No abstract available.
Orthognathic Surgery ; Books ; Orthognathic Surgical Procedures ; Cephalometry

Rapid palatal expansion(RPE) with the tooth-born appliance is not sufficient to apply to the patients with periodontal problem or insufficient tooth anchorage, and it leads to tipping of the anchorage teeth and increasing teeth mobility and root resorption. To avoid these disadvantages, we present the case using palatal screws and custommade palatal expander. A 23-year-old patient underwent surgically assisted rapid maxillary expansion with the Hyrax expansion using 4 tent screws. The study models were used to measure the pre-/-post surgical width of the anterior and posterior dental arches with a digital sliding caliper. In the result, the custom-made palatal expander with 4 tent screws is suitable for delivering a force to the mid-palatal suture expansion. And it is low cost, small sized and simply applied. The results indicated that maxillary expansion with the custom-made palatal anchorage device is predictable and stable technique without significant complications in patients.
Dental Arch ; Humans ; Hyraxes ; Palatal Expansion Technique ; Root Resorption ; Sutures ; Tooth ; Young Adult

BACKGROUND: The aim of this study was to investigate the effect of a botulinum toxin type A (BTX-A) injection in the masseter muscle using electromyography (EMG) in an animal model. METHODS: Ten male adult (>3 months of age) New Zealand white rabbits were used. Muscle activity was continuously recorded from 8 hours before to 8 hours after BTX-A injection. The rabbits received unilateral BTX-A injections of either 5 units (group 1, n = 5) or 20 units (group 2, n = 5). RESULTS: The masseter muscle activity of the rabbits was significantly reduced immediately after BTX-A injection (P < 0.05 for both groups). When the results from group 1 were compared with those from group 2, only the peak voltage was significantly decreased in group 2 (P = 0.013). CONCLUSION: Masseter muscle activity measured by EMG was immediately decreased after a BTX-A injection.
Adult ; Botulinum Toxins, Type A* ; Electromyography ; Humans ; Male ; Masseter Muscle* ; Models, Animal* ; Rabbits

BACKGROUND: This study are to identify the symptomatic changes and condylar stability after 2 jaw surgery without preceding treatments for Temporomandibular joints(TMJ) in class III patients with the TMJ symptoms; and to assess therapeutic effect of 2 jaw surgery and the necessity of preceding treatment for alleviation of TMJ symptoms. METHODS: 30 prognathic patients with preexisting TMJ symptoms were divided into 2 groups according to presence or absence of preceding treatments before the surgery. We evaluated symptomatic changes on both TMJ by questionnaires and clinical examinations. And we reconstructed 3D cone beam computed tomography images before 2 jaw surgery, immediately after the surgery, and 6 months or more after the surgery with SimPlant software, and analyzed the stability of condylar position on 3D reconstruction model. Significances were assessed by the Wilcoxon signed rank test on SPSS ver. 20.0. RESULTS: Both groups had favorable changes of TMJ symptoms after orthognathic surgery. And postoperative position of condyle had good stability during follow-up period. CONCLUSION: 2 jaw surgery without preceding treatments for TMD can have therapeutic effect for TMD patients with class III malocclusion.
Cone-Beam Computed Tomography ; Follow-Up Studies ; Humans ; Malocclusion ; Orthognathic Surgery* ; Surveys and Questionnaires ; Temporomandibular Joint

BACKGROUND: The purpose of the study is to compare the effects on the pharyngeal airway space of skeletal anchored face mask with those of tooth-borne facemask. METHODS: We used two types of facemask for maxillary protraction, the tooth-borne facemask (TBFM) and the skeletal anchored facemask (SAFM), and evaluated the effects of each facemask on the pharyngeal airway. Twenty-eight patients (mean age 10.3 years) were treated with the TBFM and 24 patients (mean age 11.2 years) were treated with the SAFM. Lateral cephalometric radiographs were taken before treatment (T1) and after treatment (T2) to assess changes in the dimensions of the upper airway. Statistical analysis was performed with independent t tests, matched t tests, Mann-Whitney U tests, and Kruskal-Wallis tests. RESULTS: There were marked increases in upper airway dimensions in both groups following treatment, but the SAFM group had a significantly greater increase in airway dimensions than the TBFM group. Also, the SAFM subgroups showed more improved airway measurements than the TBFM subgroups in both the superior and inferior pharyngeal airways. CONCLUSIONS: SAFM is more effective than TBFM in increasing upper airway dimensions.
Humans ; Masks ; Methods*

