하악 제3대구치에 대한 임상적 연구

안병근(Byoung-Keun Ahn) 대한치과의사협회 1990 대한치과의사협회지 Vol.28 No.5

안면골 골절에 대한 통계학적 고찰

안병근(Ahn Byoung Keun),이건주(Rhee Gun Joo),민복기(Min Bok Kee),한호진(Hahn Ho Jin),정기영(Chung Ki Young) 대한구강악안면외과학회 1988 대한구강악안면외과학회지 Vol.14 No.1

This is a retrospective study on 516 patients with maxillofacial bone fracture. The patients were treated at HAN GANG SANCRED HEART HOSPITAL from Jan.1,1977 to Dec. 31, 1986. The results were as follows. 1) The male to female ratio was about 4.6:1. 2) The facial bone fractures occured most frequently in the twenties (38.9%). 3) The most frequent etiologic factor was traffic accident. 4) A symphysis area was the most traumatic site of mandible. 5) A zygomatic areas were the most traumtic sites of facial middle 1/3. 6) In case of maxillofacial bone fracture with other side injuries it is most frequently accompanied by head injuries.

정상교합과 부정교합에서의 상${\cdot}$하악골과 제 1 대구치 위치에 관한 비교연구

윤병모,안병근,이건주,김선해,박영주,한호진,Yun, Byoung-Mo,Ahn, Byoung-Keun,Rhee, Geon-Ju,Kim, Sun-Hae,Park, Young-Ju,Han, Ho-Jin 대한치과교정학회 1993 대한치과교정학회지 Vol.23 No.4

There has been so much controversies about the position of upper and lower jaws, and their first permanent molars in normal occlusion and Angle's class $I{\cdot}II{\cdot}III$ malocclusions. So, the purpose of this study is to compare the position of upper and lower jaws, and their first molars in normal occlusion and Angle's class $I{\cdot}II{\cdot}III$ malocclusions by lateral cephalometric analysis. The sample consisted of one hundred and twenty girls(thirty in each group) who had completed growth. The findings of this study were as follows : 1. In class I malocclusion, both maxilla and mandible were slightly posterior position than normal occlusion, but they showed harmonious relationship. 2. In class II malocclusion, the mandible was greatly retruded, and the maxilla was also slightly retruded to the cranial base as compared with normal occlusion. 3. In class III malocclusion, the maxilla was significantly retruded to the cranial base, but no significant difference was found in mandibular position as compared with normal occlusion. 4. The maxillary first molar was located at posterior position in class II malocclusion, and anterior position in class III malocclusion to the cranium, so that the rotation of mandible was influenced by that. 5. The mandibular first molar showed constant relationship to the mandible in all four groups, but different position to the cranial base in direct proportion to the mandibular position. 6. On the treatment planning of class III malocclusion, it seems to be better to promote the mandibular horizontal growth by inhibiting the vertical growth of maxillary molar area, and on the treatment planning of class III malocclusion, it seems to be better to promote the antero-inferior growth of maxilla mi to promote the mandibular vertical growth by inducing the vertical growth of maxillary molar area.

성견 하악골 절단 후 기계적 골 견인에 의해 형성된 골 신장부에 대한 시기별 조직학적 변화

백선호,안병근,박영주,박희건,박준우,이건주,이용찬,조병욱,Baek, Sun-Ho,Ahn, Byoung-Keun,Park, Young-Ju,Park, Hee-Geon,Park, Jun-Woo,Rhee, Gun-Joo,Lee, Yong-Chan,Cho, Byoung-Ouck 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.5

Purpose : Traditionally, the treatement of choice has been a bone grafting procedure to increase the length of bone in case of actual length discrepancy. But, bone grafting procedure has many disadvantages, for example, graft resorption, donor site morbidity, and so on. So, many trials have been performed to avert the use of autogenous bone graft via introducing new materials or methods. And, one of those trials has been realized by the development of a technique inducing bone lengthening by osteotomy (or corticotomy) and slow gradual distraction of the osteotomized segments. This new technique of bone lengthening dates back to the early 20th century. But, the majority of information concerning the biology of new bone formation during bone lengthening and technical details of the procedure were produced by extensive clinical and experimental studies performed by Ilizarov, a Russian surgeon. According to Ilizarov, with adequate blood supply, preservation of periosteum, rigid fixation of the osteotomized segments, and proper rate and rhythm of distraction, intramembranous bone rapidly develops within the distraction gap in the limb lengthening procedure. In the limb lengthening, many orthopedic surgeons try to observe the biologic and clinical principles recommended by Ilizarov. In the oral and maxillofacial region, however, not a few studies must be performed to apply this surgical technique in the clinical cases. Besides, the mechanism of bone formation in the distraction gap is not clear, yet. The purpose of this experiment was to scrutinize serially the histological changes in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. In addition, it was performed to confirm the presence of specific region(s) which was important in the bone formation in the gap through the observation of the expression pattern of osteocalcin and osteonectin with the immunohistochemical examination. Materials and Methods : The experimental and control specimens were obtained from seven adult male mongrel dogs weighing over 20kg. The distractors were custom-made linear extraoral devices and bicortical fixation screws were 2.3mm in diameter, 50mm in total length, 15mm in screw length. The distractors were devised to produce a linear gap of 0.75mm between two bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side of each animal was corticotomized perpendicular to the occlusal plane and then two bony segments were separated completely by careful manipulation of the segments with bone forceps. The left side of each animal was left intact. This side was served as control. At sixth day after osteotomy and fixation of the segments were performed, distraction of the segments was commenced with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were euthanized at the 16th. 29th, and 44th day after the osteotomy. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with H&E. The prepared specimens were examined under the light microscope. And, immunohistochemical examinations using anti-osteocalcin antibody (OC1, Biodesign, USA) and anti-osteonectin antibody (Haematologic Technologies Inc., Essex, VT) to locate the expressions of osteocalcin and osteonectin, respectively, were performed. Results : 1. New bone was observed already at the 16th. day after osteotomy. This suggests that new bone formation in osteodistraction was commenced at an early stage of the regenerative process. But, radiologically and microscopically, bony union was not completed in the distraction gap at the 44th. day after osteotomy. Therefore, rigid fixation must be maintained between the bony fragments till the complete bony union is confirmed clinically rather than one month or so after the completion of distraction.

