• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권6호
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• pp.532-535
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• 2005

The objective of this study is assessment of the efficacy of upper joint space arthrocentesis on prevention of TMJ injury from patient with mantibular fractures. We divided the patients into two groups, one which consist of 24 patients who are taken arthrocentesis while open reduction of mandibular fracture, the other which consist of 27 patients without arthrocentesis from Jan 1999 to Dec 2001. We measured maximum mouth opening, excursive movement range respectively one week, one month, three months later after operation. The patients were instructed to mark on 10 cm VAS for evaluation of TMJ pain during resting, mouth opening, and mastication. We evaluated the signs and symptoms of temporomandibular disorder clinically and radiographically 6 months later. The result of this study is that there is a reduction of pain and increase of range of mandibular motion in both groups but in patients with arthrocentesis there is relatively reduction of pain and increase of range of mandibular motion compared with control group. On the points of 6 months later, temporomandibular disorder occurred in 4 patients (16.7%) in group with arthrocentesis and 13 patients (47.1%) in control group. In conclusion, we think that supplemental therapy such as arthrocentesis is helpful for the recovery of jaw function and prevention of the development of temporomandibular disorder after facial trauma.

• 대한치과보철학회지
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• 제57권3호
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• pp.238-244
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• 2019

연성 이장재는 점탄성적 특수성으로 인하여 인상 채득 후 바로 치과용 경석고를 주입할 시, 기능 인상에 사용할 수 있다. 본 증례는 78세의 남성으로 새로운 의치를 제작하고 싶다는 주소로 내원하였다. 하악 치조제의 심한 흡수로 인하여, 폐구법을 통한 기능 인상을 채득하기로 계획하였다. 먼저, 상, 하악 임시 의치의 제작을 시행하고, 연성 이장재를 내면에 도포하여 압박된 상, 하악 무치악 치조제의 치유를 유도하였다. 이후, 회복된 상, 하악 치조제에 맞게 내면이 변형된 상, 하악 임시 의치를 이용하여 폐구법을 통한 기능 인상을 채득하였으며, 상악 임시 의치의 치아 배열을 참고하여 최종 의치를 제작하였다. 이상과 같이 완전 무치악 환자에서 임시 의치를 이용하여 기능 인상을 채득하여 만족스러운 유지와 기능을 회복할 수 있었기에 본 증례를 보고하고자 한다.

• 대한치과교정학회지
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• 제44권5호
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• pp.263-267
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• 2014

Objective: To three-dimensionally elucidate the effects of occlusal hypofunction on the periodontal ligament and alveolar bone proper of rat molars by micro-computed tomography (micro-CT). Methods: Occlusal function in the molar area was restricted by attaching an anterior bite plate on the maxillary incisors and a metal cap on the mandibular incisors of 5-week-old male Wistar rats for 1 week. The periodontal ligament space and alveolar bone proper around roots of the mandibular first molar were assessed by histology and micro-CT. Results: The periodontal ligament space was narrower and the alveolar bone proper was sparser and less continuous in the hypofunction group than in the control group. Further, both the volume of the periodontal ligament and the volumetric ratio of the alveolar bone proper to the total tissue in the region of interest were significantly lower in the hypofunction group (p < 0.05). Conclusions: Occlusal hypofunction induces atrophic changes in the periodontal ligament and alveolar bone proper of rat molars.

• 대한치과의사협회지
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• 제24권5호통권204호
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• pp.439-447
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• 1986

The occurrence of osteochondroma, osteoma in mandibular condlye is rare. Sign and symptoms of enlargement of condyle are open bite, cross bite, myofascial symptoms, facial asymmetry. They are treated via condylectomy, subcondylar ostetomy, etc. We treated osteochondroma with condylectomy, osteoma with condylectomy & arthroplasty with titanium mesh & resin ball. Followings are the results 1. Condylectomy of osteochondroma resulted in good function & esthetics except slight deviation of mandible to the operation side during mouth opening. 2. Condylectomy & arthroplasty with titanium mesh & resin ball resulted in good function & esthetics & no deviation of mandible.

• 대한치과보철학회지
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• 제45권1호
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• pp.34-47
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• 2007

