• Title/Summary/Keyword: Facial esthetics

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INTRAORAL OPEN REDUCTION OF MANDIBULAR SUBCONDYLAR FRACTURES USING KIRSCHNER WIRE (Kirschner wire를 사용한 과두하 골절의 구강내 접근법)

  • Kim, Seong-Il;Kim, Seung-Ryong;Baik, Jin-Ah;Ko, Seung-O;Shin, Hyo-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.270-276
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    • 2001
  • The treatment of mandibular subcondylar fractures is a matter of controversy. The majority of mandibular subcondylar fracture are treated by closed reduction, but the displaced or dislocated mandibular subcondylar fractures may be treated by open reduction. The characteristics of open reduction are the anatomical reduction, the functional restoration, the rapid function, the maintenance of vertical ramus dimension, the better appearance and the less resultant TMJ problem etc. When an open reduction is considered, the wire, miniplate, lag screw and Kirschner wire are available with internal fixation. Of these, Kirschner wire is a simple method relatively and correct positioning of the wire achieves rigid fixation. But many open reduction methods for mandibular subcondylar fractures require extraoral approach. The extraoral approach has some problems, the facial scar and the risk of facial nerve injury. On the other hand, the intraoral approach eliminates the potency of the facial scar and the facial nerve injury, but is difficult to access the operation site. Since the intraoral approach was first described by Silverman (1925), the intraoral approach to the mandibular condyle has been developed with modifications. The purpose of this article is to describe the intraoral technique with the Kirschner wire on mandibular subcondylar fractures. Conclusion : The intraoral reduction with Kirschner wire on mandubular subcondylar fractures avoids the facial scar and facial nerve injury and is simple method to the extraoral approach. And it has minimal morbidity and better esthetics.

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Long-term follow-up of early cleft maxillary distraction

  • Park, Young-Wook;Kwon, Kwang-Jun;Kim, Min-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.20.1-20.6
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    • 2016
  • Background: Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. Case presentation: A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. Conclusions: The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.

TREATMENT OF SEVERE FACIAL ASYMMETRY:REPORT OF 2 CASES (심한 안모 비대칭 환자 치험 2례)

  • Park, Hyung-Sik;Kim, Sun-Yong;Lee, Sang-Hye;Kim, Hye-Kyung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.2
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    • pp.69-81
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    • 1990
  • Classification of facial asymmetry has not been yet well-organized because of their variety on etiologic factors, involved sites and clinical expressions. And surgical treatments are also variable and depend upon their causes and clinical abnormalities. This is a case report on surgical experiences of two patients who had severe facial asymmetry and could not treated pre-surgical orthodontics before surgery. One patient was belong to hemifacial microsomia and another was a very unusual complex type related to unilateral condylar hyperplasia, unilateral macrognathia and unilateral mandibular hypoplasia. The authors used a simultaneous two-jaw surgery, bone shaving and onlay-type bone graft in former case, and a simultaneous two-jaw surgery, condylectomy, bone shaving and only-type bone graft in latter case. In two cases, immediate post-operative results in function and esthetics were excellent, however, progressive resorption of onlay-type bone grafts have been noticed.

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Treatment of anterior open bite by posterior maxillary segmental osteotomy and miniplates: a case report

  • Choi, Sung-Kwon;Kwon, Kyung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.20.1-20.7
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    • 2020
  • Background: Anterior open bite is a challenging malocclusion to correct orthodontic treatment. Anterior open bite associated with over-erupted posterior teeth and long lower facial height should be treated by reduction of posterior dimension for esthetic results. Although the possibility of orthodontic treatment of an anterior open bite has increased with the introduction of skeletal anchorage, there are still cases requiring surgery for various reasons. Case presentation: This case report covers an anterior open bite of a 25-year-old man successfully treated with the posterior maxillary segmental osteotomy (PMSO) and miniplates. After the pre-surgical orthodontic treatment, the PMSO between canines and first premolars was performed under local anesthesia and miniplates were placed on the zygomatic buttress. As a result of 28 months of treatment, an impaction amount of 3.5 mm was obtained in the maxillary posterior teeth, and the facial esthetics improved at rest and smile. Conclusion: The impaction of the posterior dentoalveolar segment using the PMSO can be a good treatment option in patients with anterior open bite showing long lower facial height.

