각화낭성 치성종양에 관한 분석

임형섭,김수관,문성용,오지수,문경남,윤정훈,Lim, Hyoung-Sup,Kim, Su-Gwan,Moon, Seong-Yong,Oh, Ji-Su,Moon, Kyung-Nam,Yoon, Jeong-Hoon 대한악안면성형재건외과학회 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.4

We reviewed 30 cases of keratocystic odontogenic tumor (KCOT) managed during the 8-year period between 2001 and 2008. This case report described the clinical, radiographic and histopathologic features of these KCOT. Of the 30 patients in whom KCOTs were diagnosed, 18 (60%) of the patients were male and 12 (40%) were female. The mean age of these patients was 34.2 years, with peak incidence occurring in the third decade of life. The lesions were mostly located in the mandible (74.2%) and in the maxilla (25.8%). There was a marked predilection to occur in the posterior mandible. Radiographically, 19 (63%) out of the 30 cases were unilocular type with a well demarcated border, while 11 cases (37%) were multilocularin appearance. Histopathologically, 73% of the cysts were lined with parakeratinized stratified squamous epithelium, while only 3% of the cysts were lined with mixed parakeratinized of orthokeratinized epithelium. 22 cases (73%) contained keratin in the lumen. A satellite cyst was observed in 14 cases (47%). All cysts were treated by enucleation. The recurrence rate was shown as 10% for 3 patients with a follow up period and recurred lesions were treated by re-enucleation.

상악동막의 천공 시 처치의 방법

임형섭,김수관,김학균,문성용,오지수,전우진,윤대웅,양석진,Lim, Hyoung-Sup,Kim, Su-Gwan,Kim, Hak-Kyun,Moon, Seong-Yong,Oh, Ji-Su,Jeon, Woo-Jin,Yun, Dae-Woong,Yang, Seok-Jin 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.3

Sinus floor elevation is a predictable and standard procedure for the treatment of the posterior maxilla before insertion of dental implants. Although overall complication rates are low, complications can occur including sinus membrane perforation, infection of sinus, swelling and hemorrhage. The most common complication is membrane perforation. Recently, various techniques and materials for repair of perforation to the sinus membrane have been proposed. The purpose of this article is to report on various techniques and materials that can be used for repair of perforations to the sinus membrane. The search protocol used was the following electronic database: Pubmed, with a time limit from 1998 to 2009. The key words such as 'sinus lift', 'sinus augmentation', 'sinus floor elevation', 'sinus graft', 'sinus perforation', 'repair of sinus perforation' and 'repair of sinus membrane' were used, alone and in combination, when searching the database. Various techniques have been proposed to manage of perforation of sinus membranes. These include that the use of collagen membranes, demineralized freeze-dried human lamellar bone sheets, processed human allografts, lamella bone, buccal fat pads and suturing. Implant success rate ranges from 69.9% to 98.9%.

수산화인회석 코팅 임플란트와 Sandblasted, Large-grit and Acid-etched Implant의 임상적 초기 안정성 비교

임형섭,김수관,오지수,Lim, Hyoung-Sup,Kim, Su-Gwan,Oh, Ji-Su 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.2

Purpose: This study attempts to compare the stability of hydroxy-apatite coating implant with that of sandblasted, large-grit and acid-etched surface implant at an early state of installation. Methods: 35 implants were installed in 18 patients, who had visited hospital for implant installation. The early stability at operation, 6 weeks and 12 weeks after operation using Osstell$^{TM}$ mentor (Integration Diagnostics, Savedalen, Sweden) and Periotest$^{(R)}$ (Siemens AG, Benssheim, Germany) were measured, and subsequently analyzed statistically. Results: OsstellTM mentor value of hydroxy-apatite coated implant (HAPTITE) was measured as $70.14{\pm}9.07$ at the stage of installation, $76.98{\pm}5.25$ at 6 weeks and $80.28{\pm}4.23$ at 12 weeks after installation. A statistically significant increase in measurement value was observed after 6 weeks and 12 weeks than when implants were placed. In case of IMPLANTIUM (DENTIUM Co. Ltd., Seoul, Korea), the measurement value was $74.68{\pm}7.42$ at installation, $79.03{\pm}4.39$ at 6 weeks and $80.59{\pm}3.59$ at 12 weeks after installation. In addition, a statistically significant increase in the value was observed when comparative analysis of the value at after installation and 12 weeks after installation was carried out. However, no significant difference between HAPTITE and IMPLANTIUM was observed. The average measurement value of periotest$^{(R)}$ was $-1.94{\pm}3.90$ at installation of HAPTITE, $-4.03{\pm}1.48$ at 6 weeks and $-5.00{\pm}1.71$ at 12 weeks after installation. Moreover, whilst comparing the value at after installation and 12 weeks after installation, statistically significant decrease in the value was observed. In case of IMPLANTIUM, the average measurement value was measured as $-4.25{\pm}1.76$ at installation, $-4.76{\pm}0.97$ at 6 weeks and $-5.18{\pm}0.91$ at 12 weeks after installation and no statistically significant difference was observed. Furthermore, no statistically significant difference was observed between HAPTITE and IMPLANTIUM. Conclusion: In this study, both the implants demonstrated favorable early stability at the time of measurement using Osstell$^{TM}$ mentor and Periotest$^{(R)}$. Moreover, based on the observed results, both HAPTITE and IMPLANTIUM are considered as potent to exhibit clinically stable and prognostic results.

