• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.30 no.2
• /
• pp.53-58
• /
• 2021

The attractiveness of the gingiva is determined by its color, shape, and the shape and location of the boundary between the teeth and the gingival tissue. The standards beauty, balance, and health of the gingiva are all different, but the general public would agree that a coral pink gingiva is more beautiful than black or brown gingiva. Hence, one would be able to smile more confidently in public if he or she receives a gingival pigmentation removal surgery that changes the color of black or brown gums to a beautiful pink color with relative simplicity. The color of one's gingiva varies from pale pink to deep bluish purple, depending on many health components. The most prominent among these include the vascular supply, epithelial thickness, the degree of keratinization, and the presence of pigment in the epithelium. Melanin, carotene, reduced hemoglobulin, and oxyhemoglobulin are the main pigments contributing to the normal color of the oral mucosa. The health of one's gingival tissue are essential for an attractive smile. Excessive melanin deposits in the basal and early basal layers of the epithelium stored in the form of melanosomes frequently cause pigmentation. Although there are many different procedures to remove this pigmentation, the it was removed using the Er;YSGG laser. It is my wish that, through this case study, many people

• Radiation Oncology Journal
• /
• v.27 no.3
• /
• pp.120-125
• /
• 2009

Purpose: We wanted to present the preliminary results of intensity-modulated radiotherapy (IMRT) for the treatment of tonsillar cancer. Materials and Methods: We retrospectively analyzed 12 patients who underwent IMRT for tonsillar cancer at Asan Medical Center between November 2002 and February 2007. Seven patients (58%) received definitive treatment, and five (42%) were treated in the postoperative setting. Among the definitively treated patients, 6 patients received cisplatin-based chemotherapy regimens. Simultaneous modulated accelerated radiation therapy (SMART) was used in nine patients. The prescribed dose was 72 Gy at 2.4 Gy/fraction for the definitively treated cases and 61.6 Gy at 2.2 Gy/fraction for the postoperative cases. The median follow-up period was 34 months. Results: All twelve patients completed treatment without interruption, and eleven showed a complete response. One patient had persistent loco-regional disease after treatment. The three-year estimates of loco-regional control, disease-free survival and overall survival were 91.7%, 91.7%, and 100%. The worst acute mucositis was Grade 1 in four patients, Grade 2 in five patients, Grade 3 in two patients and Grade 4 in one patient. Grade 3 xerostomia was observed in six patients. Conclusion: Intensity-modulated radiotherapy was shown to be a safe and effective treatment modality for tonsillar cancer. Further studies with a larger number of patients and a longer follow-up period are needed to evaluate the ultimate tumor control and late toxicity of IMRT for treating tonsillar cancer.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.3
• /
• pp.226-237
• /
• 2005

Purpose : Extensive defect of oral and maxillofacial area is usually reconstructed with composite flap including skin paddle. However, if the defects are lined with only skin components, the mucosa's role in mastication and texture are not restored. Furthermore, stiffness and hair-growing prevent denture rehabilitation and good oral hygiene. This study was performed to overcome the disadvantages of composite soft tissue flaps including the skin and to make a model for myo-mucosal flaps. Materials and methods : Buccal mucosa sized $0.5\times1.0\;cm^2$ from New Zealand rabbit (around 1.5kg) was harvested and cultivated by the modification of Rheinwald and Green's keratinocyte culture method. Cultured mucosa was grafted on the fascia of latismus dorsi as form of mucosal sheet. After 7, 10, 14 days, the myomucosal flap was excised and evaluated under light microscope with H & E and immunohistochemical staining. As control group, harvested buccal mucosa from rabbit was transplanted to gracilis muscle(n=6). Results : From 7 days after prelamination, the basal layer of the grafted mucosa resembled that of normal mucosa. As control group, transplanted mucosa had original shape but there's slight inflammatory reaction. Prelaminated mucosa has 19.8$\pm$4.59 cell layers and some samples have more than 20 layers. The expression rate of PCNA was relatively strong (42.9%$\pm$14.1) at the basal layer of grafted mucosa and the laminin was found at the basal layer. On the contrary, prelaminated mucosa at 10 days showed moderate expression rate of PCNA(32.4%$\pm$4.62). We found the mucosal layer was somehow disappeared and there is strong inflammatory reaction. After 14 days prelamination, the grafted oral keratinocytes were almost disappeared and expression of PCNA was not observed. Conclusion : We can make 75 fold large mucosal($3850mm^2$) sheet from small samples of mucosa $(50mm^2)$. Epithelial sheet that grafted on the fascia of muscle underwent differentiation and proliferation. But after 10, 14 days, there was strong inflammatory reaction and the grafted mucosa was destroyed from surface layer. In rabbit model, transfer of fascio-mucosal flap should be done from 7 to 10 days after prelamination.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.6
• /
• pp.644-651
• /
• 2000

