• 제목/요약/키워드: 구강외과

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이하선 종양에 대한 변형된 이내 및 경부접근법 (A MODIFIED ENDAURAL AND NECK APPROACH TO THE PAROTID GLAND TUMOR)

  • 유선열;국민석;김선국;한창훈;구홍;권준경;안진석
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제31권6호
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    • pp.501-508
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    • 2005
  • 21세 여자의 이하선에 발생한 다형성 선종과 15세 남자의 이하선에 발생한 신경섬유종에 대하여 변형된 이내 및 경부접근법을 사용한 외과적 절제술을 시행하였다. 우리가 사용한 변형된 이내 및 경부접근법은 Starck 등의 변형된 이내접근법과 Gutierrez의 경부 연장술을 병용한 새로운 접근법이다. 우리는 이 접근법을 사용하여 특별한 문제없이 이하선에 접근하여 종양을 절제하였고, 수술 후 반흔은 외이와 머리카락 내에 감춰져 심미적으로 만족할 만하였다. 이 접근법은 이하선 종양에 이용될 수 있을뿐 아니라 경부 연장을 하지 않고 변형된 이내접근법만을 시행할 경우 악관절수술에도 이용될 수 있다.

코골이 및 폐쇄성 수면 무호흡증의 외과적 처치에 대한 임상적 연구 (CLINICAL STUDY OF SURGICAL TREATMENTS FOR SNORING AND OBSTRUCTIVE SLEEP APNEA)

  • 이용권;명훈;황순정;서병무;이종호;정필훈;김명진;최진영
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권4호
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    • pp.435-444
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    • 2008
  • Purpose: Clinical study to evaluate the efficacy and the safety of various surgical treatments in snoring and obstructive sleep apnea. Methods and materials: We performed surgical treatments such as radiofrequency ablation, uvulopalatopharyngoplasty(UPPP) with tonsillectomy, uvulopalatopharyngoplasty with advancement genioplasty, orthognathic surgery(maxillomandibluar advancement), distraction osteogenesis device insertion. Diagnosis was performed with clinical examination, polysomnography, lateral cephalometric and computed tomography. 62(M : F = 45 : 17, mean age 41.5, mean follow-up 4 weeks) patients underwent radiofrequency ablation and 7 (M : F = 5 : 2, mean age 38.9, mean follow-up 19months)patients experienced uvulopalatopharyngoplasty with tonsillectomy. Uvulopalatophayngoplasty with advancement genioplasty was performed for 3 (M : F = 2: 1, mean age 30.2, mean follow-up 14 months)patients. The last 3(M : F = 2 : 1, mean age 21.5, mean follow-up 24 months)patients was treated with orthognathic surgery including distraction device insertion. The results was evaluated by questionnaires, polysomnography, investigation of complications. Results: Of the patients treated with radiofrequency ablation, 95% reported improvement of their symptom. 100% improvement was reported in patients treated with UPPP with tonsillectomy and UPPP with advancement genioplasty. The two of three patients who underwent orthognathic surgery showed the satisfactory of treatments. Dryness of mouth was the most common complication during short period in radiofrequency ablation and UPPP with tonsillectomy. Relapse complication was not found in any surgical treatments. Conclusion: Treatment for snoring and OSA is determined by severity degree of the physiologic derangements, predominant type of apnea and obstructive site. Accuracy diagnosis should be performed prior to treatment for satisfactory treatment result. This study demonstrates feasibility, safety and efficacy of surgical treatments in snoring and OSA.

