• Maxillofacial Plastic and Reconstructive Surgery
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• 제21권2호
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• pp.149-165
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• 1999

The pathomechanism of obstructive sleep apnea(OSA) is not clearly elucidated. The possible mechanisms are pathologic reduction of pharyngeal muscular tonus during sleep, abnormal anatomical stenosis of nasopharyx or a combination of the above two mechanisms. It is very important to find the cause(anatomical location or pathologic dynamic change) of OSA in order to treat it. Cephalometric analysis in patients with obstructive sleep apnea is a good method for evaluating anatomical morphologic change but it cannot give any information about the dynamic changes occurring during sleep. On the contrary, nasopharyngeal endoscopy offer 3 dimensional image and information about the dynamic changes. Accordingly, these two diagnostic tools can be utilize in the diagnosis and treatment planning of OSA Cephalometric analysis of craniofacial skeletal and soft tissue morphology in 53 patients with OSA and 43 controls was performed and cephalometric analysis and nasopharygeal endoscopy were performed in 9 patients with OSA in order to come up with individualized therapy plans. Following results were obtained ; Patients with OSA showed 1. body weight gain 2. clockwise mandibular rotation 3. increased anterior lower facial height 4. inferiorly positioned hyoid bone 5. increased length of soft palate 6. decreased sagittal dimension of nasopharyx 7. increased vertical length of inferior collapsable nasopharyx 8. increased length of tongue Through cephalometric analysis and nasopharygeal endoscopy(mutually cooperative in diagnosis), 9. one can find the possible origin of OSA and make a adequate individualized therapy plan and predict accurate prognosis. Cephalometric analysis and nasopharygeal endoscopy are highly recommended as a diagnostic aid in OSA patients

• 한국전산구조공학회논문집
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• 제29권4호
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• pp.309-315
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• 2016

최근 치의학 분야에서도 인체에 대한 구조적이고 역학적인 이해를 위하여 유한요소해석 기법이 널리 사용되고 있다. 따라서 본 연구에서는 CT 이미지를 기반으로 하는 유한요소모델링 기법을 제안하고, 실험결과와 비교하여 검증하였다. 또한 제안된 해석기법을 통해 교합 시뮬레이션을 구현하여 정상 I급 교합과 Full-CUSP II급 교합상태의 두개골 모델에 대하여 기하비선형구조해석을 수행하였다. 그 결과, 하악골이 같은 거리만큼 이동할 때 사람의 실제 교합력 범위에서는 두 모델의 교합력에 큰 차이가 없는 것으로 나타났다. 그러나 응력분포를 비교했을 때 정상 I급 교합모델은 치아 및 치조골 전반에 응력이 균등하게 발생하는 반면, Full-CUSP II급 교합모델의 경우 일부 구역에 응력집중 현상이 나타났다. 이는 치아의 부재 및 재배열로 인하여 교합면이 달라지면서 생긴 결과라고 분석된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.61-68
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• 1996

1. 첫 번째 증례에서 관상 절개를 이용한 부분골 절제술과 Le Fort씨 1급 골절단술을 시행한 결과, 골절단술을 시행한 부위에 원활한 골 치유가 일어났다. 2. 두 번째 증례에서 관상 절개를 이용하여 두개안면부에 광범위한 부분골 절제술을 시행하여 만족할만한 결과를 얻었으며, 병소 부위 말초 혈관 과다는 병소의 성장에 따른 생리적 변화로 추정된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권6호
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• pp.577-583
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• 2008

Langerhans cell histiocytosis (LCH) is characterized by proliferation of pathological Langerhans cells within different organs. It mainly affects children, but adult cases also occur, with an incidence rate of one to two per million. LCH results from the clonal proliferation of Langerhans cells. And its etiopathogenesis is still unknown. The hypothesis that it is a neoplastic or inflammatory disease, as well as the existence or not of immunological, viral or genetic predisposing factors, has been widely discussed in the literature, but no conclusive proof has ever been provided. Although lesions may appear in tissues of various origins such as skin, hypothalamus, liver, lung, or lymphoid tissue, bone is the most common site of the disease. The head and neck are affected in almost 90% of cases. The maxillary and mandibular bones are affected in 5 to 10% of cases. In our report, we present four cases of LCH in patients aged 3, 4, 7 and 9 years respectively, with primary manifestation in maxillofacial area.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권6호
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• pp.584-588
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• 2008

Facial asymmetry is particularly associated with mandible among other facial bones and it could be either congenital or acquired. Congenital factors are related to Treacher Collin syndrome, Pierre Robin syndrome, hemifacial microsomia and other various syndromes. Acquired factors are such as damaged or diseased growing condyles, hormonal disorder, oral mal-habit, muscular force, tumor, infection and so on. Diagnosis and treatment of facial asymmetry are complicated due to differences in sizes and positions of mandibles. The aspects of facial asymmetry is various and complicated upon each individual. Depending on causes of the facial asymmetry, there also are morphological differences. For such reasons, precise anatomical analysis and diagnosis of the facial asymmetry are essential before any surgical procedure followed by the appropriate treatment plan. This case is regarding a 21-year old patient diagnosed as the facial asymmetry due to an infantile maxillofacial surgery. Employing various morphological evaluations, potential problems during the procedure are predicted beforehand. This case reports a favorable result of sagittal split ramus osteotomy performing the oblique vertical bone cutting in posterior-superior of the mandibular second molar.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권2호
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• pp.127-135
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• 2009

