• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.1
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• pp.5-13
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• 2003

The purpose of this study is to determine the value of serum concentration of C-reactive protein(CRP) in comparison with ESR and leukocyte as the tools for diagnosis and follow-up study of infection. For this study, thirty-one patients with head and neck infection and thirty-two patients performed the orthognathic surgery were selected for experimental and control groups each other. we analyzed the blood sample daily to measure CRP, ESR and leukocytosis. The results of this study are as the following : 1. Serum C-Reactive Protein levels in the experimental group were higher than control group and the pattern of CRP changes continued to decline in both groups(P<0.001). 2. ESR changes in both groups were scattered without any special pattern. 3. Correlation between CRP and Leukocyte was higher than others(r=0.664, P<0.01). 4. In the Receiver Operating Characteristic(ROC) Curve of experimental group, rapid increase of CRP curve and Area under the curve(AUC) value, 0.774, indicate the high accuracy of estimation. 5. In experimental group, sensitivity of CRP, ESR, and Leukocytosis on recovery day were 83%, 17% and 71%. Based on the results of this study, we could conclude that determination of CRP is more useful method to diagnosis and follow-up study of infection than other commonly used variables in oral and maxillofacial region.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.6
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• pp.481-491
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• 2005

Purpose: The aim of the present study is to evaluate the effect of autogenous bone and allograft material coverd with a bioresorbable membrane on bone regeneration after a simultaneous installation of implant. Materials and methods: Twelve healthy rabbits, weighing about $3{\sim}4$ kg, were used in this experiment. Following impalnt(with 3.25 mm diameter and 8 mm length) site preparation by surgical protocol of $Oraltronics^{(R)}$, artificial bony defect, 5mm sized in height and depth, was created on femoral condyle using trephine drill(with 5 mm diameter and 5 mm length). Then implant was inserted. In the experimental group A, the bony defect was filled with autogenous particulated bone and coverd with $Lyoplant^{(R)}$ resorbable membrane. In the experimental group B, the bony defect was filled with allograft material(Orthoblast $II^{(R)}$) containing demineralized bone matrix and covered with $Lyoplant^{(R)}$. In the control group, without any graft materials, the bony defect was covered with $Lyoplant^{(R)}$. The experimental group A and B were divided into each 9 cases and control group into 3 cases. The experimental animals were sacrificed at 3, 6 and 8 weeks after surgery and block specimens were obtained. With histologic and histomorphometric analysis, we observed the histologic changes of the cells and bone formation after H-E staining and then, measured BIC and bone density with KAPPA Image $Base^{(R)}$ system. Results: As a result of this experiment, bone formation and active remodeling process were examined in all experimental groups and the control. But, the ability of bone formation of the experimental group A was somewhat better than any other groups. Especially bone to-implant contact fraction ranged from 12.7% to 43.45% in the autogenous bone group and from 9.02% to 29.83% in DBM group, at 3 and 8 weeks. But, bone density ranged from 15.67% to 23.17% in the autogenous bone group and from 25.95% to 46.06% in DBM group at 3 and 6 weeks, respectively. Although the bone density of DBM group was better than that of autogenous bone group at 3 and 6weeks, the latter was better than the former at 8 weeks, 54.3% and 45.1%, respectively. Therefore these results showed that DBM enhanced the density of newly formed bone at least initially.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.6
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• pp.306-316
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• 2015

Objectives: The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods: A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results: The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion: This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.535-542
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• 2007

Ameloblastoma, a benign tumor of odontogenic type, represents 10% of all tumors of the jaw. It is localized in the mandible(80%) and in the maxilla(20%). In every case, the selection of the surgical treatment must consider some fundamental elements, including the age and general state of health the clinicopathological variant, and the localization and extent of the tumor. This study was invested the clinicopathological findings of 23 patients with ameloblastoma which had been diagnosed by biopsy during the period of 1987 to 2005 at Chonnam National University Hospital. And it contained the statistical analysis according to the treatment methods and the clinicopathological findings such as sex, age, location, chief complaints, duration, radiographic findings, histologic findings, treatment methods. The results obtained are were follows. The age of patient ranged from 10 to 91 years(means, 35.9 years) at biopsy. Thirteen(57%) of the 23 subjects were males, and 10(43%) were females. Twenty(87%) of the 23 ameloblastomas were located in the mandible. Swelling was the most common symptom and was experienced by 20(87%) patients. Radiographically, 11(48%) of the 23 tumors were unilocular with a well-demarcated border and 12(52%) were multilocular. The most common histologic pattern was plexiform and acanthomatous rather then follicular. Conservative treatment was performed 7 cases(30%), radical treatment 11 cases(48%), and combined treatment 5 cases(22%). Follow-up period ranged from 2.1 years to 22 years(mean 5.1 years). Based on the above results, surgical excision after marsupialization was found to be useful as a preliminary treatment of the large cystic ameloblastoma in children and adolescents. On the contrary, the lesion with a soap bubble appearance, the one with ineffective marsupialization was subjected to extensive excision of the tumor with a wide margin of normal bone.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.524-529
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• 2007

