristics. However, disadvantages, such as the time-consuming reconstructive step, difficulty in performing the osteotomies to precisely recreate the shape of the missing segment of mandible and poor bone-to-bone contact play a role in making the surgeons look for alternative flaps. With the advent of computerized design software, which accurately plans complex 3-dimensional reconstructions, has become a process that is more efficient and precise. However, the ability to transfer the computerized plan into the surgical field with stereolithographic models and guides has been a significant development in advancing reconstruction in the maxillofacial regions. The ability to "pre-plan" the case, mirror and superimpose natural structures into diseased and deformed areas, as well as the ability to reproduce these plans with good surgical precision has decreased overall operative time, and has helped facilitate functional and esthetic reconstruction. We describe a complex case treated with this technique, showing the power and elegance of computer assisted maxillofacial reconstruction from the University of Michigan, Oral and Maxillofacial Surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.6
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• pp.381-389
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• 2013

Two patients with partial edentulous maxilla were scheduled to undergo installation of implant fixtures using a tooth-supported surgical template based on computer assisted treatment planning. After 3-dimensional (3D) computed tomographic scanning was transferred to the OnDemand3D (Cybermed Co., Seoul, Korea) software program for virtual planning, fixtures of MK III Groovy RP implant of the Br${\aa}$nemark System (Nobel Biocare AB Co., G$\ddot{o}$teborg, Sweden) was installed using the In2Guide (CyberMed Co., Seoul, Korea) tooth-supported surgical template with a Quick Guide Kit (Osstem Implant Co., Seoul, Korea) system in the posterior maxilla of each patient. Sinus floor elevation with a xenogenic bone graft procedure was also performed simultaneously in one patient. Fixture installations were completed successfully without complications, such as sinus mucosa perforation, bony bleedings, fenestrations, or others. During the last two-year follow-up period after prosthetics delivery, each implant was found to be fine with no other minor complications. The entire procedures are reported and the literatures on use of tooth-supported surgical template was reviewed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.14.1-14.10
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• 2019

Background: Condylar dislocation can arise as a complication in patients who required mandibular and/or condylar reconstruction and were operated on with fibula free flap (FFF) using surgical guides designed using simulation surgery. Surgeons should be aware of the complications in these present cases when planning and performing reconstructions as well as predicting prognoses. Cases presentation: Two cases showed condylar dislocation in mandibular reconstruction using a FFF fixed with a reconstruction plate. Three cases showed condylar dislocation in mandibular reconstruction using a fibula free flap fixed with a mini-plate. Conclusion: Despite the lack of clinical symptoms in these cases following mandibular reconstruction using an FFF, the mandibular condyle was severely displaced away from the glenoid fossa. A surgeon must have sufficient time to consider the use of a long flap with thickness similar to that of the mandible, ways to minimize span and bending, and methods of fixation. The patient, moreover, should be educated on condylar dislocation. Customized CAD/CAM-prototyped temporomandibular condyle-connected plates may be a good alternative even if virtual simulation surgery is to be performed before surgery. These considerations may help reduce the incidence of complications after mandibular reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.2
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• pp.158-165
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• 2011

A 73-year-old Korean female patient with a fully edentulous mandible was planned to have five implant fixtures installed in the anterior mandible for the fixed prosthesis. After 3-dimensional (3D) computed tomographic scanning was transferred to OnDemand3D$^{(R)}$ (Cybermed Co., Seoul, Korea) software program for the virtual planning, five fixtures of MK III Groovy RP implants of Branemark System$^{(R)}$ (Nobel Biocare AB Co., Goteborg, Sweden) were installed in the anterior mandible between both mental foramens using In2Guide$^{(R)}$ (CyberMed Co., Seoul, Korea) mucosa-supported surgical template with Quick Guide Kit$^{(R)}$ (Osstem Implant Co., Seoul, Korea) systems. Fixture installations were completed successfully without any complications, such as mental nerve injury, bony bleedings, fenestrations and other unexpected events. Postoperative computed tomographic scans were aligned and fused to the planned implant, then angular and linear deviations were compared with the planned virtual implants. The mean angular deviation between the planned and actual implant axes was $3.42{\pm}1.336^{\circ}$. The mean distance between the planned and actual implant at the neck area was $0.544{\pm}0.290$ mm horizontally and $0.118{\pm}0.079$ mm vertically. The average distance between the planned and actual implant at the apex area was $1.166{\pm}0.566$ mm horizontally and $0.14{\pm}0.091$ mm vertically. These results could be considered more precise and accurate than previous reports, and even our recent results. The entire procedures of this case are reported and reviewed.

• Journal of Korea Multimedia Society
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• v.12 no.5
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• pp.737-744
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• 2009

This paper is to study and implement 3D Virtual Face Aesthetic Surgery System which provides more satisfaction by comparing the before-and-after plastic face surgery using 3D face model. For this study, we implemented 3D Face Model Generating System which resembles 2D image of the user based on 3D Korean standard face model and user's 2D pictures. The proposed 3D Virtual Face Aesthetic Surgery System in this paper consists of 3D Face Model Generating System, 3D Skin Texture Mapping System, and Detailed Adjustment System for reflecting the detailed description of face. The proposed system provides more satisfaction to the medical uses and stability in the surgery in compare with other existing systems.

• Proceedings of the Korean Society of Broadcast Engineers Conference
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• 2008.02a
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• pp.191-195
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• 2008

가상 성형 시스템은 실제 성형 수술을 시행하지 않은 상태에서도 성형 후의 형상을 가상적으로 시뮬레이션해 봄으로써 고객의 의사 결정과 성형의의 수술 계획 및 상담을 효과적으로 지원할 수 있는 그래픽 시스템이다. 본 논문은 가변 워핑 마스크와 스머지 필터를 이용한 2D 가상 성형 시스템의 반자동 필드 워핑을 제안함으로써 가상 성형의 편의성과 실용성을 제고함에 그 목적이 있다. 제안된 2D 가상 성형 시스템은 마우스로 스머지 필터를 조작하여 얼굴 구성 요소의 윤곽 형상을 원하는 형태로 변형할 수 있는 직관적인 사용자 인터페이스를 제공한다. 얼굴 구성 요소의 스머징 전후의 윤곽선을 대상으로 다각형 근사화에 기반한 계층적 제어선 매핑을 통해 획득한 제어선 쌍들을 이용하여 반자동 필드 워핑을 수행함으로써 소스 제어선으로부터 목표 제어선까지 점진적으로 변해가는 다수의 중간 프레임들을 생성한다. 또한 이 반자동 필드 워핑을 수행할 시, 성형부위의 변형을 따라 단계적으로 모양이 변하는 가변 워핑 마스크를 사용함으로써 변형 부위 이외의 얼굴 구성 요소들에 대해서는 왜곡을 최소화하는 지역적 변형 특성을 제고한 것이 특징이다. 제안된 2D 가상 성형 시스템은 직관적이고 편리한 사용자 인터페이스를 제공할 수 있기 때문에 시간이 적게 소요되고 작업 피로도가 낮아 실용성이 높다. 따라서 비숙련자도 간단한 사용자 입력만으로 만족스러운 가상 성형 결과를 얻을 수 있다. 특히 짧은 시간 내에 성형의와 고객이 만족하는 직관적인 상담을 가능케 하는 것이 장점이다.