• Korean Journal of Cleft Lip And Palate
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• v.8 no.1
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• pp.31-37
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• 2005

In alveolar deformity of cleft patient, the flap design is very important to make the functional and esthetic outcome. Especially in bilateral cleft alveolus with wide defect, deficiency of covering tissue is a greatest problem. Wound dehiscence may develop oronasal fistula of palatal and labial region and loss of the bone graft. We report 2 cases with bilateral cleft alveolus. In both case, bilateral buccal mucosal flap was used for closure of bilateral cleft alveolus with wide defect. The one was operated with iliac bone graft according to secondary grafting method, the other was closed without bone grafting. The patient was 3 years old. So, secondary alveolar bone graft will be required some years later for the establishment of bony continuity and esthetic advantage. In both cases, we found the entire soft tissue closure without the lack of covering flap. In these case, the closure of alveolus defect was accomplished successfully by the use of bilateral buccal mucosal flap. There was no complication, secondary fistula. The most important thing is the tension-free closure of the bilateral buccal mucosal flap. So, we report these cases with literatures.

• Korean Journal of Cleft Lip And Palate
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• v.8 no.1
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• pp.11-22
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• 2005

There ate anteroposterior$\cdot$vertical maxillary underdevelopment, transverse maxillary deficiency and wide cleft alveolus$\cdot$oroanual fistula among cleft lip ant palate related maxillary deformities. For treatment of these deformities, ones have used conventional treatment methods, there were often unsatisfactory results to patients and operators both. Since llizarov introduced effective technique of bone lengthening and augmentation for a variety of limb defotmities, application of distraction osteogenesis on maxillofacial area has been used to solve those disadvantages of conventional methods. Authors introduced following three cases about use of distraction osteogenesis. The first case is the application of RED(rigid external distraction) II system for the treatment of the anteroposterior$\cdot$vertical maxillary hypoplasia after several times of surgery and end of development in bilateral cleft lip and palate patient. The second case is the application of the USPD(unilateral segmental palatal distraction) for the resolution of the unilateral posterior crossbite and transverse dental arch asymmetry after alveolorraphy in growing unilateral cleft lip and palate patient. The third case is the application of transport distraction osteogenesis far closure of the wide clef alveolus and oroantral fistula in growing bilateral cleft lip and palate patient. There were satisfactory results in these cases. Particularly, in comparison with the decreases of relapse rates, the reduction of the hospitalization time and post-operative discomfort owing to minimal surgical intervention.

• Korean Journal of Cleft Lip And Palate
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• v.7 no.2
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• pp.93-106
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• 2004

본 연구의 목적은 편측성 구순구개열 (UCLP) 환자에서 술전 비치조 정형장치 (presurgical nasoalveolar molding appliance, PNAM) 와 구순 봉합수술의 치조골 정형효과를 3차원 (3-D) 분석을 통하여 평가하는 것이다. 연구대상은 16명의 UCLP 환자 (평균 파열부거리: 10.46mm) 이며 PNAM 장치에 의한 치료와 rotation-advancement법에 의한 구순 봉합수술을 받았다 처음 내원시 (평균연령: $37.0{\pm}27.89$ 일), PNAM 치료를 받고 난 후이며 구순봉합수술 1달 전 (평균연령: $119.25{\pm}40.18$ 일), 구순봉합수술 2달 후 (평균연령: $190.81{\pm}42.78$ 일)에 상악의 인상을 채득하였다. 그 후 laser scanning machine (Orapix, Dimennex, Seoul, Korea) 과 3-D view software (3Dxer, Dimennex) 를 사용하여 3-D모형을 제작하였다. 선, 각도, 정중선변이, 거리, 면적 항목을 3-D 모형상에서 계측하고, 각 시기별의 차이를 비교하기 위하여 Wilcoxon signed rank test를 사용하여 분석하였다. PNAM치료 동안과 구순 봉합수술 후에도 치조골 후방부는 안정된 구조물이었다. PNAM치료에 의한 파열부 거리의 감소는 대분절 (greater segment) 의 내측 굴곡 (bending) 에 의하여 발생하였다. 대분절 (greater segment)의 전방 성장은 PNAM치료에 의하여 억제되었으나, 구순 봉합수술 후에 회복되었다. 구순 봉합수술 후에 대분절과 소분절 사이의 전방부 각도의 증가는 구순 반흔 (lip scar) 의 압력에 의한 치조골 정형 효과 때문으로 생각된다. 정중선변이는 PNAM치료에 의하여 개선되었다. PNAM치료 동안과 구순 봉합수술 후에 구개부 (palatal segment) 의 면적은 계속 증가하였다. 치조골 면적과 거리 항목의 증가는 후방부에서 크게 나타났다. 이러한 결과는 PNAM치료에 의한 치조골 정형효과는 주로 전방부에서 발생하며, 치조골의 성장은 구순 봉합수술 후에 후방부에서 주로 발생한다는 것을 의미한다.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.717-728
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• 1996