상악 협측 치은에 발생한 모세혈관종 치험례 (TREATMENT OF CAPILLARY HEMANGIOMA ON MAXILLARY BUCCAL MUCOSA : A CASE REPORT)

  • 강근영;최남기;김선미;양규호
    • 대한소아치과학회지
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    • 제31권4호
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    • pp.680-684
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    • 2004
  • 혈관종은 혈관의 증식에 의해 발생하는 양성 종양으로 유아와 어린이에서 호발한다. 대부분 진성종양으로 보다는 과오종(hamartoma)으로 보며 구강내 호발부위는 입술 혀, 협점막, 구개부 등이다. 임상소견은 편평하거나 융기된 적청색 병소로 보통 단발성이다. 조직학적 소견을 통해 모세혈관성(capillary), 해면상(cavernous), 혼합성(mixed), 경화성(sclerosing) 등으로 분류되며 확진된다. 본 증례는 6세 남자 환아가 치은에 뭐가 났다는 것을 주소로 전남대학교 병원 소아치과에 내원하였다. 임상검사 결과 #62, 63 부위의 부착치은에 딸기모양 종물(mass)이 관찰되었다. 조직검사 시행 결과 모세혈관종으로 확진되었으며 외과적 절제로 양호한 결과를 얻었기에 보고하는 바이다. 혈관종은 재발이 드물며 악성전환이 없지만 출혈 경향이 높으므로 임상적 시술시 주의가 요구된다.

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양악 전방분절골절단술과 이부 성형술을 통한 개방교합의 치험례 (TREATMENT OF ANTERIOR OPEN BITE WITH BIMAXILLARY ANTERIOR SEGMENTAL OSTEOTOMY AND GENIOPLASTY)

  • 황용인;홍순민;박준우;이건주;조형준;천세환;박양호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권3호
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    • pp.355-364
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    • 2008
  • Skeletal anterior open bite is a difficult problem to correct in orthodontic treatment. To treat adult patients who have skeletal anterior open bite, we considered two methods. Combination treatment of orthodontics & surgery and camouflage orthodontic treatment. In adults, treatment of severe skeletal anterior open bite consists mainly of surgically repositioning the maxilla or the mandible. However, camouflage therapy is often the treatment of choice for skeletal open bite patients who have mild to moderate skeletal discrepancies when growth modification is no longer possible. But excellent results generally require careful coordination of the orthodontic and surgical phases of treatment. This is a case report of a skeletal anterior open bite patients who were treated with orthodontic treatment and orthognathic surgery. First case was diagnosed as skeletal class I malocclusion & bimaxillary protrusion with anterior open bite, and finally treatment ended for removal of open bite with orthodontic procedure and bimaxillary anterior segmental osteotomy surgery. Second case was diagnosed as skeletal class II malocclusion with open bite & mandibular retrusion, and was treated with only camouflage orthodontics because she feared to have a surgery. In a regular follow up visit after debonding we proposed to the patient advanced genioplasty, and in her agreement her facial esthetics was improved through the surgery.

치성석회화 낭종 : 증례 보고 및 문헌 고찰 (CALCIFYING ODONTOGENIC CYST: A CASE REPORT)

  • 조성웅;서동원;김동형;이준;강지연;심재환;이동근;김상중
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권3호
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    • pp.383-387
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    • 2008
  • The calcifying odontogenic cyst(COC) is considered to occupy a position between a cyst and an odontogenic tumor-having charateristics of both. Gorlin and col. described the COC for first time as an own pathological entity in 1962. Clinically, the COC represents 1% of the odontogenic lesion. It is possible to be found from the first decade to the eight decade but is more frequent during the second decade. It affects in same proportion the maxilla and jaw, being the most in tooth-bearing area of the jaw. This case of COC associated with an unerupted tooth which appeared in the right mandible of 22-year-old woman, was reported. This case report is to present a review of the literature relates to this case of COC and its treatment, discuss clinical, radiographic, histological and therapeutic aspects.

