• 대한구순구개열학회지
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• 제16권1호
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• pp.1-8
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• 2013

Purpose : To introduce a more effective and efficient protocol for protraction of maxillary complex in CLP patient and demonstrate it by case presentation. Methods : Miniplates are placed on zygomatic buttress and anterior part of mandible, at the time of secondary alveolar bone graft. During the night time, the orthopedic force is applied by wearing elastics from maxillary miniplates to facemask (500 g per side). During the day time, the intermaxillary elastics connecting maxillary miniplates to mandibular miniplates are applied (200 g per side). During the orthopedic treatment, dental alignment is possible. Results and conclusion : By the new protocol, the intermaxillary relation and occlusion are improved due to the stable intraoral anchorage and better cooperation of patients.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.284-290
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• 2012

Open reduction and anatomic reduction can create better function for the temporomandibular joint, compared with closed treatment in mandible fracture surgery. Therefore, the double miniplate fixation technique via mini-retromandibular incision was used in order to make the most stable fixation when performing subcondylar fracture surgery. Those approaches provide good visualization of the subcondyle from the posterior edge of the ramus, allow the surgeon to work perpendicularly to the fracture, and enable direct fracture management. Understanding the biomechanical load in the fixation of subcondylar fractures is also necessary in order to optimize fixation methods. Therefore, we measured the biomechanical loads of four different plate fixation techniques in the experimental model regarding mandibular subcondylar fractures. It was found that the loads measured in the two-plate fixation group with one dynamic compression plate (DCP) and one adaption plate showed the highest deformation and failure loads among the four fixation groups. The loads measured in the one DCP plate fixation group showed higher deformation and failure loads than the loads measured in the two adaption plate fixation group. Therefore, we conclude that the selection of the high profile plate (DCP) is also important in order to create a stable load in the subcondylar fracture.

• Archives of Plastic Surgery
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• 제36권6호
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• pp.735-742
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• 2009

Purpose: The management of fractures of mandibular subcondyle continues to be controversial between open and closed treatment. The purpose of this article is to explain the endoscopic assisted open reduction and internal fixation and minimize the controversy. Methods: Nine patients of mandibular subcondylar fracture were reduced and fixed by using intraoral endoscopic - assisted open reduction and internal fixation and were followed up for 14 ~ 24 months after surgery. Results: Eight patients of mandibular subcondylar fracture had been treated without significant complications. One patient, whose malocclusion had been remained, was recovered normal occlusion by maxillomandibular fixation using intermaxillary screws for 3 weeks. Conclusion: The advantages of endoscopic - assisted open reduction and internal fixation are direct visualization, accurate fracture repair, minimized scar, decreased morbidity. And maxillomandibular fixation is not needed when it is done by accurate reduction and rigid fixation with one miniplate in the region of subcondylar fracture. With the above consideration, endoscopic - assisted open reduction and internal fixation can be considered as one of the best treament for subcondylar fracture of the mandible.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권3호
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• pp.277-282
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• 1995

With the use of antibiotics and improved dental care, osteomyelitis of the jaw is less common these days, But sometimes the management of osteomyelitis is more difficult because of appearance of resistant organisms to antibiotics. Treatment of the steomyelitis are incision and drainage, closed catheter irrigations, sequestrectomy, saucerization, hyperbaric ocygen therapy, and resection with or without bone graft. We experienced advanced osteomyelitis due to delayed treatment of left mandibular angle fracture. He have medical history of pschysoprenia. We decided to treat the patient with open reduction and closed cather irrigation. We achived reconsolidation of mandibular fracture accompanied by osteomyelitis by complete removal of inflammatory tissues, rigid fixation with miniplate and closed catheter irrigation.

