• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권5호
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• pp.315-317
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• 2022

Osseous metaplasia is defined as the formation of lamellar bone inside soft tissue structures where bone normally does not exist. It results from the transformation of non-osseous connective tissue into mature bone. This condition is rare in the oral and maxillofacial region. We report a case of osseous metaplasia of the maxilla, a rare benign tumor in an uncommon region. A 60-year-old male patient visited our clinic complaining of foreign body sensation and asymptomatic swelling on the right palatal side. However, he did not experience pain and reported no local trauma that he could remember. Intra-oral examination revealed an exophytic lesion on the right palatal portion. On computed tomography, there was a round hard-tissue mass approximately 2 cm in diameter on the right palate area. The mass was biopsied and diagnosed as an osseous metaplasia. We review the clinical, radiographic, and histologic features and common causes of osseous metaplasia and report a rare case of osseous metaplasia of the palate.

• 치과방사선
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• 제24권2호
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• pp.381-390
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• 1994

The purpose of this study was to determine whether any similarity existed in craniofacial morphology between parents and offspring in cleft lip with or without cleft palate. Thirty three measurements of the various regions of cranium and face were obtained from lateral cephalometric radiograms in 28 families comprising 28 fathers, 28 mothers and 28 cleft patients. The measurements of cleft patients were compared with those of their fathers, mothers and midparents. The obtained results were as follows: 1. There were similar measurements between the cleft patients and their fathers; rama1 height(Ar-Go), mandibular angle(∠MP-RP). 2. There were similar measurements between the cleft patients and their mothers; cranial base angle(∠NSBa), relation of maxilla to the cranial base(∠SNA), relation of maxilla to the cranial base(soft tissue:∠BaN'Sn), angle of inferior border of mandible(∠SNL-MP) and convexity of nose apex(soft tissue:∠N'PmPog'). 3. There were similar measurements between the cleft patients and their midparents; ramal height (Ar-Go), cranial base angle( ∠NSBa), relation of maxilla to the cranial base(soft tissue: ∠BaN'Sn), Y axis angle(∠NSGn) and mandibular angle(∠MP-RP). 4. There was no similar measurements between the cleft patients and their fathers and mothers simultaneously.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.137-146
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• 2020

Background: Mandibular third molar removal is the most common surgical procedure encountered in oral and maxillofacial clinics. It also presents the greatest challenges and controversies for surgeons when surgical removal is considered. Furthermore, diverse anesthesia results and success rates are achieved after using the same concentrations of different solutions or the same amounts of local anesthetics. The purpose of this study was to examine the efficiency of using double-cartridge (3.4 ml) 4% lidocaine (high concentration) and 4% articaine with a 1:100000 epinephrine infiltration in the retromolar region for impacted lower third molar surgery. Methods: This double-blind study included 30 patients with symmetrically impacted lower third molars. The patients were randomly selected to receive 4% articaine on one side and 4% lidocaine on the other, as a local anesthetic for third molar surgery. The onset, duration of soft-tissue numbness, pulpal sensitivity, amount of additional local anesthetic needed, pain score during the surgical procedure, and duration of the operation were recorded. Results: The results of this research indicate that 86.7% of the operations in the 4% articaine group and 83.3% of those in the 4% lidocaine group were successful. Furthermore, the outcomes in both groups were not statistically significant (P > 0.05). Numbness onset occurred faster in the articaine group than it did in the lidocaine group. However, the duration of soft-tissue anesthesia and pain scores recorded immediately postoperatively were similar. Conclusion: It is concluded that 4% lidocaine and 4% articaine had a similar infiltration efficacy in the retromolar region and both local anesthetics are adequate for impacted lower third molar surgery. There were no statistically significant differences between the two local anesthetics regarding pain control and the duration of soft-tissue numbness during the procedure.

