• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.4
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• pp.294-305
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• 2009

Purpose: This retrospective study evaluated the changes in hyoid bone and tongue positions as well as oral cavity volume after mandibular setback by BSSRO. Materials and Methods: 18 Koreans who underwent BSSRO to correct mandibular prognathism were studied. Lateral cephalograms were taken and traced preoperatively (T0), immediately (T1) and approximately 6 months postoperatively (T2). Submentovertex radiograghs were taken and traced before surgery (T0) and about 6 months after surgery (T2). The area and volume of oral cavity, the vertical and horizontal dimensions of the hyoid bone and tongue dorsum were measured. Results: Mandibular setback surgery resulted in a significant reduction of lower oral cavity volume. The hyoid bone displaced posteroinferiorly immediately after surgery, and it tended to return to its original vertical position at 6 month after mandibular setback by BSSRO. The retropalatal space around tongue was maintained and the retrolingual space around tongue was reduced immediately postoperatively. The readaptation of tongue was not evident for that the follow up period was not long enough. No significant statistical correlations between the amounts of mandibular setback and the changes of oral cavity volume were observed. Conclusion: Mandibular setback surgery resulted in a significant reduction of lower oral cavity volume, which was most likely attributable to the posterior movement of the mandible. More subjects and long-term observations should be performed to assess the changes of oropharyngeal configuration following mandibular setback surgery.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.11.1-11.5
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• 2018

Background: Squamous cell carcinoma (SCC) is the most commonly occurring malignant tumor in the oral cavity. In South Korea, it occurs most frequently in the mandible, tongue, maxilla, buccal mucosa, other areas of the oral cavity, and lips. Radial forearm free flap (RFFF) is the most widely used reconstruction method for the buccal mucosal defect. The scar of the forearm donor, however, is highly visible and unsightly, and a secondary surgical site is needed when such technique is applied. For these reasons, buccal fat pad (BFP) flap has been commonly used for closing post-surgical excision sites since the recent decades because of its reliability, ease of harvest, and low complication rate. Case presentation: In the case reported herein, BFP flap was used to reconstruct a cheek mucosal defect after excision. The defect was completely covered by the BFP flap, without any complications. Conclusion: Discussed herein is the usefulness of BFP flap for the repair of the cheek mucosal defect. Also, further studies are needed to determine the possibility of using BFP flap when the defect is deep, and the maximum volume that can be harvested considering the changes in volume with age.

• The korean journal of orthodontics
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• v.53 no.3
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• pp.175-184
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• 2023

Objective: To evaluate and compare a series of volume changes in the nasal cavity (NC), nasopharynx, oropharynx, and maxillary sinuses (MS) in growing Class III patients after either rapid palatal expansion (RPE) or alternate rapid maxillary expansion and constriction (Alt-RAMEC) followed by facemask (FM) therapy, by using cone-beam computed tomography (CBCT). Methods: Forty growing Class III patients were retrospectively selected and divided into two matched groups: RPE/FM (14 females, 6 males; mean age, 9.66 ± 1.23 years) and Alt-RAMEC/FM groups (14 females, 6 males; mean age, 10.28 ± 1.45 years). The anteroposterior and vertical displacements of Point A, the volumes of the NC, nasopharyngeal, oropharyngeal, and MS were measured at different time points: pretreatment (T1), postexpansion (T2), and postprotraction (T3). Results: Both groups demonstrated significant maxilla advancement (by 1.3 mm) during expansion, with a statistically significant intergroup difference during protraction (RPE/FM, 1.1 mm; Alt-RAMEC/FM, 2.4 mm; p < 0.05) and throughout the treatment (RPE/FM, 2.4 mm; Alt-RAMEC/FM, 3.7 mm; p < 0.05). NC and nasopharyngeal airway volumes increased significantly in both groups after expansion, protraction, and treatment. The oropharyngeal and MS volumes increased in both groups after protraction and post-treatment. However, no volumetric differences were observed between the two groups. Conclusions: There was no significant difference in airway volume changes, including NC, nasopharyngeal, oropharyngeal airway, and MS, between RPE/FM and Alt-RAMEC/FM groups at different time points. Although there was significantly more forward movement after protraction in the Alt-RAMEC/FM group, the difference was deemed too small to be clinically relevant.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.2
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• pp.164-171
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• 2000

