• Title/Summary/Keyword: Maxillofacial abnormality

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Positional and morphologic changes of the temporomandibular joint disc using magnetic resonance imaging

  • Ahn Hyoun-Suk;Cho Su-Beom;Koh Kwang-Joon
    • Imaging Science in Dentistry
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    • v.31 no.4
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    • pp.235-240
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    • 2001
  • Purpose: To evaluate displacement and morphologic changes of the temporomandibular joint (TMJ) disc in patient with internal derangement using magnetic resonance imaging (MRI). Materials and Methods: One hundred and forty five MR images of TMJs in 73 patients were evaluated. Positional and morphologic changes of the TMJ discs were assessed. Lateral or medial disc displacement was also evaluated on coronal images. Results: Among 63 discs with anterior disc displacement, 37 discs were assessed as a biconcave disc and 21 as a deformed disc. Rotational disc displacement was observed in 35 discs. Anteromedial disc displacement was observed in 29 discs, and anterolateral direction in 6 discs. Among 35 rotational displacement, 5 biconcave discs and 21 deformed discs were observed. Conclusion : Rotational and sideways displacement of TMJ discs were found to be common and an important aspect of internal derangement. This study also suggests that sagittal and coronal images of the TMJ have complementary abilities for an assessment of joint abnormality.

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Intentional partial odontectomy-a long-term follow-up study

  • Kim, Hyun-Suk;Yun, Pil-Young;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.29.1-29.5
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    • 2017
  • Background: The surgical extraction of the third molar is the most frequently encountered procedure in oral and maxillofacial surgery and is related with a variety of complications. This study examined the efficacy of intentional partial odontectomy (IPO) in the third molars which have no periapical lesions and are located near important anatomical structures such as inferior alveolar nerve. Methods: Seven patients (four males, three females, $39.1{\pm}11.6years$), who received IPO to reduce the risk of inferior alveolar nerve injury (IANI), were followed long-term. The treated teeth were horizontally impacted third molars in the mandibular left (n = 5) or mandibular right (n = 4) areas and were all ankylosed with the surrounding alveolar bone. During the IPO, the bone around the crown was removed to expose the crown, and then the tooth was resected at cement-enamel junction (CEJ). Any secondary trauma to the healthy root was minimized and remained intact after primary suture. Results: The mean follow-up time was $63.2{\pm}29.8months$, and all sites showed good bone healing after the crown removal. Also, sensory abnormality was not found in any patients after IPO. In one patient, the bone fragments erupted 4 months after IPO. In other patient, an implant placed on second molar site adjacent to the third molar that received IPO was explanted about 2 years after the patient's persistent discomfort. Conclusions: In case where high risk of IANI exists, IPO may be chosen alternatively to surgical extraction to reduce the risk of nerve damage.

COMPREHENSIVE TREATMENT OF OBSTRUCTIVE SLEEP APNEA - THE ROLE OF DEPARTMENT OF DENTISTRY IN SLEEP CLINIC (폐쇄성 수면 무호흡증에 대한 포괄적 치료 - 수면 클리닉에서 치과의 역할)

  • Kwon, Tae-Geon;Cho, Yong-Won;Ahn, Byung-Hoon;Hwang, Sang-Hee;Nam, Ki-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.2
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    • pp.150-156
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    • 2004
  • The etiology of the obstructive sleep apnea includes the various factors such as anatomical abnormality in upper airway, craniofacial structure, obesity and personal habit. To establish reasonable treatment plan, multi-department approach is should be emphasized because the treatment modality is depend on the result of analysis for degree & site of obstruction and various behavioral factors. In Sleep Clinic in Keimyung University Medical Center, the standard of care for sleep apnea patient was established according to the Standard of practice committee of Americal Sleep Disorders Association. After one year experience of comprehensive approach for sleep apnea we could achieve following recommendation for the treatment. 1) The multi-department examination and diagnosis could prevent unnessesary treatment because the treatment plan could be established under comprehensive discussion. 2) Determination of the site of obstruction is important for treatment planning. However, no single determinant could be found. We expect multi-department approach can reduce the mistake in detection of obstruction. 3) Further evaluation of treatmet outcome should be succeeded to establish Korean standard of care for sleep apnea treatment.

