• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.6
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• pp.453-460
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• 2009

Background and Purpose: Vascular endothelial growth factor (VEGF)-C, VEGF-D and their tyrosine kinase receptor, VEGF receptor (VEGFR)-3 are recently known to have lymphangiogenic activities in various tumor types. Oral mucosal squamous cell carcinoma (OMSCC) easily metastasizes to cervical lymph nodes, so we determined the expression levels of VEGF-C, VEGF-D and VEGFR-3 in oral squamous cell carcinoma. Materials and Methods: We performed Western blot analyses with 4 OMSCC cultured tumor cell lines (SCC9, KB, YD-10B, YD-38), and with 7 surgical specimens of OMSCC for the detection of VEGF-C, VEGF-D and VEGFR-3 proteins. Expression of VEGF-C mRNA as well as mRNA for VEGFR-3 in 4 OMSCC cell lines (KB, SCC-4, SCC-9, YD-10B) was investigated by RT-PCR. We also measured VEGFC/VEGF-D protein concentrations in the media and protein concentration of VEGFR-3 in cell lysates of 4 OMSCC cell lines (SCC9, KB, YD-10B, YD-38) using commerical ELISA kits. Finally, we performed immunoprecipitation for the detection of VEGF-C in cell lysates of 4 OMSCC cells (KB, SCC-4, SCC-9, YD-10B) and real-time RT-PCR for the quantification of VEGF-C mRNA. Results: In the result of Western blotting with cell lysates of 4 OMSCC cells, we could not detect the protein expression of VEGF-C, VEGF-D, and VEGFR-3. But, all tumor tissues demonstrated VEGF-C and VEGFR-3. VEGF-C mRNA was detected at various levels in 4 OMSCC cell lines. Moreover, OMSCC cells secreted VEGF-C, not VEGF-D and VEGFR-3 was also detected in cell lysates of OMSCC by ELISA. Immunoprecipitation and real-time RT-PCR revealed VEGF-C was also expressed in 4 OMSCC cell lines. Conclusion: Taken together, tumor cells of OMSCC secrete VEGF-C, not VEGF-D. And VEGFR-3 is expressed tumor cells as well as OMSCC tumor tissues, needs further study.

• Journal of Oral Medicine and Pain
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• v.20 no.1
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• pp.141-158
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• 1995

This study was performed to invetigate the relationship between clinical manifestations related to temporomandibular joint sounds and temporomandibular joint vibrations that occurred synchronously with sounds. There have been reported in many articles that joint sounds indicate internal joint pathology. Therefore, it is necessary to evaluate type and patterns of joint sounds, and radiographic changes of temporomandibular joint(TMJ) in order to diagnose and deal with the Temporomandibular Disorders(TMD). For this study 142 patients with TMDs were collected and they were examined by routine diagnostic procedure for TMDs. The author classified TMJ sounds clinically into 3 types : click, popping, and crepitus. Transcranial and panoramic radiographs were taken for observein bony changes of TMJ, and for observing vibrations of TMJ Sonopak of Biopak system was used. The obtained results were as follows : 1. Female subjects with crepitus were older than those with click or popping and their mean ages were about 45 years old. But in male subjects, there was no age difference. 2. For all subjects, mean value of maximal mouth opening were above 40mm, which are lower limit of normal vertical opening. But in subjects with L-type opening deviation, mouth opening capacity were about 36mm of range. 3. Symptom duration stated when patient presented first were slightly longer in subjects with crepitus but there were no statistical differences. And there were also no radiographic differences among 3 types of joint sounds in regard to symptom duration. 4. In subjects wih click, it might have been interpreted that 12% had closed lock, 12% had degenerative joint disease, and about 17% of he subjects had normal joints by Sonopak. 5. There were no significant relationships between subjective loudness of joint sounds and magnitude of joint vibrations. 6. The highest value of Integral and peak amplitude were observed in popping sounds and though it was not significant, value of peak frequency was highest in crepitus. 7. Amount of mandibular positional change were differed between click and crepitus on frontal plane, between click, crepitus and popping on horizontal plane in rotational movement, respectively. However, there no difference among them in translational movements.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.46-53
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• 2001

