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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 34, Issue 6 - Nov 2012
Volume 34, Issue 5 - Sep 2012
Volume 34, Issue 4 - Jul 2012
Volume 34, Issue 3 - May 2012
Volume 34, Issue 2 - Mar 2012
Volume 34, Issue 1 - Jan 2012
Selecting the target year
3-Dimensional Micro-Computed Tomography Study on Bone Regeneration with Silk Fibroin, rh-Bone Morphogenetic Protein Loaded-Silk Fibroin and Tricalcium Phosphate Coated-Silk Fibroin in Rat Calvaria Defect
Pang, Eun-O ; Park, Young-Ju ; Park, Su-Hyun ; Kang, Eung-Sun ; Kweon, Hae-Yong ; Kim, Soeng-Gon ; Ko, Chang-Yong ; Kim, Han-Sung ; Nam, Jeong-Hun ; Ahn, Jang-Hun ; Chun, Ji-Hyun ; Lee, Byeong-Min ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 1~11
Purpose: The purpose of this study was to evaluate the bone regeneration capacity of silk fibroin (SF) when combined with beta tricalcium phosphate (
-tricalcium phosphate [TCP]) and rh-bone morphogenetic protein (BMP) in vivo by micro-computed tomography (CT), soft x-ray, and histological analysis. Methods: A total of 56 critical size defects formed by a trephine bur made on 28 adult female Spague-Dawley rats were used for this study and the defect size was 5.0 mm in diameter. The defects were transplanted with (1) no graft material (raw defect), (2) autogenous bone, (3) SF (
), (4) SF-BMP (
each), and (5) SF+
). At 4 and 8 weeks after operation, the experimental animals were sacrificed. Samples were evaluated with soft x-ray, histological examinations and 3-dimensional micro-CT analysis. Results: In the 3-dimensional micro-CT evaluation, bone volume and bone surface data were higher in the SF-BMP (
each) (P<0.05) and SF-TCP (
each) group than in the SF group (
each) (P<0.05), except for the autogenous group (
each) at 4 weeks. At 8 weeks, SF-BMP (
each) still revealed higher (P<0.05) bone volum and surface, but SF-TCP (
each) (P=0.5, P=0.2) revealed the same or lower amount compared with the SF group (
each). The % of bone area determined by radiodensity was higher in the SF-TCP (
) and SF-BMP (
) groups than in the SF (
) group at the period of 4 weeks. Also, in the histological evaluation, the SF-BMP group revealed lower inflammation reaction, lower foreign body reaction and higher bone healing than the SF group at postoperative 4 weeks and 8 weeks. The SF-TCP group revealed lower inflammation at 4 weeks, but accordingly, as the TCP membrane was absorbed, inflammatory and foreign body reaction are increased at 8 weeks. Conclusion: The current study provides evidence that the silk fibrin can be used as an effective grafted material for tissue engineering bone generation through a combination of growth factor or surface treatment.
Experimental Study of Osseointegration and Stability of Intentionally Exposed Hydroxyapatite Coating Implants
Jeong, Kyung-In ; Kim, Su-Gwan ; Moon, Seong-Yong ; Oh, Ji-Su ; Jo, Ji-Ho ; Lim, Hyoung-Sup ; Kim, Jeong-Sun ; Lim, Sung-Chul ; Jeong, Mi-Ae ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 12~16
Purpose: The purpose of this study is to evaluate the effect of exposure of hydroxyapatite coating on the amount of bone formation and stability in the dogs. Methods: In this study, hydroxyapatite coated implants (HAPTITE) was placed over the femur bone surface of four dogs about 1 mm. The experimental group was divided into 4 weeks group of 8 implants and 8 weeks group of 8 implants, and then they were sacrificed. The stability of implants was evaluated twice with Osstell
mentor (Osstell AB, Goteborg, Sweden) at right after placement and sacrifice. The amount of bone formation was evaluated through histomorphometric examination. Results: The stability of implants was in normal range, and tended to increase as time goes by. Mean percentages of new bone formation rates were
at uppermost 1 mm bone level adjacent to soft tissues (level 1) and
at next 1 mm bone level (level 2) in 4 weeks group,
at level 1 and
at level 2 in 8 weeks group. Mean percentages of bone-implant contact rates were
at level 1 and
at level 2 in 4 weeks group,
at level 1 and
at level 2 in 8 weeks group. There was no statistically significant difference of new bone formation rate and bone-implant contact rate between uppermost 1 mm bone level adjacent to soft tissues and next 1 mm bone level. However, there was no significant difference in bone formation between 4 and 8 weeks groups. Conclusion: These results suggested that exposed hydroxyapatite coated implants to soft tissue showed favorable bone formation and implant stability.
