• Title/Summary/Keyword: 수술-교정치료

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Postoperative Stability and Occlusal Plane Alternation by Orthognathic Surgery of Skeletal Class III Malocclusion with Anterior Open Bite (전치부 개교를 동반한 골격성 III급 부정교합 환자의 악교정 수술 후 교합평면의 변화와 안정성에 관한 연구)

  • Shin, Soo-Jung;Hwang, Byung-Nam;Lee, Jung-Keun;Rhee, Seung-Hoon
    • The korean journal of orthodontics
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    • v.29 no.1 s.72
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    • pp.113-127
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    • 1999
  • The purpose of this study is to investigate the stability of counterclockwise rotation of mandible by sagittal split ramus osteotomy to correct the skeletal Class III malocclusion with anterior open bite. Twenty five skeletal Class III open bite patients(mean age 20.6 years) who were treated by the sagittal split ramus osteotonues with rigid fixation were examined in this study. Cephalometric radiographs were taken for each Patients Preoperative(T1), ewly Postoperative(T2), and late postoperative Period(T3). Mean postoperative period was 8.0 months. Cephalometric analysis was done and data from T1, T2, and T3 were analyzed statistically by Paired t-test and Pearson correlation analysis. The following results were obtained. 1. Mandibular plane angle decreased $2.9^{\circ}$ and mandibular occlusal plane angle related to SN Plane decreased $2.7^{\circ}$ after orthognathic surgery(T2). At 6 months after orthognathic surgery(T3), mandibular plane angle increased $1.0^{\circ}$, but mandibular occlusal plane angle did not changed. 2. The amount of horizontal relapse long time after orthognathic surgery(T3) was 1.6 mm at B point and it was $22\%$ of the total posterior movements. There was no vertical relapse in the anterior facial height. 3. The related factor with horizontal relapse at late postoperative period was mandibular plane angle(p<0.01). The related factors with decreasing posterior facial height were amount of mandibular setback(p<0.01), increasing of mandibular ramus height(p<0.01), and decrease of the mandibular plane angle during operation(p<0.01). 4. There was no relationship between the amount of changes in mandibular occlusal plan angle during operation and the amount of relapse after surgery.

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Application of dental implant for orthodontic anchorage (보철 수복용 임플란트의 교정치료를 위한 고정원의 활용)

  • Kang, Hyo-Jin;Park, Eun-Jin;Kim, Sun-Jong;Pang, Eun-Kyoung
    • The Journal of the Korean dental association
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    • v.54 no.6
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    • pp.404-413
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    • 2016
  • Currently, dental implants have become predictable and reliable adjuncts for oral rehabilitation. Osseointegrated implants can be used to provide rigid orthodontic anchorage and have advantages compared conventional orthodontic anchorage especially when there were edentulous areas and implants were scheduled as a treatment plan. Orthodontic force doesn't cause the bone loss of osseointegrated implants. Implant materials, surgical protocols and healing time before loading follow the conventional treatment protocol. Because the implants, once installed, can't change the location, meticulous treatment planning should be preceded. Further investigations are needed to standardize the treatment protocol.

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A Comparison of Diclofenac versus Dexamethasone for the Treatment of Postcataract Inflammation

