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Journal of the Korean Association of Oral and Maxillofacial Surgeons

  • P-ISSN2234-7550
  • E-ISSN2234-5930
  • SCOPUS, KCI, ESCI

Vol.34 No.1

; ; ; ; ; ; pp.1-10
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Abstract

Oral squamous cell carcinoma (OSCC) is the most frequent form of oral cancer and holds the eighth position in the cancer incidence ranking. OSCC patients are treated by classical therapeutic modalities consisting of surgery, radiotherapy, and/or chemotherapy. But OSCC still shows significant mortality rates. Thus, new therapeutic approaches have been investigated and the most promising one is naturally acquired agents with known anti-cancer effects. Genistein is a compound extracted from soy bean. Its anti-cancer effect on breast cancer is well established now and it is investigated whether it has similar effect on OSCC. It inhibited the growth and invasiveness of OSCC cells in vitro, but these effects did not work in living animals in vivo. Catechin is a compound from green tea and its anti-cancer effect on OSCC is known better than other agents. Catechin showed its anti-cancer effect in vitro via induction of apoptosis, cell cycle arrest, inhibition of growth, and down-regulation of invasion/metastasis. These effects were confirmed in vivo with mouse model. Cordycepin is one of major pharmacologically important components in Cordyceps Militaris and may exert its anti-cancer effect as an adenosine receptor agonist. In recent study, it inhibited the proliferation of OSCC cells via A3 adenosine receptor. But because there is very scarce evidence on this effect, more researches are needed on this theme.

; ; ; ; pp.11-18
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Abstract

Human bone marrow mesenchymal stem cells are thought to be multipotent cells, which are present in adult marrow, that can replicate as undifferentiated cells and that have the potential to differentiate to lineages of mesenchymal tissues, including bone, cartilage, fat, tenden, muscle, and marrow stroma. Cells that have the characteristics of human mesenchymal stem cells could be isolated from marrow aspirates of human and animals. This study was designed to identify and characterize genes specifically expressed by osteogenic supplements -treated cells by suppression subtractive hybridization(SSH) method. The results were as follows: 1. 2 genes were upregulated genes in osteogenic diffeentiation of hMSCs, which is further proved by Northern blot analysis. 2. IGFBP-2 has been identified playing an important role in bone formation. 3. HF1 was also upregulated during osteogenic differentiation, but its role in bone formation is not clear yet

; ; ; ; pp.19-27
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Abstract

Thirty-six sinus grafts were performed in 34 patients with an alveolar crest bone height in the posterior maxilla of 3 to 5 mm before grafting. The sinuses were grafted using Bio-Oss alone or mixed with fibrin glue. Group 1 was the control group and included 25 patients who received a xenograft mixed in saline. Group 2 comprised 9 patients who received a xenograft and fibrin glue. The study was further subdivided at the time of 9 months. This histologic study evaluated by hematoxylin-eosin (H&E) and histomorphometric analysis whether fibrin glue in combination with Bio-Oss enhances bone regeneration in sinus floor elevation in humans. The new bone formation was better in Group 2 than in Group 1, but the difference was not significant. The absorption of the graft material was faster in Group 2 than in Group 1, in the short term, but better in Group 1 over the long term, although the difference was not significant. Lamellar bone was formed earlier in Group 1 compared to Group 2, but the difference was not significant. Overall, the surgery site stabilized earlier with new bone formation in Group 2 than in Group 1, but the difference was not significant. Combining a fibrin sealant and Bio-Oss could lead to improved scaffolds for bone tissue engineering based on the synergistic effects of the biomaterials. Therefore, Bio-Oss or Bio-Oss plus Tisseel may be used depending on the situation.

