• 제목/요약/키워드: Mandible reconstruction

검색결과 171건 처리시간 0.025초

하악골에 발생한 골육종의 치험예 (Osteogenic Sarcoma of the Mandible)

  • 변상길;이희경;진병로;김태주;김영준;김종원;이정미;도기용
    • Journal of Yeungnam Medical Science
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    • 제4권2호
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    • pp.173-178
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    • 1987
  • 저자 등은 1986년 8월에 하악 우측 대주치 부위의 치조융선에 종창과 동통을 주소로 내원한 23세의 남자 환자에서 임상소견 방사선사진소견 및 생검으로 골육종이라 진단하고 하악골의 부분 절제술을 시행하여 좋은 결과를 얻었기에 문헌 고찰과 함께 증례를 보고하는 바이며 앞으로 계속적인 관찰이 필요하며 재발 여부를 확인한 후에 골 이식술 및 보철시술이 필요하리라고 사료된다.

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공여부로서의 하악 상행지 전방부의 가용 용적에 관한 임상적 연구 (THE CLINICAL STUDY FOR AVAILABLE VOLUME OF ANTERIOR PART OF ASCENDING RAMUS AS A DONOR SITE IN ORAL AND MAXILLOFACIAL REGION)

  • 정성욱;이의석;윤정주;이성재;장현석;권종진;임재석
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제31권2호
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    • pp.130-136
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    • 2005
  • Bone grafts are widely used in the reconstruction of osseous defects in the oral and maxillofacial region. Autogenous bone grafts are considered the gold standard in grafting of the oral and maxillofacial region, because of its osteoconductive and osteoinductive properties. Mandibular symphysis & ascending ramus bone graft have been used more frequently because of easy surgical access, reduced operative time, and following minimal morbidity. However, even though the frequent use of the anterior part of ascending ramus and the different regions of mandible, rare of the reports provide information about the quantity of bone available in this donor site. So this study was taken to evaluate & quantify the amount of bone graft material in the anterior ascending ramus regions. This study was made on 36 samples of CT image. In 3D volume image, imaginary osteotomy & segmentation were done and the dimensions and volume of the bone grafts were measured and evaluated. the average volume of the graft materials obtained from the ascending ramus was $3656.83{\pm}108.19mm^3$, and the average dimensions of graft materials were $(33.68{\pm}0.48){\times}(34.92{\pm}0.51){\times}(15.96{\pm}0.27){\times}(9.05{\pm}0.27)mm$.

성견의 3급 이개부 병변에서 성형성 합성 펩타이드 젤의 치주재생 능력에 관한 실험적 연구 (Experimental study on the periodontal regenerative capacity of moldable synthetic peptide domain gel in degree III furcation defect of beagles)

  • 김정범;박윤정;이상철;김태일;설양조;이용무;구영;류인철;한수부;정종평
    • Journal of Periodontal and Implant Science
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    • 제38권4호
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    • pp.621-628
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    • 2008
  • Purpose: Osteopontin is one of the major non-collagenous protein of hard tissue. Use of peptide domain of biologically active protein has some advantages. The objective of this experimental study is evaluation of periodontal regenerative potency of synthetic peptide gel which containing collagen binding domain of osteopontin in the degree III periodontal defect of beagle dogs. Material and Methods: Experimental degree III furcation defect was made in the mandibular third and fourth premolar of beagles. Regenerative material was applied during flap operation. 8 weeks after regenerative surgery, all animals were sacrificed and histomorphometric measurement was performed to calculate the linear percentage of the new cementum formation and the volume percentage of new bone formation. Result: The linear percent of new cementum formation was 41.6% at control group and 67.1% at test group and there was statistically significant difference. The volume percent of new bone formation was 52.1% at control group and 58.9% at test group. Conclusion: As the results of present experiment, synthetic peptide gel containing collagen binding domain of osteopontin significantly increase new bone and cementum formation in the degree III furcation defect of canine mandible.

총상으로 인한 악안면 결손을 가진 환자에 대한 가철성 보철물 수복증례 (Removable prosthetic rehabilitation in patient with maxillofacial defects caused by gunshot: A case report)

