• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권2호
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• pp.141-147
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• 2007

The purpose of this study was to evaluate the effects of maxillary occlusal plane angle to postoperative skeletal stability by comparative analysis after two-jaw surgery of patients with skeletal CIII malocclusion. This study was made with lateral cephalometric radiography of 52 patients with skeletal class III malocclusion that were performed to Le Fort I osteotomy and BSSRO. And 52 patients were divided to Group A(n=30) and B(n=22). Maxillary posterior impaction was not conducted in Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, and for Group B, which the pre-operative maxillary occlusal plane was low, the maxillary posterior impaction was conducted. The results were obtained as follows : 1. The relapse rate of Group A, which the pre-operative maxillary occlusal plane angle was in a normal range, was relatively stable compared to Group B, which the pre-operative maxillary occlusal plane was low. 2. The relapse rate of each measurement of Group B, which had the maxillary occlusal plane altered during the operation, was somewhat high, and of those, the post-operative relapse rate of overjet, overbite, mandibular plane angle appeared to be significantly high in the statistics. The analyzed results above, was thought to be indicating that the pre-operative maxillary occlusal plane angle was closely related to the post-operative skeletal stability, and that obtaining post-operative skeletal stability only through operative normalization of occlusal plane angle may meet limitations.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.178-182
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• 2006

폐부종은 구강악안면외과 영역의 수술 도중에 발생할 가능성이 있다. 따라서 전신마취하에 수술중인 외과의와 마취의는 환자의 상태를 주의깊게 관찰하여야 하며 수술 중 폐부종이 발생할 가능성에 항상 대비하여야 한다. 폐부종 증세가 발견되는 즉시, 즉각적이고도 적절한 처치를 시행한 경우 예후가 좋으며, 근본적인 원인치료 및 타장기의 합병증 및 후유증에 대하여 검사가 필요하다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권6호
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• pp.327-331
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• 2015

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) occurs mainly in female patients. In males the occurrence rate is low, which seems to be related to the low incidence of osteoporosis in men. Unfortunately, BRONJ tends to be ignored in general dental clinics in male patients with a history of osteoporosis treatment. BRONJ occurred in a male patient due to the clinician's lack of interest in the patient's history. In this case, the male patient was on bisphosphonate therapy because of a orchiectomy, and a dental treatment was performed without consideration of his medical history, resulting in BRONJ. We performed careful examinations and treatment with antibiotics and surgical operations. The postoperative healing was successful. In light of this particular case, we concluded that careful listening to the patient's history is very important.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권2호
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• pp.103-109
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• 2024

Teriparatide has been effective in treating people diagnosed with medication-related osteonecrosis of the jaw (MRONJ). However, its efficacy is not well established to be accepted as a standard of care. The objective of this paper was to investigate the efficacy of recombinant human parathyroid hormone for the treatment of MRONJ. We report three cases of MRONJ patients with osteoporosis as the primary disease who were treated with a teriparatide agent along with other adjunctive measures. Each patient was administered a teriparatide injection subcutaneously for 16 weeks, 36 weeks, or 60 weeks. Surgical intervention including partial resection, sequestrectomy, decortication, and saucerization took place during the teriparatide administration. Complete lesion resolution was identified clinically and radiographically in all three patients. In patients diagnosed with MRONJ, teriparatide therapy is an efficacious and safe therapeutic option to improve healing of bone lesions. These findings demonstrate that teriparatide in combination with another therapy, especially bone morphogenetic protein, platelet-rich fibrin, or antibiotic therapy, can be an effective protocol for MRONJ.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권6호
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• pp.543-546
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• 2001

Primary intraosseous carcinoma(PIOC) is defined as a squamous cell carcinoma arising within the jaw, having no initial connection with the oral mucosa. The squamous cell carcinoma within the bone can be presumably developed from residues of the odontogenic epithelium, therefore, it is seen in the jaw only. Metastatic carcinoma from another primary site should be excluded in the diagnosis of Primary Intraosseous Carcinoma. This is a case of 62-year-old man, who initially diagnosed as odontogenic cyst on maxilla, but its pathologic examination was diagnosed as squamous cell carcinoma with odontogenic cyst. We treated this patient with partial maxillectomy, modified radical neck dissection(mRND), and postoperative radiation therapy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권5호
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• pp.250-252
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• 2014

