• Title/Summary/Keyword: 구강외과

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A CLINICAL STUDY ON SOFT TISSUE INJURIES OF ORAL & MAXILLOFACIAL REGION (구강 및 악안면 영역의 연조직 손상에 관한 임상적 연구)

  • You, Jun-Young;Kim, Yong-Kwan;Bae, June-soo;Chang, Hyun-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.4
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    • pp.407-413
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    • 1997
  • The soft tissue injuries of Oral & Maxillofacial region include abrasion, contusion, simple laceration, laceration of skin with underlying tissue, soft tissue injuries combined with facial bone fracture and involving functional structures such as facial nerve and vessel, orbit, lacrimal duct and salivary gland and so on. The results obtained were as follows ; 1. The age range was 1 to 97, and the highest incidence occured in the 3rd decade(23.4%), followed by the 1st decade(20.2%), 4th decade(18.1%), 4th decade(18.1), and 5th decade(14.3%) 2. The sexual ration was 4 : 1(M : F). 3. The most common cause of facial laceration was a accident(54.5), followed by blow(17.8%), traffic accident(15.9%) and unknown(10.8%). 4. The most frequently occurred site of injury was a forehead(24), followed by oral cavity(16.9%), lip(15%), eyebrow(14.5%), cheek(14%), chin(11.8%), nose(2%), scalp(1.4%) and neck(0.9%). 5. Most of wound size was less than 3cm in length. 6. 28 patients suffered facial bone fracture, representing 7%. 7. The major complications following facial laceration were infection and facial paralysis caused by facial nerve injuries, representing 4.5% and 1.9%.

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Detection of Genotype associated with Disease Activity and Development of Probe (질환활성과 관련된 유전자형 검색 및 탐색자 개발)

  • Lee, D.K.;Kim, K.J.;Kim, E.S.;Kim, J.H.;Yoo, S.K.;You, Y.O.;Kim, W.S.;Im, M.K.;Jang, S.I.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.371-383
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    • 1994
  • 질환성과 관련된 세균의 분포 및 유전자형을 탐색하고자 구강농양 및 골수염의 급성감염 혼자와 진료실 및 실험실의 정상인을 대상으로 시료를 채취하여 포도상구균을 분리 및 동정을 시행하고, 특성을 규명하였으며, plasmid 및 염색유전자를 분리하여 제한효소를 처리후 전기영동을 실시하고 분리된 plasmid로 탐색자를 제작하여 dot blot을 시행하였다. 대부분의 급성환자에서 분리된 포도상구균을 S. lugdunensis와 S. aureus이었으나, 진료실 및 실험실에서는 coagulase 음성 staphylococci가 분리되었다. 급성환자에서 분리된 포도상구균은 ampicillin과 penicillin에 내성을 보였다. 분리된 S. lugdunensis균주중 네 균주는 ${\delta}$형의 용혈소를 생산하였다. Plasmid를 분리한 결과 S. lugdunensis균주중 세 균주는 약 6.5 kilobases이었으나 S. aureus는 약 4.3 kilobases 정도 크기의 band를 보였다. S. lugdunensis에서 분리된 plasmid로 제작한 탐색자로 dot blot를 시행한 결과 치과 영역에서 분리한 plasmid를 갖는 균주는 양성반응을 보였다. 염색체유전자의 유전자형을 분석한 결과 ${\delta}$형의 용혈소를 생산한 네 균주의 S. lugdunensis는 유사한 유전자형을 보였다. 이러한 연구결과 질환의 진행에 S. lugdunensis가 중요한 역할을 하는 것으로 생각되고, 치과영역에 존재하는 plasmid는 공통적인 유전자 서열을 갖는 것으로 추정된다.

