• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제13권3호
• /
• pp.278-290
• /
• 1991

Prediction of the sop tissue changes following hard tissue movements is very important in the preoperative analysis of surgical changes of the patient who have orthognathic surgery. This study examined post operative changes of the mid-facial sop tissues in Koreans depending upon two major positional changes of the maxilla following Le Fort - I type osteotomy for orthognathic purposes. Sixty patients(41 males and 19 females) of Koreans were selected and divided into two groups according to directional change of movement of anterior bony structures of the Maxilla as follows : Group I (44 patients) was mooed anteriorly and/or inferiorly, and Group II (16 patients) was mooed posteriorly and/or superioly. Postoperative changes of the sop tissue measurements following hard tissue changes were examined on pre - and post - operative cephalometrics by means of computerized digitation methods and the ratios of changes were analysed. The results were obtained as follows : 1. In Group I, all of the sop tissue measures except the Pn was closely followed by the changes of the hard tissue measures in the horizontal plane, but the Sn and the Cm were only correlated to the vertical changes(p<0.001). In group II, all of the sop tissue measures excluding of the N' and the Pn were significantly correlated to the hard tissue measures in horizontal plane(p<0.001), but the Ls and Stm were only correlated relatively to the vertical changes of the ANS(p<0.01). 2. Predictable ratio of the Sn was 66% of the ANS or 56% of the A in the horizontal plane and 89% of the A in the vertical plane in Group I. In Group II, the Sn was predictable as 85% of the ANS or 70% of the A in the horizontal plane but was not predictable in vertical plane. 3. Predictable ratio of the Cm was 28% of the ANS or 50% of the A in the horizontal plane and 56% of the ANS or 36% of the A in the vertical plane in Group I. In Group II, the Cm was predictable horizontally as 74% of the A. Predictable ratio of the Pn was 30% of the ANS or 38% of the A in horizontal plane in Group I, but it was not predictable both horizontally and vertically in Group II. 4. Predictable ratio of the Ls was 52% of the Pr in Group I and 77% in Group II in the horizontal plane. The Stm was predictable as 34% of the pr or 22% of the I in the horizontal plane in Group I, and was also predictable as 55% of the pr or 68% of the I horizontally and 21% of the pr or 65% of the I vertically in Group II. 5. All ratios of change in the thickness. length and area of the upper lip following maxillary movement were statiscally correlated, however, mangitudes of them were meaningful clinically.

• Journal of Periodontal and Implant Science
• /
• 제35권1호
• /
• pp.53-63
• /
• 2005

Number of fixtures supporting prosthesis for rehabilitation of partial edentulism in distal area is an important factor in distal area to the bone tissue response around dental implant. Optimal number and optimal positioning of dental implant has leaded to the stable condition of bone tissue and successful long-term treatment outcome. This clinical and radiographic study was performed to document and evaluate the short-term result of occlusal rehabilitation by means of implant-supported fixed prostheses (ISPs) especially for partial edentulism in distal area in patients treated for advanced periodontal disease and to verify the number of fixture affecting the bone tissue response. A total of 30 consecutive patients referred because of advanced periodontal disease were included. Before the implant therapy was initiated, periodontal treatment was performed and the outcome evaluated during at least a 6-month period. An individual maintenance care program was designed for each patient. All 75 implants were placed using a 2-stage surgical approach. The patients were divided into 2 groups, in one of which two fixtures were placed and in the other of which three fixtures were placed with tripodal geometry. Following installation of the ISPs, all patients underwent a baseline examination including evaluation of i) oral hygiene, and ii) periodontal/ peri-implant conditions, and iii) radiographs. These examinations were repeated annually during the 1 or 2-year observation period. The results were as follows: 1.No single implant was lost during the observation follow-up period. 1.The percentage of plaque harboring surfaces and bleeding units upon probing were found to be low (<10%), and no soft tissue complications were recorded. 1.Two-fixture group showed bone destruction ranged from 0.0mm to 1.5mm and the mean was 0.31mm. Three-fixture group showed more bone destruction of 0.51mm. There was no statistically difference between two groups. These results suggested that the factor for success is not the number of fixture but the strict maintenance of peri-implant tissue health and initial stability of fixture.

