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Surgical excision of osteochondroma on mandibular condyle via preauricular approach with zygomatic arch osteotomy.

Sang Hoon PARK ; Jun Hyeong AN ; Jeong Jun HAN ; Seunggon JUNG ; Hong Ju PARK ; Hee Kyun OH ; Min Suk KOOK

Maxillofacial Plastic and Reconstructive Surgery.2017;39(10):32-. doi:10.1186/s40902-017-0129-x

BACKGROUND: Osteochondroma is a benign tumor that tends to develop in mandibular condyle and coronoid process in the craniofacial region. If tumor mass has grown from condyle into the infratemporal space with zygomatic arch obstructing the access, there are risks associated with surgical exposure and local resection of these masses. CASE PRESENTATION: This study reports on a case of osteochondroma on mandibular condylar head where we treated with surgical excision via preauricular approach with 3D analysis. After the local resection, there were no surgical and post-operative complications until 8-month follow-up period. CONCLUSIONS: In local excision of osteochondroma, our method is a minimally invasive method. It is a good example of osteochondroma treatment.
Follow-Up Studies ; Head ; Mandibular Condyle* ; Methods ; Osteochondroma* ; Osteotomy* ; Zygoma*

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Evaluation of mandibular lingula and foramen location using 3-dimensional mandible models reconstructed by cone-beam computed tomography.

Cong ZHOU ; Tae Hyun JEON ; Sang Ho JUN ; Jong Jin KWON

Maxillofacial Plastic and Reconstructive Surgery.2017;39(10):30-. doi:10.1186/s40902-017-0128-y

BACKGROUND: The positions of the mandibular lingula and foramen have been set as indexes for inferior alveolar nerve (IAN) block and ramus osteotomies in orthognathic surgery. This study aimed to evaluate the anatomical structures of mandibular ramus, especially the mandibular lingula and foramen, by analyzing the cone-beam computed tomography (CBCT) data of young adults. METHODS: We evaluated 121 sides of hemi-mandibular CBCT model of 106 patients (51 male and 55 female patients; 18 to 36 years old). All the measurements were performed using the 2- and 3-dimensional rulers of OnDemand3D® software. RESULTS: Statistical analysis of the data revealed that there was no significant difference in the mandibular angle between the genders. The mandibular lingula was found to be located at the center of ramus in males, but a little posterior in relation to the center in females. The mandibular lingula was rarely located below the occlusal plane; however, the position of the mandibular foramen was more variable (84.3% below, 12.4% above, and 3.3% at the level of the occlusal plane). CONCLUSIONS: The results of this study provide a valuable guideline for IAN block anesthesia and orthognathic surgery. CBCT can be considered effective and accurate in evaluating the fine structures of the mandible.
Anesthesia ; Cone-Beam Computed Tomography* ; Dental Occlusion ; Female ; Humans ; Male ; Mandible* ; Mandibular Nerve ; Orthognathic Surgery ; Osteotomy ; Young Adult

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Intentional partial odontectomy—a long-term follow-up study.

Hyun Suk KIM ; Pil Young YUN ; Young Kyun KIM

Maxillofacial Plastic and Reconstructive Surgery.2017;39(10):29-. doi:10.1186/s40902-017-0127-z

BACKGROUND: The surgical extraction of the third molar is the most frequently encountered procedure in oral and maxillofacial surgery and is related with a variety of complications. This study examined the efficacy of intentional partial odontectomy (IPO) in the third molars which have no periapical lesions and are located near important anatomical structures such as inferior alveolar nerve. METHODS: Seven patients (four males, three females, 39.1 ± 11.6 years), who received IPO to reduce the risk of inferior alveolar nerve injury (IANI), were followed long-term. The treated teeth were horizontally impacted third molars in the mandibular left (n = 5) or mandibular right (n = 4) areas and were all ankylosed with the surrounding alveolar bone. During the IPO, the bone around the crown was removed to expose the crown, and then the tooth was resected at cement-enamel junction (CEJ). Any secondary trauma to the healthy root was minimized and remained intact after primary suture. RESULTS: The mean follow-up time was 63.2 ± 29.8 months, and all sites showed good bone healing after the crown removal. Also, sensory abnormality was not found in any patients after IPO. In one patient, the bone fragments erupted 4 months after IPO. In other patient, an implant placed on second molar site adjacent to the third molar that received IPO was explanted about 2 years after the patient’s persistent discomfort. CONCLUSIONS: In case where high risk of IANI exists, IPO may be chosen alternatively to surgical extraction to reduce the risk of nerve damage. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40902-017-0127-z) contains supplementary material, which is available to authorized users.
Compassion Fatigue ; Crowns ; Female ; Follow-Up Studies* ; Humans ; Hypercementosis ; Male ; Mandibular Nerve ; Molar ; Molar, Third ; Surgery, Oral ; Sutures ; Tooth ; Tooth Ankylosis ; Tooth Extraction

