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Journal of the Korean Association of Oral and Maxillofacial Surgeons

Vol.42 No.1

pp.1-1
; ; ; ; pp.2-8
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Abstract

Objectives: The purpose of this study was to investigate the effects of low-level laser therapy (LLLT) with a diode gallium-aluminum-arsenide (Ga-Al-As) low-level laser device on the healing and attachment of titanium implants in bone.Materials and Methods: Thirteen New Zealand white male rabbits weighing 3.0±0.5 kg were used for this study. Dental titanium implants (3.75 mm in diameter and 8.5 mm in length, US II RBM plus fixture; Osstem, Seoul, Korea) were implanted into both femurs of each rabbit. The rabbits were randomly divided into a LLLT group and a control group. The LLLT was initiated immediately after surgery and then repeated daily for 7 con-secutive days in the LLLT group. Six weeks and 12 weeks after implantation, we evaluated and compared the osseointegration of the LLLT group and control group, using histomorphometric analysis, removal torque testing, and resonance frequency analysis (RFA). The results were statistically signifi-cant when the level of probability was 0.05 or less based on a non-parametric Mann-Whitney U-test. Results: The implant survival rate was about 96%. Histologically and histomorphometrically, we observed that the titanium implants were more strongly attached in LLLT group than in control group. However, there was no significant difference between the LLLT group and control group in removal torque or RFA.Conclusion: Histologically, LLLT might promote cell-level osseointegration of titanium implants, but there was no statistically significant effects.

(Yonsei University Wonju College of Medicine) ; Yiqin Fang(Yonsei University Wonju College of Medicine) ; (Yonsei University Wonju College of Medicine) ; (Yonsei University Wonju College of Medicine) pp.9-12
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Objectives: In this study we evaluated heat generation during the low-speed drilling procedure without irrigation. Materials and Methods: Ten artificial bone blocks that were similar to human D1 bone were used in this study. The baseline temperature was 37.0oC. We drilled into 5 artificial bone blocks 60 times at the speed of 50 rpm without irrigation. As a control group, we drilled into an additional 5 artificial bone blocks 60 times at the speed of 1,500 rpm with irrigation. The temperature changes during diameter 2 mm drilling were measured using thermocouples. Results: The mean maximum temperatures during drilling were 40.9oC in the test group and 39.7oC in the control group. Even though a statistically significant difference existed between the two groups, the low-speed drilling did not produce overheating. Conclusion: These findings suggest that low-speed drilling without irrigation may not lead to overheating during drilling.

Indu Bhusan Kar(Sriram Chandra Bhanja Dental College) ; Prashant Dilip Chopda(Sriram Chandra Bhanja Dental College) ; Niranjan Mishra(Sriram Chandra Bhanja Dental College) ; Alok Kumar Sethi(Sriram Chandra Bhanja Dental College) ; Bikas Ranjan Mahavoi(Sriram Chandra Bhanja Dental College) pp.13-19
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Objectives: As the craniofacial and neck regions are prime areas of injury in bear attacks, the careful management of soft and hard tissue injuries and selection of reconstructive options is of the utmost importance. This study will review the incidence and patterns of bear mauling in eastern India reported to our department and the various modalities used for their treatment over a period of 7 years. It also documents the risks of infection in bear mauling cases and the complications that have occurred.Materials and Methods: Twenty cases were treated over the study period. Cases were evaluated for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region. Cases were also evaluated for other associated injuries, organ damage and related complica-tions.Results: Various modalities of treatment were used for the management of victims, ranging from simple primary repairs to free tissue transfers. Sim-ple primary repairs were done in 75% of cases, while the management of the injured victims required reconstruction by local, regional or distant flaps in 25%. Free tissue transfers were performed in 15% of cases, and no cases of wound infection were detected in the course of treatment.Conclusion: Knowledge of various reconstructive techniques is essential for managing maxillofacial injuries in bear mauling cases. Modern recon-structive procedures like free tissue transfer are reliable options for reconstruction with minimal co-morbidity and dramatic improvement in treatment outcomes.

Patricia L. Carlisle(Fort Sam Houston) ; Teja Guda(Fort Sam Houston) ; David T. Silliman(Fort Sam Houston) ; Wen Lien(Fort Sam Houston) ; Robert G. Hale(Fort Sam Houston) ; Pamela R. Brown Baer(Fort Sam Houston) pp.20-30
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Objectives: To validate a critical-size mandibular bone defect model in miniature pigs.Materials and Methods: Bilateral notch defects were produced in the mandible of dentally mature miniature pigs. The right mandibular defect remained untreated while the left defect received an autograft. Bone healing was evaluated by computed tomography (CT) at 4 and 16 weeks, and by micro-CT and non-decalcified histology at 16 weeks.Results: In both the untreated and autograft treated groups, mineralized tissue volume was reduced significantly at 4 weeks post-surgery, but was comparable to the pre-surgery levels after 16 weeks. After 16 weeks, CT analysis indicated that significantly greater bone was regenerated in the auto-graft treated defect than in the untreated defect (P=0.013). Regardless of the treatment, the cortical bone was superior to the defect remodeled over 16 weeks to compensate for the notch defect.Conclusion: The presence of considerable bone healing in both treated and untreated groups suggests that this model is inadequate as a critical-size defect. Despite healing and adaptation, the original bone geometry and quality of the pre-injured mandible was not obtained. On the other hand, this model is justified for evaluating accelerated healing and mitigating the bone remodeling response, which are both important considerations for dental implant restorations.

