Kim, Won-Ki;Kim, Min-Soo;Lee, Eui-Mook;Cha, Jae-Won;Choi, Bo-Young;Kim, Bong-Chul;Min, Seung-Ki;Lee, Jun
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제38권3호
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pp.166-170
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2012
Calcifying epithelial odontogenic tumor (CEOT) is a rarely reported benign tumor, accounting for 0.4-3% of all odontogenic tumors. Approximately 150 cases have been reported in the literature between 1958 and 2003. The age range of CEOT varies from 8 to 92 years with mean of 36.9 years, and the occurrence of the lesion in both genders is almost equal. It has 2 clinico-topographic variants: the intraosseous (94%) and the extraosseous (6%) type. The intraosseous type has a predilection for mandible (maxilla : mandible ratio of 1 : 2). The intraosseous CEOT commonly associated with non-erupted teeth accounts for more than half (52%) of the cases and usually appears as painless swelling that causes bony expansion. The location of diffused round-shaped calcifying material is inside the connective tissue stroma and epithelial islands. The tumors tend to be located toward the tooth crown, which usually has a unilocular radiolucent region containing variant radiopaque materials radiologically. In this paper, we report a case of CEOT occurring in the left mandibular first premolar of a 23-year-old female and present a brief review of the literature.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제33권4호
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pp.322-330
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2007
Backgrounds: To overcome limited amount of autogenous mucosa for the reconstruction of various mucosal defect including oral mucosal defect, tissue engineered mucosa has been recently introduced. However, introduced conventional technique of tissue engineered mucosa still have serious pitfalls such as long fabrication time, fragility of the reconstructed mucosa, and complexity of the technique. Aim of the study: To examine whether the complex of preconfluent autologous keratinocytes and autologous PRP(Platelet rich plasma) can reconstruct oral mucosa on the muscular flap with easier and faster way compared to conventional mucosal tissue engineering technique. Materials and methods: One day before the operation, oral mucosa(3mm in diameter) were taken and treated for extraction of oral keratinocytes according to the routine manner. The day of operation, oral keratinocytes were prepared in the laboratory and then moved to the operating theater. Autologous PRP was also prepared and then mixed with oral keratinocytes just before grafting on the prepared muscular flap. After keratinocyte-PRP complex was seated, then a sterilized rubber sheet was placed on the graft and the elevated skin flap was replaced and sutured. Biopsies were proceeded at 3, 5, 7, 14 and 21 days. Tissue samples were evaluated clinically, histologically, and immunohistochemically. Results: All of the oral keratinocyte-PRP complexes were successfully grafted on the recipient sites(100%). On 3 days after the operation, 1-2 continuous epithelial layer and many inflammatory cells were observed. On 5 days after the operation, increase of layers of keratinocyte was observed with less inflammatory response. Thickness of the layers was gradually increased from 7 to 21 days after the operation. Cytokeratin confirms epithelium in every specimen. Conclusions: Preconfluent graft of autogenous oral keratinocytes mixed with autogenous PRP have successfully reconstructed myo-mucosal flap. This technique could be a useful alternative for oral mucosal reconstruction in the near future.
The author analyzed the clinical and radiographic findings of 109 malignant tumors of epithelial origin occured in the jaws of the patients visited the infirmaries of Dentistry, Chosun University and several university in Korea during 1978 to 1988. The observed results were as follows: 1. It appeared that 93 % of the total 397 cases diagnosed as oral malignant tumors were squamous cell carcinomas. 2. The incidence ratios between nodular type and ulcer type were 4 to 1 in maxilla and 3 to 1 in mandible. 3. In nearly 50% of all patients complained of pain due to impingement of tumor mass or ulcer. 4. Most of carcinomas of maxilla eventually invaded into maxillary sinus and palate. 5. Characteristic features on the radiographs were the lesion with ill-defined border, the direct destruction of the alveolar bone and anatomical landmark without displacement of the involved teeth and the gray shadow of the tumor mass in the lesion.
The purpose of this study was to observe the effects of early loading on the surrounding bone tissue of the implants. 12 ITI HS implants (8 mm) were inserted on the mandible at 3 mongrel dogs. The implants were divided into two groups; the functional group was functioned with crown, and nonfunctional group was functioned without crown. After 3 and 5 months animals were sacrificed and specimens were examined using radiography, light microscopy, scanning electron microscopy. The following results were obtained. 1. On light microscopic and scanning electron microscopic examination, the difference in the amounts of bone attachment between 3 months loaded and unloaded implants were a little. Sometimes more bone attachment were observed in loaded implants. 2. Many osteoids surrounded the fibrous connective tissues indicating of bone remodeling were observed along the outer surface of the implants. 3. On clinical, radiographic, microscopic examination, epithelial downgrowths were not observed and bone attachments to the outer surface of the implants were observed in 3 months loaded and unloaded implants with good oral hygiene. 4. Epithelial downgrowths and crater-like bone resorptions were observed on 5 months loaded and unloaded implants with poor oral hygiene. 5. Many inflammatory cells in the epithelial tissue were packed in the hollow on 5 months loaded implants.
Epithelial-mesenchymal interaction plays a important role in cell growth and differentiation. This interaction is already well known to have an importance during the organ development as well as cell growth and differentiation. However, in vitro experimental model is not well developed to reproduce in vivo cellular microenvironment which provide a epithelial-mesenchymal interaction. Because conventional monolayer culture lacks epithelial-mensenchymal interaction, cultivated cells have an morphologic, biochemical, and functional characteristics differ from in vivo tissue. Moreover, it's condition is not able to induce cellular differention due to submerged culture condition. Therefore, the aims of this study were to develop and evaualte the in vitro experimental model that maintains epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally reconstituted oral keratinocytes by histological and immunohistochemical analysis. The results were as follow; 1. Gingival keratinocytes reconstituted by three-dimensional organotypic culture revealed similar morphologic characteristics to biopsied patient specimen showing stratification, hyperkeratinosis, matutation of epithelial architecture. 2. Connective tissue structure was matured, and there is no difference during stratification period of epithelial 3-dimensional culture. 3. The longer of air-exposure culture on three-dimensionally reconstituted cells, the more epithelial maturation, increased epithelial thickness and surface keratinization 4. In reconstitued mucosa, the whole epidermis was positively stained by anti-involucrin antibody, and there is no difference according to air-exposured culture period. 5. The Hsp was expressed in the epithelial layer of three-dimensionally cultured cells, especially basal layer of epidermis. The change of Hsp expression was not significant by culture stratification. 6. Connexin 43, marker of cell-cell communication was revealed mild immunodeposition in reconstitued epithelium, and there is no significant expression change during stratification. These results suggest that three-dimensional oragnotypic co-culture of normal gingival keratinocytes with dermal equivalent consisting type I collagen and gingival fibroblasts results in similar morphologic and immunohistochemical characteristics to in vivo patient specimens. And this culture system seems to provide adequate micro-environment for in vitro tissue reconstitution. Therefore, further study will be focused to study of in vitro gingivitis model, development of novel perioodntal disease therapeutics and epithelial-mensenchymal interaction.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제32권4호
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pp.352-359
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2006
MMP-2 and MMP-9, type IV collagenases which degrade basement membrane, have been known to play important roles in invasion and metastasis of tumor cells, In addition, they seem to be involved in cell differentiation, apoptosis, angiogenesis and immunity, etc. We immunohistochemically examined epithelial and stromal expressions of MMP-2 and MMP-9 in irritation fibroma, oral leukoplakia, and oral squamous cell carcinoma (OSCC) and have some results as follows: 1. Irritation fibromas, oral leