• 제목/요약/키워드: Flap

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두 마리 개에서 완치가 어려운 구개 종양의 완화 수술 적용 증례 (Palliative Surgery in Two Dogs with Non-Curative Palatal Tumors)

  • 윤헌영;이정하;신동욱;박희명;정순욱
    • 한국임상수의학회지
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    • 제31권5호
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    • pp.425-429
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    • 2014
  • 식욕부진, 호흡부전, 또는 비출혈을 보이는 두 마리 개가 내원하였다. 신체검사에서 호흡곤란, 개구호흡 및 커다란 구개 종양을 확인하였다. 신체검사 중 2 번 증례에서 호흡부전으로 인한 심정지가 발생하였고 심폐소생술과 산소 공급을 통해 안정화 되었다. 1 번 증례의 CT 촬영에서 경구개 연구개를 포함하는 구강 인두, 인두 내 입구, 인후두 부위의 종양을 확인하였다. 연하곤란 및 호흡부전 개선을 위해 보호자 동의 하에 완화 수술을 결정하였다. 종양 제거 후 발생한 결손 부위 재건을 위해 구강 내 점막을 사용하여 회전 및 전진 피판술과 양측 90o 자리바꿈 피판술을 1 및 2 번 증례에 각각 적용하였다. 조직 검사 결과, 두 마리의 개 모두에서 무멜라닌 색소성 흑색종이 진단되었다. 수술 후 7 일째 두 마리 모두에서 정상 연하와 호흡이 확인되었다. 수술 후 4 주째 1 번 증례의 수술 부위에서 재발된 종양이 관찰되었다. 보호자가 추가적인 치료를 원하지 않았고, 연락 두절로 인하여 수술 후 2 개월 이후의 확인은 불가능하였다. 수술 후 3 주째 2 번 증례의 신체검사 및 방사선 촬영에서 국소적인 재발 및 전이는 확인 되지 않았다. 수술 후 7 주째 유선상으로 확인한 결과, 2 번 증례에서 원인불명의 갑작스러운 사망이 확인되었다.

구개봉합술 후 발생한 구비강누공의 폐쇄 후 말소리 결과 : 증례보고 (Speech Outcome after Closure of Oronasal Fistula Following Cleft Palate Repair: A report of a case)

  • 서민교;김다와;김은주;윤보근;김성일;임대호;고승오;문승영;김현기;신효근
    • 대한구순구개열학회지
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    • 제12권1호
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    • pp.1-6
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    • 2009
  • Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter, had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in $mm^2$. Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.

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성견의 1면 골내낭에서 탈회 냉동 건조골과 calcium sulfate 혼합이식이 치주조직 치유에 미치는 영향 (The effects of composit grafts of allogenic decalcified freeze Dried bone and calcium sulfate on the healing of 1-wall intrabony defects in dogs)

  • 서종진;최성호;조규성;채중규
    • Journal of Periodontal and Implant Science
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    • 제28권2호
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    • pp.249-264
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    • 1998
  • The present study evaluates the effects of calcium sulfate and DFDB on alveolar bone regeneration and cementum formation and connective tissue adhesion in intrabony angulated 1 wall defects of dogs. Four millimeter-deep angulated one-wall intrabony defects were surgically created in the mesial & distal aspects of premolars and with flap operaion alone(control group), with calcium sulfate(experimental group 1), with composit graft of 50% calcium sulfate and 50% DFDB(experimental group 2), with DFDB alone(experimental group 3). Histologic analysis following 8 weeks of healing revealed the following results: 1. The lengths of connective tissue adhesion was $1.05{\pm}0.48mm$ in the control, $1.30{\pm}0.67mm$ in the test group I, $0.97{\pm}0.22mm$ in the test group II and $0.93{\pm}0.15mm$ in the test group III. There was no statistical significance between control and all experimental groups. 2. Changes in alveolar bone level was $0.97{\pm}0.27mm$ in the control group, $1.45{\pm}0.42mm$ in the test group I, $2.00{\pm}0.33mm$ in the test group II, $1.88{\pm}0.34mm$ in the test group III. There was no statistically significant difference between control and experimental group I. There was a statistically significant difference between the control and experimental group II,III.(p<0.05). There was no statistically significant difference between all experimental group. 3. Cementum formation was $1.13{\pm}0.17mm$ in the control, $1.78{\pm}0.31mm$ in the test group I, $2.17{\pm}0.38mm$ in the test group II, $2.15{\pm}0.47mm$ in the test group III with statistically significant differences between control group and all experimental group(P<0.05). There was no statistically significant differences between all experimental group. These results suggest that the use of composit graft of 50% calcium sulfate and 50% DFDB and DFDB alone in angulated 1 wall intrabony defects has little effects on connective tissue adhesion, but has significant effects on new bone and new cementum formations.

