• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.25.1-25.5
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• 2019

Background: Brain abscess is a life-threatening condition that occurs due to complications during a neurosurgical procedure, direct cranial trauma, or the presence of local or distal infection. Infection in the oral cavity can also be considered a source of brain abscess. Case presentation: A 45-year-old male patient was transported with brain abscess in the subcortical white matter. Navigation-guided abscess aspiration and drainage was performed in the right mid-frontal lobe, but the symptoms continued to worsen after the procedure. A panoramic radiograph showed alveolar bone resorption around the maxillary molars. The compromised maxillary molars were extracted under local anesthesia, and antibiotics were applied based on findings from bacterial culture. A brain MRI confirmed that the three brain abscesses in the frontal lobe were reduced in size, and the patient's symptoms began to improve after the extractions. Conclusion: This is a rare case report about multiple uncontrolled brain abscesses treated by removal of infection through the extraction of maxillary molars with odontogenic infection. Untreated odontogenic infection can also be considered a cause of brain abscess. Therefore, it is necessary to recognize the possibility that untreated odontogenic infection can lead to serious systemic inflammatory diseases such as brain abscess. Through a multidisciplinary approach to diagnosis and treatment, physicians should be encouraged to consider odontogenic infections as a potential cause of brain abscesses.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.1
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• pp.32-38
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• 2005

The efficacy of bioresorbable fixation has recently been described in the osseosynthesis of the oral & maxillofacial region. However, a liitle data exist regarding the use of biodegradable plates and screws for the internal fixation of human mandible fractures. The purpose of this study is to analyze and compare the treatment of mandibular fractures by using a bioresorbable fixation system with conventional titanium system in human mandible fractures. eighteen patients constituted the bioresorbable fixation group and twenty-five patients constituted the titanium fixation group. Both groups underwent open reduction and internal fixation by use of a bioresorbable system or a titanium fixation system. Panoramic radiograph were obtained preoperatively, immediately postoperatively after reduction, at 6 months and at 12 months postoperatively. In the bioresorbable fixation group, complication(infection) occurred in 1 patient(5.6%) and was resolved by incision & drainage, plate removal and antibiotics without untoward sequelae. 2 patients(8.0%) experienced complications in the titanium fixation group and were treated using conservative treatment. There was no statistical difference in complication rates between two groups. Our data supported the use of bioresorbale plate fixation in mandibular fractures as a means of avoiding the potential and well documented problems with rigid titanium fixation systems. In conclusion, the bioresorbable fixation system provide a reliable and sufficient alternative to conventional titanium plate system.

• Journal of Oral Medicine and Pain
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• v.19 no.2
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• pp.221-231
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• 1994

Age determination in children have been criticized because they rely on subjective estimations of tooth development, as seen in radiographs. This study was undertaken to obtain the objective estimation of developing teeth. The panoramic radiograph of 254 males and 254 females ranging from 6 to 14 years of age were studied. The structures measured were crown height, apex width and root length. The data weree statistically investigated with SPSS/PC + package. The results were as follows : 1. With the aid of a multiple regression model, a linear relationship between some of these distances and age was shown. 2. In th total material(6-14yr) and four-yr. intervals, linear equations are as follow : Boys : 6-14 age = 683 + 145.6 44RL + 126.6.45RL + 71.1 46DRL - 161.3 46DAW 6-10 age = 1202 + 72.6 46DRL + 100.2 44RL + 75.1 45RL 8-12 age = 3818 + 75.9 45RL - 190.9 44AW 10-14 age = 4151 + 58.6 45RL - 84.0 45AW - 130.6 44AW Girls : 6-14 age = 1587 + 104.9 45RL + 113.4 44RL - 233.1 46DAW + 81.4 47DRL - 255.9 46MAW 6-10 age = 1821 + 55.8 46DRL + 67.2 45RL - 184.2 46MAW + 56.3 44RL 8-12 age = 2435 + 68.2 45RLL + 71.3 44RL 10-14 age = 3485 + 49.9 47DRL - 51.3 45AW - 179.9 47DAW + 33.4 45RL + 39.4 44RL (DRL, length of distal root in molars. RL, root length in premolars. DAW, width of distal apex in molars. MAW, width of mesial apex in molars. AW, width of apex n molars)

