• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.4.1-4.4
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• 2018

Background: Along with the advances in technology of three-dimensional (3D) printer, it became a possible to make more precise patient-specific 3D model in the various fields including oral and maxillofacial surgery. When creating 3D models of the mandible and maxilla, it is easier to make a single unit with a fused temporomandibular joint, though this results in poor operability of the model. However, while models created with a separate mandible and maxilla have operability, it can be difficult to fully restore the position of the condylar after simulation. The purpose of this study is to introduce and asses the novel condylar repositioning method in 3D model preoperational simulation. Methods: Our novel condylar repositioning method is simple to apply two irregularities in 3D models. Three oral surgeons measured and evaluated one linear distance and two angles in 3D models. Results: This study included two patients who underwent sagittal split ramus osteotomy (SSRO) and two benign tumor patients who underwent segmental mandibulectomy and immediate reconstruction. For each SSRO case, the mandibular condyles were designed to be convex and the glenoid cavities were designed to be concave. For the benign tumor cases, the margins on the resection side, including the joint portions, were designed to be convex, and the resection margin was designed to be concave. The distance from the mandibular ramus to the tip of the maxillary canine, the angle created by joining the inferior edge of the orbit to the tip of the maxillary canine and the ramus, the angle created by the lines from the base of the mentum to the endpoint of the condyle, and the angle between the most lateral point of the condyle and the most medial point of the condyle were measured before and after simulations. Near-complete matches were observed for all items measured before and after model simulations of surgery in all jaw deformity and reconstruction cases. Conclusions: We demonstrated that 3D models manufactured using our method can be applied to simulations and fully restore the position of the condyle without the need for special devices.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.5
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• pp.372-382
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• 2002

As the most of dentofacial deformity patients indicated to orthognathic surgery have strong desire for esthetic improvement as well as functional improvement, ideal esthetic evaluation should be made at surgical prediction. Lateral cephalographs has been commonly used for surgical prediction, however, remarkable discrepancy between esthetic viewpoint by simple looking and analysis on lateral cephalographs often found on evaluation of sagittal position of the upper and lower jaws especially in cases of mandibular prognathism of Koreans. In these cases, we have been employed Esthetic NaP(ENaP)-line for corrective evaluation and ideal surgical prediction on lateral cephalographs, but the efficacy of ENaP-line has not been evaluated. This is a study on efficacy of ENaP-line for orthognathic surgery of Korean mandibular prognathism. 170 Korean patients who had been diagnosed as mandibular prognathism and planned for orthognathic surgery at Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University during last 10 years are studied. The obtained results are as followings; among 170 patients of mandibular prognathism, 132 patients(77.6%) had not discrepancy in evaluation of sagittal position of the maxilla between cephalometric and esthetic evaluation(they are classified as Group I), however, 38 patients(22.4%) had definite discrepancy(they are classified as Group II). ENaP-line was employed in all cephalometric analysis of Group II. The proportions of male and female were similar in both Groups. Sixteen vertical reference lines perpendicular to 16 horizontal reference lines were obtained as followings; Each of the representative degree of ${\angle}SN/AFH$, ${\angle}SN/CFH$ and ${\angle}AFH/CFH$ obtained at Group I was applied to SN plane, AFH plane and CFH plane of Group II each other, and so 16 horizontal reference lines could be obtained individually according to each of the applied degree to each plane. And then their reliability to coincide with ENaP-line of Group II was evaluated. A vertical reference line perpendicular to a horizontal line made by application of the representative degree of ${\angle}$AFH/CFH in Group I to AFH line in Group II had the most highest coincidence with ENaP-line of Group II, however, its agreement was 42% in male and 47% in female. From this results, the rest of them should be determined their corrective jaw position definitely depend on

• Clean Technology
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• v.22 no.2
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• pp.89-95
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• 2016