; ; pp.28-35
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Abstract

Purpose: The nitric oxide (NO) release by inducible nitric oxide synthase (iNOS) is the key events in macrophage response to lipopolysaccharide (LPS) which is suggested to be a crucial mediator for inflammatory and innate immune responses. NO is an important mediator involved in many host defense action and may also lead to a harmful host response to bacterial infection. However, given the importance of iNOS in a variety of pathophysiological conditions, control of its expression and signaling events in response to LPS has been the subject of considerable investigation. Materials and Methods: The Raw264.7 macrophage cell line was used to observe LPS-stimulated iNOS expression. The expression of iNOS is observed by Western blot analysis and real-time RT-PCR. Protein kinase C (PKC)-α overexpressing Raw264.7 cells are established to determine the involvement of PKC-α in LPS-mediated iNOS expression. NF- κB activity is measured by IκBα degradation and NF-κB luciferase activity assay. Results: We found that various PKC isozymes regulate LPS-induced iNOS expression at the transcriptional and translational levels. The involvement of PKC-α in LPS-mediated iNOS induction was further confirmed by increased iNOS expression in PKC-α overexpressing cells. NF-κB dependent transactivation by LPS was observed and PKC-α specific inhibitory peptide abolished this activation, indicating that NF-κB activation is dependent on PKC-α. Conclusion: Our data suggests that PKC-α is involved in LPS-mediated iNOS expression and that its downstream target is NF-κB. Although PKC-α is a crucial mediator in the iNOS regulation, other PKC isozymes may contribute LPS-stimulated iNOS expression. This finding is needed to be elucidated in further study.

; ; ; ; pp.36-48
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Abstract

To repair bone defects in the oral and maxillofacial field, bone grafts including autografts, allografts, and artificial bone are used in clinical dentistry despite several disadvantages. The purpose of this study was to evaluate new bone formation and healing in rat calvarial bone defects using hydroxyapatite (HA, Ca10[PO4]6[OH]2, Bongros , Bio@ Co., KOREA) and tricalcium phosphate (β-TCP, Ca3[PO4]2, Sigma-Aldrich Co., USA) mixed at various ratios. Additionally, this study evaluated the effects of type I collagen (Rat tail, BD Biosciences Co., Sweden) as a basement membrane organic matrix. A total of twenty, 8-week-old, male Sprague-Dawley rats, weighing 250-300g, were divided equally into a control group (n=2) and nine experimental groups (n=2, each). Bilateral, standardized transosseous circular calvarial defects, 5.0 mm in diameter, were created. In each experimental group, the defect was filled with HA and TCP at a ratio of 100:0, 80:20, 70:30, 60:40, 50:50, 40:60, 30:70, 20:80, and 0:100 with or without type I collagen. Rats were sacrificed 4 and 8 weeks post-operation for radiographic (standardized plain film, Kodak Co., USA), histomorphologic (H&E [Hematoxylin and Eosin], MT [Masson Trichrome]), immunohistochemical staining (for BMP-2, -4, VEGF, and vWF), and elementary analysis (Atomic absorption spectrophotometer, Perkin Elmer AAnalyst 100 ). As the HA proportion increased, denser radiopacity was seen in most groups at 4 and 8 weeks. In general radiopacity in type I collagen groups was greater than the non-collagen groups, especially in the 100% HA group at 8 weeks. No new bone formation was seen in calvarial defects in any group at 4 weeks. Bridging bone formation from the defect margin was marked at 8 weeks in most type I collagen groups. Although immunohistochemical findings with BMP-2, -4, and VEGF were not significantly different, marked vWF immunoreactivity was present. vWF staining was especially strong in endothelial cells in newly formed bone margins in the 100:0, 80:20, and 70:30 ratio type I collagen groups at 8 weeks. The calcium compositions from the elementary analysis were not statistically significant. Many types of artificial bone have been used as bone graft materials, but most of them can only be applied as an inorganic material. This study confirmed improved bony regeneration by adding organic type I collagen to inorganic HA and TCP mixtures. Therefore, these new artificial bone graft materials, which are under strict storage and distribution systems, will be suggested to be available to clinical dentistry demands.

