• 제목/요약/키워드: Symphysis

검색결과 169건 처리시간 0.211초

피에르 로빈 연속증의 치료로써 치조 보호 장치를 이용한 혀-하순 유착술 (Tongue-Lip Adhesion Using an Alveolar Protector Appliance for Management of Pierre Robin Sequence)

  • 이장원;박병윤
    • Archives of Plastic Surgery
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    • 제38권4호
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    • pp.547-551
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    • 2011
  • Purpose: Pierre Robin sequence is a congenital malformation in which micrognathia causes glossoptosis and airway obstruction. If conservative treatment fails, surgical procedures such as tongue-lip adhesion can be performed. However, this procedure remains a subject of debate, with favorable results being countered by reports of complications. To overcome the above limitations, we revised the traditional method of tongue-lip adhesion using an alveolar protector. Methods: Between 1992 and 2011, a total of eight patients were identified with Pierre Robin sequence and were treated with tongue-lip adhesion. Two of these eight tongue-lip adhesion procedures were performed with an alveolar protector. The operative technique for tongue-lip adhesion was similar to that described in other published reports. The alveolar protector was inserted between the ventral surface of the tip of the tongue and the lower labial sulcus. Results: Tongue-lip adhesion failed in two patients because of wound dehiscence. The primary surgical success rate was 66.7%. In the two tongue-lip adhesion procedures performed with the alveolar protector, we observed no postoperative complications. Conclusion: Resistance to traction of the tongue can be encountered with nonunionized symphysis menti, causing loosening of the traction suture through the symphysis menti. This can lead to backward positioning of tongue, resulting in dehiscence of tongue lip adhesion. The alveolar protector is a good adjunct to tongue-lip adhesion because this method avoids postoperative loosening of the traction suture and wound dehiscence. It is a simple and effective auxiliary method that yields functional improvement.

Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study

  • Chandan, SN;Shetty, Sujeeth Kumar;Shetty, Sahith Kumar;Shah, Anjan Kumar
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권3호
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    • pp.183-189
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    • 2021
  • Objectives: To assess the prevalence and recovery of inferior alveolar nerve dysfunction (IAND) in mandibular fractures. Materials and Methods: This was a prospective cohort study. Clinical neurosensory testing was done preoperatively and the IAND was categorized as mild, moderate or severe. Postoperatively, neurosensory testing was repeated at 1 day, 1 week, 1 month, 3 months and every 3 months thereafter. Results: A total of 257 patients with 420 fractures were included in the study with a mean age of 31.7 years. Body fractures (95.9%) had the highest incidence of IAND, followed by the angle fractures (90.1%) and symphysis fractures (27.6%). The condyle and coronoid fractures did not have any IAND and hence were excluded from further study. After eliminating those cases, 232 patients remained in the study with 293 fractures. The overall prevalence of IAND in fractures occurring distal to the mandibular foramen was 56.3%. The changes until 1 week were minimal. From 1 month to 6 months, there was a significant reduction in the severity of IAND. A significant number of cases (60.0%) were lost to follow-up between 6 and 9 months. At 6 months, 23.9% of cases still had some form of IAND and 95.0% of the symphysis, 59.0% of the angle and 34.8% of the body fractures with IAND had become normal. Conclusion: This study documents the reduction in the degree of severity of IAND in the first six months and provides the basis for future studies with longer periods of follow-up.

