• 한국임상수의학회지
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• 제34권6호
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• pp.441-444
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• 2017

A 15-year-old spayed female Miniature Schnauzer was presented for unilateral foreleg lameness and pain. On physical examination, left elbow joint swelling and stiffness were identified. On a computed tomography (CT) scan, a periosteal reaction of the left humerus from the distal metaphysis to the epiphysis and cortical destruction of the medial condyle was observed. Based on blood tests, histopathology, and immunohistochemistry, it was concluded as a skeletal histiocytic sarcoma. Since the patient's pain was not controlled despite application of a fentanyl patch, a left forelimb amputation was decided upon as part of the palliative therapy. Metronomic chemotherapy with toceranib phosphate and pamidronate was initiated. Toceranib was administered for 3 months without the development of any adverse effects except mild neutropenia. However, 3 months after initiating treatment, the toceranib was discontinued due to moderate gastrointestinal disturbances. Over the next 2 months, a left mandibular bone mass and cortical bone destruction in the bilateral tibia and tarsal joint were identified on CT. The patient became unwilling to eat and was noted to have severe skeletal pain. The anorexia and lethargy were progressively worsening and the owner decided to euthanize the patient. A necropsy was performed and the patient was definitively diagnosed with disseminated histiocytic sarcoma based on histopathologic and immunohistochemical analyses. This report describes a Miniature Schnauzer dog with DHS managed with surgical removal and metronomic chemotherapy with toceranib that survived with an improved quality of life for 7 months.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권4호
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• pp.442-446
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• 1995

Thyroid carcinomas are usually classified as papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma and anaplastic thyroid carcinoma. Among the thyroid carcinomas, the incidence of medullary and anaplastic thyroid carcinoma is low, but the rate of lymph node & distant metastasis from them are more common compared to other types. Follicular thyroid carcinoma has a low rate of lymph node metastasis as 10% and has a high occurrence of hematogenous metastasis to lung, bone, brain and liver. Papillary thyroid carcinoma accounts for $60{\sim}70%$ of whole thyroid carcinomas and the cervical lymph node metastasis is $21{\sim}81%$ including micrometastasis, but the distant metastasis is rare. In the case of bone metastasis, follicular type reveals most frequent, and the rate is about 5%, and more likely to be found on vertebra, pelvis, ribs, femur, and skull. The clinical symptoms of bone metastasis are pain, swelling, pathological fracture and radiologically osteolytic lesions can be observed. But distant metastasis of papillary thyroid carcinoma is very rare and especially, bone metastasis has hardly been reported. The treatment modalities of metastatic thyroid carcinoma to mandible are known as follows : thyroidectomy to treat primary site, resection of the affected site of mandible, external beam radiotherapy and radioiodine therapy etc.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권4호
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• pp.319-322
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• 2011

Purpose: The purpose of this study was to examine the appropriate degree of set-back of the mandible by evaluating the rate of relapse after surgery. Methods: Among the patients who visited our hospital from January 2002 to January 2007 and who underwent orthognathic surgery, of the patients available for follow-up observation, the rate of relapse after surgery was investigated according to the set-back degree. The patients were divided into groups by the degree of set-back, and relapse was evaluated by the radiographs performed the day after surgery, 6 months after surgery, 1 year after surgery, 2 years after surgery and 3 years after surgery. Results: In cases that exceeded the limit of posterior movement of the mandible (13 mm) or that had the wrong position of the condyle, a greater tendency toward relapse was shown. Conclusion: Based on the results of this study, among the cases that required a large amount of posterior movement of the mandible, two jaw surgeries accompanied by bilateral sagittal split ramus osteotomy (BSSRO) and LeFort I osteotomy are recommended.

• 치과방사선
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• 제19권1호
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• pp.7-18
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• 1989

The authors analyzed the clinical findings, radiological findings and their correlations in the temporomandibular joint disorders. The results were as follows: 1. The most prevalent age group was in the first decade, then the second decade and the third decade. Female were more common with a ratio of 3.4:1. 2. The most common clinical findings was the pain on open mouth position (42.3%), then came the clicking and limitation of mouth opening. 3. The most common bone change on the condyle side was the erosion, then came the flattening, the osteopyte and the sclerosis in that orders. 4. In the case of the crepitus, the coarse crepitus showed more radiological change than the fine crepitus. The 27% of the patients with crepitus showed the bone change and the patients with crepitus showed more bone change than any other clinical symptoms. 5. In the case of the mouth opening limitation, the evaluation of the translatory movement by transcranial projection was in accordance with the clinical evaluation. 6. The correlation between the clinical symptom and the condylar position within the mandibular fossa was not present and in the case of diagnosis of disc displacement, the transcranial projection seemed not to be able to substitute for the arthrography. Radiographically, the most prevalent age group which showed the bone change was in the first, the second and the third decade. And the bone change seemed to have no relationship with aging.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권2호
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• pp.162-164
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• 2004

