• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.259-266
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• 2005

The function of the masseter and anterior temporal muscles was assessed by electromyography in 30 patients with mandibular prognathism (20 patients with facial asymmetry and 10 patients without facial asymmetry) before orthognathic surgery and 4weeks afterwards. Electromyogram(EMG) recordings were made during resting, clenching and swallowing. We compared with right-left difference of this recording and asymmetry index before and after orthognathic surgery. The result of this study was as follows. 1. There was no significant right-left difference in muscle activities of masticatory muscles both asymmetric groups and controls and many variable change after orthognathic surgery.(P>0.05) 2. The mean electric activity of the masticatory muscles was found to have decreased during more clenching than resting, but there was no statistically significant difference because of individual difference of measuring values.(P>0.05) 3. The asymmetry index of masticatory muscles in asymmetric groups was significantly greater during clenching compared with controls.(P<0.05) In conclusion, no right-left difference of muscle activities was found in patients with facial asymmetry before orthognathic surgery and 4weeks afterwards. Not only muscular functioning but also many other factors, such as occlusion, temporomandibular joint disorder and trauma, probably affect facial asymmetry and will be analyzed in future studies. And we will need long term follow-up after orthognathic surgery.

• 대한치과보철학회지
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• 제56권1호
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• pp.50-55
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• 2018

무치악 환자에서 악간관계의 부조화는 자주 관찰되며, 의치에서 인공치의 교합접촉 시 안정의 결여는 환자의 불편감과 점막 외상, 나아가서는 근육과 신경의 변화나 감정적 장애를 일으킬 수 있다. 따라서 기능 시 의치에 가해지는 교합력을 고려하여 적절한 교합을 설정하는 것이 성공적인 의치 치료에 중요한 요소라고 할 수 있다. 본 증례에서는 하악 전돌로 인한 상하악 악궁간의 심한 부조화를 가진 완전무치악 환자를 양악총의치로 수복하였다. 비정상적인 악간 관계를 보상하기 위해 구치부 교차교합으로 인공치를 배열함으로써 의치의 안정과 유지를 확보하였고, 환자 또한 기능적, 심미적으로 만족하였다.

• 대한소아치과학회지
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• 제36권1호
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• pp.133-138
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• 2009

Crouzon 증후군은 1912년 프랑스의 신경학자 Crouzon에 의해 처음 알려진 질환으로 10q25-10q26 염색체에 위치한 FGFR2 유전자의 돌연변이에 의해 발생되며 발생률은 25,000명당 1명 꼴로 상염색체 우성 유전 경향을 보이는 유전적 질환이다. 본 증례는 서울대학교 치과병원 소아치과에 내원한 9세의 Crouzon 증후군 환아에 대한 것으로 특징적으로 두개봉합이 조기에 폐쇄되는 두개골유합증(craniosynostosis)으로 인한 두개안면골 이상, 안구돌출증, 상악골 저성장 및 상대적인 하악전 돌증을 나타내었다. 이에 Crouzon 증후군의 의과 및 치과적 소견을 살펴보고, 이에 대해 과거의 문헌을 고찰하여 다소의 지견을 얻었기에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권1호
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• pp.32-45
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• 1995

This study was intended to evaluate condyle position and the relationship of condyle position change and post surgical relapse following the sagittal split ramus osteotomy for mandible setback in 25 patients by paired t-test and multiple regression analysis. We used oblique transcranial and cephalometric radiographs taken before operation, immediate after operation, and at least 6 months post operatively. 1. In oblique transcranial view, posterior joint space was decreased immediate after operation and increased 6 months after operation. To compare the measurement before and 6 months after operation, there was no statistically significant change in over all joint spaces(P>0.05). 2. The joint spaces changed under the 0.2mm were 30%, 0.2mm to 1.0mm were 60.7%, above 1.0mm were 9.3%. This result reveals that condyle position was relatively reproduced to pre-operative state. 3. Statistically, the amount of mandible set back didn't influence the post operative relapse(P>0.05). 4. Statistically, the amount of mandible set back didn't influence the condylar displacement(P>0.05), and the amount of joint space change didn't influence the post operative relapse.(P>0.05) The changes in joint space is in the standard tracing error or within the adaptive capacity of the individual, it was too small to influence the stability of surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권1호
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• pp.1-9
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• 1995

