• Title/Summary/Keyword: Maxillofacial procedure

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The effects of ozone therapy as an adjunct to the surgical treatment of peri-implantitis

  • Isler, Sila Cagri;Unsal, Berrin;Soysal, Fatma;Ozcan, Gonen;Peker, Elif;Karaca, Inci Rana
    • Journal of Periodontal and Implant Science
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    • v.48 no.3
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    • pp.136-151
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    • 2018
  • Purpose: The decontamination procedure is a challenging aspect of surgical regenerative therapy (SRT) of peri-implantitis that affects its success. The purpose of the present study was to determine the impact of additional topical gaseous ozone therapy on the decontamination of implant surfaces in SRT of peri-implantitis. Methods: A total of 41 patients (22 males, 19 females; mean age, $53.55{\pm}8.98years$) with moderate or advanced peri-implantitis were randomly allocated to the test group (ozone group) with the use of sterile saline with additional ozone therapy or the control group with sterile saline alone for decontamination of the implant surfaces in SRT of peri-implantitis. Clinical and radiographic outcomes were evaluated over a period of 12 months. Results: At the 12-month follow-up, the plaque and gingival index values were significantly better in the ozone group (P<0.05). Probing depth decreased from $6.27{\pm}1.42mm$ and $5.73{\pm}1.11mm$ at baseline to $2.75{\pm}0.7mm$ and $3.34{\pm}0.85mm$ at the end of the 12-month observation period in the ozone and control groups, respectively. Similarly, the clinical attachment level values changed from $6.39{\pm}1.23mm$ and $5.89{\pm}1.23mm$ at baseline to $3.23{\pm}1.24mm$ and $3.91{\pm}1.36mm$ at the 12-month follow-up in the ozone and control groups, respectively. According to the radiographic evidence, the defect fill between baseline and 12 months postoperatively was $2.32{\pm}1.28mm$ in the ozone group and $1.17{\pm}0.77mm$ in the control group, which was a statistically significant between-group difference (P<0.05). Conclusions: Implant surface decontamination with the additional use of ozone therapy in SRT of peri-implantitis showed clinically and radiographically significant. Trial registry at ClinicalTrials.gov, NCT03018795.

Interpretation of Receiver Operating Characteristics (ROC) (ROC(receiver operating characteristics) 해석)

  • Kim Jae-Duk
    • Imaging Science in Dentistry
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    • v.30 no.3
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    • pp.155-158
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    • 2000
  • The purpose of this paper is to explain the making procedure and the usage of receiver operating characteristic (ROC) curve for interpretation of radiographic images. The conventional radiograms obtained after the creation of the lesions in the acrylic plates and were enhanced in color. The observer were informed of which tooth to examine, the 'a priori' probability of a lesion present and the approximate diameter of the lesions. The two groups of films were interpreted separately by the same observer using the same rating scale. The following rating scale was used: A; definitely no lesion, B; probably no lesion, C; not sure, D; probably a lesion, and E; definitely a lesion. In analysis, for each observer the diagnostic results in terms of true positive (TP) and false positive (FP) decisions were plotted on a graph. The lowest point on the graph represents the TP and FP when only decisions designated as E according to the rating scale are included. The next point shows the TP and FP values when diagnoses designated as D are added and so forth. By connecting such plot points, a receiver operating characteristic (ROC) curves is obtained. The area under the curve represents the diagnostic accuracy resulting from a diagnostic performance at pure chance level and a value of 1.0 at perfect performance. This method has been known as an useful method to detect the minute difference for each radiographic technic, each observer and for the different lesion depths.

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A STUDY ON THE CHANGE OF AIRWAY SPACE AND CRANIAL, CERVICAL ANGULATION AFTER MANDIBULAR SETBACK OPERATION (하악골 후방이동 수술후 기도 공간과 두개 및 경추 각도의 변화에 관한 연구)

