• 제목/요약/키워드: Mandibular function

검색결과 387건 처리시간 0.025초

Lateral arthroplasty along with buccal fat pad inter-positioning in the management of Sawhney type III temporomandibular joint ankylosis

  • Malhotra, Vijay Laxmy;Singh, Virendra;Rao, JK Dayashankara;Yadav, Sunil;Gupta, Pranav;Shyam, Radhey;Kirti, Shruti
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권3호
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    • pp.129-134
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    • 2019
  • Objectives: The objective of this study was to highlight the role of lateral arthroplasty along with interposition of the buccal fat pad (BFP) in the management of Sawhney type III temporomandibular joint (TMJ) ankylosis. Materials and Methods: Ten patients with TMJ ankylosis (7 unilateral and 3 bilateral, total of 13 joints) were treated with lateral arthroplasty and BFP interposition. The bony bridge of the ankylotic mass on the lateral aspect was resected, leaving a distance of 1.5 to 2.0 cm from the base of the skull to the neck of the condyle. The condyle was left intact. Coronoidectomy was performed on the ipsilateral side via the same approach in all cases. The inter-incisal opening was measured at that time, and if it was less than 35 mm, contralateral coronoidectomy was performed by using the intra-oral approach. After satisfactory inter-incisal mouth opening (${\geq}35mm$) was achieved, the TMJ surgical site was revisited, and BFP was retrieved and used to cover the lateral aspect of the medially placed condyle. Results: With lateral arthroplasty, the medially displaced condyle can be left in-situ to maintain the mandibular ramal height and function and to act as a growth center in children. Interposition of the BFP prevents reformation of the lateral bony bridge that was removed. Conclusion: Lateral arthroplasty along with interpositioning of the BFP is a novel technique for managing Sawhney type III ankylosis that achieves management goals while avoiding complex and advanced reconstructive surgical procedures.

하악 제2대구치의 술전 교정적 정출술을 동반한 의도적 재식술 (Intentional replantation with preapplication of orthodontic force on mandibular second molar)

  • 김종순;장훈상;황윤찬;황인남;오원만;이빈나
    • 구강회복응용과학지
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    • 제37권4호
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    • pp.274-280
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    • 2021
  • 의도적 재식술은 전통적인 근관치료의 대체적 치료법으로 사용될 수 있다. 본 증례 보고에서는 기존에 근관치료 된 하악 제2대구치에 6주 동안 정출성 교정력을 가한 후 해당 치아를 발거하여 치근의 처치를 시행한 후 즉각적으로 재식립하여 의도적 재식술을 수행한 증례를 보고하고자 한다. 교정력을 부여함으로서 증가된 동요도로 인해 발치의 용이성을 증가시켰고 치주인대 폭경이 증가하여 치은 재부착을 증진 시키는 효과로 양호한 예후를 기대할 수 있었다.

비골이식을 받은 하악골절제술 환자에서 스캔중첩법을 이용한 기능적 고정성 보철물 제작: 증례 보고 (Fabrication of functionally customized fixed prosthesis in a hemimandibulectomy patient with fibular graft using double scan technique: A case report)

  • 타우 타우 윈;이두형
    • 대한치과보철학회지
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    • 제60권2호
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    • pp.195-201
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    • 2022
  • 편평세포암으로 하악골 절제술과 비골 피판 이식을 받은 경우 하악의 기능적 움직임이 저해될 수 있다. 하악골이 절제된 측은 근육부착의 소실로 인해 근기능이 약화되어 중심교합 및 편심교합에서 불안정한 교합접촉을 초래한다. 본 증례는 하악골절제술과 비골이식 재건술을 받은 63세 남성에서 전치부의 상실된 치아를 수복하기 위해 고정성 보철물이 필요했던 경우이다. 중심 및 편심교합에서 교합력의 크기에 따라 교합접촉 양상의 변화가 관찰되었다. Functionally generated path 기법과 디지털 영상기술을 적용하여 환자의 하악운동과 조화되고 적절한 수직고경이 있는 기능적으로 최적화된 고정성 보철물을 제작할 수 있었기에 보고하고자 한다.

