• Title/Summary/Keyword: Surgical reposition

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SURGICAL REPOSITIONING OF AN INTRUDED PERMANENT MAXILLARY INCISOR IN A CEREBRAL PALSY PATIENT: A CASE REPORT (뇌성마비 환자에서 함입된 상악 중절치의 외과적 재위치: 증례보고)

  • Lee, Koeun;Lee, Myeongyeon;Lee, Jae-ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.43-46
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    • 2017
  • Patients with cerebral palsy have higher risk of traumatic dental injuries because of clinical characteristics, such as, ataxia, large overjet and lip incompetency. Especially, intrusive luxation has rare occurrence but higher incidence of complications. It can be treated by expecting re-eruption, orthodontic reposition, and surgical reposition. Clinicians should be aware of management and follow-up in dealing with cerebral palsy patients who are exposed by intrusive luxation, due to their involuntary movement. This case report describes a 9-year-old male patient with cerebral palsy and epilepsy who experienced intrusion of maxillary permanent central incisor. After one-month follow-up, waiting for spontaneous eruption, pulp necrosis on maxillary permanent central incisor had proceeded. Therefore, surgical reposition with resin wire splint and apexification was performed under conscious sedation with midazolam. After two months, removal of resin wire splint was done. Gutta percha filling and composite resin restoration were performed after sixteen months. During five-year follow-up ankylosis and partial root resorption were observed. But there was no significant complications.

TREATMENT OF THE INTRUDED PERMANENT INCISORS : SURGICAL REPOSITION AND ORTHODONTIC TRACTION (외과적 재위치와 교정적 정출술을 이용한 함입된 외상치의 치험례)

  • Shin, Ji-Sun;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.4
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    • pp.654-659
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    • 2003
  • Intrusive luxation that takes approximately three percent of permanent teeth commonly occures at anterior teeth. This intrusion frequently leads to pulp necrosis, root resorption, marginal bone loss and these complications are influenced by depth of intrusion and stage of root development. Various treatment approaches have been suggested to manage of intrusive luxation. Techniques aiming to reposition the intruded tooth include an observation for spontaneous re-eruption, surgical or orthodontic repositioning. We report two cases with clinically satisfactory results for traumatically intruded maxillary central incisor. In one case which has a large open apex and mild intrusion depth, we observed for spontaneous eruption and then repositioning by forced eruption method. In other case, which has been completely intruded, was repositioned by surgical extrusion and followed by apexification.

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Anatomical repair of a bilateral Tessier No. 3 cleft by midfacial advancement

  • Oh, Ji-hyeon;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.9.1-9.4
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    • 2018
  • Background: Bilateral Tessier number 3 clefts are extremely rare, and their surgical treatments have not been well established. Case presentation: The authors describe the case of a patient with a right Tessier number 3, 11 facial cleft with microphthalmia, a left Tessier number 3 facial cleft with anophthalmia, and cleft palate. We repaired simultaneously the bilateral soft tissue clefts by premaxillary repositioning, cleft lip repair, facial cleft repair by nasal lengthening, midfacial advancement, and an upper eyelid transposition flap with repositioning both the medial canthi. Postoperatively, the patient showed an esthetically acceptable face without unnatural scars. Conclusions: We achieved good results functionally and esthetically by midfacial advancement with facial muscle reposition instead of traditional interdigitating Z-plasties. The surgical modality of our anatomical repair and 3 months follow-up results are presented.

ARREST OF ROOT DEVELOPMENT AFTER SURGICAL REPOSITIONING OF THE INVERTED MAXILLARY CENTRAL INCISOR : CASE REPORT (역위 매복된 상악 중절치의 외과적 재위치 후 치근 발육 정지)

  • Song, Je-Seon;Choi, Byung-Jai;Choi, Huung-Jun;Kim, Seong-Oh;Son, Heung-Gyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.1
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    • pp.162-168
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    • 2007
  • Impaction of the maxillary central incisor may cause social, esthetic, and functional problems in children. There are various means of treatment for the inverted maxillary central incisor, such as extraction, surgical opening followed by orthodontic traction surgical repositioning or intra-alveolar autotransplantation prior to extraction. In this case, we surgically repositioned the inverted maxillary central incisor to normal semi-erupted position in a 5-year-old boy The developmental stage of the inverted tooth was Nolla's 6.5, which indicates formation of less than one third of the root. After surgical reposition, we did follow-up for 21 months, expecting spontaneous growth Unfortunately, poor prognosis was noted further root was not observed. Such failure seems to originate from possible injury on Hertwig's epithelial root sheath by surgical trauma. We performed surgical repositioning to retain the tooth instead of extraction. However, arrest of root development occurred which is one of the critical complications. In order to increase the success rate of the surgical reposition procedure, minimal surgical trauma is required as well as selection of adequate indication and decision of proper time of treatment considering the stage of root development.

