Journal of the korean academy of Pediatric Dentistry
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v.38
no.3
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pp.296-302
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2011
Idiopathic gingival fibromatosisrarely occurs, but frequently recurred after surgical removal. It usually occurs in generalized symmetrical pattern but sometimes in localized unilateral pattern. The localized pattern usually affects the maxillary molar and tuberosity area. This disease usually causes tooth migration, malocclusion, and problems in eating, speech, and esthetics. A boy showed dense gingival fibromatosis localized at primary maxillary right lateral incisor area at the age of 5 years, and his maxillary right lateral incisor become severely displaced at the age of 9 years. He had no medical and hereditary factors relevant to the gingival fibromatosis. However, the dense fibrous tissue was dominant in his labial gingiva of maxillary right incisors. In order to realign the displaced incisors by orthodontic treatment, the dense fibrous tissue covered the defect space between the central incisor and the displaced lateral incisor was surgically removed. The removed specimen was examined by simple immunohistochemical(IHC) array method. IHC array showed increased expression of CTGF, HSP-70, MMP-1, PCNA, CMG2, and TNF-${\alpha}$ in keratinocytes, fibroblasts, endothelial cells, and macrophages of gingival fibromatosis tissue. Therefore, it was suggested that the gingival fibromatosis be caused by the concomitant overexpression of CTGF, HSP-70, MMP-1, PCNA, CMG2, and TNF-${\alpha}$, and resulted in the fibroepithelial proliferation and the inflammatory reaction of gingival tissue.
To study the mechanical behavior depended on the restoration method and alveolar bone height at endodontically treated teeth. a finite element model was made which was applied by four types of restoration methods and alveolar bone height on upper central incisor and then 1 Kg force was applied on each model as follows; 1) $45^{\circ}$ diagonal load on incisal edge. 2) $26^{\circ}$ diagonal load on lingual surface. and 3) horizontal load on labial surface. The author analyzed the displacement and stress of teeth and their supporting tissue by finite element method according to three type of loading conditions. The results were as follows : 1. The displacement by restoration method and the stress in dentin was found greater in restoration without a post than in that with a post. 2. The displacement and stress was found about the same when compared : A) in Resin model and PFM model applied by restoration method without a post and B) in PRC model and CPC model applied by restoration method with a post. 3. The lower alveolar bone height was. the greater was the displacement and stress. 4. The lower alveolar bone height was. the greater slightly was the stress of restoration without a post than in that with a post. 5. The stress in loading condition was the greatest in P1 in dentin and post. and was greatest in P3 in alveolar hone. 6. In the restoration method without a post. stress concentration in labial dentin was distributed to a figure of long belt in adjacent part to periodontal ligament. while in restoration method with a post. it was distributed in adjacent part to post side. And in all types of restoration method stress concentration in alveolar bone was distributed along the compact bone of labial and lingual surface.
Suhk, Jeong Hoon;Ji, So Young;Kim, Tae Bum;Yang, Wan Suk
Archives of Craniofacial Surgery
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v.9
no.2
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pp.55-61
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2008
Purpose: The purpose of this study is to evaluate the effectiveness of internal fixation method of $Medpor^{(R)}$ implant with $BioSorb^{TM}FX$ screw which is used for prevention of enophthalmos in posteriorly extended large orbital floor fracture. Methods: From Jun. 1997 to Dec. 2007, 21 patients who were diagnosed with posteriorly extended large orbital floor fractures were classified into two groups. One group(n=11) had undergone reduction surgery with regular $Medpor^{(R)}$ sheets without any fixation method, while the other group(n=10) had their $Medpor^{(R)}$ sheets fixed with the $BioSorb^{TM}FX$ screws. The two groups were evaluated by comparison of their enophthalmos degree and effectiveness. Results: In the non-fixation group, six patients had enophthalmos preoperatively and three of them showed persistent enophthalmos postoperatively. In postoperative CT examination, displacement of $Medpor^{(R)}$ implant with soft tissue impaction into maxillary sinus was observed in the patients. In the screw fixation group, three patients had enophthalmos preoperatively, but none of them suffer from complication such as residual enophthalmos, soft tissue impaction, muscle entrapment or optic nerve compression postoperatively. Conclusion: Internal fixation method of $Medpor^{(R)}$ implant with $BioSorb^{TM}FX$ screw on the medial surface of orbital floor provides firm stabilization of implants and surrounding soft tissues and can be an effective option especially when postoperative implant displacement or malposition was expected.
