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CLINICAL INVESTIGATION ON THE FEASIBILITY OF OUTFRACTURE OSTEOTOMY SINUS GRAFT TECHNIQUE (Outfracture osteotomy sinus graft technique의 유용성에 관한 임상적 고찰)

  • Song, Seung-Il;Jeong, Hye-Rin;Kim, Hyung-Mo;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.5
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    • pp.367-371
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    • 2009
  • Purpose: The purpose of this study was to evaluate the feasibility of the outfracture osteotomy sinus graft technique with the evaluation of 5-year survival rate of the implants placed in the atrophic edentulous posterior maxillary area. Materials and methods: One hundred and thirteen cases of 96 patients who visited our center from Aug 2004 to July 2009 and were diagnosed as atrophic edentulous maxillary alveolar ridge, were selected and underwent augmentation sinus surgery with outfracture osteotomy technique. Feasibility of the outfracture osteotomy technique was investigated with clinical and radiographic evaluation to assess the survival rate of the total dental implants in augmentation sinus surgery of this new kind. Total fixture number available in follow-up period was 179, in which the lost 10 patients were excluded out of 96 patients. Results: Five-year cumulative survival rate was 97.2% with 5 failures of total 179 fixtures. The average follow-up period was 29 and a half months, with the minimum and maximum follow-up periods of 4 months 21 days and 59 months 14 days, respectively. Conclusion: Traditional infracture technique is a popular method for an augmentation sinus surgery. The authors modified this classical method by outfracturing and readapting the bony window after sinus graft, with excellent treatment results evidenced by high survival rate of 97.2% (174 out of 179 fixtures), which proves the feasibility of the newly-designed outfracture osteotomy sinus graft technique.

Anatomical Review of Latissimus Dorsi Free Flap for Oral Cavity and Facial Reconstruction (구강 및 안면재건을 위한 광배근 유리피판의 해부학적 고찰)

  • Kim, Soung-Min;Jung, Young-Eun;Eo, Mi-Young;Kang, Ji-Young;Seo, Mi-Hyun;Kim, Hyun-Soo;Myoung, Hoon;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.6
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    • pp.549-558
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    • 2011
  • The latissimus dorsi myocutaneous flap (LDMF) was initially described at the turn of the century by Tansini et al, and latissimus dorsi myocutaneous free flap (LDMFF) was also first described for the coverage of a chronically infected scalp by Maxwell et al. As a pedicled flap, LDMF has been often used for breast reconstruction and for soft tissue replacement near the shoulder and the lower reaches of the head and neck. LDMFF is a flat and broad soft tissue flap with large-caliber thoracodorsal vessels for microvascular anastomosis. A skin paddle of the LDMFF can be more than $20{\times}40$ cm, so very large defects in the oral cavity and outer facial region can be covered by this LDMFF. Other advantages include consistent vascular anatomy, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with tumor resection. For a better understanding of LDMFF as a routine reconstructive procedure in large defects of the oral cavity and facial legion, anatomical findings must be learned and memorized by young doctors during the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article discusses the anatomical basis of LDMFF with Korean language.

Anatomical Review of Rectus Abdominis Muscle Free Flap for the Oral and Maxillofacial Reconstruction (구강악안면재건을 위한 복직근 유리피판의 해부학적 고찰)

  • Park, Jung Min;Seo, Mi Hyun;Kim, Soung Min;Kang, Ji Young;Myoung, Hoon;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.367-375
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    • 2012
  • Midfacial reconstruction following resection of extensive malignant oral cavity tumors constitutes a challenging problems for reconstructive surgeons. Rectus abdominis muscle free flap (RAMFF) can be considered as the optimal reconstructive option in this case, because this flap has some advantages including consistent deep inferior epigastric artery anatomy, easy to dissect with well defined skin boundaries, acceptable donor site morbidity and the ability to perform simultaneous flap harvest with oral cancer ablation surgery. The rectus abdominis muscle forms an important part of the anterior abdominal wall and flexes the vertebral column, which is a long strap-like muscle divided transversely by three tendinous intersections, fibrous bands which are adherent to the anterior rectus sheath, which is thickly enclosed by the rectus sheath, except for the posterior part below the arcuate line that is usually located midway between the umbilicus and symphysis pubis. Below the arcuate line, this muscle lies in direct contact with the transversalis fascia and parietal peritoneum. For the better understanding of RAMFF as a routine reconstructive procedure in oral and maxillofacial surgery, the constant anatomical findings muse be learned and memorized by the young doctors in the course of the special curriculum periods for the Korean national board of oral and maxillofacial surgery. This review article will discuss the anatomical basis of RAMFF with Korean language.

