• 대한치과교정학회지
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• 제42권3호
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• pp.100-109
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• 2012

Objective: A national survey was conducted to assess orthodontic residents' current concepts and knowledge of cleft lip and palate (CLP) management in Korea. Methods: A questionnaire consisting of 7 categories and 36 question items was distributed to 16 senior chief residents of orthodontic department at 11 dental university hospitals and 5 medical university hospitals in Korea. All respondents completed the questionnaires and returned them. Results: All of the respondents reported that they belonged to an interdisciplinary team. Nineteen percent indicated that they use presurgical infant orthopedic (PSIO) appliances. The percentage of respondents who reported they were 'unsure' about the methods about for cleft repair operation method was relatively high. Eighty-six percent reported that the orthodontic treatment was started at the deciduous or mixed dentition. Various answers were given regarding the amount of maxillary expansion for alveolar bone graft and the estimates of spontaneous or forced eruption of the upper canine. Sixty-seven percent reported use of a rapid maxillary expansion appliance as an anchorage device for maxillary protraction with a facemask. There was consensus among respondents regarding daily wearing time, duration of treatment, and amount of orthopedic force. Various estimates were given for the relapse percentage after maxillary advancement distraction osteogenesis (MADO). Most respondents did not have sufficient experience with MADO. Conclusions: These findings suggest that education about the concepts and methods of PSIO and surgical repair, consensus regarding orthodontic management protocols, and additional MADO experience are needed in order to improve the quality of CLP management in Korean orthodontic residents.

• 대한구순구개열학회지
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• 제15권2호
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• pp.69-82
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• 2012

Our Team Approach consists of following five stages; (1) Peri-natal care until lip repair After ultrasound diagnosis, some obstetricians recommend the mother with CL/P fetus to undergo prenatal counseling in our CLP clinic. On the day the CL/P baby was born, our oral surgeon, nurse, and pedodontist visit the maternity clinic, and take counseling and take impression for a feeding plate. The cheiloplasty is performed in three months old. (2) From lip repair to palatal repair At one year of age, Otorhinolaryngologist checks middle-ear disease. Palatoplasty is carried out at 1.5 - 2 years old. (3) In deciduous and early mixed dentitions Speech is the most important issue in social life for the CL/P subjects, therefore the training of velopharyngeal function is essential. Orthodontist monitors dentofacial development from 5 years of age. In the case of severe maxillary under-growth or severe collapse, maxillary protractor or lateral expansion is indicative, respectively. In early mixed dentition, upper central incisor on the cleft area erupts with some torsion, and then the traumatic occlusion with tooth torsion must be corrected. (4) In mixed dentition Right before the eruption of upper canines, secondary bone grafting is performed. One year prior to the operation, maxillary fan-type expansion is carried out to correct the collapse of maxillary segments. Following the surgical operation, the erupted canine will be moved into the transplanted bone to avoid alveolar resorption. (5) In permanent dentition Final tooth alignment is carried out after eruption of second molars. Some cases may require orthognathic surgery after physical maturation. Prosthetic oral rehabilitation including the dental-implant is carried out after age eighteen.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.204-213
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• 2016

Syndromic craniosynostosis has severe cranial stenosis and deformity, combined with hypoplastic maxillary bone and other developmental skeletal lesions. Among these various lesions, upper air way obstruction by hypoplastic maxillary bone could be the first life-threatening condition after birth. Aggressive cranial vault expansion for severely deformed cranial vaults due to multiple synostoses is necessary even in infancy, to normalize the intracranial pressure. Fronto-orbital advancement (FOA) is recommended for patients with hypoplastic anterior part of cranium induced by bicoronal and/or metopic synostoses, and posterior cranial vault expansion is recommended for those with flattening of the posterior part of the cranium by lambdoid synostosis. Although sufficient spontaneous reshaping of the cranium can be expected by expansive cranioplasty, keeping the cranial bone flap expanded sufficiently is often difficult when the initial expansion is performed during infancy. So far distraction osteogenesis (DO) is the only method to make it possible and to provide low rates of re-expansion of the cranial vault. DO is quite beneficial for both FOA and posterior cranial vault expansion, compared with the conventional methods. Associated hydrocephalus and chronic tonsillar herniation due to lambdoid synostosis can be surgically treatable. Abnormal venous drainages from the intracranial space and air way obstruction should be always considered at any surgical procedures. Neurosurgeons have to know well about the managements not only of the deformed cranial vault and the associated brain lesions but also of other multiple skeletal lesions associated with syndromic craniosynostosis, to improve treatment outcome.

