Ultrasound sonography(US) is used to evaluate various diseases of maxillofacial region including salivary glands, soft tissue and jaw lesions because of easy accessibility and no hazard of ionizing radiation. Also, US can offer dynamic study showing real-time images during diagnostic or surgical procedure. US images provide accurate information about the internal features of lesions on the jaw prior to surgical treatment. Doppler images are used to visualize the vascular distribution of the lesions and to provide additional information to enhance diagnostic value. Nevertheless, the clinical application of US imaging is limited in the dental field. This is due to the lack of knowledge about the US image and the image characteristics of the anatomical structures. It is necessary to evaluate the diagnostic value of US and evaluate its usefulness by looking at clinical cases using US images. Therefore, US imaging may be recommended as an assistant image in evaluating jaw lesions. US images provided accurate information about the internal structure of lesions on the jaw prior to surgical treatment, and diagnostic value was enhanced by visualizing the vascular distribution of the lesion using doppler imaging.
Queiroz, Polyane Mazucatto;Santaella, Gustavo Machado;Groppo, Francisco Carlos;Freitas, Deborah Queiroz
Imaging Science in Dentistry
/
v.48
no.1
/
pp.41-44
/
2018
Purpose: To evaluate the effect of different numbers of basis images and the use of metal artifact reduction (MAR) on the production and reduction of artifacts in cone-beam computed tomography images. Materials and Methods: An acrylic resin phantom with a metal alloy sample was scanned, with 450 or 720 basis images and with or without MAR. Standard deviation values for the test areas (around the metal object) were obtained as a way of measuring artifact production. Two-way analysis of variance was used with a 5% significance level. Results: There was no significant difference in artifact production among the images obtained with different numbers of basis images without MAR (P=.985). MAR significantly reduced artifact production in the test areas only in the protocol using 720 basis images (P=.017). The protocol using 450 basis images with MAR showed no significant difference in artifact production when compared to the protocol using 720 basis images with MAR (P=.579). Conclusion: Protocols with a smaller number of basis images and with MAR activated are preferable for minimizing artifact production in tomographic images without exposing the patient to a greater radiation dose.
Many myocutaneous flaps have been used for the reconstruction of intraoral defects caused by the excision of oral cancer. Among these myocutaneous flaps, cervical island flap has been introduced by Farr et al. Although different in detail, this flap was designed as the platysma myocutaneous flap by Futrell et al in the supraclavicular site. Since many authors applied this flap to cover intraoral defect, they discussed deeply the blood supply of this flap. To improve further flap survival, it was modified by Tashiro et al. This flap makes its vascularity highly reliable. The amount of tissue needed for reconstruction can be accurately planned. The surgical and reconstruction procedure can be performed simply, rapidly, and effectively. Oral functions including deglutition, speech, and denture fitting are not compromised. With it's minimal deformity, new donor fields is not necessory. Of course, we keep in mind that this flap has limitations in patients where much bulk of tissue defects is needed and more than 3000 rad radiation due to the metastasis of neck lymph node is exposed. In three patients with intraoral squamous cell carcinoma($T_{1-3}N_0M_0$), we performed induction chemotherapy with FP regimen including pepleomycin. Thereafter, we ablated oral cancer and peformed reconstruction of intraoral defects with cervical island flap designed by Tashiro et al. Due to these significant benefits and minimal limitations, we have found that this flap is adequate for reconstruction of most intraoral defects following cancer ablation.
Kim, Ae-Ra;Park, Ji-Yoon;Kim, Yeon;Jun, Sei-Won;Seo, Yoon-Jeong;Park, Sang-Won
The Journal of Korean Academy of Prosthodontics
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v.51
no.3
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pp.167-174
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2013
Purpose: This study was conducted to evaluate the roughness and surface alternations of three differently blasted titanium discs treated by $Nd:YVO_4$ Laser irradiation in different conditions. Materials and methods: Thirty commercially pure titanium discs were prepared and divided into three groups. Each group was consisted of 10 samples and blasted by $ZrO_2$ (zirconium dioxide), $Al_2O_3$ (aluminum oxide), and RBM (resorbable blasted media). All the samples were degreased by ultrasonic cleaner afterward. Nine different conditions were established by changing scanning speed (100, 300, 500 mm/s) and repetition rate (5, 15, 35 kHz) of $Nd:YVO_4$ Laser (Laser Pro D-20, Laserval $Korea^{(R)}$, Seoul, South Korea). After laser irradiation, a scanning electron microscope, X-ray diffraction analysis, energy dispersive X-ray spectroscopic analysis, and surface roughness analysis were used to assess the roughness and surface alternations of the samples. Results: According to a scanning electron microscope (SEM), titanium discs treated with laser irradiation showed characteristic patterns in contrast to the control which showed irregular patterns. According to the X-ray diffraction analysis, only $Al_2O_3$ group showed its own peak. The oxidation tendency and surface roughness of titanium were similar to the control in the energy dispersive X-ray spectroscopic analysis. The surface roughness was inversely proportional to the scanning speed, whereas proportional to the repetition rate of $Nd:YVO_4$. Conclusion: The surface microstructures and roughness of the test discs were modified by the radiation of $Nd:YVO_4$ laser. Therefore, laser irradiation could be considered one of the methods to modify implant surfaces for the enhancement of osseointegration.
