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하악각 골절의 치료 방법에 따른 하악골의 응력 분포 및 변위에 관한 삼차원 유한요소법적 연구
구제훈,김일규,장재원,양정은,사시카라 바라라만,왕붕,Ku, Je-Hoon,Kim, Il-Kyu,Chang, Jae-Won,Yang, Jung-Eun,Sasikala, Balaraman,Wang, Boon 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.3
The purpose of this study was to evaluate the effects of the stress distribution and displacement in mandible according to treatment modalities of mandibular angle fractures, using a three dimensional finite element analysis. A mechanical model of an edentulous mandible was generated from 3D scan. A 100-N axial load and four masticatory muscular supporting system were applied to this model. According to the number, location and materials of titanium and biodegradable polymer plates, the experimental groups were divided into five types. Type I had a single titanium plate in the superior border of mandibular angle, type II had two titanium plates in the superior tension border and in the inferior compression border of mandibular angle, type III had a single titanium plate in the ventral area of mandibular angle, type IV had a single biodegradable polymer plate in the superior border of mandibular angle, type V had a single biodegradable polymer plate in the ventral area of mandibular angle. The results obtained from this study were follows: 1. Stress was concentrated on the condylar neck of the fractured side except Type III. 2. The values of von-Mises stress of the screws were the highest in the just-posterior screw of the fracture line, and in the just-anterior screw of Type III. 3. The displacement of mandible in Type III was 0.04 mm, and in Type I, II, IV, and V were 0.10 mm. 4. The plates were the most stable in the ventral area of mandibular angle (Type III, V). In conclusion, the ventral area of mandibular angle is the most stable location in the fixation of mandibular angle fractures, and the just- posterior and/or the just-anterior screws of the fracture line must be longer than the other, and surgeons have to fix accurately these screws, and the biodegradable polymer plate also was suitable for the treatment of mandible angle fracture.
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구강 악안면 영역의 생체 흡수성 고정판 사용에 관한 임상 연구
김일규,박승훈,장금수,양정은,장재원,사시카라 바라라만,Kim, Il-Kyu,Park, Seung-Hoon,Jang, Keum-Soo,Yang, Jung-Eun,Jang, Jae-Won,Sasikala, Balaraman 대한구강악안면외과학회 2009 대한구강악안면외과학회지 Vol.35 No.6
Metallic bone plates and screws have been commonly used in oral and maxillofacial surgery for internal fixation. However, there are several disadvantages such as atrophy of cortical bone inherent to excessive rigid fixation systems, growth disturbance in growing individual, allergy reaction, interference with radiographic imaging, palpability, thermal sensitibity and the need for subsequent removal. To overcome these disadvantages and avoid additional surgery of removal of plates and screws, there have been many studies of biodegradable plates and screws. But, It also has complication such as foreign body reactions. We have undertaken a clinical and retrospective study on 140 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from February 2006 to March 2009. The purpose of this study is to report the clinical cases and review of the literatures with biodegradable plates and screws. And we concluded following results. 1. 6 cases(3.4%) of the 177 operation sites(140 patients) experienced complications. 1 case(0.6%) was a failure of initial fixation, 1 case(0.6%) was a postoperative infection, 4 cases(2.3%) were inflammations or foreign body reaction. 2. Postoperative infections, inflammations and foreign body reactions were completely recovered with incision and drainage, supporative care with antibiotic coverage and removal of biodegradable plates. 3. Biodegradable plates and screws provide acceptable rigidity and stability clinically. But, long-term observation is required for the tissue reactions around the biodegradable plates and screws because of long resorption periods of the biodegradable materials.
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토끼의 하악골에서 β-TCP와 rhBMP-2의 골형성 효과에 대한 형태계측학적 연구
김규남(Kyu-Nam Kim),양정은(Jung-Eun Yang),장재원(Jea-Won Jang),사시카라 바라라만(Balaraman Sasikala),왕붕(Wang Beng),김일규(Il-Kyu Kim) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.3
Introduction: This study was to assess the effectiveness of new bone formation and regeneration by using a rhBMP-2 and β-TCP as a carrier in rabbits’mandible. Materials and Methods: The mandibles of 36 rabbits were exposed and cortical bone was penetrated for this study. The experimental subjects were divided into 3 groups each 12 rabbits ; control group, experimental group 1, and experimental group 2. Control group had the defect itself without any treatment, in the experimental group 1, β-TCP only was grafted, and in the experimental group 2, rhBMP-2 soaked in β-TCP was grafted. The rabbits were sacrificed after 1, 2, 3, 4, 6, and 8weeks, and new bone formation area was examined and measured for bone quantitative and qualitative analysis with light, fluorescent and polarized microscopy. Results: In the experimental group 1, new bone formation from the adjacent host bone was made by osteoconduction, and in the experimental group 2, direct new bone formation by osteoinduction of rhBMP-2 as well as new bone formation by osteoconduction of β-TCP were observed. Conclusion: rhBMP-2 of experimental group 2 is very effective in the bone formation in early 2weeks and bone remodelling from 3weeks
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