• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.5
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• pp.359-367
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• 2004

Purpose: After the surgical correction with sagittal split ramus osteotomy, the position of the mandibular condyle in the glenoid fossa and the proximal segment of the mandible change because of bony gap between proximal and distal segment, especially in case of mandibular setback asymmetrically. In this study, positional changes in the condyle and proximal segment after BSSRO were estimated in the mandibular asymmetry patient by analyzing the in submentovertex view and P-A cephalogram for identification of ideal condylar position during surgery. Patients and Methods: The 20 patients were selected randomly who visit Dankook Dental Hospital for mandibular asymmetry. Bilateral sagittal split ramus osteotomy with rigid fixation was performed and P-A cephalogram and submentovertex view was taken at the time of preoperative, immediate postoperative, 3 month postoperative period. Results: Intercondylar length and transverse condylar angle was increased due to inward rotation of proximal segment and anteromedial rotation of lateral pole of condyle head. The condylar position had a tendency to return to the preoperative state and after 3 months return up to about half of the immediate post-operative changes, and all the results showed more changes in asymmetry patient and deviated part of the mandible. Conclusion: Based on all these results above, surgeon should make efforts to have a precise preoperative analysis and to have a ideal condylar position during rigid fixation after BSSRO.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.6
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• pp.559-564
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• 2006

According to the development of operation technique and biologic materials, oromaxillofacial surgery department have used many kinds of metal and biologic materials in ORIF and plastic surgery. In maxillofacial fracture, ORIF with metal plate and screw have short healing period and good prognosis. But ORIF with metal materials have many complications as maxillofacial abnormal growth, screw loosening, bone malunion. And metal materials have not used in infection site. The purpose of this study is to evaluate the clinical value of 10 condylar fracture patients operated with absorbable screw at Wonkwang university. Ten patients(8 males, 2 female, mean aged 28) who had mandibular condyle process fracture treated with PLLA implants(poly-l-lactide) was recalled for follow-up clinical and radiologic examination for 10 years. Mouth opening recorvered to more than 35mm and occlusion was stable in all patients. All fractured mandibular condyles showed anatomic good reduction and long-term stability with the use of resorbable miniplates and screw. Bone healing was satisfactory in all patients, and there was no evidence of abnormal resorption of condylar process.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.27 no.1
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• pp.231-241
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• 1997

The aneurysmal bone cyst is a nonmalignant reactive bone lesion. Developing rarely in the craniofacial region, and more commonly affecting the long bones and the spine, the lesion has variable etiopathogenic characteristics. The authors diagnosed a 33-year-old female as aneurysmal bone cyst after undergoing clinical, radiological and histological examinations. The characteristics were as followed: 1. The patient complained of pain and swelling of the right preauricular area. 2. The conventional radiograms showed a relatively well defined radiolucent lesion with partially scalloping margin. The cortical bone of the right condyle was thinned and expanded by the lesion. 3. Bone scintigraphy with ~c demonstrated ring-like or doughnut-pattern accumulation of radioactivity. 4. On Tl-weighted imaging of MRI, the lesion on the right condyle had middle signal intensity. T2-weighted MRI demonstrated multiple high signal intensities seperated by septa which had low signal intensity. Finger in balloon appearance was seen. 5. Histologically, the lesion was composed of large sinusoidal blood spaces lined by fibroblasts and histiocytes. Its fibrous stroma consisted of fibroblstic element, multinucleated giant cells, extravasated erythrocytes and focal hemosiderin pigmentation. New bone formation was also observed around larger sinusoidal spaces.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.27 no.1
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• pp.25-41
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• 1997

The purpose of this study was to observe mandibular condyle shape and position in an asymptomatic population. In order to carry out this study, 142 temporomandibular joints in 71 adults(35 males, 36 females), who were asymptomatic for temporomandibular joint disorders and had no history of prosthodontic or orthodontic treatments, were selected, and radiographed using the Accurd-200 head holder(Denar Co., U.S.A) for transcranial radiograms and the Sectography(Denar Co., U.S.A) for lateral individualized corrected tomograms. Mandibular condyles were classified morphologically and evaluated in positional relationships with articular fossae and articular eminences at centric occlusion and 1 inch mouth opening. The obtained results were as follows; 1. In the classification of mandibular condyle shape, the convex type was more prevalent in transcranial radiograms and tomograms taken at medial, central, and lateral locations. 2. In the mandibular condyle position at centric occlusion, the mandibular condyles were placed posterior to the center of articular fossae in transcranial radiograms and anterior to the center of articular fossae in tomograms taken at medial, central, and lateral locations. 3. In the mandibular condyle position in right and left TMJs at centric occlusion, the mandibular condyles were placed bilateral asymmetric relationships to the articular fossae in transcranial radiograms and tomograms taken at medial, central, and lateral locations. 4. In the mandibular condyle position at 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminences in transcranial radiograms and tomograms taken at central location and posterior to the articular eminences in tomograms taken at medial and lateral locations.

