• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.1
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• pp.62-67
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• 2010

The spreading pathways which is the cause of infection on head and neck area are submandibular space, masticatory space, parapharyngeal space, retropharyngeal space, carotid sheath and mediastinum, etc. If spread to parapharyngeal area involving airway, such infection can be life-threatening by airway obstruction, or can cause vascular injury followed by hemorrhage, nerve injuries. Also, if spread to superficially, necrotizing fasciitis and many complications may occur including gangrene of skin. The key to successful treatment of infection on head and neck area is recognition of spreading pathways, early diagnosis and following therapeutic management. Our department present two cases, one is infection progressed superficially to suprasternal space, another is spreading deep according to parapharyngeal space, subclavian space and carotid sheath followed by airway obstruction, and obtained significant results with surgical incision and drainage, administration of selected antibiotics, continuous post-operative treatment. We report these 2 cases with literatures review.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.454-462
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• 1996

With the increase of population, dramatic urbanization, traffic, leisure and sports, the number of maxillofacial injury has increased markedly. Subsequently the number of motor vehicle accident, sports accident and industrial accident were increased and the number of oral and maxillofacial trauma patients were also markedly increased. A clinical study on 177 patients with facial bone fracture who visited Kangnam General Hospital during 4 years(1992-1995) was done by analysing sex, cause, fracture site, treatment method, complication and involvement of other body part. The results obtained were as follows : 1. The occurrence was more frequent in male than in female with the ratio of 4.2 : 1 and most frequently in twenties. 2. Violence was the most common cause of facial bone fracture. 3. Mandible was the most frequently occurred site and there were more cases of simple fracture(81.9%) than cases of compound fracture. 4. Simple fracture was most frequently occurred(44.0%). 5. In mandible fracture, simple fracture was 86.1%, fracture site was average 1.5 sites, most frequently in symphysis. 6. As treatment methods, open reduction(78.5%) was used more frequently than closed reduction(21.5%). 7. Post-operative complication occurred in 29.4% of the cases. 8. Other injuries that were related to maxillofacial fracture occurred in 28.2%.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.4
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• pp.679-700
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• 1996

Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.

• Imaging Science in Dentistry
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• v.39 no.3
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• pp.149-156
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• 2009

Purpose : The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. Materials and Methods : We devised a patient-specific stent for patient-to-image registration and navigation. Three-dimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. Results : The accuracy over 8 anatomical landmarks showed an overall mean of $0.56{\pm}0.16\;mm$. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. Conclusion : The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.282-288
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• 2010

Surgery with the computer navigation system can make it possible to identify important anatomical structures which are difficult to be confirmed with the naked eye in the operation, and has extended their applications in various surgical fields. The head and neck surgery especially requires detailed anatomical knowledges and these knowledges have influences on postoperative functions and esthetics of a patient. In the orthognathic surgery, we should take osteotomies in the precise locations of the jawbones and move segments to the intended positions. There are so many important anatomical structures around the osteotomy-sites in the orthognathic surgery that the prevention of damage to these structures to obtain satisfactory results without any complication. There are vessels of the pterygoid plexus posterior to the pterygoid plate in the maxilla and the mandibular nerve enters the mandibluar foramen in the mandibular ramus. These locations should be confirmed perioperatively to avoid any injury to these structures. The navigation-assisted surgery may be helpful for this purpose. We performed navigational orthognathic surgeries with preoperative CT images and obtained satisfactory results. The osteotomy was performed in the proper location and damaging the surrounding important anatomical structures was avoided by keeping the saw away from them with the real-time navigation. It may be required to develop proper devices and protocols for the navigation-assisted orthognathic surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.182-186
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• 2007

A cyst is a pathologic lesion characterized by a cavity filled with fluid, celluar products, air, or a combination of these. Dentigerous cysts were formed around the crown of unerupted teeth. The reduced enamel epithelium persists around the crown after it has formed. Proliferation of the epithelium in a fluid-filled sac may be induced by osmotic pressure. In the first decade the most frequent location is the premolar site. In each subsequent decade the largest number of cysts are in the mandibular third molar site, with the second most frequent site being the maxillary canine. The treatment of odontogenic cyst can be mostly classified into three types of cyst enucleation, marsupialization and decompression. We should consider age of patient, anatomic structure, location and size for choosing a treatment method. Advantage of cyst enucleation is fast healing, but a injury of a surrounding structure is highly. Marsupialization is conservative treatment that can reduce the damage of a adjacent structure, but it is only limited at superficial lesion. Decompression also is conservative treatment, but it has the difficulty of the oral hygiene and the troublesome of the lavage. We present the possibility that reduces the defect of decompression and cures the lesion efficiently. We report a male patient with the dentigerous cyst developed at left mandibular third molar in this study. We used the decompression for a treatment and created special appliance to treat the lesion efficiently. We report a case of the cyst treatment that is association with efficiency of decompression appliance.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.4
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• pp.198-203
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• 2018

