• 대한치과보철학회지
• /
• 제36권2호
• /
• pp.245-257
• /
• 1998

This study was performed to measure the changes of the mandibular movement and the masticatory muscular activities - anterior temporal and masseter muscle of both side - reflected by intentional increase of anterior guidance angie. For this study, 5 volunteers (3 males and 2 females with average age of 24.0) were selected. Each volunteer had Angle's classification I and did not have any missing tooth except third molar and any extensive restorations. Metallic guide plate was made at volunteer's working model fabricated by improved dental stone and cemented to the palatal surface of maxillary central incisor using resin cement(Panavia $21^{(R)}$) and then adjusted not to give any occlusal interferences at intercuspal position. The activity of masticatory muscles and the changes of mandibular movement were recorded by EMG and Sirognathograph in Biopak analysing system(Bioresearch Inc., Milwaukee, Wisconsin, USA). Measurement was done at before experiment, immediatley after placement, 1 week after placement, immediately after removal, and 1 week after removal. The results were as follows: 1. Moderate phonetic disturbance and mild headache were occured to 3 volunteers for 2 days after setting and 1 volunteer had positive reaction to percussion and slight midline diastema. But all of these clinical signs were diappeared 1 week after removal and the other volunteer did not have any special clinical sign. 2. In the EMG of the mandibular rest position, the mean value of anterior tempotal muscle was increased immediately after placement(p<0.01) and then decreased 1 week after placement(p<0.05) and increased 1 week after removal(p<0.05) but not recovered as before experiment. The mean value of masseter muscle was decreased during the experiment period. 3. In the EMG during mandibular protrusive movement, all muscular activity was decreased during the experiment period. Reduced activity was not recovered 1 week after removal(p<0.03). 4. During the habitual opening, anteroposterior movement of mandible was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not statistically significant(p>0.1). Vertical movement was not shown significant difference during the experiment period(p>0.1). Lateral movement was decreased immediately after placement(p<0.05) and then increased 1 week after placement but not recovered as before experiment. The opening and closing velocity of mandible was shown minor changes but not statistically significant. 5. During the habitual opening, anteroposterior movement of mandible was decreased 1 week after placement(p<0.05) and then increased immediately after removal and recovered 1 week after removal as before experiment. Vertical movement was not shown significant changes. Lateral displacement of mandible was increased continuously and recovered 1 week after removal. Opening velocity was temporarily increased immediately after removal but recovered and closing velocity was not shown significant changes. 6. During the right side chewing, anteroposterior movement of mandible was increased immediately after removal but recovered and vertical movement was not shown statistically significant results. Lateral displacement and velocity of mandible were not shown significant results. 7. During the left side chewing, the changes of mandibular movement pattern were not shown statistically significant results.

• Journal of Oral Medicine and Pain
• /
• 제38권3호
• /
• pp.247-253
• /
• 2013

신성골이영양증 (Renal osteodystrophy)은 만성 신질환 환자에서 관찰되는 골격성 변화를 특징으로 하는 질환으로 칼슘과 인 대사의 변화, 그리고 이차성 부갑상선 기능항진증의 결과로 나타난다. 방사선학적으로 지골의 말단, 장골과 악골 부위의 골막하 부위의 침식을 흔하게 관찰할 수 있다. 악안면 영역에서 골변화는 골밀도의 감소, 방사선 투과성 병소 (갈색 종양 : brown tumor), 피질골의 비박화와 치조백선의 소실을 보인다. 그러나 이러한 골변화가 악관절에 발생하는 것은 흔치 않은 일이다. 본 증례는 양측 하악 과두의 골변화를 보인 신성골이영양증 환자를 보고하고자 한다. 지난 10년 간 혈액 투석 치료와 3개월 전 신장암 수술 병력이 있는 41세 남자 환자가 좌측 턱의 통증을 주소로 2011년 2월 단국대학교 치과대학부속 치과병원 구강내과에 내원하였다. 양측 악관절의 골관절염과 유사한 방사선학적 소견을 보였고, 전치부 개방교합이 관찰되었다. CBCT를 이용한 방사선학적 특징과 생화학적 지표를 통해 신성골이영양증으로 인한 양측 턱관절의 골관절염으로 진단 되어 환자는 내과에서 신성골이영양증의 치료 방법의 하나인 칼슘 및 비타민 D 복용고 부갑상선 절제술을 시행 받았고, 그 동안 턱관절의 통증 조절을 위해 본원에서는 행동 요법과 약물 치료, 물리치료만 시행하였다. 약 1년 3개월 후 재검사에서 하악골의 골밀도와 피질골 두께가 증가하였고, 하악 과두 외형이 비교적 명확하게 바뀌었다. 골변화는 만성 신장 질환의 초기 단계부터 시작되므로 치과의사는 이러한 질환의 징후 및 가능성을 신속히 감별할 수 있어야 한다. 또한 골관절염과 신성골이영양증의 치료 프로토콜이 다르기 때문에 두 질환을 감별하는 것이 중요하다.

