• Title/Summary/Keyword: Oral and maxillofacial reconstruction

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Assessment of apical root resorption using digital subtraction radiography (디지털공제방사선촬영술을 이용한 치근단 흡수의 평가)

  • Heo Min-Suk;Lee Sam-Sun;Lee Kyung-Hee;Choi Hang-Moon;Choi Soon-Chul;Park Tae-Won
    • Imaging Science in Dentistry
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    • v.31 no.1
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    • pp.51-55
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    • 2001
  • Purpose : This study was performed to compare the diagnostic ability of conventional intraoral radiographs with that of digital subtraction image and to assess the quantifying ability of digital subtraction image for simulated apical root resorption Materials and Methods : Conventional intraoral radiographs and digital images of ten sound maxillary central incisors and those with simulated apical root resorption were taken with varying horizontal and vertical angulations of the x-ray beam. The diagnostic accuracy to detect the lesion was evaluated on conventional intraoral radiographs and digital subtraction images by ROC analysis. The amount of simulated apical root resorption was also estimated on the reconstruction images by Emago/sup (R)/ and compared with actual amount of tooth loss using paired t-test. Results: The diagnostic accuracy of conventional intraoral radiographs to detect the apical root resorption was low (ROC area = 0.6446), and the sensitivity and the specificity of digital subtraction images were 100%, respectively. The calculated amounts of apical root resorption showed no statistically significant difference with the actual amounts of the lesion (p>0.05). Conclusion: Digital subtraction radiography is powerful tool to detect the small apical root resorption, and quantitative analysis of small amounts of the lesion can be evaluated by digital subtraction radiography.

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Evaluation of available height, location, and patency of the ostium for sinus augmentation from an implant treatment planning perspective

  • Vaddi, Anusha;Villagran, Sofia;Muttanahally, Kavya Shankar;Tadinada, Aditya
    • Imaging Science in Dentistry
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    • v.51 no.3
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    • pp.243-250
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    • 2021
  • Purpose: The objective of this study was to evaluate the amount of height available for a maxillary sinus augmentation procedure without blocking the ostium and jeopardizing the drainage of the ostiomeatal complex using cone-beam computed tomography (CBCT) imaging. Materials and Methods: A total of 200 sinonasal complexes comprising 100 dentate and 100 edentulous scans were retrospectively assessed using CBCT. Invivo 5.0, a CBCT reconstruction program, was used for image evaluation. The coronal section demonstrating the ostiomeatal complex was selected as a reference view to perform measurements of the sinus. The measurements were done by 2 evaluators in separate sessions. Comparative analyses of measurements were performed between dentate and edentulous patients and between male and female patients. Results: The safe height to which the sinus can be elevated without compromising the integrity of the ostiomeatal complex was calculated for each sinus. In the presence of significant mucosal thickening, the height available for augmentation was calculated by subtracting the height of mucosal thickening from the sinus floor to the location of the ostium. In this study, the available height was approximately 27.05 mm for dentate and 23.40 mm for edentulous patients. The inter-operator reliability was excellent for all the parameters evaluated. Conclusion: This retrospective study with a limited number of patients from a single university-based site shows that CBCT is valuable in evaluating the location and patency of the ostium for planning sinus augmentation procedures for dental implant placement.

Treatment and Rehabilitation of Repetitively Recurrent Langerhans Cell Histiocytosis: A Case Report

  • Yoo, Hee Young;Park, Kyung Soo;Lee, Baek Soo;Kwon, Yong Dae;Choi, Byung Joon;Ohe, Joo Young;Lee, Jung Woo
    • Journal of Korean Dental Science
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    • v.9 no.1
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    • pp.35-41
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    • 2016
  • Langerhans cell histiocytosis (LCH) is characterized by proliferation of histiocyte-like cells (Langerhans cell histiocytes) with characteristic Birbeck granules, accompanied by other inflammatory cells. Treatments of LCH include surgery, chemotherapy, and radiotherapy. One of the representative forms of chemotherapy is intralesional injection of steroids. Surgical treatment in the form of simple excision, curettage, or even ostectomy can be performed depending on the extent of involvement. Radiotherapy is suggested in case of local recurrence, or a widespread lesion. This article shows the case of repetitively recurrent LCH of a 56-year-old man who had been through surgical excision and had to have marginal mandibulectomy and radiotherapy when the disease recurred. After the first recurrence occurred, lesions involved the extensive part of the mandible causing pathologic fracture, so partial mandibular bone resection was performed from the right molar area to the left molar area followed by the excision of the surrounding infected soft tissues. The resected mandibular bone was reconstructed with a segment of fibula osteomyocutaneous free flap and overdenture prosthesis supported by osseointegrated implants.

