• Title/Summary/Keyword: Surgical repositioning

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REDUCTION MALARPLASTY WITH BONE OSTECTOMY & REPOSITIONING ONLY USING INTRAORAL APPROACH (구강내 접근법만을 통한 골절단술과 재위치술을 이용한 협골 축소술)

  • Shin, Sang-Hun;Heo, June
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.1
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    • pp.105-109
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    • 2000
  • The zygoma is protruded on both sides of the midface and plays an important part in determining the impression of face. There are much different esthetic consideration of zygomatic prominence between the oriental and western. Because slight prominent zygoma is thought to be esthetic in the western, there has been done many augmentation therapy. But, in the oriental, prominent zygoma, especially in the female, is thought to be aggresive and manlike image, there has been done many zygoma reduction therapy. There are two methods to reduce the prominent zygoma, one is shaving method and the other is zygoma repositioning with ostectomy. The approach to zygoma and zygomatic arch without surgical morbidity is very difficult, so this problem has been difficult subject to oral & maxillofacial surgeon in a long period. We report the treatment case of facial asymmetry with the unilateral zygoma reduction & genioplasty using only intraoral approach with the retrospective study.

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ANALYSIS OF THE CLINICAL SYMPTOMS AND THE TEMPOROMANDIBULAR JOINT DISK BY MAGNETIC RESONANCE IMAGING AFTER CONSERVATIVE TREATMENT WITH ANTERIOR REPOSITIONING SPLINT (측두하악관절 환자의 전방재위치장치 치료 전후의 임상증상 및 자기공명영상을 이용한 관절원판 변화의 분석)

  • Myoung, Shin-Won;Park, Je-Uk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.2
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    • pp.136-142
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    • 2006
  • Temporomandibular joint(TMJ) disorders have characteristic clinical findings such as pain, joint sound, and abnormal jaw function. With the rapid progress in TMJ imaging techniques, magnetic resonance imaging(MRI) especially provides the clinician and researcher with the ability to evaluate TMJ disorders(effusion, anterior disk displacement) and the hard and soft tissue of the TMJ. In order to manage the internal derangement of TMJ such as anterior disk displacement, the so-called appliance therapy is commonly used. This technique became the treatment of choice before surgical intervention by many practitioners. The purpose of the present study was to evaluate and determine the efficacy of anterior repositioning splint by means of the change of the position of the disk through pre- and post-treatment MRI. MRI and clinical symptom were carefully recorded in TMJ disorder patients. The relationship between TMJ symptoms such as pain, clicking sound, and disk displacement and effusion in MRI were analyzed. Then, splint therapy was applied for 3 months according to our protocol; at day 1, patients should wear 24 hours, in order to accomodate the splint and then, wearing time is reduced to 12 hours per day for one month. During next 2 months, it is tapered to 8 hours per day according to the evaluation of the clinical symptoms. Post-treatment MRI was obtained after 3 month protocol. This treatment strategy improved the clinical symptoms of TMJ disorder, and effusion and articular disk position showed a significant change. In conclusion, a treatment modality using an anterior repositioning splint therapy is an appropriate method for temporomandibular disorder patients.

Implant placement with inferior alveolar nerve repositioning in the posterior mandible

  • Doogyum Kim;Taeil Lim;Hyun-Woo Lee;Baek-Soo Lee;Byung-Joon Choi;Joo Young Ohe;Junho Jung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.6
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    • pp.347-353
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    • 2023
  • This case report presents inferior alveolar nerve (IAN) repositioning as a viable approach for implant placement in the mandibular molar region, where challenges of severe alveolar bone width and height deficiencies can exist. Two patients requiring implant placement in the right mandibular molar region underwent nerve transposition and lateralization. In both cases, inadequate alveolar bone height above the IAN precluded the use of short implants. The first patient exhibited an overall low alveolar ridge from the anterior to posterior regions, with a complex relationship with adjacent implant bone level and the mental nerve, complicating vertical augmentation. In the second case, although vertical bone resorption was not severe, the high positioning of the IAN within the alveolar bone due to orthognathic surgery raised concerns regarding adequate height of the implant prosthesis. Therefore, instead of onlay bone grafting, nerve transposition and lateralization were employed for implant placement. In both cases, the follow-up results demonstrated successful osseointegration of all implants and complete recovery of postoperative numbness in the lower lip and mentum area. IAN repositioning is a valuable surgical technique that allows implant placement in severely compromised posterior mandibular regions, promoting patient comfort and successful implant placement without permanent IAN damage.

