• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권6호
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• pp.653-656
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• 2008

Mesenchymal chondrosarcoma is a rare malignant tumor of bone and soft tissue. This aggressive form of chondrosarcoma represents only 3% to 9% of all chondrosarcomas. This neoplasm is characterized by sheets or clusters of undifferentiated spindle or round cells surrounding discrete nodules of well-differentiated cartilage. We experienced a case of mesenchymal chondrosarcoma on mandibular body. Two years ago, the patient had been treated the intrabony cystic lesion on mandiblular left body. At that time, cartilage portion was not detected in the cystic specimen. Two years after cyst enucleation, the recurred large neoplasm in the mandibular left body was noted, and it was diagnosed as 4.5 cm sized mesenchymal chondrosarcoma. The mandibular tumor was widely resected and rigid-plate and cervical musculocutaneous flap were used for reconstruction of resected bone and soft tissues. No complications and recurrence were noted for 6 months postoperatively.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권3호
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• pp.371-377
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• 1996

Bone graft has been used to repair one defect caused by disease and trauma, congenital and acquired deformities. Graft materials are autogenous bone, allogenic bone, xenogenic bone, synthetics. Autogenous bone graft is the most superior to other materials for immunologic reaction, compatibility to host tissue, and revascularization. However, autogenous bone graft is required for additional operation and the amount of taking is limited. Autografts are obtained at own expense and also limited in size, shape. In order to compensate these problems, allogenic bone graft has been used increasingly. But allogenic bone graft encounters immunologic complications. Therefore, it has been used after freezing, lyophilization, or demineralization. Allogenic bone processed by only lyophilization includes potential antigenic properties on its surface, therefore it is demineralized to deplete immunologic reaction. Demineralized bone releases BMP and helps the mesenchymal cells transform to the chondroblast to produce cartilage and bone. This reaction is called osteoinducation. Many authors have reported that mineralized lyophilized bone had less antigenicity clinically and favorable bony consideration with host bone. In our department from 1995 to now, we have used banked allogenic bone graft that has been prepared from Wonkwang Bone Bank in 5 cases and mineralized lyophilized bone graft in 2 cases to reconstruct the maxillofacial bone defect after tumor resection and cyst enucleation and cleft alveolus. We will report with literature review that the result is favorable functionally and esthetically.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.50.1-50.6
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• 2019

Purpose: Maxillary bone grafts and implantations have increased over recent years despite a lack of maxillary bone quality and quantity. The number of patients referred for oroantral fistula (OAF) due to implant or bone graft failure has increased, and in patients with an oroantral fistula, the pedicled buccal fat pad is viewed as a robust, reliable option. This study was conducted to document the usefulness of buccal fat pad grafts for oroantral fistula closure. Materials and methods: We retrospectively studied 25 patients with OAF treated with a buccal fat pad graft from 2015 to 2018. Sex, age, OAF location, cause, duration, presence of systemic disease, smoking, previous dental surgery, and side effects were investigated. Results: A total of 25 patients were studied. Mean patient age was 54.8 years, and the male to female ratio was 19: 6. Causes of oroantral fistula were cyst enucleation, tumor resection, implant removal, bone graft failure, and extraction. Excellent results were obtained in 23 (92%) of the 25 patients. In the other two patients that both smoked, a small fistula was observed during follow-up. No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up. Conclusions: The incidence of oroantral fistula is increasing due to implant and bone graft failures. Oroantral fistula closure using a pedicled buccal fat pad was found to have a high success rate.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제13권2호
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• pp.160-166
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• 1991

치성낭종과 법랑아세포종과의 조직학적 기준이 모호한 경우에 과거에는 병리학자들이 진단하는데 어려움이 많았으나 1970년 Robinson & Martinez가 조직학적 기준을 제시하면서 unicystic ameloblastoma라 명명하였다. Unicystic ameloblastoma는 conventional ameloblastoma 보다 젊은 연령인 10대, 20대에서, 하악 제3대구치부에서 호발하며 방사선학적으로 단방성 혹은 다방성의 비교적 경계가 뚜렷한 방사선 투과성 병소를 보인다. 이 병소는 적출술만으로 치료하였을 때 solid or multicystic ameloblastoma보다 현저히 낮은 재발율을 보인다. 임상적, 방사선학적으로 unicystic ameloblastoma가 의심되면 병소를 완전히 적출하여 정확한 병리조직학적 진단을 하여 solid or multicystic ameloblastoma일 때는 2차적으로 광범위한 수술 등을 고려하는 것이 타당할 것으로 사료되어 문헌고찰과 함께 3증례의 치료 경험을 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권2호
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• pp.120-127
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• 2021

