두개내 합병증을 유발한 저작극 농양

이상철,김여갑,류동목,이백수,최유성,한승완,오승환 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.1

Although the use of the antibiotics has minimized the dangers of the spread of odontogenic infection to adjacent important organs, sometimes the fatal cases, such as Ludwig's angina, mediastinitis, intracranial complications from the odotogenic infection, may be occurred. The odontogenic infections or oral and maxillofacial region may involve the intracranial area through systemic circulation or by direct spread into the intracranial cavity. Headache, malaise, loss of appetite, chills, fever, vomiting, apathy, and irritability are usually followed by more specific involvement of the nervous system. We experienced one patient who died of intracranial complication from odontogenic infection. So we report the case and the literatures about intracranial involvements following odontogenic infections and dental procedures.

衝擊荷重과 下顎骨 骨折發生 機轉의 有限要素法的 硏究

吳承煥,金麗甲 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.3

The purpose of this study was to investigate the dynamic response of the mandible to impact and provide insight into the fracture mechanism of the mandible, by 3-dimensional finite element method. The finite element model of the mandible was developed and calculated using NASTRAN/XL(MSC co. U.S.A.) and the linear dynamic transient analysis was performed according to the impulsive force direction, force type and impulse time to the mandible. At first, the load was applied on the mandibular symphysis, body, angle and subcondylar area in the horizontal mandibular plane and the computed stress-time histories at 14 locations of the mandible were obtained. Secondly, the impulsive force was directed to the symphyseal area with changing the force magnitude and impulse time, and calculated the node displacement at 8 locations of mandible. The conclusions from this study were as follows. 1. The appearance of impulsive energy transmission was different to the direction of impulse to the mandible. 2. The impulsive stress and deformation were large in lingual or medial side than buccal or lateral in the mandible. 3. The velocity, appearance of energy transmission and the fracture pattern in mandible were affected rather impulse time than force. 4. The horizontal impact to the one side of mandible did not have effect on the stress and displacement of contralateral mandible. From the above results, fracture pattern in symphysis can be showed as simple or comminuted, multiple or associated in body and angle and solitary in subcondyle area.

악교정 수술시 컴퓨터를 이용한 측면두부규격방사선사진 분석 및 예측의 유용성에 관한 연구

최병준,김여갑 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

Analysis and prediction on lateral cephalometric must be necessary to know present states and it is important to decide method and magnitude of real orthognathic surgery. The purpose of this study is to evaluate accuracy that post-surgical lateral cephalometric analysis compared with simulated surgical lateral cephalometric analysis using orthognathic surgery prediction system (V-ceph™version 3.0). The result as follow Skeketal position change showed significantly difference between predicted and actual means.(12 of 19). Dental position change showed significantly difference between predicted and actual means.(5 of 9).The angles which were measured among three points showed significantly difference between predicted and actual means.(13 of 18). The distances which were measured between two points significantly difference between predicted and actual means.(4 of 8). None of 2 measurement for ratio showed significantly difference between predicted and actual means. Overall 17 of 28 measurements showed significant difference in means As the result of this study, it was inappropriate to apply prediction system in clincal situation. But the difference was not servere, prediction system could show out line of post-surgical reult approximately. So, it is possible to predict the post-surgical result simply, and to explain the surgery to patient.

대전자골을 이용한 골이식증례

이백수,김여갑,이상철,김은철,류동목 大韓顎顔面成形再建外科學會 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.1

Autogenous bone graft is the useful technique for management of various bone defect in oral and maxillofacial surgery. The most common site for bone graft harvest is the anterior iliac crest. There is usually considerable cancellous bone graft available and it can be obtained with minimal morbidity. However, complications noted in iliac crest grafts include prolonged postoperative pain, hematoma and fracture, gluteal muscle weakness. Occasionally, when large amounts of bone graft are needed and previous harvest procedure had used, iliac bone harvest may be not adequate. Like the iliac crest, the greater trochanter has abundant cancellous bone and is readily accessible with acceptable morbidity. The purpose of this study was to assess the availability of cancellous bone graft from the greater trochanter, compare the quantity with that available from the anterior iliac crest, investigate anatomical hazards, and make recommendations for consistent harvest.

