In the history of medicine, many surgeons have been tried to reconstruct lost tissue and correct deformity, attempts to use implant materials have probably paralleled those involving autogenous tissue. Recently there has been an acceleration in the understanding of the requirements and potentials of implant materials caused by collaboration between material scientists, biomaterials engineers, clinicians, and clinical investigators. Alloplastic materials have become an essential part of reconstructing the function and contour of the craniofacial skeleton. Bone is a specialized form of connective tissue, which provides support, and protects vital and detion and summarizes their mechanical properties and clinical aspects.
Animal ; Bone Diseases/surgery* ; Bone Substitutes* ; Bone Transplantation* ; Facial Bones/surgery* ; Facial Bones/injuries ; Human ; Skull/surgery* ; Wounds and Injuries/surgery

injuries of Oral & Maxillofacial region include abrasion, contusion, simple laceration, laceration of skin with underlying tissue, soft tissue injuries combined with facial bone fracture and involving functional structures such as facial such as facial nerve and vessel, orbit, lacrimal duct and salivary gland and so on. The results obtained were as follows ; 1. The age range was 1 to 97, and the highest incidence occured in the 3rd decade(23.4%), followed by the 1st decade (20.2%), 4th decade(18.1%), 4th decade(18.1), and 5th decade(14.3). 2. The sexual ration was 4:1 (M:F). 3. The most common cause of facial laceration was a accident(54.5), followed by blow(17.8%), traffic accident(15.9%) and unknown(10.8%). 4. The most frequently occurred site of injury was a forehead(24), followed by oral cavity(16.9%), lip(15%), eyebrow(14.5%), cheek(14%), chin(11.8%), nose(2%), scalp(1.4%) and neck(0.9%). 5. Most of wound size was less than 3cm in length. 6. 28 patients suffered facial bone fracture, representing 7%. 7. The major complications following facial laceration were infection and facial paralysis caused by facial nerve injuries, representing 4.5% and 1.9%.]]>
Contusions ; Facial Bones ; Facial Nerve ; Facial Nerve Injuries ; Facial Paralysis ; Humans ; Incidence ; Lacerations ; Orbit ; Salivary Glands ; Skin ; Soft Tissue Injuries ; Wounds and Injuries

Utile recently, osteotomy & reposition surgery of prominent zygoma have been performed by means of a coronal incision or intraoral preauricular incision. But penalties are paid, such as scar, the possibility of facial nerve injury and long operative time. Reflecting on our past experiences of facial bone surgery, we developed an alternative approach. In our method, the protrusion in the cheekbone is corrected by performing an osteotomy and reposition method through intraoral incision only. During the past 3 years we have operated on 23 patients of malar prominences. The amount of the bone to be removed is determined on preoperative interview, physical examination and x-rays. Intraoral incision provide access to the zygomatic body and lateral orbital rim. After L-shaped osteotomy, two paralle vertical and one transverse osteotomies, at medical part of the zygomatic body, the midsegment is removed. Posterior portion of zygomatic arch was approached through medical aspect and was outfractured using curved osteotome. After completion of triple osteotomy, the movable zygomatic complex was reduced medially and fixed with miniplates and screws on the zygomaticomaxillary buttress. The patients were followed for 9.5 months with acceptable result and little complication. The author concludes that this technique is effective and safe method in reduction malarpalsty.
Cicatrix ; Facial Bones ; Facial Nerve Injuries ; Humans ; Operative Time ; Orbit ; Osteotomy ; Physical Examination ; Zygoma

