Park, Su-Hyun;Song, Young Woo;Jung, Ui-Won;Choi, Seong-Ho;Cha, Jae-Kook
Journal of Korean Dental Science
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v.13
no.1
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pp.35-41
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2020
Irritation fibroma is a reactive hyperplastic lesion caused by chronic stimuli with low intensity in the oral cavity. Irritation fibroma is common in middle-aged females but it may also occur at any age and sex. Clinical characteristics of irritation fibroma are similar to other reactive lesions or benign tumors, therefore, histological examination is essential to make an accurate diagnosis. This case report presents two cases of irritation fibroma occurred on the gingiva in young males. Two male patients in their 20s and 30s of age visited the clinic for the evaluation and treatment of painless gingival overgrowth in the anterior region. Clinically, the lesions were well-defined and firm, with similar color and texture to the adjacent normal gingiva. Excisional biopsy under local anesthesia was conducted with a scalpel, and the lesions were completely removed. Histopathologically, connective tissue consisting of dense collagen bundles, proliferation of fibroblasts and minor infiltrated inflammatory cells were observed. Based on the clinical and histopathological findings, the diagnosis of irritation fibroma was confirmed in both cases.
Arthrocentesis is a simple, less invasive, inexpensive, and highly efficient procedure for closed lock of the temporomandibular joint with regard to the lack of recurrence of symptoms during extended periods of follow-up and significiant improvement in pain and jaw function. It can be performed under local anesthesia. Arthrocentesis closed lock provide sustained normal joint function and marked pain relief. This study is the clinical outcome of arthrocentesis for closed lock of the temporomandibular joint. 160 patients(169 joints) who had experienced sudden-onset, persistent limited mouth opening were the subjects of this study. Arthrocentesis of the upper compartment of the affected TMJ was performed using normal saline. As results, at 3-60 months postarthrocentesis maximum mouth opening(MMO) had increased from mean of 27.7mm to 43.5mm, contralateral movements(CLM) from mean 5.74mm to 9.55mm, midline deviation during mouth opening from mean 3.04mm to 0.69mm. In 130 cases there was a history of joint noises, in 52 cases all noise had ceased after procedures.
Stereotactic radiofrequency dorsal root ganglionotomy can be very useful procedures for the treatment of pain emanating from the lumbar segmental nerves. This procedure is reserved for patients who have failed conservative interventional treatments and in whom open surgical intervention is not an option. The advantages of the radiofrequency lesion method are presented, excellent control of the lesion process using temperature monitoring to quantify the lesion size, prevent boiling, and to produce differential destruction of neural tissue. The afferent fibers in the ventral root which are spared by dorsal rhizotomy but nerve fibers with their cells in the ganglion from either dorsal or ventral root can be destructed with stereotactic radiofrequency ganglionotomy. This technique is performed using a 100 mm cannula with a 5 mm active tip. Repeated lateral fluoroscopic view should be taken to make sure that cannlua still resides within the superior, dorsal quadrant or the foramen. With the cannula in this position, electrostimulation is performed and good paresthesia on the leg should be noted with 0.3 and 0.5 volt at 50 Hz stimulation. At 2Hz stimulation distinct dissociation between motor and sensory should be shown. Percutaneous lumbar ganglionotomy have carried out under local anesthesia on inpatient basis in 6 patients. A series of 5 patients with metastatic cancer pain and a patient with compression fracture have been relieved of pain without serious complications.
Journal of the korean academy of Pediatric Dentistry
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v.29
no.3
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pp.455-462
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2002
Currently, the ages of the patients visiting dental hospital for dental care are becoming younger and the interest in the treatment for the handicapped and incapable of cooperation children increases. As a method for treatment of these patients, the sedation treatment is considered. A dental sedation using chloral hydrate and hydroxyzine of them were used widely and for a long time. In this study, the samples were consisted of incapable of cooperation or very young children required treatment of restoration under local anesthesia. Then, the vital signs were accessed in pediatric dental sedation using the combination of chloral hydrate and hydroxyzine. As a result of this study, the vital signs were little different in pediatric dental sedation using the combination of chloral hydrate and hydroxyzine. Simply, the respiration rate and pulse rate decreased according to sleeping of patients. Therefore, the sedation using the combination of chloral hydrate and hydroxyzine induced to appropriate sedation in incapable of cooperation or very young children with little effects of vital signs.
