• 대한소아치과학회지
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• 제29권3호
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• pp.397-406
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• 2002

본 연구는 한국인의 유치열기 아동, 영구치열기의 구개의 폭, 길이, 구개의 용적, 구개 용적과 구개면적의 상관관계 등을 조사하여 남녀간의 차이, 유치열과 영구치열과의 변화 정도를 파악하고 다양한 구개의 연구를 할 수 있는 기초자료로 삼고자 하였다. 연구대상으로 정상교합의 유치열기 아동(Hellman dental age II A) 100명(남자 50명, 여자 50명)과 영구치열기의 성인(Hellman dental age IV A) 86명(남자 43명, 여자 43명), 총 186명을 대상으로 하여 제작한 상악의 석고모형을 이용하였다. 3차원 laser scanner(DS4060, LDI, U.S.A.), cloud data를 이용하여, polygonization, section curve와 loft surface, 표준평면, 수직평면 등을 얻은 후에 구개용적, 구개의 폭, 구개의 길이 등을 측정하였다(Surfacer 10.0, Imageware, U.S.A). 상수의 결정을 위해 유치열, 영구치열을 남녀별로 구분하여 결과를 구하였으며 남녀간의 차이는 student t-test를 이용하여 검정하여 다음과 같은 결론을 얻었다. 1. 표준평면과 각 치아, 치아 및 구개사이의 측정점들간의 거리는 영구치열에서 더 멀었다. 2. 영구치열에서의 구개용적이 유치열에서 보다 3배이상 컸으며 특히 영구치열에서는 여자에 비해 남자에서 유의성 있게 크게 측정되었다(p<0.05). 3. 구개폭은 유치열과 영구치열에서 남자에서 유의성 있게 크게 나타났지만 구개길이는 영구치열에서만 유의성 있게 컸다(p<0.05). 4. 유치열과 영구치열, 남자와 여자 모두에서 후구개폭과 총구개길이가 이루는 면적 이 구개용적과 가장 큰 상관관계를 보여주었다(r=0.401, r=0.450, r=0.678, r=0.654).

• 대한소아치과학회지
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• 제49권3호
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• pp.329-339
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• 2022

이 연구의 목적은 혼합치열기의 골격성 I, II, Ⅲ급 부정교합의 구개용적, 폭경, 장경, 고경을 비교하는 것이다. 이 연구는 단국대학교 치과대학병원 소아치과에 내원하여 교정을 목적으로 인상채득한 진단모형 1400개 중 30개를 선별하여 분석하였다. 모형은 Hellman's dental age ⅢA의 골격성 I, II, Ⅲ급 부정교합으로 구성되었다. 3차원 스캐너로 모형을 스캔한 후 여러 구개 수치들을 측정하였다. SPSS에서 Kruskal-Wallis test를 이용하여 비교 분석하였고, Mann-Whitney test로 사후검정하였다. 혼합치열기의 II급 부정교합에서 I급, Ⅲ급 부정교합에 비해 구개폭경이 유의하게 작았고, 구개장경이 유의하게 길었다. 혼합치열기의 Ⅲ급 부정교합에서 구개고경이 유의하게 가장 컸으며, 그 다음으로는 II급, I급 순이었다. 구개용적은 Ⅲ급, II급, I급 순으로 컸으나, 통계적으로 유의할 만한 차이는 보이지 않았다. 각 교합 양식에 따른 구개 형태의 차이를 이해하는 것은 임상적으로 매우 중요하다. 이 번 연구를 바탕으로 구개의 형태와 골격 패턴과의 관계에 대해 이해하였고, 이는 교정 치료 계획, 부정교합 조기 진단 및 구개 형태의 통합 메커니즘을 이해하는 데에 유용한 정보를 제공한다.

