• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제42권3호
• /
• pp.144-150
• /
• 2016

Objectives: We compared the transbuccal and transoral approaches in the management of mandibular angle fractures. Materials and Methods: Sixty patients with mandibular angle fractures were randomly divided into two equal groups (A, transoral approach; group B, transbuccal approach) who received fracture reduction using a single 2.5 mm 4 holed miniplate with a bar using either of the two approaches. Intraoperatively, the surgical time and the ease of surgical assess for fixation were noted. Patients were followed at 1 week, 3 months, and 6 months postoperatively and evaluated clinically for post-surgical complications like scarring, infection, postoperative occlusal discrepancy, malunion, and non-union. Radiographically, the interpretation of fracture reduction was also performed by studying the fracture gap following reduction using orthopantomogram tracing. The data was tabulated and subjected to statistical analysis. A P -value less than 0.05 was considered significant. Results: No significant difference was seen between the two groups for variables like surgical time and ease of fixation. Radiographic interpretation of fracture reduction revealed statistical significance for group B from points B to D as compared to group A. No cases of malunion/non-union were noted. A single case of hypertrophic scar formation was noted in group B at 6 months postsurgery. Infection was noted in 2 patients in group B compared to 6 patients in group A. There was significantly more occlusal discrepancy in group A compared to group B at 1 week postoperatively, but no long standing discrepancy was noted in either group at the 6 months follow-up. Conclusion: The transbuccal approach was superior to the transoral approach with regard to radiographic reduction of the fracture gap, inconspicuous external scarring, and fewer postoperative complications. We preferred the transbuccal approach due to ease of use, minimal requirement for plate bending, and facilitation of plate placement in the neutral mid-point area of the mandible.

• Journal of International Society for Simulation Surgery
• /
• 제2권2호
• /
• pp.87-89
• /
• 2015

Closed reduction using acrylic splints with circummandibular fixation has been known to be useful techniques in pediatric mandibular fractures. However, this technique has some shortcomings, including needs for impression taking or additional laboratory process, which can increase the exposure time of general anesthesia or make an additional sedation visit. Recently, the advancement of computer-aided maxillofacial surgery offers to clinicians to expansion of its application. This case report represents a technique of computer-assisted virtual reconstruction and computer-aided designed splint fabrication in a 2-year-old boy with mandibular body fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제28권6호
• /
• pp.464-471
• /
• 2002

The purpose of this study was to evaluate the stress patterns within fractured mandibles generated by reduction forceps and to determine the optimal position of the reduction forcep. Twenty-seven mandibular models were fabricated using a photoelastic resin. Each of the three sets of mandible models prepared was osteotomized according to one of three different fracture types(symphysis, parasymphysis and body fractures). After reducing the cut segments, a reduction forcep was placed into different engagement holes to compress the segments. Photoelastic stress analysis was used to visualize the stress patterns within the fractured mandiblular models generated by the reduction forcep. In the case of symphysis or parasymphysis fractures, an optimum distribution of stress over the fracture site was achieved when placing the reduction forcep more than 12.5mm on either side of the fracture line between the midway level bisecting the mandible and 5mm below the level. In the case of body fractures, optimum stress distribution was achieved when the reduction forcep was placed more than 15mm from the fracture line on the midway level. In conclusion, a correct use of reduction forceps helps to provide a precise threedimensional reduction for mandibular fractures.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제40권
• /
• pp.36.1-36.5
• /
• 2018

Background: Botulinum toxin-A (BTX-A) injection into muscle reduces muscular power and may prevent post-operative complication after orthognathic surgery. The purpose of this study was (1) to evaluate BTX-A injection into the masseter muscle on the prevention of plate fracture and (2) to compare post-operative relapse between the BTX-A injection group and the no injection group. Methods: Sixteen patients were included in this study. Eight patients received BTX-A injection bilaterally, and eight patients served as control. All patients received bilateral sagittal split ramus osteotomy for the mandibular setback and additional surgery, such as LeFort I osteotomy or genioplasty. Post-operative plate fracture was recorded. SNB angle, mandibular plane angle, and gonial angle were used for post-operative relapse. Results: Total number of fractured plates in patients was 2 out of 16 plates in the BTX-A injection group and that was 8 out of 16 plates in the no treatment group (P = 0.031). However, there were no significant differences in post-operative changes in SNB angle, mandibular plane angle, and gonial angle between groups (P > 0.05). Conclusions: BTX-A injection into the masseter muscle could reduce the incidence of plate fracture.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제21권3호
• /
• pp.277-283
• /
• 1999

This study was aimed at furnishing the data of Naso-orbito-ethmoidal fractures and aiding treatmenting Naso-orbito-ethmoidal fractures A 5-year review of Naso-orbito-ethmoidal fractures and concomitant injuries is presented. The patients were treated in the Dept. of Oral and Maxillofacial Surgery of Wankwang University Hospital from Jan. 1, 1993 to Dec. 31, 1997. The results were as followes: Male predominated over female by a ratio of 4.6 : 1. The most common reasons is traffic accident(88.2%). The elapsed time from injury to operation is average 9.2 days, and the mean admission days were 79 days and removal of plates were average 217.3 days. The most associated facial bone fractures is Zygomatico-Maxillary complex fracture(20%). Associated injuries were neurologic injury(29.4%), orthopedic injury(23.5%), opthalmologic injury(17.6%), body injury(5.8%), neuropsychologic injury(5.8%) and otolaryngologic injury(5.8%) in this order. The most injured teeth were upper and lower incisors. The intubation methods for surgery were orotracheal(29.57%), submental(29.5%), and nasotracheal technique(41%). Most patients had complications, that were post-traumatic telecanthus, nasal depression, scar formation. This results suggest that early diagnosis and treatment is prerequisits to satisfactory result. Aggressive management of NOE fracture with direct or bicoronal exposure with aid of CT is now an accepted norm.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제31권5호
• /
• pp.436-439
• /
• 2005

