• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제23권5호
• /
• pp.471-477
• /
• 2001

Failure to use effective methods of reduction, fixation, and immobilization may lead to nonunion with osteomyelitis, owing to the compound nature of most fractures of the mandible. Nonunion results in fibrous pseudoarthrosis at the fracture site with instability that, once formed, does not improve spontaneously. Once the nonunion with osteomyelitis secondary to fractures has become established, intermaxillary fixation and drainage of infected tissue should be instituted as early as possible, because the fixation & drainage enhances the patient comfort and hinders ingress of microorganisms & debris by movement of bone fragments. The authors treated three cases of nonunion with osteomyelitis by intermaxillary fixation, incision & persistent drainage on the previous fistula site and endodontic drainage of infected teeth in the fracture site of mandible. The localization & sequestration of the infected bone around the fracture was better performed persistently by natural homeostatic mechanism in $8{\sim}10$ weeks and the bony union was then attained without bone grafting.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제16권3호
• /
• pp.348-355
• /
• 1994

Styloid process is a slender pointed bone of variable length, which project downward, forward, and slightly medialward from the posteroinferior portion of the tympanic part of the temporal bone. Embryologically, the styloid process is derived from Reichert's cartilage, a structure of second branchial arch origin. Most patients with elongated styloid process remain asymptomatic, but some patients complain pain and sensation of foreign body in the throat, dysphagia, dysphonia, referred otalgia. Recently, we have experienced a case of elongated styloid process in a fifty-nine year old man. He had been suffered from Rt. side sore throat, headache and pharyngeal discomfort during head movement. Through various X-ray examination, Xeroradiography, and palpation of tonsillar fossa, elongated styloid process on Rt. side was confirmed. Under the general anesthesia, it was successfully removed out via transoral approach technique, described by Eagle. The resected styloid process was 2.5cm in it's length and he was freed from the symptoms without further complication.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제21권3호
• /
• pp.317-323
• /
• 1999

TMJ ankylosis is defined as a mobile disorder of jaw such as mouth opening limitation, limitation of anterior or/and lateral movement of TMJ. Kazanjian published first clinical report about classification of TMJ ankylosis dividing with intracapsular ankylosis and extracapsular ankylosis. TMJ ankylosis is resulted from trauma, infection, metastatic tumor, irradiation, burn and etc. When TMJ ankylosis is manifested in growing period, it affects to functional disorder and development and position of mandible, so it can result in maxillofacial deformity such as facial asymmetry, micrognathia, malocclusion. For treatment of TMJ ankylosis, various surgical interventions were devised ; condylectomy, gap arthroplasty, interpositional arthroplasty and TMJ reconstruction. So, we report our results with documental study and cases of true ankylosis in our department.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제21권3호
• /
• pp.284-287
• /
• 1999

The nose, a striking features of the human face, is regarded by many clinicians as the keystone of facial esthetics. Clinically, as the treatment of a dentofacial deformity, the soft tissue changes that occurred normally with movement of the skeletal bases. Changes of the soft tissue in the maxillary orthognathic surgery are widening of alar base, elevated nasal tip and flattening of upper lip. In addition, soft tissue change is difficult to predict, it has considerable variability in the response of soft tissue. We reviewed patients who received Le Fort I advancement osteotomy in our department and analysed preoperative and postoperative alar base width, nasal height in clinical measurement and cephalometry and patient's satisfaction of postoperative nasal appearance.

• 대한두개안면성형외과학회지
• /
• 제21권2호
• /
• pp.99-105
• /
• 2020

Background: Due to the different handling properties of unsintered hydroxyapatite particles/poly-L-lactic acid (uHA/PLLA) and polycaprolactone (PCL), we compared the surgical outcomes and the postoperative implantation accuracy between uHA/PLLA and PCL meshes in orbital fracture repair. Methods: Patients undergoing orbital wall reconstruction with PCL and uHA/PLLA mesh, between 2017 and 2019, were investigated retrospectively. The anatomical accuracy of the implant in bony defect replacement and the functional outcomes such as diplopia, ocular motility, and enophthalmos were evaluated. Results: No restriction of eye movement was reported in any patient (n= 30 for each group), 6 months postoperatively. In the PCL group, no patient showed diplopia or enophthalmos, while the uHA/PLLA group showed two patients with diplopia and one with enophthalmos. Excellent anatomical accuracy of implants was observed in 27 and 22 patients of the PCL and uHA/PLLA groups, respectively. However, this study showed that there were neither any significant differences in the surgical outcomes like diplopia and enophthalmos nor any complications with the two well-known implants. Conclusion: PCL implants and uHA/PLLA implants are safe and have similar levels of complications and surgical outcomes in orbital wall reconstruction.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제20권2호
• /
• pp.106-111
• /
• 1998

