• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권3호
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• pp.274-287
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• 2000

The use of dental implants has increased tremendously in recent years and is expected to increase even more in the future. The successful outcome of any implant procedure is surely dependent on interrelationship of the various components of an equation that includes biocompatibility of implant material, macroscopic and microscopic nature of the implant surface, the status of implant bed, surgical technique, undisturbed healing phase and subsequent prosthetic design and long-term loading phase. The purpose of this study was to clarify the effects of adrenalectomy on the osseointegration of pure titanium implants. Seventy rats, 11 weeks of age, were divided into two groups : an adrenalectomized group and a control group. Titanium screw implant(diameter, 2.0mm; length, 3.5mm) was placed into left tibia of 70 rats, 35 in control group and 35 in the experimental group. The rats were sacrificed at different time interval (1, 2, 3, 4, 6, 8, and 12 weeks after implantation) for histopathologic observation, histomorphometric analysis and immunohistochemistry with fibronectin and CD44 antibody. The results obtained from this study were as follows: 1. Histopathogically, findings, newly formed bone was seen at 3 weeks control group and became lamellar bone at 12 weeks. At 6 weeks, lipocytes were observed in bone marrow space. Thickness of regenerated trabecular bone increased till 6 weeks after then, that decreased gradually. 2. By histomorphometric analysis, marrow bone density and contact ratio of marrow bone to implant decreased significantly from 8 to 12 weeks in experimental group compared to control group and also total bone to implant contact ratio decreased significantly from 4 to 12 weeks in experimental group compared to control group. 3. Fibronectin immunoreactivity was very strong at 3 and 4 weeks control group. And after that reduced gradually. But it was continuously strong from 1 to 12 weeks experimental group. 4. CD44 immunoreactivity was very strong in the newly formed osteoblasts at 3 and 4 weeks control group. But it reacted minimally later. However, it reacted continuously strong from 3 to 12 weeks experimental group. From these results, bone to implant contact ratio decreased gradually from 4 weeks in adrenalectomized group compared to control group. CD44 and fibronectin immunoreactivities were strong at all times in adrenalectomized rats. Therefore, it could be stated that immature bone remained continuously for a long time and not readily proceeded into mature status.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권3호
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• pp.294-300
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• 2000

Purpose: The aim of this study was to find the clinical characteristics of the patients who had temporomandibular joint internal derangement(ID) with disc adhesion(adhesion group) compared to only disc displacement without disc adhesion, perforation, hyperemia, and so on(ID group). Materials and methods: Thirty seven joints were included in adhesion group and 54 joints in ID group of all 174 patients(174 joints) treated surgically and had been checked periodically over 12 months at TMJ clinic of Yongdong Severance Hospital, Yonsei University, between 1992 and 1997. Mouth opening range, pain during mouth opening and biting, headache, neck/shoulder pain and TMJ sound were checked his/her every visit before and after surgery. Results: The maximum mouth opening was improved significantly after postoperative 3 months in two groups(p<0.01), but adhesion group was less improved. Pain during mouth opening was improved significantly over 3 months after surgery in adhesion group(p<0.01), but in ID group 1 month after surgery. Biting pain was improved and maintained it after surgery and not significant difference between two groups. Headache and neck/shoulder pain were much improved after surgery(p<0.01), but slight relapse was found in adhesion group after 12 months. TMJ sound was more found in adhesion group after 1 month(p<0.05), but after 3 months, no significant difference was found between two groups. Conclusions: The postoperative results of adhesion group were worse than ID group. Therefore, it is considered more carefully to diagnose and treat in cases of internal derangement with adhesion.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권3호
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• pp.301-309
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• 2000

