하악골 절제술후 재이식된 돌결자가골 재이식 : 치험 3례

김 식,김수관,김운규,김수민,류종희,이준길,조경안,김수흥,정태영,여환호 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.2

We described three cases of immediate reimplantation of a frozen-thawed autogenous mandible composed of a mixture of iliac bone, marrow, and particulate hydroxyapatite in tumors of the mandible. Acceptable outcomes were obtained in three patients who underwent immediate autogenous mandibular graft reconstruction. The conditions leading to successful outcome of the procedure are also discussed. Reimplantation of frozen autogenous lesioned mandible was performed in three patients with mandibular tumors. Two reimplanted grafts survived without complications following surgery. One case had postoperative infection that resolved with appropriate antibiotic treatment. There were no recurrences of the primary lesions. Satisfactory facial contour after surgery was achieved. These results are most promising, and we believe that, with further refinement, this technique will offer a new and acceptable modality for facial reconstruction in patients with cancer.

상악골 전방부 골절단술후 발생된 개방형 열개 : 증례보고 A CASE REPORT

김훈,김수관,이준길,정태영 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.3

An anterior segmental osteotomy may be complicated by malpositioning,bleeding, perfusion deficiencies, periodontal defects(dehiscence), devitalized teeth, oronasal fistula, and nonunion(delayed union).If preiodontal defects occur after surgery, though hygiene and good nutrition are all that can be recommended until primary healing has occurred. However, a soft tussue graft might be needed at the defect site when the preiodontal defects do not heal properly. We reported a patient who showed an excellent prognosis after undergoing a palatal mucosa graft accompanied by laterally positioned flap as a result of a dehiscence that occurred after anterior segmental osteotomy.

치아회분의 세포독성 및 과민성 검사

김영균,김수관,이장희 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.5

The purpose of this study was to determine the cytotoxicity and hypersensivity of toothash which we deloped. As a result of a cell toxicity experiment to use MTT assay, there were no differences between toothash group and control group. The cytotoxicity was thought to be absent. Particular allergic reaction did not appear compared with the control group in toothash group.

치조제 증강을 위한 HTR 중합체 이식후 치유과정 : 증례보고

김수관,임성철 大韓顎顔面成形再建外科學會 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.1

The purpose of this study is to evaluate the effect of HTR?? (hard tissue replacement, Bioplant Inc, U.S.A) polymer on short-term healing as a grafting material for alveolar ridge augmentation. A 48-year-old female presented insufficient bone height and width for the placement of implants. HTR?? polymer was used for ridge augmentation. Bone biopsy was harvested 8 months after the ridge augmentation procedure. HTR?? polymer displayed rapid bone regeneration and mature lamellar and trabecular bone redevelopment. Clinical and histologic observation from the treatment of the patient presented suggest that HTR?? polymer seems to be a appropriate material for alveolar ridge augmentation.

가토에서 관절원판을 전방변위시킨 후 두개하악관절의 조직병리학적 변화

김문수,여환호,김수관,강태호,박정열,장현석 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.5

To investigate the histopathologic changes of the rabbit craniomandibular joint (CMJ), anterior disc displacement (ADD) was surgically induced. Of 15 rabbits, 9 were classified as experimental group, 3 as control of group, and 3 as sham-operation group, respectively The experimental group (9 rabbit) was subdivided into 6 weeks, 12 weeks, and 20 weeks group, respectively 3 rabbits. In experimental group, the disc was displaced anteriorly at the right side(operation side) and left CMJ was not operated(non-operation side). Both CMJs were harvested at 6, 12, and 20 weeks following surgery in experimental group. The CMJ was harvested at 6 weeks following surgery in sham-operation group. The specimens were examined under light microscope after hematoxylineosin and verhoeff staining. The obtained results were as follows: 1.In midsagittal view of control and sham-operation group, there were no degenerative and hyperplastic changes in the CMJ including articular disc, mandibular condyle, and temporal fossa. 2.Disc was shortened anterior-posteriorly and deformed of biconcave shape in all experimental group. In 20 week experimental group, intermediate zone of disc width was almost same as the width of posterior band of disc. 3.Soft tissue hyperplasia at the posterior attachment area of the disc and condylar hyperplasia were seen in the all experimental groups, but the degree of the hyperplasia was greater at 12, 20 weeks than at 6 weeks. 4.The number of elastic fiber in the disc proper was decreased and the direction and morphology was chanced in all experimental groups compared with those of control of groups. 5.Fatty degeneration was shown in non-operation side of 20 weeks experimental group. These results suggest that induced ADD in craniomandibular joint of rabbits could lead to a reparative and degenerative changes of the affected joint similar to those described for osteoarthrosis and osteoarthritis in human.

