안와하연 및 측벽 ( frontozygmatic sutrue ) 에 대한 lateral canthotomy - conjunctival approach 를 이용한 협골체 골절의 치료

윤옥병(Ok Byung Yoon),이태영(Tae Young Lee),김현철(Hyoun Chull Kim),변숙(Sook Byun),강기성치(Seiji Esaki),구산충광(Tadamitsu Kameyama) 대한악안면성형재건외과학회 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.1

협골체 골절시 접근방법은 안와하연에 대해 섬모하절개, 하안검절개, 안와하연절개 및 결막절개등이 사용되고 안와측벽, frontozygomatic suture에 대해서는 lateral brow incision, 상안검절개등이 사용되며 관상절개술은 frontozygomatic suture 와 협골궁에 접근할 수 있다. 관상절개술을 제외한 접근방법은 한가지 절개술로 단지 한부위의 정복과 고정술이 가능하므로 결국 협골체 골절시 2점이상 고정을 할 경우 2가지 이상의 절개가 필요하게 된다. 이에 저자들은 관상절개술의 적응증이 아닌 협골체 골절에 lateral canthotomy-conjunctival incision을 사용하여 안와하연 및 측벽의 골절부에 대한 정복술과 고정술을 시행하여 양호한 결과를 관찰하여 이에 보고하는 바이다. Various extraoral and intraoral approaches to reduction and fixation of zygomatic complex fractures were used. The method for exposure of inferior orbital area include the subciliary, inferior eyelid, infraorbital rim and conjunctival incisions. For exposure of frontozygomatic suture, lateral brow, coronal and blephaloplasty incisions were used. It is necessary that the usual approaches to the inferior and lateral orbit have two incisions. However, lateral canthotomy-conjunctival approach presented on this paper provide optimal exposure to lateral and inferior orbit.

점막 결손부에 대한 Collagen Membrane TERUDERMIS(R) 의 임상적 적용례

윤옥병(Ok Byung Yoon) 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.3

N/A

하악과두골절시 Arthrocentesis와 Lavage를 이용한 치험에 관한 연구

윤옥병(Yoon Ok-byung) 대한구강악안면외과학회 2002 대한구강악안면외과학회지 Vol.28 No.4

In the treatment of mandibular condylar fractures, arthrocentesis, lavage and selective intermaxillary fixation were performed after closed reduction. In this lavage group, the physiotherapy performed for 3-6 months after injury. in control group, continuous intermaxillary fixation was done for 1-3 weeks, and physiotherapy followed in the same method of the lavage group. In the comparative study of the both groups, the following results are shown. 1. Compared to control group, the lavage group had a slightly superior result at range of motion, joint pain and occlusal deviation, from I day after arthrocentesis to 6 months after injury. 2. The significant differences between both groups were seen at range of motion and joint pain in 1 month after injury. 3. At 6 months after injury, the differences between both groups were not significant at range of motion, joint pain and occlusal deviation. From this study, in the mandibular condylar fracture, the arthrosentesis, lavage and selective intermaxillary fixation after closed reduction can improve symptoms such as joint pain and occlusal deviation, also increase range of motion. in this therapeutic way, intracapsular hemarthrosis which can cause TMJ ankylosis or dysfunction can be removed effectively. in addition, patient’s discomfort such as swallowing disturbance, speech disturbance and emotional stress can be reduced signuficantly.

하악지시상분할골절단술 시행 후 von-Miese 항복강도에 대한 유한요소법적 연구

윤옥병(Ok-Byung Yoon),김여갑(Yeo-Gab Kim) 대한구강악안면외과학회 2002 대한구강악안면외과학회지 Vol.28 No.3

For the study of its stability when the screw has been fixed after sagittal split ramus osteotomy(SSRO) of the mandible, the methods of screw arrangement are classified into two types, triangular and straight. The angles of screws to the bone surface are classified as perpendicular arrangements, the 60o anterioinferior screw, known as triangular, and the most posterior screw, called straight arrangement, thus there are four types. The finite element method model has been made by using a three dimensional calculator and a supercomputer. The load directions are to the anterior teeth, premolar region, and molar region, and the bite force is 1 Kgf to each region. The distribution of stress, the von-Mises yield strength, and safety of margin refer to the total sum of transformed energy have been studied by comparison with each other. The following conclusion has been researched : 1. When shear stress is compared, in the triangular arrangement in the form of “ㄱ“, the anterosuperior screw is seen at contributing to the support of the bone fragment. In the straight arrangement, substantial stress is seen to be concentrated on the most posterior angled screw. 2. When the von-Mises yield strength is compared, it seemed that the stress concentration on the angled anteroinferior screw is higher, it shows a higher possibility of fracture than any other screw. In the straight arrangement, stress appeared to be concentrated on the most posteriorly angled screw. 3. When the safety margins of the transfomed energy are compared, the energy conduction is much greater in the case of the angled screw than in the case of the perpendicular screw. The triangular arrangement in the form of “ㄱ“ shows a superior clinical sign to that of the straight arrangement. Judging from the above results, when the screw fixation is made after SSRO in practical clinical cases, two screws should be inserted in the superior border of mandibular ramus and a third screw of mandibular inferior border should be inserted in the form of triangular. All screws on the bony surface should be placed perpendicularly-90o angles apparently best promote bony support and stability.

