• 제목/요약/키워드: Tissue displacement

검색결과 185건 처리시간 0.021초

특발성 치은 섬유종증에 의한 상악 측절치의 변위 (DISPLACEMENT OF MAXILLARY LATERAL INCISOR CAUSED BY IDIOPATHIC GINGIVAL FIBROMATOSIS)

  • 정지숙;박호원;이주현;서현우;이석근
    • 대한소아치과학회지
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    • 제38권3호
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    • pp.296-302
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    • 2011
  • 특발성 치은 섬유종증은 드물게 나타나는 질환으로 외과적 제거 후에도 쉽게 재발될 수 있다. 이 질환은 보통 전반적인 양상으로 양측성으로 나타나고, 때때로 국소적인 양상으로 편측성으로 나타나기도 하며, 국소적인 양상일 경우 보통 상악구치 부나상악 결절 부위에 나타난다. 이 질환으로 인해 치아 변위, 부정 교합, 저작, 발음, 심미적인 문제 등이 발생할 수 있다. 5세 남아가 상악 우측 유측절치 부위의 치은 비대를 주소로 내원하였고, 9세경에 재내원 시 상악 우측 측절치의 심한 변위가 관찰되었다. 본 환아는 이 질환에 연관된 어떠한 의과적 병력 및 가족력이 없었으며, 임상적, 조직병리학적 검사 결과 특발성 치은 섬유종증으로 진단되었다. 교정적인 방법으로 변위된 치아를 재배열시키기 위해 상악 우측 중절치와변위된상악 우측 측절치 부위의 과증식된섬유성 조직을 외과적으로 제거하였다. 이 질환의 유전적 특성을 알기 위해 제거된 조직을 간단한 면역조직화학 배열법을 사용해 평가하였다. 평가 결과 병소 조직의 각질세포, 섬유모세포, 내피세포, 대식세포 내에 CTGF, HSP-70, MMP-1, PCNA, CMG2, TNF-${\alpha}$의 증가된 발현이 관찰되었다. 따라서 치은 섬유종증은 치은 조직의 섬유 상피성 증식과 염증 반응에 의한 CTGF, HSP-70, MMP-1, PCNA, CMG2, TNF-${\alpha}$의 수반하는 과발현에 의해 발생되었다.

근관치료를 받은 전치부에서 수복방법과 치조골높이에 따른 응력분석에 관한 연구 (STRESS ANALYSIS OF ENDODONTICALLY TREATED ANTERIOR TEETH BY ALVEOLAR BONE HEIGHT AND RESTORATION METHOD)

  • 이연재;조영곤
    • Restorative Dentistry and Endodontics
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    • 제16권1호
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    • pp.133-150
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    • 1991
  • To study the mechanical behavior depended on the restoration method and alveolar bone height at endodontically treated teeth. a finite element model was made which was applied by four types of restoration methods and alveolar bone height on upper central incisor and then 1 Kg force was applied on each model as follows; 1) $45^{\circ}$ diagonal load on incisal edge. 2) $26^{\circ}$ diagonal load on lingual surface. and 3) horizontal load on labial surface. The author analyzed the displacement and stress of teeth and their supporting tissue by finite element method according to three type of loading conditions. The results were as follows : 1. The displacement by restoration method and the stress in dentin was found greater in restoration without a post than in that with a post. 2. The displacement and stress was found about the same when compared : A) in Resin model and PFM model applied by restoration method without a post and B) in PRC model and CPC model applied by restoration method with a post. 3. The lower alveolar bone height was. the greater was the displacement and stress. 4. The lower alveolar bone height was. the greater slightly was the stress of restoration without a post than in that with a post. 5. The stress in loading condition was the greatest in P1 in dentin and post. and was greatest in P3 in alveolar hone. 6. In the restoration method without a post. stress concentration in labial dentin was distributed to a figure of long belt in adjacent part to periodontal ligament. while in restoration method with a post. it was distributed in adjacent part to post side. And in all types of restoration method stress concentration in alveolar bone was distributed along the compact bone of labial and lingual surface.

