• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.251-259
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• 2020

Oral and maxillofacial infection is a common complication in patients undergoing chemotherapy. The treatment of oral diseases in such patients differs from that administered to healthy patients. This paper reports a case of acute osteomyelitis of odontogenic origin following a recent chemotherapy session. The patient's condition was life-threatening because of neutropenic fever and sepsis that developed during the inpatient supportive care. However, the patient showed prompt recovery within 40 days following the use of appropriate antibiotics and routine dressing, without the requirement for surgical treatment, except tooth extraction. As seen in this case, patients undergoing chemotherapy are more susceptible to rapid progression of infections in the oral and maxillofacial areas. Therefore, accurate diagnosis through prompt clinical and radiological examination, identification of the extent of infection, and assessment of the patient's immune system are crucial for favorable outcomes. It is also necessary to eliminate the source of infection through appropriate administration of antibiotics. In particular, a broad-spectrum antibiotic with anti-pneumococcal activity is essential. Proper antibiotic administration and wound dressing are essential for infection control. Furthermore, close consultation with a hemato-oncologist is necessary for effective infection management based on the professional evaluation of patients' immune mechanisms.

• Journal of the korean academy of Pediatric Dentistry
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• v.24 no.3
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• pp.678-687
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• 1997

Cystic lesions of the mandible are fairly common and usually a presumptive diagnosis is made readily, more often on the basis of roentgenographic appearance than by any other means. Occasionally, however, it is easy to fall into errors of diagnosis which may affect one's choice of treatment. The diagnosis in these situations are usually resolved by the histopathologic examination of material obtained by surgical exploration. The present discussion to the lesions which can be most easily confused in the roentgenographic interpretation, that is, the traumatic bone cyst, the dentigerous cyst, the radicular cyst. These lesions often grow to considerable size before they cause any subjective or objective symptoms. Less frequently, perhaps, the patient presents himself with the complaint of enlargement of the affected part, a discharge, or pain. On rare occasions the first sign is fracture through the cyst cavity. In any case, an adequate roentgenographic survey by means of extraoral films is essential. This is the primary means of diagnosis. The three lesions in mandible, reported here, resembled each other roentgenographically in that they were osteolytic lesions. The follicular and radicular cysts usually have a smooth periphery and may be surrounded by a white line. The follicular cyst, slow-growing lesions, is usually associated with an unerupted tooth. The radicular cyst, the most common type of the odontogenic cyst, is always associated with a nonvital tooth, or it may persist as a "residual" radicular cyst after the causative tooth has been extracted. The traumatic bone cyst can often be differentiated from the first two in that the periphery is less definite and is irregular. It is thought that because it does not occur in older people, the lesion is self-limiting and heals spontaneously if left alone.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.1
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• pp.84-89
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• 2012

The radicular cyst is the most common odontogenic cyst which is caused by pulpal inflammation, pulp death, and secondary to trauma or dental caries. Usually, the radicular cyst is asymptomatic, but a secondary inflammation can cause pain, swelling and redness. Getting larger, the radicular cyst can cause facial asymmetry and paresthesia by pressure on nerves. It requires conservative endodontic treatment or surgical approach. When the size of cyst is large or invasion of the adjacent tissue is not expected, cyst enucleation is carried out. And most of the case can be completely cured and shows low recurrence. In these radicular cysts cases, by cyst enucleation or apicoectomy after root canal treatment simultaneously, the infected teeth can be preserved successfully.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.2
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• pp.86-90
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• 2023

Objectives: An ectopic tooth is a rare eruption of a tooth out of the normal dental apparatus and occurs commonly with the third molar. Thus, in this study, we reported a case series of ectopic teeth in rare jaw locations and highlight the associated pathology and our experience in the surgical management. Patients and Methods: All cases of ectopic tooth managed at the Department of Oral and Maxillofacial Surgery, University of Maiduguri Teaching Hospital from January 2011 to December 2020 were reviewed. The information retrieved includes biodata, location of the ectopic tooth, signs, symptoms, type of tooth and associated pathology, surgical approach and complications. Results: Ten cases of ectopic teeth were identified over the study period. This comprised 80.0% males with a mean age was 23.3 years. The antrum and lower border of the mandible accounted for 50.0% and 40.0% of the ectopic locations, respectively. Dentigerous cyst was the most associated pathology (70%) and usually presented with pain and swelling. Surgical intervention predominantly via the intraoral route was performed if indicated. Conclusion: Ectopic teeth are rare and not always associated with pathology. A high index of suspicion and radiological investigation are necessary for diagnosis. A more extensive multi-center study is however recommended to determine the prevalence of ectopic teeth other than the third molar.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.82-88
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• 2008