1986년 1월부터 1993년 12월까지 8년간 외과적 교정술을 시행한 117 증례에대하여 임상적인 관찰을 시행하였다. 1) 남녀 성비는 1:1.4로 여자가 많았으며 평균연령은 23.0세였다. 2) 악교정수술을 받기위하여 내원한 환자의 진단에 따른 분류를 보면 하악 전들증의 경우가 87증례(75.0%)로 주종을 이루고 있었다. 3) 수술방법중 하악단독수술은 88증례, 상악골 단독수술은 6증례, 상하악 동시이동술은 23증례였으며 이중 하악지 시상골절단술이 사용된 경우가 84증례(71.8%)로 가장 많았다. 4) 골편의 고정을 위하여 강선고정보다 Miniplate나 Screw 를 이용한 고정이 점차 선호되고 있으며 전체수술에서 견고고정의 비율은 66.0%였다. 5) 본 교실에서는 외가적 교정수술 환자를 대상으로 1992년 2월부터 저혈식 자가수혈을 이용하고 있으며 One Jaw surgery 에서는 2 pints, Two Jaw surgery 에서는 3 pints를 준비하고 잇다. 6) 악교정수술의 합병증으로는 하순지각마비등의 신경손상이 전체수술의 63증례(53.8%)로 가장 많았으며 골편의 잘못된 위치, 과두위치보존의 실패, 견고고정의 불안정등이 원인이 되어 5증례에서 재수술을 시행하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권4호
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• pp.319-322
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• 2011

Purpose: The purpose of this study was to examine the appropriate degree of set-back of the mandible by evaluating the rate of relapse after surgery. Methods: Among the patients who visited our hospital from January 2002 to January 2007 and who underwent orthognathic surgery, of the patients available for follow-up observation, the rate of relapse after surgery was investigated according to the set-back degree. The patients were divided into groups by the degree of set-back, and relapse was evaluated by the radiographs performed the day after surgery, 6 months after surgery, 1 year after surgery, 2 years after surgery and 3 years after surgery. Results: In cases that exceeded the limit of posterior movement of the mandible (13 mm) or that had the wrong position of the condyle, a greater tendency toward relapse was shown. Conclusion: Based on the results of this study, among the cases that required a large amount of posterior movement of the mandible, two jaw surgeries accompanied by bilateral sagittal split ramus osteotomy (BSSRO) and LeFort I osteotomy are recommended.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권1호
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• pp.25-34
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• 1997

This study was made with lateral cephalometric radiography of 28 skeletal class III malocclusion patients that were performed to setback surgery of mandible. The 28 patients were selected by four standards as follows. 1) Set-back amount of mandible is below 10 mm 2) No extrusion and intrusion of posterior tooth or alteration of interincisial angle at period of postoperative orthodontic treatment. 3) Change of mesial segment location of mandible on lateral cephalometrics 4) No genioplasty And 28 patients were divided to three group(1,2,3 group) by degree of preoperative occlusal plane angle to Burstone's horizontal plane. The preoperative occlusal plane angle, which of 1 group was smaller than $7^{\circ}$ and 2 group was between $7^{\circ}$ to $15^{\circ}$ and 3 group was larger than $15^{\circ}$. The results were as follows : 1. As the preoperative occlusal plane angle was larger, the degree of mandibular prognathism was not severe. 2. On comparsion of preoperative and immediate postoperative cephalometric analysis, specific relationship of occlusal plane angle and set-back amount of mandible was not present. 3. As the preoperative occlusal plane angle was smaller, the alteration of postoperative occlusal plane angle was increased tendency. As the preoperative occlusal plane angle was larger, the alteration of postoperative occlusal plane angle was decreased tendency. 4. The relapsed degree of B point distance to Vertical plane was not relationship to the degree of preoperative occlusal plane angle.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권1호
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• pp.37-43
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• 1991

