• Title/Summary/Keyword: Oral procedure

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Risk of Hemorrhage Attributed to Underlying Chronic Diseases and Uninterrupted Aspirin Therapy of Patients Undergoing Minor Oral Surgical Procedures: A Retrospective Cohort Study

  • Rojanaworarit, Chanapong;Limsawan, Soontaree
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.3
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    • pp.165-176
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    • 2017
  • Objectives: This study aimed to estimate the risk of bleeding following minor oral surgical procedures and uninterrupted aspirin therapy in high-risk patients or patients with existing chronic diseases compared to patients who did not use aspirin during minor oral surgery at a public hospital. Methods: This retrospective cohort study analyzed the data of 2912 patients, aged 20 years or older, who underwent 5251 minor oral surgical procedures at a district hospital in Thailand. The aspirin group was comprised of patients continuing aspirin therapy during oral surgery. The non-aspirin group (reference) included all those who did not use aspirin during surgery. Immediate and late-onset bleeding was evaluated in each procedure. The risk ratio of bleeding was estimated using a multilevel Poisson regression. Results: The overall cumulative incidence of immediate bleeding was 1.3% of total procedures. No late-onset bleeding was found. A significantly greater incidence of bleeding was found in the aspirin group (5.8% of procedures, p<0.001). After adjusting for covariates, a multilevel Poisson regression model estimated that the bleeding risk in the aspirin group was 4.5 times higher than that of the non-aspirin group (95% confidence interval, 2.0 to 10.0; p<0.001). However, all bleeding events were controlled by simple hemostatic measures. Conclusions: High-risk patients or patients with existing chronic diseases who continued aspirin therapy following minor oral surgery were at a higher risk of hemorrhage than general patients who had not used aspirin. Nonetheless, bleeding complications were not life-threatening and could be promptly managed by simple hemostatic measures. The procedures could therefore be provided with an awareness of increased bleeding risk, prepared hemostatic measures, and postoperative monitoring, without the need for discontinuing aspirin, which could lead to more serious complications.

THE STUDY OF BONE MINERAL DENSITY IN THE MANDIBLE OF STREPTOZOTOCIN-INDUCED DIABETIC RATS (흰쥐에서 당뇨 유도 후 하악골 골밀도 변화에 관한 연구)

  • Jeong, Seok-Young;Shin, Sang-Hun;Kim, Uk-Kyu;Park, Bong-Soo;Chung, In-Kyo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.2
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    • pp.95-102
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    • 2002
  • DM is a systemic disease with many complications. One of them, diabetic osteopenia is important sequelae and many authors reported reduced bone mass in diabetic rats. However, in mandible, study has been rare because of its anatomical limits. So the objective of this study was to investigate bony change in mandible of diabetic rats. Thirty-two adult rats were used in this study. Half of them were male and female respectively. In sixteen rats, streptozotocin was injected intraperitoneally to induce DM and the serum glucose concentration was checked to ensure the induction of DM prior to the time of sacrifice. At 1, 2, 3, 4, 6, 8, 12, 16weeks, control group and diabetic group rats were sacrificed respectively. And then bone mineral density of mandibles and femurs of the rats was measured using dual energy X-ray absorptiometry(DEXA). In addition serum osteocalcin and urine deoxypyridinoline were measured as markers of bone formation and resoption respectively. Mandibular and femoral bone density in streptozotocin induced rats was decreased with significance statistically after 4 weeks from injection. In mandible, comparing with femur, bone density was moderately decreased. The alveolar bone in mandible was more decreased bone density than the whole body in the mandible From these results, bone mineral density decreased in uncontrolled diabetic group with time, and especially alveolar bone was more destructive in the mandible. So authors think that consideration of reduced bone mineral density is necessary in dental procedure.

COMPLEX DISTRACTION OSTEOGENESIS ON HEMIMANDIBULAR HYPOPLASIA : A CASE REPORT (하악과두 골절후 발생한 편측성 하악골 형성부전의 치료로서 복합적 악골 신장술의 임상증례)

  • Oh, Sung-Hwan;Min, Seung-Gi;Kwon, Kyong-Hwan;Koh, Se-Wook;Lee, Kyong-Seuk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.3
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    • pp.246-250
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    • 2004
  • Uni- or bilateral mandibular hypoplasia can be associated with various syndromes or is acquired after early traumatic or inflammatory disease in the temporomandibular joint(TMJ). Early treatment is necessary to avoid consequent impairment of midfacial growth. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth, but the new procedure of bone lengthening which was presented by McCarthy et al. represents a limited surgical intervention and therefore open up a new perspective of treatment, especially in younger children with severe deformities. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, a tilted occlusal plane, and a short mandible. A 14-years-old boy with facial asymmetry, who was fractured on both condyle and mandibular symphysis before 8 years ago, was treated by mandibular ramus lengthening, symphysial widening and surgically assisted rapid palatal expansion with corticotomy. After allowing 1 week for the healing of the periosteum, the distraction was performed at the rate of 0.5-1.0mm per day for 7 days on maxilla and 14 days on mandible. The device was maintained on maxilla and mandible for 12 weeks following distraction. The difference in ramus and mandibular transverse deficiency were corrected and facial asymmetry was improved with complex distraction osteogenesis.