Objective: Autologous transfusion is frequently used with orthognathic surgery. The necessity of autologous transfusion has begun to question alone in bilateral sagittal split ramus osteotomy. The aim of this study was to evaluate the availability of autologous transfusion. Methods: The chart reviews of sixty patients who had undergone bilateral sagittal ramus osteotomy were done. The subjects were divided into two groups: In experimental group, 30 patients who autodonated 320ml in the preoperative 3 weeks actually received a transfusion in the postoperative 6 hours were included. In control group, 30 patients who underwent the same operation without preoperative donation and any other transfusion were included. Hemoglobin, hematocrit, and changes of these values in both groups were evaluated. Results: 1. From postoperative 3 hours to postoperative 1 day, the increases of hemoglobin(0.8g/dL in experimental group, 0.2g/dL in control group) and hematocrit(0.3% in experimental group, 0.6% in control group) were not statistically significant between both groups. 2. From postoperative 1 day to postoperative 1 week, the increase of hemoglobin(0.6g/dL in experimental group, 0.3g/dL in control group) was not statistically significant between both groups. But the increase of hematocrit(2.5% in experimental group, 1.0% in control group) was statistically significant between both groups over the same period(hematocrit p=0.043). 3. On postoperative 1 week, the values of hemoglobin(12.3% in both groups) and hematocrit(35.6% in experimental group, 36.8% in control group) were not statistically significant between both groups. Conclusion: The autologous transfusion in surgery of just a little blood loss was not effective. The most results show that there is little availability of autologous transfusion according to changes of hemoglobin and hematocrit in bilateral sagittal split ramus osteotomy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.511-517
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• 2007

Purpose: The aim of this study is to determine whether a difference in the amount of bone graft material is needed between edentulous patients and dentulous patients and to calculate the amount of augmentation for a sinus lift procedure. Methods: 19 patients(20 sinuses) were included to measure maxillary sinus volume. Facial CT scanning was performed using MX 8000 IDT CT devices(Philips, USA). And it was used for IDLvm(The IDL Virtual Machine) 6.0, CT Volume Analyzer Ver 2.3 program to measure maxillary sinus volumes Results: At edentulous patients, volumes(mean${\pm}SD$) of the inferior portion of the sinuses were $0.56{\pm}0.13cm^3$(5mm height), $2.35{\pm}0.57cm^3$(10mm height), $4.85{\pm}1.10cm^3$(15mm height). At dentulous patients, volumes(mean${\pm}SD$) of the inferior portion of the sinuses were $0.41{\pm}0.18cm^3$(5mm height), $1.76{\pm}0.42cm^3$(10mm height), $3.80{\pm}0.84cm^3$ (15mm height). A significant correlation was found between augmentation height(5mm, 10mm, 15mm) and the calculated sinus volume.(p=0.027, p=0.018, p=0.044) Conclusions: A significant correlation was found between augmentation height(5mm, 10mm, 15mm) and the calculated sinus volume. Detailed preoperative knowledge of sinus lift augmentation volume is helpful in determining the appropriate amount of the bone graft material.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.504-510
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• 2007

Purpose: The purpose of this study was to determine the incidence of antral septa and the accuracy of panoramic radiograph in identifying maxillary sinus septa. In addition, when panoramic radiograph led to a false diagnosis of more than majority, we analyzed findings of the panoramic radiograph. Patients and methods: This study included 180 patients who were radiographically examined before the surgery was done using both panoramic and computerized tomographic radiographs(CT scan), Samsung Medical Center from April 2003 to March 2006, and examined the incidence of antral septa, the false diagnosis rate of panoramic radiograph, and radiographic characters in case of false diagnosis. Only those bone lamellae were considered as septa that showed a height of at least 3.0mm. It was thus possible to exclude the alveolar recess. One oral and maxillofacial surgeon(OMFS) determined the presence or absence of sinus septa in CT scan, and five OMFS determined the presence or absence of sinus septa in panoramic radiograph. Results: The septa were observed in 81 of 360 sinuses(22.5%). All septa were oriented in a buccopalatal plane. More or less greater prevalence was observed in the second molar region(38.2%) but no predominant location was found. Panoramic radiograph led to false diagnosed septa in 361 of 1800 cases(20.1%). In case of false diagnosis of more than majority, superimposed image on zygomatic process was 44.1%, faint image in the region not related to sinus lifting 26.5%, faint image in the region related to sinus lifting 17.6%, and misconception for superimposed image 11.8% Conclusion: In this study we could get clinico-anatomical information of septum in the maxillary sinus. Compared to CT scan, panoramic radiograph can not clearly differentiate the sinus septa, but we consider that panoramic radiograph may improve its usefulness if we take additional modified panoramic radiograph and clinical exam.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.485-493
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• 2007

