• 대한두개안면성형외과학회지
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• 제21권4호
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• pp.237-243
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• 2020

Background: The scalp is an important functional and aesthetic structure that protects the cranial bone. Due to its inelastic characteristics, soft-tissue defects of the scalp make reconstruction surgery difficult. This study aims to provide an improved scalp reconstruction decision making algorithm for surgeons. Methods: This study examined patients who underwent scalp reconstruction within the last 10 years. The study evaluated several factors that surgeons use to select a given reconstruction method such as etiology, defect location, size, depth, and complications. An algorithmic approach was then suggested based on an analysis of these factors. Results: Ninety-four patients were selected in total and 98 cases, including revision surgery, were performed for scalp reconstruction. Scalp reconstruction was performed by primary closure (36.73%), skin graft (27.55%), local flap (17.34%), pedicled regional flap (15.30%), and free flap (3.06%). The ratio of primary closure to more complex procedure on loose scalps (51.11%) was significantly higher than on tight scalps (24.52%) (p=0.011). The choice of scalp reconstruction method was affected significantly by the defect size (R=0.479, p<0.001) and depth (p<0.001). There were five major complications which were three cases of flap necrosis and two cases of skin necrosis. Hematoma was the most common of the 29 minor complications reported, followed by skin necrosis. Conclusion: There are multiple factors affecting the choice of scalp reconstruction method. We suggest an algorithm based on 10 years of experience that will help surgeons establish successful surgical management for their patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권2호
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• pp.153-159
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• 1991

외상성, 혹은 선천적 결손으로 인한 함몰부에 사용한 자가 유리지방 이식은 잘 알려진 방법이다. 이를 위해 사용되는 주된 공여부는 복부나 둔부의 피하지방이었다. 그러나, 1977 년 Egyedi는 협지방대를 유경피판으로 처음 사용하였다. 협지방대는 안면골 절단술시, 협측 피판을 들어올릴 때, 혹은 이하선관 수술 같은 구강내 수술시 항상 귀찮은 구조물로써, 수술 시야를 방해한다. 협지방대는 매우 세밀한 막으로 둘러싸인 소엽형태의 볼록한 물질로, body와 네 개의 prccess들로 구성된다. 이 돌기들은 여러 근육층 사이의 충전물로 작용하며, 유아에서는 sucking시 보조작용으로, 성인에서는 윤활재로 사용되기도 한다. 본 교실에서는 협지방대를 사용하여 세 증례의 협골 함몰부에, 그리고 한 증례의 비순구 재건을 위해 사용한 바, 양호한 결과를 얻었기에 문헌고찰과 함께 증례보고를 하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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• pp.238-242
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• 2000

Recurrent mandibular dislocation is frequent morbidity of temporomandibular joint relatively. There are many etiologic causes in TMJ disorders but, difficult to find obvious one. Various treatment methods have been utilized for a mandibular dislocation. It is categorized into two groups broadly - nonsurgical or surgical methods. The basic rationale of the surgical method is to allow free movement of the condyle by reducing height of articular eminence or to limit anterior excessive movement of the condyle by increasing height of articular eminence or soft tissue anchoring procedure. In this case, 69 year-old woman was treated by augmentation of the articular eminence with mandibular symphysial bone graft leading to osteosynthesis without difficulty. As a result, favorable postoperative outcome was obtained functionally without any complication or recurrence.

• 대한치과교정학회지
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• 제14권1호
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• pp.53-65
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• 1984

The purpose of this study was to investigate the histopathological change and adaptation process of the mandibular joint of the rat by muscle alteration. For this study, one hundred and twenty eight rats of 25 - and 60 - day old of age were used. Unilateral and bilateral detachment, with anterior positioning of the Masseter muscle, was performed under anesthesia. The animal was sacrified 10, 20, 50, 80 days postoperatively. This alteration in muscle function led to change in neuromuscular activity and demonstrated the adaptive nature of the condyle cartilage to functional demand. The results were as follows : 1. In the right muscle detached group, operated at 25 days of age, marked decrease on the chondroblastic zone was found in the condyle head on the right side of animals examined 10 days postoperatively. Comparing with the control group, no difference was found on the chondroblastic zone in the condylar head of animals examined 20, 50 and 80 days postoperatively. 2. In the bilateral muscle detached group, operated at 25 days of age, the chondroblastic zone was slightly decreased in the anterior parts of condylar head of animals examined 10 days postoperatively. 3. In the unilateral and bilateral muscle detached group, operated at 60 days of age, no significant change was found in the mandibular joint regardless of the post operative experimental periods. 4. Under Toluidine blue staining, slightly decreased metachromasia was found in the condyle head on the right side of unilateral experimental animals, operated at 25 days of age and examined 10 days postoperatively. 5. Under Masson's trichrome staining, increased metachromasia was found in the condyle head on the right side of unilateral experimental animals, operated at 25 days of age and examined 10 days postoperatively. In summary, the condyle of the rat could respond to changes in neuromuscular activity depend on the level of maturation of the tissue, because the endochondral bone formation of the condyle of the rat was almost ended within 3 months.

