• Archives of Plastic Surgery
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• v.35 no.5
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• pp.589-596
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• 2008

Purpose: The nasal bone fracture is most common fracture in facial bone injuries. Regardless of the severity or type of fracture, closed reduction has traditionally been the common method of treatment. However, through detailed pre-operative evaluation, we found out that many patients consider rhinoplasty prior to trauma due to aesthetic desire or nasal deformity with or without septal deviation. In treatment of nasal bone fracture, we focused not only on the fracture management but also on the patients' desire prior to trauma, and we made additional operation according to patients' desire with fracture reduction and gained rewarding outcomes. Methods: From March 2005 to June 2007, total 263 patients were treated for nasal bone fracture. Among these patients, 57 patients (21%) had the additional operation with nasal fracture reduction. The additional operations were categorized in three types: augmentation rhinoplasty with tip plasty (40%), septoplasty only (16%), corrective rhinoplasty (44%). The mean follow-up period was 5.6 months and results were evaluated by scoring. Results: Forty four of 57 patients (77%) were highly satisfied regardless of any additional operation kinds. The complications were one septal perforation, two displacement of implant and four remnant nasal deformities. For the septal perforation, no further management was performed because we lost the contact with the patient. Then 4 of the other complicated patients were revised. Conclusion: In general, many physicians tend to consider nasal fracture as a simple trauma. However through the strict history taking, physical examination and professional counseling, we could catch the patient's cosmetic desire and get the eyes on new concept: the nasal fracture is not only a trauma but a cosmetic and functional field. In the treatment of nasal bone fracture, if additional rhinoplasty is performed, patients will be more satisfied and we also can expect higher profits.

• The korean journal of orthodontics
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• v.39 no.2
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• pp.120-129
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• 2009

Objective: To estimate dental maturity using the Demirjian Index for the mandibular third molar and investigate the relationships between dental maturity and skeletal maturity among growing children. Methods: The samples were derived from panoramic, lateral cephalometric and hand-wrist radiographs of 270 female subjects registered as patients at the orthodontic department, dental hospital, Yonsei University. Dental maturity [Demirjian Index (DI)] and skeletal maturity [skeletal maturation indicators (SMIs)] and cervical vertebrae maturation indicators (CVMIs)] were estimated from these radiographs. Results: There was a significant correlation (r = 0.64) between SMIs and DI, and a similar correlation (r = 0.59) was observed between CVMIs and DI (p < 0.001). If DI was above Stage E, then the SMI was above Stage 10 and the CVMI was above Stage 5. There was a weak correlation (r = 0.26) between age at menarche and DI (p < 0.001). There was no significant difference in DI among Class I, II or III malocclusions. Conclusions: Dental maturity evaluation using the mandibular third molar will be an adjunctive tool in combination with cervical vertebrae and hand-wrist maturity evaluations.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.21-26
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• 2006

Considering the skeletal class III malocclusion that complains of mandibular prognathism, there have been some studies of the mandibular change for comparing the changes of pre operative with post operative state. Nowadays it is common to do the orthognathic 2-jaw surgery for the correction of the maxillary deficiency, the post operative stability and the esthetics. We compare and analyze the changes of soft tissue around the nose and the lip with the changes in the direction and the amount of maxilla. Patients who were diagnosed as maxillofacial deformity and received orthognathic surgery of both jaws at Yongdong Severance hospital from 2001 through 2003 were included in this study. Their lateral cephalograms were analyzed, and the post operative change of hard tissue and soft tissue were studied. Upon analyzing the preoperative cephalograms and 6 month post operative cephalograms, there were significant in the vertical change of Labialis superius(Ls) and Stomion(Stm) in soft tissue in relation to the vertical change of skeletal landmarks (Anterior Nasal Spine, Subspinale, Prosthion, Incision Superious). In addition, there were no significance in horizontal movement of the skeletal landmarks among groups. In terms of hard tissue landmarks, group 3(maxillary posterior impaction and advancement surgery group) showed significantly greater change in the vertical movement of Anterior Nasal Spine(ANS), Subspinale(A), Prosthion(Pr), and Incision Superious(Is) compared with other groups. In terms of soft tissue change, group 3 showed more significant change in the vertical movement of Ls and Stm. This study calculated the changes of the skeletal and soft tissue landmarks in order to act as a guide in planning and performing the surgery and as a reference in predicting the postoperative change of facial appearance.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.13 no.1
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• pp.37-42
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• 2017