Manikin Model Study on Reproducibility and Accuracy of Maxillofacial Measurements Determined by Stereocamera: Comparative Study of Direct Anthropometry, Digitizer and Stereophotogrammetery
Jeoung, Youn-Wook ; Yang, Ji-Woong ; Chung, Kwang ; Kook, Min-Suk ; Oh, Hee-Kyun ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 17~25
Purpose: Recently, a three dimensional approach to hard and soft tissues of the maxillofacial area has been widely used. This study was to evaluate the reproducibility and accuracy of a stereocamera compared to actual measurement methods using a digital caliper and digitizer. Methods: The stereoscopies of 7 head dummies with different sizes and shapes were obtained using a Di3D system (Dimensional Imaging, Glasgow, UK) after marking reference points on facial areas. From the obtained stereoscopy, 10 measurements representing the width, height and depth of each of the facial sections of the dummy were measured twice using a three dimensional reverse engineering software program (RapidForm
2006, Inus, Seoul, Korea). The x, y, and z coordinates of each of the three dimensional measurements were obtained and distances between two points were calculated. All procedures were repeated twice. The actual measurement method was performed twice, directly on dummies, using a digital caliper and values were compared with the previously determined values. Results: The results were as follows. In the ANOVA analysis, there were no significant statistical differences among the three measurement methods. In the Bonferroni analysis, with adjustments applied for multiple comparisons, there was no difference between actual measurement methods using a digitizer and a digital caliper. However, there was some difference between using a stereocamera and actual measurement methods using a digitizer and a digital caliper in values of
-Prn. The mean value for technical error in measurement (TEM) in Di3D (0.98 mm) was slightly higher than for a digital caliper (0.17 mm) and a digitizer (0.30 mm). In an intraclass correlation coefficient (ICC) there were no significant differences among the three measurement methods, but the Di3D system with the stereocamera showed relatively lower reproducibility compared to actual measurement methods using a digitizer and a digital caliper. Conclusion: These results indicate that some complementary measures may be needed to improve accuracy and reproducibility in the Di3D system with stereocamera.
Facial Analysis of Patients with Skeletal Malocclusion Using a Facial 'Phi' Mask
Kim, Hong-Seok ; Heo, Young-Min ; Hong, Jong-Rak ; Kim, Chang-Soo ; Paeng, Jun-Young ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 26~33
Purpose: The golden ratio has been used for a long time to objectify and quantify 'beauty'. Dr. Marqurardt claims that the golden ratio can be applied in the maxillofacial field as well. The purpose of this study was to evaluate the diagnostic significance of using a facial 'phi' mask for analyzing Korean faces with characteristics of Class I, II, and III malocclusion. Methods: We studied twenty five Korean celebrities' frontal facial photos (10 males, 15 females) and 90 malocclusion patients' frontal facial photos (30 patients in each malocclusion classification: Class I, Class II, and Class III). Patients who received orthodontic treatment at Samsung Medical Center were selected for this study. After superimposition of the selected facial photo and facial 'phi' mask using Adobe Photoshop CS3, the ratio of the entire facial area, mid facial area, lower facial area and horizontal and vertical lengths were measured. Results: The facial ratio in photos of Korean faces showed larger vertical and horizontal ratios than the facial 'phi' mask with golden ratio, regardless of skeletal malocclusion (entire face: 115%, lower face: 125% larger than the mask). The results of the frontal photos of Class I, II, and III malocclusion patients using facial 'phi' mask showed that the vertical length and frontal face area was more significantly influenced by the area of the lower face than the midface. This means that the lower face has larger proportions in the facial areas. Conclusion: The ratio of facial 'phi' mask is matched with the ideal facial appearance that the contemporary Korean general public is seeking. Thus, the facial 'phi' mask may be a convenient tool for esthetic analysis of Korean faces. Reducing the area of the lower face is esthetically more desirable for almost all Korean people when planning orthognathic surgery.