This clinical study was made of 214 cases of the jaw cysts which were diagnosed histopathologically in the Department of Oral and Maxillofacial Surgery, Wonkwang University Dental Hospital from Jan. 1, 1991 to Dec. 31, 1998. Medical records, radiographs, histopathological reports of 214 cases with jaw cysts were retrospectively reviewed. The results were as follows : 1. Among the total patient of 214 cases, male were 143 cases, and female are 71 cases, male predominated by the ratio of 2.04. 2. The periapical cysts and the dentigerous cyst are the most common cyst, irrespective of 116 cases(54.2%) and 58 cases(27.1%). 3. The periapical cyst has no gender prediction, male were 70 cases and female were 54 cases, the mean ages were 39.3 years(SD=18.4). The most common involving teeth were maxillary anterior teeth(59.7%). 4. The dentigerous cyst predominantly occurred in third decade (18 cases : 31%), and the mean ages were 31.9 years(SD=14.8). Dentigerous cysts predominantly occurred in male by the ratio of 7.29 (male : 51 cases, female : 7 cases). Maxillary anterior teeth(43.1%) and mandibular molars(32.8%) were most frequently involved. 5. The odontogenic keratocyst predominantly occurred in second and third decade and mean ages were 23.5 years(SD=17.2). The mandibular molars(60%) were most frequently involved. 6. All nasopalatine cyst occurred after fourth decade, mean ages were 49.5years(SD=10.4). In the gender incidence of nasopalatine cyst, 1 case occurred in female and 10 cases occurred in male. 7. In the surgical intervention of jaw cyst, cyst enucleation and marsupialization performed in 156 cases. Cyst enucleation with bone graft performed in 58 cases and iliac autogenous bone grafts most frequently performed in 29cases. 8. The diameter range of cyst enucleation with bone graft were from 15mm to 120mm with a cyst diameter of 33.3mm. (SD=15.2) The diameter range of cyst enucleation and marsupialization were from 7mm to 82mm with a cyst diameter of 20.4mm.(SD=9.0) The diameter of cyst enucleation with bone graft were significantly greater than diameter of cyst enucleation. (p<0.05) 9. Post-operative complications occurred in 9 cases(15.5%) in which cyst enucleation with bone grafts performed and occurred in 31 cases(19.9%) in which cyst enucleation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.87-108
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• 1996

본원에서 하악지시상골 절단술을 시행한 하악전돌증 환자 29명 (남자 12명, 여자 17명)을 대상으로 수술전, 수술후, 장기관찰기간동안 경조직과 연조직 변화를 관찰한 결과 다음과 같은 결과를 얻었다. 1. 술후 하악은 반시계방향회전하면서 후방이동 하였으며 장기관찰시 B와 Pog에서 1.23mm, 1.28mm의 재발을 보였다. 이는 술후의 하악이동에 따른 순수한 효과(Net effect)가 81.7%, 82.2% 라는 것을 의미하며 이러한 재발로 인하여 수술의 효과를 감소시킬 수 있다는 사실을 술전 치료계획에 포함시켜야 한다고 할 수 있다. 2. 하악 경조직의 수평변화에 대한 하악 연조직의 변화비율은 하순구에서 100%, 이부에서 99.1-102.1% 로 나타났으며 하순의 경우 72.7-93.7% 로 나타났으며 상순의 경우 하악 전치 이동량의 5.7% 정도 후방 이동하게 되지만 통계적 상관관계는 미약했으나. 수직적으로 8.3-9.6% 정도 유의한 하방이동양상을 보였다. 3. 술수 상순과 하순의 관계가 개선되어 심미선에 대하여 상순(Ls)은 상대적으로 동출하고 하순(Li)은 후방이동하였으며, 상순구가 얕아지고 하순구가 깊어졌으며, 비순각이 개선되어 전반적 안모가 개선되었으나 턱부위의 전돌은 수술후에도 약간 남아있었다. 4. 하악 연조직점을 종속변수로, 하악 경조직점을 독립변수로한 회귀분석에서 경조직 변화와 연조직 변화 사이의 높은 상관관계가 있다고 하여도 이를 정확하게 예측하기 어렵다는 것을 알 수 있었으며, 연조직 두께와 수평이동사이에는 통계적 유의성이 없었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.135-143
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• 1996

