• 대한치과보철학회지
• /
• 제53권1호
• /
• pp.26-38
• /
• 2015

과도한 수평 및 수직피개를 가진 과개교합 환자에서 치질의 파괴 및 대합치 정출의 문제를 흔히 관찰할 수 있다. 이는 곧 교합평면의 붕괴와 부적절한 전방유도로 이어지며, 조화로운 교합관계의 회복이 이루어지지 않으면 다수의 치아 상실과 저작기능의 감소를 야기하게 된다. 과개교합환자의 문제를 해결하려면 교정과, 구강외과 및 보철과의 협진이 이루어져야 한다. 본 증례보고는 심한 과개교합을 가진 환자에서 수직교합고경을 증가시킨 후 완전구강회복을 이룬 증례를 보고하고자 한다. 치료는 구외 및 구내검사, 진단 및 치료계획, 진단 납형형성, 분절골 절단술, 교정적 함입 및 보철치료 순으로 진행되었다. 수직고경증가를 동반한 완전구강회복술로 환자의 심미적, 기능적 문제를 해결할 수 있었다.

• 대한치과교정학회지
• /
• 제21권2호
• /
• pp.433-446
• /
• 1991

The present study was performed to evaluate the relaxation patterns of rubber elastics, elastomeric modules and chains stored in the water bath. Initial loading profiles were established for extension of $100\%,\;200\%$ of their original length for elastomeric chains and of 21, 28, 35, 42, 49mm for rubber elastics and elastomeric modules. The tests were performed on materials stored in distilled water at $37^{\circ}C$ and extraoral elastics stored in dry state at room temperature, at 0 hour, 1 hour, 6 hours, 1 day, 1 week, 2 weeks, 3 weeks, and 4 weeks, respectively. The following results were drawn: 1. The relaxation of rubber elastics manifested no correlation with increments of the extension distances, but showed correlation with time lapse. Remaining forces of rubber elastics carne out $84.6-98.52\%$ after 1 day, $70.92-89.31\%$ after 3 weeks of period. 2. The relaxation of elastomers manifested no correlation with increments of the extension distances, however represented considerable relaxation with time lapse as rapid relaxation after 1 hour and then gradual relaxations with time lapse. Modules relaxed much more than chains. $60.58-67.05\%$ of remaining forces for chains and $37.77-65.17\%$ for modules after 1 hour were turned out, and $51.48-62.22\%$ for chains and $8.04-25.15\%$ for modules after 3 weeks as well. 3. Permanent deformation rates of rubber elastics could not be measured with present investigation, but elastomers underwent severe deformations. 4. $3-9\%$ of permanent deformations for chains, $3-10\%$ for modules at 0 hour were turned out, and $25-30\%$ for chains, $96-145\%$ for modules after 3 weeks as well.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제38권
• /
• pp.46.1-46.7
• /
• 2016

Background: Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better reconstruction. Methods: A total of eight consecutive patients who underwent fibula reconstruction due to jaw necrosis from March 2008 to December 2015 were included in this study. Patients were classified according to stages, primary sites, radiation dose, survival, and quality of life. Results: Five male and three female patients underwent operation. The mean age of the patients was 60.1 years old. Two male patients died of recurred disease of oral squamous cell carcinoma. The mean dose of radiation was 70.5 Gy. All fibular free flaps were survived. Five patients could eat normal diet after operation; however, three patients could eat only soft diet due to loss of teeth. Five patients reported no change of speech after operation, two reported worse speech ability, and one patient reported improved speech after operation. The ipsilateral side of the fibular flap was used when intraoral soft tissue defect with proximal side of the vascular pedicle is required. The contralateral side of the fibular flap was used when extraoral skin defect with proximal side of the vascular pedicle is required. Conclusions: Osteonecrosis of the jaw is hard to treat because of poor healing process and lack of vascularity. Free fibular flap is the choice of the surgery for jaw bone reconstruction and soft tissue fistula repair. The design and selection of the right or left fibular is dependent on the available vascular pedicle and soft tissue defect sites.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제33권1호
• /
• pp.62-65
• /
• 2011

