구개점막과 협점막의 절개에 사용되는 칼의 개선을 위한 기초 연구

서병무,최진영,이종호,김명진,정필훈,Seo Byoung-Moo,Choi Jin-Young,Lee Jong-Ho,Kim Myung-Jin,Choung Pill-Hoon 대한구순구개열학회 2001 대한구순구개열학회지 Vol.4 No.1

Disposable blade is widely used for palatal and oral mucosal incision in oral and maxillofadal surgery nowadays, But its design and durability need for improvement, Especially, there are so many hard tissues intraoral area, such as bone and tooth, therefor the sharpness of the surgical blade was easily destroyed, The purpose of this study was to make basic data for developing new design of surgical blade using in oral and maxillofacial area including for the patients who have cleft lip and palate deformities, Some questionnaires about the usefulness of currently used surgical blades were sent to 150 dentists, the 54 of them made a reply, Secondly, The used-once blade and fresh new blade were examined under the scanning electron microscope with the 4000-times magnification, Lastly, the tissue reaction following the surgical incision with a fresh-new and a used blade on rat buccal cheek mucosa and hard palate was evaluated with light microscope with hematoxilin-eosin staining, The time interval from the surgical trauma to taking a sample were 1 day, 3 days, 7 days, and 14 days, At each time schedule, 2 Sprague-Dawley rats were sacrificed, Many dentists were agreed to need for changing the design of the surgical blades and also demand to improve the durability of the blades, They were also eager to adopt the new design of blade if it was available, The blade used in surgical extraction procedure was heavily damaged in its sharpe edge of number 15 blade, The histological differences were not prominent, but the delayed healing was detected in buccal mucosal defects especially in the surgical group with used blade, There are slight different changes in hard palatal defects between a used and a new blade group, In this study, we could find that there are imperative demanding on improvement of surgical blade design and durability for oral and maxillofadal area, The blade currently using in surgical extraction was easily damaged, The animal model of this study was not perfect for the purpose of this study.

하악전돌증 환자의 하악지 시상분할법에 의한 악교정 수술후 재발에 관한 연구

서병무(Byoung moo Seo),민병일(Byong Il Min) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.2

In a study of 20 cases have been investigated clinically and radiologically long term results (6 months and over) of the sagittal split osteotomy technique (Obwegeser - Dal Pont 1961). The overall relapse rate was 30% but reoperation is not required. A statistical analysis of cephalometric radiographs was done and possible causes of relapse was discussed. The results were as following. 1. There are 6 cases of relapse in 20 patients (30%). 2. There are significant correlationship between amount of setback and long term horizontal relapse (p<0.01). 3. There are significant correlationship between surgical change of mandibular plane angle and long term horizontal relapse(p<0.01). 4. The direction and amount of vertical changes are irregular and there are no statistical correlationship. 5. The duration of fixation and patients age at operation are not correlated to horizontal relapse. 6. In preoperative cephalometric measurements, mandibular plane angle and gonial angle are not correlated with horizontal relapse. 7. Wire osteosynthesis is inadequate comparing rigid fixation in the aspect of positional stability.

폐쇄성 수면무호흡환자에서 확대 구개수구개피판을 이용한 치험례

김지연(Ji-Youn Kim),김성민(Soung-Min Kim),명 훈(Hoon Myoung),황순정(Soon-Jung Hwang),서병무(Byoung-Moo Seo)이종호(Jong-Ho Lee),정필훈(Pill-Hoon Choung),김명진(Myung-Jin Kim),최진영(Jin-Young Choi) 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.1

The uvulopalatal flap (UPF) technique is a modification of uvulopalatopharyngoplasty (UPPP) for the surgical treatment of obstructive sleep apnea. In the UPF technique, an uvulopalatal flap is fabricated and sutured to the residual mucosa of the soft palate to expand the antero-posterior dimensions of the oropharyngeal inlet. In the extended uvulopalatal flap (EUPF) technique, an incision at the tonsillar fossa is added to the classical UPF technique followed by the removal of mucosa and submucosal adipose tissue for additional expansion of the lateral dimension. The EUPF technique is more conservative and reversible than UPPP. Therefore, complications, such as velopharyngeal insufficiency, dysphagia, dryness, nasopharyngeal stenosis and postoperative pain, are reduced. In the following case report, the patient was diagnosed with obstructive sleep apnea and treated with the EUPF technique. The patient’s total respiratory disturbance events per hour (RDI) was decreased to 15.4, the O 2 saturation during the sleep was increased, and the excessive daytime sleepiness had disappeared after the surgery without complications. The authors report this case with a review of the relevant literature.

