• Title/Summary/Keyword: Oral mucosal lesions

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RADIOLOGIC EVALUATION OF THE MAXILLARY ANTRAL PATHOLOGIC CONDITIONS IN CHILDREN (소아 상악동 병변의 방사선학적 평가)

  • Park Tae-Won;Choi Soon-Chul
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.22 no.2
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    • pp.195-201
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    • 1992
  • The authors evaluated the distribution of the antral pathologic conditions and their radiographic features on the Waters' radiolgraphs of 151 children patients who had been radiographed at the department of Oral Radiology, Seoul National University Hospitals. The obtained results were as follows: 1. The most common pathologic condition was inflammatory change(58%). Percentage of cases showing cystic lesion and fibro-osseous lesion were 25% and 11% respectively. 2. In cases of inflammatory change, odontogenic origins were 12 cases(13%) and bilateral occurrences were 37 cases(39%). 3. The most common radiographic feature of the inflammatory conditions was various types of mucosal thickenkng(78%).Percentage of cases showing totally increased radiopacity was 18%. 4. Intrinsic cystic lesions were 26 cases(65%) and dentigerous cyst was the most common extrinsic cyst. 5. Most of the fibro-osseous lesions(15 from 17 cases) were fibrous dysplasia. 6. Maxillary sinus hypoplasia(5 cases) and Burkitt's lyphoma(4 cases) were also observed.

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Primary malignant mucosal melanoma of the maxillofacial area

  • Kim, Hyounmin;Lee, Sanghoon;Cha, In-Ho;Kim, Hyung Jun;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.2
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    • pp.76-81
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    • 2021
  • Objectives: We aimed to collect and report data from all patients who have been diagnosed with mucosal malignant melanoma to obtain the epidemiology and principles of current treatments. Materials and Methods: Between January 2008 and December 2018, 20 patients underwent surgery or follow-up observations at Yonsei University Dental Hospital. The patients' clinical information was reviewed retrospectively. Results: Seventeen of 20 patients had undergone definitive surgery, while only 6 patients received adjuvant radiotherapy or systemic therapy. Eight of 20 patients, including those that had recurrent lesions, were provided immunotherapy. The 3-year survival for all stages was 50%, with a local recurrence rate of 75% and a metastasis rate of 65%. Conclusion: The overall survival of patients receiving surgical treatment was longer than that of patients who did not undergo surgical resection. Eight of 20 patients received immunotherapy as the first-line regimen at our clinic, and those patients exhibited longer overall survival compared to patients in reported keynote studies.

Primary amelanotic melanoma of the mandibular gingiva

  • Kim, Byeong Jun;Kim, Hyeong Seop;Chang, Yong Joon;Kwon, Kee Hwan;Cho, Seong Jin
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.132-136
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    • 2020
  • Oral mucosal melanoma is a very rare type of malignant melanoma, the characteristics of which differ from those of cutaneous melanoma. Primary amelanotic melanoma of the mandibular gingiva, which can invade the mandibular bone, is very rare worldwide. Here, we report a case in which we performed a reconstruction of the mandible and gingiva using the fibula osteocutaneous free flap procedure to treat a patient diagnosed with a primary amelanotic melanoma of the mandibular gingiva. The procedure was successful, and no recurrence was observed 10 months after surgery. Oral mucosal melanoma has a much poorer prognosis and a lower 5-year survival rate than cutaneous melanoma. However, recently, immunomodulatory therapies for mutations in melanocytic lesions have been used effectively to treat the increasing number of patients developing this type of melanoma, thus improving the prognosis of patients with oral mucosal melanoma.

Leukemic Oral Manifestations and their Management

  • Francisconi, Carolina Favaro;Caldas, Rogerio Jardim;Martins, Lazara Joyce Oliveira;Rubira, Cassia Maria Fischer;da Silva Santos, Paulo Sergio
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.911-915
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    • 2016
  • Leukemia is the most common neoplastic disease of the white blood cells which is important as a pediatric malignancy. Oral manifestations occur frequently in leukemic patients and may present as initial evidence of the disease or its relapse. The symptoms include gingival enlargement and bleeding, oral ulceration, petechia, mucosal pallor, noma, trismus and oral infections. Oral lesions arise in both acute and chronic forms of all types of leukemia. These oral manifestations either may be the result of direct infiltration of leukemic cells (primary) or secondary to underlying thrombocytopenia, neutropenia, or impaired granulocyte function. Despite the fact that leukemia has long been known to be associated with oral lesions, the available literature on this topic consists mostly of case reports, without data summarizing the main oral changes for each type of leukemia. Therefore, the present review aimed at describing oral manifestations of all leukemia types and their dental management. This might be useful in early diagnosis, improving patient outcomes.

Comparison of cone-beam computed tomography and panoramic radiography in the evaluation of maxillary sinus pathology related to maxillary posterior teeth: Do apical lesions increase the risk of maxillary sinus pathology?

