가토의 두개골 골결손부에 탈단백 우골 이식시 혈소판 농축 혈장과 피브린 실란트의 효과

이용인Yong-In Lee,신승윤Seung-Yun Shin,이동환Dong Hwan Lee,홍종락Jongrak Hong 대한구강악안면외과학회 2007 대한구강악안면외과학회지 Vol.33 No.3

Purpose The purpose of this study is to evaluation of effect on bone formation of PRP and fibrin sealant with deproteinized bovine bone(Bio-Oss) grafts on rabbit cranial defect. Material and Methods Twelve rabbits were used as experimental animal Two equal 9mm diameter cranial bone defects were created in each rabbit and immediately grafted with Bio-Oss only, Bio-Oss and PRP, and Bio-Oss and Fibrin sealant. Rabbits were sacrificed at 4 and 8 week. The defects were evaluated by histomorphometric analysis. Results Kruskal-Wallis tests were performed comparing new bone formation via histomorphometric analysis. No statistically significant difference of new bone formation was found between Bio-Oss only, Bio-Oss and PRP, and Bio-Oss and fibrin sealant at 4 and 8 weeks (P>0.05). Conclusion This study fails to find a stimulatory effect of PRP and Fibrin sealant on New bone formation of Bio-Oss grafts by histomorphometric analyses.

안면비대칭의 외과적 교정

홍종락(Jongrak Hong) 대한치과의사협회 2014 대한치과의사협회지 Vol.52 No.10

안면비대칭의 주원인은 하악골이며, 하악골의 비대칭 성장에 대한 상악골의 보상성장에 따라 교합면 경사 등이 초래된다. 디지털 사진과 삼차원 CT 등 다양한 방법으로 정확한 진단을 하고 수술을 포함한 치료 계획을 세운다. 술전 교정 치료는 상악골과 하악골 치열의 치성 보상(dental compensation)을 제거하면서 상악 치열의 중심은 상악골의 정중선에, 하악 치열의 중심은 하악골 정중선에 맞게 이동하여 술후 상하악 치열궁이 일치하면서 동시에 안모 정중선에 일치하게 맞추어야 한다. 악교정 수술은 일반적으로 상하악 동시 수술을 하게 되며 우각부 풍융도 교정과 이부 성형술(genioplasty) 등을 부가적으로 할 수 있으며, 교합면 경사 교정과 수평 회전 등의 이동이 상하악 위치에 서로 영향을 주면서 수술 후 안모 변화에 대한 예측을 어렵게 만들기 때문에, 다양한 분석을 통해 정확한 예측으로 최선의 결과를 얻는 것이 가장 중요하다. The facial asymmetries include maxillary, mandibular, and chin asymmetries, although the most common deformity is primarily in the mandible. Common causes of this type of asymmetry can include asymmetric growth of the condyle or the mandible. In these patients, the location of the Me would be deviated to the shorter side because of the asymmetric growth of the mandible, and, commonly, the maxillary occlusal plane would be tilted toward the deviated side because the maxilla likely grows asymmetrically according to the pattern of asymmetric mandibular growth. Three dimensional CT images are ideal for evaluating the size and location of anatomic structures, and such reconstructed images allow the use of software that can show anatomic structures from numerous angles, allowing actual measurements of distances and angles without problems of magnification, distortion, or superimposition caused by 2 dimensional imaging. In the present study using 3D CT imaging, the 8 parameters, including measurements of the upper midline deviation, maxillary canting in the canine and first molar regions, width of the upper arch, width of the mandible at the Go, vertical length of the ramus, inclination of the ramus, and deviation of the Me were easily measured. The dentition should be orthodontically decompensated and dental midline should ensure incisor midlines positioned in the midline of each jaw before surgical correction. Surgical correction could be considered such as canting or yawing correction in the frontal or horizontal aspect, respectively.