; ; pp.31-37
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Objectives: The aim of the present study was to evaluate changes in the management and 5-year survival rates of patients with oral cancer in our de-partment over a 30-year period.Materials and Methods: We investigated the patient distributions, treatment methods, method of neck dissection according to cancer stage, and 5-year survival rates for 700 oral cancer patients over the periods of 1982-1996 (256 patients), 1999-2006 (248 patients), and 2007-2011 (196 patients).Results: Stage IV patients were the largest group in all of the time periods evaluated. Although surgery and radiotherapy were the most common methods in all periods (over 50%), the prevalence of patients who underwent concomitant chemoradiotherapy increased from 7.0% to 16.2%. The use of radical neck dissection decreased from 43.0% to 5.3%, while conservative surgical methods increased from 24.1% to 76.3%. Lastly, the overall 5-year survival rate increased from 31.6% to 63.5% during the study period.Conclusion: Although the 5-year survival rate reached the same level as that of other developed countries during the course of our study, most pa-tients continue to come to the hospital with stage IV disease. In order to increase the 5-year survival rate of oral carcinoma, it may be necessary to im-prove public education and social efforts relevant to early diagnosis.

; ; ; ; ; pp.38-42
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The purpose of this study is to evaluate the degree of osseointegration of resorbable blasting media (RBM) surface implants retrieved from humans. Three implants in the mandibular molar region that were surface-treated with RBM were retrieved from two patients. The implants were used to manufacture specimens in order to measure the bone-implant contact (BIC) ratio. The BIC ratios of the three implants were found to be an average of 69.0%±9.1%. In conclusion, that RBM surface implants are integrated into the host environment with histological significance and the BIC ratio of the RBM surface-treated implant was not significantly different from that of other surface-treated implants.

Benjamin Fomete(Ahmadu Bello University Teaching Hospital) ; Ezekiel Taiwo Adebayo(Military Hospital) ; Godwin Iko Ayuba(44 Nigerian Army Reference Hospital) ; Uche Albert Okeke(Ahmadu Bello University Teaching Hospital) pp.43-46
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Ameloblastic carcinoma is a malignant form of ameloblastoma defined by histological evidence of malignancy in primary, recurrent, or metastatic tumor. Such a tumor is rare, and the maxilla is an unusual site. Due to its rarity, the characteristics of this tumor in the maxilla have not been well de-scribed. Case 1: A 55-year-old, ill-appearing Nigerian male presented to our center with left maxillary swelling of seven-year duration. The swelling had been slow-growing and painless until one year prior, when the growth became rapid and was coupled with severe pain. The swelling affected both oral function and facial esthetics, and the patient reported difficulty breathing. There was a maxillary, ulcerated swelling extending from teeth 12 to 18 and blocking the left nostril. The involved teeth were moderately mobile. Case 2: A 32-year-old male farmer presented with recurrent right maxillary swelling of six-year duration. Prior to this episode, he had undergone surgery for ameloblastoma (follicular type). The present swelling was fungating through the skin and protruding into the right nostril. Ameloblastic carcinoma is an aggressive odontogenic tumor that requires aggressive surgical treatment.

K. S. Krishna Kumar(Baby Memorial Hospital) ; Suresh Vylopilli(Baby Memorial Hospital) ; Anand Sivadasan(Baby Memorial Hospital) ; Ajit Kumar Pati(Baby Memorial Hospital) pp.47-50
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Patients with Pierre Robin sequence exhibit varying degrees of airway obstruction and feeding difficulty. In some patients, airway obstruction may be profound, warranting surgical intervention to maintain a patent airway. The purpose of this article is to highlight the advantages of the tongue-lip adhe-sion procedure for the management of airway obstruction in such patients compared to the currently available options.

; ; pp.51-54
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The present case report describes an external auditory canal injury following extraction of the lower molar. The external auditory canal was torn in the same fashion that occurs in an anterior tympanic plate fracture. This case demonstrates one of the rare complications associated with dental extractions.

Ezekiel Taiwo Adebayo(Military Hospital) ; Godwin Iko Ayuba(44 Nigerian Army Reference Hospital) ; Sunday Olusegun Ajike(Ahmadu Bello University) ; Benjamin Fomete(Ahmadu Bello University) pp.55-59
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The two main forms of myositis ossificans are congenital and acquired. Either form is rare in the head and neck region. The acquired form is often due to trauma, with bullying as a fairly common cause. This report of myositis ossificans of the platysma in an 11-year-old female patient emphasizes the need for a high index of suspicion in unexplainable facial swellings in children and the benefit of modern investigative modalities in their management.

; pp.60-64
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Abstract

Neurilemmomas are well-encapsulated, benign, slow-growing tumors originating from Schwann cells of the nerve sheath surrounding cranial, periph-eral, or autonomic nerves. Intraoral neurilemmomas are relatively rare and have a wide variety of morphologic and radiologic features. This makes differential diagnosis difficult, and only histopathological features can lead to a definitive neurilemmoma diagnosis. In this report, we present the case of a 30-year-old woman whose chief complaint was a solitary, nodular mass on the right floor of the mouth. After computed tomography and magnetic resonance imaging, we performed an incisional biopsy that showed the typical characteristics of a neurilemmoma. The mass was removed completely through an intraoral surgical approach. Despite losing a portion of the lingual nerve, the patient did not complain of any specific discomfort. Wound healing was uneventful and there were no signs or symptoms of recurrence.

Journal of the Korean Association of Oral and Maxillofacial Surgeons