• Title/Summary/Keyword: Mandibular resection

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Paradoxical Lower Lip Twitching after Removal of the Submandibular Gland (악하선 절제술 후 발생한 역설적 아랫 입술 경련)

  • Yoo, Ji Seob;Hong, Yong Tae
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.1
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    • pp.29-32
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    • 2021
  • Benign submandibular gland tumor is a common disease in the head and neck region and can be completely removed by transcervical approach. Typical submandibular gland resection can lead to neurological complications. The most common complications are damage to the marginal mandibular branch of the facial nerve and weakening of the lower lip. We report a case of ipsilateral lower lip twitching occurring 3 months after surgery. There was no difficulty during the operation, and there were no neurologic complications immediate after surgery. However, in the present case, the patient experienced lower lip twitching paradoxically after surgery which has not been reported in the literature yet. Therefore, we reported this case with a review of relevant literature.

Buccal nerve schwannoma mimicking a salivary gland tumor: a rare case report

  • Jeong-Kui Ku;Dawool Han;Jong-Ki Huh;Jae-Young Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.3
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    • pp.148-151
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    • 2023
  • Schwannomas are benign tumors originating from myelinating cells constituting nerve sheaths but rarely contain cellular elements of the nerve. The authors encountered a 47-year-old female patient with a schwannoma on the anterior mandibular ramus arising from the buccal nerve, measuring 3 cm×4 cm. Surgical resection was performed with preservation of the buccal nerve via microsurgical dissection. After one month, the sensory function of the buccal nerve was recovered without complications.

Evaluation of Microleakage with Retrograde Filling Materials in Blood Contamination (혈액 오염된 역충전 재료의 미세누출 평가)

  • Cho, Hye-Jin;Moon, Jhong-Hyun;Chon, Seong-Min;Yu, Mi-Kyung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.23 no.1
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    • pp.85-93
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    • 2007
  • The purpose of this study was to evaluate the microleakage of root-end filling material filled in blood contaminated root-end cavity and self-etching adhesive placed over blood contaminated resected root apices without root-end preparation. Extracted, human maxillary incisors, canines and mandibular premolar were randomly divided into four groups of 15 teeth each. After canal preparation, resection of the apex and root-end preparation, MTA and IRM were filled in the root-end cavity (A and B group). After canal preparation and resection of the apex, Clearfil SE Bond and Prompt L-Pop were applied over the contaminated root-end surfaces (C and D group). The roots were then subjected to 15cm of water pressure to simulate periapical microleakage stress. Data were analyzed using one-way ANOVA. The results were as follows : 1. All groups showed a tendency of decreasing microleakage in process of time after 2weeks later except IRM group. 2. After 2 weeks and 1 month, MTA group showed less microleakage significantly than other groups(p<0.05). After 2 months, Prompt L-Pop group showed less microleakage significantly than other groups(p<0.05). 3. After 9 months, there were no significant differences among four groups(p>0.05). Thus it is considered that apical sealing using adhesives system without root-end preparation is good method in endodontic surgery.

Treatment of cemental tear associated with periapical lesion using regenerative surgery; A case report (재생술식을 이용한 치근단 병소를 동반한 백악질 열리의 치료)

  • Kang, Hyo-Jin;Jung, Gyu-Un;Pang, Eun-Kyoung
    • The Journal of the Korean dental association
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    • v.54 no.5
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    • pp.365-373
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    • 2016
  • Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

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SURGICAL MANAGEMENT OF THE TUMOR IN THE PARAPHARYNGEAL SPACE AND INFRATEMPORAL FOSSA USING ZYGOMATIC ARCH AND MANDIBULAR OSTEOTOMY (하악골 및 관골궁 절단술을 이용한 측두하와와 인두주위간극에 발생한 종양적출술 1례)

  • Lee, Bong-Seo;Nam, Jung-Soon;Koo, Myoung-Sook;Kim, Shin-Yu;Kwon, Dae-Hyun;Lee, Yong-Gyu;Kwon, Tae-Geon;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.6
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    • pp.565-569
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    • 2001
  • A new surgical approach to the area of the infratemporal fossa and parapharyngeal space is described. This approach results in a wide-field exposure of the infratemporal fossa, pterygomaxillary space and parapharyngeal space. We used two osteotomies on the patient's mandible and temporary resection of zygomatic arch for superior margin of tumor. Lower lip splitting was not needed because the incision was started in the frontal scalp, curved in front of and below the external auditary canal, and extended anteriorly to the greater horn of hyoid bone on the neck along a skin crease. We had good results without sacrifice of the facial nerve, mandibular function and sensory supply of the face and oral cavity.

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Treatment and Rehabilitation of Repetitively Recurrent Langerhans Cell Histiocytosis: A Case Report

  • Yoo, Hee Young;Park, Kyung Soo;Lee, Baek Soo;Kwon, Yong Dae;Choi, Byung Joon;Ohe, Joo Young;Lee, Jung Woo
    • Journal of Korean Dental Science
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    • v.9 no.1
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    • pp.35-41
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    • 2016
  • Langerhans cell histiocytosis (LCH) is characterized by proliferation of histiocyte-like cells (Langerhans cell histiocytes) with characteristic Birbeck granules, accompanied by other inflammatory cells. Treatments of LCH include surgery, chemotherapy, and radiotherapy. One of the representative forms of chemotherapy is intralesional injection of steroids. Surgical treatment in the form of simple excision, curettage, or even ostectomy can be performed depending on the extent of involvement. Radiotherapy is suggested in case of local recurrence, or a widespread lesion. This article shows the case of repetitively recurrent LCH of a 56-year-old man who had been through surgical excision and had to have marginal mandibulectomy and radiotherapy when the disease recurred. After the first recurrence occurred, lesions involved the extensive part of the mandible causing pathologic fracture, so partial mandibular bone resection was performed from the right molar area to the left molar area followed by the excision of the surrounding infected soft tissues. The resected mandibular bone was reconstructed with a segment of fibula osteomyocutaneous free flap and overdenture prosthesis supported by osseointegrated implants.