  • 이동규;강정경
    • 대한치과보철학회지
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    • 제55권2호
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    • pp.198-204
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    • 2017
  • 악안면부의 결손은 선천적으로 결손을 가지고 있거나 외상이나 수술적인 절제 등에 의한 후천적 원인에 의해 발생할 수 있다. 특히 구강 내 결손을 가진 환자 중 상악의 결손과 연관되어 있는 경우가 높은 비중을 차지하고 있으며 보철적 치료의 필요성이 높다. 하악의 부분적 결손을 가질 경우 기능적 회복에 상당한 한계점을 보이나 양측 턱관절이 정상적으로 남아 있을 경우 국소의치를 이용한 악안면 보철물을 제작함으로써 양호한 결과를 기대할 수 있다. 본 증례의 환자는 58세 남자 환자로서 안면부 총상으로 인한 구개부 및 좌측 하악 구치부 결손을 가진 분으로 obturator와 하악 RPD 재제작을 위해 내원하였다. 환자의 상악 결손 범위는 Aramany 분류법 Class IV에 해당되는 상태이며, 하악은 Cantor와 Curtis 분류법 Type V resection 상태이다. 상, 하악의 우측 구치부가 잔존하였으나, 수술 후 악골 변형으로 인해 서로 교합되지 않았으며 치주상태 불량으로 인한 동요도도 존재하는 상태였다. Obturator의 유지를 위해 잔존 지대치를 최대한 활용하였고 안정적인 교합이 형성되도록 치아를 배열하였다. 하악 RPD는 하악 절제술로 변형된 연조직에 적합하도록 제한된 범위를 피개하는 RPD를 제작하였다. 이에 환자분의 저작, 연하, 발음 기능이 많이 개선되었으며 만족할 만한 결과를 보여주어 본 증례를 발표하는 바이다.

심한 협-설골 위축에서 치조골 수평 확장술을 이용한 골 재건 (RECONSTRUCTION OF SEVERE BUCCO-LINGUAL BONE RESORPTION AREA USING "RIDGE SPLITTING TECHNIQUE")

  • 여덕성;임소연;이현진;안미라;손동석
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제28권6호
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    • pp.590-594
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    • 2006
  • Dental implant has become one of the important option for completely or partially edentulous patients, But it is challenging to reconstruct the severely atrophic ridge. Insufficient bone volume could restrict to place the wide and long implant and because of excessive interocclusal clearance, improper prosthetics could be produced. In this case bone augmentation for implant dentistry is necessary procedure to improve the insufficient bone volume. Therefore, bone augmentation or GBR is the most important procedure for successful implant placement and for ideal crown- root ratio. There are various bone augmentation techniques have been introduced recently; like block bone graft, distraction osteogenesis, inlay graft, onlay graft, etc.... In severe bucco-lingual resorption area, ridge splitting is the first choice of the treatment, because it provides a place for implantation and also has compaction effect. This technique may be indicated for sharp mandible and maxillary ridges in patients whose bone quantity is inadequate for primary stabilization. We report that the clinical experience of bone augmentation using ridge splitting technique in bucco-lingual bone resorption area.

Treatment and Rehabilitation of Repetitively Recurrent Langerhans Cell Histiocytosis: A Case Report

  • Yoo, Hee Young;Park, Kyung Soo;Lee, Baek Soo;Kwon, Yong Dae;Choi, Byung Joon;Ohe, Joo Young;Lee, Jung Woo
    • Journal of Korean Dental Science
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    • 제9권1호
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    • pp.35-41
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    • 2016
  • Langerhans cell histiocytosis (LCH) is characterized by proliferation of histiocyte-like cells (Langerhans cell histiocytes) with characteristic Birbeck granules, accompanied by other inflammatory cells. Treatments of LCH include surgery, chemotherapy, and radiotherapy. One of the representative forms of chemotherapy is intralesional injection of steroids. Surgical treatment in the form of simple excision, curettage, or even ostectomy can be performed depending on the extent of involvement. Radiotherapy is suggested in case of local recurrence, or a widespread lesion. This article shows the case of repetitively recurrent LCH of a 56-year-old man who had been through surgical excision and had to have marginal mandibulectomy and radiotherapy when the disease recurred. After the first recurrence occurred, lesions involved the extensive part of the mandible causing pathologic fracture, so partial mandibular bone resection was performed from the right molar area to the left molar area followed by the excision of the surrounding infected soft tissues. The resected mandibular bone was reconstructed with a segment of fibula osteomyocutaneous free flap and overdenture prosthesis supported by osseointegrated implants.

관골에 발생한 혈관종의 수술적 절제술 (Intraosseous Hemangioma of the Zygoma and Its Management)

  • 박범진;임소영;박진홍;변재경;문구현;방사익;오갑성
    • Archives of Plastic Surgery
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    • 제35권6호
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    • pp.735-738
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    • 2008
  • Purpose: Intraosseous hemangiomas are rare and account for fewer than 1% of all bone tumors. The site that is most commonly involved are the vertebral column and the skull. Within the facial skeleton, hemangiomas can occur in the mandible, maxilla, the nasal bones, and rarely the zygoma. Methods: We report a case of an intraosseous hemangioma of the zygoma in a 49-year-old male. The patient had a slow growing hard mass in the left zygoma, which had been present for 8 years. Other than the cosmetic deformity, the patient experienced no pain and did not have any problem. He had no history of trauma in that area and no ocular symptoms. Preoperative computed tomography showed a trabeculated mass arising from the body of the left zygoma. The mass was surgically removed without having to reconstruct the bone defect by spairing the inner cortex. Results: Histopatholgical examination indicated a cavernous hemangioma. After 4 months of follow up, no functional and cosmetic impairment was identified. The patient was satisfied with the result. Conclusion: An intraosseous hemangioma of the zygoma can be treated with total surgical excision with preservation of the inner cortex, thus eliminating the need for reconstruction of bone defect.

