Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.38
no.5
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pp.276-283
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2012
Objectives: Curettage and enucleation are two of the most common procedures performed in oral and maxillofacial surgery units. To access a cystic lesion, the buccal cortical plate is removed. The no reposition (NR) group underwent surgery without repositioning the buccal cortical plate. The reposition (R) group underwent surgery with a repositioning of the buccal cortical plate. This study compared the two surgical procedures in terms of bone healing and complications. Materials and Methods: Patients who underwent curettage and enucleation surgery were enrolled in this study. Panoramic radiographs of the patients in both the NR group (n=26) and R group (n=34) were taken at the baseline and at 6, 12 and 24 months after surgery. The radiolucent area was calculated to evaluate bony healing in each radiograph. The complications were analyzed through a review of the medical records. Results: The correlation between bony healing and surgical approach was not significant in the 6th, 12th, and 24th month (P<0.05). The complication rate was not associated with gender, graft material, bone graft and drain insertion (P<0.05). On the other hand, the R group had a higher complication rate (35.3%) than the NR group (0%). The difference in the mean lesion size between the NR group ($37,024{\pm}3,617$ pixel) and R group ($92,863{\pm}15,931$ pixel) was significant (independent t test, P=0.004). Conclusion: Although the reposition method is chosen when the lesion size is large, it is associated with more complications. Indeed, infection, discomfort and recurrence of the lesion were the most common complications in the R group. Furthermore, the R method does not have a strong point in terms of bone healing compared to the NR method. Therefore, the R method cannot be considered an ideal approach and should be used in limited cases.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.23
no.1
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pp.27-44
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1993
This study was performed to investigate the changes of mandibular condyle by low calcium diet and the effects of irradiation on the bone in osteoporotic state. In order to carry out this experiment, 80 seven-week old Sprague-Dawley strain rats weighing about 150 gm were selected and equally divided into one experimental group of 40 rats and one control group with the remainder. The experimental group and the control group were then subdivided into two group and exposed to irradiation. The two irradiation groups received a single dose of 20 Gy on the jaw area only and irradiated with a cobalt-60 teletherapy unit. The rats in the control and experimental groups were serially terminated by fours on the 3rd, the 7th, the 14th, and the 21st day after irradiation. After termination, both sides of the dead rats mandibular condyle were removed and fixed with 10% neutral formalin. The bone mineral density of mandibular condyle was measured by use of dual energy X-ray bone densitometer(model DDX-alpha, Lunn Corp., U. S. A.). The mandibular condyle was radiographed with Hitex HA-80(Hitex Co., Japan). Thereafter, the obtained radiographs were observed, and the mandibular condyle was further decalcified and embedded in paraffin as the general method. The specimen sectioned and stained with hematoxylin-eosin, PAS and Rabbit Anti-Human Tumor Necrosis Factor-a observed by a light microscope. The obtained results were as follows: 1. In the non-irradiated group with the low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days, and decrease the number of trabeculae of the condyle and resorption of the calcified cartilaginous zone were observed after 3 days. On microscopic observations, the number nd size of trabeculae were decreased after 7 days of experiment. 2. In the irradiated group with the low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days and resorption of the calcified cartilaginous zone and decrease the number and coarse of the trabeculae of the condyle were observed. These findings were extended rather than in non-irradiated group with low calcium diet. On microscopic observations, many osteoclasts were detected and the number and size of trabeculae were somewhat decreased after 7 days. Also there was degenerative changes of tissues of bone marrow on the 14th day but that condition was restored on the 21st day of experiment. 3. In the irradiated group with normal diet, the bone mineral density of the condyle was somewhat decreased with times and degree of decrease of the number of trabeculae was somewhat larger than in the non-irradiated group with normal diet. On microscopic observations, the tissues of bone marrow were atrophic and degenerative changes but that condition was restored on the 21st day of experiment. 4. In immunocytochemical findings, in the irradiated and non-irradiated groups with low calcium diet, negative or partial positive response to TNF was observed, but positive response in the normal diet groups.
We compared the characteristics of Siemens virtual wedge device with physical wedges for clinical application. We investigated the characteristics of virtual and physical wedges for various wedge angles (15, 30, 45, and 60) using 6- and 15-MV photon beams. Wedge factors were measured in water using an ion chamber for various field sizes and depths. In case of virtual wedge device, as upper jaw moves during irradiation, wedge angles were estimated by accumulated doses. These measurements were performed at off-axis points perpendicular to the beam central axis in water for a $15\;cm\;{\times}\;20\;cm$ radiation field size at the depth of 10 cm. Surface doses without and with virtual or physical wedges were measured using a parallel plate ion chamber at surface. Field size was $15\;cm\;{\times}\;20\;cm$ and a polystyrene phantom was used. For various field sizes, virtual and physical wedge factors were changed by maximum 2.1% and 3.9%, respectively. For various depths, virtual and physical wedge factors were changed by maximum 1.9% and 2.9%, respectively. No major difference was found between the virtual and physical wedge angles and the difference was within 0.5. Surface dose with physical wedge was reduced by maximum 20% (x-ray beam : 6 MV, wedge angle : 45, SSD : 80 cm) relative to one with virtual wedge or without wedge. Comparison of the characteristics of Siemens virtual wedge device with physical wedges was performed. Depth dependence of virtual wedge factor was smaller than that of physical wedge factor. Virtual and physical wedge factors were nearly independent of field sizes. The accuracy of virtual and physical wedge angles was excellent. Surface dose was found to be reduced using a physical wedge.
