• Title/Summary/Keyword: gingiva

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Recurrent Herpes-Stomatitis Mimicking Acute Necrotizing Ulcerative Gingivitis (급성괴사성궤양성 치은염을 닮은 재발성 허피스 구내염)

  • Kim, Han-Seok;Lee, Suk-Keun;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.89-92
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    • 2011
  • Herpes simplex is caused by viruses of the herpesvirus hominus family. HSV have four categories: type 1, 2, 6, and 8. Generally HSV-1 affects the mouth. Once infected by HSV, the person's infection is permanent. Retrograde transport through adjacent neural tissue to sensory ganglia leads to a lifelong latent infection. Recently, we treated a patient with recurrent herpes-stomatitis mimicking acute necrotizing ulcerative gingivitis (ANUG). The results were satisfactorty so we report this case. 31 years old male patient showed sore throat, gingival ulceration, palpable both submandibular lymph node, and sulcular pus formation around posterior decayed teeth. This is the third time he has suffered from this symptom. Tentative diagnosis was acute necrotizing ulcerative gingivitis. Antibiotic therapy was started. But, intraoral symptom got worse in process of time. Especially ulcer of marginal gingiva got worse. Viral disease was suspected. We carried out viral cultivation. At the same time topical application of antiviral ointment (herpecid$^{(R)}$) was performed on oral ulcer unilaterally for the purpose of diagnosis and reducing pain experimentally. The next day pain was decreased dramatically on application area. Basing on the viral cultivation and clinical effect of antiviral ointment (herpecid$^{(R)}$), we have diagnosed it as a recurrent herpes-stomatitis and concluded that viral infection was major cause of disease and bacterial infection was secondary.

Immunohistochemical Observation of Plasma Cell Granuloma in Intraoral Chronic Inflammatory Lesions (구강내 만성염증병소에서 보이는 형질세포육아종의 면역조직화학적 관찰)

  • Kim, Yeon-Sook;Lee, Suk-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.26-31
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    • 2011
  • Purpose: Chronic inflammatory gingival lesions occur as pyogenic granulomas or non-specific chronic suppurative lesions. Methods: Of the 59 chronic inflammatory gingival lesions examined, plasma cell granuloma (n=14), which showed an intense antibody-mediated immune reaction with the increased infiltration of plasma cells, was observed as a pseudotumor-like gingival overgrowth and myofibroblastic or fibrohistiocytitc proliferation of stromal cells with a heavy collection of plasma cells. The levels of CD3, CD20, CD31, CD68, RANKL, cathepsin G, cathepsin K, lysozyme, TNF${\alpha}$, MMP-2, and MMP-9 in the 14 cases of gingival plasma cell granuloma with immunohistochemical detection were measured to determine the pathogenetic progresses of the plasma cell granuloma compared to the common pyogenic granuloma (n=45) in the gingiva. Results: The gingival lesions of the plasma cell granuloma could be divided into three histological types, plasma cell predominant type (PPT, n=8), mixed inflammatory cell type (MICT, n=2), and sclerosed fibrosis type (SFT, n=4). The PPT showed a condensed infiltration of plasma cells into the perivascular spaces of the granulomatous lesion with frequent formation of Russel's body in their cytoplasm. The MICT showed the concomitant infiltration of many macrophages together with plasma cells, resulting in the diffuse destruction of stromal fibrous tissue. The SFT showed granulomatous lesions replaced gradually by thick collagenous fibrous tissue, resembling an inflammatory pseudotumor. The SFT expressed strongly the lymphocytic markers, CD3 and CD20, and the macrophage/monocyte markers, CD31 and CD68, but showed reduced expression of common inflammatory markers, TNF${\alpha}$, cathepsin G, lysozyme, MMP-2, and MMP-9, as well as the reduced expression of osteoclastogenic markers, RANKL and cathepsin K. Conclusion: These results suggest that a gingival plasma cell granuloma shows variable gene expression for cell-mediated immunity and stromal tissue degeneration, undergoing sclerotic fibrosis with a persistent inflammatory reaction.

A Study on the Clinical Characteristics in Oral Lichen Planus (구강편평태선 환자의 임상적 특징에 관한 연구)

