• Title/Summary/Keyword: 교정적 처치

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The effect of cortical punching on the expression of OPG, RANK, and RANKL in the periodontal tissue during tooth movement in rats (백서의 치아이동 시 피질골 천공이 치주조직의 OPG, RANK, RANKL의 발현에 미치는 영향)

  • Park, Woo-Kyoung;Kim, Seong-Sik;Park, Soo-Byung;Son, Woo-Sung;Kim, Yong-Deok;Jun, Eun-Sook;Park, Mi-Hwa
    • The korean journal of orthodontics
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    • v.38 no.3
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    • pp.159-174
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    • 2008
  • Objective: The purpose of this study was to investigate whether cortical punching could stimulate the expression of OPG, RANK, and RANKL during tooth movement by immunohistochemistry. Methods: 34 sprague-dawley rats (15 weeks old) were allocated into 3 groups: TMC group (experimental group; Tooth Movement with Corticotomy, n = 16), TM group (control group; Tooth Movement only group, n = 16), and non-treatment group (n = 2). 20 gm of orthodontic force was applied to rat incisors by inserting elastic bands. The duration of force application was 1, 4, 7 and 14 days. A microscrew (diameter 1.2 mm) was used for cortical punching of the palatal side of the upper incisors in the TMC group. Results: Distributions of OPG, RANK, and RANKL were evaluated by immunohistochemistry. OPG, RANK and RANKL were observed on experimental and control groups. On the compression side, the degree of the expression of OPG decreased in both groups. The expression of RANK was most prominent in the experimental group of day 4. The expression of RANKL was most intensive and extensive in the experimental group of day 7. However, the expression of OPG was decreased in the experimental and control groups compared to the non treatment group. The expression of OPG, RANK and RANKL after force application were decreased at day 14. Conclusions: These findings suggested that cortical punching might stimulate remodeling of alveolar bone during a 2 week period of tooth movement without any pathologic change.

ORTHODONTIC TRACTION OF HORIZONTALLY ERUPTED LOWER LATERAL INCISOR ON THE LINGUAL SIDE (설측으로 수평 맹출한 하악 측절치의 교정적 견인)

  • Mah, Yon-Joo;Sohn, Hyung-Kyu;Choi, Byung-Jai;Lee, Jae-Ho;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.117-123
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    • 2010
  • Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.

THE ANOMALIES OF PERMANENT DENTITION IN CLEIDOCRANIAL DYSPLASIA (쇄골두개 이형성증 환아의 치아발육이상)

  • Shin, Eun-Young;Choi, Byung-Jai;Lee, Jae-Ho;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.1
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    • pp.180-184
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    • 2001
  • Cleidocranial Dysplasia(CCD) is an autosomal dominant human bone disease characterized by abnormal clavicles, patent sutures and fontanelles, and dental anomalies. Among dental anomalies, it is characterized that permanent dentition is severly disturbed due to multiple supernumerary teeth and abnormalities of tooth morphology. A eight-year-old female patient diagnosed as cleidocranial dysplasia visited in our hospital. Upon clinical oral exam, retained deciduous teeth, constriction of dental arch, anterior cross bite, and multiple dental caries were observed. In the dental panoramic radiograph, retained deciduous teeth and multiple supernumerary teeth in the maxilla and the mandible were found. In the cephalometric radiograph, open sutures and wormian bones were seen. In the chest P-A view absence of clavicles was observed. The cleidocranial dysplasia patients have eruption problems in permanent dentition both in regions with and without supernumerary teeth. The severely delayed or arrested eruption of permanent teeth has been ascribed to various factors : 1) The presence of multiple supernumerary teeth, 2) malformed roots with lack of cellular cementum, 3) the jaw bone being too dense, and 4) abnormal resorption of bone and primary teeth. Formation and maturation of primary teeth in cleidocranial dysplasia are normal, whereas the permanent dentition has various anomalies. Therefore, dentists should understand the development of dentition in cleidocranial dysplasia, and treat them in proper time.

