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A STATISTICAL SURVEY OF DENTAL TREATMENT IN DISABLED PATIENTS (장애인의 치과치료에 관한 통계적 연구)

  • Rhee, Ye-Ri;Lee, Keung-Ho;Park, Jae-Hong;Choi, Sung-Chul;Kim, Kwang-Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.1
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    • pp.6-10
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    • 2007
  • Many disabled patients need extensive dental treatment because they have much difficulty in maintaining their oral hygiene. However, because they are not cooperative and not manageable, they require physical restraints, drug induced sedation or general anesthesia. General anesthesia is useful in control of the patients who cannot be treated in other ways. Additionally, general anesthesia provides more safe environment for medically compromised patients. The aim of the present study was to investigate a kind of disorder, sources of referral, preoperative oral condition, experience of dental visit, and performing general anesthesia or not of 930 disabled patients in Kyung-Hee University dental hospital for 30 years.

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Correction of Unilateral Nostril Hypoplasia with Z-Plasty in a Child

  • Lee, Dong-Han;Oh, Kap Sung
    • Archives of Craniofacial Surgery
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    • v.15 no.2
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    • pp.94-97
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    • 2014
  • Unilateral nostril hypoplasia is an extremely rare congenital malformation of unknown etiology, and only a few cases have been reported in literature. Owing to variability and complexity of the deformity, surgical correction of unilateral nostril hypoplasia represents one of the most significant reconstructive challenges to reconstructive plastic surgeons. We report a 7-year-old Vietnamese child with nasal and periocular deformity resembling a craniofacial cleft. Grossly, the right nostril was patent but with alar rim deformity, and the left nostril was not readily identifiable. A dystopic medial canthus was present on the left side as well. Closer inspection and palpation of the left side of nose revealed a patency through the soft tissue and underlying bony structure, Thus, a new alar rim were reconstructed with an irregularly shaped Z-plasty to create patency on the involved side. Simulatneously, a second Z-plasty was performed to address the medial canthal deformity. Postoperative appearance and function was sastisfactory at one-year follow up visit. In the treatment of patients with nostril hypoplasia, a careful preoperative physical examination is a prerequisite, and Z-plasty can be a valuable option for surgical correction.

A Study on the Improvement of Visual Acuity and Refractive Power According to General Characteristics of Cataract Surgery Patients

  • Cho, Seon Ahr;Lee, Seong Jae
    • International Journal of Advanced Culture Technology
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    • v.6 no.4
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    • pp.71-79
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    • 2018
  • For 299 patients who had undergone cataract surgeries we investigated the difference in visual acuity and refractive power before and after cataract surgery and the clinical change of the visual acuity and the refractive power according to age, gender, hospital visit time and specific medical history. We found the factors affecting preoperative and postoperative outcomes of the cataract patients in metropolitan hospitals by input, process, and outcome and analyzed medical characteristics and patient characteristics as the input variables. T-test and ANOVA have been performed for statistical analysis of functional status, and general status and the technical characteristic as the process variable and the outcome variable of diagnosis. Visual acuity improved significantly in patients who had undergone cataract surgery. However, the change in refractive power did not show a statistically significant difference but only a slight difference. The improvement of male patients was greater than that of female patients. The difference in age was more effective in patients under 50 years old and the effect of cataract surgery was relatively high in patients without the presence of specific medical history. Cataract surgery did not seem to help all of the patients, but it is more effective in improving visual acuity and refractive power. We conclude that simultaneous cataract surgery in both eyes is reasonable in order to have at least the better effect.

Atypical proliferative nodule in congenital melanocytic nevus with dural invasion: a case report

  • Jung, Jae Hoon;Jang, Kee-Taek;Kim, Ara;Lim, So Young
    • Archives of Craniofacial Surgery
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    • v.20 no.2
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    • pp.139-143
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    • 2019
  • Here we report a case of a focal atypical proliferative nodule (PN) arising from a congenital melanocytic nevus (CMN). Diagnosis was challenging because it had both benign and malignant clinical features. Unusual histopathology, immunohistochemistry, and intraoperative findings of this atypical PN are discussed. A 5-year-old girl was admitted for a congenital $5{\times}5cm$ sized scalp mass. This hemangioma-like soft mass showed biphasic characteristics such as a slow, gradual, and benign increase in size but worrisome dural invasion with cranial bone defect. We removed the scalp mass with clear resection margins. Interoperatively, we found that the cranial bone defect had already filled. Histopathologic examination showed CMN with focal atypical PN. The nodule showed sharp demarcation and cellular pleomorphism. However, in immunohistochemical study, Ki-67 proliferation index and expression levels of protein S-100 and Melan-A were very low. These were unusual findings of atypical PNs. Despite her worrisome preoperative radiologic features, she showed an indolent clinical course compatible with previously reported biologic behavior. The patient underwent follow-up inspection with magnetic resonance imaging every 6 months for up to 3 years. The nodule appeared to be stationary at the last visit.