BACKGROUND: The incidence of tongue squamous cell carcinoma (TSCC) in young patients has recently increased, and these TSCCs are believed to be etiologically distinct from those in older patients, who have longer exposure to risk factors such as tobacco and alcohol. The prognosis of TSCCs in young patients remains controversial. METHODS: We retrospectively reviewed the records of 117 patients (2001–2011) who were diagnosed with squamous cell carcinoma of the oral tongue. Patients were divided into two age groups, older (ages over 40) and younger (ages 40 and younger). Data were compared between the two groups, and survival rates were analyzed. RESULTS: The results show that there are significant differences in overall, disease-free, and distant metastasis-free survival rates between the two groups. Five-year overall survival rates were 70% in older patients and 42% in young patients (p = 0.033). Five-year disease-free survival rates were 73% in older patients and 40% in young patients (p = 0.011), and 5-year distant metastasis-free survival rates were 97% in older patients and 62% in young patients (p = 0.033). Multivariate analysis revealed that histologic grade was the only independent risk factor for overall survival in both groups of patients (p = 0.002, HR = 2.287). The analysis also demonstrated that age was the critical risk factor for distant metastasis (p = 0.046, HR = 9.687). CONCLUSION: In this study, young (ages 40 and younger) patients with squamous cell carcinoma of the oral tongue had a higher rate of distant metastasis and a worse prognosis. Accordingly, we propose the necessity of an extensive therapeutic regimen that should be used in all young patients with TSCC.
Carcinoma, Squamous Cell* ; Disease-Free Survival ; Epithelial Cells* ; Humans ; Incidence ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tobacco ; Tongue Neoplasms ; Tongue*

BACKGROUND: The goal of this study is to evaluate complication and effectiveness of alveolar ridge augmentations using a hydroxyapatite-based alloplastic bony substitute with rhBMP-2. METHODS: A total of 10 patients (4 males, 6 females; 58.5 ± 8.6 years) participated in this clinical research. Alveolar ridge augmentations were performed in edentulous (4 maxillary posterior, 5 mandibular posterior, and 1 mandibular anterior) regions. Anorganic bovine bone (ABB; Bio-Oss®, Geistlich Pharma AG, Wolhusen, Switzerland) was used as the bone graft material in the control group (n = 5)) while hydroxyapatite-based alloplastic bony substitute with rhBMP-2(HA+rhBMP-2; NOVOSIS®-Dent, CGBio Inc., Seongnam, Korea) was used in the experimental group (n = 5). In order to evaluate relative changes in bone volume and resorption rate of the bone graft material, CBCT radiographs were taken immediately and at 4 months after the bone graft in all subjects. Among the 10 patients, 8 received dental implants in Seoul National University Bundang Hospital, while the others received in local clinics. Bone specimens for further histomorphometric examinations were gained from these 8 patients using trephine burs during the implant placements. Clinical, radiographic, and histomorphometric evaluations were focused because of the small sample size. RESULTS: When CBCT radiographs were compared between immediately and at 4.07 ± 0.13 months after the bone graft, both alveolar bone widths (ABB 2.52 ± 0.18 mm, HA+rhBMP-2 1.75 ± 0.85 mm) and heights (ABB 1.68 ± 0.17 mm, HA+rhBMP-2 1.57 ± 0.28 mm) increased in the two groups. Resorption rates of transplanted bone graft material in the alveolar bone widths and heights were (ABB 29.7 ± 8.8%, HA+rhBMP-2 31.5 ± 7.4%) and (ABB 39.2 ± 21.8%, HA+rhBMP-2 52.6 ± 6.5%), respectively. Histomorphometrically, ABB group showed bone formation via osteoconduction and HA+rhBMP-2 group via osteoinduction. HA+rhBMP-2 group showed more bone formation around the bone graft materials than the ABB group. Postoperative complications were not found in all subjects. CONCLUSIONS: Our study had following conclusions: (1) Ridge augmentations using HA+rhBMP-2 could be clinically useful to supplement implant placements in edentulous regions. (2) Serious postoperative complications related to the graft material did not occur.
Alveolar Ridge Augmentation ; Bone Morphogenetic Protein 2 ; Bone Regeneration ; Dental Implants ; Durapatite* ; Female ; Gyeonggi-do ; Humans ; Male ; Observational Study* ; Osteogenesis ; Postoperative Complications ; Prospective Studies* ; Sample Size ; Seoul ; Transplants

