Won-Wook Song

Sequential treatment for a patient with hemifacial microsomia: 10 year-long term follow up

Hemifacial microsomia (HFM) is the most common craniofacial anomaly after cleft lip and cleft palate; this deformity primarily involves the facial skeleton and ear, with either underdevelopment or absence of both components. In patients with HFM, the management of the asymmetries requires a series of treatment phases that focus on their interception and correction, such as distraction osteogenesis or functional appliance treatment during growth and presurgical orthodontic treatment followed by mandibular and maxillary surgery. Satisfactory results were obtained in a 9-year-old girl with HFM who was treated with distraction osteogenesis. At the age of 19, genioplasty and mandible body augmentation with a porous polyethylene implant (PPE, Medpor®, Porex) was sequentially performed for the functional and esthetic reconstruction of the face. We report a case of HFM with a review of the literature.

Maxillary Yaw as the Primary Predictor of Maxillary Dental Midline Deviation: 3D Analysis Using Cone-Beam Computed Tomography

PURPOSE The purpose of this study was to investigate which factors affect upper dental midline deviation in dentofacial deformity patients using cone-beam computed tomography analysis. PATIENTS AND METHODS Twenty-eight patients were selected for this study. Subjects were divided into 2 groups according to the amount of upper incisor (U1) midline deviation from the clinical facial midline: group 1 (U1 deviation <2 mm) and group 2 (U1 deviation >2 mm). Linear measurements, angles, and reference planes on 3-dimensional (3D) computed tomograms were obtained. The predictor variables were maxillary yaw, palatal plane angle, differences of maxillary point to the coronal and sagittal planes, and maxillary canting. The outcome variable was U1 deviation. The variables between the 2 groups and 2 sides were analyzed with a t test. Pearson correlation coefficient and multiple regression analysis were also calculated within each group for each measurement against the U1 deviation to determine which variables affect U1 deviation. P < .05 was considered statistically significant. RESULTS The patients were evenly distributed between each group (n = 14 in each group). There was significant deviation of U1 from the sagittal plane in group 2 compared with group 1 (0.99 mm in group 1 vs 1.73 mm in group 2, P < .05). When we compared yaw with the sagittal plane, group 2 was more rotated than group 1 (1.16° in group 1 vs 2.28° in group 2, P < .01). Through multiple regression analysis, the primary predictor variable for U1 deviation was maxillary yaw (P < .05). CONCLUSIONS This study suggests that maxillary yaw is the primary contributing factor for upper dental midline deviation. The use of maxillary yaw should be considered when one is performing orthognathic surgery in patients with U1 deviation to achieve optimum esthetics.

Osseointegration of magnesium-incorporated sand-blasted acid-etched implant in the dog mandible: Resonance frequency measurements and histomorphometric analysis

The aim of this pilot study was to investigate the bone responses of novel magnesium (Mg)–incorporated sand-blasted and acid-etched (SLA) titanium (Ti) implant in an experimental animal model. Novel Mg-incorporated SLA Ti implant was obtained via vacuum arc source ion implantation method and Mg-ions were implanted into the SLA implant surface. Control group consisted of two commercial implants; resorbable blasting media (RBM) and SLA. Twelve implants from each group were placed into the mandibles of 6 mongrel dogs. Experimental animals were divided into 2 groups of 3 animals, with 4 weeks and 8 weeks healing time points. Resonance frequency analysis was performed at the time of fixture installation, 1, 2, 4, and 8 weeks after installation. Bone to implant contact (BIC) measurements were assessed at the 4 and 8 weeks healing time points. The overall implant survival rate was 97.2%. The Mg-incorporated SLA Ti implants showed more rapid osseointegration than control group implants at follow-up periods of 4 weeks. Histomorphometric analysis showed a tendency for BIC% values of Mg-incorporated SLA Ti implant to be higher than that of other the implant groups. The results of this study suggest that Mg-incorporated SLA Ti implant may be effective in enhancing the bone responses by rapid osseointegration in early healing periods.

Effects of low level laser therapy (LLLT) on pressured human osteoblasts: A histomorphologic and quantitative study

Previous research has investigated the effects of LLLT during titanium implantation, tooth movement and bone graft using deproteinized bovine bone and recognized that these circumstances were nothing more than intentional controlled overpressure against static cells since this controlled trauma could affect cell function/malfunction, or cell recovery/apoptosis. The present preliminary study was conducted to prove if LLL would influence cell viability and cell function after excessive damage, which is enough to diminish cell numbers and distort the features of cells. Our aim is to evaluate whether low level laser irradiation (LLLi) could be helpful in the recovery of traumatized osteoblasts (pressure damaged cells) by observing the morphology and the survival rate of those cells. This model used bone cell cultures which were traumatized by a pressure with 250 G of centripetal force and observed their response to such trauma and low level laser irradiation. In this experiment, a Ga-Al-As diode LLL (IMPRA-ORT, NDLux, Seoul, KOREA) was used with a wavelength of 808 nm, a focus of 14 × 24 mm, which was wide enough to cover the whole dish surface or well within at least 2 times radiation, and an output of 100 mW. Statistical analysis showed a higher recovery rate of damaged osteoblasts in the radiation group than the non-radiation group (p < 0.05). The nonradiation group had a very poor proliferation rate in comparison to the control group (p < 0.05) in every time period. In the control group, actin filaments showed a random orientation and cell process branched variously around each cell. In contrast, compressed cells, these patterns were turned into thicker and shorter cytoskeletons. As time progressed, every living cell recovered from the severe stress and recovered both form and function. In summary, the present study showed the capacity of LLLT to aid the recovery of the cell skeleton and affect cell viability on overpressured osteoblasts. These results may contribute toward a better understanding of the effect of LLLT on the recovery of cells after trauma. In addition, our results demonstrated that LLLT could be used in the field of bone tissue engineering to traumatized bone conditions and repair large bone defects such as bone graft and implant installation.