• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.6
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• pp.572-576
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• 2008

Gorham-Stout disease is a rare skeletal disease which is progressive and spontaneous and idiopathic resorption of whole body bone. In the initial stage, the osteolytic site is replaced by histologically benign vascular proliferation without new bone formation and finally by dense fibrous tissues. We encountered with a patient involving the mandible with attention by the clinical, radiographic, scintigraphic, angiographic, and computed tomography. We resected the mandibular lesion which was reconstructed with a fibular free flap. We report literature review with a mandibular lesion involved with Gorham-Stout disease.

• Journal of Oral Medicine and Pain
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• v.31 no.3
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• pp.237-243
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• 2006

The aims of this study was to investigate the clinical and radiographic features of temporomandibular dysfunction in the patients with RA to elucidate whether the RA patients would be a risk group for TMD. The 35 patients with temporomandibular joint dysfunction were included for this study, of which 15 had rheumatoid arthritis diagnosed by a rheumatologist, and other 20 was control group and they didn't have any history or clinical signs related to it. Clinical symptoms and signs of temporomandibular joint disorders, radiographic and MRI findings of temporomandibular joint were investigated. The results were compared between two groups. In RA group bilateral pain, morning stiffness, reduced opening range, and crepitations were more frequently reported than control group. Radiologic findings such as sclerosis and flattening of condylar head, marginal proliferation, and erosion of glenoid fossa were more frequently observed in RA group than control group. Disk destruction, cortical bone erosion, and intraarticular enhancement were more prominenet in RA group. From theses results, it can be concluded that many RA patients will develop TMD symptoms and the structural changes of TMJ is more extensive than the usual TMD cases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.1
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• pp.26-34
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• 2003

Intraoral Vertical Ramus Osteotomy,along with Sagittal Split Ramus Osteotomy,is an popular surgical technique performed on mandibular prognathism. However Intraoral Vertical Ramus Osteotomy has been suspected for an initial mobilization at the healing phase of segment because it does not employ the rigid fixation between segments. To execute a study on the healing phase of segment after Intraoral Vertical Ramus Osteotomy on the horizontal plane, 102 patients (204 parts) who were diagnosed mandibular prognathism and took Intraoral Vertical Ramus Osteotomy at the Yonsei University dental hospital were observed during the period of before operation, immediately postoperation, 1 month, 3 months, 6 months, and 12 months. The change in the width of segment and horizontal angle of proximal segment and condylar head on the Submentovertex Cephalogram taken from those patients represented following results. 1. The width of proximal and distal segment decreased with the lapse of time. It decreased into 84.5% between immediate postoperative and 6M and even continued to decrease till 12M. 2. The horizontal angle of the proximal segment did medial rotation according as the lapse of time and rigorously continued till 3M. The rotation angle of condylar head indicated its tendency of recurrence to the original position but the entire recurrence was not allowed. The bigger an initial angle was, the higher was the tendency of recurrence after the operation while the rotation angle remained still bigger. 3. After grouping into group 1, group 2,and group 3 based on the extent of the variation of rotation angle of condylar head at immediate postoperative, the variation of rotation angle was measures in each group. The result presented that the initial rotation angle of condylar head had correlation with that of proximal segment but had no relation with the extent of setback of the mandible. However a quantitative analysis alone is not a sufficient method for analyzing the healing phase of segment on the horizontal plane.Therefore a multilateral analysis using 3 dimensional data such as CT is recommendable for the future study.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.6
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• pp.481-491
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• 2005

Purpose: The aim of the present study is to evaluate the effect of autogenous bone and allograft material coverd with a bioresorbable membrane on bone regeneration after a simultaneous installation of implant. Materials and methods: Twelve healthy rabbits, weighing about $3{\sim}4$ kg, were used in this experiment. Following impalnt(with 3.25 mm diameter and 8 mm length) site preparation by surgical protocol of $Oraltronics^{(R)}$, artificial bony defect, 5mm sized in height and depth, was created on femoral condyle using trephine drill(with 5 mm diameter and 5 mm length). Then implant was inserted. In the experimental group A, the bony defect was filled with autogenous particulated bone and coverd with $Lyoplant^{(R)}$ resorbable membrane. In the experimental group B, the bony defect was filled with allograft material(Orthoblast $II^{(R)}$) containing demineralized bone matrix and covered with $Lyoplant^{(R)}$. In the control group, without any graft materials, the bony defect was covered with $Lyoplant^{(R)}$. The experimental group A and B were divided into each 9 cases and control group into 3 cases. The experimental animals were sacrificed at 3, 6 and 8 weeks after surgery and block specimens were obtained. With histologic and histomorphometric analysis, we observed the histologic changes of the cells and bone formation after H-E staining and then, measured BIC and bone density with KAPPA Image $Base^{(R)}$ system. Results: As a result of this experiment, bone formation and active remodeling process were examined in all experimental groups and the control. But, the ability of bone formation of the experimental group A was somewhat better than any other groups. Especially bone to-implant contact fraction ranged from 12.7% to 43.45% in the autogenous bone group and from 9.02% to 29.83% in DBM group, at 3 and 8 weeks. But, bone density ranged from 15.67% to 23.17% in the autogenous bone group and from 25.95% to 46.06% in DBM group at 3 and 6 weeks, respectively. Although the bone density of DBM group was better than that of autogenous bone group at 3 and 6weeks, the latter was better than the former at 8 weeks, 54.3% and 45.1%, respectively. Therefore these results showed that DBM enhanced the density of newly formed bone at least initially.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.511-517
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• 2007

