치성각화낭과 법랑모세포종의 임상 및 방사선학적 감별진단

정호걸,이장렬,김기덕,박창서 大韓口腔顎顔面 放射線學會 2000 Imaging Science in Dentistry Vol.30 No.4

Purpose : To clarify the clinical and radiologic parameters that can be used to differentiate odontogenic keratocyst and ameloblastoma Materials and Methods : The records of 46 patients of ameloblastoma and 48 patients of odontogenic keratocyst at the Yonsei University Dental Hospital during the period of 1979 to 1995 were retrospectively reviewed. As a possible means for differentiating between the odontogenic keratocyst and ameloblastoma, the clinical parameters and the radiologic parameters were evaluated. Results : In the clinical parameters, there was no significant difference in age, sex, and sign and symptoms (p 〉 0.05). In the radiologic parameters, there was significant difference in site, shape of the lesion, and external root resorption of adjacent teeth (p 〈 0.05). Conclusion : The site, shape of the lesion, and external root resorption of adjacent teeth can be the parameters to differentiate odontogenic keratocyst and ameloblastoma, but a definite differentiation of these two lesions needs a more specialized imaging modality. (Korean J Oral Maxillofac Radiol 2000;30:249-254)

3차원 전산화단층촬영 영상을 이용한 얼굴 연조직 두께 계측

정호걸,김기덕,한승호,신동원,허경석,이제범,박혁,박창서 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.37 No.1

Purpose : To evaluate accuracy and reliability of program to measure facial soft tissue thickness using 3D computed tomographic images by comparing with direct measurement. Materials and Methods : One cadaver was scanned with a Helical CT with 3 mm slice thickness and 3 mm/sec table speed. The acquired data was reconstructed with 1.5 mm reconstruction interval and the images were transferred to a personal computer. The facial soft tissue thickness were measured using a program developed newly in 3D image. For direct measurement, the cadaver was cut with a bone cutter and then a ruler was placed above the cut side, The procedure was followed by taking pictures of the facial soft tissues with a high-resolution digital camera. Then the measurements were done in the photographic images and repeated for ten times. A repeated measure analysis of variance was adopted to compare and analyze the measurements resulting from the two different methods. Comparison according to the areas was analyzed by Mann-Whitney test. Results : There were no statistically significant differences between the direct measurements and those using the 3D images (p>0.05). There were statistical differences in the measurements on 17 points but all the points except 2 points showed a mean difference of 0.5 mm or less. Conclusion : The developed software program to measure the facial soft tissue thickness using 3D images was so accurate that it allows to measure facial soft tissues thickness more easily in forensic science and anthropology. (Korean J Oral Maxillofac Radiol 2006; 36 : 49-54)

두개골의 3차원 영상 분석을 위한 전산화단층촬영 방법의 비교 : 상층 두께가 3차원 영상의 계측에 미치는 영향

정호걸,김기덕,박혁,김동욱,정해조,김희중,유선국,김용욱,박창서 대한구강악안면방사선학회 2004 Imaging Science in Dentistry Vol.34 No.3

Purpose : To evaluate the quantitative accuracy of three-dimensional (3D) images by means of comparing distance measurements on the 3D images with direct measurements of dry human skull according to slice thickness and scanning modes. Materials and Mathods : An observer directly measured the distance of 21 line items between 12 orthodontic landmarks on the skull surface using a digital vernier caliper and each was repeated five times. The dry human skull was scanned with a Helical CT with various slice thickness (3, 5, 7 mm) and acquisition modes (Conventional and Helical). The same observer measured corresponding distance of the same items on reconstructed 3D images with the internal program of V-works 4.0 (Cybermed Inc., Seoul, Korea). The quantitative accuracy of distance measurements were statistically evaluated with Wilcoxons’ two-sample test. Results : 11 line items in Conventional 3 mm, 8 in Helical 3mm, 11 in Conventional 5 mm, 10 in Helical 5 mm, 5 in Conventional 7 mm and 9 in Helical 7 mm showed no statistically significant difference. Average difference between direct measurements and measurements on 3D CT images was within 2 mm in 19 line items of Conventional 3 mm, 20 of Helical 3 mm, 15 of Conventional 5 mm, 18 of Helical 5 mm, 11 of Conventional 7mm and 16 of Helical 7 mm. Conclusion : Considering image quality and patient’s exposure time, scanning protocol of Helical 5 mm is recommended for 3D image analysis of the skull in CT.

