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Bisphosphonate-related osteonecrosis of the jaw의 병리조직학적 소견 및 방사선학적 특징에 대한 임상적 고찰
오주영(Joo-Young Ohe),권용대(Yong-Dae Kwon),김여갑(Yeo-Gab Kim),이백수(Baek-Soo Lee),윤병욱(Byoung-Wook Yoon),최병준(Byoung-Jun Choi) 대한구강악안면외과학회 2008 대한구강악안면외과학회지 Vol.34 No.5
Bisphosphonates (BPs) are a class of agent used to treat patient with osteoporosis or malignant bone metastases. BPs can be categorized into 2 groups: nitrogen-containing and non-nitrogen containing. Nitrogen-containing BPs are considered to have more toxicity. Despite their clinical benefits, bisphosphonate-related osteonecrosis of jaw(BRONJ) is a significant complication to patients receveing these drugs. Since the first description of BRONJ in 2003 by Marx, the number of reports on BRONJ has been rapidly increasing. BRONJ is considered as an emerging problem in oral & maxillofacial surgery. Generally, osteonecrosis in the maxilla is rare, however BRONJ is found both in the maxilla and the mandible. This is an important feature of BRONJ compared to common infectious osteomyelitis of the jaw. Growing number of case reports, suggest that bisphosphonate therapy may cause exposed, necrotic bone. BRONJ has simillar features compared to IORN (infected osteoradionecrosis). BRONJ has meaningful features established through the interestigation on histopathologic and radiographic findings. These features have an impact on treatment plan and prognosis. This presentation contemplates on features of histopathologic and radiographic findings in bisphosphonate-related osteonecrosis of the jaw.
오주영 ( Joo-young Ohe ),심규조 ( Kyu-jo Shim ) 경희대학교 경희의료원 2021 慶熙醫學 Vol.36 No.1
The orthognathic surgical procedures are performed for the correction of abnormalities of the facial skeleton that are present from the birth or arise during growth or acquired secondarily during lifetime. We would prefer to summarize some commonly used techniques to correct the dentofacial deformities. Even we have described all these techniques at their popular time with our orthodontist colleagues; skeletal anchor systems, some basic interdental osteotomies, or complex mechanics that are applying orthopedic corrective forces are currently being used by the orthodontists rather than surgeons. Le Fort I osteotomy in maxilla and Bilateral sagittal split ramus osteotomies (BSSRO) in mandible are commonly used techniques to solve the deformity problems of the facial skeleton; therefore, the scope of this paper is going to be including my personal experience and some technical details with Le Fort I and SSRO.
전치부 분절골절단술과 통상적인 교정 치료의 치근 흡수에 대한 비교 및 고찰
오주영 ( Joo-young Ohe ) 경희대학교 경희의료원 2018 慶熙醫學 Vol.33 No.1
Patients undergoing orthodontic treatment are more likely to have apical root shortening. Many literatures showed the etiologic factors were complex and multifactorial. It appears that external apical root resorption results from a combination of patient-related risk factors such as previous history of root resorption, genetic influences and systemic factors and orthodontic treatment-related factors like treatment duration, magnitude of applied force, direction of tooth movement, amount of apical displacement, method of force application, type of appliance, treatment technique and so on. We could encounter the patients having the short teeth root and the poor periosteum in a case that much maxillary setback be needed, such as bimaxillary protrusion or skeletal class II. The anterior segmental osteotomy (ASO) has been known that this could complement the possibility of external apical root resorption and buffer the periodontal problems, so it could be the choice of treatment. But the studies about the efficacy of ASO in aspects of preserving the root are deficient. So in this study, we compared the amount of root resorption after orthodontic procedure between patients group who had been taken a conventional orthodontic and patients group in whom ASO had been included in orthodontic treatment procedure.
관절원판의 유착을 동반한 하악과두의 골연골종의 치료: 증례보고
설동주,최병준,김여갑,이백수,오주영,임지민,Seol, Dong-Ju,Choi, Byung-Joon,Kim, Yeo-Gab,Lee, Baek-Soo,Ohe, Joo-Young,Lim, Ji-Min 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.3
Osteochondroma is a benign neoplasm, osseous projection surrounded with cartilage, 35.8% of benign osseous tumor, 8.5% of whole osseous tumor and usually arises from the skeletal bone. Osteochondroma is a cartilaginous derivation and relatively uncommon in the craniofacial bone. Osteochondroma of the mandible has slow growth rates which mainly affect women around forty years of age and it can appear through the coronoid process and mandibular condyle, especially in the medial half. Clinical finding associated with osteochondroma of condyle are primarily a palpable, painless temporomandibular area mass with facial asymmetry, malocclusion and midline deviations. Sometimes pain and dysfunction like trismus often accompany the anatomic derangement. Other features include malocclusion with open-bite on the affected side and cross-bite on the contralateral side. In this study, a 45-years old female patient exhibits pain on the left temporo-mandibular joint area and malocclusion due to loss of the molar region with osteochondroma on the top left of her mandibular condyle head. The patient is able to recover gradually from the symptom through treatments on manipulation, stabilization splint, arthroscopic lavage and surgical excision, thus, this is reported as a clinical case.
