• Title/Summary/Keyword: 하악골절

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증례보고 : 양측 하악지 시상골 절단술 후 발생한 안면신경 마비 (Case report: Treatment of Facial Nerve Palsy Following Bilateral Sagittal Split Ramus Osteotomy)

  • 유지원
    • Journal of Oral Medicine and Pain
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    • 제38권3호
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    • pp.255-260
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    • 2013
  • 양측 하악지 시상 골절단술은 악안면 기형 및 부정교합을 치료하기 위해 흔히 사용되는 필수불가결한 술식이라고 할 수 있다. 하악지 시상 골절단술 후 발생할 수 있는 합병증으로는 하치조 신경 손상, 출혈, 측두하악장애, 부적절한 골면의 유합 및 골절, 재발 등이 있다. 악교정 수술 후 안면신경 마비의 발생 유병율은 최근 0.1 퍼센트로 보고되고 있다. 증상 발생의 원인으로는 안면신경의 압박, 신경의 불완전 또는 완전 손상, 신경의 견인, 마취제에 의한 신경의 허혈 등이 있다. 술 후 발생된 안면 신경의 마비는 환자의 삶의 질을 저해하고 사회활동을 기피하게 함으로써 가장 심각한 합병증 중 하나라고 볼 수 있다. 본 증례에서는 양측 하악지 시상 골전달술을 시행 후 발생한 안면신경 마비에 대하여 보고하고 있다.

Le Fort III 골절단술을 이용한 중안면성장부전을 동반한 하악전돌증의 치험례 (A CASE REPORT OF SURGICAL CORRECTION OF MANDIBULAR PROGNATHISM WITH MIDFACIAL DEFICIENCY USING LE FORT III OSTEOTOMY)

  • 이백수;류동목;이상철;김여갑;황혜욱;조세종
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권1호
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    • pp.1-4
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    • 2000
  • 저자 등은 경희대학교 구강악안면외과에 내원한 중안면성장 부전을 동반한 하악전돌증 환자의 치료에 있어 관상절개를 통한 Le Fort III 골절단술 및 Le Fort I 골절단술과 양측 하악지시상분 할골절단술을 2회법으로 시행하여 기능적 심미적으로 만족할만한 결과를 얻었기에 보고하는 바이다.

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하악 과두에 이환된 악골 골수염 (Osteomyelitis involved in Mandibular Condyle)

  • 박주현;권정승;안형준;김성택;최종훈
    • Journal of Oral Medicine and Pain
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    • 제33권4호
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    • pp.383-386
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    • 2008
  • 골수염이란 엄밀히 따지면 수질골 부위의 염증을 의미하지만 대개 피질골, 골막까지 함께 이환된다. 급성에서는 주로 통증과 간헐적인 고열, 하순의 감각 저하, 통증 등의 임상적 양상이 나타날 수 있고, 초기에 발견되지 못하거나 적절한 치료가 이루어지지 않는다면 만성 골수염으로 진행되게 된다. 골수염은 치료 시기가 늦어질수록 치료에 대한 반응이 더디거나 예후가 좋지 않을 수 있고, 병리학적 골절 등 합병증 또한 증가하기 때문에 발생 초기 단계에서 세심한 병력 청취와 주의 깊은 임상 검사가 필수적이다. 본 증례에서처럼 측두하악장애 유사 증상으로만 나타나더라도 통상적인 관련 치료에 반응하지 않고 악화되는 경우, 통상적인 안면 방사선사진 외에 방사선 동위원소를 사용한 골스캔 촬영이나 전산화 단층촬영 등 부가적인 진단 검사를 적극적으로 시행하는 것이 바람직할 것으로 사료된다.

