• Title/Summary/Keyword: 술후 교정치료시기

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THE INITIAL TISSUE CHANGE TO THE IMMEDIATE ORTHODONTIC FORCE FOLLOWING BUCCAL HORIZONTAL SUBAPICAL OSTEOTOMY OF MAXILLA (상악골 협측 수평 골절단술 직후 교정력에 의한 초기 치아주위 조직반응)

  • Hong, Kwang-Jin;Ahn, Byoung-Keun
    • The korean journal of orthodontics
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    • v.25 no.1 s.48
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    • pp.101-110
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    • 1995
  • The purpose of this study was to observe the tissue response to the orthodontic force applied immediately after buccal horizontal subapical osteotomy of maxilla. Five mongrel cats weighing about 2.5 Kg were used for this experiment. The left upper canine and premolar of each cat served as a experimental side and the right ones as a control side. On the experimental side, a 100gm orthodontic force was applied between the upper canine and premolar immediately after the osteotomy. On the control side, the same orthodontic force was applied without the osteotomy. After 7days, the experimental animals were sacrificed. The results were as follows: 1. In the pressure zones of the experimental group, significant increase of osteoclasts and direct resolution along the alveolar bone surface was observed as compared with those of the control group. 2. In the pressure 2ones of the experimental group, a less extensive hyalinized zone was observed than those of the control group. 3. In the pressure zones of both group, no root resorption was found. 4. Tn the tension zones of the experimental group, new bone deposition increased along the alveolar bone surface as compared with those of the control group. In conclusion, the results suggest the possibility that early orthodontic treatment after orthognathic surgery may have some benefits if the stability of the repositioned segment at surgery is secured.

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Surgical Treatment of Pectus Excavatum (누두흉의 외과적 치료)

  • 윤경찬;박창권;유영선;이광숙;최세영;금동윤
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.286-290
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    • 1998
  • The pectus excavatum is the most common deformity of chest wall. The most common cause of surgical correction is cosmetic problem. From January 1981 to July 1996, 24 patients had undergone surgery for pectus excavatum and they were corrected by Ravitch operation(n=4) or modified Wada operation(n=20) respectively. We analyzed each surgical cases according to age, sex, chief complaint, degree of deformity, EKG findings, complications and satisfaction degree of patient. In some cases, we measured Welch index preoperatively and postoperatively. The postoperative complications were wound infection in two, pneumothorax in two and reccurrence in one. The average value of Welch index was significantly improved from 5.86$\pm$0.51 preoperatively to 4.10$\pm$0.51 postoperatively(P<0.05). The results by Humphreys' criteria were satisfiable in 88%(excellent 71%, good 17%). The findings of this study suggest that surgical correction of pectus excavatum with modified Wada rocedure and submammary s in incision is effective method in physical and psychiatric aspect.

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A Clinical Study on Bone Grafting of Alveolar Clefts (치조열 환자의 골이식에 대한 임상적 연구)

  • Ryu, Sun-Youl;So, Kwang-Sub
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.256-262
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    • 1998
  • The aim of this study was to evaluate treatment plan and treatment procedure such as bone graft material, timing of bone graft and orthodontic treatment in 31 alveolar cleft bone graft patients treated at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital from Jan. 1992 to Dec. 1996. Results obtained were as follows : In total 31 patients of alveolar bone grafts, males(64.5%) were more than females(35.5%). The patients' age ranged between 2 - 33 years of age. Secondary bone grafting was the highest incidence(58.1%) when procedures were undertaken in patients between 6 - 16 years of age. In distribution of cleft side, unilateral clefts(93.5%) were the major part with the left side was larger than the right side. The Missing teeth were found most in lateral incisor, the supernumary teeth were found most between lateral incisor and canine. The most common occlusion before operation was class III malocclusion and anterior cross-bite(65.1%), orthodontic treatment was performed similarly between before and after the bone graft. The most common combined operation with alveolar bone graft was secondary cheiloplasty. The complications were 6 cases of bone defect, a case of oronasal fistula, 3 cases of dehiscence. PMCB and DFDB were used bone graft materials. In marginal bone height after operation, PMCB grafts were higher than DFDB grafts and marginal bone level was increased in the PMCB group but not in the DFDB group.

