• Archives of Craniofacial Surgery
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• v.21 no.2
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• pp.92-98
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• 2020

Background: Posttraumatic acquired facial deformities require surgical treatment, with options including scar revision, fat grafts, implant insertion, and flap coverage. However, each technique has specific advantages and disadvantages. Methods: From 2016 to 2018, 13 patients (eight with scar contracture and five with a depressed scar) were treated using dermofat grafts from the groin. The harvested dermofat was then inserted into the undermined dead space after the contracture was released, and a bolster suture was done for fixation considering the patient's contour and asymmetry. A modified version of the Vancouver Scar Scale and satisfaction survey were used to compare deformity improvements before and after surgery. Results: In most cases, effective volume correction and an aesthetically satisfactory contour were maintained well after dermofat grafting, without any major complications. In some cases, however, lipolysis proceeded rapidly when inflammation and infection were not completely eliminated. A significant difference was found in the modified Vancouver Scar Scale before and after surgery, with a p-value of 0.001. The average score on the satisfaction survey was 17.07 out of 20 points. Conclusion: A dermofat graft with the groin as the donor site can be considered as an effective surgical option that is the simplest and most cost-effective method for the treatment of acquired facial deformities with scar contracture.

• Proceedings of the KACD Conference
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• 2002.11a
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• pp.721-721
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• 2002

For about half a century. dental implants made of titanium have developed as a method of restoration for the tooth loss. In these days. the titanium implants seem to be considered as the alternative for the conventional prosthodontics. But its hard to say that the titanium implants are superior to the treatments that preserve the natural tooth. As this is a general opinion among dentists. the implant will not be able to be the alternative for all the prosthetic treatments. Clinically, there are many causes for extracting tooth. The severe destruction of the tooth structure or periodontal diseases leads to inevitable tooth extraction. When the complete cure is doubtful because of narrow intraoral visibility and improper accessibility in approaching to the tooth and periodontal lesion, we. clinicians often inevitably extract tooth. Passive treatments like conventional restoration, curettage or surgical flap cant be the perfect treatments for the tooth that has subgingival root caries or severe periodontal diseases involved furcation. Many clinicians might have been forced to pull out the relatively healthy tooth by the difficulties of approaching to the lesions and poor prognosis. Though the intentional tooth replantation is performed sometimes. as it doesnt have enough scientific foundation. it has not been considered as a popular treatment method yet. I have been felt keenly the necessity of positive tooth preservation, so I have been attempting the treatment that has new concept. calling Natural Tooth Implantation (NTI) clinically. NTI differs from the tooth replantation in the goal for the treatment and biological healing process. Now. I confirm that NT! is a very positive and valid method of tooth preservation. Like you can get from the name. NTI is the dental implant procedure using natural teeth and similar to the healing process of the titanium implants in many aspects. I have been using biocompatible composite resin. DRM. with NTI and got affirmative clinical results from that. So I would like to introduce.roduce.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.553-560
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• 1999

The aim of the present study was to evaluate the effect of the expanded polytetrafluoroethylene (e-PTFE) membrane exposure on the initial healing of the periodontal tissue in guided tissue regeneration (GTR) procedure. 90 sites selected from 90 patients were treated with gingival flap surgery supported by an e-PTFE membrane. The material included angular bony defects with probing attachment loss of > 5mm or degree II furcation involvement. Treated sites were classified with membrane exposure group and non-exposure group at membrane removal and evaluated healing type. The results were obtained as follows. 1. e-PTFE membrane was exposed at 61 sites (67.8%) among 90 sites. 2. Thirteen sites (14.4%) depicted rapid healing type, 65 sites (72.2%) depicted typical healing type, 9 sites (10%) showed delayed healing type and 3 sites (3.3%) were categorized as adversed healing type. 3. In e-PTFE membrane exposure group, 1 site (1.6%), 51 sites (83.6%), 6 sites (9.8%) and 3 sites (4.9%) showed rapid healing type, typical healing type, delayed healing type and adverse healing type respectively. 4. In e-PTFE membrane non-exposure group, 12 sites (41.3%), 14 sites (48.3%) and 3 sites (10.3%) showed rapid healing type, typical healing type and delayed healing type respectively. Adverse healing type was not observed. 5. The rate of favourable healing between e-PTFE membrane exposure group and non-exposure group was not statistically significant(p=0.56). These results suggest that the prevention of membrane exposure may be important to obtain rapid healing type. However favourable healing could be obtained with stringent infection control program even if membrane was exposed.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.625-636
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• 2007

Marginal tissue recession makes problems like esthetics, root caries, hypersensitivity and plaque accumulation. Request for root coverage is higer than ever, especially esthetic problems involved. So techniques for root coverage hav been developed. There are some kinds of surgical techniques using soft tissue for root coverage. For example, free gingival graft, kinds of pedicle flap, subepithelial connective tissue graft(SCTG), and so on. Subepithelial connective tissue graft has many advantage for root coverage, that is less pain on donor site, good blood supply for graft, and more esthetic result. For this reaseon, this case report was performed to evaluate the effect of root coverage using subepithelial connective tissue graft. Three patients has Miller's class I marginal tissue recession and one patients has Miller's class III marginal tissue recession. The following period is 36.5 month on average. The results are as follows: 1. Root coverage of 100% was obtained in 5 of 6 defects, and 80% was obtained in 1 of 6 defects, The mean root coverage was 96,6% in six cases on 4 patients. 2. The mean root coverage was 3.83mm and mean recession depth decreased from 4mm to 0.16mm. 3. The mean width of clinical attached gingiva increased from 1.5mm to 4mm. The mean width of gained attached gingiva after surgery was 2.5mm. 4. The mean follow up period was 36.5 months. The longest follow up period was 50 months and the shortest follow up period was 22 months. 5. The result that obtained by surgery was stable during follow up period. Within the above results, root coverage with SCTG is an effective procedure to cover marginal tissue recession defect with long term stability.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.2
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• pp.308-315
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• 1996

Osteoarthritis is a noninflammatory degenerative disease affecting the articular surfaces and is accompanied by remodeling of the underlying bone. The sympotms of osteoarthritis of the temporomandibular joint are pain in the joint and muscles of mastication, limitation. Osteoarthritis is generally accepted that several factors can contribute to the trauma, aging process, internal derangement and MPDS. Radiographic features of the osteoarthritis are seen flattening of joint, sclerosis on flattened area and osteophyte or anterior lipping. In the past, osteoarthritis was considered to self-limiting disease. Currently, synovial chondromembrane is part of the process of osteoarthritis secondary to trauma. Synovial chondromatosis is an uncommon disease of cartilaginous transformation of synovial membrane with formation of loose bodies within the joint space. The pathogenesis is more an active metaplastic than a neoplastic process. The cause of synovial chondromatosis is unknown. Although trauma and inflammation have all been cited as possible factors in tis pathogenesis. The clinical sign and symptoms are unilateral swelling of the joint region, pain in the joint area and crepitus seem to be the most reliable signs and symptoms. Radiographic evidence of loose bodies may or may not be present. This is a case report of 66 year old female with synovial chondromatosis, that is advanced disease of the osteoarthrits. We treated patient with surgical excision of lose bodies, diskectomy and synovectomy. The defected articular fossa area was reconstructed with temporalis fascia flap. The result was satisfactory.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.348-352
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• 1996

Soft tissue defects in oral & maxillofacial region caused by tumor resection, trauma, congenital deformities have been treated in autogenous soft tissue flap, allogenic material, free dermal graft, fascia graft. Of these methods, autogenous dermis graft had initially been applied in hernia treatment at the beginning of nineteenth century and have been applied in soft tissue augmentation coverage of vital structure, dead space removal and reconstruction of fascia. A fat graft is used in reconstruction of orbit at the enucleation, restoration of facial contours, etc. In this case, patient with chin soft tissue defect in traffic accident was treated in autogenous dermis-fat graft from patient's abdominal and gluteal region. Chin defect was reconstructed favorably. There was no severe atrophy of grafted area 12 months postoperatively. We will report the result that is favorable esthetically with literature review.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.358-365
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• 1996