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2급 및 3급 치근이개부 병변에서 합성골이식의 효과에 대한 임상적 및 방사선학적 연구 (A CLINICAL AND RADIOLOGICAL STUDY ON THE EFFECT OF SYNTHETIC BONE IN CLASS II AND III FURACATION INVOLVEMENTS)

  • 염규선;김병옥;한경윤
    • Journal of Periodontal and Implant Science
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    • 제23권3호
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    • pp.475-492
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    • 1993
  • The effect of synthetic bone materials was assessed in the patients with pure periodontal class II and III furcation defects. The buccal aspects of the maxillary and mandilular first and second molars were surgically exposed, and synthetic bone materials were interposed between the gingival flap and the furcation defects in the experimental group. The control group were treated without the use of synthetic bone materials by same operator. Probing pocket depth, gingival recession, and loss of attachment, were measured by Michigan O-probe and tooth mobility was evaluated by an electronic mobility tester(Periotest(R), Siemens co. Germany) at preoperation and 3-, 6-, and 12-month postoperation. Standardized radiogrphs were taken at preoperation and 6-month and 12-month postoperation. The postoperative change of clinical parameters and the difference between experimental group and control group were statistically analyzed by Student, t-test. The results were as follows: 1. The probing pocket depth at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at preoperative examination in both experimental group and control group(P<0.005), but there was no significantly difference between experimental group and control group. 2. The amount of gingival recession at the 3-, 6-, and 12-month postoperative examination was increased, compared to that at the preoperative examination in both experimental and control group(P<0.005). In the case of the class III furcation involvement, the amount of gingival recession at the 3-, 6-, and 12-month postoperative examination was more significantly increased in control group than experimental group(P<0.05). 3. The amount of loss of attachment at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at the preoperative examination in both experimental and control group in the case of class II furcation involvement, and in experimental group only in the case of furcation III involvement(P<0.005). The amount of loss of attachment at, the 3-, 6-, and 12-month postoperative examination was more significantly decreased in experimental group than control group in the case of the class III furcation involvement(P<0.05), but in the case of class II furcation involvement there was no significant difference between experimental group and control group. 4. The tooth mobility at the 3-, 6-, and 12-month postoperative examination was significantly decreased, compared to that at the preoperative examination in both experimental and control group(P<0.005), but there was no significant difference between experimental group and control group. 5. Radiopacity of furcation area was greatly increased in the experiment group, but there was no radiographic change in the control group.

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레이저 조사가 치주낭 조직에 미치는 영향 (An effect of laser irradiation on periodontal pocket tissue)

  • 한경윤;김상목;김병옥;김현섭;임기정
    • Journal of Periodontal and Implant Science
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    • 제26권2호
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    • pp.511-521
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    • 1996
  • Periodontal pocket is one of the most frequently developed clinical feature on the teeth with periodontal disease. In order to determine the gingival curettage effect of intrapocket irradiation of a pulsed Nd : YAG laser on periodontally involved teeth, bilateral 60 teeth with $4{\sim}6mm$ in probing pocket depth 1 week after supragingival scaling were selected. On half of them the intrapocket irradiation($300{\mu}m$ fiber optic, 1.5W power, for 2min.) of a pulsed-Nd : YAG laser(EL.EN.EN06O, Italy) was applied as the lased group. On the contralateral 30 teeth the subgingival curettage was accomplished by Gracey curettes as the curattage group. The periodontal pocket tissues were surgically excised by the modified Widman flap technique immediately after the intrapocket irradiation or subgingival curettage, subsequently fixed with 10% neutral formalin, sectioned in $4{\sim}6{\mu}m$ thickness, and stained with hematoxylin-eosin. Surface characteristics and incomplete removal of the pocket epithelium were evaluated under light microscope. And the difference between the lased group and the curettage group was statistically analyzed by Chi-square test in Microstat program. The results were as follows ; 1. The plane surface was observed more frequently in the curettage group(73.3%) than in the lased group(23.3%), and the rough surface was observed more frequently in the lased grOoup(63.3%) than in the curettage group(6.7%)(p<0.05). 2. The rate of incomplete removal of the pocket epithelium was relatively high in both the lased group(76.6%) and the curettage group(86.6%), and there was no significant difference between the lased group and the curettage group(p>0.l). The results suggest that the further studies including various power control of laser should be succeeded in order to obtain more favorable results by the intrapocket irradiation of a pulsed Nd:YAG laser than the subgingival curettage with Gracey curettes.

