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악교정수술 골절단술시 컴퓨터 네비게이션 시스템의 이용: Technical Note
김문기,강상훈,최영수,김정인,변인영,박원서,이상휘,Kim, Moon-Key,Kang, Sang-Hoon,Choi, Young-Su,Kim, Jung-In,Byun, In-Young,Park, Won-Se,Lee, Sang-Hwy 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.3
Surgery with the computer navigation system can make it possible to identify important anatomical structures which are difficult to be confirmed with the naked eye in the operation, and has extended their applications in various surgical fields. The head and neck surgery especially requires detailed anatomical knowledges and these knowledges have influences on postoperative functions and esthetics of a patient. In the orthognathic surgery, we should take osteotomies in the precise locations of the jawbones and move segments to the intended positions. There are so many important anatomical structures around the osteotomy-sites in the orthognathic surgery that the prevention of damage to these structures to obtain satisfactory results without any complication. There are vessels of the pterygoid plexus posterior to the pterygoid plate in the maxilla and the mandibular nerve enters the mandibluar foramen in the mandibular ramus. These locations should be confirmed perioperatively to avoid any injury to these structures. The navigation-assisted surgery may be helpful for this purpose. We performed navigational orthognathic surgeries with preoperative CT images and obtained satisfactory results. The osteotomy was performed in the proper location and damaging the surrounding important anatomical structures was avoided by keeping the saw away from them with the real-time navigation. It may be required to develop proper devices and protocols for the navigation-assisted orthognathic surgery.
자극성 섬유종, 구강백반증 및 구강편평세포암종에서 MMP-2 및 MMP-9 발현에 대한 면역조직화학적 연구
김문기(Moon-Key Kim),이은하(Eun-Ha Lee),김진(Jin Kim),이의웅(Eui-Woong Lee),차인호(In-Ho Cha) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.4
MMP-2 and MMP-9, type IV collagenases which degrade basement membrane, have been known to play important roles in invasion and metastasis of tumor cells, In addition, they seem to be involved in cell differentiation, apoptosis, angiogenesis and immunity, etc. We immunohistochemically examined epithelial and stromal expressions of MMP-2 and MMP-9 in irritation fibroma, oral leukoplakia, and oral squamous cell carcinoma (OSCC) and have some results as follows: 1. Irritation fibromas, oral leukoplakias and OSCCs mostly showed increased expression of MMP-2 and MMP-9 in the epithelium and connective tissue compared with normal mucosa. 2. There was a significant difference in the epithelial expression of MMP-2 and MMP-9 between irritation fibroma and oral leukoplakia. 3. There was a significant difference in the epithelial and stromal expression of MMP-2 and MMP-9 between irritation fibroma and OSCC. 4. There was a significant difference in the stromal expression of MMP-9 between oral leukoplakia and OSCC. We concluded that rritation fibroma, oral leukoplakia and OSCC have somewhat different characteristics of MMP-2 and MMP-9 expressions, which perhaps result from different pathogenesis.
치성상피종양으로부터 상악에 발생한 치성유령세포암종의 치험례
김진학(Jin-Hak Kim),김문기(Moon-Key Kim),차인호(In-Ho Cha),김진(Jin Kim),김현실(Hyun-Sil Kim),최희수(Hee-Soo Choi),김형준(Hyung-Jun Kim) 대한구강악안면외과학회 2004 대한구강악안면외과학회지 Vol.30 No.3
The neoplastic variant of calcifying odontogenic cyst has various designation, and its malignant counterpart has been reported as aggressive epithelial ghost cell tumor or odontogenic ghost cell carcinoma. Odontogenic ghost cell carcinoma(OGCC) is a rare carcinoma first documented in 1985. It is composed of varying sized islands of anucleated cells with homogenous, pale eosinophilic cytoplasm, so called ghost cells, were admixed with nucleated cells. We report a case of maxillary OGCC developed from odontogenic epithelial tumor in a 25-year-old man with literature review.
