• Journal of Yeungnam Medical Science
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• v.20 no.1
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• pp.28-35
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• 2003

Purpose: To evaluate physeal remodeling after internal fixation of slipped capital femoral epiphysis, We performed a retrospective review of the medical records and radiographs of 14 children (17 cases) who had had slipped capital femoral epiphysis. Materials and Methods: We reviewed 14 patients who had slipped capital femoral epiphysis. They were divided two groups. Group I were in situ pinning with single screw and group II were corrective osteotomy with multiple pinning. We identified physeal remodeling camparing with their preoperative, postoperative and last follow-up radiographs with measuring physeal-shaft angle. Results: Early closure of the physis was observed in 6 cases among 14 patients (17 hips). Compared with their postoperative radiographs, the last follow up radiographic study revealed that physeal remodeling was observed in 4 patients (4 hips) at group I (mean, $7.8^{\circ}$), in 2 patients (3 hips) at group II (mean, $10.7^{\circ}$). Conclusion: In this study, physeal remodeling was observed in 4 patients (4 hips) in group I and 2 patients (3 hips) in group II. The incidence of physeal remodeling was related with degree of epiphyseal slippage, and age was not related with physeal remodeling potential.

• Restorative Dentistry and Endodontics
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• v.36 no.6
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• pp.465-476
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• 2011

In current endodontic practice, introduction of operating microscope, ultrasonic instruments, and microinstruments has induced a big change in the field of surgical retreatment. In this study, we aimed to offer key steps of endodontic microsurgery procedure compared with traditional root-end surgery, and to evaluate factors influencing success and failure based on published articles. Endodontic microsurgery is a surgical procedure performed with the aid of a microscope, ultrasonic instruments and modern microsurgical instruments. The microscope provides magnification and illumination - essential for identifying minute details of the apical anatomy. Ultrasonic instruments facilitate the precise root-end preparation that is within the anatomical space of the canal. Modern endodontics can therefore be performed with precision and predictability, thus eliminating the disadvantages inherent in traditional periapical surgery such as large osteotomy, beveled apicoectomy, inaccurate root-end preparation and the inability to observe isthmus. Factors influencing the outcomes of endodontic microsurgery may be diverse, but standardization of procedures can minimize its range. Among patient and tooth-related factors, periodontal status and tooth position are known to be prognostic, but there are only few articles concerning this matter. High-evidence randomized clinical trials or prospective cohort studies are needed to confirm these findings.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.6
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• pp.360-367
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• 2013

Purpose: The purpose of this study was to perform three-dimensional (3D) assessment of facial soft tissue in patients with skeletal Class III and mandibular asymmetry after orthognathic surgery. Methods: Samples consisted of 3D facial images obtained from five patients with A point-nasion-B point angle less than 2 degrees, and more than 5 mm of menton deviation. All patients had been treated at Gangneung-Wonju National University Dental Hospital from 2009 to 2012. They had undergone orthognathic surgery of Lefort I, and sagittal split osteotomy for correction of skeletal deformity, and orthodontic treatment. Facial scanning was performed before treatment (T1) and post-surgical orthodontic treatment (T2). Linear and angle variables of soft tissue landmarks, antero-posterior facial depth, and facial volume were measured. Results: No significant differences in width of the alar base, mouth width, and nasal canting were observed between T1 and T2. However, lip deviation, menton deviation, alar canting, lip canting, and menton deviation angle were significantly reduced at T2. Antero-posterior facial depth on the axial plane parallel to the left cheilion was significantly reduced on the deviated side and significantly increased on the non-deviated side at T2. Volume of the lower lateral and lower medial parts of the face was reduced on the deviated side, and volume of upper lateral and lower lateral parts on the non-deviated side was significantly increased at T2. Conclusion: After orthognathic surgery, facial asymmetry of soft tissue was improved following skeletal changes, especially the mandibular region. Although the length of the alar base and mouth width did not change, lip and soft tissue menton were displaced to the medial side after treatment. Facial depth also became symmetric after treatment. Facial volume showed a decrease on the lower part of the deviated side and that on lateral parts of the non-deviated side showed an increase after treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.6
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• pp.368-375
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• 2013

Purpose: This study is to evaluate the location of descending palatine artery, the anatomy of pterygomaxillary junction, and the association between the obtained anatomic values and several variables. Methods: We studied 40 patients who were treated for dentofacial deformites from January 2010 to December 2012 in Ulsan University Hospital, Ulsan, Korea. Cone beam computed tomogram (CBCT) was done for all patients. The reference point was approximately 5 to 7 mm above anterior nasal spine on axial image. We evaluated the location of the greater palatine canal (line a: on the coronal view, the shortest line between the center of greater palatine canal and pterygoid fossa; distance a: the distance of line a). We also measured the thickness (line b: on the coronal view, the shortest line between maxillary posterior sinus wall and pterygoid fossa; distance b: distance of line b), width (line c: on the coronal view, the line perpendicular to the line b and the nearest line from the most concave point of lateral pterygoid plate to the medial pterygoid plate; distance c: distance of line c) and height (line d: on sagittal view, the vertically longest line of pterygoid junction; distance d: the distance of line d) in pterygomaxillary junctions. We evaluated the association between the obtained anatomic values and several variables (sex, age, height and weight). Results: The mean distance a was 4.78 mm, mean distance b was 5.53 mm, mean distance c was 8.01 mm and mean distance d was 13.22 mm. The differences between age and mean distance c and weight and mean distance d in pterygomaxillary junctions are statistically significant. Conclusion: There apparently is anatomic variation of pterygomaxillary junctions by various values, particularly weight and age in a Korean clinical population.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.5
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• pp.401-406
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• 2011