• Journal of Oral Medicine and Pain
• /
• 제18권2호
• /
• pp.43-53
• /
• 1993

The aim of this study was to investigate the relationship between the presence or absence of anterior tooth contact and the changes in temporomandibular joint space. The study sample consisted of 32symptom-free dental students and 79 craniomandibular disorders patients with unilateral joint dysfunction. The two groups were categorized into control group or experimental group, respectively. Recordings of the number and distribution of occlusal contacts were made by T-Scan system. Transcranial radiographs were taken with using of accurad-100 head positioner. Measured items in transcranial radiographs were anterior, superior, posterior joint space and relative condylar position to deepest position of glenoid folla. According to the presence or absence of anterior tooth contact, each group was subdivided and compared with each other with respect to TM joint space. Data were processed and tested with SPSS/PC + package. The results of the study showed that the joint space in control group were wider than those of experimental group and the difference of the width of joint space was more remarkable in subjects with anterior contact between control group and experimental group. However, in same group whether the presence of anterior tooth contact could hardly affect the difference of the width of joint space. And anterior tooth contact in grouip are more frequent than in experimental group.

• 대한장애인치과학회지
• /
• 제9권2호
• /
• pp.118-121
• /
• 2013

과잉 소구치는 장애 환자에서 교정적 문제를 일으켜 구강 위생 관리의 어려움을 초래할 수 있는데 발생 시기가 늦고 병리학적 문제의 발생 가능성이 낮으며 재발의 가능성이 높으므로 발거 시기를 전체 영구치열이 완전한 성숙을 이룬 후로 미루어야 하며 매복되어 있어 특이할 만한 합병증이 발견되지 않는 경우, 수술적 위험성을 감수하기보다는 남겨 두는 것을 추천한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제39권1호
• /
• pp.35-40
• /
• 2013

Osteochondroma is a common benign tumor of the axial skeleton, especially in the distal metaphysis of the femur and the proximal metaphysis of the tibia, that can occur on the facial skeleton (albeit rarely). Osteochondroma is differentiated from chondroma, osteochondromatosis and osteoma. Osteochondroma shows an irregular radiopaque lesion and chondromatic area surrounded by the osteoma. When it develops in the long bone, it has a marked tendency to occur at 10 to 20 years of age and ceases with the end of pubertal growth. However, when it develops in the mandibular condyle, it is prevalent in the third decade and continuous to develop. Tumors that develop in the long bone have a predilection for men, but tumors in the mandible have a predilection for women. In osteochondroma of the mandibular condyle, clinical features presented include occlusal changes, facial asymmetry, headaches, pain and joint noise on the temporomandibular joint, mouth opening limitations, and jaw deviation at the involved site. The first choice of treatment for the massive osteochondroma is surgical removal. A 70-year-old female patient with an osteochondroma on her right mandibular condyle visited our clinic. We surgically removed the mass with favorable results. It is presented here along with a review of literature on osteochondroma.

• Journal of Oral Medicine and Pain
• /
• 제32권1호
• /
• pp.69-79
• /
• 2007

하악과두 흡수(condylar resorption)는 하악과두 용해라고도 하며 과두형태변화와 크기 감소가 점진적으로 또는 갑작스럽게 일어나는 것으로 정의할 수 있다. 원인은 잘 알려져 있지 않지만 류머티스 관절염, 전신성 홍반성 낭창, 스테로이드 복용(usage), 교정치료, 악교정 수술후 일어나는 과두흡수(secondary condylar resorption)와 특별한 원인 없이 일어나는 특발성 과두흡수(primary condylar resortion)로 나눌 수 있다. 이러한 하악과두 흡수가 발생하는 경우에는 골소실로 인해 이환측 과두에서 후방 지지의 갑작스런 상실이 초래된다. 이로인해 하악이 변위될수 있으며 교합변화, 개방교합과 같은 교합변화와 하악의 후퇴가 나타날 수 있다. 이에 저자는 하악과두 흡수가 일어난 증례를 보고하며 과두흡수와 관련된 인자, 병리기전, 환자관리에 대해 고찰하고자 한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제43권5호
• /
• pp.331-335
• /
• 2017

Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

• 대한치과보철학회지
• /
• 제36권4호
• /
• pp.533-548
• /
• 1998

The purpose of this study was to investigate the influence of balancing interference on the mandibular movement and masticatory muscle activity. 5 subjects(male. average age of 24.3) without dysfuction in masticatory system were selected. The balancing interference was provided by construction of cast metal crown and onlay on the upper and lower first molars. Clinical examination, changes displacement and velocity, and muscle activity were recorded and analyzed by means of BioPak system(Bioresearch Inc., Milwaukee Wisconsin. USA). The results were as follows ; 1. In clinical examination, various symptoms were reported by all subjects after application of interference. Almost symptoms were subsided after elimination of interference. 2. In the border movements in frontal plane, lateral border movement toward non-interference side was changed according to the interference after application of interference. Immediately after removal of interference, border movements' pattern was recovered as same as before experiment. 3. During gum chewing on the non-interference side, horizontal movement was decreased immediately after application of interference(p<0.05). 1 week after application of interference, horizontal movement was more decreased in 3 subjects and showed a chopping type masticatory stroke. But in 2subjects, horizontal movement was increased to avoid interference. 4. In EMG of the mandibular rest position, no significant changes were showed in the experiment period(p>0.05). 5. During gum chewing on the interference side, the activity of opposite temporal muscle was increased immediately after application of interference(p<0.05). 1 week after application of interference. The activity of ipsilateral temporal muscle and left and right masseter muscles was increased (p<0.05). 1 week after elimination of interference, increased muscle activity was recovered about the same level as before experiment. 6. During gum chewing on the non-interference side, 1 week after application of interference, the activity of ipsilateral temporal muscle was increased (p<0.05). 1 week after elimination of interference. increased muscle activity was returned about the same level as before experiment.

• 치과방사선
• /
• 제17권1호
• /
• pp.123-135
• /
• 1987

The author observed the effects of retrograde infusion of water soluble contrast media (Tele- brix 30) on the rabbit submandibular glands and compared the effects of different degrees of filling. 26 rabbits were divided into 2 groups of 12 each as experimentals and I group of 2 as normal controls. One experimental group was filled with 0.2㎖ and the other with 0.4㎖. Right submandibular gland of each rabbit was infused with contrast media and left one with physiologic saline as a experimental control, at a constant rate of 0.12㎖/min. using an infusion pump via the main excretory duct. Immediately after the infusion of contrast media, oblique lateral radiographs of the glands were made with occlusal film in order to confirm the glandular filling. The rabbits were sacrificed after varying periods (1, 8, 24 hours and 3, 6, 10 days) and the tissues were prepared for light and electron microscopic examination. The results were as follows: 1. In glands filled with 0.2㎖ contrast media, the initial changes were a few vacuole formation in the acini and slight dilation of the intralobular duct. The moderately severe changes such as vacuole formation in the acini, the abnormal substructure within the secretory granule, dilation of acinar and intercalated duct lumen, scalloping of striated duct lumen and inflammatory cell infiltrate were observed at 3 days. The general appearance was successively recovered, so the tissue had a normal appearance at 10 days. 2. In glands filled with 0.4㎖ contrast media, the most prominent alterations such as severe acinar atrophy, decreased number of secretory granules, proliferation of connective tissue stroma and pronounced inflammatory cell infiltrates appeared at 6 days. Although the general appearance returned to be almost normal at 10 days, acinar cells showed some atrophy and decreased secretory granules. 3. In glands subjected to 0.4㎖ infusion, the alterations were more severe and the recovery was slower than those seen in the glands to 0.2㎖ infusion.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제41권
• /
• pp.48.1-48.7
• /
• 2019

Background: Soft tissue asymmetry such as lip canting or deviation of the philtrum is an important influencing factor for unbalanced facial appearance. Lip canting could be improved by the correction of the occlusal canting or positional change of the mentum. Although there are many studies about changes of lip canting, however, postoperative changes of philtrum deviation have not been yet reported. In this study, we investigate the positional change of the philtrum after orthognathic surgery and influencing factors. Methods: Positional change of the philtrum was evaluated in 41 patients with facial asymmetry who underwent bimaxillary surgery, in relation to other anatomical soft tissue landmarks using a frontal clinical photo. The surgical movement of the maxillary and mandibular dental midline and canting were measured in postero-anterior cephalogram before and 1 day after surgery. The same procedure was repeated in patients with more than 1.5 mm perioperative change of the mandibular dental midline after bimaxillary surgery. Results: Maxillary dental midline shifting and canting correction did not have a significant correlation with lateral movement of the philtrum midline. However, the mandibular shift had a statistically significant correlation with a lateral movement of the philtrum (p < 0.05) as well as other linear parameters and angle values. Conclusion: The horizontal change of the philtrum is influenced by lateral mandibular movement in patients with facial asymmetry, rather than maxillary lateral movement.