• 제목/요약/키워드: 수술후 교정치료

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A study of post-operative changes in facial height and width of mandibular prognathic patients (하악전돌증 환자의 수술후 안모길이 및 폭경의 변화에 관한 연구)

  • Kim, Eun-Joo;Moon, Cheol-Hyun
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.367-375
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    • 2000
  • If a mandibular prognathic patient has an extremely unnatural anteroposterior and vertical maxilla or keen esthetical perception for facial profile, orthognathic surgery must be performed along with orthodontic treatment, which alone cannot provide satisfactory results in this case. Esthetical improvement becomes an important factor in the satisfaction level of the patient's treatment result, but an attempt to objectively measure beauty holds many problems. Therefore, in the end, the patient submits the final esthetical evaluation based on his/her subjective viewpoint. Because Korean people have a tendency to prefer the facial appeareance of westerners, they favor an oval shaped face over the traditional round face. This research was conducted in response to the complaints raised by patients who claim that their face had become more round from widening of facial width after the orthognathic surgery for manidibular prognathism than before the surgery. The following results were obtained on the changes in facial appearance and patient satisfaction level by analyzing the skull P-A analysis of total of 14 patients (8 male and 6 female) who underwent orthognathic surgery primarily chief complaint for manidibular prognathism and from their responses on questionnaires. These results are to be used in the research on the pre- and post- operative changes in facial height and width from orthognatic surgery. 1. Three ($21.4\%$) of 14 patients said that their face had widened. 2. The A group showed no change in mandibular width but B group showed a 0.7mm reduction. The facial width increased by 0.45mm and 0.66mm in groups A and B, respectively, after the orthognathic surgery 3. After the surgery the facial length changed by an 0.52mm increase in upper facial height , 1.19mm reduction in lower facial height, and 0.7mm reduction in mandibular height in group A. In group B group, there was a 0.67mm reduction in upper facial height, 3.66mm reduction in lower facial height, and 5mm reduction in mandibular height. 4. In reference to facial width, the facial height showed $1.5\%$ reduction in group A and $3.6\%$ reduction in group B after the surgery. 5. In reference mandibular height-to-facial width ratio, there was a $1.3\%$ reduction in group A, and $4.4\%$ reduction in group B after the surgery. 6. In reference to the mandibular height-to-width ratio, there was a $1.3\%$ reduction in group A and $4.3\%$ reduction in group B after the surgery. 7. Although the change in the facial width due to surgery can be ignored, sufficient explanation should be Provided to the patient before surgery on the fact that the face can appear to be relatively wide because of the reduced facial length as result of the surgery.

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Congenital Pulmonary Vein Stenosis with Normal Anatomical Connection -One case report- (정상적인 해부학적 연결을 가진 선천성 폐정맥 협착증 -치험 1예 보고-)

  • 박준석;장윤희;정미진;강이석;전태국
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.364-368
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    • 2004
  • Congenital pulmonary vein stenosis is a rare anomaly and related to high mortality due to progressive pulmonary hypertension and heart failure in infancy. Aggressive anti-failure medication and surgical treatment is recommended. Surgical options are balloon dilatation, endovascular stent, pneumonectomy, lung transplantation, patch grafting, and sutureless repair. We report a case of congenital pulmonary vein stenosis with normal anatomical connection successfully treated with sutureless technique and using pulmonary vasodilators, such as Sildenafil, lloprost and iNO postoperatively.

Surgical Treatment for Longitudinal Epiphyseal Bracket of the Finger (수지의 종적 Bracket 골단에 대한 수술적 치료)

  • Kim, Sung Soo;Kim, Ki Woong;Kim, Jung Ho;Lee, Chan Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.154-161
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    • 2020
  • Purpose: To describe the clinical and radiology results of a surgical treatment for clinodactyly due to a longitudinal epiphyseal bracket. Materials and Methods: This study analyzed the records of 11 patients (27 case) with clinodactyly due to a longitudinal epiphyseal bracket who underwent an osteotomy or physiolysis between March 1999 and April 2017. The preoperative range of motion of the proximal and distal interphalangeal joints, the subjective satisfaction of the patient, and the degree of angulation to the ulnar side were examined. The patients were classified into two groups: osteotomy and physiolysis. The results were reviewed retrospectively and compared according to the surgical method. Results: The mean age of the patients who underwent osteotomy was 10.3 years. The average preoperative angle was 25.7° and the average postoperative angle was 13.5° the mean correction rate was 47.4%. The mean age of the patients who underwent physiolysis was 6.0 years the mean preoperative angle was 24.5° and the postoperative angle was 10.7°. The average correction rate was 59.4%. No significant difference in the correction angles was observed between the group who underwent the correction osteotomy and the group who underwent the osteotomy. In each group, the postoperative correction was statistically significant. The range of motion at the last follow-up was not significantly different from the preoperative range of motion. Conclusion: In patients with clinodactyly due to longitudinal epiphyseal bracket, osteotomy or physiolysis may be performed selectively according to age, bone age, and radiological progression. Both surgical methods showed good clinical results and deformity correction.

