• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.2
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• pp.62-66
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• 2014

Osteoradionecrosis is one of the most serious complications of patients receiving radiation therapy. It is characterized by hypovascularity, hypocellularity, and hypoxia-inducing necrosis of bone and soft tissue following delayed healing. In this case, a 72-year-old man was referred to the Department of Oral and Maxillofacial Surgery complaining of trismus following extraction three months before first visit. He had a history of right tonsillectomy, radical neck dissection and radiotherapy performed due to right tonsillar cancer seven years prior. After the diagnosis of osteoradionecrosis on right mandibular body and angle, conservative antibiotic therapy was used first, but an orocutaneous fistula gradually formed, and extensive bony destruction and sequestrum were observed. Sequestrectomy, free particulated iliac bone and umbilical fat pad graft were performed via a submandibular approach under general anesthesia. Preoperative regular exams and delicate wound care led to secondary healing of the wound without vascularized free flap reconstruction.

• The korean journal of orthodontics
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• v.46 no.6
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• pp.395-408
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• 2016

We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.

• The korean journal of orthodontics
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• v.28 no.3 s.68
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• pp.479-486
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• 1998

Bimaxillary Protrusion can be treated effectively in growing patients and in adults with conventional orthodontic therapy. However, In the adult patient, combined surgical and orthodontic treatment modalities may offer distinct advantages over such conventional therapy. In those cases complicate by vertical jaw dysplasia, sagittal dysplasia, or transverse skeletal discrepancy in addition to bimaxillary protrusion, the possibilities of obtaining successful results through orthodontic treatment alone greatly diminish. Surgical retraction of both maxillary and mandibular anterior segments with subapical osteotomies and ostectomies in the extraction site may be a good treatment alternative. Treatment time and possible adverse effects of lengthy orthodontic therapy may be reduced and optimum esthetic improvement may be facilitated. On the following cases, patient who had bimaxillary protrusion with Angle class III malocclusion was treated with combined orthodontic - surgical therapy by anterior subapical segmental osteotomies.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.311-313
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• 2005

Generally, many Asian women tend to dislike the square jaw, as they believe it makes the face look wider, giving a stubborn and strong impression. Contouring of the mandible is therefore a relatively common aesthetic procedure among Asians. These days, the use of botulinum toxin for contouring of the lower face offer simple alternative to surgery. Motor point, which is the site over a muscle where its contraction may be elicited by a minimal intensity short duration electrical stimulus, is the optimal injection point of botulinum toxin. Study was undertaken to identify the location of motor point of the masseter muscle and the skin surface landmark. First, the thickest point of the masseter muscle was inspected through palpation and inspection by 3 different individual plastic surgeons and then compound muscle action potentials(CMAPs) of masseter muscle in 15 health volunteers were recorded using EMG. For the localization of the measured points, line between lateral canthus to the mandibular angle was used. Location of motor points were mapped to skin surface from lateral canthus in a percentage of the distance along the landmark line and in distance in millimeters. The clinical injection point was located at 71.69 percentile and 7.3 mm of the landmark line. The motor point test was located at 72.54 percentile and 7.1 mm of the landmark line. The depth of motor point was 16mm. There was no statistically significant difference between the clinical injection point and the motor point. We conclude that surface mapping of motor point of the masseter muscle would increase accessibility and accuracy in botulinum toxin injection for contouring of the lower face.

• The Journal of Advanced Prosthodontics
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• v.8 no.6
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• pp.439-448
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• 2016

PURPOSE. The purposes of this study are to evaluate the internal and marginal adaptation of two widely used CAD/CAM systems and to study the effect of porcelain press veneering process on the prosthesis adaptation. MATERIALS AND METHODS. Molar of a lower jaw typodont resin model was prepared by adjusting a 1.0 mm circumferential chamfer, an occlusal reduction of 2.0 mm, and a $5^{\circ}$ convergence angle and was duplicated as an abrasion-resistant master die. The monolithic crowns and copings were fabricated with two different CAD/CAM system-Ceramil and Zirkonzahn systems. Two kinds of non-destructive analysis methods are used in this study. First, weight technique was used to determine the overall fitting accuracy. And, to evaluate internal and marginal fit of specific part, replica technique procedures were performed. RESULTS. The silicone weight for the cement space of monolithic crowns and copings manufactured with Ceramil system was significantly higher than that from Zirkonzahn system. This gap might cause the differences in the silicone weight because the prostheses were manufactured according to the recommendation of each system. Marginal discrepancies of copings made with Ceramil system were between 106 and $117{\mu}m$ and those from Zirkonzahn system were between 111 and $115{\mu}m$. Marginal discrepancies of copings made with Ceramil system were between 101 and $131{\mu}m$ and those from Zirkonzahn system were between 116 and $131{\mu}m$. CONCLUSION. Marginal discrepancy was relatively lower in Ceramil system and internal gap was smaller in Zirkonzahn system. There were significant differences in the internal gap of monolithic crown and coping among the 2 CAD/CAM systems. Marginal discrepancy produced from the 2 CAD/CAM systems were within a reported clinically acceptable range of marginal discrepancy.

