안와 골절의 치료 전략

정승곤(Seunggon Jung) 대한치과의사협회 2016 대한치과의사협회지 Vol.54 No.10

Orbital fractures have a significant portion in facial bone trauma. The important thing in treatment of orbital fractures is variable depending on the patient. Reconstruction of orbital wall demands an understanding of the anatomy and function of the orbit, including the orbital tissues, and the approacheds, materials, and methods available.

e-PTFE의 산소 및 질소 플라즈마 표면처리에 따른 조골모세포의 증식효과

정승곤(Seunggon Jung),박홍주(Hong-Ju Park),오희균(Hee-Kyun Oh),문대선(Dae-Seon Moon),국민석(Min-Suk Kook) 대한치과재료학회 2015 대한치과재료학회지 Vol.42 No.1

e-Polytetrafluoroethylene (e-PTFE) is a commonly used medical polymer due to its biological stability and excellent mechanical properties such as high hardness and wear resistance. However, the superhydrophobic surface and lack of functional groups to interact with the cellular environment have severely limited its applications in bone or cartilage replacements. In this study, e-PTFE surface was modified by oxygen (O₂) or nitrogen (N2) RF plasma treatment in order to improving the hydrophilic property and preosteoblast cell proliferation. After the plasma treatment, e-PTFE surface was characterized by using a contact angle measurement, atomic force microscopy, and scanning electron microscopy. The contact angle of e-PTFE surface was significantly decreased and surface morphology did not changed. The MC3T3-E1 cell proliferation was evaluated by MTT assay. The N₂ or O₂ plasma- treated e-PTFE groups showed the higher cell proliferation than untreated group. In conclusion, the N₂ or O₂ gas plasma surface modification used in this study indicates the potential technique as a promising e-PTFE biomedical application.

가토의 두개골에서 Pore의 유무에 따른 티타늄 반구에서의 골형성 능

박정표,오철중,정승곤,박홍주,오희균,유선열,국민석,Park, Jung-Pyo,Oh, Chul-Jung,Jung, Seunggon,Park, Hong-Ju,Oh, Hee-Kyun,Ryu, Sun-Youl,Kook, Min-Suk 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.1

Purpose: This study is performed to determine the effects of titanium cap with various sizes of pores on bone formation during guided bone regeneration (GBR). Methods: Calvaria from 10 adult male rabbits were chosen as the recipient sites. A trephine bur with a diameter of 10 mm was used to form one round groove on each side of sagittal suture of the cranium, and a round bur with a diameter of 1.5 mm was used to form 6 small holes on the inner circles of round grooves to induce bleeding. In the control group, bone graft was not conducted, and closed titanium cap was fixed in the round groove. Bone graft was not performed in groups 1 and 2, but fixed on titanium caps with 0.2 mm, and 0.5 mm sized pores, respectively. For groups 3, 4, and 5, a synthetic bone graft material (${\beta}$-tricalcium phosphate, Cerasorb$^{(R)}$, Germany) was transplanted, and titanium caps without pore, with 0.2 mm and 0.5 mm sized pore were fixed, respectively. The animals were sacrificed 4 weeks after, and clinical, radiographical, and histomorphometrical evaluation of bone regeneration was performed. Results: In all groups, there were no clinical signs of infection, inflammation or wound dehiscence. Radiographic evaluation revealed well-defined semi-circular radiopacity inside the titanium cap of groups 3, 4, and 5. Histologically, the inner surface of the hemisphere was evenly lined with newly formed bone tissue, as well as grafted bone material in the group 3. In groups 4 and 5, the insertion of connective tissue was observed along the inner surface. However, the overall surface area between the grafts with different holes yielded no statistical significance in the histomorphometrical evaluation. Conclusion: Although the total area of newly formed bone showed no significant difference, excellent bone formation tendency was observed histologically when closed caps were used with bone graft was accompanied.