Severe bimaxillary protrusion with adult periodontitis treated by corticotomy and compression osteogenesis (치조골 소실과 심한 양악전돌을 동반한 성인환자에서의 피질골 절단술과 Compression osteogenesis를 이용한 교정치료)

  • Kim, Seong-Hun;Lee, Kye-Bok;Chung, Kyu-Rhim;Nelson, Gerald;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.39 no.1
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    • pp.54-65
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    • 2009
  • This paper describes the case of a 50-year-old female with a Class II malocclusion who presented with severe bimaxillary protrusion and generalized alveolar bone loss due to adult periodontitis. The treatment plan consisted of extracting both upper and lower first premolars and periodontal treatment. Anterior segmental osteotomy(ASO) of the mandible and upper anterior segment retraction using compression osteogenesis after peri-segmental corticotomy(Speedy orthodontics) was performed. Correct overbite and overjet, facial balance, and improvement of lip protrusion were obtained. However, a slight root resorption tendency was observed on the lower anterior dentition. The active treatment period was 9 months and the results were stable for 27 months after debonding. This new type of treatment mechanics can be an effective alternative to orthognathic surgery.

A STUDY ON THE MANDIBULAR MOVEMENT CHANGES AFTER ORTHOGNATHIC SURGERY IN SKELETAL CLASS III PATIENTS (악교정 수술 후 골격성 III급 부정교합 환자의 하악운동 변화에 관한 연구)

  • Nahm, Dong-Seok;Suhr, Cheong-Hoon;Yang, Won-Sik;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.273-282
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    • 1997
  • The purpose of this study was to evaluate changes in mandibular movement patterns after orthognathic surgery in skeletal Class III patients. The sample consisted of 20 Class III malocclusion patients(9 males, 11 females). Just before and after(2-7months) surgery, maximum opening & closing movement, mandibular border movement on sagittal, frontal and horizontal planes were recorded using Sirognathograph & BioPak EGN. On each record, 21 items were measured and statistically analyzed. The results were as follows 1. Angle of protrusive movement on sagittal plane showed greatest change after surgery. Also, as the incisal guidance was established by surgery, straight path of protrusive movement became curved line. 2. Maximum opening distance and maximum antero-posterior distance on maximum opening & closing movement, maximum opening distance on sagittal plane, angle of left lateral excursion on frontal plane were statistically significant after snrgery(p<0.01). 3. Maximum width of lateral excursion on frontal plane, distane of right lateral excursion and angle of maximum left lateral excursion on horizontal plane were statistiraily significant after surgery(p<0.05). 4. Maximum opening distance and maximum antero-posterior distance on maximum opening & closing movement showed significant differences according to post-surgical time(p<0.05). More recovery of range of movement occured in 5-7month group than in 2-3month group. 5. As the occlusal interferences were removed by orthognathic surgery, irregular opening & closing path became smooth curve.

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CLINICAL STUDY ON THE RELAPSE OF DIASTEMA (전치부 공극의 치료후 재발에 관한 임상적 고찰)

  • Park, Hyo-Sang;Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.24 no.1 s.44
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    • pp.95-104
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    • 1994
  • There are orthodontic closure, surgincal closure, prosthetic solution in the treatment of diastema. The orthodontic closure has been widely used owing to its conservative nature, but retention after treatment has been difficult and problematic. So, authors observed relapse and retention after the orthodontic closure of 3 diastema cases. The results might be summarized as follows : The space that had been approximated between central incisors, was reopened by the use of retention appliance which did not join two central incisors together though fixed prothesis. By the frenectomy, circumferential supracrestal fibrotomy and lingual bonded retainer which joined two central incisors together after the orthodontic closure of diastema, were good results obtained. The frenectomy, fibrotomy, and the fixed retention appliance which joined two central incisors together must be needed after the orthodontic closure of diastema.

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The effects of Cox distraction manipulation on functional assessment measures and disc herniation index in patients with L4-5 herniated disc (칵스 신연교정이 L4-5 추간판 탈출증 환자의 기능적 평가측정과 추간판탈출지수에 미치는 효과)

  • Kwon, Won-An;Ryu, Young-Sang;Ma, Sang-Yeol
    • Journal of the Korean Data and Information Science Society
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    • v.23 no.4
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    • pp.727-738
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    • 2012
  • The purpose of the present study was to determine the effect of a 4 week course of Cox distraction manipulation (CDM) combined with therapeutic modalities on the treatment of patients with L4-5 herniated nucleus pulposus (HNP). A total of 15 patients with L4-5 HNP (mean age, 37.76 years; age range 20-50years) participated in the study. A 4 week course of CDM combined with therapeutic modalities was delivered to the patients for 6 days per week for the first two weeks, and three times per week for two additional weeks. The entire treatment consisted of 18 visits over 4 week period. Comparisons of changes in the muscle strengthening (MS), straight leg raise (SLR), and oswestry disability index (ODI) at pre-intervention, after two weeks treatment sessions, and at discharge (after 18 treatment sessions) were analyzed. Comparisons of changes in the disc herniation index (DHI) at pre-intervention and at discharge were analyzed using the paired t-test. There were significant improvements in the outcome measures of MS Ibs, SLR test, and ODI score after 2 weeks and 4 weeks sessions of CDM combined with therapeutic modalities as compared with the pre-intervention. However, no significant different pre-test and post-test DHI. CDM combined with therapeutic modalities appears to be a safe and efficacious, noninvasive treatment modality for patients with L4-5 HNP.