성견 하악 골체부 신장시 신장부위의 증식세포핵항원과 제 1형 교원질 발현에 관한 연구

임순모,안병근,박영주,박희건,박준우,이건주,이용찬,조병욱,Lim, Sun-Mo,Ahn, Byoung-Keun,Park, Young-Ju,Park, Hee-Geon,Park, Jun-Woo,Rhee, Gun-Joo,Lee, Yong-Chan,Cho, Byoung-Ouck 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.5

The purpose of this experiment was to examine the histological changes and the pattern of expression of proliferating cell nuclear antigen(PCNA) and type I collagen in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. Seven adult male mongrel dogs weighing over 20kg were used for this experiment. The author excluded 3 animals because they died before the planned time of sacrifice. The custom-made linear extraoral device and 4 bicortical fixation screws 2.3mm in diameter, 50mm in total length, 15mm in screw length were used in each animal. The distal part of the distractor produced a 0.75mm gap between proximal and distal bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side from each animal was experimental side and the left side was left intact and served as control. At the experimental side, the mandibular body was osteotomized. After 5-day latency period, the segments were distracted with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were sacrificed at the 4th. 17th, and 32th day after the end of the distraction. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with Masson trichrome and examined under the light microscope. The immunohistochemical examinations using anti-PCNA antibody and anti-type-I collagen antibody were performed to examine the pattern of the expression of PCNA and type I collagen, respectively. Results : 1. The mean increment of the distance between the proximal and distal screw-holding parts of the distractor was 6.8mm. The average elongation of the mandible in the experimental side was 5.3mm. The loss of elongation was 1.5mm in average. 2. New bone was already observed at the 4th. day after the end of distraction. But, bony union was not completed in the distraction gap at the 32th. day after the end of distraction by radiographic and microscopic examinations. 3. The expression rate of PCNA positive cells in the distraction gap had a tendency of decrease from 35.1-68.8% initially, to 49.1%, and finally to 17.6-27.2%. But at the final period, the tissue of the elongated gap still had the ability of cell proliferation. On the other hand, the expression of PCNA positive cells in the control side were negligible through the experimental period. 4. PCNA positive cells were observed primarily both at the central fibrous zone and at the region of just adjacent to CFZ which initiated new bone formation. 5. The expression pattern of the type I collagen was not zone-specific. They were observed diffusely throughout the elongation gap. 6. The predominant mechanism of new bone formation in the distraction gap was intramembranous. But, some of the regenerated bone was formed by endochondral ossification.

내과적 질환을 수반한 치성감염

김원겸,이건주,안병근,Kim, Weon-Gyeom,Rhee, Gun-Joo,Ahn, Byoung-Keun 대한악안면성형재건외과학회 1991 Maxillofacial Plastic Reconstructive Surgery Vol.13 No.2

Pyogenic orofacial infections are most commonly odontogenic in origin. Although such infections are usually self-limiting and spatially confined, purulent material may occasionally borrow deeply into contiguous fascial space or planes far from the initial site of involvement. The incidence of orofacial infection remains low in this modern era of preventive dental care and antibiotic therapy, but severe orofacial infections are most frequently observed in the medically compromised patients. We experienced 5 cases of severe orofacial odontogenic infection associated with medical diseases, and then concluded as follows : 1. The average hospitalized period was about 5 weeks, and the signs that indicated that the infections were controlled usually appeared in third week after incision and drainage. 2. The involved medical diseases were diabetes mellitus iatrogenic Cushing's syndrome, rheumatoid arthritis, malnutrition, etc. 3. The medical diseases should be treated coincidently with control of infection.

