• International Journal of Oral Biology
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• v.40 no.2
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• pp.71-77
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• 2015

The activation of glial cells in the spinal cord has been contribute to the initiation and maintenance of pain facilitation induced by peripheral inflammation and nerve injury. The present study investigated effects of botulinum toxin type A (BoNT-A), injected subcutaneously or intracisternally, on the expression of microglia and astrocytes in rats. Complete Freund's Adjuvant (CFA)-induced inflammation was employed as an orofacial chronic inflammatory pain model. A subcutaneous injection of $40{\mu}L$ CFA into the vibrissa pad was performed under 3% isoflurane anesthesia in SD rats. Immunohistochemical analysis for changes in Iba1 (a microglia marker) and GFAP (an astrocyte marker), were performed 5 days after CFA injection. Subcutaneous injection of CFA produced increases in Iba1 and GFAP expression, in the ipsilateral superficial lamia I and II in the medullary dorsal horn of rats. Subcutaneous treatment with BoNT-A attenuated the up-regulation of Iba1 and GFAP expressions induced by CFA injection. Moreover, intracisternal injection of BoNT-A also attenuated the up-regulated Iba1 and GFAP expressions. These results suggest that the anti-nociceptive action of BoNT-A is mediated by modulation activation of glial cells, including microglia and astrocyte.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.5
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• pp.383-389
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• 2002

This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.6
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• pp.253-258
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• 2014

Purpose: Maxillofacial fractures are rapidly increasing from car accidents, industrial accidents, teenaged criminal activity, and sports injuries. Accurate assessment, appropriate diagnosis, and preparing individual treatment plans are necessary to reduce surgical complications. We investigated recent trends of facial bone fracture by period, cause, and type, with the objective of reducing surgical complications. Methods: To investigate time trends of maxillofacial fractures, we reviewed medical records from 2,196 patients with maxillofacial fractures in 1981~1987 (Group A), 1995~1999 (Group B), and 2008~2012 (Group C). We analyzed each group, comparing the number of patients, sex ratio, age, fracture site, and etiology. Results: The number of patients in each period was 418, 516, and 1,262 in Groups A to C. Of note is the increase in the number of patients from Group A to C. The sex ratios were 5.6:1, 3.5:1, and 3.8:1 in Groups A, B, and C. The most affected age group for fracture is 20~29 in all three groups. Traffic accidents are the most common cause in Groups A and B, while there were somewhat different causes of fracture in Group C. Sports-induced facial trauma was twice as high in Group C compared with Group A and B. Mandible fracture accounts for a large portion of facial bone fractures overall. Conclusion: We observed an increase in facial bone fracture patients at Kyungpook National University Dental Hospital over the years. Although facial injury caused by traffic accidents was still a major cause of facial bone fracture in all periods, the percentage decreased. In recent years, isolated mandible fracture increased but mandible and mid-facial complex fracture decreased, possibly because of a reduction in traffic accidents.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.2
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• pp.163-170
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• 1995

The purpose of this study was to investigate the epidemiology of midface fractures. We observed clinically 71 patients with midface fracture who visited the Department of oral and maxillofacial-surgery, Chosun University, Dental Hospital, from 1991 to 1994. The results obtained were as follows. 1. There was the highest age incidence in the third decade(29.6%). 2. There was the highest incidence in the summer(36.6%). 3. The most etiologic factor of midface fracture was traffic accidents(43.6%) and next factor was fall down(38.0%). 4. The highest incidence fracture was zygomatic arch(38.7%) and next fracture was ZMC fracture(31.5%). 5. Most midface fracture was treated within 2 weeks(86.7%). 6. Midface fractures was most frequently combined with mandibular fracture(15.5%), head injuries(14.1%), orthhopedic injuries(8.5), thorax & abdomen(5.6%). 7. The highest complication was the nerve injury(8명), and next complications were infection(3명), epiphora(3명) etc.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.255-260
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• 1989

Unfavorable healing of maxillary fractures may impose functional and esthetic burdens upon the trauma victim. Malunited maxillary fractures are generally a result of treatment delay, incomplete or inaccurate immobilization of the fracture fragments, or infection. Dysfunctions of mastication, distortions in speech, gross defects in facial contour, and related psychic changes are problems which may require secondary correction. When it is necessary to delay definitive treatment or when inadequate maxillary fracture reduction is recognized within the first week following injury, the maxilla can be mobilized by heavy handed dental manipulation under anesthesia or by elastic traction to an external fixation appliance attached to the maxilla by arch bars or an acrylic splint. But malunited maxillary fracture that have progressed to bony malunion require osteotomy procedure in order to establish normal anatomic relationships. This report parents two cases of malunited unilateral maxillary fracture surgically corrected by unilateral Le Fort I osteotomy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.416-421
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• 2010