Surgical Treatment of Patello-Femoral Joint Lesions - Arthroscopic treatment - (슬개-대퇴관절의 수술적 치료 - 관절경적 치료를 중심으로 -)

  • Choi, Chong-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.2
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    • pp.79-85
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    • 2005
  • The symptoms in patello-femoral joint can be occurred from various causes. Most of patients complained chronic discomfort and it is rare to have a characteristic acute pain. Initial management should be started conservatively and if it has no effect to relieve symptoms, surgical treatment would be considered. The selection of operative treatment should be decided in the consideration of patients age, activity and ability of performing rehabilitation. Before surgery, accurate diagnosis is essential and causative factors should be removed or corrected with surgery. Arthroscopic surgery is effective for the most of disease in the patello-femoral joint disorder with low morbidity and early rehabilitation. At arthroscopy, superomedial or superolateral portal can be used for the evaluation and treatment of articular surface in the patella. The structure of normal variants should be saved if it does not have pathological changes for prevention of post operative morbidity. If the arthroscopic surgery has difficulties during the procedure or no effect in removal of lesion, open surgery should be considered.

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ORTHODONTIC AND PROSTHODONTIC TREATMENT IN CLEFT LIP AND PALATE PATIENT (순/구개열 환자에서의 교정-보철 치험례)

  • Chang, Weon-Suk;Choi, Yeong-Chul;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.3
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    • pp.388-393
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    • 2000
  • Cleft lip and palate is one of the most common congenital defects in oro-maxillo-facial region. Because most patients undergo surgical repair in early life, the sagittal jaw relationships used to be deteriorated gradually from palate surgery up to adulthood. Also, the maxillary lateral incisor may be absent or atypical-shaped in the cleft site and may not erupt or erupt ectopically, so multidisciplinary dental cares are needed for cleft lip and palate patients. The effects of the cleft lip and alveolus seem to be limited to that part of the dentofacial complex that surrounds the cleft area. In the maxillary arch, the anterior part of the non cleft segment has a tendency to be rotated forward. On the other hand, the cleft segment has a tendency to rotated slightly medially ; hence, the tendency for canines to be edge-to-edge and sometimes in crossbite. Lip and alveolus surgery adequetely correct these problems, with little untoward effect on the skeletal maxillary-mandible relationships. In this report, the patient has a repaired lip and cleft alveolus on the left side with congenital missing on '62, '22, oronasal fistula, and skeletal class III malocclusion which is not affected by lip surgery. Dental treatments for this patient including orthodontic(space supervision, functional regulator in mixed dentition, fixed therapy in permanent dentition) and prosthodontic(removable obturator with key and keyway attachment and Konus crown) therapy were performed to improve the patient's functions and esthetics.

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Effect of estrogen on growth hormone receptor expression of human periodontal ligament cell line (치주인대세포 배양에서 estrogen이 growth hormone receptor의 발현유도에 미치는 영향)

  • Hong, Sung-Gyu;Jeon, Young-Mi;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.30 no.4 s.81
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    • pp.441-452
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    • 2000
  • The present studies were performed to investigate the interaction of $17{\beta}$-estradiol and human growth hormone(hGH) on the proliferation of human periodontal ligament(WDL) cell. The independent effects of $17{\beta}$ estradiol and hGH on hPDL cell proliferation were investigated and the effects of hGH on hPDL cell proliferation after $17{\beta}$-estradiol pre-treatment were also investigated. Lastly, the change of hGH receptor expression in hPDL cell after $17{\beta}$-estradiol pre-treatment were investigated. The obtained results were as follows; 1. The treatment of $17{\beta}$-estradiol or hGH had no significant effects on hPDL cell proliferation. 2. After pre-treatment of $17{\beta}$-estradiol, hGH stimulated the proliferation of the hPDL cell, regardless of hHG concentration. 3. Although there was not hGH receptor in the hPDL cell, hGH receptors were expressed in hPDL cell after more than 6 hours pre-treatment of $17{\beta}$-estradiol. 4. The effect of hGH on hPDL cell proliferation was related to the hGH receptor expression. $17{\beta}$-estradiol pre-treaaent contributed to the hGH effects on the hPDL cell by stimulating hGHR expression.

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