Bisphosphonate가 인간 골수유래 간엽줄기세포의 증식과 알칼리성 인산분해효소 활성에 미치는 영향
정준호,이백수,권용대,오주영,김영란,Jung, Jun-Ho,Lee, Baek-Soo,Kwon, Yong-Dae,Ohe, Joo-Young,Kim, Young-Ran 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.1
Purpose: The purpose of this study is to find out the effects of bisphosphonates (BPs) on the proliferation and the alkaline phosphatase (ALP) activity of human bone marrow derived mesenchymal stem cells (hMSCs), and thus state its correlation with bisphosphonate related osteonecrosis of the jaw (BRONJ). Methods: hMSCs was obtained by collecting and culturing cancellous bone fragments from a patient undergoing iliac bone graft. Alendronate (Aln) and Pamidronate (Pam), Ibandronate (Ibn) were added to the culture media in the concentration from $10^{-3}$ M to $10^{-11}$ M and cell toxicity, viability were measured. For ALP activity evaluation, Aln and Pam were added to the culture media in the concentration from $5{\times}10^{-7}$ M to $1{\times}10^{-8}$ M and were cultured for 1 week, 2 weeks and 3 weeks. ALP activity data were standardized using protein assay. Control groups were prepared for each examination. Results: Aln, Pam and Ibn all failed to increase the proliferation of hMSCs. With 1 week, 2 weeks of $5{\times}10^{-8}$M of Aln treatment, the ALP activity increased. Pam treatment increased the ALP activity with 2 weeks of $5{\times}10^{-8}$ M and$1{\times}10^{-8}$M. Also Ibn treatment increased the ALP activity with 2 weeks of $5{\times}10^{-8}$ M and $1{\times}10^{-8}$ M. Conclusion: It is considered that BPs are not capable of improving the proliferation of hMSCs. Also, after a transient increase in the ALP activity with the lower concentration of BPs, the activity decreased again. Therefore, in patients on long-term medication of BPs, the proliferation and osteoblast differentiation of hMSCs are restrained, and thus delayed wound healing and increase in BRONJ complications may occur.
상기도 폐쇄를 보이는 Pierre Robin Sequence 환아의 순차적 치료: 증례보고
김배경,권용대,유선열,최용하,오주영,서준호,고수진,Kim, Bae-Kyung,Kwon, Yong-Dae,Ryu, Sun-Youl,Choi, Yong-Ha,Ohe, Joo-Young,Suh, Joon-Ho,Ko, Su-Jin 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.3
Pierre Robin Sequence (PRS) is known as an anomaly consisting of respiratory obstruction with glossoptosis, micrognathia and cleft palate in a newborn. The etiology of PRS is not known, but several factors may be involved simultaneously. Mortality rate of PRS is about 5~30% and the treatment method is divided into both conventional treatments and surgical interventions. If the respiratory obstruction is not resolved by the conventional method, surgical treatment, such as subperiosteal release of the floor of the mouth, tongue-lip adhesion, tracheostomy, distraction osteogenesis may be needed. This study reports a case of PRS in a newborn male at 20 days, with dyspnea and feeding difficulties. Clinical examination showed micrognathia with glossoptosis and cleft palate as the typical PRS triad. We tried surgical intervention with subperiosteal release of the floor of the mouth and tongue-lip adhesion and surgery was successful. At $19^{th}$ months, we also repaired the incomplete cleft palate successfully using 2-Flap palatoplasty.
전치부 개교합을 가진 골격성 3급 부정교합 환자에서 하악의 반시계 방향 회전 시 술 후 안정성
유정민,유경선,이백수,권용대,최병준,김여갑,오주영,박성원,Ryu, Jeong-Min,Ryu, Kyung-Sun,Lee, Baek-Soo,Kwon, Yong-Dae,Choi, Byung-Joon,Kim, Yeo-Gab,Ohe, Joo-Young,Park, Seong-Won 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.4
Purpose: This study evaluated the postoperative stability of counter clockwise rotation of the mandibular plane in anterior openbite patients, who have had one jaw surgery performed. Methods: This study includes patients with skeletal class III malocclusion accompanied by anterior openbite among the patients who have had BSSRO performed, resulting in counter clockwise rotation of the mandibule. We excluded the patients with genioplasty and segmental surgery, and included 23 patients who underwent BSSRO. Results: We found no statistical significance between the amount of counter clockwise rotation in the mandible in the Pearson correlation test. Also, there was no significant difference between Group 1 (< $3^{\circ}$) and Group 2 (> $3^{\circ}$). Conclusion: This study evaluated the amount of horizontal relapse, and the degree of relapse. Stable results were obtained. Although there was no statistical significance between the degree of openbite and the amount of horizontal relapse, the group with a greater amount of openbite had a greater amount of relapse.
