• Journal of Korean Dental Science
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• 제1권1호
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• pp.10-14
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• 2008

The fracture of facial bone usually accompanies alveolar bone fracture and dislocation or fracture of teeth. Thus, aside from the reduction of fracture, the reconstruction of occlusion through the rehabilitation of lost teeth should be considered. The dislocation of tooth after trauma accompanying alveolar bone fracture needs bone grafting in case of implant treatment. Although autogenous bone graft shows good prognosis, it has the disadvantage of requiring a secondary surgery. This is a case of a mandibular condyle head fracture accompanied by alveolar bone fracture. The condylar head fragment removed during open reduction was grafted to the alveolar bone fracture site, thereby foregoing the need for secondary surgery.

• 대한치과보철학회지
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• 제44권3호
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• pp.295-313
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• 2006

Statement of problem. Higher fracture rates were reported for Branemark implants placed in the maxilla and for 3.75 mm diameter implants installed in the posterior region. Purpose. The purpose of this study was to investigate the fracture of a fixture by finite element analysis and to compare different diameter of fixtures according to the level of alveolar bone resorption. Material and Methods. The single implant and prosthesis was modeled in accordance with the geometric designs for the 3i implant systems. Models were processed by the software programs HyperMesh and ANSA. Three-dimensional finite element models were developed for; (1) a regular titanium implant 3.75 mm in diameter and 13 mm in length (2) a regular titanium implant 4.0 mm in diameter and 13 mm in length (3) a wide titanium implant 5.0 mm in diameter and 13 mm in length each with a cementation type abutment and titanium alloy screw. The abutment screws were subjected to a tightening torque of 30 Ncm. The amount of preload was hypothesized as 650 N, and round and flat type prostheses were 12 mm in diameter, 9 mm in height were loaded to 600 N. Four loading offset points (0, 2, 4, and 6 mm from the center of the implants) were evaluated. To evaluate fixture fracture by alveolar bone resorption, we investigated the stress distribution of the fixtures according to different alveola. bone loss levels (0, 1.5, 3.5, and 5.0 mm of alveolar bone loss). Using these 12 models (four degrees of bone loss and three implant diameters), the effects of load-ing offset, the effect of alveolar bone resorption and the size of fixtures were evaluated. The PAM-CRASH 2G simulation software was used for analysis of stress. The PAM-VIEW and HyperView programs were used for post processing. Results. The results from our experiment are as follows: 1. Preload maintains implant-abutment joint stability within a limited offset point against occlusal force. 2. Von Mises stress of the implant, abutment screw, abutment, and bone was decreased with in-creasing of the implant diameter. 3. With severe advancing of alveolar bone resorption, fracture of the 3.75 and the 4.0 mm diameter implant was possible. 4. With increasing of bending stress by loading offset, fracture of the abutment screw was possible.

• 대한치과교정학회지
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• 제46권6호
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• pp.379-385
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• 2016

Objective: Forced eruption has been proposed for the reconstruction of deficient bone and soft tissue. The aim of this study was to examine the changes in the alveolar ridge width and the vertical levels of the interproximal bone and papilla following forced eruption. Methods: Patients whose hopeless maxillary anterior teeth were expected to undergo severe bone resorption and soft tissue recession upon extraction were recruited. In addition, patients whose maxillary anterior teeth required forced eruption for restoration due to tooth fracture or dental caries were included. Before and after forced eruption, the interproximal bone height was measured by radiographic analysis, and changes in the alveolar ridge width and the interproximal papilla height were measured with an acrylic stent. Results: This prospective study demonstrated that the levels of the interproximal alveolar bone and papilla were significantly increased by 1.36 mm and 1.09 mm, respectively, in the vertical direction. However, the alveolar ridge width was significantly reduced by an average of 0.67 mm in the buccolingual direction. The changes in the level of the interproximal alveolar bone and papilla were positively correlated. Conclusions: Although the levels of the interproximal bone and papilla were significantly increased, the alveolar ridge width was significantly decreased following forced eruption. There was a modest positive and significant correlation between the changes in the height of the interproximal alveolar bone and the papilla. Based on our findings, modification of vertical forced eruption should be considered when augmentation of the alveolar ridge width is required.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권4호
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• pp.280-285
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• 2012

From the standpoint of general guidelines of a dentist, the following conditions should be considered before replanting a permanent tooth. The avulsed tooth should be without advanced periodontal disease. The alveolar socket should be reasonably intact in order to provide a seat for the avulsed tooth. The extra-alveolar period should be considered, i.e. periods exceeding. 2 hours are usually associated with marked root resorption. But, the above mentioned regulations are often difficult to keep in the actual situation of the medical emergency room, owing it to the delay of primary medical care in multiple trauma patients. The successful cases have been reported with minimal root resorption in the long-term periods, in spite of extra-alveolar periods of several hours and combined alveolar bone fracture. This is a case report regarding the effect of endodontic drainage in delayed replantation after a prolonged extra-alveolar period of the avulsed teeth with alveolar bone fracture.

