• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.267-274
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• 2013

This study was performed to investigate the skeletal factors related to open lock of the temporomandibular joint(TMJ). We compared the skeletal measurements on the cephalogram and transcranial radiograph among 3 groups, open lock group consisting of consecutively filed 50 patients with at least one open lock episode within recent 1 year, temporomandibular disorder(TMD) group of 50 TMD patients without open lock diagnosed by Research Diagnostic Criteria for TMD (RDC/TMD) Axis I, and normal group of 50 patients without TMD or open lock. The patients of TMD and normal group were randomly selected in an age-and-gender-matched way with ones of open lock group. Open lock group showed smaller saddle angle than normal group on cephalograms and steeper inclination of the articular eminence than TMD and normal groups on transcranial radiographs. These results imply that the patients with the joint located more anterior and the articular eminence with steeper inclination might be riskier to TMJ open lock.

• Journal of Oral Medicine and Pain
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• v.22 no.2
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• pp.241-252
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• 1997

본 연구는 임상검사 및 방사선 사진상 악관절장애로 진단된 환자중 물리치료,악관절 안정장치 등의 보존적 치료방법을 시행하였으나 증상의 개선이 별로 없는 퇴행성 관절질환이나 중등도의 개구제한을 가진 환자를 대상으로하여 aspirin을 이용한 활액성분 분석 및 악관절 도약술과 sodium hyaluronate의 주입을 시행한후 이에 따른 치료결과를 평가하기 위하여 시행되었다. 평균연령이 31.2세(21-42세)인 11명의 악관절 장애환자를 대상으로 하였다. 악관절 도약술과 sodium hyaluronate의 주입은 악관절의 동통과 개구제한의 해소를 위해 시행되었으며 그 결과를 시술전, 시술 즉시, 시술 1주후 및 4주후로 나누어 분석하였으며 활액 채취시 생리식염수의 희석에 의한 활액성분의 농도 변화에 따른 오차를 막고자 활액과 혈액내의 aspirin의 농도차를 이용하여 정확한 활액 성분농도를 측정하였다. 이상의 연구를 통하여 다음과 같은 결론을 얻었다. 1. 전체 환자의 생리식염수에 의한 악관절 활액의 희석계수는 1.4-12.9(5.5$\pm$4.2)로 상당히 넓은 범위를 나타내었다. 2. 만성 폐구성 과두걸림 환자군(n=7)의 생리식염수에 의한 활액의 희석계수 (6.2$\pm$3.5)는 퇴행성 관절질환을 갖는 환자군(4.4$\pm$5.7, n=4)과 유의한 차이가 없었다. 3. 만성폐구성 과두걸림군과 퇴행성 관절 질환군간의 활액성분의 농도는 유의한 차이가 없었으나 희석계수를 이용한 수정된 Hyaluronic acid와 총단백질의 농도는 만성 폐구성 과두걸림군의 경우에서 유의하게 더 높게 나타났다. 4. 악관절 도약술과 sodium hyaluronate의 주입 직후 만성 폐구성 과두걸림 환자군의 경우 평균 8.3mm의 추가적인 개구 증가로 유의한 차이가 관찰되었고 퇴행성 관절질환의 경우 평균 1.3mm의 추가적인 개구증가가 있었으나 유의한 차이가 관찰되지 못했다. 5. 시술전, 시술 1주후 및 4주후의 여러 검사항목을 비교한 결과 두 군에서 모두 시간의 경과에 따라 기능이상 및 동통 감소의 경향을 나타내었으나 유의하지는 않았으며 만성 폐구성 과두걸림의 경우 기능장애지수(dysfunction index) 와 최대개구시 동통의 정도는 시술전과 시술 4주후간에 유의한 차이가 관찰되었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.167-180
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• 1997

79 surgically managed mandibular condylar fracture patients included the 25 patients treated with Dr, Nam's method were analysed the postoperative resluts in Oral and Maxillofcial Surgery, School of Dentistry, Wonkwang University since 1993 to 1995. Mean patient's age is 32.5 years (range, 8 to 65 years), and follow-up periods were a minimum of 3 months to 28 months. 19% condylar fractures were associated with mostly symphysis portion. According to the patient's age, severity of condylar fractures, clinical signs and symptoms, radiographic findings, treatmenet plans had been performed. Rigid fixation have performed greatly, and then fragment removal of fractured mesial pole of proximal segment of the condylar and little cases of reshaping and eminoplasty and lag screw have been applied. Two cases of the both condylar resorption and deviated condyle posteriorly in Dr. Nam's method. None of infection or necrosis signs of treated condyle surgically. In my opinion, whenever possible, displaced condylar fracture can be managed surgically with rigid fixation, but not Dr. Nam's method. Usually if perform the surgical management of condylar fractures you should maintain maxillomandibular fixation for 2 weeks, or more and has to follow-up functional mandibular exercise should be kept continuously.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.295-301
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• 2009

