• Journal of Korean Neurosurgical Society
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• 제48권4호
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• pp.383-387
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• 2010

Complete removal of three-compartment trigeminal schwannomas is a challenge to neurosurgeons. To expand exposure of each compartment, the combination and modification of skull base approaches are necessary. The 61-year-old woman was admitted with chronic headache. Preoperative magnetic resonance imaging showed $47{\times}50{\times}40\;mm$-sized tumor originating primarily in the middle cranial fossa extended to the posterior and the infratemporal fossa. We performed operation in five stage; 1. Zygomatic osteotomy, 2. Inferior temporal fossa plate removal and foramen ovale opening, 3. Cavernous sinus opening, 4. Tailored anterior petrosectomy, 5. Meckel's cave opening. Combination of skull base surgery should be concerned according to the patient. In this study, extradural basal extension with zygomatic osteotomy, interdural posterior extension with tailored anterior petrosectomy, and intracavemous exploration are reasonable options for remodeling three-compartment lesion into a single compartment. Tailoring of bone resection and exploring through natural pathway between meningeal layers accomplish single-stage operation for complete removal of tumors.

• 대한두개안면성형외과학회지
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• 제21권1호
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• pp.53-57
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• 2020

A mucocele is an epithelium-lined, mucus-filled cavity in the paranasal sinuses. Mucocele may develop due to scarring and obstruction of the sinus ostium caused by midface sinus trauma, such as orbital bone fracture or endoscopic sinus surgery. The authors report two cases of orbital mucocele as complications following midface sinus injury (endoscopic sinus surgery in one case, and orbital fracture repair in the other). In both cases, imaging studies showed a large orbital mucocele accompanied by bony erosion and orbital wall remodeling, compressing the ocular muscle. Using an open approach, the lesion was excised and marsupialized. The symptoms resolved, and the postoperative eyeball position was normal. Orbital mucocele may cause serious complications such as ocular symptoms, orbital cellulitis, osteomyelitis, and the formation of an abscess with the potential to invade the brain. Therefore, surgeons should consider the possibility of mucocele as a late complication of surgery and initiate an immediate work-up and surgical treatment if needed.

• Archives of Plastic Surgery
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• 제33권2호
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• pp.263-267
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• 2006

In both cosmetic and functional aspects, loss of digital pulp is a common problem. Compound or composite defects of the hand and fingers with exposed denuded tendon, bone, joint, or neurovascular structures may require flap coverage. Most often these lesions can be repaired by using simple local flap, neurovascular flap, thenar flap, and cross-finger flap. But microvascular reconstruction is sometimes needed for large defects. But Authors do not recommend these procedures in case of severe crushing injuries involving multiple finger pulp losses because they have possibility of damage of the vascular network and infection. So we applied distant flaps such as chest flaps, groin flaps, abdominal flaps and etc. And then we applied surgical rubber gloves for remodeling the flap after cutaneous healing. We have acquired satisfactory results, after the simple molding method for distant flap finger by using surgical rubber gloves treatment.

• International Journal of Oral Biology
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• 제41권3호
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• pp.119-123
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• 2016

Acetylcholine receptors (AChR) including muscarinic and nicotinic AChR are widely expressed and mediate a variety of physiological cellular responses in neuronal and non-neuronal cells. Notably, a functional cholinergic system exists in oral epithelial cells, and nicotinic AChR (nAChR) mediates cholinergic anti-inflammatory responses. However, the pathophysiological roles of AChR in periodontitis are unclear. Here, we show that activation of AChR elicits increased cytosolic $Ca^{2+}([Ca^{2+}]_i)$, transient cytotoxicity, and induction of receptor activator of nuclear factor kappa-B ligand (RANKL) expression. Intracellular $Ca^{2+}$ mobilization in human gingival fibroblast-1 (hGF-1) cells was measured using the fluorescent $Ca^{2+}$ indicator, fura-2/AM. Cytotoxicity and induction of gene expression were evaluated by measuring the release of glucose-6-phosphate dehydrogenase and RT-PCR. Activation of AChR in hGF-1 cells by carbachol (Cch) induced $[Ca^{2+}]_i$ increase in a dose-dependent manner. Treatment with a high concentration of Cch on hGF-1 cells caused transient cytotoxicity. Notably, treatment of hGF-1 cells with Cch resulted in upregulated RANKL expression. The findings may indicate potential roles of AChR in gingival fibroblast cells in bone remodeling.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권2호
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• pp.120-124
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• 2017

Osteonecrosis of the jaw (ONJ) is commonly described as an adverse effect of the use of bisphosphonates. A few cases of ONJ associated with tyrosine kinase inhibitors (sunitinib, imatinib) have been reported in the literature and usually they occurred in patients simultaneously treated with bisphosphonates. We report an atypical case of ONJ related only to imatinib. A 72-year-old male patient was treated with imatinib for metastases from gastrointestinal stromal tumors (GISTs). The patient developed ONJ after 22 months of imatinib only therapy. During his whole life, the patient had never been treated with bisphosphonates or radiotherapy. Microscope examination of the tissues confirmed the clinical diagnosis of diffuse osteonecrosis and showed absence of neoplastic cells. Thus, secondary localisations from GISTs were ruled out. Osteonecrosis of the lower jaw appeared 22 months after initial and exclusive therapy with imatinib. Therefore, imatinib monotherapy can induce ONJ in patients that have never been treated with bisphosphonates or radiotherapy.

