• Title/Summary/Keyword: 안면손상

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Emergency bleeding control in a mentally retarded patient with active oral and maxillofacial bleeding injuries: report of a case (구강악안면 손상 후 과도한 출혈을 보인 정신지체 응급환자에서 신속지혈 예: 증례보고)

  • Mo, Dong-Yup;Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Kim, Ha-Rang;Lee, Chun-Ui
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.303-308
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    • 2010
  • Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.

THE EFFECT OF OBTURATOR FOR CLEFT LIP AND PALATE INFANTS: A CASE REPORT (구순 구개열 신생아에 적용한 Obturator의 효과에 관한 증례보고)

  • Hong, Sung-Joon;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.2
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    • pp.352-360
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    • 1997
  • It has been reported that There is a relatively high incidence of congenital cleft lip and palate among congenital anomalies. Children with the cleft lip and palate confront various problems ranging from feeding difficulties as infants to frequent ear infections, compromised speech, aberrant dentofacial development, malocclusion and esthetic impairment with its unfavorable effects on the psychosocial adaptation of the individual. Management of these patients is a process that starts in infancy and continues on into adulthood. Through a team approach, professionals from various fields convene to assess the needs of the child and to assist the parents in dealing with the situation. A pediatric dentist, one of the team, must advise the parents the way of feeding or make an obturator for normal feeding and weight gain of infants with cleft lip and/or palate. An obturator can aid nursing, stimulate orofacial development, help develop the palatal shelves, prevent tongue distortions, prevent nasal septum irritation, decrease chance of ear infections, expand collaped maxillary segments, constrict the expanded anterior part of the maxilla, reposition the premaxilla, and help the parents psychologically. Three cases of infants with cleft lip and palate were managed with the obturator at the Dept. of Pediatric Dentistry, Kyung Hee University. In all cases, infants showed normal feeding and weight gaining after the insertion of the obturator.

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Anterior Cervical interbody Fusion with Cervical Spine Locking Plate (경추 물림 금속판을 이용한 경추 전방추체간 유합술)

  • Park, Joo-Tae;Ahn, Gil-Young;Lee, Young-Tae;Ahn, Myun-Whan
    • Journal of Yeungnam Medical Science
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    • v.14 no.1
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    • pp.209-219
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    • 1997
  • Objectives: Anterior approach to achieve arthrodesis of the cervical spine has become a widely accepted and often-used approach since its earliest reports by Bailey and Badgley, Smith and Robinson and Cloward. However, anterior interbody fusion in the presence of the posterior instability may be complicated by the bone graft dislodgement, kyphotic defomity or nonunion. As an attemp to prevent this undesirable complication, additional methods such as skeletal traction, halo appratus or even posterior fusion has been utilized. Therefore, The cervical spine locking plate(CSLP) with the anterior intervertebral body bone grafting provide immediate cervical stabilization and widely successful in achieving fusion. Material and methods: This study analysed 14 patients who underwent a single anterior procedure and application of CSLP for the treatment of the cervical spinal disorder. Eleven patients were disc herniations and three patients were traumatic lesion. The average age of the patient was 47 years and the mean follow up periods was 20 months ranging from 13 to 27 months. Results: Ambulation was started 2nd day after the operation with the aid of the Philadelpia orthoses. Bone union was observed 13 cases on average 12 weeks after operation. The one case was nonunion with plate breakage without clinical symptom. Conclusion: Anterior fusion with CSLP are thought to be a safe and valuable method for treating cervical spine disorder.

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TREATMENT OF RADICULAR CYST USING DECOMPRESSION (감압술을 이용한 치근단 낭의 처치)

  • Kim, Nam-Hyuk;Choi, Byung-Jai;Lee, Jae-Ho;Son, Heung-Kyu;Kim, Seong-Oh;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.2
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    • pp.275-280
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    • 2009
  • Radicular cyst is a true epithelium lined cyst formed when epithelium at the apex of a nonvital tooth is stimulated by inflammation. It is the most common type of cyst in the oral cavity, but its frequency is low in the primary dentition. Treatment of large-sized cyst aims at conservation of adjacent structure and allowance of proper eruption of the successive permanent teeth in the primary dentition. Considering these two aspects, marsupialization or enucleation following decompression is recommended as a treatment means for large-sized radicular cyst. In this case, 8-year old boy visited the pediatric dentistry department. Yonsei University Dental Hospital, with the chief complaint of pain on the lower right area. Clinical and radiographic examinations revealed periapical radiolucent lesion on #84, which had previous pulp treatment and restorated with the stainless steel crown. Dislocation of its successive tooth, #44, was also observed. #84 was extracted and sent for biopsy. Through histologic examination, it was diagnosed as radicular cyst. Following its extraction, removable space maintainer was delivered, which was also used as a decompressor. During periodic check-up for next 22 months, favorable healing of the lesion and eruption of the successive tooth were observed.

