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Correction of Lip Canting Using Bioabsorbables during Orthognathic Surgery.

Maxillofacial Plastic and Reconstructive Surgery.2014;36(4):178-183.

Lip canting is associated with facial asymmetry, and is one of the most challenging problems in surgical correction of facial deformities. The author corrected lip canting using bioabsorbable devices during orthognathic surgery. Soft tissue suspension procedures were performed on four patients with facial asymmetry. Lip lines improved for all patients. Over an observation period of five years, no complications were noted, nor did any late relapse develop. Furthermore, as time past, the effect of the Endotine suspension procedure increased probably due to induction of fibrosis on surrounding soft tissues.
Congenital Abnormalities ; Facial Asymmetry ; Fibrosis ; Humans ; Lip* ; Orthognathic Surgery* ; Recurrence

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A clinical evaluation of botulinum toxin-A injections in the temporomandibular disorder treatment.

Hyun Suk KIM ; Pil Young YUN ; Young Kyun KIM

Maxillofacial Plastic and Reconstructive Surgery.2016;38(1):5-. doi:10.1186/s40902-016-0051-7

BACKGROUND: This study clinically evaluated the effect of botulinum toxin type A (BTX-A) in the temporomandibular disorder (TMD) treatment using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). METHODS: A total of 21 TMD patients were recruited to be treated with BTX-A injections on the bilateral masseter and temporalis muscles and were followed up by an oral and maxillofacial surgeon highly experienced in the TMD treatment. For each patient, diagnostic data gathering were conducted according to the RDC/TMD. Characteristic pain intensity, disability points, chronic pain grade, depression index, and grade of nonspecific physical symptoms were evaluated. Wilcoxon signed-rank test was applied for statistical analysis. RESULTS: The results showed that more than half of the participants (85.7 %) had parafunctional oral habits such as bruxism or clenching. In comparison between pre- and post-treatment results, graded pain score, characteristic pain intensity, disability points, chronic pain grade, and grade of nonspecific physical symptoms showed statistically significant differences after the BTX-A injection therapy (p < 0.05). Most patients experienced collective decrease in clinical manifestations of TMD including pain relief and improved masticatory functions after the treatment. CONCLUSIONS: Within the limitation of our study, BTX-A injections in masticatory musculatures of TMD patients could be considered as a useful option for controlling complex TMD and helping its associated symptoms.
Botulinum Toxins, Type A ; Bruxism ; Chronic Pain ; Depression ; Humans ; Muscles ; Oral and Maxillofacial Surgeons ; Temporomandibular Joint Disorders*

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

Kazuhiro TOMINAGA ; Manabu HABU ; Hiroki TSURUSHIMA ; Osamu TAKAHASHI ; Izumi YOSHIOKA

Maxillofacial Plastic and Reconstructive Surgery.2016;38(1):4-. doi:10.1186/s40902-016-0050-8

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.
Computer-Aided Design ; Congenital Abnormalities ; Facial Asymmetry* ; Humans ; Jaw ; Methods ; Orthognathic Surgery ; Osteotomy ; Splints*

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Retrospective study on factors affecting the prognosis in oral cancer patients who underwent surgical treatment only.

Byeong Guk KIM ; Jun Hwa KIM ; Myung In KIM ; Jeong Joon HAN ; Seunggon JUNG ; Min Suk KOOK ; Hong Ju PARK ; Sun Youl RYU ; Hee Kyun OH

Maxillofacial Plastic and Reconstructive Surgery.2016;38(1):3-. doi:10.1186/s40902-015-0047-8

BACKGROUND: This study was performed to evaluate their 5-year survival rates and identify the factors affecting the prognosis of oral cancer patients who had undergone surgical treatment only. METHODS: Among 130 patients who were diagnosed with malignant tumor of oral, maxillofacial, and surgical treated in the Department of Oral and Maxillofacial Surgery at Chonnam National University Hospital within a period from January 2000 to December 2010, for 11 years, 84 patients were investigated who were followed up for more than 5 years after radical surgery; oral cancer is primary and received only surgical treatment. The survival rate according to gender, age, type and site of cancer, TNM stage, cervical lymph node metastasis and its stage, recurrence or metastasis, time of recurrence and metastasis, and differentiation were investigated and analyzed. RESULTS: Overall, 5-year survival rate in patients who received only surgical treatment was 81.2 %, and disease-specific 5-year survival rate was 83.1 %. The disease-specific 5-year survival rate based on TNM stage, metastasis of cervical lymph node, N stage, and presence of recurrence/metastasis was a significant difference (p < 0.05). The disease-specific 5-year survival rate based on sex, age, type of tumor, primary site, and differentiation was not a significant difference (p > 0.05). CONCLUSIONS: These results suggest that good survival rate can be obtained with surgical treatment only, and stage of oral cancer, cervical lymph node metastasis and stage, recurrence or metastasis, time of recurrence, and metastasis have a significant effect on survival rate in oral cancer patients.
Humans ; Jeollanam-do ; Lymph Nodes ; Mouth Neoplasms* ; Neoplasm Metastasis ; Prognosis* ; Recurrence ; Retrospective Studies* ; Surgery, Oral ; Survival Rate

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Computer-aided design/computer-aided manufacturing of hydroxyapatite scaffolds for bone reconstruction in jawbone atrophy: a systematic review and case report.

