• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.2
• /
• pp.308-315
• /
• 1996

Osteoarthritis is a noninflammatory degenerative disease affecting the articular surfaces and is accompanied by remodeling of the underlying bone. The sympotms of osteoarthritis of the temporomandibular joint are pain in the joint and muscles of mastication, limitation. Osteoarthritis is generally accepted that several factors can contribute to the trauma, aging process, internal derangement and MPDS. Radiographic features of the osteoarthritis are seen flattening of joint, sclerosis on flattened area and osteophyte or anterior lipping. In the past, osteoarthritis was considered to self-limiting disease. Currently, synovial chondromembrane is part of the process of osteoarthritis secondary to trauma. Synovial chondromatosis is an uncommon disease of cartilaginous transformation of synovial membrane with formation of loose bodies within the joint space. The pathogenesis is more an active metaplastic than a neoplastic process. The cause of synovial chondromatosis is unknown. Although trauma and inflammation have all been cited as possible factors in tis pathogenesis. The clinical sign and symptoms are unilateral swelling of the joint region, pain in the joint area and crepitus seem to be the most reliable signs and symptoms. Radiographic evidence of loose bodies may or may not be present. This is a case report of 66 year old female with synovial chondromatosis, that is advanced disease of the osteoarthrits. We treated patient with surgical excision of lose bodies, diskectomy and synovectomy. The defected articular fossa area was reconstructed with temporalis fascia flap. The result was satisfactory.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.34 no.3
• /
• pp.220-225
• /
• 2012

Wegener's granulomatosis (WG) is an autoimmune disease of unknown etiology characterized by the triad of necrotizing granulomatous lesion in the upper and lower respiratory tracts or both, disseminated vasculitis involving both small arteries and veins, and necrotizing glomerulonephritis. The most common oral lesions associated with WG are ulceration and strawberry gingivitis. A 47-years old man in medical care associated WG was consulted our Division of Oral and Maxillofacial Surgery for the chief complaint of toothaches. Pre-operative panorama showed the alveolar radiolucency and the loss of lamina dura regarding the left upper teeth. An oropharyngeal magnetic resonance imaging also revealed the increased bone marrow signal intensity on the left maxilla. Under the impression of maxillary osteonecrosis due to WG, maxillary saucerization with removal of involved teeth was performed. We obtained good results and report the first case of WG in Korea, with the review of literatures regarding oral and general systemic features.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.30 no.1
• /
• pp.30-40
• /
• 2008

The objectives of this study was to check up the effect of celecoxib, COX-2 inhibitor, on the pathogenesis of oral squamous cell carcinoma. After mefenamic acid, aspirin and celecoxib, COX-2 inhibitor, were inoculated to HN 22 cell line, the following results were obtained through tumor cell viability by wortmannin, growth curve of tumor cell line, apoptotic index, PGE2 synthesis, total RNA extraction, RT-PCR analysis and TEM features. 1. When wortmannin and celecoxib were given together, the survival rate of tumor cells was lowest about 47 %. So wortmannin had an effect on the decrease of survival rate of tumor cells. 2. In growth curve, the slowest growth was observed in celecoxib inoculated group. 3. The synthesis of PGE2 was decreased in all group and the obvious suppression and highest apoptotic index was observed in celecoxib inoculated group. 4. Suppression of expression of COX-2 mRNA was evident in celecoxib inoculated group. But that of COX-1,2 mRNA was observed in mefenamic acid inoculated group and aspirin inoculated group. 5. In celecoxib inoculated group, mRNA expression of AKT1 was decreased and that of PTEN & expression of caspase 3 and 9 was evidently increased. Depending on above results, when celecoxib was inoculated to oral squamous cell carcinoma cell line, an increase of mRNA expression of caspase 3,9 and PTEN is related to a decrease of mRNA expression of AKT1. Wortmannin had an effect on the decrease of survival rate of tumor cells. Celecoxib might induce apoptosis of tumor cell by suppression of AKT1 pathway and COX-2 inhibition. This results suggested that COX-2 inhibitor might be significantly effective in chemoprevention of oral squamous cell carcinoma.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.1
• /
• pp.68-71
• /
• 2010

