• Imaging Science in Dentistry
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• 제51권3호
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• pp.291-297
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• 2021

Purpose: This study was performed to evaluate the prevalence, distribution, and radiological features (as per the Shear classification) of dentigerous cysts in a Lebanese sample. Materials and Methods: It was an epidemiological, cross-sectional, 5-year retrospective study of 137 dentigerous cysts treated at Lebanese Army Dental Departments. The collected data comprised demographic and radiological information corresponding to patients from July 2015 to July 2020. Syndromic cases were excluded. Demographic data and the radiological features of cases were studied and analyzed. Results: Dentigerous cysts were treated in 109 patients (58.7% males and 41.3% females; mean age: 28.3±16.3 years) out of 6,013 patients(52% males and 48% females), with a prevalence of 1.8%. Dentigerous cysts were more commonly found in patients in their second and third decades of life than in older age groups. Of the 109 patients, 22.9% had multiple dentigerous cysts. Of the 137 cysts, 71.5% were mandibular. The most prevalent anatomical location was the posterior mandible, followed by the posterior maxilla. The most commonly involved tooth was the mandibular third molar. Regarding radiological types, the central type was the most common (60.6%), followed by the lateral type (29.2%), and the circumferential type (10.2%). Conclusion: The results of this study were similar to studies of other populations in terms of distribution and features. Multiple non-syndromic dentigerous cysts were more common than reported in other studies, which warrants further clinical studies to reveal previously undetected factors.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권3호
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• pp.152-159
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• 2012

Objectives: This study evaluated bisphosphonate-related osteonecrosis of the jaws (BRONJ) in patients diagnosed with malignant bone tumors. Demographic findings, laboratory, and radiographic analyses were performed to characterize disease severity and progression. Materials and Methods: Patients who had been diagnosed with BRONJ (2005-2010) at the authors' hospital according to the American Association of Oral and Maxillofacial Surgeons were investigated. Twenty-one patients (12 with multiple myelomas, 7 with breast cancer, and 2 with prostate cancer) who had been treated with bisphosphonates (BPs) for malignant bone tumors were included. Radiographic evaluations with a panorama, computed tomography, whole body bone scan, and laboratory findings were evaluated for erythrocyte sedimentation rate (ESR), c-reactive proteins (CRPs), and c-terminal cross-linked telopeptides (CTXs). Results: The average age of the patients was 64.3 (range 51-80), and they were treated with BPs for an average of $35{\pm}19$ months before BRONJ was diagnosed. Types of BPs were zolendronic acid (81%, intravenous [IV]), pamidronate (4.8%, IV), zoledronic acid+pamidronate (4.8%, IV), alendronate (4.8%, per os [PO]), and ibadronate (4.75%, PO). Extraction (67%) and persistent irritation of dentures (20%) were the most common triggering factors. BRONJ in the mandible was reported in 62% of the cases, in the maxilla 24%, and both 14%. BRONJ occurred more frequently in patients with multiple myelomas (n=12, 57.1%). Most of the patients revealed an advanced BRONJ stage; Stage I (n=2, 9%), Stage II (n=13, 62%), and Stage III (n=6, 29%). Conclusion: The differences of the ESR, CRP, and CTX values between the BRONJ-recurring and non-recurring patients after the treatment were not evident. Later stage BRONJ patients showed lower CTX levels. A drug holiday after the diagnosis of BRONJ did not remarkably influence the surgical outcomes. However, the limited number of patients in the study should be considered.

• 대한치과보철학회지
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• 제36권2호
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• pp.258-272
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• 1998

