• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.914-921
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• 1997

Hereditary hemorrhagic telangiectasia(Osler-Rendu-Weber Syndrome) is characterized by telangiectasia of the skin and mucous membranes and intermittent bleeding from vascular abnormalities. About 20% of patients with this syndrome have pulmonary arteriovenous fistulas. Pulmonary arteriovenous fistula is uncommon malformation which has an abnormal connection between the pulmonary capillary bed, in which venous blood in the pulmonary artery is shunted through the fistula into the pulmonary vein without exposure to alveolar oxygen and result in unoxygenated, desaturated systemic arterial blood, polycythemia, cyanosis and clubbing. Death often results from cerebral abscess and rupture of the malformation with massive hemorrhage. Therapeutic intervention is recommended for all symptomatic patients because of the risk of those serious complications. Treatment options include surgery and transcatheter obliteration with steel coils or detachable balloons. Therapeutic embolization has the advantages that multiple bilateral pulmonary arteriovenous fistulas can be occluded and also that the procedure can be repeated if necessary. Recently we experienced a case of the multiple bilateral pulmonary arteriovenous fistulas associated with telangiectatic change of hepatic artery and multiple angiodysplasia on the gastric mucosa in 41 years old female patient who had mild dyspnea of exertion(NYHA class II). clubbing finger, severe iron deficiency anemia. She was treated with embolization technique using steel coils and iron replacement. After the therapeutic embolization. significant improvement of dyspnea of exertion with disappearance of multiple pulmonary nodule on follow-up simple chest x-ray was noted. During the subsequent six months follow-up period, she had the improvement of symptoms and iron deficiency anemia.

• The Journal of the Korean dental association
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• v.56 no.3
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• pp.142-150
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• 2018

In the posterior maxillary area, due to resorption of the ridge after extraction and pneumatization of the maxillary sinus, the height of the alveolar ridge may not be sufficient for placement of implants. To solve this problem, sinus augmentation using both crestal and lateral approaches have been widely used. Jung et al. (2010) introduced the modified lateral approach technique, which is a simplified technique that combines the advantages of crestal and lateral approaches. The purpose of this case report is to report two cases in the posterior maxilla in which simultaneous implant placement with maxillary sinus augmentation has been performed using the modified lateral approach technique. In two female patients, 67 and 74 years old, respectively, simultaneous implant placement was performed using the modified lateral approach technique on the left maxillary second premolar and the first molar. In both patients, the residual bone height on the distal side of the maxillary second premolar was measured to be approximately 5 mm, and the residual bone height of the first molar was measured to be 2-3 mm. After flap elevation, osteotomy of the lateral window was performed in the form of a mesiodistally extended slot above the sinus floor and the Schneiderian membrane was elevated. Sequenced drilling was performed while protecting the membrane with a periosteal elevator. Bone graft and implant placement was performed after preparation of the implant site. Sufficient primary stability was achieved for each implant and sinus membrane was not perforated. After four and five months respectively, implant second surgery was performed. Clinically, the implants were observed to be stable. Implants and surrounding peri-implant mucosa were well maintained after prosthodontic treatment. In conclusion, the modified lateral approach could be a predictable and efficient technique for implant placement in the atrophied posterior maxilla.

• Journal of the korean academy of Pediatric Dentistry
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• v.32 no.1
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• pp.26-32
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• 2005

A tooth impaction means a state that a tooth does not erupt out of oral mucosa or alveolar bone for many reasons. The reasons for an impaction of the Maxillary central incisor are an odontoma, supernumerary tooth, space loss, prolonged remaining or early loss of a preceding deciduous tooth, abnormalities of crown or root caused by trauma of a deciduous tooth and an ectopic position of a tooth germ. In the case of the impacted maxillary incisor, a rapid mesial movement of a lateral incisor leads a space loss and a midline deviation can be happened. Furthermore, it can cause a cyst. When we treated a patient with an impacted central incisor early, we could see a better prognosis. It means an early diagnosis and an exact treatment are very important. Generally if the impaction is not severe or it is caused by a keratinized covering tissue, a surgical exposure can induce an eruption easily but an orthodontic force is recommended when an eruption does not happen after a surgical method, when the eruption path is too transpositioned to be corrected spontaneously and when an impacted tooth is located so deeply. In the treatment using an orthodontic force, careful considerations about a root length, pulp, and a periodontal tissue can improve the periodontal and esthetic prognosis for the long follow-up results. This case is using an orthodontic traction following a periodic observation and in no expectation of spontaneous eruption. After treatment of this case, I have got some knowledges, so I report this case.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.151-156
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• 2006

