• Imaging Science in Dentistry
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• 제51권3호
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• pp.313-321
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• 2021

Ankylosis of the temporomandibular joint (TMJ) is a disabling disease resulting from fibrous or bony fusion of the mandibular condyle and the glenoid fossa. Early diagnosis and surgical treatment are essential to prevent facial deformity and other complications. Conventional radiography has limitations in demonstrating the true extent of ankylosis. It is important for surgeons to be aware of the size and degree of bony ankylosis in order to perform complete resection of the ankylotic mass. In addition, a detailed evaluation of the relationship with adjacent vital structures such as the internal maxillary artery, inferior alveolar nerve canal, external auditory canal, and skull base are crucial to avoid iatrogenic injury. Multidetector computed tomography (MDCT) is the current imaging modality of choice for preoperative assessments. Herein, the authors propose a structured CT reporting template for TMJ ankylosis to strengthen the value of the preoperative imaging report and to reduce the rates of intraoperative complications and recurrence.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권4호
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• pp.327-339
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• 1992

This study was undertaken to investigate the effect of orthognathic surgery on occlusal force. The maximum bite force was measured in 26 dentofacial deformity patients, aged 14-26(mean age 20.3) years, before surgery and at IMF removal, 3, 6, and 12months postsurgery. To grope the correlation of bite force and skeletal change after orthognathic surgery, the cephalometric headplates were measured, tabulated and statistically analyzed. The results were as follows. 1. The presurgical maximum bite force was 13.7kg in upper first molar(rt. Side 12.7kg, it. Side 14.6kg). There was remarkable difference with that of normal occlusion. 2. The recovery of bite force was very significant in according to the operation method and the duration of IMF that was 7.6kg at IMF removal, 14.2kg at 3 months, 19.7kg at 6 months. 26.1kg at 12 months postsurgery. 3. To fasten the recovery and to increase the bite force after orthognathic surgery, the long IMF time and the injury to the masticatory muscle should be avoided by the internal rigid fixation and early physical exercise. 4. The bite force was positively correlated to the changes of mandibular plane angle, the angle between platatal plane and mandibular plan, the angle between occlusal plane and mandibular plane, and negatively correlated to the changes of mandibular body length in craniofacial structure. 5. There was no correlationship between bit force and mesial inclination of tooth long axis of first molar in this subject. 6. There was no correlation between the changes of bite force and the changes of mechanical advantage of the temporal and masseter muscle.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권3호
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• pp.250-255
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• 1998

The purpose of this study was to evaluate the histologic change of the inferior alveolar nerve according to distraction amount following mandibular lengthening. Seven rabbits weighing about 2 kg were used. Corticotomy was performed on the mandibular body anterior to the right first premolar region and unilateral external fixation device was placed. Every effort was made to preserve the inferior alveolar nerve during the corticotomy. The rabbits were then allowed to heal for 7 days without distraction of the device. The mandible was lengthened 0.36 mm/day, 0.76 mm/day, or 1.0 mm/day. Corticotomy and lengthening of mandible were not performed in control group. After the completion of the lengthening process, a 14-day-consolidation period was allowed. After consolidation, rabbits were sacrificed, and histologic examination of the inferior alveolar nerve was performed. The results obtained were as follows : 1. In the control group, normal trifascicular pattern of inferior alveolar nerve was observed. Epineurium, perineurium, endoneurium, and axon with myelin sheath were observed in normal appearance. 2. In 0.36 mm/day distraction group, the trifascicular pattern was normally shown, and there was no destruction in epineurium, perineurium, and endoneurium. The mild changes including myelin attenuation, axoplasmic swelling and darkening were observed. 3. In 0.72 mm/day distraction group, it was possible to differentiate the epineurium from the perineurium. Two normal fascicles and one injuried fascicle were observed with a partially destructed perineurium. Most of the axons had axoplasmic swelling and darkening. 4. In 1 mm/day distraction group, it was difficult to differentiate the nerve structures such as fascicles, epineurium, perineurium, and endoneurium. The axons were severely destroyed, except few which showed decreases in size and changes in shape. Some collagen matrices were observed around the axons. These results suggest that the higher the distraction amount, the more severe the injury to the inferior alveolar nerve, fascicles, axons. Although distraction osteogenesis may be useful, the amount of distraction should be carefully selected.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권1호
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• pp.1-9
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• 1995