Improvement of phonetic function using modified two-flap palatoplasty and velar myoplasty : Report of a case (변형 피판 구개성형술 및 구개내 근육성형술의 언어기능의 개선 : 증례보고)

  • Yi, Ho;Myoung, Hoon;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pil-Hoon;Kim, Myung-Jin;Seo, Byoung-Moo
    • Korean Journal of Cleft Lip And Palate
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    • v.9 no.2
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    • pp.79-84
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    • 2006
  • Cleft palate is one of the most devastating congenital facial deformities frequently accompanied by cleft lip. In many cases, it causes phonetic and swallowing difficulties although surgical interventionwas applied. Among the surgical methods, Veau-Wardill-Kilner pushback palatoplasty (V-Y reposition) is widely used in the most cleft palate cases. It is designed to lengthen the palate posteriorly, hence to overcome the speech and swallowing problems, but broad postoperative palatal scar might interfere the normal maxillary growth. If the velar muscles were not reoriented, it could result in incomplete speech recovery. In this case report, the modified two-flap palatoplasty with minimal pushback was successfully applied to a 21 month-old girl who has had incomplete cleft palate extended to the posterior third of hard palate. The speech evaluation was confirmed as functional reconstruction of cleft palate was achieved.

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Human papilloma virus in oral cancer

  • Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.6
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    • pp.327-336
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    • 2016
  • Cervical cancer is the second most prevalent cancer among women, and it arises from cells that originate in the cervix uteri. Among several causes of cervical malignancies, infection with some types of human papilloma virus (HPV) is well known to be the greatest cervical cancer risk factor. Over 150 subtypes of HPV have been identified; more than 40 types of HPVs are typically transmitted through sexual contact and infect the anogenital region and oral cavity. The recently introduced vaccine for HPV infection is effective against certain subtypes of HPV that are associated with cervical cancer, genital warts, and some less common cancers, including oropharyngeal cancer. Two HPV vaccines, quadrivalent and bivalent types that use virus-like particles (VLPs), are currently used in the medical commercial market. While the value of HPV vaccination for oral cancer prevention is still controversial, some evidence supports the possibility that HPV vaccination may be effective in reducing the incidence of oral cancer. This paper reviews HPV-related pathogenesis in cancer, covering HPV structure and classification, trends in worldwide applications of HPV vaccines, effectiveness and complications of HPV vaccination, and the relationship of HPV with oral cancer prevalence.

OPEN REDUCTION OF MANDIBULAR CONDYLE FRACTURES WITH AND WITHOUT DISCAL INJURY : A CASE REPORT (관절원판의 손상과 관련된 하악과두 골절의 관혈적 정복술의 치험례)

  • Song, Sun-Chul;Kang, Souk-Ki;Kang, Jung-Hoon;Kim, Jin;Kim, Kyung-Wook;Yim, Chang-Joon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.3
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    • pp.300-304
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    • 1991
  • This is case report of open reduction of condylar fractures with or without discal injury. Many articles described open reduction and internal fixation of condylar fractures emphasize the method of bony reduction and fixation without mention of the position of the disc. So we like to present our cases of open reduction of condylar fractures in conjunction with reconstruction of the disc and associated structures. The pupose of this presentation is to emphasize several well - established principles of trauma management and management of temporomandibular joint injuries, such as 1) in situations of traumatic injury, anatomic restoration is the goal of treatment and, 2) anatomic alignment of the TMJ disc over the condyle is preferable to disc subluxation because the latter may lead to chronic pain, limitation of opening and degenerative arthritis. Although our case is small with short term follow up, we believe that open reduction and internal fixation of condylar fractures in conjunction with disc repair is a biologically sound approach to those fractures indicated for open surgery. Long term follow up will allow better judge the validity of this treatment approach to us.

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A CASE REPORT OF THE ARTHROSIS OF THE TEMPOROMANDIBULAR JOINT RESULTED NONTREATED FRACTURES OF THE ZYGOMATIC ARCH AND CORONOID PROCESS (협골궁과 근돌기 골절의 미처치로 초래된 악관절증의 외과적 치험례)

  • Chung, Hoon;Oh, Byung-Sub
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.215-220
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    • 1994
  • In the case of the trauma on the maxillofacial region occurred, we think that one of the most important thing is recovery of the function as well as reconstruction of the anatomical form. Especially, it has been that the structure of the surrounded temporomandibular joint has a great possibility to cause mouth opening limitation when a bit of displacement is caused. Therefore, in the case of the trauma on mid-face we think that we treat it after complete evaluate condition of soft and hard tissue surrounding the articular disc as well as fracture site. We report results of our study, since we obtained good results from our study concerning the refixation of the zygomatic arch, high condylectomy, coronoidectomy and myotomy for the patient being suffered from the arthrosis of the temporomandibular joint caused by insufficient fracture treatment of zygomatic arch and coronoid process.

