Journal of the Korean Association of Oral and Maxillofacial Surgeons
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- P-ISSN2234-7550
- E-ISSN2234-5930
- SCOPUS, KCI, ESCI
ISSN : 2234-7550
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e-SubmissionVol.41 No.5
Abstract
Objectives: The purpose of this study was to evaluate changes in the pharyngeal airway space and hyoid bone position after mandibular setback sur-gery with bilateral sagittal split ramus osteotomy (BSSRO) and to analyze the correlation between the amount of mandibular setback and the amount of change in pharyngeal airway space or hyoid bone position. Materials and Methods: From January 2010 to February 2013, a total of 30 patients who were diagnosed with skeletal class III malocclusion and underwent the same surgery (BSSRO) and fixationmethod in the Division of Oral and Maxillofacial Surgery, Department of Dentistry at the Ajou University School of Medicine (Suwon, Korea) were included in this study. Lateral cephalograms of the 30 patients were assessed preoperatively (T1), immediately postoperatively (T2), and 6 months postoperatively (T3) to investigate the significanceof changes by time and the correlation between the amount of mandibular setback and the amount of change in the airway space and hyoid bone position. Results: Three regions of the nasopharynx, oropharynx, and hypopharynx were measured and only the oropharynx showed a statistically significantdecrease (P<0.01). A significantposterior and inferior displacement of the hyoid bone was found 6 months after surgery (P<0.01). Analysis of the cor-relation between the amount of mandibular setback and the amount of finalchange in the airway space and hyoid bone position with Pearson’s correla-tion showed no significant correlation.Conclusion: In this study, the oropharynx significantlydecreased after mandibular setback surgery, and changes in the surrounding structures were identifiedthrough posteroinferior movement of the hyoid bone during long-term follow-up. Therefore, postoperative obstructive sleep apnea should be considered in patients who plan to undergo mandibular setback surgery, and necessary modifications to the treatment plan should alsobe considered.
Abstract
Objectives: The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated.Materials and Methods: Ninety-fivepatients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric sta-bility was evaluated by serial CBCT images.Results: No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was 74.6%±8.4%. Conclusion: Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want den-tal implants regardless of atrophic alveolar bone.
Abstract
Objectives: This study was performed to evaluate patterns of failure time after insertion, failure rate according to loading time after insertion, and the patterns of failure after loading.Materials and Methods: A total of 331 mini-implants were classifiedinto the non-failure group (NFG) and failure group (FG), which was divided into failed group before loading (FGB) and failed group after loading (FGA). Orthodontic force was applied to both the NFG and FGA. Failed mini-implants after insertion, ratio of FGA to NFG according to loading time after insertion, and failed mini-implants according to failed time after loading were analyzed.Results: Percentages of failed mini-implants after insertion were 15.79%, 36.84%, 12.28%, and 10.53% at 4, 8, 12, and 16 weeks, respectively. Mini-implant failure demonstrated a peak from 4 to 5 weeks after insertion. The failure rates according to loading time after insertion were 13.56%, 8.97%, 11.32%, and 5.00% at 4, 8, 12, and 16 weeks, respectively. Percentages of failed mini-implants after loading were 13.79%, 24.14%, 20.69%, and 6.9% at 4, 8, 12, and 16 weeks, respectively.Conclusion: Mini-implant stability is typically acquired 12 to 16 weeks after insertion, and immediate loading can cause failure of the mini-implant. Failure after loading was observed during the first 12 weeks.
Abstract
Objectives: This study investigated patients with oral and maxillofacial lacerations who visited the emergency room over a three-year period in an ef-fort to determine the optimal treatment for these injuries.Materials and Methods: This study examined 1,742 patients with oral and maxillofacial lacerations with 2,014 different laceration locations who visited the emergency room of Pusan National University Hospital (Busan, Korea) over three years, from January 2011 to December 2013. Patients were classified by sex, age, visit da, cause of injury, injury site, and the presence or absence of soft tissue and tooth injuries.Results: The male to female ratio was 2.50:1. Patients under 10 years old were seen most frequently. Most emergency room visits were on weekends. Among intra-oral lacerations, the lip area was the most vulnerable site; among extra-oral lacerations, the chin area was most frequently injured. The most frequent etiology was a slip down. Most lacerations occurred without bone fracture or tooth damage. Conclusion: Laceration may differ in large part as compared with the fracture. Therefore, it is necessary to continue collecting data on oral and maxil-lofacial lacerations to establish optimal emergency room diagnosis and treatment strategies.
