• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.3
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• pp.337-342
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• 2000

Purpose : The purpose of this study was to analyze the lower third facial changes in frontal view after mandibular setback surgery. Materials and Methods : In this study, fifteen subjects(6 males and 9 females) with class III dental and skeletal malocclusions who were treated with BSSRO(Bilateral Sagittal Split Ramus Ostetomy) were used. Frontal cephalometric radiographs were taken preoperatively and more than 6 months postoperatively, and hard tissue(H2-Hl) and soft tissue changes (S2-S1) were measured on vertical and horizontal reference lines. In 15 cases, changes which developed more than 6 months after surgery were studied. Results : The results were as follows. 1. In the facial height, hard tissue $decreased(2.46{\pm}2.76mm)$ with statistical significance(P<0.01), and soft tissue also $decreased(1.64{\pm}3.66mm)$. As a result, the facial height generally becomes shorter after sagittal split ramus osteotomy. 2. In the mandibular width, hard tissue $decreased(2.08{\pm}3.59mm)$ with statistical sgnificance(P<0.05), but soft tissue $increased (2.14{\pm}5.73mm)$ without statistically significant difference(P>0.05) postoperatively. 3. In the facial index, hard tissue $decreased(0.23{\pm}2.21%)$, but soft tissue $increased(2.41{\pm}3.46%)$ with statistical significance. Conclusion : One of the main purpose of orthognathic surgery is to achieve facial esthetics and harmony. In order to fullfill this purpose, it is important to carry out a precise presurgical treatment planning by estimating the changes of frontal profile after surgery.

• The korean journal of orthodontics
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• v.28 no.4 s.69
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• pp.581-589
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• 1998

In order to correct a maxillofacial-skeletal disharmony successfully and achieve a favorable facial profile, orthodontic treatment must begin at pubertal growth spurt. Therefore predicting the pubertal growth pattern and evaluating the growth potential is very important. For an orthodontist, estimating skeletal maturity in relation to one's personal growth spurt is essential and it must be considered into the treatment. The objective of this study was to find out whether there was a difference in menacheal age among different malocclusion groups and to evaluate the skeletal maturity at menarche. The subjects were 64 Class I malocclusion patients, 51 Class II patients and 38 Class III patients. Skeletal maturity was estimated from handwrist radiographs of these patients. Handwrist radiographs were taken between 3 months before and after the menarche. The results were as follows. 1. The mean chronologic age of menarche was $12.50{\pm}1.01$ years. 2. For the Class I malocclusion group the mean age of menarche was $12.36{\pm}1.04$ years, for Class II $12.81{\pm}1.03$ years and for Class III $12.32{\pm}0.82$ years. According to these results Class II malocclusion patients started mensturation later than Class I and Class III malocclusion patients. 3. No difference was found considering the skeletal maturity at menarche among the malocclusion groups. 4. The skeletal maturity index at menarche was SMI 7 for $45.10\%$, SMI 8 for $27.25\%$, SMI 9 for $10.46\%$, SMI 6 for $7.84\%$, SMI 10 for $7.84\%$ and SMI 5 for $1.31\%$ patients. 5. Statistically there was a significant correlation between skeletal maturity estimated by handwrist radiographs and menacheal age(p<0.05, r=0.25430).

• The korean journal of orthodontics
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• v.48 no.2
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• pp.113-124
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• 2018

The purpose of this case report was to introduce the concept of orthodontic and orthopedic treatment for a growing patient with Tessier number 0 cleft. A 5-year-old boy patient with Tessier number 0 cleft presented congenitally missing maxillary central incisors (MXCI), a bony defect at the premaxilla, a constricted maxillary arch, an anterior openbite, and maxillary hypoplasia. His treatment was divided into three stages: management of the bony defect at the premaxilla and the congenitally missing MXCIs using a fan-type expansion plate, iliac bone grafting, and eruption guidance of the maxillary lateral incisors into the graft area for substitution of MXCIs; management of the maxillary hypoplasia using sequential facemask therapy with conventional and skeletal anchorage; and management of the remaining occlusal problems using fixed orthodontic treatment. The total treatment duration was 15 years and 10 months. Class I canine and Class II molar relationships and normal overbite and overjet were achieved at the end of treatment. Although the long-term use of facemask therapy resulted in significant protraction of the retrusive maxilla, the patient exhibited Class III profile because of continued mandibular growth. However, the treatment result was well maintained after 2 years of retention. The findings from this case suggest that interdisciplinary and customized approaches are mandatory for successful management of maxillary hypoplasia, bony defect, and dental problems in Tessier number 0 cleft. Moreover, considering the potential of orthognathic surgery or distraction osteogenesis, meticulous monitoring of mandibular growth until growth completion is important.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.167-173
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• 2007

The temporalis fascia graft has been widely used in the correction of nasal deformities. The fascia can be used alone or combined for augmentation rhinoplasty. The fascia graft provides adequate coverage, contour, and bulk on the profile of the nose, as well as an inconspicuous donor site. A depressed radix area can be successfully corrected by the fascia graft. We present two cases of nasal radix augmentation by using temporalis fascia graft. Two male patients presented with the skeletal class III malocclusion and the depressed radix. A planned orthognathic surgery and the temporalis fascia graft to the radix were performed. The malocclusion and the profile of the patients were markedly improved after the operation. Not only the radix but also the nose was improved in its size and length. There was no noticeable resorption or displacement of the radix area at follow-up. The temporalis fascia graft could be an appropriate surgical technique in radix augmentation and nose lengthening.