  • Terlemez, Arslan;Tassoker, Melek;Kizilcakaya, Makbule;Gulec, Melike
    • Imaging Science in Dentistry
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    • v.49 no.2
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    • pp.115-122
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    • 2019
  • Purpose: The aims of this study were first, to compare panoramic radiography with cone-beam computed tomography (CBCT) for evaluating topographic relationships, such as the classification of maxillary posterior teeth and their distance to the maxillary sinus floor; and second, to determine the relationship between maxillary sinus pathology and the presence of apical lesions. Materials and Methods: In total, 285 paired CBCT and panoramic radiography records of patients (570 maxillary sinuses) were retrospectively analyzed. Both imaging modalities were used to determine the topographic relationship of the maxillary posterior teeth to the sinus floor. Mucosal thickening >2 mm was considered a pathological state. Data were analyzed using the chi-square, Wilcoxon, and Mann-Whitney U tests. Odds ratios (ORs) and confidence intervals(CIs) were calculated. Results: The closest vertical distance measurements made between posterior maxillary teeth roots and the maxillary sinus on panoramic radiography and CBCT scans showed statistically significant differences from each other(P<0.05). Compared to panoramic radiography, CBCT showed higher mean values for the distance between the maxillary sinus floor and maxillary posterior teeth roots. The CBCT images showed that at least 1 apical lesion adjacent to the right maxillary sinus increased the risk of maxillary sinus pathology by 2.37 times(OR, 2.37; 95% CI, 1.58-3.55, P<0.05). Conclusion: Panoramic radiography might lead to unreliable diagnoses when evaluating the distance between the sinus floor and posterior roots of the maxillary teeth. Periapical lesions anatomically associated with maxillary sinuses were a risk factor for sinus mucosal thickening.

A RADIOGRAPHIC STUDY ON THE EXPERIMENTAL LESIONS OF THE MAXILLARY SINUS (상악동 실험병소에 관한 방사선학적 연구)

  • Kim Young-Il;Kim Jae-Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.25 no.1
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    • pp.39-49
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    • 1995
  • This study was performed to determine the each location of lesions in the maxillary sinus and to evaluate the relationship between the floor of the antrum and the apical regions of teeth by the comparison of the panoramic view and panoramic sinus view. For this study, experimentally with two dry skulls, jelly balls of 8mm and 15mm in diameter containing a short wire for the radiopacity similar to the cyst and clinically 5 patients having mucosal cyst in the antrum and 10 patients having periapical lesion of molar were used. The experimental cystic lesions were simulated with jelly ball being attached in turn to each wall of the antrum. The radiolucent periapical lesions of upper molars were formed by using round bur and the radiopaque periapical lesions were simulated by filling the former lesions with lead foil. Each panoramic view and each panoramic sinus view of the experimental lesions and patients were obtained by using panoramic machine and analyzed. The obtained results were as follows : 1. On the panoramic sinus view, the innominate line was approximately coincided with the most lateral portion of the antrum and the posterior wall appeared as the narrow area at the mesial side of the innominate line. The anterior wall occupied totally the mesial side of the innominate line, and the medial wall occupied the mesial half of the antrum. 2. In all cases of experimental cystic lesion attached to each wall of the antrum, the location of each lesion was able to be determined by applying Tube shift technic. 3. The palatal root and mesiobuccal root of the molar appeared as being transposed each other mesiolaterally on the panoramic and panoramic sinus views. 4. The panoramic sinus view was superior to the panoramic view in revealing the relationship between the floor of the antrum and the periapical lesion.

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A RADIOGRAPHIC STUDY ON THE MUCOSAL CYST OF THE MAXILLARY SINUS (상악동 점액성 낭에 관한 방사선학적 연구)

  • Park Eung-Chun;Kim Jae-Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.23 no.2
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    • pp.277-285
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    • 1993
  • This study was performed to evaluate the role of Waters' view and panoramic view for the interpretation of mucosal cyst of the maxillary sinus and to determine the radiographic features of that according to the sites and sizes. For this study, clinically 25 cases of mucosal cyst of the maxillary sinus were used, and experimentally with two dry skulls, rubber ball of 15mm in diameter for marked radiopacity, and two jelly balls of 8 and 20㎜ in diameter for the similar radiopacity to cyst were used. The 25 cases with 25 panoramic views and 15 Waters' views were first analyzed, and secondly, the radiographic features of artificial lesions attached to the each wall of the antrum on Waters' view and panoramic view were analyzed. The obtained results were as follows: At clinical analysis, 1. 4 cases of 13-14㎜, 4 cases of 15-19mm, 14 cases of 20-25㎜, 3 cases of over 30㎜ in dia- meter were found on panoramic views. And 24 cases of 25 cases showed no relationship with teeth, and only 1 case was associated with advanced periodontal disease 2. The majority of mucosal cysts appeared to arise the posterior portion of the floor of the sinus and were superimposed with the inominate line of zygoma and the horizontally linear image of hard palate on panoramic view. 3. Only 2 cases of 15 cases were identified on both films. At experimental analysis, 4. On Waters' view, the images of the artificial lesion of the anterior portion and midportion of the floor of the sinus were lessend in diameter compared with the real size. On panoramic views, the images of the lesion were more radiolucent with lessened diameter than images on Water' view. 5. The images of the lesion of the posterior wall and the posterior portion of the floor of sinus on panoramic view were well detected by the preeducated group but not or poorly detected by the non-preeducated observer group. 6. On Waters' view, both observer groups recognized that the cystic images of the posterior portion of the floor of the maxillary sinus were superimposed with the petrous portion of the skull.

