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Journal of the Korean Association of Oral and Maxillofacial Surgeons

Vol.35 No.4

; ; ; ; pp.199-204
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Abstract

Purpose: The purpose of this study is to investigate the epithelial-mesenchymal transition (EMT) induced by Snail transcription factor and Snailtransfectedin vivo tumors with histopathological features. Materials and methods: We induced in vivo xenografted tumorigenesis in the oral vestibules of nude mice by a Snail transfected HaCaT cell lineand investigated morphological and immunohistochemical features in Snail expressive tumors. Results: We identified tumor masses in 14 out of 15 nude mice in the HaCaT-Snail cell inoculation group, but no tumors were present in any of theHaCaT cell inoculation group. Induced tumors showed features of poorly differentiated carcinoma with invasion to neighboring muscles and bones. The HaCaT-Snail tumors showed decreased expressions of E-cadherin and cytokeratin, but showed increased expressions of vimentin and N-cadherin. Discussion: The Snail transfected xenograft can improve productivity of malignant tumors, show various histopathological features including invasivegrowth, and aid in the investigation of tumor progression and the interaction with surrounding tissues.

; ; ; ; ; ; ; ; ; pp.205-212
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Abstract

erived cells and the effects of osteogenic inductive medium of periosteal-derived cells on the proliferation of endothelial progenitor cells. Materials and methods : Periosteal-derived cells were obtained from mandibular periosteums and introduced into the cell culture. After passage 3, the cells were divided into two groups and cultured for 21 days. In one group, the cells were cultured in the DMEM supplemented with osteogenic inductive agent, including 50g/ml L-ascorbic acid 2-phosphate, 10 nM dexamethasone and 10 mM -glycerophosphate. In the other group, they were cultured in DMEM supplemented without osteogenic inductive agent. VEGF isoforms, VEGFR-1, VEGFR-2, and neuropilin-1 mRNA expression was observed. Human umbilical cord blood-derived endothelial progenitor cell proliferation was also observed. Results : The expression of VEGF isoforms was higher in osteogenic inductive medium than in non-osteogenic inductive medium. The expression of VEGFR-2 was also higher in osteogenic inductive medium than in non-osteogenic inductive medium. However, the expression of VEGFR-1 and neuropilin-1 was similar in both osteogenic inductive medium and non-osteogenic inductive medium. In addition, conditioned medium from differentiated periosteal-derived cells stimulated human umbilical cord blood-derived endothelial progenitor cell numbers compared to conditioned medium from non-differentiated periosteal-derived cells. Conclusion : These results suggest that in vitro osteoblastic differentiation of periosteal-derived cells has angiogenic capacity to support endothelial progenitor cell numbers.

; pp.213-220
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Abstract

patients with oral cancer. Materials and methods: Twenty-two patients who underwent neck dissection to treat oral cancer were subjected for examination. The cervical node metastasis was evaluated by means of clinical examination, CT scan, PET, and histologic examination. By comparing the results of each examination modality with those of histologic examination, it's sensitivity, specificity, positive predictive value, and negative predictive value were determined. Results: The oral cancer was more frequent in males with a ratio of 2.14:1. The sixth decade showed the highest incidence in age distribution with mean of 56±16. Histologic findings showed that squamous cell carcinoma was the most common (15 patients), and mucoepidermoid carcinoma (3), malignant melanoma (2), and adenoid cystic carcinoma and ghost cell odontogenic carcinoma (1 each), in order. In most cases, wide surgical excision of the primary cancer and neck dissection was performed, followed by reconstruction with free flaps when necessary. When comparing the results of each examination modality with those of the histologic examination, clinical examination showed sensitivity, specificity, positive predictive value, and negative predictive value at 11%, 85%, 33%, and 58%, respectively. CT scans showed at 67%, 77%, 67%, and 77%, while 18F-FDG PET/CT at 78%, 77%, 70%, and 83%, respectively. Conclusions: These results suggest that PET is more useful, compared with clinical examination and CT scans, in the evaluation of cervical lymph node metastasis in patients with oral cancer.