• Journal of Periodontal and Implant Science
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• v.40 no.6
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• pp.283-288
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• 2010

Purpose: The aim of this case report is to present a case of incomplete bone formation after sinus augmentation. Methods: A patient having alveolar bone resorption of the maxillary posterior edentulous region and advanced pneumatization of the maxillary sinus was treated with sinus elevation using deproteinized bovine bone in the Department of Periodontology, Kyung Hee University School of Dentistry and re-evaluated with computed tomography (CT) follow-up. Results: Even though there were no significant findings or abnormal radiolucency on the panoramic radiograph, incomplete bone formation in the central portion of the augmented sinus was found fortuitously in the CT scan. The CT scan revealed peri-implant radiolucency in the apical portion of the implant placed in the augmented maxillary sinus. Nevertheless, the dental implants placed in the grafted sinus still functioned well at over 15 months follow-up. Conclusions: The result of this case suggests that patients who received maxillary sinus augmentation may experience incomplete bone formation. It is possible that 1) osteoconductive graft material with poor osteogenic potential, 2) overpacking of graft material that restricts the blood supply, and 3) bone microbial contamination may cause the appearance of incomplete bone formation after sinus augmentation. Further studies are needed to elucidate the mechanism of this unexpected result and care must be taken to prevent it.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.339-344
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• 2008

When a delayed eruption of tooth is diagnosed, the causative factor should be detected before an establishment of treatment plan, if possible. Although a panoramic radiograph is enough to evaluate the position of tooth and the stage of tooth development, a 3-D Dental CT would be a powerful tool to reveal a spatial relationships between objects. The reported case showed a delayed eruption of lower left permanent canine and a mini-plate with screws adjacent to the impacted canine. Although the screws adjacent to the root of impacted tooth showed a close proximity, it was not presumed that these screws would interfere the eruption of the tooth. The impacted canine did not show any spontaneous eruption during observation. After the mini-plate and screws were removed, an orthodontic traction using elastic power chain was performed. The position of mini-plates and screws should be carefully designed to avoid damaging the tooth follicles or tooth roots in the jaw. Also the screws should be removed before an orthodontic traction to prevent damaging the root surface of impacted tooth.

• The korean journal of orthodontics
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• v.50 no.3
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• pp.216-226
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• 2020

Root resorption can be caused by several factors, including contact with the cortical bone. Here we report a case involving a 21-year-old female with Angle Class II, division 1 malocclusion who exhibited significant root resorption in the maxillary right central incisor after orthodontic treatment. The patient presented with significant left-sided deviation of the maxillary incisors due to lingual dislocation of the left lateral incisor and a Class II molar relationship. Cephalometric analysis demonstrated a Class I skeletal relationship (A point-nasion-B point, 2.5°) and proclined maxillary anterior teeth (upper incisor to sella-nasion plane angle, 113.4°). The primary treatment objectives were the achievement of stable occlusion with midline agreement between the maxillary and mandibular dentitions and appropriate maxillary anterior tooth axes and molar relationship. A panoramic radiograph obtained after active treatment showed significant root resorption in the maxillary right central incisor; therefore, we performed cone-beam computed tomography, which confirmed root resorption along the cortical bone around the incisive canal. The findings from this case, where different degrees of root resorption were observed despite comparable degrees of orthodontic movement in the bilateral maxillary central incisors, suggest that the incisive canal could be an inducing factor for root resorption. However, further investigation is necessary to confirm this assumption.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.362-371
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• 2004

