하악골에 발생한 원발성 상피암 2례

장헌수(Heon Soo Chang),김종필(Jong Pil Kim),안재진(Jye Jynn Ann) 대한구강악안면외과학회 1994 대한구강악안면외과학회지 Vol.20 No.3

The primary intraosseous carcinoma(PIOC) of the jaw is extremely rate condition and I defined as a squamous cell carcinoma arising within the jaw having no initial connection with the oral mucosa and developing from the residues of odontogenic epithelium, according to WHO. We present 2 cases of PIOC in the mandible. The first patient 62-year0old male, visited our hospital with a complaint of a nonhealing extraction wound. A biopsy was performed and the microscopic diagnosis of PIOC was made. the patient underwent combined surgical and radiation therapy with no recurrence for 5 years. The second patients, 21-year-old female, complained a intraosseous lesion in the anterior mandible and a lump of submental area. The intraosseous lesion was resected widely and the result of tissue examination was the calcifying odontogenic cyst. Sine the submental lump remained postoperatively, excisional biopsy of the mass was performed and it has turned out to be metastatic lymph node. So that the first surgical specimen was reviewed and fnal dignosis of PIOC was made. The patient underwent radiotherapy and has remained free of local recurrence for 12 months postopertively. We could obtained the interesting clinical experience, that is, the difficulty of diagnosis and atypical clinical manifestation different with most oral carcinoma.

THE CLINICAL STUDY ABOUT THE CORRELATIONS BETWEEN THE CHEWING MOVEMENTS AND THE DENTAL ARCH SHAPES

Byung-Woan Jo(조병완),Heon-Soo Chang(장헌수),Jong-Pil Kim(김종필) 대한턱관절교합학회 1995 구강회복응용과학지 Vol.11 No.1

Temporary Cement가 상아질 접착제의 접착성능에 미치는 영향

장헌수 慶北大學校 齒科大學 1995 慶北齒大論文集 Vol.12 No.1

Temporary cement가 상아질 접착제의 접착성능에 미치는 영향을 평가하기 위해 소의하악 전치 100개를 사용하여 순면의 상아질을 노출시키고 유지놀을 함유하지 않은 Nogenol 및 TempBond NE와 유지놀을 함유한 TempBond 및 산화아연 유지놀세멘트를 각각 도포하여 7일 경과 후 제거하였다. All-Bond 2 및 Super-Bond C&B 상아질 접착제를 제조회사의 지시대로 사용하여 접착시킨뒤 37℃ 항온조에서 24시간 보관 후 인장접착강도를 측정하고, 응집파단율을 산정하였다. 그리고 temporary cement를 적용하지 않은 상아질면과 temporary cement를 도포하였다가 제거한 상아질면에 10% 인산 수용액 및 10% 구연산 수용액으로 각각 산처리한 상아질 표면성상과 접착실험후의 파단면을 주사전자현미경으로 관찰하여 다음의 결과를 얻었다. 1. All-Bond 2로 접착시킨 경우에는 사용한 temporary cement의 종류에 관계없이 실험군의 인장접착강도가 temporary cement를 사용하지 않은 대조군에 비해 유의하게 낮게 나타났으나(P<0.05), Super-Bond C&B로 접착시킨 경우에는 유ㅢ한 차이가 없었다(P>0.05). 2. 유지놀을 함유하는 temporary cement와 유지놀을 함유하지 않는 temporary cement를 각각 적용한 실험군들의 인장접착강도 간에는 유의한 차이가 없었다(P>0.05). 3. 응집파단율 산정결과 All-Bond 2로 접착시킨 경우에는 대조군에서 응집-부착성의 혼합파단양상이, 실험군에서는 부착성 파단양상이 주로 나타났으나, Super-Bond C&B로 접착 시킨 경우에는 대조군과 실험군 모두에서 응집성파단양상이 우세하게 나타났다. 4. 주사전자현미경적 관찰상에서 temporary cement의 종류에 관계없이 temporary cement를 도포한후 제거하고 10% 인산 수용액 또는 10-3 용액으로 전처리한 모든시편에서 미세한 temporary cement 잔존물을 관찰할 수 있었다. This study was conducted to the effect of temporary cement on the adhesiveness of dentin bonding agent to dentin surface. One hundred freshly extracted bovine mandibular incisors were grinded to expose flat labial dentin surface. The dentin surfaces were temporarized with either eugenol-containing temporary cement(TemBond and Zinc Oxide Eugenol cement) or non-eugenol temporary cement(Nogenol and TempBond NE) for 7days, and then the temporarization was removed with surgical currette and the exposed dentin surfaces were water-rinsed. Bonding specimens were made by use of All-Bond 2 and Super-Bond C&B dentin bonding agent, and stored in 37℃ distilleed water for 24hours. The tensile bond strenth and the cohesive failure rate were measured, and then the pretreated dentin surfaces to which the temporary cement had been applied and removed, and finally the fractured dentin surfaces after bonding test were examined under scanning electron microscopoe. The results were as follows: In case of bonding with All-Bond 2, tensile bond stregth of each experimental group was lower than that of the control group(P<0.05), but there was no significant difference between the bond strengths of the control group and each experimental group in case of bonding with Super-Bond C&B(P>0.05). No significant difference between tensile bond strength of experimental group, whether temporary cement contains eugenol or not, was seen(P>0.05). In case of bonding with All-Bond 2, the control group showed cohesive-adhesive mixed failure mode and the experimental groups mainly showed adhesive failure mode, but in case of bonding with Super-Bond C&B, allmost of the control and the experimental groups mainly showed cohesive failure mode. On SEM examination, all of the dentin specimens pretreated with either 10% phosphoric acid or 10% citric acid after application of the temporary cements demonstrated remnants of temporary cement attached to dentin surface.

