• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.688-696
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• 1996

Garre's osteomyelitis is a unique form of osteomyelitis characterized rediographically by localized thickening of the periosteum and deposition of laminated subperiosteal bone. The most common inciting factor is a mandibular infection in permanent first molar with necrotic pulp. This disease occurs primarily in children and to date in all instances it has occured only in mandible. It usually results in hard swelling over the jaws, producing facial asymmetry with little or no pain. The overlying skin is normal but can occasionally be inflammed mostly when pain is present. Palpation reveals a usually smooth, bone-hard lesion which feel like an inherent part of the mandible. Unlike other forms of osteomyelitis, there is no marked increase in fever, white bloods cell count, sedimentation rate or alkaline phosphatase value. The treatment of Garre's osteomyelitis usually consist of elimination of the sourses of infection, i.e., either extration of an offending infected teeth or root canal therapy. This treatment almost always results in resolution of the Garre's osteomyelitis. Resistant cases have involved secondary surgery, i.e., decortication and sequestrectomy. This report presents three cases of Garre's osteomyelitis resolved by endodontic treatment. Cliniqtl examination revealed swelling on the face with no tenderness. Periapical radiograph showed deep caries lesion extending into pulp chamber and periapical radiolucency. Occlusal radiograph showed an enlargement of bone and stretching the periosteum. A clinical diagnosis of the Garre's osteomyelitis was made. Endodontic treatment was accomplished with conventional method and restored facial symmetry. Long-term check-ups are necessary to evaluate the results of endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.41 no.4
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• pp.310-315
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• 2016

Two case reports describing a new technique of creating a repositionable piezoelectric bony window osteotomy during apicoectomy in order to preserve bone and act as an autologous graft for the surgical site are described. Endodontic microsurgery of anterior teeth with an intact cortical plate and large periapical lesion generally involves removal of a significant amount of healthy bone in order to enucleate the diseased tissue and manage root ends. In the reported cases, apicoectomy was performed on the lateral incisors of two patients. A piezoelectric device was used to create and elevate a bony window at the surgical site, instead of drilling and destroying bone while making an osteotomy with conventional burs. Routine microsurgical procedures - lesion enucleation, root-end resection, and filling - were carried out through this window preparation. The bony window was repositioned to the original site and the soft tissue sutured. The cases were re-evaluated clinically and radiographically after a period of 12 - 24 months. At follow-up, radiographic healing was observed. No additional grafting material was needed despite the extent of the lesions. The indication for this procedure is when teeth present with an intact or near-intact buccal cortical plate and a large apical lesion to preserve the bone and use it as an autologous graft.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.1
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• pp.37-46
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• 1998

The purpose of this study was to evaluate the diagnostic performance of the senior dental students for the proximal dental caries on intraoral radiographs and to compare it with the dental hospital residents, the reference group. It was also investigated the diagnostic performance according to the carious lesion depth. Thirty-five intraoral periapical and bitewing radiographs with 213 proximal surfaces included in this study were selected from the dental patients at Chonnam National University Hospital. The observers were 181 senior dental students from 5 dental schools and 40 dentists who were second year resident from 5 dental hospitals. They were asked to evaluate the presence or the absence of the proximal dental caries. The results were as follows: 1. The mean of the hitting rate for the overall observers was 184.51 surfaces and the diagnostic accuracy was 86.62％. 2. The diagnostic performance of the sound proximal tooth surfaces was very high, i.e., 91.5％ true negative rate and 8.5％ false positive rate. 3. The diagnostic performance of the dentist group was higher than the student group(P<0.05). 4. The proximal dental caries perceptibility increased as the lesion depth increased significantly(P<0.001) except no difference between the carious lesion depth III and IV (P>0.001).

