Medication-related osteonecrosis of the jaw: a preliminary retrospective study of 130 patients with multiple myeloma / 대한악안면성형재건외과학회지

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.

Bone Regeneration Using Bilayer Bone Augmentation around Dental Implants: A Preliminary Study by Micro-CT in Dogs

The purpose of this preliminary study was to compare the effects of the bilayer bone augmentation technique (BBA) for the treatment of dehiscence-type defects around implants and evaluate the role as a membrane of the xenogenic bone positioned as the outer layer in the BBA technique using a micro-computed tomography (micro-CT). Four standardized dehiscence defects were prepared on each mandible bilaterally in 3 dogs and 1 implant was placed per defect, where each defect was treated with autograft (AB), xenograft (XB), BBA technique, or negative control without a membrane. Two months post-regenerative surgery, sectioned bone blocks were obtained. The image acquisitions were then scanned by micro-CT. Bone volume (BV), horizontal bone width (HBW) and vertical bone height (VBH) were measured through the analyses program. The BV were 11.08 mm3, 10.42 mm3, 8.1 mm3, and 7.01 mm3 in XB, BBA, control, and AB group in sequence of high value, respectively. HBW were 1.33 mm, 1.3 mm, 1.06 mm, and 1.03 mm in XB, BBA, AB, and control group, respectively. VBH were 4.88 mm, 4.85 mm, 4.74 mm, and 4.67 mm in XB, BBA, AB, and control group, respectively. However, there was no significant difference between the 4 groups. VBH tended to be higher in sequence of control, AB, BBA, and XB group (p for trend <0.05). The results showed the usefulness of the BBA technique involving mechanical support for prolonged space maintenance of xenogenic bone, for the treatment of dehiscence-type defects around implants. However, further studies with a larger sample size are required to confirm the results.

Cervical Necrotizing Fasciitis Caused by Dental Infection / 대한악안면성형재건외과학회지

Necrotizing fasciitis (NF) is defined as rapidly progressive necrosis of subcutaneous fat and fascia. Although NF of the face is rare, its mortality rate is nearly 30%. It usually originates from dental infection and can lead to involvement of the neck, mediastinum, and chest wall. Complications resulting from pre-existing systemic diseases can increase the mortality rate. Known complication factors for NF include diabetes, malnutrition, advanced age, peripheral vascular disease, renal failure, and obesity. Here, we report a case of NF originating from dental infection in an 88-year-old woman already diagnosed with hypertension, thoracic aortic aneurysm, and renal diseases. Such conditions limited adequate surgical and antibiotic treatment. However, interdisciplinary treatment involving multiple departments was implemented with good results.

Gastroprotective Effects of Glutinous Rice Extract against Ethanol-, Indomethacin-, and Stress-induced Ulcers in Rats / 전남의대학술지

This study was designed to evaluate the efficacy of an orally administered aqueous extract of glutinous rice (GRE) to protect against acute gastric mucosal lesions induced by ethanol, indomethacin, and water immersion restraint stress in rats and to characterize the active substances responsible for the protection. GRE was shown to dose-dependently prevent the gastric lesions induced by the above ulcerogenic treatments at doses of 30 to 300 mg/kg. GRE treatment increased the gastric mucin content and partially blocked the ethanol-induced depletion of the gastric mucus layer. Also, it increased the nonprotein sulfhydryl concentration in the gastric mucosa. The gastroprotective action of GRE was markedly enhanced by co-treatment with 4-8 mg/kg tea extracts. The activity of GRE was completely lost by heat treatment at 80degrees C for 3 min or treatment with 0.01% pepsin at 37degrees C for 1 h. Protein extraction studies indicated that prolamins are involved in the gastroprotective activity of GRE. Our results suggest that glutinous rice proteins are useful for the prevention and treatment of gastritis and peptic ulcer.

