• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권5호
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• pp.373-381
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• 2021

Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class III malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated. Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed. Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement. Conclusion: When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.

• 대한치과의사협회지
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• 제52권10호
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• pp.623-632
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• 2014

안면비대칭의 주원인은 하악골이며, 하악골의 비대칭 성장에 대한 상악골의 보상성장에 따라 교합면 경사 등이 초래된다. 디지털 사진과 삼차원 CT 등 다양한 방법으로 정확한 진단을 하고 수술을 포함한 치료계획을 세운다. 술전 교정 치료는 상악골과 하악골 치열의 치성 보상(dental compensation)을 제거하면서 상악 치열의 중심은 상악골의 정중선에, 하악 치열의 중심은 하악골 정중선에 맞게 이동하여 술후 상하악 치열궁이 일치하면서 동시에 안모 정중선에 일치하게 맞추어야 한다. 악교정 수술은 일반적으로 상하악 동시 수술을 하게 되며 우각부 풍융도 교정과 이부 성형술(genioplasty) 등을 부가적으로 할 수 있으며, 교합면 경사 교정과 수평 회전 등의 이동이 상하악 위치에 서로 영향을 주면서 수술 후 안모 변화에 대한 예측을 어렵게 만들기 때문에, 다양한 분석을 통해 정확한 예측으로 최선의 결과를 얻는 것이 가장 중요하다.

• 대한치과교정학회지
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• 제41권6호
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• pp.431-439
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• 2011

Objective: To determine whether there is any difference between the cleft and non-cleft sides of the mandible in unilateral cleft lip and palate (UCLP) patients, or the right and left sides in control patients; and to determine if there is any difference between the mandibular asymmetry of UCLP patients and that of control patients. Methods: We examined cone-beam computed tomography (CBCT) scans of 15 patients with UCLP and 15 age- and gender-matched control patients. We evaluated 8 linear, 3 surface, and 3 volumetric measurements and compared the cleft/non-cleft sides of UCLP patients and the right/left sides of controls. Results: There were no statistically significant gender differences in any linear, surface, or volumetric measurement. The single significant side-to-side difference in UCLP patients was a longer coronoid unit on the cleft side than on the non-cleft side ($p$ = 0.046). Body volume was significantly lower in the UCLP group than in the control group ($p$ = 0.008). Conclusions: In general, UCLP patients have symmetrical mandibles, although the coronoid unit length is significantly longer on the cleft side than on the non-cleft side. UCLP patients and controls differed only in body volume.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권5호
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• pp.537-542
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• 2008

BSSRO is most frequently operated among orthognathic surgery techniques for repairment of maxillofacial deformities. In case of patients with maxillofacial asymmetry accompanying mandibular protrusion who are operated by BSSRO, this study considers the recovering time for masticatory force of each tooth and Masseteric EMG and the adequate time enabling normal occlusion. The patients who are operated with BSSRO under general anesthesia in Dankook Dental Hospital, Department of OMS are selected for this study. The control group is devided into 2. 26 patients with facial asymmetry accompanying mandibular protrusion are selected for group 1 and their maximum voluntary bite force and masseteric EMG are measured. Group 2 is formed by volunteers with healthy dentition who are measured maximum bite force and masseteric EMG on both sides of the mouth. At the week of 3rd, 5th, 7th, 9th and 11th, Mann-Whitney U test is carried on for statistical analysis and the result is as follows. 1. Patients with mandibular protrusion showed apparently low maximum bite force and masseteric EMG than patients with normal occlusion. 2. In comparison with control group 1, Occlusal force is regained in incisors and canines at the 9th week and in premolars and molars, 11th week and masseteric EMG is regained at 11th week. 3. Comparing to normal occlusal patients, no recovery could be found in experimental group in every parts of the mouth.

• Korean Journal of Acupuncture
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• 제34권3호
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• pp.179-184
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• 2017

목적 : 안면 비대칭에 대한 한의학적 치료의 적용가능성에도 불구하고, 아직까지 관련 연구는 보고되지 않고 있다. 이 증례보고에서 저자들은 하악골 측방변위로 인한 안면 비대칭에 대하여 한의학적 치료의 효과와 안전성을 보고하였다. 방법 : 3명의 안면 비대칭 환자가 동작침법, 기능적 뇌척주요법의 음양균형장치, 연부조직이완술로 구성된 한의학적 치료를 12회 받았다. 치료 전후에 환자의 사진이 촬영되었다. 치료 전후의 4개의 주요 기준선의 변화가 평가되었다. 결과: 모든 환자들은 사진상의 호전을 보였다. 하지만 통계적으로 유의한 차이는 없었다. 결론 : 이 증례보고는 안면 비대칭에 대해 한의학적 치료의 효과를 보고하는 첫 번째 보고이다. 추후 이러한 결과를 확인하기 위한 더 잘 설계된, 무작위화, 플라세보 대조 연구가 필요하다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권4호
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• pp.249-256
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• 2021

