• Title/Summary/Keyword: Midfacial growth

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Outcomes for Patients with Submucous Cleft Palate Accompanying Hypernasality Treated with Double Opposing Z-plasty (과대비성을 동반한 점막하구개열 환자에 대한 Double Opposing Z-plasty를 통한 수술적 치료 결과)

  • 김현준;김진영;배정호;김광문;최홍식
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.1
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    • pp.81-86
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    • 2000
  • Submucous cleft palate is a relatively uncommon congenital anomaly accompanying velopharyngeal incompetence(VPI). Double opposing Z-plasty has many advantages including prolongation of soft palate, normal midfacial growth, midline scar. We analyzed postoperative results comparing with those of preoperative evaluation by several variables(nasometer, endoscopy, satisfactory scale) in 14 patients treated with double opposing Z-plasty due to submcous cleft palate. Nasalance score in Ah sound, Ma phrase, and Pa phrase decreased 20.23%, 3.25%, and 23.26% in the average, respectively. As a result, hypernasality improved significantly. Closure rate in velum evaluated by endoscopy was increased from 0.44 to 0.76. In objective satisfactory scale checked by each patient's guardian at the postoperative period, much improved in 3, improved in 6, minimally improved in 1, and no difference in 1 was reported. (n=11 patients) Double opposing B-plasty is a good surgical modality in patients accompanying VPI with submucous cleft palate or incomplete cleft palate and will be used more usefully and widely.

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A STUDY ON CRANIOFACIAL GROWTH ANALYSIS OF KOREAN CHILDREN BY THE FINITE ELEMENT METHOD (한국아동의 악안면성장에 관한 유한요소법적 연구)

  • Tahk, Seon-Gun
    • The korean journal of orthodontics
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    • v.18 no.2
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    • pp.343-366
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    • 1988
  • Craniofacial complex is influenced by numerical skeletal elements. Though the analysis of growth change has been done by various analytical methods, it was dependent on any method of registration and superimposition, based on reference plane and reference point. However, the craniofacial growth is composed of a number of local growth elements. Therefore, it will be necessary to use a clinically useful method for estimating craniofacial skeletal growth independently. The author analysed longitudinal cephalometric roentgenogram of 15 Korean males and 15 Korean females aged from 6 to 12 years by the finite element method and results were as follows : 1. The finite element method for craniofacial skeletal complex and soft tissue made it possible to analyze the independent local growth. 2. Regression equations from the value of each strain will make it possible to predict the craniofacial growth. 3. The growth of anterior cranial base was different from that of other facial bone. 4. The growth of posterior cranial base influenced the growth of upper pharyngeal region, midfacial region, maxilla and posterior region of mandible. 5. The growth of maxillary complex was vertical rather than horizontal. 6. The growth direction of ramus, mandibular body, alveolar bone was various. 7. The relation between hard tissue and soft tissue by finite element method was variant.

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Facial Morphology and Growth in Unilateral Cleft Lip and Palate Patients (편측성(片側性) 순렬(脣裂) 및 구개렬환자(口蓋裂患者)의 안면형태(顔面形態)와 성장(成長)에 관(關)한 연구(硏究))

  • Yang, Won Sik
    • The korean journal of orthodontics
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    • v.14 no.1
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    • pp.7-13
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    • 1984
  • A roentgeno cephalometric comparative study was undertaken to reveal significant differences of craniofacial morphology and growth between unilateral cleft lip and palate and normal individuals. The material for this study consisted 32 subjects with repaired unilateral cleft lip and palate (27 male, 5 female) and 44 normal subjects (22 male, 22 female). The analysis was performed by Coben's method and the measurements were compared by Student's t-test. The following conclusions were obtained. 1. In the UCLP subjects there is definite decrease in midfacial growth, so they showed concave profile. 2. The ramus inclination angle and AR-GO of UCLP subjects are larger than normal subjects. 3. The craniofacial height of UCLP subjects is smaller than normal subjects, especially in midface. 4. The lower part of craniofacial height of UCLP subjects is larger than normal subjects.

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A LONGITUDINAL ROENTGENO-CEPHALOMETRIC STUDY ON THE CRANIOFACIAL DEPTH AND HEIGHT BY COBEN'S METHOD (Coben법에 의한 한국 아동의 두개안면골의 성장 변화에 관한 누년적 연구)

  • Ahn, Hyo-il;Ryu, Young-Kyu
    • The korean journal of orthodontics
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    • v.15 no.1
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    • pp.23-42
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    • 1985
  • The morphology and growth changes of the Craniofacial Complex are important in orthodontics and cephalometrics for analysis and evaluation of facial bone growth are widely used. The author analyzed the data using lateral cephalometric roentgenogram of 75 Korean male and 50 Korean females age of 6 to 10 with normal occlusion to provide informations-relative rates of facial bone growth of Korean which is to be contributed in Korean standard. The results were as follows: 1. Means, standard deviation and coefficient of variation of Korean children were obtained. 2. The item which showed significent difference between male and female was craniofacial height in absolute dimension. 9. No difference of sex was showed in increment of craniofacial height and depth. 4. Among the craniofacial depth increments, the lower facial depth dimension increased most, midfacial depth dimension increased less, and cranial depth dimension increased the least. 5. The horizontal body of mandible showed rapid growing tendency more than did the ascending ramus.