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Effectiveness of Computed Tomography for Blow-out Fracture.

Seung Hyun RHEE ; Tae Seup KIM ; Jae Min SONG ; Sang Hoon SHIN ; Jae Yeol LEE

Maxillofacial Plastic and Reconstructive Surgery.2014;36(6):273-279.

PURPOSE: This study assessed the association between eye symptoms (enophthalmos or diplopia) and site of damage, volume, deviated inferior rectus muscle (IRM) and type of fracture with computed tomography (CT). The intent is to anticipate the prognosis of orbital trauma at initial diagnosis. METHODS: Forty-five patients were diagnosed with fractures of the inferior wall of one orbit. Fracture area, volume of displaced tissue, deviated IRM, and type of fracture were evaluated from coronal CT by one investigator. The association of those variables with the occurrence of eye symptoms (diplopia and enophthalmos) was assessed. RESULTS: Of 45 patients, 27 were symptom-free (Group A) and 18 had symptoms (Group B) of enophthalmos and/or diplopia. In Group B, 12 had diplopia, one was enophthalmos, and five had both. By CT measurement, group A mean area was 192.6 mm2 and the mean volume was 673.2 mm3. Group B area was 316.2 mm2 and volume was 1,710.6 mm3. The volume was more influential on symptom occurrence. Each patient was categorized into four grades depending on the location of IRM. Symptom occurrence and higher grade were associated. Twenty-six patients had trap-door fracture (one side, attached to the fracture), and 19 had punched-out fracture (both sides detached). The punched-out fracture was more strongly associated with symptoms and had statistically significantly higher area and volume. CONCLUSION: In orbital trauma, measurement of fracture area and volume, evaluation of the deviated IRM and classification of the fracture type by coronal CT can effectively predict prognosis and surgical indication.
Classification ; Diagnosis ; Diplopia ; Enophthalmos ; Humans ; Orbit ; Orbital Fractures* ; Prognosis ; Research Personnel

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The Retrospective Study of Closed Reduction of Nasal Bone Fracture.

Han Kyul PARK ; Jae Yeol LEE ; Jae Min SONG ; Tae Seup KIM ; Sang Hun SHIN

Maxillofacial Plastic and Reconstructive Surgery.2014;36(6):266-272.

PURPOSE: This study was conducted in order to investigate the therapeutic effect of closed reduction according to a classification in patients with nasal bone fracture. METHODS: The study was conducted retrospectively on 186 patients with a mean age of 38 years (range: 7 to 80 years). All patients were diagnosed by clinical and radiologic examination, and then classified according to Hwang's classification by computed tomography. The patients were further classified by their age, gender, causes of fracture, operation timing after fracture, concurrent facial bone fracture, and complications. All patients underwent the same reduction and treatment protocol and were then followed up regularly for at least three months. RESULTS: The cause of the fracture was slip down, and the highest prevalence was shown in the 20s. The mean operation timing after fracture was 4.1 days (range: 1 to 14 days), and it tended to be longer in the case of defected septal bone or more severe fracture. The most common concurrent facial bone fracture was orbital blow-out fracture, and zygomaticomaxillary complex and maxillary fracture occured frequently. The largest number of complications occurred in class III and IIBs patients, and the main complication was postoperative pain. CONCLUSION: Results of nasal bone closed reduction on the 186 patients showed that serious complications rarely occurred. Closed reduction is generally an effective treatment for nasal bone fracture. However, in the case of severe concurrent septal bone fracture or comminuted fracture with depression, open reduction should be considered. Further study with a larger number of patients and further classification is required.
Classification ; Clinical Protocols ; Depression ; Facial Bones ; Fractures, Bone ; Fractures, Comminuted ; Humans ; Maxillary Fractures ; Nasal Bone* ; Orbit ; Orbital Fractures ; Orthopedics ; Pain, Postoperative ; Prevalence ; Retrospective Studies*

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Anatomical and Functional Recovery of Intracapsular Fractures of the Mandibular Condyle: Analysis of 124 Cases after Closed Treatment.