• 치과방사선
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• 제29권2호
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• pp.549-559
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• 1999

Leiomyosarcoma is extremely rare in the oral cavity and especially in the mandible. At first. the case of this report was diagnosed as odontogenic fibroma but after approximately 3.5 years. it was diagnosed as leiomyosarcoma. Conventional radiograph of the first time showed an ill-defined radiolucent lesion in the mandible. After local recurrence. CT images showed a large irregular soft tissue mass with some necrotic areas. These findings were not specific for leiomyosarcoma, but they suggested that this lesion was a recurrent soft tissue sarcoma. Histopathological examinations using H & E staining, immunohistochemical staining and Masson's trichrome staining confirmed this case as leiomyosarcoma. Deciding its malignancy or benignancy, defining the tumor extent and its relationship to the surrounding anatomic structures, and evaluating the distant metastasis are more important roles of radiographic examination than finding out the name of disease.

• Imaging Science in Dentistry
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• 제47권4호
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• pp.275-279
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• 2017

Soft tissue calcification is a pathological condition in which calcium and phosphate salts are deposited in the soft tissue organic matrix. This study presents an unusual calcification noted in the cartilaginous portion of the Eustachian tube. A 67-year-old woman presented for dental treatment, specifically for implant placement, and cone-beam computed tomography (CBCT) was performed. The CBCT scan was reviewed by a board-certified oral and maxillofacial radiologist and revealed incidental findings of 2 distinct calcifications in the cartilaginous portion of the Eustachian tube. To the authors' knowledge, no previous study has reported the diagnosis of Eustachian tube calcification using CBCT. This report describes an uncommon variant of Eustachian tube calcification, which has a significant didactic value because such cases are seldom illustrated either in textbooks or in the literature. This case once again underscores the importance of having CBCT scans evaluated by a board-certified oral and maxillofacial radiologist.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권4호
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• pp.282-287
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• 2020

Undifferentiated pleomorphic sarcoma (UPS) is a high-grade neoplasm that is usually located in the extremities and retroperitoneum. In the past, UPS was considered the most common soft tissue sarcoma in adults; due to improvements in diagnostic techniques, most cases have been reclassified as other lineage-specific tumors. Gnathic bones are rarely affected, and the clinicopathological characteristics of this neoplasm when diagnosed in the jaw remain to be better described. In this report, we present a rare case of mandibular UPS affecting an 88-year-old female who demonstrated a painful swelling on the right side of the mandible that was accompanied by a pathological fracture. Microscopic examination revealed a pleomorphic spindle-cell neoplasm with mitotic figures and necrosis. The patient underwent surgery and adjuvant radiotherapy but experienced metastasis after 12 months of follow-up and died. Diagnosis of UPS is challenging, and oral pathologists must be aware of this entity when dealing with aggressive undifferentiated neoplasms.

• Journal of Periodontal and Implant Science
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• 제42권3호
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• pp.105-109
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• 2012

Purpose: Soft tissue recessions frequently cause esthetic disharmony and dissatisfaction. Compared with soft tissue coverage around a tooth, the coverage of an implant site is obviously unpredictable. Particularly in the cases of thin mucosa, a significant greater amount of recession takes place compared to thick mucosa. To overcome this problem, this case report demonstrates a two-step mucosal dehiscence coverage technique for an endosseous implant. Methods: A 33-year-old female visited us with the chief complaint of dissatisfaction with the esthetics of an exposed implant in the maxillary left cental incisor region. A partial-thickness pouch was constructed around the dehiscence. A subepithelial connective tissue graft was positioned in the apical site of the implant and covered by a mucosal flap with normal tension. At 12 months after surgery, the recipient site was partially covered by keratinized mucosa. However, the buccal interdental papilla between implant on maxillary left central incisor region and adjacent lateral incisor was concave in shape. To resolve the mucosal recession after the first graft, a second graft was performed with the same technique. Results: An esthetically satisfactory result was achieved and the marginal soft tissue level was stable 9 months after the second graft. Conclusions: The second graft was able to resolve the mucosal recession after first graft. This two-step approach has the potential to improve the certainty of esthetic results.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권1호
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• pp.87-108
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• 1996