THE CLINICAL STUDY ON THE EFFECT OF DEXAMETHASONE AND NAPROXEN TO THE SYMPTOMS AFTER REMOVAL OF IMPACTED LOWER THIRD MOLARS (Dexamethasone과 Naproxen 병용투여가 하악 제3대구치 발거 후 증상에 미치는 영향에 관한 임상적 연구)

  • Shin, Kwang-Ho;Lee, Jeong-Keun;Hwang, Byung-Nam
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.1
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    • pp.69-77
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    • 2001
  • PURPOSE : The Purpose of this study was to investigate the anti-inflammatory effect on combination dosage of dexamethasone and naproxen after removal of impacted 3rd molars. We evaluated postoperative pain, swelling, and mouth opening limitation quantitatively. PATIENTS AND METHODS : Removal of an impacted lower third molar was done under local anesthesia with 2% lidocaine to 239 healthy patients. We randomly gave experimental group 1.5mg dexamethasone and 200mg naproxen three times a day for postoperative 2days, and also gave control group 200mg naproxen alone three times a day for postoperative 2days. Swelling and pain were measured by visual analogue scale (VAS). Mouth opening limitation was measured by maximum interincisal opening length. We estimated these measurements in the first and second postoperative days. Differences between experimental and control group were investigated considering age, sex, BMI(body mass index), impacted type, surgical site(right or left), and operation time by independent student T-test. RESULTS : In general, swelling, pain, and mouth opening limitations were significantly reduced (p<0.01) by combination dose of dexamethasone and naproxen in postoperative one day. But there was no difference in pain on the second postoperative day. As variables being considered, in the postoperative pain, there was significant difference between experimental group and control group in only male, little bony removal group, left side extraction group. In case of postoperative swelling, there was no significant differences in male, adolescence, long operating time group (over 20 minutes), medium BMI group and right side extraction group. In case of postoperative mouth opening limitation, there was significant difference between only female and long operating time group (over 20 minutes). CONCLUSION : Variables being considered, postoperative swelling was more reduced by the combination dose of naproxen and dexamethasone than that of naproxen alone after removal of impacted 3rd molars. But there was varoius results in pain and mouth opening limitation.

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Comparison of the observer reliability of cranial anatomic landmarks based on cephalometric radiograph and three-dimensional computed tomography scans (삼차원 전산화단층촬영사진과 측모두부 방사선규격사진의 계측자에 따른 계측오차에 대한 비교분석)

  • Kim, Jae-Young;Lee, Dong-Keun;Lee, Sang-Han
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.262-269
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    • 2010
  • Introduction: Accurate diagnosis and treatment planning are very important for orthognathic surgery. A small error in diagnosis can cause postoperative functional and esthetic problems. Pre-existing 2-dimensional (D) chephalogram analysis has a high likelihood of error due to its intrinsic and extrinsic problems. A cephalogram can also be inaccurate due to the limited anatomic points, superimposition of the image, and the considerable time and effort required. Recently, an improvement in technology and popularization of computed tomography (CT) provides patients with 3-D computer based cephalometric analysis, which complements traditional analysis in many ways. However, the results are affected by the experience and the subject of the investigator. Materials and Methods: The effects of the sources human error in 2-D cephalogram analysis and 3-D computerized tomography cephalometric analysis were compared using Simplant CMF program. From 2008 Jan to 2009 June, patients who had undergone CT, cephalo AP, lat were investigated. Results: 1. In the 3 D and 2 D images, 10 out of 93 variables (10.4%) and 11 out 44 variables (25%), respectively, showed a significant difference. 2. Landmarks that showed a significant difference in the 2 D image were the points frequently superimposed anatomically. 3. Go Po Orb landmarks, which showed a significant difference in the 3 D images, were found to be the artificial points for analysis in the 2 D image, and in the current definition, these points cannot be used for reproducibility in the 3 D image. Conclusion: Generally, 3-D CT images provide more precise identification of the traditional cephalometric landmark. Greater variability of certain landmarks in the mediolateral direction is probably related to the inadequate definition of the landmarks in the third dimension.

