• 제목/요약/키워드: 과두위치

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하악골 절제술후 간단한 과두재위치 소형금속판을 이용한 재건 금속판의 적용: 증례보고 (APPLICATION OF RECONSTRUCTION PLATE USING SIMPLE CONDYLAR REPOSITIONING MINIPLATE AFTER SEGMENTAL RESECTION OF MANDIBLE)

  • 김영균
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권3호
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    • pp.231-233
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    • 2002
  • Temporary reconstruction of the mandibular continuity defect resulting from the ablative tumor surgery with a reconstruction plate can be used for the preservation of normal facial contour and oral function and for periodic follow up of recurrence. Reconstruction plates are adapted to the bone before the resection and provisionally fixated with some screws. Accurate contouring and adaptation are very important for the prevention of displacement of bony stumps and decubituous skin ulcer. However, if there is large expanding buccal tumor mass in mandible, it is very difficult or even impossible to contour the plate before resection. I, therefore, introduce the reconstruction plate application technique using a simple condylar repositioning miniplate after segmental mandibular resection.

한국 성인에서 이하 두정 방사선 계측사진 분석 (Submentovertex cephalometrics in korean adults)

  • 남동석;서정훈;양원식;장영일
    • 대한치과교정학회지
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    • 제30권1호
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    • pp.1-7
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    • 2000
  • 교정 치료계획을 세우기 전에 부정교합에 기여하는 안면 비대칭의 정도를 정확히 평가하는 것은 무엇보다도 중요하다. 안면 비대칭의 진단은 주로 정모, 이하 두정, 두정 이하 방사선 사진이 이용되고 있다. 이중 이하 두정 방사선 사진은 반복재현성이 벌어지고 연구자료와 적절한 분석방법이 없다는 이유로 많이 사용되지 않고 있다. 이에 이 연구의 목적은 교정환자나 악교정 수술을 요하는 환자의 치료를 위하여 임상적으로 이용할 수 있는 이하 두정 방사선 계측사진의 분석방법을 개발하고 한국 성인에서의 정상치를 얻는데 있다. 연구 대상은 조화를 이루고 균형 잡힌 안모를 가진 교정치료 경험이 없는 40명의 성인을 대상으로 하였으며, 이하 두정 방사선 사진을 촬영하여 2개의 각도계측 항목과 9개의 선 계측항목을 측정하였다. 이하 두정 방사선 사진 분석에서 정상인에서 하악체의 길이는 좌, 우측 차이를 발견할 수 없었으나 정모, 측모 방사선사진의 계측 값과는 큰 차이를 보여, 비대칭의 절대적 양의 측정에는 어느 정도 한계가 있다. 기준선에 대한 좌, 우측 비교는 기준선을 설정하는 방법에 따라 큰 차이를 보였다. 과두의 위치 평가는 f. spinosum을 연결한 선의 수직이등분선을 정중선으로 사용하는 것이 가장 작은 편차를 보였으며, 상, 하악의 skeletal midline과 dental midline의 일치 여부 등을 판단할 때는 crista gli와 anterior process of atlas와 같이 midsagittal line 상에 위치하는 구조물을 이용하여 정중선을 설정하는 것이 가장 작은 편차를 보였다. 그리고 하악 과두 및 하악체의 형태이상을 관찰하는데는 매우 높은 진단적 가치를 가지고 있다. 그러므로 이하 두정방사선사진의 한계를 정확히 이해하고 정모, 측모 두부방사선사진과 함께 비대칭 분석에 이용한다면 보다 정확하게 비대칭 부위와 정도를 측정하는데 도움이 될 것이다.

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악교정 수술 후 하악과두의 위치 및 골변화에 관한 단층방사선학적 연구 (A TOMOGRAPHIC STUDY OF POSITIONAL AND BONY CHANGES IN THE TEMPORO-MADIBULAR JOINT FOLLOWING ORTHOGNATHIC SURGERY)

  • 송남규;김민숙;고광준
    • 치과방사선
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    • 제22권2호
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    • pp.203-213
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    • 1992
  • The purpose of this study was to aid in the evaluation of prognosis of temporomandibular joint following orthognathic surgery. For this study, 20 patients (40 TMJ) who undergone orthognathic surgery were examined. Preoperative and postoperative tomograms of TMJ were taken. And the subjects were divided into 3 groups according to postoperative periods. The obtained results were as follows; 1. There were no significant differences between preoperative and postoperative changes in joint spaces in each group and between groups(P<0.05). 2. There were no significant differences between preoperative and postoperative ratio of joint space(P<0.05). 3. There were no significant differences between preoperative and postoperative changes in the range of motion of condylar head(P<0.05). 4. The bony changes of condylar head were observed in 14(35%) condyles (6 erosion, 2 flattening, 5 double contour, 1 osteophyte).

