• 치과방사선
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• 제27권2호
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• pp.135-144
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• 1997

The primary intra-osseous carcinoma (PIOC) is a very rare lesion. PIOC is an odontogenic carcinoma defined as a squamous cell carcinoma arisinig within a jaw having no initial connection with the oral mucosa, and presumably developing from residues of the odontogenic epithelium. The authors diagnosed a 51-year-old female as primary intra-osseous carcinoma after undergoing clinical, radiological and histological examinations. The characteristics were as followed : 1. The patient complained of gingival bleeding on the premolar area in the left maxilla 2. The conventional radiograms showed a relatively well-defined unilocular radiolucent lesion from the mesial aspect of the upper left canine to the mesial aspect of the upper left 1st molar. The 2nd premolar was separated from the 1st molar and the floor of the maxillary sinus was elevated by the lesion. There was a external root resorption of the upper left canine, the 1st premolar, and the 2nd premolar. 3. On the computed tomograms, the osteolytic bony lesion expanded the cortical plate of the left maxilla and displaced the margin of the left maxillary sinus upwards. But the bony lesion was separated from the maxillary sinus by a bony septum. 4. Bone scintigram with /sup 99m/Tc demonstrated the increased uptake in the left maxilla. Sonograms in the neck area and chest P-A radiogram didn't show any abnormalities. 5. Histologically, the tumor islands infiltrating into the surrounding bone increased in alveolar pattern, composed of the malignant cells, and there was a necrosis in the center of the tumor islands.

• 치과방사선
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• 제29권2호
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• pp.533-547
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• 1999

Malignant fibrous histiocytoma is one of the most common soft tissue sarcomas in late adult life. but its incidence in oral and maxillofacial region is extremely rare. We report a case of malignant fibrous histiocytoma which occurred in the infratemporal fossa. Conventional radiograph of this case showed an ill-defined radiolucent lesion in the alveolar bone of the right maxillary first molar area. the lateral wall of the maxillary sinus. and the ascending ramus of mandible. MRI demonstrated a well defined mass of intermediate signal intensitiy in Tl weighted images but T2 weighted images showed two distinctive regions of different characteristics. Upper portion of the lesion was of hyperintense signal but (at) lower portion, the signal intensity decreased clearly, which might mean that this lesion(mass) is composed of two different subtypes though it couldn't be confirmed by histopathological examination. Biopsy was taken the lesion as only in the soft tissue of the maxillary posterior alveolar region and confirmed the storiform-pleomorphic type of malignant fibrous histiocytoma. Histopathological subtype was well consistent with the relatively aggressive imaging findings of that region. We expect more detailed analysis of the nature of malignant fibrous histiocytoma with improvement of the imaging modality and the identification of the relationship between diagnostic imaging and histopathologic findings.

• Restorative Dentistry and Endodontics
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• 제39권2호
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• pp.137-142
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• 2014

This article presents the successful surgical management of a failed mineral trioxide aggregate (MTA) orthograde obturation of a tooth with a history of impact trauma and perforated internal root resorption. A symptomatic maxillary lateral incisor with a history of perforation due to internal root resorption and nonsurgical repair using MTA was referred. Unintentional overfill of the defect with MTA had occurred 4 yr before the initial visit. The excess MTA had since disappeared, and a radiolucent lesion adjacent to the perforation site was evident radiographically. Surgical endodontic retreatment was performed using calcium enriched mixture (CEM) cement as a repair material. Histological examination of the lesion revealed granulation tissue with chronic inflammation, and small fragments of MTA encapsulated within fibroconnective tissue. At the one and two year follow up exams, all signs and symptoms of disease had resolved and the tooth was functional. Complete radiographic healing of the lesion was observed two years after the initial visit. This case report illustrates how the selection of an appropriate approach to treatment of a perforation can affect the long term prognosis of a tooth. In addition, extrusion of MTA into a periradicular lesion should be avoided.

• 대한치과의사협회지
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• 제54권5호
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• pp.365-373
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• 2016

Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

• 대한골관절종양학회지
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• 제5권1호
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• pp.17-22
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• 1999

Over 60 cases were enlisted, but only 31 cases among 24 patients were eligible with a minimum follow-up of 1 year and complete medical documents with imaging data. There were 18 boys and 6 girls, and 7 patients had bilateral lesions. The age of the patients ranged from 2 to 20 years(mean:10.5 years). At their first visit, most lesions had a highly characteristic location and radiographic appearance of radiolucent lesion(s) ranging from 1 to 3cm, except for one case of 5.5 cm in the posteromedial comer of distal femoral metaphysis. The margins were generally well-defined, although some were ill-defined. After reviewing our cases from the viewpoint of clinical course and radiographic patterns, we divided these lesions into two types. Type I is the osteolytic lesion excavated into the posteromedial aspect of the distal femur without cortical defect; and type II is the buldged out lesion of the femur with cortical irregularity into the surrounding soft tissues. Both types have distinctive clinical courses. Type I lesions were easy to make a definite diagnosis with plain radiographs alone, but in type II, it was sometimes very difficult to differentiate it from malignant tumors or chronic localized osteomyelitis. For this lesion, Gd-enhanced MRI was the most effective method for differential diagnosis. In this study, biopsy was not necessary to confirm the diagnosis. Clinical symptoms of type I were very minor or even absent. Many of them were accidentally found after minor trauma around the knee joint. Clinical symptoms disappeared far earlier than radiographical lesions. No treatment such as restriction of activity or drugs was necessary. For type II, the clinical symptoms were more accentuated and lasted longer, and it was necessary to restrict the activity for a certain period in many cases. However, all were self-limited.

