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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Maxillofacial Plastic and Reconstructive Surgery
Journal Basic Information
Journal DOI :
Korean Association of Maxillofacial Plastic and Reconstructive Surgeons
Editor in Chief :
Volume & Issues
Volume 33, Issue 6 - Nov 2011
Volume 33, Issue 5 - Sep 2011
Volume 33, Issue 4 - Jul 2011
Volume 33, Issue 3 - May 2011
Volume 33, Issue 2 - Mar 2011
Volume 33, Issue 1 - Jan 2011
Selecting the target year
Twisting Effect on Supermicroanastomosis of the Superficial Inferior Epigastric Artery in a Rat Model
Seo, Mi-Hyun ; Kim, Soung-Min ; Eo, Mi-Young ; Kang, Ji-Young ; Myoung, Hoon ; Lee, Jong-Ho ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 375~384
Purpose: The advent of microsurgical technique and instruments, particularly in the field of perforator flap and supermicrosurgery, which have expanded the scope of microsurgery. However, supermicroanastomosis without any compression, tension, or distortions must be achieved to reach successful outcomes. Small-caliber vessels, such as those with an internal diameter less than 0.2 mm, are susceptible to inadvertent twisting of the anastomosis. In this study, using the superficial inferior epigastric artery (SIEA)-based flap model in Sprague-Dawley (SD) rats, we evaluated the acceptable limits of twisting effects on supermicroanastomotic sites. Methods: A total of 20 supermicroanastomoses were performed using the SIEA-based flap model in 10 male SD rats, 10-weeks-of-age, weighing 300~350 g. Rats were divided into five groups of two with four flaps as follows: 1) sham, 2) control group with end to end SIEA arterial supermicroanastomosis, 3) experimental I (EA1) with
twisting, 4) experimental II (EA2) with
twisting, and 5) experimental III (EA3) with
twisting of the supermicroanastomosis. Each SIEA was anastomosed using six 11-0
(Ethicon Inc. Co., NJ, USA) stitches except in the sham group where the SIEA was only clamped with Supermicro vascular
(S&T, Neuhausen, Switzerland) for 20 minutes. Results: The anastomosed arterial patency showed no remarkable changes according to doppler waveforms measured with a Smardop 45 Doppler System (Hadeco Inc., Kawasaki, Japan). The pulsatility index (PI) was increased at postoperative day 10 in the EA2 and EA3 groups, and the resistance index (RI) showed no statistically significant difference between preoperative and postoperative values at 10 days. Histologic specimens from the EA3 group showed increased tunica media necrosis, convolution of the internal elastic lamina, densely packed platelets, fibrin, and erythrocytes. Flap viability and anastomosed vessel patency were not significantly affected by the degree of arterial twisting in this study, other than in the EA3 group where minor effects on arterial patency of the microanastomoses were encountered. Conclusion: It appears that minor twisting on small caliber arteries, used in supermicroanastomoses, can be tolerated. However, twisting should be avoided as much as possible, and more than
twisting must be prevented in clinical practice.
Use of Peristeum as a Source of Endothelial-like Cells
Park, Bong-Wook ; Kim, Shin-Won ; Kim, Uk-Kyu ; Hah, Young-Sool ; Kim, Jin-Hyun ; Kim, Deok-Ryong ; Sung, Iel-Young ; Cho, Yeong-Cheol ; Son, Jang-Ho ; Kim, Jong-Ryoul ; Byun, June-Ho ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 385~391
Purpose: The periosteum is a well-known source of osteogenic precursor cells for tissue-engineered bone formation. However, cultured endothelial or endothelial-like cells derived from periosteum have not yet been investigated. This study focused on endothelial-like cell culture from the periosteum. Methods: Periosteal tissues were harvested from the mandible during surgical extraction of lower impacted third molars. The tissues were treated with 0.075% type I collagenase in phosphate-buffered saline (PBS) for 1 hr at
to release cellular fractions. The collagenase was inactivated with an equal volume of DMEM/10% fetal bovine serum (FBS) and the infranatant was centrifuged for 10 min at 2,400 rpm. The cellular pellet was filtered through a
nylon cell strainer, and the filtered cells were centrifuged for 10 min at 2,400 rpm. The resuspended cells were plated into T25 flasks and cultured in endothelial cell basal medium (EBM)-2. Results: Among the hematopoietic markers, CD146 was more highly expressed than CD31 and CD34. The periosteal-derived cells also expressed CD90 and CD166, mesenchymal stem cell markers. Considering that the expression of CD146 was constant and that the expression of CD90 was lower at passage 5, respectively, the CD146 positive cells in passage 5 were isolated using the magnetic cell sorting (MACS) system. These CD146 sorted, periosteal-derived cells formed tube-like structures on Matrigel. The uptake of acetylated, low-density lipoprotein, labeled with 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI-Ac-LDL) was also examined in these cells. Conclusion: These results suggest that the CD146-sorted positive cells can be referred to as periosteal-derived CD146 positive endothelial-like cells. In particular, when a co-culture system with endothelial and osteoblastic cells in a three-dimensional scaffold is used, the use of periosteum as a single cell source would be strongly beneficial for bone tissue engineering.