• Journal of The Korean Dental Society of Anesthesiology
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• v.7 no.1
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• pp.22-26
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• 2007

상악과 하악이 선천적으로 붙어서 태어나는 선천성 유합증은 드문 선천성 기형으로 단순히 점막이 붙은 점막유합증에서 악골이 붙은 골유합증까지 다양하게 나타난다. 이중 상악골과 하악골의 골자체가 붙는 골유합증은 아주 드물어서 현재까지 26증례만 보고되고 있는데, 보고된 대부분의 증례는 편측에만 발생하는 불완전형으로 알려져 있다. 7세 된 여아환자가 인디아의 GSR 병원에 입이 벌어지지 않는다는 주소로 내원하였는데 환아의 턱은 완전히 움직이지 않았으며, 2-3 mm 정도 벌어지는 앞니부위에서는 2.5 cm 폭경의 3.0 mm 두께의 단단한 치조점막이 관찰되었다. 전기메스로 전방부의 부착성 섬유밴드를 잘라준 후 즉각적인 개구정도는 16 mm 정도까지 가능하여 구강으로의 기관삽관이 가능하였다. 삽관후 양쪽 후방부 협측점막의 두꺼운 밴드들을 모두 제거하여 개구량을 33 mm까지 증진시킨 후 수술을 종결하였다. 환아의 보호자에게 거즈 블록과 설압자를 이용하여 개구 연습을 능동적으로 시키도록 강조하여 교육하였으며 술후 16개월 경과시까지 특별한 합병증이나 개구량 감소는 관찰되지 않았다. 독립적으로 발생한 선천성 치조점막 유합증 환자에서 비정상적으로 커져있는 과두와 설골이 관찰되었는데, 설-하악 구조의 비정상적인 발육에 기인하여 지속적인 비정상적 운동으로 인한 이차적인 치은과 협점막의 섬유성 부착이 생긴 것으로 추측되었다. 이에 마취과와의 효율적인 협진으로 기관절개술 등의 부가적인 마취방법 없이 효과적으로 치료할 수 있었다.

• The korean journal of orthodontics
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• v.24 no.4 s.47
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• pp.945-956
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• 1994

In the past the jaw and occlusal relationship in centric occlusion were merely considered in case of orthodontic diagnosis and treatment planning. As the fact that functional disturbance of the temporomandibular joint may be caused by occlusal interference was recognized, the importance of functional occlusion and centric relation is emphasized today. Known the importance of centric relation, there are various opinions about definition of centric relation and its taking methods. The purpose of this study was to investigate the relative centric condyle position and to compare the reproducibility of the recordings utilizing different centric relation records obtained by different taking methods. The 15 adults with normal occlusion were participated in this study. Every four centric relation records were taken in each of three methods - leaf gauge, Dawson and myomonitor method. Then the relative centric condyle position, the distance between the condylar position in centric occlusion and the position in centric relation and the reproducibility were studied using SAM 2 articulator and mandibular position indicator. The results were as follows ; 1. The trend of condyle position was different depending on centric relation taking methods. 2. The position of condyle in centric relation by leaf gauge and Dawson methods was superior to that by myomonitor method, and the position by myomonitor method was relatively antero-inferior. 3. The distance between the condylar positions in centric occlusion and the position in centric relation was longest in myomonitor method. 4. The reproducibility had little differences in transverse direction among three methods, while leaf gauge method showed the highest reproducibility and myomonitor method did the lowest reproducibility in antero-posterior and supero-inferior direction.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.19 no.1
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• pp.105-121
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• 1989

The author analysed tomograms and submento-vertex radiograms of 90 temporomandibular joints from 45 asymptomatic young adults. 15 had Angle class Ⅰ malocclusion, 15 classⅡ and 15 class Ⅲ. Corrected lateral tomograms were obtained in three condylar positions; centric occlusion, centric relation and 1 inch mouth opening. The condylar angulation, depth of cut, joint spaces were analysed in each radiogram. The obtained results were as follows; 1. The mean condylar angulation in Angle class Ⅰ, Ⅱ, Ⅲ group was 17.55±5.51° 13.33±8.85° 16.25±6.60° respectively, and there was no significant difference in each group. The mean condylar angulation of right side (16.62±7.23°) was larger than left side (14.80±7.33°). 2. The mean depth of cut in Angle class Ⅰ, Ⅱ, Ⅲ group was 8.13±1.61㎝, 3.05±3.80㎝, 7.75±2.19㎝, respectively. Angle class Ⅰ and class Ⅱ group revealed significant difference in measurement (p<0.0l). 3. The mean height of articular fossa in Angle class Ⅰ, Ⅱ, Ⅲ group was 8.67±3.06㎜, 9.61±2.57㎜, 8.93±2.83㎜, respectively. And the mean width of articular fossa was 19.90±2.80㎜, 19.48±3.83㎜, 20.36±4.82㎜, respectively. 4. The mean height and width of condylar head was 5.11±1.16㎜, 11.20±2.26㎜, respectively. 5. In centric occlusion, the superior joint space was the largest (3.42±1.42㎜), followed by anterior joint space (2.94±1.95㎜) and the posterior joint space (2.64±1.19㎜. In centric relation, the anterior joint space was the largest (3.86±2.17㎜), followed by the superior joint space (3.64±3.68㎜) and the posterior joint space (1.18±0.77㎜). 6. The displaced measurement from centric relation to centric occlusion was 1.10±1.04㎜ anteriorly and 0.24±0.97㎜ inferiorly. In 1 inch mouth opening state, the condylar head displaced posteroinferiorly (2.49±2.49㎜ posteriorly, 1.17±1.34㎜ inferiorly) from the apex of articular eminence. And Angle class Ⅰ and Ⅱ group, Angle class Ⅱ and Ⅲ group revealed significant difference in posterior measurement, respectively (p<0.01).

