• Title/Summary/Keyword: 수술-교정치료

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Study of horizontal skeletal pattern and dental arch in skeletal Class III malocclusion patients (골격성 III급 부정교합자의 횡적인 골격과 악궁 형태에 관한 연구)

  • Park, Hee-Chan;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.38 no.5
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    • pp.358-370
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    • 2008
  • Objective: The purpose of this study was to investigate the horizontal skeletal pattern and dental arch differences between Class III malocclusion patients and normal occlusion patients. Methods: Twenty skeletal Class III malocclusion patients and ten normal occlusion patients were selected and 3D facial CT were taken to analyze the horizontal skeletal differences between the two groups. Results: In the horizontal comparison of the maxilla, skeletal width and perimeter were significantly smaller in skeletal Class III patients on ANS and A point reference planes. The difference between maxillary width of ANS and A point reference planes showed that there was greater constriction of the first and second premolar in skeletal Class III patients. In the horizontal comparison of the mandible, the widths of the canine and premolar area were significantly larger in skeletal Class III patients on B point reference plane. The differences between width of the upper and lower jaws (comparison of A and B reference planes) were significantly large in the canine and premolar area. Conclusions: From this study, the characteristics of Class III malocclusion patients were shown through horizontal constriction of the maxilla. But to make clear further detailed characteristics of Class III malocclusion patients, additional studies are necessary.

Orthodontic Traction of Impacted Teeth with Modified Nance Appliance : Case Reports (Modified Nance Appliane를 이용한 매복치의 교정적 견인 치료 증례 보고)

  • Park, Sehee;Choi, Namki;Kim, Seonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.4
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    • pp.454-462
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    • 2020
  • Proper treatment of an impacted tooth is required as it causes functional and esthetic disharmony, as well as it can cause root absorption of adjacent teeth. Treatment options for impacted teeth include periodic observation, surgical exposure, orthodontic traction followed by surgical exposure, tooth transplantation, and extraction. Modified Nance appliance, used for orthodontic traction, is clinically useful because it does not require patient cooperation. Through orthodontic traction combined with surgical exposure of impacted maxillary incisors, canines, and molars using modified Nance appliance, adequate results can be obtained.

Follow-up in Adult after Total Repair of Tetralogy of Fallot (수술 후 성인 Fallot 4징 환자의 임상적 고찰)

  • Jang, Gi Young;Kim, Sun Young;Moon, Joo Ryung;Huh, Joon;Kang, I-Seok;Park, Seung Woo;Jun, Tae Gook;Park, Pyo Won;Lee, Heung Jae
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.661-667
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    • 2003
  • Purpose : This study was performed to find the chief clinical problems associated with the ages of adult patients of tetralogy of Fallot(TOF) who had undergone total correction. Methods : Of the 30 patients who were registered at the Grown-Up Congenital Heart Disease (GUCH) Clinic of Samsung Medical Center for TOF, a retrospective investigation was carried out on 28 patients who underwent total correction. Results : Mean age at retrospective study was 30.8(range : 16-53) years old. Age at total correction was 15.8(range : 2-49) years old. Problems after corrective surgery were assessed. They were arrhythmia, pulmonary valve regurgitation, left pulmonary artery stenosis, residual ventricular septal defect, mitral valve regurgitation, tricuspid valve regurgitation, right ventricle outflow tract obstruction, aortic valve regurgitation, infective endocarditis and protein losing enteropathy. After repair of TOF, such arrhythmias as atrial arrhythmia and AV conduction disturbances were observed in some patients. Cardiomegaly was found significantly in the subjects with arrhythmia(P<0.05), and arrhythmia was less observed in patients who underwent surgery at a young age. Eight patients required a reoperation; the main indications were residual ventricular septal defect, right ventricle outflow tract obstruction and peripheral pulmonary artery stenosis. Conclusion : The majority of the patients seemed to live normal lives after Tetralogy of Fallot repair. However, as residual anatomic and functional abnormalities exist postoperatively, continued careful follow-up is needed to detect and correct structural and functional abnormalities.

Surgical Results and Risk Facor Analysis of the Patients with Single Ventricle Associated with Total Anomalous Pulmonary Venous Connection (총폐정맥연결이상증을 동반한 단심증 환아의 수술결과 및 위험인자 분석)

