• Applied Microscopy
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• 제34권2호
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• pp.145-157
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• 2004

불소 투여가 백서태아 발육에 따른 법랑질형성 과정에 미치는 영향을 알아보고자 임신한 어미흰쥐에 대조군은 증류수만을 음용시켰고, 실험군은 100, 200 및 300 ppm의 불소가 함유된 음용수를 투여하였다. 이후, 생후 11일 된 어린 흰쥐를 희생하였고, 하악절치를 발치하여 법랑질형성 동안에 일어나는 법랑모세포의 형태 및 구조적 변화를 광학현미경과 투과전자현미경으로 관찰하였다. 흰쥐태아 치아기의 조직학적 구성은 전분비대, 분비대 및 성숙대로 관찰되었으며, 특히 성숙대의 법랑질에서 물과 유기물을 선택적으로 제거하는 평탄끝법랑모세포(smooth-ended ameloblast)와 무기이온을 추가로 공급하는 주름끝법랑모세포(ruffle-ended ameloblast)가 관찰되었다. 또한 치아기는 가장 외측으로부터 외법랑상피, 성상세망, 중간층, 법랑모세포층, 법랑기질층, 상아기질층, 치수로 이루어져 있었다. 이러한 조직학적 구성은 백서태아에서도 성체에서 관찰되는 구조들과 동일한 것으로 확인되었다. 한편, 불소투여군에서 각 대(zone)의 법랑모세포들은 구조적 및 형태적인 변화가 확인되었는데, 조면소포체가 공포화되고 막성계의 유실로 붕괴되었으며, 라멜라 형태인 동심원상의 팽윤된 구조가 미토콘드리아의 기질에서 관찰되었다. 특히 고농도 실험군인 300 ppm투여군에서 법랑모세포사이에 세포막이 유실된 세포들이 관찰되었다. 그러므로 임신중인 흰쥐에 투여된 불소는 흰쥐태아의 치아발육과정 중 법랑질형성에 관여하는 법랑모세포에 영향을 미쳐 전환주기에 변화를 주고 법랑모세포의 미세구조적 변화와 형태적인 변화를 초래하였다.

• Archives of Plastic Surgery
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• 제38권5호
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• pp.616-620
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• 2011

Purpose: Mayer-Rokitansky-Kuster syndrome (MRK) is second common cause of primary amenorrhea. It is a syndrome of vaginal aplasia and Mullerian duct anomaly. Vaginal aplasia varies from agenesis of whole vagina to aplasia of upper 2/3. For reconstructing vagina, various methods are introduced. Gracilis myocutaneous flap was the first attempt in that the flap is used in vaginal reconstruction. Various flap-based vaginal reconstruction methods have been introduced. Modified Singapore flap (pedicled neurovascular pudendal thigh fasciocutaneous flap) is one of those methods that used posterior labial artery as pedicle, and pudendal nerve branch as sensory root. As its donor lies on inguinal crease that is easily hidden and there are benefits on sexual intercourse by early sensory recovery, authors think that modified Singapore flap is effective for young MRK syndrome patients. Methods: Eight patients underwent surgery between 2008 and 2010. The flap was designed on both groin area with external pudendal artery branch as a pedicle. All flaps were fixated in pelvic cavity with absorbable suture, and additional compression on neovaginal wall was supplied by polyvinyl alcohol sponge ($Merocel^{(R)}$). Results: All patients were successfully reconstructed without flap related complications such as congestion or partial flap loss. The average size of the flap (each side) was 69.34 $cm^2$. Polyvinyl alcohol sponge ($Merocel^{(R)}$) was inserted into neovagina for 5 days on every patient. One case of rectal laceration was occurred while making pelvic pocket by OBGY team. Other complications such as lumen narrowing, wound contracture or vaginal prolapsed were not reported during 8 months of follow up. Conclusion: Modified Singapore flap is a sensate fasciocutaneous flap that is thinner than other myocutaneous flap such as VRAM, and more durable over skin graft. Therefore this is a good choice for vaginal reconstruction in MRK syndrome. And known complications of Modified Singapore flap could be reduced with careful procedure and mild compression techniques.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.376-382
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• 2011

