• 대한치과보철학회지
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• 제34권4호
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• pp.833-849
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• 1996

The material of choice for functional and esthetic reconstruction of maxillofacial defects is silicone. Silicone has appropriate physical properties for maxillofacial prosthesis but it has weak edge strength. Therefore, a proper combination of silicone and polyurethane sheet is recommended to improve this weakness. Various primers are also used to enhance the adhesive strength between silicone and polyurethane sheet. The purpose of this study was to determine the adhesive strength of silicone and polyurethane sheet. Silicone elastomer mixture was made by admixing MDX4-4210 elastomer (40%) and Silastic Medical Adhesive Type A(60%). This silicone elastomer mixture was attached to polyurethane sheet, using one of three different primers(1205, S-2260, or A-304), treated for 1, 2, 4, 6, and 8 hours. These were then polymerized in room temperature, dry-heat oven or microwave oven. Six specimens per each group, a total of 270 specimens were prepared for final test. The differences of T-peel bonding strengths were then determined by a test. The differences of T-peel bonding strengths were then determined by a test method that was recommended by American Society for Testing and Materials C794-80. The results were statistically analyzed using the ANOVA and Mutiple Range Tests(Tukey' HSD). The reults were as follow. 1. Type of primer, primer reaction time, and methods of polymerization showed significant correlation on the T-peel bonding strengths in adhesiveness between silicone and polyurethane sheet. 2. A-304 primer showed statistically higher in T-peel bonding strength than otehr type of primers except for the polymerization in microwave oven with reaction times of 2, 6 hours(p<0.05). 3. No significant differences in T-peel bonding strength were observed among the polymerization methods. 4. The effect of reaction time by the primer type and polymerization method showed statistically significant differences in bonding strength among different reaction times. And in most cases, reaction time of 1 or 2 hours showed higher T-peel bonding strength.

• 구강회복응용과학지
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• 제25권4호
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• pp.329-336
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• 2009

선천적 기형이나 후천적인 외상 또는 신생물에 의해 상악골 절제술을 받은 경우, 상악에서 발생하는 구강내 결손은 흔히 비강과 상악동 및 구강이 연결된 형태로 나타난다. 이러한 상악골의 결손은 구강과 비강이 교통되어 발음, 저작, 연하 등의 기능에 이상을 초래하게 된다. 이러한 경우에도 보철치료의 기본적인 목표가 적용되며, 후천적 상악 결손부에 수복되는 폐색장치는 발음, 연하, 저작 기능을 회복할 수 있어야 하고, 적절한 심미적 만족을 제공해야 하며, 환자가 편안하게 사용할 수 있어야 한다. 상악 폐색장치의 무게를 감소시키는 것은 잔존 조직의 건강과 정상적인 기능 및 환자의 안락함을 개선시킬 수 있다. 개방형 폐색장치는 결손부의 크기에 따라 6.55~33.06% 까지 무게를 줄여줌으로써 환자에게 편안함과 편의성을 제공해 주며, 생리적 기능을 향상시켜 치아와 지지 조직에 불필요하게 가해지는 부하를 감소시켜 준다. 본 증례는 hemi-maxillectomy를 시행한 환자에서 이중온성법을 이용하여 기존의 방법보다 더 균일한 의치상 두께를 가진 폐색장치를 제작하여 환자의 기능적, 심미적인 만족을 얻었기에 이를 보고하는 바이다.

• 대한치과보철학회지
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• 제54권1호
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• pp.35-40
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• 2016

상악골 결손은 악안면 부위의 해부학적 기형과 기능 장애를 초래한다. 기능적 측면에서, 상악골 결손은 발음, 저작, 연하 장애를 일으킬 수 있다. 상악절제술을 받은 환자에게 폐색장치는 이러한 기능적 회복에 큰 역할을 한다. 폐색장치가 구강 내에서 적절히 기능하기 위해서는 충분한 유지가 필요하며, 이러한 유지의 증가를 위해서는 폐색장치의 무게 감소가 필요하다. Hollow bulb 폐색장치에는 개방형, 폐쇄형 두 가지 형태가 존재한다. 폐쇄형 형태는 많은 장점을 가지나, 제작이 어렵고 누수가 발생할 경우 처치의 어려움 등의 단점이 존재하여 많은 술자들은 개방형 형태로 제작한다. 본 증례에서 두 열가소성 레진 시트로 만든 hollow body를 이용하여 one-step 중합 기술로 폐쇄형 hollow bulb 폐색장치를 제작하였고, 이는 기존의 폐쇄형 hollow 폐색장치 제작법의 단점들을 보완할 것이다.