• The Journal of Advanced Prosthodontics
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• v.11 no.6
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• pp.331-340
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• 2019

PURPOSE. The purpose of this study is to assess the accuracy of three intraoral scanners along the complete dental arch and evaluate the feasibility of the assessment methodology for further in vivo analysis. MATERIALS AND METHODS. A specific measurement pattern was fabricated and measured using a coordinate measuring machine for the assessment of control distances and angles. Afterwards, the pattern was placed and fixed in replica of an upper jaw for their subsequent scans (10 times) using 3 intraoral scanners, namely iTero Element1, Trios 3, and True Definition. 4 reference distances and 5 angles were measured and compared with the controls. Trueness and precision were assessed for each IOS: trueness, as the deviation of the measures from the control ones, while precision, as the dispersion of measurements in each reference parameter. These measurements were carried out using software for analyzing 3-dimensional data. Data analysis software was used for statistical and measurements analysis (α=.05). RESULTS. Significant differences (P<.05) were found depending on the intraoral scanner used. Best trueness values were achieved with iTero Element1 (mean from 10 ± 7 ㎛ to 91 ± 63 ㎛) while the worst values were obtained with Trios3 (mean from 42 ± 23 ㎛ to 174 ± 77 ㎛). Trueness analysis in angle measurements, as well as precision analysis, did not show conclusive results. CONCLUSION. iTero Element1 was more accurate than the current versions of Trios3 and True Definition. Importantly, the proposed methodology is considered reliable for analyzing accuracy in any dental arch length and valid for assessing both trueness and precision in an in vivo study.

• The Journal of the Korean dental association
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• v.55 no.6
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• pp.400-410
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• 2017

Approximately 30% of adult patients who want orthodontic treatment have transverse discrepancy with insufficient width of the maxilla. Particularly, in Class III patients requiring orthognathic surgery, the frequency of insufficient width of the maxillary arch related to respiratory problems is high. We report a case of non-surgical maxillary expansion using a Hyrax type expander with an orthognathic surgery, based on the reports that the ratio of non-fused midpalatal suture is not high in adults. A 30 years and 2 months old woman with a long face showed an Angle Class III with a vertical growth pattern. Class III molar and canine relation, anterior edge bite, and mandibular incisor compensatory lingual inclination were observed. The posterior buccal overjet seemed to be appropriate, but I diagnosed that there was a transverse discrepancy, for the following reasons. The inter-canine and inter-molar widths were sufficient but excessive lingual inclination of the mandibular molars was observed when assessing the bucco-lingual inclination based on the center of resistance of the maxillary and mandibular first molar. For this reason, it was expected that intercuspal interference would occur during orthodontic decompensation. Therefore, slow maxillary expansion using Hyrax type expander was performed and 2-jaw rotation surgery was performed to improve aesthetic and occlusion. Adults can also improve width discrepancy by non-surgical methods, which can avoid SARPE requiring additional surgery or segmental surgery lacking stability and predictability.

• Korean Journal of Ichthyology
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• v.32 no.3
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• pp.136-142
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• 2020

Morphology and osteology of the slender ribbonfish, Trachipterus ishikawae was described and figured in detail. The morphological characteristics are as follow: body elongate and compressed; upper jaw protrusile; tubercles along ventral edge of body and tail; eyes are large; body naked; caudal fin long and at a right angle to the body; from (3~4)+(7~8) gill rakers; from 180 to 185 dorsal fin rays, from 12 to 13 pectoral fin rays; 9 caudal fin rays and 5+2 short spine at caudal spine. The osteological characteristics are as follow: premaxillary is long and has four teeth; dentary is triangle shape; interopercle and subopercle are wide and flat; 5 branchiostegal rays; post clavicle is thin and long; from 79 to 80 centrum; posterior vertebrae elongate; 5~6 tubercles at urostyle bone.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.364-373
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• 2019

Unlike class I patients, skeletal class II patients have unstable occlusion thus leading to instability of mandibular complete denture. Therefore, mandibular implant overdenture has been the standard of care due to its advantages in stability and retention. The types of attachments can be divided into two categories: solitary and bar type. The indications vary between two categories. In this clinical report, digital technology was utilized from the implant planning to the choice of appropriate attachment. Implants were placed at the desired location as previously planned in terms of angle and depth. Maxillary removable partial denture and mandibular implant overdenture are expected to have fair prognosis.

• Archives of Craniofacial Surgery
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• v.23 no.1
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• pp.23-28
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• 2022

Background: Intermaxillary fixation (IMF) is a technique that allows for the reduction and stabilization of mandibular fractures. Several methods of IMF, such as self-tapping screws or arch bars, have been developed. This study aimed to validate the usefulness of IMF with a self-tapping screw compared to IMF with arch bars with focus on the patients' perspective. Methods: We retrospectively reviewed the medical records of all patients who were treated for mandibular fractures at our hospital between August 2014 and February 2021. A total of 57 patients were enrolled in this study. Thirteen patients were excluded from the analysis: three patients were lost to follow-up, and 10 patients did not undergo IMF. Finally, 44 patients were analyzed, of which 31 belonged to the arch bar group, and 13 belonged to the screw group. Patient discomfort and pain during IMF application and removal were analyzed using a patient self-assessment questionnaire. The surgeon also assessed oral hygiene, IMF stability, and occlusion. Results: We applied IMF to 34 men (77%) and 10 women (23%). The mean age of the patients was 37.3 years. The most common fracture site was the angle (30%), followed by the parasymphysis (25%), the body (23%), the condyle (11%), and the ramus (11%). Patient discomfort and oral hygiene were statistically favorable in the screw group. The IMF application time was statistically shorter in the screw group (p< 0.001). IMF stability was not statistically different between the two groups. The pain score during IMF removal was lower in the screw group (p< 0.001). Conclusion: Compared to arch bars, IMF screws provide more comfort during the IMF period, help maintain favorable oral hygiene, and have a shorter application time. From the patient's perspective, IMF screws are an excellent alternative to conventional arch bars when applicable.