Iatrogenic epidermoid cyst in the parotid gland: A case report (이하선에서 발견된 유표피낭: 증례 보고)

  • Lee, Choong-Sang;Kim, Hyoung-Keun;Lim, Jae-Hyung;Jeon, Kug-Jin;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.237-240
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    • 2011
  • Epidermoid cysts presents as a nodular and fluctuant subcutaneous lesion beneath the skin and are most common in acne-prone areas of the head, neck and back. This cyst often arises after localized inflammation of the hair follicle and occasionally after the implantation of epithelium following trauma and surgery including a biopsy procedure. It is often associated with Gardner syndrome, particularly before puberty. The lesion is normally treated by a surgical excision or enucleation, and recurrence is uncommon. A 27 year old woman complained of a swelling of the left parotid gland when she visited our clinic. A cystic lesion was found in the left parotid gland from the high signal intensity on the MR images. Ultrasonography showed that the cystic lesion was heterogeneous echogenic. Six months earlier, botulinum toxin was injected in her left masseter muscles six months earlier and progressive swelling of the left parotid area was noticed four months after treatment. The lesion was surgically removed. It was encapsulated by a thin wall and filled mainly with keratin. The final diagnosis was an epidermoid cyst.

Shear bond strength of zirconia to resin: The effects of specimen preparation and loading procedure

  • Chen, Bingzhuo;Yang, Lu;Lu, Zhicen;Meng, Hongliang;Wu, Xinyi;Chen, Chen;Xie, Haifeng
    • The Journal of Advanced Prosthodontics
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    • v.11 no.6
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    • pp.313-323
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    • 2019
  • PURPOSE. Shear bond strength (SBS) test is the most commonly used method for evaluating resin bond strength of zirconia, but SBS results vary among different studies even when evaluating the same bonding strategy. The purpose of this study was to promote standardization of the SBS test in evaluating zirconia ceramic bonding and to investigate factors that may affect the SBS value of a zirconia/resin cement/composite resin bonding specimen. MATERIALS AND METHODS. The zirconia/resin cement/composite resin bonding specimens were used to simulate loading with a shear force by the three-dimensional finite element (3D FE) modeling, in which stress distribution under uniform/non-uniform load, and different resin cement thickness and different elastic modulus of resin composite were analyzed. In vitro SBS test was also performed to validate the results of 3D FE analysis. RESULTS. The loading flat width was an important affecting factor. 3D FE analysis also showed that differences in resin cement layer thickness and resin composite would lead to the variations of stress accumulation area. The SBS test result showed that the load for preparing a SBS specimen is negatively correlated with the resin cement thickness and positively correlated with SBS values. CONCLUSION. When preparing a SBS specimen for evaluating bond performance, the load flat width, the load applied during cementation, and the different composite resins used affect the SBS results and therefore should be standardized.

The Effect of Autogenous Demineralized Dentin Matrix and Interleukin-6 on bone Regeneration

  • Jang, Won Seok;Kim, Min Gu;Hwang, Dae Suk;Kim, Gyoo Cheon;Kim, Uk Kyu
    • International Journal of Oral Biology
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    • v.42 no.4
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    • pp.203-211
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    • 2017
  • The aim of this study was to evaluate the role of demineralized and particulate autogenous tooth, and interleukin-6 in bone regeneration. A demineralized and particulate autogenous tooth was prepared and human osteoblast-like cells (MG63) and human osteosarcoma cells were inoculated into the culture. The rate of cell adhesion, proliferation and mineralization were examined, and the appearance of cellular attachment was observed. An 8 mm critical size defect was created in the cranium of rabbits. Nine rabbits were divided into three groups including: An experimental group A (3 rabbits), in which a demineralised and particulate autogenous tooth was grafted; an experimental group B (3 rabbits), in which a demineralized, particulate autogenous tooth was grafted in addition to interleukin-6 (20 ng/mL); and a control group. The rabbits were sacrificed at 1, 2, 4 and 6 weeks for histopathological examination with H-E and Masson's Trichrome, and immunohistochemistry with osteocalcin. The cell-based assay showed a higher rate of cell adhesion, mineralization and cellular attachment in the experimental group A compared with the control group. The animal study revealed an increased number of osteoclasts, newly formed and mature bones in the experimental group A compared with the control group. Eventually, a higher number of osteoclasts were observed in the experimental group B. However, the emergence of newly formed and mature bone was lower than in the experimental group A. The current results suggest that treatment with demineralized and particulate autogenous tooth and interleukin-6 is not effective in stimulating bone regeneration during the bone grafting procedure.