Jong Sung LEE ; Eun Gyu JEON ; Guk Jin SEOL ; So Young CHOI ; Jin Wook KIM ; Tae Geon KWON ; Jun Young PAENG

Maxillofacial Plastic and Reconstructive Surgery.2014;36(6):259-265.

PURPOSE: The purpose of this study is to evaluate the influence of intracapsular fracture lines of the mandibular condyle on the anatomical and functional recovery after non-surgical closed treatment. METHODS: Clinical and radiological follow-up of 124 patients with intracapsular fractures of the mandibular condyle was performed after closed treatment between 2005 and 2012. The intracapsular fractures were classified into three categories: type A (medial condylar pole fracture), type B (lateral condylar pole fracture with loss of vertical height) and type M (multiple fragments or comminuted fracture). RESULTS: By radiological finding, fracture types B and M lost up to 24% vertical height of the mandibular condyle compared to the height on the opposite side. In Type M, moderate to severe dysfunction was observed in 33% of the cases. Bilateral fractures were significantly associated with the risk of temporomandibular joint (TMJ) dysfunction in fracture types A and B. Bilateral fracture and TMJ dysfunction were not statistically significantly associated in type M fractures. CONCLUSION: Most of the mandibular intracapsular condylar fractures recovered acceptably after conservative non-surgical treatment with functional rehabilitation, even with some anatomical shortening of the condylar height. The poor functional recovery encountered in type M fractures, especially in cases with additional fracture sites and bilateral fractures, points up the limitation of closed treatment in such cases.
Follow-Up Studies ; Humans ; Mandibular Condyle* ; Mandibular Fractures ; Rehabilitation ; Temporomandibular Joint ; Temporomandibular Joint Disorders

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Maxillofacial Trauma Trends at a Tertiary Care Hospital: A Retrospective Study.

Eun Gyu JEON ; Dong Young JUNG ; Jong Sung LEE ; Guk Jin SEOL ; So Young CHOI ; Jung Young PAENG ; Jin Wook KIM

Maxillofacial Plastic and Reconstructive Surgery.2014;36(6):253-258.

PURPOSE: Maxillofacial fractures are rapidly increasing from car accidents, industrial accidents, teenaged criminal activity, and sports injuries. Accurate assessment, appropriate diagnosis, and preparing individual treatment plans are necessary to reduce surgical complications. We investigated recent trends of facial bone fracture by period, cause, and type, with the objective of reducing surgical complications. METHODS: To investigate time trends of maxillofacial fractures, we reviewed medical records from 2,196 patients with maxillofacial fractures in 1981~1987 (Group A), 1995~1999 (Group B), and 2008~2012 (Group C). We analyzed each group, comparing the number of patients, sex ratio, age, fracture site, and etiology. RESULTS: The number of patients in each period was 418, 516, and 1,262 in Groups A to C. Of note is the increase in the number of patients from Group A to C. The sex ratios were 5.6:1, 3.5:1, and 3.8:1 in Groups A, B, and C. The most affected age group for fracture is 20~29 in all three groups. Traffic accidents are the most common cause in Groups A and B, while there were somewhat different causes of fracture in Group C. Sports-induced facial trauma was twice as high in Group C compared with Group A and B. Mandible fracture accounts for a large portion of facial bone fractures overall. CONCLUSION: We observed an increase in facial bone fracture patients at Kyungpook National University Dental Hospital over the years. Although facial injury caused by traffic accidents was still a major cause of facial bone fracture in all periods, the percentage decreased. In recent years, isolated mandible fracture increased but mandible and mid-facial complex fracture decreased, possibly because of a reduction in traffic accidents.
Accidents, Occupational ; Accidents, Traffic ; Athletic Injuries ; Criminals ; Diagnosis ; Facial Bones ; Facial Injuries ; Gyeongsangbuk-do ; Humans ; Mandible ; Maxillofacial Injuries ; Medical Records ; Retrospective Studies* ; Sex Ratio ; Tertiary Healthcare*

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Comparative Study of the Early Loading of Resorbable Blasting Media and Sandblasting with Large-grit and Acid-etching Surface Implants: A Retrospective Cohort Study.