Diagnosis of split fractures of the mandible in adults

  • Taesik Kim;Sung Gyun Jung;In Pyo Hong;Young Joong Hwang
    • 대한두개안면성형외과학회지
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    • 제24권4호
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    • pp.167-173
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    • 2023
  • Background: Mandibular split fractures, in which the fracture occurs exclusively in the posterior wall, are uncommon. This study aimed to enhance clinicians' understanding of mandibular split fractures and offer insights for future research. Methods: This study included six patients who visited our hospital between January 2020 and June 2023 and were diagnosed with mandibular split fractures. We retrospectively collected data from patients' medical records on their age, sex, symptoms, mechanism, impact site, associated injuries, and treatment method, as well as the location, pattern, and number of fractures observed on computed tomography (CT) and panoramic images. The frequency of split fractures among all mandibular fractures was calculated. Results: The six patients included three men (50%) and three women (50%), ranging in age from 20 to 71 years (mean age, 49.8 years). The split fractures were located in the symphysis in one patient (16.7%), symphysis to parasymphysis in two patients (33.3%), parasymphysis in one patient (16.7%), and parasymphysis to the body in two patients (33.3%). Four patients (66.7%) had condylar head fractures, while two patients (33.3%) had single split fractures. The mechanism of trauma was a slip-down incident in four cases (66.7%), while two cases (33.3%) were caused by motorcycle traffic accidents. Four patients (67%) underwent intermaxillary fixation, while two patients (33%) improved with conservative treatment. Split fractures were diagnosed in all six patients on CT, whereas the fracture line was not clearly visible on panoramic images. Mandibular split fractures accounted for 5.6% of all mandibular fractures. Conclusion: This study provides insights into the clinical characteristics of rare mandibular split fractures and the diagnostic imaging findings. Furthermore, CT scans and three-dimensional image synthesis-instead of panoramic images-may be essential for accurately diagnosing mandibular fractures, including mandibular split fractures, in the future.

하악골 매식 부위 계측을 위한 나선형 단층촬영술의 신뢰도 (RELIABILITY OF SPIRAL TOMOGRAPHY FOR IMPLANT SITE MEASUREMENT OF THE MANDIBLE)

  • 김기덕;박창서
    • 치과방사선
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    • 제27권2호
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    • pp.27-47
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    • 1997
  • The purpose of this study was to evaluate the accuracy and usefulness of spiral tomography through the comparison and analysis of SCANORA cross-sectional tomographs and DentaScan computed tomographic images of dry mandibles taken by a SCANORA spiral tomographic machine and a computed tomographic machine. Thirty-one dry mandibles with full or partial edentulous areas were used. To evaluate the possible effect of location in the edentulous area, it was divided into 4 regions of Me (region of mental foramen), MI (the midportion between Me and M2), M2 (the midportion between mental foramen and mandibular foramen) and S (the midportion of the mandibular symphysis). A ZPC column (sized 4 mm x 5 mm) was seated on the edentulous regions of Me, MI, M2 and S using the acrylic stent. Then SCANORA spiral tomography and computed tomography were taken on the edentulous regions which contained the ZPC column. The ZPC columns and cross-sectional images of the mandible were measured in the radiographs by three observers and the differences between the two imaging modalities were analysed. The results were as follows: 1. In comparing the actual measurements of the ZPC column and measurements in the radiographs, the mean error of the DentaScan computed tomography was 0.07 mm in vertical direction and -0.06 mm in horiwntal direction, while the mean error of the SCANORA spiral tomography was 0.06 mm in vertical direction and -0.12 mm in horizontal direction. There was a significant difference between the two radiographic techniques in the horizontal measurement of the ZPC column of the symphysis region (p<0.05). But there was no significant difference in the measurements of other regions (p>0.05). 2. In measurements of the distance from the alveolar crest to the inferior border of the mandible (H), and of the distance from the alveolar crest to the superior border of the mandibular canal (Y), there was no significant difference between the two radiographic techniques (p>0.05). 3. In measurements of the distance from the lingual border of the mandible to the buccal border of the mandible (W), and of the distance from the lingual border of the mandible to the lingual border of the mandibular canal (X), there was a significant difference between the two radiographic techniques in measurements of the midportion between the mental foramen and the mandibular foramen (M2) (p<0.05). But there were no significant differences in measurements of the other regions of symphysis (S), mental foramen (Me), the first one-fourth portion between the mental foramen and the mandibular foramen (M1) (p>0.05). 4. Considering the mean range of measurements between observers, the measurements of SCANORA spiral tomography showed higher value than those of DentaScan computed tomography, except in measurements of symphysis (S). 5. On the detectability of the mandibular canal, there was no significant difference between the two radiographic techniques (p>0.05). In conclusion, SCANORA spiral tomography demonstrated a higher interobserver variance than that of DentaScan computed tomography for implant site measurements in the posterior edentulous area of the mandible. These differences were mainly the result of difficulty in the detection of the border of the mandible in SCANORA spiral tomography. But considering the cost and the radiation exposure, SCANORA spiral tomography can be said to be a relatively good radiographic technique for implant site measurement.