하악전돌증에 있어서 전산화단층촬영을 이용한 하악지의 형태학적 평가 (MORPHOLOGICAL EVALUATION OF MANDIBULAR RAMUS IN MANDIBULAR PROGNATHISM BY COMPUTED TOMOGRAPHY)

  • 차두원;장지영;이상한
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권3호
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    • pp.370-375
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    • 2008
  • Sagittal split ramus osteotomy (SSRO) is widely used in treatment of dentofacial deformities. But, many complications can occur including unfavorable fractures during osteotomy. To prevent these complications, it is necessary to understand comprehensively the anatomy of the mandiular ramus. The purpose of this study was to evaluate the morphology of the madibular ramus in manibular prognathism patients by computed tomography comparing with normal control group. The study group consisted of 33 skeletal class III patients (20 males, 13 females) and the control group consisted of the 52 patients without dentofacial deformities (32 males, 20 females). The mean age of study group was 22.0-year old, and that of control group was 37.1-year. For the CT examination, following scan parameters was used: 1mm slice thickness, 0.5 second scan time, 120kV and 100mA/s. The axial scans of the head were made parallel to the mandibular occlusal plane. The anteroposterior length of the ramus, the distance from anterior border of the ramus to lingula, the relative distance from the anterior border of the ramus to lingula compared to the anteroposterior length of the ramus, the thickness of anterior and posterior cortical plate, the thickness of medial cortical plate of the ramus at lingula level, the thickness of cancellous bone of the ramus at lingula level were measured. The skeletal class III mandibular prognathism patients exhibited shorter anteroposterior length of the ramus, thicker anterior and posterior cortical plate, thinner mediolateral cancellous bone thickness. The lingula has a relative stable anteroposterior position in ramus in all groups. There was higher possibility of fusion of medial and lateral cortical plate at lingula level in the mandibular prognathism group. In conclusion, the mandibular prognathism patients have narrow rami with scanty cancellous bone, which means that careful preoperative examination including CT scan can prevent undesirable fractures during osteotomy.

하악전돌증환자에서 악교정수술후 저작근의 부피 및 교합력의 변화 (EFFECT OF MANDIBULAR SET BACK SURGERY ON VOLUMETRIC CHANGE AND BITE FORCE OF MASSETER MUSCLE)

  • 설정은;이명환;김창수;홍종락
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권3호
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    • pp.300-305
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    • 2008
  • Purpose: The purpose of our study was to evaluate the volume of pre- and post operative masseter muscle and bite force in mandibular prognathic patients treated with SSRO with the use of the 3D CT imaging technique and occlusal force meter. Materials and methods: The study group consisted of 12 patients with mandibular prognathism (5 males and 7 females) who underwent mandibular setback surgery (BSSRO) in the Department of Oral and Maxillofacial Surgery, Samsung medical center. Bite force was measured at pre op, post op 3, 6 and 12 months by occlusal force meter(GM10, Nagano Keiki, Japan) The preoperative CT examination of subjects was performed between one month prior to operation and one year after to operation. And muscle volume was measured. Result: As compared to preoperative measurements at 1 year postoperatively the masseter & internal pterygoid muscle volume were diminished (p<0.05) The bite force steadily recovered, so at postoperatively 6 months reached the preoperative level. And at 1 year after operation, the maximum bite force was significantly greater than preoperative levels. No significant correlation was presented between masseter muscle and bite force (p>0.05), internal pterygoid muscle and bite force (p>0.05). Conclusion: In this study, the results showed that volume and bite force of the masticatory muscles decreased significantly immediate after orthognathic surgery for mandibular set-back. However, reduction of maximum bite force disappears within 6 months after surgery.

