198 research outputs found

    μ„ μ²œμ„± κΈ°ν˜•ν™˜μžμ—μ„œμ˜ μ•…κ΅μ •μˆ˜μˆ  적용과 수술 증둀 뢄석

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    Distraction osteogenesis and orthognathic surgery are the widely used surgical methods for treating hemifacial microsomia and cleft lip and palate, the representative forms of congenital deformity. Distraction osteogenesis is an outstanding treatment of choice when more traction is needed than what can be achieved by general orthognathic surgery. However, the stability of distraction osteogenesis has not yet been established, and in most of the cases, additional orthognathic surgery is mandatory. Moreover, the difficulty in precise control of the traction directions is another disadvantage of distraction osteogenesis. Therefore, it would be desirable not to conduct distraction osteogenesis when the patient is suitable for an orthognathic surgery. Also, distraction osteogenesis should be recognized as an accessorial method of treatment, and be used restrictively.ope

    Expression patterns of tenascin-N in the developing mandible

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    Previous studies have demonstrated that tenascin-N belongs to the family of tenascins, which are found in the extracellular matrix of various embryonic tissues, wounds, and tumors. Tenascin is expressed in the embryonic epithelium, including the neural epithelium from which neural crest cells emerge. However, the expression pattern and role of tenascin-N in the craniofacial region remains unknown. In this study, expression patterns of tenascin-N were confirmed in the mouse craniofacial region from embryonic day 12.5 (E12.5) to postnatal 11. In the diastema region, tenascin-N was strongly expressed in the mesenchyme from E12.5 to E14.5. Tenascin-N expression was also detected in the developing tooth germ. From the bell stage to the premature stage, tenascin- N was expressed in the odontoblasts and ameloblasts of the molar tooth germ, and the ameloblasts of the incisor tooth germ. These findings indicate that the spatial and temporal expression of tenascin-N might have a role in proper mouse craniofacial development, especially tooth developmentope

    Alveolar cleft graft

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    Bone grafting the alveolar cleft allows for stability and continuity of the dental arch, provides bone for eruption of permanent teeth or placement of dental implants, and gives support to the lateral ala of the nose. Closure of residual oronasal fistula can occur simultaneously. Repair of alveolar clefts can occur at a variety of stages defined as primary, early secondary, secondary, and late. Most centers perform this surgery as secondary bone grafting. Autogenous bone provides osteogenesis, osteoinduction and conduction and is recommended for grafting to the cleft alveolus and several donor sites are available. The surgeon should select the best flap design considering the amount of mucosa available, blood supply and tension-free closure, and the extent of the oronasal communication. The authors provide a comprehensive understanding of alveolar clefts and their repair by reviewing the historical perspective, objectives for treatment, timing, source of graft, presurgical orthodontics, surgical techniques, postoperative care, and complicationsope

    Onset of analgesia and analgesic efficacy of tramadol/acetaminophen and codeine/acetaminophen/ibuprofen in acute postoperative pain : a single-center, single-dose, randomized, active-controlled, paral