• 대한치과교정학회지
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• 제43권5호
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• pp.225-234
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• 2013

Objective: The purpose of this study was to classify Korean young adults into 3 groups on the basis of upper incisor exposure rates (UIERs) and to compare the skeletal, dental, and soft tissue variables. Methods: Samples were obtained from 127 students at the College of Dentistry, Wonkwang University in South Korea. Facial photographs of frontal posed smiles and lateral cephalograms of the subjects were taken. The subjects were divided into 3 groups on the basis of UIERs and 20 measurements were compared among the 3 groups. The correlations between the variables were determined. Results: Male and female subjects showed significant differences in the group distribution. Male subjects showed higher frequencies of low smiles, and female subjects showed higher frequencies of high smiles. The vertical height of the anterior alveolar process of the maxilla directly correlated with the UIER. However, the UIER showed no significant correlation with the vertical height of the anterior basal bone or the inclination of the upper incisor axis. In female subjects, the upper central incisor clinical crown length showed an inverse correlation with the UIER. However, this variable showed no significant correlation with the UIER in male subjects. Conclusions: The UIER was directly correlated with the levator muscle activity of the upper lip and inversely correlated with the upper lip thickness, yet there was no correlation between the UIER and upper lip length at rest.

• International Journal of Oral Biology
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• 제39권1호
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• pp.15-22
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• 2014

Aggregatibacter actinomycetemcomitans is an important pathogen in the development of localized aggressive periodontitis. Lipopolysaccharide (LPS) is a virulent factor of periodontal pathogens that contributes to alveolar bone loss and connective tissue degradation in periodontal disease. Our present study was designed to investigate the cytokine expression and signaling pathways regulated by A. actinomycetemcomitans LPS (Aa LPS). Cytokine gene expression profiling in RAW 264.7 cells was performed by microarray analyses. The cytokine mRNA and protein levels and related signaling pathways induced by Aa LPS were measured by RT-PCR, ELISA and western blotting. Microarray results showed that Aa LPS strongly induced the expression of NF-${\kappa}B$, NF-${\kappa}B$-related genes, inflammatory cytokines, TNF-${\alpha}$ and IL-$1{\beta}$ in RAW 264.7 cells. NF-${\kappa}B$ inhibitor pretreatment significantly reduced the levels of TNF-${\alpha}$ and IL-$1{\beta}$ mRNA and protein. In addition, the Aa LPS-induced TNF-${\alpha}$ and IL-$1{\beta}$ expression was inhibited by p38/JNK MAP kinase inhibitor pretreatment. These results show that Aa LPS stimulates TNF-${\alpha}$ and IL-$1{\beta}$ expression through NF-${\kappa}B$ and p38/JNK activation in RAW 264.7 cells, suggesting the essential role of this pathway in the pathogenesis of localized aggressive periodontitis.

• 구강회복응용과학지
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• 제19권4호
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• pp.281-290
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• 2003

Platelet-rich plasma which is made with the newly developed technique concentrating platelets 3-folds or more is also proven to be very effective method to stimulate and accelerate the healing of bone and soft tissue. This study is aimed to investigate the effect of platelet-rich plasma on the attachment of osteoblast. To evaluate the effect on human, human osteoblast cell line was cultured. Platelet-rich plasma was extracted from the blood of a healthy volunteer. The effect on the attachment was evaluated by MTT assay. To evaluate autocrine and paracrine effect on osteoblast, conditioned medium was made and compared with platelet-rich plasma. By western blot analysis, the expression of fibronectin and vitronectin in experimental groups was examined. The results were as following: The cellular attachment of osteoblast cell line increased depending on the concentration of platelet-rich plasma and conditioned medium. The amount of increasing was similar between two groups. The expression of fibronectin and vitronectin in platelet-rich plasma and conditioned medium is more than control group in western blot analysis. These findings imply that platelet-rich plasma enhance the cellular attachment by inducing fibronectin, vitronectin from osteoblast and maximize the cellular attachment by using the autocrine and paracrine effect of platelet-rich plasma.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권5호
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• pp.246-250
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• 2015

