• Title/Summary/Keyword: Mandibular surgery

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Effects of platelet-derived growth factor loaded bioresorbable membrane on periodontal regeneration (혈소판유래 성장인자 함유 흡수성 차폐막이 치주조직의 재생에 미치는 영향)

  • Ku, Young;Kim, Jeong-Eun;Han, Soo-Boo;Chung, Chong-Pyoung;Park, Yoon-Jeong;Lee, Seung-Jin;Kwon, Youg-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.27 no.1
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    • pp.61-78
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    • 1997
  • PDGF-BB has been recognized as a highly potential growth factor for guided tissue regeneration in periodontal defect. This study carried out histologic and histometric evaluation of $200ng/cm^2$ PDGF-BB loaded bioresorbable membrane made from polyglycolic and polylactic acid. It was tested for its biocompatibility, ability to prevent epithelial downgrowth and amount of periodontal regeneration. Without membrane and PDGF-BB unloaded bioresorbable membrane were used as control. Healthy six beagle dogs were used. Each dog was anesthetized and buccal flaps were reflected in the mandibular and maxillary premolar areas. Buccal alveolar bone between the mesiobuccal and distobuccal line angles was surgically removed on the lower 2nd and 4th premolar in mandible, 2nd premolar in maxilla, to a level 4mm apical to the cementoenamel junction with creating a Class II buccal furcation defect for available space. Care was taken not to remove the root cementum layer and rubber impression materials were placed over each surgically created defect. Flaps were repositioned and sutured. Reconstructive surgery was performed 1 month after defect preparation. PDGF-BB loaded membranes and controls were randomly placed on maxillary 2nd premolars and mandibular 2nd and 4th premolars. Plaque control regimen was instituted with daily brushing with a 0.1% chlorhexidine digluconate during experimental periods. The animals were sacrificed 2 and 5 weeks after surgery and undecalcified specimens were prepared for histologic evaluation. The degree of coronal regrowth of new bone, new cementum and the amonut of new bone areas formed on the defected area of the PDGF-BB loaded membrnae turned superior to without membrane and drug unloaded membrane. Experimental membrane could prevent the epithelial downgrowth irrespective of drug loaded or not and showed good biocompatiblity, These results implicated that PDGF-BB loaded bioresorbable membrane could be highly useful tool for guided tissue regeneration of periodontal defects.

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Development of 3D statistical mandible models for cephalometric measurements

  • Kim, Sung-Goo;Yi, Won-Jin;Hwang, Soon-Jung;Choi, Soon-Chul;Lee, Sam-Sun;Heo, Min-Suk;Huh, Kyung-Hoe;Kim, Tae-Il;Hong, Helen;Yoo, Ji-Hyun
    • Imaging Science in Dentistry
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    • v.42 no.3
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    • pp.175-182
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    • 2012
  • Purpose: The aim of this study was to provide sex-matched three-dimensional (3D) statistical shape models of the mandible, which would provide cephalometric parameters for 3D treatment planning and cephalometric measurements in orthognathic surgery. Materials and Methods: The subjects used to create the 3D shape models of the mandible included 23 males and 23 females. The mandibles were segmented semi-automatically from 3D facial CT images. Each individual mandible shape was reconstructed as a 3D surface model, which was parameterized to establish correspondence between different individual surfaces. The principal component analysis (PCA) applied to all mandible shapes produced a mean model and characteristic models of variation. The cephalometric parameters were measured directly from the mean models to evaluate the 3D shape models. The means of the measured parameters were compared with those from other conventional studies. The male and female 3D statistical mean models were developed from 23 individual mandibles, respectively. Results: The male and female characteristic shapes of variation produced by PCA showed a large variability included in the individual mandibles. The cephalometric measurements from the developed models were very close to those from some conventional studies. Conclusion: We described the construction of 3D mandibular shape models and presented the application of the 3D mandibular template in cephalometric measurements. Optimal reference models determined from variations produced by PCA could be used for craniofacial patients with various types of skeletal shape.

Erk AND RETINOIC ACID SIGNALING PARTICIPATE IN THE SEGREGATION AND PATTERNING OF FIRST ARCH DERIVED MAXILLA AND MANDIBLE (Erk와 retinoic acid의 제1인구둥 패터닝 조절)

  • Park, Eun-Ju;Tak, Hye-Jin;Park, Eun-Ha;Baik, Jeong-Mi;Zhengguo, Piao;Lee, Sang-Hwy
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.2
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    • pp.103-115
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    • 2009
  • In vertebrates, the face is mainly formed with neural crest derived neural crest cells by the inherent programs and the interactive environmental factors. Extracellular signaling-regulated kinase (Erk) is one of such programs to regulate the various cellular functions. And retinoic acid (RA) also plays an important role as a regulator in differentiation process at various stages of vertebrate embryogenesis. We wanted to know that the segregation as well as the patterning of maxillary and mandibular structure is greatly influenced by the maxillomandibular cleft (MMC) and the failure of this development may result in the maxillomandibular fusion (syngnathia) or other patterning related disorder. It has been well documented that the epithelium at this cleft region has significant expression of Fibroblast growth factor (Fgf) 8, and it is essential for the patterning of the first arch derived structures. By the morphological, skeletal, cell proliferation and apoptotic, and hybridization analysis, we checked the effects of Erk inhibition and/or RA activation onto MMC and could observe that Erk and RA signaling is individually and synergically involved in the facial patterning in terms of FGF signaling pathway via Barx-l. So RA and Erk signaling work together for the MMC patterning and the segregation of maxilla-mandible by controlling the Fgf-related signaling pathways. And the abnormality in MMC brought by aberrant Fgf signaling may result in the disturbances of maxillary-mandibular segregation.

The relationships between panoramic indices and dental implant failure (파노라마방사선사진 지수와 임플란트 실패와의 관계에 관한 연구)

  • Cho Hyun-Jung;Yi Won-Jin;Heo Min-Suk;An Chang-Hyeon;Lee Jin-Koo;Lee Sam-Sun;Choi Soon-Chul
    • Imaging Science in Dentistry
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    • v.34 no.1
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    • pp.25-30
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    • 2004
  • Purpose: Several panoramic indices have been suggested to assess bone quality from the morphology and width of mandibular cortex on panoramic radiography. The purpose of this study was to compare dental implant failure group with control group in panoramic mandibular index (PMI), mandibular cortical index (MCI), and gonion index (GI) and to determine the effect of these panoramic indices on dental implant failure. Materials and Methods: A case-control study was designed. Test group (n=42) consisted of the patients who had their implants extracted because of peri-implantitis. Control group (n=139) consisted of the patients who retained their implants over one year without any pathologic changes and had been followed up periodically. They had dental implants installed in their mandibles without bone augmentation surgery from 1991 to 2001. The following measures were collected for each patients: 1) PMI, MCI, and GI were measured twice at one-week interval on preoperative panoramic views; and 2) age, sex, implant length, implant type, installed location, occluding dentition state, and complication were investigated from the chart record. Results: The PMI showed moderate level of repeatability. The intra-observer agreement of MCI and GI were good. There was statistically significant difference in PMI between two groups. There were significant different patterns of distribution of MCI and GI between two groups. Among the panoramic indices, PMI and MCI showed significant correlation with dental implant failure. Conclusion: Panoramic indices can be used as reference data in estimating bone quality of edentulous patients who are to have implants installed in their mandibles.

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ORIGINAL ARTICLE - The incidence and types of C-shaped canal of permanent mandibular second molar in Korean sub-population: Cone-Beam CT data analysis (한국인의 영구 하악 제2대구치의 C형 근관 빈도와 형태 : Cone-Beam CT 자료 분석)

  • Moon, Jung-Bon;Jang, Ju-Kyong;Son, Sung-Ae;Park, Bong-Soo;Lee, Hyo-Jin;Kim, Hyeon-Cheol
    • The Journal of the Korean dental association
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    • v.50 no.4
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    • pp.203-210
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    • 2012
  • Objective: The aim of this study was to investigate the incidence of the C-shaped canal of permanent mandibular second molar (PMSM) in Korean sub-population using Cone-Beam CT (CBCT) data and analyze the types of C-shaped canal. Materials & Methods: The protocol for this study was approved by the Institutional Review Board at the Pusan National University Hospital (E-2011039). Among the CBCT images taken of patients who visited the St. Bennedict Dental Hospital (Busan, Korea) from May 2008 to April 2011 for implant surgery and surgical removal of impacted teeth, high-quality CBCTs from 705 patients (361 male and 342 female) were screened and 607 PMSMs of 383 patients were evaluated retrospectively. All PMSMs were anatomically analyzed in detail by using image viewer software (EasyDent; Vatech). PMSMs were evaluated in the axial plane to investigate the shape of root and canals. The C-shaped canals were classified into five types. The total incidence, gender ratio, bilateral and unilateral appearance. and the correlation between right-side and left-side occurrences of C-shaped PMSMs were computed and compared statistically using the chi-square test. Results: Among the 607 PMSMs of 383 CBCTs of 187 females and 196 males, 198 PMSMs(32.6%) had C-shaped root and 158 PMSMs(26.0%) had C-shaped canals. The shape of C-shaped root canals at the furcalion level did not have significant change at the level of mid root (P<0.0001). Female had more prevalence of C-shaped root canals than male (P<0.0001). The prevalence of bilateral occurrence of C-shaped root canals was higher than unilateral occurrence. Conclusions: The occurrence of C-shaped PMSMs among a Korean population was 32.6% and was higher than other countries and ethnicities. Understanding the prevalence of PMSMs with a C-shaped root and/or canal in a Korean population may be useful for successful endodontic treatments.

