Journal of the Korean Association of Oral and Maxillofacial Surgeons
- P-ISSN2234-7550
- E-ISSN2234-5930
- SCOPUS, KCI, ESCI
34권 3호
초록
Abstract
Epidermal growth factor is a single-chain polypeptide consisting of 53 amino acids and has a potent mitogenic activity that stimulates proliferation of various normal and neoplastic cells through the interaction with its specific receptor(epidermal growth factor receptor, EGFR). Pleomorphic adenoma is the most common salivary benign tumor and histologically, it contains the epithelial cell, the myo-epithelial cell and mesenchymal ingredient, which is various aspect. Adenoid cystic carcinoma is an infiltrative malignant salivary gland tumor with three different histological patterns: cribriform, tubular or solid. The tumor cell structure composed of modified myoepithelial cell, and basaloid cell. In this study, we used an immunohistochemical technique to investigate the expression of EGF in 6 specimens of adenoid cystic carcinoma and 10 specimens of pleomorphic adenoma taken from patients treated at Dept. of Oral and Maxillofacial Surgery, Dankook University. The results were as follows. 1. In pleomorphic adenoma, ductal structure and scattered spindle cells in hyalinized stroma, disclosing myxoid stroma and hyalin, cartilage formation were observed. Immunohistologically, weak EGF expression in ductal structure and negative in stromal area were observed. 2. Cribriform type of adenoid cystic carcinoma showed numerous pseudocyst surrounded by dark small neoplastic cells in the back-ground of fibrous connective tissue and moderate EGF expression of dark cells adjacent to pseudo lumen in cribriform pattern, while weak expression in other most cells. 3. Tubular type of adenoid cystic carcinoma showed numerous ductal pattern surrounded by two layered neoplastic cells in the back-ground of fibrous connective tissue and strong EGF expression in luminal cells of ductal structure, while weak expression in outer cells. From the results obtained, we suggest that EGF is mainly biosynthesized in cells forming duct like structures of tubulo-ductal type or cribriform adenoid cystic carcinoma and it may play a role, as a cell mitogen in adenoid cystic carcinoma growth.
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Abstract
Distraction osteogenesis is a well-established clinical treatment for limb length discrepancy and skeletal deformities. Appropriate mechanical tension- stress is believed not to break the callus but rather to stimulate osteogenesis. In contrast to fracture healing, the mode of bone formation in distraction osteogenesis is primarily intramembranous ossification. Although the biomechanical, histological, and ultrastructural changes associated with distraction osteogenesis have been widely described, the basic biology of the process is still not well known. Moreover, the molecular mechanisms in distraction osteogenesis remain largely unclear. Recent studies have implicated the growth factor cascade is likely to play an important role in distraction. And current reserch suggested that mechanical tension-stress modulates cell shape and phenotype, and stimulates the expression of the mRNA for bone matrix proteins. The purpose of this study is to examine the pattern of expression of growth factors(TGF-β1, IGF-I, bFGF) and extracellular matrix proteins(osteoclacin, osteonectin) related to osteogenesis by osteodistraction of the mandible in rabbits. 24 rabbits is used for this experiment. Experimental group are gradual distraction(0.7mm, twice/day), acute distraction(1.4mm, twice/day) and control group is only osteotomized. After 5 days latency, osteotomic site is distracted for each 7 days and 3.5 days. Consolidation period is 28 days. The animal is sacrificed at the 3th, 7th, 14th, 28th. The distracted bone is examined by immunohistochemical analysis and RT-PCR analysis. The results obtained from this study were as follow : No significant difference was found on clinical examination according to distraction rate, but gradual distraction was shown to improve regenerate bone formation on radiographic and histologic examination. Growth factors and extracelluar matrix proteins expression increased in distraction group than control group. From these results, it could be stated that graudal distraction is shown to improve and accelerate bone formation and mechanical stress like distraction has considerable effects on osteogenesis related factors. And rabbit is the most appropriate animal model for further reseach on the molecular mechanisms that mediate osteodistraction. It is believed that understanding the biomolecular mechanisms that mediate distraction osteogenesis may guide the development of targeted strategies designed to improve distraction osteogenesis and accelerate bone healing.
