Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.49
no.1
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pp.21-29
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2023
Objectives: Dental or maxillofacial emergencies are uncommon during pregnancy, but if they occur, they are challenging to treat due to potential risks. The mother should not be denied necessary medical or dental care because of pregnancy. The aim of the study is to observe outcomes of pregnancy in patients requiring emergency minor oral surgical procedures during gestation and to determine the safety of the pregnant woman undergoing the procedure and the fetus. Materials and Methods: The study was conducted on 52 pregnant women requiring emergency oral surgical procedures. A standard treatment protocol for treatment of specific entities was followed. Close monitoring and observation were the primary goal of treatment. All patients were followed postoperatively until complete recovery from the surgical procedures and then until birth of the baby. A control group of 52 healthy pregnant patients who did not require oral surgical procedures was considered for statistical analysis. The measurements to calculate observation were fetal loss (spontaneous abortion), preterm birth, low-birth weight, or incidence of any congenital anomalies in the baby and its association with surgical procedures. Results: No fetal loss occurred in any of the cases. However, four patients experienced preterm birth and seven neonates exhibited low birth weights. No congenital abnormalities were discovered. In one instance, a patient who underwent surgery for a mandibular symphysis fracture under general anesthesia in the 31st week of pregnancy experienced labor pain on the fourth postoperative day, requiring an emergency Caesarean section. Conclusion: The results of our study demonstrate that, compared to the control group, minor emergency surgeries performed during pregnancy have no discernible negative effects on the fetus. These procedures can safely be performed by adhering to our described protocols.
Background: Position of the facial foramina is important for regional block and for various maxillofacial surgical procedures. In this study, we report on anthropometry and morphology of these foramina using three-dimensional computed tomography (3D-CT) data. Methods: A retrospective review was performed for all patients who have undergone 3D-CT scan of the facial skeleton for reasons other than fracture or deformity of the facial skeleton. Anthropometry of the supraorbital, infraorbital, and mental foramina (SOF, IOF, MF) were described in relation to facial midline, inferior orbital margin, and inferior mandibular margin (FM, IOM, IMM). This data was analyzed according to sex and age. Additionally, infraorbital and mental foramen were classified into 5 positions based on the anatomic relationships to the nearest perpendicular dentition. Results: The review identified 137 patients meeting study criteria. Supraorbital foramina was more often in the shape of a foramen (62%) than that of a notch (38%). The supraorbital, infraorbital, and mental foramina were located 33.7 mm, 37.1 mm, and 33.7 mm away from the midline. The mean vertical distance between IOF and IOM was 13.4 mm. The mean distance between MF and IMM was 21.0 mm. The IOF and MF most commonly coincided with upper and lower second premolar dentition, respectively. Between the sex, the distance between MF and IMM was significantly higher for males than for female. In a correlation analysis, SOF-FM, IOF-FM and MF-FM values were significantly increased with age, but IOF-IOM values were significantly decreased with age. Conclusion: In the current study, we have reported anthropometric data concerning facial foramina in the Korean population, using a large-scale data analysis of three-dimensional computed tomography of facial skeletons. The correlations made respect to patient sex and age will provide help to operating surgeons when considering nerve blocks and periosteal dissections around the facial foramina.
Background: Over the past 30-40 years, various carbon implant materials have become more interesting, because they are well accepted by the biological environment. The traditional carbon-based polymers give rise to many complications. The polymer complication may be eliminated through carbon fibres bound by pyrocarbon (carbon/carbon). The aim of this study is to present the long-term clinical results of carbon/carbon implants, and the results of the scanning electron microscope and energy dispersive spectrometer investigation of an implant retrieved from the human body after 8 years. Methods: Mandibular reconstruction (8-10 years ago) was performed with pure (99.99 %) carbon implants in 16 patients (10 malignant tumours, 4 large cystic lesions and 2 augmentative processes). The long-term effect of the human body on the carbon/carbon implant was investigated by comparing the structure, the surface morphology and the composition of an implant retrieved after 8 years to a sterilized, but not implanted one. Results: Of the 16 patients, the implants had to be removed earlier in 5 patients because of the defect that arose on the oral mucosa above the carbon plates. During the long-term follow-up, plate fracture, loosening of the screws, infection or inflammations around the carbon/carbon implants were not observed. The thickness of the carbon fibres constituting the implants did not change during the 8-year period, the surface of the implant retrieved was covered with a thin surface layer not present on the unimplanted implant. The composition of this layer is identical to the composition of the underlying carbon fibres. Residual soft tissue penetrating the bulk material between the carbon fibre bunches was found on the retrieved implant indicating the importance of the surface morphology in tissue growth and adhering implants. Conclusions: The surface morphology and the structure were not changed after 8 years. The two main components of the implant retrieved from the human body are still carbon and oxygen, but the amount of oxygen is 3-4 times higher than on the surface of the reference implant, which can be attributed to the oxidative effect of the human body, consequently in the integration and biocompatibility of the implant. The clinical conclusion is that if the soft part cover is appropriate, the carbon implants are cosmetically and functionally more suitable than titanium plates.