• 대한소아치과학회지
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• 제27권2호
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• pp.344-350
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• 2000

외상으로 인하여 치아가 받는 여러 가지 손상형태 중 치관-치근파절이 나타나는 빈도는 영구치에서 5%, 유치열에서는 2%라고 알려져 왔다. 치조정 하방에 파절선이 존재하고 치수노출을 동반한 치관-치근 파절에서는 크게 두가지의 보존적인 치료방법이 있다. 첫째, 교정력에 의해 정출시키는 방법과 둘째 치조와내에서 교합면 방향으로 재위치시키는 Intra-alveolar transplantation 등이 있다. 외과적 정출법은 1970년대에 소개된 이래로 교정적 정출법의 대안으로 많이 시행되고 있으며 높은 성공률을 가진 술식으로 여겨지고 있다. 본 증례는 외상으로 인해 상악 우측 중철치의 치수노출을 동반한 치관-치근 파절이 발생한 경우로 외과적 정출을 시행하기로 하였으나, 치근단 파절편의 길이가 짧아서 치아를 발거 후 회전시켜 재식하는 방법만으로는 파절선을 치조정 상방으로 위치시킬 수가 없었다. 따라서 치아를 발거한 후 파절편의 지지를 위해 치조와의 치근단부에 탈회냉동건조골을 이식한 후에 치근단 파절편을 노출한 후 suture splint를 시행하였다. 1년 3개월간의 관찰결과, 치조백선이 회복되고 정상적인 동요도를 보였으며, 염증성, 대체성 치근흡수 등과 같은 합병증은 발생되지 않았다.

• Archives of Plastic Surgery
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• 제36권1호
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• pp.56-60
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• 2009

Purpose: Palatal fracture and mandible fracture result in instability of dental arch. Because they divide the maxillary and mandibular alveolus sagittally and / or transversely and comminute the dentition, they permit rotation of dental alveolar segments and significantly increase the potential for fracture malalignment, complicating fracture treatment. Previous treatment of palatal fracture consisted of palatal splint application and rigid palatal vault stabilization. This procedure result in patient's oral discomfort and removal of palate and screw. Mandible fracture often results in malocclusion due to widening of posterior aspect of dental arch. So we introduce more simple method using intermolar traction wiring, which can protect the widening of dental arch and rotation of dental alveolar segment. Methods: Arch bar and intermolar traction wiring with wire 1 - 0, or 2 - 0 was applied. After exposure of fracture line, neutrooclusion was maintained with intermaxillary fixation. And then open reduction & internal fixation on maxillary fracture line, commonly maxillary buttress, alveolar ridge, pyriform aperture except palatal vault or mandibular fracture line. After 1 week, intermolar traction wiring was removed. We checked occlusion and postoperative radiologic finding. Results: From June of 2007 to October of 2007, 10 patient, who have maxillary fracture with palatal fracture and mandible fracture, underwent open reduction & internal fixation with intermolar traction wiring. All have satisfactory occlusion and there were no complication, like gingiva disease, mouth opening impairment and nonunion. Conclusion: The intermolar traction wiring accompany open reduction and internal fixation can be alternative method for restoration of dental arch in facial bone fracture.

• 대한치과의사협회지
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• 제53권8호
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• pp.545-557
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• 2015

The modified ridge splitting/expansion technique combined with guided bone regeneration (GBR) for implant surgery is used to expand the narrow and atrophied edentulous alveolar ridge. Also, the simultaneous implant placement after ridge splitting/expansion technique can reduce the treatment and healing time. This case report includes three patients with a narrow edentulous alveolar ridge of the 2 to 4mm. All three patients underwent a fracture of thin buccal cortical bone plate, and these defects were corrected by the use of the guided bone regeneration (GBR). After 7 to 18 months, all surgical area was stable, and all implant showed a good healing state on the clinical and radiographic examination. In conclusion, though this surgical method is technique sensitive, the modified ridge splitting/expansion technique combined with GBR for implant surgery is recommended for a horizontal augmentation in the narrow edentulous alveolar ridge.

