• 제목/요약/키워드: Mandibular surgery

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하악골에 발생한 근섬유종 (MYOFIBROMA OF THE MANDIBLE)

  • 윤정훈;김수관;이상호
    • 대한소아치과학회지
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    • 제30권1호
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    • pp.10-14
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    • 2003
  • 근유종은 소아에 주로 발생하는 다발성 종양으로 처음에 기술되었지만, 단독으로 발생하는 경우가 더 많고, 어느 연령층에서나 발생한다. 성인과 소아형 모두 비슷한 임상적 특성과 병리조직학적 특징을 갖는다. 이 증례는 9세 남아의 하악에 경계가 명확한 단방성의 방사선 투과성 병소로, 병리조직학적으로 방추형 세포들이 다발을 이루며 증식하며, 일부에는 혈관주피종과 유사한 부위가 관찰되었다. 면역조직화학적으로 종양세포는 vimentin과 smooth muscle actin에 양성, S-100, desmin, cytokeratin AE1/3에 음성이었다. 이 증례에서와 같이 소아에서 단방성 방사선 투과상의 고형성 종괴로 나타나는 경우 근섬유종을 감별진단에 포함시켜야 한다고 생각된다. 환자는 수술 1년이 경과한 현재까지 재발의 소견은 없지만 재발한 경우도 보고되어 있어 철저한 추적 관찰이 필요하며, 현재 #43, 44 치아의 맹출을 유도하는 중에 있다.

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심 경부 림프관종에 의한 거설증 2례 (Macroglossia secondary to lymphangioma of the deep neck space: Report of two cases)

  • 조한길;김수영;송은송;이준규;최영륜
    • Clinical and Experimental Pediatrics
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    • 제53권1호
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    • pp.97-102
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    • 2010
  • 림프관종은 드물게 발생하는 림프혈관의 양성 과오종으로, 주로 두경부에 호발하는데, 혀나 구저부 또는 심 경부에 발생할 경우 원심성 림프관 흐름의 방해로 이차적 거설증이 발생할 수 있다. 저자들은 출생 시에는 경부 또는 하악 부종 없이 거설증만 보였던 두 명의 환아에서 각각 생후 5개월과 5주에 하악 부종이 보여 MRI로 심 경부 림프관종을 확인한 2례를 경험하였기에 보고하는 바이다.

II급 치근이개부병변에서 비흡수성막과 흡수성막을 이용한 조직유도재생술의 임상적 비교 (A Clinical Comparision of Nonresorbable and Resorbable Membrane in the Treatment of Human Class II Furcation Defects)

  • 장채윤;이재목;서조영
    • Journal of Periodontal and Implant Science
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    • 제31권4호
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    • pp.689-711
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    • 2001
  • The purpose of this study was to compare clinical results of guided tissue regeneration(GTR) using either a nonresorbable ePTFE membrane or a resorbable membrane made from a synthetic copolymer of glycolide and lactide(PLGA) in the treatment of human class Ⅱ furcation defects. The ePTEE membranes were applied to 16 patients with maxillary molar buccal class Ⅱ furcation defects as Group I, PLGA membranes were applied to 15 patients with maxillary molar buccal class Ⅱ furcation defects as Group Ⅱ, ePTFE membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅲ and PLGA membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅳ and bone graft materials(DFDBA) were applied in all groups. Probing depth, gingival recession, clinical attachment level, tooth mobility and sulcus bleeding index(SBI) were measured at baseline, 3, 6 and 12months postoperatively. In addition, membrane exposure levels were measured at surgery, 1, 2 and 6weeks postoperatively and postoperative complications were evaluated. The results were as follows: In all groups, there were statistically significant differences in probing depth reduction, gain of clinical attachment and mobility reduction at values of 3, 6 and 12months postoperatively compared to values of baseline, whereas no significant differences in SBI except Group I and gingival recession(p<0.05). Membrane exposure levels were increased at 1, 2 and 6weeks postopratively compared to value of baseline in Group I(p<0.05). There were no statistically significant differences between ePTFE and PLGA membrane in probing depth, clinical attachment level and SBI. There were minimal gingival recession and membrane exposure in Group Ⅳ and pain and swelling were the most common postoperative complications in Group Ⅱ, Ⅲ(p<0.05). In conclusion, this study showed that both nonresorbable membrane and resorbable membrane were effective similarly in the treatment of class Ⅱ furcation defects, without statistical differences in clinical measurements.

