• 제목/요약/키워드: Maxillofacial Injuries

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백서 대퇴동맥에서의 혈관함입문합술과 혈관단단문합술의 주사전자현미경적 비교연구 (A SCANNING ELECTRON MICROSCOPIC STUDY OF END-IN-END AND END-TO-END MICROVASCULAR ANASTOMOSIS IN THE RAT FEMORAL ARTERY)

  • 김옥규;정인교
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제13권1호
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    • pp.16-29
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    • 1991
  • 미세혈관봉합술에서의 가장 큰 문제점은 봉합부에서의 내피손상과 혈전형성이라고 볼 수 있다. 이 연구의 목적은 봉합시 일어날 수 있는 내피손상부에서의 치유과정을 관찰코져 각각 다른 문합술인 혈관함입문합술과 혈관단단문합술을 백서 대퇴부동맥에 적용하여 개존율및 전자현미경적 관찰을 통하여 비교하였고 아울러 임상에의 적용 가능성을 검토코져 하였다. 저자는 미세현미경시야에서 혈관함입문합술 20례와 단단문합술 20례를 시행한후 1일, 3일, 1주, 2주, 3주에 각각 4마리씩 희생후 문합혈관부를 육안관찰후 주사전자현미경으로 조직변화를 관찰하여 다음의 결과를 얻었다. 1. 혈관 함입문합술 시술시 문합후 개존율은 90%였고 혈관 단단문합술은 85%였다. 2. 혈관 함입문합시 술후 3일째는 문합부에서의 혈소판 응집물이 기질화되었으며 함입으로 좁아져 있던 혈관내경이 약 1주째 혈관 합입부의 중막 위축현상으로 다소 넓어졌다. 3. 혈관 내피재생과정을 혈관 함입문합술에서는 7일에서 14일경에, 혈관 단단문합술에서는 14일에서 21일째 완성되었다.

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하치조 신경손상에 따른 하순 및 이부의 지각이상시 적외선 체열검사(DITI)의 진단적 효용 (DIAGNOSTIC EFFICACY OF DITI (DIGITAL INFRARED THERMOGRAPHIC IMAGING) FOR THE DYSESTHESIA OF THE LOWER LIP & CHIN)

  • 김예원;김명래
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권1호
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    • pp.53-60
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    • 2002
  • Neurosensory dysfunction of the injured inferior alveolarnerve(IAN) is a common and distrssing consequence of traumatic or iatrogenic injury. Conventional neurosensory testing has been used to detect and monitor sensory impairments of the injured IAN. However, these tests had low reliability and are not qualitative at best because they are based on solely on the patient's subjective assesment of symptoms. Consequently, there is need for more reliable, sensitive, and objective test measures to document and to monitor sensory dysfunction of the trigeminal nerve. This study was to investigate DITI's (digital infrared thermographic imaging) potential as a diagnostic alternative for evaluating of the nerve injures and sensory disturbance. Subjects were 30 patients who had been referred to Ewha Medical Center due to sensory disturbance of the lower lip and chin followed after unobserved inferior alveolar nerve injuries. The patients were examined by clinical neurosensory tests as SLTD (static light touch discrimination), MDD (moving direction discrimination), PPN (pin prick nociception) and DITI (digital infrared thermographic imaging). The correlation between clinical sensory dysfunction scores(Sum of SLTD, MDD, PPN, NP, Tinel sign) and DITI were tested by Spearman nonparametric rank correlation anaylsis & Kruskal-Wallis test, Wilcoxon 2-sample test. This study resulted in as follows; (1) The difference of thermal difference between normal side and affected side was as ${\Delta}-3.2{\pm}0.13$. (2) The DITI differences of the subjects presenting dysesthesia of the lip and chin were correlated significantly with the neurosensory dysfunction scores(r=0.419, p=0.021)and SLTD (r=0.429, p<0.05). (3) The MDD, PPN, NP, Tinel sign, duration, gender were not correlated with DITI(p> 0.05). Therefore, the DITI(digital infrared thermographic imaging) can be an option of the useful objective diagnostic methods to evaluate the injured inferior alveolar nerve and sensory dysfunction of trigerminal nerve.

