• Imaging Science in Dentistry
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• 제52권2호
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• pp.123-131
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• 2022

Purpose: The aim of this study was to characterize the cone-beam computed tomographic (CBCT) imaging features of central giant cell granuloma (CGCG) of the jawbone. Materials and Methods: This study retrospectively reviewed 26 CBCT studies of histologically proven cases of CGCG during a period of 20 years, from 1999 to 2019. Patients' demographic data were recorded, and radiographic features were assessed (location, border, cortication, appearance of the internal structure, locularity, septation, expansion, cortical perforation, effects on surrounding tissue, whether the lesion crossed the midline, and lesion volume). Results: In this study, CGCGs were seen almost twice as often in the mandible than in the maxilla, and 64.7% of mandibular lesions involved the anterior region. Only 26.9% of lesions crossed the midline, a feature that was considered characteristic of CGCG. Furthermore, 65.4% of lesions were unilocular and 34.6% were multilocular. The correlation between a lesion's size and its locularity was statistically significant, and larger lesions showed a multilocular appearance. The mean volume of multilocular lesions was greater than that of unilocular lesions. Conclusion: CGCGs showed variable radiographic features on CBCT, and this imaging modality is highly effective at demonstrating the radiographic spectrum and lesional extent of CGCGs in the jawbone.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권2호
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• pp.110-115
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• 2024

A 22-year-old male patient presented to the clinic with severe pain in the preauricular area with an inability to completely occlude the jaw. Facial computed tomography and magnetic resonance imaging revealed a well-defined lesion that was tentatively diagnosed as a benign tumor or cystic mass. Surgical approach of a lesion in the condyle is delicate and problematic as many vulnerable anatomical structures are present. There are several methods for surgery in this area. Typically, an extraoral approach is dangerous because of potential injuries to nerves and arteries. The intraoral approach also presents difficulties due to the lack of visibility and accessibility. On occasion, coronoidectomy may be performed. The goal here was to determine an easier and safer new surgical approach to the condyle. We reached the anterior part of the pterygoid plate in the same method as in Le Fort I surgery. From this point, through the external pterygoid muscle, approaching the anterior aspect of the condyle is relatively easy and safe, with minimal damage to the surrounding tissues. Pus was drained at the site, and the lesion was diagnosed as an abscess. Pain and inability to close the mouth resolved without recurrence.

• 치과방사선
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• 제27권2호
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• pp.135-144
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• 1997

The primary intra-osseous carcinoma (PIOC) is a very rare lesion. PIOC is an odontogenic carcinoma defined as a squamous cell carcinoma arisinig within a jaw having no initial connection with the oral mucosa, and presumably developing from residues of the odontogenic epithelium. The authors diagnosed a 51-year-old female as primary intra-osseous carcinoma after undergoing clinical, radiological and histological examinations. The characteristics were as followed : 1. The patient complained of gingival bleeding on the premolar area in the left maxilla 2. The conventional radiograms showed a relatively well-defined unilocular radiolucent lesion from the mesial aspect of the upper left canine to the mesial aspect of the upper left 1st molar. The 2nd premolar was separated from the 1st molar and the floor of the maxillary sinus was elevated by the lesion. There was a external root resorption of the upper left canine, the 1st premolar, and the 2nd premolar. 3. On the computed tomograms, the osteolytic bony lesion expanded the cortical plate of the left maxilla and displaced the margin of the left maxillary sinus upwards. But the bony lesion was separated from the maxillary sinus by a bony septum. 4. Bone scintigram with /sup 99m/Tc demonstrated the increased uptake in the left maxilla. Sonograms in the neck area and chest P-A radiogram didn't show any abnormalities. 5. Histologically, the tumor islands infiltrating into the surrounding bone increased in alveolar pattern, composed of the malignant cells, and there was a necrosis in the center of the tumor islands.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권1호
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• pp.81-85
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• 2010