; ; ; pp.221-228
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Abstract

The purpose of the study was to investigate the characteristics of the pronunciation of Korean vowels in patients with class Ⅲ malocclusion. 11 adult male patients with class Ⅲ malocclusion(mean ages 22.3 years) and four adult males with normal occlusion(mean ages 26.5 years) were selected for the analysis of eight Korean monophthongs /ㅣ, ㅔ, ㅐ, ㅏ, ㅓ, ㅗ, ㅡ, ㅜ/. The values and relationships of F1, F2 and F3 were derived from the stable section of target vowel in each sentence, and the analysis using formant plots and vowel triangles' distance and area was conducted to find the features of two groups' vowel distributions. Consequently, it was identified that the pronunciation of males patients with class Ⅲ malocclusion showed high values of F1 in the low vowels, high values of F2 in the back vowels, and remarkably low position of /ㅏ/. The vowel triangle suggested that the triangle areas of male patients with class Ⅲ malocclusion were shown wider vertically and narrower horizontally than those of males with normal occlusion. These characteristics could reflect the structural features of class Ⅲ malocclusion such as the prognathic mandible, low tongue position, and advancement of back position of the tongue.

; ; ; ; pp.229-239
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Abstract

The purpose of this study is to evaluate the change in condylar position, width, and angle before and after orthognathic surgery using 3-dimensional computed tomograph. Pre and posterative 3-D CT was taken on 38 patients and through axial, frontal, sagittal measurements and by 3-dimensional reconstruction, the changes in condylar postion, mandibular width and angle were analyzed and others such as the difference in gender, operation and fixation method, setback length and in relation with temporomandibular disorders were done together too. The results were as follows: The inward rotation of condyle in axial condylar angle, the forward movement of right condyle in sagittal anterior-posterior distance, the superior movement of both condyles in sagittal superior-inferior distance, the decrease in gonial angle, the increase in mandibular width, the decrease in distance between the axial coronoid process distance and the increase in the frontal intercondylar distance were statistically significant. There were no statistically significant changes in gender difference, however in the difference in operation method, change in the gonial angle was observed and there was more change in bilateral sagittal split osteotomy group compared to two-jaw surgery group. In the difference in fixation method, the decrease in axial coronoid process distance and the change in sagittal anterior-posterior distance were statistically significant. In the difference in setback, the increase in setback didn't relate directly with the increased change in condyle position. In the relation with temporomandibular disorder, changes in left axial condylar angle and axial coronoid process distance were statistically significant. Changes in condylar position could be observed after the orthognathic surgery but it doesn't seem to have much of a clinical importance. The orthognathic surgery is effective in decreasing the mandibular angle, and it is not related with the temporomandibular disorder.

; ; pp.240-247
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Abstract

Purpose: The purpose of this study was to evaluate marginal bone loss to the bone crest functionally loaded for up to eighteen months and also with regard to other variables of interest. Material and Methods: 135 endosseous implants(GS Ⅱ, Osstem, South Korea) were placed in 35 patients. The design of GS II implant is straight with the microthread. Radiographic examinations were conducted at baseline (implant loading) and 3, 6, 9, 12 and 18 months after loading. Marginal bone level measurement was made from the reference point to the lowest observed point of contact of the marginal bone with the fixture. The reference point of the fixture was the border between the blasted surface and machined surface of the fixture. Results: Implants were on function for a mean 12.7 months(range, 3?18 months). For the 56 maxillary and 79 mandibular implants, mean marginal bone loss was 0.68 mm and 0.70 mm. Implants placed maxillary posterior area displayed more crestal bone loss than the other position. The difference between mesial and distal bone levels was statistically significant (p<0.05) with respective means of 0.51 mm and 0.62 mm. Also, The difference between bone graft group and no-bone graft group was statistically significant(p<0.05) with respective means of 0.38 mm and 0.66 mm. But no statistically significant influence of sex, type of surgery(one or two stage surgery), the implant length was observed(p>0.05). Conclusion: This study indicates the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods.