Journal of the korean academy of Pediatric Dentistry
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v.23
no.3
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pp.640-658
/
1996
The purpose of this study was to examine the mechanism of improving acid resistance of Nd-YAG laser irradiated tooth enamel and determine the most effective energy density for improving acid resistance. The bovine tooth enamel were lased with a pulsed Nd-YAG laser. The energy densities of exposed laser beam were varied from 10 to $70\;J/cm^2$. To investigate the degree of improving acid resistance by irradiation, all the samples were submerged to demineralize in 0.5 N $HClO_4$ solution for 1 minute. After 1 minute, 0.05 % $LaCl_3$ was added to the solution for interrupting the demineralization reaction. The amounts of dissolved calcium and phosphate in the solution were measured by using an atomic absorption spectrophotometer and the UV/VIS spectrophotometer, respectively. To examine the mechanism of improving acid resistance, X-ray diffraction analysis, infrared spectroscopy, and scanning electron microscopy were taken. The X-ray diffraction pattern of the samples were obtained in the $10^{\circ}{\sim}80^{\circ}2{\theta}$ range with $Cu-K{\alpha}$ radiation using M18HF(Mac Science Co.) with X-ray diffractometer operating at 40 KV and 300 mA. The infra-red spectra of the ground samples in 300 mg KBr pellets 10 mm diameter were obtained in the $4000cm^{-1}\;to\;400cm^{-1}$ range using JASCO 300E spectrophotometer. The scanning electron microscopy was carried out using JSM6400(JEOL Co.) with $500{\sim}2000$ times magnification. The results were as follow 1. The concentration of calcium dissolved from laser irradiated enamel with $50J/cm^2$ was significantly lesser than that of unlased control group (p<0.05) 2. From the result of the X-ray diffraction analysis, $\beta$-TCP, which increases acid solubility, was identified in lased enamel but the diffraction peaks of (002) and (004) became sharp with increasing energy density of laser irradiation. This means that the crystals in lased samples were grown through the c-axis and subsequently, the acid solubility of enamel decreased. 3. The a-axis parameter was slightly increased by laser irradiation, whereas the c-axis parameter was almost constant except for a little decrease at $50J/cm^2$. 4. In the infra-red spectra of lased enamels, phosphate bands ($600{\sim}500cm^{-1}$), B-carbonate bands (870, $1415{\sim}1455cm^{-1}$), and A-carbonate band ($1545cm^{-1}$) were observed. The amounts of phosphate bands and the B-carbonate bands were reduced, on the other hand, the amount of the A-carbonate band was increased by increase the energy density. 5. The SEM experiments reveal that the surface melting and recrystallization were appeared at $30J/cm^2$ and the cracks were observed at $70J/cm^2$. From above results, It may be suggested that the most effective energy density for improving acid resistance of tooth enamel with the irradiation of Nd-YAG laser was $50J/cm^2$. The mechanism of improving acid resistance were reduction of permeability due to surface melting and recrystallization of lased enamel and reduction of acid solubility of enamel due to decrease of carbonate content and growth of crystal.