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Abstract
Purpose: This research was intended to evaluate the sedative effect of the music by measuring the anxiety-level, the pain-level, the blood pressure, and the pulse rate in patients who were going through extraction of the mandibular impacted 3rd molar. Materials and methods: Patients were selected among those who visited St. Vincent’s Hospital in Suwon for the surgical extraction of 3rd molar from April to May, 2007 and were divided into two groups : the first, experimental group consisting of 32 people was going through extraction with the music and the second, control group also consisting of 32 people was going through extraction without the music. The anxiety-level was measured by filling out Spielberger’s State-Trait Anxiety questionnaire. The pain-level was measured by VAS (Visual analog Scale). The blood-pressure and the pulse rate were recorded at waiting period, preparation and anesthesia period, 5 minutes after anesthesia, beginning of extraction and every five minutes after extraction to the end of surgery. Results: The anxiety-level was significantly lower in the experimental group than in the control group during the extraction procedure (p<0.01). The pain-level was significantly lower in the experimental group than in the control group (p<0.05). The mean systolic blood pressure was significantly lower in the experimental group than in the control group at the beginnig of extraction and 10 minutes after extraction (p<0.01, p<0.05 each). The mean diastolic blood pressure was significantly lower in the experimental group than the control group at 10 minutes after extraction (p<0.01). The mean of pulse rate was significantly lower at the beginning of extraction (p<0.05). Conclusion: The music therapy could offer not only the psychological stability but also the physiological stability during the surgical extraction of impacted 3rd molar.
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The purpose of this study was to observe the effect of calcium and vitamin D to the titanium implant osseointegration in the osteoporosis-induced animal model. Material and method: Thirty-two rats, 10 weeks of age, were divided into two groups: experimental group was ingested additional calcium and vitamin D , and a control group was not. Titanium screw implant(diameter, 2.0 mm; length, 3.5 mm; pitch-height 0.4 mm) were placed into tibia of 32 rats, 16 in the control group and 16 in the experimental group. The rats were sacrificed at 1, 2, 4 and 8 weeks after implantation for histopathologic examination, histomorphometric analysis and immunohistochemistry with fibronectin and collagen type I antibody. Result: In histopathological findings, newly formed bone was seen at 2 weeks and became lamellar bone at 4 weeks, and mature trabecullar bone was seen at 8 weeks in experimental group. In control group, thickness of regenerated bone increased till 4 weeks gradually and trabecullar bone was seen at 8 weeks. In histomorphometric analysis, marrow bone density increased significantly in experimental group compared to control group. Fibronectin immunoreactivity was strong at 2 weeks in experimental group and reduced after 4 weeks gradually. But it was maintained continuously from 2 to 8 weeks in control group. Collagen type I immunoreactivity was very strong from 2 to 4 week in experimental group. And the amount of Collagen type I expression was more abundant in experimental group. Conclusion: The results of this study suggest that calcium and vitamin D supplementation promote bone healing around titanium implants in osteoporosis induced animals.
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The present study was performed to evaluate the effect of surface treatment of the cervical area of implant on bone regeneration in fresh extraction socket following implant installation. Materials and methods: The four minipigs, 18 months old and 30 kg weighted, were used. Four premolars of the left side of both the mandible and maxilla were extracted. 3.3 mm and 11.5 mm long US II plus implants (Osstem Implant co., Korea) with resorbable blasting media (RBM) treated surface and US II implants (Osstem Implant co., Korea) with machined surface at the top and RBM surface at lower portion were installed in the socket. Stability of the implant was measured with OsstellTM (Model 6 Resonance Frequency Analyser: Integration Diagnostics Ltd., Sweden). After 2 months of healing, the procedures and measurement of implant stability were repeated in the right side by same method of left side. At four months after first experiment, the animals were sacrificed after measurement of stability of all implants, and biopsies were obtained. Results: Well healed soft tissue and no mobility of the implants were observed in both groups. Histologically satisfactory osseointegration of implants was observed with RBM surface, and no foreign body reaction as well as inflammatory infiltration around implant were found. Furthermore, substantial bone formation and high degree of osseointegration were exhibited at the marginal defects around the cervical area of US II plus implants. However, healing of US II implants was characterized by the incomplete bone substitution and the presence of the connective tissue zone between the implant and newly formed bone. The distance between the implant platform (P) and the most coronal level of bone-to-implant contact (B) after 2 months of healing was 2.66 ± 0.11 mm at US II implants group and 1.80 ± 0.13 mm at US II plus implant group. The P-B distance after 4 months of healing was 2.29 ± 0.13 mm at US II implants group and 1.25 ± 0.10 mm at US II plus implants group. The difference between both groups regarding the length of P-B distance was statistically significant(p<0.05). Concerning the resonance frequency analysis (RFA) value, the stability of US II plus implants group showed relatively higher RFA value than US II implants group. Conclusion: The current results suggest that implants with rough surface at the cervical area have an advantage in process of bone regeneration on defect around implant placed in a fresh extraction socket.