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관심영역 변화에 따른 하악골 골밀도 측정에 대한 연구 (Study on Measurements of the Mandible BMD According to the ROI Variation)

  • 탁정남
    • 대한방사선기술학회지:방사선기술과학
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    • 제32권3호
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    • pp.271-276
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    • 2009
  • 골밀도 측정은 주로 척추, 상완, 대퇴, 종골 부위에서 측정되고 있으며 이 부위를 측정하기 위한 전용 소프트웨어 및 통계자료는 잘 확립되어있지만 하악골에 대한 측정방법 및 정량적인 자료가 없어 Horner et al(1996)에 의해 제시된 이중에너지 X선 흡수 계측법(Dual energy X-ray absorptiometry, DEXA)을 이용한 하악골의 골다공증 측정법을 사용하여 본 연구를 시행하였다. 성인남자 13명(26.5세), 성인여자 22명(24.4세)을 대상으로 GE Lunar Prodigy Advance를 이용하여 반 엎드린 자세(Semiprone)에서 두개부을 정측면 자세로 측정하였다. 이때 관심영역(Region of interest, ROI)은 직사각형($30{\times}2.5\;mm^2$)을 사용하여 하악각(Mandibular angle)에서 하악결합(Mental symphysis) 사이의 중심에 놓고 측정하였으며, 직사각형 ROI의 크기와 위치를 변경하여 측정하였다. 남자의 평균 골밀도(g/$cm^3$)는 $1.320{\pm}0.358$이고 여자는 $1.152{\pm}0.340$이고, 위치를 변경하여 하악각 쪽으로 이동시켰을 때 남자 $1.201{\pm}0.361$, 여자 $1.025{\pm}0.377$, 하악결합 쪽으로 이동시켰을 때는 남자 $1.434{\pm}0.341$, 여자 $1.19{\pm}0.358$, 크기를 줄여서 측정할 때는 남자 $1.262{\pm}0.384$, 여자 $1.113{\pm}0.356$, 크기를 확대하였을 때는 남자 $1.320{\pm}0.357$, 여자 $1.129{\pm}0.340$로 나타났다. ROI 위치를 이동시켰을 때와 크기를 변화시켰을 때 모두에서 측정값 간에 차이가 있었다. 추적 검사 시 ROI 위치 값을 유지하여 세 번을 반복하여 평균값을 구하였다. 하악골의 골밀도를 측정할 때 가능한 관심영역을 크게 하고 하악지와 하악결합 사이에 위치하도록 하는 것이 좋을 걸로 생각되고, 특히 추적 검사 시에는 이전 검사를 참고하여, 동일한 크기와 위치에 관심영역이 위치하도록 하는 것이 연구되었다. 이러한 연구에 의하면 하악골의 골밀도의 측정은 전체 골밀도를 나타내는 골밀도 측정값보다는 국소적인 하악골 골밀도 측정에 정확하다. 임플란트 및 하악골 부분의 뼈 이식 분야에서도 정량적인 측정값에 도움이 되며, 이러한 DEXA법으로 BMD 임계치를 한국 사람에 맞는 정량 값으로 구하여 본다면 좋을 것이다.

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AE-MDB 시험결과에 따른 인체상해 및 차체 특성 (Characteristics of Vehicle Structure Deformation and Body Injury caused by Side Impact Test using AE-MDB)

  • 김도엽;이재완;장형진;용부중
    • 자동차안전학회지
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    • 제3권2호
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    • pp.34-41
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    • 2011
  • Side collisions (or side crash) account for 51.6% of all car to car accidents occurred in 2010. It is necessary to analyze those vehicles' structure deformation and passengers' injuries in the side collisions. A moving barrier (950kg) is currently used in the KNCAP side impact test. However, in order to enhance a passengers' safety in the side collisions, we introduce an AE-MDB (1500kg) which provides more severe conditions for this test. In this study, the test results using both barriers are compared and analyzed.

