• Title/Summary/Keyword: Jaw surgery

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Clinical Study of Jaw Cysts (악골낭종에 대한 임상적 연구)

  • Moon, Cheol;Lee, Dong-Keun;Min, Seung-Ki;Oh, Sung-Hwan;Kim, Tae-Seong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.3
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    • pp.301-309
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    • 2000
  • This clinical study was made of 214 cases of the jaw cysts which were diagnosed histopathologically in the Department of Oral and Maxillofacial Surgery, Wonkwang University Dental Hospital from Jan. 1, 1991 to Dec. 31, 1998. Medical records, radiographs, histopathological reports of 214 cases with jaw cysts were retrospectively reviewed. The results were as follows : 1. Among the total patient of 214 cases, male were 143 cases, and female are 71 cases, male predominated by the ratio of 2.04. 2. The periapical cysts and the dentigerous cyst are the most common cyst, irrespective of 116 cases(54.2%) and 58 cases(27.1%). 3. The periapical cyst has no gender prediction, male were 70 cases and female were 54 cases, the mean ages were 39.3 years(SD=18.4). The most common involving teeth were maxillary anterior teeth(59.7%). 4. The dentigerous cyst predominantly occurred in third decade (18 cases : 31%), and the mean ages were 31.9 years(SD=14.8). Dentigerous cysts predominantly occurred in male by the ratio of 7.29 (male : 51 cases, female : 7 cases). Maxillary anterior teeth(43.1%) and mandibular molars(32.8%) were most frequently involved. 5. The odontogenic keratocyst predominantly occurred in second and third decade and mean ages were 23.5 years(SD=17.2). The mandibular molars(60%) were most frequently involved. 6. All nasopalatine cyst occurred after fourth decade, mean ages were 49.5years(SD=10.4). In the gender incidence of nasopalatine cyst, 1 case occurred in female and 10 cases occurred in male. 7. In the surgical intervention of jaw cyst, cyst enucleation and marsupialization performed in 156 cases. Cyst enucleation with bone graft performed in 58 cases and iliac autogenous bone grafts most frequently performed in 29cases. 8. The diameter range of cyst enucleation with bone graft were from 15mm to 120mm with a cyst diameter of 33.3mm. (SD=15.2) The diameter range of cyst enucleation and marsupialization were from 7mm to 82mm with a cyst diameter of 20.4mm.(SD=9.0) The diameter of cyst enucleation with bone graft were significantly greater than diameter of cyst enucleation. (p<0.05) 9. Post-operative complications occurred in 9 cases(15.5%) in which cyst enucleation with bone grafts performed and occurred in 31 cases(19.9%) in which cyst enucleation.

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Conservative Treatment Using Marsupialization for Cysts Occurring in the Jaw of Adolescents: A Case Report

  • Yun, Sun-Ung;Jung, Hai-Won;Cho, Byung-Yong;Choi, Byung-Joon;Lee, Baek-Soo;Kwon, Yong-Dae;Ohe, Joo-Young;Lee, Jung-Woo
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.31-37
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    • 2014
  • Dentigerous cyst (DC) is an odontogenic cyst associated with the crown of an impacted, embedded, unerupted, or developing tooth. It is the second most common type of odontogenic cysts, accounting for 14% to 24% of all jaw cysts. Although these cysts occur more frequently during the second and third decades of life, they can also be found in children and adolescents in the mixed dentition stage. Treatment of the odontogenic cyst involves enucleation or marsupialization/decompression methods. The latter approach is preferred for larger cysts, and it is especially helpful in adolescent patients in conserving the unerupted permanent successors. The aim of treatment for DC is the complete elimination of pathology and maintenance of dentition with minimal surgical intervention. Recently defined criteria for the selection of treatment modality include the cyst size and location of the cyst, patient age, dentition involved, stage of root development, position of the tooth involved in the jaw, and relationship with the surrounding vital structure. Marsupialization or decompression technique has been advocated by several authors for treating DCs among young patients. In this conservative technique, the creation of an accessory cavity helps relieve intra-cystic pressure and accelerate the healing of cystic lesion. This technique has been successfully performed and is indicated for growing children and adolescents. Here, we report a large cyst lesion in the mandible treated by marsupialization for conservative management. In conclusion, successful reduction in size was achieved, and intraoperative complication could be prevented.