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A STUDY OF POSITION AND SIZE OF CRANIAL BASE, MAXILLA, AND MANDIBLE IN TRUE SKELETAL CLASS III PATIENTS (진성 골격성 III급 부정교합에서 두개저, 상악, 하악의 위치 및 크기에 관한 연구)

  • Woo, Soon-Seop;Choi, Yong-Soo;Park, Won-Hee;Yoo, Im-Hag;Lee, Young-Soo;Shim, Kwang-Sup
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.24-30
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    • 2002
  • The facial patterns were expressed by the interrelation of variable factors such as heredity, function and environment. Such variable factors have an effect on the growth and development of maxillofacial bones. The malocclusions with skeletal discrepancies are caused by abnormal forms, sizes and positions of cranial base, maxilla and mandible. For the proper diagnosis and treatment planning, the analysis of such structures is necessary. Lateral cephalograms of 54 adults with class III malocclusion patients (test group) and 61 adults with normal occlusion (control group) were analyzed. Anteroposterior relations and sizes of cranial base, maxilla, mandible were estimated to compare with those of normal ones. In test group, the anterior cranial base length was within normal range, but posterior cranial base, maxilla and mandibular body were longer than those in control group, significantly. Based on the cranial base, the location of maxilla in test group was normal, but the location of mandible was more anterior than that in control. Based on the maxilla, the location of mandible was more anterior in test group than that in control. Both mandibular body and ramus anteroposterior lengths in test group were larger than those in control. Both mandibular plane angle and upper gonial angle were within normal range, but lower gonial angle was significantly high in test group.

A SURGICAL METHOD FOR THE EFFECTIVE TREATMENT OF CLEFT ALVEOLUS, ESPECIALLY FOR THE ELEVATION OF ALA BASE (효과적인 비익기저부의 회복을 위한 치조열 환자의 골이식 치험례)

  • Shin, Hong-Soo;Yoo, Yang-Keun;Choi, Young-Joon;Hwang, Soon-Jung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.64-68
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    • 2002
  • The cleft alveolus is one of three parts in cleft deformity. The purpose of cleft alveolus bone grafting is the recovery of normal esthetics, occlusion and speech. If a bony defect is extended to the nasal floor, especially wide bony defect at the ala base, it is difficult to condense the cancellous bone during bone transplantation and to reconstruct the normal anatomy at the alar base. We treated with above mentioned cleft alveolus patients using the autogenous cortical bone effectively. We report this technique with two cases and the literatures review.

STUDY ON THE RELATIONSHIP OF THE INFERIOR ALVEOLAR NERVE POSITION BETWEEN BUCCAL AND LINGUAL SIDE USING CT AND ORTHPANTOMOGRAM (컴퓨터단층촬영과 파노라마상을 이용한 한국인 하치조관의 하악에서의 협, 설측 위치 관계에 대한 연구)

  • Shin, Hong-Soo;Hwang, Soon-Jung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.1-6
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    • 2002
  • When bilateral sagittal split ramus osteotomy or mandibular angle reduction are carried out, we have to consider the position of inferior alveolar nerve. For bone splitting or resection using a saw or an osteotome, the bucco-lingual position of the inferior alveolar nerve plays an important role in the preventing perioperative complications such as paresthesia or anesthesia. Because it is rare to find literatures concerning the mean anatomic position of the inferior alveolar nerve in Koreans, we investigated 30 patients who underwent to take CT and orthopantomogram for implant surgery, and evaluated the bucco-lingual position and vertical relationship of the inferior alveolar nerve at the mandible. The results showed that the distance between inferior alveolar nerve and buccal plate was the farthest at mandibular second molar ($7.1{\sim}7.4mm$) and the nearest at mandibular angle area ($4.4{\sim}4.8mm$). But it was no statistical relationship between the bucco-lingual postion of inferior alveolar nerve on the CT and its vertical position on the OPT. In conclusion, the results suggest that a careful surgical procedure is needed at the mandibular angle area to avoid a nerve damage and there are sufficient bone materials at the mandibular second molar are for bilateral sagittal split ramus osteotomy or mandibular angle reduction or plate fixation. And OPT is not usefull for the evaluation of a relative bucco-lingual position of inferior alveolar nerve in relation to its vertical postion on the OPT.