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Abstract
Bite force is created by the force of adjacent teeth accompanied with tension of masticatory muscle. The bite force value is greater in male than in female and ha maximum value at first molar. Masseter muscle is associated with bite force and during muscle contraction the electric signal is expressed in EMG form. The aim of the study is to assess recovery time for masseter muscle activity and according to each part of bite force after open reduction with internal fixation when mandibular angle fracture and subcondyle fracture occurred. And to determine the appropriate period for mandibular fracture patients to have normal masticatory activity. 30 patients with normal bite condition was selected for control group and from April, 2007 to September, 2007, 20 patients who visited our department of oral and maxillofacial surgery of Dankook University, were selected for the study and were diagnosed as mandibular angle fracture and subcondyle fracture. For control group, the bite force for incisors, canine, premolars and molars and activity of the masseter muscle was measured and compared for 1, 2, 3, 4, 6 and 8 weeks. That was divided as fracture side and normal side. Mann-Whitney U test was performed for significant difference and the following result was obtained. 1. The maximum voluntary bite force for incisors, canine, premolars and molars portion were 0.113 kN, 0.182kN, 0.295kN and 0.486kN and the masseter muscle activity was 0.192 volts in the control group. 2. The maximum bite force at fracture side was recovered by 4th weeks for incisors, 6th weeks for canine and premolars and 8th weeks for molars and the masseter muscle activity was recovered by 6th weeks in the experimental group. 2. The maximum bite force at normal side was recovered by 4th weeks for incisors, 6th weeks for canine, premolars and molars and the masseter muscle activity was recovered by 3rd weeks in the experimental group. 3. The method for internal fixation by 2.0mm miniplates at both superior and inferior border had no complications according for twenty patients and had a satisfactory recovery. According to the result, patient with mandibular angle fracture and subcondyle fracture, 8 weeks was required for bite force recovery. Therefore, patients with open reduction and internal fixation under general anesthesis, it can be assumed that 8 weeks was needed after operation in order to have normal bite force and masseter muscle recovery.
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The purpose of our study was to evaluate the volume of pre- and post operative masseter muscle and bite force in mandibular prognathic patients treated with SSRO with the use of the 3D CT imaging technique and occlusal force meter. Materials and methods: The study group consisted of 12 patients with mandibular prognathism (5 males and 7 females) who underwent mandibular setback surgery (BSSRO) in the Department of Oral and Maxillofacial Surgery, Samsung medical center. Bite force was measured at pre op, post op 3, 6 and 12 months by occlusal force meter(GM10, Nagano Keiki, Japan) The preoperative CT examination of subjects was performed between one month prior to operation and one year after to operation. And muscle volume was measured. Result: As compared to preoperative measurements at 1 year postoperatively the masseter and internal pterygoid muscle volume were diminished (p<0.05) The bite force steadily recovered, so at postoperatively 6 months reached the preoperative level. And at 1 year after operation, the maximum bite force was significantly greater than preoperative levels. No significant correlation was presented between masseter muscle and bite force (p>0.05), internal pterygoid muscle and bite force (p>0.05). Conclusion: In this study, the results showed that volume and bite force of the masticatory muscles decresed significantly immediate after orthognathic surgery for mandibular set-back. However, reduction of maximum bite force disappears within 6 months after surgery.