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하악 매복 제3대구치 발치 시 Articaine HCl과 Lidocaine HCl의 국소마취 효능에 대한 비교연구 (Comparative Study for the Anesthetic Efficacy between Articaine HCl and Lidocaine HCl during the Surgical Extraction of Bilateral Mandibular Impacted Third Molars)

  • 이원영;서광석;김현정;염광원;박창주
    • 대한치과마취과학회지
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    • 제4권1호
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    • pp.13-16
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    • 2004
  • Background: Articaine, a new amide-type local anesthetic, was recently commercially available in Korea. The purpose of this study was to compare the anesthetic efficacy between articaine HCl and lidocaine HCl for the surgical extraction of bilateral mandibular impacted third molars. Patients and Methods: Forty young and healthy patients with bilateral impacted third molars were selected with permission. Randomly, one side of impacted third molar was operated under local anesthesia using 4% articaine and the other side under 2% lidocaine after 1 or 2 week recovery time. Intraoperative pain was evaluated via 0-10 cm visual analog scale (VAS) by both the patient and operator immediately after the operation. After 1 day and 7 days, the complications of local anesthesia were checked. Results: The pain VAS scores in articaine group, evaluated by both the patient and operator, were lower than those in lidocaine group, but they were not statistically significant (P = 0.44 and 0.54, respectively). The incidence of complications of local anesthesia between articaine and lidocaine was similar. Conclusion: In this study, articaine showed at least equal efficacy compared to lidocaine. The further dose-controlled study with more pharmacokinetic parameters will be needed.

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Hypodontia and Hyperdontia of Permanent Teeth in Korean Schoolchildren

  • Moon Hyock-Soo;Cho Sun-Chul;Choung Pill-Hoon
    • 대한구순구개열학회지
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    • 제4권2호
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    • pp.19-27
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    • 2001
  • This study was performed to determine the prevalence of hypodontia and hyperdontia of permanent teeth among Korean schoolchildren, and to compare differences in the prevalence between Korea, other country, and other ethnic groups. The sample consisted of 346 girls aged 6.9~0.3 yr and 375 boys aged 6.8~0.4 yr on whom a panoramic radiograph was taken at Yeonchun-Gun community in Korea. The prevalence of congenitally missing teeth (third molars excluded) was 6.7% in boys and somewhat higher, 9.5% in girls, and 8.0% for both sexes combined. On the average, number of missing teeth per affected child was 1.9 teeth. The most commonly congenitally missing teeth were the mandibular second premolar (32.7%), followed by the mandibular incisor (28.7%), the maxillary second premolar (16.7%), and the maxillary lateral incisors (10.2%). The prevalence of supernumerary teeth was 2.1 % in boys, 1.4% in girls, and 1.8% for both sexes combined. The most common supernumerary teeth were the mesiodens (76.9%), followed by the supernumerary premolar (23.1 %). The affected male-female ratio was 1.6: 1.0. The prevalence of congenital missing teeth in this study was similar to in studies of Japanese, Danish, American and German. The frequency of hyperdontia was lower in this study than in studies of Chinese children, Japanese and American.