3차원 전산화단층촬영 영상을 이용한 안면 연조직 두께 계측의 임상적 유용성

정호걸,김기덕,한승호,허경석,이제범,박혁,최성호,김종관,박창서 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.36 No.2

Purpose : To evaluate clinical usefulness of facial soft tissue thickness measurement using 3D computed tomographic images. Materials and Methods : One cadaver that had sound facial soft tissues was chosen for the study. The cadaver was scanned with a Helical CT under following scanning protocols about slice thickness and table speed; 3 mm and 3 mm/sec, 5 mm and 5 mm/sec, 7 mm and 7 mm/sec. The acquired data were reconstructed 1.5, 2.5, 3.5 mm reconstruction interval respectively and the images were transferred to a personal computer. Using a program developed to measure facial soft tissue thickness in 3D image, the facial soft tissue thickness was measured. After the ten-time repeation of the measurement for ten times, repeated measure analysis of variance (ANOVA) was adopted to compare and analyze the measurements using the three scanning protocols. Comparison according to the areas was analyzed by Mann-Whitney test. Results : There were no statistically significant intraobserver differences in the measurements of the facial soft tissue thickness using the three scanning protocols (p>0.05). There were no statistically significant differences between measurements in the 3 mm slice thickness and those in the 5 mm, 7 mm slice thickness (p>0.05). There were statistical differences in the 14 of the total 30 measured points in the 5 mm slice thickness and 22 in the 7mm slice thickness. Conclusion : The facial soft tissue thickness measurement using 3D images of 7 mm slice thickness is acceptable clinically, but those of 5 mm slice thickness is recommended for the more accurate measurement.

전산화 단층촬영을 이용한 법랑모세포종의 방사선학적 연구

박혁,정호걸,김기덕,박창서 대한구강악안면방사선학회 2005 Imaging Science in Dentistry Vol.35 No.2

Purpose : To reveal what is the distinct differential diagnostic differences between unicystic ameloblastoma and solid or multicystic ameloblastoma. Materials and Methods : 56 cases of ameloblastoma were retrospectively reviewed and evaluated among the patients who had taken CT scans at the department of Oral & Maxillofacial Radiology in Yonsei University Dental Hospital from January 1996 to December 2003. Results : In 56 cases, 21 cases (37.5%) were unicystic ameloblastoma, 35 cases (62.5%) were solid or multicystic ameloblastoma. Only 1 case (4.8%) of unicystic ameloblastoma and 4 cases (11.4%) of solid or multicystic ameloblastoma were occurred in maxilla. 13 cases (61.9%) of unicystic ameloblastoma were observed as unilocular, and 8 cases (38.1%) as lobulated. 5 cases (14.3%) of solid or multicystic ameloblastoma were observed as unilocular, 13 cases (37.1%) as lobulated, and 17 cases (48.6%) as multilocular. In the results from the measurements after correction of the buccolingual widths and heights to the mesiodistal lengths, there is a statistically significant difference between unicystic ameloblastoma and solid or multicystic ameloblastoma in ANCOVA test (p<0.05). Hounsfield units in the lesion were 24.9±8.8 HU in unicystic ameloblastoma, 31.2±11.5 HU in solid or multicystic ameloblastoma. There is no statistically significant difference (p>0.05). Conclusion : Characteristic differences between unicystic ameloblastoma and solid or multicystic ameloblastoma is that there is higher prevalence of solid or multicystic ameloblastoma that have lobulated or multilocular patterns. To measure the Hounsfield units in the lesion is helpful, but it is not a differential diagnostic point between unicystic ameloblastoma and solid or multicystic ameloblastoma.