Three-dimensional finite element analysis of the splinted implant prosthesis in a reconstructed mandible

  • Heo, Kyung-Hoi;Lim, Young-Jun;Kim, Myung-Joo;Kwon, Ho-Beom
    • The Journal of Advanced Prosthodontics
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    • v.10 no.2
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    • pp.138-146
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    • 2018
  • PURPOSE. The purpose of this study was to analyze the effects of the splinted implant prosthesis in a reconstructed mandible using three-dimensional finite element analysis. MATERIALS AND METHODS. Three-dimensional finite element models were generated from a patient's computed tomography data. The patient had undergone partial resection of the mandible that covered the area from the left canine to the right condyle. The mandible was reconstructed using a fibula bone graft and dental implants. The left mandibular premolars and molars remained intact. Three types of models were created. The implant-supported prosthesis was splinted and segmented into two or three pieces. Each of these models was further subcategorized into two situations to compare the stress distribution around normal teeth and implants. Oblique loading of 300 N was applied on both sides of the mandible unilaterally. The maximum von Mises stress and displacement of the models were analyzed. RESULTS. The stress distribution of the natural mandible was more uniform than that of the reconstructed fibula. When the loading was applied to the implant prosthesis of reconstructed fibula, stress was concentrated at the cortical bone around the neck of the implants. The three-piece prosthesis model showed less uniform stress distribution compared to the others. Displacement of the components was positively correlated with the distance from areas of muscle attachment. The three-piece prosthesis model showed the greatest displacement. CONCLUSION. The splinted implant prosthesis showed a more favorable stress distribution and less displacement than the separated models in the reconstructed mandible.

AN IMMUNOHISTOCHEMICAL STUDY ON MANDIBULAR CONDYLE IN WEANLING RAT AFTER MASSETER MUSCLE RESECTION (이유백서에서 교근절제후 하악과두의 면역조직화학적 연구)

  • Choi, Nam-Ki;Choi, Hong-Ran;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.2
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    • pp.559-574
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    • 1996
  • The purpose of this study was to determine whether there was any correlation between temporomandibular joint dysfunction and structure of the mandibular condyle. Weanling rats had their masseter muscles resected and immunohistochemical findings were observed with a light microscope. The results obtained were as follows : 1. The condylar cartilage region was divided into articular, proliferating, cartilage cell and hypertrophic cell layers according to cell morphology. 2. In light microscopic views, the proliferating and cartilage cell layers of the experimental group decreased gradually and at the 8th week significantly. 3. In immunohistochemical staining for type I and II collagen, a reaction was detected in the lower part of proliferating cell and cartilage cell layers. In the cartilage cell layers, a stronger cellular reaction was present. Immunohistochemical staining for type II collagen reacted more strongly than that of type I collagen. 4. In immunohistochemical staining for proteoglycan, the staining of the experimental group resembled the control group and gradually showed a weak reaction. The proliferating and cartilage cell layers reacted more strongly than the hypertrophic cell layer. 5. In immunohistochemical staining for proliferating cell nuclear antigen(PCNA), the strong reaction was detected in the nucleus of the proliferating cell layer both in control and experimental groups. But the thickness of the proliferating layer decreased in experimental group, consequently the reaction of the experimental group was reduced more than that of the control group.

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Characteristics of impacted mandibular third molar-related lesions

  • Dong-Min Lee;Jihye Ryu;Hyeonjin Kim;Jae-Yeol Lee
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.3
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    • pp.153-160
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    • 2024
  • Objectives: This study identifies factors for differential diagnosis among lesions by retrospectively comparing panoramic and cone-beam computed tomography images and analyzing the characteristics of lesions associated with impacted mandibular third molars (IMTs). Materials and Methods: A retrospective cohort study was conducted in patients who simultaneously underwent IMT extraction surgery and related benign tumor resection or cyst enucleation at our institution from 2017 to 2021. To compare the characteristics of each group, two comparative analyses were conducted. The first comparison considered the most frequently observed lesions associated with IMTs: dentigerous cysts, odontogenic keratocysts (OKCs), and ameloblastoma. The second comparison involved placing dentigerous cysts, which have a relatively low recurrence rate, into group A and placing OKC, ameloblastoma, and odontogenic myxoma, which have high recurrence rates, into group B. Results: Significant differences in the size of the lesion were found in the order of ameloblastoma, OKC, and dentigerous cyst (P<0.05). The buccolingual width of ameloblastoma differed significantly from that of the other groups, with no significant difference observed between the OKCs and dentigerous cysts (P=0.083). Conclusion: Patient age and lesion size differed significantly among lesion types associated with IMTs, with younger age and larger lesions for OKCs and odontogenic tumors. OKCs are likely to have a larger mesiodistal width than dentigerous cysts. The buccolingual width of ameloblastomas was larger than those of dentigerous cysts and OKCs.

Clinical study of keratocystic odontogenic tumors

  • Tomomatsu, Nobuyoshi;Uzawa, Narikazu;Michi, Yasuyuki;Kurohara, Kazuto;Okada, Norihiko;Amagasa, Teruo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.1
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    • pp.55-63
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    • 2012
  • The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%). The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.