• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권1호
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• pp.37-41
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• 2017

Objectives: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). Materials and Methods: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal. The complications of postoperative infection, postoperative nerve injury, bone healing, and changes in occlusion and temporomandibular joint were evaluated and analyzed using statistical methods. Results: In total, 49 patients had third molars in the fracture line and underwent ORIF surgery and perioperative IMF with an arch bar. The third molar in the fracture line was retained during ORIF in 39 patients. Several patients complained of nerve injury, temporomandibular disorder (TMD), change of occlusion, and postoperative infection around the retained third molar. The third molars were removed during ORIF surgery in 10 patients. Some of these patients complained of nerve injury, but no other complications, such as TMD, change in occlusion, or postoperative infection, were observed. There was no delayed union or nonunion in either of the groups. No statistically significant difference was found between the non-extraction group and the retained teeth group regarding complications after ORIF. Conclusion: If the third molar is partially impacted or completely nonfunctional, likely to be involved in pathologic conditions later in life, or possible to remove with the plate simultaneously, extraction of the third molar in the fracture line should be considered during ORIF surgery of the mandible angle fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권2호
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• pp.137-143
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• 1991

악안면부의 기형은 기능 및 심미적인 매우 중요한 문제이며, 이러한 면에서 현대 악안면 영역의 성형술은 기능 및 사회심리적으로 많은 기여를 한다는 것은 사실이다. 악안면 성형술 중 하악 우각부에 대한 관심은 19 세기 후반부터 교근비대증 (Masseter Hypertrophy)으로 표현되었으며, 안모의 심미적인 영향에 대한 평가는 동양에서 하악골의 변형과 함께 비중있게 다루어지고 있다. 교근비대 또는 협부비대의 원인은 악성 및 양성종물, 악습관에 의한 생리적 비대, 감염, 선천적기형 등이 있을 수 있으나, 환자가 호소하는 주소는 안연의 비대칭 또는 사각형의 안모등이므로 이에 대한 수술의 주된 목적은 심미적인 면이 대부분을 차지한다고 볼 수 있다. 그러므로 안모개선 등 수술 후의 결과에 대한 깊은 관심이 요구되며, 따라서 혈종이나 감염, 하악골 골절, 개구장애 등과 같은 합병증과 후유증에 대한 올바른 이해와 최대한의 예방이 필요할 것으로 사료되어 문헌고찰과 함께 증례보고를 하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권2호
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• pp.109-113
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• 2007

Introduction. In patients with mandibular prognathism, Bilateral Sagittal Split Ramus Osteotomy(BSSRO) combined with orthodontic treatment reduces oral volume and influences tongue and other surrounding tissues. Purpose of this study was to analyze post-operative tongue position and airway dimension, as well as mandibular changes in vertical, horizontal, and angular dimensions. Materials and methods. Height of dorsum of tongue, width of airway, gonial angle and lower facial height of mandibular prognathic patients who visited Kangdong Sacred Heart Hospital from Jan. 2001 to Dec. 2006 were anaylzed via pre-operative and post-operative cephalograms. T-test was used to compare pre-operative and post-operative measurements. Also, correlations among pre-operative measurements of the patients were analyzed. Results and conclusion. A significant correlation was shown between ANS-Xi-PM area and location of dorsum of tongue in pre-operative patients. A significant superior movement of tongue and decrease of airway width was observed in post-operative patients. Also the upper gonial angle decreased significantly.

• Journal of Yeungnam Medical Science
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• 제8권1호
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• pp.32-41
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• 1991

비호흡 장애 아동에서 인두편도의 절제가 치조안면골격에 미치는 영향을 연구하기 위해 비호흡 장애 아동 24명의 인두편도 절제전과 절제 1년후의 두부방사선 계측사진과 정상교합 아동의 1년전과 후의 두부방사선 계측사진을 비교분석함으로 다음과 같은 결과를 얻었다. 1. Cranial base variables 두 group간에 유의차가 나타나지 않았다. 2. Craniofacial variables 실험군에서 1년간 성장경향을 보면 Brachyfacial pattern으로 변했지만 대조군에서의 변화는 특정한 경향이 발견되지 않았다. 3. Maxillary variables 실험군에서 1년간 palatal plane의 경사가 평탄해졌고 그 외의 항목에서는 유의차가 발견되지 않았다. 4. Mandibular variables 두 group간에 1년간 성장량의 유의치는 mandibular plane angle과 gonial angle에서 나타났고 특히 실험군에서 감소가 일어났다. 5. Facial height variables 실험군에서 1년간 성장 변화가 하악골의 수평성장회전을 일으켰다. 전항목에서 통계적인 유의차를 나타냈다.