  • Lee, Suk Hyang;Suh, Ok Kyung;Jung, Hyun Ah;An, Gi Jung
    • Korean Journal of Clinical Pharmacy
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    • v.10 no.1
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    • pp.1-6
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    • 2000
  • 백내장 수술 추 염증치료를 위해 일반적으로 부작용이 많은 국소 점안 스테로이드를 사용해왔다. 최근 NSAID계열의 점안액이 항염증 치료약물로 개발되면서 선택적인 약물치료가 가능하게 되었으나 단일치료약물로 사용하는 경우는 드물다. 본 연구는 NSAID계 diclofenac 점안액의 백내장 수술 후 염증치료 효과를 스테로이드체 dexamethasone 점안액과 비교하여 단일 치료약물로서 사용할 수 있는 지 연구하고자하였다. 백내장 수술을 받은 환자로서 안압이 22 mmHg 이상 당뇨환자, 수술대상 눈에 이미 질환 및 수술 경력이 있는 자를 제외하였다. 백내장 수술 후 항염종 약물로서 diclofenac 또는 dexamethasone을 28일 동안 투여하고 항염증효과의 평가를 위하여 세극등 검사로저 전방내 염증세포와 결막, 각막등의 전안부 관찰을 수술 전, 수술 후 1, 3, 7, 14, 28일에 시행하였고, 시력검사는 수술 추 7, 28일에 시행하였다. 안전성의 평가는 안압검사와 세극등 검사상 관찰된 이상소견으로 평가하였다. 총 73명의 연구대상 중 dexameasone군은 41명, diclofenac군은 32명이며 두 군간에 나이, 백내장의 심한 정도, 안구질환 등에 있어 유의한 차이가 없었다 전방내 항염증세포수의 감소에서 두 군간에 유의할 만한 차이가 없었고, 수술 후 최대 교정 시력에서도 동일한 효과를 보였다. 안전성에서 안압의 상승이 두군간에 통계적인 유의한 차이를 보이지 않았으나 dexamethasone군에서 1명의 환자가 45 mmHg 이상 증가하여 약물치료가 필요하였으나 diclofenac군에서는 안압이 상승한 환자가 없었다. 결론적으로 효능 및 안전성에서 두 약물간에 통제적, 임상적으로 유의한 차이가 없었으며 diclofenac 점안액은 백내장 수술 후 항염증치료제로서 충분한 효과가 있으며 안압상승, 감염 등 부작용이 우려되는 dexamethasone점안액의 대체약물로 사용될 수 있을 것으로 평가된다.

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Orthognathic surgery on Skeletal Class III patiens with collapsed vertical dimension: case report (수직고경이 붕괴된 골격성 III급 부정교합자의 악교정 수술 치험례)

  • Choi, Youn-Kyung;Kim, Yong-Deok;Park, Soo-Byung;Kim, Yong-Il;Kim, Seong-Sik;Son, Woo-Sung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.1
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    • pp.70-79
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    • 2016
  • Patients who lost posterior teeth due to periodontitis or dental caries have collapsed vertical dimension, unstable occlusion and change of the mandibular position. In particular, patients in orthognathic surgery, clinician should re-establish the pre-operative stable position of mandibular condyle in articular fossa and favorable vertical dimension for high post-operative stability of mandible. Therefore, interdisciplinary approach and co-operation, including prosthetics, orthodontics, oral and maxillofacial surgeon, from diagnosis and treatment plan is important to get a good outcome. This case report was patients who had collapsed occlusal plane due to severe dental caries on maxillary molars with skeletal Class III malocclusion. Before orthognathic surgery, resetting of maxillary occlusal plane with temporary removable denture was performed. Then successful multidisciplinary approach was done and lead to acceptable clinical outcome.

The differences of STO between before and after presurgical orthodontics in skeletal Class III malocclusions (골격성 III급 부정교합자에서 술 전 교정치료 전과 후의 수술계획의 차이)

  • Lee, Eun-Ju;Son, Woo-Sung;Park, Soo-Byung;Kim, Seong-Sik
    • The korean journal of orthodontics
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    • v.38 no.3
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    • pp.175-186
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    • 2008
  • Objective: To evaluate the discrepancies between initial STO and final STO in Class III malocclusions and to find which factors are related to the discrepancies. Methods: Twenty patients were selected for the extraction group and 20 patients for the non-extraction group. They were diagnosed as skeletal Class III and received presurgical orthodontic treatment and mandibular set-back surgery at Pusan National University Hospital. The lateral cephalograms were analyzed for initial STO (T1s) at pretreatment and final STO (T2s) after presurgical orthodontic treatment, and specified the landmarks 3s coordinates of the X and V axes. Results: Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, upper first molar mesial end surface, lower central incisor apex, lower first molar mesial end surface and mesio-buccal cusp and Y coordinates of upper central incisor edge, upper central incisor apex, upper first molar mesio-buccal cusp were statistically significant in the extraction group. Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, lower central incisor apex, lower first molar mesial end surface and Y coordinates of lower central incisor apex were statistically significant in the non-extraction group. In the extraction group, the upper arch length discrepancy (UALD) had a statistically significant effect on maxillary incisor and first molar estimation. Lower arch length discrepancy and IMPA had statistically significant effects on mandibular incisor estimation in both groups. Conclusions: Discrepancies between initial STO and final STO and factors contributing to the accuracy of initial STO must be considered in treatment planning of Class III surgical patients to increase the accuracy of prediction.