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A STUDY ON THE POSTOPERATIVE STABILITY OF OCCLUSAL PLANE IN ORTHOGNATHIC SURGERY PATIENTS DEFENDING ON THE DIFFERENCE OF OCCLUSAL PLANE (악교정 수술시 교합평면의 차이에 따른 술후 안정성에 관한 연구)

  • Hwang, Chung-Ju;Lim, Seon-A
    • The korean journal of orthodontics
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    • v.28 no.2 s.67
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    • pp.237-253
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    • 1998
  • Surgical-orthodontic treatment is performed for the skeletal Class III patients with no remaining growth and too big a skeletal discrepancy (or camouflage treatment, and two jaw surgery is needed in order to have maximum effect in such patients. In two jaw surgery cases, surgical alteration of the occlusal plane is necessary to establish optimal function, esthetics and postoperative sability, therefore the establishment of the occlusal plane is essential in diagnosis and treatment. The object of this study is to evaluate the stability of the indiviual ideal occlusal plane bsaed on the architectural and structural craniofacial analysis of Delaires. Thus, the subjects of this study were 48 patients who underwent two jaw surgery, and divided in two groups. Each group were composed of 24patients, A group were operated with ideal occlusal plane and B group were not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days), and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained: 1. There was no significance in occlusal plane angulation between $T_2\;and\;T_3$. Average long term follow-up changes of occlusal Plane angle were $0.24^{\circ}{\pm}2.43$, with FH plane and $0.15{\circ}{\pm}2.16{\circ}$ with SN plane in all 48 patients. These results demonstrated that the occlusal plane after two jaw surgery in skeletal Class III malocclusion was stable. 2. There was no significance in postoperative stability of occlusal plane between A and B group. 3. There was no significance in postoperative stability of occlusal plane depending on surgeon and operative method within each group. 4. The postoperative changes of occlusal plane were correlated to the postoperative changes of jaw rather than tooth position. 5. There was no correlation between the postoperative changes of occlusal plane and maxillary impaction and mandibular setback with surgery.

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The Role of Initial Relative Renal Function in Unilateral Hydronephrosis (일측 폐색성 및 역류성 수신증에서 술전 상대적 신기능의 의미)

  • Han Sang-Won;Kang Seon-Jung;Kwon Min-Jung;Kim Dae-Joong;Choi Seung-Kang;Lee Tack
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.203-208
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    • 1999
  • Purpose: The information on the change of the relative renal function after operation is essential to set the initial treatment plan in unilateral hydronephrosis. So we analyzed the preoperative and postoperative relative renal function, and observed the functional changes by operation and reliability of the various factors in those changes. Materials and Methods: A retrospective trial was done of 81 patients, 35 ureteropelvic junction(UPJ) obstruction and 46 vesicoureteral reflux(VUR), among 393 patients undergoing operations at our institution from March. 1992 to February. 1997. The patients who had infravesical abnormalities, abnormal contralateral kidney and insufficient research data were excluded. We determined the relative renal functions using DTPA and MAG3 scan in UPJ obstruction and DMSA scan in VUR. The mean observation period after operation was 2.01(0.25-4) years. Results: A. UPJ Obstruction 1. The relative renal function was improved significantly after operation(P=0.0007). 2. The kidneys which have preoperative functions between 20% and 40% improved significantly in relative renal function comparing to the kidneys of the other functions(P=0.0046). B. VUR 1. The renal functions didn't improve significantly after operation(P>0.05). 2. There was no significant factor affecting the prognosis in renal functions. Conclusions: 1. The kidneys with UPJ Obstruction show the difference in functional improvement after operation according to the degree of the preoperative renal function, but more investigations about the exact value are needed. 2. In VUR there was no difference between preoperative and postoperative functions, the theoretical basis on objectives of the operation could be the symptoms or factors except the operation.

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MAXILLARY ADVANCEMENT USING RIGID EXTERNAL DISTRACTION(RED) IN CLEFT LIP AND PALATE PATIENT : CASE REPORT (견고 구외 골신장술을 이용한 구순구개열 환아의 치험례)

  • Yu, Nan-Young;Kim, Sung-Min;Lee, Ju-Hyun;Seo, Hyun-Woo;Park, Ho-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.709-716
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    • 2005
  • Patients with cleft tip and palate present severe maxillary hypoplasia due to scar of lip and palate, often accompanied by compromised mastication, speech abnormalities. Sometimes maxillary hypoplasia persist even though active orthodontic treatment was done. In theses cases, patients born with cleft lip and palate will be potential candidates for maxillary advancement with bone grafting after growth to correct the functional deformities and improve aesthetic facial proportions. But, maxillary advancement using standard surgical approaches has several limitations : increased relapse tendency after maxillary advancement, necessity of additional bone graft and mandibular setback surgery. Distraction osteogenesis is current treatment modality to overcome these limitations, thus has become popular for treatment of maxillary hypoplasia associated cleft lip and palate, craniosyntosis. Especially, rigid external distraction, contrary to internal device, has advantages : better vector control of osteotomized segment, effective traction of the bony segments, the ease of the application and removal the distraction device. This study showed that relatively successful result could be generated by using rigid external distraction osteogenesis(RED) in the case of cleft lip and palate with severe maxillary hypoplasia, 6 years 7 months old.