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.4
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• pp.295-304
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• 1992

The author investigated the 162 patients with the condylar fractres of the mandible who were admitted in Dept. of Oral and Maxillofacial Surgery, Hospital of Chosun Dental School from January 1985 to September 1992 clinically, including fracture incidennce, age and sex of the patients, causes of injures, associated injures, treatments and complications and obtained the following results. 1. Of the 449 patients with mandibular fractures, 162patients suffered condylar fractures(36.1%). 2. Of the 162 patients, males with condylar fractures were 128 patients, by a ratio of 3.8 : 1. 3. The most frequently affected age group was the third decade(32.7%). 4. Falls were ranked as the predominant cause(50.6%), followed by traffic accident(27.8%) and violence (16.0%). 5. The incidence of single condylar fractures was 28% and symphysis fractures were the most commomest of the concomittant injuries(60%). 6. The subcondylar fractures occurred most frequently(41.6%) and anteromedial displacement of the condylar fragments occurred most frequently(45.4%) 7. Of the all condylar fracture patients, children under 15 of age comprized 31 patients(19.1%) and condylar head fractures occurred most frequently at those children. 8. Of the managetments in condylar fractures, open reduction was 52.5% and remainder were closed reduction(47.5%). 9. Complications ensured such as TMJ ankylosis, limitation of mouth opening and mandibular movements, TMJ dysfunction, and anterior open bite.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.189-194
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• 2013

Osteochondroma is a benign neoplasm, osseous projection surrounded with cartilage, 35.8% of benign osseous tumor, 8.5% of whole osseous tumor and usually arises from the skeletal bone. Osteochondroma is a cartilaginous derivation and relatively uncommon in the craniofacial bone. Osteochondroma of the mandible has slow growth rates which mainly affect women around forty years of age and it can appear through the coronoid process and mandibular condyle, especially in the medial half. Clinical finding associated with osteochondroma of condyle are primarily a palpable, painless temporomandibular area mass with facial asymmetry, malocclusion and midline deviations. Sometimes pain and dysfunction like trismus often accompany the anatomic derangement. Other features include malocclusion with open-bite on the affected side and cross-bite on the contralateral side. In this study, a 45-years old female patient exhibits pain on the left temporo-mandibular joint area and malocclusion due to loss of the molar region with osteochondroma on the top left of her mandibular condyle head. The patient is able to recover gradually from the symptom through treatments on manipulation, stabilization splint, arthroscopic lavage and surgical excision, thus, this is reported as a clinical case.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.2
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• pp.337-345
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• 1994

Arthrography of the temporomandibular joint is a useful method of demonstrating the soft tissue abnormalities related to disc dysfunction. In this study, 19 asymptomatic joints, 31 joints with anterior disc displacement with reduction, 31 joints with anterior disc displacement without reduction which were classified by arthrotomography under fluoroscopy were evaluated to determine the linear measurement of anterior recess of inferior joint space and the relationship between the condylar anterior translation and the severity of the internal derangements. Their fluoroscopic images were also evaluated to describe the characteristics of condylar paths in internal derangements of the temporomandibular joints. The results were as follows; 1. The mean lengths of the anterior recess in asymptomaic group. reduction group. and non-reduction group were 8.7±1.6㎜. 11.2±1.7㎜, 12.8±1.7㎜ respectively. The length of the anterior recess was increased according to the severity of the internal derangements(P<0.05). 2. Linear measurements of anterior movement of condyle on maximum mouth opening were 13.1 ±4.2㎜, 15.9±4.1㎜, 5.0±3.7㎜ in asymptomatic group. reduction group, and non-reduction group respectively. Compared with asymptomatic group, reduction group showed hypermobolity of the condyle and non-reduction group showed hypomobility. 3. Condyles moved beyond the crest of articular eminence in 80% of reduction group and did not reach it in 70% of non-reduction group. 4. The condyle moved mainly superiorly in reduction group(66%) and horizontally in asymptomatic group(47%). There were no cases to move superiorly in non-reduction group.