• Title/Summary/Keyword: Condylar area

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Metastatic thyroid follicular carcinoma of masticator space (저작근극에서 발생한 전이된 갑상선 여포상암)

  • Gang Tae-In;Heo Min-Suk;An Chang-Hyeon;Choi Mi;Lee Sam-Sun;Choi Soon-Chul;Park Tae-Won
    • Imaging Science in Dentistry
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    • v.32 no.3
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    • pp.175-179
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    • 2002
  • Follicular carcinomas are the second most common form of thyroid cancer, accounting for 10 to 20% of all thyroid cancers. Follicular carcinomas have a propensity to metastasize via the bloodstream, spreading to bone, lungs, liver, and elsewhere. We described the case of a 48-year-old woman who presented with swelling of the left preauricular area, which was a consequence of a metastatic follicular carcinoma of the masticator space. Plain films showed illdefined erosive bony changes from the left condylar head to the mandibular notch. Contrast-enhanced CT images showed a well circumscribed round mass with well enhancement within left masticator space. On MR images, the mass was heterogenously hyperintense to the muscle on T2-weighted images and isointense or hyperintense to the muscle on Tl-weighted images, and showed good enhancement on contrast-enhanced Tl-weighted images. Upon microscopic examination, the metastatic mass was found to be composed of fairly uniform cells forming small follicles containing colloid, showing capsular and vascular invasion.

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A CASE REPORT OF EAGLE'S SYNDROME WITH TMJ INTERNAL DERANGEMENT (악관절내장증을 동반한 Eagle's Syndrome)

  • Park, Kwang-Ho;Kim, Hyung-Gon;Yoon, Jung-Ho;Jeong, Sang-Hoon;Park, Jung-Hyun;Kim, Ki-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.4
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    • pp.458-463
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    • 1994
  • A thirty two year-old male was referred with a chief complaint of mouth opening limitation, and maxillofacial pain including left TMJ area. The patient had been treated in a private clinic with medications and conservative treatments, without any improvements in symptoms. MRI findings showed a limitations in condylar head movements, and signs of disc adhesion without the Positional change. Panoramic views showed elongation of stylohyoid process. Brain C-T was taken due to the patient's complaint of headache, facial pain, and paresthesia of tongue, and the result showed no abnormalities. The first surgery included meniscoplasty and the removal of disc adhesion of left TMJ under the preliminary diagnosis of internal derangement with adhesion, and the patient displayed marked improvements in opening movements despite of persistent hemiparesthesia of left facial areas and tongue, and mild dysphasia. Therefore, the second surgery was carried out with the preliminary diagnosis of Eagle's Syndrome, and a resolution of neurologic symptoms was obtained. The final diagnosis of this case was Eagle's Syndrome with internal derangement, and the difficulties in diagnosis and treatment might be due to the existence of two separate diseases with similar symptoms.

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A RADIOGRAPHIC STUDY OF SOLITARY BONE CYSTS (고립골낭에 관한 X선학적 연구)

  • KIM Kyung Rak;Hwang Eui Hawn;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.24 no.1
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    • pp.95-105
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    • 1994
  • The aim of this study was to evaluate the clinical, radiographic and histopathologic features of 23 cases of solitary bone cyst by means of the analysis of radiographs and biopsy specimens in 23 persons visited the Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University and Chunbuk National University. The obtained results were as follows; 1. The incidence of solitary bone cyst was almost equal in males(52.2%) and in females(47.8%) and the prevalent age of the solitary bone cyst were the second decade(47.8%) and the third decade (21.7%). 2. In the signs and symptoms of solitary bone cyst, pain or tenderness revealed in 17.4%, swelling revealed in 13.0%, pain and swelling revealed in 21.7%, paresthesia revealed in 4.4% and 43.5% were asymptom and the tooth vitality involved in the solitary bone cyst, 76.5% were positive and 23.5% were either positive or negative. 3. In the location of the solitary bone cyst, 47.8% present posterior region, 21.7% present anterior region, 21.6% present anterior and posterior region, 4.4% present condylar process area. 4. In the hyperostotic border of the solitary bone cyst, 47.8% were seen entirely, 21.8% were seen partialy, and 30.4% were not seen. 5. In the change of tooth, 59.1% were intact, 18.2% were loss of the alveolar lamina dura, 13.6% were root resorption 4.55% were tooth displacement, 4.55% were root resorption and tooth displacement. 6. In the change of cortical bone of the solitary bone cyst, 39.1% were intact and 60.9% were thinning and expansion of cortical bone. 7. In the histopathologic findings of 9 cases, 33.3% were thin connective tissue wall, 11.1% were thickened myxofibromatous wall, 55.6% were thickened myxofibromatous wall with dysplastic bone formation.