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TREATMENT OF HORIZONTAL AND VERTICAL ROOT FRACTURE IN IMMATURE PERMANENT TEETH - A CASE REPORT (미성숙 치근의 수직 파절과 수평 파절의 치험례)

  • Song, Seung-Ho;Park, Ho-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.92-97
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    • 2004
  • Traumatic injuries in the young peranent dentition are common, but root fractures, defined as fractures in volving dentin, cementum and pulp, are relatively uncommon. Case 1 is a 9-year-old boy who had a horizontal root fracture of his maxillary right central incisor in the apical third. Root canal therapy was performed in coronal segment and calcium hydroxide therapy was initiated. Six months after treatment, a periapical radiograph showed calcific tissue formation and normal root development. 1 year and 3 months later, the canal was permanently obturated with gutta-percha. Case 2 is a 7-year-old girl who had a vertical root fracture of her maxillary right central incisor. Fractured tooth was intentionally extracted atraumatically, and then the separated fragments are bonded with resin cement. the restored tooth was replanted into the original socket. Recalls up to 8 months showed normal mobility and no periapical pathosis. In these cases, we performed conservative treatment. Clinical and radiographic examination showed no pathosis or abnormality of the teeth and periodontal tissue.

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MARSUPIALIZATION IN RESOLVING DENTIGEROUS CYSTS: CASE REPORT (감압조대술을 이용한 함치성낭종의 치험례)

  • Kim, Hyun-Woo;Yoon, Kyu-Ho;Park, Kwan-Soo;Jung, Jung-Kwon;Ban, Jae-Hyurk;You, Myung-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.1
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    • pp.76-80
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    • 2005
  • Dentigerous cyst is one of the most prevalent types of odontogenic cysts in the jaw. Usually dentigerous cysts begin to develope through an accumulation of fluid between remnants of the enamel organ and subjacent tooth crown which is developing or submerged. The teeth most often involved are mandibular third molars, maxillary canines, and mandibular premolars. And the cysts usually occur in the second or third decade of life. The treatment of dentigerous cysts-enucleation, marsupialization, and fenestration-is dictated by the size, environmental structures of the lesion, and desirability of conserving involved tooth. Marsupialization is a conservative technique which allows the reduction or elimination of cystic lesion by making it an accessory compartment of the oral cavity in the case where complete enucleation is not desirable. Marsupialization is thought to be the most suitable method of treatment for the conserving of the involved tooth, thus guiding eruption of it. We report the positive outcome got from marsupialization in dentigerous cysts with review of literature.

ONE-VISIT APEXIFICATION USING MINERAL TRIOXIDE AGGREGATE (MTA를 이용한 미성숙 영구치의 즉일 치근단형성술)

  • Yeom, Soon-Joon;Park, Ki-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.480-487
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    • 2001
  • In children and adolescents, oral and maxillofacial trauma is one of the most common causes of dental and periodontal damage, which often induces crown fracture of the permanent anterior teeth. Frequently, these traumatized teeth lose their vitality, and require routine endodontic treatment if their root apices are closed. However if their apices are not fully closed, further root formation should be promoted by apexification or apexogenesis. Calcium hydroxide is a biocompatible & bacteriostatic material, and is widely used for apexification. However it has several disadvantages which include the need for multiple visits and patient cooperation, low strength and technical sensitivity in a broad apex. In one-visit apexification using IRM or SuperEBA, patient's visits can be minimized. However, their biocompatibility is questionable. Mineral trioxide aggregate(MTA) is a relatively new material. It is considered biocompatible with periapical hard tissue and has good marginal sealing ability. MTA is also known to help facillitate the growth of the cementum around it. In this case report, apexification with MTA was attempted on traumatized maxillary central incisors with immature root apices, and favorable clinical results were achieved.