폐쇄성 수면 무호흡 환자에서 임시 하악 전방 이동 장치를 이용한 치료결과 분석

박준형,오수석,홍종락,김창수,팽준영,Park, Joon-Hyung,Oh, Suseok,Hong, Jongrak,Kim, Chang-Soo,Paeng, Jun-Young 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.6

Purpose: The aim of this study was to evaluate the effect of temporary mandibular advancement devices (MAD) in obstructive sleep apnea (OSA) patients Methods: 28 patients (male 21, female 7) undergoing temporary mandibular advancement device treatment for OSA were selected from 2011.01. to 2012.02. in the department of Oral & Maxillofacial Surgery at SamsungMedicalCenter. Treatment efficacy was determined by polysomnography (PSG) at baseline & after MAD delivery. The response group was defined as >50% Apnea-Hypopnea Index (AHI) reduction plus post-MAD AHI <10, and the non-response group was defined as <50% AHI reduction. The lateral cephalogram was analysed including SNA, SNB, UL, MPH, PAS, PASU, and PAST using V-ceph$^{TM}$ (Cybermed, USA). Results: The responsers were 23 patients, and non-responsers were 5 patients. The AHI was significantly reduced with temporary MAD ($8.08{\pm}7.93$) compared with baseline ($28.51{\pm}20.56$) in the response group (n=23). No significant difference was observed between pre MAD and post MAD except SNB on cephalometric analysis. Among 11 patients successfully treated with the temporary device, 9 patients said that using permanent device brings better effect too. Conclusion: These results indicate that the Temporary MAD could not be the only effective tools on OSA but also be used to predict patient's reactivity about permanent appliance treatment. Further studies are warranted to evaluate the relations between temporary MAD and permanent MAD.

상하악 악교정수술 후 입술 기울기변화

이준휘(Jun-Hee Lee),홍종락(Jongrak Hong),김영호(Young-Ho Kim) 대한구강악안면외과학회 2007 대한구강악안면외과학회지 Vol.33 No.6

Purpose The purpose of study was to investigate the correlationship between lip canting change and occlusal canting change after bimaxillary orthognathic surgery, and the ratio of lip canting change and occlusal canting change after the surgery. Patients and methods The subjects for this study was obtained from a group of 25 patients who took bimaxillary orthognathic surgery for occlusal canting correction at the Department of the Oral and Maxillofacial Surgery, Samsung Medical Center in Seoul, Korea between January 2000 and December 2005 and a patient’s chart had to contain a resting frontal facial photograph in natural head position and a corresponding PA cephalogram in occlusion on the same day before the surgery and post-op 6 months later. The lip canting change was assessed with the angle each labial commissure and the bipupilary reference line. And, the occlusal caning change in the frontal plane was assessed with the angle between the each maxillary first molar occulasal surface and the bi-frontozygomatic suture reference line. Results In angular measurement, average occlusal canting change was 3.09oand standard deviation was 1.05o, average lip canting change was 1.56and standard deviation was 1.05. In linear measurement, average occlusal canting change was 2.41mm and standard deviation was 2.75mm, average lip canting change was 1.18mm and standard deviation was 0.43mm. Lip canting correction ration to occlusal canting correction was 51.5(±8.4)% in angular measurement and 48.8 (±9.1)% in linear measurement. Under Pearson’s correlation analysis, Pearson’s correlation coefficient was 0.869 in angular measurement and 0.887 in linear measurement (p-value < 0.01). High correlationship was shown between occlusal canting change and lip canting change. Conclusion First, Bimaxillary orthognathic surgery can correct lip canting as well as occlusal canting. Second, The average amount of lip canting correction is 51.5±8.4%, 48.8±9.1% of occlusal canting correction in the study.