Odontogenic keratocysts are developmental odontogenic cysts which derived from rests of dental laminas and often found in posterior area of mandible. Because this lesion has tendency of frequent recurrence, treatment of choice is often radical removal of the lesion. Sometimes in case of large cysts, however, conservative therapy like marsupialization is often selected in treatment plan. A 39-years old woman referred to our department for evaluation of large radiolucent lesion that occupies the areas from mandible angle to upper part of ramus and condyle. In cytology, the lesion was identified as odontogenic keratocyst. Marsupialization was our treatment of choice, and the result was so favorable. 2 years later, there was small radiolucent lesion on upper part of mandibular ramus on panoramic view. It was suspected as recurred lesion, and excisional biopsy was done. On biopsy result, it was not a cystic lesion but fibrosis.

• 치과방사선
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• 제28권2호
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• pp.505-519
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• 1998

The occurrence of PVNS in the TMJ is very rare. We report a case of PVNS which was misdiagnosed as a parotid tumor at first. CT and conventional radiograph revealed a well defined mass demonstrating higher attenuation than adjacent soft tissue. Erosion and expansion of the cortical plate of the mandibular condyle and sclerotic change beneath the margin of the lesion were also shown. MRI demonstrated well defined mass of very low signal intensity on both Tl and T2-weighted images due to ferromagnetic effect of the high concentrated hemosiderin and clearly delineated the extent of the lesion. Histopathologic findings and characteristic appearance of the various imaging methods were described and the usefulness of these images for diagnosis and pretreatment evaluation of PVNS were also discussed.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.19.1-19.6
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• 2018

Background: Calcium pyrophosphate dihydrate deposition disease (CPDD) is a rare disease in the temporomandibular joint (TMJ) space. It forms a calcified crystal mass and induces a limitation of joint movement. Case presentation: The calcified mass in our case was occupied in the left TMJ area and extended to the infratemporal and middle cranial fossa. For a complete excision of this mass, we performed a vertical ramus osteotomy and resected the mass around the mandibular condyle. The calcified mass in the infratemporal fossa was carefully excised, and the segmented mandible was anatomically repositioned. Scanning electronic microscopy (SEM)/energy-dispersive X-ray spectroscopy (EDS) microanalysis was performed to evaluate the calcified mass. The result of SEM/EDS showed that the crystal mass was completely composed of calcium pyrophosphate dihydrate. This result strongly suggested that the calcified mass was CPDD in the TMJ area. Conclusions: CPDD in the TMJ is a rare disease and is difficult to differentially diagnose from other neoplasms. A histological examination and quantitative microanalysis are required to confirm the diagnosis. In our patient, CPDD in the TMJ was successfully removed via the extracorporeal approach. SEM/EDS microanalysis was used for the differential diagnosis.

• Journal of Oral Medicine and Pain
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• 제46권4호
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• pp.161-164
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• 2021

The foramen of Huschke (FH) or foramen tympanicum is a persistent bony defect connecting the external auditory canal (EAC) to the temporomandibular joint (TMJ). It arises from an incomplete ossification of the tympanic part of the temporal bone that persists after the age of 5. If a herniation exists in the TMJ, otological symptoms may occur. An 80-year-old female patient complained of noise in her left TMJ and otorrhea in her left ear. On her cone beam computed tomography images, there were only degenerative joint disease signs on her left mandibular condyle. However, her computed tomography images revealed that the soft tissue of the TMJ herniate into the EAC. Additional examination was planned for the further evaluation. But the patient no longer visited the hospital due to her systemic health status, and symptoms disappeared spontaneously without any treatments. Usually this type of herniation is very rare, but years of mechanical stress from mastication may result in weakening and widening of the foramen with age. Therefore, although FH is usually congenital, sometimes it may be acquired in the elderly. The treatment plan should be determined in consideration of the patient's symptom level and the patient's general health status. If the clinical symptoms are not severe, no treatment is required.

• 대한치과교정학회지
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• 제31권1호
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• pp.39-50
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• 2001