  • 이정렬;김창영;김홍관;이정상;김용진;노준량
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.862-870
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    • 2002
  • The surgical results of the patients with single ventricle(SV) associated with total anomalous pulmonary venous connection(TAPVC) has been reported with high mortality and morbidity due to their morphologic and hemodynamic complexity. A retrospective review was undertaken to report the outcome of the first-stage palliative surgery in our institution and to determine the factors influencing early death. Material and Method: Between January 1987 and June 2002, 39 patients with SV and TAPVC underwent surgical intervention with or without TAPVC repair. Age at operation ranged from 1day to 10.7months (median age, 2.4month), and 29 patients were male. Preoperative diagnosis included 20 right-dominant SV, 15 SV with endocardial cushion defect, 3 left-dominant SV, and 1 tricuspid atresia. The pulmonary venous connection was supracardiac in 22, cardiac in 5, infracardiac in 11, and mixed in 1, Obstructed TAPVC was present in 11. First-stage palliative surgery was performed in 37. Repair of TAPVC, either alone or in association with other procedures, was performed during the initial operation in 31. Univariate and multivariate analyses were performed to analyze the risk factors influencing the operative death. Result: A mean follow-up period of survivors was 34.3 $\pm$ 43.0(0.53 ~ 146.2)months. Overall early operative mortality was 43.6%(17/39). The causes were low cardiac output in 8, failure of weaning from cardiopulmonary bypass in 3, sepsis in 2, pulmonary hypertensive crisis in 1, pulmonary edema in 1, pneumonia in 1, and postoperative arrhythmia in 1. Risk factors influencing early death in univariate analysis were body weight, surgical intervention in neonate, obstructive TAPVC, preoperative conditions including metabolic acidosis, and need for inotropic support, TAPVC repair in initial operation, operative time, and cardiopulmonary bypass(CPB) time. In multivariable analysis, body weight, age at initial operation, surgical intervention in neonate, preoperative conditions including metabolic acidosis, need for inotropic support and CPB time were the risk factors. Conclusion: In this study, we demonstrated that the patients with SV and TAPVC had high perioperative mortality. Preoperative poor condition, young age, the length of operative and CPB time, the presence of obstructive TAPVC had been proven to be the risk factors. This fact suggests that the avoidance of unnecessarily additional procedures may improve the surgical outcomes of the first-stage palliative surgery. However further observation and collection of the data is mandatory to determine the ideal surgical strategy.

Verification of Indicator Rotation Correction Function of a Treatment Planning Program for Stereotactic Radiosurgery (방사선수술치료계획 프로그램의 지시자 회전 오차 교정 기능 점검)

  • Chung, Hyun-Tai;Lee, Re-Na
    • Journal of Radiation Protection and Research
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    • v.33 no.2
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    • pp.47-51
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    • 2008
  • Objective: This study analyzed errors due to rotation or tilt of the magnetic resonance (MR) imaging indicator during image acquisition for a stereotactic radiosurgery. The error correction procedure of a commercially available stereotactic neurosurgery treatment planning program has been verified. Materials and Methods: Software virtual phantoms were built with stereotactic images generated by a commercial programming language, Interactive Data Language (version 5.5). The thickness of an image slice was 0.5 mm, pixel size was $0.5{\times}0.5mm$, field of view was 256 mm, and image resolution was $512{\times}512$. The images were generated under the DICOM 3.0 standard in order to be used with Leksell GammaPlan$^{(R)}$. For the verification of the rotation error correction function of Leksell GammaPlan$^{(R)}$, 45 measurement points were arranged in five axial planes. On each axial plane, there were nine measurement points along a square of length 100 mm. The center of the square was located on the z-axis and a measurement point was on the z-axis, too. Five axial planes were placed at z=-50.0, -30.0, 0.0, 30.0, 50.0 mm, respectively. The virtual phantom was rotated by $3^{\circ}$ around one of x, y, and z-axis. It was also rotated by $3^{\circ}$ around two axes of x, y, and z-axis, and rotated by $3^{\circ}$ along all three axes. The errors in the position of rotated measurement points were measured with Leksell GammaPlan$^{(R)}$ and the correction function was verified. Results: The image registration errors of the virtual phantom images was $0.1{\pm}0.1mm$ and it was within the requirement of stereotactic images. The maximum theoretical errors in position of measurement points were 2.6 mm for a rotation around one axis, 3.7 mm for a rotation around two axes, and 4.5 mm for a rotation around three axes. The measured errors in position was $0.1{\pm}0.1mm$ for a rotation around single axis, $0.2{\pm}0.2mm$ for double and triple axes. These small errors verified that the rotation error correction function of Leksell GammaPlan$^{(R)}$ is working fine. Conclusion: A virtual phantom was built to verify software functions of stereotactic neurosurgery treatment planning program. The error correction function of a commercial treatment planning program worked within nominal error range. The virtual phantom of this study can be applied in many other fields to verify various functions of treatment planning programs.

Orthodontic Traction of Impacted Tooth (매복된 치아의 교정적 견인을 통한 치험예)

  • Kim, Kyung-Ho;Choy, Kwang-Chul;Lee, Ji-Yeon;Kang, Chang-Soo
    • The korean journal of orthodontics
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    • v.28 no.6 s.71
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    • pp.991-999
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    • 1998
  • Tooth impaction may lead to malocclusion, root resolution, cyst or aberrant changes in adjacent teeth. Clinical and radiographic examinations are used to locate the impaction, and appropriate treatment plans must be made to relocate the impacted tooth. When surgically exposing the impacted tooth, periodontal considerations to conserve maximum amount of soft and hard tissue are used. Oral hygiene instructions are emphasized to maintain sound periodontal health. Securing enough space for the impacted tooth and proper anchorage is important. Proper use of force and mechanics is crucial to prevent such complications as root resolution. Various patterns of orthodontic traction may be employed as situation permits. Most impaction cases can be managed with orthodontic traction to restore function and esthetics, provided that early detection and proper diagnosis and treatment planning are made.