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The expression of MMP-1, -8, and -13 mRNA in the periodontal ligament of rats during tooth movement with cortical punching (백서의 치아이동 시 피질골 천공이 치주조직의 MMP-1, -8, -13 mRNA의 발현에 미치는 영향)

  • Gwack, Choon;Kim, Seong-Sik;Park, Soo-Byung;Son, Woo-Sung;Kim, Yong-Deok;Jun, Eun-Sook;Park, Mi-Hwa
    • The korean journal of orthodontics
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    • v.38 no.3
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    • pp.187-201
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    • 2008
  • Objective: The aim of this study was to determine whether cortical punching stimulates the expression of matrix metalloproteinase-1, -8, and -13 in orthodontic tooth movement in rats. Methods: A total of 32 male sprague-dawley rats at 15 weeks old were divided into two groups of 16 rats each, to form the tooth movement with cortical punching (TMC) group and tooth movement only (TM) group. A total of 20 gm of orthodontic force was applied to rat incisors to cause experimental tooth movement. Cortical punching was performed on the palatal side near the central incisor with a 1.0 mm width microscrew in the TMC group. The duration of tooth movement was 1, 4, 7, and 14 days. Results: Measurements of the mRNA expression were selected as the means to determine the identification of expression of MMP-1, -8, and -13. In the TMC group, the expression of collagen type I was greater than that of the TM group from day 4 to day 14. Expression of TIMP-1 in the TM group was greater than that of the TMC group in the pressure side of PDL and alveolar bone cell at day 4. In the TMC group, TIMP-1 was expressed at the osteoclast, but not at the tooth surface of the TM group at day 14, Maximum induction of the mRNA of MMP-1 was observed on day 4 in the TMC group, but it was observed on day 7 in the TM group. MMP-8 mRNA of the TMC group was twice greater than that of the TM group at f days. In the TMC group, maximum induction of MMP-13 mRNA was observed on day 1. Conclusions: These findings suggested that cortical punching can stimulate remodeling of PDL and alveolar bone connective tissues during experimental orthodontic tooth movement in rats.

ORAL MENIFESTATION AND TREATMENT STRATEGIES IN CLEIDOCRANIAL DYSPLASIA (쇄골두개 이형성증 환아의 구강내 증상과 치료 전략)

  • Park, Hee-Suk;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.3
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    • pp.456-463
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    • 2009
  • Cleidocranial dysplasia(CCD) is a congenital disorder of skeletal and dental abnormality, which is a mesodermal dysfunction influencing many tisssues and organs. Skeletal abnormalities in CCD are delayed closure of cranial suture and fontanelle, presence of wormian bone and clavicle aplasia. CCD also has an effect on long bones, phalanges, spine, pelvis, muscles, and central nervous system. Dental manifestations include retention of deciduous teeth, multiple supernumerary teeth, delayed eruption or impaction of permanent teeth and formation of cysts around nonerupted teeth. However, due to lack of any substansive medical or physical disability, diagnosis is often late, thereby causing masticatory and psychological problems caused by delayed eruption of permanent teeth after exfoliation of deciduous teeth. For this reason, CCD requires early diagnosis, and the patient's appearance must be improved. Also, provision for a functional masticatiory mechanism by treatment of surgical removal of supernumerary teeth followed by orthodontic eruption of the natural permanent teeth at an adequate time is necessary.

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Altered Functions of Adrenoceptors in Splanchnic Vascular Beds in Portal Hypertensive Rat Model: Effect of Propranolol (문맥 고혈압 흰쥐에 있어서 내장혈관의 아드레나린성 수용체의 기능변동과 이에 대한 Propranolol의 효과)