심한 상하악 치열궁 부조화 환자의 수술적 해결: 증례보고
유경선,이백수,김여갑,권용대,최병준,오주영,Ryu, Kyung-Sun,Lee, Baek-Soo,Kim, Yeo-Gab,Kwon, Yong-Dae,Choi, Byung-Joon,Ohe, Joo-Young 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.2
Multiple segment osteotomy orthognathic surgery serves to combine the total or segmental maxillary and mandibular correction of the dentofacial deformities with concurrent procedures to provide immediate repositioning to the dento-osseous elements. In addition, splitting the palate may often be necessary to correct a functionally poor relationship of the maxilla to the mandible or the facial skeleton by realigning the maxillary arch. In this case, the discrepancy in a bimaxillary horizontal relationship and the space between the 2nd premolar and 2nd molar was retained after lengthy preoperative orthodontic treatment. However, we could correct these dento-osseous discrepancies immediately by performing midpalatal expansion, anterior segmental osteotomy and symphyseal osteotomy with bimaxillary osteotomies. If the blood supply to each segment segments was maintained and primary closure of the operation site was feasible, multiple segment osteotomy was considered as a very effective technique for treating dentofacial deformities in vertical, transverse, and sagittal dimensions with differential repositioning of all segments.
양악전돌증 환자에서 하악 6전치 후방 이동 시 치료 방법에 따른 하악 경조직과 연조직의 변화: 하악 전방분절골절단술과 발치 교정 치료
김영주,김경아,유용재,유경선,유정민,오주영,김수정,김성훈,이백수,Kim, Young-Joo,Kim, Kyung-A,Yu, Yong-Jae,Ryu, Kyung-Sun,Ryu, Jeong-Min,Ohe, Joo-Young,Kim, Su-Jung,Kim, Seoung-Hun,Lee, Baek-Soo 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.4
Purpose: The purpose of the study is to evaluate the effectiveness of anterior segmental osteotomy (ASO) in bimaxillary protrusion (BP) patients by comparison between the mandibular soft and hard tissue changes from orthodontic treatment and ASO. Methods: All 44 patients were diagnosed with BP in Kyung-Hee Medical Center. Orthodontic treatment with teeth extractions were underwent by 23 patients (Group A) and 21 patients underwent ASO (Group B). Mandibular soft and hard tissue changes were measured and evaluated, which were based on the vertical and horizontal reference line in lateral cephalometric radiographs. Statistical significance between the changes and correlation between each measurement were analyzed. Results: The amount of B point movement was lesser than that of the lower incisal tip (LIT) retraction, and LIT was tilted lingually in group A. The posterior movement discrepancy between LIT and B point was insignificant, and the inclination of lower incisor was not changed in group B. The soft tissues, including the lower lip, showed a posterior movement and reduction in the depth of mento-labial groove. According to the correlation analysis, the movement of the lower incisor was significantly related to the movement of the lower lip in group A, and the movement of the lower incisor was significantly related to that of the movement of lower lip, B point and Pog in group B. Conclusion: The orthodontic treatment in BP patients results in posterior tilting movement of the lower incisor, but ASO results in the bodily movement of the lower incisor. Consequently, ASO is more effective in BP cases because it ensures the controlled movement of the lower incisors.
골격성 3급 부정교합 환자의 악교정 수술 후 설골의 위치와 기도변화에 관한 연구
최용하,김배경,최병준,김여갑,이백수,권용대,오주영,서준호,Choi, Yong-Ha,Kim, Bae-Kyung,Choi, Byung-Joon,Kim, Yeo-Gab,Lee, Baek-Soo,Kwon, Yong-Dae,Ohe, Joo-Young,Suh, Joon-Ho 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.5
Purpose: The purpose of this study was to investigate changes in the position of the hyoid bone and soft palate and the amount of airway space after bilateral sagittal split ramus osteotomy (B-SSRO). Methods: This study is a review of lateral cephalometric tracings of 30 patients who underwent B-SSRO with setbacks at Kyunghee Dental Hospital from 2005 to 2009. Lateral cephalograms were taken before (T0), within one month (T1), and more than six months after the surgery (T2). Results: The hyoid bone at T1 changed significantly towards the inferoposterior position. At T2, it had significantly moved superiorly, but not anteriorly. At T1, the nasopharyngeal space, extending from the posterior nasal spine to the posterior pharyngeal space, decreased significantly, but did not show a significant increase at T2. The nasopharyngeal space, extending from the middle of soft palate to the posterior pharyngeal space, decreased significantly at T1, but did not show a significant decrease at T2. The oropharyngeal airway space decreased significantly at T1 and did not return to its original position at T2. The hypopharyngeal space, extending from the anterior to the posterior pharyngeal space at the level of the most anterior point of the third cervical vertebrae, slightly decreased at T1, but the amount was insignificant; however, the amount of decrease at T2 was significant. The hypopharyngeal space extending from the anterior to the posterior pharyngeal space at the level of the lowest point of the third cervical vertebrae, decreased significantly at T1 but returned to its original position at T2. Conclusion: B-SSRO changes the position of the hyoid bone and muscles inferoposteriorly. These change allows enough space for the tongue and prevent airway obstruction. Airway changes may be related to post-operative edema, posterior movement of the soft palate, anteroposterior movement of the hyoid bone, or compensation for decreased oral cavity volume. The position of the pogonion which measures anterior relapse after surgery did not show significant differences during the follow-up period.