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    Dept. of Dentistry/박사[ν•œκΈ€] 연ꡬ배경: tramadolκ³Ό acetaminophen λ³΅ν•©μ œμ œλŠ” λ‹€μ–‘ν•œ 톡증 μž„μƒ μ‹œν—˜μ—μ„œ 쒋은 효과λ₯Ό λ³΄μ—¬μ™”μ§€λ§Œ κΈ‰μ„± 톡증 μƒνƒœμ—μ„œ 이 λ³΅ν•©μ œμ œμ™€ κ°•λ ₯ν•œ μ§„ν†΅μ œλΌκ³  μ•Œλ €μ§„ λ‹€λ₯Έ μ§„ν†΅μ œμ˜ 효과 λ°œν˜„ μ‹œμ κ³Ό μ§„ν†΅νš¨κ³Όλ₯Ό λΉ„κ΅ν•˜λŠ” 것이 ν•„μš”ν•˜λ‹€κ³  μƒκ°λ˜μ—ˆλ‹€. 연ꡬλͺ©μ : λ³Έ μ—°κ΅¬μ˜ λͺ©μ μ€ ꡬ강 μˆ˜μˆ ν›„ κΈ‰μ„± λ™ν†΅μ˜ μΉ˜λ£Œμ—μ„œ 75 ㎎ tramadol/650 ㎎ acetaminophen (Tr/Ac) λ³΅ν•©μ œμ œμ™€ 20 ㎎ codeine/500 ㎎ acetaminophen/400 ㎎ ibuprofen (Co/Ac Ib) λ³΅ν•©μ œμ œμ˜ νš¨κ³Όλ°œν˜„ μ‹œμ κ³Ό λ‹€λ₯Έ μ§„ν†΅νš¨κ³Όλ₯Ό λΉ„κ΅ν•˜κ³ μž ν•˜μ˜€λ‹€. 연ꡬ방법: 이 μ—°κ΅¬λŠ” λ¬΄μž‘μœ„, 1회 νˆ¬μ—¬, 평행그룹 λ””μžμΈμœΌλ‘œ, 단일 μ„Όν„°μ—μ„œ μ‹€μ‹œν•œ 비ꡐ μž„μƒμ‹œν—˜μ΄μ—ˆμœΌλ©°, κ³¨μ‚­μ œλ₯Ό ν•„μš”λ‘œ ν•˜λŠ” ν•˜λ‚˜ μ΄μƒμ˜ ν•˜μ•… 맀볡 제3λŒ€κ΅¬μΉ˜ 외과적 발거 μˆ˜μˆ μ„ μ‹œν–‰ λ°›λŠ” κ±΄κ°•ν•œ ν™˜μžλ“€μ„ λŒ€μƒμœΌλ‘œ ν•˜μ˜€λ‹€. ꡬ강 수술 ν›„ ν”Όν—˜μžκ°€ 쀑등도 λ˜λŠ” μ‹¬λ„μ˜ 톡증을 ν˜Έμ†Œν•˜μ˜€μ„ λ•Œ(톡증 평가λ₯Ό μœ„ν•œ 10단계 μˆœμœ„μ—μ„œ 5점 이상), 각 ν”Όν—˜μžλŠ” λ¬΄μž‘μœ„ λ°°μ • 방법에 따라 두 κ΅° μ€‘μ˜ ν•œ ꡰ에 ν• λ‹Ήλ˜μ—ˆλ‹€. μ‹œν—˜ μ•½ νˆ¬μ—¬ ν›„ 6μ‹œκ°„ λ™μ•ˆ 지각할 수 μžˆλŠ” 톡증 μ™„ν™”μ‹œμ κ³Ό μ˜λ―ΈμžˆλŠ” ν†΅μ¦μ™„ν™”μ‹œμ μ€ 2개의 stopwatch방법을 μ΄μš©ν•˜μ—¬ μΈ‘μ •ν•˜μ˜€κ³ , κ·Έ μ™Έ 톡증 강도, 톡증 μ™„ν™” 정도, μ „λ°˜μ  평가, 이상 λ°˜μ‘ 등을 κΈ°λ‘ν•˜μ˜€λ‹€. 연ꡬ결과: 128λͺ…μ˜ ν•œκ΅­μΈ ν™˜μžκ°€ 이 μ‹œν—˜μ— λ“±λ‘λ˜μ–΄ 같은 수(64λͺ…μ”©)둜 두 ꡰ에 λ¬΄μž‘μœ„λ‘œ ν• λ‹Ήλ˜μ—ˆλŠ”λ°, 성별, λ‚˜μ΄, 체쀑, μ‹ μž₯ 같은 인ꡬ톡계학적 기초 자료뿐만 μ•„λ‹ˆλΌ 두 ꡰ의 수술 νŠΉμ§•λ„ μ„œλ‘œ μœ μ‚¬ν•˜μ˜€λ‹€. 지각할 수 μžˆλŠ” 톡증 μ™„ν™”μ‹œμ μ˜ 쀑간값(median)은 Tr/Ac κ΅°κ³Ό Co/Ac/Ib ꡰ이 각각 21.0 λΆ„κ³Ό 24.4λΆ„μ΄μ—ˆκ³ , μ˜λ―ΈμžˆλŠ” ν†΅μ¦μ™„ν™”μ‹œμ μ˜ 쀑간값(median)은 56.4λΆ„κ³Ό 57.3λΆ„μ΄μ—ˆμœΌλ©°, 이듀은 ν†΅κ³„μ μœΌλ‘œ μœ μ‚¬ν•˜μ˜€λ‹€. 전체 톡증 완화정도(TOTPAR)와 졜초 톡증에 λŒ€ν•œ 톡증 강도 차이의 ν•©(SPID) 같은 λ‹€λ₯Έ 효과 λ³€μˆ˜λ“€μ€ 처음 2번의 μ‹œκ°„ ꡬ간 λ™μ•ˆ(0-2μ‹œκ°„κ³Ό 2-4μ‹œκ°„)에선 두 κ΅°κ°„μ˜ 차이가 μœ μ˜ν•˜μ§€ μ•Šμ•˜μ§€λ§Œ λ§ˆμ§€λ§‰ μ‹œκ°„ ꡬ간인 4-6μ‹œκ°„μ—μ„  ν†΅κ³„μ μœΌλ‘œ 유의 μžˆλŠ” 차이가 λ°œκ²¬λ˜μ—ˆλ‹€(P < 0.05). μ‹œκ°„λ³„ 톡증강도차이(PID)도0.5μ—μ„œ 4μ‹œκ°„κΉŒμ§€ 두 μ•½μ œλŠ” λΉ„μŠ·ν•œ 효과λ₯Ό λ³΄μ˜€μœΌλ‚˜, 5μ‹œκ°„κ³Ό 6μ‹œκ°„μ§Έ μΈ‘μ •μΉ˜μ—μ„œ Co/Ac/Ib ꡰ이 더 μ’‹μ•˜λ‹€. ν™˜μžμ˜ μ „λ°˜μ μΈ ν‰κ°€μ—μ„œ "μ’‹μŒ" μ΄μƒμœΌλ‘œ ν‰κ°€ν•œ 것도 Co/Ac/Ib ꡰ이 Tr/Ac ꡰ보닀 유의있게 λ§Žμ•˜λ‹€. Tr/Ac의 μ•ˆμ •μ„±μ€ Co/Ac/Ibκ³Ό ν†΅κ²Œμ μœΌλ‘œ μœ μ‚¬ν•˜μ˜€λ‹€. κ²°λ‘ : 이번 ꡬ강 수술 ν›„ κΈ‰μ„± ν†΅μ¦μ˜ μΉ˜λ£Œμ—μ„œ Tr/Ac 의 ν†΅μ¦μ™„ν™”μ‹œμ μ΄ Co/Ac/Ib 의 ν†΅μ¦μ™„ν™”μ‹œμ κ³Ό 차이가 μ—†μ—ˆμœΌλ©° λ‹€λ₯Έ 진톡 효과 λ³€μˆ˜λ“€λ„ μ•½λ¬Ό νˆ¬μ—¬ ν›„ μ‘°κΈ°μ—λŠ” μœ μ‚¬ν•˜μ˜€λ‹€. λ”°λΌμ„œ Tr/Ac은 수술 ν›„ κΈ‰μ„± ν†΅μ¦μ˜ λΉ λ₯΄κ³  효과적인 치료λ₯Ό μœ„ν•΄ μΆ”μ²œν•  만 ν•˜λ‹€κ³  μ‚¬λ£Œλ˜μ—ˆλ‹€. [영문]Background: The