• 제목/요약/키워드: maxillofacial injury

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구강악안면부 외상발생의 역학적 평가 (Evaluation of Etiological Factors for Injuries at Oral and Maxillofacial Area)

  • 배성숙;황순정
    • 치위생과학회지
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    • 제12권4호
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    • pp.310-319
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    • 2012
  • 본 연구는 서울에 위치한 야간 응급실이 있는 S 대학병원의 2009년 1월 1일부터 2009년 12월 31까지 내원한 환자 중 구강악안면부 외상 상병명(한국질병 분류기호: S01.5, S02.40, S02.41, S02.50, S02.51, S02.60, S02.61, S03.2)으로 집계된 1,696건의 자료 중 1,495건의 전산 통계자료를 이용하여, 구강악안면 외상발생 요인에 대한 자료를 분석하고 평가하였으며 다음과 같은 결과를 얻었다. 1. 성별 외상발생 남녀비는 1.49:1로 남자에서 더 많았고 남자가 894명(59.8%), 여자가 601명(40.2%)으로 나타났다. 2. 연령별로 외상발생은 7~14세(19.6%)에서 가장 높게 나타났고, 50~59세(13.7%), 60~69세(12.6%), 20~29세(11.8%), 30~39세(10.8%), 40~49세(9.6%), 6세 이하(9.4%), 70세 이상(605%), 15~19세(6.0%) 순으로 나타났다. 3. 원인별로는 넘어짐(25.9%)이 가장 많았고, 부딪힘(11.8%), 저작(11.6%), 교통사고((6.0%), 폭력(5.3%), 스포츠(2.4%), 추락(0.7%)의 순으로 나타났다. 4. 장소에 대한 분포는 등산, 해변, 야외 등 기타 장소가(24.7%) 가장 많았고, 공공장소 및 사무실(19.6%), 집(19.4%), 도로 길(13.8%), 학교 유치원 어린이 집(7.9%), 운동장(5.2%), 놀이터(3.6%)와 공원(3.6%), 그리고 계단(2.0%) 순으로 나타났다. 5. 외상발생 부위는 전치부(43.2%)와 구치부(43.1%)가 많았고, 이어 악골(9.2%), 혀, 입술 및 주위조직(2.6%), 악관절(1.9%) 순이었다. 6. 외상발생 시간은 15~19시(10.4%)와 19~23시 (7.1%)가 높게 나타났다. 발생 원인별 시간은 넘어짐의 경우 15~19시(14.7%), 추락의 경우 7~11시(27.3%), 부딪힘의 경우 15~19시(22.1%), 폭력에 의한 경우 19~23시와 23~3시(26.6%)에 각각 동일하게 높게 나타났고, 교통사고의 경우 15~19시(28.9%), 스포츠 활동의 경우 15~19시(48.6%), 저작 등에서는 19~23시(3.4%)에 높게 나타났다, 7. 외상 원인별 상병명은 넘어짐의 경우 S01.5 (입술 및 구강의 열린 상처), 추락의 경우 S02.51 (개방성 치아의 파절), 부딪힘의 경우 S02.50 (폐쇄성 치아의 파절), 폭력의 경우 S02.60 (폐쇄성 아래턱뼈의 골절), 교통사고와 스포츠, 저작 등의 경우 각각 S02.50 (폐쇄성 치아의 파절)이 높게 나타났다. 이상의 결과를 바탕으로 구강악안면부 외상사고에 대한 역학적 특성을 이해하고 경향을 고려하여 체계적인 구강악안면부 외상사고 예방대책 및 보완정책 수립과 적극적인 안전교육 및 홍보 활동이 필요할 것으로 생각된다.

Paresthesia diagnosed using cone-beam computed tomography: a case report

  • Kumar, Umesh;Kaur, Charan Kamal;Vashisht, Ruchi;Rattan, Vidya
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제20권2호
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    • pp.95-99
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    • 2020
  • Various dental procedures, such as injection administration, surgical treatment, and endodontic treatment, can cause injury to the nerves. The most commonly injured nerves are the inferior alveolar and lingual nerves. This can manifest as altered sensation to the area of innervation of the injured nerve, such as the lower lip, chin, teeth, tongue, and mucosa. Altered sensations or loss of sensation are relatively infrequent complications in daily dental practice. Here, we report an uncommon case of altered sensation in the midfacial region caused by an endodontic procedure and discuss the need to consider local dental causes in the differential diagnosis of numbness in the facial region.

