• Title/Summary/Keyword: 하악골 절단술

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Case Report of Maxilla/Mandible Simultaneous Distraction with Molina$^{(R)}$ Distractor (Molina distractor를 이용한 상/ 하악 동시 신장술 증례의 보고)

  • Baek, Kyung-Won;Kim, Keun-Woo;Choi, Jin-Yeong
    • Korean Journal of Cleft Lip And Palate
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    • v.9 no.2
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    • pp.55-62
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    • 2006
  • 1980년 일리자로프가 하지에서의 골 신장술을 발표한 이래 수많은 외과 의사들이 임상연구와 발표를 거듭해 현재의 골 신장술을 이루었다. 악골에서 골 신장술의 적용은 1992년 8명의 악골 기형 환아에게 하악지 신장술을 적용한 맥카시의 발표를 기점으로 시작되었다. 골 신장술의 장점은 부족한 골조직과 함께 주변 연조직을 신장시키는 것으로 복합적 조직 결손을 보이는 선천성 악골 기형 환자들에게 특히 유리하게 적용시킬 수 있다. 반안모 왜소증은 안면 반측의 상/하악골 및 악관절, 연조직의 저성장 및 결손을 보이는 비교적 흔한 악골 기형이다. 하악지 신장술의 활발한 연구로 이를 이용한 악관절 증상과 안면 비대칭의 해소가 일차적 치료기법으로 선택되고 있다. 연구자들은 악관절 증상과 안면 비대칭을 주소로 내원한 성인 반안모 왜소증 환자에게 상악 및 하악의 동시 골 신장술을 적용하여 만족할 만한 결과를 얻었기에 이를 발표한다. 상악골의 Le Fort 제1형 골 절단술과 이환측의 하악지 시상분할 골절단술 후에 Molina distractor를 하악지에 적용하고 악간 고정을 통해 동시 신장을 꾀하였다. 수술 기법 및 평가 기법에 대하여 논의하였다.

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Fabrication of functionally customized fixed prosthesis in a hemimandibulectomy patient with fibular graft using double scan technique: A case report (비골이식을 받은 하악골절제술 환자에서 스캔중첩법을 이용한 기능적 고정성 보철물 제작: 증례 보고)

  • Win, Thaw Thaw;Lee, Du-Hyeong
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.195-201
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    • 2022
  • Hemimandibulectomy and free fibular flap (FFF) in patients with squamous cell carcinoma could disturb the functional movement of the mandible. The muscular function in the sectioned side was compromised because of the incompetency of the muscle attachment to the mandible, leading to the unstable occlusal contact in the centric and eccentric occlusion. In this report, we present a case of a 63-year-old male who underwent cancer surgery and reconstruction with fibular graft, and he needed a fixed dental prosthesis to restore tooth loss in the anterior region. Occlusal contact change and instability were found according to the bite force in the centric relation and eccentric movement. This case report aimed to present the prosthetic procedure for fabricating the functionally optimized fixed prosthesis wherein the functionally generated path (FGP) technique and digital imaging method were applied to replicate mandibular movement and vertical dimension of the patient.

A MODIFICATION OF THE MICHELET TECHNIQUE FOR SLIDING HORIZONTAL OSTEOTOMY;A CASE REPORT (MICHELET 테크닉의 변형을 이용한 이부성형술의 치험례)

