Cystic lesion between a deciduous tooth and the succeeding permanent tooth: a retrospective analysis of 87 cases

Objectives@#The purpose of this study is to investigate the characteristics of dentigerous and radicular cysts that occur between deciduous and succeeding permanent teeth and to propose considerations for differential diagnosis of cysts at the treatment planning stage in the outpatient clinic. @*Materials and Methods@#A total of 87 patients with a cystic lesion located between a deciduous tooth and the succeeding permanent tooth participated in the study. Twelve variables were analyzed to diagnose such a cyst. For data analysis, Fisher’s exact test was used to determine the statistical significance of the variables. @*Results@#Of the total 87 patients who participated in this study, 69 were diagnosed with dentigerous cysts and 18 were diagnosed with radicular cysts.Seven of the 12 differential factors analyzed in this study were statistically significant: age, location, symptoms, dental caries, endodontic treatment, delayed eruption, and size. @*Conclusion@#Several criteria can be considered for diagnosis of dentigerous cysts or radicular cysts. Age, location, presence of symptoms and dental caries, previous endodontic treatment, cystic size, and delayed eruption of impacted permanent teeth are reliable factors that should be considered when diagnosing dentigerous and radicular cysts.

Cemento-osseous dysplasia: clinical presentation and symptoms

Objectives@#The purpose of this study was to evaluate risk factors and symptoms in cemento-osseous dysplasia (COD) patients. @*Materials and Methods@#In this study, 62 patients who were diagnosed histologically with COD were investigated from 2010 to 2020 at the author’s institution. We compared clinical and radiological characteristics of symptomatic and asymptomatic patients. The factors were sex, age, lesion size, site, radiologic stage of lesion, apical involvement, sign of infection, and history of tooth extraction. Statistical analysis was performed using Fisher’s exact test and the chi-square test. @*Results@#COD was more prevalent in female patients. With the exception of three cases, all were focal COD. The majority of patients presented with symptoms when the lesion was smaller than 1.5 cm in size. Symptoms were observed when the apex of the tooth was included in the lesion or there was a local infection around the lesion. The history of tooth extraction and previous endodontic treatment were evaluated, and history was not a significant predictor for the onset of symptoms. @*Conclusion@#In this study, risk factors associated with symptomatic patients were size of lesion, apical involvement, and local infection.

Primary repair of untreated cleft palate in an elderly patient:a case report

Untreated adult or elderly cleft lip and palate patients are rarely seen, but studies on delayed primary palatal closure have been performed in the less developed Asian and African countries, where access to medical care is difficult. A 64-year-old woman visited our clinic with untreated cleft palate with a 40×20-mm-wide defect in the medial palate. Two-flap palatoplasty under general anesthesia was performed to close the cleft palate. After 1 month, the result was favorable without any complications including oronasal fistula. Cleft palate primary repair in an elderly patient is rare and has some surgical problems that are associated with a wide range of defects, but good results can be obtained if surgery is performed well with appropriate considerations.

Idiopathic bone cavity: clinical and radiological features of 90 retrospective cases and surgical treatment

Objectives@#The purpose of this study was to evaluate the clinical and radiographic characteristics of idiopathic bone cavity (IBC) to determine the effect of surgical intervention on the process of healing. @*Materials and Methods@#All cases diagnosed with IBC during the period of 2011 to 2020 at our Department of Oral and Maxillofacial Surgery were searched. Ninety cases were retrieved. The features evaluated were sex, age, contour of the lesion, number of teeth involved, site, history of trauma, and postoperative healing pattern. The significance of differences was assessed by Mann–Whitney U test and chi-square test. @*Results@#The female:male ratio showed no predilection toward either sex (0.9:0.8). The mean age of the collected sample was 22.05±14.38 years, and the age ranged from 10 to 58 years. All cases presented in the mandible and showed well-circumscribed radiolucency. Margins were either scalloped or round in shape, and the size varied from one tooth to six teeth involvement. Seventy cases involved three or fewer roots. Three cases showed bilateral lesion. Four cases had a history of trauma at the area of the lesion. Fifty-one cases were followed for six months after surgery, and all showed increased bone density at the lesion. @*Conclusion@#There is no definitive radiological or clinical feature of IBC. Considering the diversity of clinical and radiological features, such a diagnosis relies primarily on surgical findings of an empty bone cavity with no epithelial lining. Our data suggest that surgical intervention be the first choice of treatment as opposed to observation.

