• 제목/요약/키워드: mandibular condyle

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하악골 하연에 발생한 골연골종: 증례보고 (Osteochondroma of the mandibular inferior border: an atypical case)

  • 길태준;김재영;김소미;김학진;남웅
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권3호
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    • pp.214-216
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    • 2010
  • An osteochondroma is an osseous protuberance with cartilaginous growth potential, usually arising in skeletal bone and relatively uncommon in the craniofacial bone. Osteochondroma of the craniofacial region usually occurs at the condyle or the tip of the coronoid process, and rarely arises in the mandibular body, symphysis, ramus, and similar areas. Excision of the lesion including the periosteum is curative, and recurrence or malignant change (usually to a chondrosarcoma) after treatment is rare. We present an atypical case of osteochondroma in the left mandibular inferior border with review of literature.

하악지 시상 분할술에 있어 술후 하악과두의 위치와 측두 하악관절장애 (THE POSTOPERATIVE CONDYLAR POSITION RELATED TO TEMPOROMANDIBULAR DISCOMFORT IN SAGITTAL SPLIT RAMUS OSTEOTOMY)

  • 유준영
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제19권2호
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    • pp.130-134
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    • 1997
  • 본 저자는 하악지시상분할법이 측두하악관절장애와 관련되어 교합의 개선과 과두의 위치적변화에 어떤영향을 미치는가에 관해 연구하고자하여 다음과 같은 결과를 얻었다. 측두하악관절증상은 약 80%에서 개선되었으며 이는 아마도 부정교합의 개선으로 일어난 것이 아닌가 생각된다. 하악지 시상분할술에 있어 측두하악관절의 구조적 변화가 야기되는데 이것이 관절의 기능에 어떤 변화를 주어 측두하악관절증상과 관련해서 발생되는 것으로 추정되고 단기 추적조사와 비교해 볼 때 장기추적조사 결과 하악두위치변화에도 불구하고 Range of adaptation이 환자 개개인에 존재하는 것이 아닐까 생각된다. 이와 같은 결과를 종합해볼 때 경미한 측두하악관절증상을 동반한 하악전돌증환자에서 악교정수술을 시행함에 있어 개인의 하악두의 위치를 지켜주어 부정교합의 개선과 정상적인 관절기능을 유지시켜주는 것이 회귀성향과 관련하여 중요한 요소가 아닌가 생각되며 회귀성향과 하악두의 위치관계 또 측두하악의 증상등을 연관하여 더 진행된 연구가 필요하리라 사려된다.

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측두하악관절의 초음파영상과 자기공명영상에서 하악과두 외측면과 관절낭간 거리 측정치 비교 (Comparison of the capsular width measured on ultrasonogrape and MR image of the temporomandibular joint)

  • 이태완;유동수;한원정;김은경
    • Imaging Science in Dentistry
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    • 제36권1호
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    • pp.41-48
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    • 2006
  • Purpose : To evaluate the reliability and clinical usefulness of ultrasonography in the temporomandibular joint (TMJ). Materials and Methods : Parasagittal and paracoronal 1.5 T MR images and 7.5 MHz ultrasonographs of 40 TMJs in 20 asymptomatic volunteers were obtained. Disc position using MR imaging was evaluated and the distance between the lateral surface of mandibular condyle and the articular capsule using MR image and ultrasonograph of 27 TMJs with normal disc position was measured and compared. Intraobserver and interobserver measurements reliability was evaluated by using interclass correlation coefficients (ICC) and measurement error. Also, the distance measured on ultrasonographs was compared, according to mouth position and disc postion. Results : The normal disc position was found in 27 of 40 asymptomatic joints. At the intraobserver reliability of measurement, ICC at the closed and open mouth position were 0.89 and 0.91. The measurement error was 0.4% and 0.5%. At the interobserver reliability, ICC at the closed and open mouth position were 0.92 and 0.81. The measurement error was 0.4% and 0.7%. At the TMJ with normal disc position, the distances between the lateral surface of mandibular condyle and the articular capsule measured on MR images and ultrasonographs were $2.0{\pm}0.7mm,\;1.8{\pm}0.5mm$, respectively (p<0.05). On the ultrasonographs, the distances at open mouth position were $1.2{\pm}0.5mm$ (p<0.05). At the TMJ with medially displaced disc, the distances at the closed and open mouth position were $1.3{\pm}0.3\;mm\;and\;0.9{\pm}0.2\;mm$ (p<0.05). Conclusion : The results suggest ultrasonography of TMJ is a reliable imaging technique for assessment of normal disc position.