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후방까지 연장된 안와하벽골절에서 안구함몰 예방을 위한 Medpor® 내고정술 (Internal Fixation of Medpor® Implant for Prevention of Enophthalmos in Posteriorly Extended Orbital Floor Fracture)

  • 석정훈;지소영;김태범;양완석
    • 대한두개안면성형외과학회지
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    • 제9권2호
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    • pp.55-61
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    • 2008
  • Purpose: The purpose of this study is to evaluate the effectiveness of internal fixation method of $Medpor^{(R)}$ implant with $BioSorb^{TM}FX$ screw which is used for prevention of enophthalmos in posteriorly extended large orbital floor fracture. Methods: From Jun. 1997 to Dec. 2007, 21 patients who were diagnosed with posteriorly extended large orbital floor fractures were classified into two groups. One group(n=11) had undergone reduction surgery with regular $Medpor^{(R)}$ sheets without any fixation method, while the other group(n=10) had their $Medpor^{(R)}$ sheets fixed with the $BioSorb^{TM}FX$ screws. The two groups were evaluated by comparison of their enophthalmos degree and effectiveness. Results: In the non-fixation group, six patients had enophthalmos preoperatively and three of them showed persistent enophthalmos postoperatively. In postoperative CT examination, displacement of $Medpor^{(R)}$ implant with soft tissue impaction into maxillary sinus was observed in the patients. In the screw fixation group, three patients had enophthalmos preoperatively, but none of them suffer from complication such as residual enophthalmos, soft tissue impaction, muscle entrapment or optic nerve compression postoperatively. Conclusion: Internal fixation method of $Medpor^{(R)}$ implant with $BioSorb^{TM}FX$ screw on the medial surface of orbital floor provides firm stabilization of implants and surrounding soft tissues and can be an effective option especially when postoperative implant displacement or malposition was expected.

가상적 수직 교합 고경 증가 시 안모의 유형에 따른 하안모 변화에 관한 연구 (A study of lower facial change according to facial type when virtually vertical dimension increases)

  • 김남우;이긍철;문철현;배정윤;김지연
    • 대한치과보철학회지
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    • 제54권1호
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    • pp.1-7
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    • 2016
  • 목적: 수직 교합 고경 증가 시 발생하는 하안모의 변화가 안모의 유형에 따라 어떤 차이가 있는 지 평가하여, 임상적으로 유의하여야 할 안모 유형을 알고자 한다. 대상 및 방법: 진단을 위해 측모두부규격방사선사진을 촬영한 환자 중 261명을 추출하여 그 대상으로 하였다. 시상적 안모 패턴은 Class I, II, III로 분류하였고, 수직적 안모 패턴은 hypodivergent, normodivergent, hyperdivergent로 나누어 환자를 9가지 집단으로 분류하였다. 각각의 환자를 가상적 시뮬레이션 프로그램을 이용하여 하악 중절치 기준 2 mm 수직 교합 고경을 증가시킨 후 연조직 Pogonion의 후방 이동량, 연조직 Menton의 하방 이동량을 측정한 후 연조직 Pogonion의 후방 이동량/연조직 Menton의 하방 이동량의 비율을 구하여 9가지 집단별로 어떤 차이가 있는 지 서로 비교하였다. 비교분석은 2-way ANOVA로 검정하고 사후 분석은 Tukey test를 이용하였다. 모든 검정은 유의수준 5%에서 수행되었다. 결과: 연조직 Pogonion의 후방 이동량은 Class I, II, III 간의 비교에서는 Class III 집단에서, hypodivergent, normodivergent, hyperdivergent 간의 비교에서는 모든 집단에서 통계적으로 유의한 차이를 보였다(P<.05). 연조직 Menton의 하방 이동량은 Class I, II, III 및 hypodivergent, normodivergent, hyperdivergent 집단에서 모두 통계적으로 유의한 차이를 보였다(P<.05). 연조직 Pogonion의 후방 이동량 대 연조직 Menton의 하방 이동량 비율은 Class I, II, III 및 hypodivergent, normodivergent, hyperdivergent 집단에서 모두 통계적으로 유의한 차이를 보였으며(P<.05) 9가지 집단 중 Class II & hyperdivergent 집단에서 가장 크게 나타났다. 결론: 수직 교합 고경의 증가 시 시상적 안모의 패턴 및 수직적 안모의 패턴에 따라 하안모의 변화는 유의한 차이가 있었으며, Class II & hyperdivergent 얼굴 패턴을 가진 환자는 수직 교합 고경 증가가 동반되는 치료 시 다른 유형에 비해 하안모의 변위량이 클 수 있다.