Successful Surgical Treatment of Severe Lower Lip Avulsion in Two Cats

  • Jang, Kwangsik;Chae, Yangwon;Yang, Euisin;Jo, Hyun Min;Shim, Kyung Mi;Bae, Chunsik;Kang, Seong Soo;Kim, Se Eun
    • 한국임상수의학회지
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    • 제39권5호
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    • pp.264-271
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    • 2022
  • Two Korean short-haired cats were admitted to the Veterinary Medical Teaching Hospital, Chonnam National University, with severe lower lip avulsion. In the first case, the treatment was performed using the tension-free suture technique with rubber tube stents. The second case was treated using the tension-free suture technique with rubber tube stents for lip avulsion and using the cerclage wiring technique for alveolar fracture. The teeth around the alveolar fracture were extracted and bone graft and collagen membrane were applied at the alveolar fracture site to stabilize the mandibular alveolar fracture. Thereafter, the cerclage wire was placed circumferentially around the mandible. In both cases, normal function of the oral cavity was successfully recovered by repairing the anatomic abnormality. In conclusion, tension-free suture technique can be a treatment option for bilateral lower lip avulsion in cats.

교합고경 증가로 발생한 전치부 공간을 자연 폐쇄시켜 새롭게 유도한 전방유도: 증례 보고 (New anterior guidance induction through spontaneous gap closure after an increase in vertical dimension: a case report)

  • 남정현;김종희;이양진
    • 구강회복응용과학지
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    • 제39권3호
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    • pp.146-157
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    • 2023
  • 구치부 교모나 소실로 인해 발생하는 교합붕괴에서는 수복공간이 불충분하고 심미적 문제가 발생하는 경우가 많다. 이를 해결하기 위해 고경을 증가시키면, 하악이 후하방으로 회전함으로써 상하악 전치부 사이에 공간이 발생하여 전방유도각이 상실되는 문제점이 생긴다. 이런 이유 때문에 통상 고경 증가 후에 생긴 상하악 전치부 사이 공간은 교정을 통해 전치 치축 변화를 유도하거나 보철적 수복으로 피개하여 적절한 전방유도를 얻는 것이 일반적이었다. 그러나 구치부 교모나 소실 후 발생한 전치 과개교합 형식은 하악이 전상방 회전하며 전치부에 교합력이 과도하게 집중되고 있는 상태이기 때문에, 교합력이 제거되면 전치는 원래의 치축으로 돌아갈 수 있을 것이라고 추정할 수 있다. 이런 사실에 착안하여 이 증례보고에서는 덜 침습적인 치료 방법을 고안, 교합 수직 고경 증가를 통한 전치부의 자연스러운 전방유도 재획득을 의도하였다. 이후 디지털 중첩 방법으로 전치부의 치축 개선을 확인할 수 있었다. 새로운 치료법의 적절한 적응증을 정의하며 임상에 적용할 수 있도록 증례보고 하는 바이다.

Effect of Feeding Enzymolytic Soybean Meal on Performance, Digestion and Immunity of Weaned Pigs

  • Zhou, S.F.;Sun, Z.W.;Ma, L.Z.;Yu, J.Y.;Ma, C.S.;Ru, Y.J.
    • Asian-Australasian Journal of Animal Sciences
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    • 제24권1호
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    • pp.103-109
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    • 2011
  • The objective of this study was to investigate the effect of enzymolytic products of soybean meal (ESBM), as one of the protein sources in the diet, on the growth performance, nutrient digestibility and immune function of weaned piglets. Soybean meal produced by bioprocessing with fermentation and enzymolysis contains reduced anti-nutritional factors and improved protein utilization. A total of 240 weaned piglets (Duroc${\times}$Landrace${\times}$Yorkshire, $9.01{\pm}0.22\;kg$ body weight) were randomly allocated to 4 treatments with 6 pens per treatment and 10 piglets per pen. The diets were based on corn-soybean meal and ESBM partially replaced soybean meal and soybean protein isolate at the inclusion level of 5, 10 or 15% in the basal diet. Feed intake and body weight were measured weekly. On days 24 to 27, faeces of each replicate were proportionally collected to determine the nutrient digestibility. On day 28 of the experiment, one piglet from each replicate was slaughtered humanely to collect immune organs. The results showed that inclusion of ESBM increased (p<0.05) the final weight, daily feed intake and daily gain of weaned pigs compared with the control diet, and ESBM at the inclusion levels of 10 and 15% improved (p<0.05) the feed/gain compared with the control diet. There were no differences (p>0.05) in daily feed intake among the levels of ESBM, but increasing the levels of ESBM from 5 to 15% improved (p<0.05) the final weight, average daily gain of pigs and feed/gain. The inclusion of ESBM at 5 to 15% increased (p<0.05) the digestibility of crude protein (CP) by 5 to 16%, and ESBM at 15% increased (p<0.05) the digestibility of digestible energy (DE), Ca and P compared with the control diet. ESBM increased (p<0.05) the relative weights of thymus and mandibular lymph nodes by 57.7 and 29.6%, respectively. The percentages of T lymphocytes, CD4+ and CD8+ in peripheral blood of weaned piglets were also increased (p<0.05) by feeding ESBM. The results suggest that ESBM can be a better protein source in improving growth performance, nutrient digestibility and immune function of weaned piglets.