DIAGNOSTIC EFFICACY OF DITI (DIGITAL INFRARED THERMOGRAPHIC IMAGING) FOR THE DYSESTHESIA OF THE LOWER LIP & CHIN (하치조 신경손상에 따른 하순 및 이부의 지각이상시 적외선 체열검사(DITI)의 진단적 효용)

  • Kim, Yae-Won;Kim, Myung-Rae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.53-60
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    • 2002
  • Neurosensory dysfunction of the injured inferior alveolarnerve(IAN) is a common and distrssing consequence of traumatic or iatrogenic injury. Conventional neurosensory testing has been used to detect and monitor sensory impairments of the injured IAN. However, these tests had low reliability and are not qualitative at best because they are based on solely on the patient's subjective assesment of symptoms. Consequently, there is need for more reliable, sensitive, and objective test measures to document and to monitor sensory dysfunction of the trigeminal nerve. This study was to investigate DITI's (digital infrared thermographic imaging) potential as a diagnostic alternative for evaluating of the nerve injures and sensory disturbance. Subjects were 30 patients who had been referred to Ewha Medical Center due to sensory disturbance of the lower lip and chin followed after unobserved inferior alveolar nerve injuries. The patients were examined by clinical neurosensory tests as SLTD (static light touch discrimination), MDD (moving direction discrimination), PPN (pin prick nociception) and DITI (digital infrared thermographic imaging). The correlation between clinical sensory dysfunction scores(Sum of SLTD, MDD, PPN, NP, Tinel sign) and DITI were tested by Spearman nonparametric rank correlation anaylsis & Kruskal-Wallis test, Wilcoxon 2-sample test. This study resulted in as follows; (1) The difference of thermal difference between normal side and affected side was as ${\Delta}-3.2{\pm}0.13$. (2) The DITI differences of the subjects presenting dysesthesia of the lip and chin were correlated significantly with the neurosensory dysfunction scores(r=0.419, p=0.021)and SLTD (r=0.429, p<0.05). (3) The MDD, PPN, NP, Tinel sign, duration, gender were not correlated with DITI(p> 0.05). Therefore, the DITI(digital infrared thermographic imaging) can be an option of the useful objective diagnostic methods to evaluate the injured inferior alveolar nerve and sensory dysfunction of trigerminal nerve.

CORRELATION OF METASTASIS AND PROGNOSTIC FACTORS IN SQUAMOUS CELL CARCINOMA OF HEAD AND NECK (두경부 편평세포암종에서 전이와 예후 인자에 대한 연구)

  • Seo, Gu-Jong;Ryu, Sun-Youl;Kim, Ok-Joon;Choi, Hong-Ran
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.7-15
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    • 2002
  • The present study was carried out to evaluate the correlation of metastasis and prognostic factors in squamous cell carcinoma of head and neck. Examination was performed on a series of thirty-seven patients who were confirmed to squamous cell carcinoma and its lymphatic metastasis by pathologist. Correlations of metastasis and other factors such as angiogenesis, histologic grading, and p53 expression and ras oncogene were studied. The depth of tumors was around 1 to 27mm. Twenty cases were more than 10mm deep, of which seventeen cases were shown lymphatic metastasis. Total score of histologic grading including keratinization, nuclear atypia, growth pattern and intensity of inflammation was ranged from 5 to 10 points. Of these factors, nuclear atypia with intensity of inflammation, and nuclear atypia with growth pattern was correlated with nuclear atypia each. For angiogenesis, number of new-formed vessels were counted 13 to 58 each. Twenty-eight cases were shown to lymphatic metastasis. No correlation with histologic grading and lymphatic metastasis was found. The results of immunohistochemical staining for p53 and ras oncogene revealed that positive cases were 16 and 22, negative for 21 and 15 each. However, both were not correlated with histologic grading and lymphatic metastasis. These results were revealed that angiogenesis was not correlated with lymphatic metastasis of squamous cell carcinoma arising in head and neck. Nuclear atypia with intensity of inflammation and dysplasia with growth pattern were correlated with histologic grading, which suggested that more careful and adequate advice is needed for effective treatment.

