• Title/Summary/Keyword: Mandibular surgery

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Effectiveness of dexamethasone or adrenaline with lignocaine 2% for prolonging inferior alveolar nerve block: a randomized controlled trial

  • Deo, Saroj Prasad;Ahmad, Md Shakeel;Singh, Abanish
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.1
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    • pp.21-32
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    • 2022
  • Objectives: Inferior alveolar nerve block (IANB) is commonly used for mandibular dentoalveolar surgery. The objective of this study was to evaluate and compare the effectiveness of coadministration of dexamethasone (4 mg/mL) or adrenaline (0.01 mg/mL) as an adjuvant with lignocaine 2% in IANB during third molar surgery (TMS). Patients and Methods: This double-blind, randomized controlled trial was conducted between March and August 2020. The investigators screened patients needing elective TMS under local anesthesia. Based on strict inclusion and exclusion criteria, patients were enrolled in this study. These patients were assigned randomly into two study groups: dexamethasone group (DXN) or adrenaline group (ADN). Outcome variables were postoperative edema, trismus, visual analogue scale (VAS), perioperative analgesia, onset time, and duration of IANB. Results: Eighty-three patients were enrolled in this study, of whom 23 (27.7%) were eliminated or excluded during follow-up. This study thus included data from 60 samples. Mean age was 32.28±11.74 years, including 28 females (46.7%) in the ADN (16 patients, 57.1%) and DXN (12 patients, 42.9%) groups. The duration of action for DXN (mean±standard deviation [SD], 4:02:07±0:34:01 hours; standard error [SE], 0:06:00 hours; log-rank P=0.001) and for ADN (mean±SD, 1:58:34±0:24:52 hours; SE, 0:04:42 hours; log-rank P=0.001) were found. Similarly, time at which 1st analgesic consume and total number of nonsteroidal antiinflammatory drugs need to rescue postoperative analgesia was found statistically significant between study groups (t (58)=-11.95; confidence interval, -2:25:41 to -1:43:53; P=0.001). Early-hours VAS was also significantly different between the study groups. Conclusion: A single injection of dexamethasone prolongs the duration of action of lignocaine 2% IANB. Additionally, it can be used in cases where adrenaline is contraindicated.

Comparison of cone-beam computed tomography and digital panoramic radiography for detecting peri-implant alveolar bone changes using trabecular micro-structure analysis

  • Magat, Guldane;Oncu, Elif;Ozcan, Sevgi;Orhan, Kaan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.1
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    • pp.41-49
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    • 2022
  • Objectives: We compared changes in fractal dimension (FD) and grayscale value (GSV) of peri-implant alveolar bone on digital panoramic radiography (DPR) and cone-beam computed tomography (CBCT) immediately after implant surgery and 12 months postoperative. Materials and Methods: In this retrospective study, 16 patients who received posterior mandibular area dental implants with CBCT scans taken about 2 weeks after implantation and one year after implantation were analyzed. A region of interest was selected for each patient. FDs and GSVs were evaluated immediately after implant surgery and at 12-month follow-up to examine the functional loading of the implants. Results: There were no significant differences between DPR and CBCT measurements of FD values (P>0.05). No significant differences were observed between FD values and GSVs calculated after implant surgery and at the 12-month follow-up (P>0.05). GSVs were not correlated with FD values (P>0.05). Conclusion: The DPR and reconstructed panoramic CBCT images exhibit similar image quality for the assessment of FD. There were no changes in FD values or GSVs of the peri-implant trabecular bone structure at the 12-month postoperative evaluation of the functional loading of the implant in comparison to values immediately after implantation. GSVs representing bone mass do not align with FD values that predict bone microstructural parameters. Therefore, GSVs and FDs should be considered different parameters for assessing bone quality.

TREATMENT OF TRANSVERSE DEFICIENCY WITH SURGICALLY ASSISTED RAPID PALATAL EXPANSION IN AN OPEN BITE PATIENT SHOWING PSEUDOMACROGLOSSIA (상대적 거대설을 보이는 전치부 개방교합 환자의 외과적 급속 구개확장술을 통한 횡적 부조화의 치험례)

  • Kim, Yoon-Ji;Lee, Kyu-Hong;Park, Jun-Woo;Rhee, Gun-Joo;Cho, Hyung-Jun;Park, Yang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.376-382
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    • 2008
  • Anterior open bite is a condition in which maxillary and mandibular incisors do not occlude at central occlusion. It is a vertical discrepancy of the jaws and dental arches that has many etiologic factors making it difficult in diagnosis, treatment and prediction of prognosis. One of the causes of open bite is abnormal size and shape of the tongue. Macroglossia, a condition in which tongue is oversized, is caused by several factors which are not clearly identifiable, and it may be a major factor of anterior and posterior open bite. Macroglossia is subdivided into true, functional and pseudomacroglossia depending on its relative size in the oral cavity. In this case report, a patient was diagnosed as skeletal Class II with pseudomacroglossia, and was treated with SARPE in order to expand the narrowed maxillary arch and Quad helix for the mandibular arch. As a result the transverse deficiency was treated. In the adult patients where no skeletal growth is expected, SARPE has shown to be effective in treating maxillomandibular transverse discrepancies in which macroglossia was accompanied as in this case.

