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Journal of the Korean Association of Oral and Maxillofacial Surgeons

Vol.49 No.5

Se-Jin Han(Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea) pp.241-242 https://doi.org/10.5125/jkaoms.2023.49.5.241
Yui Nanba(Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine) ; Yuhei Matsuda(Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine) ; Satsuki Watanabe(Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine) ; Mayu Takeda(Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine) ; Takafumi Abe(Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University) ; Kazumichi Tominaga(Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University) ; Minoru Isomura(Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University) ; Takahiro Kanno(Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine) pp.243-251 https://doi.org/10.5125/jkaoms.2023.49.5.243
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Abstract

Objectives: Although a few studies have investigated the relationship between kidney and oral function (number of remaining teeth), their results remain inconclusive. Therefore, this study aimed to investigate the relationship between kidney function and oral health in community-dwelling healthy elderlies and examine the factors associated with kidney function. Materials and Methods: We used cross-sectional data from the Shimane prefecture cohort recruited by the Center for Community-Based Health Research and Education in 2019. We collected clinical data on dental status, background factors and kidney function (estimated glomerular filtration rate [eGFR], mL/min/1.73 m2 and creatinine levels, mg/dL). Results: The study enrolled 481 participants, whose mean age was 66.7±7.4 years, and 223 (46.4%) participants were men. Multivariate analysis revealed significant correlations between eGFR (B=0.17, P=0.04), creatinine (B=–0.54, P<0.01), and the number of remaining teeth. The number of remaining teeth was associated with creatinine and eGFR, which are indicators of kidney function. Conclusion: This study suggests that preserving the teeth may prevent decline in kidney function. Dental professionals should provide instructions and professional care to reduce the risk of systemic diseases such as kidney dysfunction.

Eunjee Lee(Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) ; Yu-Jin Jee(Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) ; Jaewoong Jung(Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) ; Mu Hang Lee(Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) ; Sung ok Hong(Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong) pp.252-261 https://doi.org/10.5125/jkaoms.2023.49.5.252
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Abstract

Objectives: Patients undergoing oral surgery exhibit high anxiety, which may elevate their cortisol levels and affect postoperative recovery. Overweight patients are often encountered in the dental clinic due to the increasing prevalence of overweight. We aimed to investigate the relationships between preoperatively assessed body mass index (BMI), serum cortisol and high-sensitivity C-reactive protein (hs-CRP) levels, and visual analog scale (VAS) scores and preoperative anxiety in patients undergoing mandibular third molar (MM3) extraction and to identify predictors of postoperative complications. Patients and Methods: We analyzed 43 patients (age, 20-42 years) undergoing MM3 extraction. At the first visit, patients completed the Modified Dental Anxiety Scale (MDAS) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaires. Their BMI and VAS scores were also calculated. The participants underwent blood tests 1 hour before MM3 extraction. On the first postoperative day, the participants’ VAS scores and serum hs-CRP levels were reevaluated. Results: We found that BMI was significantly correlated with preoperative VAS scores. Further, BMI and preoperative hs-CRP levels were significantly correlated among women and patients undergoing extractions of fully impacted MM3s. No correlations were found between serum cortisol and other variables. The preoperative MDAS and VAS scores were significantly positively correlated, especially among patients undergoing extractions of fully impacted MM3s. Multiple linear regression showed that BMI and the eruption status of the MM3 were significant predictors of postoperative hs- CRP levels and VAS scores, respectively. Conclusion: In MM3 removals, patients with higher BMI showed elevated hs-CRP and higher VAS scores before surgery. Patients with higher anxiety among those undergoing extractions of fully impacted MM3s showed higher preoperative VAS scores. The two main predictors of postoperative complications were BMI and MM3 eruption status.

