• 제목/요약/키워드: Odontogenic

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Comparison of healing pattern with or without bone graft after odontogenic cyst enucleation (악골에서 발생한 치성 낭종제거 후 골이식 여부에 따른 치유속도와 양상 비교)

  • Baek, Chae-Hwan;Park, Joon-Hyung;Kim, Gun-Jong;Hong, Jong-Rak;Kim, Chang-Soo;Paeng, Jun-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권6호
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    • pp.515-519
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    • 2010
  • Introduction: Bone defects in the jaw are frequently observed after odontogenic cyst enucleation. The success of bone healing appears to be related to the size of the bone defect, the anatomical location, the patient's age and other parameters. The use of bone grafting material is dependent on the operator's preference. No evidence-based definite treatment protocol has been established. This study evaluated the effect of a bone graft into the defect after odontogenic cyst enucleation. Materials and Methods: A total of 55 patients, who had been treated for an odontogenic cyst with cyst enucleation from 2000 to 2009 at the department of Oral and Maxillofacial Surgery, Samsung Medical Center, were included in this study. Patients who were followed-up for more than 1 year were included. Two groups were defined according to the bone graft (with or without a bone graft) after cyst enucleation. The differences in the healing periods and patterns of bone healing were compared clinically and radiologically. The postoperative 1 year radiographs were analyzed for bone healing and density. Statistical analysis was performed using a Pearson chi square test and Wilcoxon rank-sum test. Results: More infection signs were observed in the bone graft group than in the other group, but there was no statistically significant difference. Radiographically, there was also no significant difference in the size of the radiolucent lesions between the two groups. Conclusion: There was no significant difference in healing between the groups with a bone graft and without bone graft after cyst enucleation.

ANTIBIOTIC SUSCEPTIBILITY OF BACTERIA ISOLATED FROM MAXILLARY SINUSITIS LESION (상악동염 병소 부위에서 세균의 분리 동정 및 항생제 감수성에 대한 연구)

  • Choi, Young-Og;Kim, Su-Gwan;Kim, Hak-Kyun;Kim, Yong-Jong;Choi, Dong-Kook;Kim, Mi-Kwang;Park, Soon-Nang;Kim, Min-Jung;Kook, Joong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권5호
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    • pp.436-446
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    • 2006
  • The purpose of this study was to isolate and identify the bacteria in chronic maxillary sinusitis (CMS) lesions from 3 patients and to determine the antimicrobial susceptibility of them against 10 antibiotics. One of them was odontogenic origin and the others were non-odontogenic origin. Pus samples were collected by needle aspiration from the lesions and examined by culture method. Bacterial culture was performed in three culture systems (anaerobic, CO2, and aerobic incubator). Identification of the bacteria was performed by 16S rRNA gene (16S rDNA) nucleotide sequencing method. To test the sensitivity of the bacteria isolated from the maxillary sinusitis lesions against seven antibiotics, penicillin G, amoxicillin, tetracycline, ciprofloxacin, cefuroxime, erythromycin, clindamycin, and vancomycin, minimum inhibitory concentration (MIC) was performed using broth dilution assay. Our data showed that enterobacteria such as Enterobacter aerogenes (30%), Klebsiella pneumoniae (25%), and Serratia marcescens (15%) were predominately isolated from the lesion of non-odontogenic CMS of senile patient (70 year old). Streptococcus spp. (40.3%), Actinomyces spp. (27.4%), P. nigrescens, M. micros, and P. anaerobius strains were isolated in the lesion of odontogenic CMS. In the lesion of non-odontogenic CMS, Streptococcus spp. (68.4%), Rothia spp. (13.2%), and Actinomyces sp. (10.5%) were isolated. The susceptibility pattern of 10 antibiotics was determined according to the host of the bacteria strains ratter than the kinds of bacterial species. Even though the number of CMS was limited as three, these results indicate that antibiotic susceptibility test must be accompanied with treatment of CMS. The combined treatment of two or more antibiotics is better than single antibiotic treatment in the presence of multidrug-resistant bacteria in the CMS lesions.

