• 대한치과교정학회지
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• 제40권4호
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• pp.227-238
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• 2010

저신장이란 같은 연령 및 성별 소아들의 표준 신장 평균치에서 -2.0 SD 이하인 경우를 말한다. 본 연구의 목적은 저신장 소아의 두개안면골격의 특성을 분석하고, 성장호르몬 치료가 신장을 성장시킴과 동시에 두개안면골격에 어떤 영향을 주는지 알아보고자 함이다. 영남대학교 의과대학 부속병원 소아청소년과에서 저신장으로 진단받은 소아를 대상으로 성장 호르몬 치료 전 그리고 치료 후 1년, 2년 후 총 3회 측모 두부 방사선 규격 사진의 촬영을 시행하였다. 대조군은 경북대학교 치의학전문대학원 교정과에 소장된 한국인 평균 신장의 2 표준오차 내의 아동들을 대상으로 측모 두부 방사선 규격사진을 2년마다 10년간 촬영한 자료를 이용하여 저신장 소아의 연령과 성별을 기준으로 짝진 표집(paired sampling)을 하였다. 성장 호르몬 치료 전 저신장 소아는 작고 후퇴된 하악골과 편평한 두개저를 가지는 것으로 나타났다. 성장 호르몬 치료 후 anterior, posterior cranial base length, upper posterior facial height, lower anterior facial height, posterior total facial height, mandibular ramus length, mandibular corpus length와 overall mandibular length 성장량이 정상군에서의 2년 성장량과 비교했을 때 유의하게 큰 것으로 나타났으며 각도 계측에서는 saddle angle, mandibular plane angle과 ANB변화량이 정상군에서의 2년 성장량과 비교했을 때 큰 변화를 보이며 정상군의 평균치를 따라잡는 경향을 보였다. 성장 호르몬 치료는 불균형적인 성장의 징후 없이 정상화를 향한 성장(따라잡기 성장)을 나타내었으며 이는 특히 하악과두의 성장과 후안면고경의 성장을 촉진시켜 저신장 소아의 convex한 profile을 완화하는 것으로 판단된다.

• Journal of Oral Medicine and Pain
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• 제37권4호
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• pp.251-256
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• 2012

오늘날 삶의 질에 대한 관심이 고조되면서 일반 대중에게서도 레져 및 스포츠가 활성화됨에 따라 구강악안면영역 외상의 발생빈도도 높아지고 있다. 이러한 구강악안면영역의 외상을 예방하기 위해 구강보호장치 사용의 중요성이 커지고 있으며, 그 중 가장 많이 사용되는 것이 마우스가드이다. 마우스가드는 1) 치아에 가해지는 충격을 흡수하고 변형시켜 치아의 손상을 방지; 2) 입술, 혀, 치은 등 연조직의 열상을 예방; 3) 충격의 발생 시 반대측 치아가 접촉되는 것을 예방; 4) 하악골을 안정화시켜 하악각 또는 하악과두의 파절을 유발할만한 충격을 흡수시킴; 그리고 5) 목 또는 뇌손상을 예방할 수 있다. 이렇듯 마우스가드가 구강악안면영역의 외상방지에 효과적이지만, 운동선수나 일반 대중들에게는 널리 보급되어 있지 않고 그 중요성에 대한 인식률도 저조한 실정이다. 레져나 스포츠 활동 시 나타날 수 있는 구강악안면 외상 예방에 가장 효과적인 마우스가드의 종류, 재료, 제작 시 고려할 사항 등을 알아보고, 사용실태에 대한 고찰을 통해 마우스가드의 중요성에 대한 인식과 대중화에 도움이 되고자 한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.446-454
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• 2000

Condylar process of mandible is an important and fuctionally versatile part of the mandible. There were quite large amount of investigations on the functional and anatomical adaptation of the temporomandibular joint(TMJ) to the surrounding tissues. But controversies on the mechanism of functional adaptation of the joint still exist. In this research, we investigated changes in the TMJ by the lateral deviation of the maxillary incisor to shift the mandible right, and bone the undecalcified microscopic sections with fluorescent microscope and von Kossa staining with bright field microscope. Results were as follows: 1. Lateral deviation rendered shifting and tilting of the mandible, There were, compressions in the right joint and opening of the left joint space at early stage. At the same time, both condyles shifted slightly to anterior. 2. After $2{\sim}4$ weeks, left condyle showed anterior displacement and compressions in the joint space. Right condyle showed only slight shift to the anterior. 3. Regardless of the direction of the lateral shift, anterior bite plate compressed both condyle heads until 2 weeks. 4. There are bone resorptions in the anterior aspect of the condyle head and apposition of posterior border. Bone remodeling were observed between 3 and 4 weeks. 5. After 8 weeks of the experiment, there were little differences in condylar morphology between experimental and control group, though slight shifting and compression were still present in the experimental group. Lateral deviation of mandible evoked active remodeling of the TMJ until functional and anatomical reconstruction of TMJ position was achieved.

