• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.16.1-16.5
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• 2018

Background: Proliferative verrucous leukoplakia (PVL) is an oral potentially malignant disorder, characterized by multifocal expression, progressive clinical evolution, and a high rate of malignant transformation. Evidence-based information regarding optimal PVL management is lacking, due to the paucity of data. The present report describes a case of PVL associated with HPV-16 infection and epithelial dysplasia treated by diode laser surgery, and the outcome of disease clinical remission over a 2-year follow-up period. Case report: A 61-year-old Caucasian male with oral verrucous hyperkeratosis presented for diagnosis. The lesions were localized on the maxillary gingiva and palatal alveolar ridge. Multiple biopsy specimens have been taken by mapping the keratotic lesion area. Microscopic examination was compatible with a diagnosis of PVL with focal mild dysplasia, localized in the right maxillary gingiva. Polymerase chain reaction (PCR) was done for human papillomavirus (HPV) detection which revealed presence of HPV DNA, and the genotype revealed HPV 16 in the sample. The PVL in the right gingival area was treated on an outpatient basis by excision with a diode laser. This approach resulted in good clinical response and decreased morbidity over a 2-year follow-up period. Conclusions: This case illustrates the benefit of a conservative approach by diode laser treatment than wide surgical excision for management of the PVL lesions associated with mild dysplasia and HPV-16 infection.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.35.1-35.6
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• 2020

Background: Miescher's cheilitis granulomatosa (MCG) is a rare chronic inflammatory disease and is known as the monosymptomatic clinical form of Melkersson-Rosenthal syndrome (MRS). It is characterised by swelling of one or both lips and more frequently affects the upper lip. Histopathological findings show the presence of numerous inflammatory infiltrates and granuloma formations. Pharmacological treatments and surgery have provided results that are positive yet insufficiently stable in the long term. The clinical case described is of a 68-year-old female patient with a diagnosis of MCG of the upper lip. Case presentation: The patient was diagnosed and treated at the Oral Medicine and Oral Pathology outpatient clinic of Maxillofacial and Odontostomatology Unit, Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico. The patient was recommended localised treatments of photobiomodulation (PBM) using a diode laser with a 635 nm and 980 nm dual-wavelength (λ) approach, a 600-micron fibre, and a handpiece with a 1-cm-diameter lens at 300 mW. Three treatments a week were administered for four weeks for a total of 12 treatment sessions (T₁-T₁₂). After that, the patient had a long follow-up period of about 2 years. The therapeutic results were clear from the initial stages of treatment. There was an immediate, gradual, and consistent reduction in labial swelling. A reduction in the size of the lip by about 35% at T₁₀-T₁₂ was observed, returning the size and volume of the upper lip within the normal clinical range. The painful symptoms subsided after the seventh treatment (T₇). The histopathological check at 3 months and the follow-up in particular confirmed the disease was in remission with satisfactorily stable treatment results. Moreover, the patient did not use any other treatments on the area from the early laser treatments through to the end of the follow-up period. Conclusions: Our experience describes a clinical case of MCG treated with PBM and effectively resolved with a reduction of the lip swelling. The real success of the treatment emerged over time, showing that the tissue healing was stable. In absence of any collateral phenomena, this confirms the effective and documented therapeutic potential of PBM for chronic inflammatory infiltrates.

• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.463-469
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• 2017

PURPOSE. To evaluate the fit of a three-unit metal framework of fixed dental prostheses made by subtractive and additive manufacturing. MATERIALS AND METHODS. One master model of metal was fabricated. Twenty silicone impressions were made on the master die, working die of 10 poured with Type 4 stone, and working die of 10 made of scannable stone. Ten three-unit wax frameworks were fabricated by wax-up from Type IV working die. Stereolithography files of 10 three-unit frameworks were obtained using a model scanner and three-dimensional design software on a scannable working die. The three-unit wax framework was fabricated using subtractive manufacturing (SM) by applying the prepared stereolithography file, and the resin framework was fabricated by additive manufacturing (AM); both used metal alloy castings for metal frameworks. Marginal and internal gap were measured using silicone replica technique and digital microscope. Measurement data were analyzed by Kruskal-Wallis H test and Mann-Whitney U-test (${\alpha}=.05$). RESULTS. The lowest and highest gaps between premolar and molar margins were in the SM group and the AM group, respectively. There was a statistically significant difference in the marginal gap among the 3 groups (P<.001). In the marginal area where pontic was present, the largest gap was $149.39{\pm}42.30{\mu}m$ in the AM group, and the lowest gap was $24.40{\pm}11.92{\mu}m$ in the SM group. CONCLUSION. Three-unit metal frameworks made by subtractive manufacturing are clinically applicable. However, additive manufacturing requires more research to be applied clinically.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.4
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• pp.374-382
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• 2006

