• 제목/요약/키워드: 구강악안면

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성견 하악골 신장술 후 신생골조직에서 Osteopontin 발현에 대한 연구 (IMMUNOHISTOCHEMICAL STUDY OF OSTEOPONTIN EXPRESSION IN THE DISTRACTED BONE AFTER CANINE MANDIBULAR DISTRACTION OSTEOGENESIS)

  • 변준호;박봉욱;성일용;조영철;김종렬
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권5호
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    • pp.418-425
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    • 2006
  • Purpose: This study was aimed at evaluating the histological changes of new bone and expression of osteopontin (OPN) after mandibular distraction osteogenesis. Materials and Methods: Unilateral mandibular distraction (0.5 mm twice per day for 10 days) was performed in eight adult dogs. Two animals were sacrificed at 7, 14, 28 and 56 days after completion of distraction, respectively. The distracted bones and contralateral non-distracted control bones were harvested and processed for histological and immunohistochemical examinations. Results: The new bone was arranged to tension direction after distraction osteogenesis. 7 days after distraction, numerous osteoblasts lining the immature trabecular bone and fibroblast-like cells in the fibrous intrezone were observed. 14 days after distraction, the new formed trabecular bones were thickened compared with 7 days after distraction. 28 days after distraction, the fibrous interzone was almost filled with newly calcified bone, and it was more hardened at 56 days after distraction. Increased OPN signals detected in the osteoblasts lining the trabecular bone and fibroblast-like cells in the fibrous interzone at 7 and 14 days after distraction. At 28 days after distraction, the OPN was weakly expressed in the osteoblasts, and it was not detected in all cellular components of distracted bone at 56 days later of distraction. Conclusions: After distraction osteogenesis, the distracted zone was completely calcified during the 56 days of consolidation period. In this study, the staining intensity of OPN increased in the osteoblasts and fibroblast-like cells at 7 and 14 days after distraction. The expression pattern of this protein shown here suggested that OPN play an important role in the osteogenesis during the early consolidation period.

두개하악장애환자의 교합안정장치에 의한 치료후 Sonopak을 이용한 악관절음 변화 (A Comparative Study on the Temporomandibular Joint Sounds before and after Occlusal Splint Therapy Using Electrovibratography)

  • Hye-Sook Park;Jong-Hoon Choi;Chang-Seo Park
    • Journal of Oral Medicine and Pain
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    • 제21권1호
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    • pp.67-78
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    • 1996
  • This study was performed to compare the TMJ sounds by means of vibration-related items by Sonopak such as integral, high integral, above 300/(0-300) ratio, peak amplitude, peak frequency and median frequency before and after occlusa1 splint therapy as well as counselling, physical modalities. For this study 22 patients with craniomandibular disorders (CMDs) were selected and examined by routine diagnostic procedure for CMDs including Transcranial and Panoramic radiographs and were classified into 3 CMDs subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Visual analogue scale (VAS) about joint sound was recorded during treatment period and VAS treatment index (VAS Ti) was calculated from the VAS data and treatment duration. The author evaluated and compared treatment results by several parmeters such as symptom duration, timing of joint sound, parafunctional habits, trauma, and diagnostic classification. The obtained results were as follows : 1. Before the treatment, the highest value of peak amplitude was observed in disc displacement with reduction group and value of median frequency was highest in degenerative joint disease group. In addition the highest values of peak frequency and ratio ware observed in degenerative joint disease group, though they were not significant. Furthermore the lowest value of high integral was observed in disc displacement without reduction group and though it was not significant, value of integral was lowest in that group. 2. Among 3CMDs subgroups disc displacement with reduction group showed the significantly decreased value of high integral and degenerative joint disease group had the significantly decreased value of integral after conservative treatment including occlusal splint therapy. Conclusively conservative treatment including occlusal splint therapy vay be effective in the treatment of CMDs including TMJ sound. 3. Fair prognosis for conservative treatment was observed in acute group under 6 months than chronic group, 6 months over in symptom duration but there was no statistical difference. The result for conservative treatment was observed slightly poor in subjects with bruxism, clenching, unilateral chewing habit and trauma history but there were no statistical differences.

