• 제목/요약/키워드: Jaw-Bones

검색결과 71건 처리시간 0.024초

비스포스포네이트 관련 악골괴사의 진단 및 치료에 대한 임상적 연구 (Clinical study of diagnosis and treatment of bisphosphonate-related osteonecrosis of the jaws)

  • 김경욱;김범진;이충현
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권1호
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    • pp.54-61
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    • 2011
  • Introduction: Bisphosphonates is used widely for the treatment of the Paget's disease, multiple myeloma, bone metastases of malignant tumors with the prevention of pain and their pathological fracture. However, it was recently suggested that bisphosphonates related osteonecrosis of the jaw (BRONJ) is a side effect of bisphosphonate use. Materials and Methods: Twenty-four individuals, who were referred to the Department of Oral and Maxillofacial surgery, Dankook University Dental Hospital, were selected from those who had exposed bone associated with bisphosphonates from January, 2005 to December, 2009 according to the criteria of American Association of Oral and Maxillofacial Surgeons (AAOMS) for BRONJ. The patients group consisted of 7 males and 17 females between the age of 46 to 78 years (average 61.8 years). Each patient had panoramic imaging, computed tomography (CT), whole body bone scanning performed for a diagnosis and biopsy sampling from the necrotizing tissue. C-terminal cross-linking telopeptide of type I collagen (CTX) level of patients who had undergone surgical intervention was measured 7 days before surgery. Results: The main cause of bone exposure was post-extraction (15), chronic periodontitis (4), persistent irritation of the denture (3). Twenty people had undergone BRONJ treatment for two to eight months except for 4 people who had to maintain the bisphosphonates treatment to prevent a metastasis and bone trabecular pain with medical treatment. When the bisphosphonate treatment was suspended at least for 3 months and followed up according to the AAOMS protocols, the exposed necrotizing bones were found to be covered by soft tissue. Conclusion: Prevention therapy, interruption of bisphophonates for at least 3 months and cooperation with the physician for conservative treatment are the essential for treating BRONJ patient with high risk factors. The CTX level of BRONJ patients should be checked before undergoing surgical intervention. Surgical treatments should be delayed in the case of a CTX level <150 pg/mL.

Surgical management of idiopathic bone cavity: case series of consecutive 27 patients

  • You, Myoung-Sang;Kim, Dong-Young;Ahn, Kang-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제43권2호
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    • pp.94-99
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    • 2017
  • Objectives: Idiopathic bone cavity (IBC) is an uncommon intra-osseous cavity of unknown etiology. Clinical features of IBC are not well known and treatment modalities of IBC are controversial. The purpose of this study was to investigate the clinical characteristics of 27 IBC patients who underwent surgical exploration. Materials and Methods: A total of 27 consecutive patients who underwent surgery due to a jaw bone cavity from April 2006 to February 2016 were included in this study. Nine male and 18 female patients were enrolled. Patients were examined retrospectively regarding primary site, history of trauma, graft material, radiographic size of the lesion, presence of interdental scalloping, erosion of the inferior border of the mandible, complications, results of bone graft, and recurrence. Results: Female dominance was found. Maxillary lesion was found in one patient, and bilateral posterior mandibular lesions were found in two patients. The other patients showed a single mandibular lesion. The posterior mandible (24 cases) was the most common site of IBC, followed by the anterior mandible (5 cases). Two patients with anterior mandibular lesion reported history of trauma due to car accident, while the others denied any trauma history. Radiographic cystic cavity length over 30 mm was found in 10 patients. Seven patients showed erosion of the mandibular inferior border. The operations performed were surgical exploration, curettage, and bone or collagen graft. One bilateral IBC patient showed recurrence of the lesion during follow-up. Grafted bone was integrated into the native mandibular bone without infection. One patient reported necrosis of the mandibular incisor pulp after operation. Conclusion: Differential diagnosis of IBC is difficult, and IBC is often confused with periapical cyst. Surgical exploration and bone graft are recommended for treating IBC. Endodontic treatment of involved teeth should be evaluated before operation. Bone graft is recommended to reduce the healing period.

