• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권4호
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• pp.178-183
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• 2014

Lip canting is associated with facial asymmetry, and is one of the most challenging problems in surgical correction of facial deformities. The author corrected lip canting using bioabsorbable devices during orthognathic surgery. Soft tissue suspension procedures were performed on four patients with facial asymmetry. Lip lines improved for all patients. Over an observation period of five years, no complications were noted, nor did any late relapse develop. Furthermore, as time past, the effect of the Endotine suspension procedure increased probably due to induction of fibrosis on surrounding soft tissues.

• Journal of International Society for Simulation Surgery
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• 제3권1호
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• pp.33-35
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• 2016

Fibrous dysplasia(FD) is a disorder in which normal bone is replaced with pathologic tissue. When occurring in craniofacial regions, the zygomaticomaxillary complex is most commonly affected and this pathologic lesion results in facial asymmetry. and By using computer-assisted virtual simulation, precise maxillofacial contouring was achieved for harmonious facial morphology and the surgical procedure was simplified and the surgery brought satisfactory results in terms of both esthetics and functionality.

• 대한치과교정학회지
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• 제47권3호
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• pp.195-206
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• 2017

Facial asymmetry can be classified into the rolling-dominant type (R-type), translation-dominant type (T-type), yawing-dominant type (Y-type), and atypical type (A-type) based on the distorted skeletal components that cause canting, translation, and yawing of the maxilla and/or mandible. Each facial asymmetry type represents dentoalveolar compensations in three dimensions that correspond to the main skeletal discrepancies. To obtain sufficient surgical correction, it is necessary to analyze the main skeletal discrepancies contributing to the facial asymmetry and then the skeletal-dental relationships in the maxilla and mandible separately. Particularly in cases of facial asymmetry accompanied by mandibular yawing, it is not simple to establish pre-surgical goals of tooth movement since chin deviation and posterior gonial prominence can be either aggravated or compromised according to the direction of mandibular yawing. Thus, strategic dentoalveolar decompensations targeting the real basal skeletal discrepancies should be performed during presurgical orthodontic treatment to allow for sufficient skeletal correction with stability. In this report, we document targeted decompensation of two asymmetry patients focusing on more complicated yaw-dependent types than others: Y-type and A-type. This may suggest a clinical guideline on the targeted decompensation in patient with different types of facial asymmetries.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.259-266
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• 2005

The function of the masseter and anterior temporal muscles was assessed by electromyography in 30 patients with mandibular prognathism (20 patients with facial asymmetry and 10 patients without facial asymmetry) before orthognathic surgery and 4weeks afterwards. Electromyogram(EMG) recordings were made during resting, clenching and swallowing. We compared with right-left difference of this recording and asymmetry index before and after orthognathic surgery. The result of this study was as follows. 1. There was no significant right-left difference in muscle activities of masticatory muscles both asymmetric groups and controls and many variable change after orthognathic surgery.(P>0.05) 2. The mean electric activity of the masticatory muscles was found to have decreased during more clenching than resting, but there was no statistically significant difference because of individual difference of measuring values.(P>0.05) 3. The asymmetry index of masticatory muscles in asymmetric groups was significantly greater during clenching compared with controls.(P<0.05) In conclusion, no right-left difference of muscle activities was found in patients with facial asymmetry before orthognathic surgery and 4weeks afterwards. Not only muscular functioning but also many other factors, such as occlusion, temporomandibular joint disorder and trauma, probably affect facial asymmetry and will be analyzed in future studies. And we will need long term follow-up after orthognathic surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권2호
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• pp.151-159
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• 2005

The purpose of this study was to evaluate the nasal deviation in mandibular prognathism with mandibulo-facial asymmetry. There were 40 patients whose mandibular prognathism with/without facial asymmetry were treated with orthognathic surgery from March 2002 to October 2003. The Group A(n=20) had a mandibulo-facial asymmetry over 6mm menton deviation in cephalogram PA and the Group B(n=20) had a mandibular prognathism. The preoperative frontal photograph, cephalogram PA and three dimensionalcomputed tomography(divided in hard tissuse image and soft tissue image) of two group was evaluated NDA(nasal deviation angle) and MDA(mandibular deviation angle). The NDA was statistical difference between asymmetry Group A and symmetry Group B(p<0.01), and was deviated in affected side of asymmetry. The MDA were also statistical difference between Group A and Group B(p<0.01), however the measurements of MDA between the frontal photograph, 3D-CT and cephalogram PA were similar to each others. The low correlation of NDA between frontal photograph and cephalogram PA in Group A and B demonstrate that we couldn't assess nasal deviation in cephalogram PA. It could be concluded that patients with mandibulo-facial asymmetry have a nasal deviation and clinician must remember this fact when they assess and treat patients.

