III급 부정교합자의 연조직 측모 감별에 관한 연구

황병남,이승훈,이정근,이재봉,Hwang, Byung-Nam,Rhee, Seung-Hoon,Lee, Jeong-Keun,Lee, Jai-Bong 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.2

This study was performed to investigate the characteristics of soft tissue profile of the class III malocclusion and to test the yardstick far differential diagnosis between surgical and orthodontic patients. Initial lateral cephalograms of orthodontic group(30 patients) that have acceptable occlusion and profile by orthodontic treatment alone and surgical group(30 patients) that have favorable occlusion and profile by combined surgical-orthodontic treatment were selected in Ajou university hospital. Powell and Burstone II analysis were made on the tracing. Descriptive, comparative, factor, cluster, and discriminant analysis were carried out with computer program. The results were as followings : 1. Patients who received surgery had a more concave profile and a longer lower facial height than patients who received orthodontic treatment alone. 2. Nasolabial angle, ratio of vertical height, and mentolabial sulcus were significantly different at the 5% level. And facial protuberance, upper lip protuberance, mentocervical angle, nasofrontal angle, nasomental angle, mandibular vertical height, angle between cervix and lower face, ratio of mandibular vertical height divided by cervical depth, ratio of vertical height between upper and lower lip, and maxillary protuberance were significantly different at the 1% level. 3. 8 factors were extracted and factor 2, 3, and 8 showed significant differences by factor analysis. 4. Orthodontic group (25) and surgical group (35) were classified by cluster analysis. 5. Discriminant function was D = 0.079Nasomental angle + 0.081Sn-Gn + 3.343Sn-Gn/C-Gn + 1.734Sn-St/St-Me' -26.460, and cutting score was 0, so we can discriminate that orthodontic group has the score above 0, and surgery group below 0. And 91.7% of original grouped cases were correctly classified.

치과진료시의 원내교차감염 방지대책에 관한 고찰

黃秉南(BYUNG NAM HWANG) 대한치과의사협회 1993 대한치과의사협회지 Vol.31 No.12

Denta $Scan^R$을 이용한 즉시 임플랜트 시술시 최적의 식립 위치 대한 통계적 연구

신광호,이재봉,황병남,Shin, Kwang-Ho,Lee, Jai-Bong,Hwang, Byung-Nam 대한치과보철학회 2000 대한치과보철학회지 Vol.38 No.4

Purpose : The purpose of this study was to determine proper position and angulation of an implant for immediate implantation. Materials and Method : From the years 1997 to 2000. 52 Denta $scan^R$ views, 22 upper and 32 lower jaw with an average age of 43 and 40 respectively, were investigated, which comprise intact upper and lower 6 anterior teeth and premolars. On the Denta $scan^R$, the optimal placement for the immediated implantation was simulated. The measuring methods included 1) Angulation difference between tooth long axis and alveolar bone process. 2) Angulation difference of long axis between tooth and installing fixture 3) Distance between center of tooth at cervical area and center of fixture. 4) Distance from root apex to the bone limit of vital structure. One sample t-test was used for statistical analysis. Result : The results were as follows. 1) At the maxillary central incisor and lateral incisor, angulation difference of long axis between tooth and installing fixture was respectively 0.5 and 3.2 degrees with the fixture center's palatally positioned 2mm apart from tooth center. 2) At the lower anterior 6 teeth, that was about $-2.8^{\circ}\;to\;-4.6^{\circ}$ with the fixture center's lingually positioned 1mm apart from tooth center. 3) At the maxillary canine and premolar, that was respectively $11.8^{\circ}\;and \;7.2^{\circ}$ with the fixture center palatally positioned $2\sim2.4mm$ apart from tooth center. 4) At the lower premolar area, that was about $0^{\circ}\;to\;2^{\circ}$ with the fixture center's lingually positioned $0.5{\sim}1mm$ apart from tooth center. 5) Distance from root apex to the bone limit of vital structure, at the maxillary anterior and premolars. was the range of 10 to 12mm, and at the mandibular anterior teeth and the 1st premolar, that was the range of 18 to 20mm. Conclusion : The proper implant position of maxillary anterior and premolar teeth is as paralleled as or more buccally angulated than long axis of tooth with the fixture center's palatally positioned. In mandiblular anterior region, long axis of implants is lingully angulated compared with long axis of tooth and in premolar, almost parelleled with long axis of tooth and alveolar process.