The effects of electro-acupuncture on the pain threshold and the amplitude of dEMG(di-gastric EMG) evoked by the noxious electric stimulation on teeth and gingiva in dogs were studied. Experiments were carried out with 10 dogs weighing 5-8kg. Each animal was anestheticed with Entobar given intraperitoneally in an initial dose of 30mg/kg. Maintenance dose of 5mg/kg/hr was given through a cannula, in the femoral vein, as required to keep up light anesthesia. Bipolar stimulating wire electrodes, 0.1mm in diameter, insulated except for tips, were inserted into the upper canine and palatal gingiva. Rectangular aluminium plate electrodes (15$\times$5mm) were placed on acupuncture points, called Yin-Hsiang, located at both sides of the upper jaw. Rectangular biphasic current pulses of 2Hz, with a $250{\mu}sec$ duration, were delivered for 15 minutes. The dEMG activities were recorded from the anterior belly of the digastric muscle(one of the jaw opening muscles) using bipolar wire electrodes. The magnitude of the jaw opening reflex at different intensties of electro-acupuncture(1volt 4volt and 10volt) was estimated by averaging the 30 superimposed dEMGs recorded on an oscilloscope and audiomonitor. Data were analysed statistically with ANOV A and paired t-test. The obtained results were as follows: 1. Pain thresholds were increased 7.7 %, 15.4 %, 17.3 % in the teeth and 11.1 %, 19.0 %, 25.4 % in the gingiva as the intensities of electro-acupuncture increased incrementally. 2. Amplitudes of dEMG were decreaed 8.3%, 22.4%, 27.4% in the teeth and 9.8%, 36.5%, 42.2 % in the gingiva as the intensities of electro-acupuncture increased incrementally. 3. Inhibition of pain responses by the electroacupuncture was more effective in the gingiva than in the teeth.

• The korean journal of orthodontics
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• v.45 no.5
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• pp.245-252
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• 2015

Objective: To assess the labial and lingual alveolar bone thickness in adults with maxillary central incisors of different inclination by cone-beam computed tomography (CBCT). Methods: Ninety maxillary central incisors from 45 patients were divided into three groups based on the maxillary central incisors to palatal plane angle; lingual-inclined, normal, and labial-inclined. Reformatted CBCT images were used to measure the labial and lingual alveolar bone thickness (ABT) at intervals corresponding to every 1/10 of the root length. The sum of labial ABT and lingual ABT at the level of the root apex was used to calculate the total ABT (TABT). The number of teeth exhibiting alveolar fenestration and dehiscence in each group was also tallied. One-way analysis of variance and Tukey's honestly significant difference test were applied for statistical analysis. Results: The labial ABT and TABT values at the root apex in the lingual-inclined group were significantly lower than in the other groups (p < 0.05). Lingual and labial ABT values were very low at the cervical level in the lingual-inclined and normal groups. There was a higher prevalence of alveolar fenestration in the lingual-inclined group. Conclusions: Lingual-inclined maxillary central incisors have less bone support at the level of the root apex and a greater frequency of alveolar bone defects than normal maxillary central incisors. The bone plate at the marginal level is also very thin.

• Restorative Dentistry and Endodontics
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• v.22 no.1
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• pp.347-357
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• 1997

An accurate working length is an essential factor in the success of endodontic treatment. There are several methods for determining working length; electronic apex locator, tactile sense by clinician, and radiography. Among these methods, the most commonly used method is radiography. But this method requires excessive radiation, long developing time, and many equipments. In additon, it could give an image distortion and two dimensional image. To improve these disadvantages, an intraoral digital radiographic system (Digora$^{(R)}$) which use an imaging plate instead of a film, was developed. The purpose of this investigation was to compare Digora imaging with conventional radiography in determining the working length. Maxillary first or second molars of human dried skull were used. Files were inserted into canals at randomly selected lengths, from 2mm short of the radiographic apex to 2rnm beyond. Radiographs and Digora images(Digora positive and Digora negative) were evaluated to determine the adjustment needed to place the file 0.5mm from the radiographic apex. The results were as follows ; 1. There was no significant difference in accuracy between those evaluated in ${\pm}0.5mm$ and those accurately evaluated in the 3 images. 2. When comparing the accuracy of each image without distinguishing the 3 images, in the group accurately determined within ${\pm}0.5mm$, the mesiobuccal group showed significantly higher accuracy compared to the palatal group(p<0.05).

