• Journal of Oral Medicine and Pain
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• v.47 no.1
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• pp.1-9
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• 2022

Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of antiresorptive agents and bone-modifying agents. It is of the utmost importance to know the management of the MRONJ to improve the patient's quality of life. This study comprehensively reviews the current definitions of MRONJs, and antiresorptive medications, clinical manifestation and staging, risk factors, treatment strategies, and prevention methods of MRONJ. The disease is defined as an exposure of bone and osteonecrosis of the jaw in the oral cavity for at least 8 weeks in patients taking antiresorptive drugs or antiangiogenic agents and with no history of radiotherapy treatment of the jaws. Many articles have reported risk factors associated with MRONJ such as systemic diseases, antiresorptive medication, oral infection, and poor oral hygiene. Osteonecrosis and antiresorptive medications including bisphosphonate and denosumab have been strongly associated, but the pathology of MRONJ is only limited. Hence, an effective and appropriate management and treatment for MRONJ is still to be defined. The objectives of MRONJ treatment are to minimize osteonecrosis and relieve symptoms, and many treatments are suggested from conservative treatment to marginal resection, but this remains controversial. Appropriate treatment of MRONJ remained difficult, although many studies are being covered.

• The Journal of the Korean dental association
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• v.55 no.11
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• pp.778-788
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• 2017

Ultrasound sonography(US) is used to evaluate various diseases of oral and 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. 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. We report the protocol and suggest the effectiveness of US for various lesions and US-guided sialography.

• Korean Journal of Acupuncture
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• v.20 no.4
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• pp.99-119
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• 2003

Objectives : The Jap Byoung(雜病) of the Young Chu(靈樞), one of the classical book of oriental medicine contains symptoms and remedies for various diseases that can be seen on human body. But it is too difficult to understand the Jap Byoung(雜病), because it is written in old chinese and there are many printer's error and omissions or adds in this book. As a consequence of above reason, the writer of this article has researched to find out the exact meaning of that. Methods : So in this part we study a woodblock-printed book of successive generation and view of annotators, and add adding notes, adjustment, translation to exact comprehension of the original text. Results & conclusions : The principle ideas of the thesis can be summarized as follows: The Jap Byoung(雜病) is consist of five part. In chapter 1, we present symptoms occurred by the upstream current of Qi(氣逆) and their treatments by taking meridian flowing the body parts on which the symptoms occur. In chapter 2, we deal with symptoms such as ikgun(?乾), a pain of the knee(膝中痛), huby(喉痺), epistaxis(?血), lumbago(腰痛), anger(怒), a pain of the jaw(痛), a pain of the nape(項痛) and their remedies. In chapter 3, since abdominal inflation occurs when the Qi(氣) of the five viscera(五臟) is damaged or go upstream, I discussed that the treatment should be given by taking the meridian accordingly. In chapter 4, we deal with the remedy for heartache, and different meridians to be taken by symptom, and parts on which needle to be used, and detailed remedies. In chapter 5, we present other diseases, detailed body parts to be cured and remedies by referring symptoms for a pain of the jaw(痛), the upstream current of Qi(氣逆), hiccup, etc. Especially, we introduce a part of Doinbup(導引法) for wegurl(?厥) and remedies for hiccup such as inducing sneeze by stimulating nostrils, holding one's breath, etc.

• Imaging Science in Dentistry
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• v.45 no.2
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• pp.109-115
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• 2015

Central odontogenic fibroma (COF) is a rare benign tumor that accounts for 0.1% of all odontogenic tumors. A case of COF (simple type) of the mandible in a four-year-old boy is described in this report. The patient showed asymptomatic swelling in the right inferior border of the lower jaw for one week. A panoramic radiograph showed a poorly-defined destructive unilocular radiolucent area. Cone-beam computed tomography showed expansion and perforation of the adjacent cortical bone plates. A periosteal reaction with the Codman triangle pattern was clearly visible in the buccal cortex. Since the tumor had destroyed a considerable amount of bone, surgical resection was performed. No recurrence was noted.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.2
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• pp.150-156
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• 2015

As dental implant treatment becomes popular for both partial and complete edentulous patients, old people with complex systemic diseases also tend to prefer implant-assisted-overdenture or implant-supported-fixed prostheses to conventional complete denture. In this case, 77-year-old female who was on medication for hypertension and osteoporosis and paralyzed on right side due to stroke visited for implant-assisted-overdenture on lower jaw. After oral and radiographic examination, root-assisted magnet overdenture on upper jaw and implant-assisted magnet overdenture on lower jaw are planned. Consequently, overdentures using self-adjusting magnetic attachment(SA) system on both jaws resulted in recovering satisfying function and retention, which is enable to insert and remove with only one hand.

• Journal of TMJ Balancing Medicine
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• v.3 no.1
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• pp.8-14
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• 2013

Objectives: This study is aimed to recognize the therapy principles of TMJ balancing in Korean medicine. Methods: TMJ diseases in Donguibogam were discussed in the view of Korean medicine basic theory. Results: Manual therapy and fixed therapy using toolswere used for treatment in dislocating jaw by yawn or TMJ diseases in Korean medicine. Conclusions: In Donguibogam, manual therapy and fixed therapy were used for TMJ dislocating, and acupuncture therapy and herbal therapy were used in toothache by dependent on the cause and the symtoms.

