• Title/Summary/Keyword: 후방 구개 폐쇄

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Maxillary complete denture fabrication cases with posterior palatal seal considering palatal form and tissue displacement (구개 형태 및 조직 변위를 고려하여 후방 구개 폐쇄를 형성한 상악 총의치 제작 증례)

  • Kim, Seon-A;Son, Mee-Kyung;Heo, Yu-Ri
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.2
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    • pp.152-159
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    • 2022
  • The role of the posterior palatal seal is important in retention of the maxillary complete denture. After taking the final impression, additional retention can be given to the maxillary denture through a mechanical method of forming a groove on master cast, but this is often overlooked in the clinical process. As a result, the posterior palatal seal is formed in a uniform way by the technician without considering the individual characteristics of the patient. Until now, various types of posterior palatal seal have been introduced by many people. This case report describes the process of manufacturing the maxillary complete denture by determining the position and form of an appropriate posterior palatal seal after considering the patient's anatomical palatal form and tissue displacement during function.

A Case of Pierre - Robin Syndrome (Pierre-Robin Syndrome 1례)

  • 천만희;박옥희;이승우;조중환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.18.1-18
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    • 1983
  • In 1923 Pierre-Robin first described the triad of micrognathia, glossptosis and high-arched or cleft palate. Respiratory distress is not an uncommon occurrence and requires prompt and appropriate treatment. The syndrome occurs once in approximately 50,000 births. Although the etiology of the syndrome is obscure, it is known that the syndrome probably results from a primary deficiency early in fetal life of mandibular development. The symptoms of airway obstruction develop as the base of the tongue falls posteriorly and approximates the posterior pharyngeal wall because of micrognathia, and is aggravated when the infant is in the supine position. The problems of mild airway obstruction can be solved by keeping the infant in the prone position. In case there are feeding difficulties, prompt glossopexy should be preformed as airway is aggravated, but tracheostomy is best avoided. There is some forms of glossopexy including Douglas operation, the insertion of Kirschner wire and Duhamel suture. We identified micrognathia, glossoptosis and high-arched palate in a 2-month-old infant who was brought to our hospital with complaints of dyspnea and feeding difficulties, and we reports this case, since we think this infant whom we observe after tracheostomy because we found Duhamel suture could not relieve the symptoms of airway obstruction as Pierre-Robin syndrome.

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Case Report: Repair of Complete Bilateral Cleft Palate Using Two-Flap Palatoplasty with Intravelar Veloplasty and Vomer Flap (연구개내근성형술 및 서골피판을 동반한 2개 점막성골막판을 이용한 완전 양측성 구개열 환자의 치험례)

  • Lee, Ui-Lyong;Seo, Byong-Moo;Choung, Pil-Hoon
    • Korean Journal of Cleft Lip And Palate
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    • v.12 no.1
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    • pp.33-40
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    • 2009
  • 구개열이 있으면 언어장애 음식섭취의 어려움, 구개범장근의 기능장애로 인한 이관의 개폐기능부전으로 중이의 액체고임, 부정교합등 여러 문제가 생길 수 있다. 따라서 구개성형술은 갈라진 경구개와 연구개를 막아주며 동적인 연구개를 만들어 주어 충분한 구개인두폐쇄를 하여 정상적 발음을 하는데 그 목표가 있다. 그 외에도 음식물을 정상적으로 섭취할 수 있고 중이염 및 난청을 일으킬 수 있는 기능을 개선시키고 정상적인 교합을 만들어주는데 있다. 위의 목표를 이루기 위해 지금까지 많은 수술 방법이 개발되었고 개선되어 왔다. 하지만 아직도 가장 효과적인 수술방법, 수술시기에 대하여 논쟁거리가 되고있다. 언어를 분명하게 하려면 연구개는 인두벽에 닿기 위해 후상방으로 올라가고 인두의 후벽과 측벽은 올라온 연구개에 닿으려고 수축함으로써 비인두와 구인두 사이의 공간이 좁아지게 됨으로써 가능하다. 따라서 발음이 정확하려면 비인두괄약(nasopharyngeal sphincter)을 합리적으로 만들어주어 비인두와 구인두를 분리해 주어야 한다. 비인두괄약을 조성해 주는 방법에는 구개범거근이 괄약기능을 할수 있도록 연구개내근성형술(intravelar veloplasty)을 시행하여 양편구개범거근을 횡위로 옮겨 연결하여 올림근 걸이(levator muscle sling)을 만드는 방법, 구개 연조직을 후방으로 밀어 구개 길이를 연장하는 방법, 인두 피판술을 하는 방법등이 있다. 구개범거근의 주행방향과 부착이 잘못되어 있는 것으로, 정상에서는 구개범거근이 횡으로 주행하여 연구개의 정중봉선(median raphe)에 부착하는 데 반해 구개열에서는 구개범거근이 전방으로 주행하여 개열 가까이에 있는 구개열 후연과 골선 개열연에 부착되어 있고 구개인두근과 구개수근이 연구개를 그냥 지나쳐직접 구개열 후연에 붙는다. 저자등은 완전 양측성 구개열을 연구개내근성형술 및 서골피판을 동반한 2개 점막성골막판을 이용한 구개성형술로 수술을 시행하여 다소의 지견을 얻었기에 문헌고찰과 함께 보고하는 바이다

