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정종철,김건중,최재선,성대경,김호성,이계혁,Jeong, Jong-Cheol,Kim, Keon-Jung,Choi, Jae-Sun,Sung, Dae-Kyung,Kim, Ho-Sung,Lee, Gye-Hyeok 대한악안면성형재건외과학회 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.2
Compound comminuted mandibular fracture is defined as the presence of multiple fracture lines with open wound resulting in many small pieces within the same area. The incidence of mandibular comminution is difficult to determine but reported as 2.7~18.6 % incidence among mandibular fractures. There are controversies in the treatment of mandibular comminuted fractures. Treatment of comminuted mandibular fracture has traditionally involved closed reduction in an effort to avoid stripping periostcum from the bony segments, but rigid internal rigid fixation is used more popular at present. The extent of comminution, displacement of bony fragments and patient general conditions are important factors in decision of the treatment methods. When significant bone displacement is present, it is necessary to reduce these comminuted fragments to an anatomic, pretraumatic relationship to restore facial form and function. In these cases, ORIF allows anantomic reduction of comminuted segments as well as pretraumatic occlusion. Gentle handling of the soft tissue, rigid fixation of bony fragments and adequate immobilization are essential for reducing the complications. This is the report the incidence, causes, complications and treatment of the patients who visited our department for compound comminuted mandibular fractures.
민흥기(Heung Ki Min),김건중(Keon Jung Kim),정종철(Jong Cheol Jeong),이정삼(Jeong Sam Lee),최재선(Jae Sun Choi) 대한구강악안면외과학회 1997 대한구강악안면외과학회지 Vol.23 No.2
Congenital branchial anomalies are congenital developmental defect resulted from incomplete obliteration of branchial cleft, arches and pouches, and usually finded as cyst, fistula and sinus. The branchial cysts are common among these congenital anomalies. Branchial cleft cysts can be classified by developmental origin and anatomical position, but second branchial cleft cyst is the majority in these branchial anomalies. The branchial cleft cyst affects men and women with approximately equal frequency, but predicted on left side The clinical symptoms are painless mobile swelling and no tenderness during palpation. Surgical excision is usual treatment. But if infection or abscess is persisted, I&D with antibiotic therapy is to be performed initially. 23-year old female visited to our hospital due to palpable mass on the right neck area. By clinical examinations and CT finding, we diagnosed as branchial cleft cyst tentatively. We performed complete surgical excision and diagnosed this lesion as branchial cyst that originate from second branchial cleft. So we report a case of branchial cleft cyst with review of literatures.
김건중,이정삼,최재선,민홍기,정종철 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4
Nasal bone fracture is common in mid-facial trauma patients. In these patients, facial bone and nasal bone fracture are reducted at same time, but definite nasal reduction is diffidulty in these patients because of nasotracheal intubation during general anesthesia and facial swelling in early facial trauma patients. If nasal packing and MMF are needed, there are difficult to maintain the reducted nasal bone because of some difficulty in airway maintenance after nasal packing and increasing the patient discomfort. So postoperative nasal deformity is more common in these combined patients. Secondary rhinoplasty is necessary in these patients who have deformed nasal bone, and there are many methods and materials for secondary rhinoplasty. But if primary nasal bone was reducted symmetrically, it is easy in secondary rhinoplasty. We present 7 cases of secondary rhinoplasty in mid-facial trauma patients who had combined nasal bone fracture. In these patients, primary nasal bone reduction carried with closed reduction method during primary facial bone reduction. About 6 months later, we performed secondary rhinoplasty with iliac bone and alloplastic materials. So we report these cases with literatures.
발치직후 매식 임프란트에서 탈회동결건조골과 우골유도 수산화인회석이 골재생에 미치는 영향
김건중,류선열 전남대학교 치과대학 1994 전남치대논문집 Vol.6 No.1
The purpose of this study was to evaluate the usefulness of HA-coated cylinder implant in immediate placement of implants into extraction sockets. The capacity of bone regeneration were compared between using demineralized freeze-dried bone and bovine-derived hydroxyapatite. After extraction of the 4th premolar of maxilla and mandible in adult dogs. Integral?? implants were placed in maxilla with 3.25mm in diameter, 8mm in length and in mandible with 3.25mm in diameter, 10mm in length. The experimental group filled with demineralized freeze-dried bone into the bony defect around the implant was designated as DFDB group, and the other group filled with bovine-derived hydroxyapatite was BDHA group. In the control group, bony defect around the implant was sutured without any graft materials. The experimental animals were killed on the 1st, 2nd, 4th and 8th week after implantation for macroscopic and light microscopic evaluation, and the fluorescent dyes were injected on the 2nd, 4th and 8th week for fluorescent microscopic examination. Results obtained were as follows : 1. Macroscopically, neither infection of graft site nor exposure of implant was noted in any animals used. 2. Osseointegration was observed in all groups without epithelial migration of fibrous tissue around the implant, and osseointegration began from the 2nd week in both experimental groups and from the 4th week in the control. After the 8th week, osseointegration was observed in all groups. 3. Experimental groups showed more rapid bone formation than the control and DFDB group showed more rapid formation than BDHA group. DFDB group showed osteoinductive bone formation and BDHA group showed osteoconductive bone formation. 4. The maxillary group showed more rapid bone regeneration than the mandibular group, while the mandibular group showed more dense and lamellated bone pattern than the maxillary group. 5. By fluorescent microscopy, bone remodeling was observed in regenerated bone tissue of all groups. Active bone formation was noted from the 2nd week in both experimental groups and from the 4th week in the control. These results suggest that the demineralized freeze-dried bone can be used as an alternative to autogenous bone and the bovine-derived hydroxyapatite as an alternative to homogenous bone. It is suggested that the HA-coated cylider implant can be used in immediate placement of implants into extraction sockets instead of screw-shaped titanium implant.