In cases of severe alveolar bony resorption in the edentulous posterior maxillae, implant placement is limited anatomically due to maxillary sinus. If the ridge is atrophic, the various bone grafting methods are required for the ridge augmentation. But the result of the onlay grafting procedure is not always promising. On the posterior maxilla, maxillary sinus mucosa lifting and bone grafting into the sinus floor, subantral augmentation(SA) technique are recommended. Various SA procedures have been developed for implant installation. We perfer to simultaneous block bone graft and implant installation through the residual alveolar ridge into the grafted block bone to fix the grafted bone and to gain the primary stability of the installed fixture. When a sagittal skeletal discrepancy in present due to the severe alveolar bony resorption of the maxilla, the advancement of the maxilla by Le Fort I osteotomy simultaneously with installation of implant fixtures combined with sinus lifting and interpositional bone graft procedure can be indicated. We applied various SA techniques for implant installtion to the 46 edentulous posterior maxillae, and total 154 implants were installed at our department from 1992 to 1999. Various SA techniques were classified in detail and the indications of each techniques were discussed. The changes of residual bony height following SA procedure were studied. The results were as follows. 1. The SA procedure combined with bone graft and simultaneous fixture installation were performed in 41 cases, 126 fixtures were installed and 5 fixtures were removed out of them. Le Fort I osteotomy procedure combined with sinus lifting and interpositional bone graft simultaneous with fixture installation were performed in 5 cases. Total 28 fixtures were installed and 2 fixtures were removed so far. 2. Autogenous block bone graft into sinus floor were performed in 35 cases, autogenous particulated marrow cancellous bone(PMCB) graft in 9 cases, and demineralized human bone powder in 2 cases. The donor site for bone graft were anterior iliac bone in 39 cases, posterior iliac bone in 3 cases and mandibular symphysis in 1 case and mandibular ramus in 1 case. 3. In 9 cases with which SA procedure had been performed with the block bone graft, the change of pre- and postoperative residual bony height were measured using MPR(multiplanar reformatted)-CT. The mean residual bony height was 8.0mm preoperatively, 20.2mm at 6 months following up operation and we gained average 12.2mm alveolar bony height. So, we can recommend this one-stage subantral augmentation and fixture installation technique as a time conserving, safe and useful method for compromised posterior edentulous maxilla.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.26 no.1
• /
• pp.1-12
• /
• 2010

The purpose of this study was to compare the strain on the alveolar ridge in the centric, eccentric and protrusive position according to the occlusal scheme (bilateral balanced occlusion with 33 degree anatomical teeth, group B; monoplane occlusion with non-anatomical teeth, group M; lingualized occlusion with 33 degree anatomical teeth and non-anatomical teeth, group L; of complete dentures. Experimental dentures were set bilateral balanced occlusion, lingualized occlusion and monoplane occlusion. They are analysed through T-Scan II(Tekscan, Boston, U.S.A) and 1.5mm thick layer was removed from the denture-supporting surface of resin model and then replaced with silicone to simulate resilient edentulous ridge mucosa. A $4{\times}6$ linear strain gauge is attached to the $1^{st}$ premolar and $1^{st}$ molar area. The strain values are recorded according to the occlusal scheme in the centric, eccentric and protrusive position after uniformly applying 50 N and 150 N force through a Universal Testing Machine(instron$^{(R)}$ 5567, Bluehill 2.0 software ,U.S.A.) with the models mounted in the articulator. When performing centric and protrusive occlusion, the three groups of occlusal scheme were compared in the anterior region and in the posterior region. The strains of each group were also compared in the working side and in the non-working side during eccentric excursion. It was observed that the strain in the bilateral balanced occlusion showed a higher value than the lingualized occlusion and monoplane occlusion in every position except the non-working side. However, during the eccentric movement the strain value in the non-working side showed the lowest value in the bilaterally balanced occlusion. The strain change amount from the working side or centric occlusion to non-working side and also the strain variation rate within the non-working side showed the highest value in bilateral balanced occlusion.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.25 no.4
• /
• pp.375-390
• /
• 2009