; ; pp.248-252
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Abstract

Purpose: This retrospective study was performed to analyze the relationship between complications of the posterior mandibular single crowns and distance from the adjacent teeth to the implant. Subjects and Methods: Of the patients who presented Ewha Womans University Mokdong Hospital & Yonsei University Dental Hospital with missing of the posterior mandibular molar and restored with implant-supported 18 Single crowns between 1996 thru 2007, 115 patients had been followed after crown delivery. The subjects were divided into complication-followed group and a control without any problems. The distance from the most distal tooth to the implant were measured. The prosthetic & biologic complications were reviewed by the cantilever distance and analyzed by abutment type, age & gender statistically using SAS version 9.1 (SAS Inc., USA). Results and Conclusion The results were as follows; 1) The posterior mandibular single crown with cantilever showed higher incidence of follow-up complications upon logistic analysis (p<0.05). 2) The prosthetic and biologic complications are related with the cantilever distance with 2.1 odds ratio and 3.39 cut-off value of specificity & sensitivity by SPSS 12.0. 3) The complications are neither significant in abutment types nor age & gender.

pp.253-256
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Abstract

Schwannoma(neurilemmoma) is a benign neoplasm that originates from the Schwann cells. Schwannoma most commonly arises in the soft tissue of the head and neck. Intraoral lesions are uncommon, however, and intraosseous schwannoma are even rare. The most common site of occurrence for these unusual lesions is the mandible. This article documents a case of an intraosseous schwannoma located in the mandibular ascending ramus. The lesion was surgically removed and no radiographic evidence of recurrence was observed after 1 year.

; ; ; ; ; pp.257-260
; ; ; ; pp.261-265
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Abstract

Cystic hygroma, a cystic subtype of lymphangioma, is relatively rare tumor of lymphatic origin. The lesion is a benign, painless, soft, compressible malformation of the lymphatic system. They can arise anywhere along the lymphatic system, however they are usually located in the head and neck regions and in most cases appear by the age of 2 years. The cases in the adult is rarely occurred and a few cases are described in the literature. Surgical excision remains the treatment of choice. But complete extirpation of these lesion is often impossible, because the tumor tends to spread along vital structures. Therefore recurrence rates are accordingly high. This is a case report about 19 year old male patient with cystic hygroma on right retromandibular area. We obtained the successful, functional and esthetic result by surgical excision of the mass. Therefore, we report the case with a review of literatures.

; ; pp.266-270
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Abstract

The osteotomy for rhinoplasty is a useful method to make the nasal bony pyramid get narrow, correct the deviated nose and prevent the open roof deformity after hump nose resection. The osteotomy for rhinoplasty is divided medial osteotomy, lateral osteotomy and transverse osteotomy. If the osteotomy is well done, it produces very effective and esthetic results. However, the osteotomy has problems that precise operation is often impossible for the difficulty of the access and that the possibility of the complication is very high. We report our clinical experience about the osteotomy for rhinoplasty.

; ; ; pp.271-275
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Abstract

The purpose of this report is to describe a treatment method of dentigerous cyst associated with unerupted permanent teeth in mixed dentition patients. In our cases, extraction of infected primary teeth was followed by decompression of the cyst. At the same time, parts of the cystic walls were sent for histopathological examination. Decompression was performed by inserting a rubber tube into the cystic cavity through the extraction socket. The cystic cavity was kept open by means of vigorous use of a syringe by patient. Postoperative panoramic radiograph was taken bimonthly. After 5~12 months, the impacted permanent teeth were erupted on the desired position. All cases presented favorable result. By extracting the infected primary teeth, and opening the cyst for continuous drainage, it was possible to achieve spontaneous eruption of the involved permanent teeth into the proper position. In all our cases, there was no sign or symptom of recurrence of the cyst up to postoperative 18 months.

; ; ; ; ; pp.276-279
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Abstract

The aim of this case study was to report the clinical outcome of immediate provisionalization using one-piece narrow diameter (3.0mm) implants in missing maxillary lateral or mandibular incisors. The present study included 36 patients who were treated with 62 one-piece narrow diameter implants. After implant placement, immediate provisional restorations were delivered. All implants showed favorable osseointegration and after progressive loading from 3 months to 9 months (average of 5 months), final restorations were completed without failure in all cases. A survival rate of 100 % (62 of 62) was observed up to 23 months of observation (average of 12.6 months).

Journal of the Korean Association of Oral and Maxillofacial Surgeons