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.
Shim, Ye Ji;Nam, Dongwoo;Kim, Bo Hae;Jin, Young Ju;Ryu, Yoon-Jong;Kim, Min-Su;Chung, Eun-Jae;Kwon, Seong Keun;Hah, J Hun;Kwon, Tack-Kyun
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
/
v.26
no.2
/
pp.127-129
/
2015
Background and Objectives : The etiology of globus pharyngeus remains uncertain. It has been known there is a relationship between the presence of air bubbles in esophagus and GERD symptoms. The aim of this study is to identify relationship between the globus symptom and the presence of air column in esophagus. Subjects and Methods : The study population consisted of 46 patients who underwent CT scan as part of evaluation for globus. Controls were chosen from the population consisted of patients with lymphadenopathy who underwent CT scan. The correlation between the presence of globus symptom and diameter, volume, and position of the air column was assessed using t-test. Reproducibility of diameter and volume of the esophageal air column was analyzed using intraclass correlation coefficient. Results : In study group, the mean volume of the air column was $769.56{\pm}983.08mm^3$, the mean diameter was $8.24{\pm}4.90mm$, the mean distance from the inferior border of posterior lamina of cricoid cartilage was $88.86{\pm}28.01mm$. In control group, $682.18{\pm}767.28mm^3$, $8.37{\pm}5.50mm$, $88.34{\pm}21.06mm$, respectively. There were no differences of diameter, volume and distance of the air column between the two groups. We failed to obtain acceptable reliability when we compare the diameter and the volume of the esophageal air column. Conclusion : There was no relationship between air column of esophagus and presence of globus symptom. And the measurement of diameter and volume of the esophageal air column change over time and it should be considered in a further study.
Seo, Hyo-Seok;Chung, Chin-Hyung;Lim, Sung-Bin;Hong, Ki-Seok
Journal of Periodontal and Implant Science
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v.36
no.2
/
pp.461-471
/
2006
In order to achieve a satisfactory esthetic result of periodontal surgery or implant in maxillary anterior area, periodontists must be aware of normal alveolar bone anatomy. The purpose of this study was to evaluate the relationship of alveolar bone morphology to tooth shape and form. 78(mean age : 25 yrs) periodontally healthy volunteers participated in this study. Two maxillary central incisor and one lateral incisor were selected to study. With minimal local anesthesia, gutta-percha cone inserted to labial gingival sulcus of selected teeth just after bone sounding with periodontal probe. Metal ball (4mm diameter) attached to palatal fossa of central incisor. Then, periapical radiograph was taken according to long cone paralleling technique. After film scan, labial alveolar bone profile reproduced along interproximal bone and apical ends of gutta-percha cones on computer screen. By utilizing computer program, the distance from height of interproximal bone to the labial bone crest in central incisor-central incisor and central incisor-lateral incisor area was measured and converted to real distance by using vertical length of metal ball on film. After measuring crown length & width of central incisor, the 10 individuals ranked lowest GW/L ratio (crown width/length ratio) and the 10 ranked highest were selected as having a long-narrow(group N), or a short-wide(group W) form of the central incisors. Means of the distance from height of interproximal bone to the labial bone crest of group N, W were calculated and compared by means of independent t-test. The results were as follows: 1. Mean distance from the height of the interproximal bone to the labial bone crest was $3.5{\pm}0.7mm$ between two central incisor, and $2.8{\pm}0.6mm$ between central and lateral incisor. 2. Mean GW/L ratio of group N was 0.57, and group W was 0.8. Mean distance from the height of the interproximal bone to the labial bone crest of group N was higher than group W in both measured area(measurements of group N, W were $3.9{\pm0.2mm$ and $3.5{\pm}0.2mm$ between two central incisor, $3.0{\pm}0.2mm$ and $2.8{\pm}0.2mm$ between central and lateral incisor), but there were no statistically significant differences when the groups were compared. Within the limits of the present study, there was a tendency that subjects with long-narrow teeth have more scalloped alveolar bone profile than subjects with short-wide teeth in upper anterior area, but no statistically significant differences were found.
