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Clinical evaluation of temporomandibular joint disorder after orthognathic surgery in skeletal class II malocclusion patients

  • Jang, Jin-Hyun;Choi, Sung-Keun;Park, Sung-Ho;Kim, Jin-Woo;Kim, Sun-Jong;Kim, Myung-Rae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.3
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    • pp.139-144
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    • 2012
  • This study was performed in order to evaluate the occurrence of temporomandibular joint disorder after surgical correction of skeletal class II malocclusion. Materials and Methods: This study included 21 patients who underwent orthognathic surgery for the correction of dentofacial deformities by a single surgeon at Mokdong Hospital, Ewha Womans University from 2000 to 2010. They underwent bilateral sagittal split ramus osteotomy for the treatment of undesirable mandibular advancement. The temporomandibular disorder (TMD) symptoms prior to surgery were recorded and the radiographic evaluation (panorama, bone scan, and magnetic resonance imaging [MRI]) of the post-surgery temporomandibular joint (TMJ) were assessed in order to evaluate condylar resorption, remodeling and disc displacement. The minimum follow-up period, including orthodontic treatment, was 12 months. Orthognathic procedures included 1-jaw surgery (n=8 patients) and 2-jaw surgery (n=13 patients). The monocortical plate was used for bilateral sagittal split ramus osteotomy fixation. Results: Among class II malocclusion patients with TMD symptom, clicking improved in 29.1%, and maximum mouth opening increased from $34.5{\pm}2.1$ mm to $37.2{\pm}3.5$ mm. The differences were not statistically significant, however. Radiographic changes in bone scan improved slightly based on the report by radiologist but not in TMJ dynamic MRI. Conclusion: No particular improvements were found in patients with joint sound only. Patients with limitation of mouth opening showed an increase in the degree of opening, but the difference was not statistically significant (P>0.05).

Maxillary molar derotation and distalization by using a nickel-titanium wire fabricated on a setup model

  • Jung, Jong Moon;Wi, Young Joo;Koo, Hyun Mo;Kim, Min Ji;Chun, Youn Sic
    • The korean journal of orthodontics
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    • v.47 no.4
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    • pp.268-274
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    • 2017
  • The purpose of this article is to introduce a simple appliance that uses a setup model and a nickel-titanium (Ni-Ti) wire for correcting the mesial rotation and drift of the permanent maxillary first molar. The technique involves bonding a Ni-Ti wire to the proper position of the target tooth on a setup model, followed by the fabrication of the transfer cap for indirect bonding and its transfer to the patient's teeth. This appliance causes less discomfort and provides better oral hygiene for the patients than do conventional appliances such as the bracket, pendulum, and distal jet. The treatment time is also shorter with the new appliance than with full-fixed appliances. Moreover, the applicability of the new appliance can be expanded to many cases by using screws or splinting with adjacent teeth to improve anchorage.

Maxillary distraction osteogenesis in the management of cleft lip and palate: report of 2 cases

  • Kim, Jin-Woo;Park, Sung-Ho;Jang, Jin-Hyun;Kim, Myung-Rae;Kim, Sun-Jong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.4
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    • pp.321-328
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    • 2011
  • This study is to evaluate the growth and development of the maxilla advanced by transoral distraction osteogenesis of cleft lip and palate children. Subjects are two patients diagnosed as maxillary hypoplasia with cleft lip and palate, and followed up over 5 years after distraction. At the age of 11.4 years (mean), the distraction had been rendered and periodically taken lateral cephalograms were analysed to trace the growth of the maxilla. This cephalometric study showed continuous growth and development of the distracted maxilla to be stable through long term follow-up.

Breast Cancer after Radiation Therapy in a Patient with Li-Fraumeni Syndrome: A Case Report (Li-Fraumeni 증후군 환자에서 방사선 치료 후 발생한 유방암: 증례 보고)

  • In Na Yoon;Eun Suk Cha;Jeoung Hyun Kim;Jee Eun Lee;Jin Chung
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.246-251
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    • 2022
  • Li-Fraumeni syndrome (LFS) is an inherited autosomal-dominant tumor-predisposition disorder caused by germline mutations in the TP53 tumor suppressor gene. Since patients with LFS are likely to develop therapy-related cancers, radiation therapy should be avoided if breast cancer is found in these individuals. Herein, we present a case of secondary breast cancer in an LFS patient after radiation and chemotherapy for the first diagnosed breast sarcoma.

Spontaneous Resolution of Nontraumatic Acute Spinal Subdural Hematoma

  • Yang, Na-Rae;Kim, Sang-Jin;Cho, Yong-Jae;Cho, Do-Sang
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.268-270
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    • 2011
  • Spinal subdural hematoma (SSDH) is an extremely uncommon condition. Causative factors include trauma, anticoagulant drug administration, hemostatic disorders, and vascular disorders such as arteriovenous malformations and lumbar punctures. Of SSDH cases, those that do not have any traumatic event can be considered cases of nontraumatic acute spinal subdural hematoma, which is known to have diverse clinical progress. Treatment typically consists of surgical decompression and cases in which the condition is relieved with conservative treatment are rarely reported. We report two nontraumatic acute spinal subdural hematoma patients who were successfully treated without surgery.