하악과두에 발생한 골연골종 및 이와 연관된 안면비대칭의 치료: 증례 보고 (OSTEOCHONDROMA OF THE MANDIBULAR CONDYLE AND ACCOMPANYING FACIAL ASYMMETRY: REPORT OF A CASE)

  • 이효지;강영훈;송원욱;김성원;김종렬
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권1호
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    • pp.72-76
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    • 2010
  • Osteochondroma is the one of the most benign tumors of the axial skeleton, but is rarely found in the facial bones. Typical facial features of condylar osteochondroma include striking facial asymmetry, malocclusion with openbite on the affected side, and prognathic deviation of the chin and crossbite to the contralateral side. In this case, twenty four year-old female showed facial asymmetry, chin deviation, openbite on the affected side but have no symptoms of pain or dysfunction. Concomitantly she had maxillary occlusal cant and hemimandibular hypertrophy. Panoramic radiograph showed radiopaque mass on right mandibular condyle extended along the lateral pterygoid muscle. Computed tomogram demonstrated enlarged condylar head and bony spur on posteromedial side of condyle and 99Tc bone scintigraphy showed a focal hot image. These findings were correspond with osteochondroma. The lesion was treated with condylectomy and residual facial asymmetry was corrected with 2-jaw orthognathic surgery. Herein, we report a case of osteochondroma of the mandibular condyle and accompanying facial asymmetry.

Osteological development of wild-captured larvae and a juvenile Sebastes koreanus (Pisces, Scorpaenoidei) from the Yellow Sea

  • Yu, Hyo Jae;Kim, Jin-Koo
    • Fisheries and Aquatic Sciences
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    • 제19권4호
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    • pp.20.1-20.12
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    • 2016
  • The osteological development in Sebastes koreanus is described and illustrated on the basis of 32 larvae [6.11-11.10 mm body length (BL)] and a single juvenile (18.60 mm BL) collected from the Yellow Sea. The first-ossified skeletal elements, which are related to feeding, swimming, and respiration, appear in larvae of 6.27 mm BL; these include the jaw bones, palatine, opercular, hyoid arch, and pectoral girdle. All skeletal elements are fully ossified in the juvenile observed in the study. Ossification of the neurocranium started in the frontal, pterotic, and parietal regions at 6.27 mm BL, and then in the parasphenoid and basioccipital regions at 8.17 mm BL. The vertebrae had started to ossify at ~7.17 mm BL, and their ossification was nearly complete at 11.10 mm BL. In the juvenile, although ossification of the pectoral girdle was fully complete, the fusion of the scapula and uppermost radial had not yet occurred. Thus, the scapula and uppermost radial fuse during or after the juvenile stage. The five hypurals in the caudal skeleton were also fused to form three hypural elements. The osteological results are discussed from a functional viewpoint and in terms of the comparative osteological development in related species.

다발성 골수종 (MULTIPLE MYELOMA)

  • 손정익;하춘호;최갑식
    • 치과방사선
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    • 제24권1호
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    • pp.173-177
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    • 1994
  • Multiple myeloma is a malignant plasma cell tumor that is thought to originate proliferation of a single clone of abnormal plasma cell resulting production of a whole monoclonal paraprotein. The authors experienced a case of multiple myeloma with severe mandibular osteolytic lesions in 46-year-old female. As a result of careful analysis of clinical, radiological, histopathological features, and laboratory findings, we diagnosed it as multiple myeloma, and the following results were obtained ; 1. Main clinical symptoms were intermittent dull pain on the mandibular body area, abnormal sensation of lip and pain due to the fracture on the right clavicle. 2. Laboratory findings revealed M-spike, reversed serum albumin-globulin ratio, markedly elevated ESR and hypercalcemia. 3. Radiographically, multiple osteolytic punched-out radiolucencies were evident on the skull, zygoma, jaw bones, ribs, clavicle and upper extremities. Enlarged liver and increased uptakes on the lesional sites in RN scan were also observed. 4. Histopathologically, markedly hypercellular marrow with sheets of plasmoblasts and megakaryocytes were also observed.

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Bone Density Relationship of Mandible and Cervical Vertebrae in Panoramic Radiography

  • Nah Kyung-Soo
    • Imaging Science in Dentistry
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    • 제30권4호
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    • pp.259-263
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    • 2000
  • Purpose: Upper cervical vertebrae are commonly imaged together with the jaw bones in panoramic radiography. There have been many studies investigating the possible role of mandible as an indicator of osteoporosis. But the result doesn't show unanimity. This study measured bone densities of mandible and second and third cervical vertebrae to find out any relationship between these two areas. These results may contribute in panorama being used as a screening method in detecting possible osteoporotic patient. Materials and Methods: Randomly selected 226 digitized panoramic images with cervical vertebrae shadows from 156 dental patients between 5 to 80 years of age were used. And the bone densities of second and third cervical vertebrae, apical areas of first and second mandibular molars and interdental areas were measured. The bone density measurements were restricted to the cancellous bone and the average and standard deviations and paired t-tests were done to each measurements. Results: All the measurements were statistically significantly related. The best relationship was found between the third cervical vertebrae and first and second mandibular apical areas. The average and standard deviations of the measured bone density ratios of these areas were 1.20±0.45 and 1.34±0.48 each. Conclusion: Patients whose panoramic bone density of the third cervical vertebrae are much below those of mandibular first or second molar apical areas may have osteoporosis.