Purpose : This study was aimed at measuring the changes in the hyoid bone position, tongue position, and pharyngeal airway space in subjects with mandibular setback osteotomies. Methods : Twenty patients were evaluated retrospectively for their changes in pharyngeal airway space, tongue and hyoid bone positions. All patients underwent surgical mandibular setback using bilateral sagittal split osteotomies. The cephalometric analysis was performed preoperatively, and 1 week, 3-6 months, and 1 year postoperatively. Result : The hyoid bone moved inferiorly and posteriorly immediately after surgery, and it returned to the preoperative position during follow-up period. The nasopharyngeal airway space was not significantly changed after surgery. A considerable decrease in the oropharyngeal and hypopharyngeal airway spaces following mandibular setback surgery was found. The upper and lower tongue was posteriorly repositioned immediately after surgery. During follow-up period, the hypopharyngeal airway space and lower tongue posture returned to the preoperative positions, but the oropharyngeal airway space and upper tongue posture were not significantly changed. The position of pogonion remarkably changed to backward immediately after surgery, but slightly anterior advancement was found during follow-up period. Conclusion : Immediately after mandibular setback surgery, the oropharyngeal and hypopharyngeal airway spaces obviously decreased due to posterior and inferior repositions of the tongue and hyoid bone. During follow-up period, lower tongue and hyoid bone returned to the preoperative positions, it was related to advancement of the pogonion in this period. The narrowing of the oropharyngeal airway space and posterior movement of the upper tongue posture were relatively permanent after mandibular setback surgery. We suspected this phenomenon had an influence on maintaining the total volume of oral cavity against mandibular setback.

• Imaging Science in Dentistry
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• v.42 no.2
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• pp.83-88
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• 2012

Purpose : The aim of this study was to investigate the initial effects of maxillary expansion therapy with Hyrax appliance and to evaluate the related changes in maxillary sinus volume. Materials and Methods : Thirty patients (20 females, 10 males; 13.8 years) requiring maxillary expansion therapy, as part of their comprehensive orthodontic treatment, were examined. Each patient had cone-beam computed tomography (CBCT) images taken before (T1) and after (T2) maxillary expansion therapy with a banded Hyrax appliance. Multiplanar slices were used to measure linear dimensions and palatal vault angle. Volumetric analysis was used to measure maxillary sinus volumes. Student t tests were used to compare the pre- and post-treatment measurements. Additionally, differences between two age groups were compared with Mann-Whitney U test. The level of significance was set at p=0.05. Results : Comparison of pre-treatment to post-treatment variables revealed significant changes in the transverse dimension related to both maxillary skeletal and dental structures and palatal vault angle, resulting in a widened palatal vault (p<0.05). Hard palate showed no significant movement in the vertical and anteroposterior planes. Nasal cavity width increased on a mean value of 0.93mm(SD=0.23, p<0.05). Maxillary sinus volume remained virtually stable. No significant age differences were observed in the sample. Conclusion : Hyrax expansion therapy did not have a significant impact on maxillary sinus volume.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.5
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• pp.401-406
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• 2011