• 치과방사선
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• 제20권2호
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• pp.299-313
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• 1990

The author analysed tomographic and cephalometric radiographs of 82 temporomandibular joints from 41 symptomatic patients and 40 temporomandibular joints from 20 asymptomatic young adults. The results were as follows; 1. The mean condylar angulation in control group and patient group was 21.72±6.48° 20.13±9.14° respectively and there was no significant difference between two groups. 2. The mean depth of cut was 6.63±0.38㎝ in control group and 6.57±0.46㎝ in patient group. 3. Mean height and width of condylar head were 6.66±1.83㎜, 12.42±0.49㎜ in control group and 6.22±1.36㎜, 11.93±l.92㎜ in patient group. 4. The mean height of articular fossa was 10.20±2.04㎜ in control group and 9.89±1.98㎜ in patient group. The mean width of articular fossa was 21.08±2.08㎜ in control group and 21.24±3.03㎜ in patient group. 5. In centric occlusion the superior joint space was largest (4.15±0.93㎜), followed by the posterior joint space (2.99±0.97㎜) and the anterior joint space (2.70±0.73㎜) in control group. The superior joint space (3.47±1.31㎜) and posterior joint space (3.47±7.07㎜) were same in patient group. There was significant difference in left superior joint spaces between two groups (p<0.05). 6. The condylar position in articular fossa was displaced anteroinferiorly (0.99±3.65㎜ anteriorly, 1.75±1.01㎜ inferiorly) in control group and posteroinferiorly (3.20±4.69㎜ posteriorly, 1.25±1.87㎜ inferiorly) in patient group with 1 inch opening. In maximum opening, it was displaced anteroinferiorly (6.09±3.55㎜ anteriorly, 1.38±2.47㎜ inferiorly) in control group and anteroinferiorly (1.70±5.96㎜ anteriorly, 1.37±1.85㎜ inferiorly) in patient group. There was significant difference in anteroposterior position of both condyles with 1 inch opening and maximum opening between two groups (p<0.01). 7. The mean inclination of upper central incisor and the posterior inclination of articular eminence in control group was 65.60±6.04° 58.88±9.18° in control group, and 67.14±8.41°, 59.70±9.08° in patient group respectively. There was no significant correlation between two groups.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권6호
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• pp.497-504
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• 2011

Purpose: Patients who had a subcondylar fracture with a displaced or deviated condylar segment were treated with a retromandibular approach (RMA) or an endoscope-assisted transoral approach (EATA) in our department of oral and maxillofacial surgery. The clinical results of the approaches were compared. A comparative study of specific approaches for subcondylar fractures has not been published before in Korea. Methods: Twenty-one patients with subcondylar fractures of the mandible were included. Ten patients were treated with the retromandibular approach and 11 were treated with an endoscope-assisted transoral approach. We examined patient age, gender, fracture sites, classifications, period of maxillomandibular fixation, facial nerve (FN) or greater auricular nerve (GAN) injuries, maximal mouth opening, deflection, occlusal changes, number of plates, follow-up period, and other complications. Preoperative computed tomography and pre-operative, post-operative, and follow-up panoramic views were taken of each patient. Results: Mean maximal mouth openings were similar between the two approaches. FN and GAN injuries were more frequent in the RMA group but the deflective rate with mouth opening was higher in the EATA than that in RMA group. Two cases of post-operative infection occurred in the EATA group, and occlusal changes were observed in one case for both approaches. Conclusion: The RMA offers more direct access and visualization of the surgical field but it can cause scars and retractive injuries of the FN and GAN. But, EATA did not result in consequent nerve injuries or scars postoperatively, but unfavorable fractures such as $medial$ $override$ condyles were more difficult to reduce endoscopically. Except cases of an expected difficult reduction, the treatment of choice for a displaced subcondylar fracture may be an EATA.