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하악전돌증 환자의 악교정 수술후 하악과두의 위치변화에 대한 연구 (A CEPHALOMETRIC AND PANORAMIC ANALYSIS OF THE CHANGES OF THE CONDYLAR POSITION AFTER ORTHOGNATHIC SURGERY)

  • 강영기;김종렬;양동규
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권4호
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    • pp.411-419
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    • 2000
  • Purpose: This study was aimed at analysis of the changes in the condyle position in subjects with mandibular setback osteotomies Method: Twenty patients were evaluated retrospectively for their changes in the condyle position who underwent surgical mandibular setback using bilateral sagittal split osteotomies with a manual condyle repositioning technique and rigid fixation. The cephalometric and panoramic analysis was performed preoperatively, 1 week, 6 months, and 1 year postoperatively. And postoperative noise, temporomandibular joint pain, and mouth opening were clinically examined 2 months, 4 months, 6 months, 8 months, 10 months, and 12 months postoperatively. Result: The condyles rotated posteriorly and laterally immediately after surgery, and they returned to the preoperative position during follow-up period but it is not significant. The statistical analysis (Paired t-test) showed no significant effects in postsurgical stability. The changes in the condyle position didn't have a significant harmful influence on temporomandibular joint disorder. Conclusion: A careful surgical mandibular setback using manual condyle repositioning and fixation technique will move condyle minimally and that will decrease the relapse and temporomandibular joint disorder.

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교합 피개 심도와 과두 위치 (THE RELATIONSHIP OF MANDIBULAR CONDYLAR POSITION TO OVERBITE DEPTH)

  • 손영화;장영일
    • 대한치과교정학회지
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    • 제21권2호
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    • pp.399-418
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    • 1991
  • This study was designed to evaluate the relationship of mandibular condylar position to overbite depth and compare the findings from transcranial radiographs and those, from individualized corrected tomographs in determination of condylar position. The subjects consisted of 20 control subjects (male 8, female 12), and 10 open-bite patients (male 3, female 7) and 23 deep-bite patients (male 17, female 6). The mean age was 23.3 years for the control group, 21.5 years for open-bite group, and 23.2 years for deep-bite group. Transcranial radiographys and individualized corrected tomographys in centric occlusion were taken from right and left temporomandibular joints of each sueject. The results were as follows. 1. In the 20 normal subjects showing no symptoms of TM disorder, the incidence of condylar retrusion was $27.5\%$, middle condylar position $60.0\%$, and anterior displacement $12.5\%$. 2. There was significant correlation between the bite depth and observed condylar position. 3. Only $45.2\%$ of the findings from transcranial radiographs coincided with those from individualized corrected tomographs in determining condylar position.

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두부 위치에 따른 하악 과두의 파노라마상 (PANORAMIC IMAGE OF MANDIBULAR CONDYLE ACCORDING TO HEAD POSITION)

  • 김정화;최순철
    • 치과방사선
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    • 제20권2호
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    • pp.219-225
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    • 1990
  • Panoramic radiography is convenient in clinic and visualizes those areas which other technique do not give. But the technique has limitation of image distortion which results from the relationship of the ramus to the focal trough and from the direction of the central ray. This study is, using 7 dry skulls, to determine the effect of rotation of patient's head on reducing those distortion and determine the magnification ratio of images of mandibular condyle in rotated patient head position. The obtained results were as follows: 1. Generally, in panoramic radiography the anterolateral portion of the mandibular condyle was best to be visualized. 2. There are no significant difference between the image readability of anteromedial portion and that of anterocentral portion of the mandibular condyle. 3. Anterolateral portion of the mandibular condyle was better visualized in rotated head position by 20 degree or horizontal condylar inclination than in conventional position or in rotated head position by 10 degree. 4. The magnification ratio of the anteroposterior diameter in the image of mandibular condyle was least in the rotated head position by horizontal inclination of the mandibular condyle and was largest by 20 degree.

