Purpose : We analyse retrospectively the clinical result of consecutive free flap and osteocutaneous flap transfer in the chronic osteomyelitis, nonunion combined with infection and soft tissue defect with infection. Materials and Methods : From December 1989 to Jun 2003, free flap and osteocutaneous flap transfer was performed in 225 patients with osteomyelitis or infected non-union. 44 cases of these patients had revealed antibitotics resistant organism in wound culture, and these 44 cases were investigated in the mechanism of the injury, recurrence of infection, radiographic union, follow-up clincal results, and postoperative complications. Results : Among the 44 cases, consecutive procedures of osteocutaneous flap transfers(26 cases) and free flaps(18 cases) were performed. Causative organisms were MRSA(20 cases), Pseudomonas aeruginosa(18 cases), acinetobacter(2 cases), and so forth. Initial bony union was obtained in the average 6.3 months. Recurrence of infection in free flap and osteocutaneous free flap were occurred in 3 and 4 cases respectively. Eventually, all the cases attained successful subsidence of the inflammation. Conclusion : Free flap and osteocutaneousflap transfer have provided the greatest improvement of surgical results in infected non-union, chronic osteomyelitis and soft tissue defect with infection. Further clincal studies maybe required to minimize failure rate.
Objective: The aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence. Methods: A survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment. Results: The database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis. Conclusions: These findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.
Immunoglobulin G4 (IgG4)-related disease is a rare systemic fibroinflammatory condition characterized by organomegaly or tumefactive lesions associated with lymphoplasmacytic infiltration rich in IgG4 plasma cells. We report a case of IgG4-related disease involving the subcutaneous layer of the left upper arm in a 48-year-old female presenting with an unusual soft tissue mass. US and MRI showed an irregular infiltrative soft tissue mass, indicating possible malignancy or inflammation. We discuss the diagnostic criteria, histopathologic features, radiological features, and treatment of IgG4-related disease.
Park, Young-Wook;Park, Jung-Min;Jang, Jae-Hyun;Kim, Ji-Hyuck;Kwon, Kwang-Jun;Lee, Suk-Keun
Maxillofacial Plastic and Reconstructive Surgery
/
v.30
no.5
/
pp.465-472
/
2008
We experienced a rare case of oral squamous cell carcinoma arisen from gingival tissues overlying prolonged chronic osteomyelitis of the mandible. A 66 years old man complained of unhealed extraction sockets of left mandibular second premolar and first molar, and showed extensive leukoplakia in the gingival tissues of the same area. The inflammation of the socket granuloma became severe and extended into adjacent mandibular proper, resulted in diffuse suppurative chronic osteomyelitis of mandibular body, exhibiting irregular osteolytic changes of mandibular trabecular patterns in mottled radiolucent appearance. The leukoplakia was initially diagnosed under microscope, and the involved gingival tissues were radically removed. Thereafter, the gingival soft tissue inflammation involving the mandibular osteomyelitis was hardly healed for two years. During the period of repeated surgical treatments for the inflamed lesion, nine biopsies were taken sequentially. Until the eighth biopsy, there consistently showed the suppurative osteomyelitis with ingrowing gingival tissues into the bony inflammatory lesion. The gingival epithelium showed the features of leukoplakia but no evidence of malignant changes. However, the ninth biopsy, taken about 2 years after initial diagnosis, showed the early carcinomatous changes of the gingival epithelium. The neoplastic epithelial cells were relatively well differentiated with many keratin pearls, and infiltrated only into underlying connective tissues. So, we presumed that the present case of squamous cell carcinoma was caused by the persistent inflammatory condition of the mandibular osteomyelitis, and also suggest that the leukoplakia should be carefully removed in the beginning to prevent the neoplatic promotion of the chronic inflammation.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.27
no.1
/
pp.273-281
/
1997
Patient with complaints of swelling, pain in the maxillaly region and discomfort visited Seoul National University Dental Hospital in August last year. Clinical examination and diagnostic imagings implied he was suffered from fungal hyphal infection but no causative fungus was found by the histopathologic and microbiologic investigation. Therefore he was diagnosed with nonspecific inflammation. But as yet, we do think this case is very similar to some kinds of mucormycosis. So we presented this case for more thorough discussion.Followings are founded in the examination. 1. Patient had suffered from Diabetes mellitus and complained of stuffness, headache, swelling in buccal cheeks and paresthesia And we found more maxillary bony destruction and ulcer with elevated margin in the palate by clinical examination. 2. In the first visit, Plain films revealed general bony destruction of the maxilla, radiopaqueness in the sinonasal cavities. or and MRI showed soft tissue mass filled in the paranasal sinus except frontal sinus and bony destruction in involved bones. 3. No causative bacteria and fungus was found in the biopsy and microbiologic cultures. 4. Caldwell-Luc operation and curettage were carried and antJbiotics were taken for 4 months. But now he was worse than in the past 5. In the second visit, involvement of orbit, parapharyngeal sinus, clivus, cavernous sinus and middle cranial fossa were seen clearly in the or and MRI.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.29
