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Correction of Secondary cleft lip-nasal deformity; secondary rhinoplasty in children and adults (구순열 이차비기형의 교정; 아동과 성인에서의 이차 비성형술)

  • Song Gin-Ah;Myung Hoon;Hwang Soon-Jung;Seo Byoung-Moo;Lee Jong-Ho;Choung Pill-Hoon;Kim Myung-Jin;Choi Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.1
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    • pp.17-25
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    • 2003
  • Correction of the cleft-lip nasal deformity is a difficult task that requires clear understanding of the associated complex anatomy and function as well as the operation time, the selection of an operation method, On the expectation that it helps enhance understanding the current trend of cleft-rhinoplasty, authors analyzed secondary rhinoplasty between 1999 and 2002, In both the unilateral and bilateral cleft lip rhinoplasty, we reviewed the timing of repair, site of correction and it's major technique, incision or approach method, autogenous cartilage graft method, All patients with a septal deviation did not have a septal surgery, We were active in alar and nasal tip surgery and passive in septal and dorsal deformity correction, And for children, we used a conservative method but for adults, we used radical approach, Most surgeries are focused on esthetic goal and we thought that objective evaluation for nasal obstruction was needed for bener and predictable outcome.

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THE ERUPTION GUIDANCE OF IMPACTED MAXILLARY ANTERIOR TEETH (맹출장애를 보이는 상악 전치의 맹출유도)

  • Sim, Jeung-Ho;Eum, Jong-Hyeok;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.34-40
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    • 2004
  • Unerupted maxillary anterior teeth is not a common case, However it may present practitioners with management problem. The cause of impaction is considered to be multifactorial, and local cause is the most common. These impacted teeth require surgical intervention, removal, transplantation, or surgical exposure, with or without orthodontic traction to align the malpositioned tooth. The preferred option is surgical exposure and orthodontic correction. Surgical intervention and orthodontic correction should not be delayed to avoid unnecessary difficulties in aligning the tooth in the arch. Surgical exposure should be performed with the intent of providing sufficient attached gingiva rather than simply uncovering the crown, which results in only alveolar mucosal attachment. Attached gingiva is essential to secure the gingival tissues to the adjacent teeth at the dentogingival junction. Thus preventing loss of periodontal tissues as a result of the pull of the surrounding soft tissues and facial muscles. Labially impacted maxillary anterior teeth uncovered with an apically positioned flap technique have more un- esthetic sequelae than those uncovered with a closed-eruption technique. In the case of severly displaced impacted teeth, autotransplantation ensures preservation of the alveolar bone and will facilitate future placement of an osseointegrated implant once growth has ceased or if ankylosis/resorption of the transplant occurs.

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ORTHODONTIC TRACTION OF HORIZONTALLY IMPACTED MAXILLARY INCISORS: CASE REPORTS (수평 매복된 상악 중절치의 교정적 견인: 증례 보고)

  • Kim, Mi-Ni;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Kim, Chong-Chul;Hahn, Se-Hyun;Lee, Sang-Hun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.757-765
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    • 2008
  • Maxillary central incisor impactions occur infrequently. Their origins include various local causes, such as odontoma, supernumerary teeth, space loss, and disturbances in the eruption path, also trauma and apical follicular cysts. Impacted teeth can cause serious dental and aesthetic difficulties as well as psychological problems especially in anterior regions. Although the impaction of maxillary incisor occurs less frequently than that of the maxillary canine, it is of concern to parents during the early mixed dentition stage because of the uneruption of the tooth. Forced eruption of impacted teeth should be considered in young patients because this technique can lead to suitable results from a periodontal, occlusal, and esthetic perspective at an earlier stage better than with other treatment options. This report presents the surgical and orthodontic treatment of cases with horizontally impacted and dilacerated maxillary central incisors. For each patient, we used the closed eruption method, placed an attachment on the impacted tooth on surgery, and fully closed the flap. Traction was applied immediately. The impacted tooth erupts through the healed tissue in a manner resembling normal eruption.