The prevalence of supernumerary teeth is between $1{\sim}3%$. Of these, $90{\sim}98%$ occur in the maxilla with particular predilection for the premaxilla, preceded by mandibular third premolars, mandibular forth molars and maxillary paramolars. The most common ones occur in the maxillary anterior region, they may occur singly between the central incisors(mesiodens), or they may be double(mesiodentes). Maxillary anterior supernumeraries may erupt into the oral cavity or remain unerupted. It is found that approximately 25% are erupted, while the rest are unerupted. They are usually a small tooth with a cone-shaped crown and a short root. They may cause delayed eruption, median diastema, bodily displacement or rotation of the adjacent permanent teeth. Occasionally they may lead to the developement of dentigerous cyst or primordial cyst, or eruption into nasal cavity. In this study, 109 supernumeraries surgically extracted from premaxilla in 84 patients are analysed. The results are as follows : 1. Sex distribution of male and female is 2.2 : 1. 2. Almost cases are in pediatric age from 5 to 12 years old (87%). 3. Problems with supernumeraries are tooth malpositon, diastema, delayed eruption, eruption to nasal cavity and cyst formation. 4. Of 109 supernumeraries, 16(15%) are erupted into oral cavity, 92(84%) are impacted, and 1(1%) is erupted into nasal cavity. 5. Of 84 patients, 59(70%) have one supernumeray while 25(30%) have two supernumeraries. 6. Of 109 supernumeraries, 96(88%) are found within the region of the central incisors. 7. Of 109 supernumeraries, 94(86%) are vertically impacted, 11(10%) are horizontally impacted, 3(3%) are labiopalatally impacted and 1(1%) is impacted in nasal cavity. 8. Of 84 patients, we used palatal flap in 67(80%), labial flap in 6(7%), both flaps in 4(5%) and no flap in 7(8%). And incisive nerve was cut in 33(49%) of 67 palatal flaps. 9. Extration with ostectomy was done in 72 supernumeraries(66%), without ostectomy in 37 teeth(34%). 10. Extraction with tooth sectioning was done in 21 supernumeraries(19%), without tooth sectioning was done in 88 teeth(81%). 11. We used local anesthesia in 70 patients(83%) and general anesthesia in 14 ones(17%).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.4
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• pp.302-309
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• 2002

In order to improve the success rate of implants, various implant designs have been developed. Although there have been enough efforts to handle the surface of the implant with careful choice of material and mechanics so that the bone and the implant can be tightly joined together, they have still failed to play the role of periodontal ligaments of the natural teeth in the past. The role of periodontal ligaments is very important since it can improve the initial stability of implant by absorbing the impacts. The purpose of this study is, thus, to test the possibility of alleviating the impact when the surface of the implant was coated with chitosan, a natural polymer, and making sure that the coated material stayed on. Then, the condition of newly developed bone formation and the degree of inflammation in response was closely observed in the surface level. In the main experiment, Chitosan coated implant ($3.3mm{\times}7mm$) was implanted on both the right and the left side of rabbit's femur. The animals were each sacrificed on the $1^{st}$, $2^{nd}$, $3^{rd}$, $7^{th}$, $14^{th}$, $21^{st}$ and 28th day. The process was observed under an light microscope after the Toluidin Blue staining. From the experiment, it was found that the chitosan was evenly distributed on the surface of the screws, and the implant was adjoined with adjacent bone. There was a sign of inflammation on the $3^{rd}$ day, but on the $14^{th}$ day, the formation of woven bone and newly formed bones were noticed. Also, chitosan filled the gap was formed between the implant and the newly formed bone. The implant, the chitosan and the newly formed bone were forming one unit as a result. Therefore, it was found that chitosan coated implant could absorbe the impact in the initial stage of implant.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.15-24
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• 2001