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Chronic non-bacterial osteomyelitis in the jaw

  • Kim, Soung Min;Lee, Suk Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.2
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    • pp.68-75
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    • 2019
  • Chronic recurrent multifocal osteomyelitis (CRMO) is one of the most severe form of chronic non-bacterial osteomyelitis (CNO), which could result in bone and related tissue damage. This autoinflammatory bone disorder (ABD) is very difficult for its clinical diagnosis because of no diagnostic criteria or biomarkers. CRMO in the jaw must be suspected in the differential diagnosis of chronic and recurrent bone pain in the jaw, and a bone biopsy should be considered in chronic and relapsing bone pain with swelling that is unresponsive to treatment. The early diagnosis of CRMO in the jaw will prevent unnecessary and prolonged antibiotic usage or unnecessary surgical intervention. The updated researches for the identification of genetic and molecular alterations in CNO/CRMO should be studied more for its correct pathophysiological causes and proper treatment guidelines. Although our trial consisted of reporting items from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), there are very few articles of randomized controlled trials. This article was summarized based on the author's diverse clinical experiences. This paper reviews the clinical presentation of CNO/CRMO with its own pathogenesis, epidemiology, recent research studies, and general medications. Treatment and monitoring of the jaw are essential for the clear diagnosis and management of CNO/CRMO patients in the field of dentistry and maxillofacial surgery.

A systematic review of therapeutic outcomes following treatment of squamous cell carcinoma of the retromolar trigone

  • Kim, Hye-Won;Kim, Moon-Young;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.4
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    • pp.291-314
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    • 2021
  • Squamous cell carcinoma (SCC) of the retromolar trigone (RMT) is a rare but potentially fatal disease that carries a poor prognosis due to its unique anatomic position. RMT SCCs tend to spread to vital nearby structures, including the tonsillar pillar, masticatory muscles, and underlying mandibular bone, even in their early stages, and aggressive treatment is often warranted. This systematic review appraises and qualitatively analyzes all available literature regarding the survival outcomes and prognosis of RMT SCC. Four databases were searched to identify all eligible articles published since January 1980. Of the 1,248 studies, a total of 15 studies representing 4,838 cases met the inclusion criteria. The evaluated patients had a high rate of advanced tumor stage (T3 or T4: 61.4%), lymph node metastasis (38.8%), and mandibular bone invasion (24%) at the time of diagnosis. Aggressive surgical treatments such as lip-splitting (92%), segmental mandibulectomy (61.1%), radical neck dissection (44.1%), and reconstruction using free flaps (49.5%) was undertaken for 92% of the pooled patient population. The mean rates for local, regional, and systemic recurrence were 23.40%, 8.40%, and 8.50%, respectively. The mean 5-year overall survival rate was 38.90%. Osteonecrosis was noted in 11.6% of the 328 patients who received radiotherapy. In conclusion, RMT SCC is generally associated with high recurrence, low survival, and high postoperative complication rates. Early diagnosis and aggressive treatment are thus warranted. However, significant methodological problems hamper current knowledge. Future studies of this topic that use randomized or cohort designs are thus needed.

Closure of radial forearm free flap donor-site defect with proportional local full-thickness skin graft: case series study of a new design

  • Han, Yoon-Sic;Lee, Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.6
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    • pp.427-431
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    • 2021
  • Objectives: The aim of this study was to describe a simple, convenient, and reliable new technique using local full-thickness skin graft (FTSG) for skin coverage of a donor-site defect of the radial forearm free flap (RFFF). Patients and Methods: Between April 2016 and April 2021, five patients with oral squamous cell carcinoma underwent mass resection combined with RFFF reconstruction. After RFFF harvesting, donor-site defects were restored by proportional local FTSG. Results: The donor-site defects ranged in size from 24 to 41.25 cm2, with a mean of 33.05 cm2. Good or acceptable esthetic outcomes were obtained in all five patients. There was no dehiscence, skin necrosis, wound infection, or severe scarring at the graft site through the end of the postoperative follow-up period, and no patient had any specific functional complaint. Conclusion: The proportional local FTSG showed promising results for skin coverage of the donor-site defect of the RFFF. This technique could decrease the need for skin grafts from other sites.