Deep burns of the face & lips often lead to scarring and contraction of the circum-oral tissues with a marked reduction in the size of the oral aperture. Such burns most commonly caused by electrical contact, for example, children sucking electric plugs, or as a result of chemical burns and the exposture to flame. Once having burns, burned tissue may contract and reduce considerably the size and mobility of the mouth ; therefore bring up the resultant functional disturbance, verbal difficulty, even digestive difficulty, and poor appearance, which fall into difficulty in social acceptability, caused by burns. In our department, 2 patients who were complain of functional limitations and esthetic problem owing to scar contracture, were visited, and we treated this microstomia with scar excision, graft and flap technique, and postoperative intensive physical therapy. We obtained relatively favorable results, thus report this cases with literature review.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.366-370
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• 1996

Bilateral cleft lip reconstruction can be performed in one-or two-stages. The choice depends on the surgeon's proficiency and experience. However the type and severity of the cleft must be considered. Complete or incomplete symmetric, bilateral clefts in which the premaxilla is within the alveolar arch or slightly protruded can be successfully treated with simultaneous lip reconstruction on both sides. There are some advantages that one-stage lip reconstruction facilitates creation of a symmetric and balanced lip, retraction of protruding premaxilla and the parent's psychologic satisfaction. However, there are some disadvantages such as micrognathia of the upper jaw by severe scar formation and poor adaptation of flap margins by severe tension. The surgeon must be able to judge and exploit the advantages offered by one-stage approach. We present the case report of one-stage reconstruction of primary bilateral cleft lip with literature reviews.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.270-275
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• 2011

Pierre Robin Sequence (PRS) is known as an anomaly consisting of respiratory obstruction with glossoptosis, micrognathia and cleft palate in a newborn. The etiology of PRS is not known, but several factors may be involved simultaneously. Mortality rate of PRS is about 5~30% and the treatment method is divided into both conventional treatments and surgical interventions. If the respiratory obstruction is not resolved by the conventional method, surgical treatment, such as subperiosteal release of the floor of the mouth, tongue-lip adhesion, tracheostomy, distraction osteogenesis may be needed. This study reports a case of PRS in a newborn male at 20 days, with dyspnea and feeding difficulties. Clinical examination showed micrognathia with glossoptosis and cleft palate as the typical PRS triad. We tried surgical intervention with subperiosteal release of the floor of the mouth and tongue-lip adhesion and surgery was successful. At $19^{th}$ months, we also repaired the incomplete cleft palate successfully using 2-Flap palatoplasty.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.47.1-47.8
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• 2016

Background: The paradigm of tonsillectomy has shifted from a treatment of recurrent throat infection to one of multi-discipline management modalities of sleep-disordered breathing (SDB). While tonsillectomy as a treatment for throat problems has been performed almost exclusively by otorhinolaryngologists, tonsillectomy as a part of the armamentarium for the multifactorial, multidisciplinary therapy of sleep-disordered breathing needs a new introduction to those involved in treating SDB patients. This study has its purpose in sharing a series of tonsillectomies performed at the Seoul National University Dental Hospital for the treatment and prevention of SDB in adult patients. Methods: Total of 78 patients underwent tonsillectomy at the Seoul National University Dental Hospital from 1996 to 2015, and 23 of them who were operated by a single surgeon (Prof. Jin-Young Choi) were included in the study. Through retrospective chart review, the purpose of tonsillectomy, concomitant procedures, grade of tonsillar hypertrophy, surgical outcome, and complications were evaluated. Results: Twenty-one patients diagnosed with SDB received multiple surgical procedures (uvulopalatal flap, uvulopalatopharyngoplasty, genioglossus advancement genioplasty, tongue base reduction, etc.) along with tonsillectomy. Two patients received mandibular setback orthognathic surgery with concomitant tonsillectomy in anticipation of postoperative airway compromise. All patients showed improvement in symptoms such as snoring and apneic events during sleep. Conclusions: When only throat infections were considered, tonsillectomy was a procedure rather unfamiliar to oral and maxillofacial surgeons. With a shift of primary indication from recurrent throat infections to SDB and emerging technological and procedural breakthroughs, simpler and safer tonsillectomy has become a major tool in the multidisciplinary treatment modality for SDB.