치아회분과 석고 혼합매식물 이식에 관한 임상적 연구 : 장기간 추적 연구 LONG-TERM FOLLOW UP STUDY

김영균,여환호,김수관 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.4

This study was undertaken to access the effect of toothash combined with plaster of Paris in the filling of jaw defect and the substitution as new bone during the follow up period. We used the toothash and plaster after the cyst enucleation, the apicoectomy, the extraction of supenumerary tooth with ratio of 2 : 1 by weigh. 15 consecutive patients were evaluated retrospectively. Complications were swelling, perforation, infection and treated without problems using incision & drainage, aspiration, antibiotic treatment, 2ndary buccal flap. The follow0up period ranged from 28 to 35 months. Based on radiographic and clinical observation, it may be concluded that toothash and dental plaster of Paris(CaSo₄ 1/2H₂0) are useful for bone substitute.

치성섬유점액종 : 증례보고

김수관,김운규,장현선 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.4

Odontogenic fibromyxomas are extremely rare benign odontogenic tumors that probably arise from interstitial portion of jaw bone. The plain X-ray showed osteolytic destructive lesions in the molar root area. CT scans demonstrated osteolytic expansile lesions with mild enhancement of the solid portion of the mass. Histologically, the tumor is composed of fibrous tissue and myxoid tissues. In this paper a case of odontogenic fibromyxoma of the maxilla and a review of the literature is presented.

치아종 제거후 시행한 자가치아이식술

김종운,김수관,김수흥,정태영 대한악안면성형재건외과학회 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.3

We report a case in which a right mandibular incisor was impacted beneath an odontoma in the anterior mandible. An odontoma at the symphyseal region was removed under general anesthesia, and bone was grafted. Tooth #41, which was beneath the lesion, was extracted and transplanted to its original site. It was splinted with resin for 2 weeks and was checked at intervals during that time. After 4 months, it was filled endodontically with calcium hydroxide.

비강상악동 미분화암종

김운규,김수관,조세인,윤정훈 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4

Sinonasal undifferentiated carcinoma(SNUC) is an uncommon aggressive malignancy of the nasal cavity and paranasal sinuses. Since the initial recognition of SNUC as a distinct clinicopathological entity, treatment regimens have evolved to include the current recommendation of combined radical resection, radio-therapy and chemotherapy. Despite this aggressive therapy, outcomes have remained dismal, with the mean survival time still being less than 1 year after diagnosis. SNUC present with locally advanced disease, with a tendency for the tumor to spread from the paranasal siuses to the orbit and anterior cranial fossa. A case of SNUC occurred in the left maxilla showing an unusual clinical manifestations and a fulminant course of disease, is described with literatures review. A 77-year-old female patient presented with rapidly growing tumor-like bulging of the left maxilla and slight ulceration of the right upper posterior vestibule. At the first biopsy, diagnosis was a radicular cyst, but SNUC was made subsequently by the second biopsy 6 month later. Rapid and wide extension from the maxilla to the orbit and nasal cavity developed with infection. Although the time relationship is not clear, local invasion could be developed from localized disease of SNUC. Despite combined therapy with chemotherapy and radiotherapy, She has been expired 13 months after the first biopsy. Focal positivity of immunohistochemical stain(CK, EMA), which is a specific characteristic of SNUC, may serve as a factor showing unfavorable prognosis.

구강악안면 감염 환자에 관한 임상 통계학적 분석

김미성,남옥현,김수관,조세인 대한악안면성형재건외과학회 2002 Maxillofacial Plastic Reconstructive Surgery Vol.24 No.4

This is a clinico-statistical study of 532 oral and maxillofacial infected patients who were treated at Chosun University Dental Hospital during the period 1996-2001. The following results were obtained. The ratio of male to female ratio was 0.85:1. The highest monthly incidence was shown in June (10.15%) and July (9.77%), and the age distribution peaked in the 60s (15.60%), followed by 50s (14.29%) and 40s (13.53%). The most frequent cause was dental caries (43.05%), periapical abscess (13.72%), periodontal lesion (8.83%), and pericoronitis (8.27%). In terms of the delay time between onset of symptoms and visit, the highest incidence (56.20%) occurred at 1-3 days. In terms of the length of treatment, the highest incidence (36.65%) occurred at 7-9 days. Underlying medical problems were found in 161 patients, the most common being hypertension (27.33%) and diabetes (26.71%). The most common facial space involved was the buccal space (34.85%), followed by the submandiblular space (29.30%), canine space (17.17%), submental space (6.23%), and sublingual space (3.87%). In respect of antibiotics therapy, penicillin, aminoglycoside and metronidazole complex were most prevalent.