• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.1
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• pp.46-54
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• 1995

Postoperative infection following orthognatic surgery is rare. When postoperative infections occur, the initial treatment consists of incision and drainage of the affected area, culturing to identify bacterial stains and verify antibiotic sensitivity, and the institution of the appropriate antibiotic regimen. Some plates and screws may eventually require removal, the initial therapy should be attempted to retain the plates and screws until adequete healing has taken place. In orthoganthic surgery, intra-operative complications as a lesion of inferior alveolar nerve, fracture of osteomised segments, incomplete sectioning, malposition of segments, haemorrhage may occur. The surgeon should be familiar with possible complications to be caused and how to manage them. Prevention of postoperative infection following the orthognathic surgery consists of minimal periosteal reflection, aseptic management of operation field, proper surgical technique, rigid fixation, prophylactic antibiotics.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.13 no.1
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• pp.117-126
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• 1983

The mandibular canal must be considered carefully during surgical treatment, especially surgical extraction of the impacted tooth and intraosseous implant because it contains the important inferior alveolar nerve and vessels. The author investigated the curvatUre of the mandibular canal, the positional frequency of mandibular foramen to the occlusal plane and gonial angle and the positional frequency of the mental foramen to the tooth site using orthopantomograms. The materials consisted of 295 orthopantomograms divided into seven groups ranging from the first decade to 6th. decade. The results were as follows: 1. The position of mandibular foramen was most frequently below occlusal plane in Group Ⅰ (78.6%) and Group Ⅱ (71.2%), above occlusal plane in Group Ⅲ (63.0%), Group IV (71.1%), Group V (57.6%), Group (76.7%) and Group VII (70.0%). 2. The curvature of mandibular canal was 142.8° in Group Ⅰ, 142.09° in Group Ⅱ, 139.34° in Group Ⅲ, 141.48° in Group Ⅳ, 138.45° in Group Ⅴ, 140.77° in Group Ⅵ and 143.89° in Group Ⅶ. 3. The gonial angie was 125.82° in Group Ⅰ, 123.18° in Group Ⅱ, 124.06° in Group Ⅲ, 120.45° in Group Ⅳ, 121.12° in Group Ⅴ, 121.63° in Group Ⅵ and 121.24° in Group Ⅶ. 4. The position of the menta] foramen was most frequently below the apex of mandibular first premolar in Group Ⅰ (57.2%), between the apex of mandibular first and second premolar in Group Ⅱ (59.6%) and Group Ⅲ (48.9%), and below the apex of mandibular second premolar in Group Ⅳ (39.2%), Group Ⅴ (48.5%) Group Ⅵ(46.6%) and Group Ⅶ(56.4%)

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.4
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• pp.286-290
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• 2010

Various treatment methods for huge cystic lesion of the jaw exist, such as, resection of the involved bone, enucleation and decompression. Among these methods, enucleation after decompression is a conservative technique that decreases the size of the cystic cavity and reduces the risk of intrabony defects, which could be induced by primary enucleation. In addition, it can save the adjacent anatomic structures. In these cases, the decompression combined with partial enucleation, which was performed before complete cyst enucleation was performed on huge cystic lesions of the mandible. During the process, a decrease in the size of the lesion and the growth of normal oral tissues was observed. The size of the lesion decreased until the time of complete enucleation, and surgery could be performed under local anesthesia. No damage to inferior alveolar nerve was observed. We report these cases with a review of the relevant literature.

• Korean Journal of Veterinary Research
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• v.35 no.2
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• pp.369-374
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• 1995

Aujeszky's disease virus(ADV) was inoculated intranasally into the Korean native goats to investigate pathological findings and pathogenesis of ADV infection by using of histological and immunohistochemical methods and in situ hybridization(ISH). Clinical signs of salvation, pyrexia, pruritus and staggering were followed by death with five days after inoculation, Pathoanatomical findings were edema of the lung and the urinary bladder with hemorrhage and congestion, petechial hemorrhages on the endo-and epicardium, renal congestion, moderate splenomegaly and cystic edema. Main microsocpic lesions observed in all infected goats were confined to the CNS and charcterized by perivascular cuffing with lymphocytes and macrophages, focal gliosis, neuronal degeneration and necrosis, and intranuclear inclusion bodies in the neurons and glial cells. Positive reactions to ADV were detected more frequently in the nuclei than in the cytoplasms of infected nerve cells in the CNS by immunohistochemistry and ISH. Frequenctly localized sites of ADV in the CNS were olfactory bulb, prietal cortex, callosal sulcus and corpus callosum. Positive reactions were also detected in the tonsillar epithelium, and alveolar macrophage and sloughed epithelium of the lung.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.10 no.1
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• pp.41-46
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• 1980

