• 대한치과보철학회지
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• 제53권1호
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• pp.74-80
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• 2015

구강암의 발생 시, 구순의 결손과 방사선치료에 의한 치주조직과 치경부우식증 등의 문제가 발생할 수 있다. ADI (Association of dental implantology)에 의하면 상 하악골에 대한 방사선치료가 최근에 시행되었을 경우 임플란트를 식립하는 것은 상대적 비적응증이 된다. 대부분의 경우 임플란트를 이용한 보철물의 제작이 어렵고 의치를 사용한 수복이 이루어지게 된다. 특히, 구강암 수술로 인한 구순결손은 의치의 유지에 심각한 영향을 주게 된다. 본 증례는 상순암을 가진 환자로 일차적으로 절제술을 시행하고, 이차적으로 방사선 치료가 정기적으로 이루어진 결과, 환자의 상악 치아들은 순차적으로 자연 발치되었고, 하악은 매우 불량한 치주상태를 나타내었다. 상악은 총의치에 의치접착제를 적용하여 구순결손에 의한 의치의 유지력 저하를 극복하였고, 하악에서는friction pin을 이용한 하악이중관의치가 2년 동안 성공적으로 사용되었다.

• Journal of Periodontal and Implant Science
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• 제40권4호
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• pp.172-179
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• 2010

Purpose: Accurate and exact measurement is an important factor for generating meaningful results in any properly designed study. If all the participating examiners are able to yield similar results, it will be possible to evaluate the objective results of the study more easily and quickly. The purpose of this study was to evaluate the intra- and inter-examiner reproducibility of histometric measurements in the intrabony periodontal defect model. Methods: One wall intrabony defects were surgically created at the distal aspect of the second and the medial aspect of the fourth mandibular premolars in the right and left jaw quadrants in twenty beagle dogs and the defect sites received the following ${\beta}$-tri calcium phosphate, growth differentiation factor-0, growth differentiation factor-100 and sham surgery. Histometric analysis was performed after 8 weeks. Histometric parameters were recorded and repeated at three months interval by three examiners. Intra- and inter-examiner reproducibility was assessed. Results: Most parameters of all the groups showed high intra- and inter-examiner reproducibility. Parameters including defect height, bone regeneration height, cementum regeneration height, and formation of junctional epithelium yielded interexaminer correlation ${\geq}0.9$. The intra-examiner reproducibility showed a high result, over 0.9. Conclusions: Histometric evaluation of the one-wall intra-alveolar periodontal defect model showed high reproducibility not only for a single given examiner but also among the three examiners.

• 대한치과의사협회지
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• 제15권5호
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• pp.359-364
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• 1977

Orthognathic surgery, ie, the surgical correction of congenital and acquaired anormalities of the jaws, is currently a field of vigorous activity among oral surgeons. Surgical correction of maxillofacial deformities benefits the patient both psychologically and functionally. Facial mutilation may precipitate adverse psychologic effects. Function is frequently impaired by malrelation of the jaws. In addition, speech, specifically articulation, is often handicapped in patient with severe jaw deformities. Therefore, in dealing with these patient, above mentioned problem should be considered deliberately. In this regard, the authors have treated 2 cases of mandible defect caused by gunshot and explosives with iliac bone graft. In both cases, the patient had Tantalum plate on defect area. But it became lose and gave functional disturbances. So, the authors have removed Tantalum plate and performed bone transplantation with autogenous soild iliac bone graft on that area with good results.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.37.1-37.4
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• 2015

Keratocystic odontogenic tumors can occur in any area of the maxilla or mandible. According to their size, location, and relations with surrounding structures, they are treated by cyst enucleation or enucleation after either marsupialization or decompression. Enucleation is performed when cysts are not large and when only minor damage to adjacent anatomical structures is expected. Although marsupialization and decompression follow the same basic bone-regeneration principle, which is to say, by reducing the pressure within the cyst, the former leaves a large defect after healing due to the large fistula necessary to induce the conversion of the cyst-lining epithelia to oral epithelia; the latter leaves only a relatively small defect, because of the continuous washing carried out by means of a tube inserted into a small hole in the cyst. In the latter case too, a decompressor appropriate for the focal position is required, owing to the importance of maintaining the device and controlling for oral hygiene. We report herein decompression treatment with a patient-customized device for an extensive cyst in the anterior region of the mandible.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.6-14
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• 2000