Purpose: To compare the case of widespread maxillary osteomyelitis treated through different approach. Method: We report the two case of osteomyelitis. In a case, we had gradually removed the small amount of sequestrum for several times. In the other case, intended Le Fort I fracture was done to approach the lesion. Result: In the gradual sequestrectomy case, bone formations were found after 4 months. In the other case, after intended Le Fort I down fracture, sequestrectomy of Lt. maxilla was done with the labiobuccal alveolar bone preserved for the prosthodontic treatment.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권4호
• /
• pp.359-362
• /
• 2010

The zygoma is second most commonly vulnerable facial bone in fracture, in number only by nasal fractures. It is difficult to evaluate reduction state intraoperatively, because almost surgeons reduce the fractured zygoma by blind method. We suggest the use of orthopedic C-arm intraoperatively. We use plain radiography, CT to evaluate preoperative state. Gilles approach or intraoral approach were used to reduce the fractured zygomatic arch. The C-arm was positioned at chin area, used to evaluate reduction intraoperatively. We got postoperative image by CT or submento-vertex view. There are variable methods to evaluate reduction intraoperatively: palpation, ultrasonography, CT, plain films. C-arm is considered superior diagnostic tool to other methods. The use of intraoperative C-arm was very efficient, it could bring better results.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제36권1호
• /
• pp.43-52
• /
• 2010

Purpose: To research about maxillofacial traumatic injuries of children in aspects of gender difference, various incidence rates between age, trauma type, cause, monthly and daily incidence rate, type of tooth damage, gingival damage, soft tissue damage, and type of facial bone fracture. Materials and methods: Study group consisted of children under 15 years of age who visited Dental Hospital, School of Dentistry, Kyung Hee University from 2004/7/1 to 2007/6/30 with chief complaint of oral and maxillofacial traumatic injuries. 1,559 cases of traumatic injuries were studied from 1,556 (1,004 male, 552 female) children. Conclusion: 1. There were slightly more boys than girls, giving a male-to-female ratio of 1.82:1.0. The 1-3 year old boys and girls had the highest number of traumatic injuries. 2. Of the 1,556 patients, 68.63% had soft tissue injuries, 50.22% had periodontal injuries, 29.89% had teeth injuries, and 3.85% had maxillofacial bone fractures. 3. Falling down was the most common cause of injury in both sexes. 4. The months with the highest incidence rates were in order May (12.12%), June (11.74%), and October (11.13%). Most of the injuries occurred on weekends. 5. The most common tooth injury was uncomplicated crown fracture, and the most common periodontal injury was subluxation. The majority of traumatizes teeth were the upper central incisors. 6. The most common soft tissue injury was intraoral lacerations. 7. Mandibular fractures were most frequent in facial bone fractures; symphysis, condylar head, and angle fractures were most frequent in mandibular fractures; maxillary and nasal bone fractures were most frequent in midfacial bone fractures.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제19권4호
• /
• pp.367-376
• /
• 1997

저자등은 1992년 1월 1일부터 1996년 12월 31일까지 최근 5년간 전남대학교병원 구강악안면외과에 입원하여 치료받은 환자중 추적이 가능한 중안면골 골절 환자 234례에 대해 임상통계학적 비교 분석하여 다음과 같은 결과를 얻었다. 남녀비는 5.3 : 1로 남자에서 호발하였고, 연령별로는 20대, 30대, 10대순으로, 월별로는 8월, 5월, 9월과 10월 순으로 발생하였다. 발생원인은 자동차사고, 추락사고, 오토바이 사고의 순이었고, 골절부위로는 관골-상악골 복합골절이 86례로 가장 많았다. 연관 손상으로는 안면열상이 가장 많았으며 신경외과적 손상, 하악골 골절순이었다. 수상후 수술시 까지 경과시간은 1주일이내가 55%였다. 사용된 금속판수는 관골 또는 상악골 단독골절시에는 2개, 관골-상악골 복합 골절시에는 3개, Le Fort I, Le Fort I, II ; II, III ; I, III ; Le Fort I,II,III 골절시에는 각각 4개, 5.5개, 7개였다. 술후 합병증으로는 감염 7례, 안면비대칭 6례, 안구함몰증 5례, 부정교합 2례로 모두 20례(8%)가 발생하였다. 이상의 결과는 중안면골 골절시에 골절 부위와 환자의 전신상태 및 연관 손상에 대한 신속한 진단과 치료가 필요하고 타과와의 협동 치료가 이루어져야 함을 시사하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제37권6호
• /
• pp.524-529
• /
• 2011

Orbital roof and supraorbital ridge fractures are frequently associated with high energy concomitant craniofacial trauma. When a displacement of the orbital roof and supraorbital rim occurs, exploration, stabilization and reconstruction are warranted to limit the ocular complications. The management of fractures involving the frontal sinus must consider the possible need for obliteration or cranialization of the sinus. Many incisions have been described and used to approach these fractures, such as a coronal incision, eyebrow incision, and an incision through the laceration. We report 3 cases of orbital roof and supraorbital ridge fracture patients with a review of the relevant literature.