Umberto GARAGIOLA ; Roberto GRIGOLATO ; Rossano SOLDO ; Marco BACCHINI ; Gianluca BASSI ; Rachele RONCUCCI ; Sandro DE NARDI

Maxillofacial Plastic and Reconstructive Surgery.2016;38(1):2-. doi:10.1186/s40902-015-0048-7

BACKGROUND: We reviewed the biological and mechanical properties of porous hydroxyapatite (HA) compared to other synthetic materials. Computer-aided design/computer-aided manufacturing (CAD/CAM) was also evaluated to estimate its efficacy with clinical and radiological assessments. METHOD: A systematic search of the electronic literature database of the National Library of Medicine (PubMed-MEDLINE) was performed for articles published in English between January 1985 and September 2013. The inclusion criteria were (1) histological evaluation of the biocompatibility and osteoconductivity of porous HA in vivo and in vitro, (2) evaluation of the mechanical properties of HA in relation to its porosity, (3) comparison of the biological and mechanical properties between several biomaterials, and (4) clinical and radiological evaluation of the precision of CAD/CAM techniques. RESULTS: HA had excellent osteoconductivity and biocompatibility in vitro and in vivo compared to other biomaterials. HA grafts are suitable for milling and finishing, depending on the design. In computed tomography, porous HA is a more resorbable and more osteoconductive material than dense HA; however, its strength decreases exponentially with an increase in porosity. CONCLUSIONS: Mechanical tests showed that HA scaffolds with pore diameters ranging from 400 to 1200 mum had compressive moduli and strength within the range of the human craniofacial trabecular bone. In conclusion, using CAD/CAM techniques for preparing HA scaffolds may increase graft stability and reduce surgical operating time.
Atrophy* ; Biocompatible Materials ; Durapatite* ; Humans ; In Vitro Techniques ; Methods ; National Library of Medicine (U.S.) ; Porosity ; Transplants

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Radiographic study of the distribution of maxillary intraosseous vascular canal in Koreans.

Juhyon LEE ; Nara KANG ; Young Mi MOON ; Eun Kyoung PANG

Maxillofacial Plastic and Reconstructive Surgery.2016;38(1):1-. doi:10.1186/s40902-015-0045-x

BACKGROUND: This study aimed to investigate the distribution and prevalence of intraosseous loop (anastomosis between posterior superior alveolar artery and infraorbital artery) in Koreans detected on computed tomography (CT) images taken prior to sinus augmentation surgery. METHODS: From the 177 patients who underwent sinus augmentation with lateral approach at Ewha Womans University Department of Implant Dentistry, 284 CT scans were evaluated. The canal height (CH), ridge height (RH), and canal height from the sinus floor (CHS) were measured on para-axial views at the first premolar, first molar, and second molar. The horizontal positions of the bony canals in the lateral wall were also classified. One-way analysis of variance (ANOVA) and t test were used to estimate the statistical differences (p < 0.05). RESULTS: The intraosseous loops were detected in 92 CT scans (32 %). The mean vertical height of the bony canals from the alveolar crest (CH) was 23.45 +/- 2.81, 15.92 +/- 2.65, and 16.61 +/- 2.92 mm at the second premolar, first molar, and second molar, respectively. In the horizontal positions of the bony canals, intraosseous type was the most predominant. The canal heights more than 15 mm and less than 17 mm were most prevalent (33.7 %) and those under 13 mm were 12.0 %. CONCLUSIONS: The radiographic findings in this study could be used to decide the lateral osteotomy line avoiding potential vascular complication. However, only one third of the canals could be detected in CT scans; a precaution should be taken for the possibility of severe bleeding during lateral osteotomy.
Arteries ; Bicuspid ; Dentistry ; Female ; Hemorrhage ; Humans ; Maxillary Artery ; Molar ; Osteotomy ; Prevalence ; Tomography, X-Ray Computed

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Decompression Device Using a Stainless Steel Tube and Wire for Treatment of Odontogenic Cystic Lesions: A Technical Report.

Eun Joo JUNG ; Jin A BAEK ; Dae Ho LEEM

Maxillofacial Plastic and Reconstructive Surgery.2014;36(6):308-310.