; ; ; ; ; pp.49-58
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Abstract

The BMPs expression and histomorphometric study of β-TCP /rhBMP-2 Grafting on the rabbit cranial bone defects Byung-Sup Lim, Jae-Yoon Jeon, Chang-Joo Park, Jae-Jung Im, Kyung-Gyun Hwang, Kwang-Sup Shim Department of Dentistry/Oral and Maxillofacial Surgery, College of Medicine, Hanyang University, Korea * Corresponding author Kyung-Gyun Hwang, DDS, MSD, PhD. Dept. of Dentistry/OMFS, College of Medicine, Hanyang Univ. E-mail: hkg@hanyang.ac.kr Objective: The Purpose of the study was to investigate the bone morphogenic protein expression of rhBMP-2(recombinant human bone morphogenic protein-2) as singnaling molecule and β-TCP(Tricalcium phosphate) as a bone substitute and carrier medium of rhBMP-2. Materials and Methods: 16 rabbits divided into 2 group of each 8 rabbit. Two standardized bone defect, round bilateral defect was made in the cranium of the 8 rabbit of first group, and was grafted with 150~500μm diameter β-TCP 0.25g in one side, which was soaked with rhBMP-2, and autogenous bone was grafted on another side as a positive control. Second group of 8 rabbit, only β-TCP was grafted with same size and same manner. After 2, 4, 8, and 12 weeks, specimen was taken for microscopic immunohiostochemical and histomorphometric analysis. Result: Grafting β-TCP with rhBMP show the early formation of the bone regenerative factor (BMP-4) and more quantity of new bone formation than only use of β-TCP (8,12 week), even show less new bone formation than autogenous bone. Conclusion : The experimental study result that β-TCP graft combination with rhBMP-2 as a delivery system is an effective with osteoinductive capacity and biodegradable properties, so that provide clinical availibility of composite use in reconstruction of bony defect.

; ; pp.59-70
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Abstract

Purpose: We evaluated the therapeutic effect of AEE788, a dual inhibitor of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) receptor tyrosine kinases on human salivary adenoid cystic carcinoma (ACC) cells growing in nude mice. Experimental Design: We examined the effects of AEE788 on salivary ACC cell growth and apoptosis. To determine the in vivo effects of AEE788, nude mice with orthotopic parotid tumors were randomized to receive oral AEE788 (50 mg/kg) three times per week, injected paclitaxel (200 μg) once per week, AEE788 plus paclitaxel, or placebo. Mechanisms of in vivo AEE788 activity were determined by immunohistochemical analysis. Results: Treatment of salivary ACC cells with AEE788 led to growth inhibition and induction of apoptosis. AEE788 inhibited tumor growth and prevented lung metastasis in nude mice. Furthermore, AEE788 potentiated growth inhibition and apoptosis of ACC tumor cells mediated by paclitaxel. Tumors of mice treated with AEE788 and AEE788 plus paclitaxel exhibited down-regulation of activated EGFR and its downstream mediators (Akt and MAPK), increased tumor and endothelial cell apoptosis, and decreased microvessel density, which correlated with a decrease in the level of MMP-9, MMP-2 and bFGF expression and a decrease in the incidence of vascular metastasis. Conclusions: These data show that tumor-associated endothelial cells are important in the process of tumor-metastasis. And VEGFR can be a molecular target for therapy of metastatic lung lesion of salivary ACC.

; ; ; ; pp.71-82
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Abstract

Survivin is a member of the inhibitors of apoptosis (IAP) family that have been known to inhibit activated caspases in apoptosis. In contrast to most IAP family members, survivin mRNA is expressed during fetal development, is not found in normal adult tissues and is overexpressed again in the cancer. Though survivin expression has been documented in most human cancers, little is known about its expression in OSCC and its potential value as a predictor of cancer survival. The purpose of this study was to investigate survivin expression in OSCC and to evaluate its value as a prognostic marker. We evaluated survivin expressions in cancer lines and OSCC samples and investigated the relationships between survivin expressions and clinico- pathological parameters including stage, differentiation, proliferation, lymph node metastasis, blood vessel density, and gelatinolytic activity. With immunohistochemistry, we analyzed survivin expression in 38 OSCCs. Patients’clinico-pathological parameters and their survival rate were analyzed to reveal their correlations with Survivin expressions. We cultured oral cancer cell lines and evaluated the correlation between gelatinolytic activities and survivin expressions of them. Survivin protein was observed both in nuclei and cytoplasm of tumor specimens while little or not observed in normal gingival mucosal tissues. Additionally, survivin expressions were correlated with lymph node metastasis, tumor proliferation and survival rate. Survivin expression was observed in 100% of 38 samples of OSCC and its expression levels are statistically associated with the proliferative activity of the tumors, lymph node metastasis and the survival of the patients. Based on these results, survivin is commonly expressed in OSCC and may thus provide valuable prognostic information related with lymph node metastasis, proliferation and survival rate as well as a potential therapeutic target in OSCC.