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측두하악관절 내장증시 측방 개별화 보정단층방사선사진에서의 하악과두의 위치 (Condylar position on the lateral individualized corrected tomography in internal derangement of temporomandibular joint)

  • 김근민;황의환;이상래
    • Imaging Science in Dentistry
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    • 제32권2호
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    • pp.67-73
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    • 2002
  • Purpose: To examine the possible relationship between condylar position and disk displacement in the temporomandibular joint. Materials and Methods: 79 temporomandibular joints in 40 patients having temporomandibular disorders were classified into three categories: no disk displacement (NDD) , disk displacement with reduction (DDWR), and disk displacement without reduction (DDWOR). Disk positions were assessed from clinical and MRI findings. The relationship between the three categories and condylar positions was evaluated using lateral individualized corrected tomography. Results: Clinical findings regarding the relationship between condyle and disk positions having anterior, centric, and posterior positions were 27%, 27%, and 46%, respectively, in NDD, 43%, 17%, and 40%, respectively, in DDWR, and 44%, 22%, and 34%, respectively, in DDWOR. There were no significant differences in condylar positions between each of the groups (P>0.05). In the relationship between condyle and disk positions with MRI findings, anterior, centric, and posterior positions were 38%, 38%, and 24%, respectively, in NDD, 29%, 21%, and 50%, respectively, in DDWR, and 44%, 9%, and 47% respectively, in DDWOR. There were significant differences in the condylar positions when MRI was utilized (P<0.05) Conclusion: There was a significant correlation between the condyle and disk positions with MRI findings on lateral individualized corrected tomography.

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하악과두의 형태 및 위치에 관한 방사선학적 연구 (A RADIOGRAPHIC STUDY OF MANDIBULAR CONDYLE SHAPE AND POSITION IN AN ASYMPTOMATIC POPULATION)

  • 이상훈;이상래
    • 치과방사선
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    • 제18권1호
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    • pp.203-212
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    • 1988
  • This study was designed to observe mandibular condyle shape and position in an asymptomatic popular ion. Using Accurad-200 head holder(Denar Corp.) for transcranial radiography of the temporo-mandibular joint region, transcranial radiographs were taken at the centric occlusion and 1 inch mouth opening in 73 males and females who were asymptomatic for TMJ disturbances, had no severe carious or missing teeth, and no history of prosthodontic or orthodontic treatments. Mandibular condyles were classified morphologically at the centric occlusion and evaluated in positional relationship with mandibular fossa and articular eminence at the centric occlusion and 1 inch mouth opening. The results were as follows: 1. In the morphologic classification of mandibular condyle, the convex shape was more prevalent in an asymptomatic population(90.4%), the locally concave shape and wedge shape were 5.5%, 4.1%. 2. At the centric occlusion, the means of joint space were 3.43nm superiorly, 2.17㎜ anteriorly, and 2.61㎜ posteriorly. 3. At the centric occlusion, the mandibular condyles were placed slightly anterior to the center of their fossa. 4. At the 1 inch mouth opening, the mandibular condyles were placed anterior to the articular eminence more than posterior to or below the top of the articular eminence.

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Cone beam형 전산화단층영상을 이용한 하악과두 위치의 연구 (Mandibular condyle position in cone beam computed tomography)

  • 황형주;김규태;최용석;황의환
    • Imaging Science in Dentistry
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    • 제36권2호
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    • pp.103-109
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    • 2006
  • Purpose : To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. Materials and Methods : Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or prosthodontic treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. Results : In the sagittal views, mandibular condyle within articular fossa was posteriorly located at medial and central sections. In the coronal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial, central, and lateral sections. Conclusion : Mandibular condyle within articular fossa in an asymptomatic population was observed nonconcentric position in the sagittal and coronal views.

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최근 8년간 본교실에서 시행한 악교정수술의 임상적 검토 (CLINICAL STUDY ON ORTHOGNATHIC SURGERY FOR 8 YEARS IN OUR DEPARTMENT)

  • 권대근;이상한
    • 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.

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