• 대한치과교정학회지
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• 제33권5호
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• pp.391-398
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• 2003

견인골 신장술은 막내골화를 유도하는 조직공학으로, 두개안면기형 영역에서 치료는 지난 10년간 지속되었다. 본 연구는 하악지를 절단한 후 구강내 견인장치를 사용하여 안모 비대칭을 치료한 증례이다. 안모 비대칭 환자를 치료하는데 섬세하게 견인골 신장술을 이용하면 성장기와 성장이 끝난 환자에게서 효율적인 치료방법으로 생각된다.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.291-300
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• 2012

The incidence of condylar fractures is high,but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

• 대한두개안면성형외과학회지
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• 제22권1호
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• pp.45-51
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• 2021

Background: Mandibular deficiency leading to facial asymmetry causes cosmetic deformity as well as psychological stigma for the patient. Correction of these mandibular asymmetries is a major challenge. The study investigates the efficacy of bidirectional mandible distraction for the treatment of mandibular deficiency. Methods: This prospective study included six individuals aged between 17 and 24.4 years. Five patients had hemifacial microsomia and one had unilateral temporomandibular joint ankyloses. All patients underwent mandibular distraction osteogenesis. Postoperative skeletal changes in affected mandible, and changes in occlusal plane and oral commissure cant were evaluated using three-dimensional reconstruction. Patient satisfaction and understanding of the procedure were assessed through three questionnaires administered during pre-distraction, distraction and post-distraction phases. Results: In pre-distraction phase, aesthetic appearance seemed to be the primary indication for surgery. In distraction phase, pain while chewing was the primary handicap. In post-distraction phase all patients were satisfied with the aesthetic outcome. The facial deformity was improved through mandibular distraction osteogenesis. On the affected side in all the patients, height and length of the mandible increased. Canting of the occlusal plane and oral commissure was corrected. Conclusion: Bidirectional mandible distraction is an effective treatment for correction of mandible deformities in adult patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.259-266
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• 2005

The function of the masseter and anterior temporal muscles was assessed by electromyography in 30 patients with mandibular prognathism (20 patients with facial asymmetry and 10 patients without facial asymmetry) before orthognathic surgery and 4weeks afterwards. Electromyogram(EMG) recordings were made during resting, clenching and swallowing. We compared with right-left difference of this recording and asymmetry index before and after orthognathic surgery. The result of this study was as follows. 1. There was no significant right-left difference in muscle activities of masticatory muscles both asymmetric groups and controls and many variable change after orthognathic surgery.(P>0.05) 2. The mean electric activity of the masticatory muscles was found to have decreased during more clenching than resting, but there was no statistically significant difference because of individual difference of measuring values.(P>0.05) 3. The asymmetry index of masticatory muscles in asymmetric groups was significantly greater during clenching compared with controls.(P<0.05) In conclusion, no right-left difference of muscle activities was found in patients with facial asymmetry before orthognathic surgery and 4weeks afterwards. Not only muscular functioning but also many other factors, such as occlusion, temporomandibular joint disorder and trauma, probably affect facial asymmetry and will be analyzed in future studies. And we will need long term follow-up after orthognathic surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권3호
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• pp.266-273
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• 2005

Purpose: To assess the relationship between soft tissue reference line and hard tissue reference line using the standardized photographs and the posteroanterior cephalometric radiographs(P-A)in facial asymmetric patients and to compare the differences of angular measurement between normal group and asymmetry group. Methods: Normal group consisted of 44 persons with normal occlusion and normal facial morphology. Asymmetry group consisted of 90 patients with facial asymmetry. Standardized facial photographs and P-A were taken in all subjects. The horizontal reference lines were bipupillary line in photographs and latero-orbitale line in P-A respectively. The vertical reference line were the line from the midpoint of horizontal reference line perpendicularly. Angular measurement of otobasion canting, lip canting, nose deviation, chin deviation, and maxillary deviation were compared and analyzed in photographs. And angular measurement of mastoid canting, mandibular canting, nose deviation, chin deviation, and maxillary deviation were compared and analyzed in P-A. Results: 1. The variables of photographs and P-A were significantly related in the asymmetry group. 2. Significant differences between all variables except for PT2 and PA2 were shown in the asymmetry group and between PT1 and PA1, PT3 and PA3 in the normal group respectively. 3. Comparison measurement scores of angular difference between control group and experimental group concerning each variable showed significant difference except for PA1. Conclusions: Soft tissue components may not compensate for underlying skeletal imbalance in nose deviation and chin deviation. The horizontal reference lines in photographs were significant related with the P-A, but angular variables between the two studies show significant differences. Therefore, we do not recommend use photography in the assessment the facial asymmetry as complemented in the P-A.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권1호
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• pp.63-67
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• 2022