1986년 1월부터 1993년 12월까지 8년간 외과적 교정술을 시행한 117 증례에대하여 임상적인 관찰을 시행하였다. 1) 남녀 성비는 1:1.4로 여자가 많았으며 평균연령은 23.0세였다. 2) 악교정수술을 받기위하여 내원한 환자의 진단에 따른 분류를 보면 하악 전들증의 경우가 87증례(75.0%)로 주종을 이루고 있었다. 3) 수술방법중 하악단독수술은 88증례, 상악골 단독수술은 6증례, 상하악 동시이동술은 23증례였으며 이중 하악지 시상골절단술이 사용된 경우가 84증례(71.8%)로 가장 많았다. 4) 골편의 고정을 위하여 강선고정보다 Miniplate나 Screw 를 이용한 고정이 점차 선호되고 있으며 전체수술에서 견고고정의 비율은 66.0%였다. 5) 본 교실에서는 외가적 교정수술 환자를 대상으로 1992년 2월부터 저혈식 자가수혈을 이용하고 있으며 One Jaw surgery 에서는 2 pints, Two Jaw surgery 에서는 3 pints를 준비하고 잇다. 6) 악교정수술의 합병증으로는 하순지각마비등의 신경손상이 전체수술의 63증례(53.8%)로 가장 많았으며 골편의 잘못된 위치, 과두위치보존의 실패, 견고고정의 불안정등이 원인이 되어 5증례에서 재수술을 시행하였다.

• 치과방사선
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• 제18권1호
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• pp.13-25
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• 1988

Bone destruction was induced experimentally by the insertion of a bit of the arsenic compound into the pulp chambers of the right premolars and the artificial bone defects were produced in the periapical regions of the left premolars in 7 dogs. The serial standardized periapical radiographs using aluminum stepwedge attached to the XCP instruments, and resin bite blocks were taken following insertion of arsenic compound and at 2, 4, 7, 10, 14, 17, 21, 24 and 28 days in case of bone destruction and following bone injury and weekly thereafter for a total of 14 weeks in case of bone formation. The errors of the method were determined with error estimators described by the Duinkerke. All radiographs were evaluated by the visual examination after joint evaluation by three dental radiologists and analysed with densitometer. The following results were obtained; 1. Analysis of the bone destruction process 1) The error of the method in estimating two distances proved to be small (S.D. for the measuring error; 0.04㎜, S.D. for the over-all error; 0.06㎜, S.D. for the positioning error; 0.05㎜) 2) The radiographic changes were observed after 7 days in 6 cases, 4 days in 1 case and 10 days in 1 case by the visual examination. 3) Aluminum equivalent values were diminished after 2 days and the diminution of 0.58±0.19㎜ was demanded to be detected by the visual examination. 2. Analysis of the bone formation process 1) The error of the method in estimating two distances proved to be small (S.D. for the measuring error; 0.03㎜, S.D. for the over-all error; 0.04㎜ S.D. for the positioning error; 0.04㎜) 2) The radiographic changes were observed after 2 weeks in 5 cases and 3 weeks in 2 cases by the visual examination. 3) Aluminum equivalent values were increased after 1 week and the increase of 0.45±0.15㎜ was demanded to be detected by the visual examination. 4) Aluminum equivalent values were increased continuously for 7 or 9 weeks but there as only extremely small change after 10 weeks.

