• The Journal of the Korean dental association
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• v.50 no.12
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• pp.755-762
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• 2012

Objective : The aim of this study was to investigate risk factor, precaution and treatment of aspirated foreign body during dental procedure. Material and Methods : Twenty cases of accidental aspiration of the foreign body, which removed by bronchoscopy at the Asan Medical Center between 2008 and 2012, were analyzed retrospectively. Results : Ten cases of accidental aspiration were occurred during dental procedure. Symtoms include cough(65%), dyspnea(50%), sputum(25%) and wheezing(25%). The most common location of foreign body was right bronchial tree(50%), left bronchial tree(45%) and carina(5%). Patients risk factors were chronic obstructive pulmonary disease, lung cancer, pulmonary tuberculosis, esophageal cancer and vegetative state. Conclusion : Accidental aspiration or swallowing of dental instrument or material is not uncommon accidents in dental practice. Most foreign bodies enter into gastrointestinal tract spontaneously. But aspiration into broncho-trachea can be more serious events and must be treated as an emergency situation. Prompt emergency treatment and removal of the foreign body is necessary to avoid complication. Dentists must have knowledge about the precaution and be ready to deal with foreign body aspiration during dental procedures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.5
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• pp.331-336
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• 2013

Maxillary sinus membrane elevation and bone graft have been performed routinely in alveolar bone with insufficient residual bone height. There are a number of causes for development of maxillary sinusitis after these procedures. When maxillary sinusitis is caused by sinus membrane elevation, bone graft, and implant placement, various treatment such as medication, incision and drainage (I&D), implant removal, and the Caldwell-Luc procedure can be considered. Removal of an implant or the Caldwell-Luc procedure can be harmful if inflammation is not present in the oral cavity and survival of grafted bone and implant osseointegration can be expected despite the presence of maxillary sinusitis. In this case, functional endoscopic sinus surgery, which was often used in the otorhinolaryngology department, was performed without removal of the implant for a patient with maxillary sinusitis after one month following implant placement. Thus, we report on this case with a review of the literature.

• Journal of Oral Medicine and Pain
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• v.45 no.2
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• pp.44-47
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• 2020

The case of pseudo-aneurysm of internal maxillary artery (IMA) in oral and maxillofacial region is known to be very rare. The etiology of this case was regarded as IMA injury by radiofrequency ablation (RFA) and such incidence was not reported previously. One case of false aneurysm in the IMA was referred from local dental clinic to our department. Left facial swelling was observed with severe trismus immediately after radiofrequency procedure for masseteric nerve block in local dental clinic. Despite of medication and surgical intervention, the swelling did not subside and there was massive bleeding and pulsation on one of the follow ups. The traumatic vascular disorder was suspected and finally diagnosed with angiography and treated by embolization procedure. RFA targeting masseteric nerve or trigeminal ganglion may cause traumatic injury to adjacent anatomic structures such as IMA, resulting in pseudo-aneurysm. Clinicians must be aware of potential damages of RFA. Angiography enables the solid diagnosis for pseudo-aneurysm, and selective embolization can be optimum treatment method.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.3
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• pp.201-206
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• 1992

The eyelids perform many complex functions and are esthetically important, since eye is focal point of face. Tumor extirpation or trauma can lead to full-thickness eyelid defect, which Should be reconstructed as soon as possible There are a number of operation methods for lower lid reconstruction, and among them, Hughes procedure is a time-honored method. Its advantages are good cosmetic result and conjunctival repair by using eyelid structures to rebuild eyelid structures. However, this is a two-staged procedure in which the vision of the affected eye is obstructed during the interval between the operations. We experienced a case of trauma-induced full-thickness lower lid defect extending over one-third of lid length treated by Hughes method. The cosmetic and functional result was good and there was no donor site morbidity, and now we report this case with review of literatures.

