외측 하악각 골절제술을 동반한 시상분할골절단술을 통한 골격성 3급 하악골 비대칭 환자의 치료

강희제,송인우,강영기,김종렬,Kang, Hee-Jea,Song, In-Woo,Kang, Yung-Ki,Kim, Jong-Ryoul 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.2

Purpose: The aim of this study is to identify the usefulness of unilateral mandibular angle ostectomy, so-called "Lateral Angle Reduction", in asymmetric prognathism patients by the assessment of postoperative stability and esthetic results Patients and methods: For the retrospective study, 10 skeletal class III mandibular asymmetry patients who were performed SSRO and unilateral mandibular angle ostectomy, Lateral Angle Reduction, was selected. Lateral and posterioanterior cephalogram was taken before surgery (T0), 1day after surgery (T1) and 6month after surgery (T2). To know the esthetic results the facial width and lateral facial contour were examined on posterioanterior cephalogram and to know the postoperative stability B point and Incisor inferius was examined on lateral cephalogram. Statistical analysis was performed. Results: From T0 to T1, Intergonial width was significantly decreased, dominantly at shortened side but no significant changes at lengthened side. Those were well-maintained during 6 months. Lateral facial angle and Ramus angle was significantly decreased on only shortened side from T0 to T1. As a result, after surgery, there were no significant differences in all measurements between shortened side and lengthened side. Ramus deviation angle in shortened side and ramus angle in lengthened side which reflect the angulation of ramus on frontal plane didn't show significant changes after surgery and during postsurgical periods. Lower dental midline showed no statistical changes during postsurgical period. The relapse rate on B-point was 11.92%. Conclusion: Unilateral "Lateral angle reduction" in the asymmetric mandible is valuable to obtain the narrow lower face and symmetric facial contour with a good stability.

Cone-beam CT영상으로부터 얻어진 정모두부방사선사진에서 수평기준선의 설정

강희제,김종렬,김용일,Kang, Hee-Jea,Kim, Jong-Ryoul,Kim, Yong-Il 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.4

Purpose: The purpose of this study was to measure the angular differences between the horizontal reference planes on the CBCT generated PA cephalogram and the modified interpupillary plane, which was usually used in the clinical examination, and to evaluate the validity of the horizontal reference planes. Methods: The CBCT generated PA cephalogram was used to measure the angles between the FH, Lo and IP planes. The subjects consisted of 42 patients with facial asymmetry (males: 21, females: 21, mean-age: 21.6 years). The control groups were also assessed (males: 10, females: 10, mean-age: 23.8 years). The distance of the interpupil was measured on the soft-tissue volume rendered image. The angular differences were statistically analyzed using the $Mann-Whitney$ $U$ $test$ for inter-group comparisons and the $Friedman$ $test$ for intra-group comparisions. Results: The angle between the FH plane and IP plane (the angle of the FH-IP line) showed a statistically significant difference between the two groups ($p$ <0.05). There was no statistical differences between each angle (angle of the FH-IP line, angle of the FH-Lo line, angle of the Lo-IP line) on the intra-group comparision ($p$ >0.05). Conclusion: The angle between the Lo line and IP line (angle of the Lo-IP line) showed no statistically significant difference in both the control and asymmetry groups. Therefore, the Lo line could be used as a horizontal reference plane in CBCT generated PA cephalograms.

Dexmedetomidine과 Pethidine을 이용한 정맥내 진정하에 시행된 악교정수술 후 금속나사제거

강희제,김종렬,김시엽,최태성,장광욱,Kang, Hee-Jea,Kim, Jong-Ryoul,Kim, Si-Yeob,Choi, Tea-Sung,Chang, Kwang-Uk 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.4

Purpose: The purpose of this study is to identify the changes of a physiologic nature and the sedative parameters associated with dexmedetomidine and pethidine, in patients undergoing plate and screw removal surgery, after orthognathic surgery. Methods: Twenty-three patients were sedated with dexmedetomidine and pethidine during plate and screw removal, after orthognathic surgery. An initial loading dose of dexmedetomidine ($1.0{\mu}g/kg$ infused over 10 minutes) was followed by a maintenance dose ($1.0{\mu}g/kg/hr$). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation, and heart rate were monitored. Perioperative amnesia and anxiety were recorded. Results: Significant changes were found in the blood pressure and heart rate (Freidman test, P<0.05), but not in oxygen saturation (Freidman test, P>0.05). Amnesia during local injection was observed in eight patients (34.8%). Compared with the preoperative anxiety score, the intraoperative anxiety score was decreased. Conclusion: In this study, we found cardiovascular and respiratory stability in intravenous sedation using dexmedetomidine with pethidine, in plate and screw removal, after orthognathic surgery. Furthemore, intravenous sedation using dexmedetomidine with pethidine shows adequate analgesic and sedative effects.

개구장애 환자의 병인, 감별진단 및 치료방식에 대한 임상연구

강희제(Hee-Jea Kang),황대석(Dae-Seok Hwang),김용덕(Yong-Deok Kim),신상훈(Sang-Hun Shin),김욱규(Uk-Kyu Kim),김종렬(Jong-Ryoul Kim),정인교(In-Kyo Chung) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.6