Cone Beam Computed Tomography Analysis of Mandibular Anatomical Variation in a Patient with Facial Asymmetry
Park, Seong-Won ; Oh, Sung-Hwan ; Lee, Jae-In ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 34~40
Purpose: The study was performed to compare patients with anatomical variations in facial asymmetry with patients in the normal range using cone-beam computed tomography (CBCT) and to take the preoperative condition into consideration in the case of a sagittal split ramus osteotomy (SSRO). Methods: The study was conducted on 46 adult patients composed of 2 subdivided groups, an asymmetry group (n=26) and a symmetry group (n=20). The asymmetry group was divided between patients with hemimandibular hyperplasia (HH, n=8) and hemimandibular elongation (HE, n=18). Using cross-sectional computed tomography images, the thickness of cancelleous bone in the buccal area of the mandible, thickness of buccal cortex in the buccal aspect of the mandible, thickness of cancellous bone in the inferior aspect of the mandible, thickness of buccal cortex in the inferior aspect of the mandible, and cross-sectional surface area of the mandible were measured. Results: In the asymmetry group, the cross-sectional area of the mandible including the inferior alveolar nerve positioned on the affected side was significantly different from the symmetry group. Thickness of cancelleous bone in the buccal aspect of the mandible, thickness of cancelleous bone in the inferior aspect of the mandible, and cross-sectional surface area of the mandible in the affected site of hemimandibular hyperplasia was significantly smaller than in the symmetry group. Conclusion: The inferior alveolar nerve runs lower and in a more buccal direction and shows a smaller cross-sectional surface of the mandible in the hemimandibular hyperplasia patients with asymmetry.
Accuracy Verification of Optical Tracking System for the Maxillary Displacement Estimation by Using of Triangulation
Kyung, Kyu-Young ; Kim, Soung-Min ; Lee, Jong-Ho ; Myoung, Hoon ; Kim, Myung-Jin ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 41~52
Purpose: Triangulation is the process of determining the location of a point by measuring angles to it from known points at either end of a fixed baseline. This point can be fixed as the third point of a triangle with one known side and two known angles. The aim of this study was to find a clinically adaptable method for applying an optical tracking navigation system to orthognathic surgery and to estimate its accuracy of measuring the bone displacement by use of triangulation methods. Methods: In orthognathic surgery, the head position is not fixed as in neurosurgery, so that a head tracker is needed to establish the reference point on the head surface byusing an optical tracking system. However, the operation field is interfered by its bulkiness that makes its clinical use difficult. To solve this problem, we designed a method using an Aquaplast splinting material and a mini-screw in applying a head tracker on a patient's forehead. After that, we estimated the accuracy of measuring displacements of the ball marker by an optical tracking system with a conventional head tracker (Group A) and with a newly designed head tracker (Group B). Measured values of ball markers' displacements by each optical tracking system were compared with values obtained from fusion CT images for an estimation of accuracy. Results: The accuracy of the optical tracking system with a conventional head tracker (Group A) is not suitable for clinical usage. Measured and predictable errors are larger than 10 mm. The optical tracking system with a newly designed head tracker (Group B) shows 1.59 mm, 6.34 mm, and 9.52 mm errorsin threeclinical cases. Conclusion: Most errors were brought on mainly from a lack of reproducibility of the head tracker position. The accuracy of the optical tracking system with a newly designed head tracker can be a useful method in further orthognathic navigation surgery even though the average error is higher than 2.0 mm.
