미니플레이트의 골내 고정원 적용 시 초기 안정성에 영향을 주는 요인에 대한 3차원 유한요소법적 연구

이남기,최동순,장인산,차봉근 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.5

본 연구는 골내 고정원으로 사용하는 미니플레이트 시스템의 초기 안정성에 영향을 주는 요인에 대해 알아보기 위해 시행하였다. 미니플레이트의 고정에 사용되는 미니스크류의 길이, 수 및 적용되는 교정력의 방향에 따른 골내응력 분포 양상과 미니스크류의 변위 정도를 분석하기 위하여 3차원 유한요소분석을 시행하였다. 단순화한 골 모델에 6 hole의 곡선형 미니플레이트를 위치하고 직경 2 mm의 미니스크류로 고정하되 각각 6 mm와 4 mm 길이의 두 가지 종류로 세 개 또는 두 개로 고정한 총 네 개의 유한요소모델을 제작한 후 각각의 모델에서 4 N의 교정력을 미니플레이트의 고정되지 않은(unfixed) 가장 원심측 두 개의 hole을 연결한 가상의 축에 대해 0˚, 30˚, 60˚, 90˚ 방향으로 각각 적용하였다. 미니플레이트를 고정하는 미니스크류가 동일 길이일 경우 개수가 작을수록, 동일 개수일 경우 길이가 짧을수록 골에 나타나는 최대 응력과 미니스크류의 최대 변위가 증가되었다. 골에 나타나는 최대 응력은 해면골에 비해 피질골에 집중되어 응력의 대부분은 피질골에서 흡수되었다. 미니플레이트의 가상의 축에 대해 교정력의 견인방향이 증가할수록 골내의 최대 응력과 미니스크류의 최대 변위가 증가되었다. 골내의 최대 응력과 미니스크류의 최대 변위는 적용된 견인력 지점에서 가장 가까운 미니스크류 고정 부위였다. 이상의 결과로 미니플레이트 시스템의 초기 안정성을 위해 2 mm 직경의 미니스크류를 사용 시 4 mm보다는 6 mm 길이의 미니스크류를, 2개보다는 3개식립하는 것이 더 유리하며, 미니플레이트의 가상의 축에 대해 적용하는 교정력의 견인방향이 가급적 일치되도록 미니플레이트를 위치시키는 것이 좋을 것으로 생각된다. Objective: The purpose of this study was to evaluate the stress distribution in bone and displacement distribution of the miniscrew according to the length and number of the miniscrews used for the fixation of miniplate, and the direction of orthodontic force. Methods: Four types of finite element models were designed to show various lengths (6 mm, 4 mm) and number (3, 2) of 2 mm diameter miniscrew used for the fixation of six holes for a curvilinear miniplate. A traction force of 4 N was applied at 0˚, 30˚, 60˚, and 90˚ to an imaginary axis connecting the two most distal unfixed holes of the miniplate. Results: The smaller the number of the miniscrew and the shorter the length of the miniscrew, the more the maximum von Mises stress in the bone and maximum displacement of the miniscrew increased. Most von Mises stress in the bone was absorbed in the cortical portion rather than in the cancellous portion. The more the angle of the applied force to the imaginary axis increased, the more the maximum von Mises stress in the bone and maximum displacement of the miniscrew increased. The maximum von Mises stress in the bone and maximum displacement of the miniscrew were measured around the most distal screw-fixed area. Conclusions: The results suggest that the miniplate system should be positioned in the rigid cortical bone with 3 miniscrews of 2 mm diameter and 6 mm length, and its imaginary axis placed as parallel as possible to the direction of orthodontic force to obtain good primary stability.

Miniplate anchorage를 이용한 골격성 Ⅲ급 부정교합 아동의 상악 전방견인 치료

차봉근,이남기,최동순 대한치과교정학회 2007 대한치과교정학회지 Vol.37 No.1

상악 전방견인 장치는 골격성 Ⅲ급 부정교합 특히 상악골 열성장 치료를 위해 널리 사용되고있다. 이 경우 증례에 따라 치아 치조성 이동을 허용하는 다양한 치료목표가 설정될 수 있으나, 상악골의 순수한 전방이동이 필요한 경우 다양한 구내장치를 이용하여 고정원 보강을 시도함에도 불구하고 고정원의 치아 치조성 이동을 피하기 어려운 경우가 발생된다. 이는 치아를 고정원으로 이용하는 경우 골개조(remodeling)가 상악복합체 뿐만 아니라 치주인대에서도 발생되기 때문이다. 특히 이러한 부작용은 역동적인 치열 교환이 일어나서 치성고정원이 부족한 혼합치열기 또는 비교적 늦은 나이에 악정형 치료가 시행되는 경우에 많이 발생되게 된다. 이와 같은 부작용을 방지하기 위해 임플란트의 사용이나 피질골절단술, 신연골형성술 등의 외과적 방법을 응용하여 전방견인을 시도할 수 있으나 본고에서는 악정형적 효과를 극대화하기 위한 새로운 대안으로 골 고정원 (skeletal anchorage)을 이용한 상악 전방견인 치료의 외과적 교정적 치료 술식을 증례를 통해 소개하고자 한다. The maxillary protraction headgear has been widely used in the treatment of skeletal Class Ⅲ children with maxillary deficiency. A variety of treatment objectives which allow dentoalveolar movements may be established, but when only maxillary protraction without dentoalveolar movement is needed, one of the limitations in maxillary protraction with conventional tooth-borne anchorage is the loss of dental anchorage. This is because a bone remodeling occurs not only at circummaxillary sutures but also within the periodontal tissues. During protraction treatment in the mixed dentition phase, in older children or for the patient with multiple congenitally missing teeth, it is not uncommon to observe undesirable mesial movement of maxillary teeth. Such a side effect can be eliminated or minimized using absolute anchorage such as skeletal anchorage. The purpose of this case report is to introduce a new technique of the maxillary protraction headgear treatment using surgical miniplates.