  • Kim, Chi-Dae;Hong, Ki-Whan
    • The Korean Journal of Pharmacology
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    • v.24 no.1
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    • pp.63-70
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    • 1988
  • Alterations in splanchnic circulatory hemodynamics along with reactivities to the alpha adrenoceptor agonists were assessed in association with the preventive effects of propranolol 10 days after portal ligation. Decreases in precapillary resistance (Ra) and postcapillary resistance (Rv) along with increases in mesenteric blood flow (MBF) and capillary pressure (CP) were observed in conjunction with an increment of splenic pulp pressure (SPP). Dose-dependent increase in Rv in response to noradrenaline, increases in Ra and RV to adrenaline, and increases in superior mesenteric arterial pressure (SMAP), Ra and Rv to phenylephrine observed in sham group were significantly attenuated by portal vein stenosis. In PPL-3 group (propranolol 3 mg/kg, i.p. three times daily for 10 days), MBF was significantly decreased in association with decrease in mesenteric venous pressure (MVP) when compared with those of protal ligated (PL) group, and decreased Ra and Rv in PL group were recovered toward the values of sham group. Likewise, in PPL-1 group (propranolol 5 mg/kg, i.p. once daily for 10 days), the pressor response of Rv to adrenaline was recovered up to the level of sham group. Thus, it is suggested that decreases in Ra and Rv in association with increases in MBF and CP may have a close relevance to the increased SPP, and the changes in circulatory hemodynamics and vascular reactivities were effectively reversed by longterm propranolol treatment. Based on these results, it is concluded that these changes observed in portal hypertension are closely related with the altered functions of the adrenoceptors in the splanchnic vascular beds.

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PYKNODYSOSTOSIS : A CASE REPORT (Pyknodysostosis 환아의 구강증상: 증례보고)

  • Kim, Nam-Hyuk;Lee, Jae-Ho;Kim, Seong-Oh;Choi, Hyung-Jun;Song, Je-Seon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.619-624
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    • 2009
  • Pyknodysostosis(PKND) is a rare sclerosing bone disorder that has an autosomal recessive trait, also known as Toulouse-Lautrec syndrome. Deficiency of the cathepsin enzyme K in the osteoclasts of PKND patients results in continuous endosteal bone deposits without osteoclastic resorption or remodeling. This causes a generalized increase in sclerosis and fragility of bones. Osteomyelitis in the mandible and recurrent fracture of the long bones are characteristic complicatons of PKND. The patients present typical features of PKND, such as short stature under 150 cm, open cranial suture and fontanelle, club-shaped phalanges, and underdevelopment of midface. This is a case of a 7-year-old girl with PKND, who visited our clinic with the chief complaint of anterior Open-bite and generalized crowding. The patient had been diagnosed as PKND by an orthopedist and manifested characteristic clinical and radiographic features, such as open cranial suture and fontanelle, obtuse madibular gonial angle, frontal and occipital bossing, grooved palate, club-shaped phalanges, and short stature. Orthodontic treatment was not considered because patients with PKND show abnormal bone resorption and remodeling. Instead, removal of deciduous teeth near exfoliation and TFA were performed, and periodic check-up is planned to maintain good oral hygiene.

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Relationship between disk displacement of temporomandibular joint and dentofacial asymmetry (측두하악관절 원판 변위와 치열 및 안면부 비대칭의 관계에 대한 연구)

  • Nahm, Kyoung-Soo;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.33 no.3 s.98
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    • pp.211-222
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    • 2003
  • The purpose of this study was to determine whether there is an association between disk displacement of the Temporomandibular Joint (TMJ) and dentofacial asymmetry In orthodontic patients. The subjects consisted of 60 female orthodontic patients between the ages of 18 and 38 years (mean age 23.3 years) who had visited the Department of Orthodontics at Seoul National University Dental Hospital from January 2000 to April 2002. On the basis of magnetic resonance imaging (MRI) of their bilateral TMJs, the subjects were divided Into four groups'. bilateral normal group (twenty-one persons); disk displacement of right TMJ group (six persons); disk displacement of left TMJ group (nine persons); and disk displacement of both TMJs group (twenty-four persons) Postero-anterior (PA) cephalograms and diagnostic models which had been taken before orthodontic treatment were measured. In the linear measurements, a line connecting the right and left Latero-Orbitale (Lo) represented the horizontal reference line (H). The vertical reference line (V) was constructed as a line bisecting and running perpendicular to H. One-way analysis of variance (ANOVA) was used to test whether the mean values of measurements between groups were significantly different. In addition, Bonferronil's multiple comparison test was performed at a level of 0.05. The results were as follows; 1 In the diagnostic model analysis, the overjet, nght molar relationship, and left molar relationship were significantly different among the four groups. 2. In the PA cephalometric analysis, differences in the right and left vertical position of the lower first molar and Ag were significantly dissimilar among the four groups. 3. If the disk displacement of TMJ was present on one side, the ipsilateral ramus was shorter, resulting in asymmetry in the vertical position of Ag. This study indicated that dentofacial asymmetry might be related to the disk displacement of TMJ.