이 연구의 목적은 성견의 발치와에 식립된 implants에 새로운 골 형성을 유도할 목적으로 사용한 흡수성막의 골유도재생술을 평가하고자 하였다. 성견의 제 3소구치를 발거하고 cylindrial HA-coated implants를 식립하였다. 실험군에는 흡수성막인 $GUIDOR^{(R)}$ 를 덮어 보호를 하고, 대조군은 막으로 보호하지 않았다. 성견은 1, 2, 4개월에 차례로 희생하였으며, 치유과정 및 골형성 정도의 평가를 위해 임상적, 방사선학적, 그리고 조직학적 관찰을 통한 다음과 같은 결론을 얻었다. 1. 치유리간 동안에 실험군의 흡수성막의 안정성과 조직의 만족할 만한 치유능력을 볼 수 있었다. 2. 술후 4개월 정도에서 막이 완전한 흡수를 볼 수 있었다. 3. 미숙골이 정상적인 충판의 성숙골로 바뀌는데 약 4개월의 시간이 필요하였다. 4. 대조군에 비하여 실험군에서 더 많은 골형성을 관찰할 수 있었다. 5. 흡수성막이 implant 매식에 유용하게 이용될 수 있으리라 평가한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.171-178
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• 1994

경부수활액낭종과 임파관종은 선천적으로 임파계가 발육이 정지되거나 방해 받으므로 나타나는 병소로 현재까지도 그 본태가 명확히 밝혀지지 않은 질환이다. 본 증례에서는 좌측 하악 우각부 및 상경부에 동통을 동반한 미만성 종창 및 연하장애로 1991년 7월 20일 본원을 내원한 5세 여아에서 임상 소견 및 방사선 소견을 통해 좌측 하악 우각부 및 상경부에 발생한 경부수활액낭종으로 진단하여 악하부 절개를 통해 $1{\time}6{\time}5cm$의 크기를 다방성 낭종구조를 가진 종물을 외과적으로 적출한 증례에 있어서 술후 현재까지 재발 등의 증상없이 양호한 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.186-195
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• 1994

Fibromatosis is benign fibroblastic proliferative lesion with abundant collagenous neo-formation located principally in the abdominal wall and in the upper and lower extremities (Masson & Soule, 1966). Wilkins and Waldron, in 1975, suggested that the title aggressive fibromatosis was a more appropriate term, reflecting the invasive characteristics of the disease. Synonyms listed were extra-abdominal desmoid, juvenile fibromatosis, aggressive infantile fibromatosis and congenital fibrosarcoma. A total of 12% of all fibromatosis arise in head and neck. Fibromatosis of the oral cavity is uncommon and is even more rare when in involve the mandibule. It is a locally aggressive fibrous tissue tumor, generally does not metastasize, but may cause considerable morbility and even death due to local infiltration. The degree of microscopic cellularity is variable, not only from tumor to tumor but also from area to area in the same tumor. Some tumors present with proliferation of mature fibroblasts and a dominating collagenous component : others may show a lack of the tumor in both types. The common histologic denominator appears to be cellular interlacing bundles of elongated fibroblasts, showing little or no mitotic activity and no pleomorphism. Mitosis are not a consistent index of malignancy when found in younger age groups. Fibromatosis still posses difficult problems of diagnosis and treatment. It is frequently recurrent and infliltrates neighbouring tissues. These lesion infliltrate widely and replace muscle, fat, and even bone with fibrous tissue of varying cellularity. Lesion representing fibromatosis in the oral cavity must be carefully evaulated by both surgeon and pathologists to ensure proper diagnosis and treatment planning. When these lesions involve bone, surgeon must be aware of the lesion's potential to perforate the cortex and expand while remaining hidden from the surgeon's view. Careful and precise clinical correlation with histologic appearance is essential to preclude misdiagnosis of fibrosarcoma yet provide surgical treatment plan that provides adequate local excision and long-term follow up. As regards cause, little is known. It is attributed to trauma or alteration in the sex hormone(Carlos, et al, 1986). Clinially, the lesion is reported to be not painful in most cases, but capable of rapid growth. The treatment is essentially surgical excision with wide margin of adjacent uninvolved tissue. Radiotherapy, hormone treatment or chemotherapy are of no use (WIkins et al, 1975 ; Majumudar and Winiarkl, 1978). We report a case of aggressive fibromatosis of 15-year-old with a lesion in the soft tissue of the parotid area that invaded the underlying bone of the mandibular body.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권5호
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• pp.383-393
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• 2007

