• The korean journal of orthodontics
• /
• v.38 no.2
• /
• pp.133-143
• /
• 2008

Objective: This study was performed to identify the characteristics of the MSX1 gene (locus chromosome 4p16) in Korean nonsyndromic cleft lip and palate (CL/P), which is assumed to be a major candidate gene acting as a causal factor in nonsyndromic CL/P and missing teeth. Methods: The 36 individuals (23 males and 13 females) who had visited the department of orthodontics at from 1998 to 2002 and who had nonsyndromic CL/P were included in the study. Using a PCR-based assay, the MSX1 gene was amplified, sequenced, and searched for inferred protein products (Reference: Homo sapiens MSX1, accession number AF426432 and NP_002439). The common single nucleotide polymorph isms were observed. Results: In exon 1, nucleotide "A" of the 253 basepair (bp) region was substituted for "G", and in the 255 bp region, nucleotide "G" was inserted. In exon 2, nucleotide "C" of the 11 bp region was substituted for "A", and "T" or "G" was inserted into the 351 bp region whereas "T" or "A" was inserted into the 352 bp region. In protein analysis, "Thr85Ala" missense mutation was found. The "Thr85Ala" missense mutation in this study is different from those of studies using subjects of other races. Conclusions: The results suggest that there is specific mutation of MSX1 in Korean and it plays an important role in Korean nonsyndromic CL/P. However, any distinct genetic polymorphisms between CL/P with missing teeth in the cleft region and CL/P without missing teeth could not be found.

• Korean Journal of Cleft Lip And Palate
• /
• v.12 no.1
• /
• pp.1-6
• /
• 2009

Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter, had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in $mm^2$. Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.

• Korean Journal of Cleft Lip And Palate
• /
• v.7 no.2
• /
• pp.123-132
• /
• 2004

The purpose of this study was to obtain normative nasalance scores for adult subjects speaking the Korean language. Additional objectives of the study were to determine if speaker sex played a role in differences in nasalance score and there was significantly correlation of nasalance score with nasalance slope score. The subjects include 75 healthy young Korean adults with normal oral and velopharyngeal resource and function. They had no history of speech problem, were judged as having normal speech and resonance at the time of testing, and had no upper respiratory tract infections or allergies at the time of testing. The Nasometer II 6400 was used to obtain nasalance scores and nasalance slope scores for /a/, /i/, /e/, /o/, /u/, /ja/, /je/, /wi/, /p'ap'i/ and /sasi/. The data of nasalance and nasalance slope were analyzed statistically. The mean nasalance score of the female was significantly higher than that of male at /a/, /i/, /wi/, /p'ap'i/ and /sasi/(p <0.10). The mean nasalance score of /i/ was highest and that of /o/ was the lowest. In this study, we could not and the relationship of the nasalance score and the closing slope score. However, there was negative correlation between the mean nasalance score and the opening slope score at ie/ and /;ai, positive to /sasi/. These normative nasalance scores for normal young adults speaking the Korean language provide important reference information for Korean cleft palate teams. In the future study of velopharygneal activity with the Nasometer, the opening slope score will be able to be the important parameter.

• Korean Journal of Cleft Lip And Palate
• /
• v.12 no.1
• /
• pp.33-40
• /
• 2009