no.1
/
pp.223-239
/
1999
Purpose: to evaluate the usefulness of the panoramic radiography, generally used in dental clinic, for the detection of the maxillary sinus pathosis due to the inflammation and tumor, through the comparison with CT findings as the absolute standard. Materials & Methods: 150 maxillary sinuses of 75 patients with or without particular signs and symptoms and showing soft tissue lesions or destruction of maxillary sinus walls in at least one sinus in CT, were selected as subject samples, and the panoramic radiography of the same patients were interpretated by 3 dental radiologists and 3 non dental radiologist given no previous informations. Using the CT findings as the absolute standard, the diagnostic ability of panoraimc radiography in the mucosal thickening, maxillary sinus haziness, inferior wall destruction, medial wall destruction, posterolateral wall destruction and the superior wall destruction was evaluated using the ROC curve and the difference between dental radiologist group and non dental radiologist group was also evaluated. Results: 1. When dental radiologist group interpretated the destruction of inferior wall and posterolateral wall, the kappa value which shows interobserver's coincidence was above 0.75. 2. The diagnostic ability according to site of interpretation was the highest when the inferior wall was interpretated in both observer groups and there was a statistically significant difference between the dental radiologist group and non dental radiologist group in interpretating the mucosal thickening, haziness, destruction of the inferior and medial wall(p<0.05). 3. The diagnostic ability in detecting the destruction of the sinus walls was better than in soft tissue lesions in both groups and between the groups there was a statistically significant difference(p<0.05). Conclusion: When detecting the destruction of inferior and posterolateral wall of the maxillary sinus there was coincident with that of CT findings, and so it is considered that diagnostic ability of panoramic radiography is high in this point. But in interpretating the destruction of medial wall and soft tissue lesions, diagnostic ability of the panoramic radiography was relatively low and there was a significant difference between the dental radiologist group and non dental radiologist group. Therefore CT or other auxiliary diagnostic method will be necessary when evaluating thorough pathosis of maxillary sinus objectively.
Park, Jong-Beom;YIm, Sung-Bin;Chung, Chin-Hyung;Kim, Jong-Yeo
Journal of Periodontal and Implant Science
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v.30
no.1
/
pp.167-180
/
2000
The present study evaluated the effects of guided tissue regeneration using biodegradable membrane, with and without calcium-phosphate thin film coated deproteinated bone powder in beagle dogs. Contralateral fenestration defects(6 × 4 mm) were created 4 mm apical to the buccal alveolar crest on maxillary canine teeth in 5 beagle dogs. Ca-P thin film coated deproteinated bone powder was implanted into one randomly selected fenestration defect(experimental group). Biodegradable membranes were used to provide bilateral GTR. Tissue blocks including defects with overlying membranes and soft tissues were harvested following a four- & eight-week healing interval and prepared for histologic analysis. The results of this study were as follows. 1.......The regeneration of new bone, new periodontal ligament, and new cementum was occurred in experimental group more than control group. 2.......The collapse of biodegradable membranes into defects were showed in control group and the space for regeneration was diminished. In experimental group, the space was maintained without collapse by graft materials. 3........In experimental group, the graft materials were resorbed at 4 weeks after surgery and regeneration of bone surrounding graft materials was occurred at 8 weeks after surgery. 4.......Biodegradable membranes were not resorbed at 4 weeks and partial resorption was occurred at 8 weeks but the framework and the shape of membranes were maintained. No inflammation was showed at resorption. In conclusion, the results of the present study suggest that Ca-P thin film coated deproteinated bone powder has adjunctive effect to GTR in periodontal fenestration defects. Because it has osteoconductive property and prohibit collapse of membrane into defect, can promote regeneration of much new attachment apparatus.