Purpose: In patients with unilateral cleft lip and nose deformity, alar retraction is commonly seen on the non-cleft side after cleft side is corrected. Spacer graft was used to drag down the inferior border of the alar cartilage of the non-cleft side so as to match the cleft side. By performing spacer graft and septal extension graft together, symmetry and cosmetic improvements were achieved. Methods: Seven unilateral cleft lip and nose deformity patients underwent surgery for alar retraction correction. The median age was 24 years (ranged from 15 to 34 years), and the median follow-up period was 7.4 months (ranged from 6 to 12 months). The perpendicular length from the longitudinal axis of the nostril to the alar rim, the nasolabial angle and the ala-labial angle were measured in the lateral view photo. The longest perpendicular length from the cephalic border of the alar rim to the parallel line of the alar base was measured in the frontal view photo. Results: Improvement in alar retraction was seen after the surgery. There were no specific complications during the follow-up and the symmetry of both nostrils was satisfactory. No increase in the nasolabial angle or exposure of the nostrils was seen after the tip projection via tip plasty. Conclusion: The fundamental factor in correcting alar retraction with secondary cleft lip and nose deformity is repositioning the alar rim with spacer graft, which seems to be more physiologic than other methods. The method combining spacer graft with septal extension graft will bring symmetry as well as more cosmetic improvement in correction of alar retraction with secondary cleft lip and nose deformity.

• Restorative Dentistry and Endodontics
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• 제23권1호
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• pp.68-93
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• 1998

The physical properties of polymer are greatly influenced by the extent to which a resin cures. The presence of un reacted monomer can, have a plasticizing effect on the polymer, thereby altering the physical and mechanical properties of dentin bonding agent (DBA). If the DBA does not polymerize sufficiently, it will leave a weak bonding layer and lead to lower bond strength. The purpose of this study was to evaluate the shear bond strengths(SBS) and the degree of conversion (DC) of 4 commercialy avilable dentin bonding systems which are composed of 2 multi-bottle systems [Scotchbond Multi-Purpose (SMP), AeliteBond(AB)] and 2 onebottle systems [SingleBond(SB), One-Step(OS)]. For shear bond strength measurement, labial surfaces of freshly extracted bovine incisors were ground with # 600 grit SiC paper to expose dentin. Four different groups of samples were formed, with 10 samples. being made for each of the 4 commercial DBA in each group according to the curing sequences of DBA and overlayer thickness of composites: Group I (standard cure and 1mm thick composites) : The DBA was light cured and the composites of 1mm thickness was applied ; Group II (standard cure and 2mm thick composites) : The DBA was light cured and the composites of 2mm thickness was applied; Group III (simultaneous cure and 1mm thick composites) : The DBA was not light-cured and simultaneously cured with composites of 1mm thickness; Group N (simultaneous cure and 2mm thick composites) : The DBA was. not light-cured and simultaneously cured with composites of 2mm thickness. The SBS was measured immediately after the composites was bonded to the bovine dentin using an Instron machine. The DC of the DBA was examined in a thin film under simulated conditions of the experimental groups according to the curing sequences and overlayer thickness of composites in the SBS test. using a Fourier transform Infrared(FTIR) spectrometer. The following results were obtained from SBS tests and DC measurements 1. In SBS tests, the multi-bottle DBA(SMP, AB) had a generally higher bond strength values than the one bottle DBA(SB, OS). In DC measurements, the one bottle DBA(SB, OS) had a significantly higher DC than the multi-bottle DBA(SMP, AB). 2. In all DBAs except OS, there was no significant difference between the bond strength of group I (standard cure and 1mm thick composites) and that of group III (simultaneous cure and 1mm thick composites). SMP, SB in Group I had a significantly higher DC than those in group III, but AB, OS in group I had a significantly lower DC than those in group III 3. All DBAs in Goup II (standard cure and 2mm thick composites) had significantly higher bond strength and DC than those in Group N (simultaneous cure and 2mm thick composites). 4. In all DBAs, there was no significantly different SBS and DC between Group I and Group II, but all DBAs in Group III had significantly higher SBS and DC than those in Group IV.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.35.1-35.6
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• 2020