Objectives: The purpose of this study was to evaluate the postoperative anteroposterior stability and improvements in facial asymmetry after performing LeFort I osteotomy in the maxilla, sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy (IVRO) in the mandible, and lateral corticectomy on the IVRO side. Materials and Methods: From July 2009 to October 2018, a retrospective analysis was performed on 11 subjects. Lateral cephalometric radiograph was performed preoperatively (T0), postoperatively (T1), and at 12 months of follow-up (T2), and the B point distance was measured. Posteroanterior cephalometric radiograph was performed preoperatively (S0) and at 12 months of follow-up (S1) and was used to measure five indicators (Ag angle, M-Ag, Co-Ag, Co-Me, and Ag-Me) of facial asymmetry. Results: The B point distances for T0 and T1 were significantly different (P=0.007), whereas those for T1 and T2 were not significantly different (P=0.1). In addition, there was a significant difference between the B point distances of T2 and T0 (P=0.026). Comparison of the facial asymmetry indicators before and after surgery showed a significant difference for all indicators between S0 and S1: the P-values of Ag angle, M-Ag, Co-Ag, Co-Me, and Ag-Me were 0.003, 0.003, 0.008, 0.006, and 0.004, respectively. The Z value was based on negative ranks. Conclusion: There was no significant difference in the B point distances from postoperation to the 12-month follow-up. However, there were significant differences in all five indicators related to facial asymmetry before and after surgery. The values for the five indicators of facial asymmetry all increased postoperatively.

• Imaging Science in Dentistry
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• 제38권4호
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• pp.203-208
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• 2008

Purpose : The purpose of this study was to develop a system for the measurement and simulation of the TMJ movement and to analyze the mandibular movement quantitatively. Materials and Methods : We devised patient-specific splints and a registration body for the TMJ movement tracking. The mandibular movements of the 12 subjects with facial deformity and 3 controls were obtained by using an optical tracking system and the patient-specific splints. The mandibular part was manually segmented from the CT volume data of a patient. Three-dimensional surface models of the maxilla and the mandible were constructed using the segmented data. The continuous movement of the mandible with respect to the maxilla could be simulated by applying the recorded positions sequentially. Trajectories of the selected reference points were calculated during simulation and analyzed. Results : The selected points were the most superior point of bilateral condyle, lower incisor point, and pogonion. There were significant differences (P<0.05) between control group and pre-surgical group in the maximum displacement of left superior condyle, lower incisor, and pogonion in vertical direction. Differences in the maximum lengths of the right and the left condyle were 0.59${\pm}$0.30 mm in pre-surgical group and 2.69${\pm}$2.63 mm in control group, which showed a significant difference (P<0.005). The maximum of differences between lengths of the right and the left calculated during one cycle also showed a significant difference between two groups (P<0.05). Conclusion : Significant differences in mandibular movements between the groups implies that facial deformity have an effect on the movement asymmetry of the mandible. (Korean J Oral Maxillofac Radiol 2008; 38 : 203-8)

• Journal of Korean Dental Science
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• 제12권2호
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• pp.66-72
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• 2019

Osteochondroma is a bone tumor with cartilaginous growth potential that generally appears near the growth plate of long bones in areas such as hip, knee, and shoulder joints, related to the nature of endochondral ossification and it is known a common benign bone tumor. However, it has been very rare in craniofacial region possibly because craniofacial bone is largely formed by intramembranous ossification. Moreover, reports on the solitary type of osteochondroma in mandibular condyle has been extremely rare. Osteochondroma in mandibular condylar may show various symptoms similar to general temporomandibular joint disorders (TMDs), such as pain in the condylar area during mouth opening, internal derangement, facial asymmetry or posterior open bite. Therefore, it can be disregarded for a long time period without any adequate treatment. Surgical excision has been the treatment option for the solitary osteochondroma with very low recurrence rate reportedly. In this case report, a rare case of solitary osteochondroma developed in unilateral mandibular condyle is presented with emphasis on differential diagnosis with general TMDs.

• Journal of Oral Medicine and Pain
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• 제15권1호
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• pp.79-89
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• 1991

The author examined the patterns and various ranges of mandibular movements in TMJ lock closed patients in the frontal, sagittal and horizontal plane and obtained the following results. 1. In the frontal trajectory, the mean amount of maximum mouth opening was 24.4mm and the opening paths were deviated to the affected side in 87.1% of the patients. The mean amount of maximum laterotrusion to the affected side was 10.4mm and that of non-affected side was 7.5mm. There was a significant difference between them(p<0.001). 2. In the sagittal trajectory, the mean amount of the maximum protrusion was 7.0mm, the mean amount of the maximal retrusion was 1.0mm 3. In the horizontal trajectory, the pattern of laterotrusion showed asymmetry: the mean length of non-affected side was smaller than that of the affected side. Protrusive path were deviated to the affected side in 64.5% of the patients, the mean degree of deviation was 16.4$^{\circ}$. The mandibular movements of TMJ lock-closed patients can be characterized by decreased range of mouth opening, protrusive movement, and laterotrusive movement to the non-affected side and also characterized by deviated opening and protrusive path to the affected side.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권2호
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• pp.132-135
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• 2002

The osteochondroma, also known as osteocartilaginous exostosis, is one of the most common benign tumors of the axial skeleton. These tumours rarely affect the facial skeleton and a true osteochondroma of the mandibular condyle is a very uncommon entity. The tumors are usually slow growing, and symptoms develop over a long time. The most common presentation of the condylar osteochondroma consists of a changing occlusion, the development of facial asymmetry, and a posterior open bite on the affected side. In this case, we treated an osteochondroma of Lt. mandibular condyle through excision of the lesion via the temporal approach to the temporomandibular joint.