• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제25권4호
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• pp.361-366
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• 1999

Intermaxillary fixation is routine procedure to oral and maxillofacial area in jaw bone fracture, surgical correction of jaw deformity, osseus reconstruction of jaw. After transoral surgery, accompanied by intermaxillary fixation, dysphagia or airway obstruction may be followed due to blood clot, vomitus, or laryngeal spasm resulting from irritation by blood or secretions. Lingual or pharyngeal edema is other contributing factors of airway obstruction. In addition, intermaxillary fixation itself may cause obstruction of airway. In this study, pulmonary function test and arterial blood gas analysis were evaluated before and after intermaxillary fixation in 30 patients suffered from mandibular fractures. Comparative analysis was performed by estimated values. The results were as followed. 1. The spirometric values of FEV1, FEV1/FVC and FEF25-75% without intermaxillary fixation were reduced from 97.57%, 85.1%, 98.3,% to 71.7%, 66.5%, 61.2% with intermaxillary fixation, indicating the presence of obstructive pulmonary impairment. 2. Spirometric value of MVV, as the most influencing value of sensitive to extrapulmonary factors, was changed from 84.5% to 46.48%. 3. After intermaxillary fixation, the spirometric value of FVC, as indicator of restrictive pattern of pulmonary function, was not reduced significantly as measured from 94.47% to 89.97%. 4. $O_2$ saturation of arterial blood gas analysis without intermaxillary fixation was 97.86%. While intermaxillary fixation, $O_2$ saturation was 97.47%. The results indicate that careful airway management is mandatory undergoing intermaxillary fixation of various oral and maxillofacial surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권2호
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• pp.134-137
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• 2017

Giant cell tumor (GCT) of the craniofacial bones has been reported but they are not common. This tumor occurs more often in women than in men and predominantly affects patients around the third to fifth decade of life. GCTs are generally benign but can be locally aggressive as well. We report a case of GCT involving the temporomandibular joint (TMJ), which was initially thought to be temporomandibular disorder (TMD). A 22-year-old female presented with swelling and pain over the right temporal region for 18 months associated with jaw locking and clicking sounds. On examination, her jaw deviated to the right during opening and there was a $2{\times}2$ cm swelling over the right temporal region. Despite routine treatment for TMD, the swelling increased in size. Computed tomography and magnetic resonance imaging of the brain and TMJ revealed an erosive tumor of the temporal bone involving the TMJ which was displacing the temporal lobe. Surgical excision was done and the tumor removed completely. Histopathological examination was consistent with a GCT. No clinical or radiological recurrence was detected 10 months post-surgery.

• Annals of Clinical Neurophysiology
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• 제8권2호
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• pp.171-173
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• 2006

Marcus Gunn jaw winking phenomenon has been thought to result from a congenitally abnormal innervation of the levator palpaebrae muscle by a branch of the trigeminal nerve. A 22-year old man presented with bilateral eyelid elevation on the chewing or eating since infancy. Neurological examination showed bilateral Marcus Gunn Jaw wingking phenomenon in this patient. We referred this patient to the department of ophthalmology and plastic surgery for levator resection or orbicularis oculi muscle flap. We report bilateral Marcus Gunn jaw winking phenomenon, although unilateral disorder is the most common form of trigemino-oculomotor synkinesis. Neurologists should be aware of this phenomenon for decision of proper management and take detailed neurologic examination for elucidating the association of other cranial nerves.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권3호
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• pp.135-141
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• 2023