Dexamethasone과 Naproxen 병용투여가 하악 제3대구치 발거 후 증상에 미치는 영향에 관한 임상적 연구

신광호,이정근,황병남,Shin, Kwang-Ho,Lee, Jeong-Keun,Hwang, Byung-Nam 대한구강악안면외과학회 2001 대한구강악안면외과학회지 Vol.27 No.1

PURPOSE : The Purpose of this study was to investigate the anti-inflammatory effect on combination dosage of dexamethasone and naproxen after removal of impacted 3rd molars. We evaluated postoperative pain, swelling, and mouth opening limitation quantitatively. PATIENTS AND METHODS : Removal of an impacted lower third molar was done under local anesthesia with 2% lidocaine to 239 healthy patients. We randomly gave experimental group 1.5mg dexamethasone and 200mg naproxen three times a day for postoperative 2days, and also gave control group 200mg naproxen alone three times a day for postoperative 2days. Swelling and pain were measured by visual analogue scale (VAS). Mouth opening limitation was measured by maximum interincisal opening length. We estimated these measurements in the first and second postoperative days. Differences between experimental and control group were investigated considering age, sex, BMI(body mass index), impacted type, surgical site(right or left), and operation time by independent student T-test. RESULTS : In general, swelling, pain, and mouth opening limitations were significantly reduced (p<0.01) by combination dose of dexamethasone and naproxen in postoperative one day. But there was no difference in pain on the second postoperative day. As variables being considered, in the postoperative pain, there was significant difference between experimental group and control group in only male, little bony removal group, left side extraction group. In case of postoperative swelling, there was no significant differences in male, adolescence, long operating time group (over 20 minutes), medium BMI group and right side extraction group. In case of postoperative mouth opening limitation, there was significant difference between only female and long operating time group (over 20 minutes). CONCLUSION : Variables being considered, postoperative swelling was more reduced by the combination dose of naproxen and dexamethasone than that of naproxen alone after removal of impacted 3rd molars. But there was varoius results in pain and mouth opening limitation.

전진 이부성형술을 동반한 하악지 시상분할골절단술에서 경조직 변화와 관련된 연조직 변화에 관한 연구

최은주,이정근,이승훈,황병남,Choi, Eun-Zoo,Lee, Jeong-Keun,Rhee, Seung-Hoon,Hwang, Byung-Nam 대한악안면성형재건외과학회 2000 Maxillofacial Plastic Reconstructive Surgery Vol.22 No.1

Purpose : The purpose of this study is to setup a standard treatment protocol in surgical correction of skeletal malocclusion with Angle Class III patients. We asessed the soft tissue changes according to skeletal changes of patients who have undergone orthognathic surgery with bilateral split sagittal ramus osteotomy (BSSRO) and advancing genioplasty. Materials & Methods : The soft tissue change of 9 skeletal Class III patients was assessed after BSSRO and advancing genioplasty. The patient group was skeletal Class III who was surgically treated by BSSRO & advancing genioplasty. The average follow up period is 13 months with the range of 6 and 30 months. All patients have undergone preoperative and postoperative orthodontic treatment. The assessment was devided into two groups. One was antero-posterior relationship and the other was vertical relationship of dimensional changes of soft tissue after orthognathic surgery. Results : In antero-posterior dimensional changes after surgery, the percentage of soft tissue change in comparison to hard tissue was 89%. Vertical ratio after surgery, 86% soft tissue changes were assessed.

치성의 괴사성 협부 및 측두부 근막염 치험례

이재휘(Jae Hwy Lee),황병남(Byung Nam Hwang),장동수(Dong Soo Jang) 대한구강악안면외과학회 1994 대한구강악안면외과학회지 Vol.20 No.4

Necrotizing fasciitis is a severe soft tissue infection that spreads rapidly in subcutaneous tissue and fascia through the tissue spaces underneath the intack skin. The clinical features of necrotizing fasciitis are extensive dissection and necrosis of the superficial fascia with widespread undermining of the adjacent soft tissues, and extreme systemic toxicity. Most cases of necrotizing fasciitis have occurred in the abdominal wall, perineum, and lower extremities after trauma or surgery of the general surgery. Necrotizing fasciitis is exceedingly uncommon in the cranifacial-cervical region, but an odontogenic etiolgy is most commonly implicated in necrotizing fasciitis of the head and neck. For successful treatment of necrotizing fasciitis, early recognition is essential because the rate of spread is rapid. Aggressive surgical intervention, systemic medical and supportive management, and intensive antibiotoic therapy are very important. This report describes a case of necrotizing buccal and temporal fasciitis following periapical abscess of lower left first molar in a 64-year-old male patient without any predisposing factor.