Primary intraosseous squamous cell carcinoma (PIOSCC) is very rare type of squamous cell carcinoma (SCC) that occurs within the jaw and arises from remnants of odontogenic epithelium with no connection to the oral mucosa. This study reports two cases of PIOSCC of the mandible. Reported in this article are two cases of PIOSCC of the mandible that were treated with resection and reconstruction using a fibular free flap. The first case was a 36-year-old male patient who complained of right mandibular pain. Computed tomography (CT) and panoramic radiograph revealed a large radiolucency in the mandibular ramus area. At first, an odontogenic keratocyst was tentatively diagnosed, and an excision procedure was carried out at another clinic. A final biopsy after cyst enucleation revealed well-differentiated SCC, so we proceeded with segmental mandibulectomy and reconstruction using a fibular free flap. The second case was a 48-year-old male patient with left mandibular pain. CT and panoramic radiograph revealed irregular radiolucency in the mandibular angle area near tooth #38. At first, osteomyelitis was tentatively diagnosed, and a curettage was carried out. A later biopsy revealed well-differentiated SCC, so segmental mandibulectomy and reconstruction with a fibular free flap were secondarily performed. Our two cases have had no recurrence. The facial appearance of both patients is satisfactory, and the neo-mandibular body created using a fibular bone transfer displays adequate bony volume.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권3호
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• pp.241-248
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• 2008

Tibial bone grafts provide an adequate volume of cancellous bone with cortical bone, high biologic value of bone, minimal gait disturbance and complications, and no special contraindications, and offer a superior clinical results than any other donor sites. Lateral appoach in tibial bone graft was used to gain large bone volume traditionally, but medial approach provides low morbidity associated with the tibial anatomic structure, simple and safety surgical procedure, and better comfortable to patients recently. We have undertaken clinical and retrospective studies on patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from April 2004 to January 2008. 50 patients have maxillofacial bony defect as resection of bening tumor, cyst enucleation, alveolar bone resorption, sinus pneumatization were received the tibial proximal autogenous particulated cancellous bone grafts. They were analyzed sex, age, diagnosis of recipient site, lesion size, dornor site, cortical bone repositioning, complications and we concluded favorable following results. 1. Medial approach for proximal tibia is safer and technically easier than lateral approach, associated with the proximal tibial anatomic structures, and short operative times. 2. Proximal tibia provides an adequate bone volume with predictability for oral and maxillofacial reconstruction. 3. Patients rarely complain of pain, swelling, discomfort and dysfunction such as gait disturbance. In conclusion, medial approach for proximal tibial graft seems to be a valuable tool for oral and maxillofacial reconstruction.

• 대한소아치과학회지
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• 제39권3호
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• pp.249-256
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• 2012

본 연구는 전북대학교 치과병원 소아치과에서 2005년 1월부터 2011년 7월까지 6년 7개월 동안 촬영된 Cone beam형 전산화단층영상(CBCT)를 통해 소아치과 영역에서의 CBCT의 활용도를 평가하고자 한다. 1. CBCT 촬영 환자는 총 252명, 촬영횟수 279회였으며, 남자 151회(54.1%), 여자 128회(45.9%)였다. 2. 연령에 따라 9~12세 군 53%, 6~8세 군 24%, 그리고 13~15세 군이 15%였다. 3. 촬영 주소는 매복치의 위치 및 형태 확인 49.1%, 정중과잉치 19.4%, 과잉치 7.9%, 맹출 중인 치아의 위치 및 근관의 형태 7.2%, 낭종 5.4%, 염증성 병소 3.9%, 치아종 3.9%, 그리고 종양이 2.2%를 보였다. 4. 치료 내용은 발치 29.7%, 교정적 정출 및 배열 24.0%, 정기 검진 16.5%, 타과 의뢰 11.5%, 근관 치료 3.9%, 조대술 3.9%, 외과적 제거술 2.9%, 그리고 적출술이 1.1%를 보였다.

• 대한소아치과학회지
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• 제36권4호
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• pp.613-618
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• 2009

구치부 매복은 1% 이내로 드문 편이지만 저위 교합, 반대 악궁 치아의 정출, 인접치 경사로 인한 공간 부족 등의 문제가 발생하게 된다. 구치부 치아는 교합 및 악골 발육에 관여하는 기능적으로 중요한 치아이므로 초기 혼합 치열기부터 지속적인 방사선 사진을 찍어 매복 여부를 관찰해야 한다. 매복의 원인에는 치근 발육의 저하, 과잉치, 낭종, 치아종, 유착 등이 있다. 첫 번째 증례에서는 초진 시 치근 발육이 1/2이하라서 자발적 맹출을 기대하였지만 2/3이상 발육 시에도 맹출 하지 못하여 외과적 노출 및 교정적 견인을 시함하였다. 두 번째 증례는 낭종을 포함하는 매복 구치를 주소로 내원하였고 낭종 크기가 작고 인접 부위에 주요한 해부학적 구조물이 없어 완전한 적출술을 시행 후 교정적 견인을 하였다. 교정적 견인 시 해당 치아에 직접 어태치먼트(attachment)를 붙인 후 악하고 지속적인 힘을 적용하는 것이 유착, 외흡수, 치주 부착 소실 등의 부작용이 나타나지 않는다. 또한 고정식 장치를 사용하면 환자의 협조도가 필요 없고 맹출 공간을 확보하면서 호선상에 매복치를 견인 할 수 있다. 본 증례에서는 매복 구치를 외과적 노출 및 교정적 견인을 통해 교합상으로 배열을 하여 양호한 결과를 얻었기에 보고하는 바이다.