The aim of the present study is to investigate the effect of anodized surface of osseointegration implants by using of resonance frequency analysis (RFA) and histomorphometric analysis. A total of 96 screw-shaped implants were devided into 4 groups. Seventy-two implants were prepared by electrochemical oxidation with 3 different ways; Group 1 (n=24) were prepared at galvanostatic mode in 0.25M sulfuric acid and phosphoric acid, Group 2 (n=24) were prepared at galvanostatic mode in calcium glycerophosphate and calcium acetate, and Group 3 (n=24) were prepared at galvanostatic mode in 0.25M sulfuric acid and phosphoric acid followed by Calcium metaphosphate(CMP) coating. Control group (n=24) were the RBM surfaced implants. The implants were placed in the mandibles of 12 mini pigs. Bone tissue responses were evaluated by resonance frequency analysis(RFA) and histomorphometric analysis that were undertaken at 2, 4 and 6weeks after implant placement. The following result were obtained. 1. Twenty-two of 96 implants (4 in control group, 5 in group 1, 7 in group 2, and 6 in group 3) were failed due to faliure of osseoitegration. The failure rate of osseointegration was 22.9%. 2. The mean values of RFA in control, group 2 and groups 3 showed the similar values, but there was no significant difference among groups. 3. Histomorphometric evaluation demonstrated significantly higher bone-to-implant contact ratio in group 2 at 3 and 4 weeks after implant placement than other groups (p<0.05), but there was no significant difference among groups at 6weeks after implant placement.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권1호
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• pp.55-62
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• 2007

구순열의 일차 수술 또는 이차 수술 후에 발생하는 상순의 지나친 긴장은 상하순 간의 부조화, 상악열성장, 골격성 III급 부정교합 등 안모추형을 초래한다. 상순의 긴장이 매우 심한 경우에는 하순의 여유 있는 조직을 이용하여 상순을 수정하는 Abbe 피판을 고려할 수 있다. 상순의 긴장이 큐피드궁의 2/3 이상의 조직 손실을 동반할 경우 Abbe 피판의 적응증이 된다. Abbe 피판은 상순과 하순의 반흔, 색상의 부조화, 그리고 상순의 불완전한 운동을 초래하는 단점을 가진다. 그러므로 Abbe 피판은 신중하게 사용되어야 한다. 우리는 편측성 구순열 1예와 양측성 구순열 3예에서 상순의 과도한 긴장과 큐피드궁의 조직 결핍 그리고 비변형이 심한 이차성 구순열비변형을 교정하기 위해 세 가지 형태의 Abbe 피판을 이용한 이차 교정술을 경험하였다. Abbe 피판수술을 시행한 결과 상순의 반흔과 긴장이 해소되고 큐피드궁이 재건되고 비주의 길이가 증가되어 이차 구순열비변형을 교정할 수 있었다. Abbe 피판은 신중을 기해 적용한다면 구순열 수술 후에 발생되는 상순의 수평적 긴장감이나 편평함을 해결하는 데 유용한 술식임을 알 수 있었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권1호
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• pp.85-90
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• 2007

Plasma cell neoplasms are generally categorized into four groups; multiple myeloma(MM), solitary plasmacytoma of the bone(SPB), plasma cell leukemias, and extramedullary plasmacytomas(EMP). These tumors may be further described as localized or diffuse in presentation. Localized plasma cell neoplasms are rare occurrences and include solitary plasmacytomas of the skeletal system, which account for 2-5% of all plasma cell neoplasms and extramedullary plasmacytomas of the soft tissue, which account for approximately 3% of all such neoplasms. A plasmacytoma is defined as any discrete, most likely solitary mass of neoplastic plasma cells either in the bone marrow or in various soft tissue sites. Diffuse lesions include the other two groups, multiple myeloma and plasma cell leukemia. The relationship between these processes has not yet been definitively characterized, but there appears to be a continuum in which both SPB and EMP often progress to MM. The patient was referred who had continuous deep throbbing bone pain and swelling on the left posterior gingival area of the mandible after extraction of the first and second molar. The result of intraoperative excisional biopsy of the lesion was confirmed as a plasmacytoma. And it revealed systemic multiple myeloma through the further diagnostic work-up. It is worth to report because of a rare case of multiple myeloma found in oral cavity as a form of plasmacytoma.