• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권2호
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• pp.85-93
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• 2022

Objectives: The aim of this study was to compare morbidities and duration of surgery, as well as bone formation in alveolar defects reconstructed with symphysis bone combined with allograft and iliac crest bone graft in patients with cleft palate. Patients and Methods: This randomized clinical trial was performed with 22 patients with unilateral alveolar cleft with a follow-up period of 12 months. In 12 patients, alveolar defects were reconstructed with chin bone graft plus allograft (Group A), while for the other 10 patients, iliac bone crest was used as donor site (Group B). Duration of surgery as well as occurrence of morbidities and complications were recorded. In addition, cone-beam computed tomographic (CBCT) scans were performed before surgery and 12 months after surgical procedures in order to compare bone formation between the two groups. Results: Postoperative CBCT demonstrated a mean bone fill percentage of 76.9% of the alveolar defect in Group A, compared with 77.0% in Group B. Paresthesia in the lower lip or chin did not occur in any patients of Group A. The mean duration of the surgical process was significantly shorter for Group A (40 minutes vs 76 minutes, P<0.001). In addition, patients in Group A regained normal gait faster than patients in Group B (1 day vs 9.5 days). Conclusion: Mandibular symphysis bone graft in combination with allograft results in favorable outcomes in patients with unilateral alveolar clefts.

• 대한치과교정학회지
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• 제32권5호
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• pp.361-373
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• 2002

이번 연구의 목적은 골격성 III급 부정교합자의 악교정 수술 전과 수술 후의 하악전치부 치조골의 형태 변화를 평가하는 것이다 : 하악지 시상골분할절단술만을 시행받은 30명의 성인 골격성 III급 부정교합자를 대상으로 하였다. 초진시와 수술 전과 수술 후 3개월이 경과하였을 때의 측모두부규격방사선 사진을 비교하였다 골격과 하악이부의 계측치를 비교하였으며 이들 사이의 상관성 분석을 시행하여서 다음과 같은 결과를 얻었다. 1. 술전교정후군과 악교정수술후군에서 치료전군에 비해 하악전치부의 순측과 설측의 치조골 높이가 감소하였다. 2. 치조골 기저부의 전후방적인 폭경은 두개안면골격의 수직계측항목과 역상관관계를, IMPA와는 순상관관계를 보였다(P<0.01). 3. 하악이부 계측항목중 하악이부의 장경과 폭경은 두개안면골격과 상관관계를 보이지 않았다. 4. 순측의 치조골 높이와 설측의 치조골 높이는 순상관관계를 나타냈지만(p<0.001), 설측의 치조정의 폭경과는 역상관관계를 보였다(p<0.01). 순측과 설측의 치조정의 폭경은 역상관관계를 보였다(p<0.05). 하악이부의 장경과 폭경은 서로 순상관관계를 보였다(p<0.01). 5. IMPA와 LISA는 순, 설측치조골의 장경과 설측의 치조골 폭경과는 역상관관계를 보였지만, 순측치조골폭경과는 순상관관계를 보였다

• Journal of Periodontal and Implant Science
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• 제31권3호
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• pp.581-595
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• 2001

