• Title/Summary/Keyword: facial deformity

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CAD/CAM splint based on soft tissue 3D simulation for treatment of facial asymmetry

  • Tominaga, Kazuhiro;Habu, Manabu;Tsurushima, Hiroki;Takahashi, Osamu;Yoshioka, Izumi
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.4.1-4.6
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    • 2016
  • Background: Most cases of facial asymmetry involve yaw deformity, and determination of the yaw correction level is very difficult. Methods: We use three-dimensional soft tissue simulation to determine the yaw correction level. This three-dimensional simulation is based on the addition of cephalometric prediction to gradual yaw correction. Optimal yaw correction is determined visually, and an intermediate splint is fabricated with computer-aided design and computer-aided manufacturing. Application of positioning devices and the performance of horseshoe osteotomy are advisable. Results: With this procedure, accurate repositioning of jaws was confirmed and patients obtained fairly good facial contour. Conclusions: This procedure is a promising method for a widespread, predictable treatment of facial asymmetry.

Facial nerve palsy after bilateral sagittal split ramus osteotomy: case report (양측 하악 상행지 시상분할 골절단술 후 발생한 안면신경 마비: 증례보고)

  • Kim, Hong-Seok;Kim, Su-Gwan;Oh, Ji-Su;You, Jae-Seek;Shin, Bo-Su;Jeong, Kyung-In
    • The Journal of the Korean dental association
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    • v.55 no.8
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    • pp.537-540
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    • 2017
  • BSSRO (bilateral sagittal split ramus osteotomy) is frequently performed to correct dentofacial deformity and malocclusion. Among its complications the incidence of post-operative facial nerve palsy is very rare, but it is one of the most serious complications. The case of a 21-year-old male patient who underwent facial nerve palsy after BSSRO is described. After surgical intervention and conservative therapy, the patient recovered his facial nerve function successfully.

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Clinical evaluation of autologous fat graft for facial deformity: a case series study

  • Khorasani, Mansour;Janbaz, Pejman
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.4
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    • pp.286-290
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    • 2021
  • Objectives: The use of fat grafts in maxillofacial sculpturing is currently a common technique. Unlike fillers, autologous fats unite with facial tissues, but long-term results may still be unsatisfactory. Sharing long-term follow-ups can be helpful in making outcomes more predictable. Materials and Methods: The data from patients who were admitted from 2014 to 2016 for fat augmentation were collected. In all cases, fat grafts were injected by blunt cannula using a tunneling technique in different planes. A fan shape order for the malar, periorbital, nasolabial fold, mandibular angle and body, and perioral area was established. Results: Autologous fat was used for different sites of the maxillofacial regions. Of 15 patients, two patients were not satisfied due to fat graft resorption. For this, further injections were performed six months after the first injection using preserved fat grafts. One patient continued to be dissatisfied. There were no other complications related to fat transplants. Conclusion: Fat transplantation is a safe, reliable, and non-invasive method for facial contour and facial soft tissue defect restoration. Additional methods such as mesenchymal stem cells along with fat injection increase the survival rate of transferred fat.

A Study of Facial Deformity in the Patient with Bilateral Cleft Lip before the Primary Cheiolplasty (양측성 구순열 환자의 안모 변형에 대한 연구)

  • Yoon Bo-Keun;Soh Byung-Soo;Baik Jin-Ah;Shin Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.4 no.2
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    • pp.51-68
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    • 2001
  • Midfacial hypoplasia in patients with clefts of the lip and palate is considered to be the result of congenital dysmorphogenesis. And cleft lip and palate developes facial deformity, jaw abnormality, speech problem, which is most frequent hereditary deformity in maxillofacial region. So cleft lip and palate is characterized by midface deformity which shaws maxillary anterior nasal septal deviation and deformity. Our study describes congenital correlates of midfacial hypoplasia by examining the displacement of a normal complement of parts, a triangular tissue deficiency low on the lip border on the columellar side, and a linear deficiency and displacement in the line of the bilateral cleft lip. 15 patients with bilateral cleft lip and palate were taken impression before operation, but the patient who had other abnormalities and complications were excluded. Average age is 3.4 months and they were classified into both complete, both incomplete and complete & incomplete group. The obtained results were as follows 1. There were no differences on intercanthal width and canthal width between each of the groups. 2. Both complete group had longer lateral ala length than both incomplete group, but there were no differences between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 3. Columella length was greater in both incomplete group than in both complete group, but there was no difference between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 4. Both complete group had longer ala width & ala base width than both incomplete group had. But there were no differences between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 5. There were no differences between each of the groups on upper lip length, but nose/mouth width ratio was greater in both complete group than in both incomplete group. 6. Pronasale(pm), subnasle(sn), la~rale superioris(ls), stomion(sto) points were located around the central vertical line of face but deviated to incomplete side in com. & incom. group. 7. Nasal tip protrusion was greater in both incomplete group and com. & incom. group than both complete group, but there was no difference between both incomplete group and com. & incom. group.