Controversies exist regarding the need for prophylactic extraction of mandibular third molars in patients who plan to undergo orthognathic surgery. An 18-year-old male patient was diagnosed with mandibular prognathism and maxillary retrognathism with mild facial asymmetry. He had a severely damaged mandibular first molar and a horizontally impacted third molar. After extraction of the first molar, the second molar was protracted into the first molar space, and the third molar erupted into the posterior line of occlusion. The orthognathic surgery involved clockwise rotation of the maxillomandibular complex as well as angle shaving and chin border trimming. Patients who are missing or have damaged mandibular molars should be monitored for eruption of third molars to replace the missing posterior tooth regardless of the timing of orthognathic surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권6호
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• pp.584-588
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• 2008

Facial asymmetry is particularly associated with mandible among other facial bones and it could be either congenital or acquired. Congenital factors are related to Treacher Collin syndrome, Pierre Robin syndrome, hemifacial microsomia and other various syndromes. Acquired factors are such as damaged or diseased growing condyles, hormonal disorder, oral mal-habit, muscular force, tumor, infection and so on. Diagnosis and treatment of facial asymmetry are complicated due to differences in sizes and positions of mandibles. The aspects of facial asymmetry is various and complicated upon each individual. Depending on causes of the facial asymmetry, there also are morphological differences. For such reasons, precise anatomical analysis and diagnosis of the facial asymmetry are essential before any surgical procedure followed by the appropriate treatment plan. This case is regarding a 21-year old patient diagnosed as the facial asymmetry due to an infantile maxillofacial surgery. Employing various morphological evaluations, potential problems during the procedure are predicted beforehand. This case reports a favorable result of sagittal split ramus osteotomy performing the oblique vertical bone cutting in posterior-superior of the mandibular second molar.

• 대한수의학회지
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• 제53권4호
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• pp.207-210
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• 2013

Fifteen dry dentate and complete mandible samples from the White Rasquera goat breed were studied for symmetry. Thirty-one landmarks were digitally located on the images of the lateral and medial aspects of each hemimandible. Distances between these landmarks allowed the evaluation of the whole hemimandible and also the neural mandible. In the studied samples, the mandible was rather symmetrical, especially in the medial neural part, and in general, there was no side dominance. Only the diastema differed significantly between the sides, and this was related to the rostral part (incisive arch). The incisive region was the least symmetrical region of the caprine mandible, indicating a modular structure more conservative for the neural part. If unsigned asymmetry is interpreted as a measure of developmental stability, then the studied breed presented a marked ability to develop in good fitness despite the harsh environment. The measurements presented here can also be used as a reference for researchers designing experimental studies, especially on mandibular catch-up growth, and as an aid for zooarchaeologists comparing results from dead animals with those from living goat populations.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권5호
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• pp.349-356
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• 2012

Osteochondroma is one of the most common benign tumors that occur in the bone, but in the head and neck region, osteochondroma appears rarely. Malocclusion, temporomandiublar disorders and facial asymmetry can occur in most cases with osteochondroma of the mandibular condyle. Most surgeons prefer massive removal of osteochondroma and reconstruction of condyle, simultaneously, to prevent various complications, such as a lateral open bite on the contralateral side. We report a surgical treatment and reconstruction of osteochondroma on a mandibular condyle through intraoral approach.

• 대한치과교정학회지
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• 제35권2호
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• pp.91-105
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• 2005

기존의 2차원적 진단자료는 상의 확대 및 왜곡으로 인해 형태나 크기의 정량적 평가시 부적절한 결과를 야기할 수 있어 안면비대칭의 정확한 진단과 치료계획 수립을 위해서는 3차원영상 진단의 도입이 필요하다. 본 연구는 안면비대칭 진단시 3차원적 분석에 도움이 되는 기준자료를 얻고자 정상교합자를 대상으로 하악골 3차원 영상 계측항목의 평균값과 좌우차이의 정상범주를 알아보기 위하여 시행되었다 뚜렷한 안면비대칭을 보이지 않는 성인 정상교합자 남녀 30명씩 총 80명을 대상으로 두경부 전산화단층사진을 촬영한 후 컴퓨터프로그램을 이용한 각각의 단면 촬영영상 정보를 이용하여 3차원 입체영상을 재구성한 다음, 하악골 비대칭시 좌우차이를 보일 수 있는 계측항목으로 ramus length를 나타내는 5개 condylar neck length를 나타내는 1개, mandibular body length를 나타내는 8개 등 15개의 거리 계측항목과, gonial angle을 나타내는 4개. frontal ramal inclination을 나타내는 2개. lateral ramal inclination을 나타내는 2개 등 8개의 각도계측항목, 총 23개의 계측항목을 설정한 후, 좌측과 우측을 구분하여 컴퓨터 상에서 3차원계측치를 구하고 좌우차이값을 산출하였다. 본 연구결과 얻어진 정상교합자의 하악골 3차원영상 계측항목의 좌우차이값은 안면비대칭 환자의 진단 기준치로 유용하게 사용될 수 있을 것이다.