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A cephalometric and dental cast study of obstructive sleep apnea patients (폐쇄성 수면 무호흡 환자의 측모 두부방사선계측사진 및 치아모형 연구)

  • Jung, Mi-Ra;Nam, Ki-Young;Kim, Jong-Bae;Kwon, Oh-Won;Hwang, Sang-Hee
    • The korean journal of orthodontics
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    • v.36 no.3 s.116
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    • pp.228-236
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    • 2006
  • To evaluate the cephalometric and dental characteristics of obstructive sleep apnea (OSA) patients, 23 OSA patients and 15 control, non-OSA, patients who visited the Sleep Disorder Clinic Center, Keimyung University were investigated. Patients who suffered from apnea-hypopnea episodes over 10times per hour were diagnosed as having OSA after polysomnograph testing, Impressions were taken with alginate. Cephalometric radiographs were taken at maximum intercuspation. The dental cast measurements, including transpalatal width, intercanine width, intermolar width and palatal depth did not differ between the control and OAS groups and did not have a positive correlation with the apnea-hypopnea index (AHI). Upper airway width was statistically narrower than the control group. Upper airway width had a low negative correlation with AHI, but, lower airway width had a low positive correlation, and, the higher the AHI score, the longer the mandibular border to hyoid distance.

The pattern of movement and stress distribution during retraction of maxillary incisors using a 3-D finite element method (상악 전치부 후방 견인 시 이동 양상과 응력 분포에 관한 삼차원 유한요소법적 연구)

  • Chung, Ae-Jin;Kim, Un-Su;Lee, Soo-Haeng;Kang, Seong-Soo;Choi, Hee-In;Jo, Jin-Hyung;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.37 no.2 s.121
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    • pp.98-113
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    • 2007
  • Objective: The purpose of this study was to evaluate the displacement pattern and the stress distribution shown on a finite element model 3-D visualization of a dry human skull using CT during the retraction of upper anterior teeth. Methods: Experimental groups were differentiated into 8 groups according to corticotomy, anchorage (buccal: mini implant between the maxillary second premolar and first molar and second premolar reinforced with a mini Implant, palatal: mini implant between the maxillary first molar and second molar and mini implant on the midpalatal suture) and force application point (use of a power arm or not). Results: In cases where anterior teeth were retracted by a conventional T-loop arch wire, the anterior teeth tipped more postero-inferiorly and the posterior teeth moved slightly in a mesial direction. In cases where anterior teeth were retracted with corticotomy, the stress at the anterior bone segment was distributed widely and showed a smaller degree of tipping movement of the anterior teeth, but with a greater amount of displacement. In cases where anterior teeth were retracted from the buccal side with force applied to the mini implant placed between the maxillary second premolar and the first molar to the canine power arm, it showed that a smaller degree of tipping movement was generated than when force was applied to the second premolar reinforced with a mini implant from the canine bracket. In cases where anterior teeth were retracted from the palatal side with force applied to the mini implant on the midpalatal suture, it resulted in a greater degree of tipping movement than when force was applied to the mini implant between the maxillary first and second molars. Conclusion: The results of this study verifies the effects of corticotomies and the effects of controlling orthodontic force vectors during tooth movement.

A comparative study of impression methods using stock tray and intraoral scanner in a completely edentulous patient with an atypical arch shape: a case report (비정형적인 악궁을 가진 완전 무치악 환자에서 기성 트레이와 구강 스캐너를 이용한 인상 채득 방법의 비교 연구: 증례 보고)

  • Jae-Hoon Park;Ji-Hyun Kim;Jae-Min Seo;Jung-Jin Lee;Yeon-Hee Park
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.4
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    • pp.344-355
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    • 2023
  • In complete denture fabrication, accurate preliminary impressions are crucial for obtaining an accurate final impression. However, it can be challenging in cases of atypical arch shapes. This case report compares diagnostic casts made with a stock tray and an intraoral scanner (IOS) in a patient with an atypical arch shape. A 58-year-old edentulous male patient with long, narrow, atypical arches was referred to the Oral and Maxillofacial Surgery department for complete denture fabrication. Compared to the diagnostic cast obtained using IOS with adequately captured anatomical parameters, the primary model obtained using a stock tray showed prominent overextended flanges on the labial and buccal sides of the maxillary arch and less prominent overextended flanges in the mandibular arch with pressure spots in the posterior palatal seal area. The custom tray fabricated from such a model required additional adjustment resulting in increased chair time during the final impression procedure.