Giant Sellar Xanthogranuloma after Surgical Treatment of Symptomatic Rathke's Cleft Cyst

  • Cho, Sung-Min;Cho, Hyok-Rae;Park, Yong-Seok;Chang, Hee-Gyeong
    • Brain Tumor Research and Treatment
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    • v.6 no.2
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    • pp.82-85
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    • 2018
  • Extremely massive sellar xanthogranuloma (XG) are rare, and the surgical outcome and prognosis are not well known. XG remain unknown whether they are derived from Rathke's cleft cysts (RCCs) or craniopharyngiomas (CPs) following extensive inflammation and metaplasia, to the point that no epithelium is readily identifiable. These lesions usually tend to occur in younger patients (mean 28.3 years), have a smaller diameter, and remain primarily intrasellar region with infrequent calcification. This 36-year-old man presented our hospital with visual deterioration. At the time of visit, there were no neurological problems other than visual field defect and hormonal disorder. He visited our hospital in 2007 due to headache and decreased vision, and underwent transphenoid surgery for pituitary RCC. Since then, he has received treatment at our hospital for postoperative hormonal disorders. Through preoperative imaging study, the author suspected CP and underwent surgery. During the operation, the adhesion of the tumor to the surrounding major neurovascular structures was severe in the naked eyes, but the tumor could be removed more easily than expected. The postoperative histological findings were confirmed as XG. The postoperative course was uneventful. Compared to the previous literature, this case is a case where the size of XG is very large in a sellar region and it can be proved that it originated from the RCC. And regular follow-up is necessary to confirm the prognosis after surgery.

Laminate production by manufacturing ceramic casting body and laminating using IPS Empress: a pressure casting method (가압주조방식인 IPS Empress로 세라믹 주조체를 제작 후 적층 형 성한 라미네이트 제작 증례)

  • Wook Tae Kim
    • Journal of Technologic Dentistry
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    • v.45 no.3
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    • pp.81-86
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    • 2023
  • Purpose: This study aimed to observe the effect of laminate veneer on patient's teeth based on the manufacturing of laminate veneer restorations, which are produced by fabricating a ceramic cast body using IPS Empress, a pressure casting method and then forming the veneer by layering. Subsequently, we assessed the potential of its clinical application. Methods: This study discusses and preserves various treatment plans, such as diagnostic wax-up and treatment room diagnosis, for patients who visit the hospital to improve the appearance of teeth due to diastema of maxillary teeth, inexperienced resin filling, lack of esthetics, and external teeth. A ceramic cast body is constructed using IPS Empress, which is an effective and aesthetic restoration pressure casting method to restore the veneer with a laminate made by layering. Results: Compared with the preoperative state, the frontal view of the patient after the final restoration showed the formation of a natural smile line; the space between the central and lateral incisors was filled in synchronously with the adjacent teeth. In addition, the emergence profile is maintained by reducing the over-contour as much as possible. Conclusion: The patient's quality of life is improved by providing them with a satisfactory natural smile.

The effectiveness of the surgical approach and drug-holiday on the treatment of bisphosphonate related osteonecrosis of the jaw patient (비스포스포네이트 연관 악골괴사의 치료 방식과 투약 휴지기가 치료 예후에 미치는 영향)

  • Rhee, Seung-Hyun;Park, Kun-Hyo;Lee, Jae-Yeol;Kim, Yong-Deok;Shin, Sang-Hun;Chung, In-Kyo;Kim, Gyoo-Cheon;Kim, Uk-Kyu
    • The Journal of the Korean dental association
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    • v.53 no.2
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    • pp.120-131
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    • 2015
  • Objective: The purpose of this study is to compare the surgical treatment with conservative treatment and to evaluate the effectiveness of drug-holiday in bisphosphonate related osteonecrosis of the jaw (BRONJ) patients who were diagnosed as stage 2. Patients and Method: From January 2012 to October 2014, seventy-two patients who visit to Pusan National University of Dental Hospital were diagnosed as stage 2 of BRONJ. All the patients had taken computed tomography(CT) and panoramic radiography. The surgical treatment including sequestrectomy of necrotic bone and curettage of soft tissue around the sequestrum were performed to fifty patients. Twenty-two patients underwent conservative treatment such as antibiotics medications, mouth rinsing and follow up checking for every two weeks. Prognosis of treatment was classified into 3 groups - response, unresponse, and worsens - according to clinical, radiographic symptoms. P-value less than 0.05 were regarded as significant. Results: In surgery group, forty-five patients (90%) were healed without recurrence or any complication and five patients (10%) showed the wound dehiscence or infection. In conservative treatment group, fifteen patients (68.2%) were healed without any complication, four patients (18.2%) did not show improvement and three(4.2%) patients$^{\circ}{\emptyset}$ symptoms increased. P-value among groups was 0.014. Evaluation of preoperative drug-holiday in surgery group did not show the effectiveness(p=0.478). Conclusion: Statistically, the prognosis of patients with stage 2 BRONJ treated with surgery was significantly better than conservative treatment. There was no statistical difference for the preoperative drug-holiday.