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Case Report of Transparotid Approach of Mandibular Subcondylar Fracture (하악골 과두하 골절의 이하선 경유 접근법을 통한 관혈적 정복술 증례보고)

  • Moon, Mincheol;Oh, Suk Joon;Koh, Seoung Hoon
    • Archives of Craniofacial Surgery
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    • v.10 no.1
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    • pp.33-36
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    • 2009
  • Purpose: Fractures of the mandibular condylar area are common injuries that account for 29% to 40% of fractures of the facial bones and represent 20% to 62% of all mandibular fractures. Currently 3 main methods are being used in the treatment of mandibular subcondylar fractures: closed reduction; open reduction and internal fixation; Endoscopic reduction and internal fixation. Each method has its proponents and opponent as well as advantages and disadvantages, and indications for each vary among surgeons. There are six approaches of open reduction: submandibular, retromandibular, preaurilcular, postauricular, intraoral, transparotid approach. Among them, transparotid approach has been described for subcondylar exposure with dissection in the direction of facial nerve fibers to expose the bone through the parotid gland. This approach carries the risk of a parotid glandular fistula as well as facial nerve injury but has the advantage of being directly over the fracture site. We report safety and efficacy of surgical treatment using a transparotid approach for direct plating. Methods: A 43-year-old man sustained multiple facial bone fractures by driver traffic accident. Mandibular subcondyle was fractured and dislocated internally. We performed open reduction and internal fixation by transparotid approach. Fractured site was fixed by titanium mini plate & screw. We applicated arch bar for approximately 3 weeks. Results: Follow-up length was about 5months. Scar of surgical incision was indistinct, there was no symptoms and signs of facial nerve and parotid gland injury, and maximal mouth opening was measured 49.5 mm. Conclusion: Transparotid approach has high risks of facial nerve and parotid gland injury, but paradoxically it is the most effective technique in saving facial nerve. Open reduction and internal fixation of mandibular subcondylar fracture by transparotid approach with precise and versed procedure, best outcome can be expected.

ESTHETIC MANDIBULAR ANGLE REDUCTION ; IST USE AND COMPLICATIONS (하악 우각부 미용 성형술 ; 임상적 응용과 병발증)

  • Kim, Chang-Soo;Um, In-Woong;Min, Byoung-Kuk;Min, Seong-Kee;Yang, Yun-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.137-143
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    • 1991
  • The bulging of mandibular angle area, frequently, make some difficulties in social life due to its reckless appearence, especially in oriental nations. So, many authors had reported its causes and surgical techniques for correction since late 19th century with diagnosis of masseter hypertrophy. But in spite of its muscular origin, major surgical techniques, in general, should aim complete bony reduction or osteotomy and supplemental myotomy as in hemimandibular hypertrophy or mandibular elongation. We used ultrasonogram for soft tissue depth estimation and expearenced some complications such as incomplete lingual cortical bony reduction, condylar fracture in mandibular angle reduction via intraoral circumvestibular approach. So we reported our surgical technique for angle reduction with possible complications.