Clinical study on the food impaction between implant prostheses and adjacent teeth (임플란트 보철물과 인접치 사이의 식편압입에 관한 임상적 연구)

  • Shin, Dong-Wook;Lee, Jin-Han;Kim, Se-Yeon;Dong, Jin-Keun
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.1
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    • pp.27-33
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    • 2014
  • Purpose: The purpose of this study was to investigate the food impaction between implant prostheses and adjacent natural teeth. Materials and methods: For this study, 51 patients with food impaction were selected and investigated mobility, tightness of contact area, gingival index, plaque index, attachment loss, alveolar bone level, proximal caries, marginal ridge distance and occlusal relationships. Results: Food impaction was found in the upper teeth (60.7%) more than the lower teeth (39.2%). Food impaction was occurred on mesial side of implant prostheses (86.2%) more than distal side (13.7%). Food impaction was mostly found in loose or open contact area (94.2%). Food impaction was frequent on stepped relationship between implant and adjacent teeth. Conclusion: Treatment plan should include proper adjacent and antagonistic occlusal plane and occlusal surface, to prevent food impaction, and the plan should include less adjacent tooth mobility with proper tightness between implant prostheses and adjacent teeth.

Cloning and protein expression of Actinobacillus actinomycetemcomitans cytolethal distending toxin subunit CdtA (Actinobacillus actinomycetemcomitans의 cytolethal distending toxin subunit CdtA 유전자 클로닝과 단백질 발현)

  • Ko, Sun-Young;Jeong, Dong-Keun;Ryu, So-Hyun;Kim, Hyung-Seop
    • Journal of Periodontal and Implant Science
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    • v.37 no.sup2
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    • pp.339-351
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    • 2007
  • Cytolethal distending toxin(CDT)은 세포 주기 중 G2에서 M 기로의 전환을 막아 세포의 증식을 억제할 수 있는 세균 단백 독소의 일종이다. 구강 미생물 중 유일하게 Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans)만이 이 CDT를 생성 할 수 있는 것으로 알려져 있다. A. actinomycetemcomitans는 localized aggressive periodontitis (LAP)의 원인균으로 여겨지며 비 운동성의 그람 음성 구간균이고 $37^{\circ}C$, 5% $CO_2$ 하에 성장이 왕성하다. A. actinomycetemcomitans의 CDT는 3개의 인접한 유전자인 cdtA, cdtB, cdtC에 의해 형성 되며 각각의 유전자에 대한 단백질의 기능은 아직 완전히 밝혀지지 않았다. 현재까지 연구에 의하면 cdtA는 CDT의 세포부착과 관련이 있는 것으로 여겨지며 이 유전자의 기능 이상 시 CDT의 독성 효과가 현저히 감소한다고 알려져 있다. 따라서 본 연구는 A. actinomycetemcomitans의 cdtA 유전자를 클로닝, 단백질 발현하여 향후 치주질환의 발병 과정에서 CdtA의 역할을 규명하고 질환의 예방 및 치료법에 도움을 주고자 하였다. A. actinomycetemcomitans Y4균주를 cdtA 유전자 클로닝을 위해 사용하였다. A. actinomycetemcomitans의 genomic DNA는 genomic DNA 추출 kit를 사용하여 분리하고 cdtA에 특이적인 primer를 이용하여 PCR을 통해 cdtA 유전자를 증폭하였다. 증폭된 cdtA 유전자를 T-vector에 클로닝 하였으며, 클로닝 된 cdtA 유전자는 단백질 발현을 위해 pRSET Avector에 서브클로닝 한 후 발현 균주인 BL21(DE3)를 이용하여 발현시켰다. 발현 후 Ni-NTA AP conjugate를 이용한 Western blot을 통해 pRSET-CDTA를 확인하였다.