본원에서 하악지시상골 절단술을 시행한 하악전돌증 환자 29명 (남자 12명, 여자 17명)을 대상으로 수술전, 수술후, 장기관찰기간동안 경조직과 연조직 변화를 관찰한 결과 다음과 같은 결과를 얻었다. 1. 술후 하악은 반시계방향회전하면서 후방이동 하였으며 장기관찰시 B와 Pog에서 1.23mm, 1.28mm의 재발을 보였다. 이는 술후의 하악이동에 따른 순수한 효과(Net effect)가 81.7%, 82.2% 라는 것을 의미하며 이러한 재발로 인하여 수술의 효과를 감소시킬 수 있다는 사실을 술전 치료계획에 포함시켜야 한다고 할 수 있다. 2. 하악 경조직의 수평변화에 대한 하악 연조직의 변화비율은 하순구에서 100%, 이부에서 99.1-102.1% 로 나타났으며 하순의 경우 72.7-93.7% 로 나타났으며 상순의 경우 하악 전치 이동량의 5.7% 정도 후방 이동하게 되지만 통계적 상관관계는 미약했으나. 수직적으로 8.3-9.6% 정도 유의한 하방이동양상을 보였다. 3. 술수 상순과 하순의 관계가 개선되어 심미선에 대하여 상순(Ls)은 상대적으로 동출하고 하순(Li)은 후방이동하였으며, 상순구가 얕아지고 하순구가 깊어졌으며, 비순각이 개선되어 전반적 안모가 개선되었으나 턱부위의 전돌은 수술후에도 약간 남아있었다. 4. 하악 연조직점을 종속변수로, 하악 경조직점을 독립변수로한 회귀분석에서 경조직 변화와 연조직 변화 사이의 높은 상관관계가 있다고 하여도 이를 정확하게 예측하기 어렵다는 것을 알 수 있었으며, 연조직 두께와 수평이동사이에는 통계적 유의성이 없었다.

• Journal of Periodontal and Implant Science
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• 제28권2호
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• pp.321-337
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• 1998

The aims of this study were firstly to investigate soft tissue reactions around single implant-supported crowns and secondly to compare soft tissue dimensions and conditions of the crowns in relation to interdental papillae, and lastly to investigate patients'esthetic satisfaction with their single implant-supported crowns according to the interdental papillae presence/absence. Twenty-nine patients (41 implants) whose single missing tooth in the maxillary anterior region had been replaced by single implant-supported crown participated for the study and various variables of soft tissue conditions, dimensions and crown dimensions were measured around the single implant-supported crowns at clinical examination and from study models and slides. The results showed that the soft tissue conditions around the single implantsupported crowns were similar to those around implants used for partially or totolly edentulous patients. Except for the high frequency of bleeding on probing, all other parameters revealed healthy conditions. The buccal sites of the crown had a shallow pocket comparing with other sites. At all sites of the crown, similar status of little inflammation was found. Mesial sites and central-incisor positioned implantsupported crowns had lower contact point position than distal sites and lateral-incisor positioned crowns, respectively. Mucositis index, probing depth and contact point position were significantly correlated with papillae index(p < 0.05). More inflammation and lower contact point position were found at the implant-supported crown with no interdental space than that with interdental space. Patients showed high esthetic satisfaction regardless of interdental space presence. The result indicated that, despite of their submucosal crown margins, single implantsupported crowns have soft tissue conditions as good as other implants used for the treatment of the different types of edentulism and a clinician can manipulate interdental papilla height by modifying crown shapes within the limits of not violating total esthetics.

• 대한치과의사협회지
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• 제54권7호
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• pp.501-512
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• 2016

We evaluated a self-inflatable osmotic tissue expander for its utility in creating sufficient soft tissue elongation for primary closure after bone grafting. Six patients with alveolar defects who required vertical augmentation of >6 mm before implant placement were enrolled. All had more than three prior surgeries, and flap advancement for primary coverage was restricted by severely fibrosed scars. Expanders were inserted beneath the flap and fixed with a screw. After 4 weeks, expander removal and bone grafting were performed simultaneously. A vertical block autograft and guided bone regeneration and distraction osteogenesis were performed. Expansion was sufficient to cover the grafted area without additional periosteal incision. Complications included mucosal perforation and displacement of the expander. All augmentation procedures healed uneventfully and the osseous implants were successfully placed. The tissue expander may facilitate primary closure by increasing soft tissue volume. In our experience, this device is effective, rapid, and minimally invasive, especially in fibrous scar tissue.