Osteoradionecrosis of Jaw in Head and Neck Cancer Patient Treated with Free Iliac Bone and Umbilical Fat Pad Graft

  • Choi, Yuri;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su;You, Jae-Seek;Jeong, Kyung-In;Lee, Sung-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.2
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    • pp.62-66
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    • 2014
  • Osteoradionecrosis is one of the most serious complications of patients receiving radiation therapy. It is characterized by hypovascularity, hypocellularity, and hypoxia-inducing necrosis of bone and soft tissue following delayed healing. In this case, a 72-year-old man was referred to the Department of Oral and Maxillofacial Surgery complaining of trismus following extraction three months before first visit. He had a history of right tonsillectomy, radical neck dissection and radiotherapy performed due to right tonsillar cancer seven years prior. After the diagnosis of osteoradionecrosis on right mandibular body and angle, conservative antibiotic therapy was used first, but an orocutaneous fistula gradually formed, and extensive bony destruction and sequestrum were observed. Sequestrectomy, free particulated iliac bone and umbilical fat pad graft were performed via a submandibular approach under general anesthesia. Preoperative regular exams and delicate wound care led to secondary healing of the wound without vascularized free flap reconstruction.

Inferior Blow-Out Fracture Reduction Using Two Urinary Balloon Catheters

  • Jo, Eun Jun;Kim, Jong Hwan;Yang, Ho Jik
    • Archives of Craniofacial Surgery
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    • v.16 no.3
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    • pp.114-118
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    • 2015
  • Background: The reduction of orbital blowout fracture primarily aims to normalize the extra-ocular movement by returning the herniated orbital soft tissue into the original position, and to prevent enophthalmos by normalizing the orbital cavity volume. We introduce a balloon catheter-assisted orbital floor reduction technique. Methods: A retrospective review was performed for all patients with orbital floor fracture who underwent the technique described in the main body of this text. Medical records were reviewed for demographic data, clinical presentation and course, degree of enophthalmos, intraorbital volume on computed tomography scan, and postoperative outcomes. The enophthalmos and intraorbital volume of the injured site were compared to the uninjured eye and orbit. Results: The review identified 14 patients (11 male, 3 female). The mean preoperative difference in en-exopthalmos was 2.13 mm, while the mean orbital volume was 116%. The mean postoperative difference in en-exophthalmos had improved to 0.61 mm with a mean orbital volume of 101.85%. At the time of catheter removal at 10 days, three patients experienced diplopia (n=1), extra-ocular movement disorder (1), or enophthalmos (1). All of these had resolved by the 6-month follow-up visit. Conclusion: Balloon catheter-assisted reduction of the orbital floor fractures was associated with improvements in intraorbital volume and enopthalmos in the 14 patients. Notable complications included diplopia, enophthalmos, and limited extra-ocular movement, all of which were transient in the early postoperative period and had resolved by 6-month follow up.

Eagle's Syndrome Presenting Unilateral Facial Nerve Palsy: Case Report (편측 안면신경 마비를 동반한 Eagle 증후군 치험례)

  • Shin, Hee-Jin;Kwon, Young-Wook;Cho, Sung-Min;Kim, Change-Hyen;Park, Je-Uk
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.5
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    • pp.467-472
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    • 2010
  • Eagle's syndrome is the manifestation of elongated styloid process that is not a common entity in dental clinics. Without the knowledge of this syndrome misdiagnosis can be made and therefore differential diag-nosis with other diseases of oral and maxillofacial area is required. The symptoms of elongated styloid process are cervical pain, foreign body sensation, dysphagia and pharyngeal pain. A 27 years old male vis-ited our hospital. He had cervical pain with unilateral facial nerve palsy. Along with meticulous clinical examinations, 3D-CT, Plain radiographic studies were used to make the diagnosis. In computed tomogra-phy, Lt. styloid process was elongated and fractured. Patient have undergone surgical resection of elongat-ed styloid process and have been carefully observed. Characteristically, preoperative facial nerve palsy showed rapid postoperative recovery. The other clinical symptoms that were present in the initial visit were diminished. The purpose of this article is to report a case of Eagle's syndrome presenting unilateral facial nerve palsy that was treated with transoral surgical approach with literature review.