Background: Descending necrotizing mediastinitis (DNM) is a serious disease originating in odontogenic or oropharyngeal infection with high mortality despite adequate antibiotics and aggressive surgery. We analyzed results of treatment for DNM. Material and Method: We studied 8 cases diagnosed as DNM from 1998 to 2007. All patients received emergent surgical drainage and debridement with broad spectrum antibiotics just after diagnosis. Antibiotics were changed after bacterial susceptibility testing. The surgical approach included 2 cases of cervicotomy, 6 cases of cervicotomy, and a thoracotomy. Result: The interval between symptom onset and hospitalization was $4.6{\pm}1.8$ days ($1{\sim}9$ day). DNM originated in 4 cases of odontogenic infection (50%), 2 cases of oropharyngeal infection (25%), and 2 cases of unknown origin (25%). Causative organisms were found in 6 cases; Streptococcus in 4 cases, Staphylococcus in 1 case, and Klebsiella in 1 case. The Endo DNM classification was type I (2 cases), IIA (3 cases), and IIB (3 cases). The incidence of thoracotomy was 75%. The surgical mortality rate was 25% (2/8). The cause of death was multiple organ failure caused by septic shock. All mortality cases received only cervicotomy and aggravated infections after initial drainage. Conclusion: Early diagnosis, immediate surgical drainage, and adequate antibiotics, including covered anaerobes, are required. Thoracotomy should be performed with cervicotomy even for localized DNM.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.2
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• pp.194-201
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• 2011

A dentigerous cyst is the most common developmental odontogenic cyst. Patients with dentigerous cyst usually feel no pain or discomfort. If it is not treated, tooth eruption might not only be impeded, but also let the tooth translocate to the unusual area. So, early detection and appropriate treatment are important. Enucleation & marsupialization are the best options to treat a dentigerous cyst. Treatment plan depends on patient's age, health, preserve & protect of important structures, and sort of cyst. In these dentigerous cysts cases, by marsupialization and using obturator, affected tooth could be achieved spontaneous eruption into the dental arch even though they were badly dislocated.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.4
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• pp.306-313
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• 2014

Impacted teeth are teeth with a delayed eruption time or that are expected to erupt incompletely. Those teeth can cause a series of potential problems such as root displacement and resorption, periodontal problems in adjacent teeth, referred pain and the formation of cysts and odontogenic tumors. The purpose of this study was to investigate characteristics and treatment of child and adolescent patients younger than 15 years of age that were diagnosed with an impacted tooth who visited the Chosun University Dental Hospital. The impacted tooth, its etiology, treatment and traction period were surveyed through electric medical records, radiographs in 335 patients. We excluded the impacted third molar, supernumerary and deciduous teeth from this study. The most frequently impacted teeth are upper canine, followed by the upper incisor. The most common etiologies of impaction were an abnormal eruption pathway and localized pathologic lesions. The treatment of an impacted tooth was mostly orthodontic traction. The traction period was relatively short in cases with distinct obstacles, with an impacted upper incisor and if patients were younger. An orthodontic traction is considered to be more unfavorable if the patient gets older. Therefore, an early diagnosis and a precise treatment plan through a regular check-ups are mandatory.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.2
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• pp.53-59
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• 1989

The ameloblastoma is the most common form of the odontogenic tumors exhibiting minimal inductive change in connective tissue, it comprising 1% of all tumor and cysts of the jaws. It is a true neoplasm, generally considered to be a benign but persistent or, locally malignant lesion. The tumor occurs most commonly in persons between the age of 20 and 50 years. 80% and 90% of all lesions are in the mandible. The presenting clinical signs and symptoms of the ameloblastoma very from patient to patient, but most common symptom was swelling, followed by pain, draining sinuses, and superficial ulcerations. It is slow-growing lesion, and the radiographic features of the ameloblastoma depend large one the nature and the local bone reaction to the particular tumor. Recurrence rate is about 33%, but this is probably due to incommplete initial removal of lesion. We had operated a patient ; 29-year-old female immediate reconstruction combined with autocompression plate and iliac bone graft and screw fixation after hemimandibulaectomy with recurred ameloblastoma involving from premolar to ascending ramus at right side mandible. We obtained favorable results of good function, short intermaxillary fixation periods and easy operation precedure than the other reconstruction methods.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.1
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• pp.1-6
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• 2014

Purpose: This study was designed for identification of the main clinicopathological features of cysts in the oral and maxillofacial regions. Methods: A retrospective observational study was conducted on 164 patients who had been diagnosed with cyst of the jaw, from the database of 168 histopathological diagnoses at the Department of Oral and Maxillofacial Surgery of Busan Paik Hospital at Inje University, from January 2009 to December 2011. The subjects were treated and the following variables were recorded: gender, age, clinical signs and symptoms, histopathological distribution, treatment methods, and complications. A descriptive analysis of the study variables was performed using a chi-square test. Results: Among the 164 patients, there were more male than female patients (male-female ratio: 1.7:1). The most predominant ages were the 20s and 40s. Among the classes of pathological cysts, radicular cysts and dentigerous cysts were the most common, with incidences of 56.0% and 35.1%. Thirty-six percent of the patients had no symptoms; and of those who had symptoms, the main signs and symptoms were swelling (24.4%) and pain (17.1%). The most frequent management method was the combination operation, such as enucleation with or without extraction and apicoectomy of the causative teeth. Of the 164 patients, 13 had complications; and one patient who had been treated with enucleation with apicoectomy had a recurrent cyst. Conclusion: Using a chi-square test, no significant differences in prevalence were observed in relation to gender according to age. Comparative analysis of radicular and dentigerous cysts showed a significant difference in their prevalence according to their anatomical location, however, no significant differences in were observed in their incidence rates according to age.