• Journal of Pharmaceutical Investigation
• /
• 제33권3호
• /
• pp.157-162
• /
• 2003

The feasibility of [P(AA-co-PEGMM)] film as a buccal mucoadhesive patch was previously reported by estimating mucoadhesiveness and release characteristics. To find a rational penetration enhancer of [P(AA-co-PEGMM)] film containing butorphanol tartrate (Bt), penetration of Bt from [P(AA-co-PEGMM)] film which contained various additives was estimated by measuring its flux, Papp and lag tme in in vitro buccal membrane of porcine. EDTA showed almost no increase of Bt permeability, wherease SGC, STDHF and SLS increased the permeability of Bt with the order of SGC > STDHF > SLS. The rational additive concentration of SGC was 4% and its Papp and lag time were $1.93{\times}10^{-4}{\pm}4.21{\times}10^{-6},\;126.60{\pm}21.88min\;(control\;:\;Papp\;0.45{\times}10^{-4};\;lag\;time\;211.01{\pm}16.77\;min)$, respectively.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제43권4호
• /
• pp.262-266
• /
• 2017

Hemangioma is the most common benign tumor of a vascular origin, and is characterized by the abnormal proliferation of blood vessels. Intramuscular hemangioma (IMH) usually involves the skeletal muscles of the trunk or limbs, but rarely occurs in the head and neck region. This case report presents a patient with IMH showing multiple phleboliths in the buccal cheek. A 13-year-old boy was referred for the evaluation and management of painful swelling of the left cheek that had gradually increased in size over a 6 year duration. The examination revealed a palpable firm mass. Reddish-blue buccal mucosa color was observed with an aciniform shape. Preoperative magnetic resonance imaging (MRI) showed a vascular tumor in the left side adjacent to the buccinator and depressor orbicularis oris muscles. Surgical resection under general anesthesia was performed via the intraoral approach. The mass and phleboliths were extracted successfully. A histopathological examination confirmed the diagnosis of IMH. In conclusion, clinicians should be aware of the possibility of IMH in cases of a palpable mass with multiple nodules deep within the muscle in the buccal cheek. Among the several diagnostic tools, MRI provides essential information on the extent and surrounding anatomy of IMH.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제17권3호
• /
• pp.214-219
• /
• 1995

Free grafting of oral mucosa for minor oral reconstruction was first described by Propper in ridge extension surgery. Situation calling for mucosal grafting procedures may relate to periodontal surgery, minor and major preprosthetic surgery, implant surgery, reconstruction in deformity cases after trauma, congenital cleft, gross atrophy and ablative tumor surgery. In the cases of 9 patients with mucosal defect of intraoral or orbital cavity after wide excision of tumor, preprosthetic surgery, and orbitoplasty, full-thickness mucosal graft were used to close a large defect. Four patients received buccal mucosal graft for preprosthetic surgery or orbitoplasty, one patient had benign tumor and the others had malignant tumors located on the palate or upper alveolus. Buccal mucosal graft donor site morbidity and trismus were minimal and healing of surgical defect was satisfactory. So we present the case with review of literatures.

• 대한두개안면성형외과학회지
• /
• 제21권3호
• /
• pp.161-165
• /
• 2020

Background: Microstomia is defined as a condition with a small sized-mouth that results in functional impairment such as difficulty with food intake, pronunciation, and poor oral hygiene and cosmetic problems. Several treatment methods for microstomia have been proposed. None of them are universally applicable. This study aims at analyzing the cases treated at our institution critically reviewing the pertinent literature. Methods: The medical records of all microstomia patients treated in our hospital from November 2015 to April 2018 were reviewed retrospectively. Of these, all patients who received surgical treatment for microstomia were included in the study and analyzed for etiology, chief complaint, surgical method, and outcomes. The functional outcomes of mouth opening and intercommissure distance before and after the surgery were evaluated. The cosmetic results were assessed according to the patients' satisfaction. Results: Five patients with microstomia were corrected. Two cases were due to scar contracture after chemical burn, two cases derived from repeated excision of skin cancer, and one patient suffered sequela of Stevens-Johnson syndrome. The following surgical methods were applied: one full-thickness skin graft on the buccal mucosa, three buccal mucosal advancement flaps after triangular excision of the mouth corner, and one local buccal mucosal flap. Mouth opening was increased by 6.0 mm, and the intercommissure distance improved by 7.2 mm on average. Follow-up was 9.6 months (range, 5-14 months). Cosmetic assessment was as follows: two patients found the results excellent, three judged it as good. Conclusion: Microstomia has several causes. In order to achieve optimal functional recovery and aesthetic improvement it is important to precisely evaluate the etiologic factors and the severity of the impairment and to carefully choose the appropriate surgical method.

