Le Fort I 골절단술을 이용한 진구성 상악골 골절의 치험 2예

이재휘,박형식,권준호 大韓顎顔面成形外科學會 1989 Maxillofacial Plastic Reconstructive Surgery Vol.11 No.1

This is a report of 2 cases on old maxilla fractures accompanied with sagittal palatal fracture and severe malocclusion. We treated them by using of classic Le Fort 1 osteotomy and modified Le Fort I osteotomy along the old fracture lines satisfactorily. The results obtained from treatment are as follows : 1. Careful examination and correct care on sagittal palatal fracture should be need during initial diagnosis and emergency care of maxilla fracture showed malocclusion. 2. Although early definite treatment of maxilla injuries is difficult due to major organ injuries associated with accident, the positive effort to induce normal occlusion is always necessary as soon as possible. 3. In the cases of malocclusion due to transverse discrepancy of maxillary dentition associated with injury as like as our cases, classic and modified Le Fort I osteotomy and rigid internal fixation were useful to correct occlusion, to ease operation and return normal functions early.

치아종을 동반한 선천적 결손된 유견치의 공간

이정은,이제호,최형준,김성오,송제선,손흥규,최병재 大韓小兒齒科學會 2010 大韓小兒齒科學會誌 Vol.37 No.2

치열궁에서 공간이 상실되는 것은 악궁내 치아의 고유한 위치에 변화가 생겼을 때 인접 근육들간의 힘의 균형이 변함으로써 치아의 위치이동이 나타나게 되어 발생한다. 공간의 상실을 일으키는 원인으로는 인접면 우식증이나 조기 발거, 치아의 선천적 결손, 왜소치 등이 있는데, 그 중에서 치아의 선천적 결손은 유치열기에서는 영구치열기에 비하여 매우 낮은 빈도를 보이며 계승 영구치의 결손과 높은 관련성이 있다. 선전적 결손은 유측절치에서 호발하며 하악보다 상악에서 자주 발생하는 것으로 보고되었지만, 유견치에서는 드물게 나타난다. 유치의 선천적 결손은 악궁 내에서 인접치아의 경사 및 계승치를 위한 공간의 상설, 악궁 장경의 감소로 인한 치열궁 협착 등과 같은 공간문제를 야기시킬 수 있다. 이 증례는 연세대학교 치과대학병원 소아치과에 내원한 유치열기 어린이에서 상악 우측 유견치의 선천적 결손과 그 부위의 치아종이 있는 악궁의 공간에 대하여 관찰한 것이다 2년 10개월 동안의 정기검사에서 상악 우측 유견치 부위의 콩간 상실은 없었으며 정중선변위나인접치의 근심 경사, 치아종으로인한 임상및 방사선학적 증상등을보이지 않았다 주기적인 관찰을 통해 치아종이 측절치나 견치의 맹출을 방해하거나 주변으로 낭성변화 등의 합병증이 발생하지 않는다면 측절치나 견치의 맹출시기에 치아종을 외과적으로 제거할 예정이며, 상태에 따라 공간유지장치 또는 교정치료가 필요할 수 있을 것으로 생각한다. Space loss of dental arch can appear when the proper position of teeth within the dental arch changes by a certain cause, because the balance of force makes changes about tooth position as well as alignment, The causes of space loss include proximal caries, early extraction, congenital missing of a tooth and hypodontia, etc. Among those causes of space loss, congenital missing of a tooth is more rarely observed in the primary dentition than in the permanent dentition. Congenital missing in the primary dentition is associated with that in the permanent dentition. Furthermore, it can cause space problem, such as mesial tilting or drift of adjacent teeth, space loss for permanent successors and dental arch constriction, etc. Primary lateral incisors is the most commonly involved, in the maxilla rather than in the mandible, but primary canine is rarely reported. In this patient, who visited the department of pediatric dentistry at Yonsei university dental hospital. it was observed that the maxillary right primary canine was congenitally missing and an odontoma was found insteadly. However, neither the space loss for the congenitally missing primary canine nor midline deviation is remarkable during the 2-year-10-month observation period. In addition, any clinical or radiographical symptom did not occur in spite of odontoma. Therefore, surgical enucleation of odontoma is planned according to the eruption of permanent lateral incisor or canine, unless eruption failure of permanent lateral incisor or canine nor cystic change around the odontoma is occurred. Through further evaluation, space maintainer or orthodontic treatment may be necessary.

