• Title/Summary/Keyword: Surgical stability

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A CEPHALOMETRIC AND PANORAMIC ANALYSIS OF THE CHANGES OF THE CONDYLAR POSITION AFTER ORTHOGNATHIC SURGERY (하악전돌증 환자의 악교정 수술후 하악과두의 위치변화에 대한 연구)

  • Kang, Young-Ki;Kim, Jong-Ryoul;Yang, Dong-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.4
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    • pp.411-419
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    • 2000
  • Purpose: This study was aimed at analysis of the changes in the condyle position in subjects with mandibular setback osteotomies Method: Twenty patients were evaluated retrospectively for their changes in the condyle position who underwent surgical mandibular setback using bilateral sagittal split osteotomies with a manual condyle repositioning technique and rigid fixation. The cephalometric and panoramic analysis was performed preoperatively, 1 week, 6 months, and 1 year postoperatively. And postoperative noise, temporomandibular joint pain, and mouth opening were clinically examined 2 months, 4 months, 6 months, 8 months, 10 months, and 12 months postoperatively. Result: The condyles rotated posteriorly and laterally immediately after surgery, and they returned to the preoperative position during follow-up period but it is not significant. The statistical analysis (Paired t-test) showed no significant effects in postsurgical stability. The changes in the condyle position didn't have a significant harmful influence on temporomandibular joint disorder. Conclusion: A careful surgical mandibular setback using manual condyle repositioning and fixation technique will move condyle minimally and that will decrease the relapse and temporomandibular joint disorder.

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OPEN REDUCTION AND TRANSORAL FIXATION USING TROCHAR FOR MANDIBULAR SUBCONDYLE FRACTURE (구강 접근과 트로카를 이용한 하악 과두하부 골절의 정복과 고정)

  • Hur, Jun-Young;Kim, Jong-Yun;Lim, Jae-Hyung;Park, Kwang-Ho;Huh, Jong-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.1
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    • pp.43-48
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    • 2010
  • The mandibular condyle fracture occurs at 15-30% frequency of whole mandibular fracture. The treatment of choice is open reduction or closed reduction. In many cases, closed reduction is preferred for treatment of condylar fracture because it is hard to approach to condyle and there is risk of surgical complications, such as nerve damage in open reduction. Open reduction, however, has some advantages like possibility of anatomical reduction, occlusal stability and rapid functional recovery. Furthermore, it is possible to retain original ramal heights and to decrease deviation during mouth opening. There are many surgical approaches for open reduction of subcondyle fracture. At present, transoral approach using trochar device is tried for effective and minimally invasive method for open reduction of subcondyle fracture. And the authors report the cases of reduction of subcondyle fracture with transoral approach using trochar device.

Reconstruction of the Soft Tissue Defect in Fournier's Gangrene (Fournier 괴사 환자의 연부조직 결손 재건술)

  • Seo, Sung-Bo;Kang, Yang-Soo;Cheon, Ji-Seon;Yang, Jeong-Yeol
    • Archives of Reconstructive Microsurgery
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    • v.12 no.1
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    • pp.13-18
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    • 2003
  • Fournier's gangrene is a synergistic necrotizing fasciitis of the perineal, perirectal and urogenital area and can be fatal unless treated in early stage. Perianal and urogenital infections are common causes of the disease but it can occur after artificial procedure on perineal area using by surgical instruments. It is mixed aerobic and anaerobic infection and E. coli is the most common causative bacteria. Untill now many investigators have focused on early diagnosis, preserving hemodynamic stability, broad-spectrum systemic antibiotics and treatment of underlying disease in management of Fournier's gangrene. The authors have experienced five patients of chronic liver disease whose necrotizing perineal infections developed spontaneously and treated them aggressively as described above and reconstructed perineal soft tissue defects using by various surgical methods, then we got good results both functionary and cosmetically. From now on, we would better reconstruct soft tissue defect of perineum with skin graft or pedicled flap in early stage when treat Fournier's gangrene, thereafter we can get an ultimate increase in patient's life quality.