Sathish Radhakrishna(Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, India) ; Eashwari Narayanan(Department of Oral and Maxillofacial Surgery, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru, India) pp.262-269 https://doi.org/10.5125/jkaoms.2023.49.5.262
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Abstract

Objectives: Anterior maxillary sinus wall fractures are common in all types of maxillofacial trauma. They can result in various complications, including injury to the surrounding nerves. Owing to its anatomy, trauma to the maxillary antrum can result in injury to the middle superior alveolar nerve (MSAN) and the anterior superior alveolar nerve (ASAN). The purpose of this study is to evaluate neurosensory deficits (NSD) present in maxillary gingiva, incisors, and premolars after injury to the anterior wall of the maxillary antrum. Materials and Methods: This prospective study was conducted among 39 patients sustaining unilateral fractures of the anterior maxillary sinus wall. Clinical neurosensory tests including two-point discrimination and fine touch discrimination were performed to classify the extent of nerve injuries as mild, moderate, severe, or anesthetic. Additional temperature discrimination and pulpal sensibility tests (electric pulp testing and cold testing) were carried out. A comparison of radiographic fracture patterns and severity of nerve injury was done. Testing was carried out immediately after trauma and at 2-month follow-up. Results: More than half of the patients assessed in the study group presented with NSD of the teeth and gingiva after trauma. The incidence of deficits varied with the type of test used to measure them. Most frequently, patients presented with both loss of two point as well as fine touch discrimination thresholds. Severe nerve injuries were associated with loss of temperature discrimination clinically and displaced fractures radiographically. There was no significant relationship between the recovery of pulpal and gingival sensation. The patterns of injury and recovery in ASAN and MSAN were similar. Conclusion: NSD after trauma to the maxillary antrum is relatively common. Clinical loss of temperature discrimination and radiographic signs of fracture lines passing through the canalis sinuosus are predictors of persistent and severe oral NSD.

Sukkarn Themkumkwun(Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand) ; Chakorn Vorakulpipat(Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand) ; Kiatanant Boonsiriseth(Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand) pp.270-277 https://doi.org/10.5125/jkaoms.2023.49.5.270
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Objectives: Concha cartilage is recommended for correction of cleft nasal deformities. Morbidities at the donor site have been reported in esthetic rhinoplasty cases. Reports on cleft patients are limited, so we investigated the complications of concha cartilage harvesting using the retroauricular approach in cleft rhinoplasty and their management. Materials and Methods: This was a retrospective review of the charts of 63 patients with cleft deformities who underwent septorhinoplasty with concha cartilage. All cases were harvested using a retroauricular approach. Data on patient demographics, surgery type, amount of cartilage harvested, and complications were gathered. Results: Sixty-three patients were enrolled (21 males and 42 females). The mean age of patients was 20.2±5.9 years. Complications were observed in 6 cases (9.5%) and included delayed wound healing (4.8%), prolonged postoperative pain (1.6%), postoperative paresthesia (1.6%), and prominauris (1.6%). Conclusion: The rate of complications associated with concha cartilage harvesting using a retroauricular approach is low. The use of meticulous surgical techniques, especially hemostasis control and adequate wound dressing, is key to minimizing postoperative complications.

Woo-Hyun Seok(Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam) ; Pil-Young Yun(Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam) ; Na-Hee Chang(Department of Dental Hygiene, Section of Dentistry, Gangdong University, Eumseong) ; Young-Kyun Kim(Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital) pp.278-286 https://doi.org/10.5125/jkaoms.2023.49.5.278
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Objectives: This review assessed the performance of implant-supported fixed hybrid prostheses in 21 patients who received a total of 137 implants between 2003 and 2010. The implants were evaluated for marginal bone resorption, complications, success rate, and survival rate based on their vertical angularity, type of bone graft, and measured implant stability. Materials and Methods: One-way ANOVA and chi-square tests were used to analyze the relationships among long-term evaluation factors and these variables. The mean initial bone resorption in the implant group with a vertical angle of more than 20° was 0.33 mm and mean final bone resorption was 0.76 mm. In contrast, the mean initial bone resorption in the implant group with a vertical angle of less than 10° was 1.19 mm and mean final bone resorption was 2.17 mm. Results: The results showed that mean bone resorption decreased with an increase in the vertical placement angle of the implants used in fixed hybrid prostheses, as well as in the group without additional bone grafts and those with high implant stability. The success rate of implants placed after bone grafting was found to be higher than those placed simultaneously. Conclusion: These results suggest that implant-supported fixed hybrid prostheses may be an effective treatment option for edentulous patients, and intentionally placing implants with high angularity may improve outcomes.

