• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.61.1-61.8
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• 2019

Background: The prognosis of recovery following microneurosurgery for injured lingual nerves varies among individual cases. This study aimed to investigate if recovery ratios of sensory and taste functions are improved by the microneurosurgery within 6 months after lingual nerve injury. Methods: We retrospectively assessed 70 patients who underwent microneurosurgery at the Wakayama Medical University Hospital for lingual nerve injuries between July 2004 and December 2016. Sensory and taste functions in lingual nerves were preoperatively evaluated using a static two-point discrimination test, an intact superficial pain/tactile sensation test, and a taste discrimination test. They were evaluated again at 12 and at 24 months postoperatively. The abundance ratio of Schwann cells in the excised traumatic neuromas was analyzed with ImageJ software following immunohistochemistry with anti S-100β antibody. Results: In early cases (microneurosurgery within 6 months after the injury), recovery ratios of sensory and taste functions were not significantly different at 24 months after microneurosurgery compared with later cases (microneurosurgery more than 6 months after the injury). Meanwhile, the ratio of patients with taste recovery within 12 months after microneurosurgery was significantly decreased in late cases compared with early cases. The abundance ratio of Schwann cells in traumatic neuroma was also significantly lower in later cases. Conclusion: Microneurosurgery more than 6 months after lingual nerve injury did not lead to decreased recovery ratio of sensory and taste functions, but it did lead to prolonged recovery of taste. This delay may be associated with a decrease in the abundance ratio of Schwann cells in traumatic neuromas.

• International Journal of Oral Biology
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• 제31권3호
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• pp.87-92
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• 2006

Schwann cells play an important role in peripheral nerve regeneration. Upon nerve injury, Schwann cells are activated and produce various proinflammatory mediators including IL-6, LIF and MCP-1, which result in the recruitment of macrophages and phagocytosis of myelin debris. However, it is unclear how the nerve injury induces Schwann cell activation. Recently, it was reported that necrotic cells induce immune cell activation via toll-like receptors (TLRs). This suggests that the TLRs expressed on Schwann cells may recognize nerve damage by binding to the endogenous ligands secreted by the damaged nerve, thereby inducing Schwann cell activation. To explore the possibility, we stimulated iSC, a rat Schwann cell line, with damaged neuronal cell extracts (DNCE). The stimulation of iSC with DNCE induced the expression of various inflammatory mediators including IL-6, LIF, MCP-1 and iNOS. Studies on the signaling pathway indicate that $NF-{\kappa}B$, p38 and JNK activation are required for the DNCE-induced inflammatory gene expression. Furthermore, treatment of either anti-TLR3 neutralizing antibody or ribonuclease inhibited the DNCE-induced proinflammatory gene expression in iSC. In summary, these results suggest that damaged neuronal cells induce inflammatory Schwann cell activation via TLR3, which might be involved in the Wallerian degeneration after a peripheral nerve injury.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권1호
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• pp.83-89
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• 2008

Purpose: Different patterns in the causes of maxillofacial injury are thought to correlate with socioeconomic status and regional environment. This study investigated maxillofacial fractures in order to analyze maxillofacial trauma characteristics and the relationship between the causes and injury patterns in Korea. Material and methods: A total of 518 patients with maxillofacial fractures who were treated at the Seoul National University Boramae Hospital between 1996 and 2004 were retrospectively analyzed. Data were obtained from the patients' medical records and radiographs. The male to female ratio in the patient group was 2.78:1, and the mean age was 32.3 years. Results: Midfacial fractures were the most common location of injury (46.1%). The most common etiologic factor was an activity associated with daily life (42.6%) including falls, stumbling, and collisions. The second most common cause was assault (32.4%), followed by traffic accidents (13.7%). In the case of midfacial fractures and mandibular fractures, assault was the most common etiologic factor, whereas in the case of alveolar bone fractures, activities associated with daily life were the most common cause. With regard to age groups, assault was the most common cause for patients between 10 and 39 years old and an activity associated with daily life was the most common cause in those under 10 years and over 40 years. Conclusions: This study concluded that activities associated with daily life and assault causes a large proportion of Korean maxillofacial injuries and that preventive measures should be implemented in order to minimize these risks.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권3호
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• pp.264-276
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• 1995