프랙탈 분석을 이용한 치근단병소 치유과정의 골 변화

이지민,박혁,정호걸,김기덕,박창서 대한구강악안면방사선학회 2005 Imaging Science in Dentistry Vol.35 No.2

Purpose : To investigate the change of bone healing process after endodontic treatment of the tooth with an apical lesion by fractal analysis. Materials and Methods : Radiographic images of 35 teeth from 33 patients taken on first diagnosis, 6 months, and 1 year after endodontic treatment were selected. Radiographic images were taken by JUPITER Computerized Dental X-ray System. Fractal dimensions were calculated three times at each area by Scion Image PC program. Rectangular region of interest (30×30) were selected at apical lesion and normal apex of each image. Results : The fractal dimension at apical lesion of first diagnosis (L_(0)) is 0.940±0.361 and that of normal area (N_(0)) is 1.186±0.727 (p<0.05). Fractal dimension at apical lesion of 6 months after endodontic treatment (L₂) is 1.076± 0.069 and that of normal area (N₁) is 1.192±0.055 (p<0.05). Fractal dimension at apical lesion of 1 year after endodontic treatment (L₂) is 1.163±0.074 and that of normal area (N₂) is 1.225 0.079 (p<0.05). After endodontic treatment, the fractal dimensions at each apical lesions depending on time showed statistically significant difference. And there are statistically significant different between normal area and apical lesion on first diagnosis, 6 months after, 1 year after. But the differences were grow smaller as time flows. Conclusion : The evaluation of the prognosis after the endodontic treatment of the apical lesion was estimated by bone regeneration in apical region. Fractal analysis was attempted to overcome the limit of subjective reading, and as a result the change of the bone during the healing process was able to be detected objectively and quantitatively.

하악 무치악 부위의 임플란트 이식을 위한 전산화단층촬영 영상의 비교 평가

선경훈,정호걸,박혁,박창서,김기덕 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.1

Purpose : The purpose of this study was to evaluate the clinical usefulness of the recently developed multi-detector computed tomography and cone beam computed tomography in pre-operative implant evaluation, by comparing them with the single detector computed tomography, already confirmed for accuracy in this area. Materials and Methods : Five partially edentulous dry human mandibles, with 1×1 mm gutta percha cones, placed in 5 mm intervals posterior to the mental foramen on each side of the buccal part of the mandible, were used in this study. They were scanned as follows: 1) Single detector computed tomography: slice thickness 1 mm, 200 mA, 120 kV 2) Multi-detector computed tomography: slice thickness 0.75 mm, 250 mA, 120 kV 3) Cone beam computed tomography: 15 mAs, 120 kV Axial images acquired from three computed tomographies were transferred to personal computer, and then reformatted cross-sectional images were generated using V-Implant 2.0 (CyberMed Inc., Seoul, Korea) software. Among the cross-sectional images of the gutta percha cone, placed in the buccal body of the mandible, the most precise cross section was selected as the measuring point and the distance from the most superior border of the mandibular canal to the alveolar crest was measured and analyzed 10 times by a dentist. Results : There were no significant intraobserver differences in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). There were no significant differences among single detector computed tomography, multi-detector computed tomography and cone beam computed tomography in the distance from the most superior border of the mandibular canal to the alveolar crest (p>0.05). Conclusion : Multi-detector computed tomography and cone beam computed tomography are clinically useful in the evaluation of pre-operative site for mandibular dental implants, with consideration for radiation exposure dose and scanning time.

