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DENTAL TREATMENT OF PEDIATRIC EPIDERMOLYSIS BULLOSA PATIENTS : CASE REPORTS (수포성 표피 박리증 환자의 치과적 관리 : 증례보고)

  • Han, Eun-Ok;Kim, Seong Hee;Kim, Shin;Jeong, Tae-Sung
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.2
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    • pp.122-126
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    • 2012
  • Epidermolysis bullosa (EB) is a genetic disorder, characterized by blisters on skin and mucosal surfaces even upon light mechanical damage. EB is caused by genetic mutations in at least seven proteins on the basement membrane zone, which is the boundary between the epidermis and the dermis. There are many types of EB differing in clinical and genetic aspects, and the prognosis varies depending on the EB type. There are largely three types of EB, categorized by the electron-microscopic location of the blisters. The blisters form within the epidermis in epidermolysis bullosa simplex, in the lamina lucida in junctional epidermolysis bullosa, and just beneath the basal lamina in dystrophic epidermolysis bullosa. To date, there is no medication or treatment that cures EB or completely prevents the blisters, so generally symptomatic treatment is performed. EB patients must always be cautious, for blisters can form at the slightest injuries, and the patients must be dealt with gently. Injuries and infections have to be prevented and treated, and deficient nutrients must be supplied during dental treatment period. Some patients may experience pain when swallowing food or dental treatment due to blisters and resulting scars in the mouth, pharynx, and esophagus. Recently, two pediatric patients were diagnosed with EB at Pusan National University Hospital and visited the Department of Pediatric Dentistry for oral care and dental treatment. The treatment results are reported here.

THE STUDY OF RELATIONSHIP BETWEEN SAGITTAL CONDYLAR GUIDE ANGLE AND INCISAL GUIDE ANGLE DURING MANDIBULAR PROTRUSION IN NORMAL KOREAN (정상 한국인의 하악 전방운동시 시상과로각과 절치로각에 관한 연구)

  • Kwon, Kung-Rock;Woo, Yi-Hyung;Choi, Dae-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.27 no.2
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    • pp.11-36
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    • 1989
  • Mandibular movements are guided mainly by three determinants, namely the two posterior controls (the Temporomandibular joints) and the anterior control (the incisal guidance). The aim of this study was to evaluate the incisal guide angle in effort to reconcile a patient's condylar guide angle and incisu guide angle, to develop criteria for incisal guidance in clinical practice. 48 subjects (male 33, female 15) with intact intercuspation, without past history and symptoms of stomatognathic system, were selected for this study. All of the subjects had not anterior prostheses. The sagittal condylar guide angles and incisal guide angles were measured and estimated statistically by cephalogram and articulator (Whip-Mix 8500A). The results of this study were as follows: 1. Average of condylar guide angle was 43.33 degree by cephalogram, and was 35.18 degree by articulator. 95% confidence interval was from 40.43 to 46.23 degrees in cephalogram and was from 32.98 to 37.38 degrees in articulator. 2. Average of incisal guide angle was 51.51 degree by cephalogram, and was 44.11 degree by articulator. 95% confidence interval was from 49.12 to 54.95 degrees in cephalogram and was from 40.67 to 47.56 douses in articulator. 3. Difference between condylar and incisal guide angle was 8.18 degree by cephalogram, and was 8.94 degree by articulator. 95% confidence interval was from 4.61 to 11.74 degrees in cephalogram and was from 4.90 to 12.98 degrees in articulator. 4. In case of the incisal guide angle steeper than condylar guide angle, subjects were 69% (33 of 48) in cephatogram and 75% (36 of 48) in articulator. 5. By the multiple regression equation, condylar guide angle was more influenced by the anterior teeth. 6. When the mandible protrudes from the intercuspal position to the edge to edge position the incisal linear movement was 4.18mm (S.D.:1.30mm) and the condylar linear movement was 4.38mm (S.D.:1.26mm).