Benign Tumor-Like Developmental Salivary Gland Defect (양성 종양과 유사한 형태를 가진 발육성 타액선 골결손)

  • An, Seo-Young;Kim, Yong-Gun;Jung, Jae-Kwang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.3
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    • pp.301-307
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    • 2012
  • 50-year-old female and 50-year-old male were referred to the department of the oral and maxillofacial surgery of Kyungpook national university dental hospital with asymptomatic lesions on their posterior mandibular body areas. They were discovered incidentally on panoramic radiographs during routine dental examination. Physical examination revealed no remarkable findings. Each panoramic radiograph showed well defined radiolucent lesions without hyperostotic border on their posterior mandibular body area. At first they were diagnosed as benign tumors because they looked like multilocular pattern and one of the patient showed discontinuity of mandibular canal within the lesion. CT scans demonstrated well demarcated and irregular lingual depression filled with fat tissue and they were diagnosed as developmental salivary gland defects. One of the lesion showed no change on follow-up panoramic radiograph after 4 months. Developmental salivary gland defects resembling benign tumor are atypical cases and it is suggested that confirmatory imaging using CT or MRI should be taken.

THE MEDIAL SIGMOID DEPRESSION: Its Anatomic and Radiographic Considerations (하악골과 방사선사진상에서의 하악절흔 내측 함요)

  • Kang Byung-Cheol
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.1
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    • pp.7-13
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    • 1991
  • An anatomic radiolucency called medial sigmoid depression can be observed on a number of panoramic and mandibular oblique lateral views in the ramus just below and anterior to the mandibular sigmoid notch. The radiolucency may be unilateral or bilateral. Seventy-eight mandibles of dry skulls were visually examined and radiographed by panoramic machine. The observable incidence, the location center, and the mean size of the medial sigmoid depression were studied. Additionally, the radiographic incidence of the depression was determined using 500 panoramic radiographs. Normal anatomic radiolucent areas in the jaws are encountered often in the radiographs taken for the usual dental practice purpose. Some of these radiolucencies can be misdiagnosed as pathologic entities. But in most cases, the size, location, and appearance of the radiolucent area, and the presence or absence of symptoms can lead one to the correct diagnosis before surgery is undertaken. And this can be secured if diagnosticians are aware of the common and varied appearances of the normal anatomic radiolucencies A depression in the ramus just below and slightly anterior to the most inferior aspect of mandibular sigmoid notch shows occasionally foramen-like or notch-like radiolucency on some panoramic and oblique lateral views. This radiolucency was named medial sigmoid depression by Langlais et a1. in 1983. Since there're no reports about this medial sigmoid depression after that, (The author retrieved the Mediline from 1983 to 1990: Cambridge scientific abstracts, (7200 Wisconsin Ave Bethesda MD 20814 U.S.A.) National Library of Medicine) the author studied the size and the location of the depression of the mandible specimens, and determined the relationship between the observable anatomic incidence and its reproducibility on the radiographs.

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EVALUATION OF CONDYLAR DISPLACEMENT USING COMPUTER TOMOGRAPHY AFTER THE SURGICAL CORRECTION OF MANDIBULAR PROGNATHISM (전산화단층촬영법을 이용한 하악전돌증 환자의 외과적 악교정술후 하악과두 위치 변화 검토)

  • Lee, Ho-Kyung;Jang, Hyun-Jung;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.191-200
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    • 1998
  • This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after orthognathic surgery in 37 patients(male 13, female 24) using computed tomogram that were taken in centric occlusion before, immediate after, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period of intermaxillary fixation, at the 24 hours later removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.42{\pm}5.30mm$ and horizontal long axis of condylar angle was $12.79{\pm}4.92^{\circ}$ on the right, $13.53{\pm}5.56^{\circ}$ on the left side. Condylar lateral poles were located about 12mm and medial poles about 7mm away from the reference line(AA') on the axial tomogram. Mean intercondylar distance was $83.15{\pm}4.62mm$ and vertical axis angle of condylar angle was $76.28{\pm}428^{\circ}$ on the right, $78.30{\pm}3.79^{\circ}$ on the left. 2. In amount of set back, We found the condylar change(T2C-T1C) which had increasing tendency in group III (amount of setback : 10-15mm). but there was no statistical significance(p>0.05). 3. There was some correlation between condylar change(T2C-T1C) and TMJ dysfunction. It seemed that postoperative condylar change had influenced postoperative TMJ dysfunction, through there was no statistical significance (p>0.05). As we have observed the change of condylar axis in the group that complained of TMJ dysfunction in cases of large amount of mandibular setback. So we consider that the more trying to conserve condylar position will decrease occurrence rate of post operational TMJ dysfunction.