• Imaging Science in Dentistry
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• 제42권2호
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• pp.83-88
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• 2012

Purpose : The aim of this study was to investigate the initial effects of maxillary expansion therapy with Hyrax appliance and to evaluate the related changes in maxillary sinus volume. Materials and Methods : Thirty patients (20 females, 10 males; 13.8 years) requiring maxillary expansion therapy, as part of their comprehensive orthodontic treatment, were examined. Each patient had cone-beam computed tomography (CBCT) images taken before (T1) and after (T2) maxillary expansion therapy with a banded Hyrax appliance. Multiplanar slices were used to measure linear dimensions and palatal vault angle. Volumetric analysis was used to measure maxillary sinus volumes. Student t tests were used to compare the pre- and post-treatment measurements. Additionally, differences between two age groups were compared with Mann-Whitney U test. The level of significance was set at p=0.05. Results : Comparison of pre-treatment to post-treatment variables revealed significant changes in the transverse dimension related to both maxillary skeletal and dental structures and palatal vault angle, resulting in a widened palatal vault (p<0.05). Hard palate showed no significant movement in the vertical and anteroposterior planes. Nasal cavity width increased on a mean value of 0.93mm(SD=0.23, p<0.05). Maxillary sinus volume remained virtually stable. No significant age differences were observed in the sample. Conclusion : Hyrax expansion therapy did not have a significant impact on maxillary sinus volume.

• 대한소아치과학회지
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• 제30권4호
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• pp.696-706
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• 2003

본 연구의 목적은 상악 석고 모형을 이용하여 전방부, 중간부, 후방부 및 좌측부와 우측부의 구개용적 그리고 구개 전방, 중간, 후방 부위의 좌우 및 중앙 부위의 상하 구개 곡선을 측정하여 남녀간, 좌우간, 유치열과 영구치열간의 차이 정도를 파악하는데 있다. 유치열과 영구치열의 구개의 좌우 용적과 높이의 차이를 통한 구개형태를 알아보기 위하여 200개(유치열과 영구치열의 남녀 각 50)의 상악 석고모형을 제작하여 각 계측점을 결정한 후 3D Laser Scanner를 이용하여 표준평면과 수직평면 등을 형성하고 계측하여 다음과 같은 결론을 얻었다. 1. 구개용적과 구개높이는 유치열과 영구치열 남녀 모두에서 우측이 크게 나타났으나 유의성은 존재하지 않았다(P<0.05). 2. 구개높이는 남자가 높게 나타났으나 영구치열의 견치 사이와 제2소구치 사이에서만 통계적인 유의성이 존재하였다. 3. 전후 중앙부 구개높이의 경우 남녀 모두 유치열은 유중절치 치간 유두점 에서 20mm 전후, 영구치열은 중절치 치간 유두점에서 30mm 전후지점이 가장 높게 나타났다. 4. 견치 사이의 구개높이는 유견치 사이에 비하여 낮아지고 넓어졌으며, 제2소구치 사이는 제2유구치 사이보다 높아지고 넓어졌다.

• 대한소아치과학회지
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• 제32권2호
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• pp.270-277
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• 2005

본 연구의 목적은 혼합치열기(Hellman dental age III A)의 II급1류 부정교합과 정상교합 어린이간에 구개용적 및 전방구개경사의 차이가 있는지 알아보기 위하여 3차원 레이저 스캐너를 이용하여 비교, 분석하는 것이었다. 대상은 서울대학교 치과병원에 내원한 골격성 II급1류 부정교합 환자 중 혼합치열기 어린이 31명과 서울시 치과의사회에서 주관한 2000년부터 2004년까지의 건치어린이 선발대회 후보 중 교합양상이 정상이며 안모상 정상범주에 속하는 29명이었으며, 기준에 적합한 60개의 상악모형을 3차원 레이저 스캐너(Breuckmann opto-TOP HE, INUS, Korea)로 스캔한 후 Rapidform 2004 프로그램 (INUS, Korea)을 이용하여 3차원 이미지를 재구성하고 구개용적과 시상분할면 상에서의 전방구개경사를 측정하였다. 얻어진 결과를 95% 신뢰수준에서 independent samples t-test를 이용하여 통계적 유의성을 검정하여 다음과 같은 결과를 얻었다. 1. 혼합치열기의 II급1류 부정교합 어린이는 정상교합 어린이에 비해 평균구개용적이 유의하게 작은 경향을 보였다(p<0.05). 2. 혼합치열기의 II급1류 부정교합과 정상교합 어린이 사이에서 전방구개경사와 구개고경은 유의성 있는 차이를 보이지 않았다(p>0.05). 3. 혼합치열기의 II급1류 부정교합 어린이는 정상교합 어린이에 비해 구개장경이 유의하게 길었다(p<0.01). 4. 혼합치열기의 II급1류 부정교합 어린이는 정상교합 어린이에 비해 견치간 구개폭경(p<0.05)과 대구치간 구개폭경(p<0.01)이 유의하게 좁은 경향을 보였다.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.8-13
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• 2011

