• Journal of Periodontal and Implant Science
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• 제32권2호
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• pp.361-370
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• 2002

The aim of this study was to analyze various data of 120 non-submerged ITI implants placed in 64 korean adults. The data were retrieved from patients' charts and registered in the computer and coded for a statistical analysis. The results revealed that the most common type of edentulism was a distal extension case, and the largest number of implants were placed in the mandibular first molar position. Implants were placed more frequently in mandibular, posterior position than maxillary, anterior position, respectively. With respect to the implant diameter and length, an implant with 4.1mm in diameter and more than 10mm in length was the most common. Since a molar position was the most prevalent position for implant placement in korean patients, clinicians should be careful about implant diameter which can resist a strong occlusal force expected in the molar position. In addition, the distance to the mandibular canal and the floor of maxillary sinus should be considered to avoid possible damages, such as nerve injury and sinus perforation in selecting a proper implant length.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.206-210
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• 2015

Cervicofacial subcutaneous emphysema is a rare complication mainly resulting from dental procedures. The majority of cases are self-limiting and benign in clinical nature. However, although entry sites may be quite small and superficial, it can result in potential respiratory difficulties, such as pneumothorax and pneumomediastinum. We present the first case in which facial subcutaneous emphysema developed in a 6-year-old boy following use of a fish cake skewer while eating.

• 구강회복응용과학지
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• 제32권2호
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• pp.135-140
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• 2016

사고로 인하여 갑자기 치아를 상실하게 된 환자에게 정신적 안정, 심미성과 기능을 회복하기 위하여 빠른 임시 보철물 수복이 필요하다. 본 증례는 외상으로 인하여 예상치 못한 치아 상실이 발생한 환자에게 열형성 기술(thermoforming technique)을 이용한 수복을 시행하여 만족할 만한 결과를 얻었기에 보고하는 바이다.

• 대한소아치과학회지
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• 제35권1호
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• pp.11-17
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• 2008

본 연구는 Er:YAG laser에 의한 치수의 초기 조직반응과 calcitonin gene-related peptide (CGRP) 함유 신경섬유의 발현을 비교 평가하고자 시행하였다. Er:YAG laser와 conventional bur를 이용하여 상악 제1대구치의 교합면에 와동을 형성하였다. 와동형성 후 48시간 후에 조직을 처리하여 hematoxylin-eosin 염색과 CGRP 면역조직화학을 시행한 후 다음과 같은 결과를 얻었다. 1. Conventional bur를 이용하여 삭제한 경우, 상아질 바닥면은 균열이 없는 평면의 균일한 모양을 보였으며, Er:YAG laser의 경우에는 상아질의 면은 bur에 비해서 파동형의 불규칙적인 형태와 바닥면에서 상아세관의 주행방향을 따라 미세한 균열을 보였다. 2. Er:YAG laser에 의해 손상 받은 치수에서는 혈관확장과 노출된 치수의 손상부위를 따라 bur에서 손상 받은 치수보다 더 많은 염증세포의 침윤과 상아모세포층의 파괴를 보였다. 3. 노출손상 후에 치수신경 말단에서 CGRP 발현은 bur와 laser군 모두에서 손상을 받지 않은 정상 치수에 비해서 증가된 양상을 보였으며, 그 증가된 정도는 laser의 경우에서 더 강하였다. 위의 결과들을 종합하면, Er:YAG laser가 치수손상을 최소화하여 적용되면 치아우식 제거와 와동형성과 같은 여러 수복치료 시 유용하게 사용될 수 있으리라 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.32.1-32.4
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• 2020