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Beagle dog를 이용한 임프란트 사이의 간격에 따른 골흡수에 대한 방사선 및 조직학적 평가 (INFLUENCE OF INTERIMPLANT DISTANCE ON BONE RESORPTION : A RADIOLOGICAL AND HISTOLOGICAL STUDY IN BEAGLE DOGS)

  • 이수연;이재욱;김진욱;이상한
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권5호
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    • pp.571-577
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    • 2008
  • Introduction: Possible etiologic factors associated with bone loss around implants after implantation are surgical trauma, occlusal overload, periimplantitis, presence of micro gap and the formation of biologic distances. Tarnow et al. observed that the crestal bone loss was greater when the distance between the implants was <3mm than when the implants were ${\geq}\;3mm$ apart. The aim of this study was to evaluate the influence of different interimplant distance on marginal bone and crestal bone resorption in the beagle dogs. Materials and methods: The mandibular premolars of 5 dogs were extracted bilaterally. After 12 weeks of healing, each dog received 7 implants. On each side, implants were separated by 2mm (Group 1) and by 5mm (Group 2). After 16 weeks of healing, the dogs were sacrificed. Marginal bone loss was determined through linear measurements made between the implant-abutment junctions and the most coronal portions of the bone in contact with the implant surface. A line was drawn uniting the implant-abutment junctions of the adjacent implants, and a linear measurement was made at the midpoint in the direction of the most coronal peak of the interimplant bone crest to determine the crestal bone loss. Both of them was measured radiologically and histologically. Result and conclusion: In radiological analysis, the mean of marginal bone loss was $1.26{\pm}0.14mm$ for group 1 and $1.23{\pm}0.34mm$ for group 2, the mean of crestal bone loss was $1.10{\pm}0.14mm$ for group 1 and $1.02{\pm}0.30mm$ for group 2. The results were not statistically significant between 2 groups. In histological analysis, the mean of marginal bone loss was $1.63{\pm}0.48mm$ for group 1 and $1.62{\pm}0.50mm$ for group 2, the mean of crestal bone loss was $1.23{\pm}0.35mm$ for group 1 and $1.15{\pm}0.39mm$ for group 2. The differences were also not statistically significant. The clinical significance of this result is that the increase in the crestal bone loss results in the increase in the distance between the base of the interproximal contact of the crowns and the bone crest, and this determines if papilla will be present or absent between implants. Considering this fact, keeping up sufficient interimplant distance is important to minimize crestal bone loss.

고농도 포도당 환경에서 EMD(Enamel Matrix Derivatives)가 인간 치주인대 세포와 뼈모세포양 세포(MC3T3-E1)에 미치는 영향 (EFFECT OF EMD ON HUMAN PERIODONTAL LIGAMENT-DERIVED CELLS AND OSTEOBLAST-LIKE CELLS (MC3T3-E1) IN HIGH GLUCOSE CONDITION)

  • 이백수;김선욱;주성숙;권용대
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권5호
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    • pp.532-536
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    • 2008
  • Purpose: This study was designed to evaluate effect of EMD on proliferation of HPDLCs and MC3T3-E1 cells in high glucose condition in vitro. Material and method: The Human PDL fibroblasts(HPDLCs) were obtained through typical way and the cells used in this experiment were divided in 4 groups. $1{\times}10^4/ml$ HPDLCs suspension was cultured in typical DMEM and assigned to group 1. The cells cultured in DMEM which included 400mg/dl glucose are allocated to group 3. Group 2 and 4 are established by adding EMD to group 1 and 3 respectively. These control and experimental groups had been cultured for 24 and 48 hours, and MTT assay was conducted. The differences of each group in cellular proliferation was evaluated. The same experiment was conducted for preosteoblast (MC3T3-E1) with adding $25\;{\mu}g/ml$ EMD. Results: EMD had the same effect on both PDL cells and MCT3T3-E1 cells. The experimental group had more meaningful differences and active cellular proliferation than the control group did. The EMD accelerated cellular proliferation not only in normal glucose condition but also in high glucose condition. The same results were observed via MTT assay; EMD-added experimental group had more meaningful differences and showed higher cellular activity than control group did. Each experimental and control group was inspected for statistical significance through Kruskal-Wallis Test. Statistical significances were observed among these groups. (SPSS 12.0 Chicago, IL, USA, p=0.008, p=0.011) Conclusion: EMD is considered to accelerate proliferation of PDL cells and MC3T3-E1 cells in high glucose condition as well as normal glucose condition.