Objectives : The titanium fixation system has been used in orthognathic surgery for fixation of bone segments usually, but the biodegradable fixation system was developed and also being used. The strongest point in the biodegradable system is that no extra operation should be needed to remove fixation materials. In spite of this merit, oral & maxillofacial surgeons hesitate to use this system in fracture or orthognathic surgery. In this study, as we got some clinical experiences, we'd like to report the result of clinical study using the biodegradable fixation system in orthognathic surgery. Patients and Methods : A total of 35 patients composed of 17 males and 18 females with 25 osteotomies in maxilla and 34 osteotomies in mandible were fixated with the biodegradable fixation system(Inion $CPS^{(R)}$). We investigated methods of stabilization, fixation time, and complications on the basis of the method as above. Results : Four 2mm thick L shaped plates with 7 holes of which 1 hole was removed were fixed in maxilla with six $2.0{\times}7mm$ screws. Three $2.5{\times}16{\sim}18mm$ screws were used to fix superior ramus area and one mandibular angle area in mandible. It took about 27.4 minutes in maxilla, 25.3 minutes in mandible to perform the fixation which took longer time than the titanium system(9.5 minutes in maxilla, 8 minutes in mandible). Generally, there was no problem except 9 cases in which there were some complications. Conclusions : In most cases, the biodegradable fixation system can be used without problem in usual orthognathic surgery. But, this system is inferior to the titanium fixation one in some respects such as fixation time, size, and physical property. Some supplementations for such weak points as aforementioned should be needed for the universal use of biodegradable materials.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제39권
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• pp.22.1-22.9
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• 2017

Background: Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery. Methods: A prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring. Results: Among 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers. Conclusions: This study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.41.1-41.4
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• 2018

Background: Free fibular flap is one of the most useful methods in the hard tissue reconstruction of the maxillamandible. Free fibular flap presents some advantages in which the reconstruction of both soft and hard tissues can be done at the same time. It also provides a safe and successful bone graft for the reconstruction, along with a low rate of complications. Despite these advantages and the rarity of a postoperative complication, particularly in oral and maxillofacial surgery procedures, a prolonged operation might exhibit some complications related with rhabdomyolysis. We experienced the rare event of rhabdomyolysis after oral cancer surgery. Case presentation: In this article, we report the case of a patient who developed rhabdomyolysis after undergoing free fibular flap surgery. Conclusions: Despite the advantages of the free fibular flap operation, clinicians must be aware of the risk of complications because there are multiple factors that could result in rhabdomyolysis, such as duration of operation, position of the subject, and pre-existing conditions of diabetes and hypertension. Once the diagnosis of rhabdomyolysis is confirmed, a prompt treatment plan should be made and applied as soon as possible. This will increase the chance of a full recovery for the patient who is exhibiting symptoms of rhabdomyolysis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권1호
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• pp.64-67
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• 2003

본 증례는 하악골 정중부의 종창과 미맹출 매복 견치를 주소로 내원한 12세 남아 환자로 환자의 임상 및 방사선 소견상 함치성 낭종으로 가진하였다. 그러나 정확한 진단과 환자의 조절 등의 문제로 인하여 전신마취하에 낭종성 병소의 적출을 시행하여 조직 검사를 시행하였으며 그 결과 매복 견치와 관련된 점액종으로 진단되었다. 이에 저자 등은 하악 양측 견치의 미맹출 매복치과 연관되어 매우 드물게 발생되는 점액종을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한소아치과학회지
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• 제31권4호
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• pp.564-568
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• 2004

치아의 맹출지연을 일으키는 여러 원인 중 치아종은 법랑질, 상아질, 치수와 같은 치아를 구성하는 조직을 갖춘 harmartoma로 complex odontoma(복잡 치아종)와 compound odontoma(복합 치아종)로 구분된다. 치아종의 원인에는 외상, 감염, 치아발육상의 장애, 유전적 요인 등을 들 수 있으며, 호발 부위는 상악 전치부와 하악 구치부이다. 이 중 compond odontoma는 악골의 전방부에, complex odontma는 악골의 후방부에 잘 발생하는 경향이 있는데 대부분 악골내에서 발생하지만 드물게 점막을 뚫고 치조골의 상방으로 석회화 된 종괴가 맹출한 형태의 치아종을 erupted odontoma라 한다. erupted odontoma는 매우 드문 질환으로 일반적으로 맹출지연을 일으키지는 않는다. 본 증례는 맹출이 지연된 하악 제 1대구치 치관 상방에 나타난 erupted complex odontoma를 제거 후 치아를 맹출 시키는데 양호한 결과를 얻었기에 보고하는 바이다.