• Restorative Dentistry and Endodontics
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• v.41 no.2
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• pp.148-153
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• 2016

Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.515-519
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• 2011

Cemento-osseous dysplasia occurs in the tooth bearing areas of the jaws and is probably the most common fibro-osseous manifestation. They are usually classified into three main groups according to their extent and radiographic appearance: periapical (surrounds the periapical region of teeth and are bilateral), focal (single lesion) and florid (scleroticsymmetrical masses) cemental-osseous dysplasias. Florid cemento-osseous dysplasia clearly appears to be a form of bone and cemental dysplasia that is limited to the jaws. Patients do not have laboratory or radiologic evidence of bone disease in other parts of the skeleton. For asymptomatic patients, the best management consists of regular recall examinations with prophylaxis and the reinforcement of good home hygiene care to control periodontal disease and prevent tooth loss. The treatment of symptomatic patients is more difficult. At this stage, there is an inflammatory component caused by the disease and the process is basically a chronic osteomyelitis involving dysplastic bone and cementum. Antibiotics might be suggested, but are not always effective. Two cases of florid cemento-osseous dysplasia diagnosed in two Korean females are reported with a review of the relevant literature.

• Imaging Science in Dentistry
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• v.37 no.2
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• pp.83-86
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• 2007

Purpose : To evaluate the efficacy of panoramic radiography by comparing the results of clinical examination with radiographic findings. Materials and Methods: We studied 190 patients (20 men and 170 women; mean age, 40 years; range, 22 to 68 years) who visited the health promotion center of Korea Medical Science Institute and were examined both clinically and by panoramic radiography. We compared results from both examinations. Treatment options by clinical examination were described as "no treatment indicated", "treatment of dental caries", "removal of calculus", "treatment of periodontal disease", "prothodontic treatment" and "extraction of the third molar". Findings taken from the panoramic radiography were: dental caries, periapical lesion, alveolar bone loss, calculus deposition, retained root, impaction of the third molar, disease of maxillary sinus, bony change of mandibular condyle, etc. Results: The prevalence of panoramic findings were: 37.9% of dental caries, 17.4% of periapical lesions, 44.7% of alveolar bone losses, 62.6% of calculi deposition, 7.9% of retained roots, 26.8% of third molar impactions, 6.3% of diseases of maxillary sinus, 2.1 % of bony changes of mandibular condlye and 35.8% of miscellaneous lesions. Abnormal conditions revealed by panoramic radiography which had not been discovered on clinical examination were: 24.2% of the patients had dental caries, 17.4% had periapical lesions, 7.4% had calculi deposition, 5.3% had retained roots, 15.3% had third molar impactions. The opposite cases were: 5.2% had dental caries, 12.6% had calculi deposition, and 9.5% had third molar impactions. Conclusion: The use of panoramic radiography as a supplement to the clinical examination might be a valuable screening technique.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.2
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• pp.521-533
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• 1995

This study was performed to develop and evaluate the method to detect Quantitatively the serial changes in the size of artificial lesion in the spongious bone by automatic color image analyzer. 15 intraoral radiograms taken before and after endodontic treatment of 5 cases were used for contour line analysis. 30 intraoral radiograms taken by geometrically standardized apparatus before and after serially the formation of artificial lesions of 0.80, 1.20, 1.75, 2.00mm in diameter at the periapical area and interdental area of spongious bone were used. The analysis of image according to the variance of lesion size by 0.25, 0.35, 0.55, and 0.85mm serially was performed by the histogram and the color enhancement with subtraction. The images inputted by CCDcamera were digitized and analyzed by NEXUS QUBE program with NEC PC-9801 computer. The obtained results were as follows: 1. There was no reliability in the analysis of lesions by contour line 2 .. The mean difference of the grey scale at each pixel was 1 step between reference image and the corrected images. 3. In the analysis by histogram of the artificial lesion in spongeous bone, the change over 0.55mm in the mesiodistal size was detectable by the change of the numbers of pixel showing the change in grey scale. 4. In the analysis by histogram of the artificial lesion in spongeous bone, the change over 0.25mm in the buccolingual size was detectable by the change in grey scale. 5. By color enbancement with- subtraction, each lesion was able to be isolated and the change in it's mesiodistal size was detectable visually , but not in it's buccolingual size.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.2
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• pp.94-99
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• 2017