상악절제술 후 외과적 재건과 보철적 치료의 비교

권호범(Ho Beom Kwon),홍종락(Jongrak Hong) 대한구강악안면외과학회 2007 대한구강악안면외과학회지 Vol.33 No.2

One of the treatment methods for maxillary cancers or infections in maxilla is maxillectomy. Palatal defect can be resulted from this operation and it may cause functional problems with swallowing and speech, and psychological problems of patients. After maxillectomy, as rehabilitation, there can be two options. One is a prosthodontic treatment using obturator and the other is surgical reconstruction of defect with graft. As both methods have advantages and disadvantages, in determining treatment method after maxillectomy, various factors have to be considered. The purpose of this study is to compare the prosthodontic group to surgical group after maxillectomy with elapsed days prior to commencement of postoperative oral feeding, and to analyze the results of prosthodontic treatment and surgical treatment. During the period from March of 2000 to June of 2006, 74 patients were treatment by prosthodontic methods for maxillary defect. Among these patients, patients who had only velopharyngeal deficiency after surgery, whose data were incomplete, whose causes of palatal defect were not the treatment of diseases in maxilla, and who already had palatal defect due to previous surgery were excluded in this study. The patients who underwent maxillectomy for the treatment of diseases in the maxilla and were treated immediately after operation using surgical reconstruction or prosthodontic rehabilitation were included in this study. The records of 43 patients were reviewed to compare and to analyze the prosthodontic treatment and surgical reconstruction after maxillectomy. The median of days elapsed prior to commencement of postoperative oral feeding in the prosthodontic group was compared with data of surgical group. The data was analyzed using the Mann-Whitney test (α= .05). Days elapsed prior to postoperative oral feeding commencement in the prosthodontic group were less than those in the surgical group.

III급 부정교합 환자의 한국어 모음 발음에 관한 음향학적 분석

김영호(Young Ho Kim),유현지(Hyunji Yoo),김휘영(Whi Young Kim),홍종락(Jongrak Hong) 대한구강악안면외과학회 2009 대한구강악안면외과학회지 Vol.35 No.4

The purpose of the study was to investigate the characteristics of the pronunciation of Korean vowels in patients with class Ⅲ malocclusion. 11 adult male patients with class Ⅲ malocclusion(mean ages 22.3 years) and four adult males with normal occlusion(mean ages 26.5 years) were selected for the analysis of eight Korean monophthongs /ㅣ, ㅔ, ㅐ, ㅏ, ㅓ, ㅗ, ㅡ, ㅜ/. The values and relationships of F1, F2 and F3 were derived from the stable section of target vowel in each sentence, and the analysis using formant plots and vowel triangles distance and area was conducted to find the features of two groups vowel distributions. Consequently, it was identified that the pronunciation of males patients with class Ⅲ malocclusion showed high values of F1 in the low vowels, high values of F2 in the back vowels, and remarkably low position of /ㅏ/. The vowel triangle suggested that the triangle areas of male patients with class Ⅲ malocclusion were shown wider vertically and narrower horizontally than those of males with normal occlusion. These characteristics could reflect the structural features of class Ⅲ malocclusion such as the prognathic mandible, low tongue position, and advancement of back position of the tongue.

히알룬산젤이 구강 창상 치유에 미치는 영향

김형진(Hyung-Jin Kim),신창훈(Chang-Hoon Shin),홍종락(Jongrak Hong),최정한(Jung-Han Choi) 대한구강악안면외과학회 2007 대한구강악안면외과학회지 Vol.33 No.4

Purpose: In spite of various advantages of hyaluronic acid in wound healing, there are few research about wound healing process and period in oral and maxillofacial surgery. So, We evaluated the effects of local application of hyaluronic acid gel on wound healing of the oral mucosa using this animal model. Materials and methods: Young adult New Zealand White rabbits, weighting between 2.5 and 3.0kg, were used. Almost uniform round ulcers could be created on the gingival of the rabbits by chemical injury with acetic acid. In experimental group, hyaluronic acid gel was applied daily until the wounds healed and in control group, ulcer lesion was not any treatment. The lengths of ulcers were measured the longest and shortest axes of the ulcers and calculated the areas of ulcer. For histological examination, specimens were made, and observed under a light microscope. Results: The results showed that the number of fibroblasts, new blood vessels and the epithelial thickness from experimental group was higher than from control group. Hyaluronic acid promoted proliferation of the fibroblast, keratinocytes isolated from gingival tissue of rabbits in vitro. Topical application of hyaluronic acid accelerated healing of ulcers created in rabbits. Conclusion: The hyaluronic acid may be effective for wound healing of oral mucosal lesions.