  • Chang, Hyun-Ho;Kim, Jae-Seung;Yi, Choong-Kook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.115-131
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    • 2000
  • In the study of craniofacial deformity, it is very important that identifying the factor which can affect the morphology and which is closely related to the morphology, because it can not only improve the comprehension of growth and developmental process but also be applied in growth prediction and treatment modality. Several investigators have already mentioned the characterstics of head posture and airway space in relations to morphologic difference. But it is very meaningful work in clarifying the correlation between morphology, head posture and airway space that observing the change of head posture after morplologic change caused by operation and the change of airway space after same procedure. To investigate above correlation, I selected normal group which is consisted of 43 adults and mandibular prognathism group which is consisted of 47 adults who had been operated by sagittal split ramus osteotomy and were followed up more than 1 year. With their lateral skull radiograghs, reference lines which can evaluate each measuring points and areas without effect of postural change were first determined. And using above reference lines, change of airway space, positional change of tongue and hyoid, change of cranial and cervical angulations were measured. The results obtained from the study were as follows 1. In the change of head posture, the position of tongue and hyoid neighboring to pharynx is more closely related to the reference line of cervical column than to reference line of cranium. 2. After mandibular setback operation, the airway dimension was decreased to 81.6% of preoperative state at 1 month postoperatively and was slightly increased to 89.7% at 1 year postoperatively. 3. Posterior movement of tongue plays important role in decrease of airway dimension and inferior movement of hyoid was closely correlated with posterior movement of tongue. 4. Postoperative anterior movement of mandible, namely, morphologic relapse had correlation with relapse phenomenon of airway dimension. 5. Craniocervical angulation increased postoperatively. Especially in the postoperative early state, there was increased foreward inclination of cervical angulation rather than increase of cranial angulation. But at postoperative 1 year it was observed that cervical inclination was returned to preoperative state and cranial angulation was increased gradually. 6. Increase rate of airway dimension was correlated with the increase of cranial angulation from postoperative 1 month to 1 year. In conclusion, relapse tendency of airway dimension following increase of cranial angulation was found after mandibular setback operation and it is considered that increase of cranial angulation is one of compensatory mechanism in airway maintenance.

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An Unusual Cause of Acute Maxillary Sinusitis in a 9-year-old Child: Odontogenic Origin of Infected Dentigerous Cyst with Supernumerary Teeth (9세 남자 환아에서 급성 부비동염의 드문 원인 : 과잉치가 동반된 감염된 함기성 낭종)

  • Yun, Hye-Won;Kwon, Hyuck-Jin;Woo, In-Hee;Yang, Byung-eun;Lee, So-Yeon;Lee, Hae-Ran;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.201-205
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    • 2015
  • Acute maxillary sinusitis is a common disorder affecting children. Untreated acute sinusitis can develop into chronic sinusitis, and complications, such as orbital cellulitis or abscess, can occur. Maxillary sinusitis of odontogenic origin is not a well-recognized condition and is frequently missed in children. As an odontogenic source of sinusitis, the dentigerous cyst is one of the most prevalent types of odontogenic cysts, and it is associated with the crown of an unerupted or developing tooth. This report concerns a nine-year-old boy who was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. The boy visited our pediatric clinic presenting with rhinorrhea and nasal obstruction and was initially diagnosed with maxillary sinusitis only. With antibiotic treatment, his symptoms seemed to improve, but after 2 months, he came to our clinic with left facial swelling with persistent rhinorrhea and nasal obstruction. Radiographic examinations of the sinuses were performed, and he was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. After a surgical procedure involving the removal of the dentigerous cyst with supernumerary teeth, the symptoms of sinusitis gradually diminished. There are only very few cases in the pediatric medical literature that remind us that odontogenic origin can cause maxillary sinusitis in children. Our patient can act as a reminder to general pediatricians to include dentigerous cysts in the differential diagnosis of maxillary sinusitis.

Fracture of a Dental Needle during Inferior Alveolar Nerve Block in a Young Child: A Case Report (어린 아동의 하치조신경 전달마취 시 발생한 주사바늘 파절 : 증례보고)

  • Lee, Hanbyeol;Kim, Minkeun;Park, Howon;Seo, Hyunwoo;Lee, Juhyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.3
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    • pp.320-326
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    • 2016
  • The fracture of a needle during local anesthesia in dental treatment is rare; however, when it occurs, the needle should be removed without damage to surrounding structures as soon as possible. A fractured needle fragment that is buried in soft tissue would be difficult to remove, and a careful surgical procedure under general anesthesia is recommended in such cases. Children who require dental treatment are often not capable of cooperative behavior, thus unexpected movements can increase the risk of needle fracture. Clinicians can reduce the incidence of needle fracture accidents with a few precautions. In the present case report, we report a case of needle fracture due to abrupt movement during inferior alveolar nerve block anesthesia in a young child, with the purpose of drawing attention to needle fracture incidents. This report describes the possible causes and prevention methods of local anesthetic needle fracture, and the localization methods and surgical procedure for needle fragment removal.

