• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권1호
• /
• pp.63-71
• /
• 1994

Recently, we have used internal fixation with titanium miniplate which introduced by Champy in 1976 in facial bone fractures. In cases of mandibular fractures, particulary mandibular angle fractures, we usually underwent the open reduction extraorally. But extraoral approaches may leave scars and put the facial nerve at greater risk. So, we had undergone the intraoral approaches in 31 patients of mandibular angle fractures (male : 29, female : 2). These patients visited in Wonkwang university hospital from October 1991 to June 1993. We got easy operation time as average 20 minutes than extraoral approach. And reduced the postoperative nerve injury(14.2%), but postoperative infection is 6.1% nearly as same as extraoral approach. TMJ problems after intraoral open reduction was similar to extraoral approaches.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권1호
• /
• pp.79-87
• /
• 1994

The authors investigated the 17 patients with the condylar fractures of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Chosun University, Dental hospital from 1990 to 1993 and could be taken follow-up above 6 months. Helkimo's clinical dysfunction index and mandibular mobility index were applied to the evaluation of the patients and the obtained results were as follows. 1. Mean maximal mouth opening was 38.4 mm in the conservative group, 41.3 mm in the surgical group and that showed no statistically significant difference.(P>0.05) 2. Clinical dysfunction index was higher in the surgical group than in the conservative group but .that showed no statistically difference.(P>0.05) 3. The extent of maximal mouth opening was increased gradually throughout the follow-up period. 4. Both groups didn't show severe clinically dysfunction.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권1호
• /
• pp.43-48
• /
• 2010

The mandibular condyle fracture occurs at 15-30% frequency of whole mandibular fracture. The treatment of choice is open reduction or closed reduction. In many cases, closed reduction is preferred for treatment of condylar fracture because it is hard to approach to condyle and there is risk of surgical complications, such as nerve damage in open reduction. Open reduction, however, has some advantages like possibility of anatomical reduction, occlusal stability and rapid functional recovery. Furthermore, it is possible to retain original ramal heights and to decrease deviation during mouth opening. There are many surgical approaches for open reduction of subcondyle fracture. At present, transoral approach using trochar device is tried for effective and minimally invasive method for open reduction of subcondyle fracture. And the authors report the cases of reduction of subcondyle fracture with transoral approach using trochar device.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제30권1호
• /
• pp.49-55
• /
• 2004

The management of mandibular condylar fractures in children has long been a matter of controversy. The fracture, if not treated appropriately, may result in complications such as disturbance of mandibular growth and temporomandibular joint ankylosis. They are usually treated nonsurgically, which has been proved to be satisfactory in the long term results. Nineteen children with 25 condylar fractures experienced during their growth period (age at trauma from 10 months to 12 years, mean 7.0 years) were studied. All patients were treated by arch bars and intermaxillary fixation for $7{\sim}14$ days. They have been evaluated with clinical and radiographic examination. The maximum mouth opening and lateral movement of the mandible were within normal limits. There was no malocclusion or ankylosis. Beginning of remodelling was evident at postoperative $1{\sim}3$ months. Remodelling of the condyle was good in 21, while partial adjustment occured in the other 4 condyles. These results suggest that the conservative treatment of condylar fractures in growing children results in good functional results and good remodelling of the condyle.

• 구강회복응용과학지
• /
• 제22권4호
• /
• pp.271-281
• /
• 2006

Long term prediction of surgical result of skeletal class III has not been evaluated adequately because the stability of orthognathic surgery would be affected by not only set back amount of mandible but also many other factors like skeletal pattern, hyoid position, and airway size. The aimof this study is to discriminate the factors which affect the stability of post-treatment result of surgical outcome of sagittal split ramus osteotomy. We have collected 37 patients (male: 17, female: 20) from patients who have been treated at Orthodontic Department in Dankook University. The patients underwent 3 times Cephalometric X-ray taking at pre-, post-orthognathic surgery and after 12 months retention. The subjects were divided into 2 groups (Stable group: 21, Relapse group: 16) according to their relapse amount. We have taken following results from Students t-test and discriminant analysis. The discriminant factors which discern relapse and stable groupe among treatment change variables were BX and Ba-HY. Hyoid bone moved to posterior and inferior position due to surgery and repositioned superiorly and posteriorly during retention period. Skeletal patterns of the relapse group are smaller mandibular plane angle, anterior mandibular position, and greater distance from hyoid bone to cervical bone and mandible respectively.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제12권2호
• /
• pp.82-87
• /
• 1990