Recently, bisphosphonate-associated osteonecrosis of the jaw(BONJ) is added to the list of diseases of the oromaxillofacial region. BONJ is defined as exposed bone in the jaw that does not heal within 8 weeks after identification, in a patient who has been received to bisphosphonates and has not taken radiation therapy to the craniofacial region. Bisphosphonates binded to bone mineral are concentrated in highly active remodeling site, reside in the skeleton for a long time, and do a role as powerful inhibitors of bone resorption. As the patients receiving bisphosphonates therapy grow in number, the patients of BONJ would go on increasing in Korea. We would like to present two patients who were suspected to BONJ, describe the outline of BONJ, and mention importance of our understanding about BONJ. BONJ is rare disease, but once it develops, its prognosis is very poor. Our adequate understanding of BONJ is necessary to prevent it and cope with it properly.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.2
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• pp.157-161
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• 2001

The purpose of this study cephalometrically evaluated changes in the posterior airway space for patients with obstructive sleep apnea syndrome(OSAS) before and after surgical advancement of the maxilla and mandible. The change in calculated airway resistance was correlated with the respiratory disturbance index(RDI). Twenty cephalometric radiographs were traced before and after surgery to determine the posterior airway area and calculate resistance. Polysomnograms of each patient were obtained before and after surgery. All patients had a decrease in calculated airflow resistance in the airway. The mean amount of resistance was 865.15 before surgery, decreasing to 192.65 after surgery (p<0.01). Eighty-five percent of the patients experienced improvement in their RDI. Reduction in the RDI appears to be due to an increase in the posterior airway space and decrease in flow resistance.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.330-336
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• 1999

Study of dentofacial structure relationships relative to TMJ internal derangement is required to increase the predictability of TMJ internal derangement. But few studies have been reported. The purpose of this study is to reveal any correlation of dentofacial characteristics with TMJ internal derangement by lateral cephalometric analysis. Patients were devided into two groups. (1) Symptomatic patients with TMJ internal derangement (2) Asymptomatic volunteers with no TMJ internal derangement. Twenty symptomatic patients with TMJ internal derangement(7male, 13female) were selected from our clinic and had undergone a standarized clinical examination, panorama, transcranical view, TMJ tomography. Twenty asymptomatic volunteers(9male, 11female) were selected from our clinic with no pain, no limitation of motion. All subjects had undergone lateral cephalometric analysis. The results were obtained as follows. 1. No significant difference between ID and normal group is detected in cranial base. 2. Maxilla position of ID group is located more posterioly than normal group. 3. Mandible position of ID group is located more posteriorly than normal group and facial profile is hyperdivergent. 4. Posterior facial height of ID group is less than normal group thus facial profile is hyperdivergent. The patients, as mentioned, have a high prevalance of ID thus it should be careful in TMJ ID diagnosis and treatment.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.271-279
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• 1985

The authors treated a case of bimaxillary dentoalveolar protrusion corrected by anterior segmental osteotomies: As presurgical treatment & process, closing of the upper anterior spacing with fixed appliances was worked out, cephalometric predicition & model surgery was done, and fabrication of intra-arch acrylic resin splints were made. It was not necessary to make an intermaxillary fixation with wire after surgery. Only intramaxillary fixation of anterior retracted mobile segment with resin plate was required for 8 weeks. After surgical treatment, leveling of the upper and lower arch with rectangular arch wire were accomplished as the Intrusion of anterior teeth proceeded. We will continue to improve the class II molar relationship by using class II elastics and have a good occlusiion through the orthodontic treatment.

• Imaging Science in Dentistry
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• v.32 no.3
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• pp.129-134
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• 2002

Purpose : To implement the database system of oral and maxillofacial radiological images using a commercial medical image management software with personally developed classification code. Materials and methods : The image database was built using a slightly modified commercial medical image management software, Dr. Image v.2.1 (Bit Computer Co., Korea). The function of wild card '*' was added to the search function of this program. Diagnosis classification codes were written as the number at the first three digits, and radiographic technique classification codes as the alphabet right after the diagnosis code. 449 radiological films of 218 cases from January, 2000 to December, 2000, which had been specially stored for the demonstration and education at Dept. of OMF Radiology of Dankook University Dental Hospital, were scanned with each patient information. Results: Cases could be efficiently accessed and analyzed by using the classification code. Search and statistics results were easily obtained according to sex, age, disease diagnosis and radiographic technique. Conclusion : Efficient image management was possible with this image database system. Application of this system to other departments or personal image management can be made possible by utilizing the appropriate classification code system.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.1
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• pp.89-97
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• 1995