생쥐의 초기 두개악안면 발생 중 p63의 발현 양상 (Expression of p63 during Early Craniofacial Development of the Mouse Embryo)

  • 호소야 아카히로;이종민;김지연;정한성;조성원
    • 한국발생생물학회지:발생과생식
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    • 제13권2호
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    • pp.89-95
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    • 2009
  • p63은 다양한 상피 조직의 줄기세포와 전구세포에 존재한다는 사실이 잘 알려져 있으나, 치아 형성, 특히 사기질과 뿌리 형성시기에서의 p63 위치느 ㄴ아직 연구해야 할 과제로 남아 있다. 본 연구에서는 p63이 치아 발생 동안 치아상피에 편재하여 나타나는 것을 면역조직화학 기법을 이용하여 확인하였다. p63은 피부, 모낭, 구강점막 그리고 턱밑샘 도관을 포함하는 상피의 바닥층과 바닥위층에 위치하였다. 그러나 치아 부위에서는 치아관의 모든 세포, 사기질기관, 헤르트비히 뿌리상피집 그리고 말라세쯔 상피잔사에 p63이 관찰되었다. 이 결과는 치아 발생 중 p63이 줄기세포 유지 외에도 다른 기능을 한다는 사실을 보여준다.

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구강암 발생 과정에서 TGF-α 및 TGF-β 발현에 관한 연구 (EXPRESSION OF TGF-α AND TGF-β)

  • 양희창;이동근;김은철
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제19권4호
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    • pp.414-434
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    • 1997
  • Though many genetic and epigenetic alterations have been identified in hamster oral carcinogenesis model, there is no information about the possible role of transforming growth factor related with oral cancer. The purpose of this paper was to find the expression patterns of transforming growth factor alpha and beta during the stages of complete oral carcinogenesis model in hamster. 0.5% 9, 10-dimethyl-1, 2-benzanthracene(DMBA) in mineral oil was topically applied to the buccal pouch of 75 hamster three times a week during the experimental periods. The experimental animals were subdivided into two groups of control and experiment. Only the mineral oil was applied to the control group. 0.5% DMBA in mineral oil was applied to the experimental groups of 6, 8, 10, 12, 14, 16, 18 and 20 weeks. The expression of the $TGF-{\alpha}$ and $TGF-{\beta}$ protein were evaluated by the distribution and intensity of positive cells during the carcinogenesis using the immunohistochemical study. The following results were obtained ; 1. The buccal pouch epithelium of hamster was histologically changed to the dysplasia at 6, 8, 10 weeks, carcinoma in situ at 12 weeks, and squamous cell carcinoma at 14 weeks. 2. The expression of the $TGF-{\alpha}$ was restricted to the parabasal and basal layers of the normal and dysplastic mucosa, but those positive cells were extended to the spinous layers of the epithelium in the carcinoma. 3. The degree of $TGF-{\alpha}$ expression was markedly decreased in the carcinoma at 16, 18, 20. The strong positive staining in the center of cancer islands and weak positive staining in periphery of tumor were seen at the stage of squamous cell carcinoma. 4. The positive index of the $TGF-{\alpha}$ had a tendency to increase with DMBA- applied time. There was a statistically significant difference between 12, 18, 20 experimental group and control group (p<0.05). 5. The expression of the $TGF-{\beta}$ was shown at the cytoplasm of all control and experimental groups, and the parabasal and basal layers of the normal and dyslastic mucosa, but it was shown at the basal layers of the epithelium in the carcinoma. 6. $TGF-{\beta}$ was expressed diffusely at 16, 18, 20 experimental group. The strong positive staining in the center of cancer islands and positive staining in periphery of tumor were seen at the stage of squamous cell carcinoma. From the above findings, the expression of $TGF-{\alpha}$ and ${\beta}$ in oral carcinogenesis model seems to have two formal stages, the first being an overexpression step as reaction to uncontrolled growth and the second being one in which external protein accumulate in the surrounding stroma and intracytoplasm. Overexpression of $TGF-{\alpha}$ and ${\beta}$ may have important cooperative roles for the promotion of cancer and factor of prognosis.