Background: Le Fort I osteotomy is a highly effective treatment for skeletal jaw deformities and is commonly performed. High Le Fort I osteotomy is a modified surgical procedure performed for improving the depression of the cheeks by setting the osteotomy higher than the conventional Le Fort I osteotomy. Developments in three-dimensional (3D) technology have popularized the use of 3D printers in various institutions, especially in orthognathic surgeries. In this study, we report a safe and inexpensive method of performing a high Le Fort I osteotomy using a novel 3D device and piezosurgery, which prevent tooth root injury without disturbing the operation field for patients with a short midface and long tooth roots. Results: A 17-year-old woman presented with facial asymmetry, mandibular protrusion, a short midface, and long tooth roots. We planned high Le Fort I osteotomy and bilateral sagittal split ramus osteotomy. Prevention of damage to the roots of the teeth and the infraorbital nerve and accurate determination of the posterior osteotomy line were crucial for clinical success. Le Fort I osteotomy using 3D devices has been reported previously but were particularly large in size for this case. Additionally, setting the fixing screw of the device was difficult, because of the risk of damage to the roots of the teeth. Therefore, a different surgical technique, other than the conventional Le Fort I osteotomy and 3D device, was required. The left and right parts of the 3D device were fabricated separately, to prevent any interference in the surgical field. Further, the 3D device was designed to accurately cover the bone surface from the piriform aperture to the infra-zygomatic crest with two fixation points (the anterior nasal spine and the piriform aperture), which ensured stabilization of the 3D device. The device is thin and does not interfere with the surgical field. Safe and accurate surgical performance is possible using this device and piezosurgery. The roots of the teeth and the infraorbital nerve were unharmed during the surgery. Conclusions: This device is considerably smaller than conventional devices and is a simple, low-cost, and efficient method for performing accurate high Le Fort I osteotomy.

• 구강회복응용과학지
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• 제27권3호
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• pp.327-336
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• 2011

치과에서 임상적으로 신경병성 통증이 발생하는 경우는 주로 하악신경이 손상 받은 경우이며 그 원인으로는 발치, 인공치아매식, 악안면 수술, 치주치료 및 근관치료 등이 있다. 본 연구는 근관치료 후 발생한 하악신경 손상 환자의 신경병증의 원인과 증상에 따라 약물치료를 통해 개선된 정도를 분석해 보고자 하였다. 근관치료 후 발생한 이상감각 또는 통증을 주 증상으로 2004년부터 2011년까지 연세대학교 치과대학병원 구강내과에 내원한 환자 중 32명의 의료기록을 분석하였고, 약물치료를 시행한 경우 환자의 증상이 개선된 정도를 평가하였다. 초진시 감각저하 또는 감각부전의 증상을 호소한 총 32명의 환자 (남자 9명, 여자 23명, 평균나이 44세)를 분석하였다. 신경병증의 발생 원인은 근관치료 시 마취 (46.9%), 근관 내 적용한 약재에 의한 화학적 손상 (25%), 근관수술 (15.6%), 기타 원인이 불분명한 경우 (12.5%) 순으로 많았다. 처방된 약물은 스테로이드, 항경련제, 항우울제, 진통제 등이었고, 환자의 증상이 개선될 때까지 약물 용량은 조절되었으며, 약물 복용 기간은 1주일에서 11개월까지 다양하였다. 증상이 나타난 부위에 따라 하치조신경 손상으로 인한 증상을 나타내는 환자가 25명, 설신경 손상으로 인한 증상을 나타내는 환자가 7명이었으며, 약물치료 후 증상이 개선된 경우가 21명 (66%), 증상 개선이 미미하거나 없는 경우가 11명 (34%)이었다. 그 증상은 감각저하와 감각부전으로 분류하였고, 감각저하는 67%, 감각부전은 65% 개선을 보였다. 근관치료와 연관된 하악신경 손상으로 인해 신경병증이 발생된 경우 약물치료를 통한 증상 개선을 도모해 볼 수 있다. 다만, 신경병증의 종류와 회복 수준은 신경 손상의 원인, 정도와 손상 발생 후 치료 시기, 처치 방법 등에 의해 영향을 받으며, 각각의 변수에 따라 통증 강도나 회복 정도에 차이가 있을 것으로 예상되므로 향후 더 많은 개체 수에서 다양한 변수에 대한 정량적인 연구가 필요할 것으로 생각된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권5호
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• pp.375-395
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• 2006