Purpose: A palatal defect following maxillectomy can cause multiple problems like the rhinolalia, leakage of foods into the nasal cavity, and hypernasality. Use of a prosthetic is the preferred method for obturating a palate defect, but for rehabilitating palatal function, prosthetics have many shortcomings. In a small defect, local flap is a useful method, however, the size of flap which can be elevated is limited. In 12 cases of palatomaxillary defect, we used various microvascular free flaps in reconstructing the palate and obtained good functional results. Method: Between 1990 and 2004, 12 patients underwent free flap operation after head and neck cancer ablation, and were reviewed retrospectively. Among the 12 free flaps, 6 were latissimus dorsi myocutaneous flaps, 3 rectus abdominis myocutaneous flaps, and 3 radial forearm flaps. Result: All microvascular flap surgery was successful. Mean follow up time was 8 months and after the follow up time all patients reported satisfactory speech and swallowing. Wound dehiscence was observed in 4 cases, ptosis was in 1 case and fistula was in 1 case, however, rhinolalia, leakage of food, or swallowing difficultly was not reported in the 12 cases. Conclusion: We used various microvascular flaps for palatomaxillary reconstruction. For 3-dimensional flap needs, we used the latissimus dorsi myocutaneous flap to obtain enough volume for filling the defect. Two-dimensional flaps were designed with latissimus dorsi myocutaneous flap, rectus abdominis flap and radial forearm flap. For cases with palatal defect only, we used the radial forearm flap. In palatomaxillary reconstruction, we can choose various free flap techniques according to the number of skin paddles and flap volume needed.

• 대한치과교정학회지
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• 제50권2호
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• pp.75-85
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• 2020

Objective: The aim of this study was to evaluate changes in the nasal soft tissues, including movements of landmarks, changes in linear distances, and volumetric changes, using three-dimensional (3D) stereophotogrammetry after microimplant-assisted rapid palatal expansion (MARPE) in adult patients. Methods: Facial data were scanned using a white light scanner before and after MARPE in 30 patients. In total, 7 mm of expansion was achieved over a 4-week expansion period. We determined 10 soft tissue landmarks using reverse engineering software and measured 3D vector changes at those points. In addition, we calculated the distances between points to determine changes in the width of the nasal soft tissues. The volumetric change in the nose was also measured. Results: All landmarks except pronasale and subnasale showed statistically significant movement on the x-axis. Pronasale, subnasale, alar right, and alar left showed significant movement on the y-axis, while all landmarks except subnasale showed significant movement on the z-axis. The alar base width, alar width, and alar curvature width increased by 1.214, 0.932, and 0.987 mm, respectively. The average volumetric change was 993.33 ㎣, and the amount of increase relative to the average initial volume was 2.96%. Conclusions: The majority of soft tissue landmarks around the nasal region show significant positional changes after MARPE in adults. The nose tends to widen and move forward and downward. The post-treatment nasal volume may also exhibit a significant increase relative to the initial volume. Clinicians should thoroughly explain the anticipated changes to patients before MARPE initiation.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.25-30
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• 2012