치료의치와 CAD-CAM 기술을 이용한 불안정한 하악위를 가진 완전 무치악 환자의 치료 증례 (Full mouth rehabilitation in edentulous patient with unstable mandibular position using flat table treatment dentures and CAD-CAM technology)

  • 김유연;이영후;홍성진;백장현;노관태;김형섭;권긍록;배아란
    • 대한치과보철학회지
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    • 제60권4호
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    • pp.330-338
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    • 2022
  • 과두 골절 및 형태 이상으로 인해 불안정한 하악 운동 및 비정상적인 안모를 갖는 무치악 환자의 경우 환자의 안정된 하악위를 찾는 것이 중요하다. 본 증례에서는 flat table 치료의치를 이용하여 환자의 안모개선, 하악 운동의 안정, 의치의 안정성이 향상시켰다. 또한 flat table 치료의치의 수직고경 및 구순 지지도를 유지하고자 CAD-CAM 기술을 이용하여 제작한 총의치 수복을 통해 환자의 불편감을 개선하는 양호한 결과를 얻었기에 이를 보고하는 바이다.

개에서 치주질환과 연관된 하악골절의 치료 (Case Studies of Repair of Pathological Mandibular Fracture due to Periodontal Disease in Dogs)

  • 심경미;김세은;유경훈;배춘식;최석화;강성수
    • 한국임상수의학회지
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    • 제24권4호
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    • pp.653-657
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    • 2007
  • A 12-year-old, intact female Toy Poodle and a 10-year-old, intact male Yorkshire terrier were referred with bilateral mandibular fractures, severe periodontal disease and teeth loss. In the second case, mandibular fractures were repaired with periodontal disease treatment. After a fallow-up period of 1 year, fracture healing was successful in the second case, however in the first case, bone healing was not satisfactory because mandibular fractures were repaired without the treatment of diseased teeth within the fracture line. Nonunion and inflammation of fracture sites, oral malodor confirmed in the first case and normal union of fracture sites observed in the second case. It suggests that the treatment of diseased teeth within the fracture line is mandatory for successful fracture healing.

일반백서와 당뇨백서에서의 하악골절 치유시 고압산소요법이 미치는 영향에 관한 실험적 연구 (An Experimental study on the effects of Hyperbaric oxygen therapy on the healing process of mandibular fracture of normal rats and streptozotocin-prduced diabetic rats)

  • 윤중호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권3호
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    • pp.93-102
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    • 1990
  • The main objectives of this study was to observe the effects of Hyperbaric oxygen therapy on the healing processes of mandibuar fracture of normal rats & streptozotocin - induced diabetic rats. Author used 120 rats (Sprague - Dawley Strain) dividing into controf (60) & experimental group (60) of normal & diabetic rats. Complete fracture was produced on the left mandibular body of 120 rats, rendered hyperbaric oxygen therapy (2 hrs, daily at 2.5 atm) on experimental group and observed effects of hyperbaric oxygen therapy microscopically. The obtained results were as follows : 1. The experimental group of HBO in normal rats had the good effect until 6th week, especially the better effect at 3rd week, because of decrease of inflammatory cell infiltration, heavy proliferation of fibroblast & capillary and active callus formation. 2. The hyperbaric oxygen therapy in mandibular fracture of diabetic rats influenced especially on the healing process at 5th week, because there were much decrease of inflammatory cell infiltrations, heavy proliferation of fibroblast, capillary, osteoblasts, moderate fibrous callus formation, osteocastic activity and mild bony callus formation.

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하악 과두 골절과 측두하악관절과의 관계 (Correlation Between Mandibular Condylar Process Fracture and Temporomandibular Joint)

  • 문철웅;김수관;오지수
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권5호
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    • pp.488-492
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    • 2010
  • This review evaluates the literature on the relationship between mandibular condylar process fracture and temporomadibular joint (TMJ). The topic of condylar fracture generated more discussion and controversy than any other field of maxillofacial trauma associated with TMJ. Disturbance of occlusal function, devia-tion of mandible, internal derangements of TMJ, and ankylosis of the joint with resultant inability to move the jaw are sequelae of condylar process fracture. Thus it is necessary to understand how the masticatory system adapts to the structural alterations that accompany fractures of the mandibular condyle. Treatment of condylar process fracture include two methods ; closed treatment and open treatment. If one chooses totreat closed, one must understand that adaptations in the musculature, skeleton, and dentition will be necessary. Open treatment of condylar process fractures probably requires fewer adaptations within the masticatory system to provide a favorable functional outcome. However, one must weigh the risk of open surgery against the possible improvement in outcome. The risks are not just surgical risk, but biological risk as well, such as disruption of the blood supply to the condyle. This review presents relevant aspects of change of TMJ associated with condylar process fracture.