Purpose: Lingual nerve (LN) damage may be caused by either tumor resection or injury such as wisdom tooth extraction, Although autologous nerve graft is sometimes used to repair the damaged nerve, it has the disadvantage of necessity of another operation for nerve harvesting. Moreover, the results of nerve grafting is not satisfactory. The nerve growth factor (NGF) is well-known to play a critical role in peripheral nerve regeneration and its local delivery to the injured nerve has been continuously tried to enhance nerve regeneration. However, its application has limitations like repeated administration due to short half life of 30 minutes and an in vivo delivery model must allow for direct and local delivery. The aim of this study was to construct a well-functioning $rhNGF-{\beta}$ adenovirus for the ultimate development of improved method to promote peripheral nerve regeneration with enhanced and extended secretion of hNGF from the injured nerve by injecting $rhNGF-{\beta}$ gene directly into crush-injured LN in rat model. Materials and Methods: $hNGF-{\beta}$ gene was prepared from fetal brain cDNA library and cloned into E1/E3 deleted adenoviral vector which contains green fluorescence protein (GFP) gene as a reporter. After large scale production and purification of $rhNGF-{\beta}$ adenovirus, transfection efficiency and its expression at various cells (primary cultured Schwann cells, HEK293 cells, Schwann cell lines, NIH3T3 and CRH cells) were evaluated by fluorescent microscopy, RT-PCR, ELISA, immunocytochemistry. Furthermore, the function of rhNGF-beta, which was secreted from various cells infected with $rhNGF-{\beta}$ adenovirus, was evaluated using neuritogenesis of PC-12 cells. For in vivo evaluation of efficacy of $rhNGF-{\beta}$ adenovirus, the LNs of 8-week old rats were exposed and crush-injured with a small hemostat for 10 seconds. After the injury, $rhNGF-{\beta}$ adenovirus($2{\mu}l,\;1.5{\times}10^{11}pfu$) or saline was administered into the crushed site in the experimental (n=24) and the control group (n=24), respectively. Sham operation of another group of rats (n=9) was performed without administration of either saline or adenovirus. The taste recovery and the change of fungiform papilla were studied at 1, 2, 3 and 4 weeks. Each of the 6 animals was tested with different solutions (0.1M NaCl, 0.1M sucrose, 0.01M QHCl, or 0.01M HCl) by two-bottle test paradigm and the number of papilla was counted using SEM picture of tongue dorsum. LN was explored at the same interval as taste study and evaluated electro-physiologically (peak voltage and nerve conduction velocity) and histomorphometrically (axon count, myelin thickness). Results: The recombinant adenovirus vector carrying $rhNGF-{\beta}$ was constructed and confirmed by restriction endonuclease analysis and DNA sequence analysis. GFP expression was observed in 90% of $rhNGF-{\beta}$ adenovirus infected cells compared with uninfected cells. Total mRNA isolated from $rhNGF-{\beta}$ adenovirus infected cells showed strong RT-PCR band, however uninfected or LacZ recombinant adenovirus infected cells did not. NGF quantification by ELISA showed a maximal release of $18865.4{\pm}310.9pg/ml$ NGF at the 4th day and stably continued till 14 days by $rhNGF-{\beta}$ adenovirus infected Schwann cells. PC-12 cells exposed to media with $rhNGF-{\beta}$ adenovirus infected Schwann cell revealed at the same level of neurite-extension as the commercial NGF did. $rhNGF-{\beta}$ adenovirus injected experimental groups in comparison to the control group exhibited different taste preference ratio. Salty, sweet and sour taste preference ratio were significantly different after 2 weeks from the beginning of the experiment, which were similar to the sham group, but not to the control group.

• Child Health Nursing Research
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• 제5권2호
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• pp.136-150
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• 1999