A CLINICAL STUDY ON MALIGNANT SALIVARY GLAND TUMORS (타액선 악성종양의 임상적 연구)

  • Sung, Iel-Yong;Kim, Uc-Kyu;Kim, Jong-Ryoul;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.4
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    • pp.427-434
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    • 2000
  • The authors analyzed retrospectively the 36 patients with malignant salivary gland tumors who were treated at Department of Oral and Maxillofacial Surgery, Pusan National University Hospital from February, 1989 to September, 1997. The results obtained were as follows: 1. There were 14 males(38.9%) and 22 females(61.1%). The peak age of patients with major salivary gland tumors was the 6th decade, but with minor salivary gland was the 5th decade. 2. Of all salivary gland tumors, 5 cases arose in the parotid glands, 2 cases in the submanibular glands, 1 case in the sublingual gland and 28 cases in the minor salivary glands. 3. The incidence according to the anatomic primary site for minor salivary glands was 15 cases in the palate, 5 in the floor of mouth and 2 cases each arising in the tongue, lip, retromolar area and buccal mucosa. 4. Of all salivary gland tumors, adenoid cystic carcinoma was 5 cases in the major salivary glands and 8 in the minor salivary glands. mucoepidermoid carcinoma was 2 cases in the major salivary glands and 14 in the minor salivary glands and others were 2 cases of adenocarcinoma, 4 malignant mixed tumors and 1 undifferentiated carcinoma. 5. The incidence of cervical lymph node metastasis was 100%(2/2) in the submandibular glands, 80%(4/5) in the floor of mouth, 50%(1/2) in the tongue and 20%(1/5) in the parotid glands. The highest incidence of lymph node metastasis according to histopathological classfication was found in the high grade of mucoepidermoid carcinoma and tubular type of adenoid cystic carcinoma. 6. Nerve invasion was common in the adenoid cystic carcinoma. 7. The lung was the commonest site for distant metastasis comprising 7 cases among 7 cases in which distant spread occurred.

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CLINICAL STUDY OF CHRONIC OSTEOMYELITIS (만성 골수염 환자의 임상적 연구)

  • Kim, Moon-Soo;Kim, Su-Gwan;Yeo, Hwan-Ho;Kim, So-Young;Kim, Soo-Min;Lee, Jun-Gil;Cho, Gyeong-An;Park, In-Soon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.514-518
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    • 2000
  • Chronic osteomyelitis is often considered difficult to treat and may lead to refratory condition in oral and maxillofacial region. Clinical features of chronic osteomyelitis includes pain, swelling, pus discharge, and radiographic change. There are many kinds of treatment of chronic osteomyelitis. One of the most important factors in treating osteomyelitis are removal of infectious foci and administration of massive antibiotics. Recently we reviewed 29 patients with chronic osteomyelitis who visited in our department and treated successfully with our treatment protocols, consisting of surgical intervention and intravenous antibiotics for 2 weeks, and followed by oral antibiotics for 6 weeks. It is concluded that combination of surgical intervention and antibiotic therapy are sufficient to treat the chronic osteomyelitis in oral and maxillofacial region.

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A CLINICAL STUDY ON THE MIDFACE FRACTURE (안면 중앙부 골절 (Midface fracture)의 임상통계학적 연구)

  • Lee, Seung-Yeop;Park, Kwan-Soo;Kim, Tae-Youl;Cheong, Jung-Kwon;Jeon, In-Seong;Yoon, Kyu-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.4
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    • pp.399-406
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    • 2000
  • With the increase of industrialization, leisures, sports activities and traffic, the risk of trauma has increased markedly. Midfacial bones are relatively common sites of trauma, and are difficult sites of correct reduction and reconstruction, because midface is composed of mostly thin cortical bone surrounding cavities filled with either air or fat with discrete areas of bony condensation. A clinical study on 208 patients with midfacial bone fracture who visited Sanggye Paik Hospital during 5 years($1990{\sim}1995$) was done by analyzing sex, age, cause, fracture site, treatment method, complication and involvement of other body part, etc. The results obtained were as follows : 1. The occurrence was more frequent in male than in female with ratio of 2.7 : 1 and most frequently in twenties. 2. Traffic accident was the most common cause of midface fractures. 3. Zygoma was the most frequently occurred site(50%) of midface fractures. 4. Simple fracture(75%) was more frequently occurred than compound fracture(25%). 5. As treatment method, open reduction(76.4%) was used more frequently than closed reduction(23.6%) 6. Generally, operations are done in 5 days after admission(59.1%), and intermaxillary fixation was done in 78.4% of cases. 7. Teeth and alveolar bone damages were occurred in 32.2% of cases. 8. Other injuries that were related to midface fracture occurred in 63.3% of cases. 9. Post-operative complications occurred in 9% of cases.

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