Implant Survival Rates of Maxillary Sinus Augmentation: a Literature Review of Graft Materials

임형섭,김수관,오지수,Lim, Hyoung-Sup,Kim, Su-Gwan,Oh, Ji-Su Korean Association of Maxillofacial Plastic and Re 2010 Maxillofacial Plastic Reconstructive Surgery Vol.32 No.4

Purpose: By reviewing literature on the subject, we compared the survival rate of implants placed in various graft materials used for maxillary sinus augmentation. Materials and Methods: The search protocol used the Pubmed electronic database, with a time limit from 1998 to 2009. Keywords such as 'sinus lift,' 'sinus augmentation,' 'sinus floor elevation,' 'sinus graft,' 'bone graft,' 'implants,' 'oral implants,' and 'dental implants' were used, alone and in combination, to search the database. We selected articles and divided them into three groups by type of graft materials: Group 1. Autogenous bone group: autogenous bone alone; Group 2. Combined bone group: autogenous bone in combination with bone substitutes; and Group 3. Substitute group: bone substitutes alone or bone substitute combinations. Results: We selected 37 articles concerning a total of 2,257 patients and 7,282 implants; 417 implants failed. The total implant survival rate (ISR, %) was 94.3%. In Group 1, 761 patients and 2,644 implants were studied; 179 implants failed and the ISR was 93.2%. In Group 2, 583 patients and 1,931 implants were studied; 126 implants failed and the ISR was 93.5%. In Group 3, 823 patients and 2,707 implants were studied; 112 implants failed and the ISR was 95.9%. Conclusion: Implants inserted in grafts composed of bone substitutes alone or in grafts composed of autogenous bone in combination with bone substitutes may achieve survival rates better than those for implants using autogenous bone alone (P<0.05).

골유도재생술 시 비탈회 동종골와 우심막유래 차단막의 임상적 활용

임형섭,김수관,문성용,오지수,정경인,박진주,정미애,Lim, Hyoung-Sup,Kim, Su-Gwan,Moon, Seong-Yong,Oh, Ji-Su,Jeong, Kyung-In,Park, Jin-Ju,Jeong, Mi-Ae 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.4

Purpose: This study evaluated the clinical applications of implant placement and guided bone regeneration using a mineralized bone allograft and a barrier membrane derived from ox pericardium Methods: From January 2007 to June 2009, among the patients who received an implant at Chosun University Dental Hospital, patients were selected if they were treated with guided bone regeneration (GBR) with simultaneous implant placement or GBR prior to implant placement. The selected patients were sorted according to the materials and membranes used in GBR, and the implant survival rate was recorded by clinical examination and reviewing the medical records and the radiographs. Each study list was analyzed by SPSS (version 12.0, SPSS Inc., USA) software and the survival rate was verified by Chi-square tests. $P$ values less than 0.05% were deemed significant. Results: 278 implants were placed on a total of 101 patients and 8 implants resulted in failure. Three implants failed among 15 implants with only a mineralized bone allograft. No failure was shown among the 74 implants placed with mineralized bone allograft and a barrier membrane derived from ox pericardium. One group of 4 implant placements showed failure among the 102 implants placed with a mineralized bone allograft and another bone graft material. The group that had a barrier membrane derived from ox pericardium with a mineralized bone allograft or other bone materials showed no implant failure. Three failures were shown among the 21 implants placed with only bone graft and not using a membrane. The group with membranes other than a barrier membrane derived from ox pericardium showed 5 failures among 170 implants. Conclusion: The implant survival rate of the group with GBR using a mineralized bone allograft was 96.3%, which meant there was little difference compared to the groups of another bone graft materials (98.9%). The implant survival rate of the group without a membrane-was 85.7% and it showed a significant difference compared to the group using a barrier membrane derived from ox pericardium (100%) and the group using another membrane (97.1%).