The purpose of this study was first to analyze the utilization of dental examination through questionnaire to develop a diagnostic reference level of patient doses for dental radiography in korea. 77 dental institutions were classified into three groups: A group for the dental hospitals of the college of dentistry (11 institutions), B group for dental hospitals (30 institutions) and C group for dental clinics (36 institutions). The results were as follows : The mean numbers of unit chairs and medical staffs were 140.2, 15.3 and 5.8 sets, 112.6, 7.3 and 1.7 dentists, 3.1, 0.5 and no one radiologic technologists, and 19.7, 12.5 and 3.3 dental hygienists in A, B and C groups, respectively. The mean numbers of dental X-ray equipments were 14.64, 3.21 and 2.19 in A, B and C groups, respectively. Intraoral dental X-ray unit was used the most, the following equipments were panoramic, cephalometric, and cone-beam CT units. The most used X-ray imaging system was also digital system (above 50%) in all three groups. Insight dental film (Kodak, USA) having high sensitivity was routinely used for periapical radiography. The automatic processor was not used in many dental institutions, but the film-holding device was used in many dental institutions. The utilization rates of PACS in A, B and C groups were 90.9%, 83.3% and 16.7% respectively, and the PACS software program was used the most PiView STAR (Infinitt, Korea). The annual mean number of radiographic cases in one dental institution in 2008 for A group was 6.8 times and 21.2 times more than those for B and C groups, and periapical and panoramic radiographs were taken mostly. Tube voltage (kVp) and tube current (mA) for periapical radiography were similar in all three groups, but exposure time in C group was 12.0 times and 3.5 times longer than those in B and C groups. The amount of radiation exposure in C group, in which dental hygienists take dental radiographs, was more than those in other groups. The exposure parameters for panoramic radiography were similar in all three groups. In conclusion, the exposure parameters in dental radiography should be determined with reference level, not past experiences. Use of automatic processor and film-holding devices reduces the radiation exposure in film system. The quality assurance of dental equipments are necessary for the reduction of the patient dose and the improvement of X-ray image quality.
Purpose: The purpose of this study was to measure the absorbed dose and to calculate the effective dose for one periapical radiography using the portable and wall type dental X-ray machines. Materials and methods: Thermoluminescent chips were placed at 25 sites throughout the layers of the head and neck of a tissue-equivalent human skull phantom. The man phantom was exposed with the portable and wall type dental X-ray machines. For one periapical radiography taken by portable dental X-ray machine, the exposure setting was 60 kVp, 2 mA and 0.2 seconds, while for one periapical radiography taken by wall type dental X-ray machine, exposure setting was 70 kVp, 8 mA and 0.074 seconds. Absorbed dose measurements were performed and equivalent doses to individual organs were summed using ICRP 103 to calculate effective dose. Results: In the upper anterior periapical radiography using portable dental X-ray machine and in the lower posterior periapical radiography using both machines, the highest absorbed dose was recorded at the mandible body. The effective dose in upper anterior periapical radiography using portable and wall type dental X-ray machines was $4{\mu}Sv$, $2{\mu}Sv$, respectively. In the lower posterior periapical radiography, the effective dose for each portable and wall type dental X-ray machines was $6{\mu}Sv$, $2{\mu}Sv$. Conclusion: It was recommended that the operator use prudently potable dental X-ray machine because that the effective dose in the periapical radiography using wall type dental X-ray machine was lower than that in the periapical radiography using portable dental X-ray machine.
This study was performed to investigate the changes in flow and composition of saliva in oral cancer patients after radiation therapy. Stimulated whole saliva was collected from 7 patients who were scheduled for over 6,000cGy irradiation (180 - 225cGy fraction $Co^{60}$ therapy, 5 times a week). The flow rate of saliva, and concentration of total protein and IgA were measured before irradiation and 1, 2, 3, 4, 5 days and 1, 2, 3, 4, 6 weeks and 3, 6, 12 months after. The followings are results we obtained: 1. The salivary flow rate before irradiation was $0.8671{\pm}0.4057ml/min$. Significant decrease started 3 days after irradiation and reached a minimum at 4 weeks ($0.2621{\pm}0.2858ml/min$). Afterwards, flow rate started to increase and was on the way to recover at 1 year. 2. The concentration of total protein and IgA before irradiation were $137.2000{\pm}16.9912mg%$ and $3.4200{\pm}1.4114mg%$, respectively. After irradiation, these figures increased significantly and reached a maximum of $366.4000{\pm}174.0583mg%$ and $43.4800{\pm}29.1207mg/ml$, respectively at 6 weeks. Recovery towards normal values started following the end of irradiation and figures at 12 months had lowered to $165.400{\pm}21.1495mg%$ and $4.6200{\pm}2.1580mg/ml$ each. 3. The ratio of IgA to the amount of total protein was 2.5% before irradiation. This began to increase from 1 week following irradiation as the total dose of radiation received was increased (11.9% at 6 weeks). After 1 year from the start of radiation therapy, the ratio was reduced to such level that was before irradiation.
