Journal of the Korean Association of Oral and Maxillofacial Surgeons
- P-ISSN2234-7550
- E-ISSN2234-5930
- SCOPUS, KCI, ESCI
41권 4호
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Objectives: The objective of this study was to identify salivary and serum concentrations of interleukin (IL)-8, IL-6, and tumor necrosis factor alpha (TNF-α) in patients with oral lichen planus, oral leukoplakia, oral submucous fibrosis, and healthy controls.Materials and Methods: Patients selected included 54 oral lichen planus (41 to 65 years), 50 oral leukoplakia (42 to 65 years), 51 oral submucous f-brosis (41 to 65 years), and 50 healthy controls (42 to 65 years). Oral lichen planus, oral leukoplakia, and oral submucous fibross cases were diagnosed using histopathological analysis. Salivary and serum cytokine concentrations were measured using enzyme-linked immunoassay kits in all subjects. Results: The levels of serum and salivary TNF-α, IL-6, and IL-8 were statistically significantlyincreased in oral leukoplakia, submucous fibrosis,and lichen planus in contrast to normal healthy subjects (P<0.05). Serum and salivary correlation analysis revealed strong and highly significantcorrela-tions for TNF-α, IL-6, and IL-8 in all groups (r=0.72-0.82, P<0.05). Conclusion: Salivary and serum cytokines were also elevated when analyzed in oral precancerous lesions. Thus, salivary and serum IL-8, IL-6, and TNF-α levels might act as diagnostic markers for detection of oral precancer.
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Objectives: The increased prevalence of antibiotic resistance is an outcome of evolution. Most patients presenting with odontogenic space infections also have associated systemic co-morbidities such as diabetes mellitus resulting in impaired host defense. The present study aims to compare the odon-togenic spaces involved, antibiotic susceptibility of microorganisms, length of hospital stay, and the influenceof systemic comorbidities on treatment outcome in diabetic patients.Materials and Methods: A 2-year prospective study from January 2012 to January 2014 was conducted on patients with odontogenic maxillofacial space infections. The patients were divided into two groups based on their glycemic levels. The data were compiled and statistically analyzed.Results: A total of 188 patients were included in the study that underwent surgical incision and drainage, removal of infection source, specimen col-lection for culture-sensitivity, and evaluation of diabetic status. Sixty-one out of 188 patients were found to be diabetic. The submandibular space was the most commonly involved space, and the most prevalent microorganism was Klebsiella pneumoniae in diabetics and group D Streptococcus in the nondiabetic group.Conclusion: The submandibular space was found to be the most commonly involved space, irrespective of glycemic control. Empiric antibiotic ther-apy with amoxicillin plus clavulanic acid combined with metronidazole with optimal glycemic control and surgical drainage of infection led to resolu-tion of infection in diabetic as well as nondiabetic patients. The average length of hospital stay was found to be relatively longer in diabetic individuals.
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Objectives: The purpose of this study was to compare the microbial and clinical effects of mechanical debridement (MD) alone or in combination with the application of enamel matrix derivative (EMD) and sustained-release micro-spherical minocycline (MSM) for treatment of peri-implant mu-cosal inf ammation (PIMI).Materials and Methods: Subjects with at least one implant with PIMI were included and divided into control and two different test groups. In all three groups, MD was performed. In the MSM group, following MD, MSM was placed subgingivally around the implants. In the EMD group, after MD, EMD was placed in the sulcus around the implants. Sampling of peri-implant crevicular f uid for microbial analysis with real-time polymerase chain reaction and recording of probing depth (PD) and bleeding on probing (BOP) were performed prior to as well as two weeks and three months after treatment. Median values and interquartile range were estimated for each variable during the various assessment intervals of the study.Results: In all groups, at two weeks and three months, the counts of Porphyromonas gingivalis decreased signif cantly compared to baseline. Levels of P. gingivalis were signif cantly reduced in MSM (P<0.001) and EMD (P=0.026) groups compared to the control group. Also, clinical parameters improved signif cantly at two weeks and three months. Reduction of PD was signif cant in MSM (P<0.001) and EMD (P<0.001) groups. The decrease in BOP in the MSM, EMD, and control groups was 60%, 50%, and 20%, respectively.Conclusion: The use of MSM and EMD can be an adjunctive treatment for management of PIMI and improves clinical parameters and reduces P. gingivalis burden three months after treatment.
