• 대한치과보철학회지
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• 제58권2호
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• pp.110-120
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• 2020

모든 과개교합을 가진 환자를 병적인 상태로 판단할 수는 없지만 전치부에 교합접촉이 불안정하거나, 전반적인 교합 부조화가 동반된다면 과개교합은 하악 전치에 대한 지속적인 마모와 정출을 일으킬 수 있다. 이 증례는 72세 남성환자로 상악과 하악의 전치가 잔존해 있지만 골격성 2급 부정교합으로 인하여 안정위 상태에서 교합접촉이 불가능하고 교합지지가 완전히 상실되어 수직고경의 증가가 필요한 환자였다. 이 증례는 보철 수복을 위해 수직고경의 증가가 필요한 경우로 수평피개를 더욱 심화시켜 교합의 부조화를 유발할 수 있기에 정밀한 진단을 통한 수직고경 증가량 결정이 필요하였다. 이 증례에서는 Dahl concept를 응용한 가철성 국소의치 보철물을 이용하여 안정적인 교합을 완성하였으며 적절한 치료 결과를 보였기에 이를 보고하고자 한다.

• 대한구순구개열학회지
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• 제12권2호
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• pp.85-94
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• 2009

Cleft lip and palate patients show midface hypoplasia, maxillary hypoplasia due to scar of previous surgery, and manifest as a class III malocclusion, retruded midface and shallow palate. These deformities have been treated with traditional orthognathic surgery. Although conventional Le Fort I osteotomy was performed on most cleft patinets with midface hypoplasia, it showed limited amount of maxillary advancement and high relapse tendency. Recently, when great amount of advancement are required in severe maxillary hypoplasia, distraction osteogenesis using RED system is widely used. But, several months of consolidation period is needed after distraction osteogenesis, occlusal relationship is not stable until mandibular setback surgery has done in mandibular hyperplasia cases and during these period, patients may feel discomfort. We present clinical cases of immediate rigid internal fixation after completion of maxillary distraction using RED system and simultaneous mandibular setback procedure in adult cleft and lip patients who show both maxillary hypoplasia and mandibular prognathism.

• Journal of Korean Dental Science
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• 제10권1호
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• pp.35-44
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• 2017

In case of loss of many teeth due to dental caries or periodontal disease, improvement of masticatory function and aesthetics can be obtained through implant treatment. However, if the patient does not have a normal intercondylar relationship, it is difficult to achieve an ideal occlusal relationship with only prosthetic treatment. In particular, oral reconstruction with orthodontic treatment or orthognathic surgery is necessary for patients with mandibular prognathism. However, if the posterior occlusion collapses due to severe caries or periodontal disease, orthognathic surgery may be difficult. The occlusal vertical stop is very important for the stability of the mandibular position during occlusal reconstruction through orthognathic surgery. The patient in this case had posterior occlusion collapsed due to the caries of a large number of posterior teeth, and showed mandibular prognathism and long face. We planned a full arch restoration with orthognathic surgery and extracted the hopeless teeth. To secure the vertical stop required for orthognathic surgery, the implant was placed before surgery. After the orthognathic surgery and the final prosthesis application, the results were satisfactory for the improvement of the aesthetics and the restoration of the masticatory function.

• 대한장애인치과학회지
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• 제14권1호
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• pp.41-44
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• 2018

본 증례에서는 MAS 환자의 치과적인 특성에 관하여 논하였다. 본 환아는 현재 특히 하악 우측골의 팽융과 안면 비대칭 소견을 보이고 있었으며 치아의 교모, 변위, 맹출 지연, 맹출 경로 이상 등의 특징을 보이고 있었다. MAS 환자들에게서는 이러한 증상뿐 아니라 앞서 언급되었던 치아 우식에 이환될 위험성을 높이는 다른 여러 증상들이 발현될 수 있다. 따라서 환아에게 해당 증상이 발생할 수 있음을 보호자에게 설명하였고, 주기적인 관찰을 시행하고 있다. 결론적으로 MAS 환자에서 가장 중요한 것은 정기적인 검진이며, 이러한 검진 과정에서 임상적인 증상들이 나타난다면 치과의사의 교정치료나 충치치료 등의 적절한 개입이 필요하고 환자에게도 교육의 중요성이 더욱 강조된다. 장기적인 검진은 본 환아의 병소에 대한 이해를 높일 것이고 치료 결과의 질을 높여줄 것이라고 판단된다. 소아의 파노라마 방사선 사진 판독 시 치아와 주변 골조직의 주의 깊은 관찰이 동반된다면 이러한 질환의 조기 진단에 도움이 될 것이다.