• The Journal of Advanced Prosthodontics
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• v.15 no.1
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• pp.11-21
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• 2023

PURPOSE. To compare the sagittal condylar inclination (SCI) in dentate individuals measured by the different methods with mechanical articulator (MA), virtual articulator (VA), and a jaw tracking device (JTD) system. MATERIALS AND METHODS. A total of 22 healthy dentate participants were enrolled in this study. For MA workflow, the SCI was obtained by a semi-adjustable articulator with protrusive interocclusal records. The SCI was also set on a VA by aligning intraoral scan (IOS) with cone beam computed tomography (CBCT) and facial scan (FS), respectively. These virtual workflows were conducted in a dental design software, namely VAI_OS-CBCT and VAI_OS-FS. Meanwhile, a JTD system was also utilized to perform the measurement. Intraclass correlation was used to assess the repeatability within workflows. The bilateral SCI values were compared by Wilcoxon matched-pairs signed rank test for each workflow, and Kruskal-Wallis test and post hoc p-value Bonferroni correction were used to compare the differences among four workflows. The agreement of VAI_OS-CBCT, VAI_OS-FS, and JTD compared with MA was evaluated by Bland-Altman analysis. RESULTS. Intraclass correlation of the SCI revealed a high degree of repeatability for each workflow. There were no significant differences between the left and right sides (P > .05), except for VAI_OS-CBCT (P = .028). Significant differences were not found between MA and VAI_OS-FS (P > .05). Bland-Altman plots indicated VAI_OS-CBCT, VAI_OS-FS, and JTD were considered to substitute MA with high 95% limits of agreement. CONCLUSION. The workflow of VAI_OS-FS provided an alternative approach to measure the SCI compared with MA.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.4
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• pp.193-204
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• 2016

Objectives: This study examined the statistical relevance of whether the systemic predisposing factors affect the prognosis of surgical treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). All cases had undergone bone biopsies to determine the characteristics of the mechanisms of BRONJ by optical microscopy. Materials and Methods: The data included 54 BRONJ cases who underwent surgery and in whom bone biopsies were performed. The results of surgery were evaluated and the results were classified into 3 categories: normal recovery, delayed recovery, and recurrence after surgery. The medical history, such as diabetes mellitus, medication of steroids, malignancies on other sites was investigated for an evaluation of the systemic predisposing factors in relation to the prognosis. The three factors involved with the medication of bisphosphonate (BP) were the medication route, medication period, and drug holiday of BP before surgery. The serum C-terminal cross-linking telopeptide (CTX) value and presence of microorganism colony in bone biopsy specimens were also checked. Statistical analysis was then carried out to determine the relationship between these factors and the results of surgery. Results: The group of patients suffering from diabetes and on steroids tended to show poorer results after surgery. Parenteral medication of BP made the patients have a poorer prognosis after surgery than oral medication. In contrast, the medication period and drug holiday of BP before surgery did not have significance with the results of surgery nor did the serum CTX value and presence of microorganism colony. Necrotic bone specimens in this study typically showed disappearing new bone formation around the osteocytic lacunae and destroyed Howship's lacunae. Conclusion: Although many variables exist, this study could in part, predict the prognosis of surgical treatment of BRONJ by taking the patient's medical history.

• Imaging Science in Dentistry
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• v.48 no.3
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• pp.153-160
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• 2018

Purpose: This study aimed to assess the reliability of ultrasonography (US) in comparison with cone-beam computed tomography (CBCT) as a tool for monitoring the healing of jaw lesions. Materials and Methods: Twenty-one radiolucent lesions in jaws referred to the Oral Surgery Department at our institution were selected for this study. All lesions underwent CBCT and US examinations. The anteroposterior, superoinferior, and mesiodistal dimensions of the lesions were measured on CBCT and US images before surgery and at 6 months after surgery. The dimensions were compared between the US and CBCT images. Blood-flow velocity around the lesions was measured by color Doppler before surgery and at 1 week and 6 months after surgery to assess the capability of US to show changes in blood-flow velocity around the lesion. Results: Before surgery, there were no significant differences between US and CBCT in the mesiodistal and anteroposterior dimensions, although a significant difference was found in the superoinferior dimension (P<.05). However, at 6 months after surgery, significant differences were found between US and CBCT in all dimensions, and it is likely that the US measurements more accurately reflected the extent of healing. The average blood-flow velocity increased at 1 week after surgery (5.84 cm/s) compared with the velocity before surgery (4 cm/s) (P<.05). Then, at 6 months after surgery, the blood-flow velocity significantly decreased (3.53 cm/s) compared to the velocity measured at 1 week after surgery (P<.05). Conclusion: US with color Doppler was confirmed to be a more efficient tool than CBCT for monitoring bone healing.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.1.1-1.7
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• 2017

Background: Multiple myeloma (MM) is characterized by a neoplastic proliferation of plasma cells primarily in the bone marrow. Bisphosphonates (BP) are used as supportive therapy in the management of MM. This study aimed to analyze the incidence, risk factors, and clinical outcomes of medication-related necrosis of the jaw (MRONJ) in MM patients. Methods: One hundred thirty MM patients who had previous dental evaluations were retrospectively reviewed. Based on several findings, we applied the staging and treatment strategies on MRONJ. We analyzed gender, age, type of BP, incidence, and local etiological factors and assessed the relationship between these factors and the clinical findings at the first oral examination. Results: MRONJ was found in nine male patients (6.9%). The mean patient age was 62.2 years. The median BP administration time was 19 months. Seven patients were treated with a combination of IV zoledronate and pamidronate, and two patients received single-agent therapy. The lesions were predominantly located in the mandible (n = 8), and the most common predisposing dental factor was a history of prior extraction (n = 6). Half of the MRONJ were related to diseases found on the initial dental screen. Patients with MRONJ were treated with infection control and antibiotic therapy. When comparing between the MRONJ stage and each factor (sign, location, etiologic factor, BP type, treatment, and outcome), there were no significant differences between stages, except for between the stage and sign (with or without purulence). Conclusions: For prevention of MRONJ, we recommend routine dental examinations and treatment prior to starting BP therapy.