MALIGNANT FIBROUS HISTIOCYTOMA OF THE JAW : REPORT OF THE TWO CASES (악골에 발생한 악성 섬유성조직구종 2례)

  • Park, Jun-Ah;Jung, Soong-Ryong;Kim, Young-Woon;Jeong, Jong-Cheul;Oh, Hee-Kyun;Lee, Jong-Ho;Ryu, Sun-Youl;Choi, Hong-Ran
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.3
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    • pp.289-295
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    • 1995
  • Malignant fibrous histiocytoma rarely occurs in the jaws. Although the histogenesis of this tumor remains controversal, it is best regarded as a primitive and pleomorphic nature reflected by collagen production and occasional phagocytosis. It is common for metastatic foci to appear in lung and regional lymph node. There are variable treatments such as radiotherapy, surgical excision or combination therapy of surgical excision, chemotherapy and radiotherapy. With the review of literatures, the authors report the clinical study of two cases of malignant fibrous histiocytoma of the jaw.

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STUDY FOR HOUNSFIELD UNITS IN COMPUTED TOMOGRAM WITH JAW LESION (악골 병소의 켬퓨터 촬영상에서 Hounsfield Unit에 관한 연구)

  • Kim, Chul-Hwan;Jung, Jong-Il
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.4
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    • pp.391-396
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    • 2006
  • The CT number is called Hounsfield unit(HU). Generally HU has a score between +1000 from -1000, and it is standardized usingthe air(-1000), water(0), and compact bone(+1000). Hounsfield Unit to standardize the density in computed tomography using the air and water has been used to analysis of lesion in other medical field. Computed tomography is popular method to analysis of lesion in oral & maxillofacial field but the analysis about density of lesion by Hounsfield unit is still obscure. For this study, computed tomography taken in Dankook University Dental Hospital and Hounsfield unit was measured to compare the difference of jaw bone lesion as cystic lesion, benign tumor, malignant tumor.

Polydeoxyribonucleotide, as a Novel Approach for the Management of Medication-Related Osteonecrosis of the Jaw: A Preliminary Observational Study

  • Jung, Junho;Lim, Hae Soo;Lee, Deok-Won
    • Journal of Korean Dental Science
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    • v.11 no.2
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    • pp.57-61
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    • 2018
  • Purpose: Polydeoxyribonucleotide (PDRN), consisting of a mixture of deoxyribonucleotide polymers, has been suggested to have anti-inflammatory effects and enhance angiogenesis as an adenosine $A_{2A}$ receptor agonist. The aim of this study was to report the effectiveness of PDRN as an adjuvant therapy after surgical debridement in MRONJ (medication-related osteonecrosis of the jaw) patients. Materials and Methods: Five patients (1 male, 4 females, age 65~79 years) who were diagnosed with MRONJ stage 2 or 3 underwent surgical debridement and PDRN mucosal injection. After surgical debridement, patients were subject to daily injection with 1 ml of PDRN around the surgical wound for 14 days. Result: The patients' symptoms gradually disappeared. The surgical wound uneventfully healed, and no recurrence was observed during the follow-up period. Conclusion: Although further studies are required, the present study first describes the possibility of PDRN as a useful option for MRONJ treatment.

