• Title/Summary/Keyword: 구강외과

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Experimental study on the effect of low energy laser irradiation in Langerhans cell of Lanaged rat oral mucosa (저출력 레이저 조사 백서구강점막 창상부 Langerhans 세포에 미치는 영향에 관한 실험적 연구)

  • Cho, Jae-O;Hanks, Carl T.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.3
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    • pp.217-228
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    • 1993
  • The purpose or this study was to observe the histological alteration of Langerhans cells on wound healing process in applying low energy laser irradiation. For this study, 50 Spraque-Dewly rats, weighing 150Gm or more were devided into control, experimental control group(0), 47.5Hz(1), 190Hz(3), 380Hz(5), 760Hz(7), lased group. All the experimental animals were made excision wound on buccal mucosa, 2mm depth, and lased with stoma laser (904nm, semconductor type ASGaAI, Sedalac France) 47.5Hz, 380Hz, 960Hz, 3minutes one time respectively except experimental control group. After the experiment, experimental animals were sacrificed after 24hours, 48hours, 72hours on each. Taken specimens were embedden in paraffin, sectioned 6-8u in thickness. And the langerhans cell were detected using ant S-100 protein antibody, and histochemically processed with Avidin Biotin complex method. All the Langerhan cells were calculated under light microspe in 400 multiplication field and standard deviation, probability test between each group were evaluated using statistical analysis system(S.A.S)program. Following results were obtained. 1. Langerhan cells were increased in experimental control group compared to that in control group(P<0.01). 2. 24hour after experiments, Langerhans cell were decreased compare to that in control group and control experimental group 5, 1, 3. Probability test shows significance between control experimental and 5, 1, 3 group on a =0.05 range. 3. 48our after experiment, Langerhans cells were decreased compare to that on experimental control group, and probability test shows significance between control experimental and 3, 7, 5 group an a=0.05 range. 4. 72hour after experiments, Langerhans cells were decreased compare to that on experimental control group and probability test on group comparison shows significance between control experimental and 1, 5 and 1 between 3, 7 between 3, and 5, between 7, respeilively on a=0.05 range. 5. Langerhans cells number in experimental group were decreased compare to that on experimental control group in applying laser irradiation.

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Application of Perforator Flap for the Oral and Maxillofacial Reconstruction (구강악안면재건을 위한 천공지 피판의 적용)

  • Kim, Soung Min;Oh, Jin Sil;Kang, Ji Young;Myoung, Hoon;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.3
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    • pp.200-209
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    • 2013
  • Over the past few years, a large number of perforator flaps have been revised by several microsurgeons in the USA, France, Canada and Japan. A perforator flap is a flap of skin or subcutaneous tissue that is based on the dissection of a perforating vessel, which is a perforator. In short, a perforator is a vessel that has its origin in one of the axial vessels of the human body. By reducing any muscle harvesting and trauma to a minimum, perforator flaps aim to minimize donor site morbidity, and by avoiding the transfer of dennervated muscle, the long-term bulk of the free tissue transfer becomes more predictable. There are a finite number of potential perforator flaps in the body, which are based on the named source arteries. The most commonly used perforator flaps are deep inferior epigastric perforator, superior gluteal artery perforator, thoraco dorsal artery perforator, medial sural artery perforator, and anterolateral thigh perforator flap. For a better understanding of perforators as a routine reconstructive procedure in oral and maxillofacial surgery, the definition with nomenclature, classifications with special characteristics, and review points for their individual applications must be learned and memorized by the young doctors in the course regarding the special curriculum periods for the Korean national board of oral and maxillofacial surgery. Perforator flaps have been known to have many advantages, so this review article summarized their applications to the maxillofacial reconstruction in the Korean language.