• 대한소아치과학회지
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• 제38권3호
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• pp.290-295
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• 2011

치아형성 과정 중 치배 주위의 물리적 작용이나 대사 환경의 변화로 치아 발생은 영향을 받을 수 있다. 유치열기에 가해진 외상은 계승 영구치의 발생에 장애를 초래시킬 수 있는 가장 대표적인 물리적 요인으로 이로 인한 합병증으로 계승 영구치의 법랑질 변색 및 저형성증이 가장 흔히 발생하고 드물게 매복, 이소 맹출, 치근 형성 정지 및 치근 만곡 등이 나타난다. 본 증례에서는 만 6세 5개월의 여자 어린이 환자가 안면부 외상을 주소로 내원하여 상악 좌우 유중절치의 정출성 탈구, 상악 우측 유측절치의 함입성 탈구, 상악 좌측 유측절치의 구개측 측방 탈구로 진단되었고, 상악 치은부의 열상과 상악 전치부의 치조골 골절이 관찰되었다. 내원 당일 치과 응급실에서 동요도가 심한 상악 좌우 유중절치의 발치 후 치은 봉합술을 시행하였다. 24개월 정기 검진 중 방사선 사진 상에서 상악 좌,우측 측절치의 백악 법랑 경계(Cemento enamel junction, CEJ) 근방에 치근 만곡이 관찰되었고 상악 중절치 치근의 치관부 1/3부위에서 치근 형성이 정지되고 있는 양상이 관찰되었다. 치조골 골절이 어린이에서 흔하게 나타나는 외상의 유형은 아니나 본 증례에서와 같이 치근 발육이상 등 여러 합병증을 일으킬 수 있으므로 외상을 입은 환아에서 치조골 골절 여부에 대한 면밀한 검사 및 주기적인 검진은 예후 예측 및 향후 치료에 있어서 중요할 것이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권2호
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• pp.230-236
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• 2008

Purpose: This study was performed to investigate the incidence, types of fracture, treatment, associated fracture and complications in patients with nasal bone fracture. Materials and methods: Clinical examination, patient's records and radiographic images were evaluated in 230 cases of nasal bone fractures who were treated at the Department of Oral and Maxillofacial Surgery, Chonnam National University Hospital for recent 5 years; from January 2002 to December 2006. Results: 1. The age of patient was ranged from 4 to 77 years (mean age=36.6 years); Males was 75.7% (n=174), and females 24.3% (n=56). 2. The cause of the nasal bone fracture in this study was a fall or slip down (28.8%, n=66), sports accident (26.0%, n=60), fighting (21.3%, n=49), traffic accident (9.6%, n=22), industrial trauma (7.8%, n=18), and the others (6.6%, n=15). 3. For the patterns of fracture, simple fracture without displacement occured in 10.4% (n=24). Simple fracture with displacement without septal bone fracture was found in 49.5% (n=114). Simple fracture with displacement in company with septal bone fracture showed in 32.6% (n=75). Commiuted fracture with severe depression was presented in 7.4% (n=17). 4. The reduction the displaced nasal bone was carried out in 2 to 10 days (mean 6.8 days) after the injury. 5. Nasal bone fracture associated with Le Fort I fracture (6.5%, n=6.5), Le Fort II fracture (7.4%, n=17), Le Fort III fracture (1.3%, n=3), NOE fracture (13.9%, n=32), ZMC fracture (17.4%, 40), maxillary bone fracture (8.3%, n=19), orbital blow-out fracture (15.7%, n=36), frontal bone fracture (1.3%, n=3) and alveolar bone fracture (10.9%, n=25). 6. The major type of treatment method was closed reduction in 90% (n=207), open reduction in 3% (n=7), and observation in 7% (n=16). 7. There were some complications such as ecchymosis, hyposmia, hypo esthesia and residual nasal deformity which are compatible. Open rhino-plasty was conducted for 3 patients who had residual nasal deformity. Conclusions: These results suggest that most of nasal bone fractures are occurred physically active aged groups(age 10-49 years) and could be treated successfully with closed reduction at 7 days after the injury.

• 대한구강악안면병리학회지
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• 제42권5호
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• pp.153-158
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• 2018

Complicated crown-root fractures are considered rare occurrences in young permanent dentition; however, they often present complicated and unpredictable treatment options. The most common treatment option for crown-root fractured teeth is reattachment of fractured segment, but if it is thought impossible to maintain, it should be extracted. However, when unfavorable crown-root fracture occurs in the adolescents, extraction of fractured teeth is expected to be poor due to excessive resorption of alveolar and prosthetic replacement cannot be performed immediately, various treatment options should be considered. This report suggests root submergence in the complex crown-root fracture in growing patients is performed and the functional and aesthetic results including preservation of the alveolar bone are obtained.