It is essential to have adequate knowledge of the timing of root resorption of deciduous teeth for diagnosis and treatment planning in pediatric and orthodontic dentistry. Dental development is also influenced by hereditary characteristics, environmental factors, race, sex, endocrine reaction, nutrition, socioeconomic condition and secular factor. The aims of the present study were to determine the mean age of root resorption of deciduous teeth in contemporary Korean children and to compare the mean age of root resorption time of deciduous teeth between early 1990s and early 2000s. The study population was made up of Korean children attending the pediatric dentistry ward of Kyungpook National University Hospital. One thousand thirty seven children's panoramic radiograph (girls: 528 persons, boys: 509 persons) in $1990{\sim}1992$ and one thousand sixty five children's panoramic radiograph (girls: 394 persons, boys: 671 persons) in $2001{\sim}2003$ were examined. This study utilized a cross-sectional design. Due to the problems of imaging in the maxillary region and the mandibular incisor region, the mandibular deciduous canine, the mandibular deciduous first molar and the mandibular deciduous second molar were chosen for examination. The results were as follows. 1. There is a tendency for the teeth to resort earlier in the early 2000s group than the in early 1990s group. At the Res c stage, the difference of the mean age was 0.4 years. 2. At the Res c stage, the order of difference of the mean age from smaller to larger for the girls was the mandibular deciduous canine, the mandibular first deciduous molar, and the mandibular second deciduous molar. On the other hand, for the boys, the order was the mandibular second deciduous molar, the mandibular first deciduous molar, and the mandibular deciduous canine. The difference was larger with aging in girls and smaller with aging in boys. 3. There is a tendency for the teeth to resort earlier in girls in both the early 1990s group and the early 2000s group. The difference of the mean age between girls and boys was 0.3 year. 4. The commencement of root resorption of the mandibular deciduous canine was slower than that of the mandibular first deciduous molar. However, the completion of root resorption of the mandibular deciduous canine is faster than that of the mandibular first deciduous molar. The total elapsed time of root resorption from commencement to completion was shortest in the mandibular deciduous canine. 5. For each of the teeth in the early 1990s and the early 2000s groups, the speed of root resorption was in the later stage faster than in the earlier stage. In order to know about the exact timing of root resorption of deciduous teeth, periodic and longitudinal studies preferably covering the entire period of growth, is required.

• Journal of Oral Medicine and Pain
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• v.36 no.1
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• pp.39-51
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• 2011

The aims of this study were to investigate whether the facial skeletal patterns previously reported to be related to temporomandibular disorder (TMD) in other studies could be consistently observed in the TMD patients diagnosed according to Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD) Axis I and evaluate its usability in the orthodontic clinics to examine the patients with TMD related symptoms. The clinical records and radiographs of female patients who visited the TMD and Orofacial Pain Clinic of Seoul National University Dental Hospital and were diagnosed as TMD were consecutively filed for this study. Patients were clinically examined and diagnosed according to the revised diagnostic algorithms of RDC/TMD Axis I and the lateral cephalogram, panoramic orthopantomogram, temporomandibular joint (TMJ) orthopantomogram, and transcranial radiograph of each patient were taken and digitalized. The data of patients who were under 18 years of age or had any systemic disease, trauma history involving the TMJ, or skeletal deformity at the time of the first examination were excluded. The remaining data of 96 female patients were finally analyzed. The obtained results were as follows: 1. There are no significant differences of cephalometric measurements between RDC I (muscle disorders) diagnostic groups. 2. Only the articular angle of the RDC group IIc (disk displacement without reduction without limited opening) patients was larger than patients of the no diagnosis of RDC II group (disk displacement). 3. Larger articular angle and smaller facial height ratio were observed in RDC IIIc group (osteoarthrosis) compared to IIIa group (arthralgia). Larger articular angle, larger Bjork sum, smaller posterior facial height, and smaller facial height ratio were observed in RDC group IIIc compared to no diagnosis of RDC III group (arthralgia, arthritis, and arthrosis). 4. According to the results of cephalometric analysis in simplified RDC groups, smaller overjet was observed in muscle disorders (MD) group. Facial height ratio and IMPA were smaller and articular angle was larger in disk displacements (DD) group than in no diagnosis of DD group. In arthrosis (AR) group, posterior facial height, and facial height ratio were smaller, and articular angle, gonial angle, facial convexity, FMA, Bjork sum, and ANB were larger than in no diagnosis of AR group. In joint pain (JP) group, only posterior facial height was smaller than no diagnosis of JP group. In conclusion, Facial morphologic patterns showing posterior-rotated mandible and lower posterior facial height is related to RDC group II and III diagnosis of the TMJ in female TMD patients. RDC/TMD Axis I diagnosis can provide a good clinical diagnostic tool for the standardized examination of the TMJ in orthodontic clinics.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.21 no.2
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• pp.235-248
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• 1991

