• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.597-599
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• 2010

Subcutaneous emphysema and pneumomediastium is a relatively uncommon phenomenon. Most case of pneumomediastium are caused by iatrogenic injury on the cervical region and chest during tracheostomy. It is also well known that emphysema may occur secondary to dental treatment using high-speed air turbine handpiece, but there have been few cases of emphysema extended to involving the mediastinum. These complications are reported to occur mainly in patients after dental procedures, in particular during mandibular third molar extraction. Early recognition and conservative treatment of these problems is essential in preventing life-threatening complications such as airway obstruction, mediastinitis, pneumothorax and cardiac failure. As we report a case of 25-year-old woman with subcutaneous emphysema and pneumomediastium after mandibular third molar extraction using high-speed air turbine handpiece.

• Imaging Science in Dentistry
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• v.47 no.1
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• pp.63-68
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• 2017

Some complications can arise with the usage of local anesthesia for dental procedures, including the fracture of needles in the patient. This is a rare incident, usually caused by the patient's sudden movements during anesthetic block. Its complications are not common, but can include pain, trismus, inflammation in the region, difficulty in swallowing, and migration of the object, which is the least common but has the ability to cause more serious damage to the patient. This report describes a case in which, after the fracture of the anesthetic needle used during alveolar nerve block for exodontia of the left mandibular third molar, the fragment moved significantly in the first 2 months, before stabilizing after the third month of radiographic monitoring.

• The Journal of Advanced Prosthodontics
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• v.7 no.3
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• pp.264-270
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• 2015

This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.23.1-23.10
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• 2019

The choice of surgical technique in orthognathic surgery is based primarily on the surgical treatment objectives (STO), which is a fundamental component of the orthognathic treatment process. In the conventional orthodontics-first approach, presurgical planning can be performed twice, during the preorthodontic (initial STO) and presurgical phases (final STO). Recently, a surgery-first orthognathic approach (SFA) without presurgical orthodontic treatment has been introduced and combined initial and final STO at the same time. In contrast to the conventional surgical-orthodontic treatment protocol that includes preoperative orthodontics for dental decompensations to maximize stable postoperative occlusion, the SFA potentially shortens the treatment period and minimizes esthetic concerns during the decompensation period because skeletal problems are corrected from the beginning. The indications for the SFA have been proposed in the literature, but no consensus exists. Moreover, because dental occlusion of the pre-orthodontic arches cannot be used as a guide for establishing the surgical treatment plan, there are fundamental limitations in accurate prediction of postsurgical results in the SFA. Recently, the concepts of postsurgical orthodontic treatment are continuously changing and evolving to overcome this inherent limitation of the SFA. The elimination of presurgical orthodontics can change the paradigm of orthognathic surgery but still requires cautious case selection and thorough discussion and collaboration between orthodontists and surgeons regarding the goals and postoperative management of the orthognathic procedure.

• The Journal of the Korean dental association
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• v.37 no.3 s.358
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• pp.221-227
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• 1999

The aim of this study was to describe the clinical availability of a variety of facial bone grafts in oral and maxillofacial surgery. Thirty patients with oral and maxillofacial bone defects were treated with mandible, maxilla, and zygoma bone grafts. The ages of the patients ranged from 8 to 64 years, with a mean age of 28.6 years. The follow-up period ranged from 2 to 30 months, with a mean follow-up of 11.7 months. Although postoperative follow-up was of short duration, the recilient sites were favorable to healing and bone consolidation. Healing progressed normally without severe morbidity. The donor site did not present a management problem in any of the patients.Some minor complications developed in 8 patients, of which three were infections and another three were wound dehiscence. There complications were easily managed with incision and drainage, antibiotics and local wound care. We consider that a variety of facial bone grafts can be used for reconsider that a variety of facial bone grafts can be used for reconstruction of small or moderate large bony defects.