Background: Miescher's cheilitis granulomatosa (MCG) is a rare chronic inflammatory disease and is known as the monosymptomatic clinical form of Melkersson-Rosenthal syndrome (MRS). It is characterised by swelling of one or both lips and more frequently affects the upper lip. Histopathological findings show the presence of numerous inflammatory infiltrates and granuloma formations. Pharmacological treatments and surgery have provided results that are positive yet insufficiently stable in the long term. The clinical case described is of a 68-year-old female patient with a diagnosis of MCG of the upper lip. Case presentation: The patient was diagnosed and treated at the Oral Medicine and Oral Pathology outpatient clinic of Maxillofacial and Odontostomatology Unit, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico. The patient was recommended localised treatments of photobiomodulation (PBM) using a diode laser with a 635 nm and 980 nm dual-wavelength (λ) approach, a 600-micron fibre, and a handpiece with a 1-cm-diameter lens at 300 mW. Three treatments a week were administered for four weeks for a total of 12 treatment sessions (T₁-T₁₂). After that, the patient had a long follow-up period of about 2 years. The therapeutic results were clear from the initial stages of treatment. There was an immediate, gradual, and consistent reduction in labial swelling. A reduction in the size of the lip by about 35% at T₁₀-T₁₂ was observed, returning the size and volume of the upper lip within the normal clinical range. The painful symptoms subsided after the seventh treatment (T₇). The histopathological check at 3 months and the follow-up in particular confirmed the disease was in remission with satisfactorily stable treatment results. Moreover, the patient did not use any other treatments on the area from the early laser treatments through to the end of the follow-up period. Conclusions: Our experience describes a clinical case of MCG treated with PBM and effectively resolved with a reduction of the lip swelling. The real success of the treatment emerged over time, showing that the tissue healing was stable. In absence of any collateral phenomena, this confirms the effective and documented therapeutic potential of PBM for chronic inflammatory infiltrates.

• 말소리와 음성과학
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• 제10권4호
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• pp.77-89
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• 2018

Speech articulators are coordinated for the purpose of segmental constriction in terms of a task. In particular, vertical jaw movements repeatedly contribute to consonantal as well as vocalic constriction. The current study explores vertical jaw movements in conjunction with bilabial constriction in bilabial stop /p/ in the context /a/-to-/a/. Revisiting kinematic data of /p/ collected using the electromagenetic midsagittal articulometer (EMMA) method from seven (four female and three male) speakers of Seoul Korean, we examined maximum vertical jaw position, its relative timing with respect to the upper and lower lips, and lip aperture minima. The results of those dependent variables are recapitulated in terms of linguistic (different word boundaries) and paralinguistic (different speech rates) factors as follows. Firstly, maximum jaw height was lower in the across-word boundary condition (across-word < within-word), but it did not differ as a function of different speech rates (comfortable = fast). Secondly, more reduction in the lip aperture (LA) gesture occurred in fast rate, while word-boundary effects were absent. Thirdly, jaw raising was still in progress after the lips' positional extrema were achieved in the within-word condition, while the former was completed before the latter in the across-word condition. Lastly, relative temporal lags between the jaw and the lips (UL and LL) were more synchronous in fast rate, compared to comfortable rate. When these results are considered together, it is possible to posit that speakers are not tolerant of lenition to the extent that it is potentially realized as a labial approximant in either word-boundary condition while jaw height still manifested lower jaw position in the across-word boundary condition. Early termination of vertical jaw maxima before vertical lower lip maxima across-word condition may be partly responsible for the spatial reduction of jaw raising movements. This may come about as a consequence of an excessive number of factors (e.g., upper lip height (UH), lower lip height (LH), jaw angle (JA)) for the representation of a vector with two degrees of freedom (x, y) engaged in a gesture-based task (e.g., lip aperture (LA)). In the task-dynamic application toolkit, the jaw angle parameter can be assigned numerical values for greater weight in the across-word boundary condition, which in turn gives rise to lower jaw position. Speech rate-dependent spatial reduction in lip aperture may be able to be resolved by means of manipulating activation time of an active tract variable in the gestural score level.

• 대한소아치과학회지
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• 제46권1호
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• pp.93-100
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• 2019

이 연구의 목적은 상악 유중절치를 절단, 중간, 치경부로 나누어 각 부위의 색조 분포 및 각 부위 색조 사이의 관계를 분석하는 것이었다. 3세에서 6세 어린이의 건전한 상악 유중절치의 색조를 분광광도계를 이용하여 측정하였다. CIE $L^*$, $a^*$, $b^*$, $C^*$, $h^*$ 및 이에 가장 잘 맞는 shade가 각 부위와 전체 순면에 대해 얻어졌다. 각 부위 및 전체 순면에 대해 CIE $L^*$, $a^*$, $b^*$는 유의한 차이가 있었고(p < 0.05) 각 부위 사이의 색조 차이는 임상 허용의 한계치 보다 컸다. 각 부위의 색조 사이의 관계를 $L^*$, $a^*$, $b^*$ 값 사이의 관계로 정리하면 한 부위의 색조로 다른 부위의 색조를 예상하거나 유치의 색조에 더 잘 부합하는 수복 재료 및 보철물을 제작하기 위한 자료로 활용할 수 있다.

