• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.316-323
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• 2009

Purpose: This study was performed to evaluate three-dimensional positional change of the condyle using 3D CT after bilateral sagittal split ramus osteotomy (BSSRO) in skeletal class III patients. Patients and methods: Nine patients who underwent BSSRO for mandibular set-back in skeletal class III malocclusion without facial asymmetry were examined. Miniplates were used for the fixation after BSSRO. 3-D CT was taken before, immediately after, and 6 months after undergoing BSSRO. After creating 3D-CT images using V-works $4.0^{TM}$ program, axial plane, coronal plane, & sagittal plane were configured. Three dimensional positional change, from each plane to the condyle, of the nine patients was measured before, immediately after, and 6 months after undergoing BSSRO. Results: 1. The mean value of mandibular set-back for nine mandibular prognathism patients was 7.36 mm (${\pm}\;2.42\;mm$). 2. In the axial view, condyle is rotated inward immediately after BSSRO (p < 0.05), comparing with preoperative but outward 6 months after BSSRO comparing with postoperative (p < 0.05). 3. In the axial view, condyle is moved laterally immediately after BSSRO (p < 0.05), comparing with preoperative but regressed 6 months after BSSRO comparing with preoperative (p > 0.05). 4. In the frontal & coronal view, there is changed immediately after and 6 months after BSSRO, comparing with preoperative but no statistical difference. Conclusion: These results indicate that three-dimensional positional change of the condyle in skeletal class III patients is observed lateral displacement & inward rotation immediate after BSSRO, but the condyle in 6 months after BSSRO tends to regress to preoperative position.

• Clinical and Experimental Pediatrics
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• 제52권6호
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• pp.674-679
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• 2009

목 적 : 양측성 망막모세포종 환자들의 치료 후 장기후유증을 분석하고자 하였다. 방 법 : 1987년 10월부터 1998년 10월까지 원자력병원에서 치료를 받고 10년 이상 장기추적관찰 중인 양측성 망막모세포종 환자 22명의 의무기록을 분석하였다. 진단시 연령, 치료지연, Reese-Ellsworth (RE) 분류, 국소치료방법 등의 임상 변수와 생존율, 안구합병증을 포함한 장기후유증의 발생과의 관계를 알아보았다. 결 과 : 진단 시 정중 연령은 7.0 개월로(범위, 1.7-31.6개월), 백색동공으로 내원한 경우가 가장 많았다. 44개 안구의 RE 분류는 각각 group II (n=4), III (n=14), IV (n=4), V (n=22)이었다. 추적관찰 141개월째인 현재 20명이 생존하여 있으며, 10년 안구생존율은 $56.8{\pm}7.5%$이었다. 임상변수 중, 3개월 이상의 치료지연이 재발과 관련이 있었다. 방사선 치료 후 백내장, 망막박리, 안구로, 안면비대칭 등의 합병증이 관찰되었으며 현재까지 이차성 종양의 발생은 없었다. 결 론 : 안구생존율을 향상시키기 위해서는 종양을 조기에 발견하도록 노력하고 진단즉시 치료를 시작해야 할 것이다. 이와 더불어 장기적인 후유증의 발생여부에 대해서도 세심한 추적관찰이 필요하다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권2호
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• pp.137-143
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• 2011

Purpose: Orthognathic surgery is required in patients with severe skeletal disharmony and facial asymmetry, which results in functional and esthetic improvement. Recently, bimaxillary surgery has become generalized. Establishment of the occlusal plane among several other factors included in the surgery plan is a major consideration for the diagnosis and treatment plan and it is also an important factor for postoperative stability. Methods: In this study, we assessed postoperative stability of occlusal plane, B-point, and pogonion point on 20 patients who underwent two-jaw surgery in the Chosun Dental Hospital from 2000 to 2007. Preoperative and postoperative states and at least a one year postoperative follow-up were compared. Results: The postsurgical relapse volume of the occlusal plane to the SN plane and the FH plane was $-0.26{\pm}2.8^{\circ}$ and $-0.44{\pm}3.29^{\circ}$, respectively and after two-jaw surgery, the stability of occlusal plane was maintained. The horizontal relapse degree was $0.85{\pm}0.46$ mm and $0.76{\pm}0.48$ mm, respectively, and the vertical relapse degree was $1.16{\pm}0.36$ mm and $1.13{\pm}0.71$ mm of the B point and the Pogonion point at the time after minimal 1 year. Conclusion: The vertical relapse amount was shown to be slightly larger than the horizontal relapse amount.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.18.1-18.10
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• 2019