Purpose: This study was designed to investigate the present conditions of illumination techniques in dental clinics in order to contribute improvement of operating environment. This study also aimed exploring qualitative and quantitative luminous intensity required for color temperature in dental clinic illumination, which was a critical part of esthetic dentistry. Materials and methods: A total of forty-eight local dental clinics were selected for sampling a) luminous intensity, and b) color temperature. The author measured the luminous intensity and the color temperature with lux meter and color meter respectively between 12pm and 2pm. The dental unit chair placed in the general operation positions were kept the distance 60 cm then all dental units were measured three times and averaged. The author measured the luminous intensity and color temperature with both common dental operating light and then without operating light in different office environments. The study was conducted under three conditions: 1 artificial illumination in clear day light 2. artificial illumination in cloudy day light, and 3. artificial illumination alone. Results : The results obtained were as follows. 1. The average luminous intensity in dental clinic lighting was 425 lux which was not sufficient to produce the optimal shade of the patient's teeth. Furthermore, the average luminous intensity even in full operating lighting was 9532 lux which fell short of the required level of 10,000 lux. 2. The average color temperature of all dental clinics surveyed was 5169 K which met the optimal range. However, only 33.3% fell in the correct region between 5,000-5,500 K as 25% were over 5,500 K and 41.6% were below 5,000 K. As a result, 66.7% were under insufficient color temperature conditions. 3. The dental unit chair placed next to a window, hence exposure to natural lighting, had significantly higher luminous intensity and color temperature compared to the dental unit chair which didn't have a window or natural lighting. 4. The data analysis revealed that only 6.3% of the dental clinic were met the standard of the average luminous intensity and color temperature.

• Imaging Science in Dentistry
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• v.42 no.1
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• pp.1-4
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• 2012

Purpose : Hand-held dental x-ray system is a self contained x-ray machine designed to perform intraoral radiography with one or two hands. The issue about its usage as general dental radiography is still in dispute. The aim of the present study was to assess the relationship between the amount of battery charge and the tube voltage in different handheld dental x-ray systems. Materials and Methods : Seven hand-held dental x-ray units were used for the study. Tube voltage was measured with Unfors ThinX RAD (Unfors Instruments AB, Billdal, Sweden) for 3 consecutive exposures at the different amount of battery charge of each unit. The average and the deviation percentage of measured kV from indicated kV of each unit were calculated. Results : Tube voltage of only 1 unit was 70 kV (indicated by manufacturer) and those of the others were 60 kV. Tube voltage deviation percentage from the indicated kV at the fully charged battery was from 2.5% to -5.5% and from -0.8% to -10.0% at the lowest charged battery. Conclusion : Tube voltages of all units decreased as the residual amount of the battery charge decreased. It is suggested that the performance test for hand-held x-ray system should be performed for the minimum residual charged battery as well as the full charged one. Persistent battery charging is suggested to maintain the proper tube voltage of the hand-held portable x-ray system.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.3
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• pp.199-204
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• 2017

Background: Anxiety control remains an important concern in dental practice. We evaluated the incidence, nature, and sequelae of complications during and after minor oral surgeries performed under intravenous midazolam and fentanyl sedation using the titration technique. Method: The medical records of patients who had undergone minor oral surgeries under moderate intravenous midazolam and fentanyl sedation at our institution between January 1, 2015 and December 31, 2015 were retrospectively evaluated. Age, sex, body mass index, medical history, American Society of Anesthesiologists (ASA) classification, indications for sedation, amount of sedative used, surgical duration, and recovery time were evaluated for all patients. Results: In total, 107 patients aged 9-84 years were included. ASA class I and class II were observed for 56.1% and 43.9% patients, respectively. Complications associated with sedation occurred in 11 (10.2%) patients. There were no serious adverse events. Oxygen saturation reached 95% during the procedure in six patients; this was successfully managed by stimulating the patients to take a deep breath. Two patients exhibited deep sedation and one exhibited paradoxical excitement. After the procedure, one patient experienced nausea without vomiting and one exhibited a prolonged recovery time. The surgical procedures were completed in all patients. Obesity was found to be significantly associated with sedation-related complications. Conclusion: Our results suggest that complications associated with intravenous midazolam and fentanyl sedation using the titration technique for minor oral surgeries are mostly minor and can be successfully managed with no prolonged sequelae.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.1
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• pp.7-13
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• 2020