비스테로이드성 항염진통제의 투여시기가 구강외과 술 후 통증에 미치는 효과에 대한 연구
정영수,김문기,엄유정,박형식,이의웅,강정완,Jung, Young-Soo,Kim, Moon-Key,Um, Yoo-Jung,Park, Hyung-Sik,Lee, Eui-Wung,Kang, Jeong-Wan 대한치과마취과학회 2004 Journal of Dental Anesthesia and Pain Medicine Vol.4 No.2
Background: Many studies on efficacy of preemptive analgesia have been processed in different ways. But the value of preemptive analgesia is still controversial. The goal of this study was to compare analgesic effect of an NSAID according to three different administration times for oral surgical pain. Patients and Methods: Using a randomized, parallel-group, single-center, and active-controlled test design, this study was conducted to healthy 80 patients undergoing a surgical removal of an impacted mandibular third molar requiring bone removal. The oral NSAID was first administered 1 hour preoperatively, or 1 hour postoperatively, or no scheduled administration in pre or postsurgery. Whenever patients felt at least moderate pain (score ${\ge}$ 5 on a 10-point scale) after surgery, they were instructed to take the same drug. Pain intensities and times to the first and second onset of postoperative pain from end of surgery were assessed for 24 hours. Results: Of the enrolled eighty subjects in this study, 25 patients were assigned to preemptive, 26 to post-treatment and 29 to no treatment group. The demographic distribution and duration of surgery in the three groups were statistically similar. The mean time to first onset of postoperative pain was significantly prolonged in post-treatment group (277.2 minutes, p < 0.05) compared to preemptive (158.4 minutes) and no treatment group (196.5 minutes). The mean time to second onset of postoperative pain was not significantly different among the three groups. No significant statistical difference was found among the mean pain intensities at the first and second onset of postoperative pain in the three groups. Conclusions: In this small selected group of subjects and limited study design, the analgesic effects of NSAID administered preoperatively were no longer effective for postoperative pain. The results in this population imply that scheduled postoperative analgesics before pain development are adequate for postoperative analgesia without preoperative administration.
선행적 진통 요법의 효과성에 대한 연구 -발치 전과 후 진통 요법의 효과 비교-
정영수,김문기,박형식,이의웅,강정완,Jung, Young-Soo,Kim, Moon-Key,Park, Hyung-Sik,Lee, Eui-Wung,Kang, Jeong-Wan 대한치과마취과학회 2003 Journal of Dental Anesthesia and Pain Medicine Vol.3 No.1
Background: Studies on the pain have been dealing with many different ways for last several centuries. Especially, preemptive analgesia is being used as a method to control the postoperative pain. Many studies on its efficacy have been processed in different ways about various drugs, administration methods and times for various operations. And the value of preemptive analgesia are still controversial regarding the results of other clinical studies. The authors performed a clinical study on efficacy of preemptive analgesia using an non-steroidal anti-inflammatory drug (NSAID) for the surgical extraction of impacted third molar teeth and present the more effective pain treatment after oral surgery with literature review. Methods: Using a randomized double blind test design, this study compared the analgesic efficacies of an NSAID, Talniflumate 370 mg. This drug administrated first either 1 hour preoperatively (experimental group) or when the pain developed moderately to severely over 5 scale of verbal rating scales (0-10) to respective 30 patients undergoing the removal of impacted third molars. Pain intensity and the time from the end of surgery were assessed postoperatively whenever the patients demanded additional drug over 5 scale for forty eight hours using same verbal rating scales. Results: The sex distribution, the age of the patients. and the time required for surgery in two groups were similar. The average first time for demanding additional drug after surgery was 163.9 minutes in experimental group and 191.5 minutes in control group. At this time, the average pain intensity was 5.8 in experimental group and 6.1 in control group. And the average second time for demanding additional drug was 365.5 minutes in experimental group and 351.8 minutes in control group. At this time. the average pain intensities were 6.6 in experimental group and 6.2 in control group. No statistically significant difference was found between the average first times and second times, and the average pain intensities at first and second times in two groups. Conclusions: From these results the efficacy of preemptive analgesia used in this study was not appeared. This clinical study indicates that many NSAIDs administrated preoperatively in present practices have weak efficacy of preemptive analgesia for postoperative pain, thus the authors recommend that only postoperative analgesics are adequate without preoperative use of analgesics.