Nasotracheal intubation should be performed in patients with jaw fractures because maxillomandibular fixation is required. However, when there are concomitant fractures of the nose and facial bones, an intubation tube positioned at the nose makes it difficult to perform an intricate surgery. In order to overcome these problems, a variety of ways to change the position of the tube have been introduced. We describe a simple technique of switching the tube from a nasal to oral position, which was easily executed in a patient with concomitant nasal and mandibular fractures, accompanied by a literature review.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.7.1-7.8
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• 2020

Maxillomandibular advancement (MMA) is effective for the treatment of obstructive sleep apnea (OSA). In previous studies, the airway was increased in the anteroposterior and transverse dimensions after MMA. However, the effect of the opposite of mandibular movement (mandibular setback) on the airway is still controversial. Mandibular setback surgery has been suggested to be one of the risk factors in the development of sleep apnea. Previous studies have found that mandibular setback surgery could reduce the total airway volume and posterior airway space significantly in both the one-jaw and two-jaw surgery groups. However, a direct cause-and-effect relationship between the mandibular setback and development of sleep apnea has not been clearly established. Moreover, there are only a few reported cases of postoperative OSA development after mandibular setback surgery. These findings may be attributed to a fundamental difference in demographic variables such as age, sex, and body mass index (BMI) between patients with mandibular prognathism and patients with OSA. Another possibility is that the site of obstruction or pattern of obstruction may be different between the awake and sleep status in patients with OSA and mandibular prognathism. In a case-controlled study, information including the BMI and other presurgical conditions potentially related to OSA should be considered when evaluating the airway. In conclusion, the preoperative evaluation and management of co-morbid conditions would be essential for the prevention of OSA after mandibular setback surgery despite its low incidence.

• Journal of Multimedia Information System
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• 제6권2호
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• pp.67-74
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• 2019

Bone density is one of the factors in the early failure of dental implants and doctors should make a preoperative assessment of jaw bone density using patient's CT data before dental implant surgery in order to find out whether the patient has osteoporosis and osteopenia. The main goal of this study was to propose a method that based on image processing techniques in order to provide accurate information about where to drill and place an abutment screw of implants in the jaw bone for doctors and reduce human activity for the estimation of the local cancellous bone density of mandible using CT data. The experiment was performed on a computed tomography data of the jaw bone of two different individuals. We assumed that the result of the estimation of jaw bone density depends on the angle of drilling and average HU (Hounsfield Unit) values were used to evaluate the quality of local cancellous bone density of mandible. As a result of this study, we have been developed a toolbox that can be used to estimate jaw bone density automatically and found a positive correlation between the angle of the drill and time complexity but a negative correlation between the diameter of the drill and time complexity.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권2호
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• pp.62-68
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• 1990

Intraosseous carcinoma of the jaw may arise as metastatic lesions most commonly from breast, lung, kindney and thyroid and also primarily occur from ameloblastoma or odontogenic cyst. Rarely primary intraosseous carcinoma could be originated from the epithelium involved in odontogenesis. According to WHO's classification, primary intraosseous carcinoma is defined as squamous cell carcinoma, occured in the Jaw without connection to the oral mucosa. However, Elzay defined primary intraosseous carcinoma as malignant epithelial tumor related to the odontogenic apparatus, including carcinoma ex-odontogenic cyst, carcinoma ex-ameloblastoma and carcinoma de novo. We experienced 2 cases of intraosseous carcinoma of the jaw. The first case, a 59-year-old man, showed a ill-defined mass on the left maxilla, measuring $8{\times}10cm$ in size. He received radical hemimaxillectomy and was diagnosed as ameloblastic carcinoma. The second case obtained from a 79-year-old woman showed a ill-defined $6{\times}8cm$ sized mass on the left mandibular body area. The mass was surgically removed by partial mandibulaectomy, which was diagnosed as the primary intraosseous carcinoma, probably odontogenic origin.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권4호
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• pp.235-239
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• 2015

The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.