Cleft lip and/or palate (CLP) is one of the most common congenital craniofacial anomalies and occurs more frequently in Asian people. Dental abnormalities in number, size, shape, and eruption of teeth are frequently associated with CLP. The purposes of this study were to investigate the effects of CLP on number, size, shape and eruption of teeth and to provide basic clinical data for diagnosis and treatment of the CLP patients. With the orthodontic and cleft charts, diagnostic models, orthopantomograms and intraoral x-ray films from 241 CLP patients who visited Dept. of Orthodontics, Seoul National University Dental Hospital, we evaluated the frequency of congenital missing teeth, supernumerary teeth, Impacted teeth, and microdontia. The results were as fellows ; 1. Frequency of congenital missing was relatively high up to $56.8\%$. Congenital missing occurred frequently in the maxillary lateral incisor and the maxillary second premolar. Among the CLP types, frequencies of congenital missing in cleft lip and Palate group and cleft lip and alveolus group were higher than those of cleft lip group and cleft palate group. And bilateral cleft showed higher frequencies than unilateral ones. 2. Supernumerary tooth was shown in $11.2\%$ of CLP patients. It occurred frequently in the area between the maxillary lateral Incisors and the maxillary canine. Among the CLP types, cleft lip group showed relatively most highest frequency. 3. Impaction was shown in $18.3\%$ of CLP patients. It occurred most frequently In the maxillary lateral incisor and the maxillary canine than other teeth. Among the CLP types, cleft lip group and cleft lip and palate group showed most highest frequencies. 4. Microdontia was shown in $15.8\%$ of CLP patients. It occurred the most frequently In the maxillary lateral incisors and maxillary canines. Among the CLP types, cleft lip and alveolus group and cleft lip and palate group showed relatively higher frequencies. There was no microdontia in cleft palate group.
Most patients suffering from TMD appear to have unsatisfactory masticatory function and compromised values of bite force. The purposes of this study were to investigate and compare bite force between affected and unaffected sides of patients with unilateral TMD and to evaluate its relation with duration of TMD. 42 patients with unilateral TMD, from Department of Oral Medicine, Dankook University Dental Hospital, were selected for this study. The ratio of men to women was 9:33 and their mean age of $27.2{\pm}10.4$ years. The bite forces were measured over both canines (for anterior bite force) and $1^{st}$ molars (for posterior bite force) using a bite force recorder while all the subjects were asked to clench successively for 3 seconds not until pain was felt. They were compared with those measured from bilateral TMD patients(N=6, M:F=1:5, mean age: $23.0{\pm}27.3$ years). The unilateral TMD patients were divided into time groups according to duration of TMD on the basis of 1 and 6 months, respectively. Paired and unpaired t-tests were used for statistical analysis. Unilateral TMD patients in this study showed that the affected sides had significantly lower bite force than the unaffected sides(force difference of about 7-8 kgf, p<0.05) while there was no significant sides difference in the bilateral patients. Nor did bite force on the affected sides reveal significant difference between unilateral and bilateral TMD patients. With regards to TMD duration, there was significant difference between the patients with TMD < 6 months and $\geq$ 6 months (p<0.05) while no significant difference existed between < 1 month and $\geq$ 1 month. The results of this study indicated that unilateral TMD patients can exhibit more reduced bite force on the affected sides compared with that on the unaffected sides and that bite force on the unaffected sides might be deteriorated more as longer did TMD last.
This investigation examined the effect of lateral shift of mandible from functional occlusal interference on the growth of mandible and the growth pattern of mandible shown after the removal of occlusal interference. The followings were performed with the results below : the changes in mandible and condylar cartilage were studied in the experimental group with upper right, lower left incisors cut for 2 and 4 weeks- an 4-week-old rats and the experimental group which had cut for 4 weeks and suspended for 2 weeks. 1. In the 2-week experimental group, the left mandibular length, condylar length, mandibular height and condylar area seemed smaller than those on the right and the normal group ; the right mandibular length and condylar area were smaller than the normal group. 2. In the 4-week experimental group, left condylar area was smaller than the right, but due to the quick changes in adaptability of left mandible, right and left mandibular lengths were similar. compared with the normal group, however, mandibular length and condylar area still remained small. 3. In the 6-week experimental group, the left and the right appeared similar with the mandibular length remaining still shorter than the normal group. 4. In the sagittal plane, the proliferation of the cartilage layers of the left condylar cartilage of the 2-week group appeared to have general repression compared with the right and the normal group. The right side also showed repressed growth compared with the normal group. In the 4 and 6-week groups, however, it was similar to the normal group. 5. In condylar cartilage volume, no significant difference was noted in the comparisions of left and right of the experimental group, nor in the comparison of the same sides of experimental wand normal groups. Based on the above, in case of contralateral incisal cutting in rats, it was observed that the growth of mandible and condyle of the cutting side was repressed, at the same time, the quick adaptability led to similar changes of growth in left and right mandibles. But judging from the similar phenomena throughout the whole experimental period in the changes of condylar cartilage volume in the experimental, right and left, and normal groups, the general overall growth of condylar cartilage was found unrepressed. It was also recognized that the growth of condylar cartilage can take in various directions.
