Investigation of the association between orthodontic treatment and temporomandibular joint pain and dysfunction in the South Korean population / 대한치과교정학회지

OBJECTIVE@#This study investigated the relationship between orthodontic treatment and temporomandibular disorders (TMD) in South Korean population.@*METHODS@#This study obtained data from the 2012 Korean National Health and Nutrition Examination Survey. The final sample size was 5,567 participants who were ≥ 19 years of age. Logistic regression analysis was performed to evaluate the relationship between orthodontic treatment and TMD.@*RESULTS@#Participants who underwent orthodontic treatment showed higher educational level, lower body mass index, reduced chewing difficulty, and reduced speaking difficulty. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for orthodontic treatment and TMD were 1.614 (1.189–2.190), 1.573 (1.162–2.129) and 1.612 (1.182–2.196) after adjusting for age, sex and psychosocial factors. Adjusted ORs and their 95% CIs for orthodontic treatment and clicking were 1.778 (1.289–2.454), 1.742 (1.265–2.400) and 1.770 (1.280–2.449) after adjusting for confounding factors. However, temporomandibular joint pain and functional impairment was not associated with orthodontic treatment.@*CONCLUSIONS@#Temporomandibular joint pain and dysfunction was not associated with orthodontic treatment.

Osteogenic potential of adult stem cells from human maxillary sinus membrane by Simvastatin in vitro: preliminary report

OBJECTIVES: The objective of this study is to determine the adequate concentration and to evaluate the osteogenic potential of simvastatin in human maxillary sinus membrane-derived stem cells (hSMSC). MATERIALS AND METHODS: Mesenchymal stem cells derived from the human maxillary sinus membrane were treated with various concentrations of simvastatin. The adequate concentration of simvastatin for osteogenic induction was determined using bone morphogenetic protein (BMP-2). The efficacy of osteogenic differentiation of simavastatin was verified using osteocalcin mRNA, and the mineralization efficacy of hSMSCs and simvastatin treatment was compared with alkaline phosphatase and von Kossa staining. RESULTS: Expression of BMP-2 mRNA and protein was observed after three days and was dependent on the concentration of simvastatin. Expression of osteocalcin mRNA was observed after three days in the 1.0 microM simvastatin-treated group. Mineralization was observed after three days in the simvastatin-treated group. CONCLUSION: These results suggest that simvastatin induces the osteogenic potential of mesenchymal stem cells derived from the human maxillary sinus membrane mucosa.

Three-dimensional finite element analysis of the stress distribution and displacement in different fixation methods of bilateral sagittal split ramus osteotomy

OBJECTIVES: This study evaluated a range of fixation methods to determine which is best for the postoperative stabilization of a mandibular osteotomy using three-dimensional finite element analysis of the stress distribution on the plate, screw and surrounding bone and displacement of the lower incisors. MATERIALS AND METHODS: The model was generated using the synthetic skull scan data, and the surface model was changed to a solid model using software. Bilateral sagittal split ramus osteotomy was performed using the program, and 8 different types of fixation methods were evaluated. A vertical load of 10 N was applied to the occlusal surface of the first molar. RESULTS: In the case of bicortical screws, von-Mises stress on the screws and screw hole and deflection of the lower central incisor were minimal in type 2 (inverted L pattern with 3 bicortical repositioning screws). In the case of plates, von-Mises stress was minimal in type 8 (fixation 5 mm above the inferior border of the mandible with 1 metal plate and 4 monocortical screws), and deflection of the lower central incisor was minimal in types 6 (fixation 5 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws) and 7 (fixation 12 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws). CONCLUSION: Types 2 and 6 fixation methods provide better stability than the others.