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CONTOUR RECONSTRUCTION OF FACIAL DEFECT WITH SPLIT STERNOCLEIDOMASTOID MUSCULAR FLAP FOLLOWING PAROTIDECTOMY (이하선 적출술 후 흉쇄유돌근을 이용한 안모결손부의 외형재건)

  • KIM, Myung-Jin;KIM, Taek-Kyoung;YOU, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.144-152
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    • 1991
  • Various muscular flaps are used in oral and maxillofacial reconstructive surgery for the defects caused by tumor resection and trauma or for the correction of head and neck deformities. The sternocleidomastoid(SCM) muscle may be widely used as a muscular or myocutaneous flap in these lesion. The authors used SCM muscular flap for the expected parotid defect following benign tumor related conservative parotidectomy in three cases. We expected that prevention of post-operative facial deformity, reduction of dead-space and protection of denuded facial nerve etc. is lead by SCM muscular flap. But the total SCM flap can lead to some complications such as "flat neck deformity", limitation of neck movement and overcontouring of parotid defect. Therefore, the authors used split pedicled SCM muscular flap and it lead good favorable results of post-operative functional and esthetic problems.

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Reconstruction of Soft Tissue Deficit After Parotidectomy by Sternocleidomastoid Muscle Flap (이하선종양 적출술후 흉쇄유돌근을 이용한 함몰기형교정의 임상적 고찰)

  • Choi Hee-Yoon;Chung Hyo-Gyeong;Lee Young-Mann;Lew Jai-Mann
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.37-54
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    • 1987
  • The aim of surgery for all parotid masses is directed toward total removal of the tumor with adequate safe margins of adjacent normal tissue and preservation of the facial nerve whenever possible. Reconstructive procedures following parotidectomy for benign or low grade malignant lesions are most commonly necessary if soft tissue deficits appear at the angle of the mandible below the earlobe as a major cosmetic deformity. This is a report of Z4 cases with a diagnosis of parotid tumor who were treated using various surgical procedures at Department of Plastic and Reconstructive Surgery, Hanyang University Hospital over the period of 4 years from January, 1983 to December, 1986. Among 24 cases, 11 cases were reconstructed by Sternocleidomastoid muscle flap at the same time that extirpative surgery is outlined. The advantage of Sternocleidomastoid muscle flap is the coverage of the facial nerve, so adhesion between the facial nerve and skin was prevented. Absorption and loss of bulk was not found such as dermofat graft. It was a simple method. Neither donor site defect nor sternocleidomastoid muscle deformity was developed. Sternocleidomastoid muscle flap have been found satisfactory in maintaining filled-out soft tissue hollows with good result cosmetically and functionally.

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Analysis of masseter muscle in facial asymmetry before and after orthognathic surgery using 3-dimensional computed tomography (3차원 전산화 단층 사진을 이용한 안면비대칭 환자의 악교정 수술 전, 후 교근 분석)

  • Seo, Seung-Ah;Baik, Hyoung-Seon;Hwang, Chung-Ju;Yu, Hyung-Seog
    • The korean journal of orthodontics
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    • v.39 no.1
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    • pp.18-27
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    • 2009
  • Objective: The purpose of this study was to understand the differences in masseter muscle(MM) between the shifted and non-shifted sides in facial asymmetry patients, and the changes shown by MM after mandibular surgery. Methods: Pre- and post-operative CT scans were performed on 12 Class III patients with facial asymmetry who were treated by intraoral vertical ramus osteotomy and 10 subjects with normal occlusion. Using the V-works 4.0 program(Cybermed, Seoul, Korea), 3-dimensional images of the mandible, and MM were reconstructed, and evaluated. Results: In the asymmetry group, the MM angle between the shifted and non-shifted sides was only significantly different(p<0.05). Compared with normal occlusion, the asymmetry group showed a significantly smaller volume and maximum cross-sectional area in both sides of MM(p<0.05). After mandibular surgery, the angle of MM(p<0.01) and differences in angle between the shifted and non-shifted sides of MM(p<0.05) were significantly decreased. The thickness in the maximum cross-sectional area was significantly increased(p<0.01). After surgery, MM in facial asymmetry patients was similarly changed to those in the normal occlusion group except for widths. Conclusions: MM in facial asymmetry was definitely different from those in normal occlusion. However, this study suggests that MM changed symmetrically in conjunction with the mandible after proper mandibular surgery.