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Factors that influence treatment duration for patients with palatally impacted maxillary canines (구개측으로 매복된 상악견치의 교정치료기간에 영향을 미치는 요소)

  • Jeong, Song-Hwa;Jo, Bong-Hye;Kim, Seong-Sik
    • The korean journal of orthodontics
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    • v.37 no.2 s.121
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    • pp.150-158
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    • 2007
  • Objective: The aim of this study was to determine the relationship between the status of a unilateral palatally impacted maxillary canine (as seen on the panoramic radiograph) and the orthodontic treatment duration. Methods: A total of 36 subjects were chosen (8 males and 28 females, $13.7{\pm}2.5$ years). All patients had undergone orthodontic traction of the impacted canine after a closed flap surgery. The position of impacted canine on the panoramic radiograph was traced and calculated with regard to the treatment duration. Results: The canine overlap over the lateral incisor (COGr) had significant statistical difference between the short-term and the long-term treatment duration groups (divided by average treatment time of 21 months) (p<0.05). Multiple regression indicated that the variables of significance (with treatment duration as the dependent variable) were the canine vertical height from the occlusal plane $(HCV,\;r^2=0.115;\;p<0.05)$ and the mandibular anterior width $(MnDW,\;r^2=0.142;\;p<0.05)$. The treatment duration, the canine angle to the incisor midline (CA), and HCV decreased from primary dentition (under 12 yrs) to permanent dentition (15 yrs). Howerer, these increased again at the adolescent ages (over 16 yrs). Conclusion: These findings suggested that orthodontic treatment of a palatally impacted canine would show good prognosis at an age of early permanent dentition with the canine showing smaller CA and HCV.

THE EFFECTS OF TOOTH MOVEMENT AFTER CORTICOTOMY ON THE SURROUNDING BONE OF UPPER MOLAR IN RATS (백서의 상악 구치 주위골의 피질골 절단술 후 치아이동의 영향)

  • Lee, Seung-Yeon;Park, Su-Hyun;Park, Yong-Hee;Lee, Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.684-689
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    • 2007
  • The aim of this study is to examine the change of the osteoclastic activity in the surrounding bone with or without tooth movement after corticotomy by histologic study. Eighteen male Sprague Dawley rats with an average body weight of 300 g(range 250-350 g) were used. The rats were divided into three groups of six animals. They were operated corticotomy-assisted tooth movement and killed after 1 week, 2 weeks, and 3 weeks after tooth movement. Corticotomy was done in the surrounding of the both upper first molar. A split mouth design was used by referring to the contralateral side as control. After flap suturing, the upper left first molar was moved anteriorly by closed coil spring. The force applied was 1 N. The average of tooth movement of the 1 week group was $0.24{\pm}0.09mm,\;0.20{\pm}0.26mm$ in 2 weeks group and $0.41{\pm}0.39mm$ in 3 weeks group, respectively. The difference between the 1 week and the 2 weeks groups was very small to compare with the 3 weeks group. In the treatment group, the average numbers of cells that positively reacted to TRAP were 14.5 in the 1 week group, 12.0 in the 2 weeks group, and 6.0 in the 3 weeks group. In the control group, the numbers were 8.3 in the 1 week group, 12.8 in the 2 week group, and 1.5 in the 3 week group, respectively. The amount of tooth movement of the 3 week group was about twice as large as those of the 1 week and 2 week groups. From the standpoint of histology, the average number of cells that positively reacted to TRAP was initially larger in the treatment group than in the control group, similar in both group in 2 weeks, and became less in the treatment group in 3 weeks. Additionally, in the control group, their activity of osteoclast was higher in 2 weeks than in 1 week, and decreased rapidly in 3 weeks.

Extent of Hyperostotic Bone Resection in Convexity Meningioma to Achieve Pathologically Free Margins

