• Title/Summary/Keyword: 안면 비대칭

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Full mouth Rehabilitation with Orthognathic Surgery in Facial Asymmetry Patient : Case Report (안면 비대칭환자의 악교정 수술을 동반한 완전구강회복)

  • Im, So-Min;Shin, Hyoung-Joo;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.3
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    • pp.359-371
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    • 2010
  • Facial asymmetry has been found with a higher frequency (70~84%) in skeletal class III malocclusion patients. Anticipating the poor prognosis of prosthesis due to malocclusion, occlusal stability must be obtained by orthodontic treatment. Moreover, orthodontic surgery would be needed in some severe cases for better functional and esthetic results. The orthognathic surgery is performed on one jaw or two jaw depending on the results of facial diagnosis. Genioplasty may change the vertical, horizontal, sagittal position of chin by osteotomy or augmentation using implants, also. This case is about a 24 year-old male patient who visited our clinic to solve the facial asymmetry and mandibular prognathism. Skeletal class III malocclusion, maxillary canting and menton deviation to left by 13 mm were detected. Multiple ill-fitting prostheses, unesthetic maxillary anterior prostheses, and several dental caries were found. After pre-operative orthodontic treatment, Le-Fort I osteotomy, sagittal split ramus osteotomy, genioplasty, right mandibular angle augmentation were done for the correction of jaw relation and asymmetry. By diagnostic wax-up after post-operative orthodontic treatment, maxillary full mouth rehabilitation and mandibular posterior restorations were planned out. For better result, clinical crown lengthening procedure was done on #11, 12 and implant was placed on left mandibular first molar area. The patient was satisfied with the final prostheses. Because of his high caries risk, long-term prognosis will depend on the consistent maintenance of oral hygiene and periodic follow-up.

Submentovertex cephalometrics in korean adults (한국 성인에서 이하 두정 방사선 계측사진 분석)

  • Nahm, Dong-Seok;Suhr, Chung-Hoon;Yang, Won-Sik;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.30 no.1 s.78
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    • pp.1-7
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    • 2000
  • It is important that the orthodontist accurately assess the degree to which facial asymmetry contributes to a given malocclusion before treatment planning. P-A, submentovertex and verticosubmental view have been used in the assessment of facial asymmetry. Among them, submentovertex view is rarely used because it has low reproducibility and is short of normal data and proper analysis method. The purpose of this study was to develop a submentovertex cephalomentrics and obtain normal data in Korean adults. The subjects consisted of 40 normal adults (male : 22, female 18) without the experience of orthodontic treatment. We find the 2 angular and 9 linear measurements. Though submentovertex cephalomentrics has the limitation in comparing the absolute length between right and left, it is useful to examine the relationship of skeletal and dental midline, the shape and location of condyle head and the shape of mandibular body in submentovertex view Therefore, if we understand the limitation of submentovertex cephalomentrics and use lateral , P-A and submentovertex cephalomentrics together, we will measure the location and amount of skeletal disharmony more exactly.

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Reproducibility of asymmetry measurements of the mandible in three-dimensional CT imaging (전산화단층사진을 이용한 하악골 3차원 영상에서 비대칭진단 계측항목의 재현도에 관한 연구)

  • Kim, Go-Woon;Kim, Jae-Hyung;Lee, Ki-Heon;Bwang, Hyeon-Shik
    • 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.

Case Report of Maxilla/Mandible Simultaneous Distraction with Molina$^{(R)}$ Distractor (Molina distractor를 이용한 상/ 하악 동시 신장술 증례의 보고)

  • Baek, Kyung-Won;Kim, Keun-Woo;Choi, Jin-Yeong
    • Korean Journal of Cleft Lip And Palate
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    • v.9 no.2
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    • pp.55-62
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    • 2006
  • 1980년 일리자로프가 하지에서의 골 신장술을 발표한 이래 수많은 외과 의사들이 임상연구와 발표를 거듭해 현재의 골 신장술을 이루었다. 악골에서 골 신장술의 적용은 1992년 8명의 악골 기형 환아에게 하악지 신장술을 적용한 맥카시의 발표를 기점으로 시작되었다. 골 신장술의 장점은 부족한 골조직과 함께 주변 연조직을 신장시키는 것으로 복합적 조직 결손을 보이는 선천성 악골 기형 환자들에게 특히 유리하게 적용시킬 수 있다. 반안모 왜소증은 안면 반측의 상/하악골 및 악관절, 연조직의 저성장 및 결손을 보이는 비교적 흔한 악골 기형이다. 하악지 신장술의 활발한 연구로 이를 이용한 악관절 증상과 안면 비대칭의 해소가 일차적 치료기법으로 선택되고 있다. 연구자들은 악관절 증상과 안면 비대칭을 주소로 내원한 성인 반안모 왜소증 환자에게 상악 및 하악의 동시 골 신장술을 적용하여 만족할 만한 결과를 얻었기에 이를 발표한다. 상악골의 Le Fort 제1형 골 절단술과 이환측의 하악지 시상분할 골절단술 후에 Molina distractor를 하악지에 적용하고 악간 고정을 통해 동시 신장을 꾀하였다. 수술 기법 및 평가 기법에 대하여 논의하였다.