Comparison of surgical approach and outcome for the treatment of cystic lesion on lower jaw

  • Oh, Suseok;Park, Joon-Hyung;Paeng, Jun-Young;Kim, Chang-Soo;Hong, Jongrak
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.5
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    • pp.276-283
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    • 2012
  • Objectives: Curettage and enucleation are two of the most common procedures performed in oral and maxillofacial surgery units. To access a cystic lesion, the buccal cortical plate is removed. The no reposition (NR) group underwent surgery without repositioning the buccal cortical plate. The reposition (R) group underwent surgery with a repositioning of the buccal cortical plate. This study compared the two surgical procedures in terms of bone healing and complications. Materials and Methods: Patients who underwent curettage and enucleation surgery were enrolled in this study. Panoramic radiographs of the patients in both the NR group (n=26) and R group (n=34) were taken at the baseline and at 6, 12 and 24 months after surgery. The radiolucent area was calculated to evaluate bony healing in each radiograph. The complications were analyzed through a review of the medical records. Results: The correlation between bony healing and surgical approach was not significant in the 6th, 12th, and 24th month (P<0.05). The complication rate was not associated with gender, graft material, bone graft and drain insertion (P<0.05). On the other hand, the R group had a higher complication rate (35.3%) than the NR group (0%). The difference in the mean lesion size between the NR group ($37,024{\pm}3,617$ pixel) and R group ($92,863{\pm}15,931$ pixel) was significant (independent t test, P=0.004). Conclusion: Although the reposition method is chosen when the lesion size is large, it is associated with more complications. Indeed, infection, discomfort and recurrence of the lesion were the most common complications in the R group. Furthermore, the R method does not have a strong point in terms of bone healing compared to the NR method. Therefore, the R method cannot be considered an ideal approach and should be used in limited cases.

Modified Approach in Reduction Malarplasty for Repositioning and Fixation (광대뼈 축소술에 있어서 재배치와 고정)

  • Hwang, So-Min;Song, Jennifer Kim;Baek, Se-Min;Baek, Rong-Min
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.273-278
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    • 2011
  • Purpose: It has always been an aspiration for Asians to look more balanced and feminine, considering their facial features regarding relatively flat midface with marked prominences of the zygoma. Many studies have been dealt in this subject. However, the authors would like to emphasize the concept and introduce the technique of repositioning of the malar complex to a cosmetically beneficial point and stationing it on proper position by fixation on zygoma body and arch. Methods: From January 1998 to December 2007, this method was performed in 50 patients of mild to moderate prominence and malposition of the malar complex. A simplified technique of lateral orbital osteotomy and oblique osteotomy on zygomatic arch through intraoral and preauricular incision was developed. Then, liberal malar complex can be moved to a supero-posterior direction and repositioned to a more cosmetically beneficial point. To maintain the stationed position and to protect from vector affected by the attached masticating muscle to zygomatc bone, fixation was done on both zygoma body and arch. Results: We have obtained satisfactory results using this procedure without any observable complications. The advantages of this procedure are proper exposure, inconspicuous scar, safe, more natural contour, improved stability, and shorter healing time. Conclusion: The authors suggest that reduction malarplasty should be approached with underlying concept of repositioning and fixation. In mild moderate malar prominent cases, our technique will provide with maintenance of aesthetic concept, equal to the malar reduction performed under coronal approach and provide with more natural facial contour with stability even with less invasive surgical approach.

Autogenous Transplantation of Impacted teeth : Indication and Case Report (매복치 자가이식술의 적응증과 치험례)

  • Yu, Hyung-Seog;Kim, Tae-Gyun
    • The Journal of the Korean dental association
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    • v.38 no.1 s.368
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    • pp.22-29
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    • 2000
  • The purpose of this paper is to discuss the indication. treatment procedure. prognosos and complication of autogenous transplantation in treating impacted teeth of orthodontic patient. Autogenous transplantation is indicated, in cases of rejecting orthodontic treatment due to the visible orthodontic appliance, the relatively long treatment time, unfavorable tooth position for orthodontic repositioning, unrestorable advanced detal caries. advanced periodontitis and ankylosed tooth. Most process related to the decision of the prognosis is dependent on the careful surgical technique. In comparison to other orthodontic and surgical procedure, the application of the autotransplantation is limited, although its success rate is markedly increased today. Therefore we must we must pay attention to the treatment planning and cooperation with other specialties is needed.