combination of tramadol and acetaminophen has demonstrated good efficacy in various clinical pain models. However, there is a need for comparisons of the onset of analgesia and other measures of analgesic efficacy with this combination and other strong combination analgesics for the management of acute pain. Objective: The goal of this study was to compare the time to onset of analgesia and other measures of analgesic efficacy with tramadol/acetaminophen 75/650 mg (Tr/Ac) and codeine/acetaminophen/ibuprofen 20/500/400 mg (Co/Ac/Ib) in the management of acute pain after oral surgery. Methods: This was a single-center, single-dose, randomized, active-controlled, parallel-group study in healthy subjects who had undergone surgical extraction of β‰₯1 impacted third molar requiring bone removal. When patients reported at least moderate pain after dental surgery (score β‰₯5 on a 10-point scale), they were randomized to 1 of 2 treatment groups. The time to onset of analgesia was measured using a 2-stopwatch technique. The times to the onset of perceptible and meaningful pain relief, pain intensity, pain relief, patient''s overall assessment, and adverse events were recorded for 6 hours after dosing. Results: One hundred twenty-eight subjects participated in the study, 64 in each treatment group. The 2 groups were similar in terms of baseline pain severity and demographic characteristics (mean age, 23.7 and 23.4 years in the Tr/Ac and Co/Ac/Ib groups, respectively; mean body weight, 58.5 and 60.3 kg). The median times to the onset of perceptible pain relief were a respective 21.0 and 24.4 minutes, and the median times to the onset of meaningful pain relief were 56.4 and 57.3 minutes. Mean total pain relief and the sum of pain intensity difference were also similar in the early period after dosing (0-4 hours). However, between 4 and 6 hours, Co/Ac/Ib was associated with significant differences in both variables compared with Tr/Ac (P < 0.05). Although similar through the 4-hour assessment, mean pain intensity difference was significantly greater with Co/Ac/Ib at 5 and 6 hours. The proportion of the patients assessing their assigned treatment as good or better was significantly greater with Co/Ac/Ib compared with Tr/Ac (P < 0.05). The safety profile of Tr/Ac was comparable to that of Co/Ac/Ib. Conclusions: In this small and selected group of subjects, the onset of analgesia and analgesic efficacy of Tr/Ac was comparable to that of Co/Ac/Ib. Tr/Ac provided rapid and effective analgesia for acute postoperative dental pain in this population.ope