• Imaging Science in Dentistry
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• 제31권4호
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• pp.199-204
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• 2001

Purpose : To assess the relationship between soft tissue asymmetry and bone tissue asymmetry using the standardized photographs and the posteroanterior (PA) cephalometric radiographs in mandibular asymmetric patients. And to clarify that the lack of morphologic balance among different skeletal components can often be masked by compensatory soft tissue contributions. Methods: Experimental group consisted of 58 patients whose chief complaints were facial asymmetry, they were taken with standardized facial photographs and PA cephalometric radiographs. Control group consisted of 30 persons in the normal occlusion. The reproducibility of the facial photograph was confirmed by model test. The differences of fractional vertical heightand horizontal width from standardized facial photographs and PA cephalometric radiographs were compared and analyzed. Results: The difference of fractional vertical bone height was 0.63 and fractional vertical soft height was 0.58 in control group, 3.10 and 2.01 in asymmetric group, respectively. The difference of fractional horizontal bone width was 0.52 and fractional horizontal soft width was 0.70 in control group, 2.51 and 1.70 in asymmetric group, respectively. Both soft and bone tissue showed significant difference between control and asymmetric group (p<0.05). The difference of bone tissue was greater than that of soft tissue (p<0.05) in the experimental group but, not in control group. Conclusions: Soft tissue components may compensate for underlying skeletal imbalances.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권6호
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• pp.622-627
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• 2008

In orthognathic surgery, precise analysis and diagnosis are essential for successful results. In facial asymmetric patient, traditional 2D image analysis has been used by lateral and P-A Cephalometric view, Skull PA, Panorama, Submentovertex view etc. But clinicians sometimes misdiagnose because they cannot find exact landmark due to superimposition, moreover image can be magnified and distorted by projection technique or patient's skull position, when using these analysis and method. For overcome these defects, analysis by using of 3D CT has been introduced. In this way we can analysis precisely by getting the exact image free of artifact and finding exact landmark with no interruption of superimposition. So we want to review of relationship between various skeletal landmarks of mandible or cranial base and facial asymmetry by predictable analysis using 3D CT. We select the cases of the patients who visited our department for correction of facial asymmetry during 2003-2007 and who were taken image of 3D CT for diagnosis. 3D CT images were reconstructed to 3D image by using V-Work program (Cybermed Inc., Seoul, Korea). And we analysis the relationship between facial asymmetry and various affecting factor of skeletal pattern. The mandibular ramus hight difference between right and left was most affecting factor that express facial asymmetry. And in this research, there was no relationship between cranial base and facial asymmetry. The angulation between facial midline and mandibular ramus divergency has significant relationship with facial asymmetry

• 재활복지공학회논문지
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• 제11권2호
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• pp.179-186
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• 2017

안면 비대칭은 다양한 원인에 의해 발병되기 때문에 원인 분석이 중요하고, 평가하는데 있어서 정량적인 지표가 필요하다. 본 연구에서는 웹켐을 이용하여 얻은 영상을 영상처리 및 연산부를 거쳐 마커를 추적하고 마커 간의 거리를 계산하여 안면 마비를 평가하는데 정량적인 지표로 사용하던 Nottingham Grading System을 안면 비대칭을 평가하는데 적용해 보았다. 기존 Nottingham Grading System은 표정 변화에 따른 안면부의 특징점 들간의 거리변화를 합산하여 좌, 우를 비교하기 때문에 특정 케이스의 경우 측정 오류를 불러일으키는 문제점이 있었다. 기존 Nottingham Grading System과 문제점을 보완하여 개선시킨 평가지표를 이용하여 안면비대칭인 피실험자와 정상의 피실험자를 비교하였다. 기존 Nottingham Grading System에서는 안면 비대칭의 경우 99.0%, 정상의 경우 95.0%로 둘 다 정상 범위 속에 포함되었다. 하지만 개선시킨 Nottingham Grading System에서는 안면 비대칭의 경우 74.0%, 정상의 경우 93.2%의 결과가 나왔다. 본 연구의 결과로 인해, 개선시킨 Nottingham Grading System은 각 부위별 상세한 평가 및 진단이 가능하고, 기존 Nottingham Grading System의 '문제점을 보완하였음을 보여주었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권4호
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• pp.305-313
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• 1992

Facial asymmetry can be most distressing for the young child and parents. It can cause functional problems as a result of malocclusion. Classification of facial asymmetry has not been yet well-organized because of its varieties on etiologic factors, involved sites and clinical expressions. Even though, we don't know its causes definitely. It is generally believed that problems with aberrant pattern of condylar growth are related to facial asymmetry. This is a case report on surgical correction of the patients who had severe facial asymmetry. One patient was diagnosed as condylar hyperplasia and the other was diagnosed as a condylar hypoplasia related to trauma. We performed a simultaneous two-jaw surgery, condylar shaving, inferior border ostectomy of affected mandible in the former case, and a simultaneous two-jaw surgery, reverse-L osteotomy and alloplastic implantation with $Biocoral^{TM}$ in the latter case. The postoperative results of the two cases were excellent functionally and esthetically.

• 대한치과교정학회지
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• 제44권2호
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• pp.62-68
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• 2014

Objective: The purpose of this study was to examine the symmetry and parallelism of the skeletal and soft-tissue poria by three-dimensional (3D) computed tomographic (CT) imaging. Methods: The locations of the bilateral skeletal and soft-tissue poria in 29 patients with facial asymmetry (asymmetric group) and 29 patients without facial asymmetry (symmetric group) were measured in 3D reconstructed models of CT images by using a 3D coordinate system. The mean intergroup differences in the anteroposterior and vertical angular deviations of the poria and their anteroposterior and vertical parallelism were statistically analyzed. Results: The symmetric and asymmetric groups showed significant anteroposterior angular differences in both the skeletal and the soft-tissue poria (p = 0.007 and 0.037, respectively; Mann-Whitney U-test). No significant differences in the anteroposterior and vertical parallelism of the poria were noted ($p{\leq}0.05$; Wilcoxon signed-rank test). Conclusions: In general, the skeletal poria are parallel to the soft-tissue poria. However, patients with facial asymmetry tend to have asymmetric poria.