• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.4
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• pp.231-239
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• 2012

Objectives: This study sought to provide guidelines in order to decrease the incidence of nerve injury during mandibular ramus bone harvesting, and to improve understanding of the anatomical structure of the inferior alveolar canal (IAC) to include its distance from the exterior buccal cortex. Materials and Methods: In January and February 2009, 20 patients who visited the Wonkwang University Department of Oral and Maxillofacial Surgery reporting various conditions underwent cone beam computed tomography and were included in this study. Patients with missing left or right mandibular first molars or incisors, or who had jaw fracture or bone pathologies, were excluded. The reference point (R point) was defined as the point where the occlusal plane reached the anterior ramus of the mandible. The position of the IAC in relation to the R point, the buccal bone width (BW), the alveolar crest distance (ACD), the distance from the alveolar crest to the occlusal plane (COD), and the distance from the IAC to the sagittal plane (CS) were determined using proprietary image analysis software which produced cross-sectional coronal and axial images. Results: The distance medially from the R point to the IAC along the axial plane was $6.19{\pm}1.21mm$. The HD from the R point, posteriorly to IAC, in the lateral view was $13.07{\pm}2.45mm$, the VD from the R point was $14.24{\pm}2.41mm$, and the ND from the R point was $10.12{\pm}1.76mm$. The pathway of the IAC was positioned almost in a straight line along a sagittal plane within $0.56{\pm}0.70mm$. The distance from the buccal bone surface to the IAC increased anteriorly from the R point. Conclusion: Marking osteotomy lines in the retromolar area in procedures involving bone harvesting should be discouraged due to the risk of damage to IAC structures. Our measurements indicated that the area from the R point in the ramus of the mandible to 10 mm anterior can be safely harvested for bone grafting purposes.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.27 no.1
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• pp.217-230
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• 1997

The location of the mandibular canal and the cortical thickness of the mandible is important in the practice of dentistry. This study was performed on twenty chosen dry mandibles, which were of adults and included fully erupted premolars and molars. The purpose of this study was to evaluate the location of the mandibular canal and the cortical thickness of the mandible on computed tomograms and to aid in the surgical treatment plans. The obtained results were as follows; 1. The horizontal distance between the mandibular canal and the buccal external border was 6.6±0.9mm on Somesial root of the first molar), and it was increased posteriorly. The horiwntal distance between the mandibular canal and the lingual external border was 4.1±1.lmm on S/sub 0/, and it was decreased posteriorly. 2. The vertical distance between the alveolar crest and the mandibular canal was 16.9±1.6mm on S/sub 0/, and it was decreased posteriorly. The vertical distance between the inferior border of mandible and the mandibular canal was 8.8±1.3mm on S/sub 0/, and it was increased anteriorly and posteriorly. 3. The thickness of the buccal cortical plate was 2.2±0.4mm on S/sub 0/. and it was increased posteriorly. But, that of the lingual cortical plate was 2.0±0.6mm on S/sub 0/ and it was decreased posteriorly. 4. The area of the buccal cortical plate was 66.5±1.0mm² on S/sub 0/. and it was increased posteriorly. But, that of the lingual cortical plate was 65.8±0.9mm² on S/sub 0/ and it was decreased posteriorly.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.6
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• pp.263-268
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• 2013

