• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권3호
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• pp.131-134
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• 2014

Transoral vertical ramus osteotomy (TOVRO) procedure can result in a variety of complications. Complications commonly reported include extensive bleeding due to major blood vessel injury, unpredictable fracture, postoperative infection, neurosensory deficit related Inferior alveolar nerve, insufficient osteosynthesis, and temporomandibular joint problem. The authors describe a case of partial necrosis of the mandibular proximal segment following TOVRO, a rarely reported complication. A 37-year-old otherwise healthy woman underwent Lefort l osteotomy and TOVRO to correct mandibular prognathism. Postoperatively, she developed pain and swelling in the right submandibular region and was found to have a partial necrosis of proximal segment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권6호
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• pp.496-500
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• 2005

A 22-year-old male patient had developed a submasseteric abscess secondary to a mandibular osteomyelitis at the age of 7 years old. The initial presentation at that time seems to be acute suppurative parotitis. The computed tomographic scans taken before surgery demonstrated diffuse deformity, sclerotic change and osteolytic lesion in the mandible. There was no marrow space on both sides of mandibular ramus and thin-walled cortical bone was seen. So, from the results of the computed tomography, the surgery was performed intraoral vertical ramus osteotomy (IVRO) instead of performing the more commonly used bilateral sagittal split ramus osteotomy (BSSRO). In this report, we present a case of surgical correction of mandibular prognathism with fibrous-osseous lesion of mandible with using IVRO.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권2호
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• pp.102-108
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• 2015

In surgery for facial asymmetry, mandibles can be classified into two types, rotational and translational, according to the required mandibular movements for surgery. During surgery for rotational mandibular asymmetry, a bilateral sagittal split ramus osteotomy (BSSRO) may cause a large bone gap between the proximal and distal segments as well as condylar displacement, resulting in a relapse of the temporomandibular joint disorder, especially in severe cases. The intraoral vertical ramus osteotomy has an advantage, in this respect, because it causes less rotational displacement of the proximal segment on the deviated side and even displaced or rotated condylar segments may return to their original physiologic position. Unilateral intraoral vertical ramus osteotomy (UIVRO) on the short side combined with contralateral SSRO was devised as an alternative technique to resolve the spatial problems caused by conventional SSRO in cases of severe rotational asymmetry. A series of three cases were treated with the previously suggested protocol and the follow-up period was analyzed. In serial cases, UIVRO combined with contralateral SSRO may avoid mediolateral flaring of the bone segments and condylar dislocation, and result in improved condition of the temporomandibular joint. UIVRO combined with contralateral SSRO is expected to be a useful technique for the treatment of rotational mandibular asymmetry.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권2호
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• pp.126-131
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• 2002

Anatomical shape of the mandibular ramus, which includes the area from the rear of the mandibular second molar to the mandibular posterior border and from the mandibular sigmoid notch to the inferior mandibular border, must be carefully considered to perform orthognathic surgery. The locations of the lingula and mandibular foramen in medial side of mandibular ramus are one of the most important factors to decide the location of the horizontal medial osteotomy in sagittal split ramus osteotomy and to select the line of vertical osteotomy in intraoral vertical ramus osteotomy. Sixty-five different Korean human dry mandibles were surveyed. All mandible have permanent dentition including complete eruption of the mandibular second molar. The locations of the lingula and mandibular foramen in medial side of the ramus were identified and following results were obtained. Anterior ramal horizontal distance from lingula was $16.13{\pm}3.53mm(range:8.6{\sim}24.3mm)$, anterior ramal horizontal distance from mandibular foramen was $23.91{\pm}4.79mm(range: 14.1{\sim}39.7mm)$, horizontal width of mandibular foramen was $2.79{\pm}0.95mm(range:1.5{\sim}6.1mm)$, height of lingula was $10.51{\pm}3.84mm(range:3.1{\sim}22.4mm)$, vertical distance from sigmoid notch to lingula was $19.82{\pm}5.11mm(range:9.1{\sim}35.3mm)$. From this study, the result could be used to select the location of osteotomy lines and to decide amount of periosteal elevation to avoid injury of neurovascular bundle, and to accomplish the appropriate split in Korean patients in mandibular orthognathic surgery.

