• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.3
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• pp.473-480
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• 2007

The dentigerous cyst originates through alteration of stellate reticulum after amelogenesis has completed, with accumulation of fluid between the layers of the reduced enamel epithelium or between this epithelium and the tooth crown. Its incidence is relatively high on 10s or 20s of age and it is always related to the unerupted crown. Generally, it has no symptom, however, if the cyst is large or accompanied with pus formation, swelling and pain may occur. In radiographic findings, it shows impacted crown surrounded by well defined unilocular radiolucent lesion and occasionally displacement of adjacent teeth or root resorption. The goal of treatment is complete elimination of abnormal tissue preserving the tooth involved in the cyst. Enucleation and marsupialization are commonly used for the treatment. Marsupialization is the procedure which removes the partial portion of the cystic wall and connects with the oral mucosa. As the pressure in the cyst decreases, bone regeneration takes place in the defect area and cystic wall converts into normal mucosa. This procedure, however, is the most conservative procedure which allows the protection of adjacent important structures. If the eruption space is sufficient, then inducing the eruption of the permanent tooth in the cyst is also possible. In following cases, dentigerous cyst was diaganosed after clinical and radiographic examination. Marsupialazation was done to remove the cyst and induce the tooth, which was in the cyst, to erupt into the oral cavity.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.2
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• pp.246-251
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• 2010

Impactions can occur because of malpositioning of the tooth bud or obstruction in the path of eruption. However, the exact mechanism is still unknown. The impaction of mandibular first molar is rare with prevalence rates of 0.01~0.25%, but it is important to deimpact the tooth as soon as possible to avoid complications such as dental caries, root resorption, and periodontal problems on the adjacent teeth. Several biomechanical strategies have been proposed for uprighting mesially tipped mandibular first molars. However, most of these have had problems with movement of the anchorage unit because of the reciprocal force. The recent development of skeletal anchorage system(SAS) allows direct application of precise force systems to the target tooth or segment, producing efficient tooth movement in a short time. In this case, an impacted mandibular left first molar with dilacerated roots was treated with a miniplate, which provided skeletal anchorage to upright the tooth. The miniplate was installed in the mandibular ramus, and 10 months after the application of orthodontic force, the impacted tooth was exposed in the oral cavity and uprighted. At this point, the mandibular left first molar was included in the orthodontic appliance with fixed mechanotherapy, the tooth could achieve a normal occlusion. Therefore, the use of SAS simplified the orthodontic procedures and reduced the orthodontic treatment period, and had few side effects.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.1
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• pp.294-300
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• 2011

This study was performed to examine the presence of dysphagia and analyze characteristics of the symptoms in cerebrovascular accident(CVA) patients without awareness of dysphagia. A questionnaire for this study was given to CVA patients who had visited P rehabilitation medical center in Busan. Eleven patients (4 males and 7 females) who answered no awareness of dysphasia were given to VFSS, functional dysphasia scale, and NCSE. Descriptive statistics and Pearson correlation analysis were performed by SPSS 12.0. All of subjects without awareness of dysphasia showed characteristics of dysphasia symptoms. Prominent dysfunctions were problems in oral phase and delay of swallowing reflex in pharyngeal phase. For the aspect of cognition, they showed lower score in construction, memory, and similarity than other NCSE items. There was highly significant correlation between orientation, judgment and delay of swallowing reflex. Verbal comprehension and residual materials in oral cavity showed closed correlation. CVA patients without awareness had dysphagia with high probability. The early evaluation of dysphagia should be performed in CVA patients in order to prevent complications due to CVA, so it is necessary to increase the effectiveness of rehabilitation therapy.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.191-197
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• 1999

Background and Objective : Soft palate plays a great role in function of speech and swallowing. Ablation of tonsil cancer results in multi-demensional defect including soft palate in most cases and restoration of the postoperative oral cavity function is a continuing surgical challenge. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for these defect, which offers a thin, pliable, and relatively hairless skin, and a long vascular pedicle. The aim of the present study is to report the speech and swallowing function test results of our 5 consecutive radial forearm free flaps used for tonsil cancers. Materials and Methods : We reviewed the medical records of 5 patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for tonsil cancers, from Dec. 1997 to Oct. 1998, and analyzed the surgical methods, complications, and speech and swallowing function test results. We have examined with modified barium swallow to evaluate postoperative wallowing function and articulation and resonance test for speech. Results : The tumor sizes by TNM stage(AJCC, 1997) were T1(1), T2(2), and T4(3). The paddles of flaps were tailored in multilobed designs from oval shape to pentalobed design and in variable size from 24$cm^2$ to 108$cm^2$(average size = 78.4$cm^2$), according to the defect after ablation. This procedures resulted in satisfactory flap success and functional results all but 1 case of flap contracture in 2 postoperative week, achieved early oral diet until 16-57 postoperative day(average, 28 days) and social speech. The oropharyngeal defect including soft palate reconstruction with radial forearm free flap might be an excellent method for the maximal functional results, after ablative surgery of tonsil cancer that results in multidimensional defect.