Surgical exposure of impacted tooth for orthodontic forced eruption : case report (교정적 견인을 위한 매복치의 수술적 노출 방법에 관한 증례보고)

  • Choi, Yongkwan
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.28 no.2
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    • pp.86-94
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    • 2019
  • Tooth impaction make various problems which are pathologic changes, functional defect and esthetic troubles. Sometimes impacted tooth are extracted. But surgical exposure of impacted tooth and orthodontic forced eruption are usually used a lot to solve these problems. Impacted tooth for orthodontic treatment has two impacted patterns 1) Simple impaction outside alveolar bone covered soft tissue, 2) Fully impaction under alveloar bone. So I introduce way to exposure of impacted tooth for orthodontic treatment with various cases and literatures.

Surgical Experiences of Shone's Syndrome (숀 증후군의 외과적 치료)

  • Won, Tae-Hui;Lee, Jeong-Ryeol;Kim, Yong-Jin;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.862-868
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    • 1997
  • Shone's syndrome is a congenital cardiac malformation that consists of multiple levels of left heart obstruction including supravalvular mitral ring, congenital mitral stenosis(parachute mitral valve), subaortic stenosis, and coarctation of aorta. This syndrome is a very rare congenital anomaly and its prognosis is poor. We experienced 9 patients with Shone's syndrome between 1985 and 1994. There were 8 male and 1 female patients, and mean age was 33.0$\pm$31.0 months ranged from 2 months to 1 1 years. The congenital mitral, stenosis and coarctation of aorta existed in all patients and the supravalvular mitral ring and subaortic stenosis in 4 patients. Two patients had all four anatomic lesions. 3 patients underwent one stage total correction and the other 6 patients underwent two staged operation that was initial coarctoplasty with thoracotomy and later correction of intracardiac anomalies with median sternotomy. A third operation was performed in 2 patients. These procedures included reoperation for coarctation and replacement of mitral valve for persistent mitral stenosis. There was no operative death at the first operation but two operative deaths at the second operation. The cause of death in two cases was severe heart failure secondary to left ventricular hypoplasia. There was no operative death at the third operation. The seven survivors have beeli followed from 11 months to 12 years(mean follow-up 6.7 $\pm$ 3.6 years). There was no late death and the New York HeArt Association activity level was class I for all patients. We conclude that a food lone-term outcome can be expected by proper surgical treatment tailred to each individual's anatomy and pathophysiology although the operative mortality and morbidity of Shone's syndrome are high.

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The Treatment Strategies of Non-surgical Approach for Dentofacial Asymmetry Patient (치열 안면 비대칭 환자의 비수술적 절충치료의 전략적 접근)

  • Lee, Kyung-Min;Lee, Sang-Min;Yang, Byung-Ho;Yun, Min-Sung;Lee, Ju-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.1
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    • pp.77-87
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    • 2010
  • Skeletodental asymmetries are common and asymmetric orthodontic treatments are very difficult to correct successfully. The cause of asymmetries can be the skeletal asymmetry, dental, or functional, or combinations of these causes. Skeletodental asymmetries can be the result of congenital factors, such as hemifacial microsomia and environmental factors, such as trauma. Optimal treatment outcome of the severe facial asymmetry requires the orthognathic surgery. Mild asymmetry problem can be treated by only orthodontic treatment. The orthodontic treatment of asymmetry is usually difficult. Facial asymmetry orthodontic treatment are primarily based on proper diagnosis and careful treatment planning. Side effects of asymmetric elastic to treat midline discrepancies are canted occlusal plane, tipped incisors and unesthetic results. In the management of dental arch asymmetries, the clinician should select the appropriate force system and the appliance design necessary to address the asymmetry while minimizing undesirable side effects. This report presents treatment strategies for the treatment of skeletodental asymmetry. In this case report, the clinical case with midline discrepancies treated by optimal mechanics is described. Through diagnosis and strategic treatment mechanics can obtain proper midline correction with minimal side effects.

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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