• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권6호
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• pp.509-512
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• 2007

Purpose: The Le Fort I osteotomy is a commonly performed maxillary procedure for dentofacial deformity. One of the risks of this procedure is major hemorrhage resulting from injury to the descending palatine artery. So it is very important to know the exact position of the descending platine artery. An increased understanding of the position of this artery can minimize the intra-operative bleeding while allowing extension of the bone cuts to achieve exact positioning maxilla. The aim of this investigation was to study the position of the descending palatine artery as it relates to the Le Fort I osteotomy. Methods and patients: Total 40 patients who underwent Le Fort I osteotomy in SNUDH OMFS were studied in this study. We measured the distance from the pyriform aperture to the descending palatine artery (DPA distance) using a ruler. We investigated the relationship between DPA distance, the distance from A point to the McNamara line on lateral cephalography and the patient's body height. Results: The average distances from the pyriform rim to the descending palatine artery were 35.3 mm on the right (range: $30{\sim}40mm$) and 33.7mm (range: $30{\sim}41mm$) on the left in males. Those in females were 33.4 mm on the right (range: $28{\sim}40mm)$ and 32.8mm (range: $27{\sim}38mm$) on the left. The significances between the distance the DPA distance, the body height and the distance from A point to McNamara line were not found. Conclusion: Injury to the descending palatine artery during Le Fort I osteotomy can be minimized by not extending the osteotomy more than 30 mm posterior to the pyriform aperture in mal, and 27 mm in female.

• 대한간호학회지
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• 제26권3호
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• pp.688-696
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• 1996

The purpose of this study was to investigate the fluid balance of the patients who were either on soft fluid diet or total parenteral nutrition. We studied 19 patients with neurologic disorders and 22 patients with oromaxillary surgery who were admitted to either D university hospital in Choognam or S general hospital in Seoul between May and November 1995. The mean age for the patients who had oromaxillary surgery was 24 years and their average hospital stay was 9 days. The mean age of the patients with neurologic disorders was 54 years and they were bedridden for average of 71 days. For the maxillary bone surgery patients we did not limit the range of their activities in the ward during data collection period. The patients with neurological disorders were bedridden and did not move around the ward. They were all either on soft fluid diet, or total parenteral nutrition. The findings of this study are as follows ; 1) The difference of the triceps skinfold thickness between the baseline and the final measurement was 0.4cm for neurologic patient group and 0.5cm for oromaxillary surgery patient group. The difference was not statistically significant in each group. 2) In the oromaxillary surgery patient group, the daily intake of fluid in the form of pure water, other beverages, fluid diet as well as IV fluid was 4581m1 while urine output was 2979ml. The difference between fluid intake and output was statistically significant, indicating that fluid intake was far more than urine output. In neurologic patient group, the daily intake of fluid including water from fluid diet and IV fluid was 2701m1 whereas urine output was 2253m1 and they were statistically significant. 3) For a more accurate assessment we adjusted the fluid balance based on weight changes during data collection period. In the oromaxillary surgery patient group. the difference between fluid intake and output was 1238m1 after weight changes being adjusted. The difference was statistically significant, suggesting fluid overload in this patient group. In neurologic patient group, the difference between fluid intake and output considering weight changes was 124ml. The difference was not statistically significant, suggesting that the fluid intake and output was well balanced in this patient group.

• Imaging Science in Dentistry
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• 제33권2호
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• pp.79-83
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• 2003

Purpose : To assess the relationship between the direction of the indicating rod of the radiographic stent for ideal prosthetic design and the actual possible path of implant fixture placement when residual ridge resorption is considered. Materials and Methods: The study materials consisted of 326 implant sites (male 214 cases and female 112 cases) from a total of 106 patients (male 65 patients and female 41 patients) who desired implant prostheses. Computed tomography of patients were taken and reformatted using ToothPix/sup (R)/ software. Bony defects, bony sclerosis, the change of the direction of indicating rod, and root proximity of the adjacent teeth were examined on the CT-derived images. Results: The rate of the irregular crestal cortex was relatively high on premolar and molar area of maxilla. Mandibular molar area showed relatively high rate of focal sclerosis on the area of implant fixture insertion. The position of the indicating rods were relatively acceptable on the molar areas of both jaws. However, the position of the indicating rods should be shifted to buccal side with lingual rotation of the apical end on maxillary anterior teeth and premolar area. Conclusion: Clinically determined rod direction and position of the indicating rod for implant placement was not always acceptable for insertion according to the reformatted CT images. The pre-operative treatment plan for implant should be determined carefully, considering the state of the alveolar bone using the reformatted CT images.