Despite advances in radiology -- including CT scanning -- three-dimensional (3D) nature of facial bone fractures must be inferred by the spatial imagination of the physician. Thus, in order to assess the usefulness of 3D-CT, 3D-CT reformations were obtained in 24 patients presenting with facial injuries of differing severity from 7. 1993 to 5. 1995. The 3D images were compared with high resolution CT, including multiplanar reformations, and assessed under the headings of fracture detection, extent and displacement using a single scoring system.3D was valuable in extensive facial fractures, providing a clear demonstration of fracture extent and fragment displacement. 3D was equally useful in the diagnosis of malar complex fractures and mandible fractures. However, 3D was much less useful in the diagnosis of orbital blow-out fractures and minor trauma, in which little or no fragment displacement had occurred, than conventional CT. In conclusion, when used as part of a high resolution CT examination, 3D imaging can provide useful information to surgeon in cases of severe facial trauma.
Diagnosis* ; Facial Bones* ; Facial Injuries ; Head ; Humans ; Imagination ; Mandible ; Orbit ; Orbital Fractures ; Tomography, X-Ray Computed

The fracture of zygomatic arch is one of the common fracture of the facial bone and commonly reduced by Gillies or Dingman method However, if the reduced bone segments are unstable after reduction, they tend to be displaced by mastication or unintentional external forces. Though many techniques have been introduced for the treatment of the unstable zygomatic arch fracture, all of those techniques have their own shortcomings. We devised a new fixation method to prevent the displacement of the reduced zygomatic arch segments with 0.047 inch K-wire under the fluoroscope. After reduction of zygomatic arch using Gillies method under the fluoroscope, a thin K-ire was inserted along the undersurface of the zygomatic arch through zygoma body for rigid fixation. The inserted K-wire was removed in 4 weeks. In ten cases, good cosmetic and functional results were observed without complications such as infection, facial nerve injury, displacement of fractured segments, and operative scar during the follow up period of 3 months. However, while the pin was being inserted, patients complained discomfort on their cheeks. This technique may be an available method to prevent the displacement of the reduced zygomatic arch and to obtain the rigid fixation.
Cheek ; Cicatrix ; Facial Bones ; Facial Nerve Injuries ; Follow-Up Studies ; Humans ; Mastication ; Zygoma*

The surgical reconstruction of complex facial injuries have focused on the following; early one-stage repair, exposure of all fracture fragments, precise anatomic rigid fixation, immediate bone grafting, and definite soft tissue management were the main surgical procedures, as in other facial bone injuries. Complex facial bone fractures involving dentition should be managed by the same principles. However, conventional methods can not achieve accurate preinjury occlusion when there are unstable fracture segments, edentulous state, or complex palatal/maxillary and mandibular fractures. Seventeen patients were surgically reconstructed in conjunction with dental impression, model surgery, and fabrication of dental splints to establish better occlusion. Among the facial fractures that had the occlusal problem, maxillary/palatal fractures and complex mandibular fractures, were the major indications for fabrication of acrylic splints. During operation, fracture segments were reduced and repositioned according to dental wear facets of the prefabricated occlusal splint and then temporary intermaxillary fixations were performed. This allowed us to accomplish precise anatomical reduction and rigid intrenal fixations. The postoperative occlusions were acceptible and no complication occurred as direct effects of dental splint. We suggest that fabrication of an acrylic occlusal splint is necessary for the management of complex facial injuries involving dentition.
Bone Transplantation ; Dentition ; Facial Bones ; Facial Injuries* ; Humans ; Mandibular Fractures ; Occlusal Splints ; Splints* ; Tooth Wear

Plastic surgeons who perform reconstructive surgery of facial injuries have a dual responsibility: repair of the aesthetic defect and restoration of the function. The third goal is to minimize the period of disability. although emergent situations are limited in facial injuries, I would like to emphasize the advantages of prompt definitive reconstruction of the injuries and the contribution of early operative intervention to the superior aesthetic and functional outcomes. Socioeconomic and psychological factors make it imperative that an aggressive, expedient, and wellplanned surgical program be outlined, operated, and maintained to rehabilitate the patient to return to his or her active and productive life as soon as possible while minimizing aesthetic and functional disabilities. Teaching points: the techniques of extended open reduction and immediate repair or replacement of bone and microvascular tissue transfer of bone or soft tissue have made extensive and challenging injuries manageable. The principle of immediate skeletal stabilization in anatomic position has been enhanced by the use of rigid fixation and the application of craniofacial techniques that is safer and less traumatic for facial bone exposure. In this article, I will present mandibular fracture, orbital wall fracture and maxillar fracture, which are commonly encountered facial bone injuries. We can improve both the functional and aesthetic outcomes of facial fracture treatment when we manage the patients with the current concept of craniofacial techniques based on precise anatomic knowledge.
Facial Bones* ; Facial Injuries ; Humans ; Mandibular Fractures ; Orbit ; Orbital Fractures ; Psychology

