Journal of the Korean Association of Oral and Maxillofacial Surgeons
- P-ISSN2234-7550
- E-ISSN2234-5930
- SCOPUS, KCI, ESCI
ISSN : 2234-7550
Browser Articles
e-SubmissionVol.46 No.3
Abstract
Dental implants are the first option for replacement of missing teeth. Failure usually involves additional cost and procedures. As a result, the physician should limit the risk factors associated with implant failures. Implant site is one of many factors that can influence the success or failure of dental im-plants. The association between early implant failure (EIF) and implant site has yet to be documented. This review aims to estimate the impact of inser-tion site on the percentage of EIFs. An electronic and manual search of studies that reported early failure of dental implants based on collection site. A total of 21 studies were included in the review and examined for the association between EIF and alveolar site. Subgroup analysis, including a compar-ison between implants inserted in four alveolar ridge regions of both jaws was performed. The early failure rate was higher for maxillary implants (3.14%) compared to mandibular implants (1.96%). Applying a random effect, risk ratio (RR), and confidence interval (CI) of 95% revealed higher failure in the maxilla compared to the mandible (RR 1.41; 95% CI [1.19, 1.67]; P<0.0001; I2=58%). The anterior maxilla is more critical for early implant loss than other alveolar bone sites. Implants in the anterior mandible exhibited the best success rate compared of the sites.
Abstract
Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthri-tis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome.Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.
Abstract
Objectives: The purpose of this retrospective epidemiological study was to determine the etiology and pattern of maxillofacial injuries in a pediatric population.Materials and Methods: Data for pediatric maxillofacial trauma patients aged 12 years and younger who were registered at the Department of Pe-diatric and Preventive Dentistry, Dr. R. Ahmed Dental College and Hospital, Kolkata, India, were reviewed and examined. Patients who were treated between October 2016 and September 2018 were analyzed according to age, sex, cause of injury, frequency and site of facial fractures, and soft tissue injuries. The chi-square tests were carried out for statistical analyses with a significance level of 5%.Results: Of 232 patients with a mean age of 6.77±3.25 years, there were 134 males (57.8%) and 98 females (42.2%). The overall male to female ratio was 1.39:1. The most common causes of injuries were falls (56.5%) and motor vehicle accidents (16.8%). Incidence of falls decreased significantly with age (P<0.001). Dentoalveolar injuries (61.6%) and soft tissue injuries (57.3%) were more common than facial fractures (42.7%). Mandibular frac-tures (82.8%) were the most common facial fractures, and perioral or lip injuries were the most prevalent injuries in our patient population. There was a positive association between facial fractures and soft tissue injury (P<0.01) (odds ratio 0.26; confidence interval 0.15-0.46).Conclusion: Falls were the leading cause of maxillofacial trauma in our sample of children, and the most common site of fractures was the mandible.
Abstract
Objectives: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic pro-tein-2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement proper-ties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. Materials and Methods: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular se-questrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after se-questrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. Results: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann–Whitney U-test, P<0.05). Conclusion: Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.
Abstract
Objectives: We compared the outcomes of two different doses of FK506 (tacrolimus) for immunosuppression in submandibular salivary gland (SMG) allotransplantation.Materials and Methods: Three SMG allotransplantation groups were established (n=6 per group) as follows: allograft rejection control (Allo-Ctrl), low dose (0.08 mg/kg) of FK506 (FK506-L), and high dose (0.16 mg/kg) of FK506 (FK506-H). Allograft survival and rejection were assessed by clinical observation, interleukin-2 levels as determined by enzyme-linked immunosorbent assay, blood sampling for complete blood count (CBC), and histological evaluation.Results: Body weight and anorexia were higher in the FK506-H group but without a significant difference compared with the FK506-L population. CBC revealed a non-significantly reduced number of changes in the FK506-L group. Four glands in the FK506-H group and two glands in the FK506-L group were viable and functioning post-transplantation. Conclusion: The survival rate of allotransplanted glands was higher in conjunction with the high dose of 0.16 mg/kg of FK506, with no major differ-ence in the side-effect profile when compared with the low dose of 0.08 mg/kg short-term outcomes.
Abstract
Benign fibro-osseous lesions occur when normal bone is replaced by cellular fibrous connective tissue and mineralized structures. One rare type of these lesions is the ossifying fibroma (OF). The aim of this study is to report an unusual case of OF in a 57-year-old female. Physical examination showed facial asymmetry without any tenderness, fluctuation, ocular pain, or ophthalmoplegia. Imaging exams revealed a solid mass involving the left maxilla and orbital floor. Surgical resection was performed without any complications or sequelae, and the histopathological results confirmed OF. Al-though recurrence is rare in this condition, the patient remains under follow-up.
Abstract
Recently, after reviewing the online journal, Journal of the Korean Association of Oral and Maxillofacial Surgeons, we found a recently published original article by Manzano et al., entitled, “Retrospective study of osteoradionecrosis in the jaws of patients with head and neck cancer”. Although this original article was well written and provided a great deal of information regarding osteoradionecrosis in the jaws, we would like to add a few ad-ditional recommendations based on our small concerns and recently updated articles.
Abstract
In patients with insufficient bone height and width, the successful placement of dental implants is difficult with regards to maintaining an ideal pathway and avoiding important anatomical structures. Vertical and/or horizontal ridge augmentation may be necessary using various bone substitute materials and bone graft procedures. However, effective one-wall reconstruction has been challenging due to its poor blood supply and insufficient graft stability. In this paper, the authors summarize current evidence-based literature based on the author’s clinical experience. Regarding bone substitutes, it is advan-tageous for clinicians to select the types of bone substitutes including autogenous bone. The most important consideration is to minimize complications through principle-based ridge augmentation surgery. Ridge augmentation should be decided with complete consent of the patients due to the possible disadvantages of surgery, complications, and unpredictable prognosis.