Kim, Dae-Sup;Ban, Tae-Joon;Yeom, Mi-Suk;Yoo, Soon-Mi;Lee, Woo-Seok;Back, Geum-Mun;Kwon, Kyung-Tae
The Journal of Korean Society for Radiation Therapy
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v.22
no.1
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pp.53-60
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2010
Purpose: We try to calculate EDW-factor easily with the formula applies essential data of EDW-factor and evaluate the validity through a measurement. Materials and Methods: We used the given value of GSTT (Golden Segmented Treatment Table) for the calculation of the EDW-factor. As to the experimental device, 0.6 cc farmer-type ion-chamber, an electrometer and water- phantom were used. A measurement was made at the maximum dose depth of the photon beam energy 6 MV and 15 MV under the condition that SSD (Source to Surface Distance) was 100 cm. The angle of the EDW (Enhanced Dynamic Wedge) which we use in an experiment was 60 degree, 30 degree, 20 degree in the Y1-OUT direction. We used Eclipse planning system (Varian, USA) as RTP system and the EDW-factor was calculated about all fields and EDW direction. In order to show the EDW-factor feature, a measurement was made at the selected field that verify the influence of the dependability about X, Y jaw and off-axis field. Results: When we change the Y1 field, it influence on the EDW-Factor and measured value. But the error between measured values and calculated values was less than 1%. The experimental result indicated the tendency that the error of the result of calculation and measured value becomes smaller as the EDW angle become smaller whether the calculation point (measurement point) and iso-center are same or not. The influence of the field size and energy did not show up. We simulated with the same condition using the RTP system. And we found that it makes no difference between the MU which is calculated manually by applying the EDW-Factor obtained from the commercial program and the value which is calculated by using RTP system. Conclusion: We excluded fitting value from well-known EDW-Factor formula and calculated EDW-factor with the formula applies essential data of EDW-factor only. As a result, there are no significant difference between the measured value and calculated value and it showed errors less than 1%. Also, we implemented the commercial program to calculate EDW-Factor conveniently without measure a factor on each field.
Journal of the korean academy of Pediatric Dentistry
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v.27
no.1
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pp.98-102
/
2000
Ectopic eruption is out of a normal position by local eruption disturbance in the developing permanent molar. The prevalence of ectopic eruption is reported to be the between 2 and 6%, most often associated maxillary first permanent molar whereas, the occurrence for the mandibular is quite rare. The etiologic factors of ectopic eruption are inadequate arch length, lack of growth in the posterior region of the jaw, mesially inclined eruption path of first permanent molars, abnormally large first permanent molars, hereditary factor and a stainless steel crown which has been improperly restored. Ectopic eruption can be treated by the use of brass wire, separating elastics, distal disking and Humphrey appliance and the use of removable appliance and cervical traction headgear after extraction of the second primary molar. This case was that lower right first permanent molar was mesially tilted state by locking on the stainless steel crown of a lower right second primary molar. The stainless steel crown was removed and Humphrey appliance was set. Like this case, ectopic eruption could be happened by the stainless steel crown which improperly restored. In restoration of the stainless steel crown, selection of proper size, trimming and contouring are very important.
Kim, Sookhee;Ko, Mija;Nam, Okhyung;Kim, Misun;Lee, Hyoseol;Kim, Kwangchul;Choi, Sungchul
Journal of the korean academy of Pediatric Dentistry
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v.45
no.3
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pp.307-313
/
2018
The respiratory function is relevant to the craniofacial growth and orthodontic diagnosis. The size of the pharyngeal airway was measured in lateral cephalometric view in children visited Kyung Hee University Hospital from January 2015 to August 2017. A total of 74 healthy children (36 boys and 38 girls) aged 7 - 11 years (mean, 8.5 years) with a normodivergent facial pattern were divided into three groups according to anteroposterior jaw relation measuring A point-Nasion-B point (ANB) angle. Lateral cephalometric data were used to measure the airway dimensions. The dimensions of the middle airway were significantly lower, reducing the upper airway space, in large ANB angle group than in other children, suggesting that children with large ANB angle have narrower airway space than others.