A STUDY ON THE SELECTION OF ARTIFICIAL TEETH FOR THE EDENTULOUS PATIENTS IN KOREANS (한국인 무치악환자의 인공치아선택방법에 관한 연구)

  • Kim, Sung-Hun;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.34 no.3
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    • pp.457-463
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    • 1996
  • An esthetically pleasing result in denture service is dependent upon several consideration. Esthetic considerations for the edentulous patient include tooth size, shape, arrangement, positioning, gingival contour, age, sex, personality differences, and ethnic type. Especially, the form of anterior artificial teeth is an important factor on the esthetics. The selection of artificaial teeth requires understanding and knowledge on physical and biologic factors and has to meet the indivisul esthetics and functional needs of each patient. However, the selection of artificial teeth is based on the large degree of subjective judgement of the dentist, Therefore, this is one of the most unscientific processes. Many attempts have been made to find a guideline for the selection of artificial teeth. Temperamental theory by White and Hall utillized with the physical characteristics such as body size, body form, color of eyes and hair, and disposition. SPA theory by Frush and Fisher utilized with the basis of sex, personalities, and age of the indivisual. There has not been provided for a guideline and study on the selection of artificial teeth for Koreans yet. This study was aimed to evaluate the William's typal matching theory in Koreans. 1. The facial forms of korean adult were ovoid(46.3%), square(36.7%) and tapered(17.0%) form. 2. The anatomic forms of natural maxillary incisors were ovoid(45.3%), tapered(31.3%), square(23.3%) form. 3. The forms of face and natural maxillary incisors were ovoid(21.9%), squared(11%), tapered(6.3%). 4. The natural maxillary incisors were similar in form to the facial form only in 39%. There was no correlation between the form of the face and the form of natural maxillary central inisors in Koreans. 5. Artificaial teeth which was selected according to the typal matching theory did not represent the form of the natural teeth in 61 per cents of the fatal, but it felt that they harmonized with the form of the patient's face and produced good results.

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A Study on the Tetrahedral Amorphous Carbon (ta-C) Coating on Medical Polymer Materials for 3D Printing Artificial Teeth (의료용 폴리머 소재를 활용한 3D 프린팅 인공치아용 사면체 비정질 카본 코팅 기술 연구)

  • Jang, Young-Jun;Kim, Jongkuk;Shin, Chang-Hee;Yu, Sung-Mi
    • Tribology and Lubricants
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    • v.38 no.6
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    • pp.255-260
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    • 2022
  • This research presents tetrahedral amorphous (ta-C) coating on the artificial tooth for improving the durability and functionality (esthtics, foreign body of tooth) by filtered cathodic vacuum arc (FCVA). A differentiated coating method is required for a ta-C coating on polymer owing to the low melting point of the polymer, inter-facial adhesion, low friction, and non-conductivity. Herein, ta-C coating is applied below 50℃, and the potential difference of the carbon plasma drawn to the substrate was controlled by applying a positive duct bias voltage without using a substrate bias voltage. Consequently, the ta-C coating with a thickness of 70nm using the duct bias condition of 20V with the highest plasma intensity satisfies the esthetics of the artificial tooth and had a 5B level of inter-facial adhesion. In addition, the composite hardness of ta-C/polymer is 380 MPa, and correlations with esthetics, sp3 bonding, and mechanical properties. The friction coefficient (CoF) of the ta-C coating in a water-lubricated environment is 0.07, showing a six-fold reduction in CoF compared with that of a polymer.

A CLINICAL STUDY OF THE NASAL MORPHOLOGIC CHANGES FOLLOWING LEFORT I OSTEOTOMY (상악골 수평골절단술 후 비외형 변화에 관한 임상적 연구)

  • Bae, Jun-Soo;You, Jun-Young;Lyoo, Jong-Ho;Kim, Yong-Kwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.324-329
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    • 1999
  • The facial esthetics are much affected by nasal changes due to especially its central position in relation to facial outline and so appropriately evaluated should be the functional and esthetic aspects of the nose associated with the facial appearance. Generally, a maxillary surgical movement is known to induce the changes of nasolabial morphology secondary to the skeletal repositioning accompanied by muscular retraction. These changes can be desirable or undesirable to individuals according to the direction and amount of maxillary repositioning. We investigated the surgical changes of bony maxilla and its effects to nasal morphology through the analysis of the lateral cephalogram in the Le Fort I osteotomy. Subjects were 10 patients(male 2, female 8, mean age 22.3 years) and cephalograms were obtained 2 weeks before surgery(T1) and 6 months after surgery(T2). The surgical maxillary movement was identified through the horizontal and vertical repositioning of point A. Soft-tissue analysis of the nasal profile was performed employing two angles: nasal tip projection(NTP), columellar angle(CA). Also, alar base width(ABW) was assessed directly on the patients with a slide gauge. The results were as follows; 1. Both anterior and superior movement above 2mm of maxilla rotated up nasal tip above 1mm. Either anterior or superior movement above 2mm of maxilla made prediction of the amount & direction of NTP changes difficult. Especially, a correlation between horizontal movement of maxilla and NTP rotated-up was P<0.01. 2. Both much highly anterior and superior movement of maxilla is accompanied by more CA increase than either highly. Especially, the correlation between horizontal movement of maxilla and CA change was P<0.05. 3. Anterior and/or superior movement of maxilla was accompanied by the unpredictable ABW widening. 4. The amount of changes of NTP, CA, and ABW is not in direct proportion to amout of anterior and/or superior movement of maxilla. 5. Nasal morphologic changes following Le Fort I osteotomy are affacted by not merely bony repositioning but other multiple factors.