Statement of problem: Implant supported overdenture is accepted widely as a way to restore edentulous ridge providing better retention and support of dentures. Various types of attachment for overdenture have been developed. Purpose: The purpose of this study was to investigate the influence of attachment type in implant overdentures on the biomechanical stress distribution in the surrounding bone, prosthesis and interface between implant and bone. Material and methods: Finite element analysis method was used. Average CT image of mandibular body(Digital $Korea^{(R)}$, KISTI, Korea) was used to produce a mandibular model. Overdentures were placed instead of mandibular teeth and 2mm of mucosa was inserted between the overdenture and mandible. Two implants($USII^{(R)}$, Osstem, Korea) were placed at both cuspid area and 4 types of overdenture were fabricated ; ball and socket, Locator, magnet and bar type. Load was applied on the from second premolar to second molar tooth area. 6 times of finite element analyses were performed according to the direction of the force $90^{\circ}$, $45^{\circ}$, $0^{\circ}$ and unilateral or bilateral force applied. The stress at interface between implants and bone, and prosthesis and the bone around implants ware compared using von Mises stress. The results were explained with color coded graphs based on the equivalent stress to distinguish the force distribution pattern and the site of maximum stress concentration. Results: Unilateral loading showed that connection area between implant fixture and bar generated maximum stress in bar type overdentures. Bar type produced 100 Mpa which means the most among 4 types of attachments. Bilateral loading, however, showed that bar type was more stable than other implants(magnet, ball and socket). 26 Mpa of bar type was about a half of other types on overdenture under $90^{\circ}$ bilateral loading. Conclusions: In any directions of stress, bar type was proved to be the most vulnerable type in both implants and overdentures. Interface stress did not show any significant difference in stress distribution pattern.

• Journal of Life Science
• /
• v.27 no.5
• /
• pp.575-578
• /
• 2017

Here we describe the histological lesion of a viral fibro-papilloma in a hedgehog. After surgical removal from maxilla, the solitary swollen mass was round to oval, yellowish with rough surface and measuring $6{\times}3{\times}2mm$ approximately. The tumor mass was submitted to the laboratory of pathology, college of veterinary medicine, Kyungpook National University for pathological diagnosis. Pathological examination of the tumor was established, the tumor was described grossly and sample was trimmed, sectioned and routinely prepared for histopathological evaluation. The tumor mass was diagnosed as viral fibro-papilloma, as the histological picture showed characteristic features of warts caused by papillomaviruses. The tumor characterized by thickening of the stratum spinosum (acanthosis) and basale, koilocytosis, intra-nuclear inclusion bodies in keratinocytes and fibrosis of submucosa. Further, viral inclusion bodies were demonstrated by Machiavello stain giving red color to the nuclei. No lymphocytes that responsible for regression of the wart could be detected, suggesting the poor possibility of spontaneous regression of the tumor. Papillomatosis is a disease of young animals, but in our case the infected Hedgehog was 5 years old, that maybe due to an impaired immune system, which is also shown by absence of lymphocytes. To the best knowledge of the author, this case presents the first report of viral fibropapillomatosis in Hedgehog.