• 대한인간공학회지
• /
• 제29권6호
• /
• pp.875-887
• /
• 2010

The quantitative effectiveness of powered support surfaces such as APAM in preventing and treating pressure ulcers has not been sufficiently evaluated because of uncertainty of alternating pressure load input and lack of interpretation of dynamic perfusion characteristics of soft tissue. The aim was to verify the dynamic loading effects to sacral tissue perfusion characteristics from alternating set pressure changes. We developed integrated experiment system to supply alternating load to supinely positioned sacrum and concurrently measured $TcPO_2$, $TcPCO_2$ and air cell pressure. Ten aged subjects (5 female, 5 male) were tested with alternating set pressure 20, 30, 40, 50 and 60mmHg. From the dynamic perfusion response eight characteristic parameters were proposed such as average, minimum, maximum and perfusion range regarding to $TcPO_2$ and $TcPCO_2$. A one-way ANOVA was carried out to determine whether the manipulation of alternating set pressure had any effect on $TcPO_2$ and $TcPCO_2$. From the dynamic tissue perfusion response we found mean $TcPO_2$ decreased exponentially as alternating pressure load increased and perfusion range varied mainly because of minimum level change of $TcPO_2$. And perfusion range of $TcPCO_2$ affected by increase of maximum value of $TcPCO_2$. From the results we can get more strict insights about actual physiological dynamic tissue perfusion mechanism under alternating pressure load.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제26권6호
• /
• pp.636-643
• /
• 2000

Facial asymmetry is the most frequent disease in craniofacial deformities. And the primary causing area of that is mostly placing in mandible. That is to say, it is known that primarily, mandible grows excessively or deficiently, and other facial region involving maxilla undergoes compensatory growth secondarily, so asymmetric face develops. In facial asymmetry, the surgical correction of undergrowth is more difficult than that of overgrowth and the reason of it is the postoperative relapse caused by stress of surrounding soft tissues. It means the stress of surrounding soft tissues occurring after bone lengthening and reducing above stress is the same meaning with reducing postoperative relapse. Among various areas, mandibular ramus is the most difficult area to lengthen vertically and maintain its length. The reason of it is considered by many authors as the stress of surrounding pterygomasseteric sling which is enveloping lower border of mandible and interrupting elongation of ramal height. So we applied two different surgical procedures in which pterygomasseteric slings have different stress respectively to monkeys which have similar masticatory function and anatomy to human being and compared relapse by radiographic film and observed periodically the histochemical change of masseteric muscle fiber. So we could see the following results. The relapse was less in EVRO group in which we separated pterygomasseric sling in inferior border and didn't approximate muscle sling after vertical lengthening to minimize the stress of soft tissues than IVRO group in which we elongated ramal height preserving pterygomassetric sling. Of course, we could see a problem in EVRO group such as bone resorption in inferior border caused by uncovering the periosteum of inferior border. But we expect that such problem will be solved by developing periosteum substitutes for covering the exposed bone and minimizing the surgical trauma. In histochemical study of masseteric muscle fiber, the fiber constituents of EVRO group in which we minimized soft tissue stress was changed immediately after operation and maintained it for 1 year, whereas that of IVRO group in which we preserved soft tissue stress was changed in more portion after operation and recovered it by 1 year. By the histochemical results, we can see that the recovery of fiber constituents reflect the recovery of muscle stress and it is closely related with relapse phenomenon.