Anthropometric Analysis of Unilateral Cleft Lip Patient
Koh, Kwang-Moo ; Leem, Dae-Ho ; Baek, Jin-A ; Ko, Seung-O ; Shin, Hyo-Keun ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 392~400
Purpose: Cleft lip and palate is one of the most frequent hereditary deformities of the maxillofacial region which can arise in facial and jaw abnormalities as well as malocclusion and speech problems. In particular, unilateral cleft lip and palate is characterized by midface deformity resulting in maxillary anterior nasal septal deviation and nasal deformity. The aim of this study is to analyze the facial deformity of untreated unilateral cleft lip patients for contribution to primary cheiloplasty. Methods: Thirty-three patients with unilateral cleft lip and palate were impressioned before operation and facial casts were made. The casts were classified into complete cleft lip and incomplete cleft lip groups and each group were classified into affected side and normal side. Anthropometric reference points and lines were setted up and analysis between points and lines were made. Results and Conclusion: The obtained results were as follows: 1. The intercanthal width had no significant difference between the incomplete and complete cleft lip groups. 2. Cleft width and alar base width were greater in the complete group, and nasal tip protrusion was greater in the incomplete group. 3. Involved alar width and nostril width were greater in the complete group and in both complete and incomplete groups, involved alar width and nostril width were greater than the non-involved side. 4. The lateral deviation of the subnasale was greater in the complete group in both involved and non-involved sides. 5. The nasal laterale was placed inferiorly in both cleft groups. 6. The subnasale was deviated to the non-involved side in both cleft groups. 7. The nose tip was deviated to the non-involved side in both cleft groups and had greater lateral deviation in the complete cleft group. 8. The midpoint of cupid's bow had no vertical difference between complete and incomplete groups, but had a greater lateral deviation in the complete group. 9. In the complete cleft group, correlation between differences in cleft width and nostril width and columella height difference were obtained.
An Investigation of Hyoid Bone Position and Airway Space in Class III Malocclusion after Orthognathic Surgery
Choi, Yong-Ha ; Kim, Bae-Kyung ; Choi, Byung-Joon ; Kim, Yeo-Gab ; Lee, Baek-Soo ; Kwon, Yong-Dae ; Ohe, Joo-Young ; Suh, Joon-Ho ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 401~406
Purpose: The purpose of this study was to investigate changes in the position of the hyoid bone and soft palate and the amount of airway space after bilateral sagittal split ramus osteotomy (B-SSRO). Methods: This study is a review of lateral cephalometric tracings of 30 patients who underwent B-SSRO with setbacks at Kyunghee Dental Hospital from 2005 to 2009. Lateral cephalograms were taken before (T0), within one month (T1), and more than six months after the surgery (T2). Results: The hyoid bone at T1 changed significantly towards the inferoposterior position. At T2, it had significantly moved superiorly, but not anteriorly. At T1, the nasopharyngeal space, extending from the posterior nasal spine to the posterior pharyngeal space, decreased significantly, but did not show a significant increase at T2. The nasopharyngeal space, extending from the middle of soft palate to the posterior pharyngeal space, decreased significantly at T1, but did not show a significant decrease at T2. The oropharyngeal airway space decreased significantly at T1 and did not return to its original position at T2. The hypopharyngeal space, extending from the anterior to the posterior pharyngeal space at the level of the most anterior point of the third cervical vertebrae, slightly decreased at T1, but the amount was insignificant; however, the amount of decrease at T2 was significant. The hypopharyngeal space extending from the anterior to the posterior pharyngeal space at the level of the lowest point of the third cervical vertebrae, decreased significantly at T1 but returned to its original position at T2. Conclusion: B-SSRO changes the position of the hyoid bone and muscles inferoposteriorly. These change allows enough space for the tongue and prevent airway obstruction. Airway changes may be related to post-operative edema, posterior movement of the soft palate, anteroposterior movement of the hyoid bone, or compensation for decreased oral cavity volume. The position of the pogonion which measures anterior relapse after surgery did not show significant differences during the follow-up period.
