• Archives of Craniofacial Surgery
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• v.21 no.3
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• pp.156-160
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• 2020

Background: We have reported orbital wall restoration surgery with primary orbital wall fragment in pure blowout fractures using a combination of transorbital and transnasal approach in pure blow out fractures. However, this method was thought to be difficult to use for complex orbital wall fractures, since the sharp screw tip that fixate the maxillary wall increases the risk of balloon ruptures. In this study, we reviewed 23 cases of complex orbital fractures that underwent orbital wall restoration surgery with primary orbital wall fragment and evaluated the result. Methods: A retrospective review was conducted of 23 patients with complex orbital fracture who underwent orbital restoration surgery with primary orbital wall fragments between 2012 and 2019. The patients underwent orbital wall restoration surgery with primary orbital wall fragment with temporary balloon support. The surgical results were evaluated by the Naugle scale and a comparison of preoperative and postoperative orbital volume ratio. Complex fracture type, type of screw used for fixation and complications such as balloon rupture were also investigated. Results: There were 23 patients with complex orbital fracture that used transnasal balloon technique for restoration. 17 cases had a successful outcome with no complications, three patients had postoperative balloon rupture, two patients had soft-tissue infection, and one patient had balloon malposition. Conclusion: The orbital wall restoration technique with temporary balloon support can produce favorable results when done correctly even in complex orbital wall fracture. Seventeen cases had favorable results, six cases had postoperative complications thus additional procedure seems necessary to complement this method.

• Restorative Dentistry and Endodontics
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• v.19 no.1
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• pp.114-123
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• 1994

The purpose of this study was to examine the shear bond strength of resin-enamel bond formed at specific time intervals after the termination ov vital bleaching. A total of 72 human extracted maxillary premolars were divided into nine groups : untreated control (group 1) ; enamel treated with 35% hydrogen peroxide(group 2, 3, 4, 5) ; and enamel reated with 15% carbamide peroxide gel (group 6, 7, 8, 9). After the treatment with 35% hydrogen peroxide for 2 hours and 15% carbamide peroxide for 24 hours, adhesion of a resin to bleached enamel was formed at 1 hour (group 2, 6) and 24 hours(group 3, 7) ; 3days(group 4, 8) and 7 days(group 5, 9) post-termination of bleaching treatment. A $3{\times}3mm$ mold was filled with Scotchbond Multi-Purpose and Z100. After 24 hours later, the specimens were shear-tested at crosshead speed 1mm/min and analyzed statistically. Fractured specimens from group 1,2, 6 were gold-coated with Eiko ion coater and observed under Scanning electron microscope at 25KV. The following results results were obtained : 1. Bonds formed at 1 hour post-termination of 35 % hydrogen peroxide(P<0.01) and 15 % carbamide peroxide bleaching treatment groups(P<0.05) showed significantly lower shear bond strength than untreated group. 2. Bonds formed at 24 hours, 3 days and 7 days post-termination of 35% hydrogen peroxide and 15 % carbamide peroxide bleaching treatment groups showed no significant differences in shear bond strength with untreated group(p>0.05). 3. SEM examinations of the untreated fracture specimen indicated cohesive fracture within enamel and exposed enamel prisms, but the bleached fracture specimens indicated adhesive fracture.

• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.12-16
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• 2011

Purpose: This study examined the biomechanical stability of four different plating techniques in the experimental model of mandibular subcondyle fracture. Methods: Twenty standardized bovine tibia bone samples ($7{\times}1.5{\times}1.0cm$) were used for this study. Each of the four sets of tibia bone was cut to mimic a perpendicular subcondyle fracture in the center area. The osteotomized tibia bone was fixed using one of four different fixation groups (A,B,C,D). The fixation systems included single 2.0 mm 4 hole mini adaption plate (A), single 2.0 mm 4 hole dynamic compression miniplate (B), double fixation with 2.0 mm 4 hole mini adaption plate (C), double fixation with a 2.0 mm 4 hole mini adaption plate and 2.0 mm 4 hole dynamic compression miniplate (D). A bending force was applied to the experimental model using a pressure machine (858 table top system, $MTS^{(R)}$) until failure occurred. The load for permanent deformation, maximum load of failure were measured in the load displacement curve with the chart recorder. Results: Double fixation with a 2.0 mm 4 hole mini adaption plate and a 2.0 mm 4 hole dynamic compression miniplate (D) applied to the anterior and posterior regions of the subcondyle experimental model showed the highest load to failure. Conclusion: From this study, double fixation with an adaption plate and dynamic compression miniplate fixation technique produced the greatest biomechanical stability. This technique may be considered a useful means of fixation to reduce the postoperative internal maxillary fixation period and achieve early mobility of the jaw.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.298-305
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• 2016