14-15세 한국인 안모의 실물사진계측분석에 의한 연구

오재권,김여갑 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2

A PHOTOMETRIC STUDY OF MAXILLOFACIAL NORMALS IN 14∼15 YEAR-OLD KOREAN. The primary method of diagnosis in craniofacial deformity patient is used by gross inspection. The study for objective analysis and evaluation in Korean maxillofacial soft tissue portions is rare and our normals have been based on Caucasian such as American. But it is difficult to apply it to ours so we studied the frontal photometric measurements for maxillofacial Korean normals. The photograph were taken with the subject sitting in head position parallel with interpupillary plane to the floor. During taking pictures, facial analyser by Obwegeser in Martin was used for correct measurements. 54 male and 57 female ages 14 to 15 years were selected from a group of 111 healthy middle school students in Inchon. 1.The vertical measurements in glabella-subnasale, subnasale-stomion and stomion-menton in the male were higher than in the female subjects in 14∼15 years old Korean, so middle and lower third face were higher than those of female(p<0.05). 2.The horizontal measurements of female was higher than those of male in the rt. and It. eye width but smaller in nose width and lip width(p<0.05). 3.There was no significant difference in gender compared with soft cheek and mention angle measurements When our reports were compared with american white population, the vertical proportions in Korean normals were similar to american and the line measurements in middle facial length, nose width and intercanthal distance were higher than those of american. Key words : Maxillofacial korean normals, Frontal photometric measurements

상악골 비구개관 낭종의 치험예

이상철,김여갑,류동목,송우식 경희대학교 1989 慶熙醫學 Vol.5 No.2

半剛性 및 剛性固定이 頭蓋顔面骨의 成長에 미치는 影響에 관한 硏究

李相喆,金麗甲 大韓顎顔面成形再建外科學會 1993 Maxillofacial Plastic Reconstructive Surgery Vol.15 No.3

To prove the effct of semi-rigid fixation wlich utilize wire and rigid fixation which utilizes minplate toward cranio-facial growth and development of growing children for teenagers, 28 rabbits-6 weeks, about 1.5kg-were experimented. They were classified three groups the semi-rigid group was 12 rabits which were fixed with 26 gauge stainless steel wire to cross a fronto-nasal suture, the rigid group was the other 12 rabbits which were fixed with miniplate and screw, the control group was 4 rabbits which were get rid of only periosteum. The sample of fronto-nasal of rabbits which were sacrified after 2 weeks, 4 weeks, 8 weeks, and 12 weeks of the operation were investigated and made a comparative study with the light microscops. 1. At the control group, the central part of bony suture was connected with colagen bundle, the osteoblastic layer was investigated at the bony ending, new bone which covered the inside and outside faces of the bone suture was formed between periosteum. 2. Two weeks later from the experiment, ran slightly irregularly the collagen bundle which connects both bony endings of the rigid group. 3. Four weeks later from the experiment, collagen bundle of bone surface were arranged parally a little and comparing to the semi-rigid group, newly formed woven bone of surface of the adjacent bone was made obviously a little. 4. Eight weeks later from the experiment, collagen bundle which is located between both bony ending become close. Both the semi-rigid group and the rigid group showed significant formation of new bone at the periosteum and the bone surface. 12 weeks later from the experiment, both the semi-rigid group and the rigid group showed the regular running in the collagen bundle and smooth, dense peristeum. Then they assumed a similar aspect of the control group. I think that it does not give the influence to the cranio-facial growth of children or teenager to utilize a rigid fixation for a short period. Because as the time goes on, the surface of the bone suture was recovered and adjacent bone surface of the miniplate fixatin showed compensatory growth, although both the semi-rigid group which utilized wire and rigid group which utilized a miniplate brought about the change of the area of the bone suture at the early period.