구강소독제의 적용 시간 및 기계적 세척 여부에 따른 타액 내 세균 수의 감소 효과

임형섭,김재진,김미자,김학균,Lim, Hyoung-Sup,Kim, Jae-Jin,Kim, Mija,Kim, Hak Kyun 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.3

Purpose: The purpose of this study is to establish the acceptable intraoral application time of antiseptic agents and evaluate the effect of mechanical irrigation. Methods: A total of 80 subjects were selected for this study. Saliva secreted at the resting state was taken. The subjects were divided into 8 experimental groups, and kept 10% povidone-iodine (PVI) or 0.2% chlorhexidine gluconate (CHX) for 20 or 40 seconds in their oral cavity with/without irrigation of the oral cavity with sterilized normal saline, respectively. Then, the saliva was taken and diluted with phosphate buffered saline and then plated onto 5% sheep blood agar plates, which were incubated. Colony forming unit (CFU) was measured for the salivary bacterial counts. Results: After application of PVI and CHX, all the experimental groups showed statistically significant decrease in CFU (P<0.01). Group 2 (PVI, 40 s) showed more significant reduction rate in CFU than group 4 (CHX, 40 s; P<0.01). Group 6 (PVI, 40 s, irrigated) showed more significant reduction rate than group 2 (PVI, 40 s; P<0.01). Group 2 (PVI, 40 s) showed more significant reduction rate than group 1 (PVI, 20 s; P<0.01). Conclusion: Application of PVI for 40 seconds and mechanical irrigation with sterilized normal saline showed the best result among the 8 groups in terms of the reduction rate of salivary bacterial counts.

하악 과두 골절 환자의 임상분석

임형섭,김수관,오지수,정미애,Lim, Hyoung-Sup,Kim, Su-Gwan,Oh, Ji-Su,Jeong, Mi-Ae 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.1

Purpose: This study considered the effects and proper treatments of mandibular condyle fractures by comparing clinical differences and complications according to analysis and treatment plan. Methods: From September 2007 to August 2010, patients who were diagnosed with condylar fracture and monitored for more than 3 months were selected. Cases were divided in a reductive manner and evaluated by type and period of intermaxillary fixation (IMF), status of occlusion and trismus according to the Spiessle/Schroll method. A total 50 patients were examined. Results: The number of the unilateral condyle fractures was 45 and 30 patients had multiple fractures. Type of fracture was categorized by the Spiessle/Schroll method. There were 21 patients with type I, 11 patients with type II, 3 patients with type 3, 10 patients with type V and 5 patients with type VI; there were no patients with a type IV fracture. 11 patients were operated on with open reduction. Among them, 9 patients were type II and 2 patients were type I. For type I patients, an intra-oral approach was conducted with an endoscope and trocar. For 3 of the type II patients, an retromandibular approach was conducted and for the rest of the type II patients, the same approach as type I was used. The periods of IMF were 2.36 weeks (mean) in open reduction group and 2.9 weeks (mean) in closed reduction group and the total mean period is 2.78 weeks. All patients had stable occlusion after removing the IMF. Trismus occurred in 1 patient for open reduction and 5 patients for closed reduction. Facial nerve palsy was observed in one patient postoperatively that resolved after 6 months. Conclusion: In this study, similar prognosis was shown after an open and closed reduction was conducted. Therefore, treatments need to be planned depending on the degree of condyle fracture and the amount of displacement. Additionally, the period of IMF could be shortened with open reduction.

