• 대한치과교정학회지
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• 제14권1호
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• pp.103-113
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• 1984

This work was undertaken to evaluate the integumental response in lower face to hard tissue changes, and to grope the prediction equation for expected integumental profile changes. Cephalometric headplates of 25 persons consisted of 8 Angle's class 1 maxillary protrusive and 17 Angle's class II division 1 patients whose mean age was 15.2 years were traced, diagramatized, and statistically analyzed. The results were as follows; 1. Upper incisor and lips were retracted and convexity of integumental profile decreased concurrently with decrease of hard tissue procumbency, however soft tissue point A', B', and Pog' did not undergo significant changes after orthodontic treatment. 2. Remarkable increment of upper lip thickness and upper lip height was shown and this was related to upper incisor retraction. The ratio between the amount of upper incisor retraction and the increment o f upper lip thickness was approximately 1.16:1. 3. Moderate correlation of upper lip retraction to upper incisor retraction, and of lower lip retraction to lower incisor movement were arranged, and yet comparatively wide variability from subject to subject was shown. 4. It was possible to predict statistically for horizontal alteration of lip position and change of upper lip angulation ground in orthodontic treatment.

• 대한두개안면성형외과학회지
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• 제22권6호
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• pp.337-340
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• 2021

Full-thickness nasal tip reconstruction is a challenging process that requires provision of ample skin and soft tissue, and intricate cartilage structure that maintains its architecture in the long term. In this report, we describe reconstruction of a full-thickness nasal tip and ala defect using a posterior auricular artery perforator based chondrocutaneous free flap. The flap consisted of two lay ers of skin covering conchal cartilage, and was based on a perforating branch of the posterior auricular artery. A superficial vein was secured at the posterior margin. The donor perforator was anastomosed to a perforating branch of the lateral nasal artery. The superficial vein was connected to a superficial vein of the surrounding soft tissue. The donor healed well after primary closure. The flap survived without complications, and the contour of the nasal rim was sustained at follow-up 6 months later. As opposed to combined composite reconstructions using a free cartilage graft together with a small free flap or pedicled nasolabial flap, the posterior auricular artery perforator free flap encompasses all required tissue types, and is similar in contour to the alar area. This flap is a useful option in single-stage reconstruction of nasal composite defects.

• 음성과학
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• 제11권1호
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• pp.73-83
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• 2004

Electromyographic studies of the cricopharyngeus muscle using hooked wire electrodes were performed in thyroidectomized patients. The shape of the cricoid cartilage and soft tissue thickness in the postcricoid area were evaluated during pitch elevation and pitch lowering using conventional neck lateral films. The cricopharyngeus muscle simultaneously activated in the initial task of speech and continuously activated. Its activity lessened in the interrogative stress contrast of sentence terminals and increased in the pitch lowered contrast of sentence terminal. On the radiologic findings the cricoid cartilage was tilted backward during high pitched phonation and tilted forward during low pitched phonation. The soft tissue thickness of postcricoid area was thicker at the low pitch than at high pitch. At low pitch the cricoid cartilage paralleled along the vertebral column. This result suggests that the bulging of cricopharyngeus muscle in contraction induce a thickened the postcricoid area thickened, and exert pressure anteriorly exerted on the cricoid cartilage. This contraction of the cricopharyngeus muscle may result in shortening the vocal fold and lowering pitch.

• Archives of Plastic Surgery
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• 제41권2호
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• pp.126-132
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• 2014

Background Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. Methods We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Results Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. Conclusions A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft.

• Archives of Reconstructive Microsurgery
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• 제24권2호
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• pp.56-61
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• 2015

Purpose: We report on the clinical result after coverage of a soft tissue defect on the medial foot and ankle with an adipofascial flap based on the perforator from the posterior tibia artery. Materials and Methods: Nine patients with soft tissue defects on the medial foot and ankle area from March 2009 to May 2014 underwent the procedure. Average age was 54 years old (range, 8~82 years). There were five male patients and four female patients. The causes of the defect were trauma (4), tumor (3), and infection (2). The pivot point of transposition of this flap is the lower perforator originating from the posterior tibia artery. The fatty tissue side of this flap could be used to resurface the defect. The donor site was closed primarily with the preserved skin, and a small caliber drain tube was used. The split-thickness skin graft was grafted to the flap and the wound. If the wound was still infected, this skin graft could be performed at a later date. Results: All flaps survived and normal soft tissue coverage was obtained for the medial foot and ankle of all patients after the skin graft. Normal footwear was possible for all cases because of thin coverage. There was an extension contracture on the medial ray of the foot, which was resolved by contracture release and skin graft. Conclusion: For the medial foot and ankle soft tissue defect, the medial crural adipofascial flap based on a perforator branch of the posterior tibia artery could be a good option to cover it.