Risk factors of medication-related osteonecrosis of the jaw: a retrospective study in a Turkish subpopulation

  • Sahin, Onur;Odabasi, Onur;Aliyev, Toghrul;Tatar, Birkan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.2
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    • pp.108-115
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    • 2019
  • Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a well-known side effect of certain drugs that are used to influence bone metabolism to treat osteometabolic disease or cancers. The purpose of our study was to investigate how high-concentration and low-concentration bisphosphonate (BP) intake affects the disease severity. Materials and Methods: Data collected from the medical records of 52 patients treated with BPs, antiresorptive, antiangiogenic drugs and diagnosed with MRONJ were included in this study. Age, sex, type of systemic disease, type of drug, duration of drug treatment, jaw area with MRONJ, drug administration protocol, and MRONJ clinical and radiological findings were obtained. Patients were divided into two groups: anti-neoplastic (Group I, n=23) and anti-osteoporotic (Group II, n=29). Statistical evaluations were performed using the IBM SPSS ver. 21.0 program. Results: In both groups, more females had MRONJ. MRONJ was found in the mandibles of 30 patients (Group I, n=14; Group II, n=16). When we classified patients according to the American Association of Oral and Maxillofacial Surgeons staging system, significant differences were seen between groups (${\chi}^2=12.23$, P<0.01). More patients with advanced stage (stage 2-3) MRONJ were found in Group I (60.9%). Conclusion: According to our results, high-concentration BP intake, age and duration of drug intake increased disease severity.

Soft Tissue Change in Frontal View after Orthognathic Surgery for Class III Malocclusion: Analysis Using Facial 'Phi' Mask (Facial 'Phi' Mask를 이용한 3급 부정교합 환자의 악교정수술 후 정면부 연조직의 변화)

  • Heo, Young-Min;Kim, Hong-Soek;Paeng, Jun-Young;Hong, Jong-Rak;Kim, Chang-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.6
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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.

THE USEFULNESS OF BONE SCAN FOR EVALUATING JAW BONE EXTENSION OF ORAL CANCER (구강암의 악골 침윤 평가에 있어서 골스캔의 효과)

  • Park, Hong-Ju;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.658-665
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    • 2000
  • Purpose : The present study was carried out to determine the diagnostic usefulness of bone scan for evaluating jaw bone extension of oral cancer. Materials and Methods : Medical records, preoperative bone scans, computerized tomographic (CT) scans, conventional radiographs, and findings of histopathologic sections of twenty patients who had been treated for oral malignant tumors by a resection of mandible and soft tissue at Chonnam University Hospital from January, 1994 to September, 1999 were analyzed. Results : In 13 cases which showed histopathologically positive, preoperative bone scans were positive in 12 (92.3%) and false negative in 1 (7.7%). Preoperative CT scans were positive in 9 (69.2%) and false negative in 4 (30.8%) of the 13 cases. Preoperative conventional radiographs were positive in 8 (61.5%) and false negative in 5 (38.5%) of the 13 cases. In 7 cases showing negative histopathologic findings, 1 (14.3%) was in CT scans and 2 (28.6%) were false positive in preoperative conventional radiographs. Conclusion : These results suggest that bone scan is more sensitive and reliable method for evaluating jaw bone extension of oral cancer than conventional radiographs or CT scans.

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Contemporary Concept for Prevention and treatment of MRONJ (Medication Related Osteonecrosis of Jaw) (MRONJ 예방과 치료를 위한 최신지견)

  • Park, Jung-Hyun;Kim, Sun-Jong
    • The Journal of the Korean dental association
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    • v.54 no.4
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    • pp.274-283
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    • 2016
  • Bisphosphonates are widely used mainly for the treatment of osteoporosis and bone metastasis of malignancy. Since the first report of MRONJ, there have been many studies associated, however the pathogenesis of MRONJ is not yet clear. Medication-related osteonecrosis of the jaws (MRONJ) is a serious complication associated with long-term medication therapy. It is characterized by exposed necrotic bonein the jaw, which has persisted for more than 8weeks despite continuous treatment by dentist. The mechanism of development of MRONJ is still unclear and there is no definitive standard treatment for MRONJ. The purpose of this study is to investigate the jaw bone destruction mechanism of accumulated bisphosphonates, so that we can develop therapeutic method to repair the defect and stop the destruction process. The authors performed simultaneous application of PRF(Platelet rich fibrin) and BMP-2(Bone morphogenetic protein-2) to stimulate not only soft tissue healing but also osseous regeneration. Our case series demonstrate that simultaneous application of platelet rich fibrin and bone morphogenetic protein-2 can be a treatment of choice for MRONJ.

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