Facial nerve schwannomas (FNSs) are usually painless, slow-growing, and without specific symptoms, so that early diagnosis may be difficult. They are particularly liable to being misdiagnosed as parotid gland origin benign tumor before surgery, which can lead to unnecessary parotidectomy or unexpected facial nerve injury. To prevent these complications, it is important that the correct diagnosis is performed at least in intraoperative time. When an adhesion between the mass and the facial nerve is exist or when electrical stimulation of the mass triggers facial movement, FNS is highly suggested diagnosis. In such cases, frozen section analysis should always be performed. In this case, the pre-operative diagnosis from clinical examination and MRI was pleomorphic adenoma. However, intraoperative features led us to suspect that the mass originated from facial nerves, and intraoperative frozen section analysis yielded results consistent with a schwannoma. Based on this intraoperative diagnosis, we carried out a successful conservative treatment with preservation of facial nerve.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.5
• /
• pp.484-487
• /
• 2010

Cemento-ossifying fibroma is a true osteogenic neoplasm. It is also called as ossifying fibroma or cementify-ing fibroma. Small lesions seldom cause any symptoms and are detected only on radiographic examination. Large lesions result in a painless swelling of the involved bone. In radiographic features the lesion most often is well defined and unilocular. It may appear completely radiolucent, or more often varying degrees of rdiopacity. It is composed of fibrous tissue that contains a variable mixture of bony trabeculae,cementum-like spherules, or both. Treatment of most lesions generally is enucleation of tumor. However, some lesions which have grown large and destroyed considerable bone, may necessitate surgical resection and bone grafting. This case was the bony lesion that was found by accident in patient with mandibular left body and subcondylar fracture. In radiographic examination, there was a mixed radiolucent and radiopaque lesion in mandibular left body area with fracture line. We treated on mandibular left body and subcondylar fracture and enucleated the lesion on the left body area simultaneously. At surgical exploration, the lesion was well demarcated from the surrounding bone, thus permitting relatively easy separation of the tumor from its bony bed. In histopathologic examination, the lesion contained bony trabeculae and cementum-like spherules within a background of cellular fibrous connective tissue. It finally diagnosed as cemento-ossify-ing fibroma from the result of biopsy.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.1
• /
• pp.37-42
• /
• 2010

Purpose: The mental foramen (MF) is an important anatomical structure during local anesthesia and surgical procedures in terms of achieving effective mental nerve blocks and avoiding injuries to the neurovascular bundles. Thus, understanding the anatomic features of the mandibular canal and accessory mental foramen in Korean could contribute to the surgical anatomic assessment. This study was to elucidate frequency, position and course of AMF (accessory mental foramen) in Korean using 3D cone beam computed tomography. Materials and Methods: The CBCT (Conbeam computed tomography) DICOM data (Alphard, Asahi, Japan) from 540 patients in korean were analyzed. We investigated images of 3D CBCT using Ondemand (CyberMed, Korea) software program on the incidence and anatomical characteristics of accessory foramen. Results: The accessory mental foramina were found in 17 patients. Accessory mental foramina exist predominantly in the apical area of the second premolar and posteroinferior area of the mental foramen. The accessory branches of the mandibular canal showed common characteristics in the course of gently sloping posterosuperior direction in the buccal surface area. The size of most AMF was obviously smaller than that of MF. Conclusion: We could identify frequency, position and course of AMF (accessory mental foramen) by the anatomical study of the accessory mental foramen using 3D cone beam CT in Korean.

• Archives of Plastic Surgery
• /
• v.38 no.6
• /
• pp.861-866
• /
• 2011

Purpose: Together with the breast, buttocks are an important element of attractive body contour. To make a beautiful buttocks, improvement of body contour around the buttock as well as buttock augmentation and lifting is also important. The authors investigated characteristic features of buttocks in Koreans and report about the results of liposculpture and autologous fat injection for improving buttock's contour. Methods: We performed a retrospective study of 21 patients who would like to gluteal reshaping. We checked about buttock's ptosis, projection, depression, gluteal retraction and excessive fat accumulation around buttocks. Depending on it, we performed liposculpture and autologous fat injection. Under general anesthesia, we harvested fat from excessive fat accumulation areas around buttocks, and injected into buttocks medio-superiorly. Postoperatively, pillows were positioned on the bed not to press the buttocks which were injected with the fat. Results: Based on the shape of buttocks, A-shape is seen in 4 cases (19%), V-shape 3 cases (14%), squareshape 9 cases (43%), round-shape 5 cases (24%). Based on the Gonzalez's ptosis grading method, 1 degree ptosis is 1 case (4%), 2 degree ptosis is 6 cases (29%), 3 degree ptosis is 8 cases (38%), 4 degree ptosis is 6 cases (29%). There were no complications such as infection, hematoma, pain, dysparethesia. The subjective assessment of surgical results by patients was excellent. Conclusion: To make a beautiful buttock, improvement of body contour around the buttock as well as buttock augmentation and lifting is also important. Liposculpture and autologous fat grafting are very safe, useful and easy methods for improving buttock's contour.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.23 no.1
• /
• pp.40-47
• /
• 2001