Application and usefulness of Ultrasound sonography in dentistry (영상치의학에서 초음파영상의 진단과유용성)

  • Choi, Yong Suk;Seo, Yoo Kyung;Kang, Ju Hee;Oh, Song Hee;Kim, Gyu Tae;Hwang, Eui Hwan
    • The Journal of the Korean dental association
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    • v.55 no.11
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    • pp.778-788
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    • 2017
  • Ultrasound sonography(US) is used to evaluate various diseases of oral and maxillofacial region including salivary glands, soft tissue and jaw lesions because of easy accessibility and no hazard of ionizing radiation. Also, US can offer dynamic study showing real-time images during diagnostic or surgical procedure. US images provide accurate information about the internal features of lesions on the jaw prior to surgical treatment. Doppler images are used to visualize the vascular distribution of the lesions and to provide additional information to enhance diagnostic value. It is necessary to evaluate the diagnostic value of US and evaluate its usefulness by looking at clinical cases using US images. Therefore, US imaging may be recommended as an assistant image in evaluating jaw lesions. US images provided accurate information about the internal structure of lesions on the jaw prior to surgical treatment, and diagnostic value was enhanced by visualizing the vascular distribution of the lesion using doppler imaging. We report the protocol and suggest the effectiveness of US for various lesions and US-guided sialography.

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Reconstruction of the orbital wall using superior orbital rim osteotomy in a patient with a superior orbital wall fracture

  • Heo, Jae Jin;Chong, Ji-Hun;Han, Jeong Joon;Jung, Seunggon;Kook, Min-Suk;Oh, Hee-Kyun;Park, Hong-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.42.1-42.5
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    • 2018
  • Background: Fractures of the orbital wall are mainly caused by traffic accidents, assaults, and falls and generally occur in men aged between 20 and 40 years. Complications that may occur after an orbital fracture include diplopia and decreased visual acuity due to changes in orbital volume, ocular depression due to changes in orbital floor height, and exophthalmos. If surgery is delayed too long, tissue adhesion will occur, making it difficult to improve ophthalmologic symptoms. Thus, early diagnosis and treatment are important. Fractures of the superior orbital wall are often accompanied by skull fractures. Most of these patients are unable to perform an early ocular evaluation due to neurosurgery and treatment. These patients are more likely to show tissue adhesion, making it difficult to properly dissect the tissue for wall reconstruction during surgery. Case presentation: This report details a case of superior orbital wall reconstruction using superior orbital rim osteotomy in a patient with a superior orbital wall fracture involving severe tissue adhesion. Three months after reconstruction, there were no significant complications. Conclusion: In a patient with a superior orbital wall fracture, our procedure is helpful in securing the visual field and in delamination of the surrounding tissue.

ARTERIAL ARCADE OF THE MAXILLARY SINUS RELATED TO SINUS BONE GRAFT IN KOREAN POPULATION ; A PRELIMINARY STUDY USING COMPUTED TOPOGRAPHIES (한국인에서의 상악동 골이식술과 관련된 상악동 동맥 분포에 대한 예비 연구)

  • Kim, Ki-Young;Kim, Sang-Gyun;Seo, Hyun-Soo;Song, Yun-Jung;Kim, Mi-Ja;Hong, Soon-Min;Park, Jun-Woo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.4
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    • pp.475-479
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    • 2008
  • Aim: The aim of this study was to investigate the arterial arcade of maxillary sinus by determining the distance between the alveolar crest and the inferior border of the vessels in Korean population. Materials and methods: 76 patients and 87 available sinuses were determined by CT scan (Implagraphy, Vatech, Seoul, Korea). The distance between alveolar crest and inferior border of the vessel was determined considering the tooth area of posterior maxilla. Results: The lowest distance was observed on first molar area and the average distance is 16.9 mm. Discussions: it is important in sinus lift surgery that the vessels not to be damaged and that the anastomosis is situated in the lateral wall of maxillary sinus, which has to be exposed to gain access to the maxillary sinus. The knowledge of arterial arcade of maxillary sinus is important to perform the sinus floor elevation procedure effectively.

ORAL HEALTH STATUS OF PATIENTS WITH SPECIAL HEALTH CARE NEEDS IN KYUNG HEE UNIVERSITY DENTAL HOSPITAL (경희대학교 치과병원을 내원한 장애인 환자의 구강건강상태에 관한 연구)

  • Kim, Ji Hyun;Nam, Ok Hyung;Kim, Mi Sun;Kim, Kwang Chul;Choi, Sung Chul;Lee, Hyo-Seol
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.11 no.2
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    • pp.53-57
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    • 2015
  • Most special health care needs (SHCN) people suffer from oral health problems due to high incidence and severity of oral disease. The aim of the present study was to investigate the characteristics of dental treatment provided in this patient population. The study population comprised 485 SHCN patients who visited Kyung Hee University Dental Hospital from 2006 to 2014. Based on the medical record, the date were evaluated according to age, gender, type of disorder, reason for visit, type of behavior management, and type of dental treatment. The most common age group was 7-12 year olds (26%). The chief compliant was dental caries (39%), as followed by oral exam (12%) and trauma (12%). Approximately half of SHCN patients (45.9%) was treated under behavior management. Restorative treatment was the most common procedure with the average of 2.9 teeth treated per patient. The results of the present study may be valuable for establishing the data of SHCN patients for primary dental care.