The aim of this article was to examine the usefulness of costochondral graft in the temporomandibular joint reconstruction. We performed costochondral grafting in the mandibular reconstruction including condyle replacement in 3 patients, which 2 of ankylosed cases and 1 destructed case. In one case, unexpected fracture of costochondral junction has developed at post-operative 2 months, but, normal mouth opening and facial appearance have been acheived by continuing exercise. These patients showed maximum mouth opening of 35-40 mm and no restriction of lateral side movement. They have been improved esthetics and function. We proposed that the costochondral graft is one of the useful method for functional reconstruction of defected mandibular condyle.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제11권1호
• /
• pp.93-100
• /
• 1989

This is a report of comparison of condyle fracture treatment by functional treatment and surgical treatment. In cases of functional therapy, mode of action of Activator that we used; By fulcrum of posterior teeth, the mandibular elevators of the opposite side cause the gap in the dental arches to be reduced, while the mandible performs a rotational movement about the fulcrum during which the fracture surface of the large fragment moves downward. Condylar fractures are often seen in association with fractures of other regions of the mandible. In our department, such cases were treated by miniplate and intramaxillary fixation. Surgical treatment of fractures of the mandible condylar were treated by intraoral approach. The result were drawn as follows : 1. Lateral displacement of condyle ; functional therapy with activator. 2. Compound fracture ; miniplate osteosynthesis and physiotherapy. 3. Anteriormedially displacement ; surgical treatment.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권1호
• /
• pp.23-26
• /
• 2010

The vascular changes in periodontal tissues cause local hypoxia which seems to affect the periodontal tissue cells. Abrupt changes in oxygen availability within the periodontium have been suggested to have a regulatory role in alveolar bone remodeling during tooth movement, bone growth or fracture healing. The purpose of this study was to study the effects of hypoxia on formation of osteoclast responsible for bone resorption, in vitro. Primary mouse bone marrow cells were cultured in normoxic (20% $O_2$) and hypoxic (1% $O_2$) conditions and assayed for cellular proliferation. The results obtained were as follows : 1. Reducing oxygen tension increased the formation of multinucleated osteoclasts. 2. Hypoxic stimulus increased the size of mature osteoclasts.

• Archives of Reconstructive Microsurgery
• /
• 제10권2호
• /
• pp.124-130
• /
• 2001

Both of latissimus dorsi and rectus abdominis muscles are workhorse for various reconstructive surgeries. These muscle flaps have been used widely for soft tissue coverage, tissue augmentation, and functional muscle transfer. However, the traditional method for muscle harvest requires a long incision that often results in an unsightly scar and becomes the main concern of the patient. The purpose of this study is to introduce our clinical experience of endoscopic harvest of latissimus dorsi muscle and rectus abdominis muscle, and to make comparison with traditional harvest of these two muscle flaps. Of the 13 rectus abdominis muscles free flaps, 6 muscles were harvested traditionally and 7 muscles were harvested with endoscopic assistance. Of the 21 latissimus dorsi muscle free flaps, 12 muscles were harvested traditionally and 9 muscles were harvested with endoscopic assistence. Follow up period was between 6 months and 24 months. The patients age ranged from 7 to 70 years old. The result revealed no statistically significant differences in the amount of intraoperative bleeding, incidence of postoperative hematoma and seroma, and the incidence of donor-site wound infection. However, patients feel less pain and start earlier and better movement after the operation with endoscopically assisted harvest. This technique is easy to learn, is safe, and can reduce substantially the donor site morbidity comparing traditional harvesting technique.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제33권2호
• /
• pp.185-189
• /
• 2011

Tooth impaction represents the stop of eruption by clinical and radiographical disturbance in eruption path or the dislocation of tooth germ. The most common factor in tooth eruption disorders are spacial deficiency with other causes reported to be odontogenic tumors, periodontal ligament injury, etc. Impaction of the mandibular second molar is relatively rare and reported in about 3 out of 1,000 people. Because the second molars tend to erupt in a mesial direction, this situation can lead to serious problems if untreated, including dental caries, periodontal disease and root resorption of the first molar. Treatment of this problem includes, surgical repositioning and orthodontic forced eruption. Because each procedure have the definite advantages and disadvantages, and influenced by circumferential environment, these have limits for successfu1 recovery as independent treatment. In a case at St. Mary's Hospital, we performed successful correction of a horizontal impacted mandibular second molar using a miniplate skeletal anchorage system. We introduce this treatment as a valid method for an impacted second molar and consider a oromaxillofacial surgeon's role in tooth movement treatment.