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탈회동결건조골이 수직골 형성에 미치는 영향 (The effect of human demineralized freeze-dried xenograft on vertical bone formation in beagle dogs)

  • 박주희;권영혁;박준봉;정종혁;신승일;허익
    • Journal of Periodontal and Implant Science
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    • 제38권1호
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    • pp.75-82
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    • 2008
  • Purpose: The purpose of this study was to evaluate exophytically vertical bone formation in the mandibular premolar area of beagle dogs by the concept of guided bone regeneration with a titanium reinforced e-PTFE membrane combined with human demineralized freeze-dried bone. Materials and Methods: Four one-year old beagle dogs were divided into control and experimental group. All mandibular premolars were extracted and surgical vertical defects of 5 mm in height were created in the extracted sockets. At 8 weeks after the extraction, TR e-PTFE membrane sized with 8 mm in length, 5 mm in width, and 4 mm in height was placed on the decorticated mandible, fixed with metal pins and covered with full-thickness flap and assigned as control group. In experimental group, decorticated mandibule was treated with TR e-PTFE membrane and human demineralized freeze-dried bone. The animals were sacrificed at 16 weeks after the regenerative surgery, and new bone formation was assessed by histomorphometric as well as statistical analysis. Results: Average of new bone formation was 38% in the control group, whereas was 25% in the experimental group (p<0.05). Average of connective tissue formation was 42% in the experimental group, whereas was 30% in the control group (p<0.05). The lamellar bone formation with haversian canals was observed in the both groups. In the experimental group, the particles of human demineralized freeze-dried bone were observed after 16 weeks and complete resorption of graft was not observed. Conclusion: On the basis of these findings, we conclude that titanium reinforced e-PTFE membrane may be used alone for vertical guided bone regeneration, but demineralized freeze-dried bone has no additional effect on vertical guided bone regeneration.

다양한 치주 골내낭과 이개부 병변의 처치를 위한 $BBP^{(R)}$ 이식재의 임상적 효과 ($BBPY^{(R)}$ graft for periodontal intrabony defects and molar furcation lesions: Case Report)

  • 김명진;이주연;김성조;최점일
    • Journal of Periodontal and Implant Science
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    • 제38권1호
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    • pp.97-102
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    • 2008
  • Purpose: Periodontal intrabony defects have great deal of importance since they contribute to the development of periodontal disease. Current treatment regimens for intrabony defects involve grafting of numerous bony materials, GTR using biocompatible barriers, and biomodification of root surface that will encourage the attachment of connective tissue. Xenograft using deproteinized bovine bone particles seems to be very convenient to adjust because it doesn't require any donor sites or imply the danger of cross infections. These particles are similar to human cancellous bone in structure and turned out to be effective in bone regeneration in vivo. We here represent the effectiveness of grafting deproteinized bovine bone particles in intrabony defect and furcation involvements that have various numbers of bony walls. Materials and methods: Open flap debridement was done to remove all root accretions and granulation tissue from the defects within persisting intrabony lesions demonstrating attachment loss of over 6mm even 3 months after nonsurgical periodontal therapy have been completed. Deproteinized bovine bone particles($BBP^{(R)}$, Oscotec, Seoul) was grafted in intrabony defects to encourage bone regeneration. Patients were instructed of mouthrinses with chlorohexidine-digluconate twice a day and to take antibiotics 2-3 times a day for 2 weeks. They were check-up regularly for oral hygiene performance and further development of disease. Probing depth, level of attachment and mobility were measured at baseline and 6 months after the surgery. The radiographic evidence of bone regenerations were also monitored at least for 6 months. Conclusion: In most cases, radio-opacities increased after 6 months. 2- and 3-wall defects showed greater improvements in pocket depth reduction when compared to 1-wall defects. Class I & II furcation involvements in mandibular molars demonstrated the similar results with acceptable pocket depth both horizontally and vertically comparable to other intrabony defects. Exact amount of bone gain could not be measured as the re-entry procedure has not been available. With in the limited data based on our clinical parameter to measure pocket depth reduction following $BBP^{(R)}$ grafts, it was comparable to the results observed following other regeneration techniques such as GTR.