• Speech Sciences
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• v.9 no.2
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• pp.167-177
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• 2002

Uvulopalatopharyngoplasty (UPPP) is one of the popular surgical procedure for snoring and sleep apnea syndrome. The main principle of this procedure is to reduce abundant velopharyngeal soft tissues resulting in a shortened soft palate, which may cause some alterations in speech sound. The purpose of this study is to evaluate the change of velopharyngeal function after UPPP in the view of aerodynamics. Thirty three patients who received uvulopalatopharyngoplasty for correcting snoring and sleep apnea were included in this study. The airflow, airflow rate and air pressure during the production of oral and nasal consonants were measured before surgery and 4 week and 8 week after surgery. The oral air flows and pressures for oral and nasal consonants were not changed after surgery. However, oral air pressure for nasal consonants were increased significantly after surgery. The nasal air flows for oral consonants were not changed after surgery, but for nasal consonants were decreased at 8 weeks after surgery. The nasal flow rate for oral and nasal consonants were increased at 8 weeks after surgery. The uvulopalatopharyngoplasty may result in affecting the aerodynamic air streams during speech production.

• Journal of Korean Dental Science
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• v.13 no.2
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• pp.67-72
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• 2020

Purpose: This clinical study presented the effectiveness of 2-stage posterior maxillary segmental osteotomy (PMSO) under local anesthesia in gaining interarch space to restore the posterior mandibular segment with dental implants. Materials and Methods: Nine patients who received two-stage PMSO for mandibular implant placement from 2003 to 2011 were included in the study. Of the 9 patients, 7 were female and 2 were male. Ages ranged form 28 to 72 (mean 46.6). Potential complications were investigated such as sinus infection, survival of bone segment, inflammatory root resorption of adjacent teeth, relapse of bone segment and timing of implant placement, delivery of implant prosthesis and stability of bone segment. Result: None of the patients showed relapse or complication. Bone segments were stabilized by opposed implant prosthesis. Conclusion: Office-based 2-stage PMSO under local anesthesia can be considered a stable and predictable procedure. Also pedicle damage can be avoided by allowing favor of blood supply to the bone segments. From these advantages, it can be concluded that this surgical procedure can decrease post-operative complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.29 no.2
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• pp.157-166
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• 2007

Moderns have desire likely to be further good-looking concomitant with a qulitative advancement of the life. Orthognathic surgery for the correction of dentofacial deformities is a common elective procedure. It's possible to occur many complication during the operations and especially, an excessive bleeding of those may be fatal and so a tranfusion is performing for the prevention and management of that. The most notable of these for reduction of blood loss is the utilization of induced hypotensive anesthetic technique to reduce the mean arterial pressure between 55 and 60 mmHb. Another method for dealing with blood loss following orthognathic surgery is the transfusion of blood obtained as an autologous tranfusion or from banked blood. Some of the disadvantage of banked blood are overcome with the use of predeposited autologous transfusion. But currently, surgeons try so that even autologous transfusion may not transfuse the patients. We made a comparative study of hematologic change and transfusion requirement based on a series of 200 patients who had an orthognathic surgical procedure at Chonbuk National University during the period 2001-2005. This study is to make a comparative analysis of an post-operative hematologic (Hemoglobin, Hematocrit, Red blood cell) change and duration of the procedure under induced hypotensive anesthesia in healthy orthognathic patients.

• The Journal of the Korean dental association
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• v.55 no.1
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• pp.30-41
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• 2017