Abstract
Objectives: This study was performed to evaluate the impact of glycosylated hemoglobin (HbA1c) level on characteristics and prognosis of maxil-lofacial fascial infection in diabetic patients.Materials and Methods: We reviewed the medical records of 72 patients (35 patients with HbA1c lower than 7.0% and 37 patients with HbA1c higher than 7.0%) diagnosed with maxillofacial fascial space infection and hospitalized for treatment at the Department of Oral and Maxillofacial Sur-gery in Dankook University Hospital (Cheonan, Korea) from January 2005 to February 2014. We compared demographics, parameters of glucoregula-tion (HbA1c), laboratory parameters of inflammation(white blood cell [WBC], C-reactive protein [CRP] count), type and number of involved spaces, type and number of antibiotics, period of hospitalization, number of surgical operations, need for tracheostomy, complications, computed tomography (CT), and microorganisms between the two groups.Results: Compared with the well-controlled diabetes mellitus (DM) group (HbA1c <7.0%), patients in the poorly-controlled (HbA1c ≥7.0%) DM group had the following characteristics: longer hospitalization periods, higher values of laboratory parameters of inflammation(WBC, CRP count) at the time of admission, higher number of antibiotics prescribed, more frequent complications, frequent deep neck space involvement, and distinctive main causative microorganisms. As the HbA1c level increases, hospitalization periods and incidence of complications increase gradually.Conclusion: This retrospective study suggests that regulation of DM significantlyimpacts maxillofacial fascial infection. Poorly controlled DM with high HbA1c level negatively influences the prognosis of infectin.
Abstract
We describe our experience with conservative condylectomy for the correction of facial asymmetry in fivepatients with osteochondroma of the man-dibular condyle. All fivepatients presented with malocclusion and facial asymmetry, which are common clinical findingsof osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all fivepatients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma.
Abstract
The purpose of this study was to investigate implant-supported restoration as a technique for restoring missing teeth in patients with aplastic anemia. Recurrent bleeding from wound sites leads to persistent release of iron in the tissue. Excessive iron in tissue is related to clinical findings,including fibrosis,poor wound healing, and high level of angiogenesis, which are possible etiological factors of reduced osseointegration. A 44-year-old female patient with aplastic anemia was treated with multiple endosseous implants throughout the mandible and in the posterior region of the maxilla. After 14 implants were placed, radiological and clinical parameters were assessed during the follow-up period. Marginal bone did not change significantlydur-ing the follow-up period. The finetrabecular bone in intimate contact and enclosing the implant fixturewas sufficientfor successful osseointegration. None of the 14 implants were associated with compilations during the seven-year experimental period. This study suggests that dental implant proce-dures are a safe and reliable treatment option for restoration of missing dentition in patients with aplastic anemia.
Abstract
Benign firous histiocytoma (FH) is a benign tumor composed of firoblasts and histiocytes in varying proportions. This tumor is usually found in adult extremities but rarely occurs in deep soft tissues of the oral cavity. As it is difficultto diagnose with physical and radiologic exams, deep benign FH can only be diagnosed by histopathology. We report a case of a 36-year-old female patient who came to our department with painless swelling in the right buccal mucosa. This case report reviews the clinical, radiological, and histological aspects of this tumor.
Abstract
Angiosarcoma is a rare and aggressive malignant tumor that has a poor prognosis. It represents less than 1% of all malignancies occurring in the oral cavity and salivary glands. We present a 35-year-old male with angiosarcoma of the cheek following traumatic injury and a review of the current litera-ture.
Abstract
Migration of dental implants into the maxillary sinus is uncommon. However, poor bone quality and quantity in the posterior maxilla can increase the potential for this complication to arise during implant placement procedures. The aim of this report is to present a dental implant that migrated into the maxillary sinus and disappeared. A 53-year-old male patient was referred to us by his dentist after a dental implant migrated into his maxillary sinus. The displaced implant was discovered on a panoramic radiograph taken fivedays before his referral. Using computed tomography, we determined that the displaced dental implant was not in the antrum. There was also no sign of oroantral fistula.Because of the small size of the displaced implant, we think that the implant may have left the maxillary sinus via the ostium.
Abstract
Extraction of an impacted third molar is one of the most frequently performed techniques in oral and maxillofacial surgery. Surgeons can suffer numer-ous external injuries while extracting a tooth, with percutaneous injuries to the hand being the most commonly reported. In this article, we present a case involving a percutaneous injury of the surgeon’s femoral region caused by breakage of the fissurebur connected to the handpiece during extrac-tion of the third molar. We also propose precautions to prevent such injuries and steps to be undertaken when they occur.
Abstract
In cases of severe alveolar bone atrophy in the posterior maxillary area, which has only a thin sinus flor, the autogenous tooth bone graft block (ABTB) was used to wrap the implant to enhance its primary stability and osseointegration in the sinus. These cases with four years of clinical follow-up dem-onstrate the applicability of the ABTB in maxillary sinus membrane elevation to improve the outcomes of implant placement.