• 대한치과의사협회지
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• 제53권9호
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• pp.602-609
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• 2015

The aim of this document is to evaluate the effect of bite balance on physical fitness and motor capacity to determine the importance of the occlusal stability as a possible action mechanism of occlusal appliance including mouthguards on physical performances. We all remember that day when the prominent athlete was in the news wearing a mouthguard to improve human athletic performance. I once had investigated the determinants of athletic performance in all sorts of sports. Most of the studies had overinterpretation of results and lack of evidence to support the information. However, I discovered great expectations for new possibility in this field and settled for a more academic approach to this intriguing subject. The followings are some examples of the subject 1. Archers who wore occlusal appliances to increase the vertical dimension of occlusion by 2~3mm increased their ability to focus and to maintain good sense of balance. Their accuracy rate has been improved. The appliance was made of acrylic resin (a type of plastic). 2. Canoe players who wore occlusal appliances to increase the vertical dimension of occlusion by 5mm surpassed longtime competitor and won the race with 10 seconds gap. 3. A cycle rider who wore an occlusal appliance to treat his malocclusion surpassed his old record from 10.8 seconds to 10.3 seconds. His muscle reflexes (anaerobic exercise) and endurance (aerobic exercise) has been enhanced. 4. Occlusal appliances had a good effect on athletic performance in most sports such as swimming, diving, and weightlifting. As for the clenching on dentition, people clench their teeth when they push their physical and mental limits during sports activities. Clenching can be induced by physical exertion when maximum muscle strength is retained and this is similarly found in different types of exercises. In addition, restraint of respiratory function is observed. Therefore, creating a occlusal balance with occlusal appliance or mouthguard promoted a favorable influence when an athlete clenches.

• 대한치과의사협회지
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• 제54권12호
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• pp.1045-1054
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• 2016

Purpose : Aim of this study is to describe and compare clinical results and complications epending on the surgical approaches for the mandibular subcondyle fracture Materials and methods : The patients who had been diagnosed as the mandibular subcondyle fracture and underwent open reduction and internal fixation from May 2009 to December 2014 were included. They were divided into two groups depending on the surgical approaches; endoscopically assisted transoral approach and retromandibular approach. Association between the preoperative fracture classification and post-operative results was reviewed depending on the surgical approaches. Results : The number of patients selected in this study was 33. Eighteen patients (male 7, female 11) underwent open reduction and internal fixation via retromandibular approach and fifteen patients (male 12, female 3) underwent open reduction and internal fixation via endoscopically assisted transoral approach. The mean age, follow up period, and operation time were $44.29{\pm}15.19years$, $9.97{\pm}7.82months$, and $161{\pm}89.44minutes$. Post-operative results were all "good" state in the retromandibular approach group regardless of the fracture classification but two patients in the endoscopically assisted transoral approach group underwent re-operation due to "poor" results. The fracture types of two were classified as displacement and lateral override at the same time. There was no statistically significant difference between two groups. Three patients in the retromandibular approach group had experienced facial nerve palsy (17%) temporarily. No one showed malocclusion in this study. There was no significant difference on the complications such as temporomandibular disorder, local infection, and condyle resorption depending on the surgical approaches. Conclusion : In this study, there was no significant difference on the complications between the two groups but retromandibular approach has advantage over endoscopically assisted transoral approach in case of the severely displaced subcondyle fracture.