구개열이 있으면 언어장애 음식섭취의 어려움, 구개범장근의 기능장애로 인한 이관의 개폐기능부전으로 중이의 액체고임, 부정교합등 여러 문제가 생길 수 있다. 따라서 구개성형술은 갈라진 경구개와 연구개를 막아주며 동적인 연구개를 만들어 주어 충분한 구개인두폐쇄를 하여 정상적 발음을 하는데 그 목표가 있다. 그 외에도 음식물을 정상적으로 섭취할 수 있고 중이염 및 난청을 일으킬 수 있는 기능을 개선시키고 정상적인 교합을 만들어주는데 있다. 위의 목표를 이루기 위해 지금까지 많은 수술 방법이 개발되었고 개선되어 왔다. 하지만 아직도 가장 효과적인 수술방법, 수술시기에 대하여 논쟁거리가 되고있다. 언어를 분명하게 하려면 연구개는 인두벽에 닿기 위해 후상방으로 올라가고 인두의 후벽과 측벽은 올라온 연구개에 닿으려고 수축함으로써 비인두와 구인두 사이의 공간이 좁아지게 됨으로써 가능하다. 따라서 발음이 정확하려면 비인두괄약(nasopharyngeal sphincter)을 합리적으로 만들어주어 비인두와 구인두를 분리해 주어야 한다. 비인두괄약을 조성해 주는 방법에는 구개범거근이 괄약기능을 할수 있도록 연구개내근성형술(intravelar veloplasty)을 시행하여 양편구개범거근을 횡위로 옮겨 연결하여 올림근 걸이(levator muscle sling)을 만드는 방법, 구개 연조직을 후방으로 밀어 구개 길이를 연장하는 방법, 인두 피판술을 하는 방법등이 있다. 구개범거근의 주행방향과 부착이 잘못되어 있는 것으로, 정상에서는 구개범거근이 횡으로 주행하여 연구개의 정중봉선(median raphe)에 부착하는 데 반해 구개열에서는 구개범거근이 전방으로 주행하여 개열 가까이에 있는 구개열 후연과 골선 개열연에 부착되어 있고 구개인두근과 구개수근이 연구개를 그냥 지나쳐직접 구개열 후연에 붙는다. 저자등은 완전 양측성 구개열을 연구개내근성형술 및 서골피판을 동반한 2개 점막성골막판을 이용한 구개성형술로 수술을 시행하여 다소의 지견을 얻었기에 문헌고찰과 함께 보고하는 바이다

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.33 no.6
• /
• pp.681-683
• /
• 2007

Kabuki(Niikawa-Kuroki) syndrome was first reported by Niikawa et al(1981). The faces of the patients are similar to the make-up of traditional Japanese Kabuki actors: long palpebral fissures, an ectropium of the lateral third of the eyelids, and arching eyebrows with sparse lateral halves. Craniofacial findings include a depressed nasal tip, short nasal septum, large and prominent ears, and micrognathia. Other main features area mild to moderate mental deficiency, short stature, skeletal and dermatoglyphic abnormalities, including prominent finger tip pads. Oral anomalies are common in KS(over 60%) and include abnormal dentition, widely spaced teeth, cleft palate or lip, high vault of palate, hypodontia, conical incisors, screw driver-shaped incisors and ectopic upper 6-year molars. The increased occurrence of cleft lip and palate or the development of a high vault of palate has been described by a number of authors. This condition is believed to be common in Japan, but has been reported from other parts of the world. The objective of this presentation is to report a case of this syndrome in six-year-old girl, with characteristic findings.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.48 no.2
• /
• pp.85-93
• /
• 2022

Objectives: The aim of this study was to compare morbidities and duration of surgery, as well as bone formation in alveolar defects reconstructed with symphysis bone combined with allograft and iliac crest bone graft in patients with cleft palate. Patients and Methods: This randomized clinical trial was performed with 22 patients with unilateral alveolar cleft with a follow-up period of 12 months. In 12 patients, alveolar defects were reconstructed with chin bone graft plus allograft (Group A), while for the other 10 patients, iliac bone crest was used as donor site (Group B). Duration of surgery as well as occurrence of morbidities and complications were recorded. In addition, cone-beam computed tomographic (CBCT) scans were performed before surgery and 12 months after surgical procedures in order to compare bone formation between the two groups. Results: Postoperative CBCT demonstrated a mean bone fill percentage of 76.9% of the alveolar defect in Group A, compared with 77.0% in Group B. Paresthesia in the lower lip or chin did not occur in any patients of Group A. The mean duration of the surgical process was significantly shorter for Group A (40 minutes vs 76 minutes, P<0.001). In addition, patients in Group A regained normal gait faster than patients in Group B (1 day vs 9.5 days). Conclusion: Mandibular symphysis bone graft in combination with allograft results in favorable outcomes in patients with unilateral alveolar clefts.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.30 no.4
• /
• pp.380-385
• /
• 2008