측두하악관절 장애 환자에서 관절원판후조직의 에스트로겐 수용체(ER)의 단백 발현 (EXPRESSION OF ESTROGEN RECEPTORS IN RETRODISCAL TISSUE OF THE TEMPOROMANDIBULAR JOINT DISORDER PATIENTS)

  • 김종윤;임재형;박광호;김형곤;허종기
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권6호
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    • pp.403-410
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    • 2009
  • Those composing temporomandibular joint (TMJ) complex such as the temporal bone, the disc and the mandibular condyle perform their own functions with organic relation. The retrodiscal tissue is the main area of pain induction and contributes to compositional change of synovial fluid. If displacement of the disc lasts long time, not only adaptive changes, but also destructive or degenerative changes may happen. It was reported that these changes and symptoms appear mostly to female rather than male and especially, in the case of patients suffering from TMJ disorder, a large quantity of female sex hormone is found in the joint synovium. And that may play a role in bone resorption and inflammation. Also, the frequency and the intensity of pain perception for female is reported to be much more than for male. In this study, we investigated the expression extents of estrogen receptors (ER) and progesteron receptors (PR) in retrodiscal tissue with immunohistochemistry among the patients received TMJ surgery and compared with MRI findings and surgical findings. We report the relations between the expression of ER in retrodiscal tissue and the pathological change in TMJ, such as inflammation, internal derangement and osteoarthritis.

역 L 형 절골술과 Liou 신연기를 이용한 넓은 치조열의 교정 (Correction of a Wide Alveolar Cleft with Reverse L osteotomy and Liou Alveolar Distractor)

  • 이명철;유대현;박병윤;권순만
    • Archives of Plastic Surgery
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    • 제36권4호
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    • pp.445-449
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    • 2009
  • Purpose: A successful surgical treatment for a wide alveolar cleft with bone graft is difficult to achieve due to several factors such as the limitation of gingivoperiosteal flap, the presence of large scar tissues, and the poor blood circulation. To overcome these problems, alveolar distraction osteogenesis using Liou alveolar distraction device was applied. We analyzed the consequences of this surgical treatment. Method: Between 2006 January and 2007 August, we have conducted analysis on the methods and consequences of Liou alveolar distraction osteogenesis for 6 patients. The age of patients was 12 years and 6 months in average. The follow up period was 19 months in average. The Reverse L osteotomy followed by the placement of the Liou alveolar distraction device was performed. After serial distraction, the distractor was removed after 5 months of the process of osteogenesis, and the result was analyzed using the computed tomography and the x-ray films of the alveolar bone and the teeth. Results: The alveolar cleft with 12.5 mm in average width was filled with 8.5 mm of newly formed bone tissue in average width after 5 months of osteogenesis. Among the 6 cases, 5 required the additional bone graft and 1 case only required the gingivoperioplasty. The newly formed bone tissues did not show any signs of bone resorption. However, a considerable degree of teeth displacement was shown. Conclusion: For the alveolar cleft too wide to be reconstructed by a general bone graft, it is strongly recommended to perform the reverse L osteotomy of the cleft side with Liou alveolar distraction device to initiate the alveolar osteogenesis. However, the migrated teeth showed some degree of relapse, thus, the orthodontic treatment is essential following the distraction osteogenesis treatment.

측두하악관절 주변인대 질환의 초음파영상 (Ultrasounds Image on the Disorders of the Ligaments Surrounding Temporomandibular Joints)

  • 홍수민;임영관;김병국
    • Journal of Oral Medicine and Pain
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    • 제33권4호
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    • pp.387-394
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    • 2008
  • 목적 : 측두하악장애 환자에서 고가의 자기공명영상 진단을 대신하여 상대적으로 경제적인 진단방법으로 고해상도 초음파 영상을 도입하는데 있어서 그 정확성과 유용성을 확인하고자 하였다. 방법 : 측두하악장애의 임상적 증상 중 과두걸림, crepitation과 함께 통증을 호소하는 20명의 환자를 대상으로 하였다. 고해상도 초음파 촬영을 시행하였고, 고해상도를 가진 초음파촬영시의 결과를 비교하기 위하여, 통상적인 방사선 사진인 측두하악관절의 횡두개 촬영을 Accurad X-200으로, 그리고 Dental CT를 촬영하였으며, 이를 임상소견과 더불어 비교항목으로 선택하였다. 고해상도 초음파의 진단학적 가지 평가를 위하여 통계학적으로 감수성, 특이성, 양성예상치, 음성예상치 및 정확도를 계산하였다. 결과 : 고해상도의 초음파 영상은 골관절염성 변화를 진단하는데 67.5%의 정확도를 보였으며, 관절원판의 위치변화를 진단하는데 92.5%를 보였으나, 관절 주변조직인 관절낭, 관절원판 후조직 그리고 주변 인대의 이상을 측정하는데 있어서 정확도가 55%를 나타내었다. 결론 : 향후 초음파 영상을 얻기 위한 적절한 기기의 발전과 고주파수의 transducer 등이 개발되고 시술자의 훈련과 경험이 쌓이게 되면 매우 우수한 그리고 비침습적이고 접근이 용이하며 경제적인 진단학적인 검사방법으로서 일반적인 도입이 가능할 것으로 사료된다.

