• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.3
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• pp.501-505
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• 2004

Dermoid cyst is a developmental cyst that is lined by epidermis-like epithelium and contains dermal adnexal structures in the cyst wall. Dermoid cyst most occur in the eye brow although occasionally develop in other locations such as midline of the floor of the mouth, tongue, lip and buccal mucosa. The lesion is slow growing and painless without lympadenopathy. The contents of the dermoid cyst can be caseous or sebaceous. The size can vary from a few millimeters to 12cm in diameter. Histologically, dermoid cyst is lined by epidermis and adnexaes such as sweat gland, sebaceous glands and hair follicles are present in the cyst wall. The 2-year-old female of this case visited Department of Pediatric Dentistry, College of Dentistry, Yonsei University with a chief complaint of the emergence of mass on her upper lip. An excisional biopsy was carried out for a histological examination and sebaceous gland was observed in the cyst wall. The lesion was diagnosed as dermoid cyst. Dermoid cyst does not recur if complete excision is accomplished.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.216-221
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• 2000

Mucoceles and Ranulas are mucous retention phenomena, ie, they develop from the extravasation or retention of mucous after trauma to the sublingual gland or one of the minor salivary glands. Mucoceles are chronic in nature, and local surgical excision is necessary. To minimize the chance for recurrence, the underlying feeder glands should be removed in continuity with the mucocele. Ranula is a term used for mucoceles that occur in the floor of the mouth Treatment consists of marsupialization and/or removal of the feeding sublingual gland. Marsupialization entails removal of the roof of the intraoral lesion. However this procedure is often unsuccessful. Some prefer initially to excise the entire sublingual gland. This case report presents two cases. one case was developed on lower lip and treated by marsupialization. There was no recurrence during follow up period.

• Radiation Oncology Journal
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• v.5 no.2
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• pp.105-110
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• 1987

Fourty nine patients with squamous cell carcinoma of oral tongue were reviewed retrospectively for the evaluation of clinical manifestation and for the comparison between therapeutic modalites. The gross shape of the tumor was infiltrative in 22, ulcerative in 12, ad ulcer-oinfiltrative type in 10 patients. Direct extension of the tumor was most commonly to the floor of the mouth. The incidence of nodal metastasis generally increased with tumor stage. $55\%$ of the patients showed neck nodal metastasis at the time of diagnosis. Ipsilateral subdigastric node were most commonly involved, followed by submandibular nodes. The 5-year survival rate of patients treated with surgery and radiotherapy was $58.7\%$ in contrast to $21.6\%$ in radiation alone group. Overall 5-year survival rate was $31\%$ In radiation alone group, half of the patients in stage I, II were locally controlled. But the local control In stage III, IV was much inferior to early lesions. Especially, of 4 patients combined with implantation technique, 3 were completely controlled. 5-year survival rate of these implanted patients was $50\%,\;49.4\%$ of patients treated over 7,000cGy survived 5 years. This was significant in contrast to $6.4\%$ of the group treated below 7,000cGy. The most common sites of failures were primary sites. In early lesions primary radiotherapy with implantation would be an appropriate treatment in cancer of oral tongue, operation reserved for radiation failure. Operation and adjuvant radiotherapy is recommended in cases of advanced disease.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.151-156
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• 2006

Purpose : The aim of this study was to determine the accuracy of clinical and radiologic assessments in detecting positive cervical lymph nodes in oral cancer. Materials and Methods : We had reviewed the preoperative clinical, radiologic and postoperative histopathologic reports of 46 patients who had been diagnosed as oral cancer and underwent surgical excision combined with neck dissection (52 sides of neck) in the Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University from the July 1, 1992 to the April 30, 1999. Results : The results were as follows 1. The male to female ratio was 4.38 : 1 and the mean age was 57. 2. Sensitivity values for the preoperative assessment of cervical lymph node metastasis in oral cancer were 62.5 % in clinical examination and 50.0 % in radiologic assessments. Specificity values were 77.8 % in clinical examination and 94.4 % in radiologic assessments. 3. False positive values were 44.4 % in clinical examination and 20.0 % in radiologic assessments. False negative values were 17.6 % in clinical and 19.0% in radiologic assessments. 4. Overall efficiency values were 73.1 % in clinical examination and 80.8 % in radiologic assessments. Summary : There were some limits on the accuracy of clinical and radiologic assessments in the preoperative detection of the cervical lymph nodes in oral cancer. To improve the accuracy, it is important to communicate between clinician and radiologist, and adjunctive diagnostic measures, ultrasound and fine needle aspiration cytology, were helpful increasing the overall efficiency. In the high risk sites (oral tongue and floor of the mouth) the false negative value is higher and the overall efficiency in radiologic evaluation is lower than those of the low risk sites (gingiva and alveolar ridge, retromolar trigone and buccal mucosa ). The elective neck dissection should be considered in the high risk sites.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.1
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• pp.139-145
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• 2006