Objectives: This study aimed to develop and validate machine learning (ML) models using H₂O-AutoML, an automated ML program, for predicting medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis undergoing tooth extraction or implantation. Patients and Methods: We conducted a retrospective chart review of 340 patients who visited Dankook University Dental Hospital between January 2019 and June 2022 who met the following inclusion criteria: female, age ≥55 years, osteoporosis treated with antiresorptive therapy, and recent dental extraction or implantation. We considered medication administration and duration, demographics, and systemic factors (age and medical history). Local factors, such as surgical method, number of operated teeth, and operation area, were also included. Six algorithms were used to generate the MRONJ prediction model. Results: Gradient boosting demonstrated the best diagnostic accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.8283. Validation with the test dataset yielded a stable AUC of 0.7526. Variable importance analysis identified duration of medication as the most important variable, followed by age, number of teeth operated, and operation site. Conclusion: ML models can help predict MRONJ occurrence in patients with osteoporosis undergoing tooth extraction or implantation based on questionnaire data acquired at the first visit.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제39권
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• pp.1.1-1.7
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• 2017

Background: Multiple myeloma (MM) is characterized by a neoplastic proliferation of plasma cells primarily in the bone marrow. Bisphosphonates (BP) are used as supportive therapy in the management of MM. This study aimed to analyze the incidence, risk factors, and clinical outcomes of medication-related necrosis of the jaw (MRONJ) in MM patients. Methods: One hundred thirty MM patients who had previous dental evaluations were retrospectively reviewed. Based on several findings, we applied the staging and treatment strategies on MRONJ. We analyzed gender, age, type of BP, incidence, and local etiological factors and assessed the relationship between these factors and the clinical findings at the first oral examination. Results: MRONJ was found in nine male patients (6.9%). The mean patient age was 62.2 years. The median BP administration time was 19 months. Seven patients were treated with a combination of IV zoledronate and pamidronate, and two patients received single-agent therapy. The lesions were predominantly located in the mandible (n = 8), and the most common predisposing dental factor was a history of prior extraction (n = 6). Half of the MRONJ were related to diseases found on the initial dental screen. Patients with MRONJ were treated with infection control and antibiotic therapy. When comparing between the MRONJ stage and each factor (sign, location, etiologic factor, BP type, treatment, and outcome), there were no significant differences between stages, except for between the stage and sign (with or without purulence). Conclusions: For prevention of MRONJ, we recommend routine dental examinations and treatment prior to starting BP therapy.

• Journal of International Society for Simulation Surgery
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• 제3권2호
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• pp.60-63
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• 2016

Fibrous dysplasia is quite a rare disease usually involving maxilla and mandible. Because of its benign clinical course, conservative contouring surgery has been recommended for facial deformity. 3D rapid prototype (RP) model gives a lot of informations before operation such as depth of drilling, area of resection and important anatomic structure. The purpose of this study was to report maxilla-mandibular contouring surgery in fibrous dysplasia patients. A total of 14 consecutive patients were included for surgical and esthetic evaluation. Among 14 patients, RP model study was performed in two patients with severe facial deformity. The other patients underwent contouring surgery under conventional methods. Surgical evaluation was performed with computed tomography scan before and after operation. Surgical resection was successful and patients were satisfied with the surgical results.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제39권
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• pp.22.1-22.9
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• 2017

Background: Two-jaw surgery including mandibular and maxillary backward movement procedures are commonly performed to correct class III malocclusion. Bimaxillary surgery can reposition the maxillofacial bone together with soft tissue, such as the soft palate and the tongue base. We analyzed changes of pharyngeal airway narrowing to ascertain clinical correlations with the prevalence of snoring after two-jaw surgery. Methods: A prospective clinical study was designed including a survey on snoring and three-dimensional (3D) computed tomography (CT) in class III malocclusion subjects before and after bimaxillary surgery. We conducted an analysis on changes of the posterior pharyngeal space find out clinical correlations with the prevalence of snoring. Results: Among 67 subjects, 12 subjects complained about snoring 5 weeks after the surgical correction, and examining the 12 subjects after 6 months, 6 patients complained about the snoring. The current findings demonstrated the attenuation of the largest transverse width (LTW), anteroposterior length (APL), and cross-sectional area (CSA) following bimaxillary surgery given to class III malocclusion patients, particularly at the retropalatal level. The average distance of maxillary posterior movements were measured to be relatively higher (horizontal distance 3.9 mm, vertical distance 2.6 mm) in case of new snorers. Conclusions: This study found that bimaxillary surgery could lead to the narrowing of upper airway at the retropalatal or retroglossal level as well as triggering snoring in subjects with class III malocclusion. Based on the current clinical findings, we also found that upper airway narrowing at retropalatal level may contribute to increasing the probability of snoring and that polysonography may need to be performed before orthognathic surgery in subjects with class III malocclusion.