Background: Temporomandibular joint (TMJ) ankylosis during early childhood may lead to disturbances in growth and facial asymmetry and to serious difficulties in eating as well as in breathing during sleep. The purpose of this study is to describe the effectiveness of an interocclusal splint (IOS) for active mouth opening exercises in the treatment of TMJ ankylosis. Methods: A total of nine patients with 13 instances of TMJ ankylosis from 2008 to 2010 were included in this study, of which five patients were male and four patients were female. Five patients demonstrated unilateral ankylosis, while five patients showed bilateral symptoms. Ankylosed mass resection with coronoidectomy, fibrotic scar release, and resection of stylohyoid ligament calcification was performed with gap arthroplasty without an interpositional graft, and all patients were assessed for maximum mouth opening (MMO) during a mean 6.6-year follow-up period. Results: All patients were subjected to postoperative mouth opening exercises from the day of the operation with the help of an IOS, which was based on an impression taken during surgery. All patients were sufficiently comfortable moving their mandible according to the IOS's guiding plane and impingement, and satisfactory results were achieved, in which MMO was improved by 35 mm more than 6 years after surgery. Conclusions: Complete and adequate resection of the ankylosed mass and postoperative active mouth opening exercises are essential in the treatment of TMJ ankylosis. Moreover, a more comfortable mouth opening guide and interdigitation can be achieved using an IOS, and newly organized fibrosis in the gap space between the newly made resected condylar head and temporal fossa can be suggested.

• 한국융합학회논문지
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• 제9권10호
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• pp.423-432
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• 2018

본 연구는 볼링 선수의 상해 경험과 유형에 따라 상 하지 근력과 좌우 비대칭 차이를 살펴보고자 하였다. 본 연구 대상자는 상지 상해 경험 집단(upper body injury group, [UG], n=16)과 하지 상해 경험 집단(low body injury group, [LG], n=8), 상해 미경험 집단(non injury group, [NG], n=15)으로 선정하였다. 볼링 선수의 상 하지 근력은 Manual Muscle Tester 01165 (Lafayette Instrument Company, USA)로 등척성 최대 근력(Isometric strength)을 측정하였으며, 비대칭 지수(symmetry index, [SI])를 산출하였다. 그 결과는 다음과 같다. 하지 근력의 좌우 비대칭 지수는 엉덩관절의 신전과 외측회전 최대근력에서 상해 무경험 집단이 하지 상해 경험 집단에 비하여 통계적으로 크게 나타났다(p<.05). 위 결과를 통하여 하지 근력의 좌우 대칭이 하지 상해와 밀접한 관련이 있다고 판단되며, 상해 예방을 위해 하지 근력의 좌우 대칭 훈련이 필요할 것으로 판단된다.

• 대한두개안면성형외과학회지
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• 제19권1호
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• pp.13-19
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• 2018

Background: $Abb{\acute{e}}$ flap technique is one of the most challenging operations to correct horizontal deficiencies in secondary cleft lip deformity. Since its first introduction, the operative method was dynamically modified from simple variation to complete conceptual change, but conventional $Abb{\acute{e}}$ flap has many drawbacks in esthetic and functional aspect. Our purpose was reconstructing the symmetry of Cupid's bow and central vermilion tubercle with minimal sequalae. Methods: From 2008 to 2016, this technique was applied to 16 secondary cleft lip patients who had total or more than 60% of unilateral deficiency of Cupid's bow and central lip or tubercle pouting deficiency. A quadrangular-shaped flap was transferred from vermilion including skin and white line of central or contralateral lower lip. Pedicle division and insetting were made at 9 (unilateral) or 10 (bilateral) days after transfer. Secondary lip revision was done with open rhinoplasty after wound maturation. Results: Overall satisfaction was high with modified technique. Scar was minimally noticeable on both upper and lower lip especially. Balanced Cupid's bow and symmetric vermilion tubercle were made with relatively small size of flap compared to conventional $Abb{\acute{e}}$ flap. An accompanying benefit was reduced ectropion of lower lip, which made balanced upper and lower lip protrusion with more favorable profile. Conclusion: A new modified $Abb{\acute{e}}$ flap technique showed great satisfaction. It is worth considering in secondary cleft lip patient who has central lip shortage and asymmetry of upper lip vermilion border line. Our technique is one of the substitutes for correction of horizontal and central lip deficiency with asymmetric Cupid's bow.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권4호
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• pp.235-244
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• 2018

Background: Patients with intellectual disability (ID) often require general anesthesia during oral procedures. Anesthetic depth monitoring in these patients can be difficult due to their already altered mental state prior to anesthesia. In this study, the utility of electroencephalographic indexes to reflect anesthetic depth was evaluated in pediatric patients with ID. Methods: Seventeen patients (mean age, $9.6{\pm}2.9years$) scheduled for dental procedures were enrolled in this study. After anesthesia induction with propofol or sevoflurane, a bilateral sensor was placed on the patient's forehead and the bispectral index (BIS) was recorded. Anesthesia was maintained with sevoflurane, which was adjusted according to the clinical signs by an anesthesiologist blinded to the BIS value. The index performance was accessed by correlation (with the end-tidal sevoflurane [EtSevo] concentration) and prediction probability (with a clinical scale of anesthesia). The asymmetry of the electroencephalogram between the left and right sides was also analyzed. Results: The BIS had good correlation and prediction probabilities (above 0.5) in the majority of patients; however, BIS was not correlated with EtSevo or the clinical scale of anesthesia in patients with Lennox-Gastaut, West syndrome, cerebral palsy, and epilepsy. BIS showed better correlations than SEF95 and TP. No significant differences were observed between the left- and right-side indexes. Conclusion: BIS may be able to reflect sevoflurane anesthetic depth in patients with some types of ID; however, more research is required to better define the neurological conditions and/or degrees of disability that may allow anesthesiologists to use the BIS.

• 치과방사선
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• 제14권1호
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• pp.99-107
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• 1984

The auther studied clinically and. radiologically 48 cases which had been diagnosed as TMJ ankylosis in SNUDH (1974-1984). The purpose of this study is to analyse clinical features of TMJ ankylosis and to evaluate the effect of TMJ ankylosis on the growth of the mandible. The obtained results were as follows: 1. Total 48 cases of TMJ ankylosis patients consist of 23 males and 25 females. 65 percent of all cases of TMJ ankylosis occurred in patients between 1 and 10 years of age. The awerage age at the onset of ankylosis was 11.7 and average duration at the time of examination was 11.7 years. 2. Unilateral akylosis (81.3%) was more frequent than bilateral ankylosis (18.7%). 3. Traum a (57.9%) and infection (21.2%) were main etiology. 4. Inability to open the mouth (78.3%) and facial asymmetry (17.4%) were main chief complaints. 5. Mandibular morphology through radiographic features. (a) In TMJ ankylosis patients the ramus length of the ankylosed side was shorter than that of the non-ankylosed side. Comparing with the centrol group, ramus length of the each side was shorter than normal value. (b) The partial body length of the ankylosed side was longer than that of the non-ankylosed side. Comparing with the control group, partial body length of the each side was longer than normal value. Partial body length was related with antegonial notch depth. (c) Ratio of upper and lower ramus length at the level of mandibular foramen was smaller in ankylosed side than in non-ankylosed side. (d) Antegonial notch depth and ramus posterior contour depth were deeper in ankylosed side than in non-ankylosed side and those of both sides were deeper than normal value. (e) Gonial angle in ankylosed side was larger than in non-ankylosed side and that in both sides was smaller than normal value.

• Journal of Oral Medicine and Pain
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• 제18권1호
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• pp.9-19
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• 1993

The purpose of this study was to evaluate the effect of craniocervical posture on craniomandibular disorders with chronic headache. The author measured craniocervical posture on frontal and sagittal plane with photographs for 26 headache patients, 23 TMD patients, and 27 nonpatients. Range of cervical spine motion was also measured. The bilateral electromyograms of masseter and anterior temporalis muscles were recorded at rest and during maximum clenching. The results were as follows : On the lateral view photos, eye-tragus-C7 line angle was larger and the tragus-C7-horizontal line angle was smaller in the patient groups than in the nonpatient group (p<0.05). On the frontal view photos, mouth corner line angle was larger in the headache patient group than in the nonpatient group and TMD patient group (p<0.05) Interclavicular angle was smaller in the headache patient group and TMD patient grop than in the nonpatient (p<0.01) The right and left differences of SAIC-plane distance and finger tip-plane distance were significantly larger in headache patient group than TMD patient group and nonpatient group (p<0.01, p<0.001). Cervical motion range was smaller in the TMD patient group and headache patient group than in the nonpatient group (p<-.001, p<0.05, p<0.05). The resting EMG activities of right masseter muscle were higher in the headache patient group than in the nonpatient group (p<0.05). However, the EMG activities of masseter and anterior temporalis muscles during maximal clenching were lower in the patient group than in the nonpatient grop (p<0.01). The asymmetry index of resting EMG of masseter muscles was higher in the headache patient group than nonpatient group (p<0.05).

• 대한치과교정학회지
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• 제43권1호
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• pp.42-52
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• 2013

The aim of this paper was to propose a new method of bimaxillary orthognathic surgery planning and model surgery based on the concept of 6 degrees of freedom (DOF). A 22-year-old man with Class III malocclusion was referred to our clinic with complaints of facial deformity and chewing difficulty. To correct a prognathic mandible, facial asymmetry, flat occlusal plane angle, labioversion of the maxillary central incisors, and concavity of the facial profile, bimaxillary orthognathic surgery was planned. After preoperative orthodontic treatment, surgical planning based on the concept of 6 DOF was performed on a surgical treatment objective drawing, and a Jeon's model surgery chart (JMSC) was prepared. Model surgery was performed with Jeon's orthognathic surgery simulator (JOSS) using the JMSC, and an interim wafer was fabricated. Le Fort I osteotomy, bilateral sagittal split ramus osteotomy, and malar augmentation were performed. The patient received lateral cephalometric and posteroanterior cephalometric analysis in postretention for 1 year. The follow-up results were determined to be satisfactory, and skeletal relapse did not occur after 1.5 years of surgery. When maxillary and mandibular models are considered as rigid bodies, and their state of motion is described in a quantitative manner based on 6 DOF, sharing of exact information on locational movement in 3-dimensional space is possible. The use of JMSC and JOSS will actualize accurate communication and performance of model surgery among clinicians based on objective measurements.