• Journal of Oral Medicine and Pain
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• v.40 no.3
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• pp.110-114
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• 2015

Purpose: Growth and differentiation factor (GDF)-11 is a transforming growth factor-${\beta}$ family member that plays important regulatory roles in development of multiple tissues which include axial skeletal patterning, palatal closure, and tooth formation. Proteins that have been identified as GDF-11 inhibitors include GDF-associated serum protein (GASP)-1 and GASP-2. Recently, we found that mice genetically engineered to lack both Gasp1 and Gdf11 have an increased frequency of cleft palate. The goal of this study was to investigate the roles of GDF-11 and its inhibitors, GASP-1 and GASP-2, during dental and craniofacial development and growth. Methods: Mouse genetic studies were used in this study. Homozygous knockout mice for Gasp1 ($Gasp1^{-/-}$) and Gasp2 ($Gasp2^{-/-}$) were viable and fertile, but Gdf11 homozygous knockout ($Gdf11^{-/-}$) mice died within 24 hours after birth. The effect of either Gasp1 or Gasp2 deletion in $Gdf11^{-/-}$ mice during embryogenesis was evaluated in $Gasp1^{-/-}$;$Gdf11^{-/-}$ and $Gasp2^{-/-}$;$Gdf11^{-/-}$ mouse embryos at 18.5 days post-coitum (E18.5). For the analysis of adult tissues, we used $Gasp1^{-/-}$;$Gdf11^{+/-}$ and $Gasp2^{-/-}$;$Gdf11^{+/-}$ mice to evaluate the potential haploinsufficiency of Gdf11 in $Gasp1^{-/-}$ and $Gasp2^{-/-}$ mice. Results: Although Gasp2 expression decreased after E10.5, Gasp1 expression was readily detected in various ectodermal tissues at E17.5, including hair follicles, epithelium in nasal cavity, retina, and developing tooth buds. Interestingly, $Gasp1^{-/-}$;$Gdf11^{-/-}$ mice had abnormal formation of lower incisors: tooth buds for lower incisors were under-developed or missing. Although $Gdf11^{+/-}$ mice were viable and had mild transformations of the axial skeleton, no specific defects in the craniofacial development have been observed in $Gdf11^{+/-}$ mice. However, loss of Gasp1 in $Gdf11^{+/-}$ mice occasionally resulted in small and abnormally shaped auricles. Conclusions: These findings suggest that both GASP-1 and GDF-11 play important roles in dental and craniofacial development both during embryogenesis and in adult tissues.

• Tuberculosis and Respiratory Diseases
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• v.51 no.1
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• pp.65-69
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• 2001

The incidence of lung cancer and its mortality rate are increasing in Korea. At the time of diagnosis, 40% patients of lung cancer patients had metastatic lesions. The common metastatic sites are the contralateral lung, bone, liver, adrenal gland and the brain. Metastasis to oral mucosa is rarely encountered in lung cancer and metastasis to the gingiva is more uncommon. Approximately 1% of malignant carcinomas in the oral cavity are the result of metastases, and 10-25% of metastatic cancers originate from lung cancer. Clinically metastatic gingival lesions are benign including hemangioma, pyogenic granuloma, giant-cell granuloma or a peripheral fibroma. Often metastases to the gingiva are diagnosed too late and by the time they are detected, they have metastases to other organs. Here we report a case of small cell lung carcinoma that had metastased to the gingiva with review of relevant literature.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7891-7895
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• 2014