하악전돌증환자에서 악교정수술후 저작근의 부피 및 교합력의 변화

설정은(Jung-Eun Seol),이명환(Myung-Hwan Lee),김창수(Chang-Soo Kim),홍종락(Jongrak Hong) 대한구강악안면외과학회 2008 대한구강악안면외과학회지 Vol.34 No.3

Purpose: The purpose of our study was to evaluate the volume of pre- and post operative masseter muscle and bite force in mandibular prognathic patients treated with SSRO with the use of the 3D CT imaging technique and occlusal force meter. Materials and methods: The study group consisted of 12 patients with mandibular prognathism (5 males and 7 females) who underwent mandibular setback surgery (BSSRO) in the Department of Oral and Maxillofacial Surgery, Samsung medical center. Bite force was measured at pre op, post op 3, 6 and 12 months by occlusal force meter(GM10, Nagano Keiki, Japan) The preoperative CT examination of subjects was performed between one month prior to operation and one year after to operation. And muscle volume was measured. Result: As compared to preoperative measurements at 1 year postoperatively the masseter & internal pterygoid muscle volume were diminished(p<0.05) The bite force steadily recovered, so at postoperatively 6 months reached the preoperative level. And at 1 year after operation, the maximum bite force was significantly greater than preoperative levels. No significant correlation was presented between masseter muscle and bite force (p>0.05), internal pterygoid muscle and bite force (p>0.05). Conclusion: In this study, the results showed that volume and bite force of the masticatory muscles decresed significantly immediate after orthognathic surgery for mandibular set-back. However, reduction of maximum bite force disappears within 6 months after surgery.

악골에서 발생한 치성 낭종제거 후 골이식 여부에 따른 치유속도와 양상 비교

백채환(Chae-Hwan Baek),박준형(Joon-Hyung Park),김군종(Gun-Jong Kim),홍종락(Jongrak Hong),김창수(Chang-soo Kim),팽준영(Jun-Young Paeng) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.6

Introduction: Bone defects in the jaw are frequently observed after odontogenic cyst enucleation. The success of bone healing appears to be related to the size of the bone defect, the anatomical location, the patient’s age and other parameters. The use of bone grafting material is dependent on the operator’s preference. No evidence-based definite treatment protocol has been established. This study evaluated the effect of a bone graft into the defect after odontogenic cyst enucleation. Materials and Methods: A total of 55 patients, who had been treated for an odontogenic cyst with cyst enucleation from 2000 to 2009 at the department of Oral and Maxillofacial Surgery, Samsung Medical Center, were included in this study. Patients who were followed-up for more than 1 year were included. Two groups were defined according to the bone graft (with or without a bone graft) after cyst enucleation. The differences in the healing periods and patterns of bone healing were compared clinically and radiologically. The postoperative 1 year radiographs were analyzed for bone healing and density. Statistical analysis was performed using a Pearson chi square test and Wilcoxon rank-sum test. Results: More infection signs were observed in the bone graft group than in the other group, but there was no statistically significant difference. Radiographically, there was also no significant difference in the size of the radiolucent lesions between the two groups. Conclusion: There was no significant difference in healing between the groups with a bone graft and without bone graft after cyst enucleation.

과잉치의 맹출에 영향을 주는 요소에 대한 후향적인 연구

이동걸(Dong-Geul Lee),장인걸(In-Geul Chang),홍종락(Jongrak Hong) 대한구강악안면외과학회 2008 대한구강악안면외과학회지 Vol.34 No.4

Unerupted or erupted supernumerary tooth may cause crowding, diastema, cyst formation, resorption, and displacement or rotation of adjacent teeth. However, there are few studies about prognosis about the pathologic condition and expectation of spontaneous eruption. The object of this study is to evaluate factors predicting the spontaneous eruption of supernumerary tooth. 431 patients (346 males and 85 females, aged from 5 to 29 years) who visited our institution from 2002-2006 and were shown to have 471 mesiodentes was reviewed. Supernumerary teeth were classified inverted and not inverted state. In case of not inverted supernumerary tooth, eruption rate ac cording to length of supernumenary tooth, width of the tooth, angle between the tooth and incisor tooth, location (inside the incisor or not) and shape (conical or tubercle) were investigated. The regression model showed that length, width and angle were all important determinants of influencing the eruption of supernumerary tooth (p <0.001, Pearson R: 0.619). There is no relation between shape and eruption of supernumerary tooth (p > 0.05). Location of mesiodens has an effect on eruption of supernumerary tooth (p < 0.01).