Noonan syndrome is a relatively common genetic disorder which is autosomal dominant. Prevalence of Noonan syndrome is varying from 0.04% to 0.1%. It is characterized by distinctive facial features, chest deformity, short stature and congenital heart disease. Oral findings in patient with Noonan syndrome include high arched palate, dental malocclusion, articulation difficulties, and micrognathia. The purpose of this case report is to describe dental treatment of a children with Noonan syndrome. 5 year old boy with Noonan syndrome visited to the Seoul National University Dental Hospital for dental treatment. Due to need for close monitoring, concern about seizure and poor cooperation, we planned to perform the dental treatment under general anesthesia. Under general anesthesia, caries treatment was successfully performed and there was no postoperative complications related to general anesthesia. High arched palate was observed which is characteristic in Noonan syndrome.

• The korean journal of orthodontics
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• v.30 no.6 s.83
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• pp.669-675
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• 2000

Excessive production of parathyroid hormone causes bony disorder such as periosteal bone resorption and bone pain due to excessive skeletal demineralization. A Class III facial deformity case with generalized root resorption presented bete was fumed out to be due to hyperparathyroidism. Clinical and cephalometric analysis revealed a straight skeletal profile with a retruded maxilla and a prognathic mandible. The x-ray findings demonstrated generalized root resorption of entire dentition to different degree. There also appeared osteoporosis like immature trabecular structure with the evidence of ground glass appearance. Serum test showed elevated 1evel of parathyroid hormone and growth hormone. Change of cranial growth by hyperparathyroidism can be dependent up(In a decreased bone apposition in viscerocranial growth site and abnormalities in cranial suture growth. It is possible to hypothesize that growth retardation of maxilla at least partially be accounted lot hyperparathyroidism. Therefore, regarding to the definite etiology of skeletal Class III and orthodontic treatment planning considering root resorption and osteoporosis, the early diagnosis for the hyperparathyroidism should be carefully carried by clinical and laboratory studies.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.2
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• pp.63-70
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• 2005

Patients with cleft lip and palate usually show up maxillary hypoplasia. In these cases, a large amount of maxillary advancement is often needed to correct the severe deformity, but local soft-tissue scars around the maxilla restrict maxillary advancement and increase the relapse rate. Maxillary distraction osteogenesis is an effective method for facial and occlusal improvement in these patients. By gradually lengthening both the bones and the soft tissues, distracted midface can greatly increase postoperative stability and decrease the relapse rate. However, the maxillary extraoral appliances of the early days used were esthetically unappealing as well as difficult for the patient to manage. Recently, more inconspicuous intraoral distraction appliances have been developed and used with success. We acquired favorable result in two patients(bilateral 1 patient and unilateral 1 patient) with severe maxillary hypoplasia secondary to complete cleft lip and palate were treated with midface distraction using internal distractor (Zurich Pediatric Maxillary Distractor, KLS Martin, Tuttlingen, Germany). So, we report our experience with literatures.

• 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 Craniofacial Surgery
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• v.12 no.2
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• pp.93-96
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• 2011