Objectives: The interforminal region, between the mandibular foramen, is known as a relatively safe area that is free of anatomic structures, such as inferior alveolar nerve, submandibular fossa, and lingual side of the mandible is occasionally neglected for its low clinical importance. Even in the case of a severely constricted alveolus, perforation of the lingual cortical bone had been intended. However, anterior extension of the inferior alveolar canal, important anatomic structure, such as concavity of lingual bone, lingual foramina, and lingual canal, has recently been reported through various studies, and untypical bleeding by perforation of the lingual plate on implantation has also been reported. Therefore, in this study, we performed radiographic and statistical analysis on distribution and appearance frequencies of the lingual foramina that causes perforation of the mandibular lingual cortical bone to prevent complications, such as untypical bleeding, during surgical procedure. Materials and Methods: We measured the horizontal length from a midline of the mandible to the lingual foramina, as well as the horizontal length from the alveolar crest to the lingual foramina and from the lingual foramina to the mandibular border by multi-detector computed tomography of 187 patients, who visited Dankook University Dental Hospital for various reasons from January 1, 2008 to August 31, 2012. Results: From a total of 187 human mandibles, 110 (58.8%) mandibles had lingual foramina; 39 (20.9%) had bilateral lingual foramen; 34 (18.2%) had the only left lingual foramen; and 37 (19.8%) had the only right lingual foramen. Conclusion: When there is consistent bleeding during a surgical procedure, clinicians must consider damages on the branches of the sublingual artery, which penetrate the lingual foramina. Also, when there is a lingual foramina larger than 1 mm in diameter on a pre-implantation computed tomography, clinicians must beware of vessel damage. In order to prevent these complications and progress with a safe surgical procedure, a thorough radiographic examination before the surgery is indispensable. Further, clinicians should retract lingual flap definitely to confirm the shape of the lingual bone and existence of the lingual foramina.

• Imaging Science in Dentistry
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• v.51 no.3
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• pp.313-321
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• 2021

Ankylosis of the temporomandibular joint (TMJ) is a disabling disease resulting from fibrous or bony fusion of the mandibular condyle and the glenoid fossa. Early diagnosis and surgical treatment are essential to prevent facial deformity and other complications. Conventional radiography has limitations in demonstrating the true extent of ankylosis. It is important for surgeons to be aware of the size and degree of bony ankylosis in order to perform complete resection of the ankylotic mass. In addition, a detailed evaluation of the relationship with adjacent vital structures such as the internal maxillary artery, inferior alveolar nerve canal, external auditory canal, and skull base are crucial to avoid iatrogenic injury. Multidetector computed tomography (MDCT) is the current imaging modality of choice for preoperative assessments. Herein, the authors propose a structured CT reporting template for TMJ ankylosis to strengthen the value of the preoperative imaging report and to reduce the rates of intraoperative complications and recurrence.

• Imaging Science in Dentistry
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• v.51 no.2
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• pp.217-222
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• 2021

Ewing sarcoma in the head and neck is rare, and metastasis from other bones to the mandible accounts for 0.7% of cases. This report presents a case of oral metastasis in a 24-year-old male patient diagnosed with Ewing sarcoma of the femur (p53 gene mutation and EWSR1-ERG fusion). The chief complaint was numbness in the mandible and pain for 1 month and a hardened, ulcerated exophytic lesion in the right retromolar region. Imaging exams revealed an unspecified thinning of the cortical bone of the inferior alveolar canal in the right mandibular ramus, associated with erosion of the alveolar bone. Histopathological analysis confirmed metastasis of Ewing sarcoma. The patient presented an aggressive disease progression and died 1 month after the oral diagnosis. It is important to recognize the signs and symptoms compatible with rare clinical outcomes, leading to an early diagnosis that can improve patients' quality of life and survival.

• Imaging Science in Dentistry
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• v.33 no.1
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• pp.43-49
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• 2003