• 대한치과교정학회지
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• 제36권3호
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• pp.218-227
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• 2006

안면 비대칭 환자의 진단분석에 이용할 수 있는 이하두정 두부방사선 규격사진과 표면 근전도 검사 자료는 통용화된 진단분석법 부재 등의 이유로 제한적으로 사용되고 있다. 그러나 여타 진단분석법과 비교할 때, 수직 안모 유형의 평가 등 차별적인 정보를 얻을 수 있어 이에 대한 연구가 필요하리라 보인다. 본 연구의 목적은 안면 비대칭을 보이는 60명을 대상으로 이하두정 두부방사선 규격사진 및 저작근의 표면 근전도를 측정하여 수직 안모 유형과의 연관성 및 안면 비대칭과의 연관성을 평가하고자 함이다. 이하두정 두부방사선 규격사진 계측치 중 radiographic corpus length는 비편위측이 큰 값을 보였고 (p<0.001), 유의성은 없었으나 gonion to interspinosum axis는 편위측이 크고, gonion과 하악과두의 위치는 비편위측이 편위측에 비해 전방에 위치하였다 (p=0.07). 안정시 편위측 전측 두근의 근활성은 비편위측보다 높은 것으로 나타났다 (p<0.01). 또한 최대 폐구 시 교근의 활성은 유의성이 없었으나 비편위측에 비해 편위측이 큰 값을 보였다 (p<0.09). Facial index와 intercondylar axes angle은 양의 상관관계를 보였다 (p<0.01). 최대 폐구 시 편위측 및 비편위측의 교근의 활성은 facial index와 양의 상관관계를 보였다 (p<0.05). 이상의 결과를 통해 골격성 안면 비대칭을 보이는 환자에서 이하두정 두부방사선 규격사진과 표면 근전도 검사를 통해 비대칭 양상의 평가와 더불어 수직 안모 유형의 평가 또한 가능한 것으로 생각된다.

• 대한치과교정학회지
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• 제22권1호
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• pp.109-121
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• 1992

Temporomandibular joint is a major structure to play an important role in the function & stability of the occlusion as well as the stomatognathic system. Therefore, the TMJ is the structure that requires the complete analysis for diagnosing and planning treatment of pathologic changes by TMJ dysfunction and malocclusion. So, in this study, to evaluate TMJ situation in Korean malocclusion, based on the previous accomplishments, students of the dental college of Won-Kwang Univ. are surveyed and selected in terms of Angle's classification of malocclusion, whose TMJ radiographs were taken in the centric occlusion and centric relation. In each maiocclusion groups, the mean and standard deviation of anterior, posterior and superior joint space of the right, left and both side in CO & CR are evaluated and also those of the fossa height and the articular eminence angle of the right, left and both sides are evaluated. The obtained results were as follows: 1. In the correlation coefficient between the malocclusion groups, no other items except the posterior joint space of the right side in CR between in class I and class III are significant. 2. In the correlation coefficient between the right and left side, the each joint space in class I malocclusion group and class II malocclusion group are significant. 3. In the change of each joint space during the transmit from CO to CR, there is a tendency of increasing anterior joint space and decreasing posterior, superior joint spaces in class I, II malocclusion and increasing superior joint space and decreasing anterior, posterior joint space in class III malocclusion, which is significant in the correlation coefficient, but not significant in the T-test. 4. In each malocclusion group, the correlation coefficient between the posterior joint space and the superior joint space in C.R is highly significant. 5. The fossa height of class II malocclusion group is lesser than that of class I or class III, which is not significant in T-test. 6. In the correlation coefficient between Rt. and Lt. side in the fossa height, it is not significant in class I and class III group, but significant in class II malocclusion group. 7. The articular eminence angle of class II malocclusion group is larger then that of class I or class III groups, which is fairly significant. 8. In the correlation coefficient between Rt. and Lt. side in the articular eminence angle, it is significant in each malocclusion group.

• 치과방사선
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• 제29권1호
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• pp.309-325
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• 1999