Indications, Outcomes, and Complications of Pedicled Propeller Perforator Flaps for Upper Body Defects: A Systematic Review

  • Lazzeri, Davide;Huemer, Georg M.;Nicoli, Fabio;Larcher, Lorenz;Dashti, Talal;Grassetti, Luca;Li, Qingfeng;Zhang, Yixin;Spinelli, Giuseppe;Agostini, Tommaso
    • Archives of Plastic Surgery
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    • 제40권1호
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    • pp.44-50
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    • 2013
  • Background The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. Methods A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis. Results From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed. Conclusions Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.

Dental trauma trends in emergency care: a comparative analysis before, during, and after COVID-19

  • Woo-Jung Yang;Ji-Young Yoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제49권6호
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    • pp.339-346
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    • 2023
  • Objectives: This analysis details the characteristics of dental trauma in South Korea during the coronavirus disease 2019 (COVID-19) (DC) pandemic and compares them in patients before and after COVID-19 (BC and AC, respectively). Materials and Methods: Data were collected from medical records of patients who visited Seoul National University Bundang Hospital's Emergency Dental Care Center during three 12-month periods: BC, DC, and AC (BC from March 1, 2019 to February 29, 2020; DC from March 1, 2020 to February 28, 2021; AC from March 1, 2022 to February 28, 2023). A retrospective review was conducted to investigate patient age, sex, time of visit, cause, and diagnosis. The study included 1,544 patients: 660 BC, 374 DC, and 510 AC. Results: Significant difference in age and sex was not observed among the three periods; 1-9 years of age was the largest group (38.3% in BC, 29.6% in DC, and 27.8% in AC), and the percentage of male patients was greater than of female patients (male proportion as 63.5% in BC, 67.4% in DC, and 64.9% in AC). The number of patients generally peaked at a Saturday night in spring (for BC: May, Saturday, 18:00-19:59; for DC: March, Saturday, 18:00-19:59; for AC: April as the second most (October as the most peaked), Saturday, 20:00-21:59). The primary etiology of the dental trauma was identical in the three periods: falls, followed by sports. The most frequent diagnosis was laceration, followed by tooth avulsion and jaw fracture. Conclusion: Significant differences were not found between the characteristics and patterns of dental trauma in the BC, DC, and AC periods. However, due to the pandemic and social distancing, activities decreased and associated dental trauma-related incidents declined.

대구지역 안면골 골절의 임상역학적 연구 (Clinical Epidemiologic Study of Facial Bone Fractures in Daegu)

  • 권혁준;한준;김준형;정호윤;김종엽;윤신혁;송철홍;류민희;김용하;서만수
    • Archives of Plastic Surgery
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    • 제34권3호
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    • pp.365-370
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    • 2007
  • Purpose: There are many reports about facial bone fractures, but limited to retrospective data of a single hospital. Etiology and severity of the facial bone fracture have been changed and treatment method and materials have been advanced. In order to reflect those changes and provide up-to-date data of the facial bone fractures in Daegu, we gathered the data and analyzed the epidemiologic study. Methods: The medical records of 1058 fractures in 895 patients were gathered from 5 general hospitals in Daegu during last year and these data were analyzed by following parameters: age, sex, place of residence, occupation, cause of injury, time of injury, location of fracture, length of in-hospital stay, time of operation, treatment method, associated injury, complication. Statistical analysis was performed using the Chi-square test. Results: Most commonly involved age group was 20s(26%) and the sex ratio was 3.4:1(male predominance). Fractures were occurred more in unban and white-color workers. Among variable etiology of injury, traffic accident was the most common cause. Time of injury was heighest at 6 to 7 P.M., on Sunday, in July. Locations of fractures were following sequence: nasal, zygoma, mandible, orbit, maxilla. Mean length of in-hospital stay and time of operation after injury were 6.3 and 3.2 days, respectively. In treatment methods, operative methods were dominant than conservative management and general anesthesia were favored than local anesthesia. Associated injuries were noticed in 188 cases(21.2%) and complications were in 94 cases(8.9%) and among them, ocular problem were common. Conclusion: Compared to previous studies, mean age of occurrence was lowered and the etiologies showed age-specific pattern and reflected the change of lifestyle. In young age groups, sports injury, violence were more dominant and the other hand, traffic accident and fall were dominant in older groups.