To investigate epidermiologic trend in maxillofacial fractures. We retrospectively studied 934 patients with maxillofacial fractures between $1981{\sim}1987$ and $1995{\sim}1999$. The results were compared in the previous group (Group A, patients treated between $1981{\sim}1987$) with those in the recent group (Group B, $1995{\sim}1999$). Also, we studied 516 patient between $1995{\sim}1999$ for occupation, associated injuries, treatment and complications. The sex ratio of men to women decreased (5.6 : 1 in Group A vs. 3.5 : 1 in Group B), and the largest age group was 20 to 29 years. There was the highest incidence in September and Fall. The most frequent cause of maxillofacial fracture in both Group A and B was traffic accidents. The distribution of fracture site did not change appreciably, but the frequency of midfacial fracture increased. In the recent group, the largest occupational group was salaried men, and the largest associated injuries of maxillofacial fracture was head and neck injury. Open reduction was used in 91% of the cases, and post-operation complications were infection, neurologic problem, malocclusion, and mouth opening limitation etc. Our results suggest that the clinical features of patients with maxillofacial fractures have changed during the past decade.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.30 no.5
• /
• pp.465-472
• /
• 2008

We experienced a rare case of oral squamous cell carcinoma arisen from gingival tissues overlying prolonged chronic osteomyelitis of the mandible. A 66 years old man complained of unhealed extraction sockets of left mandibular second premolar and first molar, and showed extensive leukoplakia in the gingival tissues of the same area. The inflammation of the socket granuloma became severe and extended into adjacent mandibular proper, resulted in diffuse suppurative chronic osteomyelitis of mandibular body, exhibiting irregular osteolytic changes of mandibular trabecular patterns in mottled radiolucent appearance. The leukoplakia was initially diagnosed under microscope, and the involved gingival tissues were radically removed. Thereafter, the gingival soft tissue inflammation involving the mandibular osteomyelitis was hardly healed for two years. During the period of repeated surgical treatments for the inflamed lesion, nine biopsies were taken sequentially. Until the eighth biopsy, there consistently showed the suppurative osteomyelitis with ingrowing gingival tissues into the bony inflammatory lesion. The gingival epithelium showed the features of leukoplakia but no evidence of malignant changes. However, the ninth biopsy, taken about 2 years after initial diagnosis, showed the early carcinomatous changes of the gingival epithelium. The neoplastic epithelial cells were relatively well differentiated with many keratin pearls, and infiltrated only into underlying connective tissues. So, we presumed that the present case of squamous cell carcinoma was caused by the persistent inflammatory condition of the mandibular osteomyelitis, and also suggest that the leukoplakia should be carefully removed in the beginning to prevent the neoplatic promotion of the chronic inflammation.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.4
• /
• pp.332-336
• /
• 2010

We reviewed 30 cases of keratocystic odontogenic tumor (KCOT) managed during the 8-year period between 2001 and 2008. This case report described the clinical, radiographic and histopathologic features of these KCOT. Of the 30 patients in whom KCOTs were diagnosed, 18 (60%) of the patients were male and 12 (40%) were female. The mean age of these patients was 34.2 years, with peak incidence occurring in the third decade of life. The lesions were mostly located in the mandible (74.2%) and in the maxilla (25.8%). There was a marked predilection to occur in the posterior mandible. Radiographically, 19 (63%) out of the 30 cases were unilocular type with a well demarcated border, while 11 cases (37%) were multilocularin appearance. Histopathologically, 73% of the cysts were lined with parakeratinized stratified squamous epithelium, while only 3% of the cysts were lined with mixed parakeratinized of orthokeratinized epithelium. 22 cases (73%) contained keratin in the lumen. A satellite cyst was observed in 14 cases (47%). All cysts were treated by enucleation. The recurrence rate was shown as 10% for 3 patients with a follow up period and recurred lesions were treated by re-enucleation.