The nanotoxicity of ZnO nanoparticles used in cosmetics and tire industry is one of emerged issues. Herein, the removal of ZnO nanoparticles dispersed in aqueous phase and its ecotoxicity were investigated. In the short-term exposure for fertilized eggs (O. latipes), the deformity was observed at 5 mg L⁻¹ of ZnO nanoparticles in some individuals and delayed hatching of eggs by retarded growth was observed at 10 mg L⁻¹ of ZnO nanoparticles. This result show that ZnO nanoparticles have cytotoxic effect to the organisms lived in water phase. Therefore, herein, the removal of ZnO nanoparticles in aqueous phase by chemical precipitation was investigated. After addition of Na₂S and Na₂HPO₄, the precipitated ZnO was transformed to ZnS and Zn₃(PO₄)₂ particles, respectively. The removal efficiency of ZnO was reached to almost 100% for two cases. In addition, the toxicity tests about ZnS and Zn₃(PO₄)₂ particles showed no acute toxicity for D. magna. This implies that transformation of ZnO to ZnS and Zn₃(PO₄)₂ particles with very low ionization constant might decrease effectively the toxicity of ZnO.

• Korean Journal of Cleft Lip And Palate
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• v.7 no.1
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• pp.1-16
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• 2004

In the recent time, early correction of the congenital anomalies has become the focus of contemporary cleft lip care, The reason of that is mostly psychologic factor of children are respected, Although the propound object of lip adhesion is not esthetic improvement, that able to satisfy sufficiently parents of cleft children, In the unilateral or bilateral clefts, a preliminary lip adhesion has been advocated as a mean of narrowing the cleft at an early phase, of improving the nasal contour, of molding the alveolar arch, and of easing and improving the result of a definitive lip repair. The present study was earned out to investigate the effect of lip adhesion. We performed the Millard's high-half underminded adhesion and Seibert's lip adhesion followed by modified Millard's cheiloplasty for five infants had unilateral complete cleft lip. The lip adhesion reduced the actual deformity by molding the maxillary alveolar segments into better relationship and allows a easy cheiloplasty so that led to more perfect final lip result, Both Millard's high-half underminded adhesion and Seibert's lip adhesion were available methods to adhere a wide cleft lip, Especially, Seibert's lip adhesion had more advantages such as enhancement of the force of adhesion, correction of the deviated columella and acquirement of the esthetic upper lip continuity. These results suggest that the lip adhesion followed by cheiloplasty for wide unilateral complete cleft lip patients provide more favorable final result by molding the maxillary alveolar segments into better relationship.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.1
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• pp.35-40
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• 2016

The maxillary defects lead to anatomical and functional deformity of the maxillofacial region. As far as functions are concerned, such defects can produce difficulty in speech, mastication, and deglutition. Obturator prostheses play a very important role in functional recovery for post-maxillectomy patients. To achieve rigidity of the obturator, appropriate retention should be given, and the weight of the prosthesis be reduced. There are two types of hollow bulb obturator: open and closed. A closed type has many advantages. Nevertheless, some problems, including complexity of fabrication and water leakage into the bulb, have the closed hollow obturator not be widely used. The one-step polymerization technique described in this case overcomes the shortcomings by easily constructing a small hollow bulb with two thermoplastic resin sheets.

• Journal of the Korean Society of Radiology
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• v.9 no.7
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• pp.473-478
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• 2015

Abdominal obesity is one of the most influential index to predict of insulin resistance syndrome/metabolic syndrome in social demographic characteristics. It is matter of fact that radiation dose are increasing with development of medical treatment and device. In this study, we estimated distortion between reference image and entrance surface dose when take a chest radiography forward chest phantom assumed abdominal obesity. When angle of chest phantom incline $5^{\circ}$ forward, thoracic transverse and longitudinal diameter increase 1.22% and 0.44% each. Also cardiac transverse diameter increase 1.01% and cardio-throracic ratio (CTR) decrease 0.27% in the same situation of incline to $5^{\circ}$ forward. Thoracic transverse diameter shows the largest increase, and CTR was decreased. But entrance surface dose to phantom increase significantly 6.12% when angle of chest phantom incline $5^{\circ}$ forward. In conclusion, we have to pay attention to accurate positioning, to prevent a distortion of image through incline, and make patients not to expose to additional radiation.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.695-698
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• 2011