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Abstract
Anodic spark deposition method(ASD) surface treated titanium implant possesses a considerable osteoconductive potential that promoting a high level of implant osseointegration in normal bone. The purpose of this study was to observe the ASD implant's osseointegration in the osteoporosis-induced animal model. Twenty four rats, 10 weeks of age, were ovarectomized and 5 weeks later divided into two groups : ASD implant group and control implant group. Titanium screw implants (diameter; 2.0 ㎜, length, 3.5 ㎜; pitch-height, 0.4 ㎜) were designed for this study. Experimental implants were ASD treated and no treatment on control implants. ASD implants and control implants were placed in to left tibiae of rats. The rats were sacrificed at different time interval(1, 2, 4 and 8 weeks after implantation) for histopathologic observation and immunohisto -chemistrical observation, with collagen type Ⅰ, fibronectin, integrin α2β1 and integrin α5β1 antibodies. The results obtained from this study were as follow: 1. Histopathologic findings, overall tissue response and the pattern of bone formation in both groups were similar. In ASD group, more newly formed bone was seen at 1 week and 2weeks than control group. 2. The levels of type Ⅰ collagen and fibronectin expression were the most abundant at 2weeks and decreased gradually in both groups. Fibronectin and type Ⅰ collagen expression in ASD group were stronger than control group but no significance. 3. The levels of integrin α2β1 and Integrin α5β1 expression were most abundant at 2 weeks and decreased gradually in both groups. No significant difference was observed in both groups. From this results, anodic oxidized titanium implants were more advantages in early stage of bone formation than control group, but have no significance in tissue responses and late bone formations. It could be stated that although anodic oxidized titanium implant possesses considerable osteoconductive potential but in osteoporotic bone condition dental implant procedure should performed after improving or treating the osteoporotic bone condition.
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The aim of this study was to examine the incidence, location and morphology of antral septa using radiographic exam.(Panorama, CT) in the dentate/non-atrophic and edentulous/atrophic maxillary segments. Material and methods: 232 sinuses were subdivided into two groups(group1 : 175 sinuses were classified as complete and partial dentate maxillary segments, group2 : 57 sinuses were classified as complete edentulous maxillary segments) and were investigated for the incidence, location and morphology of maxillary sinus septa. Results: A total of 80 septa were observed in 232 maxillary sinuses, which corresponded to 30.65% of the sinuses(71 of 232). 67.5% of the total septa was observed in the complete and partial dentate groups, but 32.5% of the total septa was observed in the complete edentulous group. Upon analysis of the anatomical location of the septa, it was seen that 14 septa(17.5%) were located in the P1 area, 15 septa(18.7%) were located in the P2 area, 19 septa(23.8%) were located in the M1 area and 32 septa(40%) were located in the M2 area and dista area of M2. we found 45 septa in the apical lesion of teeth, Group 1. However the remaining 9 septa were found in the edentulous area. Conclusion: CT is a better method than panoramic radiography for detecting the presence of the maxillary sinus septa. Maxillary sinus septa are more commonly detected in complete edentulous maxillary segments than in complete and partial dentate maxillary segments. Also maxillary sinus septa are more commonly detected posteriorly than anteriorly.