This is a clinical and retrospective study on the patients with oral and maxillofacial trauma. This study was based on a series of 917 patients were treated as in-patients, at Chon-buk National University Hospital, during the period of Jan., 1989 through Dec., 1993. The results obtained were as follows : 1. The ratio of men to women were 3.59 : 1 in oral and maxillofacial injuries, 3.92 : 1 in facial bone fractures, and 3.18 : 1 in soft tissue injuries. 2. The oral and maxillofacial injuries occurred most frequently in the third decade(32.2%), and fourth, second, fifth decade in orders. 3. The major etiologic factors were traffic accident(57.4%) and fall-down(17.1%), interpersonal accident(16.6%), and industrial accident were next in order of frequency. 4. The incidence of facial bone fracture was 72.1%, soft tissue injury 58.8%, and dental injury 40.5%. 5. The most common site of fracture were mandible(62.9%) and maxilla(19.9%), zygoma and zygomatic arch(18.7%), and nasal bone(4.7%) were next in order of frequency. 6. The most common type of soft tissue injury was laceration(51.0%). The lesion of soft tissue injuries were mostly 1 or 2 lesions and deep.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권4호
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• pp.286-289
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• 2002

In the treatment of mandibular condylar fractures, arthrocentesis, lavage and selective intermaxillary fixation were performed after closed reduction. In this lavage group, the physiotherapy performed for 3-6 months after injury. in control group, continuous intermaxillary fixation was done for 1-3 weeks, and physiotherapy followed in the same method of the lavage group. In the comparative study of the both groups, the following results are shown. 1. Compared to control group, the lavage group had a slightly superior result at range of motion, joint pain and occlusal deviation, from I day after arthrocentesis to 6 months after injury. 2. The significant differences between both groups were seen at range of motion and joint pain in 1 month after injury. 3. At 6 months after injury, the differences between both groups were not significant at range of motion, joint pain and occlusal deviation. From this study, in the mandibular condylar fracture, the arthrosentesis, lavage and selective intermaxillary fixation after closed reduction can improve symptoms such as joint pain and occlusal deviation, also increase range of motion. in this therapeutic way, intracapsular hemarthrosis which can cause TMJ ankylosis or dysfunction can be removed effectively. in addition, patient's discomfort such as swallowing disturbance, speech disturbance and emotional stress can be reduced signuficantly.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권1호
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• pp.43-52
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• 2010

Purpose: To research about maxillofacial traumatic injuries of children in aspects of gender difference, various incidence rates between age, trauma type, cause, monthly and daily incidence rate, type of tooth damage, gingival damage, soft tissue damage, and type of facial bone fracture. Materials and methods: Study group consisted of children under 15 years of age who visited Dental Hospital, School of Dentistry, Kyung Hee University from 2004/7/1 to 2007/6/30 with chief complaint of oral and maxillofacial traumatic injuries. 1,559 cases of traumatic injuries were studied from 1,556 (1,004 male, 552 female) children. Conclusion: 1. There were slightly more boys than girls, giving a male-to-female ratio of 1.82:1.0. The 1-3 year old boys and girls had the highest number of traumatic injuries. 2. Of the 1,556 patients, 68.63% had soft tissue injuries, 50.22% had periodontal injuries, 29.89% had teeth injuries, and 3.85% had maxillofacial bone fractures. 3. Falling down was the most common cause of injury in both sexes. 4. The months with the highest incidence rates were in order May (12.12%), June (11.74%), and October (11.13%). Most of the injuries occurred on weekends. 5. The most common tooth injury was uncomplicated crown fracture, and the most common periodontal injury was subluxation. The majority of traumatizes teeth were the upper central incisors. 6. The most common soft tissue injury was intraoral lacerations. 7. Mandibular fractures were most frequent in facial bone fractures; symphysis, condylar head, and angle fractures were most frequent in mandibular fractures; maxillary and nasal bone fractures were most frequent in midfacial bone fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권3호
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• pp.247-258
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• 1994

We got this conclusion from an investigation about complications from 144 cases of 130 patients who were to be searched their personal records, admission chart, clinical laboratory sheet, anesthetic record, consult sheet and radiographic opinion. They had orthognathic surgery for maxillofacial deformity treatment at the department of oral and maxillofacial surgery in dental school of Kyung Hee university for 4 years and 10 months, from March 1989 to December 1993. 1. In the intraoperative phase, by the frequency of complication, blood vessel injury was found the most-22%, and then soft tissue injury, unfavorable osteotomy split, and there were some cases of tooth injury and inappropriate osteotomy. In the mandibular segmental osteotomy, blood vessel injury was found the most frequently-20 cases (27%), soft tissue injury, unfavorable osteotomy split were the second frequent cases, and then unfavorable fragment position was found. In the extraoral vertical ramus osteotomy and Le Fort I osteotomy also, blood vessel injury and nerve injury were found the most. 2. In the postoperative hospitalization phase, by the frequency of complication, hematoma (23%) was happened the most, except for that, lkie the complication that can be happened by adverse reaction of medicine or long hospital life. In the case of SSRO, there were 21 cases (20%) of hematoma, and this wal the most frequently case. In the case of EVRO, hematoma wasn't happened that much-2 case (4%). 3. In the follow up phase, relaps, numbness and TMJ dysfunction were happened. In mandibular surgery, the forward relapse percentage of point B, was 27% when used wire fixation on SSRO, was 15% by miniplate fixation on SSRO and was 7% on EVRO. In the case of SSRO, numbness was kind of high, comparing to ordinary surgery-12 cases(16 There were many difficulties in analyzing this data accurately, Although orthognathic surgery is done many times, only available date is from the "success" stories and data is not consistently recorded for the cases with complications. In this manner, much essential informantion is lost and overlooked. When data is charted including those cases that are seemingly insignificalt, we can have a much clearer understanding and more accurate guide on treatment protocols.