하악과두 골절의 관혈적 정복술을 위한 하악 후방 접근법 (Retromandibular Approach for the Open Reduction of Fractured Mnadibular Condyle)

  • 김학균;김수관;강동완;오상호
    • 구강회복응용과학지
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    • 제22권4호
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    • pp.283-288
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    • 2006
  • There are several manners for surgical approaches to the mandibular condyle. With the retromandiular approach, the condyle and fracture are exposed directly and allow for good inspection and reduction. The retromandibular scar is very well camouflaged and practically invisible. The aim of this study was to evaluate clinical results of retromandibular approach for the reduction and fixation of fractured mandibular condyles. We described postoperative complications such as temporary facial nerve weakness involving the marginal mandibular branch, mouth opening limitation and malocclusion in 13 patients with mandubular condylar fractures; 11 subcondylar fractures and 2 condylar neck fractures. The follow-up period was longer than 6 months in all patients. The retromandibular approach was successful in all subcondylar fracture cases. 2 patients with condylar neck fracture had mouth opening limitation and temporary marginal nerve palsy longer than 3 months. But there were no cases of permanent nerve injury and malocclusion. Our findings indicate that retromandibular approach is an easy and safe technique for subcondylar fracture but not for condylar neck fracture.

하악 제 3 대구치유무 및 매복정도가 하악과두 골절에 미치는 영향 (THE INFLUENCE OF THE PRESENCE AND IMPACTED STATE OF MANDIBULAR THIRD MOLARS ON THE INCIDENCE OF MANDIBULAR CONDYLE FRACTURE)

  • 오제경;차두원;김진수
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제28권6호
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    • pp.565-569
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    • 2006
  • The purpose of this study was to assess the influence of the presence and impacted state of the mandibular third molars on the incidence of mandibular condyle fracture. A retrospective study was designed for patients presenting to the Department of Oral and Maxillofacial Surgery, Kyungpook National University Hospital and Tae-gu Fatima Hospital for treatment of mandibular fractures from January 2003 to January 2006. The independent variables in this study were the presence, degree of impaction of third molars, and the outcome variables were the incidence of mandibular condyle fractures. Hospital charts and panoramic radiographs were used to determine and classify these variables. The demographic data included age, sex, mechanisms of injuries and number of mandibular condyle fractures. The study sample comprised 136 mandibular condyle fractures in 105 patients. Result of this study demonstrated a statistically significant difference in ipsilateral condyle fractures and mandibular third molar absence(P=0.032) and bilateral condyle fractures without another fracture and mandibular third molar absence(P=0.028).

하악상행지 시상분할골절단술 시 하악후퇴량의 방사선학적 예측 (Prediction of Amount of Mandibular Set Back with 3 Plain Radiographs in Mandibular Sagittal Split Ramus Osteotomy)

  • 노량석;김진욱;권대근;이상한
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권4호
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    • pp.323-330
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    • 2011
  • Purpose: The present study examined the reproducibility of an operation plan by comparing the jaw position of STO with the postoperative mandibular set back measurement in sagittal split ramus osteotomy. Methods: Thirty patients with class III dental and skeletal malocclusion and who were treated with BSSRO were reviewed. Three plain radiographs such as the panoramic view, the lateral cephalogram and the submentovertex view were taken before and after operation. Also, paper surgery for STO and model surgery were used to evaluate the amount of mandibular set back. Results: On the panoramic view, the amount of mandibular set back in STO was similar to the postoperative results of model surgery, but the amount of mandibular set back on the lateral cephalogram was smaller than the postoperative result of model surgery and then the amount of set back on submentovertex view was similar to the postoperative result of model surgery. Conclusion: Precise tracing and paper surgery should be performed for a combined expected STO in order to predict the exact amount of preoperative mandibular set back.