Eagle's syndrome occurs when an elongated styloid process or calcified stylohyoid ligament causes recurrent throat pain or foreign body sensation, dysphagia. It is supposed that this symptoms and signs are due to the compression of the styloid process on some neural and vascular structures. More uncommonly, symptoms such as dysphagia, tinnitus, and otalgia may occur in patients with this syndrome. It may also cause stroke due to the compression of carotid arteries. The compression depends on the size, shape, and orientation of the ossified styloid process Besides, degenerative or inflammatory changes in the tendinous portion of the styloid ligament insertion or rheumatic styloiditis may also cause this syndrome. Diagnosis can usually be made on physical examination by digital palpation of the styloid process in the tonsiller fossa. Three-dimensional computed tomography can utilized for supporting diagnosis. The treatment of Eagle's syndrome is primarily surgical. The styloid process can be shortened through an intraoral and extraoral approach. We report a 62-years-old man with the symptomatology of Eagle's syndrome and literature reviews.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제33권2호
• /
• pp.180-184
• /
• 2011

The mucocele is a mucus extravasation cyst arising from the salivary gland. Although it is a common?lesion of the minor salivary gland, it is uncommon when it originated from the submandibular gland. The ranula is a form of mucocele which specifically occurs in the floor of the mouth and the sublingual gland is generally accepted as the origin of ranula. They can be classified into two types based on extent: simple ranula are confined to the sublingual space and plunging ranula extend into the adjacent space. It is difficult to differentiate the submandibular gland mucocele from the plunging ranula because both of them can occupy the submandibular space. A 37-year old male visited our clinic with the chief complaint of left facial swelling. The patient's history revealed that he had suffered from a cystic lesion on the left side of the floor of the mouth 10 months previously. He supposed the cystic lesion had come from trauma at other dental clinics. Using CT and MRI, we diagnosed a simple ranula on the sublingual space and a submandibular gland mucocele. We then excised the mucocele with the submandibular gland by an extraoral approach and the sublingual gland by an intraoral approach under general anesthesia. We report a rare case of an enormous submandibular gland mucocele which extended into the pterygoid plate and parapharyngeal space with good surgical results.

• 대한치과보철학회지
• /
• 제28권2호
• /
• pp.125-146
• /
• 1990

The relationale for recording mandibular movement is to accurately adjust an articulator. Techniques to record mandibular movement include radiographic interpretation, extraoral tracing, and intraoral recording materials. This study was performed to compare the concylar guidance inclination and Bennett shift(immediate & progressive side shift)obtained by using an electronic pantograph, pantograph and wax interocclusal records in Korean. Ten adults who have normal occlusion and are free of TMJ dysfunction were selected and clutches were constructed. At first Pantronic survey was performed three times by using an kinematic hinge axis according to manufacturer's direction. Next pantographic survey was performed three times and the articulator was adjusted with each pantographic recording. And then maxillary cast was attached to the articulator with pantographic as a face-bow and the mandibular cast was mounted to the articulator with centric relation record. Three protrusive, three left lateral and three right lateral wax interocclusal records were taken on the subjects and the articulator was adjusted with each interocclusal record. Protrusive condylar inclination, lateral condylar inclination, immediate side shift and progressive side shift obtained by using electronic pantograph, pantograph and wax interocclusal record were compared and analized. The results were as follows; 1. The average left and right protrusive and orbiting condylar inclination($33.7^{\circ},\;37.1^{\circ},\;40.6^{\circ},\;43.5^{\circ}$) record with Pantronic was significantly greater than that recorded with other methods. 2. The average left and right protrusive and orbiting condylar inclination($24.8^{\circ},\;27.0^{\circ},\;31.4^{\circ},\;32.4^{\circ}$)recorded with wax interocclusal record was less than that of other methods. 3. The average left and right immediate side shift(0.57mm,0.44mm)recorded with wax interocclusal record was greater than that of other methods and the average left rigtht immmediate side shift(0.30mm,0.41mm)recorded with Pantronic was significantly greater than that recorded with pantograph(0.11mm,0.20mm). 4. The average variance of wax interocclusal was signivicantly higher than that of other methods.