Implant-supported overdentures with different bar designs: A retrospective evaluation after 5-19 years of clinical function

  • Rinke, Sven;Rasing, Hajo;Gersdorff, Nikolaus;Buergers, Ralf;Roediger, Matthias
    • The Journal of Advanced Prosthodontics
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    • 제7권4호
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    • pp.338-342
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    • 2015
  • PURPOSE. This retrospective study evaluated the outcome of implant-retained overdentures (IODs) after 5-19 years of clinical function. MATERIALS AND METHODS. A retrospective analysis of patient files was performed referring to 27 patients who received 36 IODs with 3 different bar designs (group A=prefabricated round bars, n=7; group B=one-piece anterior milled bars, n=20; and group C=two bilaterally placed milled bars, n=9) in the mandible (n=24) and/or in the maxilla (n=12). The analysis focused on the survival and success rates (according to Kaplan-Meier) of the implants and prostheses. Technical complication rates for each type of restoration were analyzed and compared via one-way ANOVA and the Chi-squared test. The prevalence of peri-implantitis (radiographic bone loss ${\geq}3.5mm$) was evaluated by digital analysis of panoramic radiographs taken postoperative (baseline) and after 5-19 years of clinical function (follow-up). RESULTS. The mean observational time was 7.3 years. The survival rates of the prostheses and implants were 100% and 97.7%, respectively. Technical complications occurred more frequently in group A (mean: 3.5 during observational time) than in the other two groups (B: 0.8; C: 1.0). However, this difference was not statistically significant (P=0.58). Peri-implantitis was diagnosed for 12.4% of the implants in 37% of the patients. CONCLUSION. Bar-retained IODs are an adequate treatment option for edentulous jaws. These restorations may exhibit high implant/prosthesis survival rates (>97%), and a limited incidence of technical complications after a mean observational period of >7 years. Nevertheless, peri-implantitis was identified as a frequent and serious biological complication for this type of reconstruction.

Sequential treatment for a patient with hemifacial microsomia: 10 year-long term follow up

  • Seo, Jeong-Seok;Roh, Young-Chea;Song, Jae-Min;Song, Won-Wook;Seong, Hwa-Sik;Kim, Si-Yeob;Hwang, Dae-Seok;Kim, Uk-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제37권
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    • pp.3.1-3.7
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    • 2015
  • Hemifacial microsomia (HFM) is the most common craniofacial anomaly after cleft lip and cleft palate; this deformity primarily involves the facial skeleton and ear, with either underdevelopment or absence of both components. In patients with HFM, the management of the asymmetries requires a series of treatment phases that focus on their interception and correction, such as distraction osteogenesis or functional appliance treatment during growth and presurgical orthodontic treatment followed by mandibular and maxillary surgery. Satisfactory results were obtained in a 9-year-old girl with HFM who was treated with distraction osteogenesis. At the age of 19, genioplasty and mandible body augmentation with a porous polyethylene implant (PPE, $Medpor^{(R)}$, Porex) was sequentially performed for the functional and esthetic reconstruction of the face. We report a case of HFM with a review of the literature.

미니피그에서 자가치아뼈 이식의 골형성 효과에 대한 연구 (Effectiveness of autogenous tooth bone used as a graft material for regeneration of bone in miniature pig)

  • 정혜린;황주홍;이정근
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권5호
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    • pp.375-379
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    • 2011
  • Introduction: This study examined the effect of autogenous tooth bone used as a graft material for bone regeneration in an artificial bony defect of minipigs. Materials and Methods: Four healthy minipigs, weighing approximately 35-40 kg, were used. Four standardized artificial two-walled bony defects, 5 mm in length and depth, were made on the bilateral partial edentulous alveolar ridge on the mandible of minipigs, and autogenous tooth bone was augmented in the right side as the experimental group. On the other hand, only alloplastic bone graft material HA was grafted with the same size and manner in the left side as the control group. All minipigs were sacrificed at 4 weeks after a bone graft and evaluated histologically by Haematoxylin-eosin staining. The specimens were also evaluated semi-quantitatively via a histomorphometric study. The percentage of new bone over the total area was evaluated using digital software for an area calculation. Results: All specimens were available but one in the left side (control group) and two in the right side (experimental group) were missing during specimen preparation. The amount of bone formation and remodeling were higher in all experimental groups than the control. The mean percentage area for new bone in the experimental and control groups was $43.74{\pm}11.96%$ and $30.79{\pm}2.93%$, respectively. Conclusion: Autogenous tooth bone is a good alternative to autogenous bone with the possible clinical feasibility of an autogenous tooth bone graft in the reconstruction of bony defects.