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The three-dimensional microstructure of trabecular bone: Analysis of site-specific variation in the human jaw bone

  • Kim, Jo-Eun;Shin, Jae-Myung;Oh, Sung-Ook;Yi, Won-Jin;Heo, Min-Suk;Lee, Sam-Sun;Choi, Soon-Chul;Huh, Kyung-Hoe
    • Imaging Science in Dentistry
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    • v.43 no.4
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    • pp.227-233
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    • 2013
  • Purpose: This study was performed to analyze human maxillary and mandibular trabecular bone using the data acquired from micro-computed tomography (micro-CT), and to characterize the site-specific microstructures of trabeculae. Materials and Methods: Sixty-nine cylindrical bone specimens were prepared from the mandible and maxilla. They were divided into 5 groups by region: the anterior maxilla, posterior maxilla, anterior mandible, posterior mandible, and mandibular condyle. After the specimens were scanned using a micro-CT system, three-dimensional microstructural parameters such as the percent bone volume, bone specific surface, trabecular thickness, trabecular separation, trabecular number, structure model index, and degrees of anisotropy were analyzed. Results: Among the regions other than the condylar area, the anterior mandibular region showed the highest trabecular thickness and the lowest value for the bone specific surface. On the other hand, the posterior maxilla region showed the lowest trabecular thickness and the highest value for the bone specific surface. The degree of anisotropy was lowest at the anterior mandible. The condyle showed thinner trabeculae with a more anisotropic arrangement than the other mandibular regions. Conclusion: There were microstructural differences between the regions of the maxilla and mandible. These results suggested that different mechanisms of external force might exist at each site.

COMPARATIVE STUDY OF EFFECT OF STABILIZATION SPLINT AND ANTERIOR REPOSITIONING SPLINTS FOR CLICKING SOUND (OCCLUSAL REPOSITIONING SPLINT에 의한 악관절음(顎關節音)의 치료(治療)에 관한 비교연구(比較硏究))

  • Hong, Joon-Pow;Woo, Yi-Hyung;Choi, Dae-Gyun;Choi, Boo-Byung
    • The Journal of Korean Academy of Prosthodontics
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    • v.24 no.1
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    • pp.141-150
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    • 1986
  • This study conducted 2 types of occlusal splint therapy to eliminate clicking sound. 15 patients who had clicking on their joints were selected, and divided, at random, into 3 groups. In the first group, 4 persons put on stabilization splint and in the second group, 6 persons put on anterior repositioning splint which had made condyle to protrude 3mm, and in the last group, 5 persons put on anterior repositioning splint which had made condyle to protrude 6mm. Patients who wore anterior repositioning splint were instructed to use the splint for all days. The evaluation of clicking was measured by occlusal soundscope. The clicking was converted to aucostic signal by the attached microphone, instead of vibrating sensor The in-put aucostic signal on the occlusal soundscope made it possible to observe the experiment's result. Anterior repositioning splint was produced in the centric occlusion state, when the model was mounted to articulator and inserted two pieces of 3mm and 6mm resin blocks each into the rear wall of articulator fossa. The observation of the patients who wore three different splints for 3 weeks has reached the following conclusions: 1. Stabilization splint produced no effect in eliminating the clicking sound. 2. Anterior repositioning splint therapy with 3mm condylar protrusion produced significant improvement in eliminating the clicking sound. 3. The 6mm protruded anterior repositioning splint caused pain on affected TMJ area as well as the clicking on unaffected joint.

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RECONSTRUCTION WITH A VASCULARIZED FREE ILIAC OSTEOMUSCULAR FLAP AFTER HEMIMANDIBULECTOMY FOR OSTEOSARCOMA OF THE MANDIBULAR CONDYLE REGION : A CASE REPORT (하악과두에서 발생한 악성 골육종 환자에서 외과적 절제 후 유리장골이식을 이용한 재건)

  • Park, Hong-Ju;Yu, Min-Gi;Kook, Min-Suk;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.386-394
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    • 2008
  • Osteosarcoma of the jaw is a rare malignant bone tumor which usually leads to a poor prognosis. It commonly occurs in young patients, especially in male. The tumor can involve mandible or maxilla with same frequency. The swelling in the involved area and facial deformity are common clinical findings. The pain and sensory changes are also complained by the patients. Although radical surgery plays an important role in the management of this tumor, the adjuvant chemotherapy or radiotherapy is used to enhance local control and to prevent distant metastases. We treated a 22-year-old male patient who had osteosarcoma in the left condylar region. The radical surgery which consisted of hemimandibulectomy and total parotidectomy, was done and an immediate mandibular reconstruction was performed with a vascularized free iliac osteomuscular flap. The obtained results, both esthetic and functional, were satisfactory. The patient was received postoperative chemotherapy. This is a case with reviews of the literatures.