교정치료를 함에 있어 하악골의 모양, 성장률, 성장방향에 대한 예측은 치료계획의 수립 및 치료기간과 예후를 결정하는데 있어 중요한 역할을 한다. 이를 규명하기 위해 다양한 방법들이 시도 되어왔고 측모두부방사선규격사진을 이용함으로써 좀 더 정확성을 기할 수 있게 되었다. 그러나 해부학적인 구조의 특성상 하악과두 부위에서 중첩이 발생하여 정확한 형태 및 위치의 측정에 의문이 남는다. 이 연구의 목적은 하악과두 부위에서 중첩을 피하여 좀 더 정확한 하악골의 형태 및 성장양상을 알아보고자 함에 있다. 이 연구는 1급 부정교합군 14명, 2급 부정교합군 9명, 3급 부정교합군 17명, 총 40명의 환자를 대상으로 평균 4년 3개월의 기간을 두고 최대개구상태의 측모두부방사선규격사진(Wide Open lateral cephalogram)을 촬영하여 11개의 계측항목을 설정, 계측하였고 Autocad Rl4 program을 이용하여 평균적인 외형을 작도하고 측면적을 계측하여 비교, 분석하였다. 그 결과 다음의 결론을 얻었다. 1 하악체의 길이(gonion-menton)는 3급, 1급, 2급 순으로 증가추세를 보였고 3급 부정교합군이 2급 부정교합군에 비해 2배 이상 증가하였으나 통계학적으로는 3급 부정교합군과 1급 부정교합군, 2급 부정교합군과 1급 부정교합군 사이에는 유의성이 있었고 3급 부정교합군과 2급 부정교합군 사이에는 유의한 상관성이 없는 것으로 나타났다(p<0.05). 2. Go-Me, A-Cd, B-Cp, E-F, G-H, 측면적의 항목에서 연 평균 성장량, 성장속도 들에서 3급 부정교합군에서 많은 증가를 보이고 특히 2급 부정교합군에 비해서는 명확한 차이를 보이고 있다. 3. 평균 4년 3개월 동안의 하악골 측면적의 연 평균 성장량은 1급 부정교합군이 $1.0cm^2$, 2급 부정교합군이 $0.8cm^2$, 3급 부정교합군이 $1.4cm^2$이고 성장율은 $11.9\%,\;11.8\%,\;20.3\%$로 1급 부정 교합군과 2급 부정교합군에서는 별 차이가 보이지 않았고 3급 부정교합군에서는 다른 두 군에 비해 2배에 가까운 성장율을 보였다. 이상의 결과에서 부정교합의 유형에 따른 하악골의 성장량의 차는 선천적인 악골의 크기에 의해서 라기 보다는 성장 중 발생하는 하악골의 성장속도와 성장량의 차이에 의한 것으로 사료된다.

• 대한치과보철학회지
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• 제33권4호
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• pp.731-752
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• 1995

This study was performed to research the changes of masticatory system subsequent to randomly increasing the vertical dimension. The subjects were twenty seven persons, twenty two men and five women, with a mean age of 24.3(age ranged from 22 to 26). The subjects had a complete or almost complete set of natural teeth and reported no subjected symptoms of pain or dysfunction in the masticatory system. The occlusal splint increased vertical dimension was made on semiadjustable articulator. The subjects were randomly divided to three groups according to the vertical dimension, at which the occlusal splint was made. Group I occlusal splints were made at 2mm form the occlusal vertical dimension, group II occlusal splints at 5mm, group III occlusal splints at 8mm. The occlusal splints were almost weared for 2 weeks except meal-time. Clinical examination, muscle activity, changes of free-way space, movement of mandible and articular condyle were recorded and analyzed by means of biopak system(Bioresearch Inc, Millwakee Wisconsin.) and radiograph. 1. In clinical examination, various symptoms were reported by all subjects immediately after the placement of occlusal splint. At the end of experiment, symptoms were lasted by 1 subject in Group I, 2 subjects in Group II, 6 subjects in Group III. At the other subjects, the most of symptoms were disappered within 2-4 days after the placement of occlusal splints. 2. The average free-way space before the startof experiment was 1.77mm in all twenty seven subjects. Immediately after the placement of occlusal splints, 0.67mm at Group I, 0.49mm at Group II, 0.41mm at Group III, At 2 weeks after the placement of occlusal splint 0.93mm, 0.79mm, 0.78mm each other, 1.94mm, 1.77mm, 2.3 mm at immediately after the removal of occlual splint. At 1 week after the removal of occlusal splint, free-way space was recovered to the pre-experimental state 3. In cephalometric radiograph, following either the placement or the removal of the occlusal splints, the movements of mandible in an antero-posterior direction were not statistically significant(p>0.05). 4. In transcranial radiograghs of TMJ, 1 week after the placement of occlusal splint the movement of most superior position on condyle in all group shoed antero-inferior position than before the experiment(p<0.001) and also showed antero-inferior position in mandibular postural rest position than in certric occlusion(p<0.001). Following either the placement or the removal of the splints, the amount of movement of most superior position on condyle was group III. group II and group I in order(p<0.001). 5. In anterior temporal and superficial masseter muscle, muscle activity at postural rest position decreased at 2 weeks after the placement of occlusal splint in group I and group II (p>0.05), but significantly increased in group III(p<0.001). At 1 week after the removal of the occdusal splint, muscle activity at postural rest position was recovered preconditional state 6. In anterior temporal and superficail masseter muscle, muscle activity at clenching in all group was significantly decreased after placement of the occlusal splint, slightly increased during experimental period and recovered to the original state at 1 week after removal of the occlusal splint. But was not statistically significat(p>0.05)s.