성견의 열개형 골결손 부위에 골형성 유도술식을 동반한 임플란트 식립 후의 골형성 : pilot study (Bone formation following dental implant placement with augmentation materials at dehiscence defects in dogs : pilot study)

  • 정지윤;손주연;채경준;김성태;정성민;이인섭;조규성;김종관;최성호
    • Journal of Periodontal and Implant Science
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    • 제38권2호
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    • pp.191-198
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    • 2008
  • Purpose: Guided bone regeneration(GBR) has emerged as a treatment in the management of osseous defects associated with dental implants. But several studies have reported different degrees of success of guided bone regeneration, depending upon the type of barrier selected, presence or absence of an underlying graft material, types of graft material, feasibility of technique, and clinician's preference. The aim of the present study was to evaluate bone formation following dental implant placement with augmentation materials at dehiscence defects in dogs. Material and Methods: Standardized buccal dehiscence defects($3{\times}5\;mm$) were surgically 2 Mongrel dog's mandibles, each 8 SLA surface, 8 anodizing surface implants. Each buccal dehiscence defect received flap surgery only(no treatment, control), $Cytoflex^{(R)}$ membrane only, Resolut $XT^{(R)}$ membrane only, Resolut $XT^{(R)}+Osteon^{TM}$. Animals were sacrificed at 8 weeks postsurgery and block sections were harvested for histologic analysis. Resuts: All experimental group resulted in higher bone formation than control. Resolut $XT^{(R)}+Osteon^{TM}$ group resulted appeared highest defect resolution. There was no difference between SLA and anodizing surface, nonresorbable and resorbable membrane. Conclusion: GBR results in rapid and clinically relevant bone closure on dehiscence defects of the dental implants.

용해(龍海) 발해 왕실고분 출토 유물에 관한 고찰 (A Study on the Costume Relics Excavated from Royal Family's Ancient Tombs of Balhae at the Runghai Sites)

  • 전현실;강순제
    • 복식
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    • 제61권10호
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    • pp.72-88
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    • 2011
  • This study is about the costume relics that were excavated from M10 of the 6th site, M13 and M14 of the 8th site among all the Runghai(龍海) ancient tomb sites that were known as the royal family's tombs of Balhae, which were built from the late 8th century to the early 9th century. These costume relics were also introduced in the academic journal of Chinese archaeology(考古) 6 in 2009. The summary of the results that focused on finding features of the costume relics and its meaning were as follows: 1. Male and female statues, both of which were excavated from the Runghai ancient tomb sites, had the shape and composition of the government official's costumes such as the Danryeong(團領), Bokdu, and Gwadae. The female's hairstyle and accessories were quite similar to other costume relics of Balhae. In particular, the male statues wearing the Danryeong and Bokdu were considered as the normal figures of government officials of Balhaeafter the mid 8th century. 2. The female statue wearing the male attire is considered as a maid, and we can confirm that women dressing up like a man was a popular trend in Tang(唐), and this trend was introduced to Balhae. 3. The back flap(垂脚) of Bokdu that the male statue is wearing in M10 of the 6th site, has a shape that has not been found in the ancient relics of both Balhae and Tang. Therefore, it is considered as a unique shape of Bokdu of Balhae. However, it needs to be observed more and discussed in the future. 4. In regards to the Gwadae, the outside of the Gwadae is decorated with jade and has an embossed carving that is gold inside. The Gwadae of the Runghaisites has a unique design and it is distinguished from other ancient relics. 5. The gold trefoil crown and the leather conical hat that were found in M14 of the 8th site can be seen as the basic composition of official's hats in ancient Korea. Also, the motif of the gold trefoil is closely related to Anthemion that is often seen in the relics of the Three Kingdom period. Thus, we can assume according to this important finding that the style of ancient Korea official's hats came from either the king or a royal family of Balhae after the mid 8th century.

편측성 치조. 구개 파열 환자에서 골 이식술의 치험레 (Case Reports of Bone Grafting in Unilateral Alveolar-palatal Cleft Patients)

  • 배윤호;박재현;이명진;이창곤;진병로;이희경
    • Journal of Yeungnam Medical Science
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    • 제8권1호
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    • pp.198-205
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    • 1991
  • 본 저자들은 2명의 편측성 치조, 구개 파열 환자에서 장골능에서 얻은 골수 망상골로 late secondary bone graft를 시행하여 심미적 기능적으로 양호한 결과를 얻었다. 1. 한 증례에서는 골지지가 거의 없는 우측 상악 중절치를 발거하고 술전 교정치료로 변위된 치아의 배열과 소실된 공간을 회복한 후 골 이식을 시행하였고 다른 증례에서는 술전 교정치료 없이 보철물 제거후 골 이식을 시행 하였다. 2. 파열 변연부위에 골점막 절개를 한후 순측, 구개측 및 비점막을 거상 봉합하여 구비강 누공을 폐쇄한후 장골능에서 얻은 골수 망상골을 이식하였다. 3. 수술후 구비강 누공의 폐쇄로 비음이 개선되었고, 술후 6개월뒤 방사선 사진상 파열 부위의 골 재생을 확인후 결손 치아를 보철치료하였다.

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