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전산화단층사진을 이용한 과두걸림을 가진 측두하악관절의 과두면 평가
고철희,박준상,안용우,고명연 대한안면통증∙구강내과학회 2004 Journal of Oral Medicine and Pain Vol.29 No.1
This study was designed to assess condylar bony changes of TMJ with lock sensation in temporomandibular joint disorder patients through computed tomography. the changes in plain film were compared with those in computed tomography. And the changes according to age, noise history, and existence of arthralgia were evaluated. The author performed clinical examination for TMJD patients who had visited Orofacial Pain Clinic, Department of Oral Medicine, Pusan National University Hospital. Panorama, transcranial view and computed tomography for 158 joints in 79 subjects with lock sensation were taken. Condylar bony changes were evaluated and classified by osseous remodeling, erosion, subchondral cyst and osteophyte. The obtained results were as follows: 1. Significant condylar bony changes were observed in joints with lock sensation, and erosion showed the highest frequency. 2. In comparison about condylar bony changes of plain films and CT scan in joints with lock sensation, plain films showed high false-negative rate. 3. According to increase of ages, the frequency and severity of condylar bony changes were increased in joints with lock sensation. 4. According to increase of noise history, the frequency of condylar bony changes were increased in joints with lock senation. 5. The frequency of condylar bony changes was high in joints with arthralgia.
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측두하악장애 골관절염 환자에서 cone-beam CT를 이용한 관절면의 변화 추적 연구
고철희,김병수,고명연,정성희,옥수민,안용우,Ko, Chul-Hee,Kim, Byeong-Soo,Ko, Myung-Yun,Jeong, Sung-Hee,Ok, Soo-Min,Ahn, Yong-Woo 대한안면통증구강내과학회 2012 Journal of Oral Medicine and Pain Vol.37 No.1
2007년부터 2011년까지 부산대학교 병원 구강내과를 내원한 측두하악장애 환자 중 임상 검사 및 방사선 검사, cone beam computed tomography(CBCT) 영상 촬영 결과 측두하악장애 골관절염으로 진단된 환자 114명 228개의 관절을 대상으로, 치료 후 6~35.5개월(평균 10개월)후 CBCT를 재촬영하고, 임상 검사를 실시하였다. 구강내과 전문의와 구강악안면방사선과 전문의가 영상 진단을 하였고, 임상 검사 결과와 CBCT의 영상 결과를 추적 연구 비교하여 다음과 같은 결과를 얻었다. 1. 측두하악관절 관절염의 골변화 양상은 다음과 같다. 1) 관절염의 골변화 진행 양상은 대부분 초기 상태를 유지하였다. 2) 침식은 침식, 편평화, 정상 관절, 골경화, 골증식체 순으로 골변화 진행 양상이 나타났다. 3) 편평화는 편평화, 골증식체, 정상 관절 및 골경화 순으로 진행 양상이 나타났다. 4) 골증식체는 골증식체, 침식, 골경화, 편평화 순으로 진행 양상이 나타났다. 5) 골경화는 골경화, 골증식체, 침식, 정상 관절 순으로 진행 양상이 나타났다. 2. 골변화에 따른 임상 증상의 변화는 다음과 같다. 1) 침식은 침식으로 유지된 경우 통증, 관절음, 개구제한, 최대 편이 개구량 모두 증상 개선이 있었고, 편평화로 이행된 경우 통증, 개구제한, 최대 편이 개구량에서, 정상 관절면으로 이행된 경우 통증, 관절음, 개구제한에서 증상 개선이 있었다. 침식에서 침식으로 유지된 경우 보다 침식에서 편평화로 이행된 경우 최대 편이 개구량에 있어 개선 효과가 높았다. 2) 편평화는 편평화로 유지된 경우 통증, 관절음, 개구제한에서 증상 개선을 보여 주었고, 편평화가 골경화로 이행된 경우, 개구제한에 있어 유의성있는 증상 개선을 보여주었다. 3) 골증식체가 골증식체로 유지된 경우 통증, 개구제한, 최대 편이 개구량에서 증상 개선 효과가 있었다. This study was designed to assess follow-up study of condylar bone changes using cone beam computed tomography in patients with osteoarthritis. The author performed clinical examination for osteoarthritis patients who visited Orofacial Pain Clinic, Department of Oral Medicine, Pusan National University Hospital. CBCT(Cone beam computed tomography) was taken for 228 joints in 114 subjects. After average 10 months, CBCT was retaken. A Oral medicine and Oral radiologist evaluated CBCT each other. Condyle bone changes were classified by no bone change, flattening, erosion, osteophyte and sclerosis. The obtained results were as follow. 1. The condylar bone changes of osteoarthritis in temporomandibular disorder were as follow: 1) The transitions of each types of condylar bone changes was maintained at the initial state of the majority. 2) The transition of erosion was distributed erosion, flattening, sclreosis, osteohyte in order. 3) The transition of flattening was distributed flattening, osteohyte, normal, sclreosis in order. 4) The transition of osteohyte was distributed osteohyte, erosion, sclreosis, flattening in order. 5) The transition of sclreosis was distributed sclreosis, osteohyte, erosion, normal in order. 2. The signs and symptoms according to transition of each types of condylar bone changes were as follow 1) In the transition of condylar bone changes from erosin to erosion, pain, noise, LOM and MCO had symptomatic improvement. In the transition of condylar bone changes from erosin to flattening, pain, LOM, MCO had symptomatic improvement. In the transition of condylar bone changes from erosin to no bony change, pain, noise, LOM had symptomatic improvement. In the transition of condylar bone changes from erosion to flattening than the maintenance of eosion, MCO had symptomatic improvement. 2) In the transition of condylar bone changes from flattening to flattening, pain, noise and MCO had symptomatic improvement. In the transition of condylar bone changes from flattening to sclerosis, LOM had symptomatic improvement. 3) In the transition of condylar bone changes from osteophyte to osteophyte, pain, LOM and MCO had symptomatic improvement.
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안용우,고철희,허기영,이상섭,옥수민,허준영,고명연,정성희,Ahn, Yong-Woo,Ko, Chul-Hee,Huh, Ki-Yeong,Lee, Sang-Seob,Ok, Soo-Min,Huh, Joon-Young,Ko, Myung-Yun,Jeong, Sung-Hee 대한안면통증구강내과학회 2010 Journal of Oral Medicine and Pain Vol.35 No.2
Forensic odontology in individual identification has been progressing rapidly and its significance has been increasing. But not all individual identification can be done single method solely. Therefore, understanding the advantage and disadvantage of each method is necessary to achieve forensic individual identification properly in each case for it to be applied promptly, economically and precisely. Now We have identified almost 20 case in Busan and Kyeong Nam area in 2008, 2009 and we would like to report some of cases. Finally We will consider role of forensic odontology.
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