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Objectives: A mesiodens appears most commonly as a supernumerary tooth impacted in the anterior maxilla. The purpose of this study is analyze mesiodens clinically.Materials and Methods: Gender, crown form, direction of impaction, relation to permanent incisors, and chief complaints of patients with extracted mesiodens were analyzed. Results: Patients were analyzed for motivation to visit the hospital; 85.4% of the patients were referred from other hospitals. Mesiodens was more common in males than in females (3.7:1), and 70.1% of patients had only one mesiodens, while 29.6% had two mesiodenses. Of the mesiodenses, 61.4% were of the aconical form, and the most common direction was upward (62.4%), followed by the normal position (26.0%) and the horizontal position (11.6%). The mesiodenses caused orthodontic problems with the permanent incisors in 46.3% of cases. Mesiodens associated with dentigerous cyst was rarely observed in our patient group.Conclusion: Mesiodens is more common in males than in females and often affects the permanent incisors. Thus, careful clinical and radiological evaluations of mesiodenses are important.
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The amniotic membrane is the innermost layer of fetal membrane and is attached to the chorion in the placenta. This membrane has been used for nearly a century in varied fieldssuch as ophthalmology, reconstructive surgery, and burn treatment. In this case report, we used a human amniotic membrane to repair an iatrogenic oroantral communication that occurred during the extraction of the patient’s right upper second molar. A splint was given after the perforation was covered with human amniotic membrane and healing was clinically evaluated at various intervals. The outcome of the study revealed that the human amniotic membrane was an efficint graft material for repairing the defect caused by an iatrogenic oroantral communica-tion following tooth extraction.
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Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of prolif-erative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findingswere similar to osteogenic sarcoma, an accurate differential diagnosis was important for proper treatment.
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Osteomyelitis is classifiedinto three groups according to its origin: osteomyelitis that originates from the blood supply, osteomyelitis related to bone disease or vascular disease, and osteomyelitis related to a local infection of dental or non-dental origin. The present case involved osteomyelitis related to a local infection of dental origin and was located in the rear area of the lingula of the mandible. We decided to use sagittal split ramus osteotomy to access the osteomyelitis area. Under general anesthesia, we successfully performed surgical sequestrectomy and curettage via sagittal split ramus oste-otomy.
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Keratocystic odontogenic tumor (KCOT) is a common benign tumor of osseous lesions in dental and maxillofacial practice. We describe three cases of large KCOT located in the posterior part of the mandible extending to the angle and ramus region, which were enucleated via sagittal split osteotomy (SSO) of the mandible. There are cases in which a conventional enucleation procedure does not ensure complete excision of the entire lesion without damage to vital structures like the inferior alveolar nerve. In such cases, a SSO approach could be a better choice than conventional methods. The pur-pose of this article is to describe our experience using unilateral mandibular SSO for removal of a KCOT from the mandible.
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Intraoral lipomas are a rare clinical entity, comprising only 0.1% to 5% of all benign tumors in the intraoral cavity. A 56-year-old woman suffering from diabetes presented with this relatively rare intraoral lipoma and was treated by surgical excision under general anesthesia. Because the mass was located adjacent to the mental foramen, a precise dissection was necessary to ensure minimal nerve damage. No abnormalities or recurrence was noted at 1-year follow-up and the patient did not complain of numbness. We studied the occurrence of oral lipoma in this diabetic patient and reviewed the relationship between oral lipoma and diabetes in the literature.
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Sinonasal sarcoidosis in the head and neck region is infrequent. Its occurrence can be either isolated in combination with other systems. The literature reveals that the occurrence of sinonasal sarcoidosis without lung involvement is rare. In general, sarcoidosis is a chronic non-caseating granulomatous disease of unknown origin, often identifiedafter biopsy. In this article, we report on a benign tumor of the face that produced a diagnostic dilemma, necessitating refinement of the sugical access and in toto removal of the benign tumor.