A CLINICOSTASTICAL STUDY OF ORAL AND MAXILLOFACIAL INFECTED PATIENTS FOR THE LAST 5 YEARS (최근 5년간 구강악안면 감염 환자의 임상통계학적 연구)

  • Jang, So-Jeong;Lee, Yong-Geun;Ahn, Yung;Leem, Dae-Ho;Baek, Jin-A;Shin, Hyo-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권5호
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    • pp.401-409
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    • 2006
  • Infections of the oral and maxillofacial region are one of the most common conditions for which a patient presents to a maxillofacial surgeons. Although these infections can arise from a variety of source, dental disease is the most common etiology. So, odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often respond to antimicrobial chemotherapy or surgical intervention, such as extraction of teeth, incision and drainage through clinical features. But, odontogenic infections have the potential to spread via the fascial spaces in the head and neck region, and, they spread to cavernous sinus, deep musculofascial space and other vital structure. We have undertaken clinical studies on infections in the oral and maxillofacial regions by analyzing retrospectively hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Chonbuk National University Hospital past 5 years from 2000 to 2004. And, the patients' age, sex, medical history, causes of the infection, surgical intervention, and other clinical parameters were reviewed. The obtained results were as follows : 1. The most frequent cause of oral and maxillofacial infection was odontogenic. And in the odontogenic cause, dental caries was the most common cause (47.2%). 2. The most common fascial space involved was the submandibular space (15.7%), followed by the buccal space (14.8%). 3. 60.4% of all patients required surgical drainage of the abscess, endodontic treatment or tooth extraction or periodontal treatment with drainage. 4. The most causative organism isolated from the pus culture were streptococcus viridans (53.9%). 5. Underlying medical problems were found in 136 patients (41.9%), the most common being hypertension (27.9%) and diabetes (14.7%).

BACTERIOLOGIC FEATURES INVESTIGAED BY ASPIRATION TECHNIQUE IN ORAL AND MAXILLOFACIAL INFECTIONS (구강악안면 감염 환자에서 흡인법을 이용하여 조사한 세균감염 양상)

  • Cho, Hyun-Young;Kim, Il-Kyu;Baek, Min-Kyu;Chang, Keum-Soo;Park, Seung-Hoon;Park, Jong-Won;Cho, Jung-Hyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권5호
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    • pp.562-570
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    • 2008
  • Most purulent maxillofacial infections are of odontogenic origin. Treatment of infection includes the surgical intervention, such as incision and drainage, and adjunctive treatment. The use of high-dose antibiotics is also indicated. The choice of an antibiotics should be based on the knowledge of the usual causative microbes and the results of antibacterial sensitivity test. We have undertaken clinical studies on 119 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from January 2000 to December 2007. Many anaerobic microbes are killed quickly when exposed to oxygen. Thus the needle aspiration techniques and the transfer under inert gas were used when culturing. The aim of this study was to obtain informations for the bacteriologic features and the effective antimicrobial therapy against maxillofaical odontogenic infections. The obtained results were as follows: 1. The most frequent causes of infections were odontogenic (88.3%), and in odontogenic cause, pulpal infections were the most common causes(53.8%). 2. The buccal and submandibular spaces (respectively 23.5%) were the most frequent involved fascial spaces, followed by masticator spaces (14.3%). 3. The most common underlying medical problems were diabetes (17.6%), however the relation with prognosis was not discovered. 4. The complications were the expiry, mediastinitis, necrotizing fasciitis, orbital abscess, and osteomyelitis. 5. The most common admission periods were 1-2 weeks, and the most patients were discharged within 3 weeks. However, patients who admitted over 5 weeks were about 10%. 6. A total of 99 bacterial strains (1.1 strains per abscess) was isolated from 93 patients (78.2%). The most common bacterium isolated was Streptococcus viridans (46.2%), followed by $\beta$-hemolytic group streptococcus (10.1%). 7. Penicillins (penicillin G 58.3%, oxacillin 80.0%, ampicillin 80.0%) have slightly lower sensitivity. Thus we recommend the antibiotics, such as glycopeptides (teicoplanin 100%, vancomycin 100%) and quinolones (ciprofloxacin 90.0%) which have high susceptibility in cases in which peni cillin therapy failed or severe infections.