A clinical study of masseter muscle hypertrophy treated by aesthetic contouring of mandibular angle

이재휘(Jae Hwy Lee),황병남(Byung Nam Hwang),이정근(Jeong Keum Lee) 대한구강악안면외과학회 1995 대한구강악안면외과학회지 Vol.21 No.4

교근 비대증은 교근의 크기 증대와 함께 하악골 우각부의 골성 팽창으로 인해 안모의 비대칭 혹은 사각형의 안모를 야기시키는 비교적 드문 양성 병변으로서 편측성 또는 양측성으로 발생할 수 있다. 교근 비대증의 가장 주된 증상은 수개월 혹은 수년간에 걸쳐 하악골 우각부에 서서히 커지는 무통성의 종창으로 환자는 주로 심미적인 문제의 해결에 주된 관심을 가지게 되고 따라서 이에 대한수술의 목적은 심미적인 면이 대부분을 차지한다고 볼 수 있다. 교근 비대증의 원인은 아직까지 확실하지 않으나 여러 학자들에 의해 다양한 가설들이 제기되었으며, 그 가운데 부정교합, 꽉 다물기, 야간 이갈이, 불량한 저작습관 등으로 인한 과도한 하악운동으로 발생하게 되는 생리적 운동성 비대증이 가장 널리 받아들여지고 있다. 교근 비대증은 특히 편측성인 경우 임파종, 혈관종등의 하악골 양성 및 악성종양, 그리고 이하선 종양등과의 감별진단이 중요하나 임상적, 방사선학적 검사에 의해 비교적 쉽게 진단될 수 있으며, 방사선검사는 주로 파노라마 및 정모 두부계측 방사선사진, 초음파 방사선사진, 전산화단층 방사선사진, 그리고 자기공명 방사선사진이 사용될 수 있다. 교근 비대증의 치료는 주로 외과적인 수술로 이루어 지는데 심미적인 면을 고려하여 구내 접근법에 의한 교근과 하악골 우각부 절제가 수술방법이다. 교근 비대증으로 진단된 7명의 환자를 구내 접근법에 의한 하악골 우각부 절제술과 함께 교근 절제술을 시행하는 하악 우각부 미용 성형술을 통해 심미적으로 만족할 만한 결과를 얻었기에 교근 비대중의 원인, 외과적 수술기법 및 절제된 조직편의 조직학적 소견등을 문헌고찰과 함께 보고하는 바이다. 7 patients of masseter muscle hypertrophy were operated on for aesthetic contouring of the prominent mandibular angle and/or resection of hypertrophic masseter muscle because of a cosmetic reason. The age of patients ranged from 19 to 30 years involving 4 females and 3 males and a follow-up period from 2.5 to 1.2 years. Masseter muscle hypertrophy is the physiologic condition which increases the size of the masseter muscle with bony enlargement of the mandibular angle. The most frequent complaint is asymptomatic swelling that has slowly enlarged over several years, especially a cosmetic problem. Clinical examination usually suggests palpable painless swelling in the mandibular angle. Radiographic examination, such as panoramic and cephalometric radiographs, ultrasonography, and Ctor MRI shows a hypertrophic masseter muscle and prominent mandibular angle. The cause of masseter muscle hypertrophy is not clear, although several theories have been advanced. Masseter muscle hypertrophy is mainly is mainly treated surgically for the purpose of aesthetic oontouring. In this article, a surgical mathod via an intraoral approach in facial bone contouring through the curved osteotomy of the prominent mandibular angle for correcting the prominent mandibular angle that is caused by a posterior projection and lateral flaring of the gonial angle.

전치부 개교를 동반한 골격성 III급 부정교합 환자의 악교정 수술 후 교합평면의 변화와 안정성에 관한 연구

신수정(Shin Soo-Jung),황병남(Hwang, Byung-Nam),이정근(Lee, Jung-Keun),이승훈(Rhee, Seung-Hoon) 대한치과교정학회 1999 대한치과교정학회지 Vol.29 No.1

아주대학교 병원에 내원한 하악전돌증 환자의 악교정수술후 연조직 변화에 관한 측모 두부방사선 계측학적 연구

이정근(Jeong-Keun Lee),이승훈(Seung-Hoon Rhee),이재봉(Jai-Bong Lee),황병남(Byung-Nam Hwang) 대한치과의사협회 2000 대한치과의사협회지 Vol.38 No.7

상악골, 하악골 및 이부의 외과적 동시 이동술

이재휘,이호준,이정근,황병남 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.2

Art and science to determine the treatment objectives, specifically, the desired soft tissue changes are firstly established by using the clinician's “esthetic sense” of the facial beauty and proportion aided to a few cephalometric guidelines. In this sense, the dependence on the clinician's “esthetic eye” by Dr. Bell is more important in analyzing the facial proportion than the satisfaction of rigid cephalometric norms. The purpose of this article was to elucidate the indication for simultaneous surgical repositioning of the maxilla, mandible, and chin, and to describe the clinical cephalometric analysis for orthognathic surgery. Representative 6 case reports were presented and discussed to illustrate the esthetic, orthodontic, and surgical treatment objectives with long-term follow-up.