• Title/Summary/Keyword: Mandibular surgery

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AN EXPERIMENTAL STUDY OF ELECTROPHYSIOLOGICAL AND HISTOLOGICAL ASSESSMENT ON THE INJURY TYPES IN RABBIT INFERIOR ALVEOLAR NERVE (가토의 하치조 신경 손상 형태에 따른 전기생리학적 및 조직학적 변화에 관한 실험적 연구)

  • Lee, Jae-Eun;Lee, Dong-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.679-700
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    • 1996
  • Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.

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The Effect of Platelet Rich Plasma Combined with Bovine Bone on the Treatment of Grade II Furcation Defects in Beagle Dogs (성견 2급 치근이개부 병변 치료시 이종골 이식 및 혈소판 농축 혈장의 골재생에 관한 효과)

  • Lim, Sung-Bin;Lee, Kwang-Soo;Park, Young-Chae;You, Hyung-Keun;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
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    • v.30 no.2
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    • pp.257-277
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    • 2000
  • New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration are basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, and biological mediators. Platelet Rich Plasma has been reported as a biological mediator which regulates activities of wound healing progress including cell proliferation, migration, and metabolism. The purpose of this study is to evaluate the effects of using the Platelet Rich Plasma as a regeneration promoting agent for furcation involvement defect. Five adult beagle dogs were used in this experiment. The dogs were anesthetized with Ketamin HCl(0.1 ml/kg, IV)and Xylazine hydrochloride($Rompun^{(R)}$, Bayer, 0.1 ml/kg, IM) and conventional periodontal prophylaxis were performed with ultrasonic scaler and hand instruments. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree II furcation defect was made on mandibular third(P3), forth(P4) and fifth(P5) premolar, and stopping was inserted. After 4 weeks, stopping was removed, and bone graft was performed. Ca-P was grafted in P3(experimental group I), Combination of Ca-P and plasma rich platelet were grafted in P4(experimental group II), and P5 was remained at control group.Systemic antibiotics(gentamicin sulfate)and anlgesics(phenyl butazone) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operate sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 4, 8 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. At 4 weeks after surgery, there were rapid osteogenesis phenomenon on the defected area of the Platelet Rich Plasma plus Ca-P BBP group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. In conclusion, Platelet Rich Plasma can promote rapid osteogenesis during healing of periodontalregeneration.

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Hyoid Bone Fracture Associated with Hypoglossal Nerve Palsy: A Case Report (설하신경마비를 동반한 설골골절: 증례보고)

  • Kim, Sin-Rak;Park, Jin-Hyung;Han, Yea-Sik
    • Archives of Plastic Surgery
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    • v.38 no.2
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    • pp.199-202
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    • 2011
  • Purpose: Hyoid bone is a U-shaped bone in the anterior of the neck. Hyoid bone fractures are exceedingly rare and represent only 0.002% of all fractures because of its protective position relative to the mandible and its suspension by elastic musculature. We report a patient who presented hyoid bone fracture associated with hypoglossal nerve palsy. We also discuss the possible complication and treatment. Methods: A 69-year-old man was transferred from another institution because of persistent purulent discharge from the left chin. He had a history of trauma in which a knuckle crane grabbed his face and neck in the construction site. A CT scan at the time of the accident demonstrated a comminuted fracture of the right side of the mandible and hyoid bone fracture at the junction between body and right greater cornua. The displaced fracture of hyoid bone and fullness in the pre-epiglottic space were noted, probably indicating some edema. The patient was transferred into ICU after treatment of emergency tracheostomy because the patient showed respiratory distress rapidly. When the patient was hospitalized in our emergency room, he complained of dysphagia and pain when swallowing. On examination of oral cavity, the presence of muscle wasting with fasciculation of the tongue was noted and the tongue deviates to the left side on protruding from the mouth. Pharyngolarygoscopy was performed to make sure that there was no evidence of progressive swelling and pharyngeal laceration. Results: The patient underwent surgical removal of dead and infected tissue from the wound and reconstruction of mandibular bony defect by iliac bone grafting. Hyoid bone fracture was managed conservatively with oral analgesics, soft diet and restricted movement. Hypoglossal nerve palsy was resolved within 7 weeks after trauma without complications. Conclusion: Closed hyoid bone fracture is usually uncomplicated and thus it can be treated conservatively. Surgical intervention for hyoid bone fracture is recommended for patient with airway compromise, pharyngeal perforation and painful symptoms which show no response to conservative care. Furthermore, since respiratory distress syndrome may develop quickly, close observation is required. Besides, hypoglossal nerve palsy is a rarely recognized complication of hyoid bone fracture.