• 대한치과교정학회지
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• 제21권1호
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• pp.131-170
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• 1991

This study was designed to analyze morphological characteristics of Korean young adults, norms and standard deviation of variables, sexual differences, correlationship between each area of face and correlationship between hard tissue and soft tissue. The primary sample consisted of 45 males and 57 females who were early and middle twenties and had acceptable profile, no history of previous orthodontic treatment, absence of remarkably large overjet and overbite, full complement of permanent teeth, Class I skeletal and dental relationships and good vertical facial proportions. Their cephalograms were analyzed morphologically with a computer morphometrics. Then the final sample - 25 males and 38 females - were selected within 1 S.D. of E-line, ANB, P/A facial height ratio, Interincisal angle, L1 to A-Pog, ODI and APDI. The results of the study were as follows: 1 In the form and proportion of facial skeleton there were no significant differences between males and females, but in the size males were larger than females. 2. The dental protrusion patterns had no significant sexual difference and no significant correlationship between protrusion of upper lip and inclination of upper incisor. But mentolabial angle had positively correlated with interincisal angle and negatively with inclination of upper and lower incisor. 3. In the relationship between nose and soft-tissue profile, males were larger than females in nasal length, height and angular measurements. 4. In analysis of soft-tissue profile, males were larger than females in the length and thickness. In the angular measurements and proportion of soft-tissue profile, there were no significant differences between males and females.

• 대한치과교정학회지
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• 제31권5호
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• pp.535-548
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• 2001

본 연구는 소구치 발치와 전치부 후방 이동을 통한 교정 치료시 이부 연조직의 형태 변화와 주위 경조직과의 상관관계를 알아보기위해 시행되었다. 초진시 구순 돌출감을 보인 Angle분류 I급 또는 II급 1류 부정교합의 환자로서 상하악의 제 1 또는 제 2 소구치를 발치하고 상하악 전치의 후방 이동을 시행한 성인 여성 환자 35명을 대상으로 하였다. 치료전후의 측모두부방사선사진을 계측하였으며, 특히 이부 연조직을 재현성있는 여섯 부분으로 세분화하여 살펴보았고 다음과 같은 결론을 얻었다. 1. 치료전 이부 연조직과 경조직간의 상관 관계를 살펴본 결과 B-B'와 Pm-Pm'는 수직 골격 계측 항목인 $MP{\perp}HP,\;MP{\perp}PP$, ALFH와 유의 한 순상관관계 (P<0.001)를 보이고 a-a', b-b', Me-Me'는 이부 형태 계측 항목인 SL, SW, PL와 유의한 역상관관계(P<0.01)를 보였다. 2. 이부 연조직은 치료전후에 B-B'과 Pm-Pm'에서는 유의한 감소를 보였고(P<0.001), a-a', b-b'에서는 유의한 증가(P<0.01)를 보였다. 3.치료후 이부 연조직 변화는 B-B'의 변화를 제외한 모든 부위에서 경조직의 변화와 상관관계를 보였으며 상관 계수는 0.3-0.4정도였다. 4. 치료후 Pog-Pog'이 증가한 집단과 감소한 집단간에 ${\Delta}UI-VP,\;LI{\perp}의 계측 항목이 유의한 차이를 보였다. 5. 치료후 Me-Me'이 증가한 집단과 감소한 집단간에 ${\Delta}overbite,\;NPog{\perp}HP,\;Me-Me'$의 계측 항목이 유의한 차이를 보였다.