The synovial chondromatosis of the temporomandibular joints: review of the 4 cases (측두하악관절의 활액성 연골종증 4예)

  • Lee, Dong-Hyun;Shin, Jung-Sub;Kwak, Ju-Hee;Kim, Jin-Woo;Kim, Sun-Jong;Kim, Myung-Rae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.134-140
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    • 2010
  • Synovial condromatosis of the temporomandibular joint (TMJ) is characterized by the presence of loose bodies (joint mices). It can be confused with temporomandibular disorder clinically, and be with chondrosarcoma histologically. The purpose of this clinical report was to review the clinical, radiological, arthroscopic findings, histological feature and the results of surgical treatment of TMJ synovial chondromatosis. Four patients presented with pain of TMJ and limited mouth opening. The dynamic magnetic resonance imaging (MRI) disclosed a characteristic morphologic changes and displacement of the meniscus with limited translation of the condyle head. Bone scans showed progressive resorptive changes with hot-uptake of the radioisotope. The synovial loose bodies in the joint spaces were removed and sent to pathology for diagnosis as the synovial chondromatosis. The follow-up examination with computed tomography (CT) and MRI revealed no evidence of recurrence and good in function until postoperative 18 months. Diagnostically, the distension of the lateral capsule and fluid findings in the joint on the MRI are very suggestive tool for this synovial chondromatosis, but they are not always detected on the preoperative MRI. Arthroscopic approaches are very useful to inspect the joint spaces and to remove the loose bodies without interruption of the whole synovial membranes.

The clinical study on the sedative effect and recovery in patients undergoing intravenous conscious sedation with midazolam for mandibular third molars extraction (하악 제3대구치 발치 시 midazolam을 사용한 정맥진정법의 진정효과에 관한 임상적 연구)

  • Kwak, Ju-Hee;Jang, Jin-Hyun;Kim, Jin-Woo;Kim, Myung-Rae;Kim, Sun-Jong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.5
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    • pp.408-412
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    • 2010
  • Introduction: This study examined the depth of sedation and the usefulness of the monitoring tool in determining the level of sedation in patients undergoing third molars extraction under conscious sedation with midazolam. Materials and Methods: Twenty two patients undergoing third molars extraction at the department of Oral and Maxillofacial surgery, Ewha Womans Mokdong Hospital from February 2010 to April 2010 were analyzed. All patients were classified as American Society of Anesthesiologist (ASA) class I and had no contraindications tosedation. The bispectral index was recorded continually during surgery using a bispectral monitor. The initial sedation was accomplished using a 3 mg bolus of midazolam followed by a 2 mg bolus of midazolam until the level of sedation, at which the patient’s eyes were closed or the subject was responsive only to loud or repeated calling of their name, was reached. All subjects were surveyed with a postoperative questionnaire to evaluate the level of sedation. Results: The bispectral index (BIS) decreased approximately 5 minutes after midazolam administration, but increased at the local anesthesia injection and odontomy procedure. The amnestic effect was shown effectively in the early stages of surgery. Conclusion: Conscious sedation with intravenous midazolam is effective in achieving the effect of anxiolysis, analgesia and amnesia. The BIS is an objective and useful means of assessing the depth of sedation.

Countermeasures of Specimens Showing below Reference Value in APTT Result

  • Choi, Hyun Oh;Kim, Seung Gu;Park, Sang Hee;Lee, Jae Ki;Koo, Bon Kyung;Park, Chang Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.45 no.3
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    • pp.87-90
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    • 2013
  • The activated partial thromboplastin time (APTT) is used primarily to evaluate coagulation abnormalities in the intrinsic pathway. The proper specimen is very important factor for precise results of blood coagulation analysis. The objective of this study was to get to the conclusion of whether to analyze again and to collect blood sample over again when APTT result shows below the reference value. We evaluated 126 samples showing a value below 20.0 sec at ATPT result, which consist of 48 males and 78 females candidates during night duty from March 2012 to December 2012. Average comparisons of APTT result between first and retested analysis among study subjects were significantly different in male samples. APTT results comparison of recollected subjects among clotted samples were also significantly different with both sexes (p<0.000). We suggest that we should carefully check the samples to get accurate results and collect samples again in case of only obtaining improper samples; even though the APTT result show below reference value.

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Cherubism: Review of 2 Cases (체루비즘: 2예 보고)

  • Kwak, Juhee;Kim, Ji-Youn;Kim, Myung-Rae;Kim, Sun-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.357-362
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    • 2012
  • Cherubism is a rare familial disease of childhood, characterized by proliferative lesion, which is within the maxilla and mandible. In a typical case, painless symmetric expansile lesions develop in the jaws. It shows substitution of the bone by proliferating fibrous tissue exhibiting mature fibroblasts and a number of multinucleated giant cells within an intercellular matrix. Usually, the disease manifests in early childhood, and becomes more marked until puberty, at which time the bony lesions begin to regress. As such, conservative approaches to management are advisable. However, excision of tissue through enucleation or curettage appears to be necessary in more aggressive cases, to reduce the maxillofacial deformity after puberty and to ensure a successful outcome without the risk of progression, requiring additional resection. This report describes 2 cases of manifestation of cherubism of oral and maxillofacial region. We present diagnosis, radiological - histopathologic features, and treatment of cherubism.

The Effect of Botulinum Toxin on an Iatrogenic Sialo-Cutaneous Fistula

  • Hong, Seung Eun;Kwon, Jung Woo;Kang, So Ra;Park, Bo Young
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.237-239
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    • 2016
  • A sialo-cutaneous fistula is a communication between the skin and a salivary gland or duct discharging saliva. Trauma and iatrogenic complications are the most common causes of this condition. Treatments include aspiration, compression, and the administration of systemic anticholinergics; however, their effects are transient and unsatisfactory in most cases. We had a case of a patient who developed an iatrogenic sialo-cutaneous fistula after wide excision of squamous cell carcinoma in the parotid region that was not treated with conventional management, but instead completely resolved with the injection of botulinum toxin. Based on our experience, we recommend the injection of botulinum toxin into the salivary glands, especially the parotid gland, as a conservative treatment option for sialo-cutaneous fistula.