• 구강회복응용과학지
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• 제28권4호
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• pp.397-406
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• 2012

치아가 상실되면 주위 치조골의 개조와 흡수가 일어나면서 위축성 무치악을 초래하게 되고, 치은부착은 점차적으로 감소된다. 이에 따라 총의치의 지지력 감소, 저작 효율의 저하와 통증으로 인해 무치악 환자들은 의치 사용의 어려움을 경험한다. 이를 개선하기 위해 하악에 2개의 임플란트를 식립하고 어태치먼트를 장착하는 피개의치의 형태가 유지력 측면에서 바람직한 치료 방법으로 우선적으로 고려되고 있다. 본 증례는 오래된 상, 하악 무치악을 가진 환자로 하악에 2개의 임플란트를 식립하고, 상악은 총의치, 하악은 Locator$^{(R)}$ attachment를 이용한 임플란트 피개의치로 제작하였다. 본 증례에서 기능적, 심미적으로 만족스러운 결과를 얻었기에 수복 과정과 결과에 대하여 보고하고자 한다.

• Imaging Science in Dentistry
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• 제51권2호
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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.

• 치위생과학회지
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• 제13권2호
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• pp.158-164
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• 2013

임플란트 식립 시 가장 빈번하게 맞게 되는 문제점으로 임플란트 식립 부위에서의 불충분한 골량과 해부학적 구조에 의한 접근성의 문제를 들 수 있다. 일반적으로 성장 인자들은 치유 과정이나 조직 형성에 있어서 가장 기본적인 필수 요소로 인정되고 있다. 이러한 이유로 골 이식 재료의 효과를 증진시키기 위한 성장 인자들이 최근에 주목을 받고 있다. 혈소판 내 granules에는 높은 농도의 다양한 성장 인자들이 포함되어 있다. 특히, platelet-rich fibrin (PRF)는 2세대 혈소판 농축 인자로 항응고제가 들어있지 않은 상태로 얻을 수가 있고, 혈소판과 많은 성장 인자들이 풍부한 섬유소 막을 포함하고 있다. 이번 연구의 목적은 in vitro 상에서 골아 세포에 대한 PRF의 영향을 알아보고자 하였다. 특히 치유와 재생에 연관된 주요 기능으로써 증식과 분화에 대한 영향을 조사하고자 하였다. 이를 위해서, PRF 내에서 방출되는 성장 인자(platelet-derived growth factor subunit B와 transforming growth factor-${\beta}1$)의 농도, 세포의 생존능력, alkaline phosphatase (ALP) activity, type 1 collagen 합성, 골아 세포의 분화 지표로써 ALP와 Runx2의 발현 정도와 골 기질 단백질로써 type 1 collagen의 발현 정도에 대해서 조사하였다. 이 실험을 통하여 PRF는 치유 시 필요한 타당한 기간 동안에 충분히 자가 성장 인자의 방출을 유지하고 있음을 알 수 있었고, 골아 세포의 증식과 분화에 대해서 긍정적인 효과가 있음을 보여 주였다. 제한적인 실험이지만, 골재생을 위한 PRF의 사용은 골 치유와 골 개조에 있어서 증진 효과를 가져다줄 수 있는 촉망되는 방법 중 하나가 될 수 있을 것이다.

• 대한치과교정학회지
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• 제21권2호
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• pp.259-272
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• 1991

Orthodontic traction has been suggested as the treatment of choice for intrusive luxation injuries. Prior research has shown orthodontic forces to be ineffective in the presence of ankylosis or in cases with zero mobility following the injury. If orthodontic traction is to be effective, it must be initiated prior to the onset of ankylosis. The purpose of this study was to describe the effects of intrusive luxation at various times following the injury, and to determine the time of the onset of ankylosis, and to examine what effect immediate partial luxation has on the onset of ankylosis. Eight young mongrel dogs were utilized for this study. Intrusive luxation was produced with an axial impact using a gravity hammer and a specially designed holding device on 4 teeth (2 max. and 2 man. first premolars) in each dog. The teeth were intruded approximately 3-4mm in an axial direction. One maxillary and one mandibular premolars were partially luxated with the other two teeth being untouched. Pre and posttrauma tooth position was documented with plaster models and radiographs taken with an individualized X-ray jig. Dogs were sacrificed immediately following the injury and at 1, 2, 4, 7, 10, 14 and 21 days respectively. Tetracycline was administered as a vital bone marker 24 hours before sacrifice. Block sections of the tooth and alveolus were prepared for decalcified and non decalcified histologic sections. The effects of traumatic intrusion were analyzed by means of model casts, radiographs, tetracycline bone marking and histologic preparations. The results obtained were as follows: 1. The animal sacrificed immediately following the injury displayed alveolar fractures, torn periodontal ligaments, and areas of direct tooth-bone contact. 2. The odontoblastic layer of the pulp was disorganized as early as 24 hours after the injury. 3. Bony remodeling was noted at 4 days along with active surface resorption. 4. Ankylosis was first seen 7 days after the injury. 5. Osteogenesis in the dentin (thick tetracycline bands) was observed 7 days after the injury. 6. There was no progressive root resorption and ankylosis where the periodontal ligament has been healed. 7. The Luxated group showed significantly more root resolution and ankylosis than the Nonluxated group with increased observation periods. The results suggest that ankylosis may occur within the first week following the injury, and hence orthodontic traction should be initiated as soon after the injury as possible.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권5호
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• pp.447-453
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• 2010

The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and lanned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.