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팽준영,Paeng, Jun-Young 대한치과마취과학회 2014 Journal of Dental Anesthesia and Pain Medicine Vol.14 No.1
The inferior alveolar nerve (IAN) block is the most frequently used mandibular injection technique for achieving local anesthesia for restorative and surgical procedures. However, The IAN block does not always result in successful anesthesia, especially pulpal anesthesia. Lidocaine is used as a "standard" local anesthetic for the inferior alveolar nerve. Articaine recently joined Korean market as a form of dental cartridge. It has an advantage of superior diffusion through bony tissue. A variety of trial was performed to improve the success rate of inferior alveolar nerve block. In this review, the recent update related with inferior alveolar nerve block anesthesia will be discussed on the anatomical consideration, anesthetic agent, technique, and complications.
구순구개열 환자의 상악골 열성장에서 골신장술을 위한 Internal distraction device와 Rigid external distraction의 비교
팽준영,명훈,황순정,서병무,최진영,이종호,정필훈,백승학,김명진,Paeng, Jun-Young,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Baek, Seung-Hak,Kim, Myung-Jin 대한악안면성형재건외과학회 2005 Maxillofacial Plastic Reconstructive Surgery Vol.27 No.4
Distraction osteogenesis for the advancement of hypoplastic maxilla of cleft patients has shown successful results. In this report, rigid external distraction(RED) system and internal distraction device were used for maxillary advancement. Each system has its advantages and disadvantages. Larger amount of advancement can be achieved with RED system. But complex external device may give patients psychological stress. Internal device is invisible. However its distraction amount have limitation for the advancement (< 20mm) and the vector cannot be changed freely during distraction. The authors treated five cleft patients with maxillary hypoplasia(three with RED system and two with internal distractor). Their results were clinically satisfactory. We present the pros and cons of RED and internal system for maxillary distraction osteogenesis.
악관절 흡수양상을 보이는 성인 하악 후퇴증 환자에서 양측 하악골 골신장술을 이용한 하악 전진술
팽준영,이상우,이진용,명훈,황순정,서병무,최진영,이종호,정필훈,김명진,Paeng, Jun-Young,Lee, Sang-Woo,Lee, Jin-Yong,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Kim, Myung-Jin 대한악안면성형재건외과학회 2007 Maxillofacial Plastic Reconstructive Surgery Vol.29 No.3
Purpose: Distraction osteogenesis is considered to take favorable effect on the TMJ and be beneficial to prevent the relapse after the mandibular advancement of Class II malocclusion patient. This is the report with literature review on the mandibular advancement in the patients showing preoperative condylar resorption and who need larger amount of advancement. Patients and method: Distraction osteogenesis using intraoral device was performed for three mandibular hypoplasia patients (one male and two females). All patients were adult over 18 years old. The patients showed condylar bony resorption preoperatively. The distraction was performed intraorally with modified SSRO. After 7 days of latency period, activation was performed at the rate of 1.0 mm/day with twice turn. The devices were removed after 4-8 month consolidation period. Results: Total advancement of mandible was average 13 mm. One patient showed openbite immediately after removal of distraction device. It took long time to guide the openbite with elastics. The comparison between cephalometries immediately after device removal and postoperative six month revealed average 3.4 mm relapse. This means that mandibular advancement with distraction osteogenesis needs overcorrection and elastic rehabilitation even after enough consolidation periods. Conclusion: Larger amount of mandibular advancement could be achieved with distraction osteogenesis in severe mandibular hypoplasia with condylar resorption. However, some relapse was found during the follow-up period and the over correction is considered to be needed. The effect of distraction osteogenesis seems to be investigated with long-term follow-up.
팽준영,명훈,황순정,서병무,최진영,이종호,정필훈,김명진,Paeng, Jun-Young,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Kim, Myung-Jin 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.4
Objectives: Distraction osteogenesis has recently evolved a challenging technique to overcome the limitations of conventional augmentation procedures. The aim of this report was to evaluate the clinical result of alveolar distraction osteogenesis for implant installation. Methods: Twenty five patients with alveolar ridge deficiencies were treated with vertical alveolar distraction osteogenesis by intraoral device (total 27 devices: 25 extraosseous and 2 intraosseous devices). After the latency periods of 5-7 days, activation of the device was started. The distraction rhythm and rate was 0.75-1.0 mm a day with 2 or 3 times a day. After 3-4 months, dental implants were placed with removing the distractor simultaneously. Results: On average, a vertical gain of $9.8{\pm}3.4\;mm$ was obtained by distraction osteogenesis. Total 84 implants were installed. Average follow up period was $13.5{\pm}7.5$ months. No implant was removed during the follow up period. Three patients showed infection during the distraction osteogenesis. Three devices were broken and 2 devices among them were replaced with new one. Conclusion: Relatively larger amount of alveolar bone augmentation could be obtained with distraction osteogenesis. For the ideal anatomically and functionally ideal regeneration of alveolar bone to install dental implant, the complication of distraction should be controlled.