Flexion of a metal/ceramic fixed partial denture(EPD) frameworks under function can cause fracture of porcelain or deterioration of the cement seal. This study evaluated the flexion characteristics of three-unit mandibular FPD frameworks, repacing the second pre-molar under compressive load(200g, 400g). Testing was accompished with real-time holographic interferometry, using 6 porcelain fused-to metal frameworks. Tested alloys were non-precious alloy(Heracles, Holland), semi-precious alloy(Degudent U, Germany) and precious alloy(Degudent H, Germany). Changes of the fringe patterns according to the heat treatment(porcelain firing cycle), various loads(200g, 400g), occlusal forms(occlusal porcelain veneering, facial porcelain veneering), various alloys and post-soldering units were compared. Dental study model(Nissan dental products, Inc. D51DP-500A, Japan) and six 3-unit metal/ceramic fixed partial denture frameworks were used as experimental materials. 36 holograms were taken on fixed dental study model by using the 10mW He-Ne laser and real-time holographic interferometry. On the basis of this study, the following conclusions can be drawn : 1. In the frameworks for facial porcelain veneering, the semi-precious alloy framework was least deformed and precious alloy framework, non-precious alloy framework orderly before heat treatment, and the deformation was not shown great difference among three alloys after heat treatment and post-soldering. 2. In the frameworks for occlusal porcelain veneering, the precious alloy framework was greatest deformed and the deformation was not difference between semi-precious alloy framework and non-precious alloy framework before, after heat treatment, and the deformation was not shown great difference among three alloys after post soldering. 3. In the non-precious alloy frameworks for facial porcelain veneering and occlusal porcelain veneering, the deformation was greatly decreased after heat treatment and conversely increased after post-soldering. 4. In the semi-precious alloy framework for facial porcelain veneering, the deformation was not detectable after heat treatment and increased after post-solder. And in the frame-work for occlusal porcelain veneering, the deformation was slightly decreased after heat treatment and increased after post-soldering. 5. In the precious alloy framework for facial porcelain veneering, the deformation was greatly decreased after heat treatment and increased after post-soldering, And in the framework for occlusal porcelain veneering, the deformation was greatly decreased after heat treatment and decreased after post-soldering.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.32
no.4
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pp.334-347
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2006
The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.29
no.1
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pp.56-59
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2003
The incident of false aneurysm of internal maxillary artery in the oral and maxillofacial region is known to be very rare. One case of false aneurysm in the internal maxillary artery is presented, which was experienced in our department. The etiology of this case is regarded as the mandibular condyle fracture, and/or iatrogenic trauma during open reduction. Clinically, there were systolic bruit on auscultation, pulsation and massive bleeding during operation. The lesion was finally diagnosed with angiography and treated by embolization procedure. False aneurysm can cause so massive bleeding as to threat the life of the patients. Therefore accurate diagnosis and treatment is very important. Angiography enables the solid diagnosis for the clinical one. And as the embolization has many advantages over the ligation, it can be a good treatment method.
Park Chang-Keun;Lee Sun-Hyung;Chung Hun-Young;Yang Jae-Ho
The Journal of Korean Academy of Prosthodontics
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v.32
no.4
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pp.484-514
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1994
Cantilever bridge is widely used by mny clinicians, but its worst mechanical character, so called Class I lever system, makes dentists hesitate to restore the missing tooth with it. Therefore it is important to study stress of the cantilever bridge. In this study, two models of cantilever bridges that restores the missing mandibular second molar with two abutment teeth were constructed. One model was a type of cantilever bridge supported by a normal alveolar bone, the other one was supported by an alveolar bone resorbed to its 1/3 of root length. Maximum bite force(550N) and funtional maximum bite force(300N) were vertically applied to the distal end of the pontic, distal 1/3, and distal half of the pontic. And each force was also applied to centric occlusal contacts as a distributed force. Total 16 loading cases were compared and analyzed with 3-dimensional finite element method. The results were as follows: 1. The stress was concentrated on the joint of the pontic and the retainer, grooves, and distal cervical margin of the posterior retainer. 2. In case of maximum bite force(550N) at the end of the pontic, the risk of fracture at the joint of the pontic and the retainer was high. 3. In case of distributed force in centric occlusion and functional maximum bite force(300N), the stresses were less than the yield strength of the type VI gold for any loading cases. 4. In case of alveolar bone resorption, the occlusal force to the cantilever pontic caused more stress on the root apex and less stress on the alveolar crest region of the distal surface of the posterior abutment. 5. In case of alveolar bone resorption, the displacement was larger than that of normal alveolar bone in all loading cases.
