• Title/Summary/Keyword: 외과적 노출술

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Management of Infected Immature Permanent Tooth with Pre-eruptive Intracoronal Resorption : Two Case Reports (맹출 전 치관 내 흡수에 기인한 감염 미성숙 영구치의 치험례)

  • Yang, Sunmi;Kim, Jaehwan;Choi, Namki;Kim, Seonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.220-227
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    • 2017
  • Pre-eruptive intracoronal resorption (PEIR) is a rare radiolucent lesion often located within the dentin and adjacent to the dentin-enamel junction, underneath the occlusal aspect of the crowns of unerupted teeth. The treatment approaches for these lesions involved with unerupted teeth have been known as to be relatively simple; depending on the extent of resorption, follow-up or restoration can be performed after surgical exposure. However, once the tooth is exposed to the oral cavity after eruption, it becomes highly vulnerable to the development of carious lesions. Thus, immediate intervention is required in such cases; failure to address it may result in the need for more complex treatments including endodontic therapy. The aim of this case report was to describe the characteristics of PEIR and the clinical management of the impacted immature permanent teeth diagnosed with PEIR.

ORTHODONTIC TRACTION OF IMPACTED POSTERIOR TEETH : CASE REPORTS (매복 구치부 치아의 교정적 이동 : 증례 보고)

  • Maeng, Yu-Jin;Oh, So-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.613-618
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    • 2009
  • Impacted molars are not usual with the prevalence rate of less than 1%, however problems such as infraocclusion, extrusion of the opposite tooth and lack of space are caused. If molars are impacted, radiographic check-up and observations are needed as they play an important role in skeletal development and mastication. Causes of impaction are underdevelopment of roots, supernumerary teeth, cysts, odontomas, ankylosis and etc. In our first case, we present impacted molar which was surgically exposed and orthodontically traded. As the developmental state of the root was less than half at first visit, we observed until the root was 2/3 in its length and traction was carried out. The second case is orthodontic traded molar with compleate enucleation of the existing cysts. When trading impacted molars, direct bonding of attachments to the tooth and light continuous forces are recommended so as to ankylosis, external absorption and periodontal attachment loss avoid. Fixed appliances tract the teeth on arch and obtain eruption spaces without patient's cooperation. We report surgically exposed and orthodontically traded molars which resulted in good occlusion and patients satisfaction.

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Surgical Management of Idiopathic Tracheal Stenosis -Three case reports- (특발성 기관 협착증(Idiopathic Tracheal Stenosis)의 외과적 치험 -3예 보고-)

  • Kim, Hyung-Tae;Choi, Ho;Yoon, You-Sang
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.439-443
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    • 2003
  • A lower laryngeal and upper tracheal stenosis that is of idiopathic origin is occasionally seen. It is called an idiopathic tracheal stenosis. These circumferential fibrous stenosis is rare and they are most often located in the subglottic larynx and extend to varying distances predominantly in young women. Because of the unknown nature of the disease process and uncertainty about its future progression, patients were approached conservatively. Recently, surgical resection and reconstruction have been increasingly performed, as favorable results were obtained. Three female patients with dyspnea were admitted. For two patients, they were diagnosed this conditions as bronchial asthma by mistake. All patients were performed computed tomography and bronchoscopy. For two patients with subglottic stenosis, subglottic resection was performed by cervical collar incision, and for the other one patient with distal tracheal stenosis, tracheal resection was performed by right posterolateral thoracotomy. A diagnosis of idipathic tracheal stenosis was confirmed by postoperatively pathologic finding. For one case, because of anastomosis site infection and restenosis, a whole tracheal exposure was performed by cervical collar incision and median sternotomy. And reoperation was peformed successfully.

An Effect of Endocrinological Changes related to the Stress on the Submandibular Gland in Rats (스트레스와 관련된 내분비계 변화가 백서 악하선 조직에 미치는 영향에 관한 실험적 연구)

