• 제목/요약/키워드: Mandibular surgery

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소아의 하악에 발생한 Garre 골수염의 근관치료에 관한 증례보고 (GARRE'S OSTEOMYELITIS OF THE MANDIBLE RESOLVED BY ENDODONTIC TREATMENT IN CHILDREN: A CASE REPORT)

  • 이동현;김대업;이광희
    • 대한소아치과학회지
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    • 제23권3호
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    • pp.688-696
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    • 1996
  • Garre's osteomyelitis is a unique form of osteomyelitis characterized rediographically by localized thickening of the periosteum and deposition of laminated subperiosteal bone. The most common inciting factor is a mandibular infection in permanent first molar with necrotic pulp. This disease occurs primarily in children and to date in all instances it has occured only in mandible. It usually results in hard swelling over the jaws, producing facial asymmetry with little or no pain. The overlying skin is normal but can occasionally be inflammed mostly when pain is present. Palpation reveals a usually smooth, bone-hard lesion which feel like an inherent part of the mandible. Unlike other forms of osteomyelitis, there is no marked increase in fever, white bloods cell count, sedimentation rate or alkaline phosphatase value. The treatment of Garre's osteomyelitis usually consist of elimination of the sourses of infection, i.e., either extration of an offending infected teeth or root canal therapy. This treatment almost always results in resolution of the Garre's osteomyelitis. Resistant cases have involved secondary surgery, i.e., decortication and sequestrectomy. This report presents three cases of Garre's osteomyelitis resolved by endodontic treatment. Cliniqtl examination revealed swelling on the face with no tenderness. Periapical radiograph showed deep caries lesion extending into pulp chamber and periapical radiolucency. Occlusal radiograph showed an enlargement of bone and stretching the periosteum. A clinical diagnosis of the Garre's osteomyelitis was made. Endodontic treatment was accomplished with conventional method and restored facial symmetry. Long-term check-ups are necessary to evaluate the results of endodontic treatment.

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치과 시술 후 나타난 신경손상의 관리 (Management for traumatic neuropathy after dental treatment)

  • 정성희;이선희;안용우;허준영;전혜미;옥수민
    • 구강회복응용과학지
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    • 제32권2호
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    • pp.123-129
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    • 2016
  • 의원성의 외상 혹은 감염은 신경 손상의 중요한 원인 중 하나이며, 이는 의사-환자 관계에 매우 큰 영향을 주는 일로 여겨진다. 관련 치과 술식의 예로는 임플란트 시술시 직접적인 혹은 열에 의한 손상, 근관치료시의 약제 유출, 발치시의 외력, 전달국소마취시 바늘에 의한 외상, 악골 수술로 인한 외상 등이 있다. 이러한 신경손상이 발생하지 않도록 위험군 예측 및 시술 시 주의가 필요하며, 신경 손상 시 조기 발견을 통해 제대로 대처하지 않으면 만성적 신경병증으로 발전할 수 있는 가능성이 높아질 수 있으므로 그 징후를 신속히 파악하고 적절히 관리하는 것이 매우 중요하다.

성인 환자에서 구치부 압하를 통한 개방교합의 치료와 유지 (Non-surgical treatment and retention of open bite in adult patients with orthodontic mini-implants)

  • 문철현;이주신;이현선;최진휴
    • 대한치과교정학회지
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    • 제39권6호
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    • pp.402-419
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    • 2009
  • 성장이 종료된 치성 또는 골격성 개방교합 환자를 치료하는 것은 매우 어려운 일이다. 전치부 개방교합 환자는 증가된 전안면고경, 상악 구치부의 과도한 수직성장, 큰 하악각 등의 특징을 지닌다. 이러한 증례에서 구치의 압하를 통한 개방교합의 해소는 좋은 치료전략이다. 본 연구는 교정용 미니임플란트를 이용하여 개방교합을 치료하고 성공적인 유지를 얻은 두 명의 환자에 대한 보고이다. 적절한 진단이 시행되고 교정용 미니임플란트 등의 장치를 이용한 치료기법을 적용하면 수술치료 없이 교정치료만으로 개방교합의 치료가 가능하며, 하악구치부에 posterior bite block을 추가한 가철식 유지장치 및 SFR이 개교환자를 위한 유지장치 또는 보조유지장치로 유용하게 사용될 수 있다는 결론을 얻었다.