• Imaging Science in Dentistry
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• 제52권2호
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• pp.231-238
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• 2022

Intraosseous xanthoma of the mandible is a rare benign disorder. A 17-year-old male patient presented with a suspected abscess in the right mandibular third molar, detected on a panoramic radiograph. The patient had no history of systemic or lipid-related metabolic diseases and complained of no specific symptoms or pain. A radiographic examination revealed a heterogeneous radiolucency extending from the apical to the distal aspect of the right mandibular third molar tooth germ. The lesion measured 9 × 16 × 24 mm (antero-posterior × mediolateral × supero-inferior) and showed a relatively well-defined, multilocular, foamy appearance with hyperostotic borders spreading to the inferior alveolar nerve canal. After excisional biopsy, a diagnosis of central xanthoma was made. The lesion recurred, and intraoral vertical ramus osteotomy was done near the lesion. For the treatment of xanthoma of the mandible, extensive and delicate surgical treatment under general anesthesia should be considered.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권3호
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• pp.74-80
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• 1990

This is to report a case of surgical and orthodontic of posterior scissor bite, deep bite and gummy smile by the segmental osteotomies. The surgical thechnics procedures used are Peterson's mandibular posterior segmental osteotomy, modified $K{\ddot{o}}le$ technic for mandibular anterior segment and Wunderer's maxillary anterior segmental osteotomy. The results are as follows : 1) Peterson's mandibular posterior segmental osteotomy could be achieved by the buccal approach with some difficulties in accessbility. 2) Upper and lower anterior segmental osteotomies were followed separately to correct the deep curve of Spee, deep bite and gummy smile in shortened period. 3) All alveolar segments were immobilized in preplanned position by the prefabricated palatal and lingual resin splint, therefore intermaxillary fixation was not necessary.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권3호
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• pp.107-113
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• 2023

Bimaxillary transverse width discrepancies are commonly encountered among patients with dentofacial deformities. Skeletal discrepancies should be diagnosed and managed appropriately with possible surgical corrections. Transverse width deficiencies can present in varieties of combinations involving the maxilla and mandible. We observed that in a significant proportion of cases, the maxilla is normal, and the mandible showed deficiency in the transverse dimension after pre-surgical orthodontics. We designed novel osteotomy techniques to enhance mandibular transverse width correction, as well as simultaneous genioplasty. Chin repositioning along any plane is applicable concomitant with mandibular midline arch widening. When there is a requirement for larger widening, gonial angle reduction may be necessary. This technical note focuses on key points in management of patients with transversely deficient mandible and the factors affecting the outcome and stability. Further research on the maximum amount of stable widening will be conducted. We believe that developing evidence-based additional modifications to existing conventional surgical procedures can aid precise correction of complex dentofacial deformities.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권4호
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• pp.468-475
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• 1991

Skeletal class III malocclusion with aterior deep bite is difficult to manage properly, especially in case of mild mandibular prognathism. We have designed lower anterior segmental osteotomy for improving the lower third of the facial contour. Considerable improvement of esthetic facial contour with correction of cross bite in anterior incisors was observed in patients with mandibular prognathism.

• 대한치과의사협회지
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• 제23권11호통권198호
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• pp.979-986
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• 1985

This is a case report of orthognathic surgery for the correction of maxillary retrusion and mandibular protrusion. The summary and results are as follows, 1. The maxillary retrusion was corrected by LeFort I osteotomy. 2. The mandibular protrusion was corrected by sagittal split osteotomies in the rami. 3. And, for the correction of the discrepancy between max8llary and mandibular arches, the mandibular arch was widened by the midsymphyseal step osteotomy. 4. The ratios of horizontal changes of soft tissue to hard tissue at the points, Subnasale (Sn), Labrale superius (Ls), Labrale inferius (L9), and Supramentale (B) were 67.6%, 43.2$, 70.2% and 87.7%, respectively.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권5호
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• pp.359-367
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• 2004

Purpose: After the surgical correction with sagittal split ramus osteotomy, the position of the mandibular condyle in the glenoid fossa and the proximal segment of the mandible change because of bony gap between proximal and distal segment, especially in case of mandibular setback asymmetrically. In this study, positional changes in the condyle and proximal segment after BSSRO were estimated in the mandibular asymmetry patient by analyzing the in submentovertex view and P-A cephalogram for identification of ideal condylar position during surgery. Patients and Methods: The 20 patients were selected randomly who visit Dankook Dental Hospital for mandibular asymmetry. Bilateral sagittal split ramus osteotomy with rigid fixation was performed and P-A cephalogram and submentovertex view was taken at the time of preoperative, immediate postoperative, 3 month postoperative period. Results: Intercondylar length and transverse condylar angle was increased due to inward rotation of proximal segment and anteromedial rotation of lateral pole of condyle head. The condylar position had a tendency to return to the preoperative state and after 3 months return up to about half of the immediate post-operative changes, and all the results showed more changes in asymmetry patient and deviated part of the mandible. Conclusion: Based on all these results above, surgeon should make efforts to have a precise preoperative analysis and to have a ideal condylar position during rigid fixation after BSSRO.