Clinical Evaluation of Mandibular Condyle Fractures
Lim, Hyoung-Sup ; Kim, Su-Gwan ; Oh, Ji-Su ; Jeong, Mi-Ae ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 53~57
Purpose: This study considered the effects and proper treatments of mandibular condyle fractures by comparing clinical differences and complications according to analysis and treatment plan. Methods: From September 2007 to August 2010, patients who were diagnosed with condylar fracture and monitored for more than 3 months were selected. Cases were divided in a reductive manner and evaluated by type and period of intermaxillary fixation (IMF), status of occlusion and trismus according to the Spiessle/Schroll method. A total 50 patients were examined. Results: The number of the unilateral condyle fractures was 45 and 30 patients had multiple fractures. Type of fracture was categorized by the Spiessle/Schroll method. There were 21 patients with type I, 11 patients with type II, 3 patients with type 3, 10 patients with type V and 5 patients with type VI; there were no patients with a type IV fracture. 11 patients were operated on with open reduction. Among them, 9 patients were type II and 2 patients were type I. For type I patients, an intra-oral approach was conducted with an endoscope and trocar. For 3 of the type II patients, an retromandibular approach was conducted and for the rest of the type II patients, the same approach as type I was used. The periods of IMF were 2.36 weeks (mean) in open reduction group and 2.9 weeks (mean) in closed reduction group and the total mean period is 2.78 weeks. All patients had stable occlusion after removing the IMF. Trismus occurred in 1 patient for open reduction and 5 patients for closed reduction. Facial nerve palsy was observed in one patient postoperatively that resolved after 6 months. Conclusion: In this study, similar prognosis was shown after an open and closed reduction was conducted. Therefore, treatments need to be planned depending on the degree of condyle fracture and the amount of displacement. Additionally, the period of IMF could be shortened with open reduction.
Characteristics of Dental Emergency Patients at Busan Paik Hospital
Kim, So-Hyun ; Kim, Do-Young ; Baek, Joon-Seok ; Jung, Tae-Young ; Park, Sang-Jun ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 58~64
Purpose: Dental emergencies vary from toothaches to oral and maxillofacial traumas. Because the number of dental emergency cases has increased recently, we analyzed characteristics of patients seen during the last 2 years, in an effort to find a trend. Methods: This study was carried out with emergency room patients visiting the Department of Oral and Maxillofacial Surgery from 2009 to 2010. Results: The total number of patients studied was 1,162; the ratio of males to females was 1.73:1. The most frequent age group was 0 to 9 years, followed by 20 to 29 years. Trauma (58.7%) was the most frequent cause followed by acute toothache, oral hemorrhage, infection, and temporomandibular (TMJ) disorder. In the trauma group, injuries of soft tissue and alveolus were prevalent. The most common causes of soft tissue injury were falls, safety violations and assault. The highest incidence of emergencies was seen in patients 0 to 9 years old (41.8%). The most common causes of jaw fracture were falls, assaults, and traffic accidents in that order. In the acute toothache group, most patients had pulpitis (41.2%). In the infection group, most had buccal space abscesses (40.0%). In the hemorrhage group, post-operative bleeding cases (80.5%) were the majority, and hemostasis was obtained mostly by pressure dressings. For the TMJ disorder group, masticatory muscle disorder (65.4%) was more common than TMJ dislocation. Conclusion: In this study, trauma was the most frequent reason for patients who visited the emergency room. However, acute toothache, hemorrhage, infection and TMJ disorders were also seen frequently. Dental emergency patients could be better treated by understanding patterns of dental emergencies and performing proper diagnoses.
Polymorphous Low-grade Adenocarcinoma of the Palate: Case Report
Ryu, Hye-In ; Jee, Yu-Jin ; Lee, Deok-Won ; Kim, Tae-Hee ; Hong, Sung-Ok ; Ryu, Dong-Mok ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 65~70
Polymorphous low-grade adenocarcinoma (PLGA) is a neoplasm that is regarded as the second most common malignant salivary gland tumor after mucoepidermoid carcinoma. After the diagnosis of PLGA it is important to make a treatment decision and consider the prognosis. A histopathologic examination is necessary for diagnosis. Treatment is primarily surgical excision and long-term follow up is essential to evaluate local recurrences. This report describes 2 cases of PLGA located in the soft palate without any evidence of metastasis. The first case was PLGA with bony infiltration and an irregular margin lesion. The second case was PLGA localized in palatal soft tissue. We present diagnoses, histopathologic features, treatments and prognosis of PLGA.