다양한 수술방법에 의한 진성악관절강직증의 치험례

이영훈,이상철,김여갑,류동목,이백수,윤옥병,Lee, Young-Hoon,Lee, Sang-Chull,Kim, Yeo-Gab,Ryu, Dong-Mok,Lee, Baek-Soo,Yoon, Ok-Byung 대한악안면성형재건외과학회 1999 Maxillofacial Plastic Reconstructive Surgery Vol.21 No.3

TMJ ankylosis is defined as a mobile disorder of jaw such as mouth opening limitation, limitation of anterior or/and lateral movement of TMJ. Kazanjian published first clinical report about classification of TMJ ankylosis dividing with intracapsular ankylosis and extracapsular ankylosis. TMJ ankylosis is resulted from trauma, infection, metastatic tumor, irradiation, burn and etc. When TMJ ankylosis is manifested in growing period, it affects to functional disorder and development and position of mandible, so it can result in maxillofacial deformity such as facial asymmetry, micrognathia, malocclusion. For treatment of TMJ ankylosis, various surgical interventions were devised ; condylectomy, gap arthroplasty, interpositional arthroplasty and TMJ reconstruction. So, we report our results with documental study and cases of true ankylosis in our department.

악관절 내장증의 외과적 치험1예 및 문헌고찰

이상철(Sang Chull Lee),김여갑(Yeo Gab Kim),류동목(Dong Mok Ryu),윤옥병(Ok Byung Yoon) 대한구강악안면외과학회 1988 대한구강악안면외과학회지 Vol.14 No.2

A 26-year-old male patient whose chief complaint was mouth opening and TMJ functional disturbance, visited Dept. of Oral Surgery, College of Dentistry, Kyung Hee University. The clinical symptoms were midline deviation of mandible, TMJ clicking sound and limitation of mandibular movement, o due to the result of clinical & radiographic examination, and TMJ arthrography, TMJ internal derangement was made. By that diagnosis, Eminectomy and Meniscoplasty was simultaneously performed. Two weeks after, maximum mouth opening was about 3 ㎝ without clicking sound and mandibular midline deviation, and there have been no evidences of other disturbances till now.

Erbium:YAG laser를 이용한 골절제후 골 치유에 관한 연구

이상철(Sang Chull Lee),김여갑(Yeo Gab Kim),류동목(Dong Mok Ryu),이백수(Baek Soo Lee),윤옥병(Ok Byung Yoon),지유진(Yu Jin Jee),김현철(Hyun Chull Kim) 대한구강악안면외과학회 1998 대한구강악안면외과학회지 Vol.24 No.2

Presently, Erbium:YAG laser, which is known as laser for osteotomy, is considered to have good resection effects and to bring about minimum thermal damage. Since studies on this has never been done within the country and left as a field still unexplored, I expect to use this study as experimental data on future use of laser on hard tissue. In this report, both surgical bur(diameter 0.5mm carbide roun bur) and Erbium:YAG laser(100mJ/pulse, 10pulse/sec) was used each on the femur of white mouse and after the same amount of osteotomy, the effect of bone healing on the light microscope was observed and comparative study was made histology. The results are as follows : 1. In the first group (1st day, 3rd day), the osteotomic bone portion of the experimental group was irregular with bone resorption and showed more blood cell infiltration, compared with the control group. 2. At 1 week, bone matrix and immature bone was formed in the peripheral and center of the resection area in the control group. But inthe experimental group, more bone formation was initiated in the peripheral than in the center and showed more infiltration of blood cells and inflammatory cells. 3. At 2 week, bone matrix became mature to have similar density with compact bone and showed new formed vessels in the control group. But in the experimental group, bone formation with decreased density was initiated and new formed vessels together with mature bones was observed. 4. At 3 week, mature bone with equal density and regular trabecular pattern was observed in the control group. But in the experimental group, the continuity between the new bone and old bone was rather loose with decreased maturity, but on the other hand, had even bone formation pattern. 5. At 4 week, both the control and experimental group showed perfect bone healing features. From the results above, I can observe that in osteotomy with Erbium:YAG laser bone healing is rather delayed in each step but if, effective percentage of resection could obtained it would be valuable to substitute mechnical bur or saw and bring about much progress and development in the area of oral and maxillofacial surgery. For this, more studies on bone resection and biomechanical strength of bone tissue after bone healing should be done on various animals.