나이에 따른 한국인 정상 이하선의 전산화단층촬영값의 차이

박창서,김기덕,이은숙,정호걸 大韓口腔顎顔面 放射線學會 1999 Imaging Science in Dentistry Vol.29 No.2

Purpose : To determine normal CT number range of parotid gland by analyzing the change by age increase and the difference among individuals and between both sexes in CT number of normal parotid gland. Materials & Methods : 134 subjects who took the CT scan between the period of Jan. 1996 and Dec. 1997 at Yonsei University, Dental Hospital were selected. Criteria for selection were that the patients must be within the normal range clinically and radiologically, and the entire parotid gland on the axial view must be shown. Among the axial views, the one showing the greatest parotid gland size was selected and its CT number was recorded. Also, CT numbers from both masseter muscle were recorded as its control. Results : There was statistically significant correlation between CT number of right and left of parotid glands and masseter muscles. With the increase of age, there is a significant decrease in the CT number of parotid gland(p<0.05). There was no statistically significant difference in CT number between sexes except the 7th decade and beyond age group of parotid gland(p>0.05). Conclusion : As age increases, CT number of parotid gland has a tendency to decrease, and there is no significant difference in the CT numbers between left and right parotid gland. Therefore in the CT scan of patients suspected of having a salivary gland disease of the parotid gland, to consider normal range of the age-dependent CT numbers of parotid gland and compare the CT numbers of the right and left parotid gland might be useful in diagnosing the disease.(J Korean Oral Maxillofac Radiol 1999;29:451-458)

염증성 근섬유모세포종의 증례보고

은상아,박혁,차인호,김현실,정호걸,김기덕,박창서 대한구강악안면방사선학회 2006 Imaging Science in Dentistry Vol.36 No.3

The inflammatory myofibroblastic tumor (inflammatory pseudotumor) is a rarely occurring soft tissue lesion of unknown etiology. It can be of any location, but commonly it is found in lungs. It has been considered as a nonneoplastic reactive inflammatory lesion, but nowadays, confusion and dispute about its character is increasing due to its high recurrence rate and metastasis. We present a patient who had been diagnosed with an inflammatory pseudotumor in the right maxilla area, 1 year before visiting our hospital. After that, her pain and swelling did not resolved and she visit our hospital. On radiographic examination, aggressively infiltrative growth of the lesion with destruction of adjacent bony structure was noted. We found unusual aggressiveness of the inflammatory myofibroblastic tumor of the head and neck region. Because the typical behavior of the inflammatory myofibroblastic tumor is not defined yet, we recommend the surgical excision of the lesion and close follow-up.

Risk factors of osteonecrosis of the jaw after tooth extraction in osteoporotic patients on oral bisphosphonates

Jeong, Ho-Gul,Hwang, Jae Joon,Lee, Jeong-Hee,Kim, Young Hyun,Na, Ji Yeon,Han, Sang-Sun Korean Academy of Oral and Maxillofacial Radiology 2017 Imaging Science in Dentistry Vol.47 No.1

Purpose: The aim of this study was to investigate the incidence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after tooth extraction in patients with osteoporosis on oral bisphosphonates in Korea and to evaluate local factors affecting the development of BRONJ. Materials and Methods: The clinical records of 320 patients who underwent dental extraction while receiving oral bisphosphonates were reviewed. All patients had a healing period of more than 6 months following the extractions. Each patient's clinical record was used to assess the incidence of BRONJ; if BRONJ occurred, a further radiographic investigation was carried out to obtain a more definitive diagnosis. Various local factors including age, gender, extraction site, drug type, duration of administration, and C-terminal telopeptide (CTx) level were retrieved from the patients' clinical records for evaluating their effect on the incidence of BRONJ. Results: Among the 320 osteoporotic patients who underwent tooth extraction, 11 developed BRONJ, reflecting an incidence rate of 3.44%. Out of the local factors that may affect the incidence of BRONJ, gender, drug type, and CTx level showed no statistically significant effects, while statistically significant associations were found for age, extraction site, and duration of administration. The incidence of BRONJ increased with age, was greater in the mandible than the maxilla, and was associated with a duration of administration of more than 3 years. Conclusion: Tooth extraction in patients on oral bisphosphonates requires careful consideration of their age, the extraction site, and the duration of administration, and close postoperative follow-up should be carried out to facilitate effective early management.