Purpose: The purpose of this study was to evaluate the incidence of intra- and postoperative complications of orthognathic surgery and their relevance. Materials and Methods: The clinical records and X-rays of 418 patients who underwent surgery at Chosun University Dental Hospital, Korea, over a 12-year period between 1998 and 2009 were examined. Results: The followings are some of the most common complications which happened during the oper-ations: Inadequate osteotomy in 25 cases, excessive bleeding in 11 cases, nerve injuries in 6 cases, soft tis-sue injuries in 8 cases, and tooth injury, and insertion of foreign bodies in 4 cases respectively. The most frequent complications which happened after surgery are shown below. Paraesthesia in 262 cases, dyspnea in 78 cases, pain in cervical region in 49 cases, open bite in 14 cases, plus 62 cases where other complications occurred. Despite the great variety of complications, severe life threatening complication frequency seems to be extremely low. Conclusion: Orthognathic surgery appears to be a relatively safe procedure but complications related to orthognathic surgery do still occur. Accurate evaluation and precise surgery are needed to minimize complications.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.4
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• pp.283-288
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• 2006

There are several manners for surgical approaches to the mandibular condyle. With the retromandiular approach, the condyle and fracture are exposed directly and allow for good inspection and reduction. The retromandibular scar is very well camouflaged and practically invisible. The aim of this study was to evaluate clinical results of retromandibular approach for the reduction and fixation of fractured mandibular condyles. We described postoperative complications such as temporary facial nerve weakness involving the marginal mandibular branch, mouth opening limitation and malocclusion in 13 patients with mandubular condylar fractures; 11 subcondylar fractures and 2 condylar neck fractures. The follow-up period was longer than 6 months in all patients. The retromandibular approach was successful in all subcondylar fracture cases. 2 patients with condylar neck fracture had mouth opening limitation and temporary marginal nerve palsy longer than 3 months. But there were no cases of permanent nerve injury and malocclusion. Our findings indicate that retromandibular approach is an easy and safe technique for subcondylar fracture but not for condylar neck fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.2
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• pp.185-189
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• 2011

Tooth impaction represents the stop of eruption by clinical and radiographical disturbance in eruption path or the dislocation of tooth germ. The most common factor in tooth eruption disorders are spacial deficiency with other causes reported to be odontogenic tumors, periodontal ligament injury, etc. Impaction of the mandibular second molar is relatively rare and reported in about 3 out of 1,000 people. Because the second molars tend to erupt in a mesial direction, this situation can lead to serious problems if untreated, including dental caries, periodontal disease and root resorption of the first molar. Treatment of this problem includes, surgical repositioning and orthodontic forced eruption. Because each procedure have the definite advantages and disadvantages, and influenced by circumferential environment, these have limits for successfu1 recovery as independent treatment. In a case at St. Mary's Hospital, we performed successful correction of a horizontal impacted mandibular second molar using a miniplate skeletal anchorage system. We introduce this treatment as a valid method for an impacted second molar and consider a oromaxillofacial surgeon's role in tooth movement treatment.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.2
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• pp.171-175
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• 2011

Implant placement on the anterior mandible is considered a common and safe surgical procedure. However, severe hemorrhage can occur if branches of the sublingual artery, which run through the lingual cortical plate of the mandible, are damaged. Excessive hemorrhage caused by injury to the sublingual artery can result in life-threatening problems such as airway obstruction. A 54-year old male patient without any generalized systemic conditions was referred due to active bleeding after implant placement in the anterior mandible. Gauze compression with surgicel and bosimin were performed and hemostasis was achieved. The patient was discharged after 3 days without any supplementary bleeding.

• Korean Journal of Health Education and Promotion
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• v.9 no.1
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• pp.30-38
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• 1992

The purpose of this investigation was to evaluate, by means of a questionaire, the parental awareness of the emergency management of avulsed teeth in children. 297 parents were surveyed during a six week period at Yooseuk elementary school in Seoul. The results indicated that the person who experianced a avulsion of teeth was 16.6%. 35% of parents would attempt replantation of an avulsed tooth but further questioning showed they did not know the correct procedures. 36% of parents were unaware of adequate time for emergency dental services. 62% of parents felt they should seek professional help urgently following an avulsion injury, but their knowledge of transport media for the tooth was poor. Only 8% of parents knew that milk was the medium of choice for both washing and transporting an avulsed tooth. 76% of parents surveyed had never received advice in what to do in the event of an accident where a tooth was avulsed. This study revealed the need for educational campaigns aimed at parents to increase their knowledge of the emergency procedures required when a tooth is avulsed.