Rhabdomyolysis after the free fibular flap operation for mandibular reconstruction: a case report / 대한악안면성형재건외과학회지

BACKGROUND: Free fibular flap is one of the most useful methods in the hard tissue reconstruction of the maxilla-mandible. Free fibular flap presents some advantages in which the reconstruction of both soft and hard tissues can be done at the same time. It also provides a safe and successful bone graft for the reconstruction, along with a low rate of complications. Despite these advantages and the rarity of a postoperative complication, particularly in oral and maxillofacial surgery procedures, a prolonged operation might exhibit some complications related with rhabdomyolysis. We experienced the rare event of rhabdomyolysis after oral cancer surgery. CASE PRESENTATION: In this article, we report the case of a patient who developed rhabdomyolysis after undergoing free fibular flap surgery. CONCLUSIONS: Despite the advantages of the free fibular flap operation, clinicians must be aware of the risk of complications because there are multiple factors that could result in rhabdomyolysis, such as duration of operation, position of the subject, and pre-existing conditions of diabetes and hypertension. Once the diagnosis of rhabdomyolysis is confirmed, a prompt treatment plan should be made and applied as soon as possible. This will increase the chance of a full recovery for the patient who is exhibiting symptoms of rhabdomyolysis.

A retrospective analysis of risk factors of oromaxillofacial infection in patients presenting to a hospital emergency ward / 대한악안면성형재건외과학회지

BACKGROUND@#The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay.@*METHODS@#A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression.@*RESULTS@#A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age.@*CONCLUSIONS@#The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.

Malignant lymphoma on parotid gland: a clinical case

Non-Hodgkin's lymphoma on the parotid gland is a relatively rare occurrence among head and neck tumors. The mass of parotid gland lymphoma cannot be distinguished from other benign masses of the parotid gland; therefore, it is important to consider lymphoma in the differential diagnosis when examining parotid swellings and masses. Parotid gland lymphoma is most likely to be B-cell, non-Hodgkin's lymphoma of one of three types, which include follicular, marginal zone, and diffuse large B-cell, although other histologic patterns have been described. We present a review of a patient with diffuse large B-cell lymphoma (DLBCL) who presented to the Department of Oral and Maxillofacial Surgery of Pusan National University Hospital (Yangsan, Korea).

Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review

Herpes zoster virus (HZV) infections are caused by reactivation of the varicella zoster virus. Reactivation symptoms commonly affect the thoracolumbar trunk, and rarely affect the mandibular branches of the trigeminal nerve. When the mandibular branches are involved, lesions appear proximal to the innervation area. This condition may be associated with exfoliation of the teeth and osteonecrosis of the jawbone. We report a case of mandibular osteomyelitis after herpes zoster infection and we present a review of the literature on mandibular-branch involvement of HZV-related osteonecrosis.

A clinical study of emergency room visits for oral and maxillofacial lacerations

OBJECTIVES: This study investigated patients with oral and maxillofacial lacerations who visited the emergency room over a three-year period in an effort to determine the optimal treatment for these injuries. MATERIALS AND METHODS: This study examined 1,742 patients with oral and maxillofacial lacerations with 2,014 different laceration locations who visited the emergency room of Pusan National University Hospital (Busan, Korea) over three years, from January 2011 to December 2013. Patients were classified by sex, age, visit day, cause of injury, injury site, and the presence or absence of soft tissue and tooth injuries. RESULTS: The male to female ratio was 2.50:1. Patients under 10 years old were seen most frequently. Most emergency room visits were on weekends. Among intra-oral lacerations, the lip area was the most vulnerable site; among extra-oral lacerations, the chin area was most frequently injured. The most frequent etiology was a slip down. Most lacerations occurred without bone fracture or tooth damage. CONCLUSION: Laceration may differ in large part as compared with the fracture. Therefore, it is necessary to continue collecting data on oral and maxillofacial lacerations to establish optimal emergency room diagnosis and treatment strategies.

Comparative study of chitosan/fibroin-hydroxyapatite and collagen membranes for guided bone regeneration in rat calvarial defects: micro-computed tomography analysis / 国际口腔科学杂志·英文版

This study aimed to utilize micro-computed tomography (micro-CT) analysis to compare new bone formation in rat calvarial defects using chitosan/fibroin-hydroxyapatite (CFB-HAP) or collagen (Bio-Gide) membranes. Fifty-four (54) rats were studied. A circular bony defect (8 mm diameter) was formed in the centre of the calvaria using a trephine bur. The CFB-HAP membrane was prepared by thermally induced phase separation. In the experimental group (n=18), the CFB-HAP membrane was used to cover the bony defect, and in the control group (n=18), a resorbable collagen membrane (Bio-Gide) was used. In the negative control group (n=18), no membrane was used. In each group, six animals were euthanized at 2, 4 and 8 weeks after surgery. The specimens were then analysed using micro-CT. There were significant differences in bone volume (BV) and bone mineral density (BMD) (P<0.05) between the negative control group and the membrane groups. However, there were no significant differences between the CFB-HAP group and the collagen group. We concluded that the CFB-HAP membrane has significant potential as a guided bone regeneration (GBR) membrane.