Cone beam형 전산화 단층촬영장치를 이용한 설공의 해부학적 구조 (Anatomical structure of lingual foramen in cone beam computed tomography)

  • 기민우;황의환;이상래
    • Imaging Science in Dentistry
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    • 제34권3호
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    • pp.129-136
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    • 2004
  • Purpose: To evaluate whether cone beam computed tomography can depict the distribution, position, frequency, relative vertical dimension, and the diameter of the lingual foramen and direction of lingual bone canal. Materials and Methods : Cone beam computed tomography of mandible was performed on 25 males and 25 females with no history of any orthodontic treatments or any other dental surgeries. A statistical comparison was done on the mean values of males and females. Results: In the location and distribution of lingual foramina, median lingual foramen was found in all subjects and lateral lingual foramen in 58%. In the lateral lingual foramen, bilateral type was found in 28% and unilateral type in 30%. In the number of lingual foramina, median lingual foramen had two foramina and lateral lingual foramen had one foramen, mostly. In the relative mean vertical dimension of lingual foramina, median lingual foramen was 0.03±0.08, and both lateral lingual foramina was 0.20±0.04. The mean diameter of lingual foramina, median lingual foramen was 0.9mm±0.28, right lateral lingual foramen was 0.92mm±0.23, and left lateral lingual foramen was 0.88mm±0.27. The most frequent direction of the lingual bone canals, median lingual bone canal proceeded in anteroinferior direction and lateral lingual bone canal in anterosuperolateral direction. Conclusion : Cone beam computed tomography can be helpful for surgery and implantation on the mandibular area. Radiologist should be aware of this anatomical feature and its possible implications.

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악안면 연조직에 관한 X선학적 연구 (ORENTGENOGRAPHIC STUDIES ON THE SOFT TISSUE PROFILE)

  • 박태원
    • 치과방사선
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    • 제1권1호
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    • pp.29-37
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    • 1971
  • Modern orthodontics implies not only occlusal excellence, but also the positioning of teeth to produce optimal facial harmony for the individual patients. Several methods have been used in the study of facial height, width and depth were made from living subjects. These methods, however, complicate to control the subjects, therefore many investigators have used profile cephalometric technics. Practically, cephalometric technics were used m orthodontic treatment, maxillo-facial surgery and anthropometric studies. Author was studied to investigate the normal standards of soft tissue profile in Korean adolescences. The subjects consisted of 53 males and 54 females from 17 to 22 years of age and with normal occlusion and acceptable profile. Aluminum filter was designed to obtain both hard and soft tissue structures on a single film. Eight profile landmarks were plotted and drawn on the tracings of all cephalograms and eighteen depth, height and angles were measured from each landmarks of the cephalograms. The following conclusIOns were obtained from this studies; 1. Total facial convexity was 170. 75 in males and females samples and lower facial and: labiomandibular convexity were each of 141.44, 171.05. 2. Maxillary and mandibular sulcus angulations were 137.61, 129.52 and upper and lower lip inclinations were each of 123.26 and 49.56 in male and females. 3. Soft tissue depth of several points were as follows; Subnasale 18.74㎜ in males and 16.65㎜ in females Pogonion 13.40㎜ in males and 13.07㎜ in females upper lip 14.06㎜ in males and 11.91㎜ in females . lower lip 15.46㎜, 13.63㎜ in males and females 4. The protrusion of nose were 16.28㎜ in males and 15.56㎜ in females 5. The vertical length of upper and lower lips were 25.67㎜, 52.96㎜ and the lip posture was indicated 93.43 per cent (closed state) in centric occlusions.

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Early radiographic diagnosis of peri-implantitis enhances the outcome of peri-implantitis treatment: a 5-year retrospective study after non-surgical treatment

  • Chang, Hee-Yung;Park, Shin-Young;Kim, Jin-Ah;Kim, Young-Kyun;Lee, Hyo-Jung
    • Journal of Periodontal and Implant Science
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    • 제45권3호
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    • pp.82-93
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    • 2015
  • Purpose: This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods: Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results: Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions: Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant.

Evaluating intra- and inter-examiner reproducibility in histometric measurement: one-wall intrabony periodontal defects in beagle dogs

  • Kim, Soo-Kyung;Choi, Eun-Hee;Lee, Jung-Seok;Kim, Tae-Gyun;Choi, Seong-Ho;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • 제40권4호
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    • pp.172-179
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    • 2010
  • Purpose: Accurate and exact measurement is an important factor for generating meaningful results in any properly designed study. If all the participating examiners are able to yield similar results, it will be possible to evaluate the objective results of the study more easily and quickly. The purpose of this study was to evaluate the intra- and inter-examiner reproducibility of histometric measurements in the intrabony periodontal defect model. Methods: One wall intrabony defects were surgically created at the distal aspect of the second and the medial aspect of the fourth mandibular premolars in the right and left jaw quadrants in twenty beagle dogs and the defect sites received the following ${\beta}$-tri calcium phosphate, growth differentiation factor-0, growth differentiation factor-100 and sham surgery. Histometric analysis was performed after 8 weeks. Histometric parameters were recorded and repeated at three months interval by three examiners. Intra- and inter-examiner reproducibility was assessed. Results: Most parameters of all the groups showed high intra- and inter-examiner reproducibility. Parameters including defect height, bone regeneration height, cementum regeneration height, and formation of junctional epithelium yielded interexaminer correlation ${\geq}0.9$. The intra-examiner reproducibility showed a high result, over 0.9. Conclusions: Histometric evaluation of the one-wall intra-alveolar periodontal defect model showed high reproducibility not only for a single given examiner but also among the three examiners.