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20-Year Experience of Surgical Treatment for Postpneumonectomy Empyema (전폐절제술 후 사강에 발생한 농흉의 치료)

  • 김형렬;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.542-547
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    • 2002
  • Background: Postpneumonectomy empyema(PPE) is an infrequent but potentially life-threatening complication. To date, various surgical efforts have been made to manage this complication. We reviewed our 20-year surgical experience of PPE and long-term follow-up data. Material and Method: Total of 37 patients who were treated for PPE between fan, 1980 and Jun, 2000 were included. Various clinical factors such as micro-organism, operative method and timing, presence of bronchopleural fistula(BPF), underlying disease and fate of empyema cavity were retrospectively reviewed and analyzed. Result: Majority of patients(34) underwent Eloesser operation for effective drainage. There was only one operative mortality. The causative organisms were Staphylococcus species and Pseudomonas species in 46% BPF was found in 20 cases, among which spontaneous closures took place in 4 cases. The chest wall was closed in 40%(8/20) of patients with BPF, compared to 59%(10/17) without BPF. The closure rate was statistically better in patients without BPF(p=0.006). Even though the patients with benign disease showed higher closure rate(50%) than those with lung cancer (31%), the difference was not significant(p=0.25). Conclusion: Eloesser procedure was an effective method for initial drainage of PPE cavity with low operative mortality. Given the findings of low spontaneous closure rate of BPF, aggressive approach to close the BPF is mandatory to achieve the final goal of chest wall closure. It was found that majority of patients still left their chest cavity opened, even after controlling the active inflammation of the empyema cavity. More aggnessive approach for chest wall closure is recommended in all patents with benign disease and in selective patients with lung cancer if there is no evidence of recurrence at several years after the initial operation.

Staged Fontan Operation Via Bidirectional Glenn Operation (양방향성 GLENN 수술을 통한 단계적 FONTAN 수술의 임상분석)

  • 한재진;김웅한
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1062-1068
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    • 1997
  • From August 1989 to January 1996, a total of 105 cases of bidirectional Glean operations have been done as the interim stage for the patien s with some risk of univentricular correction at Sejong General Hospital. From December 1992, we started the conversion to Fontal operations for them, and 42 cases underwent Fontal-stage operation till February 1996. Their diagnoses were univentricular heart in 19(right ventricular type : 14), tricuspid atresia 11, double outlet of right ventricle 9, and others in 3 cases. The median age of bidirectional Glerln-stage operation was 12.5 months(range 2 months to 8 years) and Fontan-stage operation was at 59.6 months of median age(range 1 year 5 months to ,9 year 7 months). The mean waiting interval between the two operations was 33.88 $\pm$ 17.85 months with a range of 10 months to 6 years 3 months. During the waiting periods, 18 patients developed significant systemic-pulmonary collaterals andfor systemic verso-veno collateral channels. There were 5 hospital deaths after operations due to low cardiac output in 4 and sepsis in one. Most of the Fontal-stage operations were done by the late al tunneling with Core-Tex tube graft patch and fenestrated with the size of 2.5 ~6 mm. All the patients were followed-up(7 months to 4 years 2 months, mean 21.97$\pm$10.82 months) and there were 5 late deaths(postoperatively 6 months to 2 years) due to thromboembolism in 1, after heart transplantation 1, plastic bronchitis 1, protein loosing enteropathy 1, and pneumonia in 1. Dividing the patients by the waiting interval of 2 years, the early correction to Fontal group (N=16) showed the better results(hospital mortality 1116, late mortality 1116, significant collateral development 2/16) compared to the other group(N=26) (4/26, 4/26, 16/26). In conclusion, after the bidirectional Glean-stage operation successfully got rid of the previous risk factors, we recommand to do the Fontan-stage operation no later than 2 years of interval.

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