Salivary Bacterial Counts on Application Time of Oral Antiseptic Agents and Mechanical Irrigation (구강소독제의 적용 시간 및 기계적 세척 여부에 따른 타액 내 세균 수의 감소 효과)

  • Lim, Hyoung-Sup;Kim, Jae-Jin;Kim, Mija;Kim, Hak Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.3
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    • pp.155-160
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    • 2013
  • Purpose: The purpose of this study is to establish the acceptable intraoral application time of antiseptic agents and evaluate the effect of mechanical irrigation. Methods: A total of 80 subjects were selected for this study. Saliva secreted at the resting state was taken. The subjects were divided into 8 experimental groups, and kept 10% povidone-iodine (PVI) or 0.2% chlorhexidine gluconate (CHX) for 20 or 40 seconds in their oral cavity with/without irrigation of the oral cavity with sterilized normal saline, respectively. Then, the saliva was taken and diluted with phosphate buffered saline and then plated onto 5% sheep blood agar plates, which were incubated. Colony forming unit (CFU) was measured for the salivary bacterial counts. Results: After application of PVI and CHX, all the experimental groups showed statistically significant decrease in CFU (P<0.01). Group 2 (PVI, 40 s) showed more significant reduction rate in CFU than group 4 (CHX, 40 s; P<0.01). Group 6 (PVI, 40 s, irrigated) showed more significant reduction rate than group 2 (PVI, 40 s; P<0.01). Group 2 (PVI, 40 s) showed more significant reduction rate than group 1 (PVI, 20 s; P<0.01). Conclusion: Application of PVI for 40 seconds and mechanical irrigation with sterilized normal saline showed the best result among the 8 groups in terms of the reduction rate of salivary bacterial counts.

Differential Diagnosis of Oral Lesions for the Initial Diagnosis of Acute Lymphoblastic Leukemia (급성림프모구성 백혈병의 조기진단 시 구강병변 양상을 통한 감별의 중요성)

  • Seo, Mi Hyun;Ha, Ji Young;Huh, Kyung Hoe;Cho, Young Ah;Kim, Soung Min;Choi, Jin Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.2
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    • pp.107-111
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    • 2013
  • Careful examination of the oral cavity may reveal findings indicative of an underlying systemic condition, and allow for early diagnosis and treatment. Examination should include evaluation for mucosal changes, periodontal inflammation and bleeding, and general condition of the teeth. A 12-year-old man visited for molar pain during 3 months. He was diagnosed with having a possibility of hematopoietic malignancy, showing the loss of lamina dura, destruction of bony crypt, and high attenuation in the bone marrow. He was referred to department of pediatrics, additional study, including peripheral cell morphology and bone marrow exam, were performed, and diagnosed as acute lymphoblastic anemia. Despite chemotherapy to cure leukemia, he was expired 8 months after initial diagnosis. The purpose of this report is to promote and evoke the awareness regarding an initial examination of the dentist to make an effort to acquire accurate knowledge and information about life-threatening disease in usual dental practice.

ANALYSIS OF $PGE_2$ CONCENTRATION IN SYNOVIAL FLUID ASPIRATES FROM TMJS OF PATIENTS WITH MANDIBULAR FRACTURE (하악골절 환자에서 악관절강내 활액의 $PGE_2$ 농도 분석)

  • Lee, Gi-Hyug;Kim, Su-Gwan;Kim, Myung-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.204-208
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    • 2001
  • The purpose of this study is to examine the change of enzymeimmuno-assay for $prostaglandinE_2$ in the synovial fluid lavage specimen of patients with mandibular fracture patients without condylar fracture. For this study, fourteen patients (eight males, six females) with mandibular fractures without condylar fracture was investigated to analyse the synovial fluid from upper temporomandibular joint cavities. Synovial fluid was collected from TMJ cavities of mandibular fracture patients before open reduction and after one week of open reduction, and then stored in liquid nitrogen tank after centrifuge. Two synovial fluid lavage samples of TMJs of 2 asymptomatic served as normal controls referred from other data. The concentrations of $PGE_2$ were measured by use of $PGE_2$ EIA System ($Amersham^{(R)}$). The following results were obtained: 1) In nine patients, the concentrations of $PGE_2$ are lower after open reduction than before. 2) In three patients, the concentrations of $PGE_2$ are higher after open reduction than before. 3) There was no statistical significant between the preoperative group and postoperative 7 days (p>0.05), but there was some difference between the two groups. In conclusion, the results suggest that $PGE_2$ probably does not play as important role in the harm of TMJ.