• 대한소아치과학회지
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• 제30권4호
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• pp.576-580
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• 2003

7세 남아가 맹출 중인 상악 영구 중절치의 외상을 주소로 내원하였다. 환아의 우측 중절치는 아탈구와 치근 파절을 보였고, 좌측 중절치는 함입성 탈구와 치근 파절을 보였다. 두 치아는 정복 후 선부자에 의해 고정하였다. 이후 주기적인 검진을 시행하였다. 4년이 지난 현재, 우측 중절치는 방사선 사진에서 파절편 사이에 방사선 투과성이 보이지 않고 정상적인 치조백선을 보여 경조직으로 치유되는 양상을 보였다. 좌측 중절치는 파절편이 분리되어있고 근관이 점차 폐쇄되는 소견을 보이고 있어 골과 결합조직의 개입에 의한 치유 양상을 보이고 있다. 임상 검사에서 정상적인 동요도와 타진 반응을 보였고, 전기치수검사에 양성 반응을 보였다. 외상을 받은 치아의 예후는 외상의 유형, 환자의 연령, 치근의 발육단계, 변위의 정도 등에 의해 영향을 받는다. 본 증례는 개방근관을 가진 치아가 외상 후 우측 중절치는 석회화 조직으로 치유, 좌측 중절치는 골과 결합조직의 개입으로 치유되고 있는 양상을 보이고 있어 이를 보고하는 바이다.

• Restorative Dentistry and Endodontics
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• 제24권2호
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• pp.372-380
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• 1999

The purpose of this study was to investigate the distribution of calcitonin gene-related peptide(CGRP) containing nerve fivers after pulp exposure in rats. The Spague-Dawley rats weighing about 250 - 300g were used. The animals were devided into normal control group and experimental groups. Experimental animals were sacrified on 2, 4, 7, 10 days after pulp exposure. The maxillary teeth and alveolar bone were removed and immersed in the 4% paraformaldehyde plus 0.1M phosphate buffer (pH 7.4). Serial frozen $50{\mu}m$ thick sections were cut with a cryostat. In the immunohistochemical staining procedure, the rabbit CGRP antibody was used as a primary antibody. The sections were incubated for 48 hours at $4^{\circ}C$, and placed into biotinylated anti-rabbit IgG as a secondary antibody and incubated in ABC (avidin-biotin complex), The sections were visualized by 0.05% 3.3 diaminobenzidine tetrahydrochloride. The results of this study were as follows: 1. In control group, CGRP containing nerve fibers ran parallel to the long axis of root and reached the coronal pulp. They were distributed on Raschkow plexus under the odontoblastic layer. 2. In 2 day group after pulp exposure, tissue necrosis and acute inflammation occurred and CGRP containing nerve fibers increased. In 4 day group, the necrotic tissue extended to the pulp and CGRP containing nerve fibers were distributed around the inflammation zone. 3. In 7 day group after pulp exposure, pulp necrosis occurred, and in 10 day group, the abscess under the necrotic pulp extended to the root apex area and CGRP containing nerve fibers were not observed in root canals. 4.The sprouting of CGRP nerve fibers was most remarkable at the pulp chamber under injury in 4 day group, and it was found at inflammation zone under the necrotic tissue in 7 day group and the remaining root pulp tissue in 10 day group. As mentioned above, CGRP nerve fibers had a tendency to increase around the inflammatory zone, especially around the acute inflammation tissue, when compared with control group. It is suggested that CGRP nerve fibers maybe related to the control of inflammatory response of pulp tissue.