• 대한치과교정학회지
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• 제50권5호
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• pp.304-313
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• 2020

Objective: The aim of this study was to evaluate the stability of bimaxillary surgery involving bilateral intraoral vertical ramus osteotomy performed with or without presurgical miniscrew-assisted rapid palatal expansion (MARPE) in adult patients with skeletal Class III malocclusion. Methods: A total of 40 adult patients with skeletal Class III malocclusion were retrospectively divided into two groups (n = 20 each) according to the use of MARPE for the correction of transverse maxillomandibular discrepancy during presurgical orthodontic treatment. Serial lateral cephalograms and dental casts were analyzed until 6 months after surgery. Results: Before presurgical orthodontic treatment, there was no significant differences in terms of sex and age between groups. However, the difference of approximately 3.1 mm in the maxillomandibular intermolar width was statistically significant (p < 0.001). Two days after surgery, the mandible had moved backward and upward without any significant intergroup difference. Six months after surgery, the maxillary intercanine (2.7 ± 2.1 mm), interpremolar (3.6 ± 2.4 mm), and intermolar (2.0 ± 1.3 mm) arch widths were significantly increased (p < 0.001) relative to the values before presurgical orthodontic treatment in the MARPE group; these widths were maintained or decreased in the control group. However, there was no significant difference in surgical changes and the postsurgical stability between the two groups. No significant correlations existed between the amount of maxillary expansion and postsurgical mandibular movement. Conclusions: MARPE is useful for stable and nonsurgical expansion of the maxilla in adult patients with skeletal Class III malocclusion who are scheduled for bimaxillary surgery.

• 대한치과교정학회지
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• 제52권6호
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• pp.399-411
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• 2022

Objective: The objective of this randomized clinical trial was to study the skeletal and dental effects of low-level laser therapy (LLLT) along with a miniscrew-assisted expander (Hyrax) after six months of retention. Methods: After sequence generation, concealed allocation, and implementation, 24 female patients were randomly divided (1:1) into two-groups: bone-borne rapid palatal expansion (BBE) without LLLT (n = 12) and BBE with LLLT (n = 12). Eligibility criteria included female patients aged 10-13 years old with bilateral posterior crossbites. Intraoral and extraoral photographs, cone-beam computed tomography images, and digital study models were obtained before expansion and six months after retention. The 7 mm Hyrax appliance was anchored to four palatal mini-screws, which were activated twice daily for 15 days, then locked and kept in place as a retainer. LLLT was performed in the laser group during expansion and retention, according to the guidelines provided. Results: The records of 24 patients were analyzed. According to the post-retention measurements, both groups showed a significant increase in nasal and maxillary widths and total facial height. In the laser group, the Sella-Nasion-Point A and Point A-Nasion-Point B angles and the interpremolar apical distance were significantly increased. Conclusions: Within the limitations of this study, the results suggest that the parameters and protocol of LLLT do not clinically affect the efficiency of BBE in prepubertal and pubertal patients.

• 대한치과교정학회지
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• 제27권1호
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• pp.55-63
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• 1997

치열궁의 크기와 폭경 변화에 대한 연구가 사용된 장치 형태, 사용시기에따라, 그리고 사용 목적에 따라 다양한 연구가 활발히 이루어져 왔다. 또한 Quad-helix도 선학들에게 관심의 대상이었으며 Quad-helix의 안정성과 장치 사용 전, 후에 대한 효과도 연구가 이루어졌다. 그러나 장치 사용에 대한 장기적인 효과에 대한 연구가 미흡하여 본 논문은 이 장치를 사용하여 치료한 환자의 치료전,후 및 보정후의 치열궁 변화에 대한 연구를 시행하여 Quad-helix사용 전, 후 구치부의 적응 양상을 연구함으로써 임상에서 Quad-helix를 통한 치료를 시행할 때 이 장치사용에 따른 효과 및 예후에 대하여 효과를 이해함으로써 교정치료에 도움을 주고자 연구를 시행하여 다음과 같은 결과를 얻었다. 1. Quadhelix를 사용한 교정치료시 상악 제 1 소구치 와 제 1 대구치는 치료전과 치료후 및 보정후에서 교두간 폭경의 증가를 보였고 제 2 소구치에서는 치료후와 보정후간에 유의성있는 증가를 보였다. 2. 상악 제 1 소구치와 제 1 대구치의 치축은 치료전과 치료후 그리고 보정후에서 협측 경사도가 유의하게 증가를 보였으며, 상악 제 2 소구치는 치료전과 치료후 및 치료전과 보정후 비교에서 설측 경사도가 유의하게 증가를 보였다. 3. 최대 풍융부 항목에서 상악 제 1, 2소구치는 치료전과 치료후의 비교에서 유의한 증가를, 제 1 대구치에서는 치료전,후, 및 보정후에 유의한 증가를 보였다. 4. 상악 제 1 대구치의 설면구 폭경은 치료전,후 및 보정기간을 통하여 유의한 증가를 보였고,구개 높이는 치료전과 치료후 비교시 유의한 증가를 보였다. 5. 확장시킨 상악 치열궁은 회귀현상을 보이지 않고 안정적으로 유지되었다.