저자등은 1989 년 8 월부터 1990 년 5 월까지 서울대학교병원 구강악안면외과에 내원한 악관절질환 환자중 5 명에 대해 7 개의 관절에서 후이개접근법을 이용하여 악관절 성형술, 하악 과두 골절정복술과 자가진피 이식술 혹은 측두근막 피판이식술을 병행한 악관절 형성술(gap arthroplasty)등을 시행한 예를 보고하였다. 국내에서 보편적으로 널리 사용되지 않았던 후이개접근법에 대하여 그 응용범위와 적용예를 통하여 악관절 영역의 수술시 심미적으로 가장 뛰어난 한가지 접근 방법으로서 긍정적으로 선택될 수 있는 수술방법으로 문헌고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제23권4호
• /
• pp.376-379
• /
• 2001

본 교실에서는 외상에 의한 발생한 악안면 골절의 정복 후 오훼돌기와 관골 상악 복합체 후외측벽 사이의 기계적 간섭에 의해 발생한 2명의 개구장애 환자에서 호훼돌기 절제술과 하악운동에 대한 물리치료술 후 좋은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제17권4호
• /
• pp.429-437
• /
• 1995

Of all facial fractures in children, condylar fractures have the greatest propensity to produce a growth disturbance. This risk appears to be greatest when the injury is during the first 3 years of during adolescence. Yet, the ability of a child to undergo compensatory growth that decrease the effects of the injury is also the greatest. Fracture dislocation of the condyle in the preadolescent often results in excellent remodeling and function. Because of this factor and the higher risRs of avascular necrosis and ankylosis open reduction of a condylar fracture in a child is not widely recommended. This retrospective study analyzed mandibular condyle fractures in the children who admitted in dept. of Oral and Maxillofacial Surgery, Pusan paik hospital from 1984 to 1993 clinically and radiologically.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제28권4호
• /
• pp.286-289
• /
• 2002

In the treatment of mandibular condylar fractures, arthrocentesis, lavage and selective intermaxillary fixation were performed after closed reduction. In this lavage group, the physiotherapy performed for 3-6 months after injury. in control group, continuous intermaxillary fixation was done for 1-3 weeks, and physiotherapy followed in the same method of the lavage group. In the comparative study of the both groups, the following results are shown. 1. Compared to control group, the lavage group had a slightly superior result at range of motion, joint pain and occlusal deviation, from I day after arthrocentesis to 6 months after injury. 2. The significant differences between both groups were seen at range of motion and joint pain in 1 month after injury. 3. At 6 months after injury, the differences between both groups were not significant at range of motion, joint pain and occlusal deviation. From this study, in the mandibular condylar fracture, the arthrosentesis, lavage and selective intermaxillary fixation after closed reduction can improve symptoms such as joint pain and occlusal deviation, also increase range of motion. in this therapeutic way, intracapsular hemarthrosis which can cause TMJ ankylosis or dysfunction can be removed effectively. in addition, patient's discomfort such as swallowing disturbance, speech disturbance and emotional stress can be reduced signuficantly.

• 대한치과의사협회지
• /
• 제17권2호통권117호
• /
• pp.129-135
• /
• 1979

This 27 year-old male patient had severe mandibular prognathism (right and left mesio-occlusion were 0.4㎝ and 1.2㎝ , respectively). He had good oral health relatively exception of missing teeth. We examined all of his oral and skeletal status with full mouth x-ray taking, study model, and cephalogram. His general condition was good but above examination indicated the surgical operation for the mandibular prognathism. His laboratory tests were within normal limits. We determined surgical operation which was done by extraoral approach bilaterally. Incisions were made bilaterally 1.5㎝ beneath the inferior border of the mandible in the selected area and then the inferior border of the ascending rami was exposed. Retracting the periosteum to the lingual and buccal a slight amount, the cut in the bone was performed by use of bone drill. Avoiding T.M.J. troubles, the proximal segmant was not fixed to anterior segment, being in overlapping state buccally, in order to expect a natural healing by the environmental muscles and ligaments. We had immobilization with intermaxillary fixation by using the multiple Stout's method. He was discharged 17 days after operation. His general condition and operation results were good and satisfactory.