The Effects of Bone Morphogenetic Protein-4 and Resorbable Membrane on the Regeneration of Periodontal Tissues (골형태형성단백질과 흡수성차폐막이 치주조직 재생에 미치는 영향)

  • Lim, Sang-Cheol;Kwon, Young-Hyuk;Lee, Man-Sup;Partk, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.30 no.4
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    • pp.757-779
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    • 2000
  • The aim of our study is to achieve complete periodontal tissue regeneration by the application of BMP and resorbable membrane. Three beagle dogs aged over one and half years and weighed 14 to 16 kg were used in this study. Mandibular 1st, 2nd premolars were extracted bilaterally. Horizontal furcation defects were induced around 3rd, 4th premolars bilaterally. BMP-4 were applied in the right side with resorbable membranes and only resorbable membranes were applied in the left side respectively. Each animal was sacrificed at 2, 4, and 8weeks, after regenerative surgery. Specimens were prepared with Hematoxylin-Eosin stain and Goldner's modified Masson Trichrome stain for light microscopic evaluation. The results were as follows: 1. At 2 weeks after regenerative surgery, downgrowth of junctional epithelium was observed both in the membraneapplied site and BMP-4-and-membrane-applied site. 2. At 4 weeks after regenerative surgery, resorbable membranes were completely resolved, therefore would not prevent downgrowth of junctional epithelium. New bone formation, new cementum formation and Sharpey's fiber were observed in BMP-4-andmembrane-applied site. 3. At 8 weeks after regenerative surgery, downgrowth of junctional epithelium was observed in the membrane-applied site. But, new cementum formation was observed in the same site. The extensive regeneration of new bone, new cementum and remarkable formation of Shapey's fiber were showed in BMP-4-and-membrane-applied site. 4. Resorbable membranes were resolved via the cell-mediated processes. 5. Periodontal tissue regeneration were better achieved in the BMP-4-andmembrane-applied site than in the membrane-applied site. Within the above results, BMP-4 may have the strong capability to form the new bone and resorbable membrane may be able to prevent the bony ankylosis. However, resolution rate of resorbable membrane may not be enough to protect rapid epithelial downgrowth for ideal periodontal regeneration. In conclusion, I suggest BMP-4 may have the strong possibility to be utilized in the clinical periodontal treat-

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THE EFFECT OF IMPLANTATION OF HYDROXYAPATITE IN THE FRESH EXTRACTION SOCKETS ON THE RESIDUAL RIDGE RESORPTION IN INDUCED DIABETIC RABBITS (당뇨병 유발 토끼에서 발치 후 Hydroxyapatite 충전이 잔존 치조제 흡수에 미치는 영향)

  • Bae Jeong-Sik;Chung Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.30 no.4
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    • pp.541-564
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    • 1992
  • The purpose of this experiment was to study the effect of implantation of the dense hydroxyapatite (HA) granules$(Apaceram^{(R)})$ in the fresh extraction sockets on the residual ridge resorption in normal and induced diabetic rabbits. Sixty-four white rabbits, weighing 3.0kg, were utilized in this study and they were divided into four group : group 1-sixteen normal rabbits without filling HA granules, group 2-sixteen normal rabbits with filling HA granules, group 3-sixteen diabetic rabbits without filling HA granules, group 4-sixteen diabetic rabbits with filling HA granules. HA granules were filled immediately after extraction in the extraction sockets of the mandibular left 1st, 2nd, and 3rd molar in group 2 and 4, and no HA granules were filled in group 1 and 3. The calculation of residual ridge resoption was done at 4th week, 8th week, 12th week, and 16th week after surgery, and histologic examination was performed to study healing process at 2nd week, 4th week, 8th week, and 16th week after surgery. The results were as follows : 1. The amount of residual ridge resorption was largest in group 3, and smallest in group 2 in every interval. There was no statistically significant difference between group 1 and 4. 2. In all groups, the amount of residual ridge resorption was high until 4th week after surgery, but the rate of residual ridge resolution slowly decreased after 4th week 3. There was more active healing process in group 1 and 2 than in group 2 and 4. 4. According to filling of HA granules, there was no difference in the amount of new bone formation, but direct contact could be observed between newly formed bone and HA granules in group 2 and 4. 5. Group 1 and 3 showed marked bone resorption and adipose marrow from 8th-16th week after surgery, but group 2 and 4 did not show maeked bone resolution, and showed fibrous tissue and a little adipose tissue among trabeculae from 8th week.

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Three cases of cholesterol granuloma in the mandible

  • Shin, Min-Jung;Shin, Jae-Myung;Huh, Kyung-Hoe;Yi, Won-Jin;Moon, Je-Woon;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • v.37 no.4
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    • pp.225-230
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    • 2007
  • Cholesterol granuloma is an unusual clinical entity described as an inflammatory granulation in response to the deposit of cholesterol crystals. It can develop in any portion of air cells within the temporal bone as a result of a lack of aeration and inadequate drainage, especially in the middle ear cavity. Here, we report very unusual three cases of cholesterol granuloma developed in mandible. In the first case a 68-year-old male with a large mass arising from the mandible was observed. Panoramic radiograph and computed tomography scans revealed a huge expanding lesion in the mandible. In the second case a 47-year-old female with a cystic lesion in the mandible was observed. And in the third case a 19-year-old male complaining atypical facial pain had a large lesion in the mandibular ramus. The histopathologic examinations of the cases showed numerous cholesterol crystals surrounded by multinucleated foreign body giant cells.