Background: Evidence has accumulated that opioids can produce potent antinociceptive effects by interacting with opioid receptors in peripheral tissues. Bupivacaine has a potent analgesic effect with early peak onset in the postoperative period. The combination of intrapelvic bupivacaine and morphine has been suggested as an ideal analgesic after endoscopic pelvic surgery. Methods: Sixty patients scheduled for endoscopic pelvic surgery under general anesthesia were allocated randomly to three groups. Group 1 received normal saline 20 ml, group 2 received morphine 5 mg in normal saline 20 ml, and group 3 received morphine 5 mg in 0.25% bupivacaine 20 ml into the pelvic cavity. Postoperative pain was assessed using the visual analogue scale at 1, 2, 4, 8, and 24 hours after the intrapelvic instillation. Supplemental analgesic requirements, vital signs, and side effects were recorded for 24 hours. Results: Intrapelvic morphine and bupivacaine produced significant analgesia after endoscopic pelvic surgery. The patients in group 3 had lower pain scores than those in the group 1 and 2 at 1, 2 and 4th hours. There were no significant differences in the pain scores at 8 hours and 24 hours postoperatively between group 2 and 3. Supplemental analgesic requirements were significantly greater in the groups 1 and 2 than the group 3 for 24 hours. No significant side effects occurred. Conclusion: The intrapelvic instillation of morphine and bupivacaine is effective for the postoperative pain control in patients undergoing endoscopic pelvic surgery.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.30
no.6
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pp.516-525
/
2004
Mandibular symphyseal distraction osteogenesis is an alternative approach for correcting mandibular transverse deficiencies and dental crowding. The traditional approaches for these are extraction of teeth and arch expansion with traditional orthodontic treatment. Also extractions are usually unavoidable in patients with severe crowding. The purpose of this study is to evaluate the effect of mandibular symphyseal distraction osteogenesis by use of tooth-borne expansion appliance. All of 12 patients had been performed distraction osteogenesis. The surgical procedures were accomplished under local anesthesia and intravenous sedation in an ambulatory surgical setting using a routine distraction protocol. The latency period was 5 days or 7 days after symphyseal osteotomies. The rate & rhyth is a intermittent, 0.75mm or 1.0 mm per day and stabilized for 6, 8 weeks after distraction. The time of orthodontic tooth movement after distraction was variable from 2 weeks to 8 weeks (mean 3 weeks). All patients had been evaluated with study casts, plain periapical films, panorama radiograms before & after surgery. Mandibular symphyseal distraction osteogenesis increased mandibular arch width and corrected dental crowding, with paralleling tooth-borne movement, without proclination of the mandibular incisors.
Purpose: Ingrown toenails are a common disease in the adolescent period and the treatments could be more conservative for this early stage of the disease. This study is a case series on the results of a gutter splint for an adolescent ingrown toe nail as a simple, comfortable treatment method. Materials and Methods: From 2011 to 2018, 22 patients (mean age, 12.2 years; range, 8~15 years) with ingrown toenails were treated with a gutter splint. There were 16 boys and 6 girls with 7 patients on both great toes, and additional 4 both corners of a nail, giving a total of 33 splints. Flat, plastic straws and glue or suture were used to protect the nail corners under local anesthesia. The medical records were reviewed retrospectively and phone calls were made to obtain the long-term results. Results: Fifteen splints were fixed with a suture and the other 18 splints were fixed with glue. There were 9 cases of recurrence out of 33 gutter splints, 8 out of 15 sutured splints and 1 out of 18 glued splints (p=0.010). There was no gender (p=0.383) or age (p=0.305) difference in the number of recurrences. Conclusion: For growing people, ingrown nails can be cured easily by conservative treatment for a transiently shortened or broken toenail. The glued gutter splint had a reasonable success rate as a first line treatment.