Purpose: This study was to evaluate marginal and internal discrepancy of 3-unit fixed dental prostheses (FDP) fabricated by subtractive manufacturing and additive manufacturing. Materials and methods: 3-unit bridge abutments without the maxillary left second premolar were prepared (reference model) and the reference model scan data was obtained using an intraoral scanner. 3-unit fixed dental prostheses were fabricated in the following three ways: Milled 3-unit FDP (MIL), digital light processing (DLP) 3D printed 3-unit FDP (D3P), stereolithography apparatus (SLA) 3D printed 3-unit FDP (S3P). To evaluate the marginal/internal discrepancy and precision of the prosthesis, scan data were superimposed by the triple-scan protocol and the combinations calculator, respectively. Quantitative and qualitative analysis was performed using root mean square (RMS) value and color difference map in 3D analysis program (Geomagic control X). Statistical analysis was performed using the Kruskal-Wallis test (α=.05), MannWhitney U test and Bonferroni correction (α=.05/3=.017). Results: The marginal discrepancy of S3P group was superior to MIL and D3P groups, and MIL and D3P groups were similar. The D3P and S3P groups showed better internal discrepancy than the MIL group, and there was no significant difference between the D3P and S3P groups. The precision was excellent in the order of MIL, S3P, and D3P groups. Conclusion: Within the limitation of this study, the 3-unit fixed dental prostheses fabricated by additive manufacturing showed better marginal and internal discrepancy than the those of fabricated by subtractive manufacturing, but the precision was poor.

• The korean journal of orthodontics
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• v.48 no.6
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• pp.395-404
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• 2018

Objective: To date, only a few studies have investigated the relationships between genetic polymorphisms and external apical root resorption (EARR). Hence, the aim of this systematic review was to explore the relationship between different gene polymorphisms and their association with EARR. Methods: A complete literature search was conducted by two independent reviewers. The PubMed, Science Direct, and Scopus databases were searched. In addition, the bibliographies of all textbooks and relevant articles were searched manually. A meta-analysis was performed using data entered into the electronic databases until February 28, 2017. Results: On the basis of the search, we identified 17 and 7 publications for the systematic review and meta-analysis, respectively. Odds ratio (OR) was used to evaluate the association of the interleukin 1B (+3954) polymorphism and the risk of EARR. The overall OR from the studies was used to estimate the risk of EARR. However, no association was found and no publication bias was apparent for the risk of EARR in patients receiving orthodontic treatment. Conclusions: More research on the relationship between gene polymorphism and EARR is necessary to determine better specificity of possible interactions.

• Journal of Korean society of Dental Hygiene
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• v.16 no.6
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• pp.863-877
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• 2016

The study aimed to investigate the influence of perceived patient safety culture on patient safety management activity in the dental hygienists. Methods: A self-reported questionnaire was completed by 292 dental hygienists in Seoul, Incheon and Gyeonggido from March 1 to April 8, 2016. The questionnaire consisted of general characteristics of the subjects (9 items), patient safety culture (44 items), and patient safety management activity (25 items) by Likert 5 point scale. Data were analyzed by t test, one way ANOVA, stepwise multiple regression test, and post-hoc Tukey test using SPSS 18.0 program. Results: The perceived patient safety culture was 3.50 on average. Entire organization was the highest score (3.68) and followed the communication process (3.55), the environment of work unit (3.47), the attitude of supervisor/manager (3.45), and the frequency of events reported (2.98). The average of patient safety management activity was 3.71. As for the factors of patient safety culture on patient safety management activity, communication process was the most influential factor (${\beta}=0.268$), and followed the entire organization (${\beta}=0.265$), the environment of work unit (${\beta} =0.166$), the frequency of events reported (${\beta}=0.104$), and among the control variables. Work place proved to be the only significant variable. Conclusions: In order to promote patient safety management activity of dental institutions, the patient safety culture should be created and established. The influence of communication process and patient safety culture at entire organization level was huge. So the environment of work unit and the perceived patient safety culture in the process of reported events were influencing factors. The strategy for patient safety management activity should be considered because of low level of perceived patient safety culture.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.2.1-2.9
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• 2016

Background: We reviewed the biological and mechanical properties of porous hydroxyapatite (HA) compared to other synthetic materials. Computer-aided design/computer-aided manufacturing (CAD/CAM) was also evaluated to estimate its efficacy with clinical and radiological assessments. Method: A systematic search of the electronic literature database of the National Library of Medicine (PubMed-MEDLINE) was performed for articles published in English between January 1985 and September 2013. The inclusion criteria were (1) histological evaluation of the biocompatibility and osteoconductivity of porous HA in vivo and in vitro, (2) evaluation of the mechanical properties of HA in relation to its porosity, (3) comparison of the biological and mechanical properties between several biomaterials, and (4) clinical and radiological evaluation of the precision of CAD/CAM techniques. Results: HA had excellent osteoconductivity and biocompatibility in vitro and in vivo compared to other biomaterials. HA grafts are suitable for milling and finishing, depending on the design. In computed tomography, porous HA is a more resorbable and more osteoconductive material than dense HA; however, its strength decreases exponentially with an increase in porosity. Conclusions: Mechanical tests showed that HA scaffolds with pore diameters ranging from 400 to $1200{\mu}m$ had compressive moduli and strength within the range of the human craniofacial trabecular bone. In conclusion, using CAD/CAM techniques for preparing HA scaffolds may increase graft stability and reduce surgical operating time.