  • Lee, Jin-Gew;Davis, Isaac E.;Swift, James Q.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.145-151
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    • 1994
  • 앞 턱 부위가 짧고 후방으로 위치해 있을 때 턱의 높이를 증가시키고 전방으로 돌출시키는 축조 이부성형술의 방법으로는, 매식체 삽입술, 골 절단술, 골 절제술 또는 이들을 동시에 시행하는 혼합술등이 행해져 왔다. 그러나 매식체 삽입술에서는 감염 또는 매식체의 유동성 등의 합병증의 발병이 빈발하고 매식체의 밑 부위에 골이 흡수된다든지 연조직의 변화를 예측하기 어렵다든지 하는 복잡한 문제점들이 종종 보고되고 있다. 따라서 매식체를 이용하지 않는 골 절단술이나 골 절제술만을 이용한 다양한 방법의 이부성형술이 많이 시행되고 있다. 하악골이 전후방 관계로 발육부전인 환자에게 양측 하악지 시상분할술을 시행하여 전방 이동시킨 후 앞 턱의 위치를 좀더 개선하기 위하여 $Michel{\'{e}}t$ 테크닉의 변형법을 이용한 이부성형술을 추가로 시행하였다. 이 방법의 이부성형술은 턱의 수직적, 수평적 길이를 증가시키기 위하여 하악결합면 부위에 장부와 장붓구멍 모양을 한 골 절단술을 시행하고 광범위한 연조직경을 보존하여 골편으로의 혈류 차단을 최소화하였으며 나사를 이용한 견고한 고정을 용이하게 하였다. 이 술식은 턱을 수직적으로 증가시킬 때 두 골편 사이의 공간에 골 이식을 시행할 필요가 없으며, 금속판을 이용하지 않아도 정확한 위치에 골편을 고정하기가 용이하고, 또한 고정용 나사가 향후 골형성 부위에 위치하게 된다는 장점을 경험하게 되어 이에 한 증례를 보고하는 바이다.

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CHONDROSARCOMA OF THE NAMDIBULAR CONDYLE (하악골 과두부의 연골육종 1예)

  • Yoon, H.J.;Cha, I.H.;Lee, C.K.;Kim, J.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.438-441
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    • 1995
  • Chondrosarcoma is a rare malignant neoplasm which constitutes approximately 10% of all primary malignant bone tumors. It occurs most often in the pelvis, femur, rib and humerus and the involvement of the jaw is rare, and what is more, chondrosarcoma arising in the condyle is extremely rare and only a few cases were previously reported and there is no domestic report. We report a chondrosarcoma of a condyle presenting as a painful swelling on the left preauricular area.

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Convergence study related in development of new intraoral jaw bone distractor in treating dentofacial deformities (악골 기형 치료를 위한 구내형 골신장기 개발에 관련된 융합 연구)

  • Lee, Jae-Gi
    • Journal of the Korea Convergence Society
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    • v.7 no.6
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    • pp.75-80
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    • 2016
  • Distraction osteogenesis is applied to correct mandible or maxilla deformities. Owing to the distractor being away from the skin, it is not aesthetic. Infection can arise due to manual part. And therefore, it is necessary to make the distractor using a new mechanism. 3D software was used for the intraoral distractor modeling. 3D meshes were used to analyze the stress distribution of the distractor was analyzed using Finite element analysis software. This research developed a intraoral distractor for continuous mandible distraction through convergence study. Base on the results, it provide helpful data for future version of the wireless intraoral distractor in other fields of bio and medical engineering.

RECONSTRUCTION OF UNILATERAL TMJ ANKYLOSIS WITH METALLIC CONDYLAR PROSTHESIS;REPORT OF A CASE (금속 이식물을 이용한 악관절 강직증의 치험례)

  • Lee, Dong-Keun;Yim, Chang-Joon;Kang, Moon-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.40-46
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    • 1989
  • Destruction of normal temporomandibular joint architechture may produce serious functional and cosmetic deficiencies. The literature is well documented as to the etiology and pathogenesis of temporomandibular joints. Numorous surgical procedure have been advocated for temporomandibular joint ankylosis from condylectomy to arthroplasty, cartilage transplant, metallic prosthesis, interpositional implant. These were to able reconstruct the normal mandibular function, and any even procedure could obtain the satisfactory results. In this paper, we reviewed young adult patient with TMJ ankylosis and facial asymmetry who was treated with metallic condylar prosthesis and orthognathic surgery.