Intramasseteric Metastasis of Renal Cell Carcinoma: Case Report
Park, Gun-Chan ; Yoon, Kyu-Ho ; Park, Kwan-Soo ; Cheong, Jeong-Kwon ; Bae, Jung-Ho ; Park, Jae-An ; Min, Sung-Chang ; Sin, Jae-Myung ; Baik, Jee-Sun ; Kim, Hyun-Jung ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 71~75
Renal cell carcinoma (RCC) is the most frequent urological malignant tumor in adults and it occurs mostly between the fifth and the sixth decades of life. The male-female ratio is 3:1 and it is more common in smokers. It accounts for approximately 3% of adult malignancies; 90~95% of neoplasms of the kidney. The classic triad of presenting symptoms of RCC is hematuria, back pain and a mass in the flank. More than 50% of RCCs show metastasis to breast, lung and regional lymph nodes, and 15% present in the orofacialmaxillary region. This case is about a 66 year-old man who was treated for painless swelling in the left masseteric area. The mass was surgically excised and sent for biopsy. It was diagnosed as RCC and two weeks later nephronectomy of the left kidney was performed. Metastasis to other organs was detected and the patient received radiation therapy. In this case we were able to find the primary lesion by the metastatic lesion.
Adenoid Cystic Carcinoma of the Submandibular Gland
Ha, Yong-Yun ; Kim, Seong-Gon ; Kim, Min-Keun ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 76~80
Adenoid cystic carcinoma is a distinctive neoplasm of the salivary gland and is the most common malignant tumor of submandibular gland. Although adenoid cystic carcinoma grows slowly, it shows aggressive tendencies with the ability to invade peripheral nerves. This ability enables an adenoid cystic carcinoma to extend along the nerves and spread long distances, resulting in high incidence of distant metastasis and recurrence. Therefore, radical resection is the treatment of choice for this carcinoma. We performed partial mandibulectomy, neck dissection and immediate reconstruction using a radial forearm free flap on a 54 year-old man with adenoid cystic carcinoma on the right submandibular gland. And as an adjunctive therapy, chemotherapy with cisplatin and 5-fluorouracil was used. We report our case along with a literature review.
Management of a Gunshot Wound at the Temporal Region: Case Report
Lee, Ju-Min ; Ahn, Kyung-Yong ; Shin, Sang-Hun ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 81~84
Gunshot wounds are unpredictable and require early, precise diagnosis and treatment. A penetrating gunshot wound can be fatal due to compromised airway, hypovolemic shock, lead poisoning and infection. This case report describes a 48-year-old male patient who had a suicidal gunshot wound on the right temporomandibular joint area using an air rifle. We successfully managed the patient by preoperative embolization, surgical removal of the foreign body and primary closure.
Treatment of a Huge Odontogenic Myxoma in the Mandible with Surgical Resection and Reconstruction Using a Vascularized Fibular Free Flap: Case Report
Suh, Jin-Won ; Kim, Eu-Gene ; Park, Won-Jong ; Kim, Soung-Min ; Lee, Jong-Ho ;
Maxillofacial Plastic and Reconstructive Surgery, volume 34, issue 1, 2012, Pages 85~90
The odontogenic myxoma is a relatively rare, benign tumor that occurs on the jaw. A 41 year-old man visited Seoul National University Dental Hospital because of swelling of the mandible. Clinical and radiographic evaluation showed a huge mass invading most of the mandible. After biopsy, he was diagnosed with odontogenic myxoma. For resection of the lesion, partial mandibulectomy and reconstruction with a vascularized fibular free flap was done. The result showed successful removal of the lesion. Reconstruction resulted in satisfactory functional and esthetic outcomes. We conclude that huge benign neoplasms such as odontogenic myxomas can be successfully treated by using a wide margin of resection followed by vascularized fibular free flap reconstruction.