토끼의 하악골체부에 식립된 임플란트 주위에서 Beta-tricalciumphosphate 골이식재의 골형성효과에 대한 조직계측학적 연구

편영훈,김일규,조현영,주상현,정범상,배상필,조현우,Pyun, Young-Hoon,Kim, Il-Kyu,Cho, Hyun-Young,Ju, Sang-Hyun,Jung, Bum-Sang,Pae, Sang-Pill,Cho, Hyun-Woo 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.5

Purpose: The purpose of this study is to assess the effectiveness of beta-tricalciumphosphate (${\beta}$-TCP) as a bone graft material on new bone formation and regeneration of mandible bone defect around dental implants. Methods: Both mandibular sites of ten rabbits were exposed. The experimental subjects were divided into two groups. Rabbits in the control group (right site of the mandible) had dental implants around cortical bone defects, without treatment, while, in the experimental group (left site of the mandible), ${\beta}$-TCP was grafted into the bone defect around the implant. Rabbits were sacrificed after one, two, three, four, and eight weeks, and histomorphometric evaluation and analysis of the bone implant contact rate were performed using an optical microscope. Results: Bone formation rates in the experimental group were greater than those in the control group from one to eight weeks, and percentages of implant surface contacted to bone were greater in the experimental group than in the control group from three weeks after implantation. Conclusion: These results suggest that the bone formation activity around dental implants was increased by osteoconduction activity of ${\beta}$-TCP.

상악골 괴사를 동반한 베게너 육아종증: 증례보고

김일규,장재원,주상현,편영훈,정범상,한지영,Kim, Il-Kyu,Chang, Jae-Won,Ju, Sang-Hyun,Pyeon, Young-Hoon,Jung, Bum-Sang,Han, Ji-Young 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.3

Wegener's granulomatosis (WG) is an autoimmune disease of unknown etiology characterized by the triad of necrotizing granulomatous lesion in the upper and lower respiratory tracts or both, disseminated vasculitis involving both small arteries and veins, and necrotizing glomerulonephritis. The most common oral lesions associated with WG are ulceration and strawberry gingivitis. A 47-years old man in medical care associated WG was consulted our Division of Oral and Maxillofacial Surgery for the chief complaint of toothaches. Pre-operative panorama showed the alveolar radiolucency and the loss of lamina dura regarding the left upper teeth. An oropharyngeal magnetic resonance imaging also revealed the increased bone marrow signal intensity on the left maxilla. Under the impression of maxillary osteonecrosis due to WG, maxillary saucerization with removal of involved teeth was performed. We obtained good results and report the first case of WG in Korea, with the review of literatures regarding oral and general systemic features.

후진 이부성형술의 경조직과 연조직 측모 변화 예측에 관한 연구

양정은,김일규,조현영,주상현,편영훈,정범상,배상필,조현우,Yang, Jung-Eun,Kim, Il-Kyu,Cho, Hyun-Young,Ju, Sang-Hyun,Pyeon, Young-Hoon,Jung, Bum-Sang,Pae, Sang-Pill,Cho, Hyun-Woo 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.6

Purpose: The purpose of this setback genioplasty study is to develop a prediction method for the calculated osteotomy angle using horizontal and vertical changes as well as to evaluate the proportion of hard and soft tissue changes. Methods: Twelve patients who had received setback genioplasty with other maxillofacial surgery were examined. Three lateral cephalograms were taken just before surgery, immediately after surgery, and 3 months later surgery. A reference line was established to the reference point of the inner most point of the lingual symphysis cortex, incisor tip, and 2nd molar cusp tip. Measuring was conducted from pogonion (Pg), menton (Me), labrale inferius (Li), Mentolabial fold, soft tissue pogonion (Pg'), and soft tissue menton (Me') to the reference lines. Results: In setback genioplasty, the skeletal Pg moved posteriorly 5.07 mm. The ratios of soft tissue to hard tissue movement were 36% posteriorly and 62% inferiorly at Pg', 67% posteriorly and 104% inferiorly at Me', and 34% anteriorly and 164% posteriorly at Li. In reduction & setback genioplasty, skeletal Pg moved posteriorly 4.63 mm and skeletal Me moved superiorly 3.63 mm. The ratios of soft tissue to hard tissue movement were 76% posteriorly and 18% superiorly at Pg', 68% posteriorly and 42% superiorly at Me', and 44% anteriorly, 124% posteriorly at Li. The calculated mean slope angle, based on ${\Delta}H/{\Delta}V$ ratio, was 61.25 and the measured mean slope angle was 60.17. Thus, the calculated and measured slope angles have a similarity. Conclusion: In setback genioplasty, soft tissue moves posteriorly and inferiorly. In particular, at the Me' and Pg', the inferior movement of the soft tissue is greater than the posterior movement. Also, the predictable results (measured slope angle) after operation can be achieved by the calculated slope angle. Thus, the relationship of soft and hard tissue changes must be considered as the results are predictable.

두개저까지 확장된 악하선 점액류

김일규,양정은,장재원,주상현,편영훈,김루시아,Kim, Il-Kyu,Yang, Jung-Eun,Chang, Jae-Won,Ju, Sang-Hyun,Pyun, Young-Hun,Kim, Lucia 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.2

The mucocele is a mucus extravasation cyst arising from the salivary gland. Although it is a common?lesion of the minor salivary gland, it is uncommon when it originated from the submandibular gland. The ranula is a form of mucocele which specifically occurs in the floor of the mouth and the sublingual gland is generally accepted as the origin of ranula. They can be classified into two types based on extent: simple ranula are confined to the sublingual space and plunging ranula extend into the adjacent space. It is difficult to differentiate the submandibular gland mucocele from the plunging ranula because both of them can occupy the submandibular space. A 37-year old male visited our clinic with the chief complaint of left facial swelling. The patient's history revealed that he had suffered from a cystic lesion on the left side of the floor of the mouth 10 months previously. He supposed the cystic lesion had come from trauma at other dental clinics. Using CT and MRI, we diagnosed a simple ranula on the sublingual space and a submandibular gland mucocele. We then excised the mucocele with the submandibular gland by an extraoral approach and the sublingual gland by an intraoral approach under general anesthesia. We report a rare case of an enormous submandibular gland mucocele which extended into the pterygoid plate and parapharyngeal space with good surgical results.

상하악에 동시 다발성 골신장술을 이용한 반안면왜소증의 치험례

김일규,박종원,이언화,양정은,장재원,편영훈,주상현,왕 붕,Kim, Il-Kyu,Park, Jong-Won,Lee, Eon-Hwa,Yang, Jung-Eun,Chang, Jae-Won,Pyun, Yeong-Hun,Ju, Sang-Hyun,Wang, Boon 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.5

The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and lanned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.