  • Yoon-Mi Lee;Myoung-Chan Kim;Jong-Youl Kim
    • Journal of Oral Medicine and Pain
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    • v.21 no.1
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    • pp.141-152
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    • 1996
  • Oral Lichen Planus(OLP) is a idiopathic chronic inflammatory disease with more difficult to clear and higher recurrent rate than cutaneous lesions. But, there has been no estabilished theories about the proper treatment for OLP. The purpose of this study is to examine the clinical feature, relationship with systemic disease and dental treatment of OLP patients of Korea and to gain helpful information about clinical characteristics and treatment of OLP. The subjects chosen for the study were 54 patients who had visited Department of Oral Diagnosis & Oral Medicine at Yonsei University Dental Hospital Dental Hospital and diagnosed as OLP. Previous clinical records has been reviewed and questionnaires, oral examination, laboratory examination were done and recorded. The following results were obtained : 1. Of the 54 patients, 21 were men and 33 were women with an average age of 47.8 years. 2. The most common intraoral site was bilateral buccal mucosa, followed by unilateral buccal mucosa, gingiva, vesibule, lip mucosa, glossal mucosa, palatal mucosa and mouth floor. 3. The mixed, erosive and reticular form of OLP was most frequent(83.3%) clinical form. 4. OLP patients with liver disease were 5, and drug medication patients were 7. But, we could not find its evidence of association with OLP. 5. Associated events on onset of symptom were stress, denture wearing, dental treatemtn, and common cold. 6. Associated symptoms were dry mouth, tingling, sore throat, and altered taste perception. 30.8% of patients had no specific associated symptoms. 7. Aggravating factors of symptom were peppery food, hot food, fatigue, toothpaste, salty food, sour food, tension, and conversation. Reducing factors were cold food, sleeping. 69.2% of patients had no specific reducing factors. 8. There were no significant differences between normal papulation and OLP patients in CBC, SGOT< SGPT, Serum iron, Total iron binding capacity. 66.7% of subjects were positive response to fungus study for Candida Albicans. The incidence of stress and dental treatment on onset of symptom appeared high in OLP patients. Especially, high incidence of positive response to fungus study for Candida albicans, prescription of anti-fungal agents and dental treatment considerations may be helpful to treatment of OLP.

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Treatment and diagnosis of oral pain without identifiable oral mucosa lesion (정상 구강 점막 소견의 구강 통증 환자의 진단 및 치료)

  • Kim, Tae-Su;Kim, Sang-Yoon;Nam, Soon-Yuhl;Roh, Jong-Lyel;Choi, Seung-Ho
    • Korean Journal of Bronchoesophagology
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    • v.14 no.1
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    • pp.29-33
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    • 2008
  • Objectives : Oral pain without identifiable oral mucosa lesion is probably multifactorial origin, which include burning mouth syndrome (BMS), oral candidiasis and so on. The aim of this study was to analyze the characteristics of oral pain without identifiable oral mucosa lesion and to evaluate treatment outcome of those patients. Materials and Methods : We reviewed 50 patients without identifiable oral mucosa lesion who were complaint of oral pain. The patients were analyzed according tothe sites, associated symptoms, laboratory tests and fungus culture. The questionnaire included questions on their current diseases, smoking and alcoholic history, psychological factors, and symptoms. Results : The average age of patients was 60 years old. The most frequently involved site was tongue (92%), followed by palate, lower lip, oropharynx, and gingiva. 60% of the patients has psychological disorder as self reported. Culture for Candida was positive in 36% of patients and serum zinc deficiency was present in 60% of patients. Serum iron, vitamin B12, hemoglobin, folic acid deficiency were present in 6-2% of patients. Seventeen patients (65%) with BMS and twelve patients (66%) with oral candidiasis were improved after treatment. Conclusion : We recommend oral candida culture to oral pain patients without oral mucosa lesion. Zinc supplementation of zinc depletion patients may be helpful whereas other laboratory tests have no diagnostic values.

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A CLINICAL STUDY OF MALIGNANT TUMORS OF THE MAXILLA (상악 악성종양의 임상적 연구)

  • Baek, Ji-Young;Choi, Sung-Won;Lee, Eui-Woong;Choi, Eun-Chang;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.4
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    • pp.391-395
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    • 2000
  • Malignant tumors of the maxilla represent about 3-4% of head and neck malignant neoplasm and the origins are maxillary gingiva, hard palate and maxillary sinus. We are to investigate clinical features and results according to various treatment modalities of maxillary malignant tumor to get information for better treatment results. Sixty patients with malignant maxillary tumors treated at Yonsei medical center from 1992 to 1997 were studied retrospectively. They are evaluated according to clinical signs & symptoms, stages at first diagnosis, primary site, histopathologic features, treatment method, recurrence and survival rate with clinical records, biopsy results and CT radiograph. The most common primary site was maxillary sinus and most common histopathology was squamous cell carcinoma. The local recurrence rate was 18% at 5 years, neck failure was 3% and distant metastasis was 18%. Overall survival rate was 78% at 2 years and 69% at 5 years. Failure at primary site is the main problem in the curative treatment. So, to improve survival in these patients efforts should be directed toward improvement of local control.

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A LIPOMA OF THE MOUTH FLOOR : A CASE REPORT (구강저에 발생한 지방종의 치험례)

  • Suh, Dong-Won;Kim, Jae-Young;Cho, Seong-Woong;Kim, Dong-Hyung;Sim, Jae-Hwan;Kim, Sang-Jung;Kang, Ji-Yeon;Lee, Dong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.1
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    • pp.41-44
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    • 2009
  • Lipoma is most common tumor that compromises 4% to 5% of all benign neoplasm, but in oral cavity it is uncommon. In oral cavity, lipoma presents painless, asymptomatic, slow growing, but sometimes it grows to larger size causing deformities, mastication and speech difficulties. While lipoma in commonly affects female patients (68-73%), oral lipoma appears more frequently in male patients. The majority of oral lipoma is seen after the age of forty (uncommon in children). Lipoma of oral cavity and maxillofacial region occurs most commonly in the parotid region, followed by the buccal mucosa, lip, tongue, palate, mouth floor, gingiva in order. A treatment of lesion is surgical excision with recurrence not expected. In this paper we present the case of a patient who has Lipoma in the mouth floor.