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ORTHOPEDIC AND SURGICO-ORTHODONTIC TREATMENT IN THE LONG FACE (Long Face(open-bite) 환자의 수술 교정 치료)

  • Baik, Hyoung Seon
    • The korean journal of orthodontics
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    • v.19 no.3
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    • pp.147-160
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    • 1989
  • Long face patients are characterized by excessive anterior facial height, lip incompetence at rest, anterior open bite, and gummy smile. A major problem is an inferior rotation of the posterior maxilla and upper molars. Long face patients have been the most difficult for orthodontist to treat successfully. In growing patients, the methods for impeding excessive vertical growth have been used high pull head gear, functional appliance, and combined type of two. One significant improvement comes from using a full arch splint to deliver force to the maxilla more vertically. In adult patients, orthodontic camouflage treatment is biomechanically difficult and doesn't work when the problem is primarilly vertical. Surgical maxillary impaction provides a means for successfully treating most of problems. Also, superior reposition of the chin via a mandibular inferior border osteotomy is effective in decrease of lower anterior facial height and correction of the poor chin-lip balance. Post-surgical stability and the physiologic response are good. The coordinated orthodontic and surgical treatment is necessary for solution the difficult skeletal deformity.

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Comparison of surgical approach and outcome for the treatment of cystic lesion on lower jaw

  • Oh, Suseok;Park, Joon-Hyung;Paeng, Jun-Young;Kim, Chang-Soo;Hong, Jongrak
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.5
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    • pp.276-283
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    • 2012
  • Objectives: Curettage and enucleation are two of the most common procedures performed in oral and maxillofacial surgery units. To access a cystic lesion, the buccal cortical plate is removed. The no reposition (NR) group underwent surgery without repositioning the buccal cortical plate. The reposition (R) group underwent surgery with a repositioning of the buccal cortical plate. This study compared the two surgical procedures in terms of bone healing and complications. Materials and Methods: Patients who underwent curettage and enucleation surgery were enrolled in this study. Panoramic radiographs of the patients in both the NR group (n=26) and R group (n=34) were taken at the baseline and at 6, 12 and 24 months after surgery. The radiolucent area was calculated to evaluate bony healing in each radiograph. The complications were analyzed through a review of the medical records. Results: The correlation between bony healing and surgical approach was not significant in the 6th, 12th, and 24th month (P<0.05). The complication rate was not associated with gender, graft material, bone graft and drain insertion (P<0.05). On the other hand, the R group had a higher complication rate (35.3%) than the NR group (0%). The difference in the mean lesion size between the NR group ($37,024{\pm}3,617$ pixel) and R group ($92,863{\pm}15,931$ pixel) was significant (independent t test, P=0.004). Conclusion: Although the reposition method is chosen when the lesion size is large, it is associated with more complications. Indeed, infection, discomfort and recurrence of the lesion were the most common complications in the R group. Furthermore, the R method does not have a strong point in terms of bone healing compared to the NR method. Therefore, the R method cannot be considered an ideal approach and should be used in limited cases.

AUTOTRANSPLANTATION OF TRANSPOSITIONED MAXILLARY CENTRAL INCISOR WITH MESIODENS AND IMPACTED MAXILLARY CANINE : A CASE REPORT (과잉치를 동반한 상악 중절치 전위와 상악 견치 매복에서 자가이식에 의한 치험례)

  • Nam, Dong-Woo;Kim, Hyun-Jung;Nam, Soon-Hyeun;Kim, Young-Jin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.4
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    • pp.727-733
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    • 1997
  • Autotransplantation is a procedure which transplants teeth from the original position to other positions in the same individual. It is classified surgical reposition by intraalveolar autotransplantation and transalveolar autotransplantation. The prognosis for successful autotransplantation is dependent on a number of factors such as root development, surgical technique, patient's age, endodontic treatment, time and type of splinting, preservation of periodontal ligament and storage medium. The most important factor is preservation of periodontal ligament. The cause of the failure of transplantation include damage of the transplant during removal from deep palatal malposition, poor regeneration of the bone around the transplant and chronic periodontal infection. In case I, Impacted maxillary canine for which surgical exposure and orthodontic treatment was impossisle was transplanted. After 2 weeks, It showed periapical radiolucency and external root resorption. So, endodontic treatment was done. One year later, permanent filling was done with gutta percha. In case II, Transpositioned maxillary central incisor was transplanted after extraction of impacted mesiodens. Pulp vitality was maintained during 5 months without other clinical symptons.