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A unique case of Turner syndrome accompanying prolactinoma and unexpected elongated styloid process: Clinical and cone-beam computed tomographic features

  • Evlice, Burcu;Tatli, Ufuk;Yazicioglu, Iffet;Evlice, Ahmet;Oztunc, Haluk
    • Imaging Science in Dentistry
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    • v.43 no.2
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    • pp.129-134
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    • 2013
  • Turner syndrome (TS) is one of the most common chromosomal abnormalities, with an estimated frequency among female live births of 1/2,000-3,000. The syndrome is characterized by the partial or complete absence of one X chromosome (45,X karyotype). We reported a unique case of a 40-year-old woman with TS accompanying unexpected elongated styloid process specific to Eagle syndrome (ES) and followed up-prolactinoma. The present article is the first report to define the cone-beam computed tomographic (CBCT) features of TS accompanying ES. Patients with TS carry various risks that make treatment more complicated; thus advanced imaging techniques for proper treatment and follow-up are extremely important. In the light of CBCT examination, craniofacial abnormalities specific to TS and accompanying syndromes such as the crowding of teeth especially in the maxillary anterior region caused by maxillary narrowness, micrognatic maxilla and mandible, relative mandibular retrusion, malocclusion, open-bite, and an elongated styloid process (length of 32.7 mm) on the right side were illustrated in detail.

Segmental osteotomy for mobilization of dental implant

  • Olate, Sergio;Weber, Benjamin;Marin, Alvaro
    • Journal of Periodontal and Implant Science
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    • v.43 no.5
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    • pp.243-247
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    • 2013
  • Purpose: The aim of this work is to evaluate a surgical technique for mobilization of mal posed dental implant in anterior area. Methods: A 38-year-old patient consulted our unit for esthetic dissatisfaction with the implant treatment of a central incisor. An implant was observed in 11 and 21, where 11 was 3 mm above the ideal limit, with excessive vestibular angulation. The choice was made to perform a segmental osteotomy and mobilize the bone block and the implant down and forward; a bone block extracted from the mandibular ramus was installed between the implant block and the bed to stabilize the segment. Results: After 4 months, a conventional fixed prosthesis was created and the esthetic result achieved was close to what the patient wanted, with no need for further surgery. The surgical condition was stabilized and maintained for the long-time and no complications how necrosis, infection or bone defects was present. Conclusions: It was concluded that the procedure is efficient, and the biological arguments in favor of the procedure are discussed.

Long-standing chin-augmenting costochondral graft creating a diagnostic challenge: A case report and literature review

  • Badr, Fatma Fayez;Mintline, Mark;Ruprecht, Axel;Cohen, Donald;Blumberg, Barton R.;Nair, Madhu K.
    • Imaging Science in Dentistry
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    • v.46 no.4
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    • pp.279-284
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    • 2016
  • To our knowledge, the imaging features of costochondral grafts (CCGs) on cone-beam computed tomography (CBCT) have not been documented in the literature. We present the case of a CCG in the facial soft tissue to the anterior mandible, with changes mimicking a cartilaginous neoplasm. This is the first report to describe the CBCT imaging features of a long-standing graft in the anterior mandible. Implants or grafts may be incidental findings on radiographic images made for unrelated purposes. Although most are well-defined and radiographically homogeneous, being of relatively inert non-biological material, immune reactions to some grafts may stimulate alterations in the appearance of surrounding tissues. Biological implants may undergo growth and differentiation, causing their appearance to mimic neoplastic lesions. We present the case of a cosmetic autogenous CCG that posed a diagnostic challenge both radiographically and histopathologically.

A cephalometric comparison of Skeletal Class III malocclusion and Cleft lip and palate patients (골격성 제 III급 부정교합환자와 구순구개열환자의 두부방사선계측치의 비교)

  • Baik Hyoung-Seon;Yu Hyung-Seog;Jeon Jai-min
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.2
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    • pp.59-67
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    • 2003
  • A cephalometric study was performed to reveal differences between skeletal Class III malocclusion patients and cleft lip and palate patients, The material for this study consisted of 16 males (mean age 19.8, range 17-29) and 9 females(mean age 19.4, range 16-27) with cleft lip and palate, and 222 Skeletal Class III malocclusion patients(males 106, females 116), Cephalometric tracing and measurements were done by one investigator. Results were followed: 1. Cleft lip and palate group had more retrusive maxilla than the skeletal Class III malocclusion group. 2, Cleft lip and palate group had smaller effective maxillary and mandibular length than skeletal Class III malocclusion group, and the difference was more prominent in the mandible than in the maxilla. 3. Dental compensation was not observed in the upper incisors of cleft lip and palate group and in the lower incisors it was smaller than skeletal Class III group. 4, In the Gonial angle and lower anterior facial height values, there was no significant difference between cleft lip and palate and skeletal Class III malocclusion group. These results can be used in orthodontic treatment planning and orthognathic surgery for the cleft lip and palate patients.

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