This study was designed to evaluate the diagnostic effect of the simulatneous multifilm individualized lateral tomography in the diagnosis of the temporomandibular disorders. The subjects consisted of 29 patients with symptoms of the temporomandibular disorders. The panoramic view, oblique lateral transcranial radiograph (OLTC) (Hirozontal angulation 0°, Vertical angulation 29°), submentovertex view, and simultaneous multifilm individualized lateral tomographs (SMFI) in centric occlusion (2.5㎜ thickness difference, 5 layers) were taken for the patients. This study compared the findings from each radiographs in the determining of mandibular condylar position with dual linear measurement of the subjective closest posterior and subjective closest anterior interarticular space and in the determining of bony changes on the studied 30 temporomandibular joints (TMJ) with symptoms of the temporomandibular disorders. The results were as follows: 1. The distribution of condylar position of OLTC and 5 layers of SMFI depended on the radiographs (p<0.05). The condylar position and the distribution of condylar position of OLTC were more similar to lateral sections of the SMFI than mesial sections, and in the distribution of the condylar position of SMFI, the more lateral sections of SMFI, the more concentric 2. positions. There were 10 cases in which all layers showed the same condylar position as that of OLTC. There were 3 cases in which no layers showed the same condylar position as that of OLTC. 3. In the SMFI of 30 Temporomandibular joints studied, there is 13 cases in which all five layers represented the same condylar position in the same TMJ and 11 cases in which 4 layers represented the same condylar position in the same TMJ and 6 cases in which 3 layers represented the same condylar position in the same TMJ. So at least 3 layers of SMFI represented same condylar position in the same TMJ. 4. The bony changes were not detected in conventional radiographs on the temporomandibular joint and the bony changes were not detected in simultaneous multifilm individualized lateral tomographs. The bony changes were detected in conventional radiographs on the temporomandibular joint and the bony changes were detected in simultaneous multifilm individualized lateral tomographs. SMFI provided a meams for a three dimensional visualization of the shape, the position and the extent of bony changes of TMJ.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.121-128
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• 2015

Background: The authors studied the hemodynamic effect influent by using the novel high concentration of lidocaine HCl for surgical removal impacted lower third molar. The objective of this study was to evaluate the hemodynamic change when using different concentrations of lidocaine in impacted lower third molar surgery. Methods: Split mouth single blind study comprising 31 healthy patients with a mean age of 23 years (range 19-33 years). Subjects had symmetrically impacted lower third molars as observed on panoramic radiograph. Each participant required 2 surgical interventions by the same surgeon with a 3-week washout period washout period. The participants were alternately assigned one of two types of local anesthetic (left or right) for the first surgery, then the other type of anesthetic for the second surgery. One solution was 4% lidocaine with 1:100,000 epinephrine and the other was 2% lidocaine with 1:100,000 epinephrine. A standard IANB with 1.8 ml volume was used. Any requirement for additional anesthetic and patient pain intra-operation was recorded. Post-operatively, patient was instructed to fill in the patient report form for any adverse effect and local anesthetic preference in terms of intra-operative pain. This form was collected at the seven day follow up appointment. Results: In the 4% lidocaine group, the heart rate increased during the first minute post-injection (P < 0.05). However, there was no significant change in arterial blood pressure during the operation. In the 2% lidocaine group, there was a significant increase in arterial blood pressure and heart rate in the first minute following injection for every procedure. When the hemodynamic changes in each group were compared, the 4% lidocaine group had significantly lower arterial blood pressure compared to the 2% lidocaine group following injection. Post-operatively, no adverse effects were observed by the operator and patient in either local anesthetic group. Patients reported less pain intra-operation in the 4% lidocaine group compared with the 2% lidocaine group (P < .05). Conclusions: Our results suggest that a 4% concentration of lidocaine HCl with 1:100,000 epinephrine has better clinical efficacy than 2% lidocaine HCl with 1:100,000 epinephrine when used for surgical extraction of lower third molars. Neither drug had any clinical adverse effects.