Purpose: Since spinal tuberculosis is increasing in prevalence, it appears that a repair of spinal soft tissue defect as a complication of spinal tuberculosis can be a meaningful work. We report this convenient and practical reconstructive surgery which use bilateral latissimus dorsi musculocutaneous advancement flap. Methods: Before the operation, $13{\times}9.5$ cm sized skin and soft tissue defect was located on the dorsal part of a patient from T11 to L3. And dura was exposed on L2. Under the general endotrachel anesthesia, the patient was placed in prone position. After massive saline irrigation, dissection of the bilateral latissimus dorsi musculocutaneous flaps was begun just upper to the paraspinous muscles (at T11 level) by seperating the paraspinous muscles from overlying latissimus dorsi muscles. The plane between the paraspinous muscles fascia and the posterior edge of the latissimus dorsi muscle was ill-defined in the area of deformity, but it could be identified to find attachment of thoracolumbar fascia. The seperation between latissimus dorsi and external oblique muscle was identified, and submuscular plane of dissection was developed between the two muscles. The detachment from thoracolumbar fascia was done. These dissections was facilitated to advance the flap. The posterior perforating vasculature of the latissimus dorsi muscle was divided when encountered approximately 6 cm lateral to midline. Seperating the origin of the latissimus dorsi muscle from rib was done. The dissection was continued on the deep surface of the latissimus dorsi muscle until bilateral latissimus dorsi musculocutaneous flaps were enough to advance for closure. Once this dissection was completely bilateraly, the bipedicled erector spinae muscle was advanced to the midline and was repaired 3-0 nylon to cover the exposed vertebrae. And two musculocutaneous units were advanced to the midline for closure. Three 400 cc hemovacs were inserted beneath bilateral latissimus dorsi musculocutaneous flaps and above exposed vertebra. The flap was sutured with 3-0 & 4-0 nylon & 4-0 vicryl. Results: The patient was kept in prone and lateral position. Suture site was stitched out on POD14 without wound dehiscence. According to observative findings, suture site was stable on POD55 without wound problem. Conclusion: Bilateral latissimus dorsi musculocutaneous advancement flap was one of the useful methods in repairing of large spinal soft tissue defect resulting from spinal tuberculosis.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.400-408
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• 2010

Purpose: Complete septal extension grafts have been widely used in rhinoplasty for effective projection of the short retruded columella in Asian patients. Autologous septal cartilages and porous high-density polyethylene sheets are frequently used as septal extension grafts. This study was conducted to compare the postoperative results of porous polyethylene sheets and septal cartilages used for correction of unilateral cleft lip nasal deformities by using photogrammetric analysis. Methods: This study investigated a total of 49 patients with cleft lip nasal deformities who underwent corrective surgery, and were followed up for at least 6 months. Septal cartilages were used in 39 patients, and porous polyethylene sheets were used in 10 patients. In all patients, through the open rhinoplasty, complete septal extension grafts were sutured to the caudal margin of the septal cartilage, and the alar cartilage was sutured with suspension. The cleft side alar cartilage was overcorrected by approximately 3 - 5 mm. Postoperative outcomes were evaluated by using photogrammetric analysis. Five indices and 4 angles were measured on their photographs taken before and after the surgery. In patients with unilateral cleft lip nasal deformities, symmetry was also evaluated by means of columellar length index. Results: The postoperative values obtained in photogrammetric analysis showed improvements in comparison with the preoperative ones. The polyethylene group produced more improved outcomes than the septal cartilage group but also resulted in more complications at the same time. Conclusion: The results of this study indicates that complete septal extension grafts are efficient for the correction of unilateral cleft lip nasal deformities. However, since postoperative complications occur more frequently in the polyethylene group than in the septal cartilage group, caution is advised in using porous high-density polyethylene sheets in patients with cleft lip nasal deformities.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.427-432
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• 2010