구치 편측확장을 위한 Precision Lingual Arch 적용시 응력분포에 관한 유한요소법적 연구 (AN ANALYSIS OF STRESS DISTRIBUTION IN THE CASE OF UNILATERAL MOLAR EXPANSION WITH PRECISION LINGUAL ARCH BY FINITE ELEMENT METHOD)

  • 구본찬;손병화
    • 대한치과교정학회지
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    • 제24권3호
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    • pp.721-733
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    • 1994
  • Orthodontic tooth movement is closely related to the stress on the periodontal tissue. In this research the finite element method was used to observe the stress distribution and to find the best condition for effective tooth movement in the case of unilateral molar expansion. The author constructed the model of lower dental arch of average Korean adult and used $.032'\times.032'\times60mm$ TMA wire. The wire was deflected in the horizontal and vertical direction to give the 16 conditions. The following results were obtained ; 1. When the moment and force were controlled properly the movement of anchor tooth was minimized and the movement of moving tooth was maximized. 2. As the initial horizontal deflection increased the buccal displacement of both teeth was also increased. As the initial horizontal deflection increased the lingual movement of anchor tooth and the buccal movement of moving tooth increased. 3. When the initial horizontal and vertical deflection rate was 1.5 the effective movement of moving tooth was observed with minimal displacement of anchor tooth.

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Surgical Treatment of Olecranon Fractures

  • Koh, Kyoung-Hwan;Oh, Hyoung-Keun
    • Clinics in Shoulder and Elbow
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    • 제20권1호
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    • pp.49-56
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    • 2017
  • Since the olecranon fractures are caused by relatively low-energy injuries, such as a fall from standing height, they are usually found without comminution. Less commonly they can be developed by high-energy injuries and have severe concomitant comminution or injuries to surrounding structures of the elbow. Because the fracture by nature is intra-articular with the exception of some avulsion-type fracture, a majority of olecranon fractures are usually indicated for surgical treatment. Even if there is minimal displacement, surgical treatment is recommended because there is a possibility of further displacement by the traction force of triceps tendon. The most common type of olecranon fracture is displaced, simple non-comminuted fracture (that is, Mayo type IIA fractures). Although tension band wiring was the most widespread treatment method for these fractures previously, there is some trends toward fixation using locking plates. Primary goal of the surgery is to restore a congruent joint and extensor mechanisms by accurate reduction and stable fixation so that range of motion exercises can be performed. The literature has shown that good clinical outcomes are achieved irrespective of surgical fixation technique. However, since the soft tissue envelope around the elbow is poor and the implants are located at the subcutaneous layer, implant irritation is still the most common complication associated with surgical treatment.

An unusual presentation of osteoblastoma of the maxilla: A case report

  • Lim, Joonbum;Hinchy, Nicole;Odingo, Nora;Colosi, Dan;Mahdian, Mina
    • Imaging Science in Dentistry
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    • 제51권4호
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    • pp.455-460
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    • 2021
  • This report presents a rare case of maxillary osteoblastoma in a 17-year-old female. The patient presented with dull pain and facial asymmetry inferior to the left zygoma. An intraoral examination found a painless swelling on the buccal gingival tissue in the left posterior maxilla. Panoramic radiographs and multidetector computed tomographic images revealed an ill-defined, non-corticated, mixed attenuating entity of osseous density located within the left posterior maxilla apical to the left maxillary molars. The entity exhibited a heterogeneous internal structure with a fine granular appearance, and the periphery showed a partial hypo-attenuating rim along the antero-medial aspect. Expansion of the left posterior maxilla accompanied with displacement of the left maxillary sinus floor was noted. External root resorption of the first and second molars was noted, as well as postero-superior displacement of the third molar. The histopathologic diagnosis of the biopsy was osteoblastoma. Complete excision of the tumor was performed.