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MAXILLOFACIAL ESTHETICS BY THREE DIMENSIONAL FACIAL MORPHOMETRICS (삼차원적 안모형태의 미적분석)

  • Lee, Sang-Han;Kwon, Tae-Geon;Baek, Sang-Heum
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.606-612
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    • 2000
  • This study was performed to investigate the average anthropometric value of normal Korean men and women and to compare the preceding literatures. Additionally, average Korean profilogram was made to serve as a template for diagnosis of facial form. Eighty five Korean subjects(41 men, 44 women) aged between 21 to 26 were selected by members of the author's department on the basis of intact dentition and Class I occlusion without facial asymmetry. Frontal and lateral photographs were taken under standardized condition with digital camera. The image was magnified and adjusted according to the FH plane of cephalometric radiographs and digitized using personal computer. To compare the Western beauty, 25 esthetically pleasing female was selected to measure various angle and distance of the face. 1. It was possible to calculate the mean coordinate value of Korean normal samples which enables the direct visualization and comparison with the use of template. The method in this study was easy to applicate under the Microsoft $Windows^{(R)}$ bases. 2. Maxillary vertical hypoplasia, upper and lower lip protrusion was characteristics of Korean norms and relatively narrow alar base distance, less conspicuous nasal projection was observed. As the vermilion exposure and upper lip length was more than western norm, chin looks shorter than western. To compare the Korean and Western esthetically pleasing profile, facial convexity and nose was less conspicuous in Korean women.

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Integrating 3D facial scanning in a digital workflow to CAD/CAM design and fabricate complete dentures for immediate total mouth rehabilitation

  • Hassan, Bassam;Greven, Marcus;Wismeijer, Daniel
    • The Journal of Advanced Prosthodontics
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    • v.9 no.5
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    • pp.381-386
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    • 2017
  • PURPOSE. To integrate extra-oral facial scanning information with CAD/CAM complete dentures to immediately rehabilitate terminal dentition. MATERIALS AND METHODS. Ten patients with terminal dentition scheduled for total extraction and immediate denture placement were recruited for this study. The patients were submitted to a facial scanning procedure using the in-office PritiMirror scanner with bite registration records in-situ. Definitive stone cast models and bite records were subsequently submitted to a lab scanning procedure using the lab scanner (iSeries DWOS; Dental Wings). The scanned models were used to create a virtual teeth setup of a complete denture. Using the intra-oral bite records as a reference, the virtual setup was incorporated in the facial scan thereby facilitating a virtual clinical evaluation (teeth try-in) phase. After applying necessary adjustments, the virtual setup was submitted to a CAM procedure where a 5-axis industrial milling machine (M7 CNC; Darton AG General) was used to fabricate a full-milled PMMA immediate provisional prosthesis. RESULTS. Total extractions were performed, the dentures were immediately inserted, and subjective clinical fit was evaluated. The immediate provisional prostheses were inserted and clinical fit, occlusion/articulation, and esthetics were subjectively assessed; the results were deemed satisfactory. All provisional prostheses remained three months in function with no notable technical complications. CONCLUSION. Ten patients with terminal dentition were treated using a complete digital approach to fabricate complete dentures using CAD/CAM technology. The proposed technique has the potential to accelerate the rehabilitation procedure starting from immediate denture to final implant-supported prosthesis leading to more predictable functional and aesthetics outcomes.

Differences in facial soft tissue deviations in Class III patients with different types of mandibular asymmetry: A cone-beam computed tomography study

  • Ho-Jin Kim;Hyung-Kyu Noh;Hyo-Sang Park
    • The korean journal of orthodontics
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    • v.53 no.6
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    • pp.402-419
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    • 2023
  • Objective: This study assessed the differences in soft tissue deviations of the nose, lips, and chin between different mandibular asymmetry types in Class III patients. Methods: Cone-beam computed tomography data from 90 Class III patients with moderate-to-severe facial asymmetry were investigated. The sample was divided into three groups based on the extent of mandibular rolling, yawing, and translation. Soft tissue landmarks on the nose, lips, and chin were investigated vertically, transversely, and anteroposteriorly. A paired t test was performed to compare variables between the deviated (Dv) and nondeviated (NDv) sides, and one-way analysis of variance with Tukey's post-hoc test was performed for intergroup comparisons. Pearson's correlation coefficient was calculated to assess the relationship between the soft and hard tissue deviations. Results: The roll-dominant group showed significantly greater differences in the vertical positions of the soft tissue landmarks between the Dv and NDv than other groups (P < 0.05), whereas the yaw-dominant group exhibited larger differences in the transverse and anteroposterior directions (P < 0.05). Moreover, transverse lip cant was correlated with the menton (Me) deviation and mandibular rolling in the roll-dominant group (P < 0.001); the angulation of the nasal bridge or philtrum was correlated with the Me deviation and mandibular yawing in the yaw-dominant group (P < 0.01). Conclusions: The three-dimensional deviations of facial soft tissue differed based on the mandibular asymmetry types in Class III patients with similar amounts of Me deviation. A precise understanding of soft tissue deviation in each asymmetry type would help achieve satisfactory facial esthetics.