A STUDY ON THE ELASTIC DEFORMATION AND STRESS DISTRIBUTION OF THE MANDIBLE WITH OSSEOINTEGRATED IMPLANT PROSTHESES USING THREE DIMENSIONAL FINITE ELEMENT ANALYSIS METHOD (골유착성 임플랜트 보철물 장착시 하악골의 탄성변형 및 응력분포에 관한 삼차원 유한요소법적 연구)

  • Kim, Yong-Ho;Kim, Yung-Soo;Kim, Chang-Whe
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.2
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    • pp.203-244
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    • 1998
  • The human mandible is always under the condition of loading by the various forces extorted by the attached muscles. The loading is an important condition of the stomatognathic system. This condition is composed of the direction and amount of forces of the masticatory muscles, which are controlled by the neuromuscular system, and always influenced by the movement of both opening and closing. Mandible is a strong foundation for the teeth or various prostheses, nevetheless it is a elastic body which accompanies deformation by the external forces on it. The elastic properties of the mandible is influenced by the various procedures such as conventional restorative treatments, osseointegrated implant treatments, reconstructive surgical procedures and so forth. Among the treatments the osseointegrated implant has no periodontal ligaments, which exist around the natural teeth to allow physiologic mobility in the alveolar socket. And so around the osseointegrated implant, there is almost no damping effect during the transmission of occlusal stress and displacements. If the osseointegrated implants are connected by the superstructure for the stabilization and effective distribution of occlusal stresses, the elastic properties of mandible is restricted according to the extent of 'splinting' by the superstructure and implants. To investigate the change of elastic behaviour of the mandible which has osseointegrated implant prosthesis of various numbers of implant installment and span of superstructre, a three dimensional finite element model was developed and analyzed with conditions mentioned above. The conclusions are as follows : 1. The displacements are primarily developed at the area of muscle attachment and distributed all around the mandible according to the various properties of bone. 2. The segmentation in the superstructure has few influence on the distribution of stress and displacement. 3. In the load case of ICP, the concentration of tensional stress was observed at the anterior portion of the ramus($9.22E+6N/m^2$) and at the lingual portion of the symphysis menti($8.36E+6N/m^2$). 4. In the load case of INC, the concentration of tensional stress was observed at the anterior portion of the ramus($9.90E+6N/m^2$) and the concentration of tensional stress was observed at the lingual portion of the symphysis menti($2.38E+6N/m^2$)). 5. In the load case of UTCP, the relatively high concentration of tensional stress($3.66E+7N/m^2$) was observed at the internal surface of the condylar neck.

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Digital technique in diagnosis and restoration of maxillary anterior implant: a case report (디지털 기법을 활용한 상악 전치부의 진단 및 수복 증례)

  • Haemin, Bang;Woohyung, Jang;Chan, Park;Kwi-Dug, Yun;Hyun-Pil, Lim;Sangwon, Park
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.4
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    • pp.249-256
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    • 2022
  • The implant prosthesis of anterior maxilla requires careful consideration in planning. In order to satisfy both esthetic and functional needs of a patient, fusion of intra-oral scan in Cone-beam computed tomography (CBCT) and facial scan can be considered. Bony structures and soft tissues captured in CBCT and occlusal surfaces of intra oral scan were incorporated into personal characteristics from facial scan. The patient had insufficient buccal bone on maxillary anterior area. The maxillary implants could not be placed on the most ideal position. However, the "top down" approach completed by computer-generated arranging of teeth in implant planning and surgery with surgical guide resulted in esthetically and functionally satisfying result regardless of the limitation. Careful diagnosis with digital technique and the usage of surgical guide resulted in successful surgery and esthetic restoration. The temporary fixed prostheses were designed, restored and evaluated. The patient was not satisfied with the first design of temporary prosthesis, which showed uneven space distribution between teeth due to the position of maxillary implant. The design was modified by changing proximal emergence contours and line angle to alter the perceived since of incisors. The patient was satisfied with the new design of provisional restoration. A digital occlusion analyzer (Arcus Digma II, KaVo, Leutkirch, Germany) was used to measure inherent condylar guidance and anterior guidance of a patient to provide a definitive prosthesis.