Surgical Methods of Zygomaticomaxillary Complex Fracture

  • Ji, So Young;Kim, Seung Soo;Kim, Moo Hyun;Yang, Wan Suk
    • 대한두개안면성형외과학회지
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    • 제17권4호
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    • pp.206-210
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    • 2016
  • Background: Zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. Zygoma fractures are classified according to Knight and North based on the direction of anatomic displacement and the pattern created by the fracture. In zygomaticomaxillary complex (ZMC) fracture many incisions (lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary, subtarsal, intraoral, direct percutaneous approach) are useful. We reviewed various approaches for the treatment of ZMC fractures and discussed about incisions and fixation methods. Methods: A retrospective review was conducted of patients with ZMC fracture at a single institution from January 2005 to December 2014. Patients with single zygomatic arch fracture were excluded. Results: The identified 694 patients who were admitted for zygomatic fractures from which 192 patients with simple arch fractures were excluded. The remaining 502 patients consisted of 439 males and 63 females, and total 532 zygomatic bone was operated. Orbital fracture was the most common associated fracture. According to the Knight and North classification the most frequent fracture was Group IV. Most fractures were fixated at two points (73%). Conclusion: We reviewed our cases over 10 years according to fracture type and fixation methods. In conclusion, minimal incision, familiar approach and fixation methods of the surgeon are recommended.

Optimal protocol for teleconsultation with a cellular phone for dentoalveolar trauma: an in-vitro study

  • Park, Won-Se;Lee, Hae-Na;Jeong, Jin-Sun;Kwon, Jung-Hoon;Lee, Grace H.;Kim, Kee-Deog
    • Imaging Science in Dentistry
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    • 제42권2호
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    • pp.71-75
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    • 2012
  • Purpose : Dental trauma is frequently unpredictable. The initial assessment and urgent treatment are essential for dentists to save the patient's teeth. Mobile-phone-assisted teleconsultation and telediagnosis for dental trauma could be an aid when a dentist is not available. In the present in-vitro study, we evaluated the success rate and time to transfer images under various conditions. Materials and Methods : We analyzed the image quality of cameras built into mobile phones based on their resolution, autofocus, white-balance, and anti-movement functions. Results : The image quality of most built-in cameras was acceptable to perform the initial assessment, with the autofocus function being essential to obtain high-quality images. The transmission failure rate increased markedly when the image size exceeded 500 kB and the additional text messaging did not improve the success rate or the transmission time. Conclusion : Our optimal protocol could be useful for emergency programs running on the mobile phones.

유치와 영구치의 외상에 관한 연구 (A study on injuries in deciduous teeth and permanent teeth)