Kim, Nam-Woo;Lee, Gung-Chol;Moon, Cheol-Hyun;Bae, Jung-Yoon;Kim, Ji-Yeon
The Journal of Korean Academy of Prosthodontics
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v.54
no.1
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pp.1-7
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2016
Purpose: The aim of this study was to evaluate the effect of increased vertical dimension of occlusion on lower facial changes by facial type. Materials and methods: Lateral cephalograms from 261 patients were obtained and classified by sagittal (Class I, II, and III) and vertical (hypodivergent, normodivergent, and hyperdivergent) facial patterns. Retrusive displacement of soft tissue Pogonion and downward displacement of soft tissue Menton were measured in each group after 2 mm of vertical dimension of occlusion was increased at the lower central incisor using a virtual simulation program. The ratio of both displacements was calculated in all groups. The statistical analysis was done by 2-way ANOVA and Post hoc was done by Tukey test (5% level of significance). Results: Retrusive displacement of soft tissue Pogonion in Class III group was statistically different compared to Class I and II, and in vertical facial groups all 3 groups were significantly different (P<.05). Downward displacement of soft tissue Menton showed statistically significant difference between all sagittal groups and vertical groups (P<.05). The ratio of both displacements showed statistically significant difference in all sagittal groups and vertical groups (P<.05), and Class II hyperdivergent group had the highest value. Conclusion: Lower facial change was statically significant according to the facial type when vertical dimension of occlusion increased. Class II hyperdivergent facial type showed the highest ratio after increase in vertical dimension of occlusion.
Kim, Jong-Yun;Lim, Jae-Hyung;Park, Kwang-Ho;Kim, Hyung-Gon;Huh, Jong-Ki
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.35
no.6
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pp.403-410
/
2009
Those composing temporomandibular joint (TMJ) complex such as the temporal bone, the disc and the mandibular condyle perform their own functions with organic relation. The retrodiscal tissue is the main area of pain induction and contributes to compositional change of synovial fluid. If displacement of the disc lasts long time, not only adaptive changes, but also destructive or degenerative changes may happen. It was reported that these changes and symptoms appear mostly to female rather than male and especially, in the case of patients suffering from TMJ disorder, a large quantity of female sex hormone is found in the joint synovium. And that may play a role in bone resorption and inflammation. Also, the frequency and the intensity of pain perception for female is reported to be much more than for male. In this study, we investigated the expression extents of estrogen receptors (ER) and progesteron receptors (PR) in retrodiscal tissue with immunohistochemistry among the patients received TMJ surgery and compared with MRI findings and surgical findings. We report the relations between the expression of ER in retrodiscal tissue and the pathological change in TMJ, such as inflammation, internal derangement and osteoarthritis.
Lee, Myung Chul;Lew, Dae Hyun;Park, Beyoung Yun;Kwon, Soon Man
Archives of Plastic Surgery
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v.36
no.4
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pp.445-449
/
2009
Purpose: A successful surgical treatment for a wide alveolar cleft with bone graft is difficult to achieve due to several factors such as the limitation of gingivoperiosteal flap, the presence of large scar tissues, and the poor blood circulation. To overcome these problems, alveolar distraction osteogenesis using Liou alveolar distraction device was applied. We analyzed the consequences of this surgical treatment. Method: Between 2006 January and 2007 August, we have conducted analysis on the methods and consequences of Liou alveolar distraction osteogenesis for 6 patients. The age of patients was 12 years and 6 months in average. The follow up period was 19 months in average. The Reverse L osteotomy followed by the placement of the Liou alveolar distraction device was performed. After serial distraction, the distractor was removed after 5 months of the process of osteogenesis, and the result was analyzed using the computed tomography and the x-ray films of the alveolar bone and the teeth. Results: The alveolar cleft with 12.5 mm in average width was filled with 8.5 mm of newly formed bone tissue in average width after 5 months of osteogenesis. Among the 6 cases, 5 required the additional bone graft and 1 case only required the gingivoperioplasty. The newly formed bone tissues did not show any signs of bone resorption. However, a considerable degree of teeth displacement was shown. Conclusion: For the alveolar cleft too wide to be reconstructed by a general bone graft, it is strongly recommended to perform the reverse L osteotomy of the cleft side with Liou alveolar distraction device to initiate the alveolar osteogenesis. However, the migrated teeth showed some degree of relapse, thus, the orthodontic treatment is essential following the distraction osteogenesis treatment.