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Longitudinal management of recurrent temporomandibular joint ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment

  • Lim, Seung-Weon;Choi, Jin-Young;Baek, Seung-Hak
    • 대한치과교정학회지
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    • 제49권6호
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    • pp.413-426
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    • 2019
  • This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

완전 무치악 환자에서 상악 총의치와 하악 임플란트 지지 고정성 보철 치료를 위한 치료법 비교: 증례 보고 (Comparison of treatments for maxillary full denture and mandibular implant-supported fixed prosthesis in completely edentulous patients: A case report)

  • 한진원;표세욱;장재승;김선재
    • 대한치과보철학회지
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    • 제61권1호
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    • pp.73-81
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    • 2023
  • 완전 무치악 환자에서 상악은 전통적인 총의치 치료를 통해 충분한 안정, 지지 및 유지를 얻기 용이하지만, 하악은 해부학적 한계로 인하여 치료에 어려움이 있기 때문에 임플란트를 동반한 치료를 고려할 수 있다. 구치부에 임플란트 식립이 어려운 경우에는 이공 전방에 4 - 5개의 임플란트를 이용하여 하악의 의치를 고정해주는 하이브리드 형 고정성 총의치로 치료할 수 있고, 구치부에 임플란트 식립이 가능한 경우라면 다수 유닛으로 구성되는 임플란트 지지 고정성 보철물을 고려할 수 있다. 이러한 접근방식은 시대가 지남에 따라 수술방식이나 사용하는 재료 등이 다양하게 변해왔다. 본 증례에서는 상악 총의치를 사용하는 완전 무치악 환자의 하악에서 임플란트를 이용한 고정성 보철 치료의 증례를 중심으로 치료 방법을 비교해 보고자 한다.

Quality of life, patient preferences, and implant survival and success of tapered implant-retained mandibular overdentures as a function of the attachment system

  • Ilze Indriksone;Pauls Vitols;Viktors Avkstols;Linards Grieznis;Kaspars Stamers;Susy Linder;Michel Dard
    • Journal of Periodontal and Implant Science
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    • 제53권3호
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    • pp.194-206
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    • 2023
  • Purpose: A novel attachment system for implant-retained overdentures (IRODs) with novel material combinations for improved mechanical resilience and prosthodontic success (Novaloc) has been recently introduced as an alternative to an existing system (Locator). This study investigated whether differences between the Novaloc and Locator attachment systems translate into differences in implant survival, implant success, and patient-centered outcomes when applied in a real-world in-practice comparative setting in patients restored with mandibular IRODs supported by 2 interforaminal implants (2-IRODs). Methods: This prospective, intra-subject crossover comparison compared 20 patients who received 2 intra-foraminal bone level tapered implants restored with full acrylic overdentures using either the Locator or Novaloc attachment system. After 6 months of function, the attachment in the corresponding dentures was switched, and the definitive attachment system type was delivered based on the patient's preference after 12 months. For the definitive attachment system, implant survival was evaluated after 24 months. The primary outcomes of this study were oral health-related quality of life and patient preferences related to prosthetic and implant survival. Secondary outcomes included implant survival rate and success, prosthetic survival, perceived general health, and patient satisfaction. Results: Patient-centered outcomes and patient preferences between attachment systems were comparable, with relatively high overall patient satisfaction levels for both attachment systems. No difference in the prosthetic survival rate between study groups was detected. The implant survival rate over the follow-up period after 24 months in both groups was 100%. Conclusions: The results of this in-practice comparison indicate that both attachment systems represent comparable candidates for the prosthodontic retention of 2-IRODs. Both systems showed high rates of patient satisfaction and implant survival. The influence of material combinations of the retentive system on treatment outcomes between the tested systems remains inconclusive and requires further investigations.