Ranula is a mucocele which occurs at the mouth floor and is mostly related to sublingual gland. In other words ranula is definded as a pseudocyst which occurs as the secretion duct of sublingual gland is destructed there as the saliva from the secretion duct flows out and retention in the soft tissue. The cause of ranula is destruction or obstruction of the duct. The clinical findings of ranula is a painless, unilateral bluish transparent swelling around the frenum and shows fluctuation when palpated. Histological finding represent a formation of cavity inside the connective tissue, but a pseudo-cyst can be seen which the wall of the cyst is composed of granulation tissue rather than epithelial cells. The first treatment of ranula can be considered as marsupialization. which induces the inner wall of the Ranula to be a part of oral mucosa. This case report shows a treatment of marsupialization with gauze packing in a young patient representing a clinical finding of characteristic ranula.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.413-417
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• 2002

Mucocele is a mucous retention phenomenon which is caused by a laceration to the duct of minor salivary glands causing extravasation of mucin into the connective tissue forming a cyst-like space. Sialolithiasis of minor salivary glands and chronic obstruction of salivary glands may also cause such a phenomenon. Mucocele is a smooth, rounded sessile mass with diameters varying from 1 to 15mm of sudden appearance. Mucocele tying directly beneath the mucosa may rupture spontaneously and decrease in size, but frequently recurs. Lower lip is most frequently affected, and the mouth floor and buccal vestibule may also be affected. Enucleation of the cyst is needed and removal of minor salivary glands, marsupialization and cryotherapy may also be done. The mucocele frequently recurs after its removal. A 1-year-old female patient visited the hospital with a complaint of a swelling on the lower lip since 4 months before. She had no pain history but 4 months ago, fell and such symptom appeared since then. On her first visit, a bullous solid, opaque lesion of 5mm in diameter was noted. Treatment choice of surgical approach and nonsurgical approach were explained to the guardian. Considering the patient's age, the guardian agreed to a nonsurgical procedure. Treatment was carried out by tieing 3-0 silk to the base of the lesion. One week later, the tie loosened and was re-tied. A week later, the mucocele disappeared. Mucocele on the lower lip may be usually be treated by surgical removal, but this may traumatize the surrounding minor salivary gland causing it to recur. Also, surgicial removal may induce an ischemic change causing sialometaplasia. In case of young patients or children with management problems, non-surgical methods such as this tie method may be used. This tie method does not need any local anesthesia and has no pain, no secondary infection, and low bleeding tendency.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.41-46
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• 2003

Background and Objectives: Surgical ablation of tumors in the oral cavity and the oropharynx results in a three dimensional defect because of the needs to resect the adjacent area for the surgical margin. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for this defect, which offers a thin, pliable, and relatively hairless skin and a long vascular pedicle. We report the clinical results of our 54 consecutive radial forearm free flaps used for oral cavity and oropharynx cancers. Materials and Methods: We reviewed the medical records of patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for oral cavity and oropharyngeal cancers from August 1994 to February 2003 and analyzed surgical methods, flap survival rate, complication, and functional results. Among these, 20 cases were examined with modified barium swallow to evaluate postoperative swallowing function and other 8 cases with articulation and resonance test for speech. We examined recovery of sensation with two-point discrimination test in 15 cases who were offered sensate flaps. Results: The primary sites were as follows : mobile tongue (18), tonsil (17), floor of mouth (4), base of tongue (2), soft palate (2), retromolar trigone (3), buccal mucosa (1), oro-hypopharynx (6), and lower lip (1). The paddles of flaps were tailored in multilobed designs from oval shape to tetralobed design and in variable size according to the defects after ablation. This procedures resulted in satisfactory flap success rate (96.3%) and showed good swallowing function and social speech. Eight of 15 cases (53.3%) who had offered sensate flap showed recovery of sensation between 1 and 6 postoperative months (average 2.6 month). Conclusion: The reconstruction with radial forearm free flap might be an excellent method for the maximal functional results after ablative surgery of oral cavity and oropharyngeal cancers that results in multidimensional defect.