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DIAGNOSTIC EFFICACY OF MENTAL NERVE SEP(SOMATOSENSORY EVOKED POTENTIALS) FOR THE INJURED INFERIOR ALVEOLAR NERVE (하치조신경 손상시 턱끝신경 체성감각유발전위검사의 진단적 유용성에 관한 연구)

  • Jeong, Hyeon-Ju;Kim, Myung-Rae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.250-257
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    • 2001
  • Sensory dysfunction following the injury of the inferior alveolar nerve requires objective examination to get a reproducible data and to provide necessary treatment. This study was designed to evaluate if the SEP(somatosensory evoked potentials) of the mental nerve can be used as an objective method for the diagnosis of nerve injury and sensory disturbances. The subjects were nineteen patients ($37.4{\pm}11.3$ years old) who had been suffered from sensory disturbance of the unilateral lower lip and mental region for over 6 months after the inferior alveolar nerve injuries confirmed by the microsurgical explorations. The clinical neurosensory tests as SLTD(static light touch discrimination), MDD(moving direction discrimination), 2PD(two point discrimination), PPN(pin prick nociception) and accompanied pain were preceded to electro-physiologic examinations as SEP. The score of sensory dysfunction (sum score of all sensory tests) ranged from 0 to 8 were compared to the latency differences of the mental nerve SEPs. The correlation between clinical sensory scores and SEPs were tested by Spearman nonparametric rank correlation analysis, the differences in SEP latency by Kruskal-Wallis test and the latency differences according to PPN and accompanied pain by Mann-Whitney U test. This study resulted that the difference of the latencies between normal side and affected side was $2.22{\pm}2.46$ msec and correlated significantly with the neurosensory dysfunction scores (p=0.0001). Conclusively, the somatosensory evoked potentials of the mental nerve can be a useful diagnostic method to evaluate the inferior alveolar nerve injuries and the change of sensory dysfunction to be reproduced as an objective assessment.

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GONIAL ANGLE REDUCTION DURING MANDIBULAR SAGITTAL SPLIT RAMUS OSTEOTOMY (하악지 시상 분할골절단술과 동시에 시행되는 우각부 절제술)

  • Kim, Jae-Seung;Chang, Hyun-Ho;Ryu, Sung-Ho;Kang, Jae-Hyun;Lee, Seung-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.258-265
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    • 2001
  • A prognathic mandible and prominent gonial angle are considered to be unattractive in the Orient because it gives the face a square and muscular appearance. Requests for contouring of the mandibular angle are rare in the other race but are much more common in Korea and, through out the Orient. So, we often encounter a patient with a prognathic mandible and squarish or broad face who wishes to have his or her facial size reduced minimally or to acquire a round or slender appearance. But, mandibular angle is located in the deepest part of the operative field and the strong tension of the lateral soft tissue makes retraction difficult. It is extremely difficult to reduce the gonial angle with sagittal split ramus osteotomy by intraoral approach at the same time. We apply the method of gonial angle reduction during SSRO and had satisfactory results. We will present our results and hope to give some useful information for management of mandibular deformity.

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CLINICAL CHARACTERIZATION OF THE MAXILLARY SINUS ASPERGILLOSIS (상악동 국균증의 임상적 특성)