• 대한치과보철학회지
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• 제37권3호
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• pp.343-357
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• 1999

The color change of maxillofacial silicone has been attributed to certain environmental factors such as exposure to the UV component of natural sunlight, wetting and drying of the elastomer and surface abrasion resulting from the application and removal of cosmetics. The purpose of this study was to evaluate the color change of maxillofacial silicone (Silastic MDX4-4210) according to type of pigment (cadmium yellow, titanium white, cosmetic red), and UV absorber application method after 200, 400, and 600 hours of 350nm UV light irradiation. The results were as follows. 1. According to type of pigments, after 200 hours cosmetic red showed significantly larger color change than cadmium yellow and titanium white, and after 400 and 600 hours color change significantly decreased in the order of cosmetic red, cadmium yellow, and titanium white (p<0.05). 2. In the cadmium yellow group, after 200 hours, the non-treatment group showed significantly larger color change, but after 400 and 600 hours, color change significantly decreased in the order of non-treatment, surface application and mixed group (p<0.05). 3. In the titanium white group, there was no significant color change difference between the three groups after 200 and 400 hours, but after 600 hours, the mixed group showed significantly smalt or color change than the non-treatment and surface application groups (p<0.05). 4. In the cosmetic red group, there was significant decrease in color change in the order of non-treatment, surface application and mixed group (p<0.05). From the results above, the effect of UV light absorber differed according to the type of pigment, but mixing UV light absorber with maxillofacial silicone is thought to give superior resistance against UV light irradiation in the long run.

• 구강회복응용과학지
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• 제27권3호
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• pp.337-342
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• 2011

악안면 부위의 선천적 결손이나 외상성 손실, 종양의 외과적 절제 등에 의한 악골의 결손은 환자에게 저작 장애, 연하 장애 등의 기능적 문제와 발음장애 및 심미적 장애를 초래하게 된다. 이러한 장애를 줄여주고 손상된 조직과 기능을 회복시켜주기 위해 많은 경우 보철적인 수복을 필요로 하게 된다. 상악골에 결손부가 생긴 경우 음식물과 액체가 비강으로 새어나가고 이 결손부로 공기가 누출되어 과비음이 발생한다. 이런 경우에 구개 폐쇄 장치가 사용되는데, 이 장치는 상악의 결손부를 채우고 구강과 상악동 또는 비강과의 개통부를 차단하여 심미성을 증진시키고 기능을 회복시킨다. 본 증례의 환자는 우측 상악동에 편평상피세포 암종이 발생하여 상악골 부분 절제술을 시행한 환자로 구개 폐쇄 장치를 제작하여 장착한 후, 발음과 연하 등의 기본적 기능이 회복되었고 안모의 심미성이 증가하였다.

• 구강회복응용과학지
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• 제39권4호
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• pp.204-213
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• 2023

구강 악안면 영역에서 외상으로 인해 발생한 골절에 대한 치료로 관혈적 혹은 비관혈적인 골절의 정복을 시행할 수 있다. 그러나, 최적의 정복이 이루어지지 않았거나 부정 유합이 발생할 경우, 하악골과 중안모 간의 구조적 관계가 상실되어 부정교합이 일어날 수 있다. 이러한 부정교합은 외상 후 부정교합이라 정의되며 안정적인 턱관절 위치의 확보 후 악교정 수술, 교정치료, 교합 재형성 및 보철적 재건 등이 외상 후 부정교합의 치료방법으로 제시되고 있다. 안정적인 턱관절은 교합 회복 전 부정교합의 재발 및 교합 변화를 방지하기 위해 필수적이며, 중심위 및 적응된 중심위는 가장 안정적인 턱관절의 위치로 교합 회복의 시작점이다. 본 증례는 다발성 안면 골절의 정복 후, 외상 후 부정교합이 발생하여 전악 교합의 회복을 위해 중심위에서 선택적 교합 조정 및 임플란트 지지 고정성 보철물로 보철적 재건을 시행한 증례로 교합 기능적으로 양호한 결과를 얻었기에 이를 보고하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권4호
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• pp.383-396
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• 2000

Before the advent of early plastic or maxillofacial reconstructive surgery, facial features could only be replaced and mimicked by prosthetic, artificial means. Facial deformity or dysfunction, whether congenital or acquired by trauma or mutilating disease, has long been an area of constant research, development and innovation in many cultures of the world. One of the greatest contributors to the need for maxillofacial prosthetics has been physical conflict and warfare. The use of maxillofacial prostheses is not merely the replacement of a missing or disfigured aspect of the face, but the rehabilitation of that individual back into the society from which they originate. Rehabilitation includes the restoration of the person's self worth and confidence, not just physically but psychologically. In sixteenth century, Ambroise Pare, French military surgeon, first have tried many maxillofacial prosthetics for injured war soldiers with papier-mache, silver, gold and copper. According to patient's demand who lost their maxillofacial figures, maxillofacial personnel have increased and prosthetic's skill have been advanced all of the world. Over the last decade, there has been a very rapid development in technical possibilities to provide patients with facial prostheses retained by skin penetrating implants. This article will present overall history of maxillofacial prostheses and some background information on the materials used from the old world. And to overcome still many limitation of prosthetic, new minds and new ideas for technique and materials should be developed.