The purpose of this study is to evaluate the tissue response in applying of various bone substitutes included toothash-plaster mixture, resorbable hydroxylapatite (HA) and demineralized freeze-dried bone and to show the clinical usefulness of toothash-plaster mixture for the repair of craniomaxillofacial bone defect. For this experiment, 100 Sprague-Dawley rats weighing 200gm or more were used. There were four experimental groups: group I, toothash-plaster mixture; group II, demineralized freeze-dried bone; group III, resorbable HA; and group IV, control group. A full thickness, round bone defect measuring 10mm in diameter was created in the midcranium, and the substitutes cited above were embedded in the experimental rats based on their group assignment. Blood clot was filled in the rats assigned to the control group. Experimental rats were sacrificed on the 1st, 3rd, 5th, 8th, 12th and 24th week after implantation and stained with the hematoxylineosin, Masson's Trichrome, using Van Gieson's stain method, and were examined under light microscope. The results were as follows: 1. In all the groups, prominent inflammatory reaction and the infiltration of multinucleated giant cells were noted during the early stage. Gradual healing decreased this reaction. 2. Among the rats in the experimental group II, which were given demineralized freeze-dried bone implants, active formation of new bone traveculae manifested. Chondroid tissues appeared, and it was suggested that the defect was filled with newly formed bone by virtue of osteoinductive activity. On the 12th week after the experiments, most of the defect was filled with newly formed bone trabeculae. 3. In experimental groups I and III, it was noted that HA manifested a healing process similar to that characterized by the toothash-plaster mixture, but inflammatory reaction was more prominent in experimental group I. Active osteoblasts were observed along the periphery of osteoid tissues, while newly formed bone trabeculae appeared adjacent to the implanted materials three weeks later. Formation increased to the extent that newly formed bone trabeculae fused directly with the host bone. Increase in new bone ingrowth into the filling materials was revealed by both experimental groups. 4. In the control group, new bone formation adjacent to the host bone was observed, but most of the defect was filled with mature connective tissue 24 weeks after the experiments.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.78-82
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• 2001

Background : The coronal incision is versatile surgical approach to upper and middle region of the facial skeletal including the zygomatic arch. The advantages of coronal approach are minimal injury of facial tissue including facial nerve and satisfactory cosmetic result by hidden scar at hair. But wide exposure of scalp, its disadvantages are operation time and massive blood loss. Methods : Thirty patients undergoing elective surgery were divided 3 groups. Group I used only coronal approach, group II used coronal with subciliary approach and group III used coronal with subciliary and intraoral approach. And then retrospected of the preoperative, postoperative red blood cell count, hemoglobin(Hb), hematocrit, transfused red blood cell units and platelet cell units, and the amount of infused crystalloids and colloids, and postoperative hemovac count was estimated. Results: 1. Red blood cell count were decreased in all groups at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II but increased group III of postoperative third day. 2. Hemoglobin and hematocrit were decreased in all group at immediated postoperation and decreased in all group of postoperative first day and decreased in group I, II., but increased group III postoperative third day. 3. Platelet was decreased in all group at immediated postoperation, and decreased in group II, III but increased in group I of postoperative first day and decreased in group I but increased group II, III of postoperative third day. 4. Mean postoperative hemovac mean drainage group I of first day is $48.63{\pm}21.12ml$ and second day is $23.92{\pm}19.53ml$ and third day is $7.82{\pm}5.32ml$ and group II of first day $60.45{\pm}22.65ml$ and second day is $22.14{\pm}13.21ml$ and third day is $7.32{\pm}6.25ml$. III group of first day $58.16{\pm}10.13ml$ and second day is $21.27{\pm}11.72ml$ and third day is $7.13{\pm}4.90ml$. 5. Infusion of group I is mean PRC $1.08{\pm}0.91$ pint, FFP $1.03{\pm}0.75$ pint, crystalloid $2562.23{\pm}1345.53ml$ and group II is mean PRC $1.05{\pm}0.89$ pint, FFP $1.71{\pm}0.78$, crystalloid $2650.47{\pm}1096.36ml$ and group III is mean PRC $1.79{\pm}1.45$ pint, crystalloid $3295.43{\pm}1472.432ml$.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.4
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• pp.199-205
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• 2003