Purpose: The purpose of this study was to investigate changes in the position of the hyoid bone and soft palate and the amount of airway space after bilateral sagittal split ramus osteotomy (B-SSRO). Methods: This study is a review of lateral cephalometric tracings of 30 patients who underwent B-SSRO with setbacks at Kyunghee Dental Hospital from 2005 to 2009. Lateral cephalograms were taken before (T0), within one month (T1), and more than six months after the surgery (T2). Results: The hyoid bone at T1 changed significantly towards the inferoposterior position. At T2, it had significantly moved superiorly, but not anteriorly. At T1, the nasopharyngeal space, extending from the posterior nasal spine to the posterior pharyngeal space, decreased significantly, but did not show a significant increase at T2. The nasopharyngeal space, extending from the middle of soft palate to the posterior pharyngeal space, decreased significantly at T1, but did not show a significant decrease at T2. The oropharyngeal airway space decreased significantly at T1 and did not return to its original position at T2. The hypopharyngeal space, extending from the anterior to the posterior pharyngeal space at the level of the most anterior point of the third cervical vertebrae, slightly decreased at T1, but the amount was insignificant; however, the amount of decrease at T2 was significant. The hypopharyngeal space extending from the anterior to the posterior pharyngeal space at the level of the lowest point of the third cervical vertebrae, decreased significantly at T1 but returned to its original position at T2. Conclusion: B-SSRO changes the position of the hyoid bone and muscles inferoposteriorly. These change allows enough space for the tongue and prevent airway obstruction. Airway changes may be related to post-operative edema, posterior movement of the soft palate, anteroposterior movement of the hyoid bone, or compensation for decreased oral cavity volume. The position of the pogonion which measures anterior relapse after surgery did not show significant differences during the follow-up period.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.1
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• pp.39-45
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• 2015

Loss of continuity of the mandible destroys the balance and symmetry of mandibular function, leading to altered mandibular movements and deviation of the residual fragment towards the resected side. Apart from deviation, other dysfunctions include difficulty in swallowing, speech, mandibular movements, mastication, and respiration are accompanied. In general, surgical reconstruction is considered first then proceeds to the prosthetic restorations. However, patients with systemic disease such as BRONJ (Bisphosphonate related osteonecrosis of the Jaw), surgical reconstruction may be limited. Thus, the prosthetic restoration remains as the only resort. Numerous prosthetic methods are employed to minimize deviation and to improve masticatory efficiency, function and esthetics. If a removable partial denture is the selected treatment modality, maximum stability of the partial denture base may be accomplished with a functional impression procedure by means of eliminating lateral and horizontal forces caused by the functional movements of the lips, cheeks and tongue. Also, Twin occlusion is used to obtain a favorable occlusal relationship and check support for esthetics. The purpose of this case report is to demonstrate how neutral zone impression technique and twin occlusion scheme were applied to restore a hemi-mandiblectomy patient with BRONJ syndrome to achieve satisfactory results in functional and esthetic aspects.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.497-509
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• 2007

Bone morphogenetic proteins(BMPs) are regarded as members of the transforming growth $factor-{\beta}$ superfamily with characteristic features in their amino acid sequences. A number of studies have demonstrated the biologic activities of BMPs, which include the induction of cartilage and bone formation. Recently there was a attempt to overcome a limitation of mass production, and economical efficieny of rh-BMPs. The method producing PTD by using bacteria have advantages of acquiry a mass of proteins. Hences, a new treatment which deliver protein employed by protein transduction domain(PTD) has been tried. The purpose of this study was to evaluate the bone regenerative effect of TATBMP-2 and TAT-HA2-BMP-2 employed by PTD from HlV-1 TAT protein for protein translocation in the rat calvarial model. An 8mm calvarial, critical size osteotomy defect was created in each of 32 male Spraque-Dawley rats(weight $250{\sim}300g$). The animals were divided into 4 groups of 32 animals each (4 animals/group/healing interval). The defect was treated with TATBMP-2/ACS(Absorbable collagen sponge) (TATBMP-2 0.1mg/ml), TAT-HA2-BMP-2/ACS(TAT-HA2-BMP-2 0.1mg/ml), ACS alone or left untreated for surgical control(negative control). The rats were sacrificed at 2 or 8 weeks postsurgery, and the results were evaluated histologically. The results were as follows: New bone formation were not significantly greater in the TATBMP-2/ACS group relative to negative, and positive control groups. New bone was evident at the defect sites in TAT-HA2-BMP-2/ACS group relative to negative, positive control and TATBMP-2 groups. There were a little bone regeneration in TATBMP-2 groups. While, enhanced local bone formation were observed in TAT-HA2-BMP-2 group. But, The results was not the same in all rat defects. Therefore, further investigations are required to develop a method. which disperse homogenously, and adhere to target cells.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.511-522
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• 2007