Gastroprotective Effects of Glutinous Rice Extract against Ethanol-, Indomethacin-, and Stress-induced Ulcers in Rats / 전남의대학술지

This study was designed to evaluate the efficacy of an orally administered aqueous extract of glutinous rice (GRE) to protect against acute gastric mucosal lesions induced by ethanol, indomethacin, and water immersion restraint stress in rats and to characterize the active substances responsible for the protection. GRE was shown to dose-dependently prevent the gastric lesions induced by the above ulcerogenic treatments at doses of 30 to 300 mg/kg. GRE treatment increased the gastric mucin content and partially blocked the ethanol-induced depletion of the gastric mucus layer. Also, it increased the nonprotein sulfhydryl concentration in the gastric mucosa. The gastroprotective action of GRE was markedly enhanced by co-treatment with 4-8 mg/kg tea extracts. The activity of GRE was completely lost by heat treatment at 80degrees C for 3 min or treatment with 0.01% pepsin at 37degrees C for 1 h. Protein extraction studies indicated that prolamins are involved in the gastroprotective activity of GRE. Our results suggest that glutinous rice proteins are useful for the prevention and treatment of gastritis and peptic ulcer.

Temporomandibular Joint Disorder from Skull Base Osteomyelitis: A Case Report

Oral Squamous Cell Papilloma in Tongue of Ventral Area: A Case Report

Injury of submandibular gland and lingual nerve as complication third molar tooth extraction in mandible : a case report

The extraction of an impacted third molar tooth is associated with many complications during the procedure and postoperative care. These complications include bleeding, swelling, pain, infection, as well as root fracture, proximal tooth injury, alveolar bone fracture, lingual nerve and inferior alveolar nerve injury etc. With the exception of a fractured root dislocation in the submandibular space, no direct submandibular gland injury related to extraction surgery has been reported until now. A 40 year old man visited the department of oromaxillofacial surgery at Yeouido St. Mary's Hospital for an extraction of the right mandible third molar. A partial third molar impaction was diagnosed by a clinical and radiographic examination. A surgical tooth extraction was practiced including buccal cortical bone osteotomy. During socket curettage, an encapsulated cyst-like lesion and a verified 3x3 cm neoplasm in the apically lingual direction were found during process of dissection. A biopsy confirmed that the neoplasm involved the submandibular gland and nerve trunk. This unusual anatomical organ injury during the surgical tooth extraction procedure is reported as a new complication during impacted third molar extraction.

Use of a Miniplate for Skeletal Anchorage in the Forced Eruption of a Severely Impacted Mandibular Second Molar: Case Report

AN EFFECT OF COMBINATION WITH ARTHROCENTESIS AND STABILIZATION SPLINT TREATMENT ON TEMPOROMANDIBULAR JOINT DISORDER PATIENT

Giant sialolithiasis of the submandibular gland: a case report

Sialolithiasis is the common pathology of salivary gland. The size of sialoliths vary from 1 mm to a few cm, but most of that are less than 10 mm. Large sialoliths (larger than 15 mm) are extremely rare. It is called Giant sialolithiasis or megalith. Symptom of the giant sialolithiasis is similar to that of regular sialolithiasis. First choice of treatment is removal of the stone. Many literatures reported various methods to remove the sialoliths. For this case report, we accidentally found the giant sialolith on the computed tomography taken for dental implant, and successfully removed the stone by minimal invasive surgical approach. Base on this result, we report this case with literature reviews.

Clinical feature and treatment of bisphosphonate-related osteonecrosis of jaw about oral bisphosphonate administrated patients: case reports

Bisphosphonates are used effectively for many medical conditions, such as multiple myeloma, Paget's disease, osteoporosis, etc. However, recently, osteonecrosis of the jaw was observed in patients receiving long-term bisphosphonate therapy, including oral administration. This osteonecrosis is refractory, and complete recovery is not guaranteed despite a standard treatment protocol being established by many associations related to oral and maxillofacial surgery. The treatment outcome of oral bisphosphonate-related osteonecrosis of jaw (BRONJ) is reported with a review of the relevant literature.