TREATMENT OF ECTOPICALLY ERUPTING FIRST PERMANENT MOLAR IN CHRONIC MYELOGENOUS LEUKEMIA (전신 질환을 동반한 환아에서 나타난 제1대구치 이소맹출의 처치)

  • Kim, Hyun-Jung;Kim, Min-Jeong;Noh, Hong-Seok;Kim, Shin;Jeong, Tae-Sung
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.1
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    • pp.33-37
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    • 2011
  • The ectopic eruption is defined as abnormal eruption which gives to displacement of the teeth and abnormal root resorption of adjacent teeth. The prevalence of ectopic eruption is reported to vary 2~6%, most of them are in the maxilla. Etiologic factors include narrow maxilla, large maxillary teeth, inclined eruption path of the first molar, retruded position of the maxilla and hereditary factor. Irreversible ectopic eruption where the second primary molar is lost often causes mesial tipping and rotation of the permanent molar, unfavorable occlusion and space deficiency for the second premolar. Ectopically erupted teeth should be treated early to maintain normal development of the dentition, harmony of facial growth and occlusal support. The method of the treatment are classified as follows : appliances that is positioned at the contact point for unlocking and the distal movement, fixed appliance that is connected to more than one tooth, and occlusion guiding method after disking or extraction of the second deciduous molar. A case report of a patient with bilaterally ectopic eruption of maxilla and mandible first permanent molar was present. Also, the patient who had experienced the chronic myelogenous leukemia, show various dental developmental complications. The ectopic eruption was treated with a Halterman appliance that was a effective way of correcting of ectopic eruption of the permanent first molar.

Clinical features and results of recent neonatal cardiac surgery - A review of 82 cases in one hospital (최근 신생아 심장 수술의 특징과 결과 - 단일 병원에서의 82례 고찰)

  • Oh, Ki Won;Kim, Jung Ok;Cho, Joon Yong;Hyun, Myung Chul;Lee, Sang Bum
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.665-671
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    • 2007
  • Purpose : The purpose of this study was to investigate the clinical features and outcome in newborns undergoing cardiac surgery. Methods : Eighty two neonates underwent heart surgery for congenital heart defect at Kyungpook National University Hospital between March 2000 and February 2006. Patient characteristics (sex, age, diagnosis), pre-operative conditions, operation type, postoperative complications and mortality were reviewed retrospectively. Results : In 82 patients, 41 (50%) were male. The mean age and weight at operation were 12 days and 3.2 kg, respectively. The common cardiac anomalies were complete transposition of the great arteries (TGA), Tetralogy of Fallot (TOF), pulmonary atresia with intact ventricular septum, and single ventricle variants. Fifty seven operations were performed with cardiopulmonary bypass and corrective surgery was done on 54 patients. Arterial switch operation and modified Blalock-Taussig shunt were most frequently performed as corrective and palliative operations, respectively. The early hospital mortality rate was 7%; the late mortality was 3.9%. Complications were acute renal insufficiency, delayed sternal closure, wound infection, arrhythmia, and brain hemorrhage. Conclusion : During the last 6 years, the outcomes of cardiac surgery for congenital heart defects in neonates improved by progress in perioperative, anaesthetic, surgical, and postoperative care.