In performing implant procedures in the anterior portion of the maxilla, many difficulties exist because of anatomical reasons, such as the proximity of the nasal floor, lateral extension of the incisive canal, and labial concavity. On the other hand, in the posterior region of the maxilla, there is often insufficient recipient bone between the maxillary sinus and alveolar ridge due to alveolar ridge resorption and pneumatization of the maxillary sinus. In order to perform implants in such regions, ridge augmentation procedures such as onlay bone graft, guided bone regeneration, and maxillary sinus grafting are performed. In studies of Caucasians, use of autograft from mandibular symphysis has been reported to be highly successful in maxillary sinus grafting. However, in a clinical study of Koreans, autograft of mandibular symphysis has been reported to have significantly low success rate. It has been hypothesized that this is because of insufficient cancellous bone due to thick cortical bone. In order to test this hypothesis, bone quality and morphology of Koreans can be compared with those of Caucasians. In this study, the bone density and morphology of the cortical bone and cancellous bone in the mandibular symphysis of 35 Korean cadavers were evaluated. The following results were obtained: 1. In terms of bone density, type I, type II, and type III consisted of 1.4%(3/213), 72.3%(154/213), and 26.3%(56/213) of the cross-sectioned specimens, respectively. In general, the bone density tended to change from type II to type III, as cross-sectioned specimens were evaluated from the midline to the canine. Type IV wasn't observed in this study. 2. The distance between the root apex and the lower border of the cancellous bone was 18.34mm-20.59mm. Considering that the bone has to be cut 5mm below the root apex during the procedure, autografts with about 15mm of vertical thickness can be obtained. 3. The thickness of cortical bone on the labial side increased from the root apex to the lower border of the mandible. The average values ranged from 1.43mm to 2.36mm. 4. The labio-lingual thickness of cancellous bone ranged from 3.43mm to 6.51mm. The thickness tended to increase from the apex to the lower border of the mandible and decrease around the lower border of cancellous bone. From the above results, the anatomic factors of the mandibular symphysis (bone density, thickness, quantity and length of the cortical bone and cancellous bone) didn't show any difference from Caucasians, and it cannot be viewed as the cause of failure in autografts in the maxillary sinus for implants.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권5호
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• pp.480-488
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• 2008

Orthodontists often treat cases which are difficult to treat with conventional orthodontics. In such cases, it could be treated with surgical procedures with the help of an oral surgeon. Especially, transverse deficiency of the mandible can be corrected by widening the transverse width of mandibular symphysis, using distraction osteogenesis. Transverse widening of mandibular sympysis is known as a safe treatment but still complications could occur during the treatment. We are reporting some complications of cases that mandibular symphysis transverse widening were applied. Some cases showed complications because of the inappropriate osteotomy line. Since straight vertical osteotomy line was inclined to the left, only the left bony segment was likely to expand. According to bio-mechanical considerations, it will be better to perform a step osteotomy, cutting the eccentric area of the alveolar crest and the centric area of the basal symphyseal area. Complications could also occur by the failure of the distraction device. The tooth borne distraction device was attached on the lingual side of the tooth with composite resin. During the distraction period, it was impossible to obtain appropriate distraction speed and rhythm because of frequent fall off of the distraction device. Therefore, distraction device should be attached firmly with orthodontic band or bone screw, etc. Tooth mobility increasement could also occur as a complication. 'Walking teeth phenomenon' was observed during the distraction period, showing severe teeth mobility and pain during mastication. These symptoms fade out during the consolidation period. Since the patient could feel insecure and uncomfortable, it should be notified to the patient before the procedure. Finally, alveolar crestal bone loss could occur. Alveolar crestal bone loss occurred because of lack of distraction device firmness and teeth trauma caused by lower lip biting habit. Therefore, adequate firmness of the distraction device and habit control will be needed.

• 대한치과의사협회지
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• 제57권6호
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• pp.344-351
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• 2019

Skeletal Class III malocclusion is a relatively common form of malocclusion in Korea. In borderline cases where only mild skeletal discrepancy exists and if worsening of the facial profile is expected as a result of premolar extraction, mandibular full arch distalization with miniscrews is the treatment of choice. The purpose of this study was to investigate the pattern of tooth movement and evaluate the stability of mandibular full arch distalization and to identify correlation between stability and factors such as initial skeletal pattern, dental changes during treatment and alveolar bone in symphysis region using lateral cephalograms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권6호
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• pp.666-671
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• 2000

Objectives: This study evaluated the availability of mandibular symphysis corticocancellous block grafts in patients treated for reconstruction of intraoral jaw defects. Materials & Methods: 8 patients with mandibular and maxillary bony defects were treated with corticocancellous block of symphysis. The types of defects included 4 pathologic jaw defects and 4 vertical and/or horizontal alveolar deficiencies. The age ranged from 13 to 45 years. Additional treatments such as plate fixation, alloplastic bony substitutes, and/or barrier membrane application were perfomred. They were evaluated for complications and healing of defects. Follow-up period ranged from 6 to 15 months. Results: 2 patients experienced complications such as wound dehiscence and mild resorption of exposed bone. None of the patients needed secondary operation. Paresthesia of lip, chin, and teeth were recovered completely by 6 months postoperatively. Reconstructed wound showed favorable healing and bony consolidation. Conclusion: Corticocancellous block of mandibular symphysis can be used for the reconstruction of a variety of intraoral local jaw defects selectively. Advantages were easy fixation of graft, possibility of restoration of original alveolar contour, and decreased donor site morbidity.