Reasonable necessity of preoperative laboratory tests in office-based oral and maxillofacial surgery

  • Mi Hyun Seo;Mi Young Eo;Kezia Rachellea Mustakim;Buyanbileg Sodnom-Ish;Hoon Myoung;Soung Min Kim
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.3
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    • pp.142-147
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    • 2023
  • Objectives: As medical history before surgery is often based on patient reporting, there is the possibility that patients intentionally hide underlying diseases or that dentists cannot recognize abnormal health states. Therefore, more professional and reliable treatment processes are needed under the Korean dental specialist system. The purpose of this study was to elucidate the necessity of a preoperative blood testing routine prior to office-based surgery under local anesthesia. Patients and Methods: Preoperative blood lab data for 5,022 patients from January 2018 to December 2019 were assembled. Study participants were those who underwent extraction or implant surgery under local anesthesia at Seoul National University Dental Hospital. Preoperative blood tests included complete blood count (CBC), blood chemistry, serum electrolyte, serology, and blood coagulation data. Values outside of the normal range were considered an "abnormality," and the percentage of abnormalities among the total number of patients was calculated. Patients were divided into two groups based on the presence of underlying disease. The rates of abnormalities in the blood tests were compared between groups. Chi-square tests were performed to compare data from the two groups, and P<0.05 was considered statistically significant. Results: The percentages of males and females in the study were 48.0% and 52.0%, respectively. Of all patients, 17.0% (Group B) reported known systemic disease, while 83.0% (Group A) reported no specific medical history. There were significant differences between Groups A and B in CBC, coagulation panel, electrolytes, and chemistry panel (P<0.05). In Group A, the results of blood tests that required a change in procedure were identified even though the proportion was very small. Conclusion: Preoperative blood tests for office-based surgery can detect underlying medical conditions that are difficult to identify from patient history alone and can prevent unexpected sequelae. In addition, such tests can result in a more professional treatment process and build patient confidence in the dentist.

Clinical image quality evaluation for panoramic radiography in Korean dental clinics

  • Choi, Bo-Ram;Choi, Da-Hye;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Choi, Soon-Chul;Bae, Kwang-Hak;Lee, Sam-Sun
    • Imaging Science in Dentistry
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    • v.42 no.3
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    • pp.183-190
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    • 2012
  • Purpose: The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Materials and Methods: Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. Results: A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Conclusion: Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

THE STUDY OF EFFICIENCY OF CORTICOTOMY IN TREATMENT OF BIMAXILLARY PROTRUSION (양악전돌증 치료에서 피질골절단술의 효율성에 관한 연구)

  • Seo, Young-Jun;Jung, Sung-Woo;Kang, Hag-Soo;Im, Jae-Jung;Huh, Young-Sung;Woo, Soon-Seop;Shim, Kwang-Sup;Hwang, Kyung-Gyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.4
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    • pp.365-371
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    • 2005
  • In esthetic treatment of bimaxillary protrusion, it is important to move backward the anterior teeth segment. For the backward movement of the anterior teeth segment, orthodontic force and segmental osteotomy have been applied on the clinical treatment until recently. These methods caused long treatment time, anchorage loss, the possibility of root resorption and the complication followed by segmental osteotomy. Therefore, corticotomy has become a major concern lately. This research has been conducted to study the efficiency of corticotomy in the treatment of bimaxillary protrusion comparing the profile change, canine retraction velocity and space closing time. The research compared and analyzed space closing time, canine retraction velocity and profile change in two groups of patients. Both groups were formed out of patients over 18 years old who visited the department of dentistry in Hanyang University for treatments. The experimental group who was treated by corticotomy and Skeletal Anchorage System(SAS). The control group who received orthodontic treatment using SAS. The following results are produced after analyzing both groups. The significant statistic difference in space closing time has been observed in the experimental group as compared with the control group(p<0.05). In the experimental group, the significant statistic increase in canine retraction velocity was also observed(p<0.05). There was no significant difference in profile change between the control group and the experimental group(p<0.05). As a result, orthodontic treatment using corticotomy has a reasonable efficiency in space closing time as compared with the existing orthodontic treatment. Therefore, it is concluded that corticotomy with orthodontic treatment can be reasonably applied to dentofacial abnormality.