• 대한두개안면성형외과학회지
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• 제17권3호
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• pp.162-164
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• 2016

Stafne bone cavity is a rare mandibular defect that was first reported by Edward C. Stafne in 1942. It commonly presents with a well-demarcated, asymptomatic, unilateral radiolucency that indicates lingual invagination of the cortical bone. A 52-year-old female patient who with nasal bone fracture, visited the hospital. During facial bone computed tomography (CT) for facial area evaluation, a well-shaped cystic lesion was accidentally detected on the right side of the mandible. Compared to the left side, no swelling or deformity was observed in the right side of the oral lesion, and no signs of deformity caused by mucosal inflammation. 3D CT scans, and mandible series x-rays were performed, which showed a well-ossified radiolucent oval lesion. Axial CT image revealed a cortical defect containing soft tissue lesion, which has similar density as the submandibular gland on the lingual surface of the mandible. The fact that Stafne cavity is completely surrounded by the bone is the evidence to support the hypothesis that embryonic salivary gland is entrapped by the bone. In most cases, Stafne bone cavity does not require surgical treatment. We believe that the mechanical pressure from the salivary gland could have caused the defect.

• 치과방사선
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• 제25권1호
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• pp.39-49
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• 1995

This study was performed to determine the each location of lesions in the maxillary sinus and to evaluate the relationship between the floor of the antrum and the apical regions of teeth by the comparison of the panoramic view and panoramic sinus view. For this study, experimentally with two dry skulls, jelly balls of 8mm and 15mm in diameter containing a short wire for the radiopacity similar to the cyst and clinically 5 patients having mucosal cyst in the antrum and 10 patients having periapical lesion of molar were used. The experimental cystic lesions were simulated with jelly ball being attached in turn to each wall of the antrum. The radiolucent periapical lesions of upper molars were formed by using round bur and the radiopaque periapical lesions were simulated by filling the former lesions with lead foil. Each panoramic view and each panoramic sinus view of the experimental lesions and patients were obtained by using panoramic machine and analyzed. The obtained results were as follows : 1. On the panoramic sinus view, the innominate line was approximately coincided with the most lateral portion of the antrum and the posterior wall appeared as the narrow area at the mesial side of the innominate line. The anterior wall occupied totally the mesial side of the innominate line, and the medial wall occupied the mesial half of the antrum. 2. In all cases of experimental cystic lesion attached to each wall of the antrum, the location of each lesion was able to be determined by applying Tube shift technic. 3. The palatal root and mesiobuccal root of the molar appeared as being transposed each other mesiolaterally on the panoramic and panoramic sinus views. 4. The panoramic sinus view was superior to the panoramic view in revealing the relationship between the floor of the antrum and the periapical lesion.

• 치과방사선
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• 제29권2호
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• pp.549-559
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• 1999

Leiomyosarcoma is extremely rare in the oral cavity and especially in the mandible. At first. the case of this report was diagnosed as odontogenic fibroma but after approximately 3.5 years. it was diagnosed as leiomyosarcoma. Conventional radiograph of the first time showed an ill-defined radiolucent lesion in the mandible. After local recurrence. CT images showed a large irregular soft tissue mass with some necrotic areas. These findings were not specific for leiomyosarcoma, but they suggested that this lesion was a recurrent soft tissue sarcoma. Histopathological examinations using H & E staining, immunohistochemical staining and Masson's trichrome staining confirmed this case as leiomyosarcoma. Deciding its malignancy or benignancy, defining the tumor extent and its relationship to the surrounding anatomic structures, and evaluating the distant metastasis are more important roles of radiographic examination than finding out the name of disease.

• 대한치과교정학회지
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• 제27권3호
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• pp.515-521
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• 1997

하악 좌측 부위 부종을 주소로 내원한 10세 남환이 낭종성 법랑아세포종으로 진단되었다. 외과적 술식으로 조대술을 시행한 후 근심 매복되었던 제1대구치는 helical spring으로 인위적 맹출을 시행한 반면, 심하게 하방 변위되었던 제2소구치는 자연적 맹출을 기대하였다. 비교적 간단한 교정치료와 교합유도에 의해 양호한 영구치 교합이 확립되었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권2호
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• pp.174-177
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• 2001

Glandular odontogenic cyst(GOC) is a rare cyst of odontogenic origin, first described in 1988 by Gardner et al. Three glandular odontogenic cysts are presented which were experienced in the Dept. of Oral and Maxillofacial surgery, Yonsei University. The clinical characteristics, radiologic and histopathologic features, and method of treatment are discussed. One occured in the anterior maxilla, others in the mandible body area. One in the anterior maxilla showed swelling and tenderness, others not. All the lesion presented radiographically unilocular radiolucent lesion. Histopathologically, those were lined by nonkeratinizing stratified squamous epithelium of varying thickness showing plaque-like or spherical thickening. Partially, eosinophilic cuboidal cells lined the intraepithelial microcysts. Also, ciliated cuboidal cells and mucinous cells were observed. The cysts were treated by enucleation.