• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.30 no.2
• /
• pp.182-190
• /
• 2008

Fracture of mandible is the most frequent fracture among many types of maxillofacial fracture, and reduction of mandible fracture is performed using various methods of treatment to maintain bonding strength of fractured bone. Among these treatment of bone fracture, a semirigid fixation method which can reduce the period of intermaxillary fixation using metal mini plate under general or local anesthesia is spotlighted these days. The metal mini plate used during this semirigid fixation procedure is Titanium which is bio-inactive one and was used widely, but because the side effect of fracture reduction using titanium have been demonstrated recently, fracture reduction using biodegradable plate become to attract people's attention. The purpose of this study was to report the clinical case and review of the literature with the reduction of mandible fracture using biodegradable plate.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.27 no.1
• /
• pp.217-230
• /
• 1997

The location of the mandibular canal and the cortical thickness of the mandible is important in the practice of dentistry. This study was performed on twenty chosen dry mandibles, which were of adults and included fully erupted premolars and molars. The purpose of this study was to evaluate the location of the mandibular canal and the cortical thickness of the mandible on computed tomograms and to aid in the surgical treatment plans. The obtained results were as follows; 1. The horizontal distance between the mandibular canal and the buccal external border was 6.6±0.9mm on Somesial root of the first molar), and it was increased posteriorly. The horiwntal distance between the mandibular canal and the lingual external border was 4.1±1.lmm on S/sub 0/, and it was decreased posteriorly. 2. The vertical distance between the alveolar crest and the mandibular canal was 16.9±1.6mm on S/sub 0/, and it was decreased posteriorly. The vertical distance between the inferior border of mandible and the mandibular canal was 8.8±1.3mm on S/sub 0/, and it was increased anteriorly and posteriorly. 3. The thickness of the buccal cortical plate was 2.2±0.4mm on S/sub 0/. and it was increased posteriorly. But, that of the lingual cortical plate was 2.0±0.6mm on S/sub 0/ and it was decreased posteriorly. 4. The area of the buccal cortical plate was 66.5±1.0mm² on S/sub 0/. and it was increased posteriorly. But, that of the lingual cortical plate was 65.8±0.9mm² on S/sub 0/ and it was decreased posteriorly.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.47 no.6
• /
• pp.465-470
• /
• 2021

Few cases of spontaneous bone regeneration after extensive resection of the jaw bone have been reported, but it is more common in young adults or children. In this case, we report spontaneous bone healing in a 73-year-old female patient. On radiological examination, necrotic regions were seen in the right mandible. She was diagnosed with medication-related osteonecrosis of the jaw due to previous bisphosphonate use. After segmental resection, stabilization achieved using a reconstruction plate. The periosteum was preserved during the procedure. Twelve months later, panoramic radiography was taken and bone formation was seen both horizontally and vertically around the plate. If the periosteum is preserved and stabilization is achieved after resection in benign lesions, the bone may regenerate spontaneously regardless of age. Therefore, instead of simultaneous autogenous bone application, such patients may be followed to determine whether spontaneous bone healing will occur. This should improve patient comfort and reduce surgical cost.

• Archives of Plastic Surgery
• /
• v.39 no.4
• /
• pp.284-290
• /
• 2012

Open reduction and anatomic reduction can create better function for the temporomandibular joint, compared with closed treatment in mandible fracture surgery. Therefore, the double miniplate fixation technique via mini-retromandibular incision was used in order to make the most stable fixation when performing subcondylar fracture surgery. Those approaches provide good visualization of the subcondyle from the posterior edge of the ramus, allow the surgeon to work perpendicularly to the fracture, and enable direct fracture management. Understanding the biomechanical load in the fixation of subcondylar fractures is also necessary in order to optimize fixation methods. Therefore, we measured the biomechanical loads of four different plate fixation techniques in the experimental model regarding mandibular subcondylar fractures. It was found that the loads measured in the two-plate fixation group with one dynamic compression plate (DCP) and one adaption plate showed the highest deformation and failure loads among the four fixation groups. The loads measured in the one DCP plate fixation group showed higher deformation and failure loads than the loads measured in the two adaption plate fixation group. Therefore, we conclude that the selection of the high profile plate (DCP) is also important in order to create a stable load in the subcondylar fracture.

• Archives of Plastic Surgery
• /
• v.37 no.5
• /
• pp.691-694
• /
• 2010

Purpose: Central giant cell granuloma is a rare, benign giant cell tumor which commonly develops in areas near the teeth. It accounts for approximately less than 7% of benign tumors of the mandible. Clinically, central giant cell granuloma is classifed into aggressive and non-aggressive type, and usually requires surgical treatment. There has been no report of central giant cell granuloma in plastic surgery field of the country, and we report a case with a brief review of the diagnosis and treatment of the disease. Methods: A 23-year-old male presented with a hard, non-tender, growing mass with the size of $4.0{\times}3.0\;cm$ on mandible for several months. Computed tomography scan showed a solid mass within thinned outer cortex on mandible. The thinned outer cortex was excised with the mass and the inner cortex was partially removed burring. After the tumor removal, mandible was fixed by reconstruction plate. Results: Pathologic report showed numerous large multinucleated giant cells, diffusely distributed in a background of ovoid-to-spindle-shaped mononuclear cells. There was no evidence of recurrence after 1 year follow up. Bony defect was regenerated and we removed the reconstruction plate. Conclusion: Removal of central giant cell granuloma results in defect of outer cortex, which can be reconstructed by using reconstruction plate, autologous bone graft or bone cement. We used reconstruction plate as a conservative method to induce secondary healing of the outer cortical defect area, which resulted in normal mastication and occlusion with no recurrence.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.17 no.1
• /
• pp.209-222
• /
• 1987