Journal of the korean academy of Pediatric Dentistry
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v.41
no.1
/
pp.85-92
/
2014
Dentigerous cyst is the most common developmental odontogenic cyst of the jaw which is associated with unerupted teeth. Treatment modalities range from enucleation to marsupialization. Enucleation is the process in which the cyst is completely removed, and this is usually indicated for smaller lesions. Larger cysts can be treated by marsupialization, which is a process that consists of making a surgical cavity on the wall of the cyst, emptying its content and maintaining the continuity between the cyst and the oral cavity. This procedure allows decompression of the cyst, regeneration of the bone-defected area, and also lets the wall of the cyst change into normal mucosa. This technique will protect adjacent structures and will promote spontaneous eruption of succedaneous teeth previously surrounded by the cyst. These are two case reports of a 5-year-old and an 11-year-old boy with dentigerous cysts found regarding supernumerary tooth and pulpotomized mandibular primary molars, respectively. Due to the large size of the cysts, both cases were treated with marsupialization. This case report shows that in cases regarding large-sized dentigerous cysts, marsupialization can be an effective surgical technique that promotes spontaneous eruption of cyst-involved succedaneous teeth and the preservation of adjacent teeth.
Kim, Hyun-Woo;Yoon, Kyu-Ho;Park, Kwan-Soo;Jung, Jung-Kwon;Ban, Jae-Hyurk;You, Myung-Soo
Maxillofacial Plastic and Reconstructive Surgery
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v.27
no.1
/
pp.76-80
/
2005
Dentigerous cyst is one of the most prevalent types of odontogenic cysts in the jaw. Usually dentigerous cysts begin to develope through an accumulation of fluid between remnants of the enamel organ and subjacent tooth crown which is developing or submerged. The teeth most often involved are mandibular third molars, maxillary canines, and mandibular premolars. And the cysts usually occur in the second or third decade of life. The treatment of dentigerous cysts-enucleation, marsupialization, and fenestration-is dictated by the size, environmental structures of the lesion, and desirability of conserving involved tooth. Marsupialization is a conservative technique which allows the reduction or elimination of cystic lesion by making it an accessory compartment of the oral cavity in the case where complete enucleation is not desirable. Marsupialization is thought to be the most suitable method of treatment for the conserving of the involved tooth, thus guiding eruption of it. We report the positive outcome got from marsupialization in dentigerous cysts with review of literature.
Purpose: The final goal of regenerative periodontal therapy is to restore the structure and function of the periodontium destroyed or lost due to periodontitis. However, the role of periosteum in periodontal regeneration was relatively neglected while bone repair in the skeleton occurs as a result of a significant contribution from the periosteum. The aim of this study is to understand the histological characteristics of periosteum and compare the native periosteum with the repaired periosteum after elevating flap or after surgical intervention with flap elevation. Methods: Buccal and lingual mucoperiosteal flaps were reflected to surgically create critical-size, "box-type" (4 mm width, 5 mm depth), one-wall, intrabony defects at the distal aspect of the 2nd and the mesial aspect of the 4th mandibular premolars in the right and left jaw quadrants. Animals were sacrificed after 24 weeks. Results: The results from this study are as follows: 1) thickness of periosteum showed difference as follows (P<0.05): control group ($0.45{\pm}0.22$ mm)> flap-elevation group ($0.36{\pm}0.07$ mm)> defect formation group ($0.26{\pm}0.03$ mm), 2) thickness of gingival tissue showed difference as follows (P<0.05): defect formation group ($3.15{\pm}0.40$ mm)> flap-elevation group ($2.02{\pm}0.25$ mm) > control group ($1.88{\pm}0.27$ mm), 3) higher cellular activity was observed in defect formation group and flap-elevation groups than control group, 4) the number of blood vessles was higher in defect formation group than control group. Conclusions: In conclusion, prolonged operation with increased surgical trauma seems to decrease the thickness of repaired periosteum and increase the thickness of gingiva. More blood vessles and high cellular activity were observed in defect formation group.
We was investigate the dosimetric characteristics of the virtual wedge and it compared to the conventional fixed wedge. Also we was evaluate the quality factor of the experimental multi-channel dosimetry system for virtual wedge. Recently virtual wedge technique and wedge fraction methods are available through the computer controlled asymmetric collimator or the independent jaw in medical linear accelerator for radiation therapy. The dosimetric characteristics are interpreted by radiation field analyzer RFA-7 system and PTW-UNIDOS system. Experimental multi-channel dosimetry system for virtual wedge was consists of the electrometer, the solid detector and array phantom. The solid detectors were constructed using commercially diodes for the assessment of quality assurance in radiotherapy. And it was used for the point dose measuring and field size scanning. The semiconductor detector and ion chamber were positioned at a dmax, 5 cm, 10 cm, 20 cm depth and its specific ratio was determined using a scanning data. Wedge angles in fixed and virtual type are compared with measurements in water phantom and it is shown that the wedge angle 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$were agree within 1$^{\circ}$ degree in 6, 10 MV photon beams. In PDD and beam flatness, experimental multi-channel disimetry system was capable of reproduceing the measured values usually to within $\pm$2.1% the statistical uncertainties of the data. It was used to describe dosimetric characteristics of virtual wedge in clinical photon beams. Also we was evaluate optimal use of the virtual wedge and improve the quality factor of the experimental multi-channel dosimetry system for virtual wedge.
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