• 대한치과교정학회지
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• 제29권1호
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• pp.113-127
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• 1999

악골의 골격적 부조화를 가진 환자의 교정치료는 악교정 수술을 필요로 하고, 악교정 수술에 의해 교합평면각은 변화된다. 특히 전치부 개교를 동반한 III급 부정교합 환자에서 치아안면 기형을 치료하기 위한 교합평면각의 변화에 대하여 많은 논란이 있어 왔다. 교합평면각을 증가시키는 하악골의 시계 방향 회전(clockwise rotation)은 전치부 개교에 대한 적절한 치료법으로 추천되어 왔고 하악골의 반시계 방향의 회전(counterclockwise rotation)은 하악지 고경을 증가시키는 방향으로 하악골을 회전시킨다는 개념으로 인해 재발(relapse)을 유발하는 불안정한 수술 방법으로 인식되어 왔다. 본 연구는 전치부 개교를 동반한 골격성 III 부정교합 환자에서 교합평면의 반시계 방향 회전을 동반한 하악지 시상분할 골절단술 시행 후 교합평면각의 변화와 술후 안정성과의 관계를 평가 하고자 하였다. 하악지 시상분할 골절 단술과 rigid fixation으로 치료받은 환자 25 명 (평균연령 20.6세)을 대상으로 하여 수술 직전(T1), 술후 2주내(T2), 그리고 술후 6 개월 이후(T3)에 촬영한 측모 두부계측 방사선 사진을 통계분석한 결과(Paired t-test, Pearson correlation analysis), 다음의 결론을 얻었다. 1. 악교정 수술 후(T2) 하악평면각은 $2.9^{\circ}$ 감소하였고 SN 평면에 대한 하악 교합평면의 각도는 $2.7^{\circ}$ 감소하였다. 술후 6 개월경과 후(T3) 후안면 고경의 감소로 인해(P<0.01) 하악 평면각은 $1.0^{\circ}$ 증가하였으나 하악 교합평면의 경사도는 변화되지 않았다. 2. 악교정 수술 후 시간 경과(T3)에 의해 발생한 수평적 재발은 하악골의 전방 이동량이 B점에서 1.6 mm로 수술시 전체 후방 이동량의 약$22\%$였다. 전안면 고경에서는 수직적 재발이 발생하지 않았으나,후안면 고경은 감소하였다. (P<0.01). 3. 수평적 재발과 상관관계를 보이는 항목은 하악평면각 이었고(P<0.01) 수술 6 개월경과 후 후안면 고경의 감소와 상관관계가 있는 요소로는 수술시 하악골의 후방 이동량(P<0.01), 하악지 고경의 증가량(P<0.01), 그리고 하악평면각의 감소량(P<0.01) 등이 있었다. 4. 수술시 하악 교합평면 경사도의 변화량과 술후 재발과는 상관관계가 없었다.

• Imaging Science in Dentistry
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• 제44권1호
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• pp.61-65
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• 2014

Purpose: This study was performed to evaluate the position of impacted mandibular third molars in different skeletal facial types among a group of Iranian patients. Materials and Methods: A total of 400 mandibular third molars in 200 subjects with different types of facial growth were radiographically investigated for their positions according to their types of facial growth on the basis of the ${\beta}$ angle. The subjects were divided into three groups (class I, II, and III) according to ANB angle, representing the anteroposterior relationship of the maxilla to the mandible. Meanwhile, the subjects were also divided into three groups (long, normal, and short face) according to the angle between the stella-nasion and mandibular plane (SNGoGn angle). ANOVA was used for statistical analysis. Results: The mean ${\beta}$ angle showed no significant difference among class I, II, and III malocclusions (df=2, F=0.669, p=0.513). The same results were also found in short, normal, and long faces (df=1.842, F=2, p=0.160). The mesioangular position was the most frequent one in almost all of the facial growth patterns. Distoangular and horizontal positions of impaction were not found in the subjects with class III and normal faces. In the long facial growth pattern, the frequency of vertical and distoangular positions were not different. Conclusion: In almost all of the skeletal facial types, the mesioangular impaction of the mandibular third molar was the most prevalent position, followed by the horizontal position. In addition, ${\beta}$ angle showed no significant difference in different types of facial growth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권5호
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• pp.428-434
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• 2001

After miniplate fixation of mandibular angle fractures, fracture line stability during functional loading was evaluated. Using panoramic radiographs, 15 mandibular angle fracture patients who were treated by open reduction and one miniplate fixation along the external oblique ridge, were evaluated at postoperative 1, 4 and 8 weeks. At each time, 2 radiographs were taken: one taken during maximum biting of hardened silicone sheet on the affected side molar area and the other on the non-affected side. The distraction gap of inferior border of mandible at each time and each side was measured and these data were analysed statistically with clinical findings. The differences of inferior border distraction gap during hardened silicone sheet biting on the affected side molar area and on the non-affected side molar area at 4 week radiographs were smaller than those of 1 week's except one case. At 8 week's radiographs, the fracture lines were so stabilized that it was almost impossible to find the gap differences except one case and there were increased radiopacity along the entire fracture lines. Clinically, bony union was confirmed in all cases during plate removal performed at postoperative 6 month. By statistical analysis(paired t-test), the inferior border distraction gap during biting of hardened silicone sheet on the affected side was significantly reduced during 1 and 4 week interval(p<0.01). The differences of inferior border distraction gap during biting on the affected side molar area and on the non-affected side molar area were also significantly reduced at 1 and 4 week interval(p<0.01). But the inferior border distraction(compression) gap during non-affected side biting was not significantly changed. From these findings, it could be concluded that fracture line stability during functional loading after one miniplate fixation of mandibular angle fractures stems mainly from reduction of inferior border distraction gap during affected side biting on time interval. According to these radiographic and clinical findings, the clinical superiority of one miniplate fixation technique in mandibular angle fracture treatment could be confirmed.