자가치아이식술의 장기적인 임상적 평가 (Evaluation of Autotransplantation)

  • 이종식;박진우;서조영;이재목
    • Journal of Periodontal and Implant Science
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    • 제38권2호
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    • pp.225-230
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    • 2008
  • Purpose: Many clinical studies have reported that higher success rates are achieved with teeth that have immature roots than other autotransplanted teeth that have more immature root. However, based on date published recently, the success rate of autotransplantation of teeth with complete root formation was higher. The purpose of this study was to examine the long term(2 to 6 years follow-up) success rate of autotransplantation of third molar with complete root formation and to discuss some conditions and prerequisites for success. Materials and Methods: 26 sites of 24 patients aged 26 to 55 (mean age 40.8) were autotransplanted with third molars with complete root formation. These cases were followed for 2 to 6 years after surgery. The success criteria included (1) no discomfort during functioning (2) absence of progressive root resorption and alveolar bone resorption. Result: Of 26 teeth 5 teeth were failed, therefore success rate is 81%(21/26 teeth). The results suggested that higher success rate is acquired from (1) extraction socket due to dental caries (2) mandibular recipient site (3) patient younger than 40 years old. Autotransplantation of third molar to replace molars with advanced periodontal disease also showed considerably high success rate(84%). Conclusion: With appropriate case selection, autotransplantation of third molar with complete root formation remains a viable alternative for replacing a missing molar tooth.

Poly(alpha-hydroxy acids) 제제 생분해성 차폐막의 치주조직 재생유도능력에 관한 조직학적 장기관찰 (The long-term study on the guided tissue regeneration with poly(${\alpha}-hydroxy\;acid$} membranes in beagle dogs)

  • 류인철;구영;정종평;한수부;최상묵
    • Journal of Periodontal and Implant Science
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    • 제27권3호
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    • pp.633-645
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    • 1997
  • The recent trend of research and development on guided tissue regeneration focuses on the biodegradable membranes, which eliminate the need for subsequent surgical removal. They have demonstrated significant and equivalent clinical improvements to the ePTFE membranes. This study evaluate guided tissue regeneration wound healing in surgically induced intrabony periodontal defects following surgical treatment with a synthetic biodegradable membranes, made from a copolymer of glycolide and lactide, in 8 beagle dogs. After full thickeness flap reflection, exposed buccal bone of maxillary and mandibular canine and premolar was removed surgically mesiodistally and occlusoapically at $6mm{\times}6mm$ in size for preparation of periodontal defects. In experimental sites a customized barrier was formed and fitted to cover the defect. Flap was replaced slightly coronal to CEJ and sutured. Plaque control program was initiated and maintained until completion of the study. In 4, 8, 16 and 24 weeks after surgery, the animals were sacrificed and then undecalcified specimens were prepared for histologic evaluation. Histologic examination indicated significant periodontal regeneration characterized by new connective tissue attachment, cementum formation and bone formation. These membranes showed good biocompatibility throughout experiodontal period. The barriers had been completely resorbed with no apparent adverse effect on periodontal wound healing at 24 weeks. These results implicated that present synthetic biodegradable membrane facilitated guided tissue regeneration in periodontal defect.

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Periodontal tissue reaction to customized nano-hydroxyapatite block scaffold in one-wall intrabony defect: a histologic study in dogs

  • Lee, Jung-Seok;Park, Weon-Yeong;Cha, Jae-Kook;Jung, Ui-Won;Kim, Chang-Sung;Lee, Yong-Keun;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • 제42권2호
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    • pp.50-58
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    • 2012
  • Purpose: This study evaluated histologically the tissue responses to and the effects of a customized nano-hydroxyapatite (n-HA) block bone graft on periodontal regeneration in a one-wall periodontal-defect model. Methods: A customized block bone for filling in the standardized periodontal defect was fabricated from prefabricated n-HA powders and a polymeric sponge. Bilateral $4{\times}{\times}4{\times}5$ mm (buccolingual width${\times}$mesiodistal width${\times}$depth), one-wall, critical-size intrabony periodontal defects were surgically created at the mandibular second and fourth premolars of five Beagle dogs. In each dog, one defect was filled with block-type HA and the other served as a sham-surgery control. The animals were sacrificed following an 8-week healing interval for clinical and histological evaluations. Results: Although the sites that received an n-HA block showed minimal bone formation, the n-HA block was maintained within the defect with its original hexahedral shape. In addition, only a limited inflammatory reaction was observed at sites that received an n-HA block, which might have been due to the high stability of the customized block bone. Conclusions: In the limitation of this study, customized n-HA block could provide a space for periodontal tissue engineering, with minimal inflammation.