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전신성 홍반성 낭창 환자에서 상악 치은에 발생한 Kaposi's Sarcoma (KAPOSI'S SARCOMA OF MAXILLARAY GINGIVA IN SYSTEMIC LUPUS ERYTHEMATOSUS)

  • 김일규;조현영;;박승훈;박종원;사시카라바라라만;김준미
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권4호
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    • pp.343-348
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    • 2009
  • 본 증례는 전신성 홍반성 낭창으로 인해 2000년 4월부터 면역 억제제인 azathioprine 75mg과 prednisolne 35mg을 복용 중인 42세 여성 환자가 2004년 12월 상악 협측 치은의 종창, 증식, 동통 및 출혈을 주소로 내원하여 조직 생검 결과 모세 혈관종으로 진단되었으나, 2005년 1월 치은의 재발 병소의 절제 및 조직 생검으로 카포시 육종으로 진단되었고, 흉부의 피부 병변의 조직 생검과 흉부 전산화 단층 촬영 검사에서도 양측 폐에 다수의 결절을 보이는 카포시 육종으로 진단되었다. 의인성 면역억제제에 의한 카포시 육종으로 최종 진단되어, 면역 억제제와 부신피질호르몬제의 중단과, paclitaxel을 이용한 전신적인 항암화학 요법으로, 2008년11월 현재까지 재발의 징후 없이 구강, 피부, 폐의 병소에 대해 양호한 치료 결과를 얻었으나, 향후 전신성 홍반성 낭창의 악화 또는 카포시 육종의 재발 가능성이 있으므로 지속적인 추적 관찰이 요할 것으로 사료된다.

구강 결손부에 적용된 요골 유리전완 피부피판 적용례 분석 (Clinical Cases Analysis of Forearm Free Fasciocutaneous Flaps on Oral Cavity Defect Area)

  • 김욱규;이광호;송원욱;황대석;김용덕;신상훈;김종렬;정인교
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권4호
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    • pp.324-331
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    • 2010
  • The radial forearm free flap (RFFF) has become a workhorse flap as a means of reconstructing surgical defects in the head and neck region. We have transferred 12 RFFFs with fasciocutaneous type on oral cavity defects in 12 patients after cancer resection and submucous fibrotic lesion ablation from 2005 to 2007 at Department of oral and maxillofacial surgery, Pusan National University Hospital. We reviewed retrospectively patients' charts and followed up the patients. Clinical analysis on the cases with RFFFs focusing on flap morbidity, indications and available vessels was done. The results of study are follows: 1. RFFF could be applied for all kind of defects after resection of tongue, floor of mouth, buccal mucosa, denuded bone of palate, maxilla, and mandible. 2. All free flaps could be used for primary reconstruction. The survival rate of 12 RFFFs was 92%. Partial marginal loss of the flaps was shown as 3 cases among 12 cases. Large size-vessels like superior thyroid artery, facial artery, internal jugular vein were favorable for microvascular anastomosis. 3. Parenteral nutrition instead of nasal L-tube also can be favorable for postoperative a week for better healing of the flap if the patients couldn't be tolerable with nasal tubing. 4. Donor sites with thigh skin graft were repaired with wrist band for 2 weeks. The complications included scarring, abnormal sensation on hand, and reduced grip strength in few patients, but those didn't induce major side effects. 5. Most RFFFs were well healed even if mortality rate of cancer patients was shown as 50% (5/10 persons). The mortality of patients was not correlated with morbidity of the flaps. We could identify the usefulness of RFFF for restoration of oral function, esthetics if the flap design, tissue transfer indications, and well controlled operation are proceeded.

하악 제 3대구치의 치근 만곡도와 매복정도의 관계 분석 (ANALYSIS OF THE RELATIONSHIPS BETWEEN THE ROOT CURVATURES OF THE MANDIBULAR THIRD MOLARS AND THEIR LOCATIONS ON THE MANDIBLE)