Full mouth rehabilitation in a patient with partial mandibulectomy using CAD/CAM zirconia framework and monolithic zirconia (하악골 부분절제술 시행한 환자에서 CAD/CAM Zirconia Framework와 Monolithic Zirconia를 이용한 전악 수복 증례)

  • Ma, Bo-Young;Park, Hongju;Im, Yeong-Gwan;Park, Chan;Shin, Jin-Ho;Lim, Hyun-Pil
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.3
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    • pp.279-285
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    • 2017
  • Defects due to mandibulectomy often cause hard and soft tissue loss and result in esthetic problems and functional disorders such as mastication, swallowing, and pronunciation. After the mandibular reconstruction, several complications including loss of alveolar bone can cause limitations in maintenance or supporting of removable prosthesis. For these patients, implant-supported fixed restorations have been an appropriate prosthetic restorative method. In this case report, we report the patient who underwent mandibulectomy and mandibular reconstruction owing to oral cancer, and then restored the current dentition functionally and aesthetically by applying zirconia frameworks and monolithic zirconia crowns by computer-aided design and computer-aided manufacturing.

A Study on the Changes of Vertical height in Teeth and Alveolar Bone with Age (증령에 따른 치아 및 치조골의 고경 변화에 관한 연구)

  • Se-Sook Kang;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.13 no.1
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    • pp.13-21
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    • 1988
  • The author studied the vertical height of tooth crown and the amounts of alveolar bone resorption with age. All 84 subjects(44 male, 40female) who visited Dental hospital of Wonkwang University with no history of sever periodontal disease and no experience of periodontal surgery. 84 subject were divided into 3 groups by age, that is, group I(28-32yrs), group II(38-42yrs), and group III(48-52yrs). Informal radiogram with bite wing film(horizontal angulation : $0^{\circ}$, vertical angulation : $+5^{\circ}~+10^{\circ}$) were taken on premolar and molar area. The distances from cusp tip to cementoenamel junction (vertical height of tooth crown) and from cementoenamel junction alveolar crest(amount of alveolar bone resorption) were measured, and then recorded data from 946 teeth were statistically analysed. This study was undertaken to obtain the data for age estimation by the changes of tooth crown height and alveolar bone resorption in the point of forensic odontology. The obtained results were as follows : 1. The average crown height of mandibular right 1st. molar was 7.1mm in group I, 6.7mm in group II, and 6.6mm group III, and the average amount of alveolar bone resorption on mandibular right 1st. molar were 1.8mm in group I, 2.5mm in group II, and 3.0mm in group III. Ratio of tooth crown height to amount of alveolar bone resorption was 4.0:1 in groupI, 2.7:1 in group II, and 2.2:1 in group III, the ratio was decreased with age. 2. In comparison with upper teeth and lower teeth in ipsilateral side, the average value of tooth crown height and amount of alveolar bone resorption were slightly higher in upper arch than those in lower arch, but there was not a statistically significant difference. 3. The ratio of height of tooth crown to amount of alveolar bone resorption was decreased with age, and which depended mainly upon the change of amount of alveolar bone resorption rather than the change of tooth crown height.

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CENTRAL GIANT CELL GRANULOMA AND CEMENTIFYING FIBROMA OCCURRING IN THE SAME LESION OF RIGHT MANDIBULAR BODY : A CASE REPORT (하악 우측 골체부에서, 동일한 병소 내에 발생한 골내성 거대세포 육아종과 백아질 섬유종의 치험례)

  • Kim, II-Kyu;Ha, Soo-Yong;Lee, Seong-Jun;Chu, Young-Chae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.177-184
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    • 1991
  • A giant cell granuloma and a cementifying fibroma occurring in the same lesion of right mandibular body in a 10 year old boy is presented with a 12 month follow up without recurrence or any other complications after operation. The relatively small lesion of cementifying fibroma was well delineated from the larger lesion of central giant cell granuloma, and as their origins are different each other(odontogenic or connective tissue origin), we have considered that both lesions had developed independently. Clinically, the evidencesa of aggressiveness of giant cell granuloma were also found, that is, large size, earlier age of 10, root resorption of lower right 1st annd 2nd molars and cortical perforation. With curettage and electric cauterization, we have treated both lesions satisfactorily.

