• Maxillofacial Plastic and Reconstructive Surgery
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• 제20권2호
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• pp.166-172
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• 1998

Missing of the upper posterior dentition can cause alveolar bone resorption & pneumatization of Maxillary sinus wall, which makes traditional implant placement impossible, The solution includes various methods to the posterior maxilla to provide adequate bone support for implant installation and long-term survival. -- sinus floor elevation, sinus-lift graft, inlay graft using LeFort I osteotomy, onlay graft, This is a clinical Sr. retrospective study on implant surgery & prosthodontic restoration with upper edentulous posterior jaw from Jan. 1990. to Jun. 1997 at implant clinic of Chonbuk National University Hospital. The results obtained were as follows: 1. Six hundred ninety-nine implants were placed on upper posterior jaw of two hundred seventeen patients, among them one hundred sixty-five implants were placed in forty-four patients with sinus lift. 2. The height of the remained alveolar bone was classified on the base of Misch's concept. This included seventy-nine SA-1s, ninety-seven SA-2s, sixty-five SA-3s and sixty SA-4s. 3. Ninety percent of implants were successfully integrated in non-grafted area and eighty-seven percent of implants were successully integrated in sinus lift area.

• Imaging Science in Dentistry
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• 제52권2호
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• pp.225-230
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• 2022

Purpose: This report presents the first known use of a rigid endoscope with augmented reality technology for the removal of an odontogenic cyst that penetrated the maxillary sinus and illustrates its practical use in a patient. Materials and Methods: In the preoperative period, cone-beam computed tomography was performed in a specially designed marker holder frame, and the contours of the cyst and the nearest anatomical formations were segmented in the 3D Slicer program. During the operation, a marker was installed on the patient's head, as well as on the tip of the endoscope, which made it possible to visualize the mass and the movement of the endoscope. The surgical intervention was performed with the support of augmented reality in HoloLens glasses (Microsoft Corporation, Redmond, WA, USA). Results: The use of this technology improved the accuracy of surgical manipulations, reduced operational risks, and shortened the time of surgery and the rehabilitation period. Conclusion: With the help of modern technologies, a navigation system was created that helped to track the position of the endoscope in mixed reality in real time, as well as to fully visualize anatomical formations.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.178-182
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• 2006

폐부종은 구강악안면외과 영역의 수술 도중에 발생할 가능성이 있다. 따라서 전신마취하에 수술중인 외과의와 마취의는 환자의 상태를 주의깊게 관찰하여야 하며 수술 중 폐부종이 발생할 가능성에 항상 대비하여야 한다. 폐부종 증세가 발견되는 즉시, 즉각적이고도 적절한 처치를 시행한 경우 예후가 좋으며, 근본적인 원인치료 및 타장기의 합병증 및 후유증에 대하여 검사가 필요하다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권6호
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• pp.490-496
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• 2011

Purpose: Dr. Marquardt made the facial 'phi' mask using golden ratio. Most class III patients have bulky faces and want a smaller face. Using a facial golden mask, this study estimated and compared frontal photographs before and after operation for soft tissue measurement. The golden mask can be considered as a reference tool for facial esthetic analyses especially in lower face. Methods: Forty patients who had undergone orthognathic surgery at Samsung Medical Center from January 2006 to December 2009 were included in this study. These patients had Class III malocclusion. Lateral cephalometric radiographs, frontal clinical photos of pre-op and 8~12 month later post-op, and the facial 'phi' mask using golden ratio, were used for analysis. Reduction of the lower face area, occlusal plane changes, amounts of mandible setback and amounts of maxilla posterior impaction were estimated. Results: Lower facial reduction ratio and mandibular setback amounts were significantly different between 1-jaw and 2-jaw groups. Average postoperative changes in the area of lower face between bilateral sagittal split ramus osteotomy (BSSRO) and BSSRO combined maxilla posterior impaction were compared by using an independent simple t-test and $P$ value was 0.016. Therefore, the lower facial reduction ratio and mandibular setback amount were significantly different in maxilla posterior impaction. Conclusion: The two-jaw surgery group showed more reduction of the lower facial area than the 1-jaw surgery group. The amount of lower facial reduction was more related with the amount of mandibular setback. There was no significant relation in lower facial reduction with amount of maxilla posterior impaction, pre-op occlusal plane, post-op occlusal plane and the mandibular angle. A relationship between the change in the lower facial area and the amount of maxilla posterior impaction or the change of mandibular angle occlusal plane at pre-op could not be found because of the difference in the amount of setback between two groups.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권3호
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• pp.191-196
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• 2020

Objectives: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein-2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement properties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. Materials and Methods: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after sequestrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. Results: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann-Whitney U-test, P<0.05). Conclusion: Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.