하악골 재건시 사용된 유리비골피판에서 임플란트 식립을 위한 수직적 골신장술
팽준영,이진용,명훈,황순정,서병무,최진영,이종호,정필훈,김명진,Paeng, Jun-Young,Lee, Jin-Yong,Myoung, Hoon,Hwang, Soon-Jung,Seo, Byoung-Moo,Choi, Jin-Young,Lee, Jong-Ho,Choung, Pill-Hoon,Kim, Myung-Jin 대한악안면성형재건외과학회 2006 Maxillofacial Plastic Reconstructive Surgery Vol.28 No.6
Introduction: The fibular free flap is now considered as the first choice for long mandibular discontinuity defect. In spite of its good bone quality for implant installation, its diameter is too narrow to rehabilitate the masticatory function with implant installation. In this report, distraction osteogenesis was used for the augmentation of bone to install the dental implant in the mandible which was reconstructed with a vascularized fibular free flap. Patients and Methods: Three patients undertook the vertical augmentation of grafted fibular bone and dental implants were installed. On the day 8 post-surgery, the activation of the distractor was started at the rate of 1 mm twice a day. The total amount of distraction was 15 mm in two patients and 12.5 mm in one patient. Twelve implants were installed in three patients. Dental implants were simultaneously installed during removal of the distraction device in two patients. In one patient, the implant installation was delayed after device had been removed. All three patients showed the symptoms of mild to severe postoperative infection during the activation and consolidation. However, the distracted site showed undisturbed bone regeneration. Conclusion: The distraction osteogenesis showed the reliable results for the vertical augmentation of fibular bone which was used for the mandibular reconstruction. However, the great tendency of postoperative infection must be considered and clinically controlled.
BRONJ(bisphosphonate related osteonecrosis of jaw)의 진단과 치료
팽준영(Jun-Young Paeng) 대한치과의사협회 2011 대한치과의사협회지 Vol.49 No.7
BRONJ(Bisphosphonate Related Osteonecrosis of Jaws) is not easy to be managed because it responds less predictably to I established surgical treatment algorithms for osteomyelitis or osteoradionecrosis. The guidelines recommend that any kind of surgery should be delayed if possible. In the latest stage-dependent recommendations of the AAOMS in 2009, a conservative regime with antibiotics, antibacterial mouthe rinses and pain control in stages 0 to II. Some investigators have described the benefits of early osteotomy with primary wound closure. However, there are only a few publications with a standardized surgical concepts. In this reviews, various aspects of diagnosis and management of BRONJ will be discussed.
내시경을 이용한 하악골 과두경부 골절의 정복 및 견고 고정술
팽준영(Jun-Young Paeng),옥용주(Yong-Ju Ok),명훈(Hoon Myoung),황순정(Soon-Jung Hwang),서병무(Byoung-Moo Seo),최진영(Jin-Young Choi),이종호(Jong-Ho Lee),정필훈(Pill-Hoon Choung),김명진(Myung-Jin Kim) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.5
The endoscopic assisted approach for the treatment of condylar fracture is a less invasive alternative treatment modality and is considered to be able to overcome the limited access to the operation field to obtain an accurate reduction and fixation. Six patients with condylar neck and subcondylar fracture underwent the endoscopic assisted open reduction and internal fixation through the transoral approach at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The endoscope was inserted through an intraoral incision and the reduction of fracture fragment was performed via a transbuccal approach with two transcutaneous stab incisions. Five patients showed anatomic reduction without any complications. One patient, whose fracture site was fixed with a single plate, showed displacement of fractured condylar segment during the follow up period. No patient had any facial nerve damage.
구강 편평세포암에서 예후 및 경부임파절 전이와 관련한 증식인자의 발현에 관한 연구
팽준영(Jun-Young Paeng),옥용주(Yong-Ju Ok),윤필영(Pil-Young Yun),명훈(Hoon Myoung),황순정(Soon-Jung Hwang),서병무(Byoung-Moo Seo),최진영(Jin-Young Choi),이종호(Jong-Ho Lee),정필훈(Pill-Hoon Choung),김명진(Myung-Jin Kim) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.2
Purpose: The purpose of this study is to evaluate the value of proliferation factors, Ki67 and PCNA, as prognostic markers predicting the survival and neck metastasis in patients with oral cancer. Methods: 101 patients with HNSCCs, were followed retrospectively for a median period of 60 months(from 16 to 82 months). All tumors were resected surgically and examined by conventional light microscopy, immunohistochemistry. The age, sex, tumor location, clinical stage(size), metastasis, proliferative activity index(assessed by proliferating cell nuclear antigen(PCNA) and Ki67 immunoreactivity) were considered as potential prognostic factors and were correlated with patient survival. Results: Ki67 staining results ranged from 5% to 80% of tumor cell nuclei, with a median of 25%. PCNA staining results ranged from 1% to 90% with a median of 50%. With a cut-off point of 25%, patients with lower Ki67 scores showed survival advantages over those with higher Ki67 scores(p=0.0089). With cut-off point of 50%, patients with lower PCNA scores showed survival advantages over those with higher PCNA scores(p=0.0104). Pathologically neck node positive patients(n=27) showed higher PCNA expression(p=0.02) than pathologically negative neck node patients(n=39). Conclusions: The lower expressions of Ki67 and PCNA were associated with favorable prognosis such as higher survival rate and lower neck node metastasis.
팽준영(Jun-Young Paeng) 대한치과의사협회 2015 대한치과의사협회지 Vol.53 No.5
Bacterial infection after implant installation or bone graft is a serious complication. Bone grafts represent a temporary foreign body lacking vascularisation and are therefore of increased susceptibility to infection, which may be introduced either intraoperatively or postoperatively. Bone graft-associated infections are due to biofilm formation on the surface of the bone graft and often require removal of the infected bone graft with substantial graft failure. In this review, the implant and graft related infection, the role of biofilm and the management will be discussed.