• The Journal of Korean Academy of Prosthodontics
• /
• v.47 no.2
• /
• pp.232-239
• /
• 2009

Statements of the problem: Many denture wearers occasionally use denture adhesives to improve denture retention, stability and chewing efficiency. An ideal denture adhesive is nontoxic, non-irritating, and provides comfort to the oral mucosa. Purpose: The purpose of this study was to evaluate the cytotoxicity and adhesive properties of a selected denture adhesive. Material and methods: To test cytotoxicity of the selected denture adhesive, mouse fibroblast cells were used in MTT testing. Cytotoxicity was examined according to the concentration of the denture adhesive and incubated for 1 to 4 days. To examine adhesive property, a denture base was fabricated on an edentulous dentiform. The adhesive was applied to the denture base, then tensile bond strength was measured, to evaluate the change in retention during 3 days. Results and Conclusion: 1. 1% and 2% concentration denture adhesive cream had no cytotoxicity. 2. The tensile bond strength of the group with both denture adhesive and artificial saliva was significantly higher than that of the group with only denture adhesive(P<.05). The tensile bond strength of the group with denture adhesive was significantly higher than that of with only artificial saliva(P<.05). 3. The tensile bond strength had no significant change during 1 hour, and then gradually decreased. After 1 day, it decrease to half. Within the limitation of this study, the tested denture adhesive had no cytotoxicilty and was effective in improving denture retention. The adhesive strength began to continuously decrease after 1 hour and it decreased to half at 1 day after application.

• Radiation Oncology Journal
• /
• v.24 no.1
• /
• pp.1-10
• /
• 2006

Puroose: To present preliminary results of intensity-modulated radiotherapy (IMRT) using the simultaneous modulated accelerated radiation therapy (SMART) boost technique in patients with nasopharyngeal carcinoma (NPC). Materials and Methods: Twenty patients who underwent IMRT for non-metastatic NPC at the Asan Medical Center between September 2001 and December 2003 were prospectively evaluated. IMRT was delivered using the 'step and shoot' SMART technique at prescribed doses of 72 Gy (2.4 Gy/day) to the gross tumor volume (GTV), 60 Gy (2 Gy/day) to the clinical target volume (CTV) and metastatic nodal station, and 46 Gy (2 Gy/day) to the clinically negative neck region. Eighteen patients also received concurrent chemotherapy using cisplatin once per week. Results: The median follow-up period was 27 months. Nineteen patients completed the treatment without interruption; the remaining patient interrupted treatment for 2 weeks owing to severe pharyngitis and malnutrition. Five patients (25%) had RTOG grade 3 mucositis, whereas nine (45%) had grade 3 pharyngitis. Seven patients (35%) lost more than 10% of their pretreatment weight, whereas 11 (55%) required intravenous fluids and/or tube feeding. There was no grade 3 or 4 chronic xerostomia. All patients showed complete response. Two patients had distant metastases and loco-regional recurrence, respectively. Conclusion: IMRT using the SMART boost technique allows parotid sparing, as shown clinically and by dosimetry, and may also be more effective biologically. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and late toxicity.

• Radiation Oncology Journal
• /
• v.13 no.3
• /
• pp.277-283
• /
• 1995

Purpose : This study was performed to measure dose alteration at the air-tissue interface resulting from rebuild-up to the loss of charged particle equilibrium in the tissues around the air-tissue interfaces. Materials and Methods : The 6 and 10-MV photon beam in dual energy linear accelerator were used to measure the surface dose at the air-tissue interface The polystyrene phantom sized $25{\times}25{\times}5\;cm^3$ and a water phantom sized $29{\times}29{\times}48\;cm^3$ which incorporates a parallel-plate ionization chamber in the distal side of air gap were used in this study. The treatment field sizes were $5{\times}5\;cm^2,\;10{\times}10\;cm^2\;and\;20{\times}20\;cm^2$. Air cavity thickness was variable from 10 mm to 50 mm. The observed-expected ratio (OER) was defined as the ratio of dose measured at the distal junction that is air-tissue interface to the dose measured at the same point in a homogeneous phantom. Results : In this experiment, the result of OER was close or slightly over than 1.0 for the large field size but much less (about 0.565) than 1.0 for the small field size in both photon energy. The factors to affect the dose distribution at the air-tissue interface were the field size, the thickness of air cavity. and the photon energy. Conclusion : Thus, the radiation oncologist should take into account dose reduction at the air-tissue interface when planning the head and neck cancer especially pharynx and laryngeal lesions, because the dose can be less nearly $29{\%}$ than predicted value.