An, Heesuk;Lee, Jung-Tae;Oh, Seo-Eun;Park, Kyeong-mee;Hu, Kyung-Seok;Kim, Sungtae;Chung, Moon-Kyu
Journal of Periodontal and Implant Science
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v.49
no.1
/
pp.2-13
/
2019
Purpose: The aim of this study was to conduct a histologic evaluation of irradiated calvarial defects in rats 4 weeks after applying fibroblast growth factor-2 (FGF-2) with hyaluronan or biphasic calcium phosphate (BCP) block in the presence or absence of adjunctive hyperbaric oxygen (HBO) therapy. Methods: Twenty rats were divided into HBO and non-HBO (NHBO) groups, each of which was divided into FGF-2 and BCP-block subgroups according to the grafted material. Localized radiation with a single 12-Gy dose was applied to the calvaria of rats to simulate radiotherapy. Four weeks after applying this radiation, 2 symmetrical circular defects with a diameter of 6 mm were created in the parietal bones of each animal. The right-side defect was filled with the materials mentioned above and the left-side defect was not filled (as a control). All defects were covered with a resorbable barrier membrane. During 4 weeks of healing, 1 hour of HBO therapy was applied to the rats in the HBO groups 5 times a week. The rats were then killed, and the calvarial specimens were harvested for radiographic and histologic analyses. Results: New bone formation was greatest in the FGF-2 subgroup, and improvement was not found in the BCP subgroup. HBO seemed to have a minimal effect on new bone formation. There was tendency for more angiogenesis in the HBO groups than the NHBO groups, but the group with HBO and FGF-2 did not show significantly better outcomes than the HBO-only group or the NHBO group with FGF-2. Conclusions: HBO exerted beneficial effects on angiogenesis in calvarial defects of irradiated rats over a 4-week healing period, but it appeared to have minimal effects on bone regeneration. FGF-2 seemed to enhance new bone formation and angiogenesis, but its efficacy appeared to be reduced when HBO was applied.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.28
no.1
/
pp.111-126
/
1998
In this study, radiographic evaluation was made using panoramic radiography and cross-sectional tomography of SCANORA/sup (R)/ in male and female adults in their 20's on the relationship between the maxillary sinus floor and the apex of the maxillary molar, to test the accuracy and effectiveness of the cross-sectional tomography, and to use this information in the assessment of preop. and postop. root canal treatment, apical surgery, extraction and implantology. Forty-one adults with an average age of 24.4 years were studied using panoramic radiography and cross-sectional tomography. In panoramic view and cross-sectional view, the position of the apices of maxillary molars were classified as separated, contacted, or protruded type; the general shape of the maxillary sinus floor was evaluated horizontally and vertically from cross-sectional tomography. The accuracy of each radiography was tested using maxilla from 5 fresh cadavers from the Anatomy Lab at Yonsei University Dental College, and panoramic view and cross-sectional tomography were taken in the same condition as with the patients. The results were as follows: 1. Panoramic view and cross-sectional view were taken in the maxilla specimen, and the actual distance between the maxillary sinus floor and the tooth apices were measured in the specimen; the median values of the distance from the tooth apices to the maxillary sinus floor in the panoramic view, cross-sectional view and in the actual maxilla specimen were 2.83 mm, 4.51mm, and 4.l5mm, respectively. In the cross-sectional view, the measured distance was close to the actual distance but in the panoramic view, the measured distance was far from the actual distance. 2. When the results of the panoramic view and cross-sectional view were compared, 40.5% of the results agreed with each other in the two radiographic methods and buccal roots of the 2nd molar were the closest to the maxillary sinus floor in the cross-sectional tomography. 3. In cross-sectional view, when the vertical relationship of the maxillary sinus floor and maxillary roots was assessed, in 1st molars, type II (the sinus floor that extends down to the buccolingual furcation area) was predominant, while in 2nd molars, type I (the sinus floor located above the level connecting the buccal and lingual apices) was predominant. In the horizontal relationship, in 1st molars, type II (the lowest floor of the maxillary sinus located in between the buccal and lingual roots) was predominant; in 2nd molars, type I (the lowest floor of the maxillary sinus located on the buccal side of the buccal roots) and type II appeared in similar frequency. In conclusion, the SCANORA/sup (R)/ cross-sectional tomography was more effective than the frequently used panoramic view, in that the relationship of the maxillary molars and maxillary sinus floor can be evaluated more accurately and the buccolingual cross-sectional view can also be observed. And maxillary sinus floor that was close to maxillary 2nd molar had tendency to be located on buccal side than that close to 1st molar. Therefore, cross-sectional tomography is an effective and accurate method to evaluate the position of the teeth in relation to the sinus floor preoperative and can be easily used to diagnose localized periapical lesions. Also, the image quality obtained was quite satisfactory.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.27
no.1
/
pp.189-201
/
1997
The purpose of this study was to evaluate the position and shape of mental foramen in panoramic radiographs. For this study, panoramic radiographs were obtained from the 200 adults and evaluated the position and shape of mental foramen. According to various positional changes in panoramic radiographs of the patients, the author also obtained panoramic radiographs from the 100 adults and then evaluated the positional and shape changes of mental foramen. The following results were obtained: 1. Shapes of mental foramen were observed elliptical(43.3%), round or oval(42.5%), unidentified(7.5%) and diffuse (6.7%) type in descending order of frequency. 2. Horiwntal position of mental foramen were most frequently observed at the 2nd premolar area(54.2%), and area between the 1st premolar and 2nd premolar(43.1%), area between the 2nd premolar and 1st molar(2.7%) in descending order of frequency. 3. Vertical position of mental foramen were most frequently observed at the inferior of apex(88.2%), and at apex (9.7%), overlap with apex(1.9%), superior of apex(0.2%) in descending order of frequency. 4. According to various positional changes in panoramic radiographs of the patients, shape changes of mental foramen were more obviously observed at the forward 10mm and chin down 100 positioned panoramic radiographs. And changes of horiwntal and vertical position were observed in similar to compared with normal positioned panoramic radiographs.