치과 치료에 대한 심한 공포가 있는 환자들에서 미다졸람 정주 후 나타난 기이반응 -증례보고- (Paradoxical Reactions following Intravenous Midazolam in Patients with Severe Anxiety for Dental Treatment -A Case Report-)

  • 오세리
    • 대한치과마취과학회지
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    • 제9권1호
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    • pp.30-35
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    • 2009
  • Intravenous midazolam has been frequently used for the relief of anxiety in dental treatment. This is likely the result of the sedative and anterograde amnestic properties of midazolam that are mediated through $\gamma$-Aminobutyric acid agonism. Unfortunately, Paradoxical reactions to midazolam include agitation, talkativeness, confusion, disinhibition, aggression,violent behavior, act of self-injury and need for restraints. These occur in less than 1% of all patients receiving midazolam, may occur at variable times after administration and are difficult to predict and diagnose. Two women with severe anxiety for dental treatment experienced paradoxical reactions associated with the use of intravenous midazolam. We are reviewed the management and prevention of paradoxical reactions and its different etiology.

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임프란트 수술이나 발치 후 지각이상 환자에서의 약물치료 (Pharmacologic management for the patient with paresthesia after implant surgery or extraction)

  • 김성택;김일영;강희석
    • 구강회복응용과학지
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    • 제19권2호
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    • pp.109-113
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    • 2003
  • The inferior alveolar nerve provides unilateral innervation to the dentition, labial mucosa and skin from about commissure to the mental protuberance. Injury to this nerve resulting in sensory impairment can be a distressing problem to some patients. The causes of this problem include trauma, extraction, implant surgery and any maxillofacial surgery and generally the altered sensation is temporary. The surgical procedure has been the most common treatment for this condition but it has some complications. The antidepressants and anticonvulsants have been effective to the treatment of trigeminal dysesthesia. This case report suggests that the use of antidepressants and anticonvulsants is an alternative method to treat the paresthesia after implant surgery or extraction.

스포츠 마우스가드의 기능성과 안정적인 착용감을 위한 제작 증례 (Fabrication of a sport mouse guard for performance and comfortable wearing)

  • 임중재
    • 대한치과기공학회지
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    • 제42권3호
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    • pp.298-305
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    • 2020
  • Here, we studied the sports mouse guard as an oral device system, to minimize the sports related facial and dental injuries, jawbone fracture and brain injury, and by layering the hardened sheets for improving the activity performance and stable wearing. By pressuring and layering 2 soft- and 1 hard-layers of ethylene vinyl acetate (EVA) thermoplastic materials, for a category of martial art, record sports and leports, here we introduce a methodology for thickness control of layers to protect the teeth and oral structure. A personally customized mouse guard optimized for sports by layering a mixture of soft and hardened sheets is not easily detached during the sporting activity, easy to breathe through, comforts to wear, and also improves the sporting record. A designed EVA thermoplastic material for individual sports is used as the mouth guard, which is stably attached, easily removed, and convenient for breathing through the mouth.

비출혈 환자에서 굴곡성 기관지를 이용한 맹목적 기관내 삽관 (Blind Intubation Using Fiberoptic Bronchoscope in Epistaxis)

  • 이승현;윤지영;김철홍
    • 대한치과마취과학회지
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    • 제12권2호
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    • pp.121-123
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    • 2012
  • Nasotracheal intubation is an essential procedure during general anesthesia for dental treatment. Fiberoptic intubation is best accomplished by those who perform it as part of their daily practice. But nasal approach of fiberoptic intubation has some complications such as epistaxis and laryngeal injury. Especially, epistaxis is common and it make fiberoptic intubation because of limited view. When the epistaxis obstruct the field of vision we have to withdraw the fiberoptic bronchoscope and consider the other method for securing the airway. We succeeded in securing the airway of patient who had epistaxis during the fiberoptic nasotracheal intubation without withdrawing the fiberoptic bronchoscope. We used blind intubation guided by light source placed the tip of fiberoptic bronchscope applied to lightwand intubation.

Anesthesia for elective bilateral sagittal slip osteotomy of the mandible and genioplasty in a young man with Klippel-Feil syndrome, Sprengel deformity, and mandibular prognathism

  • Paramaswamy, Rathna
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제19권5호
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    • pp.307-312
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    • 2019
  • Klippel-Feil syndrome is characterized by congenital fusion of two or more cervical vertebrae, a low hair line at the back of the head, restricted neck mobility, and other congenital anomalies. We report a 16-year-old young man with Klippel-Feil syndrome, Sprengel deformity of the right scapula, thoracic kyphoscoliosis, and mandibular prognathism with an anterior open bite. He was treated with orthodontic treatment and maxillofacial surgery. An anticipated difficult airway due to a short neck with restricted neck movements and extrinsic restrictive lung disease due to severe thoracic kyphoscoliosis increased his anesthesia risk. Due to his deviated nasal septum and contralateral inferior turbinate hypertrophy, we chose awake fiber optic orotracheal intubation followed by submental intubation. Considering the cervical vertebral fusion, he was carefully positioned during surgery to avoid potential spinal injury. He recovered well and his postoperative course was uneventful.