• 대한치과교정학회지
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• 제29권2호
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• pp.209-217
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• 1999

하악 전돌자에서의 치은퇴축 발생 소인을 알아보기 위하여 20세 전후의 악교정수술을 요하는 하악전돌자와 비슷한 연령대의 정상교합자를 대상으로 측모 두부방사선 사진과 하악 전치부의 단층 촬영사진을 사용하여 순측 치조골 계측치를 비교 연구한 바 다음과 같은 결과를 얻었다. 1. 하악전돌자의 순측 치조골 피질판의 단면적은 정상군보다 의미있게 작았다. 2. 하악전돌자의 치조정은 정상군에 비하여 낮은 것으로 나타났다. 3. 순측 치조골판의 면적은 백아법랑질 경계에서 치조정까지의 거리와는 역상관관계를, 치조정에서 치근단까지의 거리와는 순상관관계를 보였다. 4. 하악전돌자에서 IMPA의 증가는 symphysis의 두께와 순상관 관계를, 치조골의 높이와는 역상관 관계를 보였다. 이상의 결과에서 골격성 하악전돌자는 변연부 순측 치조골이 정상교합자보다 작음으로 치은퇴축 발생 가능성이 큼을 시사하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권3호
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• pp.266-275
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• 2008

저자들은 잔존 치조골의 흡수 및 위축으로 통상적인 임플란트 시술이 어려운 증례에서 하악골의 하악지에서 자가골을 채취하여 이를 증례에 따라 블록형 혹은 입자형으로 골 이식술을 시행하여 다양한 증례에 적용하여 비교적 만족할 만한 임플란트 식립 수술이 가능하였던 바 이를 문헌고찰과 함께 보고하며, 본 연구에서는 다양한 술식의 임상적 활용에 대해서만 보고하였으나 향후 이러한 증례들에 대하여 보다 장기적인 추적조사와 골 이식된 부위의 골 조직의 재형성 식립된 임프란트의 보철적인 기능과 장기적인 예후에 대한보다 체계적인 연구가 필요하리라 사료된다.

• Journal of Periodontal and Implant Science
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• 제29권4호
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• pp.943-953
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• 1999

Severe alveolar ridge deficiency can prevent ideal implant placement. Ridge augmentation procedures are necessary to regain lost alveolar structures. The corticocancellous block bone graft was harvested from the mandibular symphysis. This block bone was fixed to the lateral aspect of the ridge with titanium screws. Seven months later, the autogenous bone graft was reentered and sufficient bone volume was gained to allow implant placement. The fixation screws were removed and 3I implants were inserted. No complication and postoperative alteration in chin contour were observed. This report demonstrates that chin graft offers a predictable alternative in the reconstruction of ridge deficiency for implant placement.

• 구강회복응용과학지
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• 제30권3호
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• pp.215-222
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• 2014

본 연구는 수평적, 수직적 안면 골격 유형에 따른 하악 전치부 치조골의 형태학적 차이를 알아보기 위하여 시행 하였다. 연구 재료 및 방법: 40명의 Cone-beam computed tomography (Cone-beam CT)를 선별하여, 4개 군으로 분류하였다. Cone-beam CT 자료를 이용하여 하악 전치부 치조골의 부피($mm^3$), 하악 4절치 치축 기준 시상단면의 단면적(총 단면적, 해면골 단면적: $mm^2$), 백악법랑경계(cemento-enamel junction: CEJ) 2 mm, 3 mm 아래 순, 설측 치조골 두께를 측정하였다. 통계분석은 GLM, Kruskal-Wallis test and Tukey HSD를 사용하였다. 결과: 측절치의 백악법랑경계 2 mm, 3 mm 하방 설측 치조골 두께가, Class I low angle군이 나머지 3군 보다 두꺼웠다 (P < 0.05). 하악 전치 치조골의 부피, 전체 치조골 및 해면골의 단면에서의 통계적으로 유의한 차이는 없었다. 결론: Class I low angle군은 Class II high angle군에 비해 하악 전치 치조골의 설측 부위가 더 두껍다.