A comparison of fixation methods using three-dimensional finite element analysis following anterior segmental osteotomy

OBJECTIVES: This study sought to evaluate fixation methods and determine the best method for the postoperative stabilization of maxillary osteotomy. For our analysis we performed a three-dimensional finite element analysis of stress distribution on the plate, screw, and surrounding bone, as well as displacement onto the plate. MATERIALS AND METHODS: We generated a model using synthetic skull scan data; an initital surface model was changed to a solid model using software. Modified anterior segmental osteotomy (using Park's method) was made using the program, and four different types of fixation methods were used. An anterior load of 100 N was applied on the palatal surface of two central incisors. RESULTS: The Type 1 (L-shaped) fixation method gave stresses of 187.8 MPa at the plate, 45.8 MPa at the screw, and 15.4 MPa at the bone around the plate. The Type 2 (I-shaped) fixation method gave stresses of 186.6 MPa at the plate, 75.7 MPa at the screw, and 13.8 MPa at the bone around the plate. The Type 3 (inverted L-shaped) fixation method gave stresses of 28.6 MPa at the plate, 29.9 MPa at the screw, and 15.3 MPa at the bone around the plate. The Type 4 (I-shaped) fixation method gave stresses of 34.8 MPa at the plate, 36.9 MPa at the screw, and 14.9 MPa at the bone around the plate. The deflection of the plates for the four fixation methods was 0.014 mm, 0.022 mm, 0.017 mm, and 0.018 mm, respectively. CONCLUSION: The Type 3 (inverted L-shaped) fixation method offers more stability than the other fixation methods. We therefore recommend this method for the postoperative stabilization of maxillary osteotomy.

PNEUMOMEDIASTINUM AND PNEUMOTHORAX AFTER ORTHOGNATHIC SURGERY: A CASE REPORT

Computed tomography evaluation and pretreatment for a safe nasotracheal intubation, avoiding nasal cavity injuries

INTRODUCTION: In a surgery of the oral cavity, nasotracheal intubation is often carried out to secure the surgical field. By passing a tracheal tube through the nasal cavity to the pharynx, the nasotracheal intubation can lead to complications that do not occur with oral intubation, such as nasal bleeding and submucosal aberration etc. The purpose of this study is to examine the method of CT evaluation and pretreatment for a safe nasotracheal intubation. MATERIALS AND METHODS: Among 30 patients who orthognathic surgery was performed at Chung-Ang University Hospital during the period August 2009 to October 2009, 30 patients were included. RESULTS: CT evaluation with pretreatment group had a significantly lower incidence of nasal bleeding than the group with no pretreatment. CONCLUSION: CT evaluation with pretreatment helps to minimize nasal bleeding during nasotracheal intubation.

Sarcomatoid carcinoma of the mandible: report of a case

Sarcomatoid carcinoma is a rare and occurs mainly in the upper aerodigestive tract such as the oral cavity, esophagus and vocal cords. It is a unique variant of squamous cell carcinoma. We report the case of a patient with spindle cell squamous cell carcinoma involving the mandible. At initial examination, overlying mucosa of that lesion was normal appearance. One week later, that lesion showed ulcerative and bloody change and rapid growth in size. This case showed unpredictable rapid growth although rapid growth in size was suspected of undergoing malignancy.

Chondrosarcoma in the mandibular condyle: Case report

Chondrosarcoma is an uncommon neoplasm originated from cartilage cells. This occurs less than 10% in the head and neck region. Chondrosarcoma of the condyle affects mainly women. The most common symptom is swelling in the preaucricular region, limited mouth opening and pain on chewing. This report describes a case of chondrosarcoma, which occurred in the mandibular condyle.

Comparison of static MRI and pseudo-dynamic MRI in tempromandibular joint disorder patients / 대한구강악안면방사선학회지

PURPOSE: The purpose of this study was to evaluate comparison of static MRI and pseudo-dynamic (cine) MRI in temporomandibular joint (TMJ) disorder patients. MATERIALS AND METHODS: In this investigation, 33 patients with TMJ disorders were examined using both conventional static MRI and pseudo-dynamic MRI. Multiple spoiled gradient recalled acquisition in the steady state (SPGR) images were obtained when mouth opened and closed. Proton density weighted images were obtained at the closed and open mouth position in static MRI. Two oral and maxillofacial radiologists evaluated location of the articular disk, movement of condyle and bony change respectively and the posterior boundary of articular disk was obtained. RESULTS: No statistically significant difference was found in the observation of articular disk position, mandibular condylar movement and posterior boundary of articular disk using static MRI and pseudo-dynamic MRI (P>0.05). Statistically significant difference was noted in bony changes of condyle using static MRI and pseudo-dynamic MRI (P<0.05). CONCLUSION: This study showed that pseudo-dynamic MRI didn't make a difference in diagnosing internal derangement of TMJ in comparison with static MRI. But it was considered as an additional method to be supplemented in observing bony change.