The prevalence of obstructive sleep apnea (OSA) is estimated to be 1–5% of the adult population world-wide, and in Korea, it is reported at 4.5% of men and 3.2% of women (Age 40 to 69 years old). Active treatment of OSA is associated with decrease in insulin resistance, cardiovascular disease, psychosocial problems, and mortality. Surgical treatment of OSA has evolved in the era of neuromodulation with the advent of hypoglossal nerve stimulation (HGNS). We share this review of HGNS with our maxillofacial surgical colleagues to expand the scope of surgical care for OSA.
Adult ; Cardiovascular Diseases ; Female ; Humans ; Hypoglossal Nerve* ; Insulin Resistance ; Korea ; Male ; Mortality ; Oral and Maxillofacial Surgeons* ; Prevalence ; Sleep Apnea, Obstructive* ; Snoring

BACKGROUND: The impairment of the appearance is a major problem for patients with carcinomas of the oral cavity. These patients want to recover their preoperative facial appearance. Some do not realize that this is not always possible and hence develop a desire for further cosmetic and reconstructive surgery (CRS) which often causes psychological problems. METHOD: The desire of patients for CRS (N = 410; 26%) has been acquired in this DÖSAK rehab study including multiple reasons such as medical, functional, aesthetic and psychosocial aspects. They relate to the parameters of diagnosis, treatment and postoperative rehabilitation. Patients without the wish for CRS (N = 1155; 74%) served as control group. For the surgeons, knowledge of the patient’s views is relevant in the wish for CRS. Nevertheless, it has hardly been investigated for patients postoperatively to complete resection of oral cancer. In this retrospective cross-sectional study, questionnaires with 147 variables were completed during control appointments. Thirty-eight departments of Oral and Maxillofacial Surgery took part, and 1652 German patients at least 6 months after complete cancer resection answered the questions. Additionally, a physician’s questionnaire (N = 1489) was available. Statistical analysis was performed with SPSS vers. 22. RESULTS: The patient’s assessment of their appearance and scarring are the most important criteria resulting in wishes for CRS. Furthermore, functional limitations such as eating/swallowing, pain of the facial muscles, numb regions in the operating field, dealing with the social environment, return to work, tumour size and location, removal and reconstruction are closely related. CONCLUSION: The wish for CRS depends on diverse functional psychosocial and psychological parameters. Hence, it has to be issued during conversation to improve rehabilitation. A decision on the medical treatment can be of greater satisfaction if the surgeon knows the patients’ needs and is able to compare them with the medical capabilities. The informed consent between doctor and patient in regard to these findings is necessary.
Appointments and Schedules ; Cicatrix ; Cross-Sectional Studies ; Depression ; Diagnosis ; Facial Muscles ; Humans ; Informed Consent ; Methods ; Mouth Neoplasms ; Mouth* ; Quality of Life ; Rehabilitation ; Retrospective Studies ; Return to Work ; Social Environment ; Surgeons ; Surgery, Oral ; Surgery, Plastic

BACKGROUND: The conventional transcervical resection for submandibular gland disease has some risks and an unsatisfactory cosmetic result. Recently, robot-assisted surgery has been developed as a plausible substitute for conventional surgery which provides an excellent cosmetic outcome. CASE PRESENTATION: The authors performed robot-assisted sialadenectomy via modified facelift incision using the da Vinci Xi surgical system (Intuitive Surgical Inc., CA, USA) with two endowrist arms (monopolar curved scissors and Maryland bipolar forceps) successfully in a 44-year-old female patient who suffered from sialolith and severe atrophic submandibular gland. CONCLUSIONS: If similar studies are done in the future, this robot-assisted sialadenectomy may become established as an alternative to existing disadvantageous surgical methods.
Adult ; Arm ; Female ; Humans ; Maryland ; Rhytidoplasty* ; Salivary Gland Calculi ; Submandibular Gland Diseases ; Submandibular Gland*