Purpose: The purpose of this study was to investigate changes in the position of the hyoid bone and soft palate and the amount of airway space after bilateral sagittal split ramus osteotomy (B-SSRO). Methods: This study is a review of lateral cephalometric tracings of 30 patients who underwent B-SSRO with setbacks at Kyunghee Dental Hospital from 2005 to 2009. Lateral cephalograms were taken before (T0), within one month (T1), and more than six months after the surgery (T2). Results: The hyoid bone at T1 changed significantly towards the inferoposterior position. At T2, it had significantly moved superiorly, but not anteriorly. At T1, the nasopharyngeal space, extending from the posterior nasal spine to the posterior pharyngeal space, decreased significantly, but did not show a significant increase at T2. The nasopharyngeal space, extending from the middle of soft palate to the posterior pharyngeal space, decreased significantly at T1, but did not show a significant decrease at T2. The oropharyngeal airway space decreased significantly at T1 and did not return to its original position at T2. The hypopharyngeal space, extending from the anterior to the posterior pharyngeal space at the level of the most anterior point of the third cervical vertebrae, slightly decreased at T1, but the amount was insignificant; however, the amount of decrease at T2 was significant. The hypopharyngeal space extending from the anterior to the posterior pharyngeal space at the level of the lowest point of the third cervical vertebrae, decreased significantly at T1 but returned to its original position at T2. Conclusion: B-SSRO changes the position of the hyoid bone and muscles inferoposteriorly. These change allows enough space for the tongue and prevent airway obstruction. Airway changes may be related to post-operative edema, posterior movement of the soft palate, anteroposterior movement of the hyoid bone, or compensation for decreased oral cavity volume. The position of the pogonion which measures anterior relapse after surgery did not show significant differences during the follow-up period.

• Journal of Oral Medicine and Pain
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• v.39 no.2
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• pp.69-77
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• 2014

Purpose: It aims to verify the applicability of existing age estimation methods derived from data of foreign population groups to Korean population groups. Moreover it is to suggest a new way applicable to practical age estimation on the basis of newly calculated regression formulae from data of Korean population groups and develop a subsidiarily applicable method to the existing method. Methods: Ratio of pulp cavity to dental crown was calculated by measuring the height and width of dental crowns and pulp cavities at the cervical line from 4,034 first and second upper molars, first and second upper premolars, first and second lower molars and first and second lower premolars on both left and right sides of 400 patients who had been treated in Dental Hospital of Yonsei University College of Dentistry, and regression equations were derived from the values of the ratio. Results: The equation with correlation coefficients the highest among females was as follows: age=$107.96-75.684{\times}{\sharp}17$ TCHI-$53.741{\times}{\sharp}26$ TCVI-$40.664{\times}{\sharp}45$ TCVI-$56.307{\times}{\sharp}46$ TCVI. Randomized anohter Korean female subjects (n=20) are applicated to the new equation. Mean of error of estimate is 10.322 years, standard deviation is 12.852 years. Minimum of error of estimate is 1.018 years, maximum is 21.365 years Conclusions: The error range of age estimation was found to be slightly wider when the existing regression formulae of Drusini were applied to Korean population groups. Also age estimation in females using the ratio of pulp cavity to dental crown measured with the length and width of dental crowns and pulp cavities from maxillomandibular molars was observed to have the highest reliability in the research. However, we consider that advanced equations of regression are needed to apply to both molars and premolars of males and females in the future.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.41-49
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• 2011

Purpose: This study is designed to investigate radiotherapic valuation of Paraffin Wax, which is newly formed for this study and generally utilized in dentistry, and Mouth Piece and Putty impression, which are commonly used in radiotherapy, for oral cavity as a compensator. Materials and Methods: Each compensator was formed by $10{\times}10{\times}1cm$ and measured radiation dose attenuation ratio with reference of water phantom which is made of tissue-equivalent materials. Two patients with oral cancer underwent DRR (Digitally Reconstructed Radiogrph) of Offline Review Program of Aria System and Portal vision for 5 times for each material to evaluate reproducibility by each filling materials. Moreover, MU (monitor unit) changes by dose absorption were considered in the case of inevitable implication of an filling materials in the range for radiotherapy. Results: Radiation dose attenuation ratios were shown -0.7~+3.7% for Mouth Piece, +0.21~+0.39% for Paraffin Wax and -2.71~-1.76% for Putty impression. Error ranges of reproducibility of positions were measured ${\pm}3mm$ for Mouth Piece, ${\pm}2mm$ for Paraffin Wax and ${\pm}2mm$ mm for Putty impression. Difference of prescription MU from dose absorption with an filling material increased +7.8% (250 MU) in Putty impression and -0.9% (230 MU) in Paraffin Wax as converted into a percentage from the standard phantom, Water 232 MU. Conclusion: Dose reduction of boundary between cavity and tissue was observed for Mouth Piece. Mouth Piece also had low reproducibility of positions as it had no reflection of anatomy of oral cavity even though it was a proper material to separate Maxilla and Mandible during therapy. On the other hand, Putty impression was a suitable material to correctly re-position oral cavity as before. However, it risked normal tissues getting unnecessary over irradiation and it caused radiation dose decrease by -2.5% for 1cm volume in comparison of it of water phantom. Dose reduction in Paraffin Wax, Fat Tissue-Equivalent Material, was smaller than other impressions and position reproducibility of it was remarkable as it was possible to make an anatomy reflected impression. It was also well fitted to oral cavity to transfer radiation dose planned in radiotherapy. Thus, Paraffin Wax will be an ideal material in radiotherapy for patients with oral cancer.