Evaluation of Skeletal Stability Following Two-jaw Surgery via Surgery First Orthodontic Treatment in Class III Malocclusion
Hwang, Dae-Seok ; Kim, Yong-Il ; Lee, Jae-Yeol ; Lee, Seong-Tak ; Kim, Tae-Hoon ; Lee, Joo-Min ; Ahn, Kyung-Yong ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 407~412
Purpose: The purpose of the present study was to evaluate the postoperative skeletal stability of two-jaw surgery (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) via surgery first orthodontic treatment (SFOT) in class III malocclusion. Methods: Thirty-two patients who had two-jaw surgery via SFOT were included in this study. Serial lateral cephalograms were obtained before (T0), immediately after (T1), and six months after (T2) surgery. Twelve variables were measured for horizontal and vertical skeletal stability as well as for dental change. All measurements were evaluated statistically by a paired t-test (
<0.05). Results: The mean skeletal changes were
mm at point A and
mm at the pogonion. The mean horizontal relapse was 11.6% at the pogonion, and the mean vertical surgical changes included an upward displacement of
mm and a forward displacement of
mm at the pogonion. Upper incisor inclination decreased after surgery and was maintained at T2, and lower incisors were proclined from T1 to T2 by postsurgical orthodontic treatment. Conclusion: Postoperative skeletal stability of two-jaw surgery via surgery first orthodontic treatment in class III malocclusion was clinically acceptable.
Positional Changes of the Internal Reference Points Followed by Reposition of the Maxilla - A Study of a 3D Virtual Surgery Program
Suh, Young-Bin ; Park, Jae-Woo ; Kwon, Min-Su ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 413~419
Purpose: Reposition of the maxilla is a common technique for correction of midfacial deformities. To achieve the goal of the surgery, the maxilla should be repositioned based on the precisely planned position during surgery. The internal reference points (IRPs) and the external reference points (ERPs) are usually used to determine vertical dimension of maxilla, which is an important factor for confirming maxillary position. However, the IRPs are known to be inaccurate in determining the vertical dimension. In this study, we investigated the correlation of positional change of the modified IRPs with repositioned maxilla. Methods: The study group consisted of 26 patients with dentofacial deformities. For the simulation of the surgery, patient maxillary CT data and 3-D virtual surgery programs (V-
) were used. IRPs of this study were set on both the lateral wall of piriform aperture, inferior margin of both infraorbital foramen, and the labial surfaces of the canine and first molar. The distance from the point on lateral wall of the piriform aperture to the point on the buccal surface of the canine was defined as IRP-C, and the distance from the point on the inferior margin of the infraorbital foramen to the point on the buccal surface of the
molar was defined as IRP-M. After the virtual simulation of Le Fort I osteotomy, the changes in IRP-C and IRP-M were compared with the maxillary movement. All measures were analyzed statistically. Results: With respect to vertical movements, the IRP-C (approximately 98%) and the IRP-M (approximately 96%) represented the movement of the canine and the
molar. Regarding rotating movement, the IRPs changed according to the movement of the canine and the
molar. In particular, the IRP-C was changed in accordance with the canine. Conclusion: IRPs could be good indicators for predicting vertical movements of the maxilla during surgery.