This investigation evaluated patients who received Steri-Oss implants from the Dental Hospital of Chosun University during the period from March 1989 to August 1997. 346 fixtures of 127 patients were included in this study. The results were as follows ; 1.The follow-up period was defined as the period between the surgical placement of the implants and the last follow-up examination. The mean follow-up period was $2.17{\pm}1.21$ years. 2.The period between fixture installation and second surgery was $0.71{\pm}0.44$ years in the maxilla and $0.46{\pm}0.21$ years in the mandible. 3.The number of fixtures which were installed in the upper jaw(112) was less than that in the lower jaw(234) and in the posterior region(260) was more than in the anterior region(86). 4.The length of fixture which was most frequently used was 12 mm and least was 8mm. Screw implants were installed more than cylindrical implants. 3.8mm implant was the most common implans, followed by 4.5mm and 3.25mm. 5.The number of augmentation cases was more than that of non-augmentation cases and the rate of augmentation cases in the maxilla was more than that in the mandible. 6.Implant restorations for partial edentulos patients(94cases) were more than single- tooth implant restorations(33cases) or implant restorations for complete edentulos patients(10cases). 7.Free-standing prostheses for partially edentulous patients were more commom than any other type of connection between implants and natural teeth. 8.Plaque Index($0.95{\pm}0.74$) and Gingival Index($0.31{\pm}0.52$) were very similar around the natural teeth and reflected an acceptable level of plaque and gingivitis control. Mean value for keratinized mucosa index($1.93{\pm}1.20$) remained fairly constant around level 2(1-2 mm keratinized epithelium). 9.Patients were generally satisfied with implant in terms of comfort, function, speech and esthetics. 10.There was not a statistically significant differences in overall survial rate between implants placed in the maxilla (91.5%) and those placed in the mandible (93.8%). Fourteen implants lost before the prosthetic rehabilitation and eleven implants lost following variable periods in function after the prosthetic phase of the treatment. 11.Cause of implant failures was exfoliation or removal of fixture due to non-osseointegration before the prosthetic rehabilitation or due to fracture of fixture, masticatory pain after the prosthetic rehabilitation. 12.The survival rate of Steri-Oss implants using the Kaplan-Meier statistical analysis was 93.8% at 2 year and 86.6% at 5 year, In all cases, implant losses occured predominantly in the healing period. There was a steep decline in the rate of implant loss after the first year. 13.The survival rate of Steri-Oss implants in the anterior region was 94.8% at 2 year and 94.8% at 5 year and that in the posterior region was 92.8% at 2 year and 75.9% at 5 year. In conclusion, this study revealed a number of parameters and guidelines for achieving an optimal success rate in osseointegration.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권5호
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• pp.392-400
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• 2011

Purpose: Cleft lip and palate is one of the most frequent hereditary deformities of the maxillofacial region which can arise in facial and jaw abnormalities as well as malocclusion and speech problems. In particular, unilateral cleft lip and palate is characterized by midface deformity resulting in maxillary anterior nasal septal deviation and nasal deformity. The aim of this study is to analyze the facial deformity of untreated unilateral cleft lip patients for contribution to primary cheiloplasty. Methods: Thirty-three patients with unilateral cleft lip and palate were impressioned before operation and facial casts were made. The casts were classified into complete cleft lip and incomplete cleft lip groups and each group were classified into affected side and normal side. Anthropometric reference points and lines were setted up and analysis between points and lines were made. Results and Conclusion: The obtained results were as follows: 1. The intercanthal width had no significant difference between the incomplete and complete cleft lip groups. 2. Cleft width and alar base width were greater in the complete group, and nasal tip protrusion was greater in the incomplete group. 3. Involved alar width and nostril width were greater in the complete group and in both complete and incomplete groups, involved alar width and nostril width were greater than the non-involved side. 4. The lateral deviation of the subnasale was greater in the complete group in both involved and non-involved sides. 5. The nasal laterale was placed inferiorly in both cleft groups. 6. The subnasale was deviated to the non-involved side in both cleft groups. 7. The nose tip was deviated to the non-involved side in both cleft groups and had greater lateral deviation in the complete cleft group. 8. The midpoint of cupid's bow had no vertical difference between complete and incomplete groups, but had a greater lateral deviation in the complete group. 9. In the complete cleft group, correlation between differences in cleft width and nostril width and columella height difference were obtained.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권4호
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• pp.303-308
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• 2010

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권2호
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• pp.1-10
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• 1989

사회가 다양해지고 공업화됨에 따라 안면부의 외상이 크게 증가하였으며, 그 외상 정도 또한 더욱 심화되었다. 안면골절중 가장 많은 발생빈도를 차지하는 것은 비골골절이다. 그러나, 골절된 비골에 대한 즉시 치료율은 다른 안면골에 비해 높지 않다. 또한 다른 안면골 골절, 특히 악골 골절과 동반된 경우에 있어서는 마취 기술상 동시 수술이 쉽지 않다. 따라서 많은 수의 비골골절이 즉시 치료되지 못해 변형된 형태로 남게 된다. 이러한 외상성 비변형은 심미적으로나 기능적으로 환자에게 큰 불편을 초래하므로 정비술을 요하게 된다. 코의 외상성 변형은 크게 비골부변형, 비연골부 변형, 피부변형과 다른 주위 구조물(안와부, 전두부)과 동반된 변형으로 나눌 수 있다. 안와부 또는 전두부와 동반된 비변형에 있어서는 비안각 또는 전비각의 재건에 유의하여야 한다. 단순한 비변형에 있어서는 비연골간 절개 또는 구내절개술을 통한 재건술이 많이 이용된다. 정비술 방법으로는 비골절단술, 연골이식술, 골이식술 및 이물질 매식술 등이 있다. 본원에서는 비연골간 절개를 이용한 골 및 연골이식과 이물질 매식 그리고 구내절개를 이용한 골절단술로 외상성 비변형을 이차적으로 재건한 바 만족할만한 결과를 얻었기에 이에 보고하는 바이다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권1호
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• pp.31-37
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• 2013