의도적으로 연조직에 노출시킨 수산화인회석 코팅 임플란트의 골유착과 안정성에 대한 실험적 연구

정경인,김수관,문성용,오지수,조지호,임형섭,김정선,임성철,정미애,Jeong, Kyung-In,Kim, Su-Gwan,Moon, Seong-Yong,Oh, Ji-Su,Jo, Ji-Ho,Lim, Hyoung-Sup,Kim, Jeong-Sun,Lim, Sung-Chul,Jeong, Mi-Ae 대한악안면성형재건외과학회 2012 Maxillofacial Plastic Reconstructive Surgery Vol.34 No.1

Purpose: The purpose of this study is to evaluate the effect of exposure of hydroxyapatite coating on the amount of bone formation and stability in the dogs. Methods: In this study, hydroxyapatite coated implants (HAPTITE) was placed over the femur bone surface of four dogs about 1 mm. The experimental group was divided into 4 weeks group of 8 implants and 8 weeks group of 8 implants, and then they were sacrificed. The stability of implants was evaluated twice with Osstell$^{TM}$ mentor (Osstell AB, Goteborg, Sweden) at right after placement and sacrifice. The amount of bone formation was evaluated through histomorphometric examination. Results: The stability of implants was in normal range, and tended to increase as time goes by. Mean percentages of new bone formation rates were $90.5{\pm}6.6$ at uppermost 1 mm bone level adjacent to soft tissues (level 1) and $92.9{\pm}4.1$ at next 1 mm bone level (level 2) in 4 weeks group, $90.1{\pm}11.5$ at level 1 and $95.9{\pm}2.3$ at level 2 in 8 weeks group. Mean percentages of bone-implant contact rates were $85.1{\pm}10.8$ at level 1 and $88.1{\pm}13.8$ at level 2 in 4 weeks group, $88.5{\pm}14.4$ at level 1 and $95.3{\pm}3.1$ at level 2 in 8 weeks group. There was no statistically significant difference of new bone formation rate and bone-implant contact rate between uppermost 1 mm bone level adjacent to soft tissues and next 1 mm bone level. However, there was no significant difference in bone formation between 4 and 8 weeks groups. Conclusion: These results suggested that exposed hydroxyapatite coated implants to soft tissue showed favorable bone formation and implant stability.

지방공공재 수요함수를 활용한 U-City서비스의 가치 추정

조남욱(Jo Nam Wook),장훈(Hoon Chang),임형섭(Lim Hyoung Sup) 대한공간정보학회 2011 한국지형공간정보학회 학술대회 Vol.2011 No.5

본 논문은 Bergstrom and Goodman(1973)의 공공성 추정기법을 토대로, U-City서비스의 공공재적 가치를 추정한다. 기초자치단체의 인구 및 재정자료를 통해 공공재 수요함수를 추정하는 기존의 모형은 충분한 표본데이터 및 제도적 기반이 부족한 U-City서비스의 가치평가과정에 적용하는데 한계가 있다. 따라서 본 논문에서는 기존의 수요함수모형을 활용하여 공공성을 추정할 수 있는 방법으로 U-City서비스의 더미변수를 통해 서비스 구축유무를 구분하여 비교하는 방법을 제안하고, 더미변수를 사용해 화성시의 재정자료를 분석하여 U-City서비스가 공공서비스의 유형별로 나타나는 공공성의 차이를 더욱 강조하고 있다는 결론을 제시한다.

Prognosis of Maxillary Sinus Augmentation in the Presence of Antral Pseudocyst

Deuk-Hyun Mah(마득현),Su-Gwan Kim(김수관),Ji-Su Oh(오지수),Jae-Seek You(유재식),Won-Gi Kim(김원기),Jung-Eun Yang(양정은),Hyoung-Sup Lim(임형섭) 대한치과의사협회 2016 대한치과의사협회지 Vol.54 No.10

Purpose: Antral pseudocyst is a common benign lesion that exists in the maxillary sinus. Because of this possible complication, controversy remains with respect to sinus floor elevation operations. The purpose of this study was to analyze the antral pseudocyst related to maxillary sinus augmentation. Patients and Methods: The radiographs of 268 patients who visited Chosun University Dental Hospital from 2008 to 2010 and underwent the maxillary bone grafting procedure were examined. Results: Of the 268 patients who underwent the maxillary bone grafting procedure, 5 patients (1.86%) were diagnosed with antral pseudocysts. In all cases, maxillary sinus floor elevation was performed without aspiration, biopsy or extraction of the antral pseudocyst. Conclusion: Antral pseudocysts are not considered a contraindication for maxillary sinus bone grafting procedure.