두부방사선사진을 이용한 안모의 측모예측은 악교정수술에 있어서 가장 중요한 수술전 치료계획의 한부분으로 술후 경조직과 연조직의 변화를 예상하며 술자와 환자간에 술후 결과를 의논하는 대화의 재료로서도 그 중요성이 크다. 그러나, 술후 환자의 최종적인 측모와 수술 직전에 수술 계획에 따라 시행한 술후 측모의 예측과는 차이가 있다. 이러한 수술 전 시행하는 측모 예측의 부정확성을 감소시키기 위하여 새로운 경조직 대 연조직 변화비율 등을 추정하는 많은 연구가 시행되어 왔으나 측모방사선 예측의 부정확도를 조사하고 이러한 부정확성에 영향을 미치는 변수를 확인함이 측모방사선예측의 부정확성을 이해하고 감소시키는 데에 있어서 그 중요성이 크다고 생각된다. 이에 저자들은, 이미 시행되어 수술에 사용된 술후 측모예측기록을 수술직후 두부방사선 사진 및 술후 최소 6개월 추적 방사선 사진에 중첩하여 측모 예측의 부정확도를 조사한 바 총 30명의 환자에서 20명(66.6%)이 부정확도를 보였고 악골 및 치열의 술후 위치 불안정성도 측모 예측 정확군과 부정확군에 모두 19명(63.3%)에서 발생하여 측모 예측의 부정확도 영향을 주는 중요한 요인으로 확인되었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권2호
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• pp.158-166
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• 2009

The application of CT with basis on 3 dimensional-reconstruction is getting more widely practiced. With the data obtained from cone-beam computed tomography(CBCT), not only the diagnosis of the patient with skeletal abnormality but also the virtual simulation of the orthognathic surgery were performed and its application would be popular in orthodontic field. We reported a case, a 19-year old man who was diagnosed mandibular prognathism and required orthognatic surgery. In this case, the virtual orthognathic surgery was simulated and surgical wafer was fabricated by using CBCT data. That wafer was applied the actual orthognathic surgery. After preoperative orthodontic treatment, we prepared surgery as follows. : (l)Acquisition of 3D image data, (2)Reconstruction of 3-dimensional virtual model, (3)Virtual model surgery, (4)Extraction of stere-olithographic image, (5)Check-up for occlusal interference, (6)Fabrication of surgical stent by stereolithography. Bilateral sagittal split ramus osteotomy was operated and used stereolithographic surgical stent. 1 month later, we superimposed CBCT datas of virtual surgery and that of actual surgery, and then compared the result. CT data's application for othognathic surgery yielded satisfactory outcomes.

• Journal of Korean Dental Science
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• 제14권2호
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• pp.110-117
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• 2021

Purpose: The purpose of this article is to study the relationship of unintentionally extended split in the distal segment during the bilateral sagittal split ramus osteotomy (BSSRO) and skeletal relapse. Materials and Methods: Twenty patients with mandibular prognathism were divided into two groups according to whether or not unintentionally extended split had occurred. Cone-beam computed tomography images were taken before surgery (T0), immediately after surgery (T1), and postoperatively at 6 months (T2). The stability was evaluated by measuring the change of Nasion perpendicular-Pogonion (N-Pog) distance. Result: Both groups showed mild advancement of Pog during follow-up. In both groups, the condyle head rotated inward and moved posterioinferiorly after surgery, but tended to return to their original position during follow-up. Conclusion: There was no statistically significant difference between the two groups in mandible position. Moreover, the condylar position was stable. If it is difficult to proceed reduction of the unintentionally extended split, careful inspection should be performed to prevent subsequent complications during follow-up.