• Imaging Science in Dentistry
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• 제35권4호
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• pp.215-219
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• 2005

Hepatocellular carcinoma is one of the most common cancer worldwide, primarily affecting those in regions with a high prevalence of viral hepatitis. However, the metastasis of hepatocellular carcinoma to the oral cavity is a rare phenomenon. This report presents a case of metastatic hepatocellular carcinoma in the left mandibular angle and ramus region of a 62-year-old man. Panoramic radiograph revealed an ill-defined radiolucent lesion extending from the retained root of the mandibular left second molar into the ascending ramus. The lesion had irregular and ill-defined margins.

• 대한치과의사협회지
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• 제17권1호통권116호
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• pp.29-34
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• 1979

• 치과방사선
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• 제29권1호
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• pp.357-365
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• 1999

Desmoplastic fibroma is a rare. benign intraosseous fibroblastic tumor. which is locally aggressive. It is osseous counterpart of soft tissue fibromatosis. The authors experienced the patient who complained persistent mouth opening limitation with mild swelling on the left mandibular angle area. After careful analysis of clinical. radiological and histopathological findings. we diagnosed as desmoplastic fibroma of the mandible. The results were as follows: 1. Main clinical symptoms were mouth opening limitation which had been persistent for 9 months and mild swelling on the left mandibular angle area. 2. Radiographs showed the radiolucent lesion and expansion of lingual cortex. CT finding is homogeneous soft tissue mass with expansion of left mandibular ramus. Destruction of medial wall of ramus and invasion to adjacent soft tissue is also seen. 3. Histopathologically, plump spindle shaped fibroblasts arranged in bundles or fascicles are observed. The cells of tumor are infiltrating into muscle fiber with destruction of bony trabeculae and merged with surrounding salivary gland.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권5호
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• pp.271-275
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• 2012

Objectives: This study evaluated a range of fixation methods to determine which is best for the postoperative stabilization of a mandibular osteotomy using three-dimensional finite element analysis of the stress distribution on the plate, screw and surrounding bone and displacement of the lower incisors. Materials and Methods: The model was generated using the synthetic skull scan data, and the surface model was changed to a solid model using software. Bilateral sagittal split ramus osteotomy was performed using the program, and 8 different types of fixation methods were evaluated. A vertical load of 10 N was applied to the occlusal surface of the first molar. Results: In the case of bicortical screws, von-Mises stress on the screws and screw hole and deflection of the lower central incisor were minimal in type 2 (inverted L pattern with 3 bicortical repositioning screws). In the case of plates, von-Mises stress was minimal in type 8 (fixation 5 mm above the inferior border of the mandible with 1 metal plate and 4 monocortical screws), and deflection of the lower central incisor was minimal in types 6 (fixation 5 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws) and 7 (fixation 12 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws). Conclusion: Types 2 and 6 fixation methods provide better stability than the others.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권3호
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• pp.133-138
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• 2015

Objectives: To evaluate the influence of the type of osteotomy in the inferior aspect of the mandible on the mechanical performance. Materials and Methods: The study was performed on 20 polyurethane hemimandibles. A sagittal split ramus osteotomy (SSRO) was designed in 10 hemimandibles (group 1) with a vertical osteotomy in the buccal side (second molar level) and final osteotomy was performed horizontally on the lingual aspect, while the mandible body osteotomy was finalized as a straight osteotomy in the basilar area, perpendicular to the body. For group 2, the same osteotomy technique was used, but an oblique osteotomy was done in the basilar aspect of the mandibular body, forming continuity with the sagittal cut in the basilar area. Using a surgical guide, osteosynthesis was performed with bicortical screws using an inverted L scheme. In both groups vertical compression tests were performed with a linear load of 1 mm/min on the central fossa of the first molar and tests were done with models made from photoelastic resin. Data were analyzed using Student's t-test, establishing a statistical significance when P<0.05. Results: A statistical difference was not observed in the maximum displacements obtained in the two osteotomies (P<0.05). In the extensiometric analysis, statistically significant differences were identified only in the middle screw of the fixation. The photoelastic resin models showed force dissipation towards the inferior aspect of the mandible in both SSRO models. Conclusion: We found that osteotomy of the inferior aspect did not influence the mechanical performance for osteosynthesis with an inverted L system.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권3호
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• pp.246-250
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• 2004

Uni- or bilateral mandibular hypoplasia can be associated with various syndromes or is acquired after early traumatic or inflammatory disease in the temporomandibular joint(TMJ). Early treatment is necessary to avoid consequent impairment of midfacial growth. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth, but the new procedure of bone lengthening which was presented by McCarthy et al. represents a limited surgical intervention and therefore open up a new perspective of treatment, especially in younger children with severe deformities. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, a tilted occlusal plane, and a short mandible. A 14-years-old boy with facial asymmetry, who was fractured on both condyle and mandibular symphysis before 8 years ago, was treated by mandibular ramus lengthening, symphysial widening and surgically assisted rapid palatal expansion with corticotomy. After allowing 1 week for the healing of the periosteum, the distraction was performed at the rate of 0.5-1.0mm per day for 7 days on maxilla and 14 days on mandible. The device was maintained on maxilla and mandible for 12 weeks following distraction. The difference in ramus and mandibular transverse deficiency were corrected and facial asymmetry was improved with complex distraction osteogenesis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권5호
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• pp.408-413
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• 2009