The p53 protein was discovered in 1979 as cellular 53-kD nuclear phosphoprotein bound to the large transforming antigen of SV40 virus. $P21^{WAF1/CIP1}$, which has been described as the critical downstream mediator of p53, is known to suppress DNA replication and arrest the G1 cell cycle by quaternary complex with cyclin D, cyclin-dependent kinase(CDK) and proliferating cell nuclear antigen(PCNA). In these days, some studies shows that the p21 can be induced by independent pathways. There are various reports about the expression of p21 (67%.82.4%) in oral squamous cell carcinoma. But these studies are mostly done in malignant tumor not in benign tumor. So we decided to study the expression of p21 in ameloblastoma and the relationship between p53 and p21 as a downstream mediator of p53 in ameloblastoma. We investigated the expression of p21 and p53 with the method of immunohistochemistry. We selected 30 cases of ameloblastoma tissue blocks (acanthomatous type: 5 cases, follicular type: 8 cases, plexiform type: 17 cases) imbedded in paraffin. We used 30 cases of normal gingival tissues and 30 cases of squamous cell carcinoma tissues (SCC) respectively and compared their results with those of ameloblastoma. We made slides with the streptavidin-biotin methods and used monoclonal antibody DO-7 (Novocastra, Newcastle, United Kingdom) as p53 antibody and monoclonal antibody M7202 (DAKO, California, U.S.A.) as p21 antibody. We used Pearson's correlation coefficient to analyse the relationship. The results were as follows: 1. p21 was expressed in ameloblastoma about 30% and this is lower than that of normal gingiva and SCC. 2. In normal gingiva and ameloblastoma, p21 expression was correlated with p53 expression. 3. In SCC, p21 were expressed about 83.3% and this is more than that of p53. But there was no correlation between p21 and p53 expression. We confirmed p21 expression and relation with p53 in ameloblastoma. But, to confirm the function of p21, more studies about p21 expression in malignant ameloblastoma and ameloblastic carcinoma are needed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.4
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• pp.232-238
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• 2003

This study was performed to evaluate the effect of topical and intravenous heparin on thrombosis and patency in the microvascular anastomosis of the traumatized veins. Nine white rabbits weighing about 2 kg were used. After exposure of both femoral veins, the veins were crushed by the jaws of smooth needle holder in order to create a thrombosis model. Transectional incision was made in the vein. The animals were then divided into 3 groups based on the administration method of heparin: 1) Experimental Group I, topical irrigation of lumen with heparin saline solution (n=6); 2) Experimental Group 2, topical irrigation of lumen with heparin saline solution and intravenous injection of heparin (0.75 mg/kg) via the marginal ear vein for 3 days; 3) Control Group, topical irrigation of lumen with saline solution (n=6). The patency was evaluated with empty-and-refill test and thrombus formation was judged by surgical microscope. The results were as follows: 1. Thirty minutes after microvascular anastomosis, the patency of all Experimental Groups was better than Control group. However, there was no significant difference among groups. 2. Three days after anastomosis, the patency of all Experimental Groups was much more improved than that of Control Group (P<0.05). There was no significant difference between Experimental Group 1 and 2. 3. Three days after anastomosis, the amount of thrombus in all Experimental Groups was much less than that of Control Group (P<0.05). 4. In histologic findings a lot of luminal thrombus were observed around sutured area in Control Groups. Few luminal thrombus was observed in all Experimental Groups. Mild necrosis in the vessel wall was observed around sutured area in all specimens. These results indicate that topical irrigation of heparin may improve the patency and inhibit the formation thrombus in the microvascular anastomosis of the traumatized veins.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.100-107
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• 2004