Purpose : The aim of this study was to determine the accuracy of clinical and radiologic assessments in detecting positive cervical lymph nodes in oral cancer. Materials and Methods : We had reviewed the preoperative clinical, radiologic and postoperative histopathologic reports of 46 patients who had been diagnosed as oral cancer and underwent surgical excision combined with neck dissection (52 sides of neck) in the Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University from the July 1, 1992 to the April 30, 1999. Results : The results were as follows 1. The male to female ratio was 4.38 : 1 and the mean age was 57. 2. Sensitivity values for the preoperative assessment of cervical lymph node metastasis in oral cancer were 62.5 % in clinical examination and 50.0 % in radiologic assessments. Specificity values were 77.8 % in clinical examination and 94.4 % in radiologic assessments. 3. False positive values were 44.4 % in clinical examination and 20.0 % in radiologic assessments. False negative values were 17.6 % in clinical and 19.0% in radiologic assessments. 4. Overall efficiency values were 73.1 % in clinical examination and 80.8 % in radiologic assessments. Summary : There were some limits on the accuracy of clinical and radiologic assessments in the preoperative detection of the cervical lymph nodes in oral cancer. To improve the accuracy, it is important to communicate between clinician and radiologist, and adjunctive diagnostic measures, ultrasound and fine needle aspiration cytology, were helpful increasing the overall efficiency. In the high risk sites (oral tongue and floor of the mouth) the false negative value is higher and the overall efficiency in radiologic evaluation is lower than those of the low risk sites (gingiva and alveolar ridge, retromolar trigone and buccal mucosa ). The elective neck dissection should be considered in the high risk sites.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.193-200
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• 2008

Statement of problem: There have been a few studies about unsplinted implant retainted maxillary overdenture. Purpose: The purpose of this study was to examine the effect of different position of implant for 2 implants-retained maxillary overdenture. Materials and methods: Three-dimensional finite element models were used to reproduce an edentulous human maxilla with an implant-retained overdenture. Two implants in the canine tooth positions on both side and in the second premolar tooth positions on both side models were examined. Axial loads of 100 N were applied to the occlusal surface at the right first molar tooth positions. Maximum stress at the implant-bone interface and stress at the cortical bone surface just under the loading point were observed. Results and conclusion: Within the limits of this study, maximum stresses were concentrated around implant of canine position at loading side. The second premolar area was thought to be more favorable to distribution of stress on mucosa, alveolar bone and implants than canine area for maxillary overdenture.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.1
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• pp.18-23
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• 2019

Patients with cleft lip and palate have several problems such as oro-nasal communication, dental cross-bite caused by the insufficient growth of maxilla, poor pronunciation and esthetic problem. Removable denture with maxillary double crown near cleft palate and with clasp in the posterior teeth was used to solve the problems of the patient with cleft lip and plate. Double crowns make up for the insufficient mucosal support caused by the mucosa and alveolar bone loss in cleft lip and palate. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 55-year-old female patient had bilateral cleft lip and palate and few remaining teeth on anterior maxilla. Prosthetic treatment was done for patient with bilateral cleft lip and palate to close oro-nasal communication using maxillary double crown and clasp retained removable denture. As a result, oro-nasal communication was effectively closed and the cross-bite was easily corrected by double crown and clasp retained denture. In addition, pronunciation and appearance were also improved.

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

• The korean journal of orthodontics
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• v.31 no.2 s.85
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• pp.173-185
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• 2001

The orthodontic osseointegrated titanium implant, a kind of intraoral skeletal anchorage can be an alternative to tooth-borne anchorage, in case that the conventional tooth-borne anchorage is not available or the anchorage is critical. This study was conducted to elucidate the effect of early loading on the osseointegration of the orthodontic titanium implant and the healing process of the impaired bone at the site of implant after removing it. In two adult beagle dogs24 osseointegrated titanium implants were inserted into the alveolar bone, with 12 implants placed in each dog. In dog1, 6 out of 12 implants were loaded with 200-300gm of force immediately after placing, and the remaining 6 implants were not loaded for 4weeks. In dog2, all 12 implants had healing period of 4weeks, and then were loaded with 200-300gm of force for another 4weeks. Following an observation period of 4 and 8 weeks, the animals were sacrificed. Then the implants and the surrounding bone of dog1 and dog2 were removed, respectively. Undecalcified sections along the long axis of implant were made and the degree of osseointegration was examined under the light microscope. The results were as follows. 1. In the histologic features of tissues around implants anchored in dog1, there was no difference between immediately loaded implants and unloaded implants. Immature woven bone was ingrowing into the thread spaces from the original compacta and in direct contact with the implant surface in part. 2. The premature loading just after 4weeks healing period did not halt the progress of the osseointegration between bone and implant surface. The woven bone around the implants was maturing into the lamellar bone which resembled the structure of the original compacta at the end of 8weeks observation period. 3. Most implants with the inflammed surrounding mucosa were lost or mobile. The mobile implants were encapsulated by fibrous connective tissue which separated the implant surface from the bone. 4. The impaired bone at the site of the implant failed to anchor was showing recovery without inflammatory reaction 2weeks after removing, with the immaure woven bone lined by active osteoblasts and osteoid. Based on the results of this study, the integration of this orthodontic implant seemed to be impaired by the inflammation of the tissue surrounding the Implant rather than by early loading on implant, and increased with time lapsed after placing the implant. The use of implant described in this report can be recommended as an orthodontic anchorage unit immediately after insertion under the careful control of orthodontic force applied and plaque.