Correction of an unusual abnormal buccal frenum by Total Palatal Mucosal Free Graft : A Case Report (Total Palatal Mucosal Free Graft를 이용한 비정상 협소대 치험 1예)

  • Park, Hyung-Sik;Kim, Sun-Yong;Lee, Sang-Hye
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.3
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    • pp.42-48
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    • 1990
  • This is a case report on an unusual - heavy buccal frenum in young lady which was treated by frenectomy, vestibuloplasty and total-palatal mucosal free graft. The authors noticed that this abnormal condition lead several chronic complications in young patient as like as premature loss of upper molar teeth, early and rapid loss of alveolar bone around insertion of frenum, over - extended eruption of lower molar teeth and abnormal mandibular movements, etc. After frenectomy and surgical extension of buccal vestiblue on both upper and lower posterior regions, we obtained a full - sized palatal mucosal graft and moved it on upper and lower extension area seperately as two pieces of free grafts to offer inherent function of denture - bearing mucogingiva and same color - matching with oral mucosa and to prevent post - operative relapse of vestibular height. We discussed here about unusual abnormality and their complications of unusual buccal frenum and its treatment.

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Bilaterality of Internal Derangements of Temporomandibular joint (악관절 내장의 양측성)

  • Choi, Hyung-Sik;Chang, Duk-Soo;Lee, Dong-Soo;Kwon, Chil-Sung;Lee, Sung-Il;Jung, In-Won;Kim, Pan-Sik
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.221-225
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    • 1989
  • Arthrography is one of highly accurate diagnostic tools for internal derangements of the temporomandibular joint (TMJ). Both TM joints are connected by the mandible and one may have influence upon the other. We performed bilateral TMJ arthrograms in 42 patients with TMJ disorders to evaluate the bilaterality of internal derangements of the TMJ. The results were as follows : 1. We could not find any specificity in clinical symptoms according to each state of internal derangements of the TMJ. 2. The bilaterality of internal derangements of the TMJ was 61%. 3. Statistically, significant correlation was found in the aspects of the presence of arthrographic abnormality in both TMJ and each state of internal derangements in them. Therefore, the patients, who are diagnosed as any internal derangement of the TMJ, need to have assured examination in the contralateral joint.

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The 50 Most Cited Papers in Craniofacial Anomalies and Craniofacial Surgery

  • Mahon, Nicola A;Joyce, Cormac W;Thomas, Sangeetha;Concannon, Elizabeth;Murray, Dylan
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.559-566
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    • 2015
  • Background Citation analysis is a recognized scientometric method of classifying cited articles according to the frequency of which they have been referenced. The total number of citations an article receives is considered to reflect it's significance among it's peers. Methods Until now, a bibliometric analysis has never been performed in the specialty of craniofacial anomalies and craniofacial surgery. This citation analysis generates an extensive list of the 50 most influential papers in this developing field. Journals specializing in craniofacial surgery, maxillofacial surgery, plastic surgery, neurosurgery, genetics and pediatrics were searched to demonstrate which articles have cultivated the specialty within the past 55 years. Results The results show an intriguing compilation of papers which outline the fundamental knowledge of craniofacial anomalies and the developments of surgical techniques to manage these patients. Conclusions This citation analysis provides a summation of the current most popular trends in craniofacial literature. These esteemed papers aid to direct our decision making today within this specialty.

Prevalence of bony septa, antral pathology, and dimensions of the maxillary sinus from a sinus augmentation perspective: A retrospective cone-beam computed tomography study

  • Tadinada, Aditya;Jalali, Elnaz;Al-Salman, Wesam;Jambhekar, Shantanu;Katechia, Bina;Almas, Khalid
    • Imaging Science in Dentistry
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    • v.46 no.2
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    • pp.109-115
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    • 2016
  • Purpose: Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Materials and Methods: Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Results: Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Conclusion: Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy.