Journal of the Korean Association of Oral and Maxillofacial Surgeons
- P-ISSN2234-7550
- E-ISSN2234-5930
- SCOPUS, KCI, ESCI
41권 1호
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Objectives: We retrospectively evaluated the impact of mandibular third molars on the occurrence of angle and condyle fractures.Materials and Methods: This was a retrospective investigation using patient records and radiographs. The sample set consisted of 440 patients with mandibular fractures. Eruption space, depth and angulation of the third molar were measured.Results: Of the 144 angle fracture patients, 130 patients had third molars and 14 patients did not. The ratio of angle fractures when a third molar was present (1.26 : 1) was greater than when no third molar was present (0.19 : 1; odds ratio, 6.58; P<0.001). Of the 141 condyle fractures patients, the third molar was present in 84 patients and absent in 57 patients. The ratio of condyle fractures when a third molar was present (0.56 : 1) was lower than when no third molar was present (1.90 : 1; odds ratio, 0.30; P<0.001).Conclusion: The increased ratio of angle fractures with third molars and the ratio of condyle fractures without a third molar were statistically signif-cant. The occurrence of angle and condyle fractures was more affected by the continuity of the cortical bone at the angle than by the depth of a third molar. These results demonstrate that a third molar can be a determining factor in angle and condyle fractures.
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Objectives: The goal of this study was to determine the correlation of clinicopathological factors and the up-regulation of vascular endothelial growth factor (VEGF) expression in oral squamous cell carcinoma.Materials and Methods: Immunohistochemical staining of VEGF and quantitative real-time polymerase chain reaction (RT-PCR) of VEGF mRNA were performed in 20 specimens from 20 patients with oral squamous cell carcinoma and another 20 specimens from 20 patients with carcinoma in situ as a controlled group.Results: The results were as follows: 1) In immunohistochemical study of poorly differentiated and invasive oral squamous cell carcinoma, high-level staining of VEGF was observed. Significantcorrelation was observed between immunohistochemical VEGF expression and histologic differentia-tion, tumor size of specimens (Pearson correlation analysis, significancer>0.6, P<0.05). 2) In VEGF quantitative RT-PCR analysis, progressive cancer showed more VEGF expression than carcinoma in situ. Paired-samples analysis determined the difference of VEGF mRNA expression level between cancer tissue and carcinoma in situ tissue, between T1 and T2-4 (Student’s t-test, P<0.05).Conclusion: These fndings suggest that up-regulation of VEGF may play a role in the angiogenesis and progression of oral squamous cell carcinoma.
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Objectives: Quality of life (QoL) studies provide information about the impact of disease, the treatment of symptoms, and outcomes following treat-ment. The present study aims to evaluate the postoperative QoL of patients treated for oral cancer in a Nigerian government tertiary hospital. Materials and Methods: A prospective study on consenting patients with oral cancer was undertaken at Aminu Kano Teaching Hospital, Kano, Ni-geria. The subjects completed the University of Washington QoL (UW-QoL) questionnaire one day prior to surgery and postoperatively after 7 days, 1 month, 3 months, and 6 months. Results: Sixty-eight patients with oral cancer were recruited. Of these, 38 were males, and 30 were females (male : female, 1.3 : 1). Twenty-four pa-tients (12 males and 12 females) underwent surgery and completed postoperative QoL assessment using the UW-QoL questionnaire. Preoperative QoL mean score was 2.21, while postoperative mean scores after 1 week, 1 month, 3 months, and 6 months were 3.67, 3.46, 2.82, and 2.61, respectively. Conclusion: An improvement in QoL following surgical treatment for patients with oral cancer was observed. ‘Appearance,’ ‘recreation,’ and ‘chewing’ were identified as the most important determinants of postoperaive QoL in patients with oral cancer in our study.
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Objectives: The purpose of this study is to retrospectively evaluate the postoperative complication rates for absorbable type-I collagen sponge (Atelo-plug; Bioland) use in third molar extraction.Materials and Methods: From January to August 2013, 2,697 total patients undergoing third molar extraction and type-I collagen sponge applica-tion in the Department of Oral and Maxillofacial Surgery at Yonsei University Dental Hospital (1,163 patients) and Dong-A University Hospital (1,534 patients) were evaluated in a retrospective study using their operation and medical records.Results: A total of 3,869 third molars in 2,697 patients were extracted and the extraction sockets packed with type-I collagen sponges to prevent post-operative complications. As a result, the overall complication rate was 4.52%, with 3.00% experiencing surgical site infection (SSI), 1.14% showing alveolar osteitis, and 0.39% experiencing hematoma. Of the total number of complications, SSI accounted for more than a half at 66.29%.Conclusion: Compared to previous studies, this study showed a relatively low incidence of complications. The use of type-I collagen sponges is rec-ommended for the prevention of complications after third molar extraction.