• 대한치과교정학회지
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• 제52권5호
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• pp.354-361
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• 2022

Objective: To analyze the overall treatment effects in terms of the amount of uprighting with changes in the three-dimensional positions of the mandibular posterior teeth after applying the biocreative reverse curve (BRC) system. Methods: Thirty-four patients (mean age, 20.5 ± 8.56 years) were treated using the BRC system (mean period, 8.17 ± 2.19 months). Cone-beam computed tomography was performed before treatment and after treatment with the BRC system. The three-dimensional movement of each tooth was analyzed in the coordinate system at points on the crown and root apex. A paired t-test was used to analyze the treatment effects of the BRC system. Results: The application of the BRC system spanning from the first premolar to the second molar resulted not only in buccal and distal uprighting, but also in increased buccal and distal tipping of the teeth. The premolars and the first molar were extruded, and the second molar was intruded. Conclusions: When the BRC system is applied, simultaneous distal and buccal uprighting of the premolars and molars can be achieved bilaterally using a temporary skeletal anchorage device without unnecessary movement of the anterior teeth.

• 대한치과교정학회지
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• 제37권1호통권120호
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• pp.73-84
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• 2007

상악 전방견인 장치는 골격성 III급 부정교합 특히 상악골 열성장 치료를 위해 널리 사용되고있다. 이 경우 증례에 따라 치아 치조성 이동을 허용하는 다양한 치료목표가 설정될 수 있으나, 상악골의 순수한 전방이동이 필요한 경우 다양한 구내장치를 이용하여 고정원 보강을 시도함에도 불구하고 고정원의 치아 치조성 이동을 피하기 어려운 경우가 발생된다. 이는 치아를 고정 원으로 이용하는 경우 골개조(remodeling)가 상악복합체 뿐만 아니라 치주인대에서도 발생되기 때문이다. 특히 이러한 부작용은 역동적인 치열 교환이 일어나서 치성고정원이 부족한 혼합치열기 또는 비교적 늦은 나이에 악정형 치료가 시행되는 경우에 많이 발생되게 된다. 이와 같은 부작용을 방지하기 위해 임플란트의 사용이나 피질골절단술, 신연골형성술 등의 외과적 방법을 응용하여 전방견인을 시도할 수 있으나 본고에서는 악정형적 효과를 극대화하기 위한 새로운 대안으로 골 고정원 (skeletal anchorage)을 이용한 상악 전방견인 치료의 외과적 교정적 치료 술식을 증례를 통해 소개하고자 한다.

• 대한치과교정학회지
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• 제46권4호
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• pp.212-219
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• 2016

Objective: The purpose of this study was to evaluate treatment effects after distalization of the mandibular dentition using ramal plates through lateral cephalograms. Methods: Pre- and post-treatment lateral cephalograms and dental casts of 22 adult patients (11 males and 11 females; mean age, $23.9{\pm}5.52years$) who received ramal plates for mandibular molar distalization were analyzed. The treatment effects and amount of distalization of the mandibular molars were calculated and tested for statistical significance. The significance level was set at p < 0.001. Results: The mandibular first molar distalization at the crown and root were 2.10 mm (p < 0.001) and 0.81 mm (p = 0.011), respectively. In the evaluation of skeletal variables, there was a significant increase in the Wits appraisal (p < 0.001). In the evaluation of the soft tissue, there was no significant effect on upper lip position, but the lower lips showed a significant retraction of 2.2 mm (p < 0.001). Conclusions: The mandibular molars showed a significant amount of distalization accompanied by limited extrusion and mesiobuccal rotation of the crowns. A ramal plate may be a viable device for mandibular total arch distalization in Class III patients who are reluctant to undergo orthognathic surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권1호
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• pp.1-9
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• 1995