    Craniofacial Centre of Children's Hospital Boston and Sequential Management for Cleft Lip and Palate

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    Craniofacial Centre at Children's Hospital Boston is a worldwide leader in the care of children and adolescents with craniofacial anomalies especially with cleft lip and/or cleft palate, which provides a team approach to the evaluation, diagnosis and treatment of children and adults with congenital (present at birth) or acquired facial deformities. This is staffed by an experienced team of clinicians, such as in oral and maxillofacial surgery, plastic surgery, neurosurgery, dentistry, audiology, speech and language pathology, genetics, psychiatry, otolaryngology, and social work, all with specialized training in the care of children with craniofacial anomalies. Here, there is a short introduction of history, attending surgeons, works, and sequential treatment for cleft lip/palate patients about this institutionope

    Repair of Unilateral Incomplete Lesser Form Cleft Lip

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    Cleft lip arises from congenital underdevelopment with various degrees and patterns. Mulliken named a unilateral incomplete cleft lip with no severe cleft as a lesser-form cleft lip and categorized it into three subgroups. Anatomically categorized subgroups are minor-form, microform, and mini-microform cleft by the extent of vermilion-cutaneous dysjuntion. The vermillion cutaneous notch is more than 3 mm from the regular Cupid`s bow peak for minor-form, less than 3 mm for microform, and almost no gap with discontinuity on the vermillion cutaneous border for mini-microform. The treatments are rotational advancement flap for minor-form, double unillimb Z-plasty for microform, and vertical lenticular excision for mini-microform, respectively. This article aims to present the literature review about the incomplete lesser form cleft lip classified by Mulliken and to report our experiences.ope

    Volume change pattern of decompression of mandibular odontogenic keratocyst

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    Objectives: This study was aimed to analyze the reducing pattern of decompression on mandibular odontogenic keratocyst and to determine the proper time for secondary enucleation. Materials and methods: Seventeen patients with OKC of the mandible were treated by decompression. Forty-five series of CT data were taken during decompression and measured by using InVivo software (Anatomage, San Jose, Calif) and were analyzed. Results: The expected relative volume during decompression is calculated using the following formula: V(t) = V initial × exp.(at + 1/2bt 2) (t = duration after decompression (day)). There was no significant directional indicator in the rate of reduction between buccolingual and mesiodistal widths. Conclusion: The volume reduction rate gradually decreased, and 270 days were required for 50% volume reduction following decompression of OKC. The surgeon should be aware of this pattern to determine the timing for definitive enucleation. Clinical relevance: The volume reduction rate and pattern of decompression of the OKC can be predicted and clinicians should be considered when treating OKC via decompression.ope

    Repair of bilateral cleft lip and nose by the Mulliken method: a case report.

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    The simultaneous surgical correction of bilateral cleft lip and nasal deformity has become a more common surgical technique that has greatly changed conventional strategies for secondary nasal correction. Mulliken has been known as one of the earliest proponents for the synchronous repair of bilateral cleft lip and nasal deformity, and he emphasized the responsibility of the treating surgeon to evaluate nasolabial growth by comparing anthropometric measurements with age-matched normal patients. Good outcomes from this surgical method have been reported in clinical cases worldwide. Herein, we describe the management of two cases of bilateral cleft repair, following the principles and methods established by Mulliken. We also provide a relevant review of the literature.ope

    Complication rates in patients using absorbable collagen sponges in third molar extraction sockets: a retrospective study

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    OBJECTIVES: The purpose of this study is to retrospectively evaluate the postoperative complication rates for absorbable type-I collagen sponge (Ateloplug; Bioland) use in third molar extraction. MATERIALS AND METHODS: From January to August 2013, 2,697 total patients undergoing third molar extraction and type-I collagen sponge application in the Department of Oral and Maxillofacial Surgery at Yonsei University Dental Hospital (1,163 patients) and Dong-A University Hospital (1,534 patients) were evaluated in a retrospective study using their operation and medical records. RESULTS: A total of 3,869 third molars in 2,697 patients were extracted and the extraction sockets packed with type-I collagen sponges to prevent postoperative complications. As a result, the overall complication rate was 4.52%, with 3.00% experiencing surgical site infection (SSI), 1.14% showing alveolar osteitis, and 0.39% experiencing hematoma. Of the total number of complications, SSI accounted for more than a half at 66.29%. CONCLUSION: Compared to previous studies, this study showed a relatively low incidence of complications. The use of type-I collagen sponges is recommended for the prevention of complications after third molar extraction.ope
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