• 제목/요약/키워드: 구강외과

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성장기 아동 하악 과두 골절의 예후에 관한 장기 추적 조사 (THE LONG-TERM RESULT OF CONDYLE FRACTURE IN CHILDREN)

  • 최진호;류승현;류문광;김재우;김일규;하태진
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권2호
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    • pp.121-130
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    • 2004
  • The purpose of this study was the long-term clinical and radiological evaluation of conservatively treated condylar fractures in children. This study was therefore undertaken to analyze the long-term effects of treating condylar fractures in children with conservative therapy in order to resolve the controversial question of whether complete remodeling occurs in this age or, if not, whether it is more likely to be associated with certain types of fracture or with other factors. This study was based on a series of 11 consecutive children and adolescents, aged between 3 and 15 years, with fractures of the condylar process who had been treated with conservative therapy at the Department of Oral & Maxillofacial surgery, Inha University Hospital, Inchon, Korea. All patients underwent a clinical investigation with special emphasis on Temporomandibular joint function and facial asymmetry. The patients also underwent a radiologic investigation, focusing on fracture remodeling and symmetry of mandible. It consists of panoramic radiograph, PA & lateral cephalogram and 3-D CT. No patient described impaired temporomandibular joint(TMJ) function or pain on the affected side. 2 of 8 (25%) unilateral and 1 bilateral fractures show slight facial asymmetry. Despite apparently excellent recovery of function, there were marked remodeling changes evident on the CT scan. Such changes are not usually evident on panoramic radiograph. Radiologic investigation showed incomplete remodelling(54.5%) and asymmetry of the mandible (27.3%) in some patients. Conservative treatment of condyle fracture in children results in satisfactory long-term outcome of jaw function despite a relative high frequency of radiologically noted aberrations.

이하선 다형성 선종의 괴사 (NECROSIS OF A PAROTID GLAND PLEOMORPHIC ADENOMA : A CASE REPORT)

  • 유선열;백승;박홍주;최홍란
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권2호
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    • pp.165-169
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    • 2004
  • 본 증례는 우측 이하선에 종물을 가진 50세 여자 환자에서 술전에 시행한 세침흡인검사와 전산화단층촬영 소견 및 술중에 시행한 동결생검에서 괴사소견으로 인해 점액표피양암종으로 진단되어 우측 이하선 전적출술과 경부청소술 등을 시행하였으나 수술 후 조직병리학적 검사에서 괴사를 동반한 다형성 선종으로 최종 진단되었다. 괴사를 동반한 다형성 선종에서 보이는 편평 상피세포는 점액표피양암종에서 나타나는 편평세포의 특징으로 오진할 수 있으므로 주의해야 한다. 본 증례는 악성종양으로 잘못 진단할 수 있는 다형성 선종의 괴사와 조직병리학적 특징들을 이해함으로써 임상의사들의 오진 가능성을 예방하고 다형성 선종의 진단과 치료에 주의해야 함을 시사한다.

광범위한 치성각화낭종의 보존적 치료후 발생한 섬유증 (FIBROSIS THAT OCURRED AFTER CONSERVATIVE THERAPY OF LARGE ODONTOGENIC KERATOCYST)

  • 권택균;변준호;김용덕;신상훈;김욱규;정인교
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권2호
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    • pp.162-164
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    • 2004
  • Odontogenic keratocysts are developmental odontogenic cysts which derived from rests of dental laminas and often found in posterior area of mandible. Because this lesion has tendency of frequent recurrence, treatment of choice is often radical removal of the lesion. Sometimes in case of large cysts, however, conservative therapy like marsupialization is often selected in treatment plan. A 39-years old woman referred to our department for evaluation of large radiolucent lesion that occupies the areas from mandible angle to upper part of ramus and condyle. In cytology, the lesion was identified as odontogenic keratocyst. Marsupialization was our treatment of choice, and the result was so favorable. 2 years later, there was small radiolucent lesion on upper part of mandibular ramus on panoramic view. It was suspected as recurred lesion, and excisional biopsy was done. On biopsy result, it was not a cystic lesion but fibrosis.