The author invested the gonial angle, the angle of mandibular and mental canal to the lower border of the mandible, and a relationship of the position of the mandibular canal to the root apex of the posterior teeth and the cortical plate of the lower of the mandible. The materials consisted of 458 pantomograms in male and female aged 11-40 and divided into 5 groups at 5 year intervals and subdivided into 3 groups by gonial angle. The results were as follows; 1. The gonial angle decreased with age, but slight increase occurred over 26-30 years. 2. The average angle of the mandibular canal to the lower border of the mandible was 151.6° and did not correlate with age. 3. The average angle of the mental canal to the lower border of the mandible was 36.9° and didn't correlate with age. 4. The angles of mandibular and mental canal to the lower border of the mandible correlated with gonial angle. 5. The distance from the root apex of the posterior teeth to the upper wall of the mandibular canal was most short at the region of the distal root of the mandibular second molar and increased with age at the region of the mandibular second molar. 6. The distance from the lower wall of the mandibular canal to the cortical plate of the lower border of the mandible was most short at the region of the mesial root of the mandibular first molar and didn't correlate with age.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.1
• /
• pp.32-38
• /
• 2005

The efficacy of bioresorbable fixation has recently been described in the osseosynthesis of the oral & maxillofacial region. However, a liitle data exist regarding the use of biodegradable plates and screws for the internal fixation of human mandible fractures. The purpose of this study is to analyze and compare the treatment of mandibular fractures by using a bioresorbable fixation system with conventional titanium system in human mandible fractures. eighteen patients constituted the bioresorbable fixation group and twenty-five patients constituted the titanium fixation group. Both groups underwent open reduction and internal fixation by use of a bioresorbable system or a titanium fixation system. Panoramic radiograph were obtained preoperatively, immediately postoperatively after reduction, at 6 months and at 12 months postoperatively. In the bioresorbable fixation group, complication(infection) occurred in 1 patient(5.6%) and was resolved by incision & drainage, plate removal and antibiotics without untoward sequelae. 2 patients(8.0%) experienced complications in the titanium fixation group and were treated using conservative treatment. There was no statistical difference in complication rates between two groups. Our data supported the use of bioresorbale plate fixation in mandibular fractures as a means of avoiding the potential and well documented problems with rigid titanium fixation systems. In conclusion, the bioresorbable fixation system provide a reliable and sufficient alternative to conventional titanium plate system.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.5
• /
• pp.271-275
• /
• 2012

Objectives: This study evaluated a range of fixation methods to determine which is best for the postoperative stabilization of a mandibular osteotomy using three-dimensional finite element analysis of the stress distribution on the plate, screw and surrounding bone and displacement of the lower incisors. Materials and Methods: The model was generated using the synthetic skull scan data, and the surface model was changed to a solid model using software. Bilateral sagittal split ramus osteotomy was performed using the program, and 8 different types of fixation methods were evaluated. A vertical load of 10 N was applied to the occlusal surface of the first molar. Results: In the case of bicortical screws, von-Mises stress on the screws and screw hole and deflection of the lower central incisor were minimal in type 2 (inverted L pattern with 3 bicortical repositioning screws). In the case of plates, von-Mises stress was minimal in type 8 (fixation 5 mm above the inferior border of the mandible with 1 metal plate and 4 monocortical screws), and deflection of the lower central incisor was minimal in types 6 (fixation 5 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws) and 7 (fixation 12 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws). Conclusion: Types 2 and 6 fixation methods provide better stability than the others.

• Archives of Craniofacial Surgery
• /
• v.15 no.2
• /
• pp.75-81
• /
• 2014

Background: The fibular free flap has been used as the standard methods of segmental mandibular reconstruction. The objective of mandibular reconstruction not only includes restored continuity of the mandible but also the recovery of optimal function. This paper emphasizes the advantage of the fibular free flap reconstruction over that of locking mandibular reconstruction plate fixation. Methods: The hospital charts of all patients (n=20) who had a mandibular reconstruction between 1994 and 2013 were retrospectively reviewed. Eight patients had plateonly fixation of the mandible, and the remaining 12 had vascularized fibular free flap reconstruction. Complications and outcomes were reviewed and compared between the 2 groups via statistical analysis. Results: Overall complication rates were significantly lower in the fibular flap group (8.3%) than in the plate fixation group (87.5%; p =0.001). Most (7/8) patients in the plate fixation group had experienced plate-related late complications, including plate fracture or exposure. In the fibular flap group, no complications were observed, except for a single case of donor-site wound dehiscence (1/12). Conclusion: The fibular free flap provides a more stable support and additional soft tissue support for the plate, thereby minimizing the risk of plate-related complications. Fibular free flap is the most reliable option for mandibular reconstruction, and we believe that the flap should be performed primarily whenever possible.

• The Journal of the Korean dental association
• /
• v.15 no.5
• /
• pp.359-364
• /
• 1977

Orthognathic surgery, ie, the surgical correction of congenital and acquaired anormalities of the jaws, is currently a field of vigorous activity among oral surgeons. Surgical correction of maxillofacial deformities benefits the patient both psychologically and functionally. Facial mutilation may precipitate adverse psychologic effects. Function is frequently impaired by malrelation of the jaws. In addition, speech, specifically articulation, is often handicapped in patient with severe jaw deformities. Therefore, in dealing with these patient, above mentioned problem should be considered deliberately. In this regard, the authors have treated 2 cases of mandible defect caused by gunshot and explosives with iliac bone graft. In both cases, the patient had Tantalum plate on defect area. But it became lose and gave functional disturbances. So, the authors have removed Tantalum plate and performed bone transplantation with autogenous soild iliac bone graft on that area with good results.