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수직고경이 붕괴된 골격성 III급 부정교합자의 악교정 수술 치험례 (Orthognathic surgery on Skeletal Class III patiens with collapsed vertical dimension: case report)

  • 최윤경;김용덕;박수병;김용일;김성식;손우성
    • 구강회복응용과학지
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    • 제32권1호
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    • pp.70-79
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    • 2016
  • 치주 질환이나 치아 우식으로 인해 구치부 치아가 상실된 환자들은 대합치 정출 및 인접치 경사가 발생하여, 교합평면의 붕괴나 수직 고경의 상실로 하악골 위치 변화가 나타날 수 있다. 특히 악교정 수술 환자에서, 이런 증상이 나타날 경우 하악과두가 관절와 내에서 안정화된 위치에 존재하여 술 후 안정성을 높일 수 있도록, 술 전 수직 고경을 재설정하는 치료가 필요하다. 따라서 보철, 교정, 구강악안면외과 등 다분야에서 진단 및 치료 계획에서부터 원활한 의사소통을 통한 양호한 치료 결과를 얻을 수 있도록 협력하는 것이 중요하다.

Protrusive maxillomandibular fixation for intracapsular condylar fracture: a report of two cases

  • Jeong, Yeong Kon;Park, Won-Jong;Park, Il Kyung;Kim, Gi Tae;Choi, Eun Joo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제43권5호
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    • pp.331-335
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    • 2017
  • Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

하악골 관절 과두돌기 골절의 임상적 연구 (Statistical study of Mandibular condylar process fractures)

  • 이희철;강신익;고영규
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제11권1호
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    • pp.287-296
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    • 1989
  • 하악골 과두돌기 골절은 하악골에 있어서 자주 일어나는 골절중의 하나이며, 이 부위는 해부학적 구조로 이상적인 Reposition ( )이 통례적으로 불가능 하다고 할 수 있을 정도로 어렵기 때문에 치료방법이 선택적으로 이용된다. 수술후 충분한 악관절기능을 발휘하는데 문제가 있을수도 있기 때문에 (Arthropathia deformans) 치료 계획을 세우는데 있어서는 우선 관절기능이 정상적으로 회복되어져야 하며, 또한 악관절 강직에 따른 안면골의 발육 부전으로 인한 악골기형을 고려하여야 한다는데 치료의 촛점이 두어져야 한다. 본인은 1981년 부터 1987년까지 인제대학부속부산백병원에서 치료한 바 있는 73명을 대상으로 (88골절선) 임상조사와 문헌적 고찰을 통하여 악관절 과두돌기 골절에 대한 치료방법의 선택기준 및 합병증 방지에 그 일익을 하고자 이 연구를 시행하였다.

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악관절기능장애 진단을 위한 두부축방향 방사선사진에서의 하악과두의 위치분석 (A POSITIONAL ANALYSIS OF MANDIBULAR CONDYLE ON THE SUBMENTOVERTEX RADIOGRAPH FOR DIAGNOSIS OF TEMPOROMANDIBULAR JOINT DYSFUNCTION)

  • 김석호;최순철;변종수
    • 치과방사선
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    • 제21권1호
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    • pp.73-81
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    • 1991
  • 저자는 악간절기능장애의 소견을 가진 환자 75명과 악관절기능장애의 병마 및 현증이 없는 정상인 75명을 표준화된 조건하에서 두부축방향방사선촬영을 하여 과두수평각과 initial 및 final depth of cut를 측정하고 통계학적으로 분석한 결과를 다음과 같이 요약할 수 있었다. 환자군과 정상군, 환측과 비환측에 있어 과두수평각과 initial 및 final depth of cut는 통계학적으로 유의한 차가 없었으므로 두부축방향방사선사진은 임상에서 악관절기능장애의 유무 및 환측과 비환측의 감별에 이용하기에 부적합한 방법이라 사료된다. 본 연구의 계측치는 편차가 심하므로 환자마다 과두수평각을 측정하여 이각에 맞추어 악관절단층촬영을 해야 한다고 사료된다.