Kim, Myoung-Jin;Kim, Se-Jin;Nam, Won-Hee;Leem, Hyun-Hee;Jeon, Young-Hee;Son, Su-Mi;Kim, Jung-Ok
Herbal Formula Science
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v.28
no.4
/
pp.339-349
/
2020
Objectives : Wiryeong-tang (WRT) is a traditional herbal medicine used to treat kidney-related diseases. However, the anti-inflammatory and anti-gastritis effect of Wiryeong-tang was not well known. Therefore, we experimented to confirmed the anti-inflammatory and anti-gastritis effects of Wiryeong-tang. Methods : The RAW 264.7 cells were pre treated with Wiryeong-tang mix soft extract (WRT-mse; 50, 100 and 200 ㎍/mL) for 1 hrs, and then incubated with lipopolysaccharide (LPS; 500 ng/mL). Cell viability was measured by the MTT method, and nitric oxide (NO) was measured with griess reagent. In addition, pro-inflammatory cytokines were measured by enzyme-linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction (RT-PCR). For anti-gastritis effect in vivo, acute gastritis was induced using 150 mM HCl/60% ethanol used ICR mice. WRT-mse (133 mg/kg) was pre treated for 3 days and then treated with 150 mM HCl/60% ethanol 1 hrs later. Then gastritis was observed and inflammatory cytokines in the gastric tissue was measured. Results : The 8 marker components of the WRT-mse were determined by simultaneous analysis using HPLC. WRT-mse was not toxic and inhibited pro-inflammatory cytokines such as IL-1β, IL-6 and TNF-α at NO production, protein and mRNA levels. Also, it was confirmed that WRT-mse improved bleeding and edema in gastritis, and suppresses inflammatory cytokines. Conclusion : In summary, our results suggest that the treatment of the WRT-mse reduced and improved the 150 mM HCl/60% ethanol induced acute gastritis and the inflammation caused by LPS stimulation in RAW 264.7 cells. Therefore, this study may provide useful drug or clinical evidence for WRT-mse to prevent inflammation.
The term 'myositis ossificans' encompasses four categories of clinicopathological disorders. The first, myositis ossificans progressive(fibrodysplasia ossificans progressive), is a rare genetic disease characterized by progressive heterotopic ossification involving skeletal muscle, tendon, ligaments, and fascia, with congenital malformation of the great toes, and usually microdactyly, monophalangism, and mal formed proximal phalanges. with valgus deformity of metatarsophalangeal joint. The ossification begins shortly after birth and may contribute to the patient's death. The second, heterotopic ossificans, can occur in patients with neuromuscular and chronic diseases such as paraplegia, poliomyelitis, polymyositis, bum, tetanus, and infection. But the lesions in these cases often lack the typical histologic features of myositis ossificans. The third, myositis ossificans traumatica, is the most common; it develops in response to soft tissue trauma such as a single severe injury, minor repetitive injures, fracture, joint dislocation, stab wound, or surgical incision. The forth, nontraumatic myositis ossificans, also designated :pseudomalignant osseous tumors of extraskeletal soft tissues' and 'psedomalignant myositis ossificans', occurs in persons repeated small mechanical injures or nonmechanical soft tissue injuries due to local ischemia, inflammation. or other factors cannot be ruled out in such cases.
We designed the experiments to elucidate the anti-inflammatory effect of low power laser stimulation on acupoint or non-acupoint using arthrogenic solution induced poly arthritis animal model. In order to achieve the experimental purpose, change in body weight paw edema, pathological changes in inflammed pint and the serum interlukin-6 level were measured after arthritis induction in acupoint later stimulated group, non acupoint laser stimulated group and non treated control animal. The results were summerized as follows: 1. The consistent increase in body weight was observed in the normal animal during whole experimental period, while the induction of arthritis significantly suppressed increase in body weight from the 15 day after arthritis induction. Especially, non treated animal group showed more suppressive effect on increase in body weight as compared to that of low power laser stimulated groups (P<0.05). 2. Low power laser stimulation on acupoint (Zusanli) significantly inhibited edema in the left side paw from the 12th day after arthritis induction as compared to that of non treated animals. This suppressive effect on paw edema was maintained until the end of experiment. 3. Laser treatment on acupoint dramatically suppressed the radiological change (i.e. new bone proliferation and soft tissue swelling) caused by arthritis as compared to that of non treated group animals. 4. Low power laser treatment reduced the increase in serum interlukin-6 caused by arthritis induction to levels observed in the normal animals. In conclusion, the results of the present study demonstrated that low power laser stimulation on acupoint has potent anti-inflammatory effect on arthritis. Thus it is recommended that low power laser be used for long term treatment of arthritis induced inflammation. However, further study is necessary to clarify the possible side effect of laser treatment depending upon intensity and duration of stimulation.
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