• 대한치과기공학회지
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• 제29권2호
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• pp.105-117
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• 2007

As a dental technician, the aim of the present study on maxillofacial prosthesis was to research its relation with dental technology and further development aspects by looking into its history, kinds, production materials and process. Dental technicians are to expect a great potential to work as maxillofacial prosthetist if having an interest in education of maxillofacial prosthesis field, and developing and operating the education process by expanding the range of dental technology. This article is to present overall history of maxillofacial prosthesis and some background information on the materials which have been used from the past. The maxillofacial field plays essential functions of mastication and speech, as well as performs appearance, which evokes good or bad feelings as an instant and instinctive response. The use of maxillofacial prostheses is not merely the replacement of a missing part of the face, resulted from injuries, but a rehabilitation process to help individuals come back to society. Rehabilitation includes both patient's physical and psychological recovery, such as self-esteem and selfconfidence. There has been a rapid development in application potentials of maxillofacial prosthesis technology which include implant, which can penetrate skin, and new materials. In order to produce maxillofacial prosthesis, general procedures of maxillofacial laboratory work should be understood first. Maxillofacial prosthesis and the dental prosthesis have many similarities in its academic perspective and originality. Maxillofacial prosthesis should be added into the curriculum for dental technology to achieve co-enhancement of the two fields.

• 대한치과기공학회지
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• 제43권4호
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• pp.139-144
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• 2021

Purpose: This study aimed to provide basic data to identify the current status of use of maxillofacial prosthesis across the world and discuss its application and research directions in Korea. Methods: Existing literature (study period, 2010 to 2020) from international studies was collected from PsycINFO, CINAHL, and PubMed, whereas domestic studies were searched using KISS and RISS. Maxillofacial prosthesis was used as the search word. A total of three foreign and two domestic articles were searched, and as a result, a total of 12 documents were selected for analysis. Results: A total of 3,311 studies were searched in this study. Among them, 3,253 articles contained in duplicate inspection and exclusion criteria were removed, and 12 articles were selected by removing literature that did not meet the research criteria through title and green and text reviews. Finally, two researchers selected the final 12 articles through handwritten searches. Eleven of them were case studies, and the remaining one was a descriptive study. Conclusion: This study identified the current status of studies that implemented maxillofacial prosthesis, published from January 2010 to January 2020. Facial prosthetics improve the quality of life of patients by restoring defects that appear on different types of mouth and face and promote both function and aesthetics. Therefore, they can be used to treat various conditions and have a positive impact on the future.

• 대한치과보철학회지
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• 제35권2호
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• pp.330-343
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• 1997

Extraoral maxillofacial prostheses are essential for restoring facial structures that are lost as a result of congenital missing, injuries from accidents, surgical treatments of head and neck cancer. Recently, silicone is the most useful material for this purpose and is more advantageous than other maxillofacial prosthetic materials. However, there are some problems for long-term usage of silicone prostheses due to tear and color change. These are major contributing environmental factors to those problems that are such as ultraviolet light, cleansing agents, changes in humidity and successive adhesion and removal. The aim of this study is to evaluate the physical properties and color changes of maxillofacial prosthetic silicone material by those environmental factors using A-2186 silicone material (Factor II, USA) and two pigments, cadmium yellow medium and cosmetic red. Aluminium molds were fabricated according to the ASTM No. D412 & D624 specifications and resulted specimens from molds were fabicated and treated as follows. Control group and experimental I group were fabricated with 0.1% wt. pigment mixing in silicone elastomer and II-1 group, II-2 group of experimental II group were fabricated with 0.2%, 0.3% wt. pigment mixing in silicone elastomer, respectively. Control group was kept in darkroom at room temperature, I-1 group was kept under natural sunlight during 1week, I-2 group was soaked in 20% soap water during 1wk. I-3 group was successively adhered and removed 200 times on inner region of arm using Daro adhesive-33. Experimental II groups were kept in darkroom at room temperature. Instron universal testing machine was used to measure the % elongation, tensile strength, tear strength of control, experimental I, II groups and reflectance spectrophotometer(COLOR EYE-3000, Macbeth, USA) was used to measure the color differences between control group and experimental I group. The results were as follows : 1. When compared with control group, natural weathering group and 20% soap-water soaking group had no significant differences in % elongation(p>0.05). 2. 200 times successive adhesion and removal group, 0.2% wt. pigment group and 0.3% wt. pigment group had significant decreases in % elongation(p<0.05). 3. Natural weathering group, 20% soap-water soaking group and 200 times successive adhesion and removal group had no significant differences in tensile strength (p>0.05). 4. 0.2%, 0.3% wt. pigment groups had significant decreases in tensile strength(p<0.05). 5. Values of all experimental groups were decreased in tear strength. and 200 times successive adhesion and removal group had significant decrease in tear strength(p<0.05). 6. Natural weathering group and 20% soap-water soaking group had significant color differences(${\Delta}E$) and it could be detectable to naked eye(p<0.05). 7. Color differences between control group and 200 times adhesion and removal group were not detectable to the naked eye (${\Delta}E<1.0$).