ORAL CHARACTERISTIC OF ALAGILLE SYNDROME - A CASE REPORT (Alagille 증후군을 가진 환자의 구강내 특징에 대한 증례보고)

  • Kim, Tae-Wan;Kim, Young-Jin
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.1
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    • pp.17-21
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    • 2007
  • Alagille syndrome is an autosomal dominant genetic disorder and occurs in approximately 1 in 100,000 live births. Diagnostic criteria was established by Alagille. It is mainly caused by a mutation in the Jagged1 gene. Major clinical features of this syndrome are paucity of intrahepatic bile duct with cholestasis, characteristic facies, cardiac murmur, defects of vertebrae, and embryotoxon. And minor clinical features are mental retardation, renal involvement, growth retardation, other skeletal abnormalities, a high-pitched voice. The surviving prognosis of Alagille syndrome patients depends on the severity of cardiovescular malformation in the early ages of infant. However, with the increasing years, it depends on the severity of the liver disease. Cholestasis causes congenital jaundice, malnutrition and growth retardation. Also, the increase of serum cholesterol level cause xanthoma and pruritus. Even though the severity of these problems are reduce with age, there is cases where there is no way but liver transplantation. For oral features of Alagille syndrome patients, green discoloration of entire dentition, induced by bilirubin infiltration into dentinal tubules, is especially. Also, xanthoma on gingiva and partial hypodontia have been reported. This report is on the oral features of an Alagille syndrome patient who visited to Kyung-Pook University Hospital.

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Alterations of papilla dimensions after orthodontic closure of the maxillary midline diastema: a retrospective longitudinal study

  • Jeong, Jin-Seok;Lee, Seung-Youp;Chang, Moontaek
    • Journal of Periodontal and Implant Science
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    • v.46 no.3
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    • pp.197-206
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    • 2016
  • Purpose: The aim of this study was to evaluate alterations of papilla dimensions after orthodontic closure of the diastema between maxillary central incisors. Methods: Sixty patients who had a visible diastema between maxillary central incisors that had been closed by orthodontic approximation were selected for this study. Various papilla dimensions were assessed on clinical photographs and study models before the orthodontic treatment and at the follow-up examination after closure of the diastema. Influences of the variables assessed before orthodontic treatment on the alterations of papilla height (PH) and papilla base thickness (PBT) were evaluated by univariate regression analysis. To analyze potential influences of the 3-dimensional papilla dimensions before orthodontic treatment on the alterations of PH and PBT, a multiple regression model was formulated including the 3-dimensional papilla dimensions as predictor variables. Results: On average, PH decreased by 0.80 mm and PBT increased after orthodontic closure of the diastema (P<0.01). Univariate regression analysis revealed that the PH (P=0.002) and PBT (P=0.047) before orthodontic treatment influenced the alteration of PH. With respect to the alteration of PBT, the diastema width (P=0.045) and PBT (P=0.000) were found to be influential factors. PBT before the orthodontic treatment significantly influenced the alteration of PBT in the multiple regression model. Conclusions: PH decreased but PBT increased after orthodontic closure of the diastema. The papilla dimensions before orthodontic treatment influenced the alterations of PH and PBT after closure of the diastema. The PBT increased more when the diastema width before the orthodontic treatment was larger.

Simultaneous placement of an interpositional free gingival graft with nonsubmerged implant placement

  • Sohn, Joo-Yeon;Park, Jung-Chul;Cho, Kyoo-Sung;Kim, Chang-Sung
    • Journal of Periodontal and Implant Science
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    • v.44 no.2
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    • pp.94-99
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    • 2014
  • Purpose: Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the longterm outcome of this grafted gingiva. Methods: A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap. Results: At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue. Conclusions: Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.

TUNNEL TRACTION OF IMPACTED MAXILLARY CANINES (매복된 견치의 Tunnel을 통한 교정적 견인)

  • Jeon, Jeong-Hoon;Oh, You-Hyang;Lee, Nan-Young;Lee, Sang-Ho;Lee, Chang-Seop
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.33-39
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    • 2005
  • The impacted maxillary canine is a common problem of which all dental practitioners should be aware. The surgical orthodontic treatment of impacted canines is replaced correction position in dental arch without periodontal damage. Many treatment possibilities have been considered for this goal; window procedure, apically positioned flap, closed eruption technique and tunnel traction. Prognosis for these treatment may be very uncertain in many case(infraosseous impacted tooth). Other steps are required to achieve a satisfactory periodontal outcome. Satisfactory results could be expected if the physiologic eruption pattern is restored by tunnel traction, because permanent tooth erupts through the gingiva near the crest of the ridge so that periodontal damage is reduced. This article report that the surgical orthodontic treatment using tunnel traction is obtained proper position and reduced periodontal damage in facially impacted maxillary canines.

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