하악골 전돌증 수술 후 하악골 이동량에 따른 발음 양상에 관한 비교 연구

신기영,이동근,오승환,성헌모,이숙향 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.1

After performing mandibular setback surgery, we found some changes in patterns and organs of speech. This investigation was undertaken to investigate the aspect and degree of speech patterns according to the amount of surgical setback in mandibular prognathic patients. Thirteen patients with skeletal Class Ⅲ malocclusion were studied preoperative and postoperative over 6 months. They had undergone the mandible setback operation via bilateral sagittal split ramus osteotomy(BSSRO). We split the patients into two groups. Group 1 included patients whose degree of mandibular setback was 6mm or less, and Group 2 above 6mm. Control group was two adults wish normal speech patterns. A phonetician performed narrow phonetic transcriptions of tape-recorded words and sen- tences produced by each of the patients and the acoustic characteristics of the plosives, fricatives, and flaps were analyzed with a phonetic computer program (Computerized Speech Lab(CSL) Model 4300B(USA) ). The results are as fallows : 1. Genera1ly, Patients showed longer closure duration of plosives, shorter VOT(voice onset time) and higher ratio of closure duration against VOT 2. Patients showed more frequent diffuse distribution than the control group in frication noise energy of fricatives. 3. In fricatives, frequency of compact from were higher in group 1 than in group 2. 4. Generally, a short duraction of closure for /ㄹ/ was not realized in the patient's flaps. Instead, it was realized as fricatives, sonorant with a vowel-like formant structure, or trill type consonant. 5. Abnormality of the patient's articulation was reduced, but adaptation of their articulation after surgery was not perfect and the degree of adaptation was different according to the degree of surgical setback.

RECONSTRUCTION COMBINED WITH HBO THERAPY AND ILIAC BONE GRAFT IN MANDIBULAR FRCTURE SITE OSTEOMYELITIS

Lee, Dong-Kuen,Yun, Seong-Pill,Kim, Su-Nam,Lim, Chang-Joon 大韓顎顔面成形再建外科學會 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.1

하악골 골절시 감염으로 인한 합병증에는 비유합, 부정유합, 감염에 의한 골수염, 치아 및 지지골 상실, 국소부위로부터 인접부위로 감염확장 등이 있다. 그 원인으로는 크게 국소요인과 전신요인으로 분류되는데 국소요인으로는 부적절한 고정과 수복, 감염 및 개조된 혈액공급을 들 수 있고 전신 요인으로는 부적절한 고정과 수복, 감염 및 개조된 혈액 공급을 들 수 있는 전신요인으로는 환자의 나이 및 대상장애 질환이나 primary bone disease, 영양결핍을 들 수 있다. 악골골절과 관련된 골수염은 조기에 적절한 고정 및 치료, 항생제 요법, 골절선상의 치아에 대한 치료, 전신적 저항성을 항진 시킴으로서 예방할 수 있다. 본 저자들은 하악골 골절수 이차감염으로 인한 골수염에서 골 이식의 일반적인 원칙인 감염이 없는 부위가 아닌 염증이 존재한 부위에 유리장골 이식술과 고압산소 요법을 병행하여 양호한 결과를 얻었기에 이에 보고하는 바이다. Fracture site osteomyelitis begins rarely with an acute event but rather has a subacute onset. It develops almost exclusively in the mandibular region. The treatment principles of mandibular fracture site osteomyelitis are complete removal of inflammatory tissue and drainage, rigid fixation with or without autogenous bone bone graft and specific antibiotic therapy. But hyperbaric oxygen used as a modality in the treatment of intractable osteomyelitis. In this paper, we reported that the three patients who have osteomyelitis accompying secondary in fection after mandibular fracture.

