• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권1호
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• pp.70-76
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• 2001

Purpose : To evaluate the efficacy of arthrocentesis for treatment of closed lock. Material : 42 patients were diagnosed to closed lock by physical, radiographic examriation and undergone arthrocentesis. All patients have a pain and mouth opening limitation on affected site. Method : Arthrocentesis was done under conscious sedation and local infiltration anesthesia, normal saline and some steroid was injected on upper compartment of tempormandibular joint. After pumping and lavage, manual reduction procedure of anterially displaced disc was done. All the patients wear an anterior repositioning splint just after arthrocentesis. The result of arthrocentesis was assessed by pain and difference of mouth opening. Result : Difference of mouth opening after arthrocentesis was improved to 18.85mm and pain was gradually decreased. All patients were worn stabilization type splint after mean 1.84 months. 6 patients had relapse of mouth opening limitation so done arthrocentesis again and delivered good results.

• Journal of Oral Medicine and Pain
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• 제44권3호
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• pp.140-144
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• 2019

Actinomycosis is rare, chronic, slowly progressive disease caused by gram-positive anaerobic organisms from the Actinomycosis family that normally colonizes the oral cavity. Actinomycotic osteomyelitis is even more rare and refractory disease because diagnosis by bacterial culture is not easy. In our case, 80-year-old man visited our clinic with a complaint of swelling and severe sinus tracts without teeth evolvement on anterior mandible. Computed tomography (CT) scan demonstrated erosive bone destruction on anterior mandible, clinically suspected actinomycotic osteomyelitis. The patient also had thoracic actinomycosis on Lt. lower lung. We could diagnosis actinomycosis by histopathologic examination. He treated by conservative surgery and long term antibiotics. After 2 year, no recurrence was seen in CT scan.

• Journal of Oral Medicine and Pain
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• 제48권4호
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• pp.169-173
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• 2023

Hemangioma is a lesion characterized by vascular proliferation of endothelial origin, manifesting neoplastic features. The occurrence of central hemangioma in the oral and maxillofacial region is exceptionally rare, and in two-thirds of cases, it is predominant in the mandible rather than the maxilla. The main symptoms and signs associated with central hemangiomas include pulsation, bone expansion, bruit, teeth displacement, and root resorption of the adjacent teeth. Bleeding may manifest periodically from the sulcus surrounding the affected teeth, particularly when accompanied by hypermobility in the primary dentition. One of the most noteworthy complications is the potential for severe bleeding during tooth extraction or surgical procedures conducted in proximity to unrecognized hemangiomas. Such situations may pose a life-threatening risk. Taking this into consideration, we present two cases of central hemangiomas in adolescent patients who sought consultation, with subsequent embolization performed by the Department of Radiology in Chosun University Hospital.

• Imaging Science in Dentistry
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• 제32권2호
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• pp.119-122
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• 2002

Two cases of Eagle's syndrome are reported. The first case involved a 31-year-old man who complained of pain in his throat and pain at preauricular area on turning his head. Panoramic and computed tomography (CT) views showed bilateral stylohyoid ligament ossification. The symptoms were relieved after surgical removal. The second case involved a 56-year-old female whose chief complaints were a continuous dull pain and occasional 'shooting' pain on lower left molar area. During the physical examination, an ossified stylohyoid ligament was palpated at the left submandibular area. Panoramic and CT images showed prominent bilateral stylohyoid ligament ossification. CT scans also showed hypertrophy of left medial and lateral pterygoid muscles. The symptoms were relieved after medication. CT is a useful tool for the examination of ossified stylohyoid ligaments and studying the relationship between Eagle's syndrome and adjacent soft tissue.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권6호
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• pp.363-370
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• 2022

Objectives: This study aimed to investigate the efficacy of postoperative submucosal injection of hyaluronidase (HUD) for reducing sequelae and quality of life (QOL) after mandibular third molar (M3M) surgery. Materials and Methods: Participants with bilateral impacted M3M underwent surgical extraction with a split-mouth randomized controlled study design. M3M were removed by the same surgeon in 2 sessions, one a control and the other experimental. Submucosal injection of HUD was performed in the experimental session and submucosal injection of saline in the control session. Mouth opening, facial swelling, and pain intensity were measured before surgery, and then 2 and 7 days after surgery. The QOL of participants following surgery was evaluated by means of a patient-centered outcome questionnaire (PCOQ). Results: A total of 36 patients was included in the final data analysis. There was a significant reduction in the maximal mouth opening and postoperative pain in the experimental side at the 2 and 7 days after surgery (P<0.05), and a remarkable difference in facial swelling was reported on the experimental side 7 days after surgery (P<0.05). The PCOQ demonstrated that participants reported less pain and swelling on the experimental side. Conclusion: The present study provides clinical evidence that submucosal administration of HUD immediately after M3M surgery reduced postoperative discomfort and improved patients' QOL.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권5호
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• pp.380-385
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• 2010