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EFFECTS OF ADMINISTRATION PLATELET RICH PLASMA ON THE DISTRACTED MANDIBLE IN RABBITS (가토에서 신장된 하악골에 대한 혈소판농축혈장의 효과)

  • Bae, Kum-Hyu;Kook, Min-Suk;Park, Hong-Ju;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.4
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    • pp.315-323
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    • 2005
  • For reconstruction of the bony defect, distraction osteogenesis has many advantages in comparison with bone graft. However, it needs long consolidation period for sufficient bone maturity. This study is performed to evaluate the effect of PRP injection into the distracted mandible on bone formation in rabbits. Twelve house rabbits, weighing 2 kg, were used. All animals underwent bilateral mandibular osteotomy under general anesthesia. A internal distractor divice was positioned along a plane perpendicular to the line of osteotomy. After 5 days of latency period, distraction osteogenesis was started at a rate of 1 mm/day for 9 days which was distracted 9 mm totally. After completion of distraction, 0.5 ml of PRP which collected in rabbit blood was injected into the distracted mandible on experimental group, whereas no injection was done in control group. Macroscopical, radiographical, and histological, and histomorphometric examinations were performed 2, 4 and 8 weeks after distraction. All animals showed distracted mandible and severe anterior cross-bite. In radiographical findings 2 weeks after distraction, more radiopacity in the distracted gap was found in experimental group than that of control group. At 4 weeks after distraction, distracted bone was similar to normal bone in experimental group. In histological findings, 1) At 2 weeks after distraction, number of osteoblasts and angiogenesis in the distracted gap was found in experimental group than that of control group. 2) At 4 weeks after distraction, more active and distinct bone in the distracted gap was found in experimental group than that of control groups. 3) At 8 weeks after distraction, more dense and matured lamellated bone in the distracted gap was found in experimental group than that of control group. In histomorphometrical findings 8 weeks after distraction, more bone formation was observed in experimental group than control group (p<0.01). These results indicate that administration of PRP into the distracted mandible can promote bone formation.

THE EFFECT OF REPETITIVE DISTRACTION AND COMPRESSION ON NEW BONE FORMATION DURING DISTRACTION (골신장술시 반복적인 압축과 신장 방법이 골형성에 미치는 영향)

  • Yoon, Byung-Wook;Kim, Yeo-Gab;Oh, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.5
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    • pp.407-416
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    • 2008
  • Purpose: The aim of the present study is to evaluate the effect of repetitive distraction and compression on new bone formation during distraction period. Materials and methods: Sixteen healthy rabbits, weighing about 2.5kg, were used in this experiment. A unilateral mandibular osteotomy was performed in the left mandible and the distractor(Track 1 $plus^{(R)}$, Gebruder Martin $GmbH^{(R)}$, Germany) was fixed with four screws (Cross driver screw $TI^{(R)}$, Gebruder Martin $GmbH^{(R)}$, Germany). After 4 days, the mandibles were distracted at a rate of 0.6mm/day for 10 days to obtain the amount of 6mm distraction in the control group(n=4). In the experimental group A(n=6), they were distracted at a rate of 1.2mm/day for 5 days and then compression of 0.6mm length and distraction of 0.6mm per 12 hours were carried out as counter direction for 5 days, relatively. In the experimental group B(n=6), distraction of 1.2mm length and compression of 0.6mm length per 12 hours were repeated for 10 days to obtain the amount of 6mm distraction finally. The experimental animals were sacrificed at 2 and 4 weeks after surgery and block specimens were obtained. With histologic and histomorphometric analysis, we observed the histologic changes of the cells and bone formation after H-E and Masson- Trichrome staining and then, measured Bone Deposition Rate with TOMORO $ScopeEye^{TM}$ ver. 3.5(Olympus, Japan), Results: Histologically, new bone formation was examined in all experimental groups and the control. But, the ability of bone formation of the experimental group A was somewhat better than any other groups. On the histomorphometric analysis, Bone Deposition Rate was higher in the experimental group A$(50.67{\pm}4.36%)$ than in the control group$(45.94{\pm}3.97%)$ and in the experimental group B$(42.68{\pm}5.70%)$. These data showed significant differences statistically(p<0.05). Conclusion: These results show that the distraction osteogenesis using repetitive compression and distraction force in the early consolidation period may be effective for new bone formation.