Use of corticosteroids in the treatment of localized langerhans cell histiocytosis of the mandible : Case report

Clinical & Radiographic Evaluation Following Delayed Implantation using Regular Diameter Implants in the Posterior Region

The purpose of this study was to evaluate clinical and radiographic changes of regular diameter implants placed in the posterior region. A total of 47 standard diameter implants were consecutively placed in the posterior region of 20 partially edentulous patients. The diameters of the implants were 4.1mm (N=35, 74%) and 4.3mm (N=12, 26%), respectively. Peri-implant bone loss and clinical parameters such as mobility, suppuration, swelling, bleeding on probing (BOP) were evaluated at the baseline and?the final follow-up visit. The age of the patients ranged between 24~82 years (mean age: 54.7 years). The cumulative survival rate of the regular diameter implants loaded for a period of 3-24 months (Mean: 11.7+/-7.9 month) was 100%. The average bone loss over the follow-up was 0.36+/-0.67 mm. Success rate was 95.7%. Only two implants failed (bone loss exceeding 1mm after 1 year of placement). Some prosthetic complications occurred, such as screw loosening (N=1) and dissolution of cementation material (N=2). The present study describes successful outcome following the use of standard-diameter-implants placed in the posterior region, and further comprehensive maintenance practices and follow-up schedules are required.

Osteoblastoma of the mandible: A case report

Osteoblastoma is a relatively rare benign bone tumor representing less than 1% of all bone tumors. The tumor usually involves the spine and sacrum of young individuals, less than 10% being localized to the skull, and nearly half of these affect the mandible, especially the posterior segments. In clinical finding, osteoblastoma present mainly with pain, swelling, and expansion of bone cortex. Radiographic appearances are variable, but frequently a well-delineated radiolucent lesion containing varying amounts of mineral deposits is seen. Histologically, ostoeblastoma is consists of irregular trabeculeae of osteoid and immature bone present within highly vascular connective tissue matrix. Osteoblastoma must be differentiated from a number of bone-producing lesions, including osteoid osteoma, fibrous dysplasia, ossifying fibroma, fibrous dysplasia, and osteosarcoma. If diagnosis may be mistaken for osteosarcoma, there are risks of more aggressive and irreversible treatment. Differential diagnosis of osteoblastoma is important. The preferred treatment of osteoblastoma is conservative approach and surgical excision. Recurrence following surgical intervention is rare. We treated osteoblastoma located in premolar area of mandible by excision with preservation of vital structure, such as nerves and teeth. So we report our clinical treatment with literature review

A research for the relative signal intensity of the retrodiscal tissue in the temporomandibular joint disorder patients on MRI

Endoscopic approach for treatment of dentigerous cyst in maxillary sinus

The relative signal intensity of retrodiscal tissue in TMJ using a T2-weighted MRI

The study of conscious sedation in both mandibular 3rd molars extraction in Koreans

The Mri-Based Comparison Of Normal- And Abnormal-Side Retrodiscal Tissue, And Relationship Between Clinical Examination & The Mri Findings Of Retrodiscal Tissue In Patients With Unilateral Tmj Internal Derangement

The study was performed to investigate the comparison of relative signal intensity of normal- and abnormal-side retrodiscal tissue, and relationship between clinical examination, joint effusion and relative signal intensity of retrodiscal tissue in patients with unilateral TMJ internal derangement. The study group comprised 19 females and 9 males, with a mean age of 29 years. After measurements of the signal intensity were made on the MR imager for the T2 weighted images on retrodiscal tissue and brain gray matter, we calculated relative value and tried to find relationship between clinical examination, joint effusion and relative signal intensity on normal- and abnormal-side. The results are as follows. 1. The gray matter is an appropriate reference point. 2. The relative signal intensity is high significantly in abnormal-side retrodiscal tissue compared with normal-side retrodiscal tissue. 3. The relative signal intensity is high significantly in painful joints compared with nonpainful joints and in joints with joint effusion compared with joints without joint effusion. 4. The relative signal intensity in normal joints, joints with reduction and joints without reduction is increased in order significantly.