하악 전돌증으로 인한 악교정수술후의 안면 연조직 변화 예측을 위한 컴퓨터 프로그램

이충국(Choong Kook Yi),박영철(Young Chel Park) 대한구강악안면외과학회 1990 대한구강악안면외과학회지 Vol.16 No.3

The purpose of this study is to predict the change of the facial soft tissue following orthodontic surgery associated with mandibular prognathism. Twenty-one patients were selected who recieved orthognathic surgery in mandible only (13 cases) and in maxilla and mandible simultaneously (8 cases). Ages of the patients were over the 16.8 years. Lateral cephalometric head films were taken just before the operation and post operative film were used that of post-operative minimum 6 months. We evaluated the cases by two methods, 1:1 mean ratios and stepwise multiple regression analysis. The results were as follows. 1. The prediction is more accurate by stepwise multiple regression analysis than by 1:1 mean ratios. 2. The prediction by stepwise multiple regression equation is always available regardless the method of operation. 3. We can make a soft ware program for computerizing by obtaning the stepwise multiple regression equation.

개교증을 야기한 관절염

이충국(Choong Kook Yi),최수원(Soo Won Choi),전주홍(Ju Hong Jeon) 대한구강악안면외과학회 1990 대한구강악안면외과학회지 Vol.18 No.4

There can be many causative factors for open bite, and arthritides on temporomandibular joint can be one of those. Arthritides on temporomandibular joint are classified as: infectious, traumatic, inflammatory, degenerative and metabolic. Authors have examined two patients, who came in with open bites as their a chief complanits, and have found bone resorptions of mandibular condyles. Various diagnostic methods have resulted in diagnosis of rheumatoid arthritis and degenerative arthritis for each patient, and appropriate treatment planning has been established.

하악지 길이증가를 위한 수술방법들간의 회귀현상에 관한 실험적 연구

이충국(Choong Kook Yi),장현호(Hyun Ho Chang),박정현(Jung Hyun Park) 대한구강악안면외과학회 2000 대한구강악안면외과학회지 Vol.26 No.6

Facial asymmetry is the most frequent disease in craniofacial deformities. And the primary causing area of that is mostly placing in mandible. That is to say, it is known that primarily, mandible grows excessively or deficiently, and other facial region involving maxilla undergoes compensatory growth secondarily, so asymmetric face develops. In facial asymmetry, the surgical correction of undergrowth is more difficult than that of overgrowth and the reason of it is the postoperative relapse caused by stress of surrounding soft tissues. It means the stress of surrounding soft tissues occurring after bone lengthening and reducing above stress is the same meaning with reducing postoperative relapse. Among various areas, mandibular ramus is the most difficult area to lengthen vertically and maintain its length. The reason of it is considered by many authors as the stress of surrounding pterygomasseteric sling which is enveloping lower border of mandible and interrupting elongation of ramal height. So we applied two different surgical procedures in which pterygomasseteric slings have different stress respectively to monkeys which have similar masticatory function and anatomy to human being and compared relapse by radiographic film and observed periodically the histochemical change of masseteric muscle fiber. So we could see the following results. The relapse was less in EVRO group in which we separated pterygomasseric sling in inferior border and didn’t approximate muscle sling after vertical lengthening to minimize the stress of soft tissues than IVRO group in which we elongated ramal height preserving pterygomassetric sling. Of course, we could see a problem in EVRO group such as bone resorption in inferior border caused by uncovering the periosteum of inferior border. But we expect that such problem will be solved by developing periosteum substitutes for covering the exposed bone and minimizing the surgical trauma. In histochemical study of masseteric muscle fiber, the fiber constituents of EVRO group in which we minimized soft tissue stress was changed immediately after operation and maintained it for 1 year, whereas that of IVRO group in which we preserved soft tissue stress was changed in more portion after operation and recovered it by 1 year . By the histochemical results, we can see that the recovery of fiber constituents reflect the recovery of muscle stress and it is closely related with relapse phenomenon.

안모비대칭의 진단 및 처치

이충국(Choong Kook Yi),장현호(Hyun Ho Chang),김희경(Hee Kyung Kim) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.3

In some individuals, facial asymmetry appears conspicuously and it causes esthetic problem with other several symptoms. It has been long that the authors have introduced the classifications and diagnostic methods of facial asymmetry. In this report, we will introduce more developed diagnostic method in two viewpoints. First, in diagnosis of facial asymmetry, we added the concept of mandibular independent growth unit, and studied that which unit tends to cause the jaw deformity. Second, we present improved three-dimensional diagnostic method for systemize spatial problem. Several surgical cases which are applicated by this diagnostic method will be also presented. Such cases will show the necessity of treatment on the etiopathogenic area.