Gonial Angle의 단순 회귀 모델: 파노라마 영상과 측모두부 영상간의 비교 (The Simple Regression Model of Gonial Angles : Comparison between Panoramic Radiographs and Lateral Cephalograms)

  • 박성희;김영재;이상훈;김종철;장기택
    • 대한소아치과학회지
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    • 제44권2호
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    • pp.129-137
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    • 2017
  • 본 연구의 목적은 파노라마 영상과 측모두부 영상에서 유의미한 상관관계를 가지는 계측치를 확인하고, 그 관계를 수식화하는 것이다. 99명의 3급 부정교합 환자의 파노라마 영상과 측모두부 영상에서 gonial angle, 하악지 높이, 하악중절치에서 하악하연까지의 길이를 측정하여 평가하였다. 측정된 수치는 각각 대응 표본 T검증, Pearson's 상관관계 검정, 회귀 분석을 통해 평가하였다. 측모두부 영상에서의 gonial angle 평균값은 $127.50^{\circ}$, 파노라마 영상에서의 값은 $125.49^{\circ}$, 상관계수는 0.945(p < 0.001)로 나타났으며, 상관관계는 '측모두부 영상의 gonial angle = 0.920 ${\times}$ 파노라마 영상의 gonial angle + 12.072'로 나타낼 수 있다. 다른 계측치들 간의 상관관계는 gonial angle에 비해 낮게 나타났다. Gonial angle은 파노라마 영상과 측모두부 영상에서 모두 재현성 있게 측정 가능하며, 강한 양의 상관관계를 나타낸다. 파노라마 영상 또한 측모두부 영상과 같이 환자의 수직성장패턴을 평가하는데 도움을 주는 방법이다.

비골 피판을 이용한 하악 및 하악과두 재건의 장기간 임상적 평가 (LONG-TERM ANALYSIS OF RECONSTRUCTED TEMPOROMANDIBULAR JOINT AND MANDIBLE USING FREE FIBULAR FLAP)

  • 안강민;정헌종;염학렬;김항진;김윤태;황순정;명훈;김명진;김성민;장정원;이종호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제31권5호
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    • pp.409-416
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    • 2005
  • Purpose of study: The temporomandibular joint (TMJ) occupies a key functional role in mastication and contributes to normal deglutition, speech as well as cosmesis. When a large amount of mandible including the condyle head is resected, it is very difficult to reconstruct it as a functional unit. In this retrospective study, we present the functional, radiographic and cosmetic results of reconstructed temporomandibular joint using free fibular flap. Patients and Methods: Total 12 patients (M:F = 6:6) who underwent condylar reconstruction with the fibular flap were interviewed and examined by radiographs and Bio-PAK$^{(R)}$. Mean follow up periods was $47.7{\pm}20.0$ months and the average age was $38.7{\pm}15.3$ years. Remodeling of condyle and function of TMJ were evaluated and facial contour was judged subjectively. Results: All flaps were viable and no immediate postoperative complication had happened. One patient showed decreased mouth opening, so interpositional gap arthroplasty was performed. The resorption rates of reconstructed fibular were minimal and the condyle heads were changed into domeshaped neocondyle after 2 years. All patients had normal diet and no speech difficulty was reported. Nine patients were satisfied with their facial contour but three patients complained about the depression of cheek. Conclusion: The reconstruction of TMJ with free fibular flap was reliable methods and very effective means of restoring mandibular function. The functional and morphologic results were excellent and showed little complications.