Purpose: The aim of this study is to determine whether a difference in the amount of bone graft material is needed between edentulous patients and dentulous patients and to calculate the amount of augmentation for a sinus lift procedure. Methods: 19 patients(20 sinuses) were included to measure maxillary sinus volume. Facial CT scanning was performed using MX 8000 IDT CT devices(Philips, USA). And it was used for IDLvm(The IDL Virtual Machine) 6.0, CT Volume Analyzer Ver 2.3 program to measure maxillary sinus volumes Results: At edentulous patients, volumes(mean${\pm}SD$) of the inferior portion of the sinuses were $0.56{\pm}0.13cm^3$(5mm height), $2.35{\pm}0.57cm^3$(10mm height), $4.85{\pm}1.10cm^3$(15mm height). At dentulous patients, volumes(mean${\pm}SD$) of the inferior portion of the sinuses were $0.41{\pm}0.18cm^3$(5mm height), $1.76{\pm}0.42cm^3$(10mm height), $3.80{\pm}0.84cm^3$ (15mm height). A significant correlation was found between augmentation height(5mm, 10mm, 15mm) and the calculated sinus volume.(p=0.027, p=0.018, p=0.044) Conclusions: A significant correlation was found between augmentation height(5mm, 10mm, 15mm) and the calculated sinus volume. Detailed preoperative knowledge of sinus lift augmentation volume is helpful in determining the appropriate amount of the bone graft material.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.4
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• pp.419-427
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• 2008

The present study aimed to investigate the osteogenic potentials of differentiated osteoblast-like cells (DOCs) induced from bone marrow-derived mesenchymal stem cells (MSCs) on ${\beta}-tricalcium$ phosphate (${\beta}-TCP$) with recombinant human bone morphogenetic protein (rhBMP-2) in vitro. Osteoblast differentiation was induced in confluent cultures by adding 100 nM dexamethasone, 10 mM ${\beta}$-glycerophosphate, 50 mM L-ascorbic acid. The Alizarin red S staining and reverse transcriptase-polymerase chain reaction (RT-PCR) were perfomed to examine the mRNA expression of alkaline phosphatase (ALP), bone sialoprotein (BSP), osteocalcin (OCN), receptor activator for nuclear factor ${\kappa}B$ ligand (RANKL), runt-related transcription factor 2 (RUNX2), collagen-Ⅰ (COL-Ⅰ). There were no significant differences in the osteogenic potentials of DOCs induced from MSCs on ${\beta}-TCP(+/-)$. According to the incubation period, there were significant increasing of Alizadin red S staining in the induction 3 weeks. The mRNA expression of ALP, RUNX2, and RANKL were higher in DOCs/${\beta}-TCP(-)$ than DOCs/${\beta}-TCP(+)$. According to rhBMP-2 concentrations, the mRNA expression of BSP was significantly increased in DOCs/${\beta}-TCP(+)$ compared to that of DOCs/${\beta}-TCP(-)$ on rhBMP 10 ng/ml. Our study presented the ${\beta}-TCP$ will have the possibility that calcium phosphate directly affect the osteoblastic differentiation of the bone marrowderived MSCs.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.4
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• pp.428-434
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• 2008

Introduction: Piezosurgery device is one of the most commonly used instrument on the intraoral surgery such as maxillary sinus lift and autogeneous bone graft. Piezosurgery instrument also contains the tips that are manufactured especially for the convenient bone graft, which now many surgeons apply them for collecting bone graft materials in the curettage method for the restoration of skull defects. However, objective data has not been shown concerning the effects about bone graft with using Piezosurgery. Therefore we investigated the effects of Piezosurgery on the rabbit-skull defect healing. Materials & Methods: To investigate the regeneration of the bony defect with various bone graft, 10 adult New Zealand white rabbits (average weight : $2.8{\pm}0.3kg$, about 12weeks) were used. The four circular bony defects measuring 6mm in diameter were made with Piezosurgery device on each rabbit cranial bone. The harvested bone tissues during defect formation were also used for autogeneous bone graft. They were grafted into the defects in a various type; block type (Group 1), particulated type by the bone mill (Group 2), chopped type by curette shaped Piezosurgery tip (Group 3), the defect without any graft was served as control (control group). The animals were sacrificed after 6 weeks and bone regeneration capacity was evaluated histomorphometrically. Result & Conclusion: Autogeneous bone graft harvested using a Piezosurgery instrument showed satisfactory bone regeneration. There was no conspicuous difference bone prepared among by bone mill or Piezosurgery and block bone graft. Therefore, the bone harvested from the intraoral site near the operation field using the piezosurgery device can be a feasible and reliable graft for intraoral bony defects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.470-478
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• 2007