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Objectives: The aim of this study is to determine the incidence, location, and orientation of maxillary sinus septa in formalin embalmed cadavers.Materials and Methods: The study was conducted on 210 cadaveric heads available in our department. After taking the mid-sagittal section the specimens were opened from the medial aspect and the sinus cavity was explored for the presence of maxillary sinus septa, their anatomical plane, lo-cation and dimensions.Results: The mean linear distance between maxillary sinus floorand its anatomical ostium was 26.76±5.21 mm and 26.91±4.96 mm on right and left side, respectively. A total of 59 maxillary sinus septa (28.1%) were observed in 210 maxillary specimens. Septae were most common, 33 septa (55.9%), in the middle region (between frst and second molar tooth) of the sinus cavity. The maxillary sinus membrane (Schneiderian membrane) adhered tightly to the maxillary sinus and over the septae. Significantlymore maxillary sinus septa were observed in edentulous maxillae in comparison to the dentate upper jaw.Conclusion: Knowledge of location of maxillary sinus ostium is mandatory for the rhinologist for drainage of secretions in maxillary sinusitis. The morphological details of maxillary sinus septa, particularly their location and anatomical planes, will guide dentists in performance of safe implant surgeries. The maxillary antrum septa of category I and II may complicate the procedure of inversion of bone plate and elevation of sinus membrane during maxillary augmentation surgeries. The category III septa observed in the sagittal plane were embedded by one of the branches of the infraorbital nerve in it, and if accidentally cut will lead to infraorbital nerve palsy in maxillary sinus surgeries.
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Aggressive benign odontogenic neoplasms have substantial potential to grow to an enormous size with resulting bone deformities, and they often in-vade adjacent tissues and spread beyond their normal clinical and radiographic margins; as such, they have a high rate of recurrence. Historically, man-agement (conservative versus aggressive) on the basis of clinical, radiographic and/or histopathologic characteristics has been controversial. However, recent advances in the understanding of the biological features of these lesions may provide greater evidence of the benefitsof conservative manage-ment. Three patients with different complaints and finalhistopathologic diagnoses were enrolled in the study. All three cases were treated by a single operator with similar conservative surgical procedures. During follow-up, the patients had uneventful secondary healing and bone regeneration, less packing time than previously reported, no clinical or radiographic evidence of recurrence and no apparent deformity. The aggressive behavior of these lesions requires long clinical and radiographic follow-up. Conservative surgical management may be an option to reduce recurrence and morbidity and increase the probability of uneventful secondary healing and bone regeneration.
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In the Department of Oral and Maxillofacial Surgery, patients with trismus can be easily identified.If the cause of trismus is infection of the mastica-tory space near the pterygoid plexus, the possibility of cavernous sinus thrombosis should be considered. We report the case of a patient who presented with limited mouth opening and progressed to cavernous sinus thrombosis, along with a review of the relevant literature.
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Cemento-ossifying fibromasare benign tumors, and, although cases of an aggressive type have been reported, no cases of cemento-ossifying fibromatransforming into osteosarcoma have been documented previously. Low-grade osteosarcoma is a rare type of primary bone tumor, representing 1%-2% of all osteosarcomas. A 45-year-old female patient was diagnosed with cemento-ossifying fibroma,treated with mass excision several times over a period of two years and eight months, and followed up. After biopsy gathered because of signs of recurrence, she was diagnosed with low-grade osteo-sarcoma. The patient underwent wide excision, segmental mandibulectomy, and reconstruction with fibulafree flap.The aim of this report is to raise awareness of the possibility that cemento-ossifying fibromacan transform into osteosarcoma and of the consequent necessity for careful diagnosis and treatment planning.
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Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differ-ential diagnosis difficult.Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficienc. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with in-creased pain. At this time, his TMD diagnosis was confirmed.He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identifiedan abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmedpus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physi-cian. The patient’s symptoms decreased, and he was discharged.