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반조절성교합기와 구강에서의 운동 오차에 대한 비교 연구 (A study on the difference of movement between Semi adjustable articulator and Oral in vivo)

  • 문희경
    • 대한치과기공학회지
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    • 제28권1호
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    • pp.53-59
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    • 2006
  • The movement range on the semi adjustable articulator and the movement range in an oral were measured. And then I studied to analyze the gap. I got wax records by the movement on the semi adjustable articulator, the movement in an oral. I measured the distance of the cusp tips that are close to the mesial direction and the distal direction, the buccal direction and the lingual direction then I compared gaps. As I saw results on data, I knew that the semi adjustable articulator represented the range of mandibular movement restrictively. I could find the decisive contradiction that the sliding movement finished on the semi adjustable articulator although it did not finish in an oral. When the sliding movement does not reappear exactly, it brings a fatal failure to the dental prosthesis. In addition it is impossible that the semi adjustable articulator restores the movement in an oral because the lateral condyle inclination and the horizontal condyle inclination are appeared to be straight. Therefore dental prosthesisses were made by the semi adjustable articulator, they will interfere with a mastication. I have obtained the following results; 1. The distance of sliding movement on the semi adjustable articulator showed shorter than the distance of sliding movement in oral. This means the increase of cusp inclination of the dental prosthesis that was made on the semi adjustable articulator. Therefore, when the lateral movement occurs in oral, there is a possibility to become the premature as the increase of cusp inclination. 2. The difference in the range of movement is considered as the gap that is made because the movement only can be occurred as straight in the semi adjustable articulator. 3. When the dental technician understand mandibular movement and articulator deficiencies, they can attain proficiency in use of the articulator and reduce the gap.

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돼지 하악 과두의 해면골에서 유한요소분석법으로 예측한 방향에 따른 탄성율과 3차원 골 미세지표 간의 상관관계 (The relationship between 3D bone architectural parameters and elastic moduli of three orthogonal directions predicted from finite elements analysis)

  • 박관수;이삼선;허경회;이원진;허민석;최순철
    • Imaging Science in Dentistry
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    • 제38권2호
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    • pp.81-87
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    • 2008
  • Purpose: To investigate the relationship between 3D bone architectural parameters and direction-related elastic moduli of cancellous bone of mandibular condyle. Materials and Methods: Two micro-pigs (Micro-$pig^R$, PWG Genetics Korea) were used. Each pig was about 12 months old and weighing around 44 kg. 31 cylindrical bone specimen were obtained from cancellous bone of condyles for 3D analysis and measured by micro-computed tomography. Six parameters were trabecular thickness (Tb. Th), bone specific surface (BS/BV), percent bone volume (BV/TV), structure model index (SMI), degree of anisotropy (DA) and 3-dimensional fractal dimension (3DFD). Elastic moduli of three orthogonal directions (superior-inferior (SI), medial-lateral (ML), andterior-posterior (AP) direction) were calculated through finite element analysis. Results: Elastic modulus of superior-inferior direction was higher than those of other directions. Elastic moduli of 3 orthogonal directions showed different correlation with 3D architectural parameters. Elastic moduli of SI and ML directions showed significant strong to moderate correlation with BV/TV, SMI and 3DFD. Conclusion: Elastic modulus of cancellous bone of pig mandibular condyle was highest in the SI direction and it was supposed that the change into plate-like structure of trabeculae was mainly affected by increase of trabeculae of SI and ML directions.

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이유백서에서 교근절제후 하악과두의 면역조직화학적 연구 (AN IMMUNOHISTOCHEMICAL STUDY ON MANDIBULAR CONDYLE IN WEANLING RAT AFTER MASSETER MUSCLE RESECTION)

  • 최남기;최홍란;양규호
    • 대한소아치과학회지
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    • 제23권2호
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    • pp.559-574
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    • 1996
  • The purpose of this study was to determine whether there was any correlation between temporomandibular joint dysfunction and structure of the mandibular condyle. Weanling rats had their masseter muscles resected and immunohistochemical findings were observed with a light microscope. The results obtained were as follows : 1. The condylar cartilage region was divided into articular, proliferating, cartilage cell and hypertrophic cell layers according to cell morphology. 2. In light microscopic views, the proliferating and cartilage cell layers of the experimental group decreased gradually and at the 8th week significantly. 3. In immunohistochemical staining for type I and II collagen, a reaction was detected in the lower part of proliferating cell and cartilage cell layers. In the cartilage cell layers, a stronger cellular reaction was present. Immunohistochemical staining for type II collagen reacted more strongly than that of type I collagen. 4. In immunohistochemical staining for proteoglycan, the staining of the experimental group resembled the control group and gradually showed a weak reaction. The proliferating and cartilage cell layers reacted more strongly than the hypertrophic cell layer. 5. In immunohistochemical staining for proliferating cell nuclear antigen(PCNA), the strong reaction was detected in the nucleus of the proliferating cell layer both in control and experimental groups. But the thickness of the proliferating layer decreased in experimental group, consequently the reaction of the experimental group was reduced more than that of the control group.

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