Guided Bone Regeneration Using a Putty-type Demineralized Bone Matrix: Case Report
Jang, Han-Seung ; Kim, Su-Gwan ; Moon, Seong-Yong ; Oh, Ji-Su ; Park, Jin-Ju ; Jeong, Mi-Ae ; Yang, Seok-Jin ; Jung, Jong-Won ; Kim, Jeong-Sun ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 420~424
Allomatrix (Wright Medical Tech, Inc., Arlington, Tenn, USA), is a newly designed, injectable putty with a reliable demineralized bone matrix (DBM), derived from human bone. The compound contains 86% DBM and other bone growth factors such as bone morphogenic protein (BMP)-2, BMP-4, insulin-like growth factor (IGF)-1, and transforming growth factor (TGF)-
. It has excellent osteoinduction abilities. In addition, DBM is known to have osteoconduction capacity as a scaffold due to its collagen matrix. This product contains a powder, which is a mix of DBM and surgical grade calcium sulfate as a carrier. A practitioner can blend the powder with calcium sulfate solution, making a putty-type material which has the advantages of ease of handling, better fixation, and no need for a membrane, because it can function as membrane itself. This study reports the clinical and radiographic results of various guided bone regeneration cases using Allomatrix, demonstrating its strong potential as a graft material.
8 Years Follow-up of Complications after Maxillary Cyst Enucleation with Xenograft: Case Report
Lee, Eun-Young ; Kim, Kyoung-Won ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 425~429
Bone grafts are becoming increasingly common in oral and maxillofacial surgery to improve bone healing procedures. Bovine bone as a xenograft is a representative osteoconductor and space filler; however, sometimes complications, such as infection and wound dehiscence are encountered with its use. We report the result of an eight-year follow-up of a xenograft case and processing methods of inorganic bovine bone along with a review of the literature. Xenograft (
) was used in a cyst enucleation site of the maxilla, as a bone substitute and space filler. Inflammation and infection were defined several times as lack of osseous contact between the graft and host bone, caused by remodeling failure over an eight-year period. Pathologic findings of the xenograft revealed dead bony trabeculae with inflamed fibrous tissue and actinomycosis.
The Development of a Giant Extraskeletal Osteochondroma in the Masticatory Space of the Mandible
Lee, Jee-Ho ; Han, Yoon-Sic ; Cho, Young-Ah ; Hong, Sam-Pyo ; Kim, Myung-Jin ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 430~434
Extraskeletal osteochondroma is an uncommon benign tumor that arises in soft tissues lacking continuity with an adjacent bone and joint. Due to similar histopathological findings, extraskeletal osteochondroma is often misdiagnosed for a conventional osteochondroma, the most common benign tumor that arises from the epiphyseal plates of long bones. The pathogenesis of extraskeletal osteochondroma is unclear, but metaplasia of synovial mesenchymal tissue is the best supported etiology. The most common sites of extraskeletal osteochondroma are the hands and feet, and it is rarely found in the maxillofacial area. We present a case of a two-year-old boy with a giant extraskeletal osteochondroma that developed in the masticatory space of the mandible along with a review of the relevant literature.
Surgical and Orthodontic Treatment of Unicystic Ameloblastoma Related to an Impacted Molar Tooth in the Mandible: Case Report
Moon, Cheol-Hyun ; Kim, Hyeon-Min ; Park, Dae-Song ; Kim, Dong-Woo ; Lee, Sang-Chil ; Kim, Sung-Yong ; Lim, Ho-Yong ; Yeom, Hak-Yeol ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 435~439
Ameloblastoma is an aggressive benign odontogenic epithelial tumour that may arise from the enamel organ, remnants of dental lamina, or the lining of an odontogenic cyst. It is usually categorized into solid or multicystic, unicystic, and peripheral types. Treatment ofameloblastomas include conservative methods such as marsupialisation, enucleation, and curettage; and radical treatments such as marginal or segmental resection. Radical treatments have resulted in lower recurrence rates; however, may also encounter esthetic, functional, and reconstructive problems. Unicystic ameloblastoma has been considered less aggressive and a lower recurrence tendency. Thus, many authors have recommended conservative treatment in cases of unicystic ameloblastoma. An 11 year-old boy presented with displaced second and third molars by luminal unicystic ameloblastoma in the mandible. Cyst enucleation, curettage, and third molar extraction were done. No signs of recurrence or esthetic problems such as facial asymmetry were seen radiologically and clinically, up to 8 years 2 months postoperatively.