• Radiation Oncology Journal
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• 제12권3호
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• pp.315-321
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• 1994

에나멜모세포종(ameloblastoma)은 하악부에 드물게 생기는 상피성 종양으로서 치원성(齒原性)의 모든 종양과 낭(囊)의 약 $1\%$를 차지한다. 이들은 서서히 자라는 종양이지만 국소적으로 침습성을 보이고 높은 재발율을 나타낸다. 반면에 원격전이는 드물다. 에나멜모세포종은 방사선에 저항적이라고 알려져 있었기에 드문 경우들외에는 주로 수술적 요법으로 치료되어져 왔다. 그러나 최근에 에나멜모세포종이 방사선에 반응을 보이므로 수술가 병용하거나 방사선치료 단독으로 치료에 쓰일 수도 있다는 보고들이 나왔다. 저자들은 수술후 방사선치료 여부를 결정하기 위해 본 치료방사선과에 의뢰된 2예의 에나멜모세포종 중 1예에서 수술후 방사선치료를 실시하였기에 이들 2예를 문헌고찰과 함께 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권2호
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• pp.94-102
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• 2007

The ameloblastoma is a common odontogenic tumor of the jaw bone and represents approximately 1% of tumor in the jaw. However, it might be able to infiltrate into the adjacent tissue, causing bony destruction and high recurrent rate. In this study, expression of RANKL and OPG in ameloblastoma in relation to age and gender of patient and recurrence, location of the lesion were examined through immunohistochemisry study. The RANKL and OPG antibody staining were used. The obtained result were as follow. 1. Positive immunoreactivity to RANKL/OPG in all specimens was found. 2. 1n recurrenc, location of ameloblastoma and age, gender of patients using immunohistochemical expression of RANKL. There was not significant difference. 3. 1n recurrence, location of ameloblastoma and age, gender of patients using immunohistochemical expression of OPG. There was not significant difference. In summary, it is suggested that activation of osteoclasts by RANKL is an important mechanism by which ameloblastomas cause bone destruction.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권5호
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• pp.302-309
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• 2013

Purpose: This study evaluated the prognosis of conservative and surgical treatment according to the staging of bisphosphonate-related osteonecrosis of jaw (BRONJ) by American Association of Oral and Maxillofacial Surgeons and American Society for Bone and Mineral Research. Methods: We evaluated 53 patients of BRONJ who visited Department of Dentistry, Ajou University School of Medicine from May 2007 to February 2013. Twenty eight patients in stage 2, were divided into surgical and conservative groups with cessation of bisphosphonate therapy. Fifteen patients belonged to the conservative treatment group, in which mouth rinsing and antibiotics medication were done. Thirteen patients were treated with debridement or sequestrectomy, in the surgical treatment group. Each study list was analyzed by SPSS ver. 14.0 (SPSS Inc., USA) software and the favorable rate was verified by the Fisher exact test. P-values less than 0.05% were deemed significant. Results: Clinical outcome was evaluated on the basis of both clinical and radiographic findings. Of all the 28 patients of stage 2, 15 patients underwent conservative treatment and 13 patients received surgical treatment. In the surgical group, 9 of 13 (69.2%) showed good prognosis, 4 of 13 (30.7%) showed recurrence. In the conservative group, 13 of 15 (86.6%) showed no change duting the follow-up period. Two of 15 patients even showed a bad prognosis, such as pain and pus discharge, which are criteria for stage 3. P-value was 0.067 (>0.05). Conclusion: The results of the present study suggests that surgical intervention is good choice against the conservative treatment, after proper drug holidays period, while further investigation is needed for a definite solution to BRONJ.