• 제목/요약/키워드: 악안면 외상

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

  • 이경민;이상민;양병호;윤민성;이주희
    • 구강회복응용과학지
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    • 제26권1호
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    • pp.77-87
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    • 2010
  • 비대칭은 두개안면증후군 같은 선천적 요인과 외상과 같은 환경적 요인에 의해 발생할 수 있으며 심한 골격성 비대칭에서부터 경미한 치열 비대칭에 이르기까지 그 정도는 매우 다양하며 이에 대한 환자의 인지 또한 주관적이다. 심한 비대칭의 경우 악교정 수술이 필요할 수도 있으나 비대칭이 심하지 않고 환자가 수술을 원하지 않을 경우 교정치료 만으로 비대칭의 개선을 도모할 수 있다. 하지만 비대칭 고무줄을 사용한 통상적인 방법으로 장기간 치료하면 교합평면이 기울어지거나 치아가 경사이동이 되는 등의 부작용이 발생하여 만족스럽지 못한 결과를 초래할 수 있다. 이를 예방하기 위해 초진 시부터 주의 깊은 진단과 충분한 역학적 고려를 포함한 철저한 치료 계획이 필요하다. 이에 하악의 편위가 발생한 안면 비대칭 환자에서 수술 없이 비대칭을 악화시키지 않는 조절된 교정력을 적용하여 만족스런 비대칭 절충 치료 결과를 얻었기에 이를 보고하고자 한다.

COVID-19 팬데믹 상황에서 소아 환자의 구강악안면 외상의 변화 추이: 단일 기관 연구 (The Trend of Change in Oral and Maxillofacial Injuries of Pediatric Patients in the COVID-19 Pandemic: a Regional Emergency Medical Center and Dental Hospital Study)

  • 최수빈;박찬규;신종현;정태성;이은경
    • 대한소아치과학회지
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    • 제50권3호
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    • pp.318-333
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    • 2023
  • 이 연구의 목적은 코로나 바이러스 감염증(Coronavirus Disease 2019, COVID-19) 시기의 12세 이하 아동에서 발생한 치과 외상의 변화 여부를 분석해 보는 것이다. 세계보건기구에서 COVID-19를 공식적으로 팬데믹으로 선포한 시점인 2020년 3월을 COVID-19의 기시점으로 설정하였다. 2018년 3월부터 2020년 2월까지를 COVID-19 이전 시기의 대상자를 Pre-COVID-19 군, 2020년 3월부터 2022년 3월까지를 COVID-19 이후 시기의 대상자를 COVID-19 군으로 분류하였다. 전자의무기록을 통해 외상과 관련한 정보들을 수집하였다. COVID-19 발생 전후 외상 환자 수는 유의미하게 감소하였다. COVID-19 기간 동안 남·여 비율과, 연령 구간의 분포 순서는 유의한 차이가 없었다. 영구치의 COVID-19 군에서 스포츠로 인한 외상 발생보다는 개인 이동 수단에 의한 외상의 비율이 높아졌다. COVID-19 군에서 치수 침범이 있는 치관 파절 비율이 치수 침범이 없는 치관 파절 비율보다 증가하였고 유의미하였다. 미취학 아동보다 학령기 아동에서 COVID-19에 의한 외상 패턴 변화가 뚜렷하게 관찰되었다. COVID-19와 같은 팬데믹 상황에서는 환경의 변화로 인해 호발하는 진단명이 변할 수 있다는 점을 알 수 있었다.

전치부 외상성 손상시 치아고정술 후의 예후에 관한 연구 (A STUDY ON THE PROGNOSIS AFTER STABILIZATION OF THE TRAUMATIZED ANTERIOR TEETH)

  • 김미영;이의웅
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권1호
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    • pp.62-71
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    • 1990
  • This study was to evaluate the nature of traumatic injuries on anterior teeth of 530 patients and the prognosis of stabilized cases of 102 patients, including possible 18-follow up cases among them, treated at Dental Hospital, Yonsei Medical Center from Mar. 1983 to Feb. 1988. The obtained results were as follows. 1. The peak of monthly distribution of trauma to the anteriors was June and was the lowest in November. The ratio of male to female was 2.6 : 1. The most common incidence of the trauma to the anteriors was seen in the 3rd decades. The most chiefly involved teeth were central incisors in both upper and lower jaws. The causes of trauma were as followed in descending order by first blows, traffic accidents, falls, slip downs, and sports. The types of traumatic injuries of anterior teeth consisted of periodontal tissue injuries(55.9%), the injuries to the hard dental tissues and pulp(31.3%), and alveolar bone injuries(12.8%). 2. 35.1% stabilized anteriors were treated with root canal therapy. The success rate of stabilization was 95.3%, and 92.3% in replantation of avulsed teeth. 3. External root resorption, internal root resorption with calcification of pulp chamber or root canal, ankylosis of root, and other periapical pathosis were seen in follow-up radiographic findings. 4. Success rate of stabilization of the traumatized anteriors after 3 years showed 71.4% average.