Diagnostic ability of differential diagnosis in ameloblastoma and odontogenic keratocyst by imaging modalities and observers (범랑모세포종과 치성각화낭의 감별 진단시 방사선사진과 판독자에 따른 진단능의 비교)

  • Gang, Tae-In;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Lee, Sam-Sun;Kim, Jeong-Hwa;Moon, Je-Woon;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • 제36권4호
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    • pp.177-182
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    • 2006
  • Purpose: To evaluate the diagnostic ability in differentiating between ameloblastoma and odontogenic keratocyst according to the imaging modalities and observers. Materials and Methods: We evaluated thirty-six cases of ameloblastomas and forty-seven cases of odontogenic keratocysts all histologically confirmed. Six oral and maxillofacial radiologists diagnosed the lesions by 3 methods: using panoramic radiograph, using computed tomograph (CT), and using panoramic radiograph and CT. The observers were classified by 3 groups: group 1 had experienced over 10 years in oral and maxillofacial radiologic field, group 2 had experienced for 3-4 years, and group 3 was in the process of residentship. After over 2 weeks, the observers diagnosed them by the same methods. Results: The ROC curve areas except for group 3 were the highest with interpretation using panoramic radiograph and CT, followed by interpretation using CT only, and the lowest with interpretation using panoramic radiograph only. The overall difference was not found in diagnostic ability among groups in using panoramic radiograph only, but there was difference in diagnostic ability of group 1 and 2 vs 3 in using CT only, and combination panoramic radiograph and CT. Conclusions: To differentiate between ameloblastoma and odontogenic keratocyst more accurately, the experienced oral and maxillofacial radiologist should diagnose with combination of panoramic radiograph and CT.

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TREATMENT OF MULTIPLE JAW KERATOCYSTIC ODONTOGENIC TUMOR IN CHILDREN'S JAW BONE : A CASE REPORT (소아에서 발생한 악골의 다발성 각화낭성 치성종양의 치험례)

  • Kim, Ji-Young;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • 제36권3호
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    • pp.489-497
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    • 2009
  • Occurrence of multiple cysts in jaw bone is rare compared to solitary cysts. numerous cysts occurring in jaw bone which not accompany any syndromes are defined as multiple jaw cysts, and most of these cases in children are keratocystic odontogenic tumor (KCOT) Multiple KCOT occurring in children are often associated with basal cell nevus syndrome(BCNS), so if multiple cysts are found on the radiograph, we suspect this syndrome and pursue clinical and pathological tests. In this case, a pediatric patient, reporting with multiple cysts in the jaw was suspected of BCNS, but hasn't shown any other symptoms of this syndrome up to date, and has kept repeating surgical operation and recurrence of the tumor. Although no symptoms besides multiple jaw cysts is present, it is often reported that other symptoms appear late in the patient's age. Therefore, in cases where multiple odontogenic tumors are found in children, continuous radiographic and clinical follow-ups in order to check the progress of the syndrome is considered important.

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CALCIFYING ODONTOGENIC CYST ASSOCIATED WITH COMPLEX ODONTOMA : CASE REPORT (치아종을 동반한 석회화 치성낭의 치험례)

  • Lee, Sang-Yup;Kim, Dae-Eop;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • 제31권4호
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    • pp.645-650
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    • 2004
  • Calcifying odontogenic cyst(COC) is a rare developmental odontogenic cyst, which shows diverse classification and terminology. Cystic epithelial lining of COC is composed of basal cell layer of columnar cells and overlying layer of stellate reticulum. In the epithelium, ghost cells that might induce adjacent mesenchymal tissue to develop dental organ are shown characteristically. In spite of low rate of recurrence, we have to get a histopathological examination so that odontogenic lesions may recur without fully curettage of lining epithelium. 7-year-old male child came pediatric dentistry in wonkwang university dental hospital in order to check the delayed eruption of left maxillary central incisor. Radiographic examination revealed a well-defined radiopaque mass, overlapping impacted left central and lateral incisor crown. Enucleated mass was tooth-like features and also had epithelium lining. Results of histopathologic procedure, we saw the lots of ghost cell and proliferating hard dental tissues. Also we saw the cystic epithelium cells. It revealed diagnosis of the COC associated complex odontoma. For this reason one should consider of COC when patients present odontoma-like lesion with impacted tooth.

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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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    • 제22권3호
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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.