Microstomia can be occurred as a result of direct injury to tissues such as chemical, thermal and electrical burns, and animal bites. It also may be secondary to contracture of burned perioral skin, or may result from scarring after reconstructive lip surgery. Narrowing of the oral aperture is not only disfiguring, but also limiting the oral access needed for introduction of food, insertion of dentures, oral hygiene, and dental treatment. Limited mouth opening may also interfere with mastication and speech. Few reports exist regarding correction of microstomia and reconstruction of the corners of the mouth. A 16-year-old girl with a bilateral cleft lip and palate presented with the limited mouth opening (approximately 20 mm), the esthetic problem due to the small lip, and the cleft lip-nasal deformity. The microstomia was corrected by bilateral commissuroplasty using "over and out" buccal mucosa flaps proposed by Converse. The intercommissure distance was increased from the preoperative 40 mm to the postoperative 60 mm. The one-year postoperative intercommissure distance was 54 mm, because the 6 mm relapse was occurred. The bilateral commissuroplasty using "over and out" buccal mucosa flap could increase the width and general size of the oral aperture and improve the lip appearance.

• Korean Journal of Cleft Lip And Palate
• /
• v.4 no.1
• /
• pp.1-11
• /
• 2001

Disposable blade is widely used for palatal and oral mucosal incision in oral and maxillofadal surgery nowadays, But its design and durability need for improvement, Especially, there are so many hard tissues intraoral area, such as bone and tooth, therefor the sharpness of the surgical blade was easily destroyed, The purpose of this study was to make basic data for developing new design of surgical blade using in oral and maxillofacial area including for the patients who have cleft lip and palate deformities, Some questionnaires about the usefulness of currently used surgical blades were sent to 150 dentists, the 54 of them made a reply, Secondly, The used-once blade and fresh new blade were examined under the scanning electron microscope with the 4000-times magnification, Lastly, the tissue reaction following the surgical incision with a fresh-new and a used blade on rat buccal cheek mucosa and hard palate was evaluated with light microscope with hematoxilin-eosin staining, The time interval from the surgical trauma to taking a sample were 1 day, 3 days, 7 days, and 14 days, At each time schedule, 2 Sprague-Dawley rats were sacrificed, Many dentists were agreed to need for changing the design of the surgical blades and also demand to improve the durability of the blades, They were also eager to adopt the new design of blade if it was available, The blade used in surgical extraction procedure was heavily damaged in its sharpe edge of number 15 blade, The histological differences were not prominent, but the delayed healing was detected in buccal mucosal defects especially in the surgical group with used blade, There are slight different changes in hard palatal defects between a used and a new blade group, In this study, we could find that there are imperative demanding on improvement of surgical blade design and durability for oral and maxillofadal area, The blade currently using in surgical extraction was easily damaged, The animal model of this study was not perfect for the purpose of this study.

• Archives of Craniofacial Surgery
• /
• v.25 no.4
• /
• pp.201-204
• /
• 2024

Pleomorphic adenoma is a benign tumor that can occur in the salivary glands, most commonly in the parotid gland. While it primarily occurs in the major salivary glands, it can sometimes be found in the minor salivary glands. Within the minor salivary glands, it most often originates in the hard palate and soft palate, and less frequently in the upper lips. Due to its location in the minor salivary glands, most pleomorphic adenoma involve and protrude on the mucosa. A 61-year-old man presented with 1.5 cm exophytic mass on the skin of his upper lip. This mass was exophytic on the skin and did not involve or protrude into the inner lip mucosa. The mass was entirely excised, and a subsequent permanent biopsy diagnosed it as a pleomorphic adenoma. In such situations, it can be challenging to suspect pleomorphic adenoma during a physical examination, leading to potential diagnostic confusion. It might also be mistaken for an inclusion cyst or another type of mass, making it tempting to treat without verifying the pathological results.

• Korean Journal of Cleft Lip And Palate
• /
• v.13 no.2
• /
• pp.53-62
• /
• 2010

Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnosis using Nasometer. The aim of this study is to find the nasalance differences between English native speakers and Korean speakers by measuring the nasalance of Oral and Nasal sentences. 20 Americans and 20 Korean students participate to the experimentation. The results are as follows: (1) The nasalance of females for Oral and Nasal sentences is higher than that of males for both native and Korean speakers. (2) The nasalance of Oral sentences in Korean men and females is higher than that of Oral sentences in American men and females, however, the nasalance of Nasal sentences in American men and females is higher than that of Nasal sentences in Korean men and females. (3) The nasalance of stop consonants /p, t, k/ in Korean men and females is higher than that of consonants in American men and females. (4) The nasalance of nasal consonants /m, n, ɧ/ in American men and females is higher than that of consonants in Korean men and females.