• Title/Summary/Keyword: Third molar surgery

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THE MANAGEMENT OF PATIENTS WITH SEVERE APLASTIC ANEMIA IN ORAL & MAXILLOFACIAL SURGERY (중증 재생불량성 빈혈환자의 구강악안면외과적 관리)

  • Yoon, Hyun-Joong;Park, Je-Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.464-467
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    • 2001
  • Aplastic anemia is a hematopoietic disorder characterized by marked reduction or absence of erythoid, granulocytic, and megakariocytic cells in the bone marrow with resultant pancytopenia. To control of infection & bleeding secondary to leukopenia and thrombocytopenia, the inflammatory lesions in oral & maxillofacial area should be removed. Material & Method: The extractions were performed on 21 patients with severe aplastic anemia. The initial, pre-operative and postoperative CBCs were checked up. Amount and kind of transfused platelet in each patient and increment of platelet level were recorded. The complications were documented. Result : A mean of 2.9 teeth were extracted from each patient(ranging between 1 and 13). Furthermore, surgical extractions including ostectomy and odontectomy of the third molar were performed on 11 patients. The preoperative WBC levels presented between $600/{\mu}L$ and $5000/{\mu}L$(mean $2376/{\mu}L$). The WBC values decreased by an average of $145/{\mu}L$ per patient after extractions had been performed. The teeth of 16 patients were extracted under 10.0g/dL, and the mean change in postoperative hemoglobin levels in comparison with preoperative hemoglobin levels was -0.06 per patient. The initial platelet levels were between 1000/(L and $81,000/{\mu}L$(mean $20,174/{\mu}L$). In five patients, extractions were performed with platelet levels less than $50,000/{\mu}L$. Conclusion : The results suggest that more active and preventive treatments in the oral and maxillofacial area are possible and are necessary to remove the infectious foci on the patients with severe aplastic anemia. We report the results of our experiences and literature reviews in treatment of the patients with severe aplastic anemia in our department.

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A CLINICAL STUDY ON THE PATIENTS WITH INFECTION OF THE ORAL AND MAXILLOFACIAL REGION (구강 및 악안면 영역의 감염증에 관한 임상적 연구)

  • Baek, Jin-Hyun;Lee, Young-Soo;Shim, Kwang-Sup
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.2
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    • pp.323-336
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    • 1996
  • This is a retrospective study on the patients with infection of the oral and maxillofacial region with the purpose of obtaining some useful data for diagnosis and treatment plan of that relatively common disease in dentistry. The used materials of study were 87 in total, including 52 male patients, 35 female patients who diagnosed and treated at the Department of the Dentistry in Hanyang Medical College Hospital for the period of Jan. 1990 to Dec. 1994. The author analyzed the distribution and incidence of sex, age, admission period, etiologic factors, etiologic teeth, treatment method of infections, pus culture, antibiotics sensibilities and medication. The result obtained as follows : 1. The developmental incidences by sex was superior in male by the ratio of 1.5 : 1 and the infection was most frequently occurred during the third decades(35.6%). 2. The number of admitted patients elevated in February, March, and April, and average of admission period was 9.8 days. 3. Main etiologic teeth showed on lower molar region in adult(63%) and upper molar region in primary dentition(46.1%). 4. Medications were administrated in all of the cases, and surgical incision and drainage were performed in 53% and extraction of the causative teeth were performed in 63.6% of all cases. 5. The most common involved fascial spaces were Buccal space(41.4%), Infraorbital space(27.6%), Submandibular space(16.1%),in order, and 9 cases(10.3%) were Ludwig's Angina. In 68.2% of the patients, and infection involved only one fascial space and in 21.8% of the patients, it involved to more fascial spaces. 6. The most causative organisms isolated from pus culture were Gram-positive facultative cocci(55.5%), and antibiotics sensitivities on the total isolated bacterial strains were exposed chloramphenicol(88.6%), Cephalothin(88.6%), Erythromycin(81.5%), Lincomycin(77.8%) in order, but it showed resistant on Gentamycin(58.3%), Tetracycline(56.5%), Methicillin(38.5%).