The mandibular canal must be considered carefully during the surgical treatment, especially surgical extraction of the impacted tooth and intraosseous implant, because it contains the important inferior alveolar nerve and vessels. The author investigated the curvature of the mandibular canal and its relation to the mandibular molars and positional realtion between the mental foramen and the mandibular premelors in orthopantomogram. The materials consisted of 441 orthopantomograms divided four groups; Group Ⅰ consisted of 56 males and 44 females from 1 to 6 years of age, Group Ⅱ consisted of 58 males and 45 females from 7 to 12 years of age, Group Ⅲ consisted of 65 males and 33 females from 13 to 18 years of age, Group Ⅳ consisted of 86 males and 54 females over 19 years of age. The results were as followings; 1. The curvature of mandibular canal was 144.50° in Group Ⅰ, 144. 29° in Group Ⅱ, 148.11° in Group Ⅲ, 147.33° in Group Ⅳ. 2. The curvature of mandibular canal was located most frequently on the area between mandibular 1st molar and mandibular 2nd molar in Group Ⅰ (42%) and on the mandibular 2nd molar area in Group Ⅱ (54%), Group Ⅲ (59%), Group Ⅳ (53%). 3. The position of mental foramen was most frequently below the mandibular 1st premolar in Group Ⅰ (58%), between the mandibular 1st premolar and the 2nd premolar in Group Ⅱ (62%), Group Ⅲ (47%), and below the mandibular 2nd premolar in Group Ⅳ (58%).

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.584-587
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• 2014

In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.289-291
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• 2013

Moyamoya disease is a rare neurovascular disorder that involves constriction of certain arteries in the brain. In patients with moyamoya disease, it is very important to prevent cerebral ischemic attacks and intracerebral bleeding caused by fluctuating blood pressure and increased respiration. A 40-year-old woman with moyamoya disease was scheduled for extraction of her right upper and lower impacted wisdom teeth. Her lower impacted wisdom tooth was situated close to the inferior alveolar nerve. We decided to continue her oral antiplatelet therapy and planned intravenous sedation with analgesic agents administered approximately five minutes prior to extraction of the root of the mandibular wisdom tooth. Oral analgesic medications were regularly administered postoperatively to alleviate pain and anxiety. During the perioperative period, no cerebrovascular event occurred, and the wisdom teeth were successfully extracted as per the planned procedure. It is thought that the perioperative risks of wisdom tooth extraction in patients with moyamoya disease can be minimized with the use of our protocols.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.167-172
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• 2009

The maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary necrosis can occur due to bacterial infections such as osteomyelitis. viral infections such as herpes zoster and fungal infections such as mucormycosis, aspergillosis etc. Herpes zoster is a common viral infection, the oral soft tissue manifestations of which are widely known and recognized. Extremely rare complications such as osteonecrosis, and secondary osteomyelitis in maxilla were observed. But, reports of spontaneous tooth exfoliation and jaw osteonecrosis following herpes zoster infection in the distribution of the trigeminal nerve are extremely rare in the literature. We report a case of maxillary necrosis by herpes zoster in an uncontrolled diabetic patient. There was extensive necrosis of the buccal and palatal mucoperiosteum and exposure of the alveolar bone. This patient was successfully treated using a removal of necrotic bone and nasolabial flap. We briefly discuss different diseases which can lead to maxillary necrosis and a review. Analysis of the pathogenesis of herpes zoster and bone necrosis are discussed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.4
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• pp.208-212
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• 2015

Keratocystic odontogenic tumor (KCOT) is a common benign tumor of osseous lesions in dental and maxillofacial practice. We describe three cases of large KCOT located in the posterior part of the mandible extending to the angle and ramus region, which were enucleated via sagittal split osteotomy (SSO) of the mandible. There are cases in which a conventional enucleation procedure does not ensure complete excision of the entire lesion without damage to vital structures like the inferior alveolar nerve. In such cases, a SSO approach could be a better choice than conventional methods. The purpose of this article is to describe our experience using unilateral mandibular SSO for removal of a KCOT from the mandible.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.5
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• pp.303-312
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• 2020

Background: Lidocaine is the gold standard local anesthetic (LA) for UK pediatric dental treatment. Recent reports suggest frequent Articaine use in Europe and Canada, with evidence indicating more profound anesthesia. The aim of this study was to examine pediatric dentistry specialist experiences and practices relating to Articaine administration in the UK. Methods: A literature review was followed by a survey using an anonymous 15-item electronic questionnaire, which was sent to 200 registered British Society of Pediatric Dentistry (BSPD) specialists. Descriptive analyses, Z score, chi-squared test, Fisher's exact test, and Spearman's correlation test were performed. Results: Sixty-one (30.5%) participants responded, and 12 (19.7%) indicated Articaine as their first line anesthetic. Articaine was used daily or weekly by 38 (62.3%) respondents, depending on the clinical context. Articaine was commonly used to avoid inferior alveolar nerve blocks and gain more profound anesthesia in abscessed or hypomineralized teeth. Participants reported significantly more adverse effects with lidocaine (Fisher's exact test, P < 0.0001) than with Articaine. Articaine was most often administered in children aged > 4 years via infiltration techniques. Only 15 (24.6%) respondents reported awareness of guidelines for Articaine use in pediatric patients. Conclusions: Articaine use in pediatric dentistry is common; however, evidence supporting its practice is limited. Several specialists follow conventions based on anecdotal evidence. Formulating guidance to aid decision-making when treating pediatric patients under LA would be beneficial.