Introduction : The purpose of this study was to evaluate the possibility of the acellular dermal matrix (ADM) as a barrier membrane for bone regeneration, and to evaluate the osteogenic effect of ADM as a carrier system for rhBMP-2 in the rat calvarial defect model. Materials and Methods: An 8-mm, calvarial, critical-size osteotomy defect was created in each of 60 male Spraque-Dawley rats(weight $250{\sim}300g$). Three groups of 20 animals, each received either rhBMP-2(0.025mg/ml) in an ADM carrier, ADM only, or negative surgical control. And each group was divided into 2- and 8-weeks healing intervals. The groups were evaluated by histologic and histomorphometric parameters(10 animals/group/healing intervals). Data were expressed as $means{\pm}standard$ deviations($m{\pm}SD$). Comparisons between experimental and control groups were made using two-way ANOVA and post hoc t-test. Comparisons between 2 weeks and 8 weeks were made using paired t-test. The level of statistical difference was defined as P< 0.05. Results : The ADM group and rhBMP-2/ADM group results in enhanced local bone formation in the rat calvarial defect at both 2 and 8 weeks. The amount of defect closure and new bone formation were significantly greater in the rhBMP-2/ADM group relative to ADM group(P<0.05). At 8 weeks, the majority of ADM in the defect was contracted, and integrated with surrounding host tissues. In addition, host cell infiltration and neovascularization of the ADM in the absence of an inflammatory response were observed, and the newly formed bone around ADM showed a continuous remodeling and consolidation. Conclusion : The results of the present study indicated that ADM may be used as a barrier membrane for bone regeneration and that may be employed as a delivery system for BMPs.

• Journal of radiological science and technology
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• v.26 no.1
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• pp.83-89
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• 2003

The accurate measurement of the femoral anteversion is very important to the practice of orthopedic and osteotomy. It is measured by means of the axis of head and neck of the femur and the knee axis. At the present time, widely used computed tomography method of measuring anteversion on femoral necks of patients. Measurement by the manual method and image viewer of computed tomography to determine the anteversion of femoral head were carried out on both femurs. In September and October 2002, 5 patients 28 to 36 years of age were randomly selected from Seoul National University Hospital. The purpose of this paper was to introduce a new method to measure femoral anteversion angle utilizing PACS image viewer program in the MR imaging. Significant difference was observed between the right and left side the image viewer measurement of femoral anteversion. In conclusion, MR imaging very usefulness in the measured the angle of the femoral anteversion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.3
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• pp.205-217
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• 2005

Distraction osteogenesis is a technique of lengthening bone including soft tissue by gradual separation of surgically divided bone surfaces. Although the biomechanical, histological, and ultrastructural changes associated with distraction osteogenesis have been widely described, the molecular mechanisms governing the formation of new bone in distracted bone segments remain largely unclear. However, such information has significant clinical implications because it may enable targeted therapeutic manipulations designed to accelerate osseous regeneration. The purpose of this study was to evaluate the expression of TGF-$\beta$1, IGF-I and bFGF in distraction osteogenesis according to different distraction rates in a rabbit's mandible. When twenty-four adult rabbits underwent open osteotomy between the premolar and mental foramen, an external bilateral distraction device was applied. Latency was allowed for five days before distraction. Three different distraction rates were 0.7 mm/day (A, n=8), 1.4 mm/day (B, n=8) and 2.4 mm/day (C, n=8). The distraction device was activated with the same distraction rhythms of twice a day until 4.9 mm (A & B group) and 8.4 mm (C group) length gains was achieved. The animals were sacrificed at postoperative 3, 7, 14 and 28 days. The bony specimens were stained with H&E for histologic examination, and RT-PCR analysis was done for the identification of the expression of TGF-$\beta$1, IGF-I and bFGF. The results obtained from this study were as follows : The 0.7 mm/day and 1.4 mm/day distraction rate groups were shown to improve regenerative bone formation on radiographic and histologic examination. Also, TGF-$\beta$1, IGF-I and bFGF expression increased in the 0.7 mm/day and 1.4 mm/day distraction rate groups. But the 2.4 mm/day distraction rate group specimen was different with adjacent normal bone and hardly expressed of growth factors. These findings suggest that improved new bone formation in the 0.7 mm/day and 1.4 mm/day distraction rates is associated with enhanced expression of TGF-$\beta$1, IGF-I and bFGF by mechanical tension stress. Additionally, the 0.7 mm/day and 1.4 mm/day distraction rate groups were significantly different from the 2.4 mm/day distraction rate group in the expression of growth factors. According to the above results, it seems possible to apply a distraction rate of up to 1.4 mm/day a day in rabbit's mandible. And further studies are needed to evaluate growth factors of TGF-$\beta$1 and IGF-I, which are excellent in expression.