• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권4호
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• pp.330-335
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• 2002

The study was performed to investigate the comparison of relative signal intensity of normal- and abnormal-side retrodiscal tissue, and relationship between clinical examination, joint effusion and relative signal intensity of retrodiscal tissue in patients with unilateral TMJ internal derangement. The study group comprised 19 females and 9 males, with a mean age of 29 years. After measurements of the signal intensity were made on the MR imager for the T2 weighted images on retrodiscal tissue and brain gray matter, we calculated relative value and tried to find relationship between clinical examination, joint effusion and relative signal intensity on normal- and abnormal-side. The results are as follows. 1. The gray matter is an appropriate reference point. 2. The relative signal intensity is high significantly in abnormal-side retrodiscal tissue compared with normal-side retrodiscal tissue. 3. The relative signal intensity is high significantly in painful joints compared with nonpainful joints and in joints with joint effusion compared with joints without joint effusion. 4. The relative signal intensity in normal joints, joints with reduction and joints without reduction is increased in order significantly.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권1호
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• pp.69-77
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• 2001

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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권1호
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• pp.9-14
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• 2001

With the object of providing a temporary artificial periodonal ligament-like membrane around the dental implant, 10 Branemark type implants were coated with commercially available chitosan(Fluka Co., Buchs, Switzerland) which has a molecular weight of 70,000 and 80% deacetylation degree. Once this bioactive hydrophillic polymer(chitosan) contacts with blood or wound fluids, it becomes swollen and penetrates into the adjacent cancellous bone. Thus the interface between implant and surrounding bone is completely filled with chitosan. This tight junction in early healing phase enhances primary stability. The chitosan coated dental implants were implanted into the fresh patella bones from porcine knees, since the thickness of cortical bone is relatively even and their cancellous structure is homogenous. To test the shock absorbing effect, 1mm delta-rogette strain gage was installed behind the implant. The results showed 1. The principal strain peak value directed to the impact of coated implant was 0.064 0.018(p<0.05) and that of uncoated implant was 0.095(0.032 p<0.05). 2. The peak time delay of coated implant was 0.056sec(0.011 p<0.05) and that of uncoated implant was 0.024sec(0.009 p<0.05). It can be reasoned from this results that the chitosan coating has a shock absorbing effect comparable with a temporary artificial periodontal ligament.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권1호
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• pp.1-8
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• 2001

This study was designed to localize the distribution of basic fibroblast growth factor(bFGF) in the developing rat condylar region and to elucidate the associated function of bFGF in the condyle development. The condyles of temporomandibular joint of Sprague-Dawley rats (27g of weight) were used. The tissues were examined with electron microscope and immunohistochemical method. The results were as follows: 1. The developing condylar region are divided in to 5 zones apparently: proliferative, maturation, hypertrophic, calcifying, and ossification zones. 2. The cells in the proliferative zone are condensed and have under-developed cell organells in the cytoplasm. This zone shows a strong immunoreactivity of bFGF. 3. The cells in the maturation zone are typical chondroblasts showing well-developed cell organells and round nucleus. The cartilaginous matrix does not show the immunoreactivity of bFGF, while the chondroblasts show the immunoreactivity. 4. The cells in the hypertrophic zone show hypertrophic change having the degenerated cell organelles and small nucleus. There are no immunoreactivity of bFGF in this zone except the nucleus and endoplasmic region showing mild immunoreactivity. 5, The cells in the calcifying zone show hypertrophic change and cell organelles are disappeared. The cells are surrounded by the calcified cartilaginous matrix. There are no immunoreactivity of bFGF in this zone except the endoplasmic region showing mild immunoreactivity. 6. In the zone of bone formation, chondroblasts are disappeared. Newly differentiated osteoblasts secreting osteoid around the calcified cartilaginous matrix. The bone marrow shows the immunoreactivity of bFGF, while the bone matrix does not show the immunoreactivity of bFGF.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권4호
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• pp.249-255
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• 2002

Recently, Skeletal Anchorage System (SAS) has been focused clinically with the view point that it could provide the absolute intraoral anchorage. First, it began to be used for the patient of orthognathic surgery who had difficulty in taking intermaxillary fixation due to multiple loss of teeth. And then, its uses have been extended to many cases, the control of bone segments after orthognathic surgery, stable anchorage in orthodontic treatment, and anchorage for temporary prosthesis and so on. SAS has been developed as dental implants technique has been developed and also called in several names; mini-screw anchorage, micro-screw anchorage, mini-implant anchorage, micro-implant anchorage (MIA), and orthosystem implant etc. Now many clinicians use SAS, but the anatomical knowledges for the installed depth of intraosseous screws are totally dependent on general experiences. So we try to study for the cortical thickness of maxilla and mandible in Korean adults without any pathologic conditions with the use of Computed Tomography at the representative sites for the screw installation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권4호
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• pp.310-317
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• 2002

We have examined 20 tongue-tie patients who had been operated the lingual frenectomy in Dept. of Oral & Maxillofacial surgery, Pusan National University for the effect of the lingual frenectomy on the tongue motion and speech, and divided patients into groups by age. Each group was separated as follows ; the age of 5-6, 7-9, 10-12, 13-15, and 16-18. We measured the frenal lengh, the range of tongue motion and evaluated the speech pre- and postoperatively. The preoperative patient groups have larger tongue tips and smaller lingual frenums than normal ones. In the preoperative patient group, there was significant obstacle of the protrusive and superior movement of the tongue. The exception was the laterotrusive movement on both sides. There was the lower value of the Picture Consonant Articulation Test(PCAT) in the preoperative 5 to 6 year-old group compared with normal group. In other age groups, there was no significant difference. The range of postoperative PCAT in all age groups has become as similiar as that of normal group. The 5 to 6 year-old group which had significant difference in PCAT was improved in PCAT. In conclusion, we propose that the PCAT as well as anatomical tongue size and functional tongue movement is the basis of the indication of lingual frenectomy and the 5-6 year-old is the optimal time of the lingual frenectomy for improvement of the tongue movement and the speech.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권4호
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• pp.264-273
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• 2002