The Retrospective Study of Closed Reduction of Nasal Bone Fracture / 대한악안면성형재건외과학회지

PURPOSE: This study was conducted in order to investigate the therapeutic effect of closed reduction according to a classification in patients with nasal bone fracture. METHODS: The study was conducted retrospectively on 186 patients with a mean age of 38 years (range: 7 to 80 years). All patients were diagnosed by clinical and radiologic examination, and then classified according to Hwang's classification by computed tomography. The patients were further classified by their age, gender, causes of fracture, operation timing after fracture, concurrent facial bone fracture, and complications. All patients underwent the same reduction and treatment protocol and were then followed up regularly for at least three months. RESULTS: The cause of the fracture was slip down, and the highest prevalence was shown in the 20s. The mean operation timing after fracture was 4.1 days (range: 1 to 14 days), and it tended to be longer in the case of defected septal bone or more severe fracture. The most common concurrent facial bone fracture was orbital blow-out fracture, and zygomaticomaxillary complex and maxillary fracture occured frequently. The largest number of complications occurred in class III and IIBs patients, and the main complication was postoperative pain. CONCLUSION: Results of nasal bone closed reduction on the 186 patients showed that serious complications rarely occurred. Closed reduction is generally an effective treatment for nasal bone fracture. However, in the case of severe concurrent septal bone fracture or comminuted fracture with depression, open reduction should be considered. Further study with a larger number of patients and further classification is required.

Effectiveness of Computed Tomography for Blow-out Fracture / 대한악안면성형재건외과학회지

PURPOSE: This study assessed the association between eye symptoms (enophthalmos or diplopia) and site of damage, volume, deviated inferior rectus muscle (IRM) and type of fracture with computed tomography (CT). The intent is to anticipate the prognosis of orbital trauma at initial diagnosis. METHODS: Forty-five patients were diagnosed with fractures of the inferior wall of one orbit. Fracture area, volume of displaced tissue, deviated IRM, and type of fracture were evaluated from coronal CT by one investigator. The association of those variables with the occurrence of eye symptoms (diplopia and enophthalmos) was assessed. RESULTS: Of 45 patients, 27 were symptom-free (Group A) and 18 had symptoms (Group B) of enophthalmos and/or diplopia. In Group B, 12 had diplopia, one was enophthalmos, and five had both. By CT measurement, group A mean area was 192.6 mm2 and the mean volume was 673.2 mm3. Group B area was 316.2 mm2 and volume was 1,710.6 mm3. The volume was more influential on symptom occurrence. Each patient was categorized into four grades depending on the location of IRM. Symptom occurrence and higher grade were associated. Twenty-six patients had trap-door fracture (one side, attached to the fracture), and 19 had punched-out fracture (both sides detached). The punched-out fracture was more strongly associated with symptoms and had statistically significantly higher area and volume. CONCLUSION: In orbital trauma, measurement of fracture area and volume, evaluation of the deviated IRM and classification of the fracture type by coronal CT can effectively predict prognosis and surgical indication.

The impact factors on 5-year survival rate in patients operated with oral cancer

OBJECTIVES: The purpose of this study is to analyze clinical impact factors on the survival rate, and to acquire basic clinical data for the diagnosis of oral cancer, for a determination of the treatment plan with long-term survival in oral cancer patients. MATERIALS AND METHODS: Through a retrospective review of the medical records, the factors for long-term survival rate were analyzed. Thirty-seven patients, among patient database with oral cancer treated in the Department of Oral and Maxillofacial Surgery at Pusan National University Hospital within a period from March 1998 to March 2008, were selected within the study criteria and were followed-up for more than 5 years. The analyzed factors were gender, age, drinking, smoking, primary tumor site, type of cancer, TNM stage, recurrence of affected region, and metastasis of cervical lymph node. The 5-year survival rate on the impact factors was calculated statistically using the Kaplan-Meier method. RESULTS: By classification of clinical TNM at the 1st visit, there were 11 (29.7%) cases for stage I, 11 (29.7%) cases for stage II, 3 (8.1%) cases for stage III, and 12 (32.5%) cases for stage IV. The 5-year survival rate of total oral cancer patients after the operation were 75.7%, pathological TNM stage related 5-year survival rate were as follows: stage I 90.0%, stage II 81.8%, stage III 100% and stage IV 45.5%; in which the survival rate difference by each stage was significantly observed. The recurrence of cervical lymph node was the significant impact factor for the survival rate, because only 30.0% the survival rate in recurrent cases existed. During the follow-up, there were 15 (40.5%) patients with confirmed recurrence, and the 5-year survival rate of these patients was decreased as 46.7%. CONCLUSION: The classification of clinical and pathological TNM stage, local recurrence after surgery, and metastasis of cervical lymph node after surgery were analyzed as the 3 most significant factors.