The subjects, under 18 old, 2,694 children who visited ER during 1998, were surveyed by the Triage and other statitical data. The results were as follows 1. The male to female ratio was 1.7 : 1, and the toddler(1-4 old) was the majority. 2. Triage ; critical 1.3%, acute 14.6%, urgent 29.5%, nonemergent 54.6%. 3. The reasons of visiting ER ; 1) The children had diseases(46.5%), injury (36.9%), TA(5.6%) and toxication(1.0%). 2) In diseases, male to female ratio was 1.5 : 1 and in injury, male to female was 2 : 1. 3) Among the children having in TA, 12-18 old groups was the majority(34.9%). 4. The time of visiting : the 20:00 - 22:00 was the majority(16.9%). 5. By monthly and seasonal distribution ; Jan. (9.7%), Mar. and May(9% respectively, Dec. and July(6.7%) respectively. The children who visted ER in spring and autumn showed higher portion than those of summer and winter. 6. Results ; admission(27.4%), discharge(68.4%), operations(2.8%), and DOA and DAA(0.4%), The mortality of the infancy and toddler groups was 83.3%. The infancy group showed the highest rate of admission. 7. The time of staying in ER ; 1-2 hrs was the major group(23.3%) and the average was 4.6 hours. 8. By clinical departments ; Ped. was 34.4%, PS was 20.8%, Dental Surgery was 10.3% and Dermatology was 0.9%. 9. The types of visting ; the group who visited by themselves was 80%, transfer from the primary and secondary clinic was 17% and OPD was 3.0%. 10. The traffic means . by the own cars and taxi were 87.6%, by hospital ambulance was 6.1% and by 119 ambulance was 4.3%.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권5호
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• pp.365-372
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• 2021

Objectives: Mandibular fractures vary significantly with respect to epidemiological and demographic parameters among populations. To date, no study has evaluated these aspects of mandibular fractures in Nuh, Mewat, Haryana, India. To retrospectively analyze the incidence, age and sex distributions, etiology, anatomic distribution, occlusal status, treatment modality provided, and their correlation in patients who suffered isolated mandibular fractures. Materials and Methods: The records of maxillofacial injury patients who reported to the Department of Dentistry, SHKM Government Medical College from January 2013 to December 2019, were retrieved from our database, and necessary information was collected. The data collected were analyzed statistically using IBM SPSS ver. 21. Results: Totals of 146 patients and 211 fractures were analyzed. There were 127 males and 19 females with an age range of 3-70 years (mean age, 26 years). Road traffic accident (RTA) was the most common cause of fracture (64.4%), followed by fall (19.9%), assault (15.1%), and sports injury (0.7%). Of all patients, 42.5% had bilateral fractures, 31.5% had left side fracture, 21.2% had right side fracture, 3.4% sustained midline symphyseal fracture, and 1.4% had symphyseal fracture along one side of the mandible. Site distribution was as follows: parasymphysis (34.6%), angle (23.7%), condyle (20.4%), body (12.8%), symphysis (4.3%), ramus 2.4%, and dentoalveolar 1.9%. The most common facture combination was angle with parasymphysis (17.8%). Occlusion was disrupted in 69.2% patients. Closed reduction was the predominant treatment modality. Conclusion: The data obtained from retrospective analyses of maxillofacial trauma increase the understanding of variables and their outcomes among populations. The results of the present study are comparable to those of the literature in some aspects and different in others.

• 대한소아치과학회지
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• 제44권2호
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• pp.194-199
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• 2017

본 연구의 목적은 탈구성 손상을 받은 유치에 시행한 고정술의 치료 결과를 분석하는 것이다. 본 연구는 2010년부터 2015년까지 탈구성 손상으로 본과에 내원하여 유치에 고정술을 시행한 92명의 환아들을 후향적으로 분석하였다. 이들 중에서 6개월 이상 추적 검사에 참여한 환아들을 대상으로 치료 결과를 분석하였다. 치료 결과는 검진 기간동안 임상 및 방사선 검사에서 합병증의 존재에 따라 분석되었다. 평균 나이는 42.1개월이었으며 67.4%가 남아였다. 넘어짐이 가장 빈번한 원인이었으며, 평균 고정 기간은 2.4주이었다. 고정술의 성공률은 58.9%이었다. 아탈구가 가장 높은 성공률을 보였으며, 측방 탈구에서 정복 후 고정술을 시행한 경우 가장 낮은 성공률을 보였다. 탈구성 손상에서 치수괴사가 가장 빈번히 발생한 비호의적 치료 결과이었다. 본 연구결과, 유치의 탈구성 손상에서 고정술은 받아들일 만하였으며, 고정술은 유치의 탈구성 손상시 치료법으로 고려될 수 있다.