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스포츠전공 남학생의 구강악안면 외상과 보호구 착용 및 스트레스와의 관련성 (Correlation between maxillofacial injury, use of mouth guards and stress in physical education majoring male students)

  • 장종화;김지희
    • 한국응급구조학회지
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    • 제17권2호
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    • pp.89-97
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    • 2013
  • Purpose : The purpose of this study was to investigate the correlation between stress and maxillofacial injuries in male students. Methods : The subjects were 386 male students who were 18 years or more. Mean age was $20.99{\pm}2.80$ years. Data were collected using a self-reported questionnaire from March 7 to March 28, 2013. We surveyed maxillofacial injuries, mouth guards use and stress in male students majoring physical education. The data were analyzed by Cochran's Mantel-Haenszel, McNemar test and logistic multiple regression. Results : Those who had clenching habit and maxillofacial pain accounted for 48.7%. The pain was 3.23 folds higher in clenching habit than those who had not (OR=3.23, p <.001). The more stress they had, the more clenching habit (OR=2.13) and pain(OR=1.68) did they have. Within 2 years, those having maxillofacial injury accounted for 53.2% and 78.6% of them put on maxillofacial protection guard. In rule for mouth guard use, 39.9% had no maxillofacial injury. Maxillofacial injury was 2.41 folds higher in those who had no mouth guard usee (OR=2.41). Conclusion : Maxillofacial injury had a close correlation with mouth guard use and stress. Therefore, it is very important to establish the rule for mouth guard use in sports activities.

운동선수들의 구강 악 안면 영역에서의 스포츠 외상에 관한 설문조사 (THE SURVEY ON ORAL HEALTH AND MAXILLOFACIAL TRAUMA INCIDENCE OF THE SPORTS PLAYERS IN KOREA)

  • 박능석;우이형;백진;최대균
    • 대한치과보철학회지
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    • 제45권4호
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    • pp.534-545
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    • 2007
  • Statement of problem: In spite of increasing sports injury, there was no collected data on the rate and type of dental injuries for athletes in Korea. Purpose: The purpose of this study was to investigate the occurrence of maxillofacial injuries and attitude of college sports player in Korea towards mouthguard. Material and methods: Total 617 athletes answered a series of questionnaire concerning their sports injury and using mouthguard. Results: 1. 81%(502) of athletes had, playing or training a sports, suffered an injury. Female athletes suffered an injury more than male athletes(p<0.05). Contact sports athletes were injured more than non contact sports athletes(p<0.05). 2. 335 athletes(54.8%) had suffered maxillofacial injuries while playing or training. 81.8% of athletes suffered an maxillofacial injury in contact sports(p<0.05). 3. Laceration of oral area, wrick in neck, fracture or avulsion on upper incisors, concussion, TMJ injury, fracture or avulsion on lower incisors, fracture or avulsion on lower molars were frequently injured area. 4. 67.2% of athletes answered that mouthguard could prevent sports injury especially high in contact sports(p<0.05). But only 39.1% of athletes required mouthguard while playing. 44.6% of athletes showed their intention of using mouthguard. Conclusion: This study shows that the incidence of maxillofacial injuries is very high while the actual use of mouthguard is very low. To prevent sports injury, a dentist must inform sports players and coaches of accurate information about mouthguard so that they can use it well. A dentist also has to provide them with better mouthguard on the basis of user's complaint.

치과 임플란트 식립을 위한 치조골의 수직적 신장술 (VERTICAL DISTRACTION OF ALVEOLAR BONE FOR PLACEMENT OF DENTAL IMPLANT)

  • 오정환
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권4호
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    • pp.326-329
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    • 2002
  • 저자들은 위축된 치조골과 외상 또는 종양으로 상실된 치조골의 재건을 위하여 수직적 치조골 신장술을 이용하여 104명의 환자에서 평균 10.2 mm의 치조골을 신장시킬 수 있었으며, 양호하게 재건된 치조골에 치과 임플란트를 식립함으로서 기능적, 심미적으로 좋은 결과를 얻을 수 있었다. 치조골 신장술은 기존의 치조골 수복술들을 대체할 수 있는 안전하고 효과적인 방법으로 생각된다.

