Journal of the Korean Association of Oral and Maxillofacial Surgeons
- P-ISSN2234-7550
- E-ISSN2234-5930
- SCOPUS, KCI, ESCI
41권 3호
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Objectives: Dentin is composed of many minerals and growth factors. Based on this composition, we studied its effect as a possible regenerative ma-terial for alveolar healing.Materials and Methods: This study was conducted using four 2.5-year-old mongrel dogs (male; weight, 25 to 30 kg). The third mandibular premo-lars were carefully mobilized with a dental elevator and then removed using forceps. The crown portions of the extracted teeth were removed with cut-ters, and the root portions of the remaining teeth were collectively trimmed as closely as possible to 350 to 500 μm. Dentin and cementum (DC) chips harvested from the extracted teeth were soaked in blood and packed into the fresh sockets (autograft). Biopsies were performed at the ends of day 14 and day 56 following implantation. Data were expressed as mean±standard deviation and compared with t-test results.Results: The ratio of SA(bone) to total area of each probe was determined and was 170±16 μm2 for the control group and 71±14 μm2 for the DC group, a significant diference (P<0.05). Conclusion: DC particulate grafts offered no improvement in bone regeneration in alveolar extraction sockets.
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Objectives: The purpose of this study was to clarify which findingsin magnetic resonance imaging (MRI) are good predicators of pain and mouth opening limitation in patients with temporomandibular joint (TMJ) internal derangement (ID).Materials and Methods: Clinical examinations for pain and mouth opening limitation were conducted for suspected TMJ ID. MRI scans were taken within a week of clinical examinations. On the oblique-sagittal plane image, readings were obtained in terms of the functional aspect of disc position, degree of displacement, disc deformity, joint effusion, and osteoarthrosis. Multiple logistic regression analyses were conducted to identify the predic-tors of pain and mouth opening limitation. Results: A total of 48 patients (96 TMJs) were studied, including 39 female patients and 9 male patients whose ages ranged from 10 to 65 years. The resultant data showed significantcorrelations between pain and the MR imaging of the degree of disc displacement (P<0.05). The probability of there being pain in moderate to significantcases was 9.69 times higher than in normal cases. No significantcorrelation was found between mouth opening limitation and MRI findingsConclusion: We identifieda significantcorrelation between clinical symptoms and MRI findingsof ID. The degree of anterior disc displacement may be useful for predicting pain in patients with TMJ ID.
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Objectives: To evaluate the influence of the type of osteotomy in the inferir aspect of the mandible on the mechanical performance. Materials and Methods: The study was performed on 20 polyurethane hemimandibles. A sagittal split ramus osteotomy (SSRO) was designed in 10 hemimandibles (group 1) with a vertical osteotomy in the buccal side (second molar level) and finalosteotomy was performed horizontally on the lingual aspect, while the mandible body osteotomy was finalizedas a straight osteotomy in the basilar area, perpendicular to the body. For group 2, the same osteotomy technique was used, but an oblique osteotomy was done in the basilar aspect of the mandibular body, forming continuity with the sagittal cut in the basilar area. Using a surgical guide, osteosynthesis was performed with bicortical screws using an inverted L scheme. In both groups vertical compression tests were performed with a linear load of 1 mm/min on the central fossa of the firstmolar and tests were done with models made from photoelastic resin. Data were analyzed using Student’s t-test, establishing a statistical significance whenP<0.05. Results: A statistical difference was not observed in the maximum displacements obtained in the two osteotomies (P<0.05). In the extensiometric analysis, statistically significantdifferences were identifiedonly in the middle screw of the fixation.The photoelastic resin models showed force dis-sipation towards the inferior aspect of the mandible in both SSRO models. Conclusion: We found that osteotomy of the inferior aspect did not influencethe mechanical performance for osteosynthesis with an inverted L sys-tem.