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An Epidemiologic Study of Low Back Pain of Women Working at a General Hospital (종합병원 근무 여성의 요통에 대한 요인 분석)

  • Park, Dong-Gu;Ahn, Myun-Whan;Ahn, Jong-Chul;Kim, Sae-Dong;Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.186-196
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    • 2007
  • Background : The aim of this study was to confirm the risk factors for low back pain and injury to improve the prevention and treatment of lower back pain. Materials and Methods : An epidemiologic study of low back pain and injury was performed with questionnaires distributed to 471 women working at Yeungnam university hospital. The differences in low back pain and injuries among various hospital departments were analyzed by a one-way analysis of variance (ANOVA), and the relevant factors included in the questionnaire were determined by a factor analysis. Results : The frequency of low back pain in women in the department of diet and in the maintenance department was higher than among the other departments. The frequency of low back pain was mainly related to the frequency of psychosomatic symptoms. In addition, the low back pain was partially related to the frequency of psychosomatic symptoms and partially related to the frequency of pushing during the workday. The degree of disability from low back pain was increased by lifting and hard physical work and was related to the frequency of psychosomatic symptoms and the degree of work dissatisfaction. The frequency of low back injury was increased by increased standing time during work and hard physical work. The frequency of low back injury was related to advancing age and in part to psychosomatic symptoms. Conclusion : Lower back pain and its associated complications are related to psychosomatic factors and type of work. Lower back injury is related to physiological factors such as age. For the prevention and treatment of lower back pain, a multidisciplinary approach is required.

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The new approach to maxillary and mandibular anterior dental arch forms - The prediction to maxillary and mandibular anterior occlusal relationship by computer program (상하악 전치부 치열궁 형태에 대한 새로운 접근 - 컴퓨터 프로그램을 이용한 상하악 전치부 교합관계에 대한 예측)

  • Ha, Man-Hee;Yang, Hoon-Cheol;Kim, Gi-Tae;Son, Woo-Sung
    • The korean journal of orthodontics
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    • v.32 no.1 s.90
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    • pp.43-49
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    • 2002
  • When we deal with maxillary and mandibular anterior dental arches showing problems in occlusal relation and aesthetics caused by malformations of teeth and congenital missing, et al during the orthodontic treatment, we could not often decide the functional occlusion by only relying on the orthodontic treatment. If orthodontists can predict what kinds of treatments are needed for functional occlusion in maxillary and mandibular anterior dental arches, they can not only effectively treat patients but also facilitate the cooperation with other field during the treatment, Our previous research showed the correlation among intercanine width, segment depth and arch perimeter by using the Korean normal occlusion model. At this time, we produced the computer application program by taking advantage of this correlation. And then, we applied this program to setting up the treatment plans for 2 patients with the damaged maxillary and mandibular dentures. With the help of this program, we could not only easily acquire the information about the change of variables required by treatment plans but also intercanine width, segment depth and arch perimeter. Later, if we can the information about the relationship between the change of the angle of incisors depending on facial types and arch forms and, in addition, can acquire the appropriate intercanine width, we can have the ability to produce the 3 dimensional occlusogram for the anterior dental arch forms.

A SCANNING ELECTRON MICROSCOPIC STUDY OF END-IN-END AND END-TO-END MICROVASCULAR ANASTOMOSIS IN THE RAT FEMORAL ARTERY (백서 대퇴동맥에서의 혈관함입문합술과 혈관단단문합술의 주사전자현미경적 비교연구)

  • kim, Uk-Kyu;Chung, In-Kyo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.16-29
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    • 1991
  • The occurrence of thrombotic occlusion & endothelial injuries at the site of anastomosis have been considered as major problems in microvascular surgery. The purpose of this study was to ascertain whether a end-in-end(sleeve, telescope) anastomosis compared favorably with end-to-end anastomosis in healing procedures on the endothelium and to study the possibility of clinical application in end-in-end method. The microvascular anastomoses have been performed with end-in-end method in the femoral arteries of 20 rats group, also with end-to-end method on the same arteries of another 20 rats group, and then the four anastomosed vessels in subdivided groups on each group were taken after period of 1, 3, 7, 14, 21 days following by anastomoses for scanning electron microscope observation. The results were as following: 1. The patency rate was 90% in the end-in-end group and 85%in the end-to-end group and late thrombus occurred at 7, 14 days on both groups, which suggested -consistent monitoring of patency was required for two weeks at least. 2. Platelet aggregates at the site of anastomosis began to organize on post-operation 3 days and in the end-in-end group, the initially decreased lumen of inserted vessel was gradually increasing on 7 days due to atrophy of the medial layers. 3. Re-endothelialization was completed between 7 and 14 days in end-in-end group, whereas between 14 and 21 days in end-to-end group.

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