측사위경두개방사선사진(Oblique Transcranial Radiograph)을 이용한 하악전돌증환자의 하악지 시상골절단술후 하악과두위치변화 분석

권대근,이상한,장현중 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.1

This study was intended to evaluate condyle position and the relationship of condyle position change and post surgical relapse following the sagittal split ramus osteotomy for mandible setback in 25 patients by paired t-test and multiple regression analysis. We used oblique transcranial and cephalometric radiographs taken before operation, immediate after operation, and at least 6 months post operatively. 1. In oblique transcranial view, posterior joint space was decreased immediate after operation and increased 6 months after operation. To compare the measurement before and 6 months after operation, there was no statistically significant change in over all joint spaces(P>0.05). 2. The joint spaces changed under the 0.2mm were 30%, 0.2mm to 1.0mm were 60.7%, above 1.0mm were 9.3%. This result reveals that condyle position was relatively reproduced to pre-operative state. 3. Statistically, the amount of mandible set back didn't influence the post operative relapse(P>0.05). 4. Statistically, the amount of mandible set back didn't influence the condylar displacement(P>0.05), and the amount of joint space change didn't influence the post operative relapse.(P>0.05) The changes in joint space is in the standard tracing error or within the adaptive capacity of the individual, it was too small to influence the stability of surgery.

하악 전돌증 환자의 하악지 시상 골절단술후 경조직 변화에 따른 안모 연조직 변화 분석

권태근,박희대,이상한 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.1

This study was intended to perform cephalometric analysis of the facial soft tissue profile after surgical correction of skeletal Class Ⅲ malocclusion after SSRO in 29 patients (Males 12, females 17). Lateral cephalograms were taken in centric occlusion before and immediate, long term after surgeries. 1. Counter-clockwise rotation of mandible was observed after the surgery, average relapses of mandibular set back were 1.23-1.28mm. The net effects of the mandibular set-back after surgeries were 81.7-82.2%. Because these relapse tendencies may reduce the effects of the surgical outcomes, surgeon must consider these net before the surgical treatment planning. 2. The ratio of horizontal changes of hard tissue to soft tissue at lower lip, mentolabial sulcus, pogonion were 72.7-93.7%, 100.3%, 99.1-102.1% respectively. There were little changes at upper lip position anteroposteriorly. 3. The relationship of upper and lower lips were improved after surgery. Lower lip was posteriorly repostioned and upper lip was flattend and elongated in conjunction with deepening of inferior lobial sulcus. But profile of chin was still prominent after surgery. 4. Hard tissue horizontal changes and tissue vertical changes were significantly correlated with each other and there were reverse correlations with hard tissue vertical changes and soft tissue horizontal changes.

하악전돌증 환자에 대한 양악 수술의 안정성

권대근 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.4

The factors related to relapse in 20 skeletal class III patients who performed two-jaw surgery with Le Fort I maxillary osteotomy and bilateral sagittal split ramus osteotomy was investigated. All patients were fixed with miniplate on the maxilla and three screws at each mandible. Cephalograms taken at preoperative, immediate postoperative and 8 months postoperative after surgery were traced and digitized. 1.The horizontal and vertical relapse of maxilla and mandibular chin points was within 1mm postoperatively. Compare to the preceding report concerning the mandibular set-back surgery only group, this reveals two-jaw surgery for mandibular prognathism using rigid fixation is more stable. 2.Although there was no significant relapse tendancy was observed at chin points, the screw tip land-marks moves anterio-superiorly and each side of the screws moved as a one unit. The screw tip points moved similar direction to the masticatory force and this movements might be influenced by the muscular tension to the distal segment of the mandible. 3.According to the regression analysis, the amount of horizontal and vertical movement of mandibular set-back influenced the mandibular relapse. However, direction and amount of maxillary surgical movement did not inf1uenced the maxillary and mandibular relapse.

Photoshop을 이용한 하악 후퇴 수술후의 연조직 안모 예측

권대근,김종배 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4

Various computer software has been applied to predict soft tissue profile after orthognathic surgery. In this study, the Photoshop program was introduced to simulate the surgical result. The purpose of the study was to evaluate reliability of the program in prediction of profile changes as a result of mandibular set-back surgery. Based on predicted hard tissue changes, soft tissue changes were recorded with pre- and post-operative lateral cephalogram of 26 patients with skeletal Class Ⅲ deformity. All patients underwent bilateral sagittal split osteotomy. The mean mandibular set-back was 6.2㎜ (Pog) and soft tissue moved 6.3㎜, 100% in Pog' point post-operatively. Difference between the between real horizontal soft tissue changes and predicted changes has not been detected statistically. However, the result revealed vertical soft tissue profile prediction was unsatisfactory. This prediction method can be used as additional informative tool for the patient explanation.

최근 8년간 본교실에서 시행한 악교정수술의 임상적 검토

권대근,이상한 大韓顎顔面成形再建外科學會 1995 Maxillofacial Plastic Reconstructive Surgery Vol.17 No.1

We observed 117 orthognathic surgery cases with dentofacial deformity for 8 years from Jan. 1986 to Dec. 1993. The ratio of male female was 1 : 1.4 and the mean age was 23.0 years ranged from 16 to 35 years. The most dominant group was related to mandibular prognathism (75.0%). Surgery method were divided into 88 cases of mandible surgery, 6 cases of maxilla surgery and 23 cases of two jaw surgery. Sagittal split osteotomy were performed on 84 cases (71.8%). Rigid fixation was increased after 1989 and total percent of rigid fixation was 66%. We used autotransfusion method from 1992 to all orthognathic surgery patient. Lower lip numbness caused by Inferior alveolar nerve injury is the most common problem after operation, and it was 63 cases (53.8%) of total operation cases. In our clinic, we performed 5 cases of re-operation because of segment malaligment, condylar sag, and fixation instability.