The maxillary anteriors play an important role in esthetics. Therefore after extraction, it is crucial to preserve the hard tissue and soft tissue in order to promote esthetics of restoration. There are several challenges when restoring the maxillary anteriors via implant. Some of the challenges are be maintaining consistency with neighboring teeth in terms of shade, form, and texture : as well as having harmonious emergency with the gingival margin. In this case, a traumatized patient with crown-root fracture of the maxillary central and lateral incisors is presented. The cracked teeth were extracted, and implants were inserted with bone grafts to compensate the volume of damaged area of the maxillary anterior. Cantilever implant prosthetics were planned while precise adjustments to the gingival area were made using customized impression coping to perform the esthetic restorations. The final outcome of the treatment was satisfying in both esthetic and utilitarian perspective.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.165-180
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• 2007

Dental Implants have been proved to be successful prosthetic modality in edentulous patients for 10 years. However, there are few reports on the survival of implant according to location in molar regions. The purpose of this study was to evaluate the $4{\sim}5$ years' cumulative survival rate and the cause of failure of dental implants in different locations for maxillary and mandibular molars. Among the implants placed in molar regions in Gwangju Mir Dental Hospital from Jan. 2001 to Jun. 2002, 473 implants from 166 patients(age range; $26{\sim}75$) were followed and evaluated retrospectively for the causes of failure. We included 417 implants in 126 periodontally compromised patients, 56 implants in 40 periodontal healthy patients, and 205 maxillary and 268 mandibular molar implants. Implant survival rates by various subject factors, surgical factors, fixture factors, and prosthetic factors at each location were compared using Chi-square test and Kaplan-Meier cumulative survival analysis was done for follow-up(FU) periods. The overall failure rate at 5 years was 1O.2%(subject level) and 5.5%(implant level). The overall survival rates of implants during the FU periods were 94.5% with 91.3% in maxillary first molar, 91.1% in maxillary second molar, 99.2% in mandibular first molar and 94,8% in mandibular second molar regions. The survival rates differed significantly between both jaws and among different implant locations(p<0.05), whereas the survival rates of functionally loaded implants were similar in different locations. The survival rates were not different according to gender, age, previous periodontal status, surgery stage, bone graft type, or the prosthetic type. The overall survival rate was low in dental implant of too wide diameter(${\geq}5.75$ mm) and the survival rate was significantly lower for wider implant diameter(p

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.4
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• pp.454-464
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• 1999

The metal ceramic crown is currently the most popular complete veneer restoration in dentistry, but in many cases, the metal cervical collar at the facial margin is unesthetic and unacceptable. Facial porcelain margin has been used in place of it. But this dose not solve the problems, such as dark gingival discoloration and cervical opaque reflection of porcelain veneer. Recently, metal copings which were designed to terminate its labio-cervical end on the axial walls coronal to the shoulder have been clinically used to solve the esthetic problem of metal ceramic crown. But in this design, porcelain veneer of labio-cervical area which is not supported by metal may not be able to resist the stress during cementation and mastication. The purpose of this study was to evaluate fracture strength and fractured appearance of crowns according to different coping designs. A resin maxillary left central incisor analogue was prepared for a metal ceramic crown, and metal dies were made with duplication mold. Metal copings were made and assigned to one of four groups based on facial framework designs: group 1, coping with 0.5mm metal collar; group 2, metal extended to the shoulder; group 3, metal extended to 1mm coronal tn the shoulder: group 4, metal extended to 2mm coronal to the shoulder. Copings and crowns were adjusted to be same size and thickness, and cemented to metal dies with zinc phosphate cement by finger pressure. Fracture strength was measured with Instron Universal Testing Machine. Metal dies were anchored in Three-way-vice at 3mm below finish line and at $130^{\circ}$ inclined to the long axis of the crown. Load was directed lingually at 2mm below midincisal edge. Load value at initial crack and at catastrophic fracture was recorded. The results obtained were as follows : 1. Fracture strength values at initial crack were higher in groups 1, 2 than in groups 3, 4 but this difference was not statistically significant(P<0.05). 2. Conventional metal collared crown had greater catastrophic fracture strength than any other collarless crowns. 3. The greater the labial metal coping reduction, the lower the catastrophic fracture strength of crowns but when more than 1mm of labial metal reduction was done, the difference in strengths was not statistically significant(p<0.05). 4. The strongest collarless coping design was group 2.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.2
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• pp.232-242
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• 2003