  • Choi, Hee-Soo;Yoon, Jung-Hoon;Kim, Hyung-Jun;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.271-275
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    • 2001
  • Nine cases of maxillary sinus aspergillosis during a period from February of 1992 to June of 2000 were investigated to analyze the clinical, radiologic and pathologic features. Maxillary sinus aspergillosis is rare disease, but it was increasing tendency with overuse antibiotics, steroid hormones, and anticancer agents. Aspergillosis of the maxillary sinus may occur as a chronic disease in an otherwise healthy person. The clinical features of maxillary sinus aspergillosis were similar to the non-fungal, chronic sinusitis. Intrasinus calcification is known to be a characteristic feature of maxillary sinus aspergillosis. It is suggested that excess root filling materials containing zinc oxide in the maxillary sinus could favour the formation of a local, non-invasive maxillary sinus aspergillosis. And this "dental" model of pathogenensis of maxillary sinus aspergillosis is an alternative to the widely accepted concept of spore inhalation and "aero-genic" pathogenensis of maxillary sinus aspergillosis. The radical surgery such as Caldwell-Luc operation was one of the most effective treatment modalities. Our results of this study indicate that maxillary sinus aspergillosis might occur mainly in healthy individuals rather than debilitating patients. It could efficiently treated with radical surgery alone without the antifungal agents. 4 cases were suspected to be related with teeth extraction and endodontic treatment. There were no recurrence in all cases.

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A CLINICAL STUDY ABOUT NATURE AND SEVERITY OF THE ZYGOMATIC BONE FRACTURES (관골 골절의 양상 및 정도에 관한 임상적 연구)

  • Ryu, Soo-Jang;Kim, Mi-Sook;Ro, Ki-Mun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.211-218
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    • 2000
  • This is a retrospective study on the nature and severity of zygomatic bone fractures. This study was based on a series of 358 patients with zygomatic bone fractures who treated as in-patient at Soonchunhyang Chonan Hospital during the period of Jan. 1993 through Dec. 1996. The results obtained are as follows : 1. The ratio of men to women was 4.41:1. The age frequency was highest in the second, third decade. The yearly distribution was the highest in 1993. The monthly distribution was highest in Feb. and Jun. 2. The most frequent cause was the traffic accident.(66.2%) 3. The most frequent type of fractures was the class I(undisplaced fx.).(25%) 4. The most frequent associated oral and maxillofacial injuries was soft tissue.(46.9%) 5. The most frequent associated systemic injuries was upper, lower extremity.(38%) 6. In A.I.S of oral and maxillofacial area, the mean score of A.I.S was $2.5{\sim}3$. In I.S.S, the highest mean score was in the ped TA.(19) 7. In respect of treatment, the most common method was open reduction with rigid fixation on fronto-zygomatic suture area.(47.8%) 8. The incidence of complication was 12% and the most common complication was malunion.(6.1%)

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EFFECT OF TEFLON MEMBRANE AND NYLON MEMBRANE ON GUIDED BONE REGENERATON IN RABBIT TIBIA (가토 경골 골결손부에서 Nylon Membrane과 Teflon Membrane의 골유도 재생 효과)

  • Kim, Kwan-Shik;Cho, Byoung-Ouck;Lee, Young-Chan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.146-153
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    • 2000
  • The purpose of present study is comparing the effect of Teflon Membrane and Nylon Membrane on bone regeneration in rabbit tibia. The 6 defects of $8{\times}8{\times}5mm$ size were drilled with dental handpiece in rabbit tibia, which on left side as an order of Control group(no coverage), Group 1(Nylon $5{\mu}m$ size), Group 3(Nylon $10{\mu}m$ size), and on right side Control group, Group 2($5{\mu}m$ Teflon), Group 4($10{\mu}m$ Teflon). Animals were killed at 7, 10, 14, 42 days to make specimens and observed the difference of healing potentials with light microscopy. The results were as follows ; 1. New bone formation has taken place at 14 days in Guided Bone Regeneration (GBR) group comparing to the Control group of massive inflammatory status. 2. Larger pore membrane allows more favorable healing potentials. Bone formation started earlier in larger membrane pore groups than smaller groups, until 14 days. 3. Bone forming potentials of Teflon membrane group was higher than Nylon membrane groups, Control group has the lowest bone forming potentials. 4. New bone formation was almost ended in 42 days, and there was no difference of bone formation between Nylon and Teflon membrane group of different size. There was no difference of bone formation at final stage(42 days) between Nylon membrane and Teflon membrane of same pore size. So nylon membrane may be clinically usable in guided bone regeneration case with further studies.

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