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Safe and Effective Reduction Malarplasty (안전하고 효과적인 광대축소술)

  • Kang, Young Ho
    • The Journal of the Korean dental association
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    • v.58 no.2
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    • pp.103-113
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    • 2020
  • Background: Reduction malarplasty is one of the most popular facial contouring surgeries in east Asia for making patients' faces smaller. Currently in Korea, reduction malarplasty surgeries are performed mostly at plastic surgery clinics, but few cases are done at oral and maxillofacial surgery clinics. The reason might be because of post-operative complications after reduction malarplasty, such as undercorrection, overcorrection, asymmetry, cheek drooping, malunion, pain and noise. Those complications should be uneasy to be handled by oral and maxillofacial surgeons, however, they can be prevented by knowing the effective and safe reduction malarplasty techniques. Therefore, in this article the author as an oral and maxillofacial surgeon, would like to suggest safe and effective surgical methods for reduction malarplasty customized for Korean patients. Method: L- shape osteotomy of zygomatic body was performed with intraoral approach via vestibular incision, and the zygomatic arch was osteotomized with extraoral approach via sideburn incision. Then zygomatic complex was separated and rotated mesio-superiorly without removal of a bony strip and fixed with miniplates and microplates without making a bony gap. Conclusion: Surgical results were favorable and satisfied by the patients without cheek drooping, malunion, undercorrection and asymmetry.

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INFERIOR ALVEOLAR NERVE REPOSITIONING IN THE ATROPHIC POSTERIOR MANDIBULAR ALVEOLAR RIDGE (하악 무치악 인공치아매식술시 하치조신경 전위술)

  • Choi, Eui-Hwan;Ha, Jeong-Wan;Kim, Su-Gwan;Chung, Tae-Young;Kim, Soo-Heung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.226-231
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    • 2001
  • Modified surgical technique for transposition of the inferior alveolar nerve followed by immediate placement of endosseous implants in mandibles with moderate to severe atrophy are presented. Five transpositions of the inferior alveolar nerve together with the installation of 10 implants were performed in four patients. The mean postoperative follow-up time was 17 months, with a range of 8 to 20 months. All implants with functioning pontics remained stable, with no mobility or symptoms of pain and infection during the follow-up period. Neurosensory evaluation was performed using the two-point discrimination test. Two patients had objective neurosensory dysfunction at postoperative, but all the nerve function were reported as normal by the patients 4 months postoperatively.

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Prevention of Cheek Drooping in Intraoral Reduction Malarplasty without Internal Fixation (볼처짐 최소화를 위한 최소절개 및 박리 관골 축소 성형술)

  • Park, Dong-Kwon;Choi, Jae-Hoon;Lee, Jin-Hyo;You, Young-June
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.845-850
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    • 2011
  • Purpose: In general, orientals including Korean, have a mesocephalic face whereas Caucasians, among the western, have a dolichocephalic face. Unlike the western, in orientals including Korean, prominent malar bones are recognized as stubborn and unattractive appearance. That is why reduction malarplasty is one of the most popular aesthetic surgical procedure in Korea. Many surgical methods to reposition prominent malar bones have been performed by means of a coronal incision or a combined incisions, using both the intraoral and the external incision. Bicoronal approach has advantage such as wide operative field, easy to maintain symmetry and possibility of combining facial lift but has shortcoming, such as external scars, long operative time, and the possibility of facial nerve or artery injury. Intraoral approach has advantages of short operative time, simplicity of procedure and no external scar. But this approach is associated with problems of cheek drooping, limited exposure and difficulty in making symmetry. Methods: During 8 years, we performed a reduction malarplasty without internal fixation through an minimal intraoral incision and dissection in 39 patients. Results: The patients were followed for 46 months, with satisfactory results and no cheek drooping. There was no patient who want to revise the inappropriate operative result such as asymmetry and incomplete correction. Conclusion: We conclude that minimal intraoral incision and dissection could acquire satisfactory result of reduction malarplasty along with prevention of cheek drooping.