Multiple jaw cysts are one of the most constant features of the basal cell nevus syndrome. Basal cell nevus syndrome is inherited as an autosomal dominant trait with variable expressiveness. This syndrome comprises a number of abnormalities such as multiple nevoid basal cell carcinomas of the skin, skeletal abnormalities as bifid rib and fusion of vertebrae, central nervous system abnormalities as mental retardation, eye abnormalities with multiple jaw cysts. The odontogenic keratocysts in patients with this syndrome are often associated with the crowns of unerupted teeth and huge size; on radiographs they may mimic dentigerous cysts. The most important feature of the cyst is its extraordinary recurrence rate. Since recurrence may be long delayed in this lesion, follow-up of any case of odontogenic keratocyst with roentgenograms and clinical examination of basal cell carcinoma are essential for at least five years after surgery. We report the result of 7-year follow up after cyst enucleation associated with basal cell nevus syndrome with the literature of review.

• Imaging Science in Dentistry
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• 제41권1호
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• pp.23-28
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• 2011

Purpose : This study was to find the computed tomographic features of fibrous dysplasia of the maxillofacial region. Materials and Methods : All eight cases included in the study reported either to Government Dental College and Hospital or Nair Hospital Dental College, Mumbai between 2003 and 2009. The patients were prescribed computed tomogram in addition to conventional radiographs of maxillofacial region which were studied for characteristic features of fibrous dysplasia. The diagnosis of fibrous dysplasia was confirmed by histopathological report. Results : All cases showed the ill-defined margins of lesions except in the region where the lesions were extending to cortex of the involved bone. Internal structure of all cases showed ground glass appearance. Four cases of maxillary lesion showed the displacement of maxillary sinus maintaining the shape of maxillary sinus. Two cases showed complete obliteration of maxillary sinus. Displacement of inferior alveolar canal did not follow any typical pattern in any of the cases but was displaced in different directions. Conclusion : The craniofacial type of fibrous dysplasia is as common as fibrous dysplasia of jaw. The margins, extent, internal structure and effect on surrounding structure are well detected on computed tomographic images.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권5호
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• pp.494-498
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• 2007

Purpose: This study was done to know the usefulness of fractal analysis when evaluating the radiologic changes after decompression on jaw bone cystic lesions using fractal analysis. Materials and methods: 30cases of cystic lesions were followed up after decompression. Panoramic image was used to observe radiologic changes around the cystic lesion. The part of the panoramic image which showed radiologic change was defined as region of interest(ROI); The fractal dimension of the ROI was calculated using box-counting method. Results: Using sign-rank test, there was a statistically significant difference in fractal dimensions after decompression therapy(P<0.0001). The fractal dimensions statistically increased after decompression(the median of D:0.12). Conclusions: The ROI after decompression showed higher fractal dimensions which offer the objective proof of the bone healing around cystic lesions after decompression treatment.

• Imaging Science in Dentistry
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• 제48권3호
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• pp.153-160
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• 2018

Purpose: This study aimed to assess the reliability of ultrasonography (US) in comparison with cone-beam computed tomography (CBCT) as a tool for monitoring the healing of jaw lesions. Materials and Methods: Twenty-one radiolucent lesions in jaws referred to the Oral Surgery Department at our institution were selected for this study. All lesions underwent CBCT and US examinations. The anteroposterior, superoinferior, and mesiodistal dimensions of the lesions were measured on CBCT and US images before surgery and at 6 months after surgery. The dimensions were compared between the US and CBCT images. Blood-flow velocity around the lesions was measured by color Doppler before surgery and at 1 week and 6 months after surgery to assess the capability of US to show changes in blood-flow velocity around the lesion. Results: Before surgery, there were no significant differences between US and CBCT in the mesiodistal and anteroposterior dimensions, although a significant difference was found in the superoinferior dimension (P<.05). However, at 6 months after surgery, significant differences were found between US and CBCT in all dimensions, and it is likely that the US measurements more accurately reflected the extent of healing. The average blood-flow velocity increased at 1 week after surgery (5.84 cm/s) compared with the velocity before surgery (4 cm/s) (P<.05). Then, at 6 months after surgery, the blood-flow velocity significantly decreased (3.53 cm/s) compared to the velocity measured at 1 week after surgery (P<.05). Conclusion: US with color Doppler was confirmed to be a more efficient tool than CBCT for monitoring bone healing.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권2호
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• pp.103-109
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• 2024

