• 대한치과교정학회지
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• 제40권4호
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• pp.239-249
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• 2010

성장기 아동의 하악과두 조직에서의 골개조 과정은 연골세포, 조골세포, 파골세포가 연관되며 nitric oxide synthase (NOS)가 중요한 매개자의 하나로 작용할 것으로 생각되나 기능성 악정형술을 이용해 하악골을 전방유도시켰을 때 하악과두에서의 골개조와 NOS의 발현에 대해서는 아직 자세히 연구되어 있지 않다. 본 연구는 하악골을 기능적으로 전방위치시켰을 때 하악과두 조직의 조직학적 변화양상에 대해 살펴보고 NOS의 발현 정도를 조사하여 상관관계를 알아보고자 하였다. 35일령의 24마리의 Sprague-Dawley 백서를 3군으로 나누었고 각 군에 있어서 5마리는 실험군으로, 3마리는 대조군으로 나누었다. 실험군은 하악골 전방유도장치를 24시간 장착한 후 3, 14, 30일에 희생하였으며 조직절편은 시상면에 평행하게 절단하였고 $NOS_2$와 $NOS_3$의 조직면역염색을 통해 다음과 같은 결과를 얻었다. 대조군 간에는 조직학적인 변화와 NOS의 발현 변화가 뚜렷이 관찰되지는 않았으며 실험기간에 따른 조직학적 변화는 실험 14일군에서 가장 많은 신생골 형성과 조골세포 활성을 보였으며, 실험 30일군에서는 감소하는 양상으로 나타났다. 또한 모든 실험군에서 대조군에 비해 $NOS_2$와 $NOS_3$의 발현이 많이 나타났으며 실험기간에 따른 비교 시 $NOS_2$와 $NOS_3$의 발현은 실험 14일군에서 가장 많이 나타났으며 실험 30일군에서는 감소하는 양상으로 나타났다. 전체 실험군과 대조군에서 $NOS_2$의 발현은 $NOS_3$의 발현보다 많이 나타났고 $NOS_2$는 실험군 과두의 비대연골, 연골하골에서 주로 발현되었다. $NOS_3$는 실험군 과두의 골수와 모세혈관에서 주로 발현되었다. 따라서 하악과두 내의 $NOS_2$와 $NOS_3$의 발현조절이 하악과두 조직의 골개조에 관여함을 시사한다.

• Journal of Oral Medicine and Pain
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• 제38권2호
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• pp.149-159
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• 2013

이 연구의 목적은 측두하악관절장애와 외측 익돌근의 수평적 형태 간의 연관성을 조사하는 것이다. 이를 위해 10대에서 50대까지 연령군별로 각 남녀 15명씩 임의로 선정한 총 150명의 측두하악관절장애 환자에서 자기공명영상의 수평면 및 시상면상에서 나타난 외측 익돌근 및 측두하악관절의 형태적 특성을 조사하였다. 조사한 해부학적 특성은 외측 익돌근의 최대폭경, 수평 부착각도, 관절원판의 위치, 과두의 변형여부, 관절 삼출액 여부 등이며, 또한 전이부의 통증여부, 과두 주변의 압통 유무와 같은 임상적 소견이 포함되었다. 이들 해부학적 특성 및 임상적 소견의 상호 간 관련성을 분석한 결과, 비정복성 관절원판 변위를 가진 경우 외측 익돌근의 부착각도가 유의하게 높았으며 전이부에 통증이 있는 경우에는 최대 폭경이 유의하게 큰 것으로 나타났다. 뿐만 아니라 연령이 낮을수록 부착각도가 유의하게 높았으며 남성에서 최대 폭경이 더 큰 것으로 나타났다. 위의 결과를 통해 외측 익돌근 수평 부착각도가 관절원판 변위와 유의한 관련성이 있으며 전이부의 통증이 최대 폭경을 증가시키는 것으로 생각된다. 결론적으로 외측 익돌근의 높은 수평 부착각도가 관절원판 변위 발생의 중요한 해부학적 기여요인이 될 수 있으며, 측두하악관절의 통증은 외측 익돌근의 활성에 영향을 줄 수 있을 것으로 추정된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권3호
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• pp.204-210
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• 2007

