• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.3
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• pp.394-399
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• 2000

Odontoma is defined as a benign odontogenic tumor containing enmel, dentin as well as cementum. It has come to mean a growth in which both the epithelial and the mesenchymal cells exhibit complete differentiation. Most authorities accept the view today that the odontoma represents a hamartomatous malformation rather than a true neoplasm. The etiology of odontomas is uncertain but hypothesized to involve local trauma, infection, inheritance or mutant gene. The odontomas often cause various disturbances in the eruption and position of the teeth. The steps in removal of an odontoma in close relation to an adjacent impacted normal tooth should comprise 1) removal of odontoma and 2) exposure of the impacted tooth. Orthodontic therapy may be applied. Before treatment, the necessary space for the impacted tooth should be evaluated. If there is lack of space in the dental arch, orthodontic treatment should be carried out before operation.

• Journal of The Korean Dental Society of Anesthesiology
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• v.14 no.1
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• pp.63-71
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• 2014

Extension of advanced odontogenic infection from deep neck fascial spaces into the mediastinum is heralded by chest pain, dyspnea, fever, and radiographic demonstration of mediastinal widening. The critical care should be done in a team approach by multiple medical and dental departments, such as, oral & maxillofacial surgery, otolaryngology, anesthesiology, chest surgery, and infection medicine. Especially, fluid & drug therapy, adequate incision & drainage and systemic supportive psychosedation care are important. But, acute hyperventilation can be produced by several distinct causes: severe anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The orofacial fears about acute pain, trismus, dysphagia, swelling and oral surgical treatment lead to the severe anxiety and increased blood catecholamine level by stress. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the care, hyperventilation was occurred during psychosedation and local anesthesia for incision and drainage of the masticatory fascial space abscess with deep neck infection & mediastinitis. We suggest that the dental patient with advanced odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.3
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• pp.237-241
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• 2006

Infective endocarditis remains an important, life-threatening infection despite improvements in diagnosis and management. Despite the decrease in rheumatic heart disease and the improvements in antibiotic prophylaxis, infective endocarditis has been reported with increasing frequency in the last few decades. Presumably, this is due to the rise in the incidence of intravenous drug users, carriers of prosthetic valves and other intracardiac devices, and the longer survival of patients with congenital heart disease. Despite the great advances in medical and surgical treatment, infective endocarditis is still a life-threatening disease with an estimated mortality of 27%. Infective endocarditis represents one of the few potentially fatal infections that may occur in a dental patient. Efforts to reduce the incidence of this disease usually take the form of appropriate antibiotic coverage before dental treatment, together with the establishment and maintenance of good oral health. This study is a case report of a patient who developed infective endocarditis after multiple tooth extractions due to chronic periodontitis of dental origin.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.4
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• pp.687-692
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• 2005

Delayed eruption of a maxillary incisor results in midline shift, the space occupied by adjacent teeth and different levels of alveolar height. Extraction or surgical/orthodontic therapy is the most common treatment for a impacted maxillary incisor. Surgical repositioning provides another option for treatment of this problem. The advantages of this approach include immediate esthetic improvement, use of a single and simplified surgical procedure, simple and short orthodontic therapy, a normal gingival margin and the possibility of the developing root adapting to the new position. Autotransplantation of an immature tooth provides for possible adaptation of the developing root apex to the new position. A root with an open apex has good chance of pulp revascularization after transplantation.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.3
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• pp.292-306
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• 2023

Antibiotics are used for the prevention and treatment of infections. This study aimed to investigate the patterns of dental antibiotic prescription in children and adolescents. The Health Insurance Review and Assessment Service provided data on patients who visited medical institutions. It was categorized according to year, sex, age, insurance type, dental institution, and region. Chi-square tests, Fisher's exact tests, and one-way analyses of variance were performed. Statistical analyses were performed using SAS software (ver. 9.2; SAS Institute, Cary, NC, USA). Amoxicillin and cephalosporins, the most commonly used antibiotics, accounted for approximately 96% of the prescriptions. The younger the child, the more antibiotics were prescribed for trauma, pulpitis, and dental abscesses. However, closer to adolescence, the antibiotics were primarily prescribed to manage impacted teeth and periodontal problems. Antibiotics were prescribed for 3.13 days on average. There were significant differences in the prescription rates according to age, sex, type of insurance, type of medical institution, and region (p < 0.05). This study suggested that antibiotic prescriptions should be closely monitored to ensure appropriate usage of antibiotics.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.82-88
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• 2008