Teriparatide has been effective in treating people diagnosed with medication-related osteonecrosis of the jaw (MRONJ). However, its efficacy is not well established to be accepted as a standard of care. The objective of this paper was to investigate the efficacy of recombinant human parathyroid hormone for the treatment of MRONJ. We report three cases of MRONJ patients with osteoporosis as the primary disease who were treated with a teriparatide agent along with other adjunctive measures. Each patient was administered a teriparatide injection subcutaneously for 16 weeks, 36 weeks, or 60 weeks. Surgical intervention including partial resection, sequestrectomy, decortication, and saucerization took place during the teriparatide administration. Complete lesion resolution was identified clinically and radiographically in all three patients. In patients diagnosed with MRONJ, teriparatide therapy is an efficacious and safe therapeutic option to improve healing of bone lesions. These findings demonstrate that teriparatide in combination with another therapy, especially bone morphogenetic protein, platelet-rich fibrin, or antibiotic therapy, can be an effective protocol for MRONJ.

• 대한소아치과학회지
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• 제47권1호
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• pp.87-92
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• 2020

선양 치성 종양(adenomatoid odontogenic tumor)은 소아에서 드물게 발생하는 악골의 치성 기원의 종양이다. 보통 10대에서 상악 견치부분에 발생한다. 이 증례는 3세 여환으로 하악 제2유구치의 미맹출을 주소로 개인병원에서 의뢰되었다. 부종과 통증의 병력은 없었다. 파노라마 사진에서 매복된 하악 제2유구치의 주변으로 방사선투과상 병소가 관찰되었고, Cone Beam Computed Tomography (CBCT) 에서는 골팽창과 함께 방사선 불투과상 병소들이 관찰되었다. 하악 제2유구치의 발치와 함께 병소의 적출과 조직 생검이 시행되었다. 술 후 1년 검사에서 재발을 보이지 않았다. 임상적, 방사선학적 검사를 통해 이 병소는 소아 청소년의 하악 구치부에서 호발하는 법랑모세포 섬유치아종(Ameloblastic fibroodontoma)로 진단되었다. 하지만 생검의 결과를 통해 이 병소는 선양 치성 종양으로 확진 되었다. 이 증례 보고는 매우 어린 나이에 하악 유구치에 발생한 흔하지 않은 선양 치성 종양 증례를 기술하고 있다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권5호
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• pp.360-364
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• 2021

Objectives: The purpose of this study was to evaluate the clinical and radiographic characteristics of idiopathic bone cavity (IBC) to determine the effect of surgical intervention on the process of healing. Materials and Methods: All cases diagnosed with IBC during the period of 2011 to 2020 at our Department of Oral and Maxillofacial Surgery were searched. Ninety cases were retrieved. The features evaluated were sex, age, contour of the lesion, number of teeth involved, site, history of trauma, and postoperative healing pattern. The significance of differences was assessed by Mann-Whitney U test and chi-square test. Results: The female:male ratio showed no predilection toward either sex (0.9:0.8). The mean age of the collected sample was 22.05±14.38 years, and the age ranged from 10 to 58 years. All cases presented in the mandible and showed well-circumscribed radiolucency. Margins were either scalloped or round in shape, and the size varied from one tooth to six teeth involvement. Seventy cases involved three or fewer roots. Three cases showed bilateral lesion. Four cases had a history of trauma at the area of the lesion. Fifty-one cases were followed for six months after surgery, and all showed increased bone density at the lesion. Conclusion: There is no definitive radiological or clinical feature of IBC. Considering the diversity of clinical and radiological features, such a diagnosis relies primarily on surgical findings of an empty bone cavity with no epithelial lining. Our data suggest that surgical intervention be the first choice of treatment as opposed to observation.