A fractal analysis of bone phantoms from digital images (디지탈영상에서 골판톰의 프랙탈분석)

  • Kim Jae-Duk;Kim Jin-Soo;Lee Chang-Yul
    • Imaging Science in Dentistry
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    • v.35 no.1
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    • pp.33-40
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    • 2005
  • Purpose : (1) To analyse the effect of exposure time, ROI size and one impact factor in the image processing procedure on estimates of fractal dimension; and (2) to analyse the correlated relationship between the fractal dimension and the Cu-Eq value (bone density). Materials and Methods : The cylindric bone phantoms of 6 large and 5 small diameter having different bone densities respectively and human dry mandible segment with copper step wedge were radiographed at 1.0 and 1.2 sec esposure (70 kVp, 7 mA) using one occlusal film and digitized. Eleven rectangular ROIs from 11 cylindric bone phantoms and 4 rectan-gular ROIs from cortical, middle, periodontal regions, and socket of bone were selected. Gaussian blurred Image was subtracted from original image of each ROI and multiplied respectively by 1, 0.8, and 0.5, and then the image was made binary, eroded and dilated once, and skeletonized. The fractal dimension was calculated by means of a box counting method in the software ImageJ. Results : The fractal dimension was decreased gradually with continued bone density decrease showing strong correlations (bone phantom; r> 0.87, bone; r> 0.68) under 70 kVp 1.0 sec M = 0.8. Fractal dimensions showed the significant differerence (p < 0.05) between two different exposure times on the same small ROI of bone phantom. Fractal dimensions between two different sizes of ROI on bone phantom showed the significant differerence (p < 0.05) under 1.2 sec exposure, but did not show it (p > 0.05) under 1.0 sec exposure. Conclusions : Exposure time, ROI size, and modifying factor during subtracting could become impacting on the results of fractal dimension. Fractal analysis with thoroughly evaluated method considering the various impacting factors on the results could be useful in assessing the bone density in dental radiography.

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The retrospective study of the prognosis of implants in chronic periodontitis patients (만성 치주염 환자에서 임프란트의 예후에 관한 후향적 연구)

  • Kim, Ji-Eun;Park, Kwang-Ho;Cho, Kyoo-Sung;Moon, Ik-Sang
    • Journal of Periodontal and Implant Science
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    • v.33 no.3
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    • pp.373-382
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    • 2003
  • The successful use of osseointegrated implants to replace missing teeth has been demonstrated for both the completely and the partially edentulous patients. Many studies have confirmed an excellent long-term prognosis. The successful outcome of any implant procedure is surely dependent on the interrelationship of the various components that includes the following: biocompatibility of the implant material, macroscopic and microscopic nature of the implant surface, the status of the implant bed in both a health(noninfected) and a morphologic(bone quality) context, the surgical technique, the undisturbed healing phase, the subsequent prosthetic design, and long-term loading phase. Periodontally compromised patients have poor status of the implant bed and periodontal pathogen. No longitudinal data are available whether these factors affect the prognosis of implants. In this study, 102 machined $Br{{\aa}}nemark$ implants are inserted to analyze the success rate of 1-4 years and marginal bone loss in 49 chronic periodontitis patients. The following conclusions could be drawn from this study. 1. The cumulative success rate of implants at the 4-year of loading was 95.10%. 2. 5 failed implants have been removed. One implant have been removed due to infection, two implants were removed due to failure of osseointegration. and other two implants were removed due to mechanical failure caused by over-loading. 3. Mean marginal bone loss from the time of loading was 0.94mm at first year, 1.12mm at second year, 1.25mm at third year. These results suggest that implant therapy is good treatment modality in chronic periodontitis patients, and periodontal treatment including oral hygiene program is completed prior to insertion of implants.

Applying Method of Arch Bar in Maxillofacial Surgery without Orthodontic Treatment (교정치료 비적용 악안면수술에서 치열활봉 거치법)

  • Kim, Taek-Kyun;Choi, Kang-Young;Yang, Jung-Dug;Chung, Ho-Yun;Cho, Byung-Chae
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.105-109
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    • 2008
  • Temporomandibular joint(TMJ) and dental occlusion are important in functional aspect as well as in cosmetic aspect for craniofacial surgery such as orthognathic and traumatic surgery. During these operations, appropriate maxillomandibular fixation(MMF) is especially necessary to conserve or reconstruct, dynamic TMJ and functional occlusion. Arch bar is one of the most popular method to gain proper MMF. Seventeen patients including 5 patients with mandibular fracture, 12 patients with orthognathic surgery(6 patients had relatively normal occlusion, however 6 patients had facial anomalies such as hemifacial microsomia with irregular occlusal plane.) were joined in this study. Arch bar was contoured on the dental cast, which was prepared for model surgery, prior to apply it on the facial anomaly patient. On using pre-contoured arch bar, patients felt better during the procedure and surgeons saved time. Moreover, well-contoured arch bar promises precise transmission of force on the bone, which implies surgeons do not need to worry about the occlusion while fixing bony structures. Authors suggest how to apply arch bar to satisfy basic theories about dental row and occlusion based on the experience. In addition, it is proposed to contour arch bar on the dental impression prior to apply it on the patient who has irregular and complex occlusal plane.