• 대한치과보철학회지
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• 제60권2호
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• pp.168-174
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• 2022

상악 전치부의 임플란트 식립 시 치은 퇴축이나 골 결손 문제를 동반하는 경우에는 심미적인 임상 결과를 얻기가 쉽지 않다. 본 증례에서는 상악 우측 중절치에서 순측 치조골판의 소실이 진단되어 발치 후 연조직을 확보한 후에 골 이식을 동반하는 임플란트 식립을 계획하였다. 또한 이상적인 임플란트 식립 위치를 위해 디지털 가이드 수술을 시행하였고, 치조골 결손부가 광범위하기 때문에 하악지에서 자가골 채취 후 이종골과 함께 골유도재생술을 동반하였다. 충분한 임플란트의 골 유착 기간을 거친 뒤 2차 수술 및 인상 채득을 통한 임시 보철물을 제작하였고, 주기적인 외형 조정을 통해 연조직의 형태를 개선하였다. 최종 보철물 제작시에는 양극 처리를 시행한 맞춤형 지대주를 사용하여 자연 치아의 색조를 유도하였고, 구강 스캔을 통하여 임시 보철물의 형태를 재현해 줌으로써 심미적이고 기능적인 지르코니아 보철물을 장착해 주었다.

• 대한치과보철학회지
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• 제60권4호
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• pp.320-329
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• 2022

생리적 마모는 일생 동안 불가피하게 일어나고 정상현상이라고 볼 수 있다. 하지만, 병적인 마모는 교합면에 치명적 손상을 야기하고 심미 및 적절한 전방유도를 파괴 할 수 있다. 따라서 교합면 마모 회복을 위해서는 철저한 평가와 진단이 필요하다. 본 증례의 환자는 하악 치아 순면과 상악 치아 설면의 심한 마모를 보였다. 수직교합고경을 분석 하였고, 부족한 보철수복공간을 회복을 위해 수직교합고경을 높여서 치료하기로 하였다. 수직교합고경이 결정 된 후에는 보통 진단 왁스업을 하여 치료를 진행한다. 본 증례는 심한 마모로 인한 교합붕괴 및 수직교합고경이 상실된 환자에서, 기존의 진단왁스업 과정을 다양한 디지털 도구를 사용하는 방법으로 대체하였다. 진단왁스업은 소프트웨어에서 디자인되어 디지털로 임시보철물을 제작하였다. 임시보철물 검증을 통해, 수직교합고경 및 적절한 전방유도로 회복되었다.

• 대한치과보철학회지
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• 제60권4호
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• pp.404-411
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• 2022

본 증례의 환자는 80세 여성으로 #16, 13, 26, 37, 36, 35, 44, 45, 46, 47 치아가 상실되었으며, 하악 구치부의 결손으로 상실된 구치부 지지와 감소한 수직교합고경 및 전치부의 심한 수직피개를 보였다. 심미 및 기능상의 불편을 호소하였고, 보철치료를 통한 정상적인 안모 및 저작기능 회복을 주소로 내원하였다. 임상 소견, 방사선 검사, 안모 및 구내 분석 등을 시행하였다. 교합안정공극은 평균보다 과도하였고 상하악 전치 치은연 사이 거리 및 상하악 순측 전정 사이 거리, 하안면의 비율은 부족하여 수직고경 증가가 필요한 경우로 판단하였다. 소구치부 기준 약 4 mm의 수직고경 거상을 통한 교합 회복을 결정하였다. 본 증례에서는 구치부를 상실하여 전치부의 deep bite 및 수복공간의 부족을 보이는 환자에서 수직고경 거상 및 고정성, 가철성 보철물을 이용한 수복으로 안정된 교합관계 및 전방, 측방유도를 형성하여 환자의 심미적, 기능적인 수복 결과를 이끌어냈기에 이를 보고하는 바이다.