• Journal of Periodontal and Implant Science
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• v.49 no.6
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• pp.346-354
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• 2019

Maxillary implants are inserted in the upward direction, meaning that they oppose gravity, and achieving stable support is difficult if the alveolar bone facing the maxillary sinus is thin. Correspondingly, several sinus-lifting procedures conducted with or without bone graft materials have been used to place implants in the posterior area of the maxilla. Even with these procedures available, it has been reported that in about 5% of cases, complications occurred after implantation, including acute and chronic sinusitis, penetration of the sinus by the implant, implant dislocation, oroantral fistula formation, infection, bone graft dislocation, foreign-body reaction, Schneiderian membrane perforation, and ostium plugging by a dislodged bone graft. This review summarizes common maxillary sinus pathologies related to implants and suggests an appropriate management plan for patients requiring dental implantation.

• The Journal of the Korean dental association
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• v.55 no.8
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• pp.537-540
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• 2017

BSSRO (bilateral sagittal split ramus osteotomy) is frequently performed to correct dentofacial deformity and malocclusion. Among its complications the incidence of post-operative facial nerve palsy is very rare, but it is one of the most serious complications. The case of a 21-year-old male patient who underwent facial nerve palsy after BSSRO is described. After surgical intervention and conservative therapy, the patient recovered his facial nerve function successfully.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.10.1-10.9
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• 2020

Background: The aim of this study was to evaluate the long-term clinical stability of implants with acid-etched surfaces sandblasted with alumina using retrospective analyses of the survival rate, success rate, primary and secondary stability, complications, and marginal bone loss of the implants. Methods: Patients who had implants placed (TS III SA, SS II SA, SS III SA, and U III SA) with SA surfaces from Osstem (Osstem Implant Co., Busan, Korea) at the Seoul National University Bundang Hospital, from January 2008 to December 2010 were selected for the study. Patients' medical records and radiographs (panorama, periapical view) were retrospectively analyzed to investigate sex, age, location of implantation, diameter, and length of the implants, initial and secondary stability, presence of bone grafting, types of bone grafting and membranes, early and delayed complications, marginal bone loss, and implant survival rate. Results: Ninety-six implants were placed in 45 patients. Five implants were removed during the follow-up period for a total survival rate of 94.8%. There were 14 cases of complications, including 6 cases of early complications and 8 cases of delayed complications. All five implants that failed to survive were included in the early complications. The survival of implants was significantly associated with the occurrence of complications and the absorption of bone greater than 1 mm within 1 year after prosthetic completion. In addition, the absorption of bone greater than 1 mm within 1 year after prosthetic completion was significantly associated with the occurrence of complications, primary stability, and implant placement method. Five cases that failed to survive were all included in the early complications criteria such as infection, failure of initial osseointegration, and early exposure of the fixture. Conclusions: Of the 96 cases, 5 implants failed resulting in a 94.8% survival rate. The failed implants were all cases of early complications such as infection, failure of initial osseointegration, and early exposure of the fixtures. Periimplantitis was mostly addressed through conservative and/or surgical treatment and resulted in very low prosthetic complications. Therefore, if preventive measures are taken to minimize initial complications, the results can be very stable.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.3 no.2
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• pp.75-79
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• 2007

Background: Down's syndrome, or trisomy 21, is the commonest congenital chromosome anomaly. With improvement in medical care, these patients increasingly reach adulthood in spite of their physical maldevelopment and mental retardation. And, the number of those who required general anesthesia for dental treatment is increasing. Methods: We reviewed the 26 cases of 22 patients with Down's syndrome who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 22 years. They all had severe mental retardation and some had congenital heart anomaly, epilepsy, hypothyroidism, acute leukemia, autism, cleft palate, and chronic renal failure. For anesthesia induction, 4 cases was needed physical restriction, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (17 cases) and sevoflurane (9 cases). All patients received nasotracheal intubation and 3 cases needed difficult airway management. Mean total anesthetic time was $166{\pm}60$ min and staying time at PACU was $92{\pm}48$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.4
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• pp.338-344
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• 2018

This article describes cases of applying non-surgical treatment including scaling and root planing, occlusal adjustment and tooth splinting of periodontally compromised lower anterior incisors Clinical and radiographic evaluations were performed over a 1-3-year period. All clinical parameters and radiographic bone levels improved in both cases. Dramatic regeneration of alveolar bone and lamina dura were observed on radiographic images, and no specific complications occurred during the follow-up period. Within the limitations of this study, these cases demonstrated the possibility of tooth rescue through non-surgical treatment and splinting of periodontally compromised teeth typically considered for extraction.