RP titanium cap과 rhBMP-2를 이용하여 형성된 신생골의 미세전산화단층촬영을 이용한 평가

한만승(Man-Seung Han),정승곤(Seunggon Jung),김방신(Bang-Sin Kim),양지웅(Ji-Woong Yang),국민석(Min-Suk Kook),박홍주(Hong-Ju Park),유선열(Sun-Youl Ryu),오희균(Hee-Kyun Oh) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.6

Introduction: This study examined the effect of recombinant human bone morphogenetic protein (rhBMP)-2 and β-tricalcium phosphate (β-TCP) on new bone formation in a rabbit calvarium using a rapid prototype titanium cap (RP Ti cap). Materials and Methods: Eight New Zealand white rabbits were used in this study. Hemispherical RP Ti caps (10 mm in diameter) were implanted subperiosteally on the rabbit calvaria. β-TCP was filled in the RP Ti cap in the control group, and rhBMP-2 soaked β-TCP was used in experimental group. The rabbits were sacrificed 2 and 4 weeks after the operation. The volume and pattern of newly formed bone was analyzed by micro computed tomography (CT). Results: Macroscopically, there were no abnormal findings in any of the animals. The micro CT images revealed new bone from the calvaria that expanded gradually toward the top of the titanium cap, particularly along the inner surface of the titanium cap in the experimental group at 4 weeks after grafting. There was no significant difference in new bone volume ratio between the control and experimental groups at 2 weeks after grafting. There was a statistically significant difference in the new bone volume ratio between the experimental (14.1±1.8 %) and control (7.2±1.5 %) groups at 4 weeks after grafting (P<0.01). Conclusion: The RP Ti cap can effectively guide new bone formation and rhBMP-2 can induce the new bone formation

비글견 경골에서 임플란트 식립 시 혈소판 농축 혈장이 골형성에 미치는 영향

국민석(Min-Suk Kook),정승곤(Seunggon Jung),심경미(Kyung-Mi Shim),강성수(Seong-Soo Kang),박홍주(Hong-Ju Park),유선열(Sun-Youl Ryu),오희균(Hee-Kyun Oh) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.2

Introduction: The purpose of this study is to evaluate the effect of platelet rich plasma in bone formation and osseointegration of implant installed in the bone marrow space. Materials and Methods: Five beagle dogs were used as experimental animals. Two implants were installed on each tibia in the dogs. Implants of the control group were installed with no additional graft. Those of the experimental group 1 were installed with autogenous bone graft from the ilium autogenous bone. Platelet rich plasma (PRP) alone was used in experimental group 2 and the mixture of PRP and autogenous bone was used in experimental group 3. The animals were sacrificed at 8 weeks after implantation. The parts of tibia containing implant were harvested and radiographs were taken for radiographic examination. The specimens were prepared for histological examination and histomorphometric analysis of implant-bone contact ratios. Results: 1. All implants showed sufficient osseointegration in the cortical bone radiographically and histologically, but osseointergration in the marrow space was not satisfactory. 2. Histomorphometrically, the implant-bone contact ratios in the bone marrow was sequentially high in the experimental group 3 (autogenous bone+ PRP group), group 1 (autogenous bone group), group 2 (PRP group), and control group (non-additive). 3. It was verified that there was statistical significance between two experimental groups (group 1 and 3) and the other groups (group 2 and control group). (P<0.005) 4. However, there was no statistical significance between group 3 and group 1, also group 2 and control group respectively. Conclusion: These results suggest that platelet rich plasma is effective to osseointegration in the implant installation but there is no statistical significance.