This study was intended to compare the cranial base morphology between the mandibular prognathism and maxillary retrognathism in skeletal class III patients. The subject of the present study was composed of 88 patients divided into two groups; Group 1 (Skeletal Class III with mandibular prognathism. SNA within normal range, SNB over normal range, n=54) and Group 2(Skeletal Class III with maxillary retrognathism. SNA below normal range, SNB within normal range, n=34). Lateral cephalogram were taken immediate before surgery and 18 landmarks were used to analyze the characteristics of cranial base and maxillomandibular skeleton. The result revealed that cranial base angle is significantly smaller in Group 1 than Group 2, which implies the influence of the cranial base angulation on the mandibular position. However the posterior cranial base length did not influence the mandibular horizontal position and anterior cranial base length did not influence the maxillary horizontal position. As the anterior cranial base length was closely related with ramal height, it is recommendable to investigate the regulatory mechanism of chondrogenesis of cranial base and condyle cartilage in the future research.

• Journal of International Society for Simulation Surgery
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• 제2권2호
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• pp.90-93
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• 2015

The fibula free flap has now become the most reliable and frequently used option for mandible reconstruction. Recently, three dimensional images and printing technologies are applied to mandibular reconstruction. We introduce our recent experience of mandibular reconstruction using three dimensionally planned fibula free flap in a patient with gunshot injury. The defect was virtually reconstructed with three-dimensional image. Because bone fragments are dislocated from original position, relocation was necessary. Fragments are virtually relocated to original position using mirror image of unaffected right side of the mandible. A medical rapid prototyping (MRP) model and cutting guide was made with 3D printer. Titanium reconstruction plate was adapted to the MRP model manually. 7 cm-sized fibula bone flap was designed on left lower leg. After dissection, proximal and distal margin of fibula flap was osteotomized by using three dimensional cutting guide. Segmentation was also done as planned. The fibula bone flap was attached to the inner side of the prebent reconstruction plate and fixed with screws. Postoperative evaluation was done by comparison between preoperative planning and surgical outcome. Although dislocated condyle is still not in ideal position, we can see that reconstruction was done as planned.

• 구강회복응용과학지
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• 제36권2호
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• pp.80-87
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• 2020

목적: JT-3D system를 통해 하악의 운동을 측정하고 측두 하악 장애의 진단에 참고할 수 있는 하악의 운동 범위를 제공하고자 하였다. 연구 재료 및 방법: 성인 60명을 대상으로 JT-3D system을 이용하여 최대 개구와 폐구 운동을 기록하였고, 5회의 반복 운동을 1번의 운동 주기로 간주하여 총 3회의 운동 주기를 기록하였다. 최대 개구 시 하악의 수직적 위치, 전후방 위치, 측방 편위량, 최대 개구량을 기록하였다. JT-3D system의 재현성 평가를 위해 통계분석을 시행하였다(α = 0.05). 결과: 최대 개구 시의 평균값은 수직적 위치 31.56 mm, 후방 24.42 mm, 측방 편위량 0.72 mm, 최대 개구량 40.32 mm로 나타났다. JT-3D system으로 기록한 3회의 운동 주기의 모든 측정값에서 통계적 유의성은 없었다(P > 0.05). 결론: 최대 개구 시 평균 측방 편위량에서 0.72 mm, 최대 개구량은 40.32 mm로 나타났으며, JT-3D system을 이용한 하악 운동 분석은 재현성 있는 결과를 보였다.

• Journal of Mechanical Science and Technology
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• 제18권2호
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• pp.211-220
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• 2004

It is well known that the geometry of the articular surface has a major role in determining the position of articular contact and the lines of action for the contact forces. The contact force calculation of the knee joint under the effect of sliding and rolling is one of the most challenging issues in this field. We present a 3-D human knee joint model including sliding and rolling motions and major ligaments to calculate the lateral and medial condyle contact forces from the recovered total internal reaction force using inverse dynamic contact modeling and the Least-Square method. As results, it is believed that the patella, muscles and tendon affect a lot for the internal reaction forces at the initial heel contact stage. With increasing flexion angles during gait, the decreasing contact area is progressively shifted to the posterior direction on the tibia plateau. In addition, the medial side contact force is larger than the lateral side contact force in the knee joint during normal human walking. The total internal forces of the knee joint are reasonable compared to previous studies.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권1호
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• pp.32-36
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• 2014