Woo Young Jeon(Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University) ; Jung Ho Park(Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University) ; Jeong-Kui Ku(Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University) ; Jin-A Baek(Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University) ; Seung-O Ko(Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University) pp.287-291 https://doi.org/10.5125/jkaoms.2023.49.5.287
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Odontogenic keratocysts (OKCs) located in the maxillae have rarely been reported in the literature. Standard treatment modalities for OKC range from marsupialization to marginal resection. However, most of the studies on OKC treatment have been related to mandibular OKCs. The anatomical structure and loose bone density of the maxillae and the empty space of the maxillary sinus could allow rapid growth of a lesion and the ability to tolerate tumor occupancy in the entire maxilla within a short period of time. Therefore, OKCs of the maxillae require more aggressive surgery, such as resection. As an alternative, this report introduces a modified Carnoy’s solution, a strong acid, as an adjuvant chemotherapy after cyst enucleation. This report describes the clinical outcomes of enucleation using a modified Carnoy’s solution in patients with large OKCs on the posterior maxillae. In three cases, application of a modified Carnoy’s solution had few side effects or morbidity. Each patient was followed for four to six years, and none showed any signs of recurrence. In conclusion, adjuvant treatment with a modified Carnoy’s solution can be considered a treatment option capable of reducing the recurrence rate of OKC in the maxillae.

Sung Bin Youn(Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ; Hoon Myoung(Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) ; Ik-Jae Kwon(Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University) pp.292-296 https://doi.org/10.5125/jkaoms.2023.49.5.292
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Abstract

Generally, if the size of a lip cancer defect exceeds 30% of the lower lip, a local flap or free flap is recommended. However, defects up to 50% of the lower lip in size have been reconstructed successfully by primary closure without a local flap or free flap. In one case, an 80-year-old male farmer who had smoked for more than 50 years presented with squamous cell carcinoma of the lower lip and underwent mass resection and supraomohyoid neck dissection. The defect accounted for almost 2/3 of the lower lip and was repaired by primary closure with V-shaped resection. Biopsy results confirmed pT2N0cM0 stage II disease with clear margins. In another case, a 68-year-old male also presented with squamous cell carcinoma of the lower lip and underwent mass resection. The defect accounted for about half the size of the lower lip but was repaired by primary closure with V-shaped resection. Both patients experienced no discomfort while eating or speaking and were satisfied with the cosmetic and functional outcomes with no evidence of recurrence. Thus, direct closure can be considered even in large lower lip cancers.

Won-Jun Joung(Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul) ; Seo-Hyoung Yun(Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul) ; Yongjin Kim(Department of Oral and Maxillofacial Surgery, Woori General Hospital, Pocheon) ; Yong-Seok Cho(Department of Oral and Maxillofacial Surgery, The 22nd Century Seoul Dental Hospital, Incheon) ; Won-Woo Lee(Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul) ; Jin-Won Seo(Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul) ; Marco Tallarico(Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sassari) ; Kyung-Gyun Hwang(Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul) ; Chang-Joo Park(Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul) pp.297-303 https://doi.org/10.5125/jkaoms.2023.49.5.297
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Abstract

A resorbable barrier membrane is commonly used for the repair of perforated sinus membranes during sinus lifting surgeries. However, repairing largescale perforations poses challenges for clinicians as the protection and isolation of graft material remain uncertain. With this technique, we aimed to prevent graft material loss and subsequent sinus-related complications using intra-sinus rigid fixation of the resorbable barrier membrane in cases with a large perforation of the sinus membrane.

Kezia Rachellea Mustakim(Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea) ; Soung Min Kim(Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea) pp.304-307 https://doi.org/10.5125/jkaoms.2023.49.5.304
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Abstract

Venous malformation (VM) is a benign lesion of blood vessels caused by an error in vascular morphogenesis during the embryologic phase. This entity mostly affects the head and neck region, including the lips, tongue, buccal mucosa, gingiva, or palate. VM may cause functional and aesthetic impairments. The anatomical structure and shape of the lips provide an important aesthetic accent for an individual. Therefore, management of VM in the lip area without postoperative defects or scarring is challenging. In this brief communication article, we present a conservative approach to lip VM in a nine-year-old boy using a bleomycin injection that had good aesthetic and functional outcomes. Injection of 2 mL of 1/10 of 15 mg bleomycin in a saline dilution into the lip mucosa may present a drug reaction as a white plaque and reddish owl eye lesion that takes up to three weeks to resolve without a scar. It is important to recognize the characteristics and self-limiting nature of postoperative bleomycin complications to avoid unnecessary treatment.

Journal of the Korean Association of Oral and Maxillofacial Surgeons