• 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.

• 대한치과교정학회지
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• 제35권1호
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• pp.82-89
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• 2005

하악 이부 확장은 해부학적으로 가동성인 하악골에서 시행하는 견인골 신장술의 한 형태로 곡면화된 표면과 하악 과두, 좁은 치열궁 형태로 많은 제약을 받게 된다. 본 연구는 이러한 한계를 보완하기 위해 적용되는 다양한 형태의 이부 확장을 이해하기 위해 시도되었다 골 절단선의 위치와 견인 장치의 위치를 다르게 하여. 각 8가지 군으로 구분한 후 이부 확장을 시행하였다. 이부 확장은 견인기의 위치와 골 절단선의 형태에 따라 다르게 이루어지는 결과를 얻었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권3호
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• pp.246-250
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• 2004

Uni- or bilateral mandibular hypoplasia can be associated with various syndromes or is acquired after early traumatic or inflammatory disease in the temporomandibular joint(TMJ). Early treatment is necessary to avoid consequent impairment of midfacial growth. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth, but the new procedure of bone lengthening which was presented by McCarthy et al. represents a limited surgical intervention and therefore open up a new perspective of treatment, especially in younger children with severe deformities. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, a tilted occlusal plane, and a short mandible. A 14-years-old boy with facial asymmetry, who was fractured on both condyle and mandibular symphysis before 8 years ago, was treated by mandibular ramus lengthening, symphysial widening and surgically assisted rapid palatal expansion with corticotomy. After allowing 1 week for the healing of the periosteum, the distraction was performed at the rate of 0.5-1.0mm per day for 7 days on maxilla and 14 days on mandible. The device was maintained on maxilla and mandible for 12 weeks following distraction. The difference in ramus and mandibular transverse deficiency were corrected and facial asymmetry was improved with complex distraction osteogenesis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.32.1-32.8
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• 2018

Background: The free vascularized fibula flap presents many advantages such as sufficient length of the bony segment, good vascularization, better quality of the bone, and a long vascular pedicle, but it is also associated with some disadvantages with regard to prosthetic rehabilitation because of its limited height. Improvement in bone height is necessary for ideal dental implant treatment of reconstructed mandibles. Case presentation: For two squamous cell carcinoma patients, mandibular bone reconstruction was performed secondarily with the peroneal flap after tumor resection. Since the bone height was insufficient at the time of implant treatment, occlusion reconstruction by dental implant was performed after vertical distraction osteogenesis. Conclusions: Vertical distraction osteogenesis is a suitable treatment option for alveolar ridge deficiency resulting from fibula transplantation for mandibular reconstruction following tumor surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.447-453
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• 2010

The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and lanned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.

• 대한치과교정학회지
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• 제41권1호
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• pp.59-69
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• 2011

The aim of this report is to present the treatment of a 14-year-old boy with scissors-bite. Mandibular symphyseal distraction osteogenesis (MSDO) with tooth-supported distractor was performed to expand the mandible, and intermaxillary cross elastics were used. The mandible was expanded approximately 9 mm. Asymmetric widening was done by using cross elastics and MSDO simultaneously. The buccal crossbite was corrected successfully. After a 2-year observation period, widening of the mandible using this procedure was judged to be stable.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권2호
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• pp.103-113
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• 2002

Distraction osteogenesis is a biologic process of new bone formation between the surfaces of bone segments that are gradually separated by incremental traction. Distraction osteogenesis is clinically applied as a new treatment modality of mandibular hypoplasia or bony defect area in maxillofacial area by many studies of distraction devices and method. But, disadvantages of distraction osteogenesis shows unfavorably long consolidation period and relapse tendency. Therefore, this experiment was designed to investigate the effectiveness of combined application of distraction and compression force for improving of bone quality and shortening of treatment period during distraction osteogenesis. Twenty-five Sprague-Dawley rats with $300{\sim}350gm$ were used. These were divided into two group as distraction group and combination group. The distraction group was added with conventional method during distraction osteogenesis, but the combination group was applied with compression force in the consolidation period. The rats were sacrificed for gross finding, radiographic and histologic findings at 3, 6 weeks after distraction. The results were as follow: 1. On radiographic finding, all combination of distraction and compression force group appeared more radiopacity than distraction group both at 3 weeks and 6 weeks after distraction group. 2. On histologic finding, the formation of mature lamellar bone were showed increasingly in combined group at 6weeks after distraction group. From this study, we may suggest that compression force application in consolidation period during distraction osteogenesis can be useful method to improve bone quality and to shorten the treatment period. But more experimental and clinical studies is necessitated on ideal application timing and method of compression force application during distraction osteogenesis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.470-478
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• 2007

The purpose of this study was to investigate the clinical, biomechanical, and histologic changes in new distraction osteogenesis(DO) technique combined with a compression stimulation in accordance to different compression-distraction force ratio. 23 adult male rabbits underwent open-osteotomy at the mandibular body area and a external distraction device was applied. In the control group of 8 rabbits, only a 8 mm of distraction was performed by conventional DO technique. In an experimental group of 15 rabbits, a distraction followed by a compression force was performed according to the ratio of compression-distraction suggested by authors. The rate of experimental group I was set up as a 2 mm compression versus 10 mm distraction and the rate of experimental group II was set up as a 3 mm compression versus 11 mm distraction. All the rabbits were sacrificed for a gross finding, biomechanical, histomorphometric and histologic findings at the time of 55 days from the operation day. The results were as follows: 1. On the gross findings, because all rabbits had a sufficient healing time, every distracted new bone had good bone quality and we could not find any difference among all three groups. 2. In the histologic findings, rapid bone maturation(wide lamellar bone formation in the cancellous and cortical bone areas) was observed in two experimental groups compared to the control group. 3. On the bone density tests, the experimental group II showed higher bone density than the other experimental group and control group(control group-$0,2906g/cm^2$, experimental group I-$0.2961g/cm^2$, experimental group II-$0.3328g/cm^2$). 4. On the biomechanical tests, the experimental group II had significantly higher bone microhardness than the other experimental group and control group(control group-252.7 MPa, experimental group I-263.5 MPa, experimental group II-426.0 MPa). 5. On the microhardness tests, when we compared the hardness ratio of distracted bone versus normal bone, we could find experimental group II had significantly higher hardness ratio than the other experimental group and control group(control group-0.47, experimental group I-0.575, experimental group II-0.80). From this study, we could deduce that the modified distraction osteogenesis method with a compression stimulation might improve the quality of bone regeneration and shorten the consolidation period in comparison with conventional distraction osteogenesis techniques.

• 대한치과교정학회지
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• 제31권5호
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• pp.499-504
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• 2001

하악골 횡적 성장결핍에 의한 하악 전치부의 총생을 치료하는데 성인의 경우 발치가 종종 요구된다. 그러나 발치에 의한 안모 변화가 바람직하지 않을 때 견인골 신장술을 시행하여 하악 정중부의 확장은 횡적 공간을 확보하여 빠른 교정치료 및 안정성을 확보할 수 있는 방법으로 고려된다. 하악 정중부 견인골 신장술을 시행한 후 tooth-borne type 과 tooth & bone-borne type distractor를 사용하여 latency, distraction, consolidation period를 거쳐 하악 정중부 횡적 확장을 시행하여 전치부 총생을 빠르게 치료할 수 있었으며, 두가지 방법에 의한 치유과정을 비교한 결과 치주적인 요소와 골 형성과정은 유사하였으며, 악관절 부위의 퇴행적 증상변화는 관찰되지 않았다.

• 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.