Objectives: This study investigated patients with oral and maxillofacial lacerations who visited the emergency room over a three-year period in an effort to determine the optimal treatment for these injuries. Materials and Methods: This study examined 1,742 patients with oral and maxillofacial lacerations with 2,014 different laceration locations who visited the emergency room of Pusan National University Hospital (Busan, Korea) over three years, from January 2011 to December 2013. Patients were classified by sex, age, visit day, cause of injury, injury site, and the presence or absence of soft tissue and tooth injuries. Results: The male to female ratio was 2.50:1. Patients under 10 years old were seen most frequently. Most emergency room visits were on weekends. Among intra-oral lacerations, the lip area was the most vulnerable site; among extra-oral lacerations, the chin area was most frequently injured. The most frequent etiology was a slip down. Most lacerations occurred without bone fracture or tooth damage. Conclusion: Laceration may differ in large part as compared with the fracture. Therefore, it is necessary to continue collecting data on oral and maxillofacial lacerations to establish optimal emergency room diagnosis and treatment strategies.

• Journal of Periodontal and Implant Science
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• 제26권4호
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• pp.823-840
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• 1996

The purpose of this study was to evaluate the effect of dexamethasone on the healing aspect of gingiva and alveolar bone after extraction. Extracted socket of 24 Sprague-Dawley rat was used. To extract easily and minimize injury, ${\beta}-APN$ 0.2g/kg/day soluted in mineral water was administrated for 5 days before extraction in both group. Ampicillin 1.5ml/kg i.m.,q.d, was administered for preventing infection after teeth extraction in both group, and dexamethasone 0.2mg/kg/day was injected for 3 days in experimental group.3 rats on each day was sacrificed on 1, 3, 7, 15 days after extraction. Histologic examination and the activity of osteoclasts by tartrate resistant acid phosphatase was observed. The results were as follows : 1. The Overall healing pattern was similar with both the experimental and control group, but in experimental group osseous healing was delayed. 2. The activity of osteoclasts was increased to day 3 and then decreased after day 3 in the experimental group. In comparison to the control group, the experimental group showed increased appearance to day 7 and then decreased appearance following day. 3. Regarding to the change of osseous tissue, the activity of osteoblasts was shown at day 7,but osteoclastic activity of the experimental group was less than that of the control group. The osteoclastic activity was statistically significant between two groups except day 7(p<0.05, p<0.01). In conclusion, the effects of dexamethasone for healing of extraction socket were considered as limiting the activity of osteoclasts, and the healing of extraction socket was delayed.

• 대한소아치과학회지
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• 제35권3호
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• pp.556-561
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• 2008

신경섬유종증은 상염색체 우성 유전성 질환으로, 17번 염색체의 장완에 위치한 종양 억제 유전자의 변성에 의해 발생한다. 이는 두가지 형이 있으며 신경섬유종의 발생은 제1형 신경섬유종증의 임상적 진단 기준 중 하나이다. 신경섬유종증의 임상적 증상으로는 피부병소, 골변형, 중추신경계의 종양 등이 있으며 환자의 25%가 구강내 신경섬유종을 보인다. 악골내 신경섬유종은 드물며 방사선학적으로 하악공, 하악관, 이공을 포함하고 단방성으로 잘 경계된 방사선 투과성으로 나타난다. 신경섬유종은 하나 또는 그 이상의 병소에서 신경육종으로 전이된다는 점에서 임상적으로 중요하며 현재 특이한 치료법은 없으나, 외과적 절제술이 좋은 치료법으로 여겨지고 있다. 본 증례는 제1형 신경섬유종증 진단을 받은 환아로, 구강내 신경섬유종의 외과적 절제 후 양호한 결과를 보여 이를 보고하는 바이다.