Objectives: Idiopathic bone cavity (IBC) is an uncommon intra-osseous cavity of unknown etiology. Clinical features of IBC are not well known and treatment modalities of IBC are controversial. The purpose of this study was to investigate the clinical characteristics of 27 IBC patients who underwent surgical exploration. Materials and Methods: A total of 27 consecutive patients who underwent surgery due to a jaw bone cavity from April 2006 to February 2016 were included in this study. Nine male and 18 female patients were enrolled. Patients were examined retrospectively regarding primary site, history of trauma, graft material, radiographic size of the lesion, presence of interdental scalloping, erosion of the inferior border of the mandible, complications, results of bone graft, and recurrence. Results: Female dominance was found. Maxillary lesion was found in one patient, and bilateral posterior mandibular lesions were found in two patients. The other patients showed a single mandibular lesion. The posterior mandible (24 cases) was the most common site of IBC, followed by the anterior mandible (5 cases). Two patients with anterior mandibular lesion reported history of trauma due to car accident, while the others denied any trauma history. Radiographic cystic cavity length over 30 mm was found in 10 patients. Seven patients showed erosion of the mandibular inferior border. The operations performed were surgical exploration, curettage, and bone or collagen graft. One bilateral IBC patient showed recurrence of the lesion during follow-up. Grafted bone was integrated into the native mandibular bone without infection. One patient reported necrosis of the mandibular incisor pulp after operation. Conclusion: Differential diagnosis of IBC is difficult, and IBC is often confused with periapical cyst. Surgical exploration and bone graft are recommended for treating IBC. Endodontic treatment of involved teeth should be evaluated before operation. Bone graft is recommended to reduce the healing period.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.209-214
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• 1997

Odontogenic cysts are relatively common pathologic lesions found in the oral and perioral structures, but the case of squamous cell carcinoma arising from those cysts are very uncommon. After first reported of that case in 1889 by Herman, Schwimmer collected 56 cases of previously reported squamous cell carcinoma arising in residual odontogenic cyst during about past one century. More than 60% of cases of carcinoma developing in odontogenic cysts arising in inflammatory periapical or residual cyst, and these tumors are usually well-differentiated with relatively good prognosis, and often are diagnosed as benign lesion in radiographic or clinical examination, therefore definitive diagnosis must be made by histologic examintation. We report a case and review the literatures, in our case, 78-year old woman were clinically and radiographically diagnosed as residual odontogenic cyst. But in histologic examination after enucleation of lesion, mass of squamous cell carinoma were observed, but in other area, typical cyst wall and lining epithelium were observed. And in some area, carcinoma in situ and invading squamous cell carcinoma into the lining epithelium were also observed.

• Imaging Science in Dentistry
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• v.43 no.3
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• pp.197-200
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• 2013

Florid osseous dysplasia (FOD) is an uncommon, benign, cemento-osseous lesion of the jaws. The etiology of FOD is still unknown. It is often asymptomatic and may be identified on routine dental radiographs. The classic radiographic appearance of FOD is amorphous, lobulated, mixed radiolucent/radiopaque masses of cotton-wool appearance with a sclerotic border in the jaws. In our case the lesion was found incidentally on routine periapical radiographs taken for restored teeth and edentulous areas. For further and detailed examination, a panoramic radiograph and cone-beam computed tomograph (CBCT) were taken. The panoramic radiograph and CBCT revealed maxillary bilateral and symmetrical, non-expansile, well-defined, round, radiopaque masses in contact with the root of the maxillary right second molar and left first molar teeth. Our aim in presenting this case report was to highlight the importance of imaging in diagnosis of FOD.