• 대한치과교정학회지
• /
• 제29권3호
• /
• pp.285-301
• /
• 1999

악교정 수술의 계획에 있어서 수술 후 경조직의 이동에 따른 연조직 변화 양상을 보다 정확히 예측하는 것은 매우 중요하다. 최근에는 측모 두부 규격 방사선 사진과 실제 측모 사진을 병합하여 수술 후 측모 변화에 대한 가시성을 높인 여러 종류의 video imaging 프로그램들이 개발되어 널리 사용되고 있다. 그러나 이들 프로그램의 정확도를 판단하는 연구는 아직 미비한 실정이며 특히 국내에서 많이 시행되고 있는 골격성 III급 부정교합 환자의 수술 후 변화 양상에 대한 연구가 임상적인 활용에 앞서 선행되는 것이 필요하다. 이에 저자는 video imaging프로그램의 하나인 Power $Ceph^{\circledR}$ (Power Soft Co. Ver 3.3)을 이용하여 국내에서 양악수술을 시행 받은 골격성 III급 부정교합 환자 30명(남 14명, 여 16명)을 대상으로 예측도와 실제 술후의 측모를 비교하여 정확도를 평가하였으며 정확도에 영향을 미치는 요인을 분석하기 위해 이동량 및 술식별로 분류 비교하여 다음과 같은 결론을 얻었다. 1. 예측치와 실제 계측치의 비교에서 24개의 계측항목 중 14개 항목에서 유의성 있는 차이를 보였다. 2. 계측항목 중 유의성 있는 차이를 보이는 항목은 대부분 상악에 관련된 연조직으로 하악에 관련된 연조직에 비해 다양한 차이를 나타내었다. 3.상악 및 하악의 이동량에 따른 비교에서 이동량이 적은 군이 이동량이 많은 군에 비하여 예측치와 실제 계측치 비교에서 유의성 있는 차이를 보인 항목이 적게 나타났다. 4. 이부 성형술 여부에 따른 비교에서 이부 성형술을 시행하지 않은 군에서 이부 성형술을 시행한 군에 비하여 예측치와 실제 계측치 비교에서 유의성 있는 차이를 보인 항목이 적게 나타났다. Video imaging(Power $Ceph^{\circledR}$ Ver 3.3)프로그램에 의한 예측치와 실제 계측치 비교시 그 차이는 대부분 2mm 이내로써 임상적으로 수용할 수 있는 수준이었다.

• 대한핵의학회지
• /
• 제31권1호
• /
• pp.90-101
• /
• 1997

FDG-PET의 반정량적인 당대사지표인 pSUV, aSUV, $TBR_{51}$과 $TBR_{area}$는 비관혈적으로 악성과 양성 연부조직 병변을 감별하는 데 모두 높은 정확도를 나타내었다. FDG-PET은 연부조직 종양의 평가에서 MRI와 상호보완적인 역할을 할 수 있을 것이다. 또한 FDG-PET은 악성 연부조직 종양환자들의 전이의 발견과 치료 후 추적관찰에도 도움이 될 것으로 생각되며 이에 관한 연구가 계속되어야 할 것이다.

• Archives of Plastic Surgery
• /
• 제33권2호
• /
• pp.219-224
• /
• 2006

Augmentation rhinoplasty is one of the most popular aesthetic procedure in Asians. Numerous alloplastic implants have been used until now, but no accurate comparative analysis about the implant materials has been reported yet. This study in animal model was designed to determine the safety and effectiveness of various implant materials in augmentation rhinoplasty. The $15{\times}15{\times}2mm$ sized square shaped plate of $Gore-Tex^{(R)}$, silicone rubber, and $15{\times}15{\times}1.5mm$ sized $Medpor^{(R)}$ were implanted under panniculus carnosus of the abdomen wall of rat. And tissue specimens including the implant and surrounding soft tissue were obtained by en bloc excision in 6 months after implantation. The implants were estimated in weight and volume, and also the specimens were examined grossly and microscopically. The results revealed that increase of average weight 26.9%, decrease of average volume 55.4% in $Gore-Tex^{(R)}$ implant, increase of each average weight and volume 62.6%, 8.7% in $Medpor^{(R)}$ implant and very slight increase of both average weight and volume 4.7%, 1.1% in silicone rubber implant. Grossly, the $Gore-Tex^{(R)}$ was deformed, $Medpor^{(R)}$ was strongly adherent to surrounding soft tissue and the silicone rubber was well encapsulated and easily peeled off. Microscopically, silicone rubber showed foreign body reaction slightly and there were no inflammatory responses in all alloplastic implants. In our study, silicone rubber showed very proper alloplastic features for augmentation rhinoplasty due to causing no inflammatory response, no physical change, and no deformity.