Pulsed electromagnetic field (PEMF) was used first to induce osteogenesis in 1974. The appliance which was consisted of the Helmholtz coil configuration have used to osteogensis. The objective of this study was to determine whether PEMF, a frequency of 100 Hz and magnetic field strength of 38 gauss applied to the calvarial defect in rabbit, could affect the induction of osteogenesis and the healing of the graft bone. This field should not produce excitation of nerve or muscle and heating the tissue. To evaluate the effect of PEMF on osteogenesis, 16 rabbit under the same condition was divided into 8 experimental groups and 8 control groups. 10 mm calvarial bone defects were formed around sagittal suture. The defect of left side was left without graft while the defect of right side was grafted by bone harvested from left side. A pulsed electromagnetic field was applied for 8 hours per day. Each group was sacrificed after 1 week, 2 weeks, 4 weeks, 8 weeks. Microscopic specimens were obtained from the calvarial bone defects and surrounding tissue using Hematoxylin-Eosin staining method. The results were as follows. 1. In the group which pulsed electromagnetic field was applied, new bone formation filled up the defect was observed after 4 and 8 weeks effectively. 2. There are no difference in the healing period for the fusion between the bone and graft bone. According to the result, the PEMF with 38 Gauss, 100 Hz was very effective in the healing of bone defect and new bone formation. So The PEMF will be useful in clinical aspect for oseteogenesis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권4호
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• pp.212-218
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• 2003

Matrix metalloproteinases (MMPs) play an important role in the normal morphogenesis, maintenance, and repair of matrix and also have important functions in pathologic conditions characterized by excessive degradation of extracellular matrix, such as rheumatoid arthritis, osteoarthritis, periodontitis and in tumor invasion and metastasis. In this study, expression of MMP-1 and -2 mRNA in retrodiscal tissue of the temporomandibular joint (TMJ) was examined and compared with magnetic resonance imaging (MRI) and surgical findings. MMP mRNAs in the retrodiscal tissue samples were detected by reverse transcription - polymerase chain reaction. TMJ internal derangement (ID) was categorized as normal disc position, disc displacement with reduction, early stage of disc displacement without reduction (DDsR) and late stage of DDsR. TMJ osteoarthrosis (OA) was classified with normal, mild and advanced OA. The amount of synovial fluid collection was divided into not detected, small, large and extremely large amount on MR T2-weighted imaging. Perforation and adhesion were examined during open surgery of the TMJ. Six out of 37 samples were excluded because of little amount of extracted total mRNA. MMP-2 mRNA was detected whole joints, and so the MMP-2 mRNA seems to be expressed normally in retrodiscal tissue. However, MMP-1 mRNA was expressed in 8 of 31 joints. Frequencies of MMP-1 mRNA expression according to the TMJ IDs, amount of synovial fluid and surgical findings made no significant difference. MMP-1 mRNA was detected more frequently in OA groups (7/16 joints, 43.8%) than in normal bony structure group (1/15 joints, 6.7%). Expression of MMP-1 mRNA in retrodiscal tissue might be related with OA of the TMJ.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권4호
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• pp.257-260
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• 2003

The purpose of the present study lied in examining the incidence, treatment and failure causes of peri-implantitis by analyzing medical charts of those patients who underwent implant placement for the past 2 years. The subjects included those patients who underwent implant placement at the present hospital from January 2001 to December 2002. 3i implants were used for the analysis for the comparison of significance. A total of 301 patients were examined, among whom 102 were females and 199, males. Implants were placed in a total of 578 cases. The number of peri-implantitis was present in a total of 29 cases (21 males and 8 females), giving the incidence at 9.6%. The evidence of peri-implantitis was seen in 60 cases, which was in 10.4% of the patients. Among those cases with peri-implantitis, 28 cases (47%) underwent bone graft and 22 cases (43%) underwent maxillary sinus lift. Furthermore, 4 of these patients had systemic diseases such as diabetes or hypertension. Regular management is important for the prevention of peri-implantitis. In other words, early prevention through regular follow-ups to check the status of surrounding soft tissue would be needed to maintain implants.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권4호
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• pp.226-231
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• 2003

The contour of mandibular angle is important for facial esthetics in the oriental population, because the wide and square face is thought to have had an unhappy life. A prominent mandibular angle produces a characteristics quardrangle, coase, and muscular appearance. So, uni- or bi-lateral mandibular angle reduction is usually performed. However, there is little guideline for bi-lateral angle reduction. So, this study was to investigate the pattern of Korean mandibular angle for bi-lateral mandibular angle reduction as guideline. This study was included 66 adult men and women over 19 years old who are having the normal mandibular angle. We measured the posterior border, angle, and inferior border of mandible using cephalometric view. The results of study was as followed : 1. The ratio of posterior mandible was 96.6, 97.3% in male, and 103.0, 106.0% in female. 2. The ratio of mandibular angle(R1-Go/R1-R2) was 120.2% in male, and 117.3% in female. 3. The ratio of inferior mandible(D5, 6, 7, E, F, G/D4) was 97.3, 90.9, 79.5, 65.2, 57.8, 46.9% in male, and 98.5, 91.2, 80.5, 67.6, 59.1, 50.2% in female. The results of this study should be useful to decide accurate amount of reduction.