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Full-mouth rehabilitation of a patient with reduced occlusal vertical dimension due to severe wear: a clinical report (심한 마모로 인하여 교합 고경이 감소된 환자의 완전 구강 회복술)

  • Kim, Min-Jung;Kim, Hyeong-Seob;Woo, Yi-Hyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.1
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    • pp.39-46
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    • 2013
  • The loss of posterior support may cause attrition of anterior teeth, and loss of occlusal vertical dimension (OVD). The collapse of the posterior support will eventually cause the pathologic change of the TMJ and masticatory muscles, unesthetic facial appearance and decreased masticatory function. Patients with destroyed dentition need extensive prosthetic treatments. Proper diagnosis and treatment planning are necessary for the stability of the neuromuscular system and the TMJ, and esthetic and functional definitive restorations. In this case, 63 year-old male presented with decreased masticatory force and esthetic problems due to pathologic destruction of teeth structure on entire dentition. Based on assessment of OVD including intraoral findings, radiographic examination and diagnostic cast, full-mouth rehabilitation with increase of OVD was planned using fixed partial denture and removable partial denture. Diagnostic wax-up was done after 4 mm increase of OVD determined by assessment of OVD. The OVD was maintained with the overlay type removable interim prostheses for 12 weeks to ascertain his comfort and adaptation to the new OVD. After the adaptation period, second interim prostheses with tooth preparation maintaining the established OVD was delivered. After 4 weeks, final prostheses were fabricated and delivered. After 7 month follow-up period, occlusal stability is maintained. Through this procedure, satisfactory outcomes were achieved both in functional and esthetic aspects.

ONE-VISIT APEXIFICATION USING MINERAL TRIOXIDE AGGREGATE (MTA를 이용한 미성숙 영구치의 즉일 치근단형성술)

  • Yeom, Soon-Joon;Park, Ki-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.480-487
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    • 2001
  • In children and adolescents, oral and maxillofacial trauma is one of the most common causes of dental and periodontal damage, which often induces crown fracture of the permanent anterior teeth. Frequently, these traumatized teeth lose their vitality, and require routine endodontic treatment if their root apices are closed. However if their apices are not fully closed, further root formation should be promoted by apexification or apexogenesis. Calcium hydroxide is a biocompatible & bacteriostatic material, and is widely used for apexification. However it has several disadvantages which include the need for multiple visits and patient cooperation, low strength and technical sensitivity in a broad apex. In one-visit apexification using IRM or SuperEBA, patient's visits can be minimized. However, their biocompatibility is questionable. Mineral trioxide aggregate(MTA) is a relatively new material. It is considered biocompatible with periapical hard tissue and has good marginal sealing ability. MTA is also known to help facillitate the growth of the cementum around it. In this case report, apexification with MTA was attempted on traumatized maxillary central incisors with immature root apices, and favorable clinical results were achieved.

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AUTOTRANSPLANTATION OF IMPACTED MAXILLARY CANINES (매복된 상악 견치의 자가치아이식을 통한 치험례)

  • Kim, Tae-Wan;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.2
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    • pp.326-333
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    • 2003
  • The appropriate treatment for eruption guide of impacted teeth necessitates the formulation of a comprehensive treatment plan, which is dependent upon a number of factors such as the condition of the deciduous teeth, dental and skeletal relationship, dental age of the patient, willingness of the patient to undergo extensive dental treatment and financial considerations. If the etiology of the eruption disturbance has been identified, the elimination of the causes and various procedures can be used for eruption guide. Particularly the transplantation is a valuable alternative to extraction of impacted teeth, where surgical exposure and subsequent orthodontic realignment are difficult or impossible. This report present three cases of autotransplantation of impacted maxillary canine. As the result in these cases, atraumatic removal of donor tooth during operation is prerequisite to an optimal clinical result. Due to a high possibility of pulp necrosis, endodontic treatment of fully developed transplanted teeth should be undertaken. In complex case, autotransplantation can save time and less expensive than orthodontic forced eruption. Recipient socket should be prepared to a size that is slightly larger than the root of the donor tooth, and can be prepared with open or close procedure depends on root size of donor tooth and buccolingual width at transplantion site.

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Usefulness of Tunneled Trans-saphenous IVC Catheters for Long Term Venous Access in Pediatric Patients (소아환자에서 대복재정맥을 통한 하대정맥도관법의 유용성)