Purpose: To find out the effects that different tomographic angles have on the osteophytic lesion detectability of condyle head by comparison the individualized lateral tomographic image with the various tomographic angled images using SCANORA/sup (R)/. Materials & Methods: This study is performed to simulate osteophytic lesions by a series of dentin chips placed at six locations on condyle head. The control angle is 15° and from this angle. tomographic angle were varied with -10°, +10°, +20°. All the images with each sized dentin chip were scored by three dental radiologists with the use of confidence levels for presence or absence of the lesion, each examiner viewed one of the images twice. A rating scale from 0 to 2 (0, lesion definitely not present; 1. uncertain if lesion is present; 2, lesion definitely present). Responses were assessed by Tukey' s multiple comparison method and kappa value. Results: 1. The lesion size of 0.3 mm could not be detected in all the tomographic angles. As the size of the lesion increased the average value of lesion detectability also increased. 2. In the lesion sizes of 0.7 mm there was statistically significant difference between the 15° control angle and the altered tomographic angles (p<0.05). In 1.0 mm lesion there was no significant difference in the ±10° altered angles (p >0.05). but there was significant difference in the altered angle (p<0.05). In the lesion sizes of 0.3 mm and 2.0 mm there was no significant difference between the 15° control angle and all the altered angles (p >0.05). 3. In the anteromedial. anterosuperior, anterolateral area there was no significant difference between the 15° control angle and the ±10° altered angle (p >0.05), but in the comparison with the +20° altered angle there was significant difference (p<0.05). Conclusion: When imaging the lateral tomography of the temporomandibular joint used by SCANORA/sup (R)/, it can be considered that in the osteophytic lesion size of 2 mm and above, the tomographic angle difference within +20° to the horizontal angle of the condyle. has little effect on the lesion detectability. And in the lesion size of 1 mm, the altered angle within ±10° also has little effect on the lesion detectability.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권4호
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• pp.229-239
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• 2009

The purpose of this study is to evaluate the change in condylar position, width, and angle before and after orthognathic surgery using 3-dimensional computed tomograph. Pre and posterative 3-D CT was taken on 38 patients and through axial, frontal, sagittal measurements and by 3-dimensional reconstruction, the changes in condylar postion, mandibular width and angle were analyzed and others such as the difference in gender, operation and fixation method, setback length and in relation with temporomandibular disorders were done together too. The results were as follows: The inward rotation of condyle in axial condylar angle, the forward movement of right condyle in sagittal anterior-posterior distance, the superior movement of both condyles in sagittal superior-inferior distance, the decrease in gonial angle, the increase in mandibular width, the decrease in distance between the axial coronoid process distance and the increase in the frontal intercondylar distance were statistically significant. There were no statistically significant changes in gender difference, however in the difference in operation method, change in the gonial angle was observed and there was more change in bilateral sagittal split osteotomy group compared to two-jaw surgery group. In the difference in fixation method, the decrease in axial coronoid process distance and the change in sagittal anterior-posterior distance were statistically significant. In the difference in setback, the increase in setback didn't relate directly with the increased change in condyle position. In the relation with temporomandibular disorder, changes in left axial condylar angle and axial coronoid process distance were statistically significant. Changes in condylar position could be observed after the orthognathic surgery but it doesn't seem to have much of a clinical importance. The orthognathic surgery is effective in decreasing the mandibular angle, and it is not related with the temporomandibular disorder.

• 치과방사선
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• 제25권2호
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• pp.319-330
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• 1995

This study was designed to evaluate the interrelationship between the condylar head position in transcranial view and the articular disc position in the arthrography. The condylar positions were assessed by subjective method and linear measurement method on the transcranial view. The subjects for this study consisted of 24 symptomatic joints with normal disc position, 37 joints with anterior disc displacement with reduction and 44 joints with anterior disc displacement without reduction that were classified by arthrotomography under the fluoroscopic guidance. The interrelationship between the condylar head position in transcranial view and the articular disc position in the arthrography was evaluated by Chi square test. The obtained results were as follows : 1. There was no significant interrelationship between the position of condylar head in closed mouth state on transcraniaJ view and articular disc position in the arthrography (p>0.05). 2. There was no significant interrelationship between the changes of interarticular distance in 1 inch opening state and articular disc position in the arthrography (p>0.05). 3. There was no significant interrelationship between the position of condylar head related to the apex of articular eminence in 1 inch opening state and articular disc position in the arthrography(p>0.05). 4. There was significant interrelationship between the changes of interarticular distance that is assessed by linear measurement method in maximum opening state and articular disc position in the arthrography(p<0.05), but there was no significant interrelationship when the condylar head position was assessed by subjective method(p>0.05). 5. There was significant interrelationship between the degree of condylar translation in maximum opening state and articular disc position in the arthrography(p<0.05). 6. The correlation coefficient between two methods to assess the position of condylar head were 0.7989: the condylar head position in articular fossa in closed state, 0.6847: interarticular space in 1 inch opening state, 0.8965: the degree of condylar translation in 1 inch opening state, 0.5944: the changes of interarticular space in maximum opening state, 0.9215: the degree of condylar translation in maximum opening state.