• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.21 no.2
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• pp.341-351
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• 1991

The purpose of this study was to aid in the evaluation of prognosis of temporomandibular joint after open reduction of fractured mandible. The author studied the bony changes (remodelling) of 116 temporomandibular joints and facial asymmetry in 58 patients. Subjects were divided into 4 Groups according to the follow up periods after open reduction of fractured mandible. The bony changes and facial asymmetry were observed on lateral tomograms and cephalometric posteroanterior skull radiograms. The results were as follows: 1. The bony changes of condyles were observed in 56 cases (38 flattening, 14 osteophyte, 3 erosion, 1 sclerosis). Flattening was observed in 32.8% (Group Ⅰ 27.8%, Group Ⅱ 37.5%, Group Ⅲ 35.7%, Group Ⅳ 32.1%). Osteophyte was observed in 12.1% (Group Ⅰ 11.1%, Group Ⅱ 8.3%, Group Ⅲ 7.1%, Group Ⅳ 21.4%). Erosion and sclerosis were observed in 2.6%, 0.9%, respectively. 2. The bony changes of articular fossa were observed in 18 cases (15.5%). Flattening was observed in 12.1% (Group Ⅰ 2.8%, Group Ⅱ 4.2%, Group Ⅲ 10.7%, Group Ⅳ 17.9%). Sclerosis was observed in 3.4% (Group Ⅰ 5.6%, Group Ⅲ 3.6%, Group Ⅳ 3.6%). 3. The amount of facial asymmetry was 2.81±2.20㎜ (Group Ⅰ 3.06±1.93㎜, Group Ⅱ 2.38±2.44㎜, Group Ⅲ 2.74±1.19㎜, Group Ⅳ 2.93±2.93㎜). There was no significant difference between all groups according to bony changes of temporomandibular joints after open reduction of fractured mandibles (x²-Test, P>0.05).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.13.1-13.12
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• 2016

Background: Mandibular motion tracking system (ManMoS) has been developed for orthognathic surgery. This article aimed to introduce the ManMoS and to examine the accuracy of this system. Methods: Skeletal and dental models are reconstructed in a virtual space from the DICOM data of three-dimensional computed tomography (3D-CT) recording and the STL data of 3D scanning, respectively. The ManMoS uniquely integrates the virtual dento-skeletal model with the real motion of the dental cast mounted on the simulator, using the reference splint. Positional change of the dental cast is tracked by using the 3D motion tracking equipment and reflects on the jaw position of the virtual model in real time, generating the mixed-reality surgical simulation. ManMoS was applied for two clinical cases having a facial asymmetry. In order to assess the accuracy of the ManMoS, the positional change of the lower dental arch was compared between the virtual and real models. Results: With the measurement data of the real lower dental cast as a reference, measurement error for the whole simulation system was less than 0.32 mm. In ManMoS, the skeletal and dental asymmetries were adequately diagnosed in three dimensions. Jaw repositioning was simulated with priority given to the skeletal correction rather than the occlusal correction. In two cases, facial asymmetry was successfully improved while a normal occlusal relationship was reconstructed. Positional change measured in the virtual model did not differ significantly from that in the real model. Conclusions: It was suggested that the accuracy of the ManMoS was good enough for a clinical use. This surgical simulation system appears to meet clinical demands well and is an important facilitator of communication between orthodontists and surgeons.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.2
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• pp.48-54
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• 1990

This is a report of 4 cases of the surgical correction of mandibular prognathism with chief complaint of mastication difficulty, facial asymmetry and protrusive chin. We performed sagittal spit ramus osteotomy for the prognathism, we used the repositioning plate for conserving the condylar segment into its original position and fixed the osteotomized bone segments rigidly with adjustable monocortical plate. Intermaxillary fixation was performed during 2 weeks. As a results, we found the following advantage. 1. Rigid fixation effect like the fixation by the tandem screw. 2. Decreased postoprative swelling. 3. It is needless to do the stab incision for the transbuccal set instrument. 4. It is more convenient to perform the rigid fixation in the monocortical plate method than screw technique.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.3
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• pp.207-216
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• 1992

The congenital condition referred as hemifacial microsomia is characterized by underdevelopment, malformation or abscence of certain soft and hard tissue derivatives of the first and second branchial arches and open also of structures which are not derived from the branchial arches, such as the zygoma, temporal bone. This is a report about a 14 years old male patient with the chief complaint of severe facial asymmetry, who was diagnosed as hemifacial microsomia having agenesis of the right mandibular condyle and zygomatic arch. Deformities and rib bone graft on the affected mandibular condyle and body, and LeFort I osteotomy in the maxilla. To correct contour-deficient chin, we performed the genioplasty, and the zygomatic arch was reconstructed with rib bone graft.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.594-606
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• 1996