  • Fathalla, Hussein;Tawab, Mohamed Gaber Abdel;El-Fiki, Ahmed
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.821-826
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    • 2020
  • Objective : Hyperostosis in meningiomas can be present in 4.5% to 44% of cases. Radical resection should include aggressive removal of invaded bone. It is not clear however to what extent bone removal should be carried to achieve pathologically free margins, especially that in many cases, there is a T2 hyperintense signal that extends beyond the hyperostotic bone. In this study we try to investigate the perimeter of tumour cells outside the visible nidus of hyperostotic bone and to what extent they are present outside this nidus. This would serve as an initial step for setting guidelines on dealing with hyperostosis in meningioma surgery. Methods : This is a prospective case series that included 14 patients with convexity meningiomas and hyperostosis during the period from March 2017 to August 2018 in two university hospitals. Patients demographics, clinical, imaging characteristics, intraoperative and postoperative data were collected and analysed. In all cases, all visible abnormal bone was excised bearing in mind to also include the hyperintense diploe in magnetic resonance imaging (MRI) T2 weighted images after careful preoperative assessment. To examine bony tumour invasion, five marked bone biopsies were taken from the craniotomy flap for histopathological examinations. These include one from the centre of hyperostotic nidus and the other four from the corners at a 2-cm distance from the margin of the nidus. Results : Our study included five males (35.7%) and nine females (64.3%) with a mean age of 43.75 years (33-55). Tumor site was parietal in seven cases (50%), fronto-parietal in three cases (21.4%), parieto-occipital in two cases (14.2%), frontal region in one case and bicoronal (midline) in one case. Tumour pathology revealed a World Health Organization (WHO) grade I in seven cases (50%), atypical meningioma (WHO II) in five cases (35.7%) and anaplastic meningioma (WHO III) in two cases (14.2%). In all grade I and II meningiomas, bone biopsies harvested from the nidus revealed infiltration with tumour cells while all other bone biopsies from the four corners (2 cm from nidus) were free. In cases of anaplastic meningiomas, all five biopsies were positive for tumour cells. Conclusion : Removal of the gross epicentre of hyperostotic bone with the surrounding 2 cm is adequate to ensure radical excision and free bone margins in grade I and II meningiomas. Hyperintense signal change in MRI T2 weighted images, even beyond visible hypersototic areas, doesn't necessarily represent tumour invasion.

Comparison the Preoperative MRI Findings with Postoperative Arthroscopic Findings on Meniscus Injury with Anterior Cruciate Ligament Rupture (전방십자인대 파열에 동반된 반월상 연골판 손상의 관절경 수술 소견과 수술 전 자기공명영상 검사와의 비교)

  • Sohn, Hong Moon;Lee, Gwang Chul;Kim, Dong Hwi;Park, Sang Soo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.147-152
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    • 2012
  • Purpose: The purpose of this study was to compare the preoperative magnetic resonance image (MRI) findings with postoperative arthroscopic findings on meniscus injury with anterior cruciate ligament (ACL) rupture. Materials and Methods: We reviewed MRI images and arthroscopic findings of 225 patients treated by ACL reconstruction due to rupture, from February 2001 to November 2010. There were 154 cases of meniscus tear in arthroscopic findings. We examined the sensitivity for detecting meniscal tears varied with the presence of a rupture of the ACL, with the location of the tear within the meniscus, and among configurations of meniscal tears. Results: In the presence of a rupture of the ACL, the sensitivity of MRI was 0.88 for medial meniscal tears and 0.69 for lateral meniscal tears. And sensitivity of MRI was lowest in posterior horn and peripheral portion tears in lateral meniscus injury accompanying ACL rupture, sensitivity was low in anterior horn and flap shape tears in medial meniscus injury accompanying ACL rupture. Conclusion: In Meniscus injury with ACL rupture, a special attention shoulder given to the posterior horn and peripheral portion injury in lateral meniscus during arthroscopic surgery due to difficulty in detecting on MRI.

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Internal Jugular Vein Patency after Modified Radical Neck Dissection (변형적 경부청소술 후 내경정맥의 유지)

  • Cho Jung-Il;Kim Young-Mo;Kim Chul-Ho;Kim Hyung-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.169-174
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    • 1998
  • Background: To avoid the major mobidity associated with bilateral radical neck dissection, modified radical neck dissection has become established as an effective adjunctive procedure in the management of head and neck cancer. But several studies reported early postoperative internal jugular vein(IJV) occlusion in patients who underwent modified radical neck dissection. Objectives: To determine internal jugular vein patency following modified radical neck dessection performed in various head and neck cancer and to identify factors associated with venous occlusion. Materials and Methods: From Aug. 1996 to Oct. 1997, twenty three patients underwent either unilateral or bilateral modified radical neck dissection; 19 males and 4 females, ranging in age from 28 to 75 were retrospectively examined. All patients had a preoperative doppler imaging or CT or both for their initial evaluation. A follow-up examination was obtained(after a minimum postoperative period of 2 months and a maximum one of 4 months). Results: Thirty-four IJVs were examined. All but six IJVs examined were found patent postoperatively. The preservation rate of patency of the IJV in modified radical neck dissection was found to be high(28 of 34 IJVs or 82%). Conclusion: The preservation rate of patency of the IJV in modified radical neck dissection was found to be high. These results favor the use of modified radical neck dissection for IJV preservation, particularly in bilateral neck dissection. A retrospective chart review revealed that trauma of the vessel and extrinsic compression of the vein by the musculocutaneous flap or recurrent carcinoma in the neck may be the cause of the vein occlusion.