Le Fort I 골절단술을 이용한 상악골 전진 후 안정성에 관한 3차원적 연구

오철중,허정우,정광,조민성,정승곤,박홍주,오희균,유선열,국민석,Oh, Chul-Jung,Hur, Jung-Woo,Chung, Kwang,Cho, Min-Sung,Jung, Seunggon,Park, Hong-Ju,Oh, Hee-Kyun,Ryu, Sun-Youl,Kook, Min-Suk 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.2

Purpose: This study evaluated postoperative maxillary stabilities in patients with skeletal Class III malocclusion who were taken both maxillary advancement surgery and mandibular retrusive surgery, using Le Fort I osteotomy, through three-dimensional computed tomography. Methods: We selected 14 patients who were taken postoperative three-dimensional computerized tomography at the time before surgery, immediately after surgery, six months after surgery among the patients undergone both maxillary advancement surgery using Le Fort I osteotomy and mandibular retrusive surgery using bilateral sagittal split ramus osteotomy. We measured and compared the vertical distance of A-point and posterior nasal spine (PNS), the horizontal distance of A-point and PNS in transverse plane and coronal plane of the three-dimensional reconstructed images, respectively. Results: In transverse plane, the distance difference between immediately after surgery ($S_1$) and immediately before surgery ($S_0$) of A-point was $-0.04{\pm}1.80$ mm, $S_2$ and $S_0$ was $-0.15{\pm}1.69$ mm, and between $S_1$ and $S_2$ was $0.11{\pm}0.58$ mm. There were no significant differences between these data (P>0.05). In transverse plane, the distance between $S_1-S_0$ of PNS was $-3.87{\pm}2.37$ mm, $S_2-S_0$ of PNS was $-3.79{\pm}2.39$ mm, and $S_1-S_2$ of PNS was $-0.08{\pm}0.18$ mm. There were significant differences between these data (P<0.05). In coronal plane, the distance between $S_1-S_0$ of A-point was $3.99{\pm}0.86$ mm, $S_2-S_0$ was $3.57{\pm}1.09$ mm, and $S_1-S_2$ was $0.42{\pm}0.42$ mm. There were significant differences between these data (P<0.05). In coronal plane, the distance between $S_1-S_0$ of PNS was $3.82{\pm}0.96$ mm, $S_2-S_0$ was $3.43{\pm}0.91$ mm, and $S_1S_2$ was $0.39{\pm}0.49$ mm. There were significant differences between these data (P<0.05). In transverse plane, it was estimated that PNS has no statistical postoperative stability in the same direction. In coronal plane, it was estimated that both A-point and PNS had no statistical postoperative stability (P<0.05). Conclusion: Clinically, the operation plan needs to take into account of the maxillary relapse.

악교정 수술 후에 발생한 기관 삽관성 육아종의 증례보고

하지원,윤성환,이상민,정광,정승곤,국민석,박홍주,유선열,오희균,Ha, Jiwon,Yoon, Sunghwan,Yi, Sangmin,Chung, Kwang,Jung, Seunggon,Kook, Minsuk,Park, Hongju,Ryu, Sunyoul,Oh, Heekyun 대한치과마취과학회 2013 Journal of Dental Anesthesia and Pain Medicine Vol.13 No.3

Three patients who underwent orthognathic surgery under general anesthesia complained about difficulty in vocalization and hoarseness after surgery. Intubation granuloma was diagnosed by the department of otorhinolaryngology in our hospital and the masses were excised by laryngoscopy assisted surgery. Chief complaints and symptoms of patients were relieved after surgery. These cases report with review of articles is presented, and the etiology, diagnosis, treatment and prognosis of intubation granuloma after orthognathic surgery are evaluated.

수직 치조골 신장술 후 증대된 치조골과 임플란트의 예후 평가

Uttom Kumar Shet,국민석(Min-Suk Kook),정승곤(Seunggon Jung),오희균(Hee-Kyun Oh) 대한구강악안면외과학회 2011 대한구강악안면외과학회지 Vol.37 No.5

Introduction: The purpose of this study was to evaluate the clinical result of vertical alveolar distraction, especially the distracted alveolar bone and installed implants. Materials and Methods: Twenty-one patients who have been received the vertical alveolar distraction and implant installation on 22 areas (3 maxilla and 19 mandible) using intraoral alveolar distraction device were examined. After consolidation period of 3-4 months, distraction devices were removed and 91 implants were installed in the distracted alveolar bone. The distracted bone and implants were evaluated clinically and radiographically. Results: Mean height of distracted alveolar bone was 7.5±3.2 mm (range: 2.5-15.0 mm). Mean follow-up period after completion of the distraction was 3.1 years (range: 1.4-11.5 years). Mean resorption of distracted alveolar bone was 1.6±1.8 mm. The success and survival rates of implants was 95.3% and 100%, respectively.. Conclusion: Results of this study indicate that vertical alveolar distraction procedure is a useful and stable method for alveolar ridge augmentation and implantation.