Introduction: The iliac crest has been the accepted place to obtain bone for reconstruction in oral and maxillofacial surgery. The iliac crest has many advantages because of its accessibility, large amount of cancellous bone, relative ease of bone harvest, possibility of two team approach and ability to close the wound primarily. This study evaluated retrospectively the morbidity of bone harvesting from the anterior iliac crest to provide a logical guide for recognizing the complications and morbidities of an iliac crest bone graft. Materials and Methods: Fifty healthy patients (mean age of 35.5 years; range 7 to 59) underwent iliac crest bone harvesting for a maxillofacial reconstruction from January 2007 to September 2009 at the Department of Oral and Maxillofacial Surgery in Kyungpook National University Hospital. Age, sex, size and kind of grafted bone, duration of pain on donor site, duration of gait disturbance, sensory deficit, scar, contour defect were measured in each patients by retrospective research. Results: The mean duration of pain is 6.7 days, and mean duration of gait disturbance is 7.2 days. Most patients were free from gait disturbances and pain within 2 weeks and there was no correlation between the size of the harvesting block bone and the duration of gait disturbance or pain. However, this study showed that the duration of pain is associated with gait disturbance. In addition, most patients had no complaints regarding their surgical scar and contour defect, and only one patient had permanent impairment of the sensory function. Moreover, an iliac bone graft did not extend the length of hospitalization. Conclusion: This study suggests that split thickness bone harvesting from the inner table of the anterior iliac crest is a well accepted procedure with relatively low morbidity.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권1호
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• pp.47-53
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• 2017

Background: Every patient who undergoes mandibular third molar surgery is concerned about post-operative pain. Indeed, previous researchers have used various methods to treat such pain. This study aimed to assess the effectiveness of sublingual injection of dexamethasone (8 mg) to treat post-operative pain after mandibular third molar surgery. Method: This was a randomized, double-blind, split-mouth, clinical trial, involving 48 healthy patients who required surgical removal of two mandibular third molars with similar bilateral positions. All operations were performed by the same experienced surgeon. The patients were randomized into a study group (8 mg dexamethasone injection) and a placebo group (normal saline injection). Both interventions were injected into the sublingual space immediately after local anesthesia, 30 min before the first incision. The study group received an 8 mg dexamethasone injection, while the placebo group received a normal saline injection. The wash period between the patients' two operations was 3 to 4 weeks. Pain was assessed by recording the number of analgesic tablets (rescue drug) consumed, as well as by noting the patients' responses to the visual analog scale (VAS) on the first, second, and third days after surgery. Results: The study group differed significantly from the placebo group in terms of VAS score and analgesic consumption. Conclusion: Dexamethasone (8 mg), injected sublingually, significantly eased post-operative pain after surgical removal of the mandibular third molar.

• Journal of Oral Medicine and Pain
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• 제47권1호
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• pp.52-61
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• 2022

Purpose: Most cases of oral and maxillofacial infections are usually easily treated by proper diagnosis, elimination of causative factors, and antibiotic therapy. However, the emergence and the increase of multidrug-resistant bacteria make treatment challenging. "ESKAPE" pathogens are the most common opportunistic organisms in nosocomial infections and have resistant to commonly used antibiotics. There are many medical reviews of ESKAPE pathogens, but few in dentistry. This study focuses on oral and maxillofacial infection especially with ESKAPE pathogens. The purpose of this study is to prepare feasible data about tracing and treatment of infection related to pathogens that may be beneficial to clinicians. Methods: A total of 154 patients with oral and maxillofacial infections were reviewed by analyzing retrospectively hospitalized data in the Department of Oral and Maxillofacial surgery, Chosun University Hospital, Korea, past 5 years from January 2014 to December 2018. Based on the medical records and microbiological tests, the results were divided into two groups: infections with ESKAPE pathogens and other bacteria. Results: A total of 22 species were isolated from 154 patients. The proportion of ESKAPE pathogens among all bacterial isolates collected from infected patients was 39.6%. Causative factors, especially in post-operative infection, showed a statistically significant correlation to ESKAPE infections (29 cases). And average of treatment period in ESKAPE group was longer than non-ESKAPE groups. Overall, Klebsiella pneumoniae (60.7%) was the most frequently isolated ESKAPE pathogen. And high antibiotic resistance rates had been detected in the ESKAPE during the five-year period. Conclusions: Infections with ESKAPE pathogens are now a problem that can no longer be overlooked in Dentistry. Based on results of this study, ESKAPE pathogens were highly associated with post-operative or opportunistic infections. Clinicians should be careful about these antibiotic resistant pathogens and use appropriate antibiotics to patients while having dental treatments.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권6호
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• pp.366-370
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• 2012

Initially described in 1929, Warthin's tumor is a benign neoplasm predominantly found in the parotid gland of the salivary glands. Warthin's tumor is synonymous for cystadenoma lymphomatosum, adenolymphoma, and cystadenolymphoma. This tumor usually causes minimal pain, but the patient may complain of tinnitus, pain in the ear, or deafness. The tumor is treated with surgical excision, which is easily performed due to the superficial location of the tumor. In our case, a 69-year-old man visited our clinic primarily complaining of swelling in the left parotid gland area. Computed tomography revealed well-defined margins of the tumor in the superficial lobe of the left parotid gland and heterogeneous contrast enhancement. We performed superficial parotidectomy, with the pathological examination confirming Warthin's tumor. We report a typical case of Warthin's tumor and a literature review.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권2호
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• pp.95-102
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• 2016

Background: Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery. Methods: A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo. Results: The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences. Conclusions: Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.