  • Chang, Bong-Youl;Kim, Sung-Hoon;Chun, Yang-Hyun;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.25 no.3
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    • pp.279-289
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    • 2000
  • 현대에는 날로 복잡해지는 생활양식의 변화에 따라 다양한 스트레스에 노출되고 그로 인한 면역계, 신경계 또는 각종 장기의 기능이상이 점차로 증가되고 있다. 최근 치과에 내원하는 환자들 중 구강건조증을 호소하는 환자들의 다수는 스트레스에 노출되어 있고, 임상적으로도 방사선 타액선 기능 검사에서 타액선, 특히 악하선의 기능이 현저하게 저하되어 있는 소견을 관찰할 수 있 다. 더욱이 이는 타액선 조영술에서 이미 보고된 바 있는 면역성 질환인 $Sj\ddot{o}gren$ 증후군과는 다른 양상으로 관찰되고 있어, 이에 본인은 백서에 스트레스와 관련이 깊은 내분비적 환경 변화를 유도함으로써 이와같은 변화가 악하선 조직의 병리적 변화와 어떠한 연관성을 갖는 지를 관찰하고자 본 실험을 시행하였다. 생후 7주된 Sprague-Dawley계 웅성 백서(165-209g/bw) 40마리를 2 개의 실험군(부신 제거군 : ADX 군, 부신 제거 후 dexamethasone 투여군 : DEX 군)으로 나누어 실험하였다. ADX 군은 외과적으로 부신을 제거한 후 다른 조건을 부여하지 않았고, DEX 군은 외과적으로 부신을 제거한 후 매일 dexamethasone($1.5*10^{-46}mg/g$ I.V./day)을 투여하였으며, 이들을 각각 실험 후 즉시, 1일, 3일, 5일, 7일에 희생시켰다. 그 후에는 즉시 악하선을 적출하여 면역조직화학법으로 Clusterin의 발현 정도 및 부위를 관찰하였다. 그 결과는 다음과 같았다. 1. 광학현미경 하에서, 양 군 모두 유의할만한 조직학적 변화는 관찰되지 않았다. 2. ADX 군에서는 실험기간 전반에 걸쳐 도관세포와 선포세포에서 clusterin이 발현되었다. 3. DEX 군에서는 소수의 선세포에서 국소적으로 clusterin이 관찰되었으나, 전반적으로 도관세포, 선포세포에서 공히 clusterin이 관찰되지 않았다. 부신을 제거한 군에서는 실험기간 전반에 걸쳐 clusterin이 발현되었는데, 이는 clusterin이 스트레스의 생리적 반응의 결과로서 세포보호작용을 한다는 사실에 기초하여 볼 때, 부신을 제거하였을 때도 스트레스를 받았을 때와 같은 영향이 백서의 악하선에 가해졌을 것으로 생각된다. 반면, 부신제거후 glucocorticoid agonist인 dexamethasone을 투여하였을 때, clusterin이 감소 내지 관찰되지 않았던 것은 부신제거에 의해 악하선에 가해졌던 영향을 dexamethasone이 길항하여 나타난 결과로 볼 수 있어, 스트레스에 의해 부신으로부터 분비되는 glucocorticoid가 타액선을 보호하는데 중요한 작용을 하는 것을 시사한다.

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CONTOUR RECONSTRUCTION OF FACIAL DEFECT WITH SPLIT STERNOCLEIDOMASTOID MUSCULAR FLAP FOLLOWING PAROTIDECTOMY (이하선 적출술 후 흉쇄유돌근을 이용한 안모결손부의 외형재건)

  • KIM, Myung-Jin;KIM, Taek-Kyoung;YOU, Jun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.144-152
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    • 1991
  • Various muscular flaps are used in oral and maxillofacial reconstructive surgery for the defects caused by tumor resection and trauma or for the correction of head and neck deformities. The sternocleidomastoid(SCM) muscle may be widely used as a muscular or myocutaneous flap in these lesion. The authors used SCM muscular flap for the expected parotid defect following benign tumor related conservative parotidectomy in three cases. We expected that prevention of post-operative facial deformity, reduction of dead-space and protection of denuded facial nerve etc. is lead by SCM muscular flap. But the total SCM flap can lead to some complications such as "flat neck deformity", limitation of neck movement and overcontouring of parotid defect. Therefore, the authors used split pedicled SCM muscular flap and it lead good favorable results of post-operative functional and esthetic problems.

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Combined Repair of Pectus Excavatum and Open Heart Surgery in Marfan's Syndrome (Marfan 증후군 환자에서 개심수술 및 누두흉의 교정)

  • 신제균;정종필;이용직
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.556-559
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    • 2002
  • The presense of pectus excavatum in Marfan's syndrome may complicate cardiac operation by making midline sternotomy technically more difficult and limiting the operative exposure of the heart. We operated on a 33 year old male patient with Marfan's syndrome and severe pectus excavatum who had severe mitral regurgitation and moderate aortic regurgitation with 52mm aortic root dilation. The operative field was adequately exposed through a midline sternal incision with two sternal retactors. The patient underwent Bentall operation and mitral valve replacement. The repair of pectus excavatum was performed after completion of CPB and the administration of protamin. Permanent internal stabilization achieved by overlapping of the ends of lower ribs and reinforced with sternal closure wire.

PERFORATION OF THE TEMPOROMANDIBULAR JOINT MENISCUS: DIAGNOSED BY MAGNETIC RESONANCE IMAGING (MAGNETIC RESONANCE IMAGING을 이용한 악관절 원판 천공 진단)

  • Kim, Houng-Gon;Dolan, Eward;Vogler, James B.;Nokes, Steven R.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.11-18
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    • 1989
  • Advancement of surgical techniques has made it necessary to accurately diagnose internal derangements. Arthrography and computerized tomography have been used to diagnose the majority of temporomandibular joint disorders, however, these methods have had their disadvantages. Magnetic resonance imaging utilizing surface coils has greatly improved the ability to diagnose meniscus abnormalities without using intrarticular injections or ionizing radiation. Ninety-two patients (184 joints) were evaluated by means of magnetic resonance imaging(MRI). Thirty-one patients (39 joints) were diagnosed as having meniscus perforation. Retrospective review of fifteen patients (20 joints) with a perforated meniscus diagnosed by magnetic resonance imaging pre-operatively demonstrated a sixty-five percent correlation between the radiographic diagnosis and the surgical findings.