The expression of FGF-5 and FGF-7 in the cyclosporin a-induced gingival hyperplasia

Cyclosporin A-induced gingival hyperplasia is frequently found in the patients who have been received an immunosuppressant for the organ transplantation. However, its exact mechanism is still unknown. The expression of FGF-5 and FGF-7 were studied in cyclosporine A-induced gingival hyperplasia (CGH) and inflammatory gingival hyperplasia (IGH). Immunohistochemistry and in situ hybridization were used for localization of protein and mRNA. The expression of FGF-5 and FGF-7 was different from CGH and IGH. FGF-5 and FGF-7 was strongly expressed in fibroblast in CGH (P<0.005 and P<0.05, respectively). FGF-5 mRNA was localized in the middle portion of connective tissue. FGF-7 mRNA was also identified in fibroblasts and mast cells. In conclusion, FGF-5 and FGF-7 were produced excessively by fibroblasts in CGH. Considering their known functions, their expression in CGH is important for production of collagen and proliferation of fibroblasts.

Limited or Le fort I down fracture access for widespread osteomyelitis of maxilla

PURPOSE: To compare the case of widespread maxillary osteomyelitis treated through different approach. METHOD: We report the two case of osteomyelitis. In a case, we had gradually removed the small amount of sequestrum for several times. In the other case, intended Le Fort I fracture was done to approach the lesion. RESULT: In the gradual sequestrectomy case, bone formations were found after 4 months. In the other case, after intended Le Fort I down fracture, sequestrectomy of Lt. maxilla was done with the labiobuccal alveolar bone preserved for the prosthodontic treatment.

The Expression Of Mmp-2, Mmp-3, Mmp-10, Mmp-13 In Squamous Cell Carcinoma Of The Tongue

Matrix metalloproteinase(MMP) is the proteolytic enzyme of the extracellular matrix. MMPs play a role in the invasion and metastasis of malignant tumor, but it is not known whether the expression of MMPs in squamous cell carcinoma of the tongue is related to the prognostic factors of this tumor. In this study, 32 paraffin-embedded tumor specimens were examined immunohistochemically using monoclonal antibodies of MMP-2, MMP-3, MMP-10 and MMP-13. The possible relationships between the expressions of the MMPs and TNM staging, the differentiation of tumor cells, size of tumor mass and lymph node metastasis were anlaysed statistically. The results were as follows. 1. The expression of MMP-2 increased according to TNM staging (P < 0.05) and lymph node metastasis (P < 0.05) and the expression of MMP-2 was not affected by the differentiation of tumor cells or tumor size. 2. The expression of MMP-3 increased with increasing tumor size (P < 0.05). However it was not related to TNM staging, the differentiation of tumor cells or lymph node metastasis. 3. The expression of MMP-10 was unrelated to TNM staging, differentiation of tumor cells, lymph node metastasis or tumor size. 4. The expression of MMP-13 increased as tumor size increased (P < 0.05). However it was not related to TNM staging, the differentiation of tumor cells or lymph node metastasis. We concluded that the expression patterns of MMP-2, MMP-3, and MMP-13 may play a role in the diagnosis, treatment plan and prognostic evaluation of malignant tumors of the tongue.

The histological and immunohistochemical findings of the newly formed human bone after distraction osteogenesis

Clinical Aspect of Arthrocentesis

The temporomandibular joint arthrocentesis is indicated the `closed lock' due to anterior disc displacement without reduction. It can be easily carried out under local anesthesia with little complications. We performed arthrocentesis to the 24 patients, 9 patients who suffered from acute or chronic closed lock with anterior disc displacement, 2 patients from temporomandibular joint dysfunction related to systemic disease and 13 patients from joint dysfunction with pain. We present the common clinical aspect of arthrocentesis that operator can be easily faced with and possible modifications of this method.

Treatment of the 'blow-out' fracture using micro-titanium mmesh