Background: Tobacco products continue to be used in large quantities in India despite the mandatory inclusion of pictorial health warnings (PHWs) on all tobacco packaging. The circumstances as to how people could continue the use of tobacco to the point of developing head and neck cancer despite enhanced awareness about the ill effects of tobacco is the main focus of this study. Materials and Methods: This study concerned patients with least 5-years history of tobacco use, having been diagnosed with histopathologically proven malignancies of the hypopharynx, larynx, oropharynx and oral cavity presenting at the Government Medical College-Haldwani, Nainital, India. A total of 183 patients were eligible for inclusion during July 1 2013 - June 30 2014. Of these, 59 patients used smoked tobacco exclusively, 22 patients used smokeless tobacco exclusively, and 102 patients used both forms of tobacco. Among users of smoked forms, 75.2% (n=121) were beedi users, and 24.8% (n=40) were cigarette users. Patients were asked direct questions as to whether they had noticed the presence of PHWs upon tobacco products. The reasons as to why PHWs were not effective in stopping the patients from tobacco use were investigated. Results: Of the 183 patients, 146 reported being aware about the presence of PHWs, and when they were asked reasons as to why they continued tobacco despite being aware of ill-effects, the commonest reason chosen (by 53.4%) was that patients had not regarded themselves as using tobacco heavy enough to cause cancer. Among the 36 patients who reported as being oblivious to the presence of PHWs on tobacco products, 63.9% reported that the products they used never displayed any PHWs, and 36.1% reported never having paid attention to the packaging. The awareness about PHWs was higher among cigarette smokers in comparison to beedi smokers (100% vs 76.1%, p=0.0002). Conclusions: Locally produced and marketed tobacco products such as beedis and oral tobacco often fail to display PHWs. The presence of PHWs without doubt enhances awareness about the carcinogenic risks of tobacco. However, enhanced awareness alone may not be enough, and as elucidated by this study, some persons continue to use tobacco to the point of developing malignancies. The need of the hour is the implementation of legal and economic sanctions discouraging the use of tobacco products.

• The Journal of Korean Medicine
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• v.31 no.1
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• pp.23-29
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• 2010

Objective: The aim of this prospective, case-controlled study was to assess the difference of the amount of tongue coating between halitosis and non-halitosis patients using a digital tongue diagnosis system (DTDS). Methods: Sixty-five patients complaining of oral malodor were recruited for the study. The level of volatile sulfur compounds (VSC) in the oral cavity of the patients was measured by a portable gas chromatography. All patients were then divided into two groups, the halitosis group ($H_2S{\geq}1.5ng$/10ml, or $CH_3SH{\geq}0.5ng$/10ml) and the non-halitosis group ($H_2S$<1.5ng/10ml and $CH_3SH$<0.5ng/10ml), according to the VSC level criteria published by Tonzetich. Tongue images of the two groups were acquired and analyzed by DTDS, followed by the analysis of the tongue coating scores. Results: The tongue coating scores of the halitosis group were significantly higher than of the non-halitosis group (P=0.033). Furthermore, the difference of the posterior tongue coating between the two groups was more significant (P=0.000). Conclusions: Halitosis patients were shown to have a thicker tongue coating than those in the non-halitosis group. Moreover, the posterior dorsum of the tongue should be observed more cautiously when dealing with halitosis patients. Also, the progress and state of the patient's symptom of halitosis as diagnosed objectively by the portable gas chromatography could also possibly be analyzed instead by the DTDS tongue coating score.

• 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.

• Parasites, Hosts and Diseases
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• v.27 no.1
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• pp.57-66
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• 1989

A scanning electron microscopic study was performed to observe the tegumental ultrastructures of Paragonimus iloktuenensis according to its developmental stages. The metacercariae were obtained from the liver of the brackish water crab, Sesarma dehaani. Juvenile and adult p. iloktsuenensis were recovered from the experimental rats on 2, 4 and 8 weeks after infection. The findings were summarized as follows: 1. The encysted metacercariae were charaeteristically gourd-shape, with their whole body surface beset with numerous spade-shape spines. The Barge, type II sensory papillae (non-ciliated round swellings) were arranged along the rim of the oral and ventral suckers, 11~12 and 6~8 in numbers respectively, 2. Two-week old juvenile worms, recovered chieay from the liver of the experimental rats, were slender in body shape: with their ventral sucker near the anterior one-third level. The distribution of tegumental spines was less dense than in the encysted metacercariae. The spines were with 1~2 pointed tips and 3~.4 longitudinal splits. Numerous ciliated knob-like, type I papillae were observed in both sides of the oral sucker, and 6 large, type If papillae were arranged along the rim of the ventral sucker. 3. Four week old worms, recovered from the thoracic cavity and/or lung parenchyme of the experimental rats, were thicker than wide in body configuration, and their ventral sucker was located near the anterior one.fourth level. The tegumental spines at ventral surface were grouped, each group with 3~5 aggregated ones. The type I and type II papillae (small-sired) were distributed chiefly around the rim of two suckers. 4. Adult (eight-week old) worms, recovered from the capsules in the lung parenchyme, were very stout, and covered densely with bearfoot like spines. At dorsal surface, cobblestone-like cytoplasmic processes were well-developed, with many tegumental spines embedded in them. It was observed in this study that the tegument of p. iloktsuenensis continued to change and differentiate as the worms grew to be adults.