• Journal of Korean Academy of Dental Administration
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• v.8 no.1
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• pp.1-7
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• 2020

Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.267-275
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• 1993

Eighty five patients of oral cavity cancer, treated with radiation at the Department of Therapeutic Radiology, Korea Cancer Center Hospital, during the period from March 1985 to September 1990 were analyzed retrospectively. Among 85 patients, 37 patients were treated with radiation only and 48 patients were treated with radiation following surgery. And 70 patients received external irradiation only by $^{60}Co$ with or without electron, the others were 7 patients for external irradiation plus interstitial implantation and 8 patients for external irradiation plus oral cone electron therapy. Primary sites were mobile tongue for 40 patients, mouth floor for 17 patients, palate for 12 patients, gingiva including retromolar trigone for 10 patients, buccal mucosa for 5 patients, and lip for 1 patient. According to pathologic classification, squamous cell carcinoma was the most common (77 patients). According to AJC TNM stage, stage I + II were 28 patients and stage III+IV were 57 patients. Acturial overall survival rate at 3 years was $43.9\%,$ 3 year survival rates were $60.9\%$ for stage I + II, and $23.1\%$ for stage III+IV, respectively. As a prognostic factor, primary T stage was a significant factor (p<0.01). The others, age, location, lymph node metastasis, surgery, radiation dose, and cell differentiation were not statistically significant. Among those factors, radiation plus surgery was more effective than radiation only in T3+T4 or in any N stage although it was not statistically sufficient (p<0.1). From those results, it was conclusive that definitive radiotherapy was more effective than surgery especially In the view of pertainig of anatomical integrity and function in early stage, and radiation plus surgery was considered to be better therapeutic tool in advanced stage.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.1
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• pp.117-123
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• 2010

Tooth eruption is the movement of the tooth from the developing place in the alveolar bone to the functional position in the oral cavity. The permanent incisors originate from the dental lamina on the lingual side of preceding deciduous tooth and erupt to the level of the occlusion through the well developed gubernacular cord. Ectopic eruption is a developmental disturbance in the eruption pattern of the permanent dentition. Most of the ectopically erupted lower incisor has been found in lingual side. The ectopically erupted tooth could be repositioned by orthodontic force in the early mixed dentition, which could help preventing the problems of loss of space and the lingual tilting of the lower anterior teeth. An eight-year-old girl visited the department of pediatric dentistry, Yonsei Dental University Hospital, for the evaluation and the treatment of the lower right lateral incisor, which was horizontally erupted in the lingual side, parallel to the mouth floor. Her tongue was placed on the labial side of that tooth. There was no previous dental history of dental caries or trauma on the pre-occupied primary incisor. Clinical and radiographic examinations including the computed tomography(CT), showed no evidence of dilacerations on root. Therefore, we decided to start active orthodontic traction of the lower right lateral incisor. We designed the fixed type of buccal arch wire and the lip bumper with hook for the traction. Button was attached to the lingual side of the ectopically positioned tooth. Elastic was used between the appliance and the button on that tooth. After the tooth become upright over the tongue level, appliance was change to the removable type and periodic check-up with occlusal guidance was followed to monitor the position of the tooth. In this case using the fixed appliance with modified form of lip bumper and hook embedded in acrylic part instead of extraction was very efficient up-righting the ectopically erupted tooth toward the occlusal plane.