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IMPLANT REHABILITATION IN THE UNFAVORABLE ALVEOLAR RIDGE (불량한 치조제에서의 임플랜트 시술증례)

  • Park, Jae-Bum;Ahn, Sang-Hun;Cheung, Soo-Il;Jo, Byung-Woan;Ahn, Jae-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.1
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    • pp.35-44
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    • 1997
  • The most critical factor in determining which type of implant to be used would be the available bone of the patient. Usually a minimum of 5mm in the bone width and 8mm in the bone height is necessary to ensure primary implant stability and maintain the integrity of bone contact surface. Placement of implant is limited by the several anatomic strutures such as maxillary sinus, floor of the nose, inferior alveolar neurovascular bundle and nasopalatine foramen, etc. When severe resorption of alveolar ridge is encountered, implant placement would be a problematic procedure. A number of techniques to improve the poor anatomic situations have been proposed. This article reports 4 cases of patients using surgical procedures such as blade implant technique, cortical split technique in the anterior maxillary area, sinus lifting and lateral repositioning of inferior alveolar nerve, We treated dental implant candidates with unfavorable alveolar ridge utilizing various surgical techniques, resulted in successful rehabilitation of edentulous ridge.

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A rare case of isolated schwannoma in infraorbital nerve

  • Choi, June Seok;Park, Sang Min;Choi, Kyung-Un
    • Archives of Craniofacial Surgery
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    • v.19 no.3
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    • pp.231-234
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    • 2018
  • A schwannoma is a benign tumor that develops from Schwann cells. It is known to occur more frequently in women than men, and about one third of schwannoma cases occur in the head and neck area. It is also known to originate mainly in the auditory nerve. However, it is rarely associated with the trigeminal nerve, and especially, schwannomas related to the infraorbital nerve are very rare. we report a rare case of a schwannoma involving the infraorbital branch of the trigeminal nerve in a 45-year old male adult. The patient underwent physical examination and magnetic resonance imaging. The mass was approached through subciliary approach that is familiar to the plastic surgeon and completely resected. Histopathological findings showed pointed to a benign schwannoma. Infraorbital nerve schwannoma is difficult to distinguish from other diseases by means of clinical symptoms, physical findings, or imaging. In spite of its rarity, infraorbital nerve schwannoma may be considered a possible diagnosis in the case of mass on cheek. Assessment by computed tomography or magnetic resonance imaging is necessary for proper diagnosis. About the surgical approach, excision through the subciliary approach should be considered rather than the direct transfacial approach in view of stability, cosmetic effects, and familiarity.

Cardiopulmonary bypass preparation is mandatory in cardiac exploration for blunt cardiac injury patients: two case reports

  • Son, Shin-Ah;Cho, Joon Yong;Kim, Gun-Jik;Lee, Young Ok;Jung, Hanna;Oh, Tak-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.356-360
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    • 2021
  • Treating cardiac injuries following blunt trauma to the chest requires thorough examination, accurate diagnosis, and therapeutic plan. We present two cases; pulmonary vein rupture and left atrial appendage laceration, both as a result of blunt chest trauma. Through these cases, our team learned the importance of maintaining hemodynamic stability during the examination of injured cardiac structures. And based on the comprehensive cardiac examination, a decision to surgically intervene with median sternotomy via cardiopulmonary bypass was made, saving lives of the patient. This report introduces how such decision was made based on what supporting evidence and the diagnostic process leading to the initiation of surgical intervention. This report may help with decision-making process when confronted by blunt cardiac injury patients who need cardiac exploration.

Indications of Lateral Ankle Ligament Reconstruction with a Free Tendon and Associated Evidence (유리건을 이용한 족관절 외측 인대 재건술의 적응증과 근거)

  • Kang, Hwa-Jun;Jung, Hong-Geun
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.91-94
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    • 2018
  • Ankle sprain is one of the most common musculoskeletal injuries. Although most ankle sprains respond well to conservative measures, chronic instability following an acute sprain has been reported to occur in 20% to 40% of patients. Some individuals are eventually indicated for a lateral ankle ligament reconstruction due to persistent ankle instability. More than 80 surgical procedures have been described to address lateral ankle stability. These range from direct repair of the anterior talofibular ligament (ATFL) and of the calcaneofibular ligament (CFL) to reconstructions based on the use of autograft or allograft tissues. However, the best surgical option remains debatable. The modified $Brostr{\ddot{o}}m$ procedure is most widely used for direct ligament repair, but not always possible because of the poor ATFL or CFL quality or deficiency of these ligaments, which prevents effective shortening imbrication. Furthermore, the importance of a CFL reconstruction has been emphasized recently. On the other hand, it is difficult to achieve an efficient CFL reconstruction during the $Brostr{\ddot{o}}m$ procedure. Others have reported that an anatomic reconstruction of injured ligaments restores the normal resistance to anterior translation and inversion without restricting subtalar or ankle motion, and as a result, anatomic reconstructions for lateral ankle instability utilizing an autograft or allograft tendon have gained popularity.