• 구강회복응용과학지
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• 제19권2호
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• pp.109-113
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• 2003

The inferior alveolar nerve provides unilateral innervation to the dentition, labial mucosa and skin from about commissure to the mental protuberance. Injury to this nerve resulting in sensory impairment can be a distressing problem to some patients. The causes of this problem include trauma, extraction, implant surgery and any maxillofacial surgery and generally the altered sensation is temporary. The surgical procedure has been the most common treatment for this condition but it has some complications. The antidepressants and anticonvulsants have been effective to the treatment of trigeminal dysesthesia. This case report suggests that the use of antidepressants and anticonvulsants is an alternative method to treat the paresthesia after implant surgery or extraction.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권1호
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• pp.25-30
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• 2013

Purpose: Many surgical procedures in oral and maxillofacial area can induce trauma to the peripheral nerve. The aim of the study is to evaluate the effects of short-term steroid therapy on nerve recovery after crush injury. Methods: Sixteen rats were randomly divided into two groups. The right sciatic nerves were exposed, crushed, and sutured. The control group was not given steroids. The test group was injected with dexamethasone disodium phosphate (2 mg/kg body weight/day) for 7 days. In all animals, compound muscle action potential (CMAP) was recorded before and at 1, 7, 14, 21, and 28 days after injury. Results: The amplitude of the CMAP before and at 1, 7, 14, 21, and 28 days after injury were $53.20{\pm}4.80$ mV, $20.12{\pm}5.38$ mV, $30.01{\pm}14.15$ mV, $31.14{\pm}13.56$ mV, $31.73{\pm}16.33$ mV, and $37.23{\pm}16.98$ mV in the control group, and $55.25{\pm}6.72$ mV, $18.62{\pm}6.26$ mV, $29.50{\pm}13.06$ mV, $32.90{\pm}13.226$ mV, $30.17{\pm}11.80$ mV, and $38.41{\pm}12.27$ mV in the test group, respectively. The nerve conduction velocity was $18.82{\pm}3.94$ m/s, $16.73{\pm}3.48$ m/s, $19.60{\pm}2.45$ m/s, $18.68{\pm}3.94$ m/s, $18.02{\pm}3.51$ m/s, and $19.25{\pm}3.88$ m/s in the control group, and $18.94{\pm}3.48$ m/s, $17.28{\pm}2.53$ m/s, $7.57{\pm}2.54$ m/s, $18.77{\pm}2.12$ m/s, $19.48{\pm}1.55$ m/s, and $19.22{\pm}2.97$ m/s in the test group, respectively. There was no significant difference between both groups (P>0.05). Conclusion: This study did not show any therapeutic effect of short-term administration of steroids on injured rat sciatic nerve. Further studies are needed.

• 치위생과학회지
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• 제12권4호
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• pp.310-319
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• 2012