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CARE OF ANXIETY DISORDER AND HYPERVENTILATION DURING REFRACTORY TOOTH EXTRACTION IN A PSYCHOLOGIC DISABLED PATIENT (정신장애 환자에서 난발치 중의 불안장애와 과환기 관리 : 증례보고)

  • Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.2
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    • pp.106-113
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    • 2014
  • Hyperventilation is produced by several distinct causes: anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The dental fears about acute pain, bleeding, needle, drill and dental surgery lead to the severe anxiety and increased blood catecholamine level. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the gentle care, a hyperventilation were occurred during the surgical extraction of impacted third molar with pericoronitis. We suggest that the dental patients with anxiety disorder must be attention for the manifestation of hyperventilation, especially in the psychologic disabled patient.

Numb Chin Syndrome as the First Symptom of Diffuse Large B-cell Lymphoma

  • Oh, Duwon;Woo, Keoncheol;Kim, Seong Taek;Ahn, Hyung Joon;Choi, Jong-Hoon;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.41 no.4
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    • pp.200-204
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    • 2016
  • Numb chin syndrome, or mental neuropathy is a rare sensory neuropathy characterized by abnormal sensation such as hypoesthesia, paresthesia, or dysesthesia in the chin and lower lip innervated by the mental nerve. Sensory neuropathy of mental nerve is somewhat familiar to dentists because it can occur following nerve damage by trauma or dental treatment such as implant surgery or third molar extraction. It can also result from dental causes including abscess or osteomyelitis. However, it can be the first sign of the systemic disease or malignancy if it is not related to dental causes. In this study, we present the case of a patient who present with hypoesthesia and pain in chin area without other symptoms and is later diagnosed with diffuse large B-cell lymphoma.

Role of cone-beam computed tomography in the evaluation of a paradental cyst related to the fusion of a wisdom tooth with a paramolar: A rare case report

  • Ozcan, Gozde;Sekerci, Ahmet Ercan;Soylu, Emrah;Nazlim, Sinan;Amuk, Mehmet;Avci, Fatma
    • Imaging Science in Dentistry
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    • v.46 no.1
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    • pp.57-62
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    • 2016
  • Fusion is an abnormality of tooth development defined as the union of two developing dental germs, resulting in a single large dental structure. This irregular tooth morphology is associated with a high predisposition to dental caries and periodontal diseases. As a result of recurring inflammatory periodontal processes, disorders such as periodontal pocket, pericoronitis, and paradental cysts may develop. A rare mandibular anatomic variation is the retromolar canal, which is very significant for surgical procedures. The fusion of a paramolar and mandibular third molar associated with a paradental cyst co-occurring with the presence of a retromolar canal is rare, and the aim of the present study is to describe the evaluation of this anatomical configuration using cone-beam computed tomography.

Maxillary ameloblastoma in an 8-year-old child: A case report with a review of the literature

  • Sheela, Sangeetharaj;Singer, Steven R.;Braidy, Hani F.;Alhatem, Albert;Creanga, Adriana G.
    • Imaging Science in Dentistry
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    • v.49 no.3
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    • pp.241-249
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    • 2019
  • Ameloblastoma is a benign locally invasive tumor with a high tendency to recur. It is considered rare in the pediatric population, with most cases diagnosed in the third to fifth decades of life. Approximately 80% of ameloblastomas occur in the molar and ramus region of the mandible, while 20% of cases occur in the maxillary posterior region. This report presents a case of plexiform ameloblastoma in an uncommon location in an 8-year-old child. The lesion was initially thought to be a dentigerous cyst, based on its location and radiographic appearance. The clinical and radiographic features, histopathology, and treatment of solid, plexiform, maxillary ameloblastoma are reviewed, with an added emphasis on a literature review of ameloblastoma in children. This report emphasize the importance of long-term follow-up, since recurrence may occur many years after initial tumor removal.

Simple Qualitative Sensory Assessment of Patients with Orofacial Sensory Dysfunction