하악골에 광범위하게 발생한 치성각화낭종 2례 (TWO CASES OF LARGE ODONTOGENIC KERATOCYST(OKC) IN THE MANDIBLE)

  • 심광섭
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권2호
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    • pp.279-285
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    • 1996
  • The odontogenic keratocyst(OKC) was used of term and described some of clinical, radiological and microscopic features by Philipsen 1956. The microscopic finding of OKC is characterized by the production of keratin, Which sometimes fills the lumen and thinning of epithelium of cyst. The most clinical importance of OKC is its extraordinary recurrence rate owing to the incomplete removal of the cyst wall. The final diagnosis of OKC should be evaluated by histologic findings and follow-up of any case of OKC with annual roentgenograms and clinical evaluations is essential for at least five years after surgery. This article is report of 2 cases of large OKC involved both molar portion and symphysis of mandible with facial asymmetry, severe bone destruction and paresthesia of lower lip on clinically, roentgenographically. By the postoperative findings the patients showed normal regeneration of bone defect area without recurrence signs by panorama films after surgery.

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측두하악관절에서 발생한 골연골종과 활액막 연골종증 (Osteochondroma and synovial chondromatosis of the temporomandibular joint)

  • 김성은;김재덕
    • Imaging Science in Dentistry
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    • 제32권1호
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    • pp.41-47
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    • 2002
  • Osteochondroma is a benign lesion of osseous and cartilagenous origin. It is a relatively common benign tumor of the skeleton, occurring most often in the metaphyseal region of long bone. However, it is rare in the facial bones. Reported foci in the mandible were the condyle, coronoid process, and symphysis region. Synovial chondromatosis is an uncommon benign condition of unknown etiology which affects the articular joints. Foci of cartilage develop through metaplasia in the underlying connective tissue of the synovial membrane. These cartilagenous foci and fragments may undergo calcification and ossification. We experienced 4 patients with abnormal appearance of mandibular condyle. This report describes 3 cases of osteocondroma and 1 case of synovial chondromatosis of the mandibular condyle with review of the literature.

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Correction of dental Class III with posterior open bite by simple biomechanics using an anterior C-tube miniplate

  • Ahn, Hyo-Won;Chung, Kyu-Rhim;Kang, Suk-Man;Lin, Lu;Nelson, Gerald;Kim, Seong-Hun
    • 대한치과교정학회지
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    • 제42권5호
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    • pp.270-278
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    • 2012
  • In the correction of dental Class III molar relationship in skeletal Class II patients, uprighting of the mandibular posterior segments without opening the mandible is an important treatment objective. In the case reported herein, a C-tube miniplate fixed to the lower labial symphysis and connected with a nickel-titanium reverse-curved archwire provided effective uprighting of the lower molars, without the need of orthodontic appliances on the mandibular anteriors. Using this approach, an appropriate magnitude of force is exerted on the molars while avoiding any negative effect on the mandibular anteriors.

혈관종에 관한 연구 (A STUDY ON THE HEMANGIOMA)

  • 박원길;김영일
    • 치과방사선
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    • 제24권1호
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    • pp.161-169
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    • 1994
  • Hemangioma is a common tumor characterized by the proliferation of blood vessels. Some authorities believe that this lesion is not a true neoplasm, but rather a developmental anomaly or harmatoma. This lesion may be present at any age, but most cases are present at birth or arise at an early age, and the central hemangioma of the jaw is uncommon. The usual radiographic appearance of a hemangioma may have one or more of the following characteristics: a soap-bubble or honey-comb effect with multiloculated cyst like lesions having a fine fibrillar framework visible within them. The roots of teeth mayor may not show resorption. The authors have experienced a case of hemangioma, that occured in anterior mouth floor and Mn.symphysis area cured by means of surgical excision without dysfunction and facial disfigurement.

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