The purpose of this study was to investigate the clinical, biomechanical, and histologic changes in new distraction osteogenesis(DO) technique combined with a compression stimulation in accordance to different compression-distraction force ratio. 23 adult male rabbits underwent open-osteotomy at the mandibular body area and a external distraction device was applied. In the control group of 8 rabbits, only a 8 mm of distraction was performed by conventional DO technique. In an experimental group of 15 rabbits, a distraction followed by a compression force was performed according to the ratio of compression-distraction suggested by authors. The rate of experimental group I was set up as a 2 mm compression versus 10 mm distraction and the rate of experimental group II was set up as a 3 mm compression versus 11 mm distraction. All the rabbits were sacrificed for a gross finding, biomechanical, histomorphometric and histologic findings at the time of 55 days from the operation day. The results were as follows: 1. On the gross findings, because all rabbits had a sufficient healing time, every distracted new bone had good bone quality and we could not find any difference among all three groups. 2. In the histologic findings, rapid bone maturation(wide lamellar bone formation in the cancellous and cortical bone areas) was observed in two experimental groups compared to the control group. 3. On the bone density tests, the experimental group II showed higher bone density than the other experimental group and control group(control group-$0,2906g/cm^2$, experimental group I-$0.2961g/cm^2$, experimental group II-$0.3328g/cm^2$). 4. On the biomechanical tests, the experimental group II had significantly higher bone microhardness than the other experimental group and control group(control group-252.7 MPa, experimental group I-263.5 MPa, experimental group II-426.0 MPa). 5. On the microhardness tests, when we compared the hardness ratio of distracted bone versus normal bone, we could find experimental group II had significantly higher hardness ratio than the other experimental group and control group(control group-0.47, experimental group I-0.575, experimental group II-0.80). From this study, we could deduce that the modified distraction osteogenesis method with a compression stimulation might improve the quality of bone regeneration and shorten the consolidation period in comparison with conventional distraction osteogenesis techniques.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.5
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• pp.405-418
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• 2007

Mesenchymal stem cells(MSCs) have been though to be multipotent cells that can replicate that have the potential to differentiate into lineages of mesenchymal tissue including the bone, cartilage, fat, tendon, muscle, and marrow stroma. Especially, scaffolds to support cell-based tissue engineering are critical determinants of clinical efforts to regenerate and repair the body. Selection of a matrix carrier imvolves consideration of the matrix's role as a scaffold for physical support and host tissue integration as well as its ability to support of synergize the osteoinductive program of the implanted mesenchymal stem cell. The aim of this study is to evaluate the effect of autobone and Bio-$Oss^{(R)}$ to adherent mesenchymal stem cells as scaffolds on sinus augmentation with fibrin glue mixture in a rabbit model. 16 New Zealand White rabbits were divided randomly into 4 groups based on their time of sacrifice(1, 2, 4 and 8 weeks). First, mesenchymal stem cells were isolated from iliac crest marrow of rabbits and expanded in vitro. Cell culture was performed in accordance with the technique described by Tsutsumi et al. In the present study, the animals were sacrificed at 1, 2, 4 and 8 weeks after transplantation, and the bone formation ability of each sides was evaluated clinically, radiologically, histologically and histomorphologically. According to the histological observations, autobone scaffolds group showed integrated graft bone with host bone from sinus wall. At 2 and 4 weeks, it showed active newly formed bone and neovascularization. At 8 weeks, lamellae bone was observed in sinus graft material area. Radiologically, autobone with stem cell showed more radiopaque than Bio-$Oss^{(R)}$ scaffolds group. there were significant differences in bone volume between 4 and 8 weeks(p<0.05).

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.201-205
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• 2015

Acute maxillary sinusitis is a common disorder affecting children. Untreated acute sinusitis can develop into chronic sinusitis, and complications, such as orbital cellulitis or abscess, can occur. Maxillary sinusitis of odontogenic origin is not a well-recognized condition and is frequently missed in children. As an odontogenic source of sinusitis, the dentigerous cyst is one of the most prevalent types of odontogenic cysts, and it is associated with the crown of an unerupted or developing tooth. This report concerns a nine-year-old boy who was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. The boy visited our pediatric clinic presenting with rhinorrhea and nasal obstruction and was initially diagnosed with maxillary sinusitis only. With antibiotic treatment, his symptoms seemed to improve, but after 2 months, he came to our clinic with left facial swelling with persistent rhinorrhea and nasal obstruction. Radiographic examinations of the sinuses were performed, and he was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. After a surgical procedure involving the removal of the dentigerous cyst with supernumerary teeth, the symptoms of sinusitis gradually diminished. There are only very few cases in the pediatric medical literature that remind us that odontogenic origin can cause maxillary sinusitis in children. Our patient can act as a reminder to general pediatricians to include dentigerous cysts in the differential diagnosis of maxillary sinusitis.