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LONG TERM EVALUATION OF VOLUME CHANGE IN FREE VASCULARIZED FIBULAR FLAP MANDIBLE RECONSTRUCTION (하악골 결손의 재건을 위한 혈행화된 비골 이식술에서의 장기간의 체적변화)

  • Kim, Yoon-Tae;Jeon, Seung-Ho;Yeom, Hak-Ryol;Ahn, Kang-Min;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Choung, Pill-Hoon;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.138-141
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    • 2006
  • Introduction : In recent years, vascularized, i.e., living bone grafts, have been widely applied in the field of oral and maxillofacial surgery, as a method of treatment of congenital or acquired non-unions, and a large defects in mandible. The vascularized fibular graft has been especially used for this purpose because of its shape and mechanical strength. The postoperative hypertrophy of grafted fibula is of particular interest to us. Material and methods : This study was undertaken to determine the volume change(indirect methods) and radiographic appearance of a free vascularized fibular graft as it responds to the mechanical and physiologic features of its new environment. In order to elucidate the long term effect on fibular mass after mandibular reconstruction, change in various method of volume change was utilized as indirect measure of change in long-term. Results : The younger the patient, the more prominent and rapid the hypertrophy of the graft. the hypertrophy of the graft never exceeded the diameter of the recipient bone, except for callus enlargement after stress fracture of the grafted bone. Conclusion : Etiologic explanations for this phenomenon have not been clarified in the previeous literature. some of the factors implicated include a periosteal reaction or new bone formation, as seen at the onset of bone union after a fracture in a child, a reaction to the mechanical loading on the graft and a reaction to the circulatory changes resulting from the grafting procedure.

Distribution of the lingual foramina in mandibular cortical bone in Koreans

  • Kim, Dae Hyun;Kim, Moon Yong;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.6
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    • pp.263-268
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    • 2013
  • Objectives: The interforminal region, between the mandibular foramen, is known as a relatively safe area that is free of anatomic structures, such as inferior alveolar nerve, submandibular fossa, and lingual side of the mandible is occasionally neglected for its low clinical importance. Even in the case of a severely constricted alveolus, perforation of the lingual cortical bone had been intended. However, anterior extension of the inferior alveolar canal, important anatomic structure, such as concavity of lingual bone, lingual foramina, and lingual canal, has recently been reported through various studies, and untypical bleeding by perforation of the lingual plate on implantation has also been reported. Therefore, in this study, we performed radiographic and statistical analysis on distribution and appearance frequencies of the lingual foramina that causes perforation of the mandibular lingual cortical bone to prevent complications, such as untypical bleeding, during surgical procedure. Materials and Methods: We measured the horizontal length from a midline of the mandible to the lingual foramina, as well as the horizontal length from the alveolar crest to the lingual foramina and from the lingual foramina to the mandibular border by multi-detector computed tomography of 187 patients, who visited Dankook University Dental Hospital for various reasons from January 1, 2008 to August 31, 2012. Results: From a total of 187 human mandibles, 110 (58.8%) mandibles had lingual foramina; 39 (20.9%) had bilateral lingual foramen; 34 (18.2%) had the only left lingual foramen; and 37 (19.8%) had the only right lingual foramen. Conclusion: When there is consistent bleeding during a surgical procedure, clinicians must consider damages on the branches of the sublingual artery, which penetrate the lingual foramina. Also, when there is a lingual foramina larger than 1 mm in diameter on a pre-implantation computed tomography, clinicians must beware of vessel damage. In order to prevent these complications and progress with a safe surgical procedure, a thorough radiographic examination before the surgery is indispensable. Further, clinicians should retract lingual flap definitely to confirm the shape of the lingual bone and existence of the lingual foramina.