Objectives : This study was conducted to investigate the actual state of dental hygienist's behavior for infection control during dental practice and radiologic examination and to evaluate the dental hygienist's awareness of the importance of infection control in dental office. Methods : A survey on 218 dental hygienists was carried out. The respondents to complete a questionnaire were the dental hygienists who were in dental office on Gwang-ju area or attended complementary training conducted by the Seoul Branch of Korean Dental Hygienists Association in April 2010. The data were collected and analyzed with $x^2$ test, t-test, ANOVA using SPSS program. Results : The ratios of educational experience for infection control in dental practice and radiologic examination room accounted for 87.6% and 30.3% respectively. Behavior degree of mask-wearing in the dental practice and radiologic examination room were $4.60{\pm}0.70$ and $3.77{\pm}1.09$ respectively. Behavior degree of glove-wearing in the dental practice and radiologic examination room were $4.40{\pm}0.91$ and $3.68{\pm}1.17$ respectively. In case of the relation between educational experience and behavior degree in mask-wearing or glove-wearing, there was no significant difference in the performance of mask or glove wearing during dental practice, and mask-wearing during radiologic examination. However, there was a significant difference (p<0.05) in the performance of glove-wearing during radiologic examination, which revealed that behavior degree between the respondents having educational experience and the others no having it were $3.92{\pm}1.19$ and $3.58{\pm}1.14$ respectively. The surface disinfection control for radiation and protective equipments used in radiologic examination room was done by occasional needs without premeditated schedules. Conclusions : The result of this study shows lower behavior degree during radiologic examination compared with one during dental practice. We suggest that there are needs to raise the awareness of infection control and to improve infection control behavior, and through this study, the importance of education was verified.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.30
no.6
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pp.474-481
/
2004
Squamous cell carcinoma is the most prevalent oral cancer, which is characterized by its low survival rate, high malignancy, mortality with facial defects, and poor prognosis. Exact cause and pathogenesis of the squamous cell carcinoma is still unknown. Various routes including smoking, radiation, and viral infections predispose its genesis, and recent studies revealed that genetic defects which fail to prevent cancer proliferation play a role. Generally, a cancer develops from the decreased rate of apoptosis which is an active and voluntary cell death, and from the altered cell cycles. Anticancer effect can be obtained by recovering the apoptotic process, and by suppressing the cell cycles. Among the apoptosis related factors, bcl-2, caspase-9, and VDAC (voltage-dependent anion channel)are produced in mitochondria of the cell. Cyclosporin-A is known to induce apoptosis through its activation with VDAC. This study was to reveal the anticancer effect of Cyclosporin A to the oral squamous cell carcinoma. The inverted microscope was used to find alterations in the tissue, and sensitivity test to the anticancer cells was performed with MTT (Tetrazolium-based colorimetric) assay. Following cell line culture of primary and metastastic oral squamous cell carcinoma, electrophoresis was performed with extracted total RNA. Finally, semi-quantitative study was carried out through RT-PCR (Reverse Transcription-Polymerase Chain Reaction). The results of this study are as follows: 1. The inverted microscopic observation revealed a poorly defined cytoplasm at $2000ng{\sim}3000ng/ml$, indistinct nucleus, and apoptosis. 2. The Growth of cancer cells was decreased at 1000ng/ml of cyclosporin-A. No cancer cell growth was observed at over 2000ng/ml concentration of cyclosporin-A, and at one week, growth of cancer cells was ceased. 3. The MTT assays were decreased as cyclosporin-A concentration was increased. This means that the activation of succinyl dehydrogenase in mitochondria was decreased following administration of cyclosporin A. 4. A result of RT-PCR showed that amount of mRNA of VDAC-2 was decreased half times at a cyclosporine-A concentration of 2000ng/ml. In bcl-2, amount of mRNA was significantly decreased 1/5 times at 2000ng/ml. caspase-9, however, showed slight increase compared to the control group. From the results obtained in this study, administration of cyclosporin-A to the cell lines of oral squamous cell carcinoma induced alterations in morphology and growth of the cells as its concentration increased. Since apoptosis related factors such as VDAS-2, bcl-2, and caspase-9 also showed distinct alterations on their mRNAs, further research on cyclosporin A as an anti-cancer agent will be feasible.
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