  • Kim, Seung-Hwan;Kim, Seong-Min;Oh, Jung-Tak;Han, Seok-Joo;Choi, Seung-Hoon
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.167-174
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    • 2006
  • Central venous catheter (CVC) for long-term venous access is indispensable for various reasons including hyperalimentation, frequent blood sampling, frequent IV drug use in pediatric patients. We report clinical experience of surgical neonates in whom CVC was inserted primarily via great saphenous vein into suprarenal inferior vena cava. From March 2004 to March 2006, we performed CVC insertion via saphenous vein - contralateral side to main wound - into suprarenal inferior vena cava in surgeries of neonates. 2.7Fr or 4.2Fr, single lumen, tunneled Broviac catheters (Bard Access system, Inc, Salt Lake City, Utah) were used. Skin exit site of tunneled catheter was located in ipsilateral flank area just below edge lower rib. At the end of the procedure, location of the catheter tip was confirmed by plain radiography of abdomen. We retrospectively reviewed the admission records of the patients including nursing staff charts. Nine (50.0 %) patients were male and nine (50.0%) were female. Median gestational age was 38 weeks (range, 29-42 weeks) and median birth weight was 3,105 gm (range, 1,040-3,720 gm). Median age at catheter insertion was 38.5 days (range, 1-236 days). The purpose of CVC insertion was short-and long-term hyperalimentation in nine (50.0 %) patients. CVC insertion was performed in operation room under general anesthesia in sixteen (88.9 %) patients (in these cases, CVC insertion was performed just prior to concurrent operation) and neonatal intensive care unit (NICU) under local anesthesia with adequate sedation in two (11.2%). During the admission period (total catheter-indwelling time: 553 days), CVC functioned well without any significant side effects. Transient swelling of the ipsilateral leg (n=1, 5.6 %) and transient migration of catheter tip (n=1, 5.6 %) were noted, which did not affect function of the indwelled CVC. Mean catheter-indwelling time was 30.7days (range, 3-72 days). All catheters were removed electively except two mortality case. Complications, such as thrombosis, infection, kinking or extravasation of drugs, were not observed in our study period. Tunneled trans-great saphenous vein inferior vena cava catheters are not only comparable to cervical CVCs in terms of function and complication rates, but also very beneficial in selected patients, especially those in whom cervical approach is technically impossible or contraindicated.

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SURGICAL EXTRUSION OF THE CROWN-ROOT FRACTURED INCISORS: CASE REPORTS (외과적 정출술을 이용한 치관-치근 파절된 미성숙 영구치의 치험례)

  • Lee, Eun-Mi;Kim, Tae-Wan;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Sun-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.305-312
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    • 2008
  • Crown-root fractures occur throughout both crown and root, and are defined as fractures involving enamel, dentin and cementum. The fractures may be grouped according to pulpal involvement into complicated and uncomplicated one. Crown-root fractures often occur on maxillary anterior teeth and comprise 5% of injuries affecting the permanent dentition and 2% in the primary dentition. To restore crown-root fractured tooth, biologic width must be maintained. For maintaining biologic width, such methods as gingivectomy following osteoplasty or orthodontic extrusion or surgical extrusion are available. Surgical extrusion is a method that extracts the tooth and replants the fractured tooth supragingivally. It is indicated when the length of the crown fragment is less than half the length of the clinical root. In these cases, root canal treatment and crown restoration using light-cured composite resin were performed after surgical extrusion. In following periodic examinations, favorable outcome was observed.

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Dietary Patterns and Risk of Breast Cancer in Women in Guilan Province, Iran

  • Ahmadnia, Zahra;Joukar, Farahnaz;Hasavari, Farideh;Roushan, Zahra Atrkar;Khalili, Malahat
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2035-2040
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    • 2016
  • Background: Several studies have pointed to roles of dietary and food groups in the pathogenesis of breast cancer, but information on dietary patterns among women with breast cancer and their healthy counterparts in Iran is limited. Therefore the present investigation was conducted in Guilan province in 2014-2015. Materials and Methods: In a case-control study, 450 women with breast cancer and one of their relatives (third-rank) were investigated. At first the phone numbers of patients in Razi Hospital in radiotherapy and chemotherapy and oncology centers of Guilan were taken. Data were collected through telephone interviews by the researcher. The questionnaire had two parts comprising demographic clinical and food frequency data including a list of 40 food items. To analyze the variables, Chi-square test and univariate logistic regression models were used. Results: In each group, 225 subjects were investigated. The majority of samples in both groups of experiment and control were consumed than two glasses of milk and dairy products per day. Regarding consumption of meat and its products, 56% of the cancer group had more than three servings per day while 26.7% of the control group had less than 2 servings per day. The majority of subjects had less than six servings of cereal per day. Some 54. 7 % of the cancer and 62.2 % of the control group consumed less than two servings of fruit per day. Consumption of vegetables in experimental and control groups were 52.9% and 76.9% respectively, more than five servings per day. There was a meaningful difference between two groups regarding the consumption of milk and dairy items (OR=0.6,95%CI= 0.4-0.9), meat and its products (OR=0.49,95%CI=0.3-0.7), bread and cereals (OR=0.4,95%CI=0.2-0.8), vegetables (OR=0.5,95%CI= 0.3-0.9). (P-value<0.05). Conclusions: The results of this study emphasize the importance of informing women, particularly those at higher risk of breast cancer, in relation to dietary factors.