타액선 다형성 선종에서의 PLAG1과 CTNNB1 유전자 융합 (FUSION OF THE PLAG1 AND CTNNB1 GENES IN PLEOMORPHIC ADENOMA OF THE SALIVARY GLANDS)

  • 김재진;김은석;고승오;김효분;조남표
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권4호
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    • pp.206-211
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    • 2003
  • The pleomorphic adenoma is the most common neoplasm involving both the major and minor salivary glands. It is a benign, slowgrowing tumor, but local recurrences can occur. The pleomorphic adenoma gene 1 (PLAG1), which is a novel zinc finger gene, is frequently activated by reciprocal chromosomal translocations involving 8q12 in a subset of salivary gland pleomorphic adenomas. This experimental study was preformed to observe the translocation patterns between PLAG1 gene and the three translocation partner genes. We also have analyzed the presence of PLAG1 transcripts by RT-PCR. CTNNB1/PLAG1 gene fusion was observed in three of nine pleomorphic adnomas. However, LIFR/PLAG1 and SII/PLAG1 gene fusions were not detectable. All of three gene fusions was not detectable in one Warthin's tumor and three inflammatory salivary gland tissues. PLAG1 transcripts were expressed in all inflammatory salivary gland tissues and tumors except for three pleomorphic adenomas. Of particular one pleomorphic adenoma showing CTNNB1/PLAG1 gene fusion did not express PLAG1 transcipt. Our data indicate that gene fusion involving PLAG1 is a frequent event in pleomorphic adenoma, but correlation between gene fusion involving PLAG1 and PLAG1 transcription is not definite.

악교정수술 환자에서 교합기 석고 모형과 측면두부방사선사진의 교합평면에 관한 비교 연구 (THE COMPARATIVE STUDY FOR OCCLUSAL PLANE BETWEEN ARTICULATED CAST MODEL AND CEPHALOGRAM IN ORTHOGANTIHIC SURGERY PATIENTS)

  • 서경숙;박미화;이주현;김철환;채종문
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권4호
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    • pp.239-244
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    • 2003
  • The common errors in preoperative treatment plan for the orthognathic surgery can be occurred during cast impression, cast mounting procedure with face-bow transfer, surgical stent fabrication, and so on. One of the most common errors exists during mounting process of the model on the articulator. Accurate mounting of dental casts to articulator should be achieved by transferring the 3-dimensional spatial relationship of the maxillary arch to an articulator. A face-bow is used for transfer this relationship to articulator, usually by relating the face-bow to a plane of reference of maxillary cast. The purpose of this study is evaluation of the accuracy of face-bow transferring of maxillary model to the articulator. The maxillary casts of thirty patients for orthognathic surgery were mounted on articulator with an face-bow instrument. The relationship of occlusal plane angle to Frankfort horizontal plane relations were compared the cephalogram with the cast-mounted articulator. As a result of this study, the significant difference between the maxillary occlusal planes angle in the cephalogram and articulator were found. The results were followed, 1. The mean occlusal plane angle in cast-mounted articulator was $13.5^{\circ}\;(SD{\pm}5.4)$. 2. The mean occlusal plane angle in cephalogram was $10.4^{\circ}\;(SD{\pm}4.3)$. 3. The mean difference of occlusal plane angle between cast-mounted articulator and cephalogram was $3.3^{\circ}\;(SD{\pm}4.6)$. According to the result, we should suggest that the occlusal plane angle to Frankfort plane in cast-mounted articulator is more steeper than that of cephalogram. And then, maxillofacial surgeon should try to get a more predictable result by suggesting the proper correction method and mounting the cast accurately.