Cleft Lip and Palate Surgery in Kyrgyzstan - Two Times of Our Experiences in Central Asia

박주영,서병무,정필훈,Park, Joo-Young,Seo, Byoung-Moo,Choung, Pill-Hoon Korean Cleft Lip and Plate Association 2010 대한구순구개열학회지 Vol.13 No.1

키르기즈스탄은 옛 실크로드의 한 가운데에 위치한 중앙아시아 국가로서 소련연방이 해체된 뒤 1991년에 독립한 신독립국(Newly Independent States, NIS)의 일원이다. 대한민국과의 공식적인 수교가 1992년에 이루어진 이후 18년이 지났지만 키르기즈스탄 거주 한국인의 숫자는 약 900명에 불과하며 특히 이들 중 대부분은 수도인 비쉬켁(Bishkek)에 살고 있다. 남 키르기즈스탄 제 1의 도시이자 옛 실크로드의 중심지로 유명했던 오쉬(Osh)시에는 2009년 말 기준 약 50여명의 한국인이 살고 있다. 한국얼굴기형환자후원회의 후원으로 구순구개열 자선수술팀은 2002년~2009년까지 11개국, 19회의 자선수술 활동을 다녀왔으나 중앙아시아 국가로의 방문은 키르기즈스탄이 최초였다. 많은 봉사활동국에서 지역적, 문화적 그리고 의료환경적인 어려움이 있었지만 2008년 12월, 2009년 7월 두 번의 키르기즈스탄 오쉬시로의 활동도 예외는 아니었다. 본 논문에서는 최초의 중앙아시아 키르기즈스탄 구순구개열 자선봉사활동에 대한 자세한 보고를, 준비과정에서부터 활동 완료시점까지 서술하고자 한다.

섬유성이형성증 유래세포의 특성연구

이찬희,한인,서병무,Lee, Chan-Hee,Han, Ihn,Seo, Byoung-Moo 대한구강악안면외과학회 2009 대한구강악안면외과학회지 Vol.35 No.5

Purpose: Fibrous dysplasia (FD) is a fibro-osseous disease associated with activating missense mutations of the gene encoding the $\alpha$-subunit of stimulatory G protein. FD may affect a single bone (called monostotic form) or multiple bones (called polyostotic form). The extent of lesions reflects the onset time of mutation. In this study, cells from monostotic FD in maxilla of a patient were isolated and cultured in vitro for characterization. Materials and Methods: The single cells were released from FD lesion which was surgical specimen from 15 years-old boy. These isolated cells were cultured in vitro and tested their proliferation activity with MTT assay. In osteogenic media, these cells underwent differentiation process comparing with its normal counterpart i.e. bone marrow stromal cells. The proliferated FD cells were detached and transplanted into the dordsal pocket of nude mouse and harvested in 6 weeks and 12 weeks. Results and Summary: FD cells have an increased proliferation rate and poor differentiation. As a result, cells isolated from FD lesion decreased differentiation into osteoblast and increased proliferation capacity. MTT assay presented that proliferation rate of FD cells were higher than control. However, the mineral induction capacity of FD was lesser than that of control. Monostotic FD cells make fewer amounts of bone ossicles and most of them are woven bone rather than lamellar bone in vivo transplantation. In transplanted FD cells, hematopoietic marrow were not seen in the marrow space and filled with the organized fibrous tissue. Therefore, they were recapitulated to the original histological features of FD lesion. Collectively, these results indicated that the FD cells were shown that the increased proliferation and decreased differentiation potential. These in vitro and in vivo system can be useful to test FD cell's fate and possible.

하악골 재건시 사용된 유리비골피판에서 임플란트 식립을 위한 수직적 골신장술

팽준영,이진용,명훈,황순정,서병무,최진영,이종호,정필훈,김명진,Paeng, Jun-Young,Lee, Jin-Yong,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Kim, Myung-Jin 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.6

Introduction: The fibular free flap is now considered as the first choice for long mandibular discontinuity defect. In spite of its good bone quality for implant installation, its diameter is too narrow to rehabilitate the masticatory function with implant installation. In this report, distraction osteogenesis was used for the augmentation of bone to install the dental implant in the mandible which was reconstructed with a vascularized fibular free flap. Patients and Methods: Three patients undertook the vertical augmentation of grafted fibular bone and dental implants were installed. On the day 8 post-surgery, the activation of the distractor was started at the rate of 1 mm twice a day. The total amount of distraction was 15 mm in two patients and 12.5 mm in one patient. Twelve implants were installed in three patients. Dental implants were simultaneously installed during removal of the distraction device in two patients. In one patient, the implant installation was delayed after device had been removed. All three patients showed the symptoms of mild to severe postoperative infection during the activation and consolidation. However, the distracted site showed undisturbed bone regeneration. Conclusion: The distraction osteogenesis showed the reliable results for the vertical augmentation of fibular bone which was used for the mandibular reconstruction. However, the great tendency of postoperative infection must be considered and clinically controlled.