• The Journal of the Korean dental association
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• v.55 no.4
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• pp.296-302
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• 2017

The traditional orthognathic surgery treatment consists of three steps: preoperative orthodontic treatment, orthognathic surgery, and postoperative orthodontic treatment, and the average treatment period is usually two years. Also, patients with Class III malocclusion should spend more time getting their facial features worse during the decompensation process. However, most of the patients who want orthognathic surgery visit the chief complaints of appearance improvement, and resolve this address as soon as possible. The concept of $^{\circ}{\AE}$Surgery - First 'does not cause a facial imbalance caused by decompensation for the pre - operative correction period, and the patient can obtain an improved facial profile immediately after the operation. In addition, the correction period is shortened by Regional Acceleratory Phenomenon (RAP) after surgery. However, it is not applicable to all patients. Patients with severe crowding, severe curve of spee or reverse curve of spee, severe transverse discrepancy of the maxilla and mandibular arch, and severe incisal angles are less likely to apply the technique. Although it is not yet possible to apply this technique to all patients, it has many advantages over the conventional method. Especially, the patients' preference is increasing due to the rapid appearance improvement and the shortening of the total treatment period.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5401-5406
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• 2015

Background: Brain metastases are the most common intra-cranial neoplasms. The incidence is on a rise due to advanced imaging techniques. Aims: The objective of the study was to analyse the clinical and demographic profile of patients with brain metastases from primary solid tumors. Materials and Methods: This is a retrospective single institutional study covering 130 consecutive patients with brain metastases from January 2007 to August 2014. Results: Some 64.6% of the patients were females. The majority were in the sixth decade of life. The site of the primary tumor was the lungs in 50.8% of the cases. The overall median time from the diagnosis of the primary malignancy to detection of brain metastases was 21.4 months. Survival was found to be significantly improved in patients with solitary brain lesions when compared to patients with multiple brain metastases, and in patients undergoing surgical excision with or without cranial irradiation when compared to whole brain irradiation alone. The majority of the cases belonged to the recursive partitioning analysis class II group. Whole brain radiation therapy was delivered to 79% of the patients. Conclusions: Most of the patients with brain metastases in the study belonged to recursive partitioning analysis classes II or III, and hence had poor prognosis. Most of the patients in the Indian context either do not satisfy the indications for surgical excision or are incapable of bearing the high cost associated with stereotactic radiosurgery. Treatment should be tailored on an individual basis to all these patients.

• The korean journal of orthodontics
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• v.49 no.6
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• pp.413-426
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• 2019

This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

• The korean journal of orthodontics
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• v.46 no.6
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• pp.395-408
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• 2016

We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.

• Journal of Korean Neurosurgical Society
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• v.65 no.4
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• pp.523-530
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• 2022

Objective : To evaluate the safety and efficacy of an overlapped stenting-assisted coiling technique in treating vertebral artery dissecting aneurysm (VADA) via Low-profile Visualized Intraluminal Support (LVIS) stent-within-Neuroform EZ stent. Methods : From January 2017 to June 2019, 18 consecutive patients with VADAs (ruptured : unruptured=5 : 13) were treated with the overlapping stents assisted-coiling technique in our center. The overlapping manner was a Neuroform EZ stent being deployed first, followed by LVIS stents placement using the 'shelf' technique. The patients' clinical characteristics, technical feasibility and safety, and immediate and follow-up angiographic results were retrospectively reviewed. Results : Seventeen (94.4%) procedures were technically successful with an exact deployment of the stents and patent parent or perforator arteries. The immediate angiographies after procedure confirmed Raymond class I, II, and III occlusion of VADAs were in 12 (66.7%), two (11.1%), and four cases (22.2%), respectively. Post-procedural complications developed in one patient (5.6%) with minor brainstem infarctions, which resulted from an in-stent thrombosis during the procedure. Angiographic follow-up at 5.7 months (range 3 to 9 months) demonstrated Raymond class I and II occlusion were in all cases (100%). The modified Rankin Scale scores at 21.3 months (range 15 to 42 months) 0-2 in 17 cases (94.4%) and three in one case (5.6%). Conclusion : Overlapping stents via LVIS stent-within-Neuroform EZ stent combined with coiling is safe and effective for patients with VADA in the midterm results.

• The korean journal of orthodontics
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• v.29 no.3 s.74
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• pp.285-301
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• 1999

There is a need for more accurate prediction in surgical orthodontic treatment. Video imaging is an important technology in planning orthognathic surgery and educating patients about the esthetic results after treatment. Preoperative and postoperative lateral cephalogram of 30 patients who had one piece Le Fort I osteotomy advancement and mandibular set back by bilateral intraoral vertical ramal osteotomy with or without genioplasty were used in this study. The computer generated soft tissue line drawing prediction were compared with the actual postoperative cephalograms .The results are as follows. 1. 14 variables showed Statistically significant differences from 24 variables between computer predicted profile and post operative profile 2. Most of the differences were found in the maxilla-related soft tissue landmarks. 3. The predicted results were more accurate in the groups who had small amount of mandibular set back. 4. The predicted results were more accurate in the groups who had no genioplasty. Most of these differences were within 2mm ranges. Therefore profile change prediction by video imaging could be considered clinically acceptable.