Preoperative surgical simulation in orthognathic surgery has progressed in recent years; the movement of the mandible can be anticipated through three-dimensional (3D) simulation surgery before the actual procedure. In this case report, the mandible was moved to the intended postoperative occlusion through preoperative surgical 3D simulation. Right-side condylar movement change was very slight in the surgical simulation, suggesting the possibility of mandibular surgery that included only left-side ramal osteotomy. This case report describes a patient with a mild asymmetric facial profile in which the mandibular menton had been deviated to the right and the lips canted down to the left. Before surgery, three-dimensional surgical simulation was used to evaluate and confirm a position for the condyle as well as the symmetrical postoperative state of the face. Facial asymmetry was resolved with minimal surgical treatment through unilateral intraoral vertical ramus osteotomy on the left side of the mandible. It would be a valuable complement for the reduction of the surgical treatment if one could decide with good predictability when an isolated intraoral vertical ramus osteotomy can be done without a compensatory osteotomy on the contralateral side.

• 치과방사선
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• 제17권1호
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• pp.223-232
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• 1987

The author obtained the transcranial-oblique lateral radiograms from 78 patients(26 male, 52 female) with temporomandibular dysfunction problem. And then, the author analyzed the dimensional changes of the TMJ space on centric occlusion, horizontal condylar movement and antero-posterior positional relationship of condyle to the articular eminence on 2.54㎝ mouth opening with clicking, TMJ pain and mouth opening limitation repectively, which were the symptoms of the temporomandibular joint pain dysfunction problem, and compared these data with control group. The results were as follows: 1. In centric occlusion, anterior and posterior TMJ space of experimental group was slightly lesser than those of the control group, also superior TMJ space of experimental group was significantly lesser than that of the control group. (p<0.01) 2. In 2.54㎝ mouth opening, the condylar horizontal movement and the antero-posterior positional relationship to the articular eminence were significantly lesser than those of the control group. (p<0.01) 3. Examined experimental group, the degree of condylar horizontal movement of affected ide was lesser than that of the normal side in 2.54㎝ mouth opening.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.21.1-21.8
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• 2015

Computer Assisted Simulation Surgery (CASS) is a reliable method that permits oral and maxillofacial surgeons to visualize the position of the maxilla and the mandible as observed in the patient. The purpose of this report was to introduce a newly developed strategy for proximal segment management according to Balanced Orthognathic Surgery (BOS) protocol which is a type of CASS, and to establish the clinical feasibility of the BOS protocol in the treatment of complex maxillo-facial deformities. The BOS protocol consists of the following 4 phases: 1) Planning and simulation phase, 2) Modeling phase, 3) Surgical phase, and 4) Evaluation phase. The surgical interventions in 80 consecutive patients were planned and executed by the BOS protocol. The BOS protocol ensures accuracy during surgery, thereby facilitating the completion of procedures without any complications. The BOS protocol may be a complete solution that enables an orthognatic surgeon to perform accurate surgery based on a surgical plan, making real outcomes as close to pre-planned outcomes as possible.

• Imaging Science in Dentistry
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• 제42권3호
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• pp.169-174
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• 2012

Purpose: To investigate the prevalence of osteoarthritic changes and condylar positioning of the temporomandibular joint (TMJ) in Korean children and adolescents with or without temporomandibular disorders (TMDs). Materials and Methods: A total of 101 asymptomatic and 181 symptomatic children and adolescents aged 10 to 18 years old were included in the study. Osteoarthritic changes such as flattening, sclerosis, osteophytes, or erosion, and the parasagittal positioning of the condyle were assessed using cone-beam computed tomography (CBCT) images. Results: The overall prevalence of osteoarthritic changes was higher in symptomatic (26.8%) than in asymptomatic adolescents (9.9%) (p<0.05). In the symptomatic group, the frequency was higher in males (33.3%) than in females (23.0%) (p<0.05). Erosion was the most common change for the symptomatic group (15.6%), whereas sclerosis was the most common change for the asymptomatic group (5.4%). Posterior condylar position was more frequently observed in the symptomatic group (p<0.05). Erosion was more common in the samples with TMJ pain or mouth opening limitations as compared to those without them (p<0.05). Conclusion: This study showed that osteoarthritic changes in TMJ were common in children and adolescents, with a much higher prevalence in symptomatic patients.