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ORTHODONTIC TRACTION OF HORIZONTALLY IMPACTED MAXILLARY INCISORS: CASE REPORTS (수평 매복된 상악 중절치의 교정적 견인: 증례 보고)

  • Kim, Mi-Ni;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Kim, Chong-Chul;Hahn, Se-Hyun;Lee, Sang-Hun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.4
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    • pp.757-765
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    • 2008
  • Maxillary central incisor impactions occur infrequently. Their origins include various local causes, such as odontoma, supernumerary teeth, space loss, and disturbances in the eruption path, also trauma and apical follicular cysts. Impacted teeth can cause serious dental and aesthetic difficulties as well as psychological problems especially in anterior regions. Although the impaction of maxillary incisor occurs less frequently than that of the maxillary canine, it is of concern to parents during the early mixed dentition stage because of the uneruption of the tooth. Forced eruption of impacted teeth should be considered in young patients because this technique can lead to suitable results from a periodontal, occlusal, and esthetic perspective at an earlier stage better than with other treatment options. This report presents the surgical and orthodontic treatment of cases with horizontally impacted and dilacerated maxillary central incisors. For each patient, we used the closed eruption method, placed an attachment on the impacted tooth on surgery, and fully closed the flap. Traction was applied immediately. The impacted tooth erupts through the healed tissue in a manner resembling normal eruption.

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SURGICAL REPOSITIONING OF THE DISPLACED IMPACTED MAXILLARY CENTRAL INCISOR WITH DILACERATED ROOT : CASE REPORT (비정상 맹출로와 치근 만곡을 지닌 매복 상악영구전치의 자가치아이식 치험례)

  • Rhee, Ye-Ri;Choi, Sung-Chul;Park, Jae-Hong;Kim, Gwang-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.3
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    • pp.516-522
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    • 2008
  • In the case of the impacted teeth, the clinician has to consider development of tooth, site of impaction, eruption path, and cooperation of patient. If there are genetic or general factors to effect the eruption of tooth, the clinician treats these first and then takes the early treatment for eruption guidance. If there are physical factors to intercept eruption, the clinician put them off first. However, if there are no factors to effect eruption of tooth and enough space for eruption, the clinician can consider extraction of deciduous teeth, forced eruption and surgical reposition. In case of surgical repositioning, proper time for root development, proper socket formation, and minimal trauma are important for success. This case presents displaced impacted maxillary central incisor with dilacerated root. The development of root is Nolla's stage 7, and the tooth was treated by surgical repositioning. We can observe no root resorption and good healing pattern.

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Routine Off-pump Total Arterial Coronary Revascularization (심폐바이때스 없이 시행된 동맥 도관만를 이용한 관상동맥 완전 재관혈화)

  • Lee, Jae-Won;Park, Nam-Hee;Kang, Seong-Sik;Choo, Suk-Jung;Park, Seung-Jung;Park, Seung-Wook;Hong, Myeong-Ki;Song, Hyun;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.309-315
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    • 2003
  • Background: To avoid the adverse effects of cardiopulmonary bypass and to overcome late vein graft failure we routinely peformed off-pump total arterial coronary revascularization. Material and Method: From July 2000 to August 2001, 104 consecutive patients underwent first elective off-pump total arterial coronary revascularization. Both internal mammary, radial and gastroepiploic arteries were used. Sequential and composite grafts were used to achieve complete revascularization. Perioperative adverse events and postoperative angiograms were analyzed. Result: A total of 252 arterial conduits were used with an average of 2.47 grafts per patient. A total of 326 distal anastomosis were performed with a mean of 3.13 distal anastomosis per patient. Cross over to on-pump occurred in seven patients (6.7%). Of these 4 were due to unstable hemodynamics during lateral or posterior wall stabilization as a result of cardiomegaly and 3 were due to uncontrolled bleeding during dissection of diffusely dimunitive deeply placed intramyocardial coronary arteries. There were no opeartive deaths. Two cases of perioperative myocardial infarction and transient neurologic complications occurred, respectively. Of the 312 distal anastomoses, 308 (98.7%) were compatible with Fitz-Gibboll A or B patency grading. Conclusion: Off-pump total arterial coronary revascularization was technically feasible in most elective cases with satisfactory early results. However, on-pump coronary bypass surgery should be considered in difficult circumstances, such as cardiomegaly or unfavorable anatomy of the target coronary artery.