facial bone fractures. Optical endoscopic magnification minimizes the disadvantages associated with open surgical repair, including the risk of facial nerve injury and external facial scarring, and no postoperative complications have been attributable to the endoscopic approach. This technique was used in 14 patients treated at Ulsan University Hospital, Korea, from September 2004 to August 2006, including six mandibular subcondyle fractures, five blowout fractures and three zygomaticomaxillary complex (ZMC) fractures. Careful preoperative evaluation and proper surgical technique were essential to achieve optimal results in the selected patients.]]>
Cicatrix ; Endoscopes ; Facial Bones ; Facial Nerve Injuries ; Fractures, Open ; Humans ; Korea ; Postoperative Complications ; Ulsan

BACKGROUND: The zygoma is the most prominent portion of the face. Almost all simple zygomatic arch fractures are treated in a closed fashion with a Dingman elevator. However, the open approach should be considered for unstable zygomatic arch fractures. The coronal approach for a zygomatic arch fracture has complications. In this study, we introduce our method to reduce a special type of unstable zygomatic fracture. METHODS: We retrospectively reviewed zygomatic arch view and facial bone computed tomography scans of 424 patients who visited the Wonju Severance Christian Hospital from 2007 to 2010 with zygomaticomaxillary fractures, among whom 15 patients met the inclusion criteria. RESULTS: We used a Dingman elevator and K-wire simultaneously to manage this type of zygomatic arch fracture. Simple medial rotation force usually collapses the posterior fractured segment, and the fracture becomes unstable. Thus, the posterior fracture segment must be concurrently elevated with a Dingman elevator through Keen's approach with rotation force applied through the K-wire. All fractures were reduced without any instability using this method. CONCLUSION: We were able to reduce unstable and difficult zygomatic arch fractures without an open incision or any external fixation device.
Elevators and Escalators* ; External Fixators ; Facial Bones ; Facial Injuries ; Gangwon-do ; Humans ; Maxillofacial Injuries ; Retrospective Studies ; Zygoma* ; Zygomatic Fractures

BACKGROUND: The zygoma is the most prominent portion of the face. Almost all simple zygomatic arch fractures are treated in a closed fashion with a Dingman elevator. However, the open approach should be considered for unstable zygomatic arch fractures. The coronal approach for a zygomatic arch fracture has complications. In this study, we introduce our method to reduce a special type of unstable zygomatic fracture. METHODS: We retrospectively reviewed zygomatic arch view and facial bone computed tomography scans of 424 patients who visited the Wonju Severance Christian Hospital from 2007 to 2010 with zygomaticomaxillary fractures, among whom 15 patients met the inclusion criteria. RESULTS: We used a Dingman elevator and K-wire simultaneously to manage this type of zygomatic arch fracture. Simple medial rotation force usually collapses the posterior fractured segment, and the fracture becomes unstable. Thus, the posterior fracture segment must be concurrently elevated with a Dingman elevator through Keen's approach with rotation force applied through the K-wire. All fractures were reduced without any instability using this method. CONCLUSION: We were able to reduce unstable and difficult zygomatic arch fractures without an open incision or any external fixation device.
Elevators and Escalators* ; External Fixators ; Facial Bones ; Facial Injuries ; Gangwon-do ; Humans ; Maxillofacial Injuries ; Retrospective Studies ; Zygoma* ; Zygomatic Fractures