1986년 1월부터 1993년 12월까지 8년간 외과적 교정술을 시행한 117 증례에대하여 임상적인 관찰을 시행하였다. 1) 남녀 성비는 1:1.4로 여자가 많았으며 평균연령은 23.0세였다. 2) 악교정수술을 받기위하여 내원한 환자의 진단에 따른 분류를 보면 하악 전들증의 경우가 87증례(75.0%)로 주종을 이루고 있었다. 3) 수술방법중 하악단독수술은 88증례, 상악골 단독수술은 6증례, 상하악 동시이동술은 23증례였으며 이중 하악지 시상골절단술이 사용된 경우가 84증례(71.8%)로 가장 많았다. 4) 골편의 고정을 위하여 강선고정보다 Miniplate나 Screw 를 이용한 고정이 점차 선호되고 있으며 전체수술에서 견고고정의 비율은 66.0%였다. 5) 본 교실에서는 외가적 교정수술 환자를 대상으로 1992년 2월부터 저혈식 자가수혈을 이용하고 있으며 One Jaw surgery 에서는 2 pints, Two Jaw surgery 에서는 3 pints를 준비하고 잇다. 6) 악교정수술의 합병증으로는 하순지각마비등의 신경손상이 전체수술의 63증례(53.8%)로 가장 많았으며 골편의 잘못된 위치, 과두위치보존의 실패, 견고고정의 불안정등이 원인이 되어 5증례에서 재수술을 시행하였다.

• 대한두개안면성형외과학회지
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• 제9권1호
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• pp.17-22
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• 2008

Purpose: For several decades, open reduction has been a controversial issue in mandibular condyle fracture. The authors have successfully used the open reduction and internal fixation with retromandibular approach and have found it to be satisfactory for mandibular condyle fracture. Methods: A total of 10 patients with mandibular condyle fracture underwent open surgical treatment using retromandibular approach. The incision for the retromandibular approach was carried below the ear lobe and the facial nerve branches were identified. Dissection was continued until the fracture site was exposed and internal fixation was performed with miniplate following intermaxillary fixation. The average period of joint immobilization was 1 weeks and the arch bars were removed in 3 weeks on average. The preoperative and postoperative panoramic view and three-dimensional computed tomography were compared. During the follow up period, we evaluated the presence of malocclusion, chin deviation, trismus, pain, click sound, facial nerve palsy, hypertrophic scar and skin fistula. Results: According to the radiographic findings, the fractured condyle was reducted satisfactorily in all patients without any symptoms of facial palsy. During the follow up period ranged form 6 to 12 months, all clinical symptoms were improved except in one case with chin deviation and malocclusion. Conclusion: Using open reduction and internal fixation of mandibular condyle fracture with retromandibular approach, all results were satisfactory with good functional outcomes and minimal complication. We concluded that the open surgical treatment should be considered as the first choice for mandibular condyle fracture management.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권3호
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• pp.270-276
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• 2001

The treatment of mandibular subcondylar fractures is a matter of controversy. The majority of mandibular subcondylar fracture are treated by closed reduction, but the displaced or dislocated mandibular subcondylar fractures may be treated by open reduction. The characteristics of open reduction are the anatomical reduction, the functional restoration, the rapid function, the maintenance of vertical ramus dimension, the better appearance and the less resultant TMJ problem etc. When an open reduction is considered, the wire, miniplate, lag screw and Kirschner wire are available with internal fixation. Of these, Kirschner wire is a simple method relatively and correct positioning of the wire achieves rigid fixation. But many open reduction methods for mandibular subcondylar fractures require extraoral approach. The extraoral approach has some problems, the facial scar and the risk of facial nerve injury. On the other hand, the intraoral approach eliminates the potency of the facial scar and the facial nerve injury, but is difficult to access the operation site. Since the intraoral approach was first described by Silverman (1925), the intraoral approach to the mandibular condyle has been developed with modifications. The purpose of this article is to describe the intraoral technique with the Kirschner wire on mandibular subcondylar fractures. Conclusion : The intraoral reduction with Kirschner wire on mandubular subcondylar fractures avoids the facial scar and facial nerve injury and is simple method to the extraoral approach. And it has minimal morbidity and better esthetics.