백서 상부 소화기계의 발달 시기별 Telomerase 활성 및 PCNA(proliferating cell nuclear antigen)의 발현 변화 (THE CHANGES OF TELOMERASE ACTIVITY AND PROLIFERATING CELL NUCLEAR ANTIGEN(PCNA) EXPRESSION IN THE DEVELOPMENTAL STAGES OF RAT'S UPPER DIGESTIVE SYSTEM)

  • 성일용;김종렬
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권2호
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    • pp.85-99
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    • 2004
  • Purpose: This study observed the changes in the telomerase activity, it's developmental regulation, PCNA expression, and their correlation in rat's upper digestive organs during growth and aging. Materials and Methods: Upper digestive organs(buccal mucosa, gingiva, palate, submandibular and parotid glands, and tongue) were aseptically removed from Sprague-Dawley rats of fetal(gestational 20 days), growing(1, 2, 3, 5, and 7 weeks after birth) and adult(12 week old). Samples for telomerase activity were frozen on liquid nitrogen immediately after sacrifice, and stored until the use at $-75^{\circ}C$ in order to measure it. Telomerase activity was measured by a PCR-based telomeric repeat amplication protoco(TRAP) assay and quantitated with Photometric Telo TAGGG Telomerase PCR ELISA plus(Roche Diagnostics GmbH. Mannheim. Germany). PCNA expression were measured immunohistochemistry with anti PCNA Ab-1, Clone PC10(NeoMark. California. USA). Results: 1. Telomerase activities in buccal mucosa, palate and gingiva were the highest in fetus and decreased gradually or rapidly after birth and then diminished, but In salivary gland and tongue were the highest in fetus and also high at 1 week and then decreased rapidly. 2. PCNA expression in buccal mucosa, gingiva, Tongue and salivary gland was the highest in fetus and decreased gradually and then diminished. but only in palate decreased rapidly after birth and then diminished. Conclusion: The highest telomerase activity of embryonic stage decreased rapidly after birth in rat's upper digestive organs. There may be a developmental regulation of telomerase activity, but not a tissue-specific. This telomerase activity seems correlated closely with PCNA expression in rat's upper digestive system.

Stability of unilateral sagittal split ramus osteotomy for correction of facial asymmetry: long-term case series and literature review

  • Lee, Seong-Geun;Kang, Young-Hoon;Byun, June-Ho;Kim, Uk-Kyu;Kim, Jong-Ryoul;Park, Bong-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권3호
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    • pp.156-164
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    • 2015
  • Bilateral sagittal split ramus osteotomy is considered a standard technique in mandibular orthognathic surgeries to reduce unexpected bilateral stress in the temporomandibular joints. Unilateral sagittal split ramus osteotomy (USSO) was recently introduced to correct facial asymmetry caused by asymmetric mandibular prognathism and has shown favorable outcomes. If unilateral surgery could guarantee long-term postoperative stability as well as favorable results, operation time and the incidence of postoperative complications could be reduced compared to those in bilateral surgery. This report highlights three consecutive cases with long-term follow-up in which USSO was used to correct asymmetric mandibular prognathism. Long-term postoperative changes in the condylar contour and ramus and condylar head length were analyzed using routine radiography and computed tomography. In addition, prior USSO studies were reviewed to outline clear criteria for applying this technique. In conclusion, patients showing functional-type asymmetry with predicted unilateral mandibular movement of less than 7 mm can be considered suitable candidates for USSO-based correction of asymmetric mandibular prognathism with or without maxillary arch surgeries.

Aplastic anemia and dental implant rehabilitation: a clinical trial

  • Kim, Jun-Hwa;Shet, Uttom Kumar;Kim, Byeong-Guk;Kim, Myung-In;Kook, Min-Suk;Oh, Hee-Kyun;Ryu, Sun-Youl;Park, Hong-Ju;Jung, Seunggon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권5호
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    • pp.265-269
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    • 2015
  • The purpose of this study was to investigate implant-supported restoration as a technique for restoring missing teeth in patients with aplastic anemia. Recurrent bleeding from wound sites leads to persistent release of iron in the tissue. Excessive iron in tissue is related to clinical findings, including fibrosis, poor wound healing, and high level of angiogenesis, which are possible etiological factors of reduced osseointegration. A 44-year-old female patient with aplastic anemia was treated with multiple endosseous implants throughout the mandible and in the posterior region of the maxilla. After 14 implants were placed, radiological and clinical parameters were assessed during the follow-up period. Marginal bone did not change significantly during the follow-up period. The fine trabecular bone in intimate contact and enclosing the implant fixture was sufficient for successful osseointegration. None of the 14 implants were associated with compilations during the seven-year experimental period. This study suggests that dental implant procedures are a safe and reliable treatment option for restoration of missing dentition in patients with aplastic anemia.