출생 시 발생한 특발성 치은섬유종증

이효설,최형준,최병재,손홍규,이제호 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.4

치은섬유종증(Gingival fibromaotsis)은 치은조직의 섬유성 증식을 나타내는 드문 구강질환이다. 원인은 명확히 규명되지 않았으나 상염색체 우성 또는 열성의 유전성이거나 특발성일수 있다. 주로 영구치 맹출 시기에 나타나기 시작하나, 드물게 유치열기나 출생시부터 이환되는 경우도 있다. 치은은 서서히 증식하여 치아의 해부학적 치관부위를 덮거나 구개 변이를 일으켜 혀 운동장애를 야기하거나 입술 폐쇄를 방해하기도 한다. 이 증례의 환아는 14개월 된 여아로 출생 시부터 계속딘 치은증식을 주소로 내원하였다. 특별한 가족력이나 의학적 병력은 없었고, 임상 유전검사 결과 알려진 어떤 증후군으로 진단되지 않았으나, 신체발달이 지연되어 있었다. 펀치 생검을 하였으며, 조직검사명은 치은섬유유종증이었다. 가족력이 없어 특발성 치은섬유종증으로 진단하였다. 환아의 연령 및 전신 상태를 고려해 치은 절제술 등의 외과적 치료는 연기하기로 하였다. Gingival fibromatosis is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. It usually appears at the time of eruption of permanent dentition but, can develop at the time of eruption of the primary dentition and rarely at birth. It may deform palatal contour and subsequently restrict the tongue movement, resulting in interference during speech and mastication. In addition, it incapacitates maintenance of normal lip closure. A 14-month-old girl visited the department of pediatric dentistry, Yonsei University Dental Hospital, for the congenital gingival overgrowth. There was no one in the family, who showed similar pattern of gingival growth. The intraoral clinical examination revealed generalized severe enlargement throughout the maxillary and the mandibular arches. Enlarged gingival tissue was pink and had firm consistency. She was referred for chromosomal analysis, which confirmed absence of any known syndrome. Under local anesthesia, "Punch-biopsy" was performed on the labial area, and the specimen was histologically diagnosed as gingival fibromatosis. For she did not have any medical problem nor familiar history, she was diagnosed as having idiopathic gingival fibromatosis. Regarding her age and behavior, close follow-up was decided.

상악 정중부에 역위 매복된 과잉치의 악골 내 이동

이석우,이제호,김성오,최형준,손홍규,최병재 大韓小兒齒科學會 2008 大韓小兒齒科學會誌 Vol.35 No.4

과잉치는 상악 정중부에서 주로 발견되며,과잉치의 발생 기전은 유전적 또는 환경적 원인에 의하여 치배 형성기 동안에 정상 치판의 비정상적 증식에 의한 것으로 보고되었다. 과잉치로 인한 합병증으로는 인접 영구치의 맹출 장애와 전위,회전,정중이개,비강으로의 맹출,낭종 형성 등 이 있다. 과잉치를 외과적으로 발거하기 위한 시기에 대해서는 논란이 되고 있다. 인접치의 배열과 맹출 장애,전위를 야기할 수 있기 때문에 조기에 발거하자는 견해와 어린이의 행동 조절 및 인접 영구치의 치근 형성 정도를 고려하여 8~l0세 이후에 발거 하자는 견해가 있다. 후자와 같이 외과적 발거 시기를 연기할 경우,역위 및 수평 매복된 과잉치는 악골 내에서 비강 또는 경구개,소구치 부위 등으로 이동할 수 있으며,과잉치의 이동과 전상악골의 수직고경 증가로 인하여 외과적 발거 시 난이도가 높아질 수 있다. 따라서,역위 및 수평 매복된 과잉치의 외과적 발거 시기를 결정하기 위하여 연기하는 경우에 과잉치의 악골 내 이동을고려해야한다. 이 증례는 상악 정중부에 역위 매복된 과잉치가 있어서 내원한 6~7세의 어린이에서 과잉치의 외과적 발거 시기를 결정하기 위하여 주기적인 방사선 학적 검사로 관찰하던 중에 2~3년 후 과잉치 위치가 악골 내에서 초진 시 위치로부터 이동된 경우로 이를 보고하는 바이다. Supernumerary teeth are frequently found in the anterior portion of the maxilla and develop as a result of abnormal proliferation of the dental lamina during tooth germ formation, caused by genetic or environmental factors. They may result in various complications, such as eruption interference, displacement, rotation of adjacent teeth, diastema, eruption into the nasal cavity, and development of dentigerous cyst. The optimal time for surgical extraction of supernumerary teeth has been a controversial issue. Someone prefer early surgical extraction because supernumerary teeth can cause eruption interference and displacement of adjacent teeth, eventually altering occlusion. Others prefer to delay surgical extraction until 8~10 years of age in consideration of root maturation of the adjacent teeth and also patient's behavior. When surgical extraction of supernumerary teeth is postponed, there is possibility that impacted supernumerary teeth in the inverted or horizontal position move toward the nasal cavity, hard palate, or premolar area. When such intraosseous tooth migration is combined with the vertical growth of the maxilla. surgical approach becomes even harder. Therefore, possibility of intraosseous tooth migration should be considered as an important factor when deciding appropriate time for surgical extraction. We are presenting cases of mesiodens which showed intraosseous migration during 2~3 years of follow-up period since the first diagnosis had been made at the 6~7 years of age.