관절원판 절제술후 중간삽입물 고정에 피브린 접착제의 응용

정훈,김형근,김영수,유기준,안병근,Chung, Hoon,Kim, Hyeong-Keun,Kim, Young-Soo,Yu, Ki-Jun,Ahn, Byoung-Guen 대한악안면성형재건외과학회 1992 Maxillofacial Plastic Reconstructive Surgery Vol.14 No.3

Meniscectomy is indicated for the internal derangement of disk with perforation and gross morphological changes, nonreactive to conservative treatment procedures. After the meniscectomy, permanent disk replacement can be followed. Variable materials have been introduced for disk replacement. Of them, relatively harder replacing materials should have been fixed with surgical wire only. This poor fixation method provide inadequate retentive force and conclusively can be attributed to postoperative noise, poor prognosis. We tried to use biocompatible fibrin adhesive in order to obtain additional fixation force in the method above mentioned and treated two patients with the late stage of internal derangement of disk In both cases, satisfactory results were obtained.

전기화상 환자에서 나타난 파상풍-증례보고

하태영(Tae-Young Ha),강진한(Jin-Han Kang),신미란(Mee-Ran Shin),안병근(Byoung-Keun Ahn),김미자(Mija Kim) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.4

Tetanus is rare in Korea due to the introduction of vaccination programs and the advancement in public health. Its common signs are trismus, voice disturbance, neck stiffness, and difficulty in swallowing, etc. A 56 years old man was injured by grasping a high voltage electric cable. After the accident, he fell down on a steel plate and had a head trauma. When he visited Emergency Department, there was multiple electric burn wound on left arm and left facial area. He was hospitalized on a department of neurosurgery, because intra cranial hemorrhage was presumed. 12 days later, he was referred to department of OMFS with developed painful masseter spasms and trismus. That night he violently bit his tongue with his denture. Because masseter muscle and temporal muscle constriction was involuntary, tongue was lacerated and denture was distorted. At first we supposed that the symptom was related with neurologic disturbance following head trauma or electric shock. But it was revealed that trismus was caused by tetanus on an electrophysiological test. By using mechanical ventilation and administration of tetanus immunoglobulin, muscle- relaxant, and sedatives at ICU, symptoms had subsided (4-weeks). Because tetanus is rare disease, we rarely suppose tetanus infection to be a cause of a trismus. Especially it is more difficult to diagnose in patient who has head trauma, burn and neurologic problem as in this case.

가토의 하악골 측방 변위에 의한 하악과두 변화

박해승(Hae Sung Park),박영주(Young Ju Park),안병근(Byoung Keun Ahn),이건주(Gun Joo Rhee),박준우(Jun Woo Park),이용찬(Young Chan Lee),조병욱(Byoung Ouck Cho) 대한구강악안면외과학회 2000 대한구강악안면외과학회지 Vol.26 No.5

Condylar process of mandible is an important and fuctionally versatile part of the mandible. There were quite large amount of investigations on the functional and anatomical adaptation of the temporomandibular joint(TMJ) to the surrounding tissues. But controversies on the mechanism of functional adaptation of the joint still exist. In this research, we investigated changes in the TMJ by the lateral deviation of the maxillary incisor to shift the mandible right, and bone the undecalcified microscopic sections with fluorescent microscope and von Kossa staining with bright field microscope. Results were as follows: 1. Lateral deviation rendered shifting and tilting of the mandible, There were, compressions in the right joint and opening of the left joint space at early stage. At the same time, both condyles shifted slightly to anterior. 2. After 2~4 weeks, left condyle showed anterior displacement and compressions in the joint space. Right condyle showed only slight shift to the anterior. 3. Regardless of the direction of the lateral shift, anterior bite plate compressed both condyle heads until 2 weeks. 4. There are bone resorptions in the anterior aspect of the condyle head and apposition of posterior border. Bone remodeling were observed between 3 and 4 weeks. 5. After 8 weeks of the experiment, there were little differences in condylar morphology between experimental and control group, though slight shifting and compression were still present in the experimental group. Lateral deviation of mandible evoked active remodeling of the TMJ until functional and anatomical reconstruction of TMJ position was achieved.

外科的 顎關節鏡術의 臨床成績

Hoon Chung(鄭勳),Wean Gyeom Kim(金元謙),Seang Pal Hong(洪性八),Byoung Keun Ahn(安秉根),Yukou lzumi(泉祐幸),Koji Kino(木野孔司) 대한구강악안면외과학회 1991 대한구강악안면외과학회지 Vol.17 No.3

It has been admitted that arthroscopy on the temporomandibular joint diseases is useful not only as a diagnostic aid but also treatment method through surgical operation. Its value could be conspicuous by good case selection through accurate diagnosis and correct operation. We report the method, results of surgical arthroscopy that has been done in our department in 25 patients, 29 joints, and basic laboratory results for the application of Nd-YAG laser, having the action of vaporization, coagulation, hemostasis to the temporomandibular joint.