Purpose : To evaluate the differences in bone height, bone width, and visibility of posterior spiral tomographic images according to various exposure directions, image layer thickness, and inclination of the mandibular inferior border. Materials and Methods: Six partially and completely edentulous dry mandibles were radiographed using Scanora spiral tomography. Spiral tomography was performed at different exposure directions (dentotangential and maxillotangential projection), image layer thicknesses (2 mm, 4 mm and 8 mm), and at various inclinations to the mandibular border (+ 100, 00 and -10°). The bone height and width was measured using selected tomographic images. The visibility of mandibular canal, crestal bone, and buccal and lingual surfaces were graded as 0, 1, or 2. Results : The bone width at the maxillo-tangential projection was wider than at the dento-tangential projection (p < 0.05). The visibility of buccal and lingual surface at the maxillo-tangential projection was higher than at the dento-tangential projection (p<0.05). Thinner image layer thicknesses resulted in greater visibility of buccal and lingual surfaces (p < 0.05). Bone height was greatest in the -10° group, and at the same time the bone width of the same group was the narrowest (p < 0.05). The visibility of alveolar crest and buccal surface of the + 10° group was the highest, while the visibility of the mandibular canal was greatest in the 00 group. Conclusion: When spiral tomography is performed at the mandibular posterior portion for visualization prior to implant surgery, it is important that the inferior border of mandible be positioned as parallel as possible to the floor. A greater improvement of visibility can be achieved by maintaining a thin image layer thickness when performing spiral tomography.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.327-336
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• 2011

Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.119-124
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• 2010

Introduction: Surgical extraction of third molar is one of the most frequently performed procedures in oral and maxillofacial surgery unit as the impacted wisdom teeth could cause various complications. Even though, however, extraction of the impacted wisdom teeth is an obligation for the reason of possible complication even for general practitioners, it has been avoided. Various factors concerning surgical extraction of impacted third molar are considered: general condition of patients, relationship with relative anatomies, aspects of impaction, surgeon's skill. Materials and Methods: The consideration and crossing analysis of these factors with 2,463 patients who visit Dankook University dental hospital to extract those impacted third molar. Results: 1. Gender doesn't affect. 2. Medical problems have more complications. 3. There are more complications in high difficulty index (DI) impacted teeth. 4. When inferior alveolar canal overlap mandibular third molar, complication rate is 26.92%. 5. The most common complication was swelling and pain. 6. There is no statistical difference between the incidence of complication and surgeon's experience. Conclusion: In regard to these results, it seems that clinical or radiological examination can predict potential complications of wisdom teeth, and it is helpful to bear in mind the fact.

• Imaging Science in Dentistry
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• v.41 no.1
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• pp.23-28
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• 2011

Purpose : This study was to find the computed tomographic features of fibrous dysplasia of the maxillofacial region. Materials and Methods : All eight cases included in the study reported either to Government Dental College and Hospital or Nair Hospital Dental College, Mumbai between 2003 and 2009. The patients were prescribed computed tomogram in addition to conventional radiographs of maxillofacial region which were studied for characteristic features of fibrous dysplasia. The diagnosis of fibrous dysplasia was confirmed by histopathological report. Results : All cases showed the ill-defined margins of lesions except in the region where the lesions were extending to cortex of the involved bone. Internal structure of all cases showed ground glass appearance. Four cases of maxillary lesion showed the displacement of maxillary sinus maintaining the shape of maxillary sinus. Two cases showed complete obliteration of maxillary sinus. Displacement of inferior alveolar canal did not follow any typical pattern in any of the cases but was displaced in different directions. Conclusion : The craniofacial type of fibrous dysplasia is as common as fibrous dysplasia of jaw. The margins, extent, internal structure and effect on surrounding structure are well detected on computed tomographic images.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.23-34
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• 1991

Even if we can recover the function of mastication, pronunciation and esthetic using the fixed or removable prosthesis in the loss of teeth or hard tissue in the oral cavity, we use several kinds of implants in order to solve the problem which can be occured when we can't install the denture because of excessive bone resolution or psychlogical affairs. At present Titanium implant plays a major role in this field and has osseointegrated. And the study on the modern material is going on, that result in developing and using the implant which is coated with HA, bone induced material. In this, I studied histologically the change of the bone tissue which is occured when three kinds of HA coated implants. Such as Integral, Sustain, Biovent implanted into mandible of dog and got a 8-weeks healing period. I got the conclusion as follows: 1. Most of the implant which is covered with serveral kinds of HA coating implant in bone after 8 weeks being implanted and has osseointegrated, partially converted into the connective tissue. 2. Biovent formed the connective tissue in the perforated area of inferior alveolar canal and has osseointegrated.