Cone-beam computed tomography based evaluation of rotational patterns of dentofacial structures in skeletal Class III deformity with mandibular asymmetry

  • Ryu, Hyeong-Seok;An, Ki-Yong;Kang, Kyung-Hwa
    • The korean journal of orthodontics
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    • v.45 no.4
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    • pp.153-163
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    • 2015
  • Objective: The purpose of this study was to assess rotational patterns of dentofacial structures according to different vertical skeletal patterns by cone-beam computed tomography (CBCT) and analyze their influence on menton deviation in skeletal Class III deformity with mandibular asymmetry. Methods: The control group consisted of 30 young adults (15 men, 15 women) without any severe skeletal deformity. The asymmetry group included 55 adults (28 men, 27 women) with skeletal Class III deformity and at least 3-mm menton deviation from the midsagittal plane; it was divided into the hyperdivergent and hypodivergent subgroups using a mandibular plane angle cutoff of $35^{\circ}$. Fourteen rotational variables of the dental arches and mandible were measured and compared among the groups. Correlations between menton deviation and the other variables were evaluated. Results: The asymmetry group showed significantly larger measurements of roll and yaw in the mandible than the control group. The hypodivergent subgroup showed significant differences in maxillary posterior measurements of yaw (p < 0.01) and maxillary anterior shift (p < 0.05) compared with the hyperdivergent subgroup. All the mandibular measurements had significant correlations with menton deviation (p < 0.01). Most measurements of roll were positively correlated with one another (p < 0.01). Measurements of yaw and roll in the posterior regions were also positively correlated (p < 0.05). Conclusions: Menton deviation in skeletal Class III deformity with mandibular asymmetry is influenced by rotation of mandibular posterior dentofacial structures. The rotational patterns vary slightly according to the vertical skeletal pattern.

Dentofacial transverse development in Koreans according to skeletal maturation: A cross-sectional study

  • Hwang, Soonshin;Noh, Yoonjeong;Choi, Yoon Jeong;Chung, Chooryung;Lee, Hye Sun;Kim, Kyung-Ho
    • The korean journal of orthodontics
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    • v.48 no.1
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    • pp.39-47
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    • 2018
  • Objective: The aim of this study was to establish the normative data of dentofacial transverse dimensions according to the skeletal maturation stage in Korean adolescents with good occlusion, assess gender differences and determine correlations between transverse variables. Methods: A total of 577 Korean subjects between ages 7 to 19 years and exhibiting skeletal Class I occlusion were categorized by skeletal maturation index (SMI) of Fishman using hand-wrist radiographs. Dentofacial transverse dimensions were assessed using posteroanterior cephalograms. Independent two-sample t-tests were used to analyze differences between genders. Pearson correlation coefficient was used to determine the correlation between transverse measurements. Results: Dentofacial transverse norms relevant to skeletal maturation stages were established. The average maxillomandibular width difference and ratio at growth completion was 22.16 mm and 77.01% for males; 23.70 mm and 74.06% for females, respectively. Males had greater facial, maxillary and mandibular widths compared to females at every SMI stage. The maxillary and mandibular intermolar widths showed the strongest correlation for both sexes (r = 0.826 for males, r = 0.725 for females). Conclusions: Dentofacial transverse norms of Korean adolescents were established according to developmental stage. All dentofacial widths were greater in males at growth completion. Maxillary and mandibular intermolar widths were strongly correlated. This study may serve as a guideline for the assessment of dentofacial transverse growth according to skeletal maturation stage in Korean adolescents with good occlusion.

Clinical Experiences on the Treatment of Congenital Cutis Aplasia and Craniosynostosis (선천성 두피결손증 및 두개골 조기유합증의 치험 5례)

  • Lee, Kyung-Ho
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.493-505
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    • 1993
  • The congenital cutis aplasia mainly occurs in head, sometimes involving the skull and dura mater. It's cause and the rate of falling ill are not known yet, it is the disease that rate of death is high by the infection, such as, the injured vascular hemorrhange of meningitis. Craniosynostosis is the disease the appears the skull as well as the facial deformity with growing, has from the developmental difficiency, visual distibance, motor disturbance, convulsion to the neurologic impairment of mental retardation, and accompanies the each characteristic deformity following the suture fused. Satisfactory results was achieved by local flap surgery and conservative treatment on the infant, diagnosed as the congenital cutis aplasia, case 1 Also successful treatment experiences of craniosynostosis(oxycephaly, brachycephaly, trigonocephaly, cloverleaf deformity) through the frontal bone advancement and the barrel stave asteotomy, were reviewed & pursues and investigates the intracranial volume of before and after of surgery, and then reports with the literature investigation.

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