Central Mucoepidermoid Carcinoma of the Mandible: Case Report
Lee, Choong-Sang ; Kim, So-Mi ; Nam, Woong ; Cha, In-Ho ; Kim, Hyung-Jun ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 440~444
Mucoepidermoid carcinoma generally arises from salivary glands and represents 5~10% of all salivary tumors. Arising within the jaws as primary central bony lesions, central mucoepidermoid carcinomas are extremely rare, accounting for only 2~3% of all mucoepidermoid tumors. Central mucoepidermoid carcinoma of the mandible was first reported in 1939 and since then approximately 100 cases have been documented in the literature. Several hypotheses have been proposed to explain the pathogenesis of intraosseous salivary tumors. The most likely source of most intraosseous tumors is odontogenic epithelium. Waldron and Mustoe suggested that central mucoepidermoid carcinoma be included in primary intraosseous carcinoma of the jaw. We report here on a case of central mucoepidermoid carcinoma affecting the mandible and discuss the clinical, radiographic, and histological findings.
Sepsis Developed from an Odontogenic Infection: Case Report
Kim, Moon-Seob ; Kim, Su-Gwan ; Moon, Seong-Yong ; Oh, Ji-Su ; Park, Jin-Ju ; Jeong, Mi-Ae ; Yang, Seok-Jin ; Jung, Jong-Won ; Kim, Jeong-Sun ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 445~448
Mortality associated with maxillofacial infection is relatively low due to the development of antibiotics, and improved oral care. However, inappropriate treatment, delayed treatment, old age, underlying systemic disease, and drug-resistant microorganisms can potentially result in life threatening situations such as cavernous sinus thrombosis, mediastinitis, and sepsis. Sepsis is the most dangerous state with high mortality, ranging from 20~60%. The treatment of sepsis involves properly monitoring vital functions, fluid resuscitation, surgical drainage, and empirical use of high doses of antibiotics until culture results are available. Ventilatory support maybe be required as well. We encountered a 64-year-old patient who died from sepsis that developed as the result of an odontogenic infection. The initial diagnosis was right temporal, infraorbital, buccal, pterygomandibular space abscess. Despite surgical and medical supportive care, the condition progressed to sepsis and after four days the patient died due to multiple organ failure.
Orbital Abscess from Odontogenic Infection of Maxillary Molar: Case Report
Jin, Soo-Young ; Kim, Su-Gwan ; Moon, Seong-Yong ; Oh, Ji-Su ; Kim, Moon-Seob ; Park, Jin-Ju ; Jeong, Mi-Ae ; Yang, Seok-Jin ; Jung, Jong-Won ; Kim, Jeong-Sun ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 449~453
Orbital infection is typically caused by spread of inflammation from the paranasal sinuses. Less common causes can be skin infections, trauma, and hematogenous spread from other infections located elsewhere in the body. Odontogenic orbital infections account for 2~5% of all orbital infections, and occur as a result of periodontitis, odontogenic abscess from caries, tooth extraction, and oral surgery. Orbital infections can be divided into preseptal infection, orbital subperiosteal abscess, orbital abscess, and postorbital abscess. Symptoms which can be observed are swelling of the eyelids and erythema, orbital edema, displacement of the eyeball, exophthalmos, ophthalmoplegia, and even impairment of the optic nerve. Here we present the case of a patient who had an orbital abscess secondary to an abscess of the right maxillary third molar. Rapid recovery occurred following surgical treatment and antibiotic therapy. In addition a brief review of the literature is included.
Cemento-Osseous Dysplasia Largely Occurring in the Mandible: Case Report
Kim, Sin-Guen ; Park, Jong-Wook ; Nam, Jong-Hoon ; Bok, Sung-Cheol ; Lee, Young-Man ; Park, Ki-Nam ; Choi, Dong-Ju ;
Maxillofacial Plastic and Reconstructive Surgery, volume 33, issue 5, 2011, Pages 454~458
Cemento-Osseous dysplasia is a benign condition of the jaw known to orginate from the periodontal ligament or medullary bone. Its treatment can be categorized according to clinical symptom. If there is no pain or other discomfort, a regular recall examination and having patients maintain proper oral hygeine are the best management. However, if clinical symptoms do exist, proper treatments such as resectioning of the mandible or mandibulectomy are needed. This clinical report describes a rare symptomatic case of cemento-osseous dysplasia which was treated with a conservative surgical method. Using this method, we obtained satisfactory results without additional grafts.