Background: Descending necrotizing mediastinitis (DNM) is a serious disease originating in odontogenic or oropharyngeal infection with high mortality despite adequate antibiotics and aggressive surgery. We analyzed results of treatment for DNM. Material and Method: We studied 8 cases diagnosed as DNM from 1998 to 2007. All patients received emergent surgical drainage and debridement with broad spectrum antibiotics just after diagnosis. Antibiotics were changed after bacterial susceptibility testing. The surgical approach included 2 cases of cervicotomy, 6 cases of cervicotomy, and a thoracotomy. Result: The interval between symptom onset and hospitalization was $4.6{\pm}1.8$ days ($1{\sim}9$ day). DNM originated in 4 cases of odontogenic infection (50%), 2 cases of oropharyngeal infection (25%), and 2 cases of unknown origin (25%). Causative organisms were found in 6 cases; Streptococcus in 4 cases, Staphylococcus in 1 case, and Klebsiella in 1 case. The Endo DNM classification was type I (2 cases), IIA (3 cases), and IIB (3 cases). The incidence of thoracotomy was 75%. The surgical mortality rate was 25% (2/8). The cause of death was multiple organ failure caused by septic shock. All mortality cases received only cervicotomy and aggravated infections after initial drainage. Conclusion: Early diagnosis, immediate surgical drainage, and adequate antibiotics, including covered anaerobes, are required. Thoracotomy should be performed with cervicotomy even for localized DNM.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.4
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• pp.420-429
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• 2000

Oral & maxillofacial infections are most commonly odontogenic in origin. Although such infections are usually self-limiting, they may occasionally spread deeply into fascial spaces or planes far from the initial site of involvement. If early diagnosis and appropriate therapy is delayed, complications such as mediastinal extension, retropharyngeal spread and airway obstruction could happen to the patients. For the study of the microbiology, we have retrospectively analysed the oral & maxillofacial infected patients in the Dept. of Oral & Maxillofacial Surgery. In-Ha University Hospital from 1997 September to 2000 April. The results were as follows 1. The male patients were more common than female, with male 61.9% and female 38.1%. 2. Dental originated infections were most common cause with the incidence of 62%. 3. Most common fascial space involved was buccal space 42cases(37.2%) followed by submandibular space 13cases(11.5%), infraorbital space 13cases(11.5%), masseteric space 11cases(9.7%), periapical abscess 11cases(9.7%). 4. The causative organisms isolated from the pus culture were Gram Positive Bacterial species, which were 46cases(31.9%) of Streptococcus viridans, 16cases(8.6%) of ${\alpha}$ and ${\beta}-hemolytic$ streptococcus, 4cases(3.1%) of Strep.-group D non enterococci, 7cases(5.1%) of Staphylococcus Coa. neg., 5cases(3.9%) of Staphylococcus aureus, 3cases(2.3%) of Enterococcus faecalis, 1case(0.8%) of Bacillus species, 1case(0.8%) of Peptostreptococcus, 1case(0.8%) of Clostridium and Gram negative bacterial species, which were 4cases(3.1%) of Acinetobacter baumannii, 2cases(1.6%) of Pseudomonas aeruginosa, 2cases(1.6%) of Burkholderia cepacia, 1case(0.8%) of Neisseria species, 1case(0.8%) of Klebsiella pneumoniae, 1case(0.8%) of Klebsiella oxytoca, 1case(0.8%) of Escherichia coli. 5. In drug sensitivity test, high resistant tendency was found in Penicillin system(Penicillin G 83.3%, Ampicillin 60%) and Aminoglycosides (Gentamycin 50%, Tobramycin 45.5%), but tertiary Cephalosporin system(Cefoperazone 9.1%, Ceftazidime 18.2%), and glycopeptides system (Teicoplanin 0%, Vancomycin 0%) showed lower resistancy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.4
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• pp.236-242
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• 2013

Purpose: The objective of this retrospective study is to evaluate the factors affecting the spread of odontogenic infection. Furthermore, this study was performed to apply to future treatments. Methods: A total of 65 patients, who had received treatment for odontogenic infections from 2010 to 2012 for 3 years, were enrolled in this study. The causes of infection, presence of systemic disease, and complications, durations of treatment, treatment methods, and inflammation levels were compared with the data. Results: Patients over 70 years with systemic disease required immediate drainage, systemic antibiotic therapy and hospitalization. We can determine the direction of the early diagnosis and treatment through blood tests (white blood cells, neutrophil, C-reactive protein [CRP]) and computed tomography. Patients over 70 years with systemic disease had the highest percentage. In addition, these patients showed high levels of inflammation index, such as CRP average of 24.8 and needed for a long-term treatment period and a wide range of surgical incision & drainage several times. Systemic diseases, particularly diabetes mellitus and hypertension, accelerate the spread of infection and had a negative effect that delays healing. Eventually, five of the 65 patients showed serious systemic complications. Conclusion: When evaluating cervico-facial infected patients due to odontogenic infection, the most important thing is deciding the appropriate diagnosis and degree of disease. Considering the patient's systemic status and age, we need to decide the treatment plan. Especially, those patients over 70 years with systemic disease should be treated with rapid surgical approach, and the use of a wide range of antibiotics and intensive care. If proper treatment principle does not apply, severe life-threatening complications will result, such as necrotizing fascitis, acute airway obstruction, mediastinitis, and others.