• 구강회복응용과학지
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• 제28권3호
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• pp.277-290
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• 2012

최근 치과 임플란트는 구강 내 무치악 부위의 보편적인 수복 방법으로 임상가 뿐만 아니라 환자들에게도 널리 인식되어 있다. 외상, 만성 치주염 등 다양한 원인에 의해 상악 전치부는 발치 후 급속한 순측 골흡수가 진행될 수 있다. 그로 인해 협소한 순구개 폭경을 가진 상악 전치부 치조제 상에 임프란트 식립 시 열개 및 천공형 골결손이 발생할 수 있다. 이 경우 골유도 재생술을 사용하여 상악 전치부 치조제를 증강시킬 수 있다. 골유도 재생술시 골이식재에 조직 접착제를 혼합하여 기계적 및 생물학적 이점을 얻을 수 있다. 본 증례에서는 순설 폭경이 얇은 상악 전치부 치조제 상에 임플란트 식립에 의한 열개 및 천공형 골결손 발생시 자가골을 제외한 동종골, 이종골, 그리고 합성골 입자형 골이식재 등을 다양하게 조합한 후 조직 접착제와 혼합하여 골유도 재생술을 진행하였다. 모든 증례에서 양호한 치조제 증강을 보였음에 보고하는 바이다.

• Journal of Trauma and Injury
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• 제37권3호
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• pp.220-223
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• 2024

The nasotracheal tube (NTT) is frequently used in oral and maxillofacial surgery and is generally considered a safe means of protecting the airway while ensuring an adequate surgical field. The most common complication associated with NTT is epistaxis, and only a few cases of foreign body obstruction have been reported. In this case report, the authors aimed to highlight the potential for NTT obstruction following surgery. A 24-year-old female patient, who underwent mandibuloplasty and rhinoplasty at a local clinic, was referred to our hospital patient due to dyspnea and edema on her right mandibular angle. Even with NTT, patient continued to experience mild dyspnea and tachypnea, so a T-piece was applied. However, tachycardia accompanied by a sudden worsening of dyspnea was observed, and bag-valve-mask ventilation was initiated promptly. But oxygen saturation remained unimproved, so an emergency cricothyroidotomy was performed. After 4 hours, the patient's condition stabilized. Upon examination, the previously inserted NTT was identified, and a blood clot approximately 10 cm long at the NTT tip was discovered, causing lumen obstruction. The obstructions of NTT can lead to serious or life-threatening consequences if left unobserved or ignored. Therefore, when a patient with an NTT complains of dyspnea, clinicians should promptly investigate the possibility of partial NTT obstruction to ensure the airway's security.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권3호
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• pp.189-199
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• 2006

Purpose of study: Partial thickness skin graft is the golden standard regimen for full-thickness skin defect caused by burn or trauma. However, in case of extensive burns of more than 50% of total body surface area, the donor site is not sufficient to cover all defects. As a second choice, allograft, xenograft and synthetic materials have been used to treat skin defect. Among them the amniotic membrane(AM) was used as a biological dressing for centuries because of its potential for wound healing. In this study, quantification of EGF in AM and effect of AM-collagen complex on full thickness skin defects was examined. Materials & Methods: The concentration of EGF in fresh, deep frozen and freeze-dried AM was evaluated by ELISA. EGF-R immunostaining was performed in freeze-dried AM. SD rats weighing 250${\sim}$300g was used for wound healing experiment. Three full thickness skin defects(28mm diameter) were made on dorsal surface of SD rat. The control group was covered by Vaselin gauze and AM-collagen complex and $Terudermis^{(R)}$. was grafted in two other defects. Healing area, Cinamon's score were evaluated before biopsy. Grafted sites were retrieved at 3 days, 1 week, 2 weeks and 4 weeks after operation. H & E and Factor VIII immunohistochemical stain was performed to evaluate the microscopic adhesion and structural integrity and microvessel formation. Results: 1. EGF concentration of fresh, deep frozen and freeze-dried AM showed similar level and EGF-R was stained in epithelial layer of freeze-dried AM. 2. At 4 weeks after grafting, the healing area of AM-collagen and Terudermis group was 99.29${\pm}$0.71% and 99.19${\pm}$0.77 of original size. However, that of control group was 24.88${\pm}$2.90. 3. The Cinamon's score of AM-Collagen and $Terudermis^{(R)}$. group at 4 weeks was 15.6${\pm}$1.26 and 14.6${\pm}$3.13 and that of control group was 3.7${\pm}$0.95. Significant difference was observed among control and experimental groups(p<0.05). 4. Histologic examination revealed that AM protected leukocyte infiltration and epithelial migration was nearly completed at 4 weeks. $Terudermis^{(R)}$. group showed mild neutrophil infiltration until 2 weeks and completion of epithelization at 4 weeks. Control group showed massive leukocyte infiltration until 4 weeks. 5. Microvessels were increased sharply at 1 week and control group at 1 and 4 week showed significant differences with $Terudermis^{(R)}$. group of same interval(p<0.05) but no differences were found with AM group(p<0.05). Conclusion: EGF and EGF-R were well preserved in freeze-dried AM. AM attached to collagen acted as excellent biologic dressing which had similar effect with $Terudermis^{(R)}$. AM showed anti-inflammatory action and healing was completed at 4 weeks after full-thickness skin defect.