치조골 파열 부위로부터의 치아 맹출 유도

이충국(Choong Kook Yi),박형래(Hyung -ae Park) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.4

The choice of the optimal time for secondary bone-grafting must depend on the tooth eruption stage than the chronologic age. And the success of alveolar graft is affected by the grafting materials and the appropriate orthodontic treatment. This is a case report of 2 bilateral alveolar clefts and 1 unilateral alveolar cleft, which impacted tooth was erupted through the alveolar grafted area.

DEEP BITE를 동반한 골격형 제Ⅱ급 부정교합의 치험례

이충국(Choong Kook Yi),차인호(In Ho Cha) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.1

Skeletal Class Ⅱ malocclusion with deep bite is difficult to manage properly. Generally the lower facial height is short and the curve of Spee is severe. We managed these cases as fellowe. 1) Tooth alignment through the pre-op. orthodontic treatment. 2) Surgically mandibular advanced with modified wafer. 3) Using the modified wafer, by rapid extrusion of posterior teeth, Curve of Spee was decreased during IMF. The rapid extrusion process is begun the IMF periods, thereby decreasing total treatment time. Our two cases result were satisfactory by means of more simple surgical technique and orthodontic treatment.

A study on the temporomandibular disorders in dentofacial deformity patients

이충국(Choong Kook Yi),박정현(Jung Hyun Park) 대한구강악안면외과학회 1995 대한구강악안면외과학회지 Vol.21 No.4

악안면기형은 측두하악장애의 발생과 예후에 있어 중요한 기여인자 중의 하나이다. 최근에는 여러 학자들에 의해 교합평면의 변화가 악안면기형환자의 악기형수술을 통한 기능적, 심미적 개선에서 중요한 한 요인임이 보고되었다. 저자는 41명의 악안면기형환자를 대상으로 하여 측두하악장애의 발생율을 조사하고 교합평면 및 하악평면을 중심으로한 두개안면방사선사진 계측을 통해 악교정수술 전후의 측두하악장애의 변화양상을 관찰하고 그 상관관계를 조사하여 다음과 같은 결론을 얻었다. 1. 악안면기형환자의 측두하악장애의 발생율은 46%로 나타났고 악교정수술후 전체환자의 20%로 감소하였다. 2. 측두하악장애의 술전후의 변화양상과 악안면기형의 유형 및 전치부의 피개상태 사이에는 상관관계가 없었다. 3. 측두하악장애의 술전후의 변화양상과 교합평면 및 하악평면의 변화사이에는 상관관계가 높았다. 4. 악안면기형의 교정시에 적절한 저작계의 기능을 얻기 위해서 술후의 교합평면 및 하악평면을 각 개인의 이상적인 교합평면 및 하악평면과 평행하도록 설정하는 것이 바람직할 것으로 사료된다. Dentofacial deformities are important contributing factors in developments and prognosis of temporomandibular disorders. Nowadays, several authors have reported that alteration of occlusal plane is the important factor in functional and esthetic improement of orthognathic surgery of dentofacial defomty patients. The objects of this article are to investigate the incidence and the changes of the symptoms of the temporomandibular disorders through the orthognathic surgery of 41 dentofacial deformity patients and to suggest the interrelation between changes of temporomandibular disorder and occlusal plane and mandibular plane. The result s are as follows ; 1. The incidence of the temporomandibular disorder was 46% and it was decreased to 20% after orthognathic surgery. 2. There were no significant relationships between types of DFDs, types of anterior bite and changes of temporomandibular disorder symptoms. 3. There was a significant relationship between postoperative occlusal and mandibular planes and changes of temporomandibular disorder symptoms. 4. To obtain a optimal function of gnathologic system in correction of dentofacial deformities, it is proposed to achieve the parallelism of postoperative occlusal plane and mandibular plane to its individual ideal occlusal plane and mandibular plane.

장골의 해면 입자골 또는 블럭골을 이용한 치조열의 재건에 관한 비교 연구

최병호,이충국,민연숙,홍순재,Choi, Byung-Ho,Yi, Choong-Kook,Min, Yon-Sook,Hong, Soon-Xae 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.2

Objective : The objective of this study was to determine which forms of iliac cancellous bone grafts better restore alveolar clefts. Study design : Forty consecutive patients who required a unilateral alveolar cleft graft were studied. Group I (20 patients) had reconstruction with iliac cancellous particulate bone grafts and group II (20 patients) had reconstruction with iliac cancellous block bone grafts. The two groups were evaluated radiographically and clinically. Results : The group with the block bone grafts showed less postoperative problems and better incorporation of the bone graft than the group with the particulate grafts. Conclusion : Surgical reconstruction of alveolar process defects in patients with alveolar cleft using iliac cancellous block bone is a more reliable method than particulate bone grafts both for closing the oronasal fistula and for building interalveolar septal height.