골격성 3급 부정교합자시 악교정 수술후 골격이동량에 따른 설골의 위치와 상기도 변화에 관한 연구

조세종,김여갑 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.3

The goal of this study is the comparison of upper airway size and change of skeletal Class I group and skeletal Class III group (before operation, within 2 weeks after operation, 6 months after operation) respectively. At first, we measured the lines between selected upper air way landmarks on lateral cephalometric x-ray film of skeletal Class I 40 persons whoes age were 23-26 years old, ,and did the same lines of landmarks of skeletal Class III 44 persons who had not been operated yet, were within 2 weeks after operation, were 6 months after operation. And we compared it respectively and analyzed it with paired t-test. We studied the relationship of those on produced data. 1.Skeletal Class III group was narrower in nasopharyngeal air way space than that of skeletal Class I group, and increased in thickness of oropharyngeal, hypopharyngeal wall within 2 weeks after operation, and reduced in nasopharyngeal, oropharyngeal air way space, and did in thickness of nasopharngeal, hypopharyngeal wall 6 months after operation. 2.Skeletal Class III group reduced in nasopharyngeal, oropharyngeal air way space, and increased in thickness of nasopharyngeal, oropharyngeal, hypopharyngeal wall within 2 weeks after operation, restored the thickness of nasopharyngeal, oropharyngeal wall, but did not restored nasopharyngeal, oropharyngeal, hypopharyngeal air way space. 3.Vertical length from hyoid bone to mandibular plane did not have signifacant difference from Class I group but after operation, it increased more than Class I group significantly. 4.The size of airway reduced after operation. Among this, oropharyngeal airway most reduced.

顎橋正術이 咬合力에 미치는 影響에 關한 硏究

吳承煥,金麗甲 大韓顎顔面成形再建外科學會 1992 Maxillofacial Plastic Reconstructive Surgery Vol.14 No.4

This study was undertaken to investigate the effect of orthognathic surgery on occlusal force. The maximum bite force was measured in 26 dentofacial deformity patients, aged 14-26(mean age 20.3) years, before surgery and at IMF removal, 3, 6, and 12months postsurgery. To grope the correlation of bite force and skeletal change after orthognathic surgery, the cephalometric headplates were measured, tabulated and statistically analyzed. The results were as follows. 1. The presurgical maximum bite force was 13.7kg in upper first molar(rt. Side 12.7kg, it. Side 14.6kg). There was remarkable difference with that of normal occlusion. 2. The recovery of bite force was very significant in according to the operation method and the duration of IMF that was 7.6kg at IMF removal, 14.2kg at 3 months, 19.7kg at 6 months. 26.1kg at 12 months postsurgery. 3. To fasten the recovery and to increase the bite force after orthognathic surgery, the long IMF time and the injury to the masticatory muscle should be avoided by the internal rigid fixation and early physical exercise. 4. The bite force was positively correlated to the changes of mandibular plane angle, the angle between platatal plane and mandibular plan, the angle between occlusal plane and mandibular plane, and negatively correlated to the changes of mandibular body length in craniofacial structure. 5. There was no correlationship between bit force and mesial inclination of tooth long axis of first molar in this subject. 6. There was no correlation between the changes of bite force and the changes of mechanical advantage of the temporal and masseter muscle.

矢狀分割骨折斷術 後 나사固定方法에 따른 應力分布에 관한 有限要素法的 硏究

韓勳,金麗甲 慶熙大學校 齒科大學 1995 慶熙齒大論文集 Vol.17 No.2

A finite element study was done for stress distribution on various rigid fixation methods with screw after sagittal split ramus osteotomy. The purpose of this study was to analyze the various methods used for screw fixation after sagittal split ramus osteotomy. The fixation methods were classified as the Type I-triangular pattern at 90 degree to the bone surface(2 above and 1 below the mandibular canal), Type II-triangular pattern at 70 degree to the bone surface(2 above and 1 below the mandibular canal), and Type III-linear pattern at 90 degree to the bone surface (3 above the mandibular canal). Also the applied direction of force was classified as the anterior, premolar, and molar area with 100 Kg F/cm2 on each region. The results were as follows 1. The stress was mainly concentrated on the condylar neck of the mandible and the superior area of proximal bone fragment after sagittal split ramus osteotomy with screw fixation 2. The stress acting on the screw was principally shear stress, which cause the screw to bend, and increased in magnitude as the applied force was moved from posterior to anterior, and increased in angulated case than perpendicular case. 3. The triangular pattern was clinically more favorable compared to the linear pattern, because the stress distribution on the screw was comparably uniform, and inferior screw significantly contributed to prevent the screw bending 4. The perpendicular pattern to the bone surface was clinically more favorable than the angulated pattern, because the actual differences of shear stress on the screw was increased as the applied force was moved from posterior to anterior.