• Journal of Oral Medicine and Pain
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• v.30 no.4
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• pp.457-464
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• 2005

The purpose of our study was to investigate whether the intrapulpal temperature during cavity preparation of enamel or dentin with Er:YAG laser still remained in range of safety for dental pulp protection when combined with appropriate water flow rate. The effect of different pulse repetition rates at the same pulse energy during ablation was evaluated as well. Caries-free, restoration-free extracted human molar teeth were prepared for the specimen and divided two experimental groups of enamel and dentin. Each group comprised 5 specimens and each of tooth specimens were embedded into a resin block each and measuring probe was placed on the irradiated pulpal walls. For experiments of dentin ablation, enamel layers were prepared to produce dentin specimen with a same dentin thickness of 2 mm. A pulse energy of Er:YAG laser was set to 300 mJ and three different pulse repetition rates of 20 Hz, 15 Hz and 10 Hz were employed. Laser beam was delivered with 3 seconds and less per application over enamel and dentin surfaces constant sized by $3\;mm{\times}2\;mm$ and water spray added during irradiation was a rate of 1.6 ml/min. Temperature change induced by Er:YAG laser irradiation was monitored and recorded While enamel was ablated, there was no significant difference of temperature related to pulse repetition rates(p=0.358) and temperature change at any pulse repetition rate was negligible. Significant statistical difference in temperature changes during cavity preparation in dentin existed among three different pulse groups(p=0.001). While temperature rise was noticeable when the dentinal wall was perforated, actual change of temperature due to Er:YAG laser irradiation was not enough to compromise safety of dental pulp when irradiation was conjugated with appropriate water spray. Conclusively, it can be said that cavity preparation on enamel or dentin with an Er:YAG laser is performed safely without pulp damage if appropriate volume of water is sprayed properly over the irradiated site.

• Journal of Life Science
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• v.20 no.10
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• pp.1519-1524
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• 2010

Apigenin (4', 5, 7-trihydroxyflavone), a common dietary flavonoid abundantly present in fruits and vegetables, has shown remarkable anti-proliferative effects against various malignant cell lines. To observe the anti-proliferative effects, oral cavity cancer cell lines, $6{\times}10^3$ cells/well (96 well plate) of KB oral cavity tumor cells were plated and 24 hr later treated with apigenin for one day, after which MTT assay was performed. Apigenin induced cell death in a dose-dependent manner after incubation. Cell viability was significantly decreased in the group treated with 100 ${\mu}M$ apigenin for 24 hr (p<0.05) compared to the control group. To assess apoptosis, the nuclei of KB cells were stained with DAPI. The presence of chromatin condensation in the apigenin treated cells was detected on a fluorescent microscope (${\times}200$). We investigated the in vivo growth inhibitory effects of apigenin on oral cavity cancer KB tumor xenograft subcutaneously implanted in male nude mice. Apigenin was administered to mice by gavage at doses of 25 and 50 mg/kg/day in 0.2ml of PBS. Tumor volume was significantly decreased in 25 and 50 mg/kg apigenin-administration groups compared to the control group. For apoptosis analysis, TUNEL staining was performed. A significant increase in TUNEL positive cells was found in the 25 mg/kg apigenin administration group compared to the non- apigenin administration group. Histopathological changes were not observed. These results indicate that apigenin inhibits oral cavity cancer cell growth through the induction of apoptosis.