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Abstract
The purpose of this study was to evaluate the artificial dental plaque by Streptococcus mutans on 4 different implant surfaces. In this study, the specimens were divided into 4 groups according to implant surface treatment. Uncoated implant group(n=5) which has an uncoated, smooth surfaced implant(Osstem, Korea), SLA implant group(n=5) which has an sandblasted large grit and acid-etched surface implant(Bicon, USA). Oxidized implant group(n=5) which has an oxidized surfaced implant (Osstem, Korea), and RBM implant group(n=5) which has resorbable blasting media(RBM) surfaced implant(Osstem, Korea). Acquired pellicle by human saliva and dental plaque by Streptococcus mutans were made on each implant surface. To analyze the plaque condition on implants surfaces, cell count and optical density were taken as a microbiologic method, and SEM(Scanning Electronic Microscope) findings was also taken for evaluation of surface condition. The following results were obtained. 1. Cell counting results of artificial dental plaque were Uncoated group(658.0±102.0), RBM group(878.0±170.0), SLA group (946.0±42.0), Oxidized group(992.0±40.0), and there was difference between Oxidized group and Uncoated implant group(p<0.05). In case of modified cell counting results by v/w% were RBM group(197.8±45.2), Oxidized group(207.04±8.34), Uncoated group(261.6±40.6), SLA group(315.4± 14.0), and there was difference between RBM group and SLA group(p<0.05). 2. Optical density results of artificial dental plaque after ultrasonic treatment was that there was difference among groups, and optical density of RBM group was higher than that of Uncoated group(p<0.05). In case of modified optical density results by v/w%, there was difference among groups, and the modified optical density of Uncoated group and SLA group was higher than those of Oxidized group and RBM group(P>0.05). 3. SEM findings of artificial dental plaque on the surfaces of implant as follows; there were artificial dental plaque on the surfaces of all test implants. Streptococcus mutans and by-product were observed at 10,000 times magnified condition on all test implants. Adhesion area of artificial dental plaque was about 1/2 of total surface after 24 hours incubate at 37℃. These results showed that there were differences among implant surfaces on the growth of Streptococcus mutans, and bacteria and by-product were covered about 1/2 area of total implant surfaces at 24 hours incubate at 37℃.
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Abstract
The purpose of this study was to evaluate the Osstem implants (US II/SS II implants) through the retrospective study for the clinical success rate during the installation of the Osstem implants (US II/SS II implants) by using of the procedures of maxillary sinus floor elevation. Materials and methods: The current study was researched in the 6 medical institutions: Chonnam National University, Chosun University, Pusan DaeDong Hospital, Bundang Seoul National University Hospital, Ap-Seon Clinic, and All Clinic. Based on the total number of 116 patients whose treatment was the installation of the US II/SS II implants with the procedures of the maxillary sinus floor elevation, they were conferred on the dental records of the patients under the joint consultation of the 6 medical institutions. On the dental recording charts, there were included in as the following; the name of the institutions, gender, age, with or without smoking or drinking, with or without the generalized diseases, the height of the alveolar bone on the operational sites, elapsed edentulous state period, the state of the opposed or adjacent teeth, the methods of the maxillary sinus floor elevation, secondary time period for surgery, the lengths, types, and diameters of implants, with or without bone transplantation or the types of bone, postoperative current bone height, current adjacent soft tissue state of the implants, with or without the success of the installations of the implants. We have done our survey with the clinical and radiolographical examinations and dental questionaries. The success and survival rate of the implants was evaluated. Results 1. Total number of the patients with the installation of the US II implants were 62. The 252 numbers of US II implants were installed on the 89 maxillary sinuses. The patient's mean age was 54.1 years old and there were 36 men and 27 women. 2. Total number of patients with the installation of SS II implant were 57. The 165 numbers of SS II implants were planted on the 80 maxillary sinuses. Their mean age was 48.7 years old and there were 37 men and 20 women. 3. The follow-up period was 30.7 months(21-49 mon) on average. The vertical bone loss of installed implants after the procedures of the maxillary sinus elevation was 1.1 mm on average in SS II and 1.3 mm on average in US II. There existed no statistical significance on each group. The mean enlarged bone height after the maxillary sinus floor elevation was 8.2 mm. 4. For the procedures of the maxillary sinus elevation, the Lateral approach technique occupied 87.1%, which was the most used one. In addition, the most frequently used transplanted bone was autogenous bone only which was 72.7% during the maxillary sinus floor elevation. 5. The complication of maxillary sinus floor elevation were perforation of sinus membrane, disesthesia on doner site, exposure of cover screw and exposure of maxillar bone. 6. The survival rate of US II and SS II after maxillary sinus floor elevation was 99.2% and 95.8%, respectively. And the success rate of US II and SS II after maxillary sinus floor elevation was 97.6% and 89.7%, respectively. Conclusion : On the evaluation of the analysis of our study, both US II and SS II implants showed the excellent clinical results by use of the procedures of maxillary sinus floor elevation.