Inadequate keratinized mucosa around dental implants can lead to more plaque accumulation, tissue inflammation, marginal recession and attachment loss. We evaluated the effects of free gingival and extracellular matrix membrane grafts performed to increase the insufficient width of keratinized tissue around dental implants in the posterior mandible. A 47-year-old female patient presented with discomfort due to swelling of the lower right second premolar area. Due to severe destruction of alveolar bone, the tooth was extracted. After 3 months, a guided bone regeneration (GBR) procedure was performed and then a dental implant was placed 6 months later. During the second-stage implant surgery, free gingival grafting was performed to increase the width of the keratinized tissue. After 12 months, a clinical evaluation was performed. A 64-year-old female patient had a missing tooth area of bilateral lower molar region with narrow zone of keratinized gingiva and horizontal alveolar bone loss. Simultaneous implant placement and GBR were performed. Five months after the first-stage implant surgery, a gingival augmentation procedure was performed with an extracellular matrix membrane graft to improve the width of the keratinized tissue in the second-stage implant surgery. After 12 months, a clinical evaluation was performed. In these two clinical cases, 12 months of follow-up, revealed that the increased width of the keratinized tissue and the deepened oral vestibule was well maintained. A patient showed a good oral hygiene status. In conclusion, increased width of keratinized tissue around dental implants could improve oral hygiene and could have positive effects on the long-term stability and survival rate of dental implants. When planning a keratinized tissue augmentation procedure, clinicians should consider patient-reported outcomes.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.3
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• pp.137-146
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• 2020

Background: Mandibular third molar removal is the most common surgical procedure encountered in oral and maxillofacial clinics. It also presents the greatest challenges and controversies for surgeons when surgical removal is considered. Furthermore, diverse anesthesia results and success rates are achieved after using the same concentrations of different solutions or the same amounts of local anesthetics. The purpose of this study was to examine the efficiency of using double-cartridge (3.4 ml) 4% lidocaine (high concentration) and 4% articaine with a 1:100000 epinephrine infiltration in the retromolar region for impacted lower third molar surgery. Methods: This double-blind study included 30 patients with symmetrically impacted lower third molars. The patients were randomly selected to receive 4% articaine on one side and 4% lidocaine on the other, as a local anesthetic for third molar surgery. The onset, duration of soft-tissue numbness, pulpal sensitivity, amount of additional local anesthetic needed, pain score during the surgical procedure, and duration of the operation were recorded. Results: The results of this research indicate that 86.7% of the operations in the 4% articaine group and 83.3% of those in the 4% lidocaine group were successful. Furthermore, the outcomes in both groups were not statistically significant (P > 0.05). Numbness onset occurred faster in the articaine group than it did in the lidocaine group. However, the duration of soft-tissue anesthesia and pain scores recorded immediately postoperatively were similar. Conclusion: It is concluded that 4% lidocaine and 4% articaine had a similar infiltration efficacy in the retromolar region and both local anesthetics are adequate for impacted lower third molar surgery. There were no statistically significant differences between the two local anesthetics regarding pain control and the duration of soft-tissue numbness during the procedure.

• Journal of Periodontal and Implant Science
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• v.40 no.2
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• pp.69-75
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• 2010

Purpose: Implant survival rates using a bone-added osteotome sinus floor elevation (BAOSFE) procedure with simultaneous placement of a non-submerged sand blasted with large grit and acid etched (SLA) implant are well documented at sites where native bone height is less than 5 mm. This study evaluated the clinical results of non-submerged SLA Straumann implants placed at the time of the BAOSFE procedure at sites where native bone height was less than 4 mm. Changes in graft height after the BAOSFE procedure were also assessed using radiographs for 5 years after the implant procedure. Methods: The BAOSFE procedure was performed on 4 patients with atrophic posterior maxillas with simultaneous placement of 7 non-submerged SLA implants. At least 7 standardized radiographs were obtained from each patient as follows: before surgery, immediately after implant placement, 6 months after surgery, every year for the next 3 years, and after more than 5 years had passed. Clinical and radiographic examinations were performed at every visit. Radiographic changes in graft height were calculated with respect to the implant's known length and the original sinus height. Results : All implants were stable functionally, as well as clinically and radiographically, during the follow-up. Most of the radiographic reduction in the grafted bone height occurred in the first 2 years; reduction after 2 years was slight. Conclusions: The simultaneous placement of non-submerged SLA implants using the BAOSFE procedure is a feasible treatment option for patients with severe atrophic posterior maxillas. However, the grafted bone height is reduced during the healing period, and patients must be selected with care.