  • 임재석;권종진;장현석;박영준;전상호;현승돈
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권1호
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    • pp.46-52
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    • 2002
  • Purpose : We examined the relationships between the root curvatures of the mandibular third molars and their locations on the mandible, so that it might be contributed to elucidate the origin of the formation and development of the Korean mandibular third molar and help many clinicians to treat the mandibular third molars. Materials and Methods : Panoramic radiographs of 237 patients who had been treated at Korea University Ansan Hospital from March, 2000 to April, 2001 and had bilateral mandibular third molars were examined and analyzed. Results : There was no statistically significant difference between men and women (p<0.05). But there were significantly fewer subjects with bilateral curved roots in bilateral third molars regardless of their status (p<0.01) and were statistically significant differences between the groups with bilateral curved roots in the mandibular third molars with same status and with unilateral curved roots in the mandibular third molars with different status and between the groups with unilateral curved roots in the mandibular third molars with same status and with bilateral curved roots in the mandibular third molars with different status(p<0.05). Subjects with bilateral curved roots in the mandibular third molars with bilateral partial impacted status and with bilateral curved roots in the mandibular third molars with bilateral complete eruption status were significantly fewer (p<0.01) and subjects with the mandibular third molars with partial impacted and complete impacted status and with the mandibular third molars with complete erupted and partial impacted status had significantly fewer bilateral curved roots (p<0.05). Conclusions : When we postulate that it is genetic and environmental factors that affect the root formation, it seems that environmental factors have more effects on the formation of the mandibular third molars than on that of the mandibular first and second molars

한국성인 정상교합자에서 Delaire의 이상적 교합평면과 저작근 근활성도와의 관계에 대한 연구 (A STUDY ON THE RELATION BETWEEN DELAIRE'S IDEAL OCCLUSAL PLANE AND MASTICATORY MUSCLE ACTIVITY IN KOREAN NORMAL ANGLE CLASS I OCCLUSION INDIVIDUALS)

  • 변성규;이충국
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권3호
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    • pp.229-237
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    • 2000
  • According to the functional matrix theory, Delaire proposes that individual occlusal plane was determined by variable effects of teeth, maxilla, mandible, cranium, cranial base and soft tissue matrix including the orofacial musculature. and that there is the ideal occlusal plane determined by the most proper spatial position of maxilla and mandible, functionally and esthetically. This study was designed to find out the relation between Delaire's ideal occlusal plane and muscle activity of masticatory muscles in individuals who have normal maxillo-mandibular relationships. Lateral cephalometric radiographs were taken and his/her individual occlusal plane and ideal occlusal plane were analyzed with Delaire's architectural and structural craniofacial analytic method. For evaluation of muscle activities of masticatory muscles, electromyography of anterior temporal muscle, superficial masseter muscle, and anterior belly of digastric muscle was recorded in fifty Korean normal Angle class I occlusion individuals. According to the average value of ideal occlusal plane, fifty normal Angle class I occlusion individuals were classified into three groups: Ideal occlusal plane group(I group), hyperrotation group(I+ group) and hyporotation group(I- group). The result of this study was as follows: 1. The results of Delaire's architectural and structural craniofacial analysis of lateral cephalography of the fifty Korean normal Angle class I occlusion individuals are that twelve persons(24%) have consistent or parallel with ideal occlusal plane and the average of angular difference was $1.22^{\circ}{\pm}3.69^{\circ}$. 2. There is no significant difference in muscle activities of masticatory muscles during resting(p<0.05), but significant increases of muscle activity of ipsilateral anterior temporal and masseter muscle, contralateral anterior belly of digastric muscle during unilateral chewing and of anterior temporal and masseter muscle during bilateral clenching(p<0.05). 3. To find out the effect of the angular difference between Delaire's ideal occlusal plane and real occlusal plane to muscle activity, muscle activities of masticatory muscles were compared with three groups in each other; I group, I+ group and I- group. The results were no significant differences during resting, unilateral chewing and bilateral clenching.(p>0.05) 4. Although there is no significant differences of masticatory muscle activities among the three groups, the fact that increasing tendency of masseter muscle activity of ideal occlusal plane group(I+) than those of any other groups(I+ and I-) during bilateral clenching was noted. There is only the implication that occlusal plane makes some effects on masticatory muscle activities, espacially that of masseter muscle during bilateral clenching. In conclusion, the hypothesis that occlusal plane is one of the factors which affect the muscle activities of masticatory muscles and that anyone whose occlusal plane consistent with Delaire's ideal occlusal plane has an extraordinary functional advantage in masticatory muscle function cannot be proven with electromyography methods.

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