미분층 흡착반응기에서 다공성 합성수지 입자내의 확산

이성식,전성균,김형준 동아대학교 환경문제연구소 1997 硏究報告 Vol.20 No.1

Synthetic porous resin particles contacting o-Cresol, 2-Picoline and o-Nitrophenol in aqueous solution, Uptake curves were collected by use of a differential reactor for various concentration ranges. The effective intraparticle diffusivity, D_(e), based on the concentration difference in the liquid phase, was determined by comparing experimental and theoretical uptake curves. The experimental data of higher values of the equilibrium amount adsorbed agreed well with the theoretical values and the values of D_(e)' was independent of the amount adsorbed. The physico-chemical properties of adsorbate affected on adsorption equilibrium and kinetic parameters. Existence of nitro group at ortho position enhance the adsorption capacity and accelerated intraparticle mass transfer.

산업용 로봇의 실시간 운용을 위한 역기구학 해석

이용중,이상태,박형준 한국공작기계학회 1998 한국생산제조학회지 Vol.7 No.1

This study solves the inverse kinematics problem of industrial FANUC robot. Because every joint angle of FANUC robot is dependent on the position of end-effector and the direction of approach vector, arm metrix T_6 is very complicated and each joint angle is a function of other joint angles. Therefore, the inverse kinematics problem can not be solved by conventional methods. Noticing the fact that if one joint angle is knows, the other joint angles are calculated by the algebraic methods, θ_1 is calculated using neumerical analysis method, and solves inverse kinematics problem. This proposed method, in this study, is more simpler and faster than conventional methods and is very useful in the real-time control of the manipulator.

세네카의 레저사상에 관한 연구

이동현,김형준,김성룡 群山大學校 1997 論文集 Vol.25 No.-

Seneca is the most important philosopher on leisure studies. It is said that his viewpoints for leisure ard written in the works of “on the Shortress of Life”“On Tranquility” On Leisure”and in western world, to say nothing of the study focused on Seneca´s philosophy of leisure. So it is the aim of this essay to make review what the Seneca´s philosophy of leisure is and, also what the philosophy tells us to think about the meaning of leisure toward our learning society.

상아질 접착제를 사용한 광중합 복합레진과 Glass lonomer Cement의 전단 결합력에 관한 연구

이제호,이종갑,권병렬,최형준 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.2

The purpose of this study was to compare shear bond strength of composite resin using several dentin bonding agents and light cured glass ionomer cement(Fuji Ⅱ LC). 40 Bovine primary anterior teeth were used for this experiment.Labial surface of teeth were flattened.It were divided into four groups.Each group was composed of 10 teeth.The material used for this experiment were Scotchbond Multipurpose-Z-100,Allbond 2-Aelitefil,Gluma-Pekalux,light and cured glass ionomer cement(Fuji Ⅱ LC). Each of the materials was applied to the exposed surface of 10 teeth by insertion into a cylindrical shaped matrix which is 3mm diamiter and 3mm in height. The completed specimens were stored at 37℃ under 100% humidity for 24 hours:the shear bond strength of material to detin surface were measured with INSTRON universal testing machine. The results were as follows: 1.Shear bond strength to detin surface increased in oder of light cured glass ionomer cement(Fuji Ⅱ LC),Gluma,Allbond 2,Scotchbond Multipurpose. 2.Between shear bond strength of light cured glass ionomer cement(Fuji Ⅱ LC) and Allbond 2,there was statistical significace(P<0.05). 3.Between shear bond strength of light cured glass ionomer cement(Fuji Ⅱ LC) and Scotchbond Multipurpose,between shear bond strength of Gluma and Scotchbond Multipurpose,there was statistical significace(P<0.01). The shear bond strength of detin bonding agents were higher than light cured glass ionomer cement.The reason is that material and quality of detin bonding agent were enhanced.Further investigation is necessary to improve shear bond strength of light cured glass ionomer cement.