• 대한치과의사협회지
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• 제21권12호통권175호
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• pp.991-995
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• 1983

A radicular cyst is a slowly-growing epithelial sac lining a pathologic cavity in the bone at the apex of a tooth. Large radicular cyst revealed by radiographic examination almost always appear to involved several teeth. The author observed a 31 year old woman with a labial swelling and palatal mucosal expansion of the maxillary anterior region. Radiographic examination indicated that the lesion extended from the left maxillary lateral incisor to the right lateral incisor. Cyst consisted of tan to gray yellow slightly firm to partly hard plaque like tissue measuring 3.4 x 2.2 x 0.3㎝. The author has treated the cyst by means of enucleation with apicoecomies of the involved teeth except the right central incisor. Recovery proceed satisfactorily and there were no clinical or radiologic signs of recurrence 8 months later.

• 대한치과교정학회지
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• 제12권2호
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• pp.109-117
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• 1982

The author has observed the gross reactions of surrounding maxillary sutures to the widening of midpalatal suture in comparison of young dog with adult dog. Experimental animals used was two young dog and two adult dog with normal palate. After midpalatal suture was seperated with rapid palatal expansion device, experimental animals were sacrificed to observe the surrounding maxillary sutures. The following results were obtained. 1. In adult dog, nasoincisive suture was not expanded, while in young dog it was expanded. 2. In adult dog, pterygopalatine suture was hardly expanded, while in young dog it was expanded definitely. 3. In adult dog, frontomaxillary suture was not expanded, while in young dog it was expanded unilaterally. 4. In adult dog, palatoethmoidal suture was not expanded, while in young dog it was expanded unilateraily.

• 치과방사선
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• 제25권1호
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• pp.151-157
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• 1995

Desmoplastic variant of ameloblastoma is a new and unusual variant of ameloblastoma with extensive stromal desmoplastic proliferation. The authors experienced a case of desmoplastic variant of ameloblastoma with moderate-defined radiolucency on the right maxillary anterior area in 62-year-old female. As a result of careful analysis of clinical, radiological, histopathological examinations, we diagnosed it as desmoplastic variant of ameloblastoma, and the following results were obtained : 1. Main clinical symptoms were nontender bony swelling with normal intact overlying mucosa on the right maxillary anterior area. 2. Radiographically, moderate-defined, multilocular radiolucency on the right maxillary anterior area were shown, and severe cortical bony thinning and expansion to labial and palatal sides were also observed. And this lesion was shown to be extended to the right nasal cavity. 3. Histopathologically, follicle-like epithelial islands with densely abundant collagenous stroma were morphologically compressed.

• 대한치과교정학회지
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• 제52권5호
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• pp.372-382
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• 2022

Anterior open bite and transverse discrepancy are often accompanied by hyperdivergent skeletal patterns. In addition, degenerative joint disorders and vertical maxillary excess contribute to an unfavorable convex facial profile with a retruded chin. Correction of this complex three-dimensional problem with orthodontic treatment alone is considered challenging owing to anatomical limitations. Moreover, a history of orthodontic treatment with premolar extraction makes retreatment difficult. This case report illustrates the application of a maxillary tissue bone-borne expander and biocreative reverse curve system in a 23-year-old female patient with a severe anterior open bite and transverse discrepancy who underwent orthodontic treatment with four premolar extractions. By setting the treatment target under precise diagnosis and using appropriate appliances, a satisfactory treatment result could be achieved without orthognathic surgery.