Statement of problem : Fiber-reinforced posts have lower modulus of elasticity than titanium post or cast post-core. With this similar elasticity to that of dentin, fiber-reinforced posts have been known to have a tendency to reduce the risk of root fracture. However, there were few studies on the teeth restored with fiber-reinforced posts under the condition of reduced periodontal support. Purpose : The purpose of this study was to evaluate the fracture strength and failure mode of endodontically treated teeth restored with fiber-reinforced posts and titanium posts under the condition of reduced periodontal support. Material and method : Extracted human maxillary incisor roots were divided into 3 groups (group 1 carbon fiber post, group 2 : glass fiber post, and group 3 : titanium alloy post). After coronectomy and endodontic treatment, teeth were restored with each post systems and resin core according to the manufacturer's recommendation. Then, teeth with simulated periodontal ligament were embedded in the acrylic resin blocks at the level of 4 mm below the cemento-enamel junction. Each specimen was exposed to $10^5$ load cycles with average 30 N force in $36.5^{\circ}C$ water using a computer-controlled chewing simulator. Loads were applied at $45^{\circ}$ angle to the long axis of the teeth. After cyclic loading, teeth were subjected a compressive load until failure at a crosshead speed of 0.5 mm/min. Fracture strength (N) and failure mode were examined. The fracture strength was analyzed with one-way ANOVA and the Scheffe adjustment at the 95% significance level. Results and conclusion : The results were as follows. 1. There was no statistically significant difference in the mean fracture strength among the groups (P<.05). 2. Carbon fiber post and glass fiber post group showed less root fracture tendency than control group. 3. All specimens with root fractures showed fracture lines above the level of acrylic resin block, except for only one specimen in group 3.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.1
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• pp.117-127
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• 1991

When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.875-878
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• 2011

Purpose: Absorbable implants are frequently used to fix facial bone fractures, because they are radiolucent and compatible with magnetic resonance imaging (MRI). Despite their increasing usage, however, there have been few reports about their long-term side-effects. In this paper, a case in which absorbable implants led to a foreign body reaction 17 months after their insertion is presented. Methods: A previously healthy 19-year-old male fell from a flight of stairs and visited the authors' hospital with right periorbital pain. Zygomaticomaxillary fracture involving right orbital floor was detected via a facial bone computed tomography (CT). Internal fixation with absorbable implants was followed by open reduction. 17 months after the surgery, the patient complained of localized periorbital swelling. Removal of the granulomatous lesion including the absorbable implants along with their biopsy and culture was performed. Results: The granulomatous lesion around the implants was firm and extended into the maxillary sinus. The histologic finding showed a microabscess with a foreign body reaction. Methicillin-sensitive Staphylococcus aureus growth was confirmed in the culture. No definite abnormal symptoms ensued after the complete removal. Conclusion: A microabscess-forming granulomatous lesion around the absorbable implant can cause delayed symptomatic foreign body reaction despite its rare occurrence. Complete removal of the lesion including implants is expected to have a successful outcome if it is encountered.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.2
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• pp.413-423
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• 1994

The purpose of this study was to clarify the spatial relationship in presurgical examination and to aid surgical planning and postoperative evaluation of patients with facial bone injury. For this study, three-dimensional images of facial bone fracture were reconstructed by computed image analysis system and three-dimensional reconstructive program integrated in computed tomography. The obtained results were as follows: 1. Serial conventional computed tomograms were value in accurately depicting the facial bone injuries and three-dimensional reconstructive images demonstrated an overall look. 2. The degree of deterioration of spatial resolution was proportional to the thickness of the slice. 3. Facial bone fractures were the most distinctly demonstrated on inferoanterior views of three-dimensional reconstructive images. 4. Although three-dimensional reconstructive images made diagnosis of fracture lines, it was difficult to identify maxillary fractures. 5. The diagnosis of zygomatic fractures could be made equally well with computed image analysis system and three-dimensional reconstructive program integrated in computed tomography. 6. The diagnosis of mandibular fractures could be made equally well with computed image analysis system and three-dimensional reconstructive program integrated in computed tomography.