• 대한치과기공학회지
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• 제33권4호
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• pp.539-550
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• 2011

Purpose: The aim of this study was to investigate distribution of the admitted patients with disease of oral cavity, salivary glands and jaws, current clinical treatment condition and clinical dental practice. Methods: The subject were 4,564 patients with disease of oral cavity, salivary glands and jaws of the Korean National Hospital Discharge Injury Survey 2004-2008 data. This study was carried out using the administrative database including patients' characteristics and comorbidity. The statistical analysis for ratio, gender, age, region, primary diagnosis, comorbidity, operation, hospital location and bed size of inpatients in Korean National Hospital Discharge Injury Survey was conducted by frequency analysis. Results: Among the total discharge injury patients in 2004-2008, the trend showed decrease of ratio of patients with disease of oral cavity, salivary glands and jaws. The portion of male was higher than female, and 20~29 age group was the highest portion compared with other age groups. Seoul-Gyunggi region was the highest among the other residences. patients with Dentofacial anomalies[including malocclusion] as primary diagnosis, digestive system as comorbidity and operations on facial bones and joins showed the highest portion respectively. Seoul-Gyunggi region was the highest portion compared with other residences. 500~999 bed size showed the highest portion. Conclusion: In this study showed that distribution of patients with disease of oral cavity, salivary glands and jaws, current dental clinical treatment condition using the Korean National Hospital data.

• 셀메드
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• 제2권1호
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• pp.6.1-6.4
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• 2012

The traumatic removal of the mandibular third molar may promote post chirurgic consequences such as orofacial pain and limited mandibular movements. The aim of this case report is to describe the use of an anterior bite plane and complementary therapies (low level laser therapy and acupuncture) to treat the muscular dysfunction and the painful symptoms. A 33 year-old male patient who had a severe malocclusion and signs and symptoms of temporomandibular dysfunction was submitted to an initial clinical examination: electromyography of the masticatory muscles and IRM of the temporomandibular joint. After treatments, the results showed reduced pain symptoms and an increase of the mandibular movements and adequated electromiographic activities. The authors concluded that the combination therapies may be used as an alternative treatment because it satisfied the functional requirements of the patient and provided an asymptomatic clinical condition.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.9.1-9.7
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• 2015

Background: This study are to identify the symptomatic changes and condylar stability after 2 jaw surgery without preceding treatments for Temporomandibular joints(TMJ) in class III patients with the TMJ symptoms; and to assess therapeutic effect of 2 jaw surgery and the necessity of preceding treatment for alleviation of TMJ symptoms. Methods: 30 prognathic patients with preexisting TMJ symptoms were divided into 2 groups according to presence or absence of preceding treatments before the surgery. We evaluated symptomatic changes on both TMJ by questionnaires and clinical examinations. And we reconstructed 3D cone beam computed tomography images before 2 jaw surgery, immediately after the surgery, and 6 months or more after the surgery with SimPlant software, and analyzed the stability of condylar position on 3D reconstruction model. Significances were assessed by the Wilcoxon signed rank test on SPSS ver. 20.0. Results: Both groups had favorable changes of TMJ symptoms after orthognathic surgery. And postoperative position of condyle had good stability during follow-up period. Conclusion: 2 jaw surgery without preceding treatments for TMD can have therapeutic effect for TMD patients with class III malocclusion.

• 대한치과교정학회지
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• 제26권1호
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• pp.113-124
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• 1996

교정치료를 위한 상악 제1 소구치, 하악 제2 소구치의 발치는 한국인에서 II급 부정교합환자가 많지 않기 때문에 그리 흔하지 않다고 생각한다. 이와 같은 발치는 다음과 같은 장점을 제공할 수 있다. 첫째, 하악 전치를 약간만 retraction을 하며, 주로 하악의 구치부를 전방이동하여 II급 관계의 key correction을 손쉽게 할 수 있다. 둘째, 하악 전치의 과도한 설측경사가 일어남을 방지한다. 이는 하악 안모의 심한 변화를 방지하여 준다. 단점으로는 하악 제1 대구치의 근심경사를 들 수 있으며 이는 적절한 mechanics의 사용으로 방지하여 줄 수 있다. 본 증례들은 II급 1류의 특성을 가진 환자들로서 상악 제1 소구치, 하악 제2 소구치의 발치를 이용하여 교정치료를 하여 비교적 양호한 결과를 얻어 다음과 같이 보고하고자 한다.