Kim, Jong-Man;Yi, Chung-Hwi;Cho, Sang-Hyun;Park, Jung-Mi;Kwon, Hyuk-Cheol;Hwang, Tae-Sun
Physical Therapy Korea
/
v.9
no.1
/
pp.81-96
/
2002
The purpose of this research was to determine the effects on the healing of fibular fractures in rabbits of low-intensity pulsed ultrasound (50 $mW/cm^2$ and 500 $mW/cm^2$) applied for periods of 4, 14 and 24 days following fibular osteotomy. Thirty-six male Japanese white rabbits were randomly divided into three groups of twelve for three treatment protocols: (1) ultrasound treatment at intensities of 50 $mW/cm^2$ and 500 $mW/cm^2$ until the 4th day following fibular osteotomy, (2) ultrasound treatment at intensities of 50 $mW/cm^2$ and 500 $mW/cm^2$ until the 14th day following fibular osteotomy, and (3) ultrasound treatment at intensities of 50 $mW/cm^2$ and 500 $mW/cm^2$ until the 24th day following fibular osteotomy. The low-intensity pulsed ultrasound was applied to only one fibula of each rabbit (these served as the experimental group). The other fibula of each rabbit served as the control group. The selection of which fibula was to be treated was made randomly. The animals were sacrificed on the 4th, 14th and 24th day after the start of ultrasound treatments. Percent of trabecular bone area and fibular radiography were carried out to compare the degree of fibular bone healing. A microscope was also used to determine any histologic changes. For statistical differences in radiological changes due to length of treatment period (4, 14 and 24 days respectively), the Wilcoxon signed-ranks test was used to compare the experimental and control groups. For statistical differences in fracture healing due to differences in ultrasound intensity, radiological studies were compared using the Mann-Whitney Test. And, to compute percentage differences in areas of trabecular bone, Two-way analysis of variance (ultrasound intensity x each group) was used. Experiment results were as follows: 1. In animals sacrificed on the 4th day, no difference was found in the radiological studies of the fibulae in the experimental and control groups (p>.05). However, experimental groups showed more rapid bone repair than control group. 2. Both radiographic and percent of trabecular bone area studies showed significant differences in rabbits sacrificed after 14 days. Fracture healing was significantly increased in the experimental group (p<.05) 3. In the animals sacrificed on the 24th day, histologic study showed rapid bone repair but fibular radiologic studies did not show statistical differences between the two groups (p>.05). 4. On the 14th day, bone union on radiograph was significantly more rapid in the treatment group with pulsed ultrasound of 50 $mW/cm^2$ than the group with 500 $mW/cm^2$ (p<.05). Histologic studies showed that both the 14 and 24 days groups had more rapid bone repair in animals treated with 50 $mW/cm^2$ ultrasound intensity than those treated with 500 $mW/cm^2$ intensity. In conclusion, it has been shown that the low-intensity pulsed ultrasound has a positive effect on bone fracture healing in the early stage and the range of pulse ultrasound from 50 $mW/cm^2$ to 500 $mW/cm^2$ is effective for fracture healing. Further study is needed to investigate the influence of pulsed ultrasound on delayed union and non-union in bone fractures and also for the clinical use of low-intensity pulsed ultrasound for bone healing in humans.
Previous studies could not offer available guideline to decide size of balloon and grade of injury before induction of spinal cord injury (SCI) because grade of SCI was assessed after inserting a catheter and each experimental animal were different in body size and weight as well as in species. This study was performed to provide guideline for standardized SCI model. Eight healthy adult beagle dogs that had 8 mm of spinal canal height were assigned to four groups according to the diameter of balloon and compression time: 4 mm/3hrs, 4 mm/6hrs, 4 mm/12hrs and 6 mm/3hrs group. Radiography was performed to standardize between experimental animal and balloon before selecting balloon diameter to induce SCI. Behaviors outcomes, somatosensory evoked potentials (SEPs), magnetic resonance imaging (MRI) and histopathological examination were evaluated. Behaviors outcomes and SEPs were not available to assess grade of SCI and those only indicate SCI. The damaged area was revealed clear hyperintensity on STIR image and T2WI after induction of SCI. The hyperintense area on MRI was cranially and caudally expanded with increasing of the diameter of balloon or the compression time. Well corresponded to expanding of hyperintense area on MRI, the damaged region and the numbers of caspase-3 and PARP immunoreactive cells were increased on histopathological findings. Therefore, these results will be considered fundamental data to induce standardized SCI model in experimental animal that has various weight and size.
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