치아 이상의 발생 빈도와 양상에 관한 연구

이제호,손홍규,전승준,최형준 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.2

An object definition of the anomaly is not avaliable and most investigators define the term differently or fail to describe their criterion.Because dental anomaly may lead to many complications,early detection and diagnosis of dental anomalies are essential steps in the evaluation of the child patient and in treatment planning.These procedures require detailed medical and dental histories,through clinical examination and the use of radiographs.So,this study was designed to find out the prevalece of dental anomalies.The clinical and roentgenographic examination was undertaken for 8,054 children at age from 0 to 15 years and statistical analysis was done.The results were as follows: 1.Among the examined subjects 2,134 subjects(26.5%) showed dental anomalies.The prevalance of individure dental anomalies were as as follows:Supernumerary teeth 15.6% congenitally missing teeth 6.6%,fusion 2.2%,odontoma 0.35%,microdontia 1.2%,macrodotia 0.05%,gemination 0.22%,talon cusp 0.36%,dens evaginatus 0.24%,dens invaginatus 0.15%,dilaceration 0.27%,taurodontism 0.09%,abnormal tooth position 1.7%,natal $ neonatal teeth 0.92%,amelogenesis imperfecta 0.01%. 2.Significant correlations between the groups with individual dental anomalies were as follows:between groupⅠand other groups,there was nagative correlation,especially groupⅠ and groupⅡ.And the correlation coefficient between male and female showed differences. 3.For the supernumerary teeth group,the prevalence of male was higher than female(p<0.001).While for the congenitally missing teeth,macrodontia,microdontia,abnormal tooth position group,the prevalence of female was greater than male(p<0.001). 4.For the congenitally missing teeth group,the mandibular primary lateral incisor showed the highet incidence in primary dentition,while mandibular lateral incisor in permanent dentition.In the mandible(72.5%),this site showed higher prevelence than in maxilla.In this case with deciduous congenitally missing teeth,the prevelence of successive permanent congenitally missing teeth was about 33.9%,the incidence was highet in mandibular lateral incisors. 5.Most supernumerary teeth existed on middle area and showed inverted position and unerupted state.In addition,supernumerary teeth showed higher incidence on maxilla(99.3%). 6.In the case with deciduous fused teeth,the prevelence of successive permanent congenitally missing teeth was 39.9%,while that of successive permanent fused teeth was 2.7%.And the highet rate of the prevalence(40.3%) appeared in fusion of mandibular deciduous lateral incisor and canine. 7.In the case of odontoma,the prevelence was higher in maxilla(78.6%) and anterior region(82.7%) the mandible and posterior region.

수종 치과재료의 제I급 와동에서의 변연 누출에 관한 실험적 연구

이선희,손흥규,최형준 大韓小兒齒科學會 1996 大韓小兒齒科學會誌 Vol.23 No.1

Microleakage is a problem of all filling materials of losted teeth structure and is clinically undetectable. Because marginal leakage may be responsible for pulp irritation, pulp inflammation, necrosis and recurrent caries, it is essential to prevent and control it. For the evaluations of microleakage of various class I filling materials, 175 extracted teeth were filled with amalgam, light curing composite resin, glass inomer cement, IRM and Fermit-N. After thermocycling, speciemens were placed in 1% methylene blue dye solution for 24 hours in an incubator set 37℃. The teeth were sectioned at filling body center and margin and degree of dye penetration was observed with a stereomicroscope. The following results were obtained. 1. Light cured composite resin has the excellent results and microleakage is increased in the order of amalgam, IRM, Fermit-N, glass ionomer cement.(SAS-6.0 system) and there was a statistically significancy in marginal leakage for each filling materials.(Kruskal-Wallis analysis, P<0.05) 2. Microleakage of the center and margin was statistically insignificant (Mann-Whitney analysis P<0.05) 3. There was less microleakage for amalgam than light cured composite resin but was statistically insignificant (Mann-Whitney analysis, P<0.05) and also showed less marginal leakage for Fermit-N compared to glass ionomer cement but also was statistically insignificant. (Mann-Whitney analysis, P<0.05).