• 대한치과교정학회지
• /
• 제32권5호
• /
• pp.355-360
• /
• 2002

교정치료 후 연조직의 변화가 나타난다. 특히, 하안면부위에 많은 변화를 일으키게 되며, 대표적으로 입술은 치아 이동량의 $60\~70\%$정도 이동한다고 알려져 있다. 하지만, 이동량은 개인마다 그 양상이 다양하다. 본 연구는 환자의 입술두께에 따라 연조직 이동 양상에 차이가 있는지 여부를 조사하는데 그 목적이 있다. 발치를 동반한 교정치료를 받은 성인환자를 대상으로 basic upper lip thickness에 따라 환자를 분류한 결과, 두께가 얇은 군(group 1)에서 치료 후 연조직 변화에 영향을 미치는 요인으로는 mentolabial angle와 하순의 변화간에 음의 상관관계를 보였다. 두께가 평균인 군(group 2)에서 상순의 변화에 영향을 미치는 요소로는 상악전치의 변화, 하악전치의 변화, 하순의 변화, nasolabial angle의 변화로 나타났으며, 하순의 변화에 영향을 미치는 요소로는 상순의 변화, 상악전치의 변화, 하악전치의 변화로 나타났다. 두께가 두꺼운 군(group 3)에서 는 상순, 하순의 변화는 전치위치의 변화나 연조직 변화와는 관련 없음으로 관찰되었다.

• Journal of Oral Medicine and Pain
• /
• 제34권3호
• /
• pp.277-294
• /
• 2009

본 연구의 목적은 II급 청소년, 성인 환자에서 발치와 비발치 후 연조직 변화를 비교하기 위한 것이었다. 원광대학교 치과병원 교정과에 내원한 환자 68명을 각각 청소년발치군, 청소년비발치군, 성인발치군, 성인비발치군으로 분류하여 치료 전후의 측모 두부방사선사진을 계측하였다. 각 군의 치료 전후를 비교하고 각 군 간의 변화량을 비교하였으며, 그 중 통계적으로 유의한 변수들의 상관성과 회귀분석을 하여 다음과 같은 결과를 얻었다. 청소년과 성인의 발치군에서 비순각은 유의하게 증가하였고 비발치군에서는 유의하게 감소하였다. 발치군에서는 vertical-U1과 E line-upper lip의 변화량 간에, vertical-U1과 E line-lower lip의 변화량 간에, vertical-L1과 vertical-Li의 변화량 간에 양의 상관관계를 보였다. 또한 발치군에서 회귀분석을 통해 E line-upper lip, E line-lower lip, Li에 대한 단순회귀방정식이 도출되었다.

• 대한치과보철학회지
• /
• 제44권1호
• /
• pp.112-123
• /
• 2006

Purpose: The biocompatibility and bio-adhesive property of a dental implant abutment are important for proper soft tissue healing and maintenance of osseointegration of implant. However, studies of soft tissue healing and mucosal attachment of various materials of implant abutment other than titanium are still needed. In this study, cell attachment, proliferation, cytotoxicity of human gingival fibroblast for ceramic, gold alloy, Ni-Cr alloy and, commercially available pure titanium as a control were evaluated, using MTS and scanning electron microscopy. Materials and Methods: Specimen was designed to disc, 4mm diameter and 1mm thickness, made of ceramic, gold alloy, Ni-Cr alloy and commercially available pure titanium. Primary culture of human gingival fibroblasts were grown in Dulbecco's modified Eagle's medium with 10% fetal bovine serum and 1% antibiotics. Cells were inoculated in the multiwell plates placed the specimen disc. Cell Titer 96 AQucous One Solution Cell Proliferation Assay were done after 1hour 3hours, 24hours, 3days, 5days of incubation. The discs were processed for scanning electron micrography to evaluate cell attachment and morphologic change. Results: The results were obtained as fellows. 1. The ceramic showed high cell attachment and proliferation and low cytotoxicity, which is as much bioadhesive and biocompatible as titanium. 2. The gold alloy represented limited proliferation of human gingival fibroblast and the highest cytotoxicity among tested materials (p<0.05). 3. The Ni-Cr alloy limited the proliferaion of the human gingival fibroblast compared to titanium(p<0.05) but cytotoxicity on the bottom of well was not so considerable, compared to titanium. 4. On the scanning electron micrographs , the ceramic showed good attachment and proliferation of human gingival fibroblast, which was similar to titanium. But gold alloy and Ni-Cr alloy showed the shrinkage of gingival fibroblast both after 24 hours and 3 days. On 5th day, small amount of the human gingival fibroblast proliferation was observed on the Ni-Cr alloy, while the shrinkage of gingival fibroblast was still observed on the gold alloy. Conclusions: These results suggest that the ceramic abutment is as biocompatible as titanium to make proper mucosal seal. The gold alloy has a high cytotoxicity to limit proliferation of gingival fibroblast, which suggest limited use on the anterior tooth where soft tissue healing is recommeded.