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CHANGES OF TEMPOROMANDIULAR JOINT SYMPTOMS AFTER ORTHOGNATHIC SURGERY IN THE ASYMMETRIC PROGNATHISM PATIENTS (안면비대칭 환자의 악교정술 후 안면비대칭의 개선에 따른 악관절장애 증상의 변화)

  • Kim, Young-Sam;Ryu, Dong-Mok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.518-523
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    • 2007
  • Purpose: The purpose of this study is to prove that orthognatic surgery on asymmetric prognathism patients improve the temporomandibular dysfunction. Materials and methods: All 30 patients underwent mandibular setback with B-SSRO including 22 patients Le Fort I surgery in KyungHee medical center. Preoperative and postoperative PA cephalograms & transcranial radiographs were measured midline deviation in Mx and Mn, occlusal canting change, condyle position, the temporomandibular dysfunction were checked before surgery, within 1 month after surgery, $3{\sim}6$ months, 12-24 months after surgery respectively. Results: The temporomandibular dysfunction were relieved after surgery in 17 patients of 25 patients. Conclusion: Orthognatic surgery may benefit the temporomandibular joint dysfunction in facial asymmetry patients by obtaining a postoperative stable occlusion and better physiologic neuromuscular function. Specially impovement of occlusal canting may reduce condyle displacement of midline deviation side and the temporomandibular joint dysfunction.

Distraction osteogenesis in facial asymmetry patient (견인골 신장술을 이용한 안모 비대칭 환자 치험례)

  • Tae, Ki-Chul;Kang, Kyung-Hwa;Lee, Su-Haeng;You, Seck-Keen
    • The korean journal of orthodontics
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    • v.33 no.5 s.100
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    • pp.391-398
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    • 2003
  • Distraction osteogenesis is a well-estabilished procedure of membraneous bone formation and has been used to correct craniofacial deformities in dentofacial orthopedic-surgery area for decades. In this articale, distraction osteogenesis is used for treatment of facial asymmetry. The patient underwent procedures to lengthen the mandibular ramus and body. After distraction, orthodontic treatment was done for ooclusal settling.

Application and effects of condylectomy in asymmetric patients with condylar hyperplasia (과두과증식을 동반한 안면비대칭 환자에서 과두절제술의 적용과 효과)

  • Lim, Kyoung-Sub;Cha, Jung-Yul;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.38 no.6
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    • pp.437-455
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    • 2008
  • Condylar hyperplasia is a pathologic condition showing 3-dimensional skeletal hyperplasia of the mandible. The reason for condylar hyperplasia is not yet known, but the effects of hormone, trauma, infection, genetics, fetal condition, and hypervascularity are known as possible reasons. When we diagnose a patient as having condylar hyperplasia, it is important to decide if it is in progress or not. Treatment for facial asymmetry due to condylar hyperplasia are decided accordingly, including condylectomy, that is removal of growth site of the affected condyle, and conventional orthognathic surgery only or condylectomy with orthognathic surgery after the completion of growth. Therefore, it is important to determine the growth state of condylar hyperplasia in treatment stability. This is verified through bone scan and regular check-ups with 3D CT or PA cephalogram. This case report introduces an improved case of facial asymmetry with condylectomy together with orthognathic surgery.

DEVELOPMENT OF THREE DIMENSIONAL MEASURING PROGRAM WITH FRONTAL AND LATERAL CEPHALOMETRIC RADIOGRAPHS -PART 2. 3-D VISUALIZATION AND MEASURMENT PROGRAM FOR MAXILLOFACIAL STRUCTURE- (정모 및 측모 두부 방사선 규격사진을 이용한 3차원 계측 프로그램의 개발 -2. 악안면 구조에 대한 3차원적 시각화 및 측정프로그램 개발-)

  • Lee, Sang-Han;Mori, Yoshihide;Minami, Katsuhiro;Lee, Geun-Ho;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.4
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    • pp.321-329
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    • 2001
  • To establish systematic diagnosis and treatment planning of dentofacial deformity patient including facial asymmetry or hemifacial microsomia patient, comprehensive analysis of three dimensional structure of the craniofacial skeleton is needed. Even though three dimensional CT has been developed, landmark identification of the CT is still questionable. In recent, a method for correcting cephalic malpositioning that enables accurate superimposition of the landmarks in different stages without using any additional equipment was developed. It became possible to compare the three-dimensional positional change of the maxillomandible without invasive procedure. Based on the principle of the method, a new program was developed for the purpose of diagnosis and treatment planning of dentofacial deformity patient via three dimensional visualization and structural analysis. This program enables us to perform following menu. First, visualization of three dimensional structure of the craniofacial skeleton with wire frame model which was made from the landmarks observed on both lateral and frontal cephalogram. Second, establishment of midsagittal plane of the face three dimensionally, with the concept of "the plane of the best-fit". Third, examination of the degree of deviation and direction of deformity of structure to the reference plane for the purpose of establishing surgical planning. Fourth, simulation of expected postoperative result by various image operation such as mirroring, overlapping.

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