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Three Cases of Submucous Cleft Palate with Hypernasality Treated with Double Opposing Z-plasty (과대비성을 동반한 점막하 구개열 환자에 대한 Double Opposing Z-plasty 3례)

  • 최홍식;이승수;김성국;김태만;김현준
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.9 no.2
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    • pp.168-172
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    • 1998
  • Several kinds of surgical methods have been used to treat the submucous cleft palate with hypernasality. The purpose of this study was to evaluate the double opposing Z-plasty which is one of the newly established surgical methods by Dr. Furlow in three cases of submucous cleft palate with hypernasality operated in this department. There were a number of advantage of double opposing Z-plasty. The surgery is adaptable for use in early patient. Midfacial growth retardation and complication were not seen in all cases. Hypernasality was improved subjectively. Using the nasometer, the nasalance score of the postoperative period was compared with that of before surgery, much improvement were noted in 'Ah', 'PaPa'. And fiberoptic endoscope was used to evaluate the velopharyngeal closure pattern. Velopharyngeal closure pattern with velum was improved dramatically, Double opposing Z-plasty seem to be a good procedure for the treatment of submucous cleft palate with hypernasality.

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Recent Advances in Surgical Treatments for Growing Patients with Cleft (성장기 구순구개열 환자의 수술치료의 최신지견)

  • Park, Young-Wook
    • The Journal of the Korean dental association
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    • v.55 no.12
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    • pp.862-869
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    • 2017
  • Cleft lip and palate is the most common teratologic condition of oromaxillofacial units, probably associated with genetic and environmental causes. The goal of cleft surgery is to optimize facial esthetics and stomatognathic function while minimizing growth disturbances from surgical intervention. In this article, the author suggests the recent surgical strategies that minimize cleft nasal deformity and midfacial skeletal constriction. From the author's surgical experiences and literature reviews, only considerate surgeries would achieve functional improvement and facial esthetics in patients with cleft lip and palate.

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Long-term Orthodontic Treatment and Phonetic Assessment of a Congenital Cleft Lip and Palate Patient (선청성 구순구개열 환자의 장기적인 교정 치료 및 음성언어학적 고찰)

  • Hong, Ji-Suk;Kim, Yoon-Ji;Hwang, Yong-In;Kim, Dae-Sung;Park, Yang-Ho
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.1
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    • pp.7-20
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    • 2009
  • Orthodontic treatment planning of cleft lip and palate requires consideration of the characteristic features, growth pattern and functional disorders related to cleft lip and palate patients. Tissue deficiencies and constriction of the scar tissue in surgically treated cleft lip and palate results in disturbance of maxillary growth and deficiency of midfacial region with anterior and posterior crossbite. These patients often present congenital missing of teeth, supernumerary teeth, malformed teeth, or ectopic position of teeth, which should be treated by orthodontic treatment by expanding upper arch followed by fixed appliance. Proper use of retainer and continuous follow-up is needed to prevent relapse after orthodontic treatment has finished. Also we have to pay attention to correct speech disorder which is caused by the velopharyngeal insufficiency.

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Long-term follow-up of early cleft maxillary distraction

  • Park, Young-Wook;Kwon, Kwang-Jun;Kim, Min-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.20.1-20.6
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    • 2016
  • Background: Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. Case presentation: A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. Conclusions: The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.

Juvenile psammomatoid ossifying fibroma of the maxilla

  • Kwon, Yongseok;Shin, Donghyeok;Kim, Jeenam;Lee, Myungchul;Choi, Hyungon
    • Archives of Craniofacial Surgery
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    • v.21 no.3
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    • pp.193-197
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    • 2020
  • Juvenile psammomatoid ossifying fibroma (JPOF) is a rare, benign, fibro-osseous variant of ossifying fibroma. It exhibits short-term rapid growth and has a high recurrence rate. Herein we describe a case of JPOF of the maxilla that was treated via complete excision utilizing an intraoral approach with immediate reconstruction using an iliac bone graft, in conjunction with a comprehensive review of the literature. A 20-year-old man presented with a mass on his right cheek that he reported had been growing over the last 10 months. In that cheek he had noticed fullness and experienced pressure, tenderness, and fluffiness, with no other ophthalmic or dental symptoms. After clinical, radiological, and histological examinations, the diagnosis was confirmed as JPOF. Surgical excision was performed, followed by immediate reconstruction with an autologous iliac cortical and cancellous bone graft harvested from the right iliac crest under general anesthesia. Good cicatrization of the intraoral surgical wounds and right iliac crest were evident. He was monitored for 6 months after the surgery and exhibited appropriate midfacial contour. There were no signs of recurrence or complications.

COMPLEX DISTRACTION OSTEOGENESIS ON HEMIMANDIBULAR HYPOPLASIA : A CASE REPORT (하악과두 골절후 발생한 편측성 하악골 형성부전의 치료로서 복합적 악골 신장술의 임상증례)

  • Oh, Sung-Hwan;Min, Seung-Gi;Kwon, Kyong-Hwan;Koh, Se-Wook;Lee, Kyong-Seuk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.3
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    • pp.246-250
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    • 2004
  • Uni- or bilateral mandibular hypoplasia can be associated with various syndromes or is acquired after early traumatic or inflammatory disease in the temporomandibular joint(TMJ). Early treatment is necessary to avoid consequent impairment of midfacial growth. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth, but the new procedure of bone lengthening which was presented by McCarthy et al. represents a limited surgical intervention and therefore open up a new perspective of treatment, especially in younger children with severe deformities. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, a tilted occlusal plane, and a short mandible. A 14-years-old boy with facial asymmetry, who was fractured on both condyle and mandibular symphysis before 8 years ago, was treated by mandibular ramus lengthening, symphysial widening and surgically assisted rapid palatal expansion with corticotomy. After allowing 1 week for the healing of the periosteum, the distraction was performed at the rate of 0.5-1.0mm per day for 7 days on maxilla and 14 days on mandible. The device was maintained on maxilla and mandible for 12 weeks following distraction. The difference in ramus and mandibular transverse deficiency were corrected and facial asymmetry was improved with complex distraction osteogenesis.