Schwann cell, one of important components of peripheral nervous system, interact with neurons to mutually support the growth and replication of embryonal nerves and to maintain the different functions of adult nerves. The Ara-C, known as an antimitotic agent, have been used to have high effectiveness in eliminating fibroblasts during Schwann cell culture period. This enrichment effect is also known to be cummulative with each successive pulse of Ara-C applied and is due to a progressive loss of fibroblasts. But the cytotoxicity by Ara-C is also cummulative and noticeable over the period. To determine the most effective application time and interval of Ara-C in the Schwann cell culture, we observed the Schwann cell purity and density with the Ara-C treatment in plain and three-dimensional culture from dorsal root ganglion of new born rat. By culturing dispersed dorsal root ganglia, we can repeatedly generate homogenous Schwann cells, and cellular morphology and cell count with mean percentages were evaluated in the plain culture dishes and in the immunostainings of S-100 and GFAP in the three-dimensional culture. The Ara-C treated cultures showed a higher Schwann cell percentage ($31.0%{\pm}8.09%$ in P4 group to $65.5%{\pm}24.08%$ in P2 group), compared with that obtained in the abscence of Ara-C ($17.6%{\pm}6.03%$) in the plain culture after 2 weeks. And in the three-dimensional culture, S-100 positive cells increased to $56.22%{\pm}0.67%$ and GFAP positive cells to $66.46%{\pm}1.83%$ in G2 group (p<0.05), higher yield than other groups with Ara-C application. Therefore, we concluded that the Ara-C treatment is effective for the proliferation of Schwann cells contrast to the fibroblasts in vitro culture, and the first application after 24 hours from cell harvesting and subsequent 2 pulse treatment (P2 group in plain culture and G2 group in three-dimensional culture) was more effective than other application protocols.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.108-120
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• 2004

Object : Patients with facial asymmetry accompanying mandibular prognathism have various causes and clinical features. So, it is difficult to find a satisfactory treatment method functionally and esthetically. Every traditional classification and interpretation to find etiopathogenesis and/or to establish ideal surgical modality has many limitations because it can't be applied simply to various conditions of patients with facial asymmetry accompanying mandibular prognathism. Therefore, we employ a new classification to interpret more details of the morphologic change of mandible and the spatial change of mandible and maxilla. Materials and Methods : Using panoramic X-ray films, PA cephalograms and submentovertex films of 126 patients diagnosed with facial asymmetry accompanying mandibular prognathism as resources, the following results were gathered after analyzing each characteristics through distributing the patterns according to the morphological mandibular asymmetry and mandibular and maxillary spatial asymmetry. Results : Almost frequency of morphological mandibular asymmetry was shown. In case of condyle-ramus elongation and body elongation group, it's frequency was the highest. Higher frequency of compensating vertical growth was shown on the side of over growing maxilla in case of vertical length difference between left and right condyle-ramus. On the other hand, higher frequency of no compensating vertical growth difference between left and right side was shown in case of no vertical length difference in condyle-ramus. Spatial mandibular asymmetry generally occurred when there was no morphological mandibular asymmetry. Correlation between condyle length difference and condyle-ramus length difference between left and right side was very high, but correlation between condyle length difference and body length difference, and correlation between condyle length difference and body vertical length difference was low. Conclusion : In case of patients with facial asymmetry accompanying mandibular prognathism, it is suggested that various pattern of facial asymmetry is occurred by the independent growth of each unit rather than dependent growth of other unit by major growth unit abnormality. Due to the untypical pattern and the various asymmetry occurring according to the changes of each mandibular growth unit, it is considered that an appropriate surgical method should be searched based on the accurate recognition of the each pattern for patients with facial asymmetry accompanying mandibular prognathism.