A Study on the Electromyographic Activity of Masticatory Muscles, Muscle Tenderness and Occlusal Contacts in Patients with Temporomandibular Disorders (측두하악장애환자에서 근활성, 근압통 및 교합접촉에 관한 연구)

  • Gyu-Mee Lee;Kyung-Soo Han;Myung-Seok Seo
    • Journal of Oral Medicine and Pain
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    • v.21 no.2
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    • pp.293-304
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    • 1996
  • The purpose of this study was to investigate the peak electromyographic activity(EMG) and time intervals in firing sequence of Anterior temporalis(TA) and Masseter(MM) on clenching, the number of tender points in the head and neck muscles, the occlusal contact state on clenching, and their relationship. 78 patients with Temporomandibular Disorders(TMDs) participated and were classified into articular or muscular group by clinical signs and symptoms. BioEMG$\textregistered$ of integrated masticatory function analyzer, Biopak$\textregistered$ system(Bioresearch Inc., USA), was used to measure EMG and related items, and T- Scan$\textregistered$(Tekscan, USA), computerized occlusal analyser, was used to record occlusal contact state on maximum voluntary clenching. EMG and occlusal contact were synchronously recorded and analysed with SAS Statistical program. The results of this study were as follows : 1. In total subjects, EMG of TA was lower than that of MM in articular group but in muscular group, vice versa, As a result, the ratio TA to MM was significantly different between the two groups. no significant differece. 3. The number and force of occlusal contact were more in articular group, but there was no significant difference in Total Left-Right statistics(TLR) between the two groups. 4. In unilaterally affected subjects for muscle function, no significant difference was observed between the affected side and the contralateral side in articular group, but in muscular group, the item of the number of tender points showed significant difference. However, for occlusal contact items, contact force in articular group shows significant difference between the two sides. 5. Rate of coincidence of the first firing side of TA with affected side or preferred chewing side was higher and not different between the two groups, but no significant correlation was showed between the first firing side and the first occlusal contact side.

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Effectiveness of autogenous tooth bone used as a graft material for regeneration of bone in miniature pig (미니피그에서 자가치아뼈 이식의 골형성 효과에 대한 연구)

  • Jeong, Hye-Rin;Hwang, Ju-Hong;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.5
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    • pp.375-379
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    • 2011
  • Introduction: This study examined the effect of autogenous tooth bone used as a graft material for bone regeneration in an artificial bony defect of minipigs. Materials and Methods: Four healthy minipigs, weighing approximately 35-40 kg, were used. Four standardized artificial two-walled bony defects, 5 mm in length and depth, were made on the bilateral partial edentulous alveolar ridge on the mandible of minipigs, and autogenous tooth bone was augmented in the right side as the experimental group. On the other hand, only alloplastic bone graft material HA was grafted with the same size and manner in the left side as the control group. All minipigs were sacrificed at 4 weeks after a bone graft and evaluated histologically by Haematoxylin-eosin staining. The specimens were also evaluated semi-quantitatively via a histomorphometric study. The percentage of new bone over the total area was evaluated using digital software for an area calculation. Results: All specimens were available but one in the left side (control group) and two in the right side (experimental group) were missing during specimen preparation. The amount of bone formation and remodeling were higher in all experimental groups than the control. The mean percentage area for new bone in the experimental and control groups was $43.74{\pm}11.96%$ and $30.79{\pm}2.93%$, respectively. Conclusion: Autogenous tooth bone is a good alternative to autogenous bone with the possible clinical feasibility of an autogenous tooth bone graft in the reconstruction of bony defects.

Retentive Force of Adjustable Dental Impression Trays with Different Synthetic Resin Materials (합성수지 재료에 따른 가변형 치과 인상용 트레이의 유지력에 관한 연구)

  • Lee, In-Seob;Lee, jin-Han;Kim, Yu-Lee;Dong, Jin-Keun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.22 no.1
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    • pp.11-21
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    • 2006
  • The adjustable dental impression trays were made for being adjusted their width automatically along the width of patient's dental arch. The purpose of this study was to investigate the retentive force of adjustable dental impression trays made of different synthetic resin materials. Three pairs of adjustable trays were made of ABS(acrylonitrile butadiene styrene) synthetic resin, polyurethane synthetic resin and polycarbonate synthetic resin with a hole and without a rim on the border area of them. The experiment was done with the horse-shoe shaped metal plate to pull out the set impression body from the tray jig which was made for holding the tray on the lower part of Universal Testing Machine(UTM, Zwick Z020, Zwick Co., Germany). After the alginate impression in the tray was allowed to set four minutes, a tensile force was applied at right angles to the tray which had been previously seated on the jig. The force was applied to measure a maximum force by use of UTM at a constant strain rate 100mm per minute. The results obtained in this study were as follows : 1. The upper trays were showed higher retentive force than lower trays in three tray materials. 2. There was no significant difference in the retentive force of the tray materials(p>0.05).