Effects of 4-hexylresorcinol on facial skeletal development in growing rats: Considerations for diabetes / 대한치과교정학회지

Objective@#To investigate the long-term effects of 4-hexylresorcinol (4HR) on facial skeletal growth in growing male rats, with a focus on diabetic animal models. Methods: Forty male rats were used. Of them, type 1 diabetes mellitus was induced in 20 animals by administering 40 mg/kg streptozotocin (STZ), and they were assigned to either the STZ or 4HR-injected group (STZ/4HR group).The remaining 20 healthy rats were divided into control and 4HR groups. We administered 4HR subcutaneously at a weekly dose of 10 mg/kg until the rats were euthanized. At 16 weeks of age, whole blood was collected, and microcomputed tomography of the skull and femur was performed. Results: All craniofacial linear measurements were smaller in the STZ group than in the control group. The mandibular molar width was significantly smaller in the 4HR group than in the control group (P = 0.031) but larger in the STZ/4HR group than in the STZ group (P = 0.011). Among the diabetic animals, the STZ/4HR group exhibited significantly greater cortical bone thickness, bone mineral density, and bone volume than the STZ group. Serum testosterone levels were also significantly higher in the STZ/4HR group than in the STZ group. @*Conclusions@#4HR administration may have divergent effects on mandibular growth and bone mass in healthy and diabetic rats. In the context of diabetes, 4HR appears to have beneficial effects, potentially through the modulation of mitochondrial respiration.

Retrospective comparative clinical study for silk mat application into extraction socket / 대한악안면성형재건외과학회지

BACKGROUND@#Silk mats have been approved for clinical trials by the Korean Food and Drug Administration as membranes for guided tissue regeneration (GTR). In this study, silk mat application was compared to high-density polytetrafluoroethylene (dPTFE) membrane application or no membrane group.@*METHODS@#To compare the silk mat group to the dPTFE group or the no membrane group, a retrospective sample collection was conducted. Bony defects were measured at the time of extraction (T0) and then at 3 months (T1) and 6 months after extraction (T2) on a digital panoramic view. Bone gain (BG) was calculated by subtracting from the bony defect at T0 to the bony defect at each follow-up.@*RESULTS@#The BG at T2 was 2.44 ± 2.49 mm, 4.18 ± 1.80 mm, and 4.24 ± 2.05 mm in the no membrane group, silk mat group, and dPTFE group, respectively. Both membrane groups had significantly higher BG than BG in the no membrane group at T2 (P < 0.05).@*CONCLUSIONS@#Both membrane groups showed higher BG than the no membrane group.

Surgically assisted rapid palatal expansion with tent screws and a custom-made palatal expander: a case report / 대한악안면성형재건외과학회지

Rapid palatal expansion(RPE) with the tooth-born appliance is not sufficient to apply to the patients with periodontal problem or insufficient tooth anchorage, and it leads to tipping of the anchorage teeth and increasing teeth mobility and root resorption. To avoid these disadvantages, we present the case using palatal screws and custommade palatal expander. A 23-year-old patient underwent surgically assisted rapid maxillary expansion with the Hyrax expansion using 4 tent screws. The study models were used to measure the pre-/-post surgical width of the anterior and posterior dental arches with a digital sliding caliper. In the result, the custom-made palatal expander with 4 tent screws is suitable for delivering a force to the mid-palatal suture expansion. And it is low cost, small sized and simply applied. The results indicated that maxillary expansion with the custom-made palatal anchorage device is predictable and stable technique without significant complications in patients.

Comparable efficacy of silk fibroin with the collagen membranes for guided bone regeneration in rat calvarial defects

PURPOSE: Silk fibroin (SF) is a new degradable barrier membrane for guided bone regeneration (GBR) that can reduce the risk of pathogen transmission and the high costs associated with the use of collagen membranes. This study compared the efficacy of SF membranes on GBR with collagen membranes (Bio-Gide(R)) using a rat calvarial defect model. MATERIALS AND METHODS: Thirty-six male Sprague Dawley rats with two 5 mm-sized circular defects in the calvarial bone were prepared (n=72). The study groups were divided into a control group (no membrane) and two experimental groups (SF membrane and Bio-Gide(R)). Each group of 24 samples was subdivided at 2, 4, and 8 weeks after implantation. New bone formation was evaluated using microcomputerized tomography and histological examination. RESULTS: Bone regeneration was observed in the SF and Bio-Gide(R)-treated groups to a greater extent than in the control group (mean volume of new bone was 5.49 +/- 1.48 mm3 at 8 weeks). There were different patterns of bone regeneration between the SF membrane and the Bio-Gide(R) samples. However, the absolute volume of new bone in the SF membrane-treated group was not significantly different from that in the collagen membrane-treated group at 8 weeks (8.75 +/- 0.80 vs. 8.47 +/- 0.75 mm3, respectively, P=.592). CONCLUSION: SF membranes successfully enhanced comparable volumes of bone regeneration in calvarial bone defects compared with collagen membranes. Considering the lower cost and lesser risk of infectious transmission from animal tissue, SF membranes are a viable alternative to collagen membranes for GBR.