시상골 골절단술시 근심골편의 변위를 방지하기위한 lingual fracture technique

장헌수,안재진,우성도,김종필 大韓顎顔面成形再建外科學會 1994 Maxillofacial Plastic Reconstructive Surgery Vol.16 No.1

The sagittal split osteotomy of the mandibular ramus is a common procedure which has been used in the correction of mandibular deformities for a few decades. Although the technical improvements have increased the reliability and stability of SSRO procedure, the postoperative relapse is imperative and clinically more significant than any other complication. One of the major causes of the relapse is due to the displacement of the proximal segment during SSRO procedure, which is well documented in the literature. Therefore it is important to preserve the original position of the proximal segment during SSRO proced and maxillofacial fixation period. In the case of mandibular asymmetry, if one side of mandible is advanced and the other side of mandible is setback during SSRO procedure, the proximal segment in the advancement site will rotate laterally and the proximal segment in the setback site will rotate medially. For the prevention of the lateral rotation or flaring of the proximal segment in the advancment site. we deliberately fracture the posterior protion of the distal segment in green-stick fashion during SSRO procedure, and there is no need to fix the fractured lingual segment. We fix the two octeotomized bony segments in the buccal cortex area rigidly with adjustable monocortical plates and screws. During SSRO procedure the lingual fracture technique was applied to nine patients with severe mandibular asymmetry who underwent orthognathic surgery in our hospital since march, 1992. These clinical experiencies enable us to find the lingual fracture technique has the following advantages. 1. The proximal segment is displaced minimally. 2. The osteotomized bony segments are contacted intimately. 3. The postoperative relapse and the healing period are decreased.

Temporary Cement가 상아질 접착제의 접착성능에 미치는 영향

조규증,장헌수 大韓齒科保存學會 1995 Restorative Dentistry & Endodontics Vol.20 No.2

측두하악관절염에서 발생한 희귀한 골화현상

신미정,안상헌,박재범,장헌수,김종필,안재진 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.2

Osteoarthritis is a noninflammatory degenerative disease affecting the articular surfaces and is accompanied by remodeling of the underlying bone. The sympotms of osteoarthritis of the temporomandibular joint are pain in the joint and muscles of mastication, limitation. Osteoarthritis is generally accepted that several factors can contribute to the trauma, aging process, internal derangement and MPDS. Radiographic features of the osteoarthritis are seen flattening of joint, sclerosis on flattened area and osteophyte or anterior lipping. In the past, osteoarthritis was considered to self-limiting disease. Currently, synovial chondro-membrane is part of the process of osteoarthritis secondary to trauma. Synovial chondromatosis is an uncommon disease of cartilaginous transformation of synovial membrane with formation of loose bodies within the joint space. The pathogenesis in more an active metaplastic than a neoplastic process. The cause of synovial chondromatosis is unknown. Although trauma and inflammation have all been cited as possible factors in tis pathogenesis. The clinical sign and symptoms are unilateral swelling of the joint region, pain in the joint area and crepitus seem to be the most reliable signs and symptoms. Radiographic evidence of loose bodies may or may not be present. This is a case report of 66 year old female with synovial chondromatosis, that is advanced disease of the osteoarthrits. We treated patient with surgical excision of lose bodies, diskectomy and synovectomy. The defected articular fossa area was reconstructed with temporalis fascia flap. The result was satisfactory.