순열 및 구개열 환자의 임상적 연구

이동근(Dong Kuen Lee),임창준(Chang Joon Yim),민승기(Seung Ki Min) 대한악안면성형재건외과학회 1988 Maxillofacial Plastic Reconstructive Surgery Vol.10 No.1

N/A The authors studied 61 cases of cleft lip and/or palate who visited the Department of Oral & Maxillofacial Surgery, College of Dentistry, Won Kwang Univ., during past 3 years. (1984, 7 - 1987, 8) The obtained results were as follows; l. In total 61 cases, male patients were 32 cases (52.5%) and female patients were 29 cases (47.5%). 2. Cleft lip k palate patients were 28 cases (46.1%), cleft lip 25 cases (40.9%), cleft palate 8 cases (13.0%). 3. In cleft lip patients, the Lt. side cleft group (49.0%) was larger than the Rt. aide cleft group (37.7%). 4. In velopharyngcal insufficiency, high nasal sound was much improved by pharyngoplasty. 5. Possible application of some etiology of cleft lip and/or palate were associated with the inheritance, maternal age and drug medication, nutritional insufficiency, mental stress during pregnancy period.

체계구성 자동화 및 성능 분석 인터페이스 프로그램 개발

기동우(Dong-woo Ki),조주형(Joohyung Cho),곽성준(Seongjoon Kwak),강주엽(Ju yup Kang),이용구(Yonggu Lee),금동정(Dong-jung Kuem),노근래(Kuen-lae No),이건우(Kunwoo Lee) 한국정밀공학회 1997 한국정밀공학회 학술발표대회 논문집 Vol.1997 No.11월-2

배양액 내 질소의 혼용 비율이 심비디움 유묘의 생육에 미치는 영향

이동수(Dong Soo Lee),권오근(Oh Kuen Kwon),김미선(Mi Seon Kim),박부희(Pue Hee Park),박필만(Pil Man Park),이영란(Young Ran Lee),안혜련(Hye Ryun An),조강석(Kang Seok Cho) 한국원예학회 2014 한국원예학회 학술발표요지 Vol.2014 No.10

임상원저 : 편측 하악 과두골절의 관혈적 치료에 있어서 예후에 영향을 줄 수 있는 인자들에 관한 임상 통계학적 연구

이동근(Dong Kuen Lee),오승환(Seung Hwan Oh),성헌모(Hun Mo Sung),장관식(Kwan Sik Chang),민승기(Seung Ki Min) 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.1

The purpose of this study is to reveal the factors leading to the problem of unilateral condylar fractures and suggest a treatment guideline of treatment for good prognosis in surgical treatment. The factors can be age, sex, fracture site, degree of displacement, posterior occlusion loss, post-operative alteration of condylar head position, post-operative condylar head resorption, and maxillomandibular fixation period. One hundred and eleven patients with unilateral condylar fractures, who were treated by surgical method from 1990 Feb. to 2000 Feb., were studied. Minimum follow-up period was 6 months. The results were as follows; 1. In the age group of 41 60,females had significantly higher complication rate than males, therefore we must be careful about treatment of female in this age group 2. In level Ⅰfractures of the mandibular condyle, because there were abundant complications when the patients were treated with fragment removal, conservative treatment is recommended over the surgical approach. 3. There were no differences in the complication rate, in the level Ⅱ, Ⅲ fractures. but were severe complications in the cases of patients treated by Dr. Nam's method or fragment removal. Therefore, open reduction and internal fixation is recommended over Dr. Nam's method or fragment removal. 4. In level Ⅳfractures, open reduction and internal fixation is recommended 5. Although there was a higher complication rate depending on the degree of deviation, there was no correlation between the degree of deviation and development of complications in each level of fracture 6. Because the complication rate was higher in cases of condylar resorption, vertical dimension loss, and alteration of condylar head position, we must make an effort to prevent such complications during treatment.

복합성 하악골 골절 환자에서의 십이지장 궤양으로 인한 범발성 복막염의 증례

이동근(Dong Kuen Lee),엄인웅(In Woong Um),김귀희(Kue Hee Kim),민승기(Seung Ki Min) 대한구강악안면외과학회 1992 대한구강악안면외과학회지 Vol.18 No.1

A 54 year-old man was transferred to our OMS department room (ER) with chief complaint of massive intra-oral bleeding due to mandibular open fracture. Emergency treatment and operation was performed within a day. He suffered from severe epigastric pain immediately after emergency operation. The diagnosis was made as acute Pan-peritonitis by General surgeon consult with clinical & radiographic examination. Emergency operation was performed in three days after first operation for Pan-peritonitis. Patient sign & symptom was improved and recovered uneventfully after surgery.

관수방법이 심비디움의 생육과 용수 절감에 미치는 영향

이동수(Dong Soo Lee),권오근(Oh Kuen Kwon),김미선(Mi Seon Kim),박필만(Pil Man Park),박부희(Pue Hee Park),이영란(Young Ran Lee),안혜련(Hye Ryun An) 한국원예학회 2014 한국원예학회 학술발표요지 Vol.2014 No.10