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From Exoscope into the Next Generation

  • Nishiyama, Kenichi
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.289-293
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    • 2017
  • An exoscope, high-definition video telescope operating monitor system to perform microsurgery has recently been proposed an alternative to the operating microscope. It enables surgeons to complete the operation assistance by visualizing magnified images on a display. The strong points of exoscope are the wide field of view and deep focus. It minimized the need for repositioning and refocusing during the procedure. On the other hand, limitation of magnifying object was an emphasizing weak point. The procedures are performed under 2D motion images with a visual perception through dynamic cue and stereoscopically viewing corresponding to the motion parallax. Nevertheless, stereopsis is required to improve hand and eye coordination for high precision works. Consequently novel 3D high-definition operating scopes with various mechanical designs have been developed according to recent high-tech innovations in a digital surgical technology. It will set the stage for the next generation in digital image based neurosurgery.

ERUPTION GUIDANCE OF IMPACTED MANDIBULAR FIRST MOLAR BY SURGICAL EXPOSURE (외과적 노출술을 이용한 매복된 하악 제1 대구치의 자발적 맹출유도)

  • Kim, Eun-Jung;Kim, Nan-Jin;Jo, Ho-Jin;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.598-604
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    • 2004
  • Impaction of mandibular first molar is relatively rare and its overall frequency has been reported to be 0.01%. The etiology of impaction are lack of eruption space, physical obstacles such as supernumerary teeth, odontomas or odontogenic tumors, hereditary factors, functional disturbances of endocrine glands and traumas. Impaction of mandibular first molar can result in a short lower facial height, formation of a follicular cyst, pericoronal inflammation, resorption of the roots of neighboring teeth and malocclusion. The treatment options available for impacted teeth include surgical exposure, orthodontic forced eruption, surgical repositioning and surgical removal of unerupted molar. This report presents two cases of distally tilted and impacted mandibular first molars which were treated by surgical exposure. In these cases, we could observe spontaneous eruption of the impacted mandibular first molars after surgical exposure.

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Medical adhesive related skin injury after dental surgery

  • Kim, Tae-Heung;Lee, Jun-Sang;Ahn, Ji-Hye;Kim, Cheul-Hong;Yoon, Ji-Uk;Kim, Eun-Jung
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.5
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    • pp.305-308
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    • 2018
  • An 87-year-old woman was referred for the extraction of residual teeth and removal of tori prior to prosthetic treatment. After surgery under general anesthesia, the surgical tape was removed to detach the bispectral index sensor and the hair cover. After the surgical tape was removed, skin injury occurred on the left side of her face. After epidermis repositioning and ointment application, a dressing was placed over the injury. Her wound was found to have healed completely on follow-up examination. Medical adhesive related skin injury (MARSI) is a complication that can occur after surgery and subjects at the extremes of age with fragile skin are at a higher risk for such injuries. Careful assessment of the risk factors associated with MARSI is an absolute necessity.

3D computer-assisted orthognathic surgery (3차원 디지털 시스템을 이용한 턱교정 수술)

  • Kim, Choong Nam;Kimm, Soo Ho;Lim, Ho Kyung;Lee, Eui Seok
    • The Journal of the Korean dental association
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    • v.57 no.2
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    • pp.100-104
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    • 2019
  • Orthognathic surgery is designed to correct problems of the jaw and face and restore facial harmony. The limitations of orthognathic surgery occur at all steps of the surgical workflow: preoperative planning, simulation, and operation. Many studies have shown the accuracy and advantages of 3 dimensional computer-assisted program for orthognathic surgery. The purpose of this paper is to introduce the accuracy of the maxillary repositioning in patients who underwent orthognathic surgery using a 3 dimensional computer assisted surgery program. The reliability of computer guided orthognathic surgery using splint and surgical guide need to be improved further. The 3 dimensional computer assisted analysis seems to be more precise to interpret than two-dimensional analysis. High-precision planning of orthognathic surgery has predictable results. Three-dimensional computer assisted orthognathic surgery has the following advantages : planned surgical movement is possible, splints guide with CAD/CAM technology; and increase predictable results .Computer assisted simulation surgery ensures accuracy during surgery, thereby facilitating predictable results. It may provide solution that enables surgeon to perform planned surgery more accurately.

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