• 한국치위생학회지
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• 제13권4호
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• pp.561-568
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• 2013

Objectives : The purpose of this study is to examine the recognition and needs on the national health insurance coverage of scaling in industry accident injury patients. National health insurance coverage of dental scaling will start in September, 2013. Methods : Subjects were 649 industrial injury patients and they completed self-reported questionnaire. Data were analysed using SPSS version 20.0 for percentage, chi-square test, t-test, ANOVA, post-hoc Scheffe test, and Pearson's correlation coefficient. Results : Recognition on national health insurance coverage of dental scaling was not fully known to industrial injury patients (24.5%). Highly educated and high income workers seemed to recognize national health insurance coverage of dental scaling (p<.001). Recognition for national health insurance coverage of dental scaling revealed a significance (r=.576, p<.001). Most of the industrial injury workers thought that 50,000 to 100,000 Korean Won of dental scaling fee is reasonable. The coverage of dental scaling should be more than twice over 20 years old. Conclusions : It is necessary to encourage the patients to take regular dental scaling checkup and make them know the health insurance coverage of scaling. The preventive oral health care may improve oral health care and quality of life.

• Journal of Oral Medicine and Pain
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• 제42권4호
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• pp.109-115
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• 2017

Purpose: This study analyzed the effects of digastric muscle injury on mandibular growth in young rats. Methods: Fourteen 4-week-old Wistar rats were divided into 3 groups; experimental group A (n=6) with unilateral (right) shortening of the posterior digastric muscle, experimental group B (n=6) with bilateral shortening of the posterior digastric muscles, and control group C (n=2) who underwent a sham operation. Eight weeks after the operation all animals were sacrificed and the outcomes were compared using body weight evaluation, mensurations on lateral radiograph of hemimandibles and histological evaluation. Results: There was no significant difference between groups A and B in body weight gain. Comparison of the mean values of hemimandible distance on radiograph was performed. The difference in group mean value of mandible-related distances was analyzed using the Wilcoxon test (rank sum test) and a comparison of the homonymous distances of group A and B was performed using the Mann-Whitney test. There were differences between sides in mandibular length in group B and mandibular ramus height and transverse width of the condyle in group A (all, p<0.05). There were differences in condylar height and mandibular length on the left side between groups A and B (p<0.05). Histologic examination of temporomandibular joint showed similar findings in all specimens. Conclusions: Injury of the posterior belly of the digastric muscle during the rat growth period induced shortening of mandibular ramus height and transverse width of the condyle. It can be inferred that trauma to the posterior belly of the digastric muscle affects horizontal and vertical growth of the mandible.

• Journal of Oral Medicine and Pain
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• 제23권4호
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• pp.447-455
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• 1998

A 42-year old male patient was referred to the Department of Oral Medicine, Kyungpook National University Hospital due to the chief complaint of limite mouth opening. Three years ago, the patient was diagnosed as an infarction of both cerefellar hemispheres, acute obstructive hydrocephalus and acute epidural hematoma of frontal lobe at the department of neurosurgery.Both of the infarcted cerevellar hemispheres and the epidural hematoma of frontal lobe were removed with suboccipital and frontal craniectomu. After the brain surgery jaw opening range was decreased progressively and ultimately mouth opening became almost impossible. Spasmodic and rhythmic contractions of the masseter muscles occurred intermittently during daytime as well as sleeping. Food intake was available only through Levin -tube. Actibe jaw opening exercise was prescribed with the aids of tongue blades. A moist hot pack and indomethacin phonophesis were also applied 20 minutes three times a day to decrease discomfort muscle activities. After a month of treatments, the opening range was increased to 5mm at the premolar area and oral food intake was possibel. The L-tube was removed and the patient was discharged.