This study was intended to perform the relationships between mandibualr lateral deviation in facial asymmetry patients and morphology of the cranial vault. In 30 patients(males 14, female 16) using submento-vertical cephalograms that were taken in the pre-operaticve state and posteroanterioir cephalograms that were taken in centric occlusion before, immediate and long term after surgery. 1. Mean mandibular deviation was about $-3.12^{\circ}$and mean of absolute measurement was about $2.50^{\circ}$on the submento-vertical cephalograms. 2. On the submento-vertical cephalograms, there was no significant difference between non-deviation and deviation side but it had tendency that deviation side was larger than non-deviation side on the frontal portion of cranium(Y10 to Y6) and deviation side was smaller than non-deviation on the temporal portion of cranium(Y5, Y-1 to Y-5). 3. Mean mandibular deviation was about $1.40^{\circ}$and mean of absolute measurement was about $3.95^{\circ}$on the posteroanterioir cephalograms. 4. There was statistical significance on the influence of surgical change(PT2A-PT1A) to the relapse(PTLA-PT2A)(p<0.05). The more increasing of the change, the more relapse on the posteroanterioir cephalograms. 5. There was no statistical significance on the influence of degree of mandibular deviation to morphology of the cranium on the submento-vertical cephalograms. But it had tendency that the more mandibular deviation, the larger the non-deviation side on the anterior cranium and deviation side on the posterior cranium(p>0.05). 6. There was statistical significance on the influence of the degree of mandibular deviation on the posteroanterioir cephalograms to the difference between non-deviation and deviation side. The more increasing of mandibular deviation, the larger the non-deviation side on the Y4 to Y-6(p<0.05). 7. There was no statistical significance on the influence of difference between non-deviation and deviation side to the relapse on the posteroanterioir cephalograms. But it had tendency that the more increasing of the differece between non-deviation and deviation side, the more increasing the relapse on temporal of cranium.

• The korean journal of orthodontics
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• v.25 no.1 s.48
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• pp.13-18
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• 1995

Craniofacial asymmetry was analyzed in 39 patients with complete unilateral cleft lip and palate(UCLP). The samples are devided into three groups nine below 9 years, twenty three from 9 years 1 month to 14 years and seven over 14 years group. Seventeen measurements were obtained from the tracing of PA X-ray cephalometric headfilms to evaluate the asymmetric characteristics and changes accdording to aging in UCLP. The obtained results were as follows. 1. Facial asymmetry in UCLP is variable(1.22-3.47 $mm/^{\circ}$) and the length from midsagitta1 reference line to maxillary 1st molar, to upper central incisor and the length of mandibular ramus showed significant asymmetry 2. Nasal septum and anterior nasal spine were deviated In the cleft side and the lower border of nasal cavity was 1ower in cleft side. 3. The deviation of nasal septum was continued significantly till after 14 years old.

• The korean journal of orthodontics
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• v.38 no.5
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• pp.314-327
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• 2008

Objective: The purpose of this study was to evaluate the reproducibility of measurements representing asymmetry of the mandible and to identify which landmarks would be more useful in 3-dimensional (3D) CT imaging. Methods: Facial CT images were obtained from forty normal occlusion individuals. Eighteen landmarks were established from the condyle, gonion, and menton areas, and 25 measurements were constructed to represent asymmetry of the mandible; 8 for ramus length, 12 for mandibular body length, 1 for condylar neck length, 2 for frontal ramal inclination, and 2 for lateral ramal inclination. Inter- and intra-examiner reproducibility of the measurements was evaluated. Results: Inter-examiner reproducibility of the measurements proved to be high except for 3 measurements. Intra-examiner reproducibility also proved to be high except for 2 measurements. Inter- and intra-examiner reproducibility of the measurements including Gonion proved to be low. Conclusions: The results of the present study indicate that the landmarks and measurements constructed in 3D CT images can be used for the diagnosis of facial asymmetry.