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Odontogenic carcinosarcoma is an extremely rare malignant odontogenic tumor with only a few reported cases. It is characterized by a true mixed tumor showing malignant cytology of both epithelial and mesenchymal components. It has been assumed to arise from pre-existing lesions such as am-eloblastoma, ameloblastic fibroa, and ameloblastic fibrosaroma. To date, the reported cases have exhibited considerably aggressive clinical behavior. The case of an odontogenic carcinosarcoma in the mandible of a 61-year-old male is described herein. The tumor destroyed the cortex of the mandible and invaded the adjacent tissues. Treatment was performed by surgical resection and reconstruction. The purposes of this article are to introduce odon-togenic carcinosarcoma through this case study, to distinguish it from related diseases and to discuss features of the tumor in the existing literature.
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In 1942 Stafne reported 35 asymptomatic, radiolucent cavities that were unilaterally located in the posterior region of the mandible between the man-dibular angle and the third molar, and below the mandibular canal. The term Stafne bone cavity (SBC) is now used for such asymptomatic lingual bone depressions of the lower jaw. Since then there have been many reports of SBCs but very few studies have used cone-beam computed tomography (CBCT) for their diagnosis. The aim of this paper is to describe the clinical and radiological characteristics of two cases of SBCs and the importance of limited CBCT in confirming the diagnosis
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Surgical approaches to the condylar fracture include intraoral, preauricular, submandibular, and retromandibular approaches. Each approach has its own advantages and disadvantages. When a patient needs esthetic results and an intraoral approach is not feasible, the transmasseteric antero-parotid facelift approach is considered. This approach permits direct exposure and allow the surgeon to fixatethe fractured unit tangentially. Tangential fix-tion is critical to osteosynthesis. Disadvantages of the transmasseteric antero-parotid facelift approach include damage to the facial nerve and a longer operation time. However, after the initial learning curve, facial nerve damage can be avoided and operation time may decrease. We report three cases of subcondylar fractures that were treated with a transmasseteric antero-parotid facelift approach. Among these, two cases had trivial complications that were easily overcome. Instead of dissecting through the parotid gland parenchyma, the transmasseteric antero-parotid facelift approach uses transmas-seteric dissection and reduces facial nerve damage more than the retromandibular transparotid approach. The esthetic result is superior to that of other approaches.
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Bilateral sagittal split ramus osteotomy is considered a standard technique in mandibular orthognathic surgeries to reduce unexpected bilateral stress in the temporomandibular joints. Unilateral sagittal split ramus osteotomy (USSO) was recently introduced to correct facial asymmetry caused by asym-metric mandibular prognathism and has shown favorable outcomes. If unilateral surgery could guarantee long-term postoperative stability as well as favorable results, operation time and the incidence of postoperative complications could be reduced compared to those in bilateral surgery. This report highlights three consecutive cases with long-term follow-up in which USSO was used to correct asymmetric mandibular prognathism. Long-term post-operative changes in the condylar contour and ramus and condylar head length were analyzed using routine radiography and computed tomography. In addition, prior USSO studies were reviewed to outline clear criteria for applying this technique. In conclusion, patients showing functional-type asym-metry with predicted unilateral mandibular movement of less than 7 mm can be considered suitable candidates for USSO-based correction of asym-metric mandibular prognathism with or without maxillary arch surgeries.
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It has recently been reported that long-standing post-traumatic open bite can be successfully corrected with botulinum toxin type A (BTX-A) injection into the anterior belly of the digastric muscle (ABDM). The report documented an individual with bilaterally symmetrical and otherwise unremark-able anterior digastric musculature. However, the existence of variant anterior digastric musculature is common and may complicate the management of anterior open bite with BTX-A injection. Screening for variant ABDM can be accomplished via ultrasound, computed tomography, and magnetic resonance imaging. Screening for variant ABDM should be performed prior to BTX-A injection in order to account for musculature that may exert un-desired forces, such as inferolateral deviation, on the anterior mandible in patients with anterior open bite.