Purpose: The purpose of this study is to estimate muscle defect by ultrasonography in the patients with secondary deformities of the lip. We investigated the association between the muscle defect in the repaired cleft lip and the philtral appearance not only at resting state but also maximal puckering. Methods: From December 2006 to November 2007, 52 children were evaluated after primary or secondary cheiloplasty. Digital photographs were taken both from the front and both three quarter views in repose and at maximal pucker. Video clips were also taken in repose and at maximal pucker. A panel of four, scored the philtral ridge and dimple seen on these photographs and videos by using two visual analog scales. Eminence of the philtral ridge was scored by a 5 point grading scale, from "conspicuous groove" to "normal philtral ridge" and the philtral dimple was scored by 3 point grading scale, from "no dimple" to "prominent dimple". Ultrasound images of the upper lip were made using a linear array transducer at the resting position of the lip and evaluated by a single radiologist. Results: The philtral ridge eminence scored $2.79{\pm}0.54$ and $1.40{\pm}0.53$ at resting and maximal pucker, correlating with "flat" and "conspicous groove". The philtral dimpling scored $1.44{\pm}0.53$ and $2.27{\pm}0.66$ at resting and maximal pucker, correlating with "no dimple" and "slight dimple". Ultrasound imaging showed the average muscle dehiscence to be $3.78{\pm}2.14$ mm at resting position. Correlation between the muscle defect in ultrasound imaging and philtral ridge eminence at rest was statistically significant (p<0.050), but was not significant (p=0.756) at maximal pucker using Spearman's rank correlation. Correlation between the muscle defect in ultrasound imaging and philtral dimpling was not statistically significant both at rest (p=0.920) and at maximal pucker (p=0.815) using Spearman's rank correlation. Conclusion: Quantitative assessment of the muscle defect using ultrasonography correlates with the static philtral appearance, but does not correlate with the dynamic appearance. Also, the size of the muscle defect does not show any correlation with the philtral dimpling. Our findings reveal that ultrasound imaging partially reflect static appearance of philtrum but cannot reflect dynamic appearance and suggest the need for further research to evaluate dynamic appearance.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.629-636
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• 2009

Purposes: Wide scars occurring on the lower face and neck are a source of both functional and esthetic problems. Consequently, we can use skin grafts, pedicled flaps, free flaps, and tissue expansion for the reconstruction of this area. Compared with other reconstruction techniques, tissue expansion is advantageous in that it enables the maintenance of a color and texture similar to that of the adjacent tissue. However, the conventional method of tissue expansion has been reported to lead to an unnatural cervicomental angle and to the deformity of adjacent structures. We have therefore made efforts to prevent these problems through the use of several operative procedures. Methods: Forty-one patients with lower facial and cervical scars underwent tissue expansion. The tissue expansion was performed using a rectangular-shaped Nagosil$^{(R)}$ tissue expansion device. On insertion of the tissue expander, the intermediate area of superficial fat layer was dissected and then the tissue expander was inserted to make a flap that was as thin as possible. In advancement of the flap, a capsule-formed by the tissue expander-was used for the interrupted fixed suture of the flap to the fascia of the platysma muscle of the neck. This procedure was performed multiple times and also performed between the flap and the periosteum of the mandible, such that the tension was removed during the suture of the flap margin. Finally, the patients were fitted with a Jobst$^{(R)}$ facial garment in order to stabilize the operation site at least twelve months. Results: The most prevalent location of the scar was the cheek (15 cases), followed by the chin in 14 cases and the neck in 12 cases. The mean size of scar was $55.7{\pm}39.4cm^2$. Conclusions: Using our procedures, we have experienced no significant deformities and have also achieved a more natural cervicomental angle in the patients.