• Imaging Science in Dentistry
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• 제44권3호
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• pp.177-183
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• 2014

Recent research in endodontics has highlighted the need for three-dimensional imaging in the clinical arena as well as in research. Three-dimensional imaging using computed tomography (CT) has been used in endodontics over the past decade. Three types of CT scans have been studied in endodontics, namely cone-beam CT, spiral CT, and peripheral quantitative CT. Contemporary endodontics places an emphasis on the use of cone-beam CT for an accurate diagnosis of parameters that cannot be visualized on a two-dimensional image. This review discusses the role of CT in endodontics, pertaining to its importance in the diagnosis of root canal anatomy, detection of periradicular lesions, diagnosis of trauma and resorption, presurgical assessment, and evaluation of the treatment outcome.

• Imaging Science in Dentistry
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• 제44권4호
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• pp.315-320
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• 2014

Root resorption is loss of dental hard tissue as a result of clastic activities. The dental hard tissue of permanent teeth does not normally undergo resorption, except in cases of inflammation or trauma. However, there are rare cases of tooth resorption of an unknown cause, known as "idiopathic root resorption". This report would discuss a rare case of multiple idiopathic resorption in the permanent maxillary and mandibular teeth of an otherwise healthy 36-year-old male patient. In addition to a clinical examination, the patient was imaged using conventional radiography and cone-beam computed tomography (CBCT). The examinations revealed multiple external and internal resorption of the teeth in all four quadrants of the jaws with an unknown cause. Multiple root resorption is a rare clinical phenomenon that should be examined using different radiographic modalities. Cross-sectional CBCT is useful in the diagnosis and examination of such lesions.

• 대한치과기공학회지
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• 제44권3호
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• pp.89-96
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• 2022

Purpose: The purpose of this study was to investigate the types of mouthguards athletes who play contact sports use as well as their perceived discomfort of wearing them in order to analyze the relationship with wearing frequency so as acquire basic data for the development of more user-friendly mouthguards. Methods: The participants, who completed a self-report questionnaire, included 70 contact sports athletes, including high school contact (rugby and boxing) sport department affiliated athletes located in the city of Daejeon. Results: Breathing (p<0.01), fitting (p<0.05), ease of wearing (p<0.01), occlusion (p<0.05), and fatigue in muscles (p<0.05) were positively correlated with wearing frequency. Furthermore, the recognition of the mouthguards was not significantly correlated with wearing frequency. Conclusion: To prevent oral and maxillofacial trauma, multi-directional studies are imperative to develop mouthguards, which are comfortable and cost-efficient.

• 대한치과의사협회지
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• 제50권5호
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• pp.256-261
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• 2012

Temporomandibular joint (TMJ) prosthesis have been hesitated to use because of bitter memories about Proplast-Teflon interpositional TMJ implants. Many clinicians, however, are trying to use total TMJ prosthesis with getting continuous long-term follow-up results. Alloplastic total TMJ replacement have been applied to much more patients who have failed previous TMJ prostheses or TMJ implants, fibrous/bony ankylosis, severe osteoarthritis, degenerative joint disease, idiopathic condylar resorption, condyle loss by trauma or tumor resection, and other bony destructive diseases. Nowadays three types of total TMJ prosthesis are widely used. In this article, indications, types of prosthesis, safety and stability would be demonstrated with a case report.

• Imaging Science in Dentistry
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• 제42권3호
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• pp.147-154
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• 2012

Purpose: This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. Materials and Methods: The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. Results: The periapical radiographs of 564 teeth showed that the average root resorption was $1.39{\pm}1.27$ ($8.24{\pm}7.22$%) and $1.69{\pm}1.14$ mm ($10.16{\pm}6.78%$) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. Conclusion: These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

• 대한두개안면성형외과학회지
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• 제20권3호
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• pp.212-216
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• 2019

Zygomaticomaxillary complex (ZMC) fractures account for a substantial proportion of trauma cases. The most frequent complications of maxillofacial fracture treatment are infections and soft tissue flap dehiscence. Postoperative infections nearly always resolve in response to oral antibiotics and local wound care. However, a significant infection can cause a permanent fistula. A 52-year-old man visited our clinic to treat an oroantral fistula (OAF), which was a late complication of a ZMC fracture. Postoperatively, the oral suture site dehisced, exposing the absorbable plate. However, he did not seek treatment. After 5 years, an OAF formed with a $2.0{\times}2.0cm$ bony defect on the left maxilla. We completely excised the OAF, harvested a piece of corticocancellous bone from the iliac crest, inserted the harvested bone into the defect, and covered the soft tissue defect with a buccal mucosal transposition flap. Although it is necessary to excise OAFs, the failure rate is higher for large OAFs (> 5 mm in diameter) because of the extensive defect in the underlying bone that supports the overlying flap. Inappropriate management of postoperative wounds after a ZMC fracture can lead to disastrous outcomes, as in this case. Therefore, proper postoperative treatment and follow-up are essential.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.679-700
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• 1996

Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.