Invasion of the canalis sinuosus by dental implants: A report of 3 cases

  • Shintaku, Werner Harumiti;Ferreira, Cimara Fortes;Venturin, Jaqueline de Souza
    • Imaging Science in Dentistry
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    • 제50권4호
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    • pp.353-357
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    • 2020
  • The canalis sinuosus (CS) and its accessory canals (ACs) are anatomical structures in the anterior maxilla. These structures are often neglected when planning implant surgery because their clinical significance is still not well-defined. After a retrospective evaluation of 194 patients rehabilitated with dental implants in the anterior maxilla, 3 patients were identified who presented unexpected chronic neurosensory disturbances without any clinical signs supportive of implant failure. Tomographic assessment using cone-beam computed tomography (CBCT) revealed the invasion of the CS and ACs by dental implants, which appeared to explain the patients' symptoms. The purpose of this report was to familiarize practicing dentists and specialists with the CS and its ACs. Unanticipated neurosensory symptoms after implant placement in the anterior maxilla justify the use of CBCT to rule out an injury to this neurovascular bundle.

Biomedical Application of Silk Sericin: Recent Research Trend

  • Seong-Gon Kim;Je-Yong Choi;HaeYong Kweon
    • International Journal of Industrial Entomology and Biomaterials
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    • 제48권1호
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    • pp.1-12
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    • 2024
  • Silk sericin, a natural protein from silkworm cocoons, is emerging as a multifunctional biomaterial in biomedicine, particularly in tissue engineering and wound healing. Recent studies have highlighted its biocompatibility, biodegradability, and potential for chemical modification, which allows it to be incorporated into various scaffold architectures. This review article synthesizes current research, including the development of sericin-based hydrogel scaffolds for tissue engineering and sericin's role in enhancing wound healing. Key findings demonstrate sericin's ability to refine scaffold porosity and mechanical strength, expedite tissue healing, and reduce bacterial load in wounds. The integration of sericin into novel bioactive dressings and its use in peripheral nerve injury repair are also discussed, showcasing its adaptability and efficacy. The convergence of these studies illustrates the broad applications of sericin, from scaffold design to clinical interventions, making it a promising material in regenerative medicine and tissue engineering, with the potential to improve patient outcomes significantly.

삼차원 배양된 슈반세포 도관을 이용한 말초 신경 재생 (PERIPHERAL NERVE REGENERATION USING A THREE-DIMENSIONALLY CULTURED SCHWANN CELL CONDUIT)

  • 김성민;이종호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권1호
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    • pp.1-16
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    • 2004
  • The use of artificial nerve conduit containing viable Schwann cells is one of the most promising strategies to repair the peripheral nerve injury. To fabricate an effective nerve conduit whose microstructure and internal environment are more favorable in the nerve regeneration than existing ones, a new three-dimensional Schwann cell culture technique using $Matrigel^{(R)}$. and dorsal root ganglion (DRG) was developed. Nerve conduit of three-dimensionally arranged Schwann cells was fabricated using direct seeding of freshly harvested DRG into a $Matrigel^{(R)}$ filled silicone tube (I.D. 1.98 mm, 14 mm length) and in vitro rafting culture for 2 weeks. The nerve regeneration efficacy of three-dimensionally cultured Schwann cell conduit (3D conduit group, n=6) was assessed using SD rat sciatic nerve defect of 10 mm, and compared with that of silicone conduit filled with $Matrigel^{(R)}$ and Schwann cells prepared from the conventional plain culture method (2D conduit group, n=6). After 12 weeks, sciatic function was evaluated with sciatic function index (SFI) and gait analysis, and histomorphology of nerve conduit and the innervated tissues of sciatic nerve were examined using image analyzer and electromicroscopic methods. The SFI and ankle stance angle (ASA) in the functional evaluation were $-60.1{\pm}13.9$, $37.9^{\circ}{\pm}5.4^{\circ}$ in 3D conduit group (n=5) and $-87.0{\pm}12.9$, $32.2^{\circ}{\pm}4.8^{\circ}$ in 2D conduit group (n=4), respectively. And the myelinated axon was $44.91%{\pm}0.13%$ in 3D conduit group and $13.05%{\pm}1.95%$ in 2D conduit group to the sham group. In the TEM study, 3D conduit group showed more abundant myelinated nerve fibers with well organized and thickened extracellular collagen than 2D conduit group, and gastrocnemius muscle and biceps femoris tendon in 3D conduit group were less atrophied and showed decreased fibrosis with less fatty infiltration than 2D conduit group. In conclusion, new three-dimensional Schwann cell culture technique was established, and nerve conduit fabricated using this technique showed much improved nerve regeneration capacity than the silicone tube filled with $Matrigel^{(R)}$ and Schwann cells prepared from the conventional plain culture method.