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하악골에 발생된 골육종의 증례보고 (REPORT OF A CASE OF OSTEOSARCOMA ON THE MANDIBLE)

  • 이주현;권기정;김소현;황의환;이상래
    • 치과방사선
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    • 제23권1호
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    • pp.181-187
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    • 1993
  • The osteosarcoma is the most co1t1.mon primary malignant lesion of bone, even so it is relatively rare tumor in the jaw bones. It is derived from undifferentiated mesenchymal elements of bone, which from neoplastic osteoid and osseous tissue. It may affected primarily young adult males and more frequently mandible than maxilla. Mass, swelling and pain are the most presenting symptoms. Radiographic appearance will be sclerotic, in which bone formation is excessive: osteolytic, in which bone destruction predominates: and mixed, in which sclerotic and osteolytic changes are intermingled. We report a case of osteosarcoma on the mandibular ramus area in a 20 years old male with a brief review of the concerned literatures.

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SEGMENTATION AND EXTRACTION OF TEETH FROM 3D CT IMAGES

  • Aizawa, Mitsuhiro;Sasaki, Keita;Kobayashi, Norio;Yama, Mitsuru;Kakizawa, Takashi;Nishikawa, Keiichi;Sano, Tsukasa;Murakami, Shinichi
    • 한국방송∙미디어공학회:학술대회논문집
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    • 한국방송공학회 2009년도 IWAIT
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    • pp.562-565
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    • 2009
  • This paper describes an automatic 3-dimensional (3D) segmentation method for 3D CT (Computed Tomography) images using region growing (RG) and edge detection techniques. Specifically, an augmented RG method in which the contours of regions are extracted by a 3D digital edge detection filter is presented. The feature of this method is the capability of preventing the leakage of regions which is a defect of conventional RG method. Experimental results applied to the extraction of teeth from 3D CT data of jaw bones show that teeth are correctly extracted by the proposed method.

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Undifferentiated pleomorphic sarcoma of the mandible

  • Benites, Bernar Monteiro;Miranda-Silva, Wanessa;Fonseca, Felipe Paiva;Oliveira, Claudia Regina Gomes Cardim Mendes de;Fregnani, Eduardo Rodrigues
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권4호
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    • pp.282-287
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    • 2020
  • Undifferentiated pleomorphic sarcoma (UPS) is a high-grade neoplasm that is usually located in the extremities and retroperitoneum. In the past, UPS was considered the most common soft tissue sarcoma in adults; due to improvements in diagnostic techniques, most cases have been reclassified as other lineage-specific tumors. Gnathic bones are rarely affected, and the clinicopathological characteristics of this neoplasm when diagnosed in the jaw remain to be better described. In this report, we present a rare case of mandibular UPS affecting an 88-year-old female who demonstrated a painful swelling on the right side of the mandible that was accompanied by a pathological fracture. Microscopic examination revealed a pleomorphic spindle-cell neoplasm with mitotic figures and necrosis. The patient underwent surgery and adjuvant radiotherapy but experienced metastasis after 12 months of follow-up and died. Diagnosis of UPS is challenging, and oral pathologists must be aware of this entity when dealing with aggressive undifferentiated neoplasms.

Pediatric Non-Infectious Osteomyelitis of the Mandible: A Case Report

  • Lee, Kyu-Hoon;Moon, Seong-Yong;You, Jae-Seek;Kim, Gyeong-Mi;Lee, Nan-Young;Oh, Ji-Su
    • Journal of Oral Medicine and Pain
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    • 제45권2호
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    • pp.39-43
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    • 2020
  • Chronic recurrent multifocal osteomyelitis (CRMO) is a rare idiopathic inflammatory bone disease characterized by pain and swelling without any detectable infectious factors, the main feature is mild to moderate bone pain. CRMO commonly develops in the metaphyses of long bones and clavicles in children or adolescents. Chronic nonbacterial osteomyelitis (CNO) is the isolated form of CRMO and the etiology of CNO is still unclear. This report describes a rare case of CNO of the mandible in an 8-year-old female patient. On the basis of clinical, histological, and radiological findings, CNO was diagnosed. The patient was asymptomatic after surgical curettage followed by antibiotic therapy. Cone beam CT scan revealed a nearly completed bone healing after three months.