This study was designed to confirm the association between the pain of Tension-Type Headache(TTH) patients and their Oral Parafunction(OPF). Patients with TTH(n=58) visited the Department of Oral Medicine, Kyung Hee University Dental Hospital during two months were recruited to this study. 20 patients with OPF(bruxism, clenching, bruxism & clenching) are the experimental group and 38 patients without OPF are the control group. Both groups were asked to answer the questionnaire based on the diagnostic criteria of TTH(IHS). Then it was analyzed statistically. This study was designed to confirm the association between the pain of Tension-Type Headache(TTH) patients and their Oral Parafunction(OPF). Patients with TTH(n=58) visited the Department of Oral Medicine, Kyung Hee University Dental Hospital during two months were recruited to this study. 20 patients with OPF(bruxism, clenching, bruxism & clenching) are the experimental group and 38 patients without OPF are the control group. Both groups were asked to answer the questionnaire based on the diagnostic criteria of TTH(IHS). Then it was analyzed statistically. 1. There was no difference in sex(p=0.91) and age(p=0.73) between two groups. 2. In the experimental group, dull pain was presented more frequently than in the control group. But, there was no difference between two groups(p=0.69). 3. In the experimental group, severe pain was presented more frequently than in the control group. But, there was no difference between two groups(p=0.40). 4. In the experimental group, pain shown bilaterally was presented more frequently than in the control group. But, there was no difference between two groups(p=0.52). 5. In the experimental group, pain was more increased by physical activities than in the control group. But, there was no difference between both groups(p=0.74). The pain of TTH patients with OPF was presented to be non-dull pain frequently and more bilaterally and severely, also increased more by physical activities than the pain of TTH patients without OPF. But, there was no significant difference between two groups. Therefore, it is considered that the pain of TTH is not influenced by OPF.
Kim, Yoon-Tae;Jeon, Seung-Ho;Yeom, Hak-Ryol;Kang, Jin-Han;Ahn, Kang-Min;Kim, Sung-Min;Jahng, Jeong-Won;Park, Kyung-Pyo;Lee, Jong-Ho
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.31
no.6
/
pp.515-525
/
2005
Purpose of study: Lingual nerve damage can be caused by surgery or trauma such as physical irriatation, radiation, chemotherapy, infection and viral infection. Once nerve damage occurred, patients sometimes complain taste change and loss of taste along with serious disturbance of tongue. The purpose of this study was to evaluate the effects of unilateral lingual nerve transection on taste as well as on the maintenance of taste buds. Materials & Methods: Male Sprague-Dawley rats weighing 220-250g received unilateral transection of lingual nerve, subjected to the preference test for various taste solutions (0.1M NaCl, 0.1M sucrose, 0.01M QHCl, or 0.01M HCl) with two bottle test paradigm at 2, 4, 6, or 8 weeks after the operation. Tongue was fixed with 8% paraformaldehyde. After fixation, they were observed with scanning electron microscope(JSM-$840A^{(R)}$, JEOL, JAPAN) and counted the number of the dorsal surface of the fungiform papilla for changes of fungiform papilla. And, Fungiform papilla were obtained from coronal sections of the anterior tongue(cryosection). After cryosection, immunostaining with $G{\alpha}gust$(I-20)(Santa Cruz Biotechnology, USA), $PLC{\beta}2$(Q-15)(Santa Cruz Biotechnology, USA), and $T_1R_1$(Alpha Diagnostic International, USA) were done. Immunofluorescence of labeled taste bud cells was examined by confocal microscopy(F92-$300^{(R)}$, Olympus, JAPAN). Results: The preference score for salty and sweet tended to be higher in the operated rats with statistical significance, compared to the sham rats. Fungiform papilla counting were decreased after lingual nerve transaction. In 2 weeks, maximum differences occurred. Gustducin and $T_1R_1$ expressions of taste receptor in 2 and 4 weeks were decreased. $PLC{\beta}2$ were not expressed in both experimental and control group. Conclusion: This study demonstrated that the taste recognition for sweet and salty taste changed by week 2 and 4 after unilateral lingual nerve transection. However, regeneration related taste was occurred in the presence of preserving mesoneurial tissue and the time was 6 weeks. Our results demonstrated that unilateral lingual nerve damage caused morphological and numerical change of fungiform papilla. It should be noted in our study that lingual nerve transection resulted in not only morphological and numerical change but also functional change of fungiform papillae.