• The korean journal of orthodontics
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• v.40 no.6
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• pp.373-382
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• 2010

Objective: The purpose of this study was to assess the dentoalveolar compensation in facial asymmetry individuals using an integration of a CBCT image and a laser scanned dental cast image. Methods: The subjects consisted of 30 adults with asymmetric mandibles and 20 adults with symmetric mandibles. The CBCT and laser scanned dental cast images were integrated with a registration technique. Canine and first molar position and angulation were assessed from reference coordinates. The differences between deviated and non-deviated sides were analyzed with the paired t-test. The differences shown according to menton deviation were also statistically analyzed using Pearson correlation analysis. Results: The experimental group showed deviated and non-deviated side differences (dev.-ndev.) in the position and angle of the canine and first molars. Menton deviation showed positive correlation with the deviation side (dev.-ndev.) for the maxillary and mandibular 1st molar angles, negative correlation with the deviation side for the vertical position of the maxillary 1st molars, transverse position of the mandibular canine, transverse position and vertical position of the mesio-lingual cusp of the mandibular 1st molars. Conclusions: The upper and lower canine and first molars of facial asymmetry individuals were compensated, so the transverse position, vertical position, and angle showed differences between the deviated/non-deviated sides.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.49.1-49.9
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• 2016

Background: The aim of this report is to present a new reference for aesthetic mandible surgery using three-dimensional cone-beam computed tomography-based treatment planning for orthognathic surgery which can be implemented in surgical planning and perioperative procedure. Methods: To make an objective standard for evaluating aesthetic mandibular outline, we make an aesthetic scoring criteria with consideration of asymmetry, broad mandibular border line, and prominent mandibular angle. Two maxillofacial surgeons and two orthodontists rated their aesthetical evaluation from 1 to 5. Experimental group consisting of 47 female and 38 male patients who had rotational orthognathic two-jaw surgery from 2010 to 2011 were chosen according to aesthetic scoring done by two maxillofacial surgeons and two orthodontists. A high aesthetic score (${\geq}16$) means the facial contour is symmetric, with no broad and narrow aesthetic mandible frontal profiles. Control A group consisted of ten female and ten male patients who had no orthognathic surgery experience and low aesthetic score (${\geq}10$). Control B group consisted of ten female and ten male patients who had no orthognathic surgery experience and had anaesthetic mandibular frontal profile and a high aesthetic score (${\geq}16$). The three-dimensional image of the patient was taken from dental cone-beam CT (DCT) scanning (experimental group and control A group: 6 months DCT after surgery, control B group: 1st visit DCT). Each DCT was reformatted to reorient the 3D image using 3D analyzing program (OnDemand3D, cybermed Inc, CA, USA). After selection of 12 landmarks and the construction of reoriented horizontal, vertical, and coronal reference lines, 15 measurements were taken in 3D analysis of frontal mandibular morphology. Afterwards, horizontal and vertical linear measurements and angular measurements, linear ratio were obtained. Results: Mean $Go^{\prime}_{Rt}-Me^{\prime}-Go^{\prime}_{Lt}$ angular measurement was $100.74{\pm}2.14$ in female patients and $105.37{\pm}3.62$ in male patients. These showed significant difference with control A group in both genders. Ratio of $Go^{\prime}_{Rt}-Go^{\prime}_{Lt}-Me^{\prime}$ length to some linear measurements (ratio of $Me^{\prime}-Cd^{\prime}_{Rt}Cd^{\prime}_{Lt}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$, ratio of $Me^{\prime}-Go^{\prime}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$, ratio of $Go^{\prime}_{Rt}-Go^{\prime}_{Lt}$ to $Me^{\prime}-Go^{\prime}_{Rt}Go^{\prime}_{Lt}$) showed significant difference with control A group in both genders. Conclusion: This study was intended to find some standard measurement of mandible frontal view in 3D analysis of aesthetic patient. So, these potential measurement value may be helpful for orthognathic treatment planning to have more aesthetic and perspective outcomes.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.333-340
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• 2009

Osteomyelitis means inflammation of the bone marrow. It usually begins in the medullary cavity, involving the cancellous bone; then it extends and spreads to the cortical bone and eventually to the periosteum. The cause is usually thought to be microbiological. But there still are factors that predispose to produce a possible bone infection such as injuries, syphilis, actionomycosis, chronic kidney failure, alcoholism, malnutrition, radiotherapy, and chemotherapy. Treatment of modalities have been directed toward eradicating microbes and improving circulation in the early stage. In the case presented, surgical debridement and IV antibiotics were the treatment of choice. Osteomyelitis in children is mainly affected in the mandible. And in childhood, the mandibular condyle is regarded as an important center of mandibular growth. Therefore, in young patients, osteomyelitis involving this region may cause a restraint of mandibular development, resulting in facial asymmetry. So diagnosis in the early stage is important in child with osteomyelitis. Recently, we have encountered an interesting case of osteomyelitis of the mandibular condyle in 9-year-old boy. So we present the case and review the literature about osteomyelitis.