• Journal of the Korean Academy of Esthetic Dentistry
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• v.31 no.1
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• pp.26-35
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• 2022

Patients who miss teeth partially or fully show many changes which make them lose function and esthetics.From the esthetic point of view, loosing teeth makes lower face unharmonized. There are various changes of lower and whole face according as how much change oral cavity is. Restoring the multiple teeth missing properly can make patient's face harmonized. Especially full mouth implant restorations can cause drastic occlusal change affecting masticatory muscles. Because all the muscles are connected closely, the masticatory muscles which is part of lower facial muscles can cause whole muscle change. In full mouth implant restoration case, I will show the whole face muscle change harmonized by meticulous occlusal treatment process. Full mouth restorations installed in right way show whole face muscle changes extending to head and neck muscles.

• The Journal of the Korean dental association
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• v.42 no.3 s.418
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• pp.219-231
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• 2004

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.4
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• pp.351-358
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• 2010

A 31-year-old woman with hemifacial microsomia presented to the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The patient was previously treated with distraction osteogenesis device to elongate right maxilla and mandibular ramus. But, the result was not satisfactory, to correct residual facial asymmetry due to hemifacial microsomia we planned costochondral graft for reconstruction of ramus and condyle, Le Fort I osteotomy and sagittal split ramus osteotomy for facial asymmetry. The right mandibular condyle and ramus was reconstructed with right eleventh costochondral graft via submandibular approach. Using costochondral graft and orthognathic surgery the facial asymmetry in hemifacial microsomia patient was corrected. 1-stage treatment consists of costochondral graft and orthognathic surgery can achieve function and esthetics at the same time, is timesaving to both patient and surgeon.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.19-27
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• 1989

Hemifacial microsomia is characterized underdevelopment of the TMJ, mandibular ramus, and associated muscles of mastication. The Maxilla and malar bones on the affected side frequently are underdeveloped. The contiguous parotid gland may be hypoplastic. Preauricular sinus tracts and tags may exist, along with underdevelopment of the associated external ear, and affected facial nerve and muscles of facial expression may also show dysfunction. Children exhibiting the more classic signs will be identified at birth. Little is known about the etiology of hemifacial microsomia. We have corrected surgically a 22-year-old woman with hemifacial microsomia. We have performed leveling Le Fort I osteotomy with iliac bone graft on the maxilla, reverse-L osteotomy and iliac bone graft on the right mandibular ramus, vertical ramus osteotomy on the left side, onlay bone graft on the right mandibular body, and augmentation genioplasty. The postoperative course was uneventful and restoration of facial asymmetry was achieved.

• The korean journal of orthodontics
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• v.26 no.5 s.58
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• pp.637-645
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• 1996

In non-growing Class III malocclusion, the critical aspects which determine the need of orthognatic surgery are the severity of skeletal discrepancy, incisor inclination, overbile and soft tissue profile. Two-jaw surgery is more effective in correcting severe sagittal, vertical, transverse skeletal discrepancies and facial asymmetry. And more esthetic and stable profile can be achieved by two-jaw surgery Some midfacial deficiency Patients can be treated by Pyramidal Le Fort II osteotomy to maintain infraorbital rim and malar complex and to advance nasomaxillary complex. Others who require advancement of infraorbital rim and malar complex can be treated by quadrangular Le Fort II osteotomy. On the following cases, patients who had represented midfacial deficiency and mandibular prognathism were treated with combined orthodontic-surgical therapy by Le Fort II osteotomy and BSSRO.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.2
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• pp.159-169
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• 2014

Panfacial fractures require complex multidisciplinary approaches for treatment. Functional stability of bilateral condylar-disc complex should be the goal of the treatment. A patient with complex clinical panfacial fractures, including a bilateral condylar fractures visited our clinic. Facial asymmetry, insufficient vertical space and multiple missing teeth of the patient were major problems. Closed reduction and splint treatment were tried for stable condylar position. A functional and esthetic rehabilitation was accomplished by using implants and full mouth rehabilitaion. Potential possibilities of unstable occlusion should be prevented with night guard and periodic occlusal adjustment.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.69-72
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• 2010

Purpose: All masks are created by craftspeople. Accordingly, most masks are generally predictable in dimensions, and the portraitures usually depict the faces and heads of humans. The authors found some masks representing the features of facial asymmetry, such as hemifacial microsomia and rerely lateral facial cleft. Methods: Reviewing the legends of wearing masks with a medley of grotesque features, the authors could deduce the tone of society in those days. Results: A mask, 'crooked mouth', of Native Americans shows typical lineament of hemifacial microsomia. The deformity of the face was legendarily regarded as resulting from trauma caused by either 'one's fault' or a 'curse of God'. 'Grandmother' mask, used in the Korean masque dance of the Kosung province and Sooyoung province also shows the typical features of hemifacial microsomia which represent the old, deserted wife. 'Kori sanni yakka' mask in Sri Lanka, shows the facial asymmetry. In the legend, the child who became demon captured humans and caused illness through wind, phlegm, and bile to revenge on his father who killed his mother by deception of her maid. Conclusion: The authors presume that the victims of severe facial asymmetry were treated contemptuously at that time.

