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하악두 골절의 미진한 처치로 인해 condylar prostheses까지 사용한 증례
정훈,이태영,성춘수 大韓顎顔面成形再建外科學會 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.1
It is a generally known fact that the patient can experience mouth opening limitation, mandibular deviation and malocclusion as a result of injury of tissues around the articular disc and complications even after successful open reduction surgery for fractured mandibular condyle. We have experienced a rare case of reconstruction using metallic condylar prostheses for a patient with complications resulted by unsuccessful management of fractured mandibular condyle. The case strongly suggested to us that careful selection of treatment methods should be taken for patient with fractured mandibular condyle. Accordingly, we are presenting a case in conjunction with reviews of fractured mandibular condyle.
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정훈,성춘수,Chung, Hoon,Sung, Choon-Su 대한악안면성형재건외과학회 1993 Maxillofacial Plastic Reconstructive Surgery Vol.15 No.2
Arthrosis of the temporomandibular joint is defined as a disease of a joint with chief complaint of pain, clicking, limited jaw movements. Generally, most patients with the temporomandibular arthrosis can be treated conservatively with muscle relaxation therapy combined with mandibular repositioning prostheses, followed by occlusal equilibration, restorative dentistry and/or orthodontics, and many other forms of treatment. In case prior nonsurgical treatment proved to be ineffective or the disease is chronic and severe, surgical operation is recommended. For patients with arthrosis of the temporomandibular joint, only discectomy as therapeutic method of the surgical treatment should not be applied and the removed articular disc of the temporomandibular joint should be replaced. Allograft such as Proplast-Teflon, Silastic, etc have been used as replacements of removed articular disc. However, these allograft materials have caused complications such as inflammatory changes, foreign body reactions. As a result, a replacement material which is autogenous, space occupying, easy to harvest and less inflammatory change has been developed. Auricular cartilage with perichondrium satisfies many of these requirements. The apparent advantages of autogenous auricular cartilage as an interpositional graft after a discectomy are as follows, (1) the form of the external ear corresponds to joint morphology, (2) a graft of adequate size can be harvested, (3) the form of the external ear remains unchanged after surgery, (4) the graft can be obtained adjacent to the surgical site, (5) biologically acceptable material is used, (6) the additional expense of allogenic graft is avoided. Because we considered autogenous auricular cartilage as a good replacement material, removed articular disc has been replaced with fresh autogenous auricular cartilage in the case of three patients. The result of the treatment is favorable, and the cases being presented here.
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악관절 과두걸림에 대한 악관절경술의 치료효과에 관한 임상적 연구
이태영(Tae Young Lee),오상윤(Sang Yoon Oh),성춘수(Choon Soo Sung),기종배(Jong Bae Kim) 대한구강악안면외과학회 1993 대한구강악안면외과학회지 Vol.19 No.4
This is a retrospective study to evaluate therapeutic arthroscopy for closed lock of the temporomandibular joint(TMJ). Eighteen subjects with 18 locked joints were treated y superior joint space arthroscopy, lysis of adhesion and lavage, and lavage, and debridement along with postoperative splint and physiotherapy. Pain, mandibular function including maximal incisal opening, and joint noises were evaluated preoperatively, postoperatively(around 2 weeks), and at the last visit. The mean follow-up was 22.8 months, with range of 3 to 38 months. The results showed that therapeutic TMJ arthroscopy was effective in managing pain and increasing motion of mandible in patients with closed lock of TMJ. In pain 66.7% of the patients reported pain-free state at the last visit And in mandibular function, maximum interincisal opening was increased by 49.1% in distance ; mandibular deviation to the affected side on opening was corrected in 93.8% and limited lateral excursion to the unaffected side was resolved in 91.7% of the symptomatic patients at the last visit. But in improving joint noises, therapeutic arthroscopy was not effective and was unpredictable ; clicking was disappeared in. 45.5% and crepitus in 50% of the symptomatic patients at the last visit.
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