상악골과 비사골동에 이환된 백악질 골화성 섬유종(cemento-ssifying fibroma)의 치험례

권대현,김신유,남정순,구명숙,이봉서,권대근,김종배 大韓顎顔面成形再建外科學會 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.6

The cemento-ossifying fibroma is a benign fibro-osseous tumor that may behave in an aggressive pattern. Although found predominantly in the mandible, most of these unusual tumors may arise in the maxilla and paranasal sinuses. Especially these lesion in the maxilla and sinuses behave more aggressively and are more prone to recur compared to mandibular counterparts. Therefore, more radical approach may be recommended than expectant observation or curettage in the initial management of this neoplasm. This is a case report of cemento-ossifying fibroma extended to maxillary sinus and naso-ethmoidal area treated by wide surgical excision after repeated conservative treatments.

삼차원적 안모형태의 미적분석

이상한,권대근,백상흠 경북대학교 병원 2002 경북대학교병원의학연구소논문집 Vol.6 No.1

This study was preformed to investigate the average anthropometric value of normal Korean men and women and to compare the preceding literatures.Additionally,average Korean profilogram was made to serve as a template for diagnosis of facial form. Eighty five Korean subjects(41 men 44 women)aged between 21 to 26 were selected by members of the author's department on the basis of intact dentition and ClassⅠocclusion without facial asymmetry.Frontal and lateral photographs were taken under standardized conition with digital camera.The image was magnified and according to the FH plane of cephalometric radiograps and digitized using personal compture. To compare the Western beauty,25 estherically pleasing famale was selected to measure various angle distance of the face. 1. It was possible to calculate the mean coordinate value of Korean normal samples which enables the direct visualization and comparsion with the use of template. The method in this study was easy to applicate under the Microsoft Windows bases. 2. Maxillary vertical hypoplasia, upper and lower lip protrusion was characteristics of Korean norms and relatively narrow alar base distance,less conspicuous nasal projection was observed.As the vermilion exposure and upper lip length was more than western norm,chin looks shorter than western. To compare the Korean and Weastern estherically pleasing profile,facial convexity and nose was less conpicuous in Korean womem.

혈관조영색전술을 이용한 비조절성 후비강부 출현의 처치 : 증례 보고

남기영,권대근,김종배 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.4

The posterior nasal bleeding sometimes develope a life threatening situation because of its limited access and the profuse vascular network of the bleeding area. There are various methods of hemostasis including packing, cautery, and arterial ligation those vary in effectiveness. But sometimes patients cannot tolerate these methods or show rebleeding sign. So, if all of these methods are not successful, we should consider the further treatment. The selective angiographic embolization has various advantages such as rapidness, repetition, good visualization, and being performed under local anesthesia, therefore it can provide useful way in patients with massive, intractable posterior nasal bleeding. We report a case of angiographic embolization for intractable posterior nasal bleeding patient and review the effectiveness of the this treatment.

하악골 골절 치료를 위한 miniplate와 관련된 매복견치의 치험례

황상희,박효상,권대근,남기영,김종배 대한치과교정학회 2005 대한치과교정학회지 Vol.35 No.2

하악 좌측 견치의 미맹출을 주소로 내원한 10세 여환의 과거 병력 조사 중 3년 전 교통사고로 하악 좌측 골체부에 골절이 생겨 miniplate로 관혈적 정복술을 시행받은 것을 발견하였다. 통상적인 외과적 노출과 교정적 견인치료로는 견치 맹출에 실패하였고, miniplate를 제거함으로써 정상적인 매복 견치 맹출에 성공하였기에 보고하는 바이다. This case report describes the treatment of an impacted tooth in relation to pediatrlc mandibular fracture. A 10-year-old girl presented with an impacted mandibular canine related with a miniplate in the left mandibular body area. An ordinary surgical traction ended in failure. Good occlusion was established by removal of the miniplate. It would be considered important to make an exact diagnosis of the cause and remove the mechanical obstruction instantly for successful orthodontlc treatment of an impacted tooth.

경안면 괴사성 근막염의 처치

김신유,이봉서,권대근,김종배 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.4

Necrotizing fasciitis is a rapidly progressive soft tissue infection with high mortality rates, characterized by diffus necrosos of fascia and subcutaneous tissue. It most commonly affects the abdominal wall, the perineum and the extermities, but head and neck involvement can occur. Patients often have an underlying systemic disease such as diabetes mellitus, alcoholism, malntrition or chronic renal failure. Successful management of this life-threatening condition requires early diagnosis, prompt institution of broad spectrum antibiotics and aggressive surgical intervention combined with supportive care such as airway maintenance anf hyperbaric oxygen therapy. We reviewed cervicofacial necrotizing fasciitis in Korea with our cases, and pathophysilogy, diagnisis and treatment of this patentially lethal entity were investigated.