Self-inflating oral tissue expander for ridge augmentation in the severely atrophic mandible

In dentistry, tissue expanders have been used to obtain sufficient soft tissue for alveolar bone augmentation in the severely atrophic ridge. Herein, we review two cases of soft tissue augmentation using a self-inflating tissue expander in patients in the Department of Oral and Maxillofacial Surgery at Ewha Womans University Mokdong Hospital for bone graft and implant operations. The results of each patient were presented using pre-operative and post-operative radiographs and clinical exams. The results of our study indicate successful bone graft and implant surgery using a self-inflating tissue expander.

Self-inflating oral tissue expander for ridge augmentation in the severely atrophic mandible

In dentistry, tissue expanders have been used to obtain sufficient soft tissue for alveolar bone augmentation in the severely atrophic ridge. Herein, we review two cases of soft tissue augmentation using a self-inflating tissue expander in patients in the Department of Oral and Maxillofacial Surgery at Ewha Womans University Mokdong Hospital for bone graft and implant operations. The results of each patient were presented using pre-operative and post-operative radiographs and clinical exams. The results of our study indicate successful bone graft and implant surgery using a self-inflating tissue expander.

Clinical evaluation of temporomandibular joint disorder after orthognathic surgery in skeletal class II malocclusion patients

OBJECTIVES: This study was performed in order to evaluate the occurrence of temporomandibular joint disorder after surgical correction of skeletal class II malocclusion. MATERIALS AND METHODS: This study included 21 patients who underwent orthognathic surgery for the correction of dentofacial deformities by a single surgeon at Mokdong Hospital, Ewha Womans University from 2000 to 2010. They underwent bilateral sagittal split ramus osteotomy for the treatment of undesirable mandibular advancement. The temporomandibular disorder (TMD) symptoms prior to surgery were recorded and the radiographic evaluation (panorama, bone scan, and magnetic resonance imaging [MRI]) of the post-surgery temporomandibular joint (TMJ) were assessed in order to evaluate condylar resorption, remodeling and disc displacement. The minimum follow-up period, including orthodontic treatment, was 12 months. Orthognathic procedures included 1-jaw surgery (n=8 patients) and 2-jaw surgery (n=13 patients). The monocortical plate was used for bilateral sagittal split ramus osteotomy fixation. RESULTS: Among class II malocclusion patients with TMD symptom, clicking improved in 29.1%, and maximum mouth opening increased from 34.5+/-2.1 mm to 37.2+/-3.5 mm. The differences were not statistically significant, however. Radiographic changes in bone scan improved slightly based on the report by radiologist but not in TMJ dynamic MRI. CONCLUSION: No particular improvements were found in patients with joint sound only. Patients with limitation of mouth opening showed an increase in the degree of opening, but the difference was not statistically significant (P>0.05).

Comparative study on the estimated blood loss follwing to orthognathic surgeries

PURPOSE: The aim of this study was to compare the estimated blood loss and determine the change in hemoglobin depending on the combination of each orthognathic surgery. SUBJECTS AND METHODS: The subjects of this study were patients who underwent orthognathic surgery among those diagnosed with a dentofaical deformity in Mok-Dong hospital, Ewha Womans University from 2002 to 2009. One hundred patients (men - 36, women - 64, mean age of 24.5+/-4.6) participated in the study and were divided into four groups (group 1 - bilateral sagittal ramus osteotomy [BSSRO], group 2 - BSSRO+Genioplasty, group 3 - Lefort 1+BSSRO+genioplasty, group 4 - anterior segmental osteotomy on maxilla and mandible). A comparative study on the estimated blood loss (EBL), operation time, peri-operative changes in hemoglobin was performed using anesthesia records. The results were analyzed statistically using a Mann-Whitney U-test and Spearman's Rho test - SPSS 12.0 (SPSS Inc. Chicago, IL, USA). RESULTS: In group 1 (BSSRO), the mean EBL, operation time and change in hemoglobin was 394.43+/-52.69 ml, 184+/-42.33 minutes, and 1.43, respectively, In group 2 (BSSRO+genioplasty), it was 556.32+/-63.42 ml, 231+/-37.45 minutes, and 1.80, respectively. In group 3 (Lefort 1+BSSRO+Genioplasty), it was 820.55+/-105.54 ml, 320+/-15.41 minutes, and 2.73, respectively. In group 4 (segmental osteotomy), it was 1025.39+/-160.21 ml, 355+/-20.10 minutes, and 3.33, respectively. In particular, in group 3, significant differences were observed depending on the method of the orthognathic surgery. The mean EBL in a Lefort 1 osteotomy with advancement was only 687 ml, whereas Lefort 1 osteotomy with canting correction (992 ml), even impaction (764 ml), and posterior nasal spine impaction (100 ml) showed a much higher EBL. CONCLUSION: From these results, the EBL and peri-operation hemoglobin increased as treatment plans became more complicated and increasing operation time. Safe orthognathic surgery should be performed by applying proper autologous transfusion plans based on the average EBL of each orthognathic surgery type.

Maxillary distraction osteogenesis in the management of cleft lip and palate: report of 2 cases

This study is to evaluate the growth and development of the maxilla advanced by transoral distraction osteogenesis of cleft lip and palate children. Subjects are two patients diagnosed as maxillary hypoplasia with cleft lip and palate, and followed up over 5 years after distraction. At the age of 11.4 years (mean), the distraction had been rendered and periodically taken lateral cephalograms were analysed to trace the growth of the maxilla. This cephalometric study showed continuous growth and development of the distracted maxilla to be stable through long term follow-up.