The Acoustic Changes of Voice after Uvulopalatopharyngoplasty (구개인두성형술 후 음성의 음향학적 변화)

  • Hong, K.H.;Kim, S.W.;Yoon, H.W.;Cho, Y.S.;Moon, S.H.;Lee, S.H.
    • Speech Sciences
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    • v.8 no.2
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    • pp.23-37
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    • 2001
  • The primary sound produced by the vibration of vocal folds reaches the velopharyngeal isthmus and is directed both nasally and orally. The proportions of the each component is determined by the anatomical and functional status of the soft palate. The oral sounds composed of oral vowels and consonants according to the status of vocal tract, tongue, palate and lips. The nasal sounds composed of nasal consonants and nasal vowels, and further modified according to the status of the nasal airway, so anatomical abnormalities in the nasal cavity will influence nasal sound. The measurement of nasal sounds of speech has relied on the subjective scoring by listeners. The nasal sounds are described with nasality and nasalization. Generally, nasality has been assessed perceptually in the effect of maxillofacial procedures for cleft palate, sleep apnea, snoring and nasal disorders. The nasalization is considered as an acoustic phenomenon. Snoring and sleep apnea is a typical disorders due to abundant velopharynx. The sleep apnea has been known as a cessation of breathing for at least 10 seconds during sleep. Several medical and surgical methods for treating sleep apnea have been attempted. The uvulopalatopharyngoplasty(UPPP) involves removal of 1.0 to 3.0 cm of soft palate tissue with removal of redundant oropharyngeal mucosa and lateral tissue from the anterior and sometimes posterior faucial pillars. This procedure results in a shortened soft palate and a possible risk following this surgery may be velopharyngeal malfunctioning due to the shortened palate. Few researchers have systematically studied the effects of this surgery as it relates to speech production. Some changes in the voice quality such as resonance (nasality), articulation, and phonation have been reported. In view of the conflicting reports discussed, there remains some uncertainty about the speech status in patients following the snoring and sleep apnea surgery. The study was conducted in two phases: 1) acoustic analysis of oral and nasal sounds, and 2) evaluation of nasality.

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Surgical Invasiveness is Important for Determining Severity of Postoperative Pain after Oral & Maxillofacial Surgery (구강악안면 수술의 침습도 및 술 후 통증의 정도와의 상관성)

  • Shin, Teo-Jeon;Park, Yun-Ki;Seo, Kwang-Suk;Han, Hyo-Jo;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.11 no.1
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    • pp.9-15
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    • 2011
  • 배경: 술 후 통증은 술 후 합병증의 발생가능성을 증가시키며 생체기능의 회복을 방해한다. 술 후 통증을 효과적으로 조절하기 위해선 통증의 정도를 객관적으로 평가하는 것이 필요하다. 술 후 통증은 수술의 침습도와 관련이 높을 가능성이 많다. 본 연구에서는 수술 침습도의 정도와 술 후 통증의 정도 사이의 상관관계를 확인하고자 한다. 방법: 총 153명의 환자를 수술의 침습도에 따라 4개의 그룹으로 나누었다(그룹 1: 악성종양 수술 (malignancy surgery), 그룹 2: 양악수술(bimaxillary surgery), 그룹 3: 양성 종양수술(benign cancer surgery) 그룹 4: 임플란트 & 골절 수술(implant & frature)) 수술이 끝나갈 무렵 fentanyl 700 ${\mu}g$, ketorolac 1,500 mg (총 용적 120 ml)가 포함된 자가통증조절장치를 정맥로에 연결하였다. 술 후 통증의 정도는 시각통증등급(visual analogue scale)을 이용하여 측정하였고 자가통증조절장치의 총 사용시간, 투여된 진통제의 양, bolus 투여 총 횟수를 측정하였다. 결과: 술 후 시각통증등급은 술 후 1일부터 3일까지 그룹 1, 2 군에서 유의하게 높았다. 또한 시각통증등급 3점 이상의 통증을 호소하는 환자의 비율 역시 그룹 1, 2 군에서 유의하게 높았다. 진통제 총 투여용량 및 자가로 주입한 진통제의 양 역시 그룹 1, 2군에서 3, 4 군에 비해 유의하게 높은 것을 확인하였다. 결론: 본 연구결과 외과적 수술의 침습도가 술 후 통증의 정도를 결정하는데 있어 중요한 요소임 을 확인하였다.