  • 이미라;지민경;민희홍
    • 한국치위생학회지
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    • 제11권1호
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    • pp.127-136
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    • 2011
  • Objectives : The writer aimed to examine the dynamic aspect on damage and to be conducive to the swift cure according to right treatment to educate prevention of injury through surveying on the number of the damaged teeth given injury, tooth kind, type in damage, place and cause for being damaged, frequency by month and by time level, and location of the damaged tooth. Methods : Targeting 343 teeth of receiving injury in 201 patients who visited the department of pediatric dentistry, the department of preservation, and the oral and maxillofacial surgery in a dental hospital in Cheonan city from April 2007 to April 2009, by having the dental injury as the main reason, the following conclusions were obtained. Results : 1. Deciduous teeth were indicated to be the highest in imperfect luxation with 60.7%, and were indicated to be in order of crown fracture with 25.5%, root fracture with 12.4%, and perfect luxation with 1.4%. The permanent teeth were indicated to be the highest in crown with 58.1%, and were indicated to be in order of imperfect luxation with 27.3%, root fracture with 13.1%, and perfect luxation with 1.5%(p<0.001). 2. In case of deciduous teeth for a place with damage, the home was indicated to be the highest with 31.7%. The permanent teeth were indicated to be the highest(p<0.001) in the road and stairs with 40.4%. As to a cause for damage, both deciduous and permanent teeth were indicated to be the highest(p<0.001) in a cause for falling with 53.1% and 30.8%, respectively. 3. As for a treatment method, in case of deciduous teeth, the close observation was indicated to be the highest with 46.9%. In permanent teeth, the resin restoration was indicated to be the highest(p<0.001) with 22.2%. Dental injuries in deciduous teeth and permanent teeth are showing diverse aspects. Conclusions : It is important to arrange guidelines on cure of the damaged teeth by injury through continuing a dynamic research on these aspects. Also, the damage in deciduous teeth may have direct and indirect influence upon growth in successional permanent teeth. Thus, through careful treatment, the injury needs to be minimized. It is considered to be likely necessary for a right coping method when injury occurs, and above all, for enough prior education so that injury cannot occur.

치료법을 달리한 상악골절후 부정유합 2예 (THE CARE OF DELAYED MALUNION AFTER MAXILLARY FRACTURE BY DIFFERENT METHODS:REPORT OF THREE CASES)

  • 유재하;이원유;류수장
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제13권1호
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    • pp.117-127
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    • 1991
  • 현대 사회에서 외상의 특성은 다발성 손상이 빈발하는 것이며 상악골절시 생명을 위협하는 다발성 전신손상이 동반되면 수술이 지연되어 골절부의 지연된 부정유합을 보일 수 있다. 또한 골절된 양상에 따라서는 관혈적 정복술의 적용여부가 고려되는데 특히 골절편의 분쇄가 심하면 수술시 골절부위의 이개 후 정상위치로의 이동이 어렵고 설사 골절편의 이동이 이루어졌다고 하여도 정상위치로의 고정이 용이하지 않을 뿐만 아니라 분쇄골절편의 상실량이 많아지면 골이식까지 시행해야 하는 등 외과적이술식의 적용에 많은 난관이 예상된다. 따라서 상악골절 후 통상 6주일 간의 시간경과가 없다면 오히려 상악골절편의 이동방향을 예측하여, 전방견인용 headgear 또는 headcap 을 사용한 교정적인 치료를 시도함이 바람직할 수도 있다. 더우기 reverse headgear를 이용한 치료법은 골절된 경우가 아니더라도 상악골의 전방이동에 유용함이 실험적으로나 임상적으로 입증된 만큼 이를 상악골절후 후퇴된 상악골의 전방견인에 적용할 경우 교정치료의 최대장애인 cortical bone의 연속성이 골절로 인해 끊어지고 섬유성 유착상태로 남게되어 교정력의 효과가 치아이동 뿐만 아니라 골편의 이동에 매우 유익하리라 사료된다. 이에 저자는 상악골적이 분쇄양상인 한 환자에서 headgear와 headcap을 이용한 교정치료법을 5개월간 적용해 양호한 결과를 얻었고, 골절양상이 분쇄형이 아닌 증례에서는 외상후 5주간 경과 되었지만 관혈적 정복술을 시행하여 정상교합을 회복했으며, 심한 두부 손상으로 6개월만에 의식 회복을 한 LeFort I, II, III, 환자에서는 두부방사선 계측학적 분석, 교합기 상에서의 모형분석, 전산화 단층촬영 검사 등을 시행한 후 새로운 골면에다 LeFort I -osteotomy with iliac bone graft를 시행해 정상교합 및 안모추형을 개선시켰기에 이를 보고한다.

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한국인 악안면 기형환자의 하악골 상행지에 관한 해부학적 연구 (AN ANATOMICAL STUDY OF THE MANDIBULAR RAMUS IN KOREAN PATIENTS WITH DENTOFACIAL DEFORMITY)

  • 김기정;이의웅
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제27권3호
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    • pp.193-203
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    • 2001
  • Orthognathic surgery of the mandibular prognathism and the retrognathism is tend to be performed on the mandibular ramus to prevent inferor alveolar nerve injuries. The purpose of this study is to find a safe and accurate reference point on mandibular ramus for orthognathic surgery by comparative anatomical study of dentofacial deformity patients. We use 38 Korean Cadavers with normal occlusion(Group 1), 3-dimensional simulation of computerized tomogram of 23 patients with retrognathism (Group 2), 27 patients with mandibular prognathism (Group 3). Following results are obtained : 1. The maximum thickness of the mandibular ramus is $8.78{\pm}1.15mm$ for Group 2, $7.61{\pm}1.26mm$ for Group 1, $6.95{\pm}0.82mm$ for Group3 respectively (P=0001). The minimum thickness is $5.51{\pm}1.08mm$ for Group 1, $5.06{\pm}0.40mm$ for Group 2, $4.56{\pm}0.78mm$ for Group3, respectively (p=0.0001). But, the thickness at the level of 5mm above the lingular is $0.78{\pm}0.65mm$ for Group 2, $5.63{\pm}1.28mm$ for Group 1, $5.32{\pm}0.91mm$ for Group 3, respectively. There is no significant difference between these groups(P=0.0510). 2. The horizontal location from the midwaist point to lingular is $0.18{\pm}1.57mm$ for Group 1, $0.69{\pm}1.33mm$ for Group 2, $0.66{\pm}1.66mm$ for Group 3, and there is no significant difference between these groups(p=0.0835). But the vertical location from the midwaist point to lingular is $1.45{\pm}2.64mm$ for Group 1, $0.63{\pm}1.44mm$ for Group 2, $0.34{\pm}1.81mm$ for Group 3, and there is significant difference between these groups(p=0.0030). 3. The horizontal location from the midwaist point to mandibular foramen is $0.29{\pm}1.75mm$ for Group 1, $0.63{\pm}1.44mm$ for Group 2, $0.34{\pm}1.81mm$ for Group 3, and there is no significant difference between these groups(p=0.5403). But the vertical location from the midwaist point to mandibular foramen is $-3.33{\pm}4.43mm$ for Group1, $-4.79{\pm}2.26mm$ for Group 2, $-6.06{\pm}2.99mm$ for Group 3, and there is significant difference between these groups(P=0.0001). 4. The horizontal length from the disto-buccal cusp tip of mandibular second molar to lingula is $30.97{\pm}4.17mm$ for Group 3, $28.29{\pm}2.65mm$ for Group 1, $25.48{\pm}0.77mm$ for Group 2 (p=0.0000), and also vertical length is $7.72{\pm}3.22mm$ for Group 3, $6.38{\pm}1.83mm$ for Group 1, $5.89{\pm}2.30mm$ for Group 2 (P=0.0014). 5. The location of lingular is 0.50 from anterior border of mandibular ramus in all groups, if it assumed the length from anterior border to posterior border is 1. And it is almost 0.33 from the sigmoid notch, if it assumed the length from sigmoid notch to antegonial notch is 1. 6. In Group 1, Antilingular prominence is located on ($1.12{\pm}1.43mm,\;4.01{\pm}2.36mm$) from the midwaist point, and there is no correlation between antilingular prominence and lingular, mandibular foramen.

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