치성의 다양한 안와 연조직 감염 (THE VARIOUS ORBITAL INFECTIONS FROM ODONTOGENIC ORIGIN)

  • 김일규;김주록;장금수;전원
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권6호
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    • pp.669-676
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    • 2007
  • 본 교실에서는 당뇨와 지방간의 전신 질환이 있는 환자에서 구강 내 외상으로 안검의 안와 격막을 통한 안와 연조직염, 상악 제1대구치 치근단 농양이 측두와를 통한 안와 외측 골막하 농양, 상악 제2유구치 치료 후 상악동염 및 사골미로염을 통한 안와 내측 골막하 농양, 하악 제1대구치 치근단 농양이 저작간극과 측두와를 거쳐 관골의 안와부 골수염 및 안와 외측 하방에 골막하 농양, 상악 제2,3대구치 치근단 농양이 익돌구개와, 측두하와 및 하안와열을 거쳐 안구 후방에 안와농양을 형성한 후 기존의 농양 전상방부에 새로운 농양을 형성하며 상안와열증후군으로 까지 진행된 증례를 비롯하여 다양한 안와연조직 감염의 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

외상과 턱관절 장애 연관성에 관한 연구 (THE RELATIONSHIP BETWEEN TRAUMA AND TEMPOROMANDIBULAR JOINT DISORDER)

  • 김영균;윤필영;안민석;김재승
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권5호
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    • pp.375-380
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    • 2009
  • Objective : Trauma has been a controversial issue although it has been considered to be a major factor for the temporomandibular disorder(TMD). We evaluated the relationship between macrotrauma or microtrauma and TMD. Methods : This study was performed in patients with TMD undergoing treatment at SNUBH from October 2006 to January 2007. Sixty one male patients and 166 female patients(total 227) were included and the average age was 34 years(ranging from 14 to 85 years). We investigated the possible etiologic factors, diagnosis and treatment with the review of medical records and radiography. Chronic pain, depression, somatic score(including pain item), somatic score(excluding pain item) were evaluated on the basis of diagnostic index from the Research Diagnostic Criteria on TMD. Results : Eighteen patients(7.9%) out of 227 patients suffered from TMD as a result of macrotrauma. Ninety four(41.4%) patients had microtrauma and six patients(2.6%) had both macro- and microtrauma(etiologic factor). The main symptoms included pain. joint noise and mouth opening limitation while the other symptoms were headache and tinnitus. The patients had suffered from TMD for average 41 weeks (ranging from 1 to 480 weeks). 116 patients took splint as a major treatment. As a prognosis, 19 patients(8.4%) recovered completely. 26(11.0%) had improvement and 181(80%) had persistent symptoms. 1 patient(0.4%) underwent an arthroplasty. Diagnostic index from RDC chart showed that macrotrauma was the highest score(except depression score) among the other etiologic factors. Conclusion : This study showed that macro- and microtrauma can be considered to be the major etiologic factors of TMD, which also affect the chronic, depression and somatic discomfort.

편평세포암종으로 오인된 협부에 발생한 간질 호산구 증다증을 동반한 외상성 궤양성 육아종: 증례보고 (Traumatic ulcerative granuloma misjudged as oral squamous cell carcinoma (SCC) on the buccal cheek: case report)

  • 권진일;김현우;남웅;차인호;김형준
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권3호
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    • pp.217-220
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    • 2010
  • Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is an ulcerative lesion on oral mucosa featuring as a benign mass of self-limiting growth. It can be easily misdiagnosed as squamous cell carcinoma (SCC) due to its long healing period and elevated or rolled-up margin. A 57-year old male patient who visited our department was diagnosed as SCC according to the clinical features, results of positron emission tomography (PET) and magnetic resonance imaging (MRI) of the oral lesion. However, after performing incisional biopsy, histopathologically, there were no atypical cells, but eosinophil and CD 30+ T-cells were clustered in subcutaneous and muscle tissue. It is very significant to consider this reactive lesion in the field of oral and maxillofacial surgery because of its possibility of mistaken as malignant disease. Here, we will report a couple of cases of TUGSE with references and limit of radiographic tools used for diagnosis of head and neck cancer.

Nasotracheal intubation시 비강 내 외상을 줄이기 위한 술전 computed tomography를 이용한 평가 및 전처지 (Computed tomography evaluation and pretreatment for a safe nasotracheal intubation, avoiding nasal cavity injuries)

  • 김한림;윤경인;김경수;강현;최영준
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권3호
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    • pp.197-201
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    • 2010
  • Introduction: In a surgery of the oral cavity, nasotracheal intubation is often carried out to secure the surgical field. By passing a tracheal tube through the nasal cavity to the pharynx, the nasotracheal intubation can lead to complications that do not occur with oral intubation, such as nasal bleeding and submucosal aberration etc. The purpose of this study is to examine the method of CT evaluation and pretreatment for a safe nasotracheal intubation. Materials and Methods: Among 30 patients who orthognathic surgery was performed at Chung-Ang University Hospital during the period August 2009 to October 2009, 30 patients were included. The 30 patients were divided into two groups; 15 patients intubated with CT evaluation with pretreatment, and the other 15 patients intubated with no pretreatment. We evaluated nasal bleeding of the two groups during nasotracheal intubation. Results: CT evaluation with pretreatment group had a significantly lower incidence of nasal bleeding than the group with no pretreatment. Conclusion: CT evaluation with pretreatment helps to minimize nasal bleeding during nasotracheal intubation.