Sung Beom KIM ; Young Kyun KIM ; Su Gwan KIM ; Ji Su OH ; Byung Hoon KIM

Maxillofacial Plastic and Reconstructive Surgery.2014;36(6):247-252.

PURPOSE: This study compares the prognosis (the survival rate and marginal bone loss) of resorbable blasting media (RBM) surface implants and sandblasting with large-grit and acid-etching (SLA) surface implants in the early loading. METHODS: This study targeted 123 patients treated by implants installation from January 2008 to March 2010. The loading was initiated in the maxilla within three to four months and in the mandible within one to two months. The types of restoration were single crown and fixed partial prosthesis. Those functioned over one year. The implants were classified by the surface of implants as Group 1: RBM surface (GS III; OSSTEM, Busan, Korea) and, Group 2: SLA surface (Superline; Dentium, Seoul, Korea). The groups were categorized by maxilla and mandible and compared by survival rate, marginal bone loss through clinical records evaluation, and radiographic measurements. RESULTS: The marginal bone loss in the maxilla was 0.14+/-0.34 mm (Group 1) and 0.30+/-0.37 mm (Group 2), a statistically significant difference (P <0.05). In the mandible those were 0.28+/-0.54 mm (Group 1) and 0.20+/-0.33 mm (Group 2), not significant (P >0.05). There was no significant difference of marginal bone loss between maxilla and mandible by groups. During observation there was no implant failure, a survival rate of 100%. CONCLUSION: Both surfaces showed an excellent survival rate, and the marginal bone loss was not substantial.
Busan ; Cohort Studies* ; Crowns ; Humans ; Immediate Dental Implant Loading ; Mandible ; Maxilla ; Prognosis ; Prostheses and Implants ; Retrospective Studies* ; Seoul ; Survival Rate

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Membranes for the Guided Bone Regeneration.

Sang Woon LEE ; Seong Gon KIM

Maxillofacial Plastic and Reconstructive Surgery.2014;36(6):239-246.

Many kinds of membrane have been used for the guided bone regeneration (GBR) technique. However, most membranes do not fulfill all requirements for the ideal membrane for the GBR technique. Among them, collagen membrane has been most widely used. However, its high price and weak tensile strength in wet condition are limitations for wide clinical application. Synthetic polymers have also been used for the GBR technique. Recently, silk based membrane has been considered as a membrane for the GBR technique. Despite many promising preclinical data for use of a silk membrane, clinical data regarding the silk membrane has been limited. However, silk based material has been used clinically as vessel-tie material and an electrospun silk membrane was applied successfully to patients. No adverse effect related to the silk suture has been reported. Considering that silk membrane can be provided to patients at a cheap price, its clinical application should be encouraged.
Bone Regeneration* ; Collagen ; Humans ; Membranes* ; Polymers ; Silk ; Sutures ; Tensile Strength

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Partial Necrosis of the Mandibular Proximal Segment Following Transoral Vertical Ramus Osteotomy.

Somi KIM ; Sang Yoon KIM ; Gi Jung KIM ; Hwi Dong JUNG ; Young Soo JUNG

Maxillofacial Plastic and Reconstructive Surgery.2014;36(3):131-134.

Transoral vertical ramus osteotomy (TOVRO) procedure can result in a variety of complications. Complications commonly reported include extensive bleeding due to major blood vessel injury, unpredictable fracture, postoperative infection, neurosensory deficit related Inferior alveolar nerve, insufficient osteosynthesis, and temporomandibular joint problem. The authors describe a case of partial necrosis of the mandibular proximal segment following TOVRO, a rarely reported complication. A 37-year-old otherwise healthy woman underwent Lefort l osteotomy and TOVRO to correct mandibular prognathism. Postoperatively, she developed pain and swelling in the right submandibular region and was found to have a partial necrosis of proximal segment.
Adult ; Blood Vessels ; Female ; Hemorrhage ; Humans ; Mandibular Nerve ; Necrosis* ; Orthognathic Surgery ; Osteonecrosis ; Osteotomy* ; Prognathism ; Temporomandibular Joint

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