The treatment of intraosseous ateriovenous malformation in the jaw is difficult because of life threatening frequent bleeding tendency. The surgical resection of AVM may be mortal due to massive blood loss .In the growing pediatric patient, surgery may cause facial deformity and growth disturbance. So currently, the treatment of AVM is only embolization using various material through endovascular access, direct-puncture or embolization in conjunction with surgical resection. We report a case of combined techniques.
Congenital Abnormalities ; Hemorrhage ; Humans ; Jaw ; Mandible*

Nowadays facial skeletal contouring which have developed in craniofacial surgery, acquired popularity in aesthetic surgery. On planning aesthetic surgery, patient's desire must be considered first but it seems to be essential to have an objective standard of facial form. Anthropometric analysis, cephalometric analysis, and photogrammetric analysis were developed for this purpose but with a limitation in three dimensional analysis. Barnett and Whitaker(1986) developed a simple three dimensional analytic system of middle and lower face and reported average values and standard deviations for young Caucasian women. We performed the same analysis for age matched young Korean women and found some difference between young Caucasian women and young Korean women as follows; 1. Young Korean women's middle and lower face is wider than young Caucasian women's face in horizontal dimension. 2. Young Korean women's middle and lower face is shorter than young Caucasian women's face in anterior-posterior dimension. 3. The difference in vertical dimension between the two groups is minimal. 4. In angular relationship, young Korean women's anterior and inferior angles are larger than young Caucasian women's angles. These findings are coincident with other author's observations that Oriental face is wider and rounder than Caucasian face and Orientals have more prominent malar area and mandible angle. For Korean people, with many needs for aesthetic correction of prominent zygoma and mandible angle, this three dimensional analytic system will be useful in planning surgery and research for middle and lower face deformities.
Congenital Abnormalities ; Female ; Humans ; Mandible ; Vertical Dimension ; Zygoma

Nowadays facial skeletal contouring which have developed in craniofacial surgery, acquired popularity in aesthetic surgery. On planning aesthetic surgery, patient's desire must be considered first but it seems to be essential to have an objective standard of facial form. Anthropometric analysis, cephalometric analysis, and photogrammetric analysis were developed for this purpose but with a limitation in three dimensional analysis. Barnett and Whitaker(1986) developed a simple three dimensional analytic system of middle and lower face and reported average values and standard deviations for young Caucasian women. We performed the same analysis for age matched young Korean women and found some difference between young Caucasian women and young Korean women as follows; 1. Young Korean women's middle and lower face is wider than young Caucasian women's face in horizontal dimension. 2. Young Korean women's middle and lower face is shorter than young Caucasian women's face in anterior-posterior dimension. 3. The difference in vertical dimension between the two groups is minimal. 4. In angular relationship, young Korean women's anterior and inferior angles are larger than young Caucasian women's angles. These findings are coincident with other author's observations that Oriental face is wider and rounder than Caucasian face and Orientals have more prominent malar area and mandible angle. For Korean people, with many needs for aesthetic correction of prominent zygoma and mandible angle, this three dimensional analytic system will be useful in planning surgery and research for middle and lower face deformities.
Congenital Abnormalities ; Female ; Humans ; Mandible ; Vertical Dimension ; Zygoma

Humans ; Incisor ; Mandible ; Rare Diseases ; Tooth Crown ; abnormalities ; Tooth, Impacted

Dear Editor, Reconstruction of mandibular defects resulting from ablative surgery for benign and malignant tumors remains a reconstructive challenge. For the past decade, the fibular free flap has been the workhorse for large mandibular defects because of its length, versatility, and ability to be harvested with a skin paddle for soft tissue closure. Although its success rate has continuously improved to almost 95%, donor site morbidity remains a matter of concern.1,2 Bone grafts are already widely used in dental surgery but only as fillers for chipped or marginal defects and not for large segmental mandibular defects. We present a new technique of reconstructing segmental mandibular defects using bone grafts combined with autologous platelet-rich fibrin (PRF), a biomaterial derived intra-operatively from the patient that incorporates leukocytes, platelets, growth factors, and a wide range of glycoproteins in a dense fibrin matrix. Moreover, we describe the essential role of PRF in bone healing and regeneration that offers an invaluable reconstructive option that is free of donor site morbidity without sacrificing the main goal of reconstruction in restoring both form and function.
Human ; Male ; Adult ; Mandible ; Fibrin ; Bone Transplantation ; abnormalities