• 치과방사선
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• 제13권1호
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• pp.117-126
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• 1983

The mandibular canal must be considered carefully during surgical treatment, especially surgical extraction of the impacted tooth and intraosseous implant because it contains the important inferior alveolar nerve and vessels. The author investigated the curvatUre of the mandibular canal, the positional frequency of mandibular foramen to the occlusal plane and gonial angle and the positional frequency of the mental foramen to the tooth site using orthopantomograms. The materials consisted of 295 orthopantomograms divided into seven groups ranging from the first decade to 6th. decade. The results were as follows: 1. The position of mandibular foramen was most frequently below occlusal plane in Group Ⅰ (78.6%) and Group Ⅱ (71.2%), above occlusal plane in Group Ⅲ (63.0%), Group IV (71.1%), Group V (57.6%), Group (76.7%) and Group VII (70.0%). 2. The curvature of mandibular canal was 142.8° in Group Ⅰ, 142.09° in Group Ⅱ, 139.34° in Group Ⅲ, 141.48° in Group Ⅳ, 138.45° in Group Ⅴ, 140.77° in Group Ⅵ and 143.89° in Group Ⅶ. 3. The gonial angie was 125.82° in Group Ⅰ, 123.18° in Group Ⅱ, 124.06° in Group Ⅲ, 120.45° in Group Ⅳ, 121.12° in Group Ⅴ, 121.63° in Group Ⅵ and 121.24° in Group Ⅶ. 4. The position of the menta] foramen was most frequently below the apex of mandibular first premolar in Group Ⅰ (57.2%), between the apex of mandibular first and second premolar in Group Ⅱ (59.6%) and Group Ⅲ (48.9%), and below the apex of mandibular second premolar in Group Ⅳ (39.2%), Group Ⅴ (48.5%) Group Ⅵ(46.6%) and Group Ⅶ(56.4%)

• Imaging Science in Dentistry
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• 제35권2호
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• pp.83-86
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• 2005

Purpose : To evaluate the effect of deviation of mandibular positioning, by changing the mandibular plane inclination, on the measured height and width of mandible in spiral conventional tomography. Materials and Methods : By means of the Scanora multifunctional unit, cross-sectional tomograms were taken from two human dried mandibles at the mandibular angulations: -15 degree, -10 degree, -5 degree, and 0 degree. Twenty-eight sites in two dried mandibles were imaged. One examiner measured the bone heights and widths at selected sites on the images and the actual bone heights were recorded. Results : The bone heights at the four mandibular inclinations overestimated real bone heights and the mean difference between actual heights and image heights on 0 degrees was the smallest (P<0.01). The bone widths on -15 degrees were narrowest and there were significant differences between bone widths measured at the four mandibular inclinations (P<0.001). We found statistically significant differences between both bone heights and widths as measured according to the mandibular plane angle for the posterior region (P<0.01). Conclusion : The use of different mandibular positioning may result in discrepancies in heights and widths when measured from the cross-sectional tomographic images. It is suggested that the mandibular positioning may play a significant role in the measurement of mandibular heights and widths.

• 대한치과보철학회지
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• 제27권1호
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• pp.55-81
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• 1989

Recently the instantaneous center concept has been to understand the biomechanics by which a tissue derangement causes a mechanical derangement in human joint. Therefore, to understand the biomechanics of temporomandibular joint (T.M.J.) as a part of human joint, it is necessary to clarify the instantaneous center of rotation (I.C.R.) in the mandibular movement. Twenty male subjects without T.M.J. disorder and mandibular deviation during the mandibular movement were selected for this study. The habitual opening and closing paths were recorded on the paper of the sagittal metal plate by two pencil markers connected to the resin open clutch attached on the lower teeth, which was designed for this study. The coordinates of the 33-target points and the 109-anatomical landmarks were obtained using a Summagraphic digitizer connected to a 18AT computer. The original raw data of the opening and closing paths were smoothed by B-spline curve fitting technique and then the I.C.R. pathways were determined mathematically by the computer using algorithm for finding the I.C.R. of a planer rigid body model. Also the opening and closing movements of the mandible were simulated according to the determined I.C.R. The results obtained from this study were as follows. 1. At the early opening and the last closing, I.C.R's were almost distributed around the mastoid process outside the mandibular body without the presence in the region of the mandibular condyle. 2. The I.C.R. pathway showed variable patterns to each subject at the opening and closing movements. 3. The K constant with uniform pattern was obtained by the rotation angle times the radius, which was assumed to the index of the mandibular movement. 4. The opening and closing movements of the mandible were simulated by the I.C.R. pathways at the habitual opening and closing movements. 5. The mandibular condyle was rotated or translated accordng to the relative rotation angle and radius of the determinant factors of K contant.