• Journal of Periodontal and Implant Science
• /
• 제42권3호
• /
• pp.105-109
• /
• 2012

Purpose: Soft tissue recessions frequently cause esthetic disharmony and dissatisfaction. Compared with soft tissue coverage around a tooth, the coverage of an implant site is obviously unpredictable. Particularly in the cases of thin mucosa, a significant greater amount of recession takes place compared to thick mucosa. To overcome this problem, this case report demonstrates a two-step mucosal dehiscence coverage technique for an endosseous implant. Methods: A 33-year-old female visited us with the chief complaint of dissatisfaction with the esthetics of an exposed implant in the maxillary left cental incisor region. A partial-thickness pouch was constructed around the dehiscence. A subepithelial connective tissue graft was positioned in the apical site of the implant and covered by a mucosal flap with normal tension. At 12 months after surgery, the recipient site was partially covered by keratinized mucosa. However, the buccal interdental papilla between implant on maxillary left central incisor region and adjacent lateral incisor was concave in shape. To resolve the mucosal recession after the first graft, a second graft was performed with the same technique. Results: An esthetically satisfactory result was achieved and the marginal soft tissue level was stable 9 months after the second graft. Conclusions: The second graft was able to resolve the mucosal recession after first graft. This two-step approach has the potential to improve the certainty of esthetic results.

• Restorative Dentistry and Endodontics
• /
• 제34권4호
• /
• pp.340-345
• /
• 2009

구강점막은 흡입되거나 압력을 받아, 병적이진 않으나 임상적으로 뚜렷한 변화를 일으키는 수많은 상황에 놓이게 된다. 협점막과 혀는 치아가 상실되었거나 여분의 공간이 존재하는 부위에서 돌기가 형성될 수 있다. 점막이 여분의 공간으로 압력을 받거나 흡입되어 섬유성 과증식이 발생하게 되는 것이다. 이번 증례보고에서는 구강점막의 섬유성 과증식의 처치에 대해 기술하고자 한다. 섬유성 과증식은 구강점막에 가해진 습관성 압력이나 흡입에 의해 형성될 수 있다. 섬유성 과증식의 치료는 단순 절제술과 원인을 제거하는 것이다. 또한 습관 조절이 재발을 방지하기 위한 중요한 요소가 된다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제27권3호
• /
• pp.226-237
• /
• 2005

Purpose : Extensive defect of oral and maxillofacial area is usually reconstructed with composite flap including skin paddle. However, if the defects are lined with only skin components, the mucosa's role in mastication and texture are not restored. Furthermore, stiffness and hair-growing prevent denture rehabilitation and good oral hygiene. This study was performed to overcome the disadvantages of composite soft tissue flaps including the skin and to make a model for myo-mucosal flaps. Materials and methods : Buccal mucosa sized $0.5\times1.0\;cm^2$ from New Zealand rabbit (around 1.5kg) was harvested and cultivated by the modification of Rheinwald and Green's keratinocyte culture method. Cultured mucosa was grafted on the fascia of latismus dorsi as form of mucosal sheet. After 7, 10, 14 days, the myomucosal flap was excised and evaluated under light microscope with H & E and immunohistochemical staining. As control group, harvested buccal mucosa from rabbit was transplanted to gracilis muscle(n=6). Results : From 7 days after prelamination, the basal layer of the grafted mucosa resembled that of normal mucosa. As control group, transplanted mucosa had original shape but there's slight inflammatory reaction. Prelaminated mucosa has 19.8$\pm$4.59 cell layers and some samples have more than 20 layers. The expression rate of PCNA was relatively strong (42.9%$\pm$14.1) at the basal layer of grafted mucosa and the laminin was found at the basal layer. On the contrary, prelaminated mucosa at 10 days showed moderate expression rate of PCNA(32.4%$\pm$4.62). We found the mucosal layer was somehow disappeared and there is strong inflammatory reaction. After 14 days prelamination, the grafted oral keratinocytes were almost disappeared and expression of PCNA was not observed. Conclusion : We can make 75 fold large mucosal($3850mm^2$) sheet from small samples of mucosa $(50mm^2)$. Epithelial sheet that grafted on the fascia of muscle underwent differentiation and proliferation. But after 10, 14 days, there was strong inflammatory reaction and the grafted mucosa was destroyed from surface layer. In rabbit model, transfer of fascio-mucosal flap should be done from 7 to 10 days after prelamination.