Objective: To present the case of a midline Tessier 30 cleft in a baby boy who initially underwent a glossoplasty, cheiloplasty and mentoplasty. Methods: Design: Case Report. Setting: Tertiary Government Training Hospital. Patient: One. Result: A 4-month-old boy with a complete midline cleft of the lower lip, alveolus and mandible, and bifid distal tongue that was fused with the floor of the mouth, underwent glossoplasty, cheiloplasty and mentoplasty with subsequent excellent aesthetic outcome and normal oral competency. Conclusion Tessier 30 is a rare congenital midline mandibular cleft. Prompt glossoplasty, cheiloplasty and mentoplasty can correct the gross deformity, restore oral competency, and address functional needs such as feeding, swallowing and early speech development. Future bony repair will hopefully complete the reconstruction.
Mandible ; Cleft Lip ; Tongue Diseases ; Jaw Abnormalities ; Plastic Surgery Procedures

Bone Plates ; Humans ; Mandible ; abnormalities ; surgery ; Reconstructive Surgical Procedures

OBJECTIVETo analyze the asymmetry of measurements in facial asymmetry patients with skull positioning posterior-anterior radiographs after orthodontic-orthognathic treatment.

METHODSPosterior-anterior cephalometric radiography and cephalometric analysis were performed in forty-five patients with different degrees of facial asymmetry. A single sample t-test was conducted to compare the asymmetry of measurements before treatment and individual normal occlusion. The measurement and reference values in facial asymmetry patients who underwent orthodontic-orthognathic treatment were summated by analyzing the correlation coefficient. The paired t-test was employed to compare the difference between the two groups before and after the treatment.

RESULTSFourteen measurements were significantly different before the treatment and individual normal occlusion (P < 0.05). Me[X] exhibited a higher correlation index of Ag[X] in forty-five cases. Twenty-eight patients showed the main asymmetry in the mandibular body, whereas fifteen patients in the ramus. Two patients showed the main asymmetry in both mandibular body and ramus. Fifteen measurements were significantly different before and after the treatment (P < 0.05).

CONCLUSIONFacial asymmetry is mainly concentrated in one-third of the surface, primarily manifested in the mandibular body. Orthodontic-orthognathic treatment is preferred when Ag[X] is greater than the minimum reference value of 11.31%, Go[X] is greater than 9.79%, and Me[X] is greater than 5.2 mm.

OBJECTIVEA surgical procedure was developed to improve the operative results for bilateral mandibular prominence with microgenia.

METHODSThrough an oral approach the bilateral prominent mandibular angles were resected using the technique of continuous curve-line ostectomy with the masseteric muscle intact. Meanwhile, the chin was elongated and moved forward by horizontal osteotomy. The distal part of the chin was rigid fixed with miniplates and screws, and the bone gaps were filled with autogenous bone of the resected mandibular angle.

RESULTSFrom November 1996 to August 1999, 20 cases of bilateral mandibular angle prominence with microgenia were corrected with this procedure. The postoperative appearance was improved greatly after 3-6 months. The lower face was not only narrowed but elongated, and consequently in harmony with the upper and middle face.

CONCLUSIONBilateral continuous curve-line mandibular angle ostectomy together with chin osteotomy and autogenous bone graft is a good procedure for the management of the above-mentioned deformities.

Purpose: To propose an objective method for evaluating the craniofacial asymmetry in congenital muscular torticollis patients, and to determine the correlation between the craniofacial asymmetry and clinical parameters such as age and the limitation of neck motion. Materials and Methods: Forty eight patients with congenital muscular torticollis, who underwent cephalometry for an evaluation, were enrolled in this study. The craniofacial curvature on the coronal plane, calvarial asymmetry, and mastoid process length were analyzed on the radiograph of the cephalometry. These radiographic measurements were analyzed to determine the correlation between the craniofacial asymmetry and clinical parameters. Results: The craniofacial axis was tilted to the affected side by 5.2degrees+/-2.8degrees. The skullbase axis was tilted to the affected side by 2.6degrees+/-2.6degrees, and the mandible axis was tilted to the affected side by 1.0degrees+/-2.3degrees. The difference in the mastoid process length from the skullbase was 7.0%+/-8.5%. The calvarial width from the vertical midline was 15.4%+/-11.6% larger in the affected side. In patients older than 5 years, the mandibular tilting angle (p=0.017) and the length of the mastoid process (p=0.007) were greater than those of the younger patients. Conclusion: We proposed a new objective method for quantifying the craniofacial asymmetry in congenital muscular torticollis patients. This method confirmed the patients to have an angular deformity and asymmetry in the craniofacial bone.
Axis ; Cephalometry* ; Congenital Abnormalities ; Humans ; Mandible ; Mastoid ; Neck ; Torticollis*