Monolithic zirconia framework으로 제작된 fixed detachable prostheses를 이용한 심미적인 임플란트 전악 수복 증례 (Esthetic Full Zirconia Fixed Detachable Implant-Retained Restorations Manufactured from Monolithic Zirconia : Clinical Report)

  • 홍준태;최유성;한세진;조인호
    • 구강회복응용과학지
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    • 제28권3호
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    • pp.253-268
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    • 2012
  • 수직적, 수평적 골흡수가 심한 환자에서 임플란트를 이용한 전악수복의 경우 경조직과 연조직 이식을 통해서 임플란트를 원하는 위치에 식립할 수도 있지만, 치은과 치아의 기능과 심미를 회복할 수 있는 fixed detachable prostheses를 대체 술식으로 사용할 수도 있다. 이러한 증례에서 다양한 재료가 수복물의 제작에 사용 가능하지만, metal/acrylic 보철물에서는 레진치아의 파절 및 탈락이 일어날 수 있고, metal/ceramic 혹은 zirconia/ceramic 보철물에서는 도재의 chipping이나 파절과 같은 문제가 발생할 수 있다. 이에 최근에 심미적이면서도 기능적인 보철수복을 위해 zirconia에 도재를 축성하지 않고 임상적으로 적용가능한 monolithic zirconia framework이 출시되어 사용되고 있다. 본 임상 증례는 심미적인 요구도가 높은 완전 무치악 환자에서 임플란트를 식립하고 chipping이나 파절의 위험을 감소시키기 위해 monolithic zirconia framework을 이용해 만들어진 complete fixed detachable 보철물을 이용한 수복에 대해 보고하고자 한다. 이번 증례에서 보철물은 심미적, 기능적으로 만족스러웠으며, 2년 간의 정기검사에서 임상적인 합병증은 보고되지 않았다.

($IL-1{\beta}$), PDGF-BB 그리고 $TGF-{\beta}$가 사람 배양 치주인대 섬유모세포의 PDLs17 mRNA의 발현에 미치는 영향 (The Effect of Interleukin $1-{\beta}$, Platelet Derived Growth Factor-BB and Transforming Growth $Factor-{\beta}$ on the expression of PDLs17 mRNA in the Cultured Human Periodontal Ligament Fibroblasts)

  • 임기정;한경윤;김병옥;임창엽;박주철
    • Journal of Periodontal and Implant Science
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    • 제31권4호
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    • pp.787-801
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    • 2001
  • The molecular mechanisms control the function of PDL(periodonta1 ligament) cells and/or fibroblasts remain unclear. PDLsl7, PDL-specific gene, had previousely identified the cDNA for a novel protein from cultured PDL fibroblasts using subtraction hybridization between gingival fibroblasts and PDL fibroblasts. The purpose of this study was to determine the regulation by growth factors and cytokines on PDLsl7 gene expression in cultured human periodontal ligament cells and observe the immunohistochemical localization of PDLsl7 protein in various tissues of mouse. Primary PDL fibroblasts isolated by scraping the root of the extracted human mandibular third molars. The cells were incubated with various concentration of human recombinant $IL-1{\beta}$, PDGF-BB and TGF\;${\beta}$ for 48h nd 2 weeks. At each time point total RNA was extracted and the levels of transcription ere assessed by reverse transcription-polymerase chain reaction (RT-PCR assay). polyclonal antiserum raised against PDLsl7 peptides, CLSVSYNRSYQINE and SEAVHETDLHDGC, were made, and stained the tooth, periodontium, developing bone, bone marrow and mid-palatal suture of the mouse. The results were as follows. 1. PDLsl7 mRNA levels were increased in response to PDGF (10ng/ml) and $TGF\;{\beta}$(20ng/ml) after treatment of the $IL-1{\beta}$, PDGF-BB and $TGF{\beta}$for 48 h. 2. PDLsl7 was up-regulated only by $TGF{\beta}$(20 ng/ml) after treatment of the $IL-1{\beta}$, PDGF-BB and $TGF\;{\beta}$ for 2 weeks and unchanged by the other stimulants. 3. PDLsl7 was a novel protein coding the 142 amino acid peptides in the ORF and the nucleotide sequences of the obtained cDNA from RT-PCR was exactly same as the nucleotides of the database. 4. Immunohistochemical analysis showed that PDLsl7 is preferentially expressed in the PDL, differentiating osteoblast-like cells and stromal cells of the bone marrow in the adult mouse. 5. The expression of PDLsl7 protein was barely detectable in gingival fibroblasts, hematopoetic cells of the bone marrow and mature osteocytes of the alveolar bone. These results suggest that PDLsl7 might upregulated by PDGF-BB or $TGF{\beta}$ and acts at the initial stage of differentiation when the undifferentiated mesenchymal cells in the bone marrow and PDL differentiate into multiple cell types. However, more research needs to be performed to gain a better understanding of the exact function of PDLsl7 during the differentiation of bone marrow mesenchymal and PDL cells.

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