This study investigated the clinical effectiveness and safety of sealed bleaching compared to conventional in-office bleaching using a randomized clinical trial of split arch design. Ten participants received a chairside bleaching treatment on the upper anterior teeth, and each side was randomly designated as sealed or control side. A mixture of Brite powder (PacDent, Walnut, USA), 3% hydrogen peroxide and carbamide peroxide (KoolWhite, PacDent, Walnut, USA) were used as bleaching agent. The control side was unwrapped and the experimental side was covered with a linear low density polyethylene (LLDPE) wrap for sealed bleaching. The bleaching gel was light activated for 1 hour. The tooth shades were evaluated before treatment, after treatment, and at one week check up by means of a visual shade (VS) assessment using a value oriented shade guide and a computer assisted shade assessment using a spectrophotometer (SP). The data were analyzed by paired t-test. In the control and sealed groups, the visual shade scores after bleaching treatment and at check up showed statistically significant difference from the preoperative shade scores (p<.05). The shade scores of the sealed group were significantly lighter than the control immediately after bleaching and at the check-up appointment (p<0.05). Compared to prebleaching status, the ${\Delta}E$ values at post bleaching condition were $4.35{\pm}1.38\;and\;5.08{\pm}1.34$ for the control and sealed groups, respectively. The ${\Delta}E$ values at check up were $3.73{\pm}1.95\;and\;4.38{\pm}2.08$ for the control and sealed groups. ${\Delta}E$ values were greater for the sealed group both after bleaching (p<.05) and at check up (p<.05). In conclusion, both ${\Delta}E$ and shade score changes were greater for the sealed bleaching group than the conventional bleaching group, effectively demonstrating the improvement of effectiveness through sealing.
Background: Pulmonary atresia (PA) with ventricular septal defect has various morphology of pulmonary arteries and pulmonary blood flow sources, so pulmonary arterial hypoplasia and arborization abnormality make this anomaly difficult to manage surgically. In cases associated with juxtaductal stenosis, we evaluated the change of the pulmonary arterial and juxtaductal stenotic site after shunt operations, and would like to find useful information in surgical planning and methodology of these patients. Material and Method: Among 59 cases diagnosed as PA with ventricular septal defect associated with juxtaductal stenosis, 29 cases who had cardiac catheterization before and after shunt operation were selected from July, 1991 to July, 1996. In 10 cases of right shunt operation(Group I) and 19 cases of left shunt operation (Group II), the diameters of the descending aorta, both pulmonary arteries, and the juxtaductal stenosis site were measured before and after the shunt operation. Result: In both Group I and II, the pre- and postoperative ratio of diameters of the ipsilateral pulmonary artery to the descending aorta was from 0.78${\pm}$0.31 units to 1.01${\pm}$0.26 units and from 0.67${\pm}$0.18 units to 0.84${\pm}$0.27 units respectively, showing a signigicant increase. The contralateral pulmonary artery index was increased from 0.92${\pm}$0.28 units to 1.05${\pm}$0.15 units and from 0.94${\pm}$0.27 units to 1.08${\pm}$0.37 units respectively, but could not be confirmed statistically. In both groups, the change of juxtaductal stenosis showed an aggravating tendency but of no statistical significance from 0.43${\pm}$0.27 units to 0.39${\pm}$0.25 units and from 0.32${\pm}$0.10 units to 0.30${\pm}$0.16 units respectively, and we experienced 2 total obstruction in Group II. Because the increased pulmonary blood flow by shunt operation has a favorable effect to the pulmonary arterial growth, the shunt operation is a recommended treatment in patients with hypoplastic pulmonary arteries. But in PA with ventricular septal defects, the change of juxtaductal stenosis is very important. In conclusion, the growth of ipsilateral (shunt site) pulmonary artery was promoted by shunt operation, but there is a tendency for the juxtaductal stenosis to be aggravated. And we experienced 2 total obstruction in Group II. Conclusion: Thus, in cases operated with shunt method, much careful postoperative follow up study including angiographic evaluation is needed, and after the shunt operation on the side of pulmonary artery associated with juxtaductal stenosis, early precise planning for total correction is recommended.