Trismus is a common problem to most people experiencing at once in his or her life and to most dental practitioners experiencing frequently. It has a number of potential causes which are single factor or complex factors. Its treatment will depend on the cause. The purpose of this study was to discuss the causes of trismus condition and the various treatments available. This study was made by reviewing of collected data from 86 patients complained of trismus among patients who were diagnosed by TMD, tumor, infection including tetanus, soft tissue anomalies, bony fracture and ankylosis from Jan 2002 to Dec 2004 on department of oral and maxillofacial surgery at Pusan National University Hospital, South Korea. The clinical reviews regarding chief complaints, clinical characteristics, diagnostic examination, treatments and the results on the patients were given as follows. 1. The etiology of trismus commonly were derived from temporomandibular joint(TMJ) disorder, TMJ ankylosis, TMJ tumor, odontogenic maxillofacial infection, mandibular condylar fracture, tetanus. 2. The chief complaints of trismus patients were progressive mouth opening limitation, TMJ pain, malocclusion, facial asymmetry, retrognathic state. 3. Especially, for the differential diagnosis between the fibrous ankylosis and true bony ankylosis, computed tomogram (CT) was useful. Surgical gap arthroplasty on bony ankylosis patients was applied and the gain of mouth opening after operation was average 35.8 mm during 19 months. 4. The tetanus, rarely, also induced the trismus with the range of mouth opening less than 10 mm. The average serum level of tetanus anti-toxin was 0.02-0.04 IU/mL. The limitation of mouth opening was improved into average 38 mm on 4 weeks after injection of 10,000 units of tetanus immune globulin. 5. In the treatment of osteochondroma, TMD, odontogenic infection and fracture , and the others inducing trismus, to obtian the maximum result and decreased inadequate time and effort, it is important to finding the causes from the exact clinical examination and diagnosis.

스트렙토조토신으로 유도된 당뇨백서의 하악골 골절 치유에 관한 조직형태계측학적 연구

강희제(Hee-Jea Kang),김용덕(Yong-Deok Kim),신상훈(Sang-Hun Shin),김욱규(Uk-Kyu Kim),김종렬(Jong-Ryoul Kim),정인교(In-Kyo Chung) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.3

Diabetes mellitus, as a major health problem for the elderly, is associated with an extensive list of complications involving nearly every tissue in the body and has been shown to alter the properties of bone and impair fracture healing in both human and animals. The objective of this study was to examine the healing process of a mandibular fracture in the streptozotocin-induced rats histomorphometrically and histologically. A standardized fracture model was chosen and based on blood-glucose value at the time of surgery. A total of 11-weeks old 36 rats were divided into 2 groups; One is a streptozotocin-induced diabetic group and the other is a non-diabetic group. All was fractured experimentally. Three animals from each group were killed 1, 2, 4, 6, 8 and 12 weeks after fracture and specimens were processed undecalcified for quantitative bone histomorphometric and histologic studies. The diabetic group showed a significant decrease of histomorphometry-based parameter including trabecular bone volume, trabecular thickness in comparison to the non-diabetic rat. This was confirmed histologically. In conclusion, this study suggests that in streptozotocin-induced diabetics, the healing process of bone fracture was impaired and delayed about 2-3 weeks comparing to non-diabetics.

치성감염으로 발생한 상악동염을 동반한 관골의 골수염

강희제(Hee-Jea Kang),이정훈(Jung-Hun Lee),김용덕(Yong-Deok Kim),변준호(June-Ho Byun),신상훈(Sang-Hun Shin),김욱규(Uk-Kyu Kim),정인교(In-Kyo Jung) 대한구강악안면외과학회 2004 대한구강악안면외과학회지 Vol.30 No.3

Osteomyelitis is the inflammatory disease occured in the bone, involving a bone marrow, a Harversian system and the underlying cortical bone. Osteomyelitis is divided into acute and chronic osteomyelitis. Chronic osteomyelitis. is presented as a pain, swelling, pus discharge and radiographic change. The pathogenesis of osteomyelitis occcuring in the facial bone is predominately due to odontogenic microorgarnisms, Staphylococcus, resulted in odontogenic infection or post-traumatic infection. The mandible is the most commonly involved facial bone and the bones in the middle of third of the face is rare because of a abundant blood supply. Moreover, Osteomyelitis occuring in the zygoma is extremely rare. In our department, we report the case that osteomyelitis occuring in the zygoma with diabetes is resulted by odontogenic maxillary sinusitis.

골막기원세포의 조골세포로의 분화과정에서 염증성 사이토카인의 효과

박봉욱(Bong-Wook Park),최문정(Mun-Jeoung Choi),하영술(Young-Sool Hah),조희영(Hee-Young Cho),김덕룡(Deok Ryong Kim),김욱규(Uk-Kyu Kim),강희제(Hee-Jea Kang),김종렬(Jong-Ryoul Kim),변준호(June-Ho Byun) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.5

Introduction: Skeletal homeostasis is normally maintained by the stability between bone formation by osteoblasts and bone resorption by osteoclasts. However, the correlation between the inflammatory reaction and osteoblastic differentiation of cultured osteoprogenitor cells has not been fully investigated. This study examined the effects of inflammatory cytokines on the osteoblastic differentiation of cultured human periosteal-derived cells. Materials and Methods: Periosteal-derived cells were obtained from the mandibular periosteum and introduced into the cell culture. After passage 3, the periosteal-derived cells were further cultured in an osteogenic induction Dulbecco’s modified Eagle’s medium (DMEM) medium containing dexamethasone, ascorbic acid, and β-glycerophosphate. In this culture medium, tumor necrosis factor (TNF)-αwith different concentrations (0.1, 1, and 10 ng/mL) or interleukin (IL)-1βwith different concentrations (0.01, 0.1, and 1 ng/mL) were added. Results: Both TNF-αand IL-1βstimulated alkaline phosphatase (ALP) expression in the periosteal-derived cells. TNF-αand IL-1βincreased the level of ALP expression in a dose-dependent manner. Both TNF-αand IL-1βalso increased the level of alizarin red S staining in a dose-dependent manner during osteoblastic differentiation of cultured human periosteal-derived cells. Conclusion: These results suggest that inflammatory cytokines TNF-αand IL-1βcan stimulate the osteoblastic activity of cultured human periosteal-derived cells.