• 대한치과의사협회지
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• 제53권2호
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• pp.120-131
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• 2015

Objective: The purpose of this study is to compare the surgical treatment with conservative treatment and to evaluate the effectiveness of drug-holiday in bisphosphonate related osteonecrosis of the jaw (BRONJ) patients who were diagnosed as stage 2. Patients and Method: From January 2012 to October 2014, seventy-two patients who visit to Pusan National University of Dental Hospital were diagnosed as stage 2 of BRONJ. All the patients had taken computed tomography(CT) and panoramic radiography. The surgical treatment including sequestrectomy of necrotic bone and curettage of soft tissue around the sequestrum were performed to fifty patients. Twenty-two patients underwent conservative treatment such as antibiotics medications, mouth rinsing and follow up checking for every two weeks. Prognosis of treatment was classified into 3 groups - response, unresponse, and worsens - according to clinical, radiographic symptoms. P-value less than 0.05 were regarded as significant. Results: In surgery group, forty-five patients (90%) were healed without recurrence or any complication and five patients (10%) showed the wound dehiscence or infection. In conservative treatment group, fifteen patients (68.2%) were healed without any complication, four patients (18.2%) did not show improvement and three(4.2%) patients$^{\circ}{\emptyset}$ symptoms increased. P-value among groups was 0.014. Evaluation of preoperative drug-holiday in surgery group did not show the effectiveness(p=0.478). Conclusion: Statistically, the prognosis of patients with stage 2 BRONJ treated with surgery was significantly better than conservative treatment. There was no statistical difference for the preoperative drug-holiday.

• Journal of Korean Dental Science
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• 제8권2호
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• pp.65-73
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• 2015

Purpose: Parathyroid hormone (PTH) therapy has drawn attention, as an alternative to anti-resorptive drugs since PTH accelerates bone density by anabolic action. The purpose of this study was to identify the effect of intermittent PTH administration on jaw bones of rat undergone bilateral ovariectomy. Materials and Methods: Nine female Sprague-Dawley rats were divided into three groups. PTH group was ovariectomized (OVX) to induce osteoporosis and PTH $30{\mu}g/kg$ was administered 1 week after the surgery. In OVX group, ovariectomy was performed and only vehicle was administered by subcutaneous injection 3 times per week. Control group was subjected to sham surgery. The animals were sacrificed 8 weeks after the surgery and specimens were obtained from ilium and upper and lower jaw bones. Histological investigation was carried out by using an optical microscope and micro-computed tomography was taken to examine structural property changes in each bone sample. Result: In the ilium, the bone volume ratio (bone volume/total volume, BV/TV) of PTH, OVX and control groups was $53.75%{\pm}7.57%$, $50.61%{\pm}12.89%$, $76.20%{\pm}5.92%$ (P=0.061) and bone mineral density (BMD) was $1.12{\pm}0.09$, $0.88{\pm}0.48$, $1.38{\pm}0.07g/cm^3$ (P=0.061). In the mandible, BV/TV of PTH, OVX and control groups was $64.60%{\pm}12.17%$, $58.26%{\pm}9.63%$, $67.54%{\pm}14.74%$(P=0.670) and BMD was $1.21{\pm}0.17$, $1.19{\pm}0.13$, $1.27{\pm}0.18g/cm^3$ (P=0.587). In the maxilla, BV/TV of PTH, OVX and control groups was $61.19%{\pm}8.92%$, $52.50%{\pm}11.22%$, $64.60%{\pm}12.17%$ (P=0.430) and BMD was $1.20{\pm}0.11$, $1.11{\pm}0.16$, $1.21{\pm}0.17g/cm^3$ (P=0.561). No statistically significant difference was found in any variables in all groups. Histological observation revealed that the ilium in OVX group demonstrated sparsely formed trabecular bones compared with other groups. However, upper and lower trabecular bones did not present significant differences. Conclusion: Intermittent administration of PTH appears to affect the microstructure of rat jaw bones, but statistical significance was not found. However, the measurements in this study partly implicated the possible anabolic effect of PTH in vivo.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권6호
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• pp.332-337
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• 2015

Dental infections and maxillary sinusitis are the main causes of osteomyelitis. Osteomyelitis can occur in all age groups, and is more frequently found in the lower jaw than in the upper jaw. Systemic conditions that can alter the patient's resistance to infection including diabetes mellitus, anemia, and autoimmune disorders are predisposing factors for osteomyelitis. We report a case of uncommon broad maxillary osteonecrosis precipitated by uncontrolled type 2 diabetes mellitus and chronic maxillary sinusitis in a female patient in her seventies with no history of bisphosphonate or radiation treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권2호
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• pp.101-103
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• 2015

In oral and maxillofacial surgery, many complications associated with nasotracheal tube can be caused. In this case, we reported ballooning tube damage of nasotracheal tube during orthognathic double-jaw surgery and replacement of tube through cut down of tube and tube exchange using airway exchange catheter. The patient scheduled for high Le Fort I osteotomy and bilateral sagittal split osteotomy was intubated nasotracheally with nasal endotracheal tube. During maxilla osteotomy, air bubble was detected in the oral blood. In spite of our repeated ballooning, the results were the same so we changed damaged tube using airway exchange catheter aseptically. Tiny and superficial cutting site was detected in the middle of pilot tube. As we know in our case, tiny injury impeded a normal airway management and prevention is important.

• 대한두경부종양학회지
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• 제39권2호
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• pp.35-39
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• 2023

Solitary fibrous tumor (SFT), which was initially believed to be a subtype of mesothelioma, has been reported to occur outside the pleura. In the head and neck region, it primarily manifests in the oral or nasal cavity, with rare occurrences in the facial region. A 40-year-old woman visited our hospital with a mass on her chin. Prior to surgery, involuntary movement was observed in the ipsilateral corner of the mouth upon palpation of the mass. Special care was taken during the surgical procedure to avoid damaging the facial nerve. The mass was excised, and histological examination and immunohistochemical analysis confirmed the diagnosis of an SFT. Here, we present the first reported case of an SFT diagnosed in a jaw mass in Korea. The objective of this study was to highlight the importance of the diagnostic accuracy of SFTs in lower jaw masses.