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Abstract
Mandibular chronic osteomyelitis with diffuse osteosclerosis is recognized as an intractable infectious disease. We emplyed decortication and intra-arterial infusion of antibiotics in 6 cases. Decortication on the affected mandible was performed with retrocatherization to the superficial temporal artery of affected side under general anesthesia. Antibiotics, IPM/CS or FOMX was used through the artery for 4-11 days. In addition, we administered FOMX, PIPC intravenously for 8-17 days. CT and MRI were taken postoperatively. The postoperative follow-up period ranged from 1 year and 6 months to 2 years and 5 months. Postoperative MR showed that bone marrow signal was recovered to approximately normal in 4 cases. High signal area of bone marrow and osteosclerosis image remained in 2 cases, but showed improvement. The results were satisfactory without recurrence in all of 6 cases.
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Abstract
Skeletal anterior open bite is a difficult problem to correct in orthodontic treatment. To treat adult patients who have skeletal anterior open bite, we considered two methods. Combination treatment of orthodontics and surgery and camouflage orthodontic treatment. In adults, treatment of severe skeletal anterior open bite consists mainly of surgically repositioning the maxilla or the mandible. However, camouflage therapy is often the treatment of choice for skeletal open bite patients who have mild to moderate skeletal discrepancies when growth modification is no longer possible. But excellent results generally require careful coordination of the orthodontic and surgical phases of treatment. This is a case report of a skeletal anterior open bite patients who were treated with orthodontic treatment and orthognathic surgery. First case was diagnosed as skeletal class I malocclusion and bimaxillary protrusion with anterior open bite, and finally treatment ended for removal of open bite with orthodontic procedure and bimaxillary anterior segmental osteotomy surgery. Second case was diagnosed as skeletal class II malocclusion with open bite and mandibular retrusion, and was treated with only camouflage orthodontics because she feared to have a surgery. In a regular follow up visit after debonding we proposed to the patient advanced genioplasty, and in her agreement her facial esthetics was improved through the surgery.
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This study analyzed the incidence of wound infection after the operation of mandibular third molar extraction in relation with antibiotic prophylaxis with the object of young and healthy patients. The study object was 1,177 mandibular third molars of 850 men of 20 to 25 years old without any specific systemic disease. Three methods of preventive antibiotic medication were selected according to the preventive antibiotic medication previously reported; three experimental groups were selected based on them, and the antibiotic used was amoxicillin( Kymoxin, Yuhanyanghaeng, Seoul). The group 1 includes the patients that took the antibiotic orally before the operation(one hour earlier, 500mg) and for three days after the operation(250mg per time, three times/day), the group 2 is the ones that took the same antibiotic orally only once about one hour before the operation(500mg), and the group 3 did not take any antibiotics before and after the operation. And to compare the difficulties and the degrees of extraction during operations which can be possibly related to the wound infection after the operations, the mandibular third molars’impacted depths and extraction methods were investigated as well. To check if the wound was infected, observations with an internal of one week were performed twice after the operation, and the meaningfulness of the infection incidence was verified through Chi-square test using SPSS program(SPSS Inc., IL, USA). There was no statistically significant difference between the antibiotic medication methods and the wound infection incidence after the operation among the experimental groups. As examining the relations between the mandibular third molar operation methods and the wound infection incidence after the operation, there existed a statistically meaningful difference in the infection incidence according to the operation methods(p=0.020). And there was no statistically significant difference in the wound infection incidence according to the impacted depth of the mandibular third molar. Therefore, it is thought that there exists little necessity of prophylatic antibiotics medication when extracting the mandibular third molar of young and healthy men without any systemic disease in general; however, in case when it is expected that the possibility of infection will be high or the wound on the tissue will be severe, it is sure that the prophylactic antibiotics medication will be necessary.