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Cephalometric difference according to the differential treatment methods in Class III malocclusion; (제 III급 부정교합 환자들의 각 치료법에 따른 측모두부방사선사진 계측치의 비교)

  • Baik, Hyoung Seon
    • The korean journal of orthodontics
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    • v.27 no.2
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    • pp.197-208
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    • 1997
  • Class III malocclusion patients can be approached with many different types of treatment methods, and thus, each patient's problems must be accurately evaluated to allow selection of the best possible treatment method. Cephalometric analysis is an essential part of diagnosis and treatment planning of orthodontic patients, and it would certainly be helpful if reliable cephalometric guidelines could be set. The author divided 482 Class III malocclusion patients(253 males and 229 females) into fourgroups according to different types of treatment methods they have received to correct imbalance between upper and lower jaws: 1) orthopedic appliance (face mask & RPE), 2) camouflage treatment with fixed appliance, 3) surgical-orthodontic treatment, 4) cross-bite correction with removable plates/ functional appliance. Cephalometric values at the time of first clinical examination were compare among the four groups. Cephalometric analysis indicates the following results: 1)the amounts of antero-posterior and vertical skeletal discrepancies and dental compensation were greatest in surgery group 2) SNB, Wits, distance from Nasion Perpendicular Plane to point a facial angle, facial convexity, and APDI were greater in orthopedic appliance group than fixed appliance(camouflage) group, but there was no statistical difference 3) removable plates/ functional appliance group showed least amounts of skeletal discrepancies and dental compensation with statistical significance.

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Treatment strategies on Class III malocclusion based on Long term follow up study (III급 부정교합의 치료전략)

  • Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.26 no.2 s.55
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    • pp.125-139
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    • 1996
  • The author obtained some useful information for the class III treatment from long term observation on the growing patients with class III malocclusion. 8 patients were selected for this study and presentation. From these observation so far my conclusions might be as follows: First in the early correction of the anterior crossbite, considerable forward growth changes were observed in the maxilla Second, as for the growth modification of jaws by orthopedic treatment only limited effects were recognized from the long-term observation Thrid, at early age of patients with anterior crossbite, any data couldn't make me predict the stability after treatment on the long-term basis. Fortunately, however, genial angle showed a marginal possibility of it prediction. Fourth, at an advanced age/ retraction orthopedic force on the mandible and the rapid change in the mandibular position may cause some trouble in the T.M.joint. Finally, the followings are recommendable. As for the anterior crossbite, correct it early as possible, and use orthopedic force under the age of ten. Do not enter the phase II treatment directly. Just wait and observe until the growth were almost completed, focusiong on some important factors such as airway problem, tongue position, and third molar development. Of course, these factors may have some effects on the mandibular growth. for the female, at the age of around 14 years old and the male, around 17 years old, make a final decision whether the patients will continue to be treated orthodontically or surgically Thereby, (I think) the relapse and retreatment problem after treatemnt we have observed so far might be minimized. Furthermore, the active treatment time may be also reduced.

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Classification of the skeletal variation in the normal occlusion (정상교합자의 골격 변이의 분류)

  • Kim, Ji-Young;Kim, Tae-Woo;Nahm, Dong-Seok;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.33 no.3 s.98
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    • pp.141-150
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    • 2003
  • The purposes of this study were to classify the anteroposterior and vertical skeletal pattern of normal occlusion samples into specific types with factor and hierarchical cluster analysis, and to evaluate the range and limit of skeletal relationships that permit the establishment of normal occlusion via natural dentoalveolar compensation. Lateral cephalograms of 294 normal occlusion samples were measured, as selected from 15,836 persons through a community dental health survey who cooperated in record taking. Using a factor analysis, two factors representing anteroposterior and vertical skeletal relationships were extracted from 18 skeletal measurements. Then cluster analysis classified the skeletal patterns into nine types. The means and the standard deviations of 8 anteroposterior skeletal measurements and 10 vertical skeletal measurements were determined and comparisons of these measurements among the types were performed. The results obtained in this study showed that the range of normal occlusion included very diverse anteroposterior and vertical skeletal relationships.

Surgical Treatment of Bronchoesophageal Fistula Caused by a Self-Expanding Esophageal Stent (부식성 식도협착 환자에서 식도스텐트 삽입 후 발생한 기관지 식도 누공의 수술적 치료)

  • 이재익;우종수;이길수;노미숙
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.197-200
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    • 2004
  • Although the formation of fistula between esophagus and adjacent organ is a known complication of the self-expanding esophageal stent, only a few cases of surgically treated bronchoesophageal fistula have been reported. Increasing application of endoscopic stent for benign esophageal strictures increases the chance for this type of delayed complication. We experienced a case of bronchoesophageal fistula caused by esophageal stent for which we performed fistulectomy and Ivor Lewis operation simultaneously. To the best of our knowledge, this is the first report on the successful surgical treatment of this complication in Korea.