Dyke-Davidoff-Masson syndrome is a non-inherited rare condition that presents during childhood and is characterized by seizures, hemiplegia, mental retardation, cerebral hemiatrophy, calvarial thickening, and hyperpneumatization of the frontal sinuses. The present article highlights a case of a 12-year-old male child with additional clinical findings of $caf{\acute{e}}$-au-late pigmentation and ocular lipodermoid. This is the first case report of DykeDavidoff-Masson syndrome to describe oral manifestations, such as unilateral delayed eruption of teeth, hypoplasia, and taurodontism, which could be unique and characteristic of this condition. Oral health care providers and physicians should be aware of these oral observations as dental referrals could warrant early dental prophylactic care and can be useful in diagnosing the possible time of injury and type of Dyke-Davidoff-Masson syndrome.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.1
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• pp.40-46
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• 2021

Marsupialization is widely used as a primary treatment modality for reducing size of large cysts. However, there is no recommendation for specific duration of marsupialization. In addition, Carnoy's solution usually is applied at the time of enucleation as a fixative agent. In this report, we present an appropriate marsupialization duration of ameloblastoma involving two unerupted teeth. In this present study, marsupialization using a Foley catheter was performed in two cases of ameloblastoma of the mandible involving two adjacent impacted teeth. Carnoy's solution was applied for 3-5 minutes after enucleation in both patients. Periodically during marsupialization, the size of the radiolucency was measured in panoramic view, and clinical examination was performed. No remarkable paresthesia or soft tissue injury was observed after application of Carnoy's solution or during follow-up. We recommend 12 to 16 weeks as an adequate marsupialization duration for a large ameloblastoma involving two impacted teeth based on increased radiopacity along the margins of the lesions. Poor oral hygiene was an issue after 12 weeks of marsupialization in one case. There were no remarkable complications with Carnoy's solution in either case. The Foley tube has a two-way system that is more effective for irrigating the cavity than is the conventional one-way system.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.4
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• pp.174-181
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• 2016

Objectives: This retrospective study aims to evaluate the prevalence of maxillofacial trauma in a developing country, along with its pattern, etiology and management. Data for the present study were collected from the Department of Dentistry, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research, Chennai in India. Materials and Methods: The medical records of patients treated for maxillofacial injuries between May 2014 and November 2015 were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma. SPSS software version 16.0 was used for the data analysis. Results: Maxillofacial fractures accounts for 93.3% of total injuries. The mean and standard deviation for the age of the patients were $35.0{\pm}11.8$ years and with a minimum age of 5 years and maximum age of 75 years. Adults from 20 to 40 years age groups were more commonly involved, with a male to female ratio of 3:1. There was a statistically significantly higher proportion of males more commonly involved in accident and injuries (P <0.001). Conclusion: The most common etiology of maxillofacial injury was road traffic accidents (RTA) followed by falls and assaults, the sports injuries seem to be very less. In RTA, motorized two-wheelers (MTW) were the most common cause of incidents. The majority of victims of RTA were young adult males between the ages of 20 to 40 years. The malar bone and maxilla were the most common sites of fracture, followed by the mandible. The right side of the zygomatic complex was the predominant side of MTW injury. The majority of the zygomatic complex fractures were treated by conservative management. Open reduction and internal fixation were performed for indicated fracture patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.47-52
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• 1989

There were increased number of maxillofacial trauma in recent years accompanied by the change in the type and the severity of the injury thus it was necessary to set up new therapeutic concepts. Among many fixation methods, miniplate osteosynthesis, compression osteosynthesis, wire osteosynthesis and so forth were considered. In this paper we are reporting case of the multiple facial bone fracture, which mainly treated with miniplate osteosynthesis and the additionally used craniofacial suspension wire and transpaltal wire. It was concluded that miniplate osteosynthesis was useful in multiple facial bone fractures.