미성숙 제3대구치의 자가치아이식; 치수치유, 치주치유, 치근발달 (AUTOTRANSPLANTATION OF IMMATURE THIRD MOLARS; PULP HEALING, PERIODONTAL HEALING AND ROOT DEVELOPMENT)

  • 민현기;이주현;신정섭;이동현;곽주희;강나라;김명래
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권6호
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    • pp.657-664
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    • 2008
  • Purposes: The aim of this study was to evaluate pulp healing, periodontal healing, root development of autotransplantation of immature third molars and show its viability in treatment of early loss of tooth in young patients Materials and methods: In this article we performed a retrospective study with 41 transplanted teeth in 36 patients. The Mean age at the time of surgery was 17 years(range $13{\sim}24$ years) and mean postoperative follow up period was 2.4 years(range $1{\sim}6$ years) We evaluated the survival rate, pulp healing, periodontal healing, root development of the above teeth Results: At the last examination 40 teeth among 41 transplants were still present so survival rate was 97.6%. The pulpal healing was found in 38 teeth of 41 transplants. The periodontal healing was found in 38 transplants. The continuous root development was seen in 38 transplants. Conclusions: From the above results, the autotransplantation of immature third molars was found to be a useful and reliable treatment method for early loss of teeth in adolescents and young adults.

하악 제 3대구치의 맹출 양상과 제 2대구치의 후방 치아우식과의 상관관계 (CORRELATION OF DISTAL CARIES IN THE MANDIBULAR SECOND MOLAR AND ERUPTION STATE OF THE MANDIBULAR THIRD MOLAR)

  • 이명환;설정은;장인걸;홍종락;김창수
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권6호
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    • pp.640-643
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    • 2008
  • Distal caries of the second molar is common indication for the mandibular third molar surgery and there are no universally acceptable predictive criteria for distal caries of the second molar. To analyze the correlation of the distal caries of the second molar and the eruption state of the mandibular third molar using panoramic radiographs statistically and propose the acceptable guideline for preventive extraction of the mandibular third molar. 786 patients who were extracted the mandibular third molar from 2002 to 2006 at Samsung medical center were examined. The presence and absence of distal caries of mandibular second molar, age, gender, angulation, impaction degree, distance between distal cementoenamel junction of the second molar and mesial cementoenamel junction of the mandibular third molar were assessed. 79.6% of third molars had a mesial angulation of between $40^{\circ}$ and $80^{\circ}$. The mean age of third molar removal for distal caries of second molar was $33.86{\pm}9.81$. The prophylactic removal of a mesio-angular third molar about $40^{\circ}$ and $80^{\circ}$ could prevent distal cervical caries forming in the mandibular second molar.

다양한 소독방법이 PPDO-hybrid-PLGA nanofiber scaffold의 형태와 세포부착에 미치는 영향에 관한 연구 (EFFECT OF DIFFERENT STERILIZATION METHODS ON THE SURFACE MORPHOLOGY OF PPDO-hybrid-PLGA NANOFIBER SCAFFOLD AND ATTACHMENTS OF PC12 CELL)

  • 이주현;민현기;정주영;강나라
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권6호
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    • pp.635-639
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    • 2008
  • Objectives : the effect of different sterilization methods on the surface morphology of PPDO-hybrid-PLGA nanofiber scaffold and attachments of PC12 cell were investigated. Methods : Poly (p-dioxone)-hybrid-Poly (lactide-glycolide) (PPDO-hybrid-PLGA) nanofiber scaffold, fabricated in a tube form with 1.5 mm internal diameter, 0.2 mm thickness and 5 mm length, was prepared using electrospinning method. To study the surface morphology using SEM, The study group and control group in respective were; Control:Non-sterilized scaffold, Group I:scaffold sterilized with 70% Alcohol, Group II: scaffold sterilized with Ethylene Oxide at $65^{\circ}C$, and Group III: scaffold sterilized with Ethylene Oxide at $37^{\circ}C$. To investigate viability of the PC12 cell on the scaffold, The study group and control group in respective were; Control: sterilized with 70% Alcohol, Group I: sterilized with Ethylene Oxide at $65^{\circ}C$, and Group II: sterilized with Ethylene Oxide at $37^{\circ}C$. Results : 1. The surface morphology was slightly changed in Group I, II and Group III, compared with control. 2. The attachment of PC12 cells in Group I, II was not higher than in control Discussion : The attachment of PC12 cell is not influenced by different sterilization methods.