The radiographic findings of soft tissue calcification in the oral and maxillofacial area was analysed using panoramic, skull P-A and intraoral radiographs in 250 patients. The obtained results were as follows ; 1. Salivary stone had the highest rate of occurrence at 46％(116 cases), followed by lymph node calcification(97 cases), phleholith(21 cases), multiple miliary osteoma(15 cases), antrolith(l case), vessel calcification(l case) and cysticercosis(1 case). 2. The prevalence of salivary stone was slightly higher in females, on the right side and in the middle-aged group and was especially higher in the submandibular gland(83％). The majority of them were round-shaped, homogeneously radiopaque and associated with sialodochitis. 3. The prevalence of lymph node calcification was higher in the female and old-aged group. Irregular shape and radiopaque bodies were seen in the cervical area, bilaterally. 4. The prevalence of phlebolith was slightly higher in the male, and the third decade group. The radiopaque bodies were 4-8 mm in diameter and had laminated appearance. 5. The prevalence of multiple miliary osteoma was higher in old-aged females. The numerous doughnut-shaped radiopaque bodies, sized 2-4 mm in diameter, were seen bilaterally in the cheek and were usually associated with the edentulous ridge.

• Journal of Oral Medicine and Pain
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• v.25 no.3
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• pp.279-289
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• 2000

현대에는 날로 복잡해지는 생활양식의 변화에 따라 다양한 스트레스에 노출되고 그로 인한 면역계, 신경계 또는 각종 장기의 기능이상이 점차로 증가되고 있다. 최근 치과에 내원하는 환자들 중 구강건조증을 호소하는 환자들의 다수는 스트레스에 노출되어 있고, 임상적으로도 방사선 타액선 기능 검사에서 타액선, 특히 악하선의 기능이 현저하게 저하되어 있는 소견을 관찰할 수 있 다. 더욱이 이는 타액선 조영술에서 이미 보고된 바 있는 면역성 질환인 $Sj\ddot{o}gren$ 증후군과는 다른 양상으로 관찰되고 있어, 이에 본인은 백서에 스트레스와 관련이 깊은 내분비적 환경 변화를 유도함으로써 이와같은 변화가 악하선 조직의 병리적 변화와 어떠한 연관성을 갖는 지를 관찰하고자 본 실험을 시행하였다. 생후 7주된 Sprague-Dawley계 웅성 백서(165-209g/bw) 40마리를 2 개의 실험군(부신 제거군 : ADX 군, 부신 제거 후 dexamethasone 투여군 : DEX 군)으로 나누어 실험하였다. ADX 군은 외과적으로 부신을 제거한 후 다른 조건을 부여하지 않았고, DEX 군은 외과적으로 부신을 제거한 후 매일 dexamethasone($1.5*10^{-46}mg/g$ I.V./day)을 투여하였으며, 이들을 각각 실험 후 즉시, 1일, 3일, 5일, 7일에 희생시켰다. 그 후에는 즉시 악하선을 적출하여 면역조직화학법으로 Clusterin의 발현 정도 및 부위를 관찰하였다. 그 결과는 다음과 같았다. 1. 광학현미경 하에서, 양 군 모두 유의할만한 조직학적 변화는 관찰되지 않았다. 2. ADX 군에서는 실험기간 전반에 걸쳐 도관세포와 선포세포에서 clusterin이 발현되었다. 3. DEX 군에서는 소수의 선세포에서 국소적으로 clusterin이 관찰되었으나, 전반적으로 도관세포, 선포세포에서 공히 clusterin이 관찰되지 않았다. 부신을 제거한 군에서는 실험기간 전반에 걸쳐 clusterin이 발현되었는데, 이는 clusterin이 스트레스의 생리적 반응의 결과로서 세포보호작용을 한다는 사실에 기초하여 볼 때, 부신을 제거하였을 때도 스트레스를 받았을 때와 같은 영향이 백서의 악하선에 가해졌을 것으로 생각된다. 반면, 부신제거후 glucocorticoid agonist인 dexamethasone을 투여하였을 때, clusterin이 감소 내지 관찰되지 않았던 것은 부신제거에 의해 악하선에 가해졌던 영향을 dexamethasone이 길항하여 나타난 결과로 볼 수 있어, 스트레스에 의해 부신으로부터 분비되는 glucocorticoid가 타액선을 보호하는데 중요한 작용을 하는 것을 시사한다.