; ; ; ; ; pp.83-89
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Abstract

Purpose: Different patterns in the causes of maxillofacial injury are thought to correlate with socioeconomic status and regional environment. This study investigated maxillofacial fractures in order to analyze maxillofacial trauma characteristics and the relationship between the causes and injury patterns in Korea. Material and methods: A total of 518 patients with maxillofacial fractures who were treated at the Seoul National University Boramae Hospital between 1996 and 2004 were retrospectively analyzed. Data were obtained from the patients’ medical records and radiographs. The male to female ratio in the patient group was 2.78:1, and the mean age was 32.3 years. Results: Midfacial fractures were the most common location of injury (46.1%). The most common etiologic factor was an activity associated with daily life (42.6%) including falls, stumbling, and collisions. The second most common cause was assault (32.4%), followed by traffic accidents (13.7%). In the case of midfacial fractures and mandibular fractures, assault was the most common etiologic factor, whereas in the case of alveolar bone fractures, activities associated with daily life were the most common cause. With regard to age groups, assault was the most common cause for patients between 10 and 39 years old and an activity associated with daily life was the most common cause in those under 10 years and over 40 years. Conclusions: This study concluded that activities associated with daily life and assault causes a large proportion of Korean maxillofacial injuries and that preventive measures should be implemented in order to minimize these risks.

; ; ; ; pp.90-94
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Abstract

The purpose of this study was to investigate the effects of immediate non-functional loading by analyzing histomorphology around the implant tissues in dogs. Five eight- to nine-month-old full-grown dogs weighing around 12 kg were used in the study. Group I (control group) comprised those in which delayed loading was applied to the right side of the mandible, and Group II (experimental group) consisted of dogs in which immediate loading was performed on the left side of the mandible. Resorbable blast media (RBM)-treated double-threaded US III implants measuring 3.5 mm in diameter and 11 mm long were used in the study. Each animal received four implants in each group, for a total of 40 implants. Cemented type abutments were used after implantation. An 8-week period was allowed for bone healing and an abutment was placed after exposing the periosteum for loading. An implant sample was obtained from bone blocks taken when the dogs were killed at 16 weeks after loading. A Mann-Whitney U-test was performed to evaluate statistical significance. Student’s t-test was used for the histological evaluation. The bone formation ratio in Groups 1 and 2 was 88.23 and 86.41%, respectively. No significant difference in new bone formation was observed in the two groups. As no significant difference was seen in new bone formation between the delayed and immediate loading groups, early loading might be possible after implant placement.

; ; ; pp.95-98
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Abstract

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.

; ; ; ; pp.99-107
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Abstract

The objective of this review was to provide reliable comparative results regarding the effectiveness of any interventions either open or closed that can be used in the management of fractured mandibular condyle Patients and Methods : Research of studies from MEDLINE and Cochrane since 1990 was done. Controlled vocabulary terms were used. MeSH Terms were “ Mandibular condyle”AND “Fractures, bone”. Only comparative study were considered in this review using the “limit”function. According to the criteria, two review authors independently assessed the abstracts of studies resulting from the searches. The studies were divided according to some criteria, and following were measured: Ramus height, condyle sagittal displacement, condyle Towns’s image displacement, Maximum open length, Protrusion & Lateral excursion, TMJ pain, Malocclusion, and TMJ disorder. Results : Many studies were analyzed to review the post-operative result of the two methods of treatment. Ramus height decreased more in when treated by closed reduction as opposed to open reduction. Sagittal condyle displacement was shown to be greater in closed reduction. Condyle Town’s image condyle displacement had greater values in closed reduction. Maximum open length showed lower values in closed reduction. In protrusive and lateral movement, closed reduction was less than ORIF. Closed reduction showed greater occurrence of malocclusion than ORIF. However, post-operative pain and discomfort was greater in ORIF. Conclusion : In almost all categories, ORIF showed better results than CRIF. However, the use of the open reduction method should be considered due to the potential surgical morbidity and increased hospitalization time and cost. To these days, Endoscopic surgical techniques for ORIF (EORIF) are now in their infancy with the specific aims of eliminating concern for damage to the facial nerve and of reducing or eliminating facial scars. Before performing any types of treatment, patients must be understood of both of the treatment methods, and the best treatment method should be taken on permission.

Journal of the Korean Association of Oral and Maxillofacial Surgeons