하악과두 골절의 임상통계학적 연구

이상철(Sang Chull Lee),김여갑(Yeo Gab Kim),류동목(Dong Mok Ryu),이백수(Baek Soo Lee),윤옥병(Ok Byung Yoon),진택현(Taek Hyun Jin) 대한구강악안면외과학회 1998 대한구강악안면외과학회지 Vol.24 No.3

This is a retrospective study on condylar fracture of mandible. The study based on a series of 112 patients who had treated for the fractures of mandibular condyle on KyungHee Dental Hospital from January , 1989 to August. 1997. We studied the age and sex distributions, causes of fractures, location of fractures and so on. The results as follows; 1. The ratio of male:female was 4:1, and the highest frequency of condylar fractures was registered among patients aged to 21 to 30 years. 2. The most common cause of condylar fracture was fall-down(47.7%), followed in incidence by direct-blow(27.9%) and traffic accidents(20.7%). 3. Subcondylar fracture had highest incidence(50%), and followed by condyle head(27.4%) and condylar neck(22.6%). 4. 9.7% of condylar fractures had occurred bilaterally, and in cases of bilateral condylar fractures, condyle head fracture(58.33%) was highest incidence. 5. Mandibular symphysis was most commonly involved in condylar fracture(63.4%), and 27.7% of condylar fractures had not any other mandibular fractures.

악골에 이환된 Histiocytosis X의 치험례

이상철(Sang Chull Lee),김여갑(Yeo Gab Kim),류동목(Dong Mok Ryu),이백수(Baek Soo Lee),윤옥병(Ok Byung Yoon),최유성(You Sung Choi) 대한구강악안면외과학회 1996 대한구강악안면외과학회지 Vol.22 No.4

Since the nonlipid reticuloendotheliosis which include eosinophilic granuloma. Hand-Schuller-Christian disease, Letterer-Siwe disease were first described by Hand in 1983, many clinicians reported various diseases similar to the above. Because the cause and the clinical and microscopic features of these various disease were not known, this disorder is sometimes called histiocytosis X. Among these diseases, eosinophillic granuloma of bone usually has a benign course. But, Hand-Schuller-Christian disease and Letterer-Siwe disease are more aggressive form. Especially in Hand-Schuller-Christian disease, both skeletal system and soft tissue may be involved. This is a case with gingivostomatitis and delayed healing of extracted right upper molar area. The microscopic examination from the delayed healing site showed the characteristics of the histiocytosis X consisted of Langerhans cells, eosinophils, and lymphocytes. The continuous examination showed the liver and the lung of the patient had been involved. We experienced a case of Hand-Schuller-christian disease which was one of histiocytosis X treated. with the chemotherapy of vincristine and cyclophosphamide.

최근 5년간 안면근막극 농양의 임상적 연구

이상철(Sang Chull Lee),김여갑(Yeo Gab Kim),류동목(Dong Mok Ryu),이백수(Baek Soo Lee),오승환(Sung Hwan Oh),윤옥병(Ok Byung Yoon),지유진(Yu Jin Jee) 대한구강악안면외과학회 1997 대한구강악안면외과학회지 Vol.23 No.1

Maxillofacial infection often place the oral and maxillofacial surgeon in situations where timely decisions have to be made. These decisions can be lifesaving. Odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often repond to surgical and antimicrobial management. Otheriwise odontogenic infections have the potential to spread via the fasical spaces in the head and neck region. They can compromise vital structures in this region or involve distant structures. The classic signs of maxillofacial infections include pain, swelling, fever, dysphagia, and dehydration. The goals of management should be to correct these conditions. We have undertaken clinical studies on infections in the oral and maxillofacial regions (facial space) by analyzing hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Kyung Hee University Hospital past 5 years from 1991. to 1995. And bacterial cultures and antibiotics sensitivity test were performed and the comparative analysis of the antibiotics was done. The results were as follows: 1. The most frequent cause of oral and maxillofacial infection was odontogenic 68% and in 23% patients with signs and symptom aggrevated after teeth extraction. 2. The most common fascial spaces involved was buccal space 36.1%, followed by submandibular space 12.3% and 3 cases were Ludwig s angina. 3. Antibiotics were administrated in all cases and surgical incision and drainage was performed in 88.6%. 4. The most causative organisms isolated from the pus cultures were streptococci group 51.1%