• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.1
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• pp.33-39
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• 1996

Human Dura mater treated by various processes was used to restore small periodontal defects, large bony defects for improvement of new bone formation, and soft tissue defects and replace the disc of TMJ, etc.. Tutoplast Dura is the solvent-preserved Human Dura mater and sterilized by gamma radiation. In our department, Tutoplast Dura was implanted in 32 patients, from 1994, 6 to 1995, 7. We implanted the Tutoplast Dura at 11 various cysts, 6 implantations, 4 fractures, 3 clefts, 2 TMJ disease, 2 maxillary sinusitis, etc.. We performed the retrospective study about the purpose of Tutoplast Dura implantation, postoperative complication and histologic examination of biopsy specimen at implant second surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.6
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• pp.599-603
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• 2008

Calcifying odontogenic cyst(COC) is comparatively rare in occurrence. COC represents about 1% of jaw cysts, and although it may occur in soft tissue, it is most commonly found within bone. Both the intraosseous and extraosseous forms occur with about equal frequency in the maxilla and mandible, mainly in the incisor and canine areas The most notable features of this pathologic entity are histopathological and include a cyst lining demonstrating characteristic "ghost" epithelial cells with a propensity to calcify and the occasional association of this finding with certain odontogenic tumors including the odontoma and the ameloblastoma. In this case, COC was associated with anterior wall of the maxillary sinus which appeared in the anterior maxilla of 64-year-old woman, was reported. We report that the clinical experience of COC with review of literatures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.7.1-7.5
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• 2018

Background: Oroantral communicating defects, characterized by a connection between the maxillary sinus and the oral cavity, are often induced by tooth extraction, removal of cysts and benign tumors, and resection of malignant tumors. The surgical defect may develop into an oroantral fistula, with resultant patient discomfort and chronic maxillary sinusitis. Small defects may close spontaneously; however, large oroantral defects generally require reconstruction. These large defects can be reconstructed with skin grafts and vascularized free flaps with or without bone graft. However, such surgical techniques are complex and technically difficult. A buccal fat pad is an effective, reliable, and straightforward material for reconstruction. Case presentation: This report describes three cases of reconstruction of large oroantral defects, all of which were covered by a pedicled buccal fat pad. Follow-up photography and radiologic imaging showed successful closure of the oroantral defects. Furthermore, there were no operative site complications, and no patient reported postsurgical discomfort. Conclusion: In conclusion, the use of the pedicled buccal fat pad is a reliable, safe, and successful method for the reconstruction of large oroantral defects.

• Imaging Science in Dentistry
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• v.51 no.2
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• pp.203-208
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• 2021

Ghost cell odontogenic carcinoma (GCOC) is a rare malignant neoplasm characterized by the presence of ghost cells. It is considered to originate from either a calcifying odontogenic cyst(COC) or a dentinogenic ghost cell tumor(DGCT). Its clinical and radiographic characteristics are non-specific, including slow growth, locally aggressive behavior, and eventual metastasis. This case report describes a 43-year-old Thai man with plain radiographs and cone-beam computed tomographic images revealing a unilocular radiolucency with non-corticated borders surrounding an impacted left canine associated with radiopaque foci around the cusp tip. Based on the microscopic findings, the lesion was diagnosed as GCOC. Partial maxillectomy of the right maxilla was performed, and radiotherapy was administered. An obturator was made to support masticatory functions Three years later, the lesion showed complete bone remodeling and no signs of recurrence, and long-term follow-up was done regularly.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.5
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• pp.287-291
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• 2023

Odontogenic keratocysts (OKCs) located in the maxillae have rarely been reported in the literature. Standard treatment modalities for OKC range from marsupialization to marginal resection. However, most of the studies on OKC treatment have been related to mandibular OKCs. The anatomical structure and loose bone density of the maxillae and the empty space of the maxillary sinus could allow rapid growth of a lesion and the ability to tolerate tumor occupancy in the entire maxilla within a short period of time. Therefore, OKCs of the maxillae require more aggressive surgery, suchas resection. As an alternative, this report introduces a modified Carnoy's solution, a strong acid, as an adjuvant chemotherapy after cyst enucleation. This report describes the clinical outcomes of enucleation using a modified Carnoy's solution in patients with large OKCs on the posterior maxillae. In three cases, application of a modified Carnoy's solution had few side effects or morbidity. Each patient was followed for four to six years, and none showed any signs of recurrence. In conclusion, adjuvant treatment with a modified Carnoy's solution can be considered a treatment option capable of reducing the recurrence rate of OKC in the maxillae.