Correction of the Traumatic Enophthalmos Using Titanium Reinforced Porous Polyethylene

Simultaneous Involvement of Nervous and Gastrointestinal Systems in Behcet's Disease

No abstract available.

Partial sublingual glandectomy with ranula excision: a new conservative method for treatment

OBJECTIVES: This study evaluated the clinical results of partial sublingual glandectomy accompanying the excision of ranula as new treatment modality. MATERIALS AND METHODS: A total of 43 patients who were treated between 1999 and 2007 for oral or plunging ranula were reviewed. All patients were treated surgically by various methods with a total of 55 different procedures performed. Ten cases of partial sublingual glandectomy with excision of the ranula were conducted. All excised specimens were examined. We compared the clinical outcomes resulting from each treatment method. RESULTS: The recurrence rates for marsupialization, excision of ranula, marsupialization with gauze packing, total excision of sublingual gland and ranula, and partial sublingual glandectomy with excision of ranula were 50%, 25%, 25%, 0% and 10%, respectively. Of the 10 patients treated by partial sublingual glandectomy with ranula excision, only one experienced recurrence (10%), i.e., plunging ranula. None of the ranulas contained an epithelial lining, and the excised portion of the feeding sublingual glands showed degenerative changes. CONCLUSION: In removal of ranulas, we found that excision of the attached sublingual gland, which removed the feeding portion and degenerative acinar cells, yielded good outcomes. Thus, as a new conservative method for treatment, we recommend partial sublingual glandectomy to accompany excision of the ranula.

Stability and Considerations of Total Maxillary Setback Le Fort I Osteotomy for the Correction of Maxillary Protrusion

Evaluation of Maxillary Sinus Using Cone-beam Computed Tomography in Patients Who Underwent Le Fort I Osteotomy

or =2 mm and 6 mm but not complete), total opacification, and polypoidal mucosal thickening. The diameters of the maxillary sinus ostium on the coronal cross-sectional view were also calculated.RESULTS: Out of 166 maxillary sinuses in 83 patients, 42 (25.3%) maxillary sinuses before surgery and 37 (22.3%) maxillary sinuses after surgery showed abnormalities. A decrease in the diameters of maxillary ostium was observed after surgery (P<0.05). However, there was no significant difference in mucosal thickness both, preoperatively and postoperatively.CONCLUSION: The orthognathic surgery didn't deteriorate the maxillary sinus abnormaility. Despite the low prevalence of sinus complications in orthognathic surgery, all the patients should be informed of the possibility of sinusitis that could require the surgical intervention before surgery.

Orbital roof and supraorbital ridge fracture: a report of three cases

Orbital roof and supraorbital ridge fractures are frequently associated with high energy concomitant craniofacial trauma. When a displacement of the orbital roof and supraorbital rim occurs, exploration, stabilization and reconstruction are warranted to limit the ocular complications. The management of fractures involving the frontal sinus must consider the possible need for obliteration or cranialization of the sinus. Many incisions have been described and used to approach these fractures, such as a coronal incision, eyebrow incision, and an incision through the laceration. We report 3 cases of orbital roof and supraorbital ridge fracture patients with a review of the relevant literature.

Acral Pigmented Spitz Nevus That Clinically Mimicked Acral Lentiginous Malignant Melanoma

Pigmented Spitz nevus is a benign melanocytic skin lesion with distinct clinical features and it is frequently found on the extremities. However, it rarely occurs on acral area of the body, and such a case has not yet been fully documented. We present a case of acral pigmented Spitz nevus occurring on the foot, and this mimicked acral lentiginous malignant melanoma. Clinicians should be well aware of this entity and its possible clinical presentations. Since acral pigmented Spitz nevus is benign in nature, making the correct diagnosis is important to avoid unnecessary mutilating or excessive surgery.