Roles of MicroRNA-21 and MicroRNA-29a in Regulating Cell Adhesion Related Genes in Bone Metastasis Secondary to Prostate Cancer

  • Mohamad, Maisarah;Wahab, Norhazlina Abdul;Yunus, Rosna;Murad, Nor AzianAbdul;Zainuddin, Zulkifli Md;Sundaram, Murali;Mokhtar, Norfilza Mohd
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3437-3445
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    • 2016
  • Background: There is an increasing concern in the role of microRNA (miRNA) in the pathogenesis of bone metastasis (BM) secondary to prostate cancer (CaP). In this exploratory study, we hypothesized that the expression of vinculin (VCL) and chemokine X3C ligand 1 (CX3CL1) might be down-regulated in clinical samples, most likely due to the post-transcriptional modification by microRNAs. Targeted genes would be up-regulated upon transfection of the bone metastatic prostate cancer cell line, PC3, with specific microRNA inhibitors. Materials and Methods: MicroRNA software predicted that miR-21 targets VCL while miR-29a targets CX3CL1. Twenty benign prostatic hyperplasia (BPH) and 16 high grade CaP formalin-fixed paraffin embedded (FFPE) specimens were analysed. From the bone scan results, high grade CaP samples were further classified into CaP with no BM and CaP with BM. Transient transfection with respective microRNA inhibitors was done in both RWPE-1 (normal) and PC3 cell lines. QPCR was performed in all FFPE samples and transfected cell lines to measure VCL and CX3CL1 levels. Results: QPCR confirmed that VCL messenger RNA (mRNA) was significantly down-regulated while CX3CL1 was up-regulated in all FFPE specimens. Transient transfection with microRNA inhibitors in PC3 cells followed by qPCR of the targeted genes showed that VCL mRNA was significantly upregulated while CX3CL1 mRNA was significantly down-regulated compared to the RWPE-1 case. Conclusions: The down-regulation of VCL in FFPE specimens is most likely regulated by miR-21 based on the in vitro evidence but the exact mechanism of how miR-21 can regulate VCL is unclear. Up-regulated in CaP, CX3CL1 was found not regulated by miR-29a. More microRNA screening is required to understand the regulation of this chemokine in CaP with bone metastasis. Understanding miRNA-mRNA interactions may provide additional knowledge for individualized study of cancers.

The Surgical Treatment of Chronic Avulsion Fracture of the Anterior Cruciate Ligament (진구성 전방 십자 인대 견열 골절의 수술적 치료)

  • Song Eun-Kyoo;Seol Jong-Yoon;Choi Jin
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.31-36
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    • 2002
  • Objective : The purpose of this study was to evaluate the clinical and radiological results after treatment of old ACL(anterior cruciate ligament) avulsion fracture of tibia. Materials and Method : 11 cases who were followed up at least 2 years after treatment in chronic ACL avulsion fracture of tibia were included in this study. The average age of patients was 26(9-66) years and the mean period of follow up was 53(24-131) months. After evaluation of the lesion and treatment of associated lesion under arthroscope, open reduction and internal fixation or fragment removal was performed. Pull-out suture was performed in 8 cases, screw fixation in 2 cases. Results : The Lysholm knee score was 64.3 in average preoperatively and improved to 96.2 average at follow up. On the Lachman test, there were mild(+) instabilities in 7 cases, moderate(++) in 4 cases. On the postoperative Lachman test, there were no instabilities in 9 cases, mild(+) instabilities in only 2 cases. According to Meyers and Mckeever's evaluation protocol, 9 cases $(81.8\%)$ were excellent, 2 case $(18.2\%)$, good. On preoperative instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference in 201b was 7.8(10-4) min in average and 2.1(6-0) mm in average at follow-up. Conclusion : In chronic ACL avulsion fracture, it is thought that combination of arthroscopic evaluation of associated injury and open reduction and fixation and fragment removal can bring about satisfactory results.

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