• Restorative Dentistry and Endodontics
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• 제20권2호
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• pp.432-461
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• 1995

The basic principles in the design of Class II amalgam cavity preparations have been modified but not changed in essence over the last 90 years. The early essential principle was "extension for prevention". Most of the modifications have served to reduce the extent of preparation and, thus, increase the conservation of sound tooth structure. A more recent concept relating to conservative Class II cavity preparations involves elimination of occlusal preparation if no carious lesion exists in this area. To evaluate the ideal ClassII cavity preparation design, if carious lesion exists only in the interproximal area, three cavity design conditions were studied: Rodda's conventional cavity, simple proximal box cavity and proximal box cavity with retention grooves. In this study, MO amalgam cavity was prepared on maxillary first premolar. Three dimensional finite element models were made by serial photographic method. Linear, eight and six-nodal, isoparametric brick elements were used for the three dimensional finite element model. The periodontal ligament and alveolar bone surrounding the tooth were excluded in these models. Three types model(B option, Gap option and R option model) were developed. B option model was assumed perfect bonding between the restoration and cavty wall. Gap option model(Gap distance: $2{\mu}m$) was assumed the possibility of play at the interface simulated the lack of real bonding between the amalgam and cavity wall (enamel and dentin). R option model was assumed non-connection between the restoration and cavty wall. A load of 500N was applied vertically at the first node from the lingual slope of the buccal cusp tip. This study analysed the displacement, 1 and 2 direction normal stress and strain with FEM software ABAQUS Version 5.2 and hardware IRIS 4D/310 VGX Work-station. The results were as followed. 1. Rodda's cavity form model showed greater amount of displacement with other two models. 2. The stress and strain were increased on the distal marginal ridge and buccopulpal line angle in Rodda's cavity form model. 3. The stress and strain were increased on the central groove and a part of distal marginal ridge in simple proximal box model and proximal box model with retention grooves. 4. With Gap option, Rodda's cavity form model showed the greatest amount of the stress on distal marginal ridge followed by proximal box model with retention grooves and simple proximal box model in descending order. 5. With Gap option, simple proximal box model showed greater amount of stress on the central groove with proximal box model with retention grooves. 6. Retention grooves in the proximal box played the role of supporting the restorations opposing to loads.

• 대한치과보철학회지
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• 제57권4호
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• pp.448-455
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• 2019

법랑모세포종은 치성 상피성 양성 종양으로 재발률이 높아 주변 조직의 광범위한 절제 및 결손부의 재건을 필요로 한다. 술 후 치아 결손 부위의 보철치료 시에 재건 부위의 해부학적 한계로 인해 임플란트 식립을 동반한 보철 치료가 추천된다. 본 증례에서는 법랑모세포종으로 인해 하악골 분절 절제술 및 장골을 이용한 하악골 재건술을 시행한 환자에서 재건 부위 상실치를 임플란트 고정성 보철물로 수복하였고 임플란트 보철물을 장착 완료 한 14개월 뒤 원인 미상의 인접치 정출로 인해 임플란트를 포함한 전방부 치아에서 1 mm 가량의 개방 교합이 발생하였다. 성인에서 상악 전치부 임플란트 식립 후 잔존 성장으로 인해 임플란트 저위 교합이 발생하는 경우는 보고된 바 있으나 본 증례는 구치부에서 인접한 자연치의 정출로 인해 임플란트 보철물을 포함한 전방 치열의 개방 교합이 발생한 것으로 그 유사 보고가 흔하지 않다. 이에 정출된 치아를 압하 하는 교정 치료를 동반한 전체 치료 과정을 보고하고 원인 미상의 자연치 정출이 발생한 원인에 대해 고찰해보고자 한다.