Reconstruction of the composite mandibular defect resulting from ablative resection of tumor involved jaw has been challenging task to the plastic surgeon. A wide variety of different techniques were used with limited success until the advent of microsurgery. The high success rate of microsurgical procedures has allowed for significant improvement in both functional and aesthetic results. A variety of free flap donor sites have been used successfully for mandibular reconstruction. Between April of 1991 and August of 1998, 20 mandibular reconstructions were performed for oncologic defects. 4 patients underwent mandibular reconstruction with pectoralis major flap, 3 patients with free nonvascularized bone graft, 1 patient with metal plate. 12 patients underwent microvascular mandibular reconstruction(8: fibula, 4: ilium). The type of free flap was determined by the requirements of the defect. Satisfactory aesthetic and functional results were achieved in all cases without significant complications. So microvascular mandibular reconstruction should be considered as primary choice in all mandibular defect without hesitation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권2호
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• pp.57-61
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• 2014

Bisphosphonate is used widely for osteoporosis treatment, but a rising concern is the risk of osteonecrosis after long-term bisphosphonate use. Such cases are increasing, suggesting a need for research to prevent and treat bisphosphonate-related osteonecrosis of jaws. A 63-year-old female took bisphosphonate (Fosamax$^{(R)}$) for four years for treatment of osteoporosis and stopped medication two months ago because of unhealed wound. She was treated with marginal mandibulectomy maintaining the inferior border, and a metal plate was placed to prevent mandible fracture. Four months after the mandibulectomy, mandible reconstruction surgery using iliac bone and allograft was done. Six months after reconstruction, implant placement and treatment with an overdenture was done without complications. This study presents a case with a successful result.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.771-777
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• 1996

This study was undertaken to access the effect of toothash combined with plaster of Paris in the filling of jaw defect and the substitution as new bone during the follow up period. We used the toothash and plaster after the cyst enucleation, the apicoectomy, the extraction of supenumerary tooth with ratio of 2 : 1 by weigh. 15 consecutive patients were evaluated retrospectively. Complications were swelling, perforation, infection and treated without problems using incision & drainage, aspiration, antibiotic treatment, 2ndary buccal flap. The follow-up period ranged from 28 to 35 months. Based on radiographic and clinical observation, it may be concluded that toothash and dental plaster of Paris($CaSo_4\;{\cdot}\;1/2H_2O$) are useful for bone substitute.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.130-136
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• 1994

Toothash and plaster of Paris (Calcium sulfate) have been studied for bone substitute through experimental studies and clinical studies. Toothash is like resorbable hydroxyapatite. Plaster of Paris is resorbable and biocompatible. The toothash combined with plaster of Paris has the advantages of individual characteristics. The authors used this composite material in the jaw defect filling. In operation, we could manage this implant material easily and remove the dead space. During the followup period, this composite material was resorbed gradually and substituted as new-forming bone from the surrounding tissue. Complications were minor and treated completely without problems.

• Journal of Yeungnam Medical Science
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• 제10권1호
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• pp.218-225
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• 1993

저자들은 악골 변위로 인한 심미적인 문제로 내원한 23세 여자환자에서 안면비대칭, 부정교합을 관찰하였고 두부방사선 계측사진과 전후 방사선사진 및 파노라마사진을 통해 반측안면 왜소증으로 진단하였다. 이에 심미적 개선을 위해 우측하악관절부에 costchodral graft한 후 상악에 Lefort I osteotomy와 하악에 bilateral intraoral sagittal split ramus osteotomy을 시행한 후 양호한 결과를 얻었으며 수술 후 6개월동안 감염이나 골흡수는 보이지 않았다. 부가적으로 하악과두의 비대칭을 보기위한 towns' view와 연조직 분석을 위한 전산단층 촬영술을 첨가하면 진단에 도움이 될것으로 사료되고, 본 증례에서 향후 연조직 재건을 위한 수술이 첨가되면 더 양호한 결과를 얻을것으로 사료된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권6호
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• pp.588-593
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• 2006

Cyst is pathologic disease develops in hard tissue as well as soft tissue, which is lined by epithelium filled with liquid, semi-liquid, or air. Origins and symptoms of the cyst are various according to region, and symptoms are malocclusion, diversion of root, tooth mobility, periapical swelling, discoloration and lesion expansion, because the odontogenic cysts begin in the numerous rests of odontogenic epithelium. But almost cysts produce no symptoms unless secondary infection occurs. Treatment of small cysts may include extraction, endodontic therapy, and apical surgery. Treatment of a large cysts usually involves surgical removal (enucleation), Marsupialization(a method of decompression) or combination of two before mentioned. Bone graft is done for helping of bone defect healing at the same time of enucleation This clinical research from January 2000 to December 2005, analyzed by the age, sex, classification, size, region, treatment method, whether or not of bone graft of cyst in the jaw in Daegu Catholic University Hospital.