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A POSITIONAL ANALYSIS OF MANDIBULAR CONDYLE ON THE SUBMENTOVERTEX RADIOGRAPH FOR DIAGNOSIS OF TEMPOROMANDIBULAR JOINT DYSFUNCTION (악관절기능장애 진단을 위한 두부축방향 방사선사진에서의 하악과두의 위치분석)

  • Kim Seok-Ho;Choi Soon-Chul;Byun Jong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.21 no.1
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    • pp.73-81
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    • 1991
  • The purpose of this study was to analyze the position of mandibular condyle on the submentovertex radiograph, thereafter to evaluate the usefulness of submentovertex radiograph in diagnosis of temporomandibular joint dysfunction, and to check the best method of tomographic techniques. Submentovertex radiographs which were taken in 75 temporomandibular joint dysfunction patients and 75 normal persons were used as the sample for this study. The obtained results were as follows: The submentovertex radiograph was a improper method in diagnosis of temporomandibular joint dysfunction and discrimination of affected side. The selective tomography was a better method than any other tomographic techniques in diagnosis of temporomandibular joint dysfunction.

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MYOFIBROMA OF THE MANDIBLE (하악골에 발생한 근섬유종)

  • Yoon, Jung-Hoon;Kim, Su-Gwan;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.1
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    • pp.10-14
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    • 2003
  • Myofibroma is a rare spindle cell neoplasm that consists of myofibroblsasts. Although it was originally described as a multicentric tumor process affecting infants and young children, it is now recognized that most cases of the tumor are soliatary and that it can occur at any age. This case is a myofibroma involving the right mandibular body in a 9-year-old boy. Radiographic examination revealed a relatively well-demarcated radiolucent lesion surrounding the impacted right mandibular canine and first premolar crown. The histologic sections composed of interlacing bundles of spindle cells with tapered or blunt-ended nuclei admixed with a foci of hemangiopericytoma-like appearance. Immunohistochemical staining demonstrated a positive reaction to vimentin and smooth muscle actin, but they are negative for desmin and S-100. The presence of well circumscribed radiolucent solid lesion in children as observed in this case, differential diagnosis of myofibroma must be included. In this case, there was no recurrence 6 months after enucleation and eruption guide of the impacted tooth is ongoing now.

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Macroglossia secondary to lymphangioma of the deep neck space: Report of two cases (심 경부 림프관종에 의한 거설증 2례)

  • Cho, Han-Gil;Kim, Soo-Young;Song, Eun-Song;Lee, Joon-Kyoo;Choi, Young-Youn
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.97-102
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    • 2010
  • Lymphangioma is a rare, benign, and hamartomatous tumor of the lymphatic vessels that shows a marked predilection for the head and neck region. When this tumor occurs on the tongue or mouth floor or in the deep neck space, blockage of the efferent lymphatic vessels can result in secondary macroglossia. We report here two patients who showed unusual macroglossia from birth. Initially, there was no noticeable cervical or mandibular swelling. However, mandibular swellings were noted during follow-up examinations, which led to MRI scans on the two infant patients at 5 months and 5 weeks of age, respectively. Subsequently, both patients were diagnosed with lymphangioma or lymphangiohemangioma in the deep neck space.

A Clinical Comparision of Nonresorbable and Resorbable Membrane in the Treatment of Human Class II Furcation Defects (II급 치근이개부병변에서 비흡수성막과 흡수성막을 이용한 조직유도재생술의 임상적 비교)

  • Jang, Chae-Yun;Lee, Jae-Mok;Suh, Jo-Young
    • Journal of Periodontal and Implant Science
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    • v.31 no.4
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    • pp.689-711
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    • 2001
  • The purpose of this study was to compare clinical results of guided tissue regeneration(GTR) using either a nonresorbable ePTFE membrane or a resorbable membrane made from a synthetic copolymer of glycolide and lactide(PLGA) in the treatment of human class Ⅱ furcation defects. The ePTEE membranes were applied to 16 patients with maxillary molar buccal class Ⅱ furcation defects as Group I, PLGA membranes were applied to 15 patients with maxillary molar buccal class Ⅱ furcation defects as Group Ⅱ, ePTFE membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅲ and PLGA membranes were applied to 20 patients with mandibular molar buccal class Ⅱ furcation defects as Group Ⅳ and bone graft materials(DFDBA) were applied in all groups. Probing depth, gingival recession, clinical attachment level, tooth mobility and sulcus bleeding index(SBI) were measured at baseline, 3, 6 and 12months postoperatively. In addition, membrane exposure levels were measured at surgery, 1, 2 and 6weeks postoperatively and postoperative complications were evaluated. The results were as follows: In all groups, there were statistically significant differences in probing depth reduction, gain of clinical attachment and mobility reduction at values of 3, 6 and 12months postoperatively compared to values of baseline, whereas no significant differences in SBI except Group I and gingival recession(p<0.05). Membrane exposure levels were increased at 1, 2 and 6weeks postopratively compared to value of baseline in Group I(p<0.05). There were no statistically significant differences between ePTFE and PLGA membrane in probing depth, clinical attachment level and SBI. There were minimal gingival recession and membrane exposure in Group Ⅳ and pain and swelling were the most common postoperative complications in Group Ⅱ, Ⅲ(p<0.05). In conclusion, this study showed that both nonresorbable membrane and resorbable membrane were effective similarly in the treatment of class Ⅱ furcation defects, without statistical differences in clinical measurements.

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