하악 전돌증 환자의 악교정 수술에서 기도 공간의 부피변화에 관한 3차원적 분석

이지호,팽준영,명훈,황순정,서병무,최진영,이종호,정필훈,김명진,Lee, Jee-Ho,Paeng, Jun-Young,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Kim, Myung-Jin 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.6

Orthognathic surgery changes patient's mandibular position and environment of related anatomic structures. Many clinicians were interested in these changes and studied about this problem. However, most of them were based on two dimensional cephalogram. According to the development of image and computer system, it would be possible that the airway change is analyzed with three dimensional CT. So we tried to measure the volumetric change of airway and analyzed the relationship between the airway structure and volumetric change. Nineteen patients who experienced orthognathic surgery due to mandibular prognathism were analyzed with 3D CT data (preoperative and postoperative 6 months) and 2D lateral cephalometry. Volumetric change was measured and 3 dimensional change of related structure was assessed with simulation program ($V-works^{(R)}$, 4.0 Cybermed, Korea). Ten patients showed the decrease of airway volume change and nine showed the increase of airway volume change. Volumetric change was determined by dimensional change of mandible and hyoid bone. The dimensional positions of mandible and hyoid bone were the key factor for determining the airway change after surgery. Airway change is also predictable with the dimensional change of mandible and hyoid bone.

구순구개열 환자의 상악골 열성장에서 골신장술을 위한 Internal distraction device와 Rigid external distraction의 비교

팽준영,명훈,황순정,서병무,최진영,이종호,정필훈,백승학,김명진,Paeng, Jun-Young,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Baek, Seung-Hak,Kim, Myung-Jin 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.4

Distraction osteogenesis for the advancement of hypoplastic maxilla of cleft patients has shown successful results. In this report, rigid external distraction(RED) system and internal distraction device were used for maxillary advancement. Each system has its advantages and disadvantages. Larger amount of advancement can be achieved with RED system. But complex external device may give patients psychological stress. Internal device is invisible. However its distraction amount have limitation for the advancement (< 20mm) and the vector cannot be changed freely during distraction. The authors treated five cleft patients with maxillary hypoplasia(three with RED system and two with internal distractor). Their results were clinically satisfactory. We present the pros and cons of RED and internal system for maxillary distraction osteogenesis.

한국인에 있어서 하행구개동맥의 위치 연구 (Le Fort I형 골 절단술과 관련하여)

이일구,명훈,황순정,서병무,이종호,정필훈,김명진,최진영,Lee, Il-Gu,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Lee, Jong-Ho,Choung, Pil-Hoon,Kim, Myung-Jin,Choi, Jin-Young 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.6

Purpose: The Le Fort I osteotomy is a commonly performed maxillary procedure for dentofacial deformity. One of the risks of this procedure is major hemorrhage resulting from injury to the descending palatine artery. So it is very important to know the exact position of the descending platine artery. An increased understanding of the position of this artery can minimize the intra-operative bleeding while allowing extension of the bone cuts to achieve exact positioning maxilla. The aim of this investigation was to study the position of the descending palatine artery as it relates to the Le Fort I osteotomy. Methods and patients: Total 40 patients who underwent Le Fort I osteotomy in SNUDH OMFS were studied in this study. We measured the distance from the pyriform aperture to the descending palatine artery (DPA distance) using a ruler. We investigated the relationship between DPA distance, the distance from A point to the McNamara line on lateral cephalography and the patient's body height. Results: The average distances from the pyriform rim to the descending palatine artery were 35.3 mm on the right (range: $30{\sim}40mm$) and 33.7mm (range: $30{\sim}41mm$) on the left in males. Those in females were 33.4 mm on the right (range: $28{\sim}40mm)$ and 32.8mm (range: $27{\sim}38mm$) on the left. The significances between the distance the DPA distance, the body height and the distance from A point to McNamara line were not found. <Simple Regression Analysis> Conclusion: Injury to the descending palatine artery during Le Fort I osteotomy can be minimized by not extending the osteotomy more than 30 mm posterior to the pyriform aperture in mal, and 27 mm in female.

임플란트 식립을 위한 치조골 증강술의 임상적 분석

팽준영,명훈,황순정,서병무,최진영,이종호,정필훈,김명진,Paeng, Jun-Young,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Kim, Myung-Jin 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.4

Objectives: Distraction osteogenesis has recently evolved a challenging technique to overcome the limitations of conventional augmentation procedures. The aim of this report was to evaluate the clinical result of alveolar distraction osteogenesis for implant installation. Methods: Twenty five patients with alveolar ridge deficiencies were treated with vertical alveolar distraction osteogenesis by intraoral device (total 27 devices: 25 extraosseous and 2 intraosseous devices). After the latency periods of 5-7 days, activation of the device was started. The distraction rhythm and rate was 0.75-1.0 mm a day with 2 or 3 times a day. After 3-4 months, dental implants were placed with removing the distractor simultaneously. Results: On average, a vertical gain of $9.8{\pm}3.4\;mm$ was obtained by distraction osteogenesis. Total 84 implants were installed. Average follow up period was $13.5{\pm}7.5$ months. No implant was removed during the follow up period. Three patients showed infection during the distraction osteogenesis. Three devices were broken and 2 devices among them were replaced with new one. Conclusion: Relatively larger amount of alveolar bone augmentation could be obtained with distraction osteogenesis. For the ideal anatomically and functionally ideal regeneration of alveolar bone to install dental implant, the complication of distraction should be controlled.