• 대한소아치과학회지
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• 제48권3호
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• pp.291-301
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• 2021

이 연구의 목적은 발거 된 매복 상악 과잉치에서 얻은 치수유래 줄기세포의 초기 계대와 후기 계대의 상아질모세포 유전자의 특성을 알아보는 것이다. 전신 의과 병력이 없는 6 - 9세 사이의 남녀아이 12명에게서 서면동의를 얻고 모두 상악에 위치한 과잉치를 발거하여 당일 발거된 과잉치의 치수세포를 채취하였다. 12개의 세포를 각각 3계대와 10계대에서 골형성 유도 분화제를 처리한 군과 처리하지 않은 군을 나누어 실시간 중합효소 연쇄반응을 시행하여 상아질모세포의 특성을 알아보았다. 사용된 유전자는 osteonectin (ONT), alkaline phosphatase (ALP), osteocalcin (OCN), dentin matrix protein 1 (DMP-1), 그리고 dentin sialophosphoprotein (DSPP)였다. 유전자 발현양은, 분화제를 처리하지 않은 군 3계대에서는 ONT, ALP, OCN, DMP-1, DSPP순서로 많이 발현하였다. 분화제를 처리하지 않은 군 10계대에서는 ONT, DMP-1, OCN, ALP, DSPP순으로 ONT, OCN, DSPP의 순서에는 변화가 없지만 ALP, DMP-1의 순서는 서로 바뀌었다. 이상의 결과를 종합해 볼 때, ALP와 DMP-1은 3계대와 10계대 세포의 분화를 위한 중요한 표지자로 사용될 수 있다. 과잉치 치수유래 줄기세포는 상아질모세포의 특성을 가지며, 또한 과잉치가 어린 나이에 발거되고 10계대까지 소요되는 시간이 적게 걸린다는 것을 고려하면, 과잉치는 치아 유래 줄기세포의 공여부로서 훌륭한 활용가능성이 있음을 확인하였다.

• 구강회복응용과학지
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• 제34권4호
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• pp.324-330
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• 2018

심하게 흡수된 치조제에서 안정적으로 유지될 수 있는 의치를 제작하기 위해서는 적절한 교합의 형성뿐만 아니라 주변근육 조직과의 조화를 고려한 적절한 연마면의 형성에 대한 고려가 필요하다. 중립대 인상 기법을 통해 기능하는 동안 혀, 볼, 입술에 대한 근신경계가 평형을 이루는 잠재적인 영역을 고려하여 인공치아를 배열하고, 연마면 형태가 동적인 근육의 해부학적 형태를 따르도록 할 수 있으며, 이는 의치의 안정과 유지 및 심미성을 향상시킬 수 있다. 본 증례는 심한 잔존 치조제의 흡수를 보이는 환자에게 중립대 개념을 적용하여 기능과 심미적인 측면에서 임상적으로 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

• 대한치과보철학회지
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• 제60권2호
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• pp.160-167
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• 2022

잔존골 흡수가 진행된 상악 무치악 환자의 수복 계획시 전통적인 총의치로의 치료보다는 임플란트를 식립 한 뒤 milled bar와 가철성 보철물을 제작하여 attachment로 연결하는 임플란트 피개의치를 우선적으로 고려할 수 있다. Milled bar와 attachment를 사용하면 상악 의치의 유지력 및 안정성의 증가뿐만 아니라 구개 피개 부위를 일부 감소시킬 수 있어 환자의 불편감을 줄여줄 수 있다는 장점이 있다. 또한 소수의 임플란트를 식립 할 경우 상부 보철물을 milled bar로 제작하면 임플란트 고정체 간에 연결고정되는 효과가 있어 저작과 같은 기능 하에서 역학적으로 유리해진다. 본 증례의 환자는 기존의 실패한 임플란트를 제거한 뒤 잔존 치조골이 상당량 소실된 상악 무치악 환자로 양측에 각 3개의 임플란트를 식립한 후 milled bar와 ADD-TOC attachment를 사용하여 임플란트 피개의치를 제작하였다. Attachment 장착을 통해 얻어진 부가적인 유지력을 바탕으로 구개부 피개량 감소하여 총의치 제작 가능하였고 이렇게 milled bar와 attachment를 병용하여 충분한 유지력 뿐만아니라 지지 및 안정을 얻음으로써 심미성 및 기능성 모두에서 만족할 만한 결과를 얻었기에 보고하는 바이다.