Odontogenic keratocyst (OKC) is a epithelial developmental cyst which were first described by Phillipsen in 1956. The frequency of OKC has been reported to vary from 3% to 11% of odontogenic cysts. The most characteristic clinical aspect of OKC is the high frequency of recurrence. The mechanism of recurrence is thought to be related to residues of cyst epithelium and an intrinsic growth potential following excision. And since the lining of the OKC is thin and friable, removal of the cyst in one piece may sometimes be difficult. Complete removal of the cyst lining without leaving behind remnants attached to the soft tissue or bone is necessary to avoid recurrence. Therapeutic approaches vary in different studies from marsupialization and enucleation, which may be combined with adjuvant therapy such as cryotherapy or Carnoy's solution, to marginal or radical resection. The recurrent rate varies from approximately 20% to 62%. And OKC in the angle-ramus region of the mandible had a higher tendency to recur, because of the difficulty in accessing and removing OKC from the ramus. By employing a sagittal splitting of the mandible a good surgical access was provided and cyst could be removed completely. We present an illustrative case of a small, lobulated OKC that involved ramus on mandible, and a review of the contemporary literature.

• Journal of Oral Medicine and Pain
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• 제24권2호
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• pp.171-179
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• 1999

최근 저자들은 좌측 안검하수, 안면마비, 좌측 협궁부의 부종 및 안모비대칭을 호소하는 49세 한국 여성 환자로부터, 임상적으로 우측 하악지 부위에서의 융기성 경결성 병소를 발견하고, 이에 대한 진단 및 감별진단을 위해 (1) 문진상 직장 선암(直腸 腺癌)에 대한 과거 수술병력 소견, (2) 두부 전산화단층촬영사진상 우측 하악지 전내방에서의 비교적 균질한 괴(塊)의 존재와 이것에 의한 우측 하악지 내측 피질골의 파괴, 또한 경사대(傾斜臺)를 중심으로 뇌실질 조직에 비해 약간 고밀도를 보이는 불규칙한 괴(塊)의 존재와 이것에 의한 접형동(蝶形洞)과 주변 골 및 좌측 상악골의 파괴, 그리고 전신 골스캔상 비강 부위와 좌측 상악골 부위에서의 hot spot의 존재, 그리고 후전방 흉부 일반방사선촬영사진상 전폐야에 걸친 다양한 크기의 수 많은 결절의 산재를 나타낸 영상화 검사 소견, (3) 과거 전신병력 추적 소견상 간 우엽에서의 중심부에 hyperechoic focus를 가진 과녁 모양의 경계가 양호한 괴(塊)의 존재를 나타낸 간부위 초음파 검사 소견을 채득한 후 이들 자료를 종합, 분석, 평가한 결과, 과거 전신병력상의 원발성 직장 선암의 원격 전이에 의해 발생된 것으로 판단되었으며, 또한 영상화 검사에서 관찰된 우측 하악지 내측 피질골의 파괴상 및 좌측 상악골의 파괴상 역시 원발성 직장 선암의 원격 전이에 의해 발생된 것으로 판단되었다.

• 대한소아치과학회지
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• 제38권4호
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• pp.368-375
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• 2011

본 연구는 소아에서의 성공적인 하치조신경 전달 마취를 위한 정보를 얻기 위해 파노라마 방사선 사진에서 한국인 소아의 하악공 위치를 분석하였다. 총 240명의 7-15세의 파노라마 방사선 사진을 수집하여, 연령에 따라 7-8세, 9-10세, 11-12세, 13-15세의 하위 그룹으로 나누었으며 각 그룹은 남녀 각 30명씩을 포함하였다. 좌우측의 하악공으로부터 하악절흔, 악각전절흔, 하악지 전연, 하악지 후연까지의 최단거리와 교합평면까지의 수직거리를 측정하였으며, 하악공으로부터 하악절흔과 악각전절흔의 거리의 비와 하악공으로부터 하악지 전연과 하악지 후연의 비를 계산하였다. 연구 결과는 다음과 같다. 1) 하악공의 하악지 내 상대적 위치는 남녀 모두에서 연령 증가에 따라 전방으로 이동하는 경향이 관찰되나, 수직적인 위치는 연령과 유의한 상관관계를 보이지 않았다. 2) 하악공의 교합평면과의 상대적인 위치는 연령 증가에 따라 교합평면 하방에서 상방으로 이동하였으며, 연령과 높은 상관관계를 나타내었다(p<0.05). 3) 여자보다 남자에서 하악공이 교합평면을 기준으로 더 상방에, 하악지 내 전후방 및 수직적으로는 하악지의 후상방에 위치하여 성별에 따른 차이를 보였다(p<0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권5호
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• pp.359-367
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• 2004

Purpose: After the surgical correction with sagittal split ramus osteotomy, the position of the mandibular condyle in the glenoid fossa and the proximal segment of the mandible change because of bony gap between proximal and distal segment, especially in case of mandibular setback asymmetrically. In this study, positional changes in the condyle and proximal segment after BSSRO were estimated in the mandibular asymmetry patient by analyzing the in submentovertex view and P-A cephalogram for identification of ideal condylar position during surgery. Patients and Methods: The 20 patients were selected randomly who visit Dankook Dental Hospital for mandibular asymmetry. Bilateral sagittal split ramus osteotomy with rigid fixation was performed and P-A cephalogram and submentovertex view was taken at the time of preoperative, immediate postoperative, 3 month postoperative period. Results: Intercondylar length and transverse condylar angle was increased due to inward rotation of proximal segment and anteromedial rotation of lateral pole of condyle head. The condylar position had a tendency to return to the preoperative state and after 3 months return up to about half of the immediate post-operative changes, and all the results showed more changes in asymmetry patient and deviated part of the mandible. Conclusion: Based on all these results above, surgeon should make efforts to have a precise preoperative analysis and to have a ideal condylar position during rigid fixation after BSSRO.