Decompression is considered an effective treatment for odontogenic cystic lesions in the jaw. A variety of decompression devices are successfully used for the treatment of keratocystic odontogenic tumors, radicular cysts, dentigerous cysts, and ameloblastoma. The purpose of these devices is to keep an opening between the cystic lesion and the oral environment during treatment. The aim of this report is to describe an effective decompression tube using a stainless steel tube and wire for treatment of jaw cystic lesions.
Ameloblastoma ; Decompression* ; Dentigerous Cyst ; Jaw ; Jaw Cysts ; Odontogenic Cysts* ; Odontogenic Tumors ; Radicular Cyst ; Stainless Steel*

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Undifferentiated Pleomorphic Sarcoma in Mandible.

Chul Hwan KIM ; Jong Won JANG ; Moon Young KIM ; Yong Hwan KIM ; Hang Gul KIM ; Joo Hwan KIM

Maxillofacial Plastic and Reconstructive Surgery.2014;36(6):303-307.

Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma, occurs commonly in the soft tissues in adult, but is rare in the maxillofacial region. It consists of undifferentiated mesenchymal tumor cells resembling histiocytes and fibroblasts. The purpose of this article is to report a case of UPS in the mandible. A 44-year-old patient presented with a painful growing mass in the mandible of two months' duration. Computed tomography and positron emission tomography-computed tomography revealed an ill-defined heterogenous, hypermetabolic mass about 4 cm in size in the left mandible invading adjacent soft tissues. A left mandiblulectomy and reconstruction with a fibular free flap were performed. Immunohistochemical study gave a diagnosis of UPS. The patient was referred for adjuvant chemotherapy after surgical removal of the tumor.
Adult ; Chemotherapy, Adjuvant ; Diagnosis ; Electrons ; Fibroblasts ; Free Tissue Flaps ; Histiocytes ; Histiocytoma, Malignant Fibrous ; Humans ; Mandible* ; Sarcoma*

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Defatting Vestibuloplasty for Functional and Esthetic Reconstruction of Tongue.

Si Yeok PARK ; Min Keun KIM ; Seong Gon KIM ; Kwang Jun KWON ; Jin Soo BYUN ; Chan Jin PARK ; Young Wook PARK

Maxillofacial Plastic and Reconstructive Surgery.2014;36(6):298-302.

The radial forearm free flap (RFFF) is a thin and pliable tissue with many advantages for tongue reconstruction. However, tongues reconstructed with RFFF occasionally need revision surgery because inadequate defect measurement at primary surgery can lead to bulkiness and limited movement of reconstructed tongue. In this case, the patient underwent partial glossectomy and RFFF reconstruction for treatment of tongue cancer five years prior. We could not make a lower denture for the patient, because the alveolo-lingual sulcus of tongue was almost lost. So we performed vestibuloplasty with a modified Kazanjian method on the lingual vestibule of the mandibular right posterior area, and defatting surgery to debulk the flap. After surgery, we observed that the color and texture of the revised tongue changed to become similar with adjacent tissue. The patient obtained a more functional and esthetic outcome. Accordingly, we present a case report with a review of relevant literature.
Dentures ; Forearm ; Free Tissue Flaps ; Glossectomy ; Humans ; Tongue Neoplasms ; Tongue* ; Vestibuloplasty*

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Nevoid Basal Cell Carcinoma Syndrome: A Case Report and Review of Korean Cases.

Eun Joo JUNG ; Hyokeun SHIN ; Jin A BAEK ; Dae Ho LEEM ; Seung O KO

Maxillofacial Plastic and Reconstructive Surgery.2014;36(6):292-297.

Nevoid basal cell carcinoma syndrome (NBCCS) is a rare autosomal genetic disease caused by a PTCH mutation. The disease is characterized by multiple basal cell carcinomas of the skin, multiple keratocystic odontogenic tumors (KCOTs) in the jaw, palmar and/or plantar pits, bifid ribs, ectopic calcification of the falx cerebri, and skeletal abnormalities. Early diagnosis is difficult in many cases because there may be a number of systemic symptoms. The purpose of this study is to report the case of a 12-year-old girl who was hospitalized with multiple KCOTs that occurred in the upper and lower jaws. Through characteristic clinical symptoms and radiologic findings, she was finally diagnosed as having NBCCS. This study also aims to organize the symptoms often observed in Korea using previously published case reports to provide useful information for the early diagnosis of NBCCS.
Basal Cell Nevus Syndrome* ; Carcinoma, Basal Cell ; Child ; Early Diagnosis ; Female ; Humans ; Jaw ; Korea ; Odontogenic Cysts ; Odontogenic Tumors ; Ribs ; Skin

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