본 연구는 서울에 위치한 야간 응급실이 있는 S 대학병원의 2009년 1월 1일부터 2009년 12월 31까지 내원한 환자 중 구강악안면부 외상 상병명(한국질병 분류기호: S01.5, S02.40, S02.41, S02.50, S02.51, S02.60, S02.61, S03.2)으로 집계된 1,696건의 자료 중 1,495건의 전산 통계자료를 이용하여, 구강악안면 외상발생 요인에 대한 자료를 분석하고 평가하였으며 다음과 같은 결과를 얻었다. 1. 성별 외상발생 남녀비는 1.49:1로 남자에서 더 많았고 남자가 894명(59.8%), 여자가 601명(40.2%)으로 나타났다. 2. 연령별로 외상발생은 7~14세(19.6%)에서 가장 높게 나타났고, 50~59세(13.7%), 60~69세(12.6%), 20~29세(11.8%), 30~39세(10.8%), 40~49세(9.6%), 6세 이하(9.4%), 70세 이상(605%), 15~19세(6.0%) 순으로 나타났다. 3. 원인별로는 넘어짐(25.9%)이 가장 많았고, 부딪힘(11.8%), 저작(11.6%), 교통사고((6.0%), 폭력(5.3%), 스포츠(2.4%), 추락(0.7%)의 순으로 나타났다. 4. 장소에 대한 분포는 등산, 해변, 야외 등 기타 장소가(24.7%) 가장 많았고, 공공장소 및 사무실(19.6%), 집(19.4%), 도로 길(13.8%), 학교 유치원 어린이 집(7.9%), 운동장(5.2%), 놀이터(3.6%)와 공원(3.6%), 그리고 계단(2.0%) 순으로 나타났다. 5. 외상발생 부위는 전치부(43.2%)와 구치부(43.1%)가 많았고, 이어 악골(9.2%), 혀, 입술 및 주위조직(2.6%), 악관절(1.9%) 순이었다. 6. 외상발생 시간은 15~19시(10.4%)와 19~23시 (7.1%)가 높게 나타났다. 발생 원인별 시간은 넘어짐의 경우 15~19시(14.7%), 추락의 경우 7~11시(27.3%), 부딪힘의 경우 15~19시(22.1%), 폭력에 의한 경우 19~23시와 23~3시(26.6%)에 각각 동일하게 높게 나타났고, 교통사고의 경우 15~19시(28.9%), 스포츠 활동의 경우 15~19시(48.6%), 저작 등에서는 19~23시(3.4%)에 높게 나타났다, 7. 외상 원인별 상병명은 넘어짐의 경우 S01.5 (입술 및 구강의 열린 상처), 추락의 경우 S02.51 (개방성 치아의 파절), 부딪힘의 경우 S02.50 (폐쇄성 치아의 파절), 폭력의 경우 S02.60 (폐쇄성 아래턱뼈의 골절), 교통사고와 스포츠, 저작 등의 경우 각각 S02.50 (폐쇄성 치아의 파절)이 높게 나타났다. 이상의 결과를 바탕으로 구강악안면부 외상사고에 대한 역학적 특성을 이해하고 경향을 고려하여 체계적인 구강악안면부 외상사고 예방대책 및 보완정책 수립과 적극적인 안전교육 및 홍보 활동이 필요할 것으로 생각된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권4호
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• pp.373-378
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• 1998

In the midfacial fracture, the orbital region presents many additional complication unique to the orbit. Among them are ectropion, entropion, lid ptosis, injury to the lacrimal apparatus, diplopia or the late development of enophthalmos. The residual problem confronting the surgen is usually enophthalmos or diplopia. Enophthalmos becomes cosmetically obvious at 3mm and if more severe it can interfere with vision from obstruction by the orbital rim. In this clinical situation, many patients prefer the simpler intraorbital volume expansion to the more complex orbital osteotomy. In general, except in mild cases of enophthalmos, the procedure of choice is osteotomy and repositioning for zygoma fracture and volume augmentation for blow-out fracture. Late treatment is performed by volume augmentation based on the CT findings behind the axis of the globe. Inferiorly placed grafts elevate the globe, posterior superior grafts move the globe anterior and medially positioned grafts push the globe laterally. In this two cases, the patients who has stable orbitozygomatic rim, the use of calvarial bone grafts more than 3 areas around intraorbital content, we corrected late enophthalmos combined with diplopia. As result, the first patient had 2mm advance in exophthalmometric check with improvement of the diplopia gradually. The second patient had 1.5mm advance with correction of vertical ocular dystopia and cosmetically good results respectively.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권2호
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• pp.163-170
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• 1995

The purpose of this study was to investigate the epidemiology of midface fractures. We observed clinically 71 patients with midface fracture who visited the Department of oral and maxillofacial-surgery, Chosun University, Dental Hospital, from 1991 to 1994. The results obtained were as follows. 1. There was the highest age incidence in the third decade(29.6%). 2. There was the highest incidence in the summer(36.6%). 3. The most etiologic factor of midface fracture was traffic accidents(43.6%) and next factor was fall down(38.0%). 4. The highest incidence fracture was zygomatic arch(38.7%) and next fracture was ZMC fracture(31.5%). 5. Most midface fracture was treated within 2 weeks(86.7%). 6. Midface fractures was most frequently combined with mandibular fracture(15.5%), head injuries(14.1%), orthhopedic injuries(8.5), thorax & abdomen(5.6%). 7. The highest complication was the nerve injury(8명), and next complications were infection(3명), epiphora(3명) etc.