• Korean Journal of Cleft Lip And Palate
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• v.9 no.2
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• pp.79-84
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• 2006

Cleft palate is one of the most devastating congenital facial deformities frequently accompanied by cleft lip. In many cases, it causes phonetic and swallowing difficulties although surgical interventionwas applied. Among the surgical methods, Veau-Wardill-Kilner pushback palatoplasty (V-Y reposition) is widely used in the most cleft palate cases. It is designed to lengthen the palate posteriorly, hence to overcome the speech and swallowing problems, but broad postoperative palatal scar might interfere the normal maxillary growth. If the velar muscles were not reoriented, it could result in incomplete speech recovery. In this case report, the modified two-flap palatoplasty with minimal pushback was successfully applied to a 21 month-old girl who has had incomplete cleft palate extended to the posterior third of hard palate. The speech evaluation was confirmed as functional reconstruction of cleft palate was achieved.

• Korean Journal of Cleft Lip And Palate
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• v.15 no.2
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• pp.61-68
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• 2012

Cleft lip and palate is the most common congenital facial malformation and has a significant developmental, physical, and psychological impact on those with the deformity and their families. When treating the patients with unilateral cleft lip, many surgeons adopt the rotation advancement flap method originally developed by Millard, or the triangular flap technique developed by Tennison, Randall or the modifications of these techniques. Among these, Millard's rotation advancement flap method has its advantage in designing the flap using the patient's anatomic landmarks. For performing this rotation advancement technique, skillful operation is needed to obtain esthetically satisfactory results. Vomer flap sometimes is used to repair anterior hard palate in complete cleft lip and palate patients. Vomerine tissue is readily available in the vicinity of the palatal defect and elevation of the vomerine flap is relatively simple procedure. In this article, we will introduce the comprehensive vomer flap technique conjunction with primary lip closure and review the comparative studies of the outcome of simultaneous repair of cleft lip and cleft hard palate with Millard's rotation advancement method and vomer flap.

• Imaging Science in Dentistry
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• v.47 no.3
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• pp.181-187
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• 2017

Purpose: The purpose of this study was to measure the buccal bone thickness and angulation of the maxillary incisors and to analyze the correlation between these parameters and the root position in the alveolar bone using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of 398 maxillary central and lateral incisors from 199 patients were retrospectively reviewed. The root position in the alveolar bone was classified as buccal, middle, or palatal, and the buccal type was further classified into subtypes I, II, and III. In addition, the buccolingual inclination of the tooth and buccal bone thickness were evaluated. Results: A majority of the maxillary incisors were positioned more buccally within the alveolar bone, and only 2 lateral incisors(0.5%) were positioned more palatally. The angulation of buccal subtype III was the greatest and that of the middle type was the lowest. Most of the maxillary incisors exhibited a thin facial bone wall, and the lateral incisors had a significantly thinner buccal bone than the central incisors. The buccal bone of buccal subtypes II and III was significantly thinner than that of buccal subtype I. Conclusion: A majority of the maxillary incisor roots were positioned close to the buccal cortical plate and had a thin buccal bone wall. Significant relationships were observed between the root position in the alveolar bone, the angulation of the tooth in the alveolar bone, and buccal bone thickness. CBCT analyses of the buccal bone and sagittal root position are recommended for the selection of the appropriate treatment approach.

• Korean Journal of Cleft Lip And Palate
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• v.4 no.2
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• pp.69-78
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• 2001

Alveolar cleft exists in 75% of cleft patients, In alveolar cleft patients, alar base is widening, palatal fistular formation, maxillary growth disturbance & tooth loss of adjacent area is raised, Alveolar bone grafting, especially iliac bone grafting, is a general treatment method. As operation timing, bone grafting is classified with primary, early secondary, secondary, & late secondary, Here we report cleft width, marginal bone height, bone resorption rate, grafted shape & bone densities after secondary iliac bone grafting was done in the Dept. of oral and maxillofacial surgery of chonbuk national university hospital. We compared cleft width to bone resorption rate and grafted shape. Also, alveolar bone densities of grafted and contralateral site was compared with Emago 3 package? (Oral Diagonostic System, The Netherlands), The data obtained were analyzed using Spearman's rho coefficients and sign test with SPSS for window, The results were obtained as follows. 1. As alveolar cleft width is increase, bone resorption rate is, too. This relation showed significant difference(P<.01). 2, In proximal & distal area, alvolar cleft width and bone graft contour after bone grafting had a reverse proportional difference. It was not significant difference(P>.05). 3. After 3 month, in bone density results by using Emago 3 package? with periapical standard view, occlusal view & panoramic view, differences between grafted bone and alveolar bone of contralateral site didn't show a significant difference(P>.05). Thus, differences of bone densities in the alveolar bones didn't exist.