Modified Extracorporeal Reduction of the Mandibular Condylar Neck Fracture

Condylar repositioning using centric relation bite in bimaxillary surgery / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to evaluate displacement of the mandibular condyle after orthognathic surgery using a condylar-repositioning device. METHODS: The patient group comprised 20 adults who underwent bimaxillary surgery between August 2008 and July 2011. The degree of condylar displacement was measured by pre- and postoperative tomographic analysis using centric relation bite and a wire during surgery. A survey assessing temporomandibular joint (TMJ) sound, pain, and locking was performed. The 20 tomographs and surveys were analyzed using the Wilcoxon signed-rank test and McNemar's test, respectively. RESULTS: No significant changes were observed in the anterior, superior, or posterior joint space of the TMJ (p > 0.05). In addition, no significant change was observed in TMJ sound (p > 0.05). However, TMJ pain and locking both decreased significantly after surgery (p < 0.05). CONCLUSIONS: Due to its simplicity, this method may be feasible and useful for repositioning condyles.

Cemento-Ossifying Fibroma in the Maxilla: A Case Report

Gingival Squamous Carcinoma with Metastatic Lymph Node Involvement of Papillary Thyroid Carcinoma

A Comparison of the Effects of Concomitant Analgesics with Midazolam for Sedative Dental Therapy

Treatment of large sized cystic lesion of the jaws with specific appliance for decompression: cases report

Cystic lesions on the jaws with expansion can invade the adjacent anatomical structure, infiltrate and expand the jaws, cause facial deformity, etc. There is great potential for pathologic fractures after cyst enucleation, and damage to the major structures like the nerve, artery. For these reasons, marsupialization and decompression are commonly used to reduce the cystic size. In 1947, Thomas first mentioned decompression that reduces the osmotic pressure in a cyst by making a hole in the cyst and insert a drain. In our cases, a large sized cystic lesion was treated with a specific device made from an orthodontic band and spinal needle. This device is easy and effective for applications and self irrigation.

A clinical study on the dental emergency patients visiting an University Hospital emergency room

INTRODUCTION: In today's society, the rapid and appropriate care of the dental emergency patients is much more important. So, a retrospective study on the characteristics of emergency dental injuries and diseases will be very meaningful. MATERIALS AND METHODS: This retrospective clinical study was carried by reviewing the radiographic films and emergency chart of 11,493 patients who had visited the emergency room of Hallym Sacred heart Hospital and were treated in the Department of Oral and Maxillofacial Surgery from January 2006 to December 2010. RESULTS: The male to female ratio was 1.9:1. The highest monthly incidence was observed in May (10.4%) and June (8.9%) and the peak age distribution was the first decade (56.0%), followed by the second decade (16.0%). Trauma was the most common cause in dental emergency patients, followed in order by toothache, odontogenic infection, temporomandibular joint (TMJ) disorder and oral hemorrhage. Soft tissue injury was most prevalent in the trauma group, followed by tooth injury and facial bone fractures. In the tooth injury group, tooth fracture (56.7%) showed the highest incidence followed in order by tooth subluxation (18.2%), tooth concussion (16.9%), tooth avulsion (11.5%) and alveolar bone fractures (3.7%). In the facial bone fracture group, mandibular fractures (81.8%) showed the highest incidence followed in order by maxilla fractures (15.7%), nasal bone fractures (9.0%), zygomaticomaxillary complex fractures (5.4%), orbital bone fractures (2.5%). In mandibular bone fractures, the most common location was the symphysis (70.1%), followed in order by the mandibular angle (33.0%), mandibular condyle (22.8%) and mandibular body (13.6%). In the infection group, a submandibular space abscess (46.2%) was most common followed in order by a buccal space abscess (17.4%), canine space abscess (16.9%) and submental space abscess (12.3%). TMJ dislocation (89.3%) showed the highest incidence in the TMJ disorder group, followed by TMJ derangement (10.7%). In the other group, a range of specific symptoms due to post operation complications, trigeminal neuralgia, chemical burns and foreign body aspiration were reported. CONCLUSION: For the rapid and appropriate care of the dental emergency patients, well-organized system should be presented in oral and maxillofacial surgery. And it is possible under analysis of pattern and the variation of the dental emergency patients.