The combined use of computer-guided, minimally invasive, flapless corticotomy and clear aligners as a novel approach to moderate crowding: A case report

  • Cassetta, Michele;Altieri, Federica;Pandolfi, Stefano;Giansanti, Matteo
    • The korean journal of orthodontics
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    • v.47 no.2
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    • pp.130-141
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    • 2017
  • The aim of this case report was to describe an innovative orthodontic treatment method that combined surgical and orthodontic techniques. The novel method was used to achieve a positive result in a case of moderate crowding by employing a computer-guided piezocision procedure followed by the use of clear aligners. A 23-year-old woman had a malocclusion with moderate crowding. Her periodontal indices, oral health-related quality of life (OHRQoL), and treatment time were evaluated. The treatment included interproximal corticotomy cuts extending through the entire thickness of the cortical layer, without a full-thickness flap reflection. This was achieved with a three-dimensionally printed surgical guide using computer-aided design and computer-aided manufacturing. Orthodontic force was applied to the teeth immediately after surgery by using clear appliances for better control of tooth movement. The total treatment time was 8 months. The periodontal indices improved after crowding correction, but the oral health impact profile showed a slight deterioration of OHRQoL during the 3 days following surgery. At the 2-year retention follow-up, the stability of treatment was excellent. The reduction in surgical time and patient discomfort, increased periodontal safety and patient acceptability, and accurate control of orthodontic movement without the risk of losing anchorage may encourage the use of this combined technique in appropriate cases.

Stability of periodontally compromised teeth after splint and non-surgical therapy: two cases followed-up for 1 to 3 years (Splint 및 비외과적 치주치료를 통하여 치주질환에 이환된 치아의 안정화 증례 보고)

  • Kim, Yeon-Tae;Park, Ye-Sol;Kim, Do-Hyung;Jeong, Seong-Nyum;Lee, Jae-Hong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.4
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    • pp.338-344
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    • 2018
  • This article describes cases of applying non-surgical treatment including scaling and root planing, occlusal adjustment and tooth splinting of periodontally compromised lower anterior incisors Clinical and radiographic evaluations were performed over a 1-3-year period. All clinical parameters and radiographic bone levels improved in both cases. Dramatic regeneration of alveolar bone and lamina dura were observed on radiographic images, and no specific complications occurred during the follow-up period. Within the limitations of this study, these cases demonstrated the possibility of tooth rescue through non-surgical treatment and splinting of periodontally compromised teeth typically considered for extraction.

Treatment efficacy of gingival recession defects associated with non-carious cervical lesions: a systematic review

  • Oliveira, Livia Maria Lopes de;Souza, Camila Agra;Cunha, Sinara;Siqueira, Rafael;Vajgel, Bruna de Carvalho Farias;Cimoes, Renata
    • Journal of Periodontal and Implant Science
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    • v.52 no.2
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    • pp.91-115
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    • 2022
  • Purpose: This systematic review aimed to compare the efficacy, defined in terms of the mean percentage of root coverage (mRC), of surgical treatment approaches combined with adhesive restorations of non-carious cervical lesions (NCCLs) to that of root coverage alone in patients with a single gingival recession (GR) and NCCL. Methods: A literature search was conducted to identify longitudinal studies reporting the mRC following treatment for the correction of GR defects associated with NCCLs using a combination of surgical and restorative techniques in systemically and periodontally healthy patients. Results: The search resulted in the retrieval of 12,409 records. Seven publications met the inclusion criteria for the qualitative synthesis of data. The mRCs ranged from 69% to 97%. In the medium term, the gingival margin position was more stable when a connective tissue graft (CTG) was used, independently of whether restoration of teeth with NCCLs was performed. Conclusions: The strength of the evidence was limited by methodological heterogeneity in terms of study design as well as the unit and period of analysis, which precluded a metaanalysis. Although no definitive conclusion could be drawn due to the lack of sufficient evidence to estimate the effectiveness of the interventions, CTG-based procedures contributed to gingival margin stability regardless of the performance of restoration to treat NCCLs.