Background : The soft palate functions as a valve and helps generate the oral pressure required for normal speech resonance. Speech problems and nasal regurgitation can result from a soft palatal defect. Reduction of the size of the velopharyngeal orifice is required to compensate for the lack of mobility in a reconstructed soft palate. We suggest a large volume folded free flap for reduction of the caliber and a palmaris longus tendon sling for suspension of the reconstructed palate. Methods : Six patients had total soft palate resection for tonsillar cancer and reconstruction with a large volume folded radial forearm free flap combined with a palmaris longus sling. A single surgeon and speech therapist examined the patients with three standardized speech assessment tools: nasometer test, consonant articulation test, and speech acuity test performed for speech evaluation. Results : Mean nasalance score was 76.20% for sentences with nasal sounds and 43.60% for sentences with oral sounds. Hypernasality was seen for oral sound sentences. The mean score of the picture consonant articulation test was 84% (range, 63% to 100%). The mean score of the speech acuity test was 5.84 (range, 5 to 6). These mean ratings represent a satisfactory level of speech function. Conclusions : The large volume folded free flap with a palmaris longus tendon sling for total soft palate reconstruction resulted in satisfactory prognosis for speech despite moderate hypernasality.

• 대한치과교정학회지
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• 제53권3호
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• pp.175-184
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• 2023

Objective: To evaluate and compare a series of volume changes in the nasal cavity (NC), nasopharynx, oropharynx, and maxillary sinuses (MS) in growing Class III patients after either rapid palatal expansion (RPE) or alternate rapid maxillary expansion and constriction (Alt-RAMEC) followed by facemask (FM) therapy, by using cone-beam computed tomography (CBCT). Methods: Forty growing Class III patients were retrospectively selected and divided into two matched groups: RPE/FM (14 females, 6 males; mean age, 9.66 ± 1.23 years) and Alt-RAMEC/FM groups (14 females, 6 males; mean age, 10.28 ± 1.45 years). The anteroposterior and vertical displacements of Point A, the volumes of the NC, nasopharyngeal, oropharyngeal, and MS were measured at different time points: pretreatment (T1), postexpansion (T2), and postprotraction (T3). Results: Both groups demonstrated significant maxilla advancement (by 1.3 mm) during expansion, with a statistically significant intergroup difference during protraction (RPE/FM, 1.1 mm; Alt-RAMEC/FM, 2.4 mm; p < 0.05) and throughout the treatment (RPE/FM, 2.4 mm; Alt-RAMEC/FM, 3.7 mm; p < 0.05). NC and nasopharyngeal airway volumes increased significantly in both groups after expansion, protraction, and treatment. The oropharyngeal and MS volumes increased in both groups after protraction and post-treatment. However, no volumetric differences were observed between the two groups. Conclusions: There was no significant difference in airway volume changes, including NC, nasopharyngeal, oropharyngeal airway, and MS, between RPE/FM and Alt-RAMEC/FM groups at different time points. Although there was significantly more forward movement after protraction in the Alt-RAMEC/FM group, the difference was deemed too small to be clinically relevant.

• Asian Pacific Journal of Cancer Prevention
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• 제16권16호
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• pp.7045-7047
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• 2015

Background: Mean platelet volume (MPV) is a marker which has been investigated in many cancers but data for head and neck lesions are limited. We aimed to study the MPV levels in head and neck cancers as a diagnostic marker. Materials and Methods: A total of 96 head and neck cancer patients and 31 control patients who did not meet exclusion criteria were enrolled in the study. The cancer locations, the platelet and MPV levels at the first diagnosis time were collected. Results: The head and neck cancer location distribution between these patients was 2 (2.1%) buccal, 9 (9.4%) tongue, 6 (6.3) lip, 1 (1%) gingiva, 1 (1%) hypopharynx, 1 (1%) ear, 58 (60.4%) larynx, 2 (2.1%) maxilla, 2 (2.1%) nasal, 1 (1%) nasopharynx, 2 (2.1%) palatal, 3 (3.1%) primary unknown, 1 (1%) retromolar, 1 (1%) thyroid, 2 (2.1%) tonsil, and 4 (4.2%) salivary gland. MPV levels were significantly different between cancer and control group (p=0.002). The cut-off point for MPV predicting head and neck cancer is >10 fL (sensitivity=55.21, specificity=87.10). Conclusions: MPV level increase, a readily assessable parameter which does not bring extra costs can warn us regarding head and neck cancer risk.