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RECONSTRUCTION OF MANDIBULAR DEFECT WITH COMPOSIITE AUTOGENOUS ILIAC BONE AND COSTOCHONDRAL GRAFTS (자가장골 및 늑연골의 복합이식을 통한 하악골 재건술)

  • Chang, Se-Hong;Ann, Jye-Jynn;Soh, Jae-Jung;Park, Chi-Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.104-109
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    • 1991
  • Loss of mandibular continuity due to neoplasm, trauma, or infection results in major esthetic and biologic compromise. The use of costochondral grafts for reconstruction of temporomandibular joint, described first by Gillies in 1920, has been accepted as a suitable method for replacing the mandibular condyle, especially in growing children. Autogenous iliac bone graft has been a satisfactory source of mandibular reconstruction since Sykoffs report in 1900. Autogenous bone grafts from the posterior aspects of the ilium provide large amount of PMCB with acceptable donor site morbidity. In timing of reconstruction, initial disease, age, medical history, growth and development, esthetic and psychologic factors should be considered. We present a case of osteosarcoma in the mandible that was treated by a hemimandibulectomy and the defect was reconstructed 20 months later with composite method of costochondral and posterior iliac bone graft.

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Biomechanics in various mandibular widening procedures (다양한 하악 이부 확장 패턴에 관한 연구)

  • Tae, Ki-Chul;Kang, Kyung-Hwa;Kim, Kyung-Hwan
    • The korean journal of orthodontics
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    • v.35 no.1 s.108
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    • pp.82-89
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    • 2005
  • Mandibular widening is one method of mandibular distraction osteogenesis, which has anatomic limitations such as curved surface, mandibular condyle and narrow arch. The purpose of this study was to understand the biomechanics of various mandibular widening procedures Experimental models consisted of 6 groups according to different osteotomy hues and distractor positions. The results of this study showed different expansion patterns. which meant the feed for proper approaches in mandibular widening.

SKELETAL RELAPSE AFTER ORTHOGNATHIC SURGERY OF CLASS III SKELETAL OPEN-BITE (개구교합을 가진 3급 부정교합환자의 악교정수술후 재발에 관한 연구)

  • Song, Jae-Chul;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.3
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    • pp.229-237
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    • 1993
  • This study was intended to evaluate a post-operative relapse tendency in mandibular prognathism patients with open-bite. 18 patients with or without open-bite have undergone sagittal split ramus osteotomy and were investigated radiologically with cephalogram. The results were as following 1. The preoperative anterior facial height, mandibular plane angle and mandibular gonial angle were larger in open-bite patients than in nonopen-bite patients.(p>0.05) 2. There was significant correlation between surgical change of SNA, mandibular plane length and long-term relapse.(p<0.01). 3. There was relatively stable postoperative anterior facial height in open bite patients. 4. There was no significant correlation between the surgical change of mandibular plane angle, amount of mandibular setback and long-term relapse.(p>0.01) 5. This study showed that horizontal relapse was more significant than vertical relapse.

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CHANGES OF TRANSVERSE MANDIBULAR WIDTH AFTER INTRAORAL VERTICAL RAMUS OSTEOTOMY (구내 하악골 상행지 수직골 절단술 후 하악골 우각부의 수평적 길이 변화)

  • Park, Sung-Yeon;Jung, Young-Soo;Choi, Young-Dal;Park, Hyung-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.5
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    • pp.447-452
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    • 2006
  • Purpose: In order to clarify the correlation of mandibular setback using bilateral intraoral vertical ramus osteotomy (BIVRO) and post-surgical transverse mandibular width (TMW), this study examined the pre- and postsurgical changes in hard and soft tissues of TMW and the relationship of TMW and the amount of mandibular setback. Patients and Methods: One-hundred seven patients who had undergone BIVRO were evaluated radiographically and clinically. A comparison study of the changes in hard and soft tissue after surgery in all 107 patients was performed with preoperative, 1 month, 3 month, 6 month and 1 year postoperative posteroanterio cephalograms and clinical photographs by tracing. And this changes were evaluated in parts to amounts of mandibular setback. Results: Statistically significant increases of TMW in hard and soft tissue from preoperative to postoperative 1 month were seen. TMW in hard tissue from 1 month to 1 year postopertive were gradually decreased. TMW in soft tissue was not changed uniformly but almost equal to pre-operative width. And there was no significant correlation between TMW and amount of mandibular setback. Conclusions: The results show that mandibular setback using BIVRO did not significantly influence increasing of TMW in soft tissue.