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Polydioxanone mesh를 이용한 구강점막의 조직 공학적 재건
문선재(Seon-Jae Moon),주소연(So-Yeon Joo),김진(Jin Kim),김학용(Hak-Yong Kim),박정극(Jung-Keug Park),차인호(In-Ho Cha) 대한구강악안면외과학회 2003 대한구강악안면외과학회지 Vol.29 No.4
The lack of sufficient oral mucosa available for intra-oral reconstruction has been dealt with by the use of skin or oral mucosa grafts harvested from donor sites but grafts requires more than one surgical procedures and could cause donor site morbidity. Many investigators have attempted to increase available soft tissue by tissue engineered skin or oral mucosa replacements for clinical applications. But, reconstructed mucosa by several methods have low physical properties such as rolling and contraction. The aims of this study were to develope an in vitro experimental model that maintains an epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally cultured oral mucosa embedded with Polydioxanone mesh by histological and immunohistochemical analysis. The results were as follows; 1. Oral mucosa reconstructed by three-dimensional organotypic culture revealed similar morphologic characteristics to equvalent normal oral mucosa in the point that they show stratification and differentiation. 2. The expression of cytokeratin 10/13 and involucrin in the cultured tissue showed the same pattern with normal oral mucosa suggesting that organotypic co-culture condition is able to induce cellular differentiation. 3. After insertion of polydioxanone mesh, increased tensile strength were observed. These results suggest that three-dimensional organotypic co-culture of the oral mucosa cell lines with the dermal equvalent consisting type I collagen and fibroblasts reproduce the morphologic and immunohistochemical characteristics similar to those in vivo condition. And increased physical properties by use of polydioxanone mesh will helpful for clinical applications.
김종배,유재하,문선재,김승범,Kim, Jong-Bae,Yoo, Jae-Ha,Moon, Seon-Jae,Kim, Seung-Beom 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.6
The experienced surgeon can be surprised & challenged by the hazards of active bleeding during oral & maxillofacial surgical procedure, because of alterations in the surgical anatomy, bleeding disorders and surgical intervention of infected tissues. This is a report of two cases of active bleeding during surgical extraction of mandibular third molar, that had the pericoronitis, osteitis and adjacent neurovascular bundle in its apex. When the abrupt active bleeding was occurred during surgical extraction of mandibular third molar, pressure packing by hemostatie agent(bone wax) & wet gauze biting were applied into the extraction socket during 30 minutes. After 30 minutes, the wound was explored about the bleeding and active bleeding was then continued. In spite of repeated bleeding control method of the pressure dressing, the marked hemorrhage was generated continuously. Therefore, the author decised the bleeding as immediately uncontrollable hemorrhage and the pressure dressing was again applied for the more longer duration without wound closure. After 3 days, the pressure dressing was removed and iodoform gauze drainge was then established without the bleeding. The drain was changed as the interval of 3~5 days for prevention of infection & secondary hemorrhage and relatively good wound healing was then resulted in 6 weeks.
지속적인 교상을 가진 무의식 환자에서 치근관 및 발치창 통한 배농술의 효과 : 증례 보고
김종배,유재하,최병호,문선재,Kim, Jong-Bae,Yoo, Jae-Ha,Choi, Byung-Ho,Moon, Seon-Jae 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.5
In the unconscious patient with general muscle rigidity, the natural teeth can be luxated and then bite wounds may be occurred around lip, owing to the pathologic involuntary self-biting habit. If the forceful biting is generated continuously, the teeth may be avulsed and aspirated into the aerodigestive tract with the infection of biting wound. For the prevention of pulmonary aspiration of the teeth and wound infection, the biting teeth should be cared before the fact. The authors treated the teeth as endodontic drainage with removal of the crown or iodoform gauze drainage into the socket with extraction of the teeth. The prognosis was more favorable without biting wounds.
최근 8년간 K지방대학병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구
유재하,김종배,김태우,문선재,권혁찬,김승범 大韓顎顔面成形再建外科學會 2001 Maxillofacial Plastic Reconstructive Surgery Vol.23 No.6
The delivery of the proper care to the emergency dental patients is more important in the aspdect of community dental service. To attain such a purpose requires the sacred duty to the training of oral and maxillofacial surgeons. This is a retrospective study on the characteristics of dental injuries and diseases in emergency patients. Ths study was based on a series of 2,649 patients treated as dental emergency patients at K country hospital of medical college, from Jan. 1, 1993, to Dec. 31, 2000. The obtained results were as follows. The trauma(71.6%) was the most frequent cause in dental emergency patients, odontogenic infection and oral hemorrhage were next in order of frequency. The primary interdental wiring and transpalatal wiring were frequent proper methods with rubber drainage for prevention of hemorrhage and infection in the primary care of jaw fracture. The peak incidence(45.0%) about the infection group was occurred in the pulpitis of advanced dental caries, and common treatments were the medication of antibiotics & anagesics and I&D. In the dentoalveolar hemorrhage group, a major cause was postoperative hemorrhage(57.9%) and hemostasis was obtained by pressure dressing, suture and drainage of infected wound. About TMJ disorder group, the peak incidence was showed in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medications(anagesics & sedatives). In the other groups, various irritable specific pains were complained, such as trigeminal neuralgia-form pain, acute stomatitis, chemical burn, terminal stage neuritis of head & nech cancer and their primary care methods were various individually. For the rapid and correct care of the emergency dental disease above, well-trained education should be presented in the intern and resident curriculum of oral & maxillofacial surgery.