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Abstract
Sagittal split ramus osteotomy (SSRO) is widely used in treatment of dentofacial deformities. But, many complications can occur including unfavorable fractures during osteotomy. To prevent these complications, it is necessary to understand comprehensively the anatomy of the mandiular ramus. The purpose of this study was to evaluate the morphology of the madibular ramus in manibular prognathism patients by computed tomography comparing with normal control group. The study group consisted of 33 skeletal class III patients (20 males, 13 females) and the control group consisted of the 52 patients without dentofacial deformities (32 males, 20 females). The mean age of study group was 22.0-year old, and that of control group was 37.1-year. For the CT examination, following scan parameters was used: 1mm slice thickness, 0.5 second scan time, 120kV and 100mA/s. The axial scans of the head were made parallel to the mandibular occlusal plane. The anteroposterior length of the ramus, the distance from anterior border of the ramus to lingula, the relative distance from the anterior border of the ramus to lingula compared to the anteroposterior length of the ramus, the thickness of anterior and posterior cortical plate, the thickness of medial cortical plate of the ramus at lingula level, the thickness of cancellous bone of the ramus at lingula level were measured. The skeletal class Ⅲ mandibular prognathism patients exhibited shorter anteroposterior length of the ramus, thicker anterior and posterior cortical plate, thinner mediolateral cancellous bone thickness. The lingula has a relative stable anteroposterior position in ramus in all groups. There was higher possibility of fusion of medial and lateral cortical plate at lingula level in the mandibular prognathism group. In conclusion, the mandibular prognathism patients have narrow rami with scanty cancellous bone, which means that careful preoperative examination including CT scan can prevent undesirable fractures during osteotomy.
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Abstract
Anterior open bite is a condition in which maxillary and mandibular incisors do not occlude at central occlusion. It is a vertical discrepancy of the jaws and dental arches that has many etiologic factors making it difficult in diagnosis, treatment and prediction of prognosis. One of the causes of open bite is abnormal size and shape of the tongue. Macroglossia, a condition in which tongue is oversized, is caused by several factors which are not clearly identifiable, and it may be a major factor of anterior and posterior open bite. Macroglossia is subdivided into true, functional and pseudomacroglossia depending on its relative size in the oral cavity. In this case report, a patient was diagnosed as skeletal Class II with pseudomacroglossia, and was treated with SARPE in order to expand the narrowed maxillary arch and quad helix for the mandibular arch. As a result the transverse deficiency was treated. In the adult patients where no skeletal growth is expected, SARPE has shown to be effective in treating maxillomandibular transverse discrepancies in which macroglossia was accompanied as in this case.
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The calcifying odontogenic cyst(COC) is considered to occupy a position between a cyst and an odontogenic tumor-having charateristics of both. Gorlin and col. described the COC for first time as an own pathological entity in 1962. Clinically, the COC represents 1% of the odontogenic lesion. It is possible to be found from the first decade to the eight decade but is more frequent during the second decade. It affects in same proportion the maxilla and jaw, being the most in tooth-bearing area of the jaw. This case of COC associated with an unerupted tooth which appeared in the right mandible of 22-year-old woman, was reported. This case report is to present a review of the literature relates to this case of COC and its treatment, discuss clinical, radiographic, histological and therapeutic aspects.
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The present study was performed to evaluate the function of the mandible according to the pattern of fracture and treatment methods of condylar fractures of the mandible and help operators in making a treatment plan. Sixty patients (average follow-up period was 7.8±9.4 months) who were treated for condylar fracture from June, 2002 to May, 2006 at the Department of Oral and Maxillofacial surgery, Chonnam National University Hospital were reviewed. The common causes of the condylar fracture were traffic accident and fall-down (35.0%). In concomitant injuries, laceration was 46.7% and the fracture of the mandibular symphysis was highest incidence (60.0%). The common site of the fracture was the condylar head (47.8%), followed by subcondyle (36.2%) and condylar neck (15.9%). Under 15 years old patients, the closed reduction was performed in 87.5% out of the patients. All of the condylar fragments were fixed to the mandible with titanium miniplates in cases of open reduction. The mean period of intermaxillary fixation (IMF) was 14.2±6.5 days in closed reduction and 10.0±4.2 days in open reduction. The old patient with bilateral condylar head fractures, who were treated by closed reduction with IMF for 3 weeks, showed the limitation of mandibular movements. But, there was no significant different results between open reduction and closed reduction with the respect of the Helkimo's mandibular mobility index and clinical dysfunction index (DI). Complications, such as fibrous ankylosis and resorption of the mandibular condyle, were not observed in all patients. These results suggest that the good results can be obtained by closed reduction with proper IMF periods and functional exercise in most condylar fractures of the mandible except severely displaced extracapsular fractures.