All patients who underwent video-assisted thoracic surgery (VATS) for diagnostic purposes from Jan. 1992 to Aug. 1995 were reviewed. The total number of patients were 111 with 57 male and 54 female, and the mean age was 49 years (range 1 to 74). Multiple biopsies from more than one location were performed in 17 patients , pleural biopsies were performed In 49 patients, lung biopsies in 43 patients, mediastinal mass or Iymph node biopsies in 33 patients, and two pericardium biopsies and one dia- phragm biopsy, for a total of 128 biopsies. Seventeen pleural biopsy cases and one lung biopsy case underwent operation under local anesthesia , the rest were performed under general anesthesia. In patients who underwent lung biopsy, the mean age was 49.1 ye rs (range 22~ 73). The operating time was 40 to 170 minutes (mean 97), intravenous or intramuscular injection for pain control was required 0 to 22 times(mean 4.7), and chest tube was inserted from 1 to 26 days(mean 7). In all patients except two, a diagnosis was obtained from the biopsy and complication was encountered in one patient in whom intraoperative paroxysmal atrial tachycardia was detected. In 7 patients, a thorn- cotomy had to be done due to pleural adhesion or intraoperative bleeding, and 7 patients had postoperative complications associated with the chest tube. In the pleural biopsy group, the mean age was 49 years (range 17~ 74). The operating time was 25 to 80 minutes (mean 49), intravenous or intramuscular injection for pain control was needed 0 to 20 times (mean 3.6), and the chest tube was i.nserted for 0 to 67 days(mean 9.8). In all the patients, a diagnosis was possible. The chest tube was inserted for longer than 7 days in 11 patients. In the Iymph node biopsy roup, the mean age was 44.2 years (range 1 ~ 68). The operating time was )0 to 3)5 minutes(mean 105), pain control was required 0 to 15 times(mean 3.2), and a chest tube was kept in place for 1 to 36 days(mean 6.1). In one patient, a diagnosis was not possible and a chest tube was kept in place for longer than 7 days in 7 patients. In the multiple biopsy group, the mean age was 53.1 years(range 20~ 71). The operating time was 15 to 165 minutes(mean 85), and pain control was done from 0 to 17 times(mean 3.1). The chest tube was kept in place for 1 to 16 days (mean 7.9).
Most dentists are very interested in laser therapy on the intraoral soft tissue lesions because they want to accomplish the analgesic and aseptic surgery with little or no bleeding. In order to determine the difference of pain threshold according to different gingival tissues with or without inflammation, 25 patients with inflammatory periodontal disease and 10 volunteers with good general and oral health were selected as the inflamed group and the normal group, respectively. Interdental papilla, marginal gingiva, attached gingiva, and alveolar mucosa were irradiated by the contact delivery($300{\mu]m$ fiber optic, for 5 seconds) of a pulsed Nd:YAG laser(EN.EL.EN06O, Italy). And the laser power was gradually increased from 0.5W by the increment of 0.1W. The highest laser power was recorded as the first painful power when the painful gesture was recognized at first. The difference of the first painful power of laser according to different gingival tissues with or without inflammation was statistically analyzed by paired t-test in MICROSTAT program. Following results were obtained: 1. In the comparison related with the inflammation, the first painful power was significantly lower in the inflamed group than in the normal group, regardless of interdental papilla and marginal gingiva(p<0.05). 2. In the comparison related with the tissue structure, the first painful. power was significantly lower in alveolar mucosa than in attached gingiva(p<0.05). The results suggest that, for the painless therapy by a pulsed-Nd:YAG laser irradiation, the laser surgery over 2.0W of power should be necessarily accomplished under the local anethesia, and the local anesthesia should be considered according to the degree of inflammation, the tissue structure, and the purpose of laser therapy.
Kim, Sin Young;Jun, Young Joon;Kim, Young Jin;Seo, Byung Chul
Archives of Craniofacial Surgery
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v.12
no.1
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pp.63-66
/
2011
Purpose: Cranial fasciitis is a rare type of benign tumor that occurs mostly in children younger than 6 years. It arises from the deep fascia, periosteum, or fibromembranous layer that covers fontanelles. The etiology is unknown, although prior trauma has been postulated to be an underlying cause. There is a 2:1 male predominance. Despite its rapid growth, this tumor has a benign clinical course and can be cured by total excision. Methods: A 16-year-old male presented with a 3 cm-sized palpable mass in the left lateral eyebrow region that he first noticed 4 months before presentation. The mass had grown rapidly since it was first noticed. Preoperative brain computed tomography showed a well-demarcated mass approximately 3 cm in size extending from the subcutaneous layer to the periosteum. Preoperatively, the presumed diagnosis was a dermoid cyst. An operation was performed with the patient under general anesthesia. The subcutaneous mass was completely excised by periosteal dissection. Results: Histological diagnosis revealed the presence of cranial fasciitis. After 20 months of follow-up, there have been neither complications nor evidence of local recurrence besed on clinical examination. Conclusion: Although cranial fasciitis is quite rare, it should be considered in the differential diagnosis for lytic skull lesions in patient whose clinical presentation suggests this possibility. This condition could be occasionally mistaken for malignant or locally aggressive lesions. To prevent local recurrence, curettage of the underlying bone is recommended for patients with bone involvement.
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