병인론에 근거한 성인 골격성 III급 부정교합자의 분류와 그 prototype 제시를 위한 연구

홍순재,이충국,Hong, Soon-Xae,Yi, Choong-Kook 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.4

Skeletal class III had been classified by the position of the maxilla, the mandible, the maxillary alveolus, the mandibular alveolus and vertical development. This morphologic approach is simple and useful for clinical use, but it is insufficient to permit understanding of the pathophysiology of dysmorphoses. The author hypothesizes that there are different patterns of mutual relation of the skeletal components which have contributed pathologic equilibrium of skeletal class III. The purpose of this study are threefold: 1) to classify skeletal class III in subgroups, which can show the architectural characteristics of the deformity, 2) to analyse the craniofacial architecture of each subgroup on etio-pathogenic basis, and 3) to characterize and visualize the pattern as a prototype. Materials used in this study were lateral cephalograms of 106 skeletal class III adults, which were analysed with modified Delaire's architectural and structural analysis. Linear and angular measurements of the individual subject were obtained and cluster analysis was used for the subgrouping. Data were evaluated for verification of the statistical significances. The following results were obtained. 1. By the modified Delaire's architectural and structural analysis and cluster analysis, skeletal class III adults were classified into 7 clusters and presented as prototypes, which could show the pathophysiology of the skeletal architecture 2. There was significant relationship in measurement variables of each cluster, which could reflect characteristics of the skeletal pattern of growth. 3. The flexure of cranial base had a close relationship to the anterior rotational growth of the maxilla and contributes to understand the etio-pathology of skeletal class III. 4. The proportion of craniospinal area in cranial depth, craniocervical angle and vertical position of point Om had a close relationship to rotational growth of the mandible and direction of condylar growth. They contribute to understand the etio-pathology of skeletal class III. In summary, the cranium and the craniocervical area must be considered in diagnosis and treatment planning of dentofacial deformity. And the occlusal plane can be considered as a representative which shows the mutual relationships of the skeletal components.

성견하악골의 신연 부위에서 골형성에 대한 혈소판-풍부 혈장의 효과

류수장,이충국,최병호,Ryu, Soo-Jang,Yi, Choong-Kook,Choi, Byung-Ho 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.6

Distraction osteogenesis refers to the biological process responsible for new bone formation between bone segments by gradual distraction after osteotomy. For the past several years, various inconveniences including a protracted consolidation period that requires patients to wear a distractor frame longer, as well as higher medical costs, have not been remedied by improvements in osteotomy, distraction rate and monitoring system. Furthermore, side effects such as pin tract infections and soft tissue swelling may arise due to the long treatment period. These drawbacks form the rationale of this study which purports to seek a method by which the consolidation period can be reduced. This paper examines how platelet-rich plasma(PRP), known to facilitate osteogenesis, influences bone formation when applied in distracted area. Ten mongrel dogs, which were made to wear external distractor frames after osteotomy in both sides of the mandible, were used as subjects. After a 7day period of latency, distraction was carried out at a rate of 1mm/day for 14 consecutive days. After the onset of distraction, 2ml of PRP and a mixture of calcium gluconate and thrombine were injected into the center of the distracted callus on the left side of the mandible. The left was injected with PRP while the right side was set as the control site without PRP treatment. Execution at the onset of distraction and in 2 weeks, 4 weeks and 8 weeks after the consolidation period, clinical and radiographic tests, bone mineral density examination, histological examination and histomorphometric analysis were conducted to compare both sides. The results are summarized as follows: 1. Based on the clinical examination at two weeks, more remarkable cortical bone formation was found on the buccal and lingual side of the distracted area in the PRP treatment site than in the control site. No visual difference was found between the PRP treatment site and the control site at four eight weeks. 2. Based on the radiological examination, a distinct increase in the radiopaque appearance of the PRP treatment site was revealed at two weeks, but this increase appeared to slow down at four and eight weeks. 3. Examination of bone mineral density revealed a significant difference at two weeks with the PRP treatment site yielding density two times higher than the control site. This difference lessened after four weeks, and disappeared at eight weeks. 4. The histomorphometric examination revealed that about 20% more bony trabeculae area(20%, higher) was formed in the PRP treatment site than in the control site. In conclusion, it can be said that PRPs effect on stimulating bone formation in the PRP treatment site manifest as early as two weeks. Trabeculae formation likewise increased throughout the whole period. If this result can be applied to humans, the consolidation period can be reduced by injecting PRP into the distracted area.