Journal of the korean academy of Pediatric Dentistry
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v.35
no.1
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pp.175-180
/
2008
Traumatic injuries to the primary dentition are commonly encountered problems in dental practice. It is found that 30% of the children had injuries to the primary dentition and 22% to the permanent dentition. The greatest incidence of trauma to the primary dentition occurs at the ages of 2 and 3 as children start to learn motor coordination. Because teeth and alveolar bone are traumatized simultaneously, alveolar bone fractures are likely to occur when multiple teeth are involved in injuries. Dental splints are indicated for the management of maxillofacial fractures. They enable anatomic reduction of fractured segments and help immobilization and maintenance of the fragments after reduction. They also act as a stabilizer during rehabilitation. Various types of dental splints are available. In this case, routine resin-wire splint technique could not be applied because of the child's uncooperative behavior. Oral sedation was not indicated because N.P.O. had not been preceded. Therefore, we decided to use open-cap acrylic splint instead. Stabilization using open cap acrylic splint requires minimum chair time with reduced discomfort to both patient and dentist. It is an effective means of splint for uncooperative children and especially useful when other means of fixation have been failed. Because trauma on the primary dentition can affect the underlying permanent tooth germ, it is important to monitor eruption process of the permanent dentition.
Journal of Dental Rehabilitation and Applied Science
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v.35
no.2
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pp.72-80
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2019
Purpose: The purpose of this study is to compare and analyze the shear bond strength and fracture pattern in different enamel tooth surface treatments for resin splinting materials. Materials and Methods: G-FIX and LightFix were used as tooth splinting materials. Twenty bovine mandibular incisors were used for the preparation of the specimens. The exposed enamel surface was separated into four parts. Each tooth was treated with 37% phosphoric acid, 37% phosphoric acid + adhesive resin, 37% phosphoric acid + G-premio bond, and G-premio bond for each fraction. Shear bond strength was measured using a universal testing machine. After measuring the shear bond strength, the fractured surface of the specimen was magnified with a microscope to observe the fracture pattern. Two-way ANOVA was used to verify the interaction between the material and the surface treatment method. One-way ANOVA was used for comparison between the surface treatment methods of each material and post-hoc test was conducted with Scheffe's test. An independent t-test was conducted to compare shear bond strengths between materials in each surface treatment method. All statistics were conducted at 95% significance level. Results: G-FIX, a tooth splinting resin, showed similar shear bonding strength when additional adhesive resins were used when material was applied after only acid etching, and LightFix showed the highest shear bonding strength when additional adhesive resins were used after the acid etching. In addition, both G-FIX and LightFix showed the lowest shear bond strength when only self-etching adhesive was applied without additional acid etching. Verification of interactions observed interconnection between resins and surface treatment methods. Most of the mixed failure was observed in all counties. Conclusion: When using G-FIX and LightFix, which are tooth-splinting materials, it is considered that sufficient adhesion will be achieved even after applying only acid etching as instructed by the manufacturer.
Journal of Dental Rehabilitation and Applied Science
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v.39
no.4
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pp.187-194
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2023
Purpose: A mismatched size in the post and post space is a common problem during post-fixation. Since this discordance affects the bonding strength of the fiber-reinforced composite resin post (FRC Post), a corresponding luting agent is required. The aim of this study was to evaluate the bonding strength of the FRC post according to the fitness of the fiber post and the type of luting agent. Materials and Methods: Thirty mandibular premolar were endodontic-treated and assigned to two groups according to their prepared post space: Fitting (F) and Mismatching (M). These groups were further classified into three subgroups according to their luting agent: RelyX Unicem (ReX), Luxacore dual (Lux), and Duolink (Duo). A push-out test was performed to measure the push-out bond strengths. The fractured surfaces of each cross-section were then examined, and the fracture modes were classified. Results: In the ReX and Duo subgroups, the F group had a higher mean bond strength; however, the Lux subgroup had no significant difference between the F and M groups. In the analysis of the failure modes, the ReX subgroup had only adhesive failures between the cement and dentin. Conclusion: The result of this study showed that the bond strength of an FRC post was influenced by the type of luting agent and the mismatch between the diameter of the prepared post space and that of the post.
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