  • Im, Yeong-Gwan;Kim, Byung-Gook;Kim, Jae-Hyung
    • Journal of Oral Medicine and Pain
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    • v.46 no.4
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    • pp.136-142
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    • 2021
  • Purpose: Oral and facial sensation is affected by various factors, including trauma and disease. This study assessed the clinical profile of patients diagnosed with sensory dysfunction and investigated their sensory perception using simple qualitative sensory tests. Methods: Based on a retrospective review of the medical records, we analyzed a total of 68 trigeminal nerve branches associated with sensory dysfunction in 52 subjects. We analyzed the frequency and etiology of sensory dysfunction, and the frequency of different types of sensory perception in response to qualitative sensory testing using tactile and pin-prick stimuli. Results: The inferior alveolar nerve branch was the most frequently involved in sensory dysfunction (88.5%). Third molar extraction (36.5%) and implant surgery (36.5%) were the most frequent etiological factors associated with sensory dysfunction. Hypoesthesia was the most frequent sensory response to tactile stimuli (60.3%). Pin-prick stimuli elicited hyperalgesia, hypoalgesia, and analgesia in 32.4%, 27.9%, and 36.8%, respectively. A significant association was found between the two kinds of stimuli (p=0.260). Conclusions: Sensory dysfunction frequently occurs in the branches of the trigeminal nerve, including the inferior alveolar nerve, mainly due to trauma associated with dental treatment. Simple qualitative sensory testing can be conveniently used to screen sensory dysfunction in patients with altered sensation involving oral and facial regions.

An unusual presentation of osteoblastoma of the maxilla: A case report

  • Lim, Joonbum;Hinchy, Nicole;Odingo, Nora;Colosi, Dan;Mahdian, Mina
    • Imaging Science in Dentistry
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    • v.51 no.4
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    • pp.455-460
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    • 2021
  • This report presents a rare case of maxillary osteoblastoma in a 17-year-old female. The patient presented with dull pain and facial asymmetry inferior to the left zygoma. An intraoral examination found a painless swelling on the buccal gingival tissue in the left posterior maxilla. Panoramic radiographs and multidetector computed tomographic images revealed an ill-defined, non-corticated, mixed attenuating entity of osseous density located within the left posterior maxilla apical to the left maxillary molars. The entity exhibited a heterogeneous internal structure with a fine granular appearance, and the periphery showed a partial hypo-attenuating rim along the antero-medial aspect. Expansion of the left posterior maxilla accompanied with displacement of the left maxillary sinus floor was noted. External root resorption of the first and second molars was noted, as well as postero-superior displacement of the third molar. The histopathologic diagnosis of the biopsy was osteoblastoma. Complete excision of the tumor was performed.

Development and application of stent-based image guided navigation system for oral and maxillofacial surgery (구강외과 수술용 스텐트 기반 영상유도 수술 시스템의 개발)

  • Lee, Woo-Jin;Kim, Dae-Seung;Yi, Won-Jin;Lee, Sam-Sun;Choi, Soon-Chul;Heo, Min-Suk;Huh, Kyung-Hoe;Kim, Myung-Jin;Lee, Jee-Ho
    • Imaging Science in Dentistry
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    • v.39 no.3
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    • pp.149-156
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    • 2009
  • Purpose : The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. Materials and Methods : We devised a patient-specific stent for patient-to-image registration and navigation. Three-dimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. Results : The accuracy over 8 anatomical landmarks showed an overall mean of $0.56{\pm}0.16\;mm$. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. Conclusion : The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.

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A CASE REPORT OF THE HUGE CEMENTO-OSSIFYING FIBROMA OF THE MANDIBLE (하악골에 발생한 거대한 cemento-ossifying fibroma의 치험례)

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Kwon, Yong-Dae;Park, Jong-Oh
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.1
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    • pp.70-75
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    • 2000
  • The cemento-ossifying fibroma is a well-demarcated and occasionally encapsulated neoplasm composed of fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum, or both. The greatest number of cases are encountered during the third and fourth decades of life and there is a definite female predilection, with female-to-male ratios as high as 5 : 1 being reported. The mandible is involved far more than the maxilla, and 90 percent of all cases are located in the mandible. The mandibular premolar-molar area is the most common site. Radiographically, the lesion is most often well defined and unilocular. Depending on the amount of calcified produced in the tumor, it may appear as completely radiolucent ; more often it shows varying degrees of radiopacity. Some lesions may be largely radiopaque with a radiolucent halo. On microscopic study, the tumor is composed of fibrous tissue of varying degrees of cellularity containing calcified material. This may be in the form of trabeculae of osteoid and bone or basophilic ovoid calcifications that resemble cementum-like material. Admixture of the two types of calcifications are commonly seen. On this case, large cemento-ossifying fibroma has grown in the mandible and this lesion was treated by complete surgical excision and posterior iliac bone graft. A review of literature and a report of a case of cemento-ossifying fibroma are presented.

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