The prospective preliminary clinical study of open reduction and internal fixation of mandibular angle fractures using 2 miniplates

INTRODUCTION: The placement of a single miniplate is not sufficient to achieve rigid fixation in mandibular angle fractures. It often causes difficulties in reducing the intermaxillary fixation (IMF) period. Consequently, the placement of 2 miniplates is preferable. The intraoral approach in an open reduction and internal fixation (ORIF) of a mandibular angle fracture with 2 miniplates is often challenging. Accordingly, an alternative of transbuccal approach is performed. However, this method leaves a scar on the face and can result in facial nerve injury. This clinical study suggests a protocol that can maintain rigid fixation without a transbuccal approach in mandibular angle fractures. MATERIALS AND METHODS: The subjects were 7 patients who sustained fractures of the mandibular angle and treated at Department of Oral and maxillofacial surgery, Sacred Heart Hospital, Hallym University. ORIF under general anesthesia was done using the intraoral approach. One miniplate was inserted on external oblique ridge of the mandible, and the other was placed on lateral surface of the mandibular body with contra-angle drill and driver. A radiographic assessment and occlusal contact point examination was carried out before surgery, and 2, 4 and 6 weeks after surgery. RESULTS: The mean operation time was 80 minutes. Regarding the occlusion state, the number of contact points increased after surgery. Paresthesia and infection were reported to be complications before surgery. CONCLUSION: The placement of 2 miniplates using contra-angle drill for ORIF of mandibular angle fractures allows early movement of the mandible without IMF. We propose this approach to reduce the patients' discomfort and simplify the surgical procedure.

Electrospun Silk Nano-Fiber Combined with Nano-Hydoxyapatite Graft for the Rabbit Calvarial Model

Hemorrhage of Sublingual Region and Airway Obstruction That Occurred after Dental Implant Placement on Mandible Anterior Edentulous Area: Case Report

Because sublingual region is well-vascularized and sublingual artery is passed throughout this region, it should be careful not to perforate lingual cortex when placing dental implant on mandible. A 83-years-old male complained severe sublingual hematoma, hemorrhage and dyspnea came our outpatient department. He had received dental implant placement in the same day. He needed hemostasis and airway control. If soft tissue of sublingual region and the artery are injured, it may result in life-threatening excessive hemorrhage. In dental implant surgery, especially mandible, we should recognize the accurate shape of mandible and anatomy of sublingual region. It is important to stop anticoagulant agent before surgery. When a patient has airway obstruction, the operator should manage airway quickly.

Case report: Maxillary sinus aspergillosis

The incidence of aspergillosis infections in the maxillary sinus has increased recently, because of overuse of antibiotics, steroids, anticancer agents, immunosuppressant, antimetabollites, and uncontrolled diabetes mellitus. The clinical features of maxillary sinus aspergillosis include pain, swelling and foul odor nasal excretion. This needs to be differentiated from bacterial maxillary sinusitis, and surgical treatment with antifungal agents are suggested. Recently, we treated two patients with maxillary sinus aspergillosis surgically (Caldwell Luc operation) and with antifungal agents(itraconazole). The results were satisfactory so we report these cases with literature review.

The clinical study of maxillary sinus septa used in panorama, CT

PURPOSE: The aim of this study was to examine the incidence, location and morphology of antral septa using radiographic exam.(Panorama, CT) in the dentate/non-atrophic and edentulous/atrophic maxillary segments. MATERIAL AND METHODS: 232 sinuses were subdivided into two groups(group1 : 175 sinuses were classified as complete & partial dentate maxillary segments, group2 : 57 sinuses were classified as complete edentulous maxillary segments) and were investigated for the incidence, location and morphology of maxillary sinus septa. RESULTS: A total of 80 septa were observed in 232 maxillary sinuses, which corresponded to 30.65% of the sinuses(71 of 232). 67.5% of the total septa was observed in the complete & partial dentate groups, but 32.5% of the total septa was observed in the complete edentulous group. Upon analysis of the anatomical location of the septa, it was seen that 14 septa(17.5%) were located in the P1 area, 15 septa(18.7%) were located in the P2 area, 19 septa(23.8%) were located in the M1 area and 32 septa(40%) were located in the M2 area and dista area of M2. we found 45 septa in the apical lesion of teeth, Group 1. However the remaining 9 septa were found in the edentulous area. CONCLUSION: CT is a better method than panoramic radiography for detecting the presence of the maxillary sinus septa. Maxillary sinus septa are more commonly detected in complete edentulous maxillary segments than in complete and partial dentate maxillary segments. Also maxillary sinus septa are more commonly detected posteriorly than anteriorly.