• Journal of Periodontal and Implant Science
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• 제42권3호
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• pp.105-109
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• 2012

Purpose: Soft tissue recessions frequently cause esthetic disharmony and dissatisfaction. Compared with soft tissue coverage around a tooth, the coverage of an implant site is obviously unpredictable. Particularly in the cases of thin mucosa, a significant greater amount of recession takes place compared to thick mucosa. To overcome this problem, this case report demonstrates a two-step mucosal dehiscence coverage technique for an endosseous implant. Methods: A 33-year-old female visited us with the chief complaint of dissatisfaction with the esthetics of an exposed implant in the maxillary left cental incisor region. A partial-thickness pouch was constructed around the dehiscence. A subepithelial connective tissue graft was positioned in the apical site of the implant and covered by a mucosal flap with normal tension. At 12 months after surgery, the recipient site was partially covered by keratinized mucosa. However, the buccal interdental papilla between implant on maxillary left central incisor region and adjacent lateral incisor was concave in shape. To resolve the mucosal recession after the first graft, a second graft was performed with the same technique. Results: An esthetically satisfactory result was achieved and the marginal soft tissue level was stable 9 months after the second graft. Conclusions: The second graft was able to resolve the mucosal recession after first graft. This two-step approach has the potential to improve the certainty of esthetic results.

• 대한치과교정학회지
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• 제13권2호
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• pp.193-199
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• 1983

The purpose of orthodontic treatment is to produce functional occlusion and to create or maintain facial esthetic harmony. The soft-tissue covering of the face also plays an important role in facial esthetics, speech and other physiologic functions. The study of the soft-tissue profile is important for the planning of orthodontic treatment. The author studied cephalometric X-ray films on 49 patients (23boys, 26 girls) with Angle's class II division 1 malocclusion, ranged from 9 to 13 years of age. Roentgenocephalmetric X-ray films were taken pre and post orthodontic care. Tracings were made in usual manner. The obtained results were as follow. 1. There was no significant sexual difference on mean changes. 2. In the comparison of the soft-tissue thickness changes, Ls-Ls' and Si-Si' in male subjects were remarkable. 9. There were significant correlations between osseous (Ss') change and soft-tissue (Ss) chang, of maxilla in male and female subjects subsequent to orthodontic treatment. 4. The ratios between the protraction of the Ss' and that of the Ss were 1:1.5 in all sexes, the ratios between the Si' and that of the Si were 1:1.4 in male and 1:1.2 in female. 5. There were significant correlations between maxillary central incise. angulation change $({\angle}A)$ and upper lip inclination change $({\angle}B)$ in all sexes. 6. There were little correlations between change in distance difference of Is and Ii and change in distance difference of Ls and Li in all sexes in all sexes.

• 대한족부족관절학회지
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• 제11권2호
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• pp.232-237
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• 2007

Introduction: To report the result of the thigh perforator free flap for the reconstruction of the soft tissue defect of the lower extremities and usefulness of this flap. Materials and Methods: We have performed 23 cases of thigh perforator free flap to reconstruct the soft tissue defect of the lower extremities between February 2004 and July 2005. The anterior aspect of the legs were 9 cases, the ankle joints were 4 cases, the dorsal aspect of the feet were 6 cases, the sole of the feet were 4 cases as recipient sites. The anterolateral thighs were 13 cases, the anteromedial thighs were 10 cases as donor sites. The size of the flap ranged from $4{\times}5\;cm$ to $12{\times}18\;cm$. The mean flap area was $73.2\;cm^2$. The length of the pedicle ranged from 5 cm to 15 cm. Every patient except children was operated under the spinal anesthesia. Results: 21 flaps (91.3%) survived, 2 flaps (8.7%) failed. In the 21 flaps that had survived, there were partial necrosis in 4 cases, which healed without any additional operation. In the 13 anterolateral thigh perforator flaps, 9 cases survived totally, 3 cases had the partial necrosis, 1 case failed. In the 10 anteromedial thigh perforator flaps, 8 cases survived totally, 1 case had the partial necrosis, 1 case failed. Conclusion: The authors had a good result with the thigh perforator free flap and believe that this flap is a good option for the reconstruction of the soft tissue defect of the lower extremities, because this flap has a thin thickness and it is easy to dissect the vessels. Moreover the patients can be operated with supine position.