Purpose: Heart rate variability(HRV) is the clinical consequence of various influences of the autonomic nervous system(ANS) on heart beat. HRV can estimate the potential physiologic rhythm from the interval between consecutive beats(RR interval or HRV data). It is known as RSA which represents respiration-related HR rhythmic oscillation. Previous studies demonstrated a specific breathing pattern(0.1Hz, 6breaths/min) to improve a physiological body condition related to the stress. In this paper, the level of stress would be evaluated in terms of three phases of the dental treatment, combined with 6breaths/min. Methods: These phases include before, during and after tooth extraction or anesthesia or something.36 patients' stresses were assessed using HRV stress analyzer in each phase in Kangdong Sacred Heart Hospital, and Chuncheon Sacred Heart Hospital, Hallym University Medical Center from Jun. to Sept. of 2007. HRV 5-min data collected were analyzed in time-domain and frequency-domain to evaluate the activity of autonomic nervous system(ANS) which represents the level of stress. Results: All HRV parameters including HF(high frequency), LF(low frequency) and LF/HF ratio showned a significant change affecting the ANS balance. There was a 6.4% difference between R(LF/HF)s on general breathing pattern for balance of Autonomic nervous system, but on controlled breathing pattern, 0.1Hz, was made narrow till 1.4%. The activity of ANS has increased by 1.4% on general breathing pattern, and by 2.9% on controlled breathing pattern, 0.1Hz. Conclusion: After analysis of preoperative stress changes and effect of breathing pattern of 0.1 Hz on the stress in 36 patients who have undergone third molar extraction, following was concluded. In the preoperative stage, the sympathetic change was the greatest?after the?anesthetic injection, and stress was relieved by controlling the breathing pattern to a frequency of 0.1Hz.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.4
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• pp.405-411
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• 2008

Purpose : Cyclosporine A (CsA) is a versatile immunosuppresive agent used to prevent graft rejection syndrome and treat autoimmune disease. One of the major side effects associated with CsA is the abnormal gingival hyperplasia. The purpose of this study was to investigate the relationship between the mRNA expression of the MMP-1, TIMP-1, and $TGF-{\beta}_1$ and the concentration of CsA in cultured human gingival keratinocytes. Materials & Methods : Gingival keratocytes were obtained from gingival tissues of 4 healthy donors. The cultured gingival keratocytes were incubated with increasing concentrations of CsA (0-2000 ng/ml) for 24 hours and the expression of MMP-1, TIMP-1, and $TGF-{\beta}_1$ were determined by reverse transcription-polymerase chain reaction (RT-PCR). Results : The expressions of MMP-1 and $TGF-{\beta}_1$ were not significantly different according to the concentrations of CsA. The expression of TIMP-1 was significantly increased at the CsA concentration of 500 ng/ml. Conclusion : We concluded that the gingival hyperplasia induced by CsA was more related with TIMP-1 than MMP-1 or $TGF-{\beta}_1$ on gingival collagen metabolism in patients treated with CsA.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.4
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• pp.419-427
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• 2008

The present study aimed to investigate the osteogenic potentials of differentiated osteoblast-like cells (DOCs) induced from bone marrow-derived mesenchymal stem cells (MSCs) on ${\beta}-tricalcium$ phosphate (${\beta}-TCP$) with recombinant human bone morphogenetic protein (rhBMP-2) in vitro. Osteoblast differentiation was induced in confluent cultures by adding 100 nM dexamethasone, 10 mM ${\beta}$-glycerophosphate, 50 mM L-ascorbic acid. The Alizarin red S staining and reverse transcriptase-polymerase chain reaction (RT-PCR) were perfomed to examine the mRNA expression of alkaline phosphatase (ALP), bone sialoprotein (BSP), osteocalcin (OCN), receptor activator for nuclear factor ${\kappa}B$ ligand (RANKL), runt-related transcription factor 2 (RUNX2), collagen-Ⅰ (COL-Ⅰ). There were no significant differences in the osteogenic potentials of DOCs induced from MSCs on ${\beta}-TCP(+/-)$. According to the incubation period, there were significant increasing of Alizadin red S staining in the induction 3 weeks. The mRNA expression of ALP, RUNX2, and RANKL were higher in DOCs/${\beta}-TCP(-)$ than DOCs/${\beta}-TCP(+)$. According to rhBMP-2 concentrations, the mRNA expression of BSP was significantly increased in DOCs/${\beta}-TCP(+)$ compared to that of DOCs/${\beta}-TCP(-)$ on rhBMP 10 ng/ml. Our study presented the ${\beta}-TCP$ will have the possibility that calcium phosphate directly affect the osteoblastic differentiation of the bone marrowderived MSCs.