Squamous odontogenic tumor: a case report and review of literatures

A squamous odontogenic tumor (SOT) is an epithelial originated benign tumor. It has been rarely reported and most was intramural type. We observed a case of SOT in the mandible. It was associated with the odontogenic cyst. It was shown positive to pancytokeratin and p53. Considering that the case was free from recurrence for 5 years after surgery, p53 positive did not seem to be related to the prognosis of the disease.

The clinical features of the infratemporal fossa abscess and their significances

OBJECTIVE: The objective of this international comparative study was to investigate the clinical features and outcome of the treatment of infratemporal fossa abscess (IFA). STUDY DESIGN: This retrospective study was conducted at the Deptartment of Oral and Maxillofacial Surgery of Hallym University and "Iuliu Hatieganu" University of Medicine and Pharmacy. Ten-year records of patients were reviewed in Romania and six-year records were reviewed in Korea. The collected data was then analyzed. RESULTS: A total of 36 cases were found to be IFA (12 males and 24 females: average age; 36.3+/-15.5 yrs: 34 cases from Romania and 2 cases from Korea). The annual frequency of IFA in Romanian and Korean hospitals was 3.40 and 0.33 respectively (P<0.001). The etiology was septic anesthesia (33.3%), infection occurring after extraction (30.6%), periapical lesion (13.9%), impacted third molar (8.3%), post-extraction alveolitis (5.6%), and unknown (8.3%). A successful outcome was seen in 27 patients (75.0%) after initial treatment. The main complication after initial treatment was restricted movement of the mouth (9 cases). CONCLUSION: The etiology of IFA was various and minimal swelling hampered early diagnosis. To prevent IFA, preoperative painting with antiseptic agent must be stressed and proper drainage proved important to relieve pain and to prevent further complications.

The clinical significance of the expression of TGF-beta 1 and MMP-2 related to the regional lymph node metastasis in the oral squamous cell carcinoma

Several matrix metalloproteinases (MMPs) have been shown to play an important role in the invasion and metastasis of oral squamous cell carcinoma (OSCC). The members of the TGF-beta signaling pathway are being considered as predictive biomarkers for progressive tumorigenesis and molecular targets for the prevention and the treatment of cancer and metastasis. The aim of the present study was to find the clinical significance of the expression of TGF-beta 1 and MMP-2 related to the regional lymph node metastasis in OSCC. This study included 76 cases of primary OSCC, of which 42 cases showed regional lymph node metastases. Immunohistochemistry was used for the localization of protein. The relation between the expression of each protein and clinical variables was statistically evaluated. In results, the expression of TGF-beta 1 both main mass with lymph node metastasis and without lymph node metastasis was found not to be statistically significant (p>0.05). The expression of MMP-2 was found to be statistically significant related to regional lymph node metastasis (p<0.05). When compared the expression in the metastatic lymph node, TGF-beta 1 was significantly highly expressed than MMP-2 (p<0.05). In conclusion, the expression of MMP-2 was significantly elevated in patients with lymph node metastasis as compared to the patients without lymph node metastasis, which could be useful in predicting the risk of lymph node metastasis in OSCC.

Post operative evaluation for retromandibular approach of subcondylar fractures

PURPOSE: The classic technique for open reduction of subcondylar fractures is the submandibular approach. The aim of this study was to evaluate clinical result of retromandibular approach to displaced subcondylar fractures. MATERIAL AND METHODS: During a period of 24months we perfomed a prospective study with a retromandibular approach in 23 paients with displaced subcondylar fractures. In this article we describe clinical result in 23 patients with follow ups for 3 months after surgery. Preoperatively all patients had malocclusion and radiology demonstrated displacement. RESULT: The retromandibularl approach for ORIF was good in all case. Mouth opening(M/O) was 49mm. Occlusion was good too. Permanent facial nerve palsy was not detected. CONCLUSION: Our findings indicate that the retromandibular approach is a safe technique for subcondylar fractures.