Purpose: Maxilla and mandible have different patterns of cortical and trabecular bone and different bone mineral densities, even though both are components of the jaw bone. However, cellular differences between maxilla- and mandible derived osteoblasts (OBs) have rarely been studied. We hypothesize that maxilla- and mandible-derived OBs show different responses to $17{\beta}$-estradiol (E2), which is one of the critical factors for bone formation. This study compares skeletal site-specific cell responses between maxilla- and mandible-derived human OBs to E2. Methods: Maxilla- and mandible-derived OBs derived from an identical donor were separately isolated from a total of five normal healthy subjects aged 18~44 years old, cultured with a treatment of 100 nM estrogen. The responses between maxilla- and mandible-derived OBs to E2 were evaluated and compared using cell proliferation, alkaline phosphatase (ALP) activity and gene expression of osteoprotegerin (OPG), ALP, insulin-like growth factor-1 (IGF-1), and estrogen receptor ${\alpha}$ ($ER{\alpha}$). Results: E2 did not have any distinct effects on the proliferation of both types of OBs. Mandible-derived OBs exhibited higher ALP activity than maxilla-derived OBs in the non-treated condition, which was common in all tested individuals. ALP activities of both types of OBs showed a minor increasing tendency with the treatment of E2, even though there was no statistical significance in some specimens. The gene expression of OB by E2 was diverse, depending on the individuals. There was increased expression of OPG, IGF-1, or $ER{\alpha}$ gene in the part of subjects, which was more repeated in maxilla-derived OBs. In particular, OPG or ALP induction by E appeared less frequently in mandible-derived OBs. Conclusion: Current results revealed that E2 affects maxilla- and mandible-derived OBs into facilitating the osteogenic process despite individual differences. Mandible-derived OBs are less sensitive to bone-forming gene expression by E2.

• 대한치과의사협회지
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• 제15권5호
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• pp.359-364
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• 1977

Orthognathic surgery, ie, the surgical correction of congenital and acquaired anormalities of the jaws, is currently a field of vigorous activity among oral surgeons. Surgical correction of maxillofacial deformities benefits the patient both psychologically and functionally. Facial mutilation may precipitate adverse psychologic effects. Function is frequently impaired by malrelation of the jaws. In addition, speech, specifically articulation, is often handicapped in patient with severe jaw deformities. Therefore, in dealing with these patient, above mentioned problem should be considered deliberately. In this regard, the authors have treated 2 cases of mandible defect caused by gunshot and explosives with iliac bone graft. In both cases, the patient had Tantalum plate on defect area. But it became lose and gave functional disturbances. So, the authors have removed Tantalum plate and performed bone transplantation with autogenous soild iliac bone graft on that area with good results.

• 대한치과의사협회지
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• 제16권1호통권104호
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• pp.43-50
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• 1978

The purpose of this study is to determine the effects of Cyclophosphamide on the healing process of fractures of the mice. Tweny-one young adult male mice were used. All of them were experimentally fractured in the left mandibular body areas, and Cyclophosphamide 0.1mg. per 30gr. body wt. was administrated intramuscularly to the experimental group. the mice of both control and experimental groups were sacrificed 1,3,5,7,10,14, and 21st day after operations and microscopic slides were made. The author has observed the histopathological findings. The results were as follows; 1. There were no specific difference between the experimental and control group in the early stage (1~5th day after operation) of the healing process of the mandibular fracture. 2. In the healing process of fractures 7-10th day after operation, the fibrous tissure formation and osteoblastic activity were poor in the experimental groop compared with the control group. 3. In the healing process of fractures 14-21th day after operation, the connective tissue and new bone formation were very poor in the experimental group compared with the control group. 4. On the whole, cyclophosphamide affected the experimentally fractured wound to delay healing in the jaw bone of the mice.

• Journal of Periodontal and Implant Science
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• 제35권1호
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• pp.65-76
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• 2005

This retrospective study evaluates the clinical performance of the recently introduced $XiVE^{(R)}$ implant(Dentsply-Friadent) with a new macro-design to improve primary stability. A total of 208 $XiVE^{(R)}$ implants (101 in the maxilla and 107 in the mandible) were placed in 71 patients. The average age of the patients was 49 years. Of the 208 implants, 190 (91.3%) were posterior implants and 82 (39.4%) were placed in compromised sites (grafted sites). Clinical and radiographic evaluation were made at second stage surgery for exposure and after functional loading. 192 implants in 64 patients were evaluated at exposure and 146 implants in 50 patients were loaded (average 170 days-loading) and evaluated after functional loading. Of 192 implants available for evaluation before loading, 3 implants failed (early failure) ; 1 before exposure, 1 at exposure and 1 during prosthetic procedure. 2 implants were in the maxilla and 1 was in the mandible. The success rate before loading was 98.4%. After functional loading, no implant failure was occurred in 146 implants evaluated during this period (100% interval success rate). This preliminary data with a new implant showed excellent success rate although the majority of implants evaluated in this study were placed in the posterior region of the jaw and compromised sites.