구순구개열을 가진 환자의 악교정 수술 시 고려사항

심유송(You-Song Sim),최송제(Song Jay Choi),한정준(Jeong Joon Han),정승곤(Seunggon Jung),국민석(Min-Suk Kook),오희균(Hee-Kyun Oh),박홍주(Hong-Ju Park) 대한구순구개열학회 2020 대한구순구개열학회지 Vol.23 No.1

Orthognathic surgery may be the last operation for the cleft lip and palate patients. The correction of jaw discrepancy can be performed by orthognathic surgery. The growth of maxilla affects by the cheiloplasty and palatoplasty. The mandibular growth of the cleft lip and palate patient follows the normal population. So cleft lip and palate patient can have a mandibular retrognathism or prognathism with similar incidence of the normal population. There are several considerations for the planning and performing orthognathic surgery in the cleft lip and palate patient. First, nasomaxillary and velopharyngeal anatomy are different from the normal population. This anatomic difference should be considered for planning and during operation to reduce complications after surgery. Second, the surgeon should decide which jaw will be operated. Third, if the maxillary surgery is planned, the surgeon should decide which technique will be used for maxillary advancements, such as Le Fort I osteotomy as a conventional orthognathic surgery or maxillary distraction osteogenesis. Fourth, the velopharyngeal function of the cleft lip and palate patient should be considered before and after the operation. Fifth, alveolar bone graft in the cleft alveolus area is also an important consideration. The last consideration is the airway behind the mandible. If the mandibular setback surgery is considered, the airway should be analyzed before the operation. In this paper, five considerations for orthognathic surgery in cleft lip and palate patients will be discussed.

치과 임플란트에서 골개조 관련인자의 발현에 관한 연구

류승희(Seong-Hee Ryu),김방신(Bang-Sin Kim),정승곤(Seunggon Jung),한만승(Man-Seung Han),국민석(Min-Suk Kook),옥승호(Seung-Ho Ohk),오희균(Hee-Kyun Oh),박홍주(Hong-Ju Park) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.5

Introduction: Bone resorption is a unique function of osteoclasts. Osteoclasts are a specialized macrophage polykaryon whose differentiation is regulated principally by macrophage colony-stimulating factors, receptor activator of nuclear factor κB ligand (RANK) ligand, osteoprotegerin (OPG), and interleukins (IL). Reflecting the integrin-mediated signals, osteoclasts develop a specialized cytoskeleton that allows it to establish an isolated micro-environment between itself and the bone, wherein matrix degradation occurs by a process involving proton transport. The levels of IL-1, IL-6, OPG, and prostaglandin E2 (PGE2) expression were evaluated to study the correlations between dental implant teeth and the adjacent teeth. Materials and Methods: The exudate of the gingival crevice acquired from dental implants, adjacent teeth, opposite teeth and contralateral teeth of 24 patients. Results: 1. The levels of IL-1, IL-6, OPG and PGE2 expression in dental implant teeth were higher than those of the contralateral teeth. 2. IL-1 revealed a higher expression level in the adjacent teeth than in dental implant teeth. 3. The dental implant teeth and adjacent teeth did not show a remarkable difference in the level of IL-1 expression. 4. All the other cytokines were strongly expressed in the dental implant compared to the adjacent teeth. Conclusion: These results suggest that there might be close correlation between dental implant teeth and adjacent teeth in terms of the expressions of cytokines that affect the development and regulation of osteoclasts.