• Journal of TMJ Balancing Medicine
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• v.12 no.1
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• pp.28-31
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• 2022

위에서 살펴본 바와 같이 나는 급성 턱관절장애의 경우, 첫번째 유형은 주로 턱관절 디스크공간의 문제와 하악의 위치를 바로잡아주는 근육의 문제가 주 원인일 것으로 추정하고 있다. 만약 턱관절 디스크공간이 정상공간이라면 턱의 지그재그 움직임이나 턱관절잡음, 턱통증, 턱탈구, 그리고 개구장애 등이 발생할 수 없기 때문이다. 그리고 근육의 문제 중에서는 턱관절 디스크원판을 양측에서 잡아주는 내외측 익돌근의 문제가 가장 많은 영향을 미치고 있다. 특히 내측 익돌근의 긴장 및 수축이 디스크 원판을 내측으로 빠져나가게 함으로써 하악의 좌우 지그재그 움직임을 야기시키고 턱관절잡음이나 턱통증 및 개구장애를 유발하기 때문이다. 나머지는 저작에 관여하는 근육들이 그 다음으로 영향을 미치는 것으로 예측하고 있다. 그러나 제2형 급성 턱관절장애의 경우는 제1형 급성 턱관절장애가 한단계 더 발전하여 이와 연관된 근육이나 인대의 긴장수축이 오랜 시간 진행되어, 이들이 다시 상부 경추의 아탈구와 두개골의 비정상적 움직임에까지 영향을 미쳐 나타나는 것으로 생각된다. 그렇게 되면 뇌에서 필요 충분한 뇌혈액공급이나 뇌척수액순환의 문제를 일으킬 수 있기 때문이다. 그리고 제1형 만성 턱관절장애의 경우는 제2형 급성 턱관절장애가 좀 더 진행되면서 척추 및 근골격계의 구조변화, 교합 및 턱의 구조변화 그리고 안면구조의 변화에 이르기까지 점점 진행되어 나타나는 것으로 보인다. 따라서 각종 척추 디스크질환, 관절질환을 비롯해서 두개천골계의 순환문제, 부정교합 및 턱 비대칭, 안면 비대칭의 문제를 유발하게 된다고 추정된다. 그러나 두번째 유형의 만성 턱관절장애는, 턱에서 지속적이고 반복적인 그리고 과다한 부정적 자극들이 오랜 기간 누적되면서 턱에 분포된 C 섬유를 비롯한 3차신경의 가소성변화를 유발하면서 결국 중추신경계를 포함하여 전체신경계의 회로망에까지 파급되어 다양한 만성질환 또는 난치성 질환들이 양산되는 것으로 추정하고 있다. 아마도 지금까지 서양의학에서 아직 밝혀내지 못한 대부분의 질병들이 여기에 포함되지 않을까 하는 것이 나의 생각이다.

• Journal of Oral Medicine and Pain
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• v.30 no.2
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• pp.239-246
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• 2005

The purpose of this study was to examine the difference of condylar and ramal vertical asymmetric indices on paonramic radiographs between temporomandibular disorder patients and normal group and according to classification of temporomandibular disorders. One hundred and twenty temporomandibular disorder patients and thirty normal individuals were selected. After tracing the panoramic radiographs, measurements for asymmetric indices were identified. The means and standard deviations of the measurement of each group were calculated and compared between two groups. Through the comparison of the measurement between two groups, following results were obtained 1. As a result of comparing condylar and ramal vertical asymmetry indices of the temporomandibular disorder patients with that of normal group, there was significant difference in condylar vertical asymmetry index between two groups and no significant difference in ramal vertical asymmetry index between two groups. 2. Condylar and ramal vertical asymmetry indices of temporomandibular joint disorder and muscle disorder patients showed greater value than normal group, but there was no significant difference between temporomandibular joint disorder patients and muscle disorder patients. 3. Among temporomandibular joint disorder patients, muscle disorder patients, and normal group, there was only significant difference in condylar vertical asymmetry index between temporomandibular joint disorder patients and normal group. 4. Among disc displacement, disc dislocation with reduction, and disc dislocation without reduction, there were no significant difference in condylar and ramal vertical asymmetry indices. 5. There were no correlation between aging and condylar and ramal vertical asymmetry indices. The results of the present study showed that condylar vertical asymmetry index of temporomandibular disorder patients showed greater values than normal group, and this difference could be considered as the features of temporomandibular disorders. Thus measuring the condylar vertical asymmetry index on panoramic radiographs is considered as the important factor for diagnosis and treatment of temporomandibular disorders.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.137-143
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• 1991

The bulging of mandibular angle area, frequently, make some difficulties in social life due to its reckless appearence, especially in oriental nations. So, many authors had reported its causes and surgical techniques for correction since late 19th century with diagnosis of masseter hypertrophy. But in spite of its muscular origin, major surgical techniques, in general, should aim complete bony reduction or osteotomy and supplemental myotomy as in hemimandibular hypertrophy or mandibular elongation. We used ultrasonogram for soft tissue depth estimation and expearenced some complications such as incomplete lingual cortical bony reduction, condylar fracture in mandibular angle reduction via intraoral circumvestibular approach. So we reported our surgical technique for angle reduction with possible complications.