Analysis of glycosylated hemoglobin (HbA1c) level on maxillofacial fascial space infection in diabetic patients

  • Jang, Jong-Won;Kim, Chul-Hwan;Kim, Moon-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권5호
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    • pp.251-258
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    • 2015
  • Objectives: This study was performed to evaluate the impact of glycosylated hemoglobin (HbA1c) level on characteristics and prognosis of maxillofacial fascial infection in diabetic patients. Materials and Methods: We reviewed the medical records of 72 patients (35 patients with HbA1c lower than 7.0% and 37 patients with HbA1c higher than 7.0%) diagnosed with maxillofacial fascial space infection and hospitalized for treatment at the Department of Oral and Maxillofacial Surgery in Dankook University Hospital (Cheonan, Korea) from January 2005 to February 2014. We compared demographics, parameters of glucoregulation (HbA1c), laboratory parameters of inflammation (white blood cell [WBC], C-reactive protein [CRP] count), type and number of involved spaces, type and number of antibiotics, period of hospitalization, number of surgical operations, need for tracheostomy, complications, computed tomography (CT), and microorganisms between the two groups. Results: Compared with the well-controlled diabetes mellitus (DM) group (HbA1c <7.0%), patients in the poorly-controlled (HbA1c ${\geq}7.0%$) DM group had the following characteristics: longer hospitalization periods, higher values of laboratory parameters of inflammation (WBC, CRP count) at the time of admission, higher number of antibiotics prescribed, more frequent complications, frequent deep neck space involvement, and distinctive main causative microorganisms. As the HbA1c level increases, hospitalization periods and incidence of complications increase gradually. Conclusion: This retrospective study suggests that regulation of DM significantly impacts maxillofacial fascial infection. Poorly controlled DM with high HbA1c level negatively influences the prognosis of infection.

An in vitro comparison between two different designs of sagittal split ramus osteotomy

  • Andrade, Valdir Cabral;Luthi, Leonardo Flores;Sato, Fabio Loureiro;Pozzer, Leandro;Olate, Sergio;Albergaria-Barbosa, Jose Ricardo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권3호
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    • pp.133-138
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    • 2015
  • Objectives: To evaluate the influence of the type of osteotomy in the inferior aspect of the mandible on the mechanical performance. Materials and Methods: The study was performed on 20 polyurethane hemimandibles. A sagittal split ramus osteotomy (SSRO) was designed in 10 hemimandibles (group 1) with a vertical osteotomy in the buccal side (second molar level) and final osteotomy was performed horizontally on the lingual aspect, while the mandible body osteotomy was finalized as a straight osteotomy in the basilar area, perpendicular to the body. For group 2, the same osteotomy technique was used, but an oblique osteotomy was done in the basilar aspect of the mandibular body, forming continuity with the sagittal cut in the basilar area. Using a surgical guide, osteosynthesis was performed with bicortical screws using an inverted L scheme. In both groups vertical compression tests were performed with a linear load of 1 mm/min on the central fossa of the first molar and tests were done with models made from photoelastic resin. Data were analyzed using Student's t-test, establishing a statistical significance when P<0.05. Results: A statistical difference was not observed in the maximum displacements obtained in the two osteotomies (P<0.05). In the extensiometric analysis, statistically significant differences were identified only in the middle screw of the fixation. The photoelastic resin models showed force dissipation towards the inferior aspect of the mandible in both SSRO models. Conclusion: We found that osteotomy of the inferior aspect did not influence the mechanical performance for osteosynthesis with an inverted L system.