Purpose : The purpose of this study was to verify the usefulness and feasibility of ultrasonographic imaging for the detection of the disorders of the surrounding supporting structure such as articular capsule, retrodiscal tissue and related ligaments, osteoarthritic evidence and associated disc displacement at the temporomandibular joint(TMJ) Materials and Methods : 20 patients(40 joints) with periodic lock and crepitations were investigated prospectively using 12 MHz array transducer. Ultrasonographic Imagings were assessed for osteoarthritic surface changes of condyle, extent of disc displacement and disorders of surrounding structures. Ultrasonographic images were compared with clinical investigations, conventional radiography and Dental Computed Tomographic scans. Results : In clinical and conventional radiography, osteoarthritic changes were diagnosed in 8 joints. Ultrasonographically 7 of the 8 osteoarthritic changes were diagnosed correctly. Sensitivity, specificity, and accuracy of ultrasonography in the osteoarthritic detections were 87.5%, 62.5%, and 67.5% respectively. About the detection of disc displacement, disc displacement were diagnosed in 21 joints clinically. Ultrasonographically 19 of the 21 disc displacements were diagnosed correctly. Sensitivity, specificity, and accuracy of ultrasonography in the osteoarthritic detections were 95%, 90%, and 92.5% respectively. when the disorders of supportive structure were figured out, the disorders of supportive structure were diagnosed in 18 joints clinically. Ultrasonographically 1 of the 18 the disorders of supportive structure were diagnosed correctly. Sensitivity, specificity, and accuracy of ultrasonography in the osteoarthritic detections were 5.5%, 4.5%, and 55% respectively. Conclusion : Ultrasonography is an relatively reliable diagnostic tool for the detection of disc displacement and some of osteoarthritic changes. But it's not an insufficient imaging technique for the detection of the disorders of the surrounding structure.
Orthodontic tooth movement is closely related to the stress on the periodontal tissue. In this research the finite element method was used to observe the stress distribution and to find the best condition for effective tooth movement in the case of unilateral molar expansion. The author constructed the model of lower dental arch of average Korean adult and used $.032'\times.032'\times60mm$ TMA wire. The wire was deflected in the horizontal and vertical direction to give the 16 conditions. The following results were obtained ; 1. When the moment and force were controlled properly the movement of anchor tooth was minimized and the movement of moving tooth was maximized. 2. As the initial horizontal deflection increased the buccal displacement of both teeth was also increased. As the initial horizontal deflection increased the lingual movement of anchor tooth and the buccal movement of moving tooth increased. 3. When the initial horizontal and vertical deflection rate was 1.5 the effective movement of moving tooth was observed with minimal displacement of anchor tooth.
Since the olecranon fractures are caused by relatively low-energy injuries, such as a fall from standing height, they are usually found without comminution. Less commonly they can be developed by high-energy injuries and have severe concomitant comminution or injuries to surrounding structures of the elbow. Because the fracture by nature is intra-articular with the exception of some avulsion-type fracture, a majority of olecranon fractures are usually indicated for surgical treatment. Even if there is minimal displacement, surgical treatment is recommended because there is a possibility of further displacement by the traction force of triceps tendon. The most common type of olecranon fracture is displaced, simple non-comminuted fracture (that is, Mayo type IIA fractures). Although tension band wiring was the most widespread treatment method for these fractures previously, there is some trends toward fixation using locking plates. Primary goal of the surgery is to restore a congruent joint and extensor mechanisms by accurate reduction and stable fixation so that range of motion exercises can be performed. The literature has shown that good clinical outcomes are achieved irrespective of surgical fixation technique. However, since the soft tissue envelope around the elbow is poor and the implants are located at the subcutaneous layer, implant irritation is still the most common complication associated with surgical treatment.
Lim, Joonbum;Hinchy, Nicole;Odingo, Nora;Colosi, Dan;Mahdian, Mina
Imaging Science in Dentistry
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v.51
no.4
/
pp.455-460
/
2021
This report presents a rare case of maxillary osteoblastoma in a 17-year-old female. The patient presented with dull pain and facial asymmetry inferior to the left zygoma. An intraoral examination found a painless swelling on the buccal gingival tissue in the left posterior maxilla. Panoramic radiographs and multidetector computed tomographic images revealed an ill-defined, non-corticated, mixed attenuating entity of osseous density located within the left posterior maxilla apical to the left maxillary molars. The entity exhibited a heterogeneous internal structure with a fine granular appearance, and the periphery showed a partial hypo-attenuating rim along the antero-medial aspect. Expansion of the left posterior maxilla accompanied with displacement of the left maxillary sinus floor was noted. External root resorption of the first and second molars was noted, as well as postero-superior displacement of the third molar. The histopathologic diagnosis of the biopsy was osteoblastoma. Complete excision of the tumor was performed.
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