• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.295-301
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• 2009

Recently, bisphosphonate-associated osteonecrosis of the jaw(BONJ) is added to the list of diseases of the oromaxillofacial region. BONJ is defined as exposed bone in the jaw that does not heal within 8 weeks after identification, in a patient who has been received to bisphosphonates and has not taken radiation therapy to the craniofacial region. Bisphosphonates binded to bone mineral are concentrated in highly active remodeling site, reside in the skeleton for a long time, and do a role as powerful inhibitors of bone resorption. As the patients receiving bisphosphonates therapy grow in number, the patients of BONJ would go on increasing in Korea. We would like to present two patients who were suspected to BONJ, describe the outline of BONJ, and mention importance of our understanding about BONJ. BONJ is rare disease, but once it develops, its prognosis is very poor. Our adequate understanding of BONJ is necessary to prevent it and cope with it properly.

• The Journal of Advanced Prosthodontics
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• v.14 no.1
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• pp.1-11
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• 2022

PURPOSE. The maximum width between the mesial and distal labial transitional line angles, described as "esthetic width" herein, could significantly influence the visual perception of the teeth and smile. This study aimed to conduct biometric research on esthetic width and to explore whether regular distribution exists in the esthetic width of human teeth. MATERIALS AND METHODS. A total of 4,264 maxillary and mandibular anterior teeth were measured using the Geomagic studio software program. The proportions of maxillary to mandibular homonymous teeth and proportions between the adjacent teeth were calculated. Bilateral symmetry and the correlation between the esthetic and mesiodistal widths were both accounted for during the measurement procedures. RESULTS. The mean esthetic widths were 6.773 ± 0.518 mm and 4.329 ± 0.331 mm for maxillary and mandibular central incisors, respectively, 5.451 ± 0.487 mm and 5.008 ± 0.351 mm for maxillary and mandibular lateral incisors, respectively, and 3.340 ± 0.353 mm and 5.958 ± 0.415 mm for maxillary and mandibular canines, respectively. Except for the mandibular canines, no significant difference in esthetic width was found among homonymous teeth from the same jaw. A high linear correlation was found between the esthetic and mesiodistal widths of the same tooth, except for the maxillary canines. Esthetic width proportions among different tooth categories showed some regular patterns, which were similar to those of the mesiodistal width. CONCLUSION. Esthetic width is regularly distributed among the teeth in the Chinese population. This could provide an important reference for anterior dental restorations and dimension recovery in esthetic reconstruction of anterior teeth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.2
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• pp.169-172
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• 2007

The Varicella zoster virus is responsible for two common infectious diseases: chicken pox(Varicella) and shingles(Herpes zoster). Chicken pox is the primary infection. After the initial infection, the virus remains dormant in sensory ganglia until reactivation may occur decades later. The subsequent reactivation is Herpes zoster. Herpes zoster of the trigeminal nerve distribution manifests as painful, vesicle eruptions of the skin and mucosa innervated by the affected nerve. Oral vesicles usually appear after the skin manifestrations. Reports of osteomyelitis of jaw after trigeminal herpes zoster are extremely rare. We report a case of osteomyelitis on mandible caused by herpes zoster infection which was treated by antiviral drug, curettage. At 1 year post-operatively, mandibular mucosa had healed without recurrent sign. But post-herpetic neuralgia is remained.

• Journal of Oral Medicine and Pain
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• v.45 no.2
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• pp.39-43
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• 2020

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare idiopathic inflammatory bone disease characterized by pain and swelling without any detectable infectious factors, the main feature is mild to moderate bone pain. CRMO commonly develops in the metaphyses of long bones and clavicles in children or adolescents. Chronic nonbacterial osteomyelitis (CNO) is the isolated form of CRMO and the etiology of CNO is still unclear. This report describes a rare case of CNO of the mandible in an 8-year-old female patient. On the basis of clinical, histological, and radiological findings, CNO was diagnosed. The patient was asymptomatic after surgical curettage followed by antibiotic therapy. Cone beam CT scan revealed a nearly completed bone healing after three months.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.167-172
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• 2009

The maxilla rarely undergoes necrosis due to its rich vascularity. Maxillary necrosis can occur due to bacterial infections such as osteomyelitis. viral infections such as herpes zoster and fungal infections such as mucormycosis, aspergillosis etc. Herpes zoster is a common viral infection, the oral soft tissue manifestations of which are widely known and recognized. Extremely rare complications such as osteonecrosis, and secondary osteomyelitis in maxilla were observed. But, reports of spontaneous tooth exfoliation and jaw osteonecrosis following herpes zoster infection in the distribution of the trigeminal nerve are extremely rare in the literature. We report a case of maxillary necrosis by herpes zoster in an uncontrolled diabetic patient. There was extensive necrosis of the buccal and palatal mucoperiosteum and exposure of the alveolar bone. This patient was successfully treated using a removal of necrotic bone and nasolabial flap. We briefly discuss different diseases which can lead to maxillary necrosis and a review. Analysis of the pathogenesis of herpes zoster and bone necrosis are discussed.