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Ultrastructural Observations of Some Oral Mucosal Lesions II. Oral Leukoplakia (수종 구강점막질환에 관한 전자현미경적 연구 II. 구강백반증)

  • 정성창
    • Journal of Oral Medicine and Pain
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    • v.8 no.1
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    • pp.33-41
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    • 1983
  • The authors observed the ultrastructure of oral leukoplakia simplex of gingiva, buccal mucosa, tongue and alveolar ridge. For the purpose of clearly defining the lesions under investigation in this study, leukoplakias were cinsidered to be any white patches on the oral mucous membranes that could not be removed by rubbing and could not be classified clinically or microscopically as another diagnosable disease. The tissue to be examined were embedded in paraffin for light microscopic study. The tissue to be examined under the electronomicroscope were fixed in 2.5% glutaraldehyde in 0.1M cacodylate buffer and 1% osmic acid in 0.1M cacodylate buffer, dehydrated with guaded alchol, and treated with propylene oxide, and embedded in Epon.Ultrathin sections were obtained by LKB III ultrotome, stained with uranyl acetate/lead citrate, and examined with Corinth 500EM. The results were as follows : 1. Epithelium of leukoplakia consisted of stratum basale, stratum spinosum, stratum granulosum and stratum corneum. 2. There was hyperorthokerotosis or hyperparakeratosis. 3. Granular cells contained a lot number of membrane coating granule showing lamellar structure, clearing ot codensation, and a lot of keratohyaline granule varied in size. 4. An increased concentration of tonofilaments and an increased number of desmosomes were found in the stratum spinosum. 5. Basal lamina generally showed its continuity, but in some locatoins, its interreption and multiplication appeared.

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Phenytoin Induced Erythema Multiforme after Cranial Radiation Therapy

  • Kazanci, Atilla;Tekkok, Ismail Hakki
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.163-166
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    • 2015
  • The prophylactic use of phenytoin during and after brain surgery and cranial irradiation is a common measure in brain tumor therapy. Phenytoin has been associated with variety of adverse skin reactions including urticaria, erythroderma, erythema multiforme (EM), Stevens-Johnson syndrome, and toxic epidermal necrolysis. EM associated with phenytoin and cranial radiation therapy (EMPACT) is a rare specific entity among patients with brain tumors receiving radiation therapy while on prophylactic anti-convulsive therapy. Herein we report a 41-year-old female patient with left temporal glial tumor who underwent surgery and then received whole brain radiation therapy and chemotherapy. After 24 days of continous prophylactic phenytoin therapy the patient developed minor skin reactions and 2 days later the patient returned with generalized erythamatous and itchy maculopapuler rash involving neck, chest, face, trunk, extremities. There was significant periorbital and perioral edema. Painful mucosal lesions consisting of oral and platal erosions also occurred and prevented oral intake significantly. Phenytoin was discontinued gradually. Systemic admistration of corticosteroids combined with topical usage of steroids for oral lesions resulted in complete resolution of eruptions in 3 weeks. All cutaneous lesions in patients with phenytoin usage with the radiotherapy must be evoluated with suspicion for EM.

Management of Gingival Oral Lichen Planus with Free Gingival Graft: 10-Year Follow-Up Case Report

  • Chang, HeeYung;Shim, YoungJoo
    • Journal of Oral Medicine and Pain
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    • v.47 no.3
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    • pp.161-166
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    • 2022
  • Oral lichen planus (OLP) is a chronic oral mucosal disease affecting the buccal cheek, tongue, palate, lip, and gingival mucosa. Lesions in the gingiva make it difficult to control dental plaque due to pain. As a result, the disease is often accompanied by gingivitis or periodontitis. If OLP and dental plaque are not properly managed, the patient's periodontal condition will worsen. Thus, clinicians treating OLP should emphasize periodic visits and dental plaque control. Here, we report the management of a patient who struggled with OLP for 20 years and discuss the importance of periodic regular observations and active periodontal management.