• Imaging Science in Dentistry
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• v.32 no.3
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• pp.167-173
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• 2002

Purpose : To evaluate clinical and radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst (OKC) using clinical data, plain radiographs, and CT. Materials and Methods: 25 cases of ameloblastoma and 44 cases of OKC diagnosed in biopsy, were selected from the files stored in Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital from 1999 to 2001, and evaluated using following criteria: sex and age, location, shape, border to normal bone tissue, effect to adjacent tissues, homogeneity in the lumen of the lesion, response of the cortical bone, long-to-short length (LIS) ratio of the lesion, and expansion angle of the cortex. Results: Ameloblastoma and OKC were seen most frequently in third decades and no statistical significance was noted between both sexes. Ameloblastoma occurred most frequently in mandibular angle and ramus area (68%) and OKC at the maxillary molar (34.1 %), and mandibular angle and ramus area (43.2%). The root resorption of the adjacent teeth, mandibular canal displacement, and the impaction of teeth were seen more frequently in ameloblastoma than in OKC. The LIS ratio measured in CT was largest in maxillary OKC cases, followed by mandibular ameloblastoma, and mandibular OKC (1.2, 1.8 and 2.4 respectively). The expansion angle of the cortex shows a statistically significant difference between ameloblastoma (48.8°) and OKC (31.5°). Conclusion : The numeric morphology (LIS ratio) and expansion angle of the cortical bone of the lesion measured in computed tomography can be used to differentiate the ameloblastoma and odontogenic keratocyst.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.5
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• pp.276-283
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• 2012

Objectives: Curettage and enucleation are two of the most common procedures performed in oral and maxillofacial surgery units. To access a cystic lesion, the buccal cortical plate is removed. The no reposition (NR) group underwent surgery without repositioning the buccal cortical plate. The reposition (R) group underwent surgery with a repositioning of the buccal cortical plate. This study compared the two surgical procedures in terms of bone healing and complications. Materials and Methods: Patients who underwent curettage and enucleation surgery were enrolled in this study. Panoramic radiographs of the patients in both the NR group (n=26) and R group (n=34) were taken at the baseline and at 6, 12 and 24 months after surgery. The radiolucent area was calculated to evaluate bony healing in each radiograph. The complications were analyzed through a review of the medical records. Results: The correlation between bony healing and surgical approach was not significant in the 6th, 12th, and 24th month (P<0.05). The complication rate was not associated with gender, graft material, bone graft and drain insertion (P<0.05). On the other hand, the R group had a higher complication rate (35.3%) than the NR group (0%). The difference in the mean lesion size between the NR group ($37,024{\pm}3,617$ pixel) and R group ($92,863{\pm}15,931$ pixel) was significant (independent t test, P=0.004). Conclusion: Although the reposition method is chosen when the lesion size is large, it is associated with more complications. Indeed, infection, discomfort and recurrence of the lesion were the most common complications in the R group. Furthermore, the R method does not have a strong point in terms of bone healing compared to the NR method. Therefore, the R method cannot be considered an ideal approach and should be used in limited cases.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.53-59
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• 1989

The ameloblastoma is the most common form of the odontogenic tumors exhibiting minimal inductive change in connective tissue, it comprising 1% of all tumor and cysts of the jaws. It is a true neoplasm, generally considered to be a benign but persistent or, locally malignant lesion. The tumor occurs most commonly in persons between the age of 20 and 50 years. 80% and 90% of all lesions are in the mandible. The presenting clinical signs and symptoms of the ameloblastoma very from patient to patient, but most common symptom was swelling, followed by pain, draining sinuses, and superficial ulcerations. It is slow-growing lesion, and the radiographic features of the ameloblastoma depend large one the nature and the local bone reaction to the particular tumor. Recurrence rate is about 33%, but this is probably due to incommplete initial removal of lesion. We had operated a patient ; 29-year-old female immediate reconstruction combined with autocompression plate and iliac bone graft and screw fixation after hemimandibulaectomy with recurred ameloblastoma involving from premolar to ascending ramus at right side mandible. We obtained favorable results of good function, short intermaxillary fixation periods and easy operation precedure than the other reconstruction methods.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.463-468
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• 2002

The unicystic ameloblastoma deserves separate consideration on the basis of its clinical, radiologic, and pathologic features and its response to treatment. It refers to those cystic lesions that show clinical, radiographic, or gross features of a jaw cyst, but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity. The lesion is most commonly found on the mandible posterior area, and often asymptomatic, although large lesions may cause a painless swelling of the jaws. The lesion typically appears as a circumscribed radiolucency that surrounds the crown of an unerupted molar. These are usually considered to be a dentigerous, residual cyst on the relationship of the lesion to teeth in the area. Three histopathologic variants of unicystic ameloblastoma may be seen. 1) Luminal type, 2) Intraluminal type, 3) Mural type. In this case, these tumor was treated as cysts by enucleation with iliac bone graft, and the diagnosis of ameloblastoma is made after microscopic examination of the presumed cyst.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.4
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• pp.669-676
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• 1999

The dentigerous cysts originate through alteration of the reduced enamel epithelium after amelogenesis is completed, with accumulation of fluid between the layers of the enamel epithelium, or between this epithelium and the tooth crown. Next to the radicular cyst, they are the second most common type of odontogenic cyst. They occur over a wide age range with a peak frequency in the 2nd to 3rd decade. A substantial majority involve the mandibular third molars, followed in order of frequency by the maxillary permanent canines, mandibular second premolars, and maxillary third molars. With regard to the treatment of these cysts, the marsupialization procedure with obturator is recommended during the age when the eruptive force of the teeth is still strong. It can be effective when preservation of the displaced teeth is desirable. We treated the dentigerous cyst by marsupialization with obturator and guided the eruption of involved teeth to normal position. And we got the results as follows : 1. Severely dislocated teeth associated with dentigerous cyst erupted into proper position. 2. The enamel hypoplasia and the root deformity were observed some cases. 3. The bone expansion and defect were healed without infection and recurrence.