Porcine-derived soft block bone substitutes for the treatment of severe class II furcation-involved mandibular molars: a prospective controlled follow-up study

  • Jae-Hong Lee;Ji-Hoo Han;Seong-Nyum Jeong
    • Journal of Periodontal and Implant Science
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    • 제53권6호
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    • pp.406-416
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    • 2023
  • Purpose: No evidence exists regarding the advantages of periodontal regeneration treatment for furcation defects using soft block bone substitutes. Therefore, this randomized controlled trial aimed to assess the clinical and radiographic outcomes of regenerative therapy using porcine-derived soft block bone substitutes (DPBM-C, test group) compared with porcine-derived particulate bone substitutes (DPBM, control group) for the treatment of severe class II furcation defects in the mandibular molar regions. Methods: Thirty-five enrolled patients (test group, n=17; control group, n=18) were available for a 12-month follow-up assessment. Clinical (probing pocket depth [PPD] and clinical attachment level [CAL]) and radiographic (vertical furcation defect; VFD) parameters were evaluated at baseline and 6 and 12 months after regenerative treatment. Early postoperative discomfort (severity and duration of pain and swelling) and wound healing outcomes (dehiscence, suppuration, abscess formation, and swelling) were also assessed 2 weeks after surgery. Results: For both treatment modalities, significant improvements in PPD, CAL, and VFD were found in the test group (PPD reduction of 4.1±3.0 mm, CAL gain of 4.4±2.9 mm, and VFD reduction of 4.1±2.5 mm) and control group (PPD reduction of 2.7±2.0 mm, CAL gain of 2.0±2.8 mm, and VFD reduction of 2.4±2.5 mm) 12 months after the regenerative treatment of furcation defects (P<0.05). However, no statistically significant differences were found in any of the measured clinical and radiographic parameters, and no significant differences were observed in any early postoperative discomfort and wound healing outcomes between the 2 groups. Conclusions: Similar to DPBM, DPBM-C showed favorable clinical and radiographic outcomes for periodontal regeneration of severe class II furcation defects in a 12-month follow-up period.

골격성 III급 부정교합자의 편악수술과 양악수술후 재발경향에 관한 비교연구 (A COMPARATIVE STUDY ON THE DEGREE OF RELAPSE FOLLOWING ONE JAW SURGERY AND TWO JAW SURGERY IN SKELETAL CLASS III PATIENTS)

  • 김정록;손우성
    • 대한치과교정학회지
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    • 제25권5호
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    • pp.613-625
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    • 1995
  • 본 연구는 골격성 III급 부정교합 환자에서 술전 상태와 수술방법 사이의 관계 및 악교정 수술후 재발경향을 조사하기 위하여 시행하였다. 연구 대상으로는 악교정수술을 받은 31명(남자 17명, 여자 14명)을 선택하였고, 이중 20명은 편악수술, 11명은 양악수술을 시행하였으며, 평균연령은 22.5세였다. 각 대상에서 술전, 수술직후, 1년 이상 경과 후의 측모두부방사선 규격사진을 채득하여, 투사도를 작성하고, 분석하여 다음과 같은 결과를 얻었다. 1. 하악만을 수술한 군보다 양악 동시수술군에서 하악체의 길이가 4.24mm, 하안모 고경의 길이가4.64mn, 하순의 길이가 4.13mm 더 길게 나타났으며, 반면 수평피개도는 3.13mm 더 작게 나타났다. 2. 하악만을 수술한 군에서 $8.95\pm4.45mm$ 하악이 후방이동되었으며, 양악 동시수술군에서 상악은 $5.15\pm3.46mm$ 전방이동되었고, 하악은 $7.24\pm9.11mm$ 후방이동되었다. 3. 최소 1년 이상 경과 후와 수술직후의 변화에 있어서 양악 동시수술군에서 A point는 $1.02\pm2.14mm$, Pn에서는 $1.05\pm1.48mm$, Sn에서는 $1.55\pm1.37mm$ 후방이동되었다. 4. 최소 1년 이상 경과 후와 수술직후의 변화에 있어서 B point에서 하악만을 수술한 군은 $28\%$ 양악 동시수술군은 $8\%$, B' point에서 하악만을 수술한 군은 $24\%$, 양악 동시수술군은 $3\%$ 전방이동되었다.

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