• Journal of Oral Medicine and Pain
• /
• 제26권2호
• /
• pp.161-171
• /
• 2001

In order to determine how oral mucosal change relates to inducing factors of burning mouth syndrome, the difference in pain perception scale and keratinization rate between burning mouth syndrome patients and normal subjects were investigated. Twenty patients (13 female, 7 male, mean age: 59 years), presenting in the Department of Oral Medicine, Chonnam National University Hospital were participated in this study. All subjects had been complaining of constant oral burning pain for more than a year, none took any strong analgesics, and none had oral mucosal lesions. Twenty volunteers (11 females, 9 males, mean age: 25 years) were also participated in this study as a control group. The control subjects had never had any symptoms of oral burning pain. A thermal stimulation using a Nd-YAG laser and cytological smear were carried out to anterodorsal part of tongue, tip of tongue, the left buccal mucosa, the lower lip mucosa and the chief complaint site. Stimulation of the dorsum of left hand was also carried out to contrast the mucosal area of burning mouth syndrome subjects and the control subjects. The laser output power could be adjusted from 0.75W to 4W. The pain perception scale of the burning mouth syndrome subjects were lower than in control subjects in the chief complaint area, the anterodorsal part of tongue and the buccal mucosa(p<0.01). The keratinization rate of burning mouth syndrome subjects, however, was higher keratinization rate than in normal subjects in the same area and lower lip mucosa(p<0.001). From above results, the anterodorsal part of tongue is the most appropriate site to use diagnostic laser stimulation. The higher level of keratinization and the lower level of thermal pain perception of the burning mouth syndrome subjects are explained as a protective mechanism against xerostomia and burning sensations. The application of Nd-YAG laser stimuli and cytological smear to oral mucosal surface could therefore be usefully employed as appropriate and standardized diagnostic tools for chronic orofacial pain subjects.

• Journal of Oral Medicine and Pain
• /
• 제17권2호
• /
• pp.75-86
• /
• 1992

Of the many first-occuring major manifestations of Behcet's disease, the oral ulcer is most frequently observed, shows the highest mean recurrence rate, and the longest mean duration period. A study of the relationship between mechanical irritation buy local factors and the recurrence of oral ulcers was carried out to see if there is a correlation. The subjects chosen for the study were 81 patients who were referred to the Department of Oral Diagnosis at Yonsei University Dental Hospital from the Behcet clinic of Severace Hospital after being diagnosed as Behcet's disease patients. 1. By Shimuzu's classification, possible type was the most numerous with 55.55% ; while suspected type was 19.76% ; incomplete type, 17,28% ; and complete type, 7.41% were observed in that order. The male to female ration was 1 to 1.61, and the average age of onset was 17.63 years. 2. Oral ulcers developed most frequently on the tongue (48.28%), and lip(23.15%), buccal mucosa (20.69%), palate\pharynx(4.43%), and gingiva(3.45%) also showed ulceration. 3. 38.27% of the patients were HSV positive : 27.16% were CRP positive ; 12.34% were ASO positive ; 9.87% were RF positive ; and 3.7% were ANA positive. 4. According to the answers to the survey, fatigue(85.18%) was most frequently associated with Behcet's diseage. Trauma by tooth brushing (22.22%), un specified reasons (20.98%), hard food chewing (12.35%), and irritation by dentition and/or prosthesis (13.58%) were observed in association with Behcet's disease. 23.46% had a history of tonsilitis. 5. Oral ulcers on the anterior part of tongue and buccal mucosa were associated with local irritatants. 6. Oral ulcers on the lip and posterior portion of tongue were not associated with local irritants. Local irritation by dentition and oral ulcer on the anterior part of tongue and buccal mucosa was observed to coexit with one another : in other words, lo9cal factors can act to cause of recurrence of an oral ulcer and to delay the healing process in Behcet's disease. Therefore, elimination of local factors along with systemic therapy must be recommended when treating oral ulcers.

• 대한치과교정학회지
• /
• 제44권3호
• /
• pp.128-135
• /
• 2014

Objective: This study evaluated the cytotoxicity and genotoxicity of fixed orthodontic treatment with three different light-cured orthodontic bonding composites by analyzing micronucleus (MN) formation in the buccal mucosa during a 6-month period. Methods: Thirty healthy volunteers were selected from consecutive patients referred for orthodontic treatment. Equilibrium 2 brackets and molar tubes (Dentaurum) were bonded with three different lightcured orthodontic bonding composites-Transbond XT (3M Unitek), Kurasper F (Kuraray Europe), or GrenGloo (Ormco Corporation)- to all teeth in both arches. Exfoliated buccal epithelial cells were scraped from the middle part of the inner cheeks with sterile cement spatulas before treatment and at 1, 3, and 6 months after treatment. MNs and nuclear alterations, such as karyorrhexis (KR), karyolysis (KL), and binucleated cells (BNs), were scored under a light microscope. Repeated measure ANOVA was used to calculate statistical differences in degenerative nuclear abnormalities. Results: MN rates did not significantly differ among different time points within the same cell type (p > 0.05). In contrast, the number of BNs in buccal epithelial cells significantly increased in all composite groups (p < 0.01, Transbond XT; p < 0.001, Kurasper F and GrenGloo). KL frequency significantly increased between the beginning and end of the study in the Kurasfer F ($0.80{\pm}0.79$ to $1.90{\pm}1.10$; p < 0.05) and GrenGloo ($1.30{\pm}1.06$ to $2.40{\pm}1.08$; p < 0.05) groups. Conclusions: After 6 months of fixed orthodontic treatment with different light-cured composites, morphological signs of cytotoxicity were observed but genotoxic effects were absent.