• 대한소아치과학회지
• /
• 제24권3호
• /
• pp.556-561
• /
• 1997

Intentional replantation of the posterior teeth has been performed as a last resort except extraction when it is impossible to perform the conventional endodontic or surgical endodontic treatment. Many studies have done with the prognosis, and root resorption, of which the responsibility might have been injury of periodontal ligament and remaining periodontal lesion, proved to be major cause of failure. Intentional replantation, however, can exclude anatomic difficulty, risk of nerve injury, and maxillary sinus trauma that surgical access can raise, especially in posterior teeth, and it is reported that success rate is not less than surgical endodontics, independent of replantation of traumatically avulsed teeth. The success of intentional replantation can be evaluated with, clinically, reduction of pocket depth, pain and mobility(physical mobility), and, radiographically, hard tissue formation, reduction of periapical radiolucency. In this case report, for the maxillary left first bicuspid with dens evaginatus that had periapical lesion, painfulness, mobility and showed no reduction of mobility after even extirpation and a number of irrigation, extraction followed by extraoral root filling with calcium hydroxide and replantation was performed. Based on many studies, it is concluded that hard tissue formation capacity of calcium hydroxide, preceded extirpation before extraction, and careful extraction without injuring periodontal ligament affected successful results of this case.

• 대한소아치과학회지
• /
• 제24권3호
• /
• pp.678-687
• /
• 1997

Cystic lesions of the mandible are fairly common and usually a presumptive diagnosis is made readily, more often on the basis of roentgenographic appearance than by any other means. Occasionally, however, it is easy to fall into errors of diagnosis which may affect one's choice of treatment. The diagnosis in these situations are usually resolved by the histopathologic examination of material obtained by surgical exploration. The present discussion to the lesions which can be most easily confused in the roentgenographic interpretation, that is, the traumatic bone cyst, the dentigerous cyst, the radicular cyst. These lesions often grow to considerable size before they cause any subjective or objective symptoms. Less frequently, perhaps, the patient presents himself with the complaint of enlargement of the affected part, a discharge, or pain. On rare occasions the first sign is fracture through the cyst cavity. In any case, an adequate roentgenographic survey by means of extraoral films is essential. This is the primary means of diagnosis. The three lesions in mandible, reported here, resembled each other roentgenographically in that they were osteolytic lesions. The follicular and radicular cysts usually have a smooth periphery and may be surrounded by a white line. The follicular cyst, slow-growing lesions, is usually associated with an unerupted tooth. The radicular cyst, the most common type of the odontogenic cyst, is always associated with a nonvital tooth, or it may persist as a "residual" radicular cyst after the causative tooth has been extracted. The traumatic bone cyst can often be differentiated from the first two in that the periphery is less definite and is irregular. It is thought that because it does not occur in older people, the lesion is self-limiting and heals spontaneously if left alone.

• 대한소아치과학회지
• /
• 제23권3호
• /
• pp.667-673
• /
• 1996

The prevalence of class III malocclusion is approximately 5$\sim$9%, and about one fourth of this malocclusion is due to underdeveloped maxilla. Maxillary protraction appliance is an orthopedic device which promote the growth of a deficient maxilla by applying extraoral force to actively growing patients. The object of using maxillary protraction appliance is to guide a normal growth of maxilla and mandible and improve the occlusal relationship and also improve the facial profile. The author treated three patients whom were diagnosed as a class III malocclusion due to deficient maxilla using maxillary protraction appliance and the followings are the conclusions : 1. In these cases, anterior crossbite was corrected by anterior movement of maxilla and downward backward rotation of mandible and simultaneously, anterior facial height was increased. 2. The amount of dental change compare to skeletal change was greater as the patients got older. 3. When 500gm of force to each side was applied, the treatment period has been decreased. 4. As a result of applying the force between maxillary first primary molar and canine, there was a small degree of changes in palatal plane. So, it can be concluded that the maxillary protraction appliance is effective in treating growing patients with a deficient maxilla.

• 대한소아치과학회지
• /
• 제28권3호
• /
• pp.496-503
• /
• 2001

골격성 II급 1류 부정교합을 가지는 아동에서 상악골의 과도한 성장은 흔히 전후방적 요소 뿐 아니라 수직적 요소도 가지고 있는데, 그 이유는 상악골이 전하방으로 성장, 이동할 경우 하악골이 후하방 회전하기 때문이며, 하악골의 성장이 전방으로 이루어지는 것을 방해하게 된다. 따라서 이 경우 치료목표는 하악골이 더욱 돌출 되어 상악골과 정상적인 관계를 가지도록 성장하는 동안 상악골의 성장을 억제하는 것이며, 이를 위해 구외력을 적용하는 것이 현명한 방법으로 보고되고 있다. 조선대학교 소아치과에 내원한 골격성 II급 1류 부정교합 환자에서 C II activator와 headgear를 이용한 구외력을 적용후 양호한 결과를 얻었기에 보고하는 바이다.