After Le Fort I osteotomy was first performed by von Langernbeck in 1859, there has been many improvements since. Research on and development of Le Fort I osteotomy procedure has shown downward movement of the maxilla to exhibit lowest stability and accuracy. However, maxillary downgraft movement is necessary in orthognathic patients with insufficient vertical length of the maxilla, but fixation of the maxilla after elongation is often very inaccurate. In this study, the authors utilized 3D virtual surgery, CAD/CAM-assisted 3D printing technology to overcome such limitations of maxillary total elongation. In addition, accuracy at 7 different landmarks from superimposition of virtual simulation data and postoperative Cone-beam computed tomography (CBCT) data were measured. Although posterior maxilla exhibited bigger range of errors, an error of <1 mm was measured at all 7 landmarks. Operation time was greatly shortened with cutting guides and customized plates. Although this study is a single-case study, this study shows increased accuracy and efficacy from application of 3D virtual surgery, CAD/CAM, and 3D printing technology.

during cleft palate repair and its effects on eustachian tube function.

Renal cell carcinoma (RCC) is the most common tumor of the kidney. Although RCC often metastasizes to other organs, metastasis to the head and neck region is rare, and metastasis to the mandible is very unusual. Given the fact that metastasis of primary neoplasms is not always predictable, it is essential to rule out metastatic carcinoma in jaw lesions. We herein report a rare presentation of metastasis of RCC to the mandible, in which the metastatic lesion in the oral cavity was found first, followed by the primary lesion, in a 22-year-old girl who suffered from pain in the left temporomandibular joint on mouth opening and hypoesthesia of the left chin, left lower lip, and left lower gum.

Osteoma of mandibular condyle is uncommon benign tumor that grows slowly. Growth of condylar osteoma can cause functional and morphological problems such as facial asymmetry and malocclusion. Surgical removal and concurrent temporomandibular condyle replacement is a strategy that can resolve functional and aesthetic problems associated with large osteoma of mandibular condyle. Total joint replacement (TJR) with computer-associated surgical simulation (CASS) and computer-aided design/computer-aided manufacturing (CAD/CAM) technology can effectively and accurately rehabilitate debilitated condyle. A 52-year-old female visited department of Oral and Maxillofacial Surgery at Seoul National University Dental Hospital with a chief complaint of facial asymmetry and discomfort of left temporomandibular joint (TMJ). Radiographic and CT images showed a large bony mass at left TMJ surrounding left condylar head. Clinical examination revealed mandibular shift to right side, causing malocclusion and facial asymmetry. TJR of left TMJ with customized alloplastic condyle prosthesis and Biomet fossa was planned for the patient. Condyle was designed and fabricated using CAD/CAM. Surgical guides and occlusal splint fabricated with CAD/CAM technology was well. After 2 years, patient still showed occlusal stability with restored facial symmetry. No complications or recurrence were observed. TJR with customized alloplastic condyle and stock fossa can be an effective treatment strategy for large symptomatic condylar osteoma in restoration of normal function and aesthetics.