기관지 천식과 편도 증식증 환자에서 상악 정중부 과잉치 발치 전 포크랄과 케타민 투여 진정요법 시 발생된 기도폐쇄와 호흡장애 -증례 보고-
최영수,강상훈,김문기,이천의,유재하,Choi, Young-Su,Kang, Sang-Hoon,Kim, Moon-Key,Lee, Chun-Ui,Yoo, Jae-Ha 대한치과마취과학회 2010 Journal of Dental Anesthesia and Pain Medicine Vol.10 No.1
The causes for airway obstruction include foreign body aspiration, congenital structural abnormalities of the airway, infection, etc. And the potential causes of acute respiratory distress contain many situations, like hyperventilation, vasodepressor syncope, asthma, etc. A major factor that leads to the exacerbation of respiratory disorders is undue stress, either physiologic or psychologic. Psychologic stress in dentistry is the primary factor in the exacerbation of preexisting medical problems. Adequate pretreatment medical and dental evaluation of the prospective patient can often prevent respiratory problems from developing. The dentist can modify patient management to minimize the risk of exacerbating these conditions. When dental anxiety is a major factor, the use of psychosedative procedures and other stress-reduction techniques should also be considered. This is the report of a children case of airway obstruction and respiratory distress owing to sedation complication by use of Chloral hydrate and Ketamine before extraction of the mesiodens in a patient with bronchial asthma and tonsillar hyperplasia. After these situations, the patient was consulted & referred to the department of Pediatrics and Otorhinolaryngology.
김병욱(Byung-Wook Kim),정재형(Jae-Hyung Jung),김문기(Moon-Key Kim),이현중(Hyun-Jung Lee),김정인(Jung-Ihn Kim),이미경(Mi-Kyung Lee) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.2
The term odontoma, first introduced by Broca, was originally applied to all odontogenic tumors. Related to the clinical and histological differences, 2 groups of odontoma were defined: compound odontoma and complex odontoma. Complex odontoma is more common in the mandible than in the maxilla, usually occuring in the mandibular premolar-molar area. And this consists of small mass of irregularly arranged enamel, dentine, cementum, and connective tissue, but tooth-like structures are not found. In our case, 34 year old man was diagnosed as the complex odontoma of maxillary sinus by the physical exam, Panex, and C.T scan. We sectioned and removed it, and then confirmed the diagnosis histopathologically. Its uncommon location and size made us report that case and review the literature concerned.
변인영(In-Young Byun),김진홍(Jin-Hong Kim),강상훈(Sang-Hoon Kang),김문기(Moon-Key Kim) 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.6
Malignant otitis externa (MOE) originates as inflammation of the epidermis in the external auditory canal, and spreads to the surrounding structures and neck, leading to abscess formation. MOE is associated with an immunosuppressive condition and diabetes. Patients with MOE suffer from otalgia, otorrhea and hearing loss. According to the literature, surgery to the temporomandibular joint is controversial as the treatment of choice.
하악 제3대구치 발치의 결정에 관한 재고찰 - 발치 현황과 영향 인자를 중심으로
박원서(Wonse Park),김진학(Jin-Hak Kim),강상훈(Sang-Hoon Kang),김문기(Moon-Key Kim),김봉철(Bong-Chul Kim),최지욱(Ji-Wook Choi),이상휘 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.5
Introduction: Third molar extraction is one of the most common procedures in oral and maxillofacial surgery. The impacted third molar causes many pathological conditions, such as pericoronitis, caries, periodontitis, resorption of adjacent teeth, and cyst or tumors associated with impacted teeth. Extraction is often considered the treatment of choice for impacted lower third molars. On the other hand, imprudent extraction of deeply impacted third molars can cause permanent complications, such as inferior alveolar nerve damage. Therefore, guidelines for the extraction of lower third molars should be set to prevent embarrassing complications. This study examined the indication and current trends of the extracted lower third molars in the dental hospital of a dental college. Materials and Methods: 557 extracted third molars were evaluated at the department of oral and maxillofacial surgery of Yonsei University. The chief complaint, diagnosis, age and degree of impaction were analyzed to determine the tendency for the extraction of asymptomatic lower third molars. Results: The percentage of asymptomatic third molars was 40.8%. In cases of full impacted tooth or full erupted tooth, the percentage of asymptomatic teeth was more than 50% (52.4% and 54.3, respectively). Among those partially impacted teeth, 73.1% of them showed symptoms, such as pain, tenderness and swelling. In terms of age, pericoronitis was evident at a younger age, and dental caries/periodontitis was the main cause of removal in those aged over 50. Twenty nine cases (1.6%) had teeth associated with pathological changes Conclusion: The incidence of pathological changes to the lower third molar was relatively low. Surgical extraction is recommended in cases of partially impacted teeth. In Korea, the incidence of asymptomatic third molar extraction was relatively higher than in European countries. More careful attention would be desirable to consider the risks and benefits of lower third molar extraction.