Purpose: In most cases of nasal bone fracture, closed reduction with internal or external splint fixation approach is selected. However, because of indiscriminate insertion of the internal splint without considering of anatomical difference or deformity, insufficient fixation happens frequently that need additional fixation. Therefore, we suggest a new method for providing adequate support in reduced nasal bone by carving $Merocel^{(R)}$ that is fixed for the anatomical structure. Method: Closed reduction and internal fixation with carved $Merocel^{(R)}$ was performed in 15 nasal bone fracture patients from March, 2010 to July, 2010. Each patient was evaluated by physical examination, facial photographic check, simple X-ray, and computerized tomography. On the first day post-operation, location of packing and amount of reduction were checked by follow up X-ray and computerized tomography. In addition, patients' symptoms were evaluated. During the 3-month post-op follow up at out-patient clinic, operator, 2 doctors in training and one assistant performed the objective evaluations by physical examination on nasal dorsal hump, nasal deviation, nasal depression, nasal breath difficulty, and nasal airway obstruction. A survey of subjective patients' satisfaction in 4-stages was also performed. Results: The results of follow-up computerized tomography of the 15 patients revealed that 11 patients had good reduced state. Three patients with combined maxillary frontal process fracture had over reductions. A survey performed on the first day post-operation showed that 14 of 15 patients answered that their current symptoms were more than tolerable. At the 3-month follow-up physical exam, one case had a dorsal hump. However, there were no nasal deviations, nasal depressions, nasal breath difficulties, or nasal airway obstructions. Twelve of the 15 patients answered more than moderate on the 3-month survey. Conclusion: Intranasal packing after carving the $Merocel^{(R)}$ considering anatomical structure is a new effective method to promote proper-reduction, maintain stability, and minimize patients' symptoms by addition of a simple procedure.

• The korean journal of orthodontics
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• v.36 no.4
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• pp.284-294
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• 2006

Objective: Activating mutations in the fibroblast growth factor receptor-2 (FGFR2) have been shown to cause syndromic craniosynostosis such as Apert and Crouzon syndromes. The purpose of this pilot study was to investigate the resultant phenotypes induced by the two distinctive bone-targeted gene constructs of FGFR2, Pro253Arg and Cys278Phe, corresponding to human Apert and Crouzon syndromes respectively. Methods: Wild type and a transgenic mouse model with normal FGFR2 were used as controls to examine the validity of the microinjection. Micro-CT and morphometric analysis on the skull revealed the following results. Results: Both Apert and Crouzon mutants of FGFR2 induced fusion of calvarial sutures and anteroposteriorly constricted facial dimension, with anterior crossbite present only in Apert mice. Apert mice differed from Crouzon mice and transgenic mice with normal FGFR2 in the anterior cranial base flexure and calvarial flexure angle which implies a possible difference in the pathogenesis of the two mutations. In contrast, the transgenic mice with normal FGFR2 displayed normal craniofacial phenotype. Conclusion: Apert and Crouzon mutations appear to lead to genotype-specific phenotypes, possibly causing the distinctive sites and sequence of synostosis in the calvaria and cranial base. The exact function of the altered FGFR2 at each suture needs further investigation.

• The korean journal of orthodontics
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• v.36 no.2 s.115
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• pp.125-135
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• 2006

The purpose of this study was to measure and compare the level of frictional resistance generated from three currently used ceramic brackets; 1, Crystaline $V^{(R)}$, Tomy International Inc., Tokyo, Japan; 2, $Clarity^{(R)}$, 3M Unitek, Monrovia, CA, USA; 3, $Inspire^{(R)}$, Ormco, Orange, CA, USA; with composite resin brackets, Spirit, Ormco, Orange, CA, USA; and conventional stainless steel brackets, Kosaka, Tomy International Inc., Tokyo, Japan used as controls. In this experiment, the resistance to sliding was studied as a function of four angulations $(0^{\circ},\;5^{\circ},\;10^{\circ}\;and\;15^{\circ})$ using 2 different orthodontic wire alloys: stainless steel (stainless steel, SDS Ormco, Orange, CA, USA), and beta-titanium (TMA, SDS Ormco, Orange, CA, USA). After mounting the 22 mil brackets to the fixture and $.019{\times}.025$ wires ligated with elastic ligatures, the arch wires were slid through the brackets at 5mm/min in the dry state at $34^{\circ}C$. Silica-insert ceramic brackets generated a significantly lower frictional force than did other ceramic brackets, similar to that of stainless steel brackets. Beta-titanium archwires had higher frictional resistance than did stainless steel, and all the brackets showed higher static and kinetic frictional force as the angulation increased. When the angulation exceeded $5^{\circ}$, the active configuration emerged and frictional force quickly increased by 2.5 to 4.5-fold. The order of frictional force of the different wire-bracket couples transposed as the angle increased. The silica-insert ceramic bracket is a valuable alternative to conventional stainless steel brackets for patients with esthetic demands.