• The Journal of the Korean dental association
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• v.55 no.5
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• pp.365-369
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• 2017

In clinical dentistry, botulinum toxin is generally used to treat the square jaw, bruxism, and temporomandibular joint diseases. Recently, this procedure has been expanded and applied for cosmetic purposes, and it is becoming a key task to be aware of the precise anatomical structure of the target muscles to be cautious during treatment and how to prevent side effects. Therefore, the purpose of this study is to observe the anatomical structure of the superficial layer of masseter muscle and to provide a most effective botulinum toxin injection method through clinical anatomical consideration. It was observed that the muscle belly of superficial part of the superficial layer was originated from the deep to the aponeurosis of masseter muscle and descend, then changed gradually into the tendon structure attaching to the inferior border of the mandible. In this study, we named this structure deep inferior tendon. This structure was observed in all specimens. We conclude that the use of superficial layer and deep layer injection should be considered to prevent paradoxical masseteric bulging in consideration of the deep inferior tendon of superficial part of superficial layer of masseter muscle.

• Tuberculosis and Respiratory Diseases
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• v.64 no.5
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• pp.356-361
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• 2008

Background: We wanted to examine the clinical characteristics of adult patients with tracheobronchial foreign bodies (FBs) according to the risk of aspiration and the outcomes of intervention with using a fiberoptic bronchoscope. Methods: From December 1994 through December 2004 at Kyung Hee Medical Center, we retrospectively analyzed the medical records of 29 adult patients with FBs that were identified by using a fiberoptic bronchoscope. Results: 14 patients were not at risk of aspiration, whereas 15 had cerebrovascular diseases and they were at a high risk of aspiration. No history suggestive of FB aspiration was noted in 7 (24.1%) patients. Respiratory symptom(s) were noted in 22 patients, and these symptoms were cough (62.0%), dyspnea (44.8%), fever (20.7%), wheezing (13.8%), chest pain (10.3%) and hemoptysis (0.4%). Only 60% of those patients at a high risk of aspiration had symptom(s) (92.8% of those patients without a risk of aspiration had symptoms, p=0.005). Those patients at risk for aspiration had a longer duration of symptoms (median: 4 days vs. 2 days for those patients not at risk for aspiration, p=0.007) before diagnosis. Acute respiratory symptom(s) within 3 days after aspiration were more frequent in the patients without a risk of aspiration (9 vs. 4, respectively p=0.048). Chest x-ray revealed radiological abnormalities in 23 patients, and these were opacities suspicious of FB (n=11), pneumonia (n=8), air trapping (n=5) and atelectasis (n=3). There were no differences in radiological findings according to the risk of aspiration. FB aspiration developed most commonly during medical procedures (57.1% for the patients at risk) and during eating (35.7% for the patients without risk). The most common FB materials were teeth (n = 11). Alligator jaw biopsy forceps (n = 23) was the most commonly used equipment. All of the FBs were removed without significant complications. Conclusion: This study underlines that a tracheobronchial FB in the patients who are at a high risk of aspiration are more likely to overlooked because of the more gradual onset of symptoms and the symptoms develop iatrogenically in many cases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.34-42
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• 2004

The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.251-259
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• 2020

Oral and maxillofacial infection is a common complication in patients undergoing chemotherapy. The treatment of oral diseases in such patients differs from that administered to healthy patients. This paper reports a case of acute osteomyelitis of odontogenic origin following a recent chemotherapy session. The patient's condition was life-threatening because of neutropenic fever and sepsis that developed during the inpatient supportive care. However, the patient showed prompt recovery within 40 days following the use of appropriate antibiotics and routine dressing, without the requirement for surgical treatment, except tooth extraction. As seen in this case, patients undergoing chemotherapy are more susceptible to rapid progression of infections in the oral and maxillofacial areas. Therefore, accurate diagnosis through prompt clinical and radiological examination, identification of the extent of infection, and assessment of the patient's immune system are crucial for favorable outcomes. It is also necessary to eliminate the source of infection through appropriate administration of antibiotics. In particular, a broad-spectrum antibiotic with anti-pneumococcal activity is essential. Proper antibiotic administration and wound dressing are essential for infection control. Furthermore, close consultation with a hemato-oncologist is necessary for effective infection management based on the professional evaluation of patients' immune mechanisms.

• Journal of Periodontal and Implant Science
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• v.44 no.3
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• pp.102-108
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• 2014

Purpose: Rehabilitation of the incomplete dentition by means of osseointegrated dental implants represents a highly predictable and widespread therapy; however, little is known about potential risk factors that may impair long-term implant success. Methods: From 2004 to 2012, a total of 13,147 implants were placed in 4,316 patients at the Academy for Oral Implantology in Vienna. The survival rates after 8 years of follow-up were computed using the Kaplan-Meier method, and the impact of patient- and implant-related risk factors was assessed. Results: Overall implant survival was 97% and was not associated with implant length (P=0.930), implant diameter (P=0.704), jaw location (P=0.545), implant position (P=0.450), local bone quality (P=0.398), previous bone augmentation surgery (P=0.617), or patient-related factors including osteoporosis (P=0.661), age (P=0.575), or diabetes mellitus (P=0.928). However, smoking increased the risk of implant failure by 3 folds (P<0.001) and a positive history of periodontal disease doubled the failure risk (P=0.001). Conclusions: Summing up the long-term results of well over 10,000 implants at the Academy for Oral Implantology in Vienna it can be concluded that there is only a limited number of patients that do not qualify for implant therapy and may thus not benefit from improved quality of life associated with fixed implant-retained prostheses.