Statement of problem: Conventional mandibular complete denture lacks in support and stability for edentulous patients to use. Purpose: To enhance support and stability of mandibular complete denture, 2 implants were inserted on the inter-mental foramina space of edentulous patients. With 2 magnetic attachments on the inner side of the overdenture, we gave immediate loads and evaluated the stability of the implants, the responses of the supporting tissues, and the satisfaction of the patients. Material & methods: 6 edentulous patients (5 male, 1 female) each recieved 2 SLA implants in the inter-mental foramina region and implants were immediately loaded with overdenture with magnet attachments. To evaluate the implants stability and the peri-implant tissues, clinical exams, RFA tests and radiographic exams were preformed at the 1 week, 2wks, 6wks, 12wks, and 24wks. post- surgery. Results: The mean surgery time was $45.7{\pm}7.7mins$., while the denture delivery time was $45.5{\pm}12.6mins$. Only 2 of 14 implants were failed. Survived implants that remained were clincally and radiographically stable. Mean ISQ values were relatively stable, showing $69.71{\pm}5.55$, $69.00{\pm}9.48$, $67.92{\pm}7.86$, $67.92{\pm}9.58$, $70.08{\pm}7.61$, $71.92{\pm}6.43$ at the 1 wk, 2 wks, 6 wks, 12 wks, 24 wks. follow up check. Crestal bone changes were $-1.18mm{\pm}0.68mm$, $-1.35{\pm}0.69mm$, $-1.47{\pm}0.68mm$ at the 6wks, 12wks, 24wks. follow up check. Bleeding on probing(BOP index) was not significant. Conclusion: Mandibular ovedentures with 2 magnetic attachments over two interforaminal implants on edentulous patients for immediate function is a recommendable novel treatment for edentulous patients which shows stability on the implants and supporting tissue.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권1호
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• pp.55-63
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• 2012

The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%). The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.106-111
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• 1998

The aim of this article was to examine the usefulness of costochondral graft in the temporomandibular joint reconstruction. We performed costochondral grafting in the mandibular reconstruction including condyle replacement in 3 patients, which 2 of ankylosed cases and 1 destructed case. In one case, unexpected fracture of costochondral junction has developed at post-operative 2 months, but, normal mouth opening and facial appearance have been acheived by continuing exercise. These patients showed maximum mouth opening of 35-40 mm and no restriction of lateral side movement. They have been improved esthetics and function. We proposed that the costochondral graft is one of the useful method for functional reconstruction of defected mandibular condyle.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.488-492
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• 2010

This review evaluates the literature on the relationship between mandibular condylar process fracture and temporomadibular joint (TMJ). The topic of condylar fracture generated more discussion and controversy than any other field of maxillofacial trauma associated with TMJ. Disturbance of occlusal function, devia-tion of mandible, internal derangements of TMJ, and ankylosis of the joint with resultant inability to move the jaw are sequelae of condylar process fracture. Thus it is necessary to understand how the masticatory system adapts to the structural alterations that accompany fractures of the mandibular condyle. Treatment of condylar process fracture include two methods ; closed treatment and open treatment. If one chooses totreat closed, one must understand that adaptations in the musculature, skeleton, and dentition will be necessary. Open treatment of condylar process fractures probably requires fewer adaptations within the masticatory system to provide a favorable functional outcome. However, one must weigh the risk of open surgery against the possible improvement in outcome. The risks are not just surgical risk, but biological risk as well, such as disruption of the blood supply to the condyle. This review presents relevant aspects of change of TMJ associated with condylar process fracture.

• 구강회복응용과학지
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• 제22권4호
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• pp.271-281
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• 2006

Long term prediction of surgical result of skeletal class III has not been evaluated adequately because the stability of orthognathic surgery would be affected by not only set back amount of mandible but also many other factors like skeletal pattern, hyoid position, and airway size. The aimof this study is to discriminate the factors which affect the stability of post-treatment result of surgical outcome of sagittal split ramus osteotomy. We have collected 37 patients (male: 17, female: 20) from patients who have been treated at Orthodontic Department in Dankook University. The patients underwent 3 times Cephalometric X-ray taking at pre-, post-orthognathic surgery and after 12 months retention. The subjects were divided into 2 groups (Stable group: 21, Relapse group: 16) according to their relapse amount. We have taken following results from Students t-test and discriminant analysis. The discriminant factors which discern relapse and stable groupe among treatment change variables were BX and Ba-HY. Hyoid bone moved to posterior and inferior position due to surgery and repositioned superiorly and posteriorly during retention period. Skeletal patterns of the relapse group are smaller mandibular plane angle, anterior mandibular position, and greater distance from hyoid bone to cervical bone and mandible respectively.

• 구강회복응용과학지
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• 제22권4호
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• pp.283-288
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• 2006

There are several manners for surgical approaches to the mandibular condyle. With the retromandiular approach, the condyle and fracture are exposed directly and allow for good inspection and reduction. The retromandibular scar is very well camouflaged and practically invisible. The aim of this study was to evaluate clinical results of retromandibular approach for the reduction and fixation of fractured mandibular condyles. We described postoperative complications such as temporary facial nerve weakness involving the marginal mandibular branch, mouth opening limitation and malocclusion in 13 patients with mandubular condylar fractures; 11 subcondylar fractures and 2 condylar neck fractures. The follow-up period was longer than 6 months in all patients. The retromandibular approach was successful in all subcondylar fracture cases. 2 patients with condylar neck fracture had mouth opening limitation and temporary marginal nerve palsy longer than 3 months. But there were no cases of permanent nerve injury and malocclusion. Our findings indicate that retromandibular approach is an easy and safe technique for subcondylar fracture but not for condylar neck fracture.