Background: Atrial fibrillation is one of the most prevalent of all arrhythmias and in up to 79% of the patients with mitral valve disease. This study examined whether the atrial fibrillation that occur in patients with mitral valve operation could be eliminated by a concommitant maze operation without cryoablation. Material and Method: From May 1997 to April 1998, 14 patients with atrial fibrillation associated with mitral valve disease underwent Maze III operation without cryoablation. Preoperatively there were 6 men and 8 women with an average age of 46.2${\pm}$10.7 years. Eleven patients had mitral stenosis, and three had mitral insufficiency. The associated heart diseases were aortic valve disease in 4, tricuspid valve regurgitation in 1 and ASD in 2. Using transthoracic echocardiography, the mean left atrial diameters was 54.7${\pm}$5.3 mm and thrombi were found in the left atrium of 2 patients. Postoperatively the ratio between the peak speed of the early filling wave and that of the atrial contraction wave (A/E ratio) was determined from transmitral flow measurement. Operations were mitral valve replacement in 13 including 4 aortic valve replacements, 1 DeVega annuloplasty and 2 ASD closures. Maze III operation was performed in 1 patient. Result: Five patients (38%) had recurred atrial fibrillation, which was reversed with flecainide or amiodarone at the average time of postoperative 38.8${\pm}$23.5 days. Postoperative complications were postoperative transient junctional rhythm in 6, transient atrial fibrillation in 5, reoperation for bleeding in 3, postpericardiotomy syndrome(1), unilateral vocal cord palsy(1), postoperative psychosis(1), and myocardial infarction(1). Postoperatively A/E ratio was 0.43${\pm}$0.22 and A wave found in 9(64%) patients. 3 to 14 months postoperatively (average follow- up, 8.1 months), all of patients had normal sinus rhythm and 9(64%) patients had left atrial contraction and 11(79%) patients were not on a regimen of antiarrhythmic medication. Conclusion: We conclude that Maze III operation without cryoablation is an effective surgical treatment in atrial fibrillation associated with the mitral valve disease.
Purpose: The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. Materials and Methods: From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. Results: The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Conclusion: Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patientsespecially with the risk factor of neck node dissection.
Purpose : Perinatal asphyxia is an important cause of neonatal mortality and subsequent lifelong neurodevelopmental handicaps. Although many treatment strategies have been tested, there is currently no clinically effective treatment to prevent or reduce the harmful effects of hypoxia and ischemia in humans. In the clinical setting, maternal hyperthermia induces adverse effects on the neonatal brain, but recent studies have shown that hyperthermic pretreatment (PT) plays some role in hypoxic-ischemic (HI) injuries of the developing brain. The present study investigated the effect of hyperthermic PT on HI brain injuries in newborn rats. Methods : HI was produced in 7-day-old neonatal rats by unilateral common carotid artery ligation, followed by hypoxia with 8% oxygen at $38^{\circ}C$ for 2 hours. Twenty-four hours before HI, one-half of the pups were exposed to a $40^{\circ}C$ environment for 2 hours. The severity of the brain injury was assessed 7 days after the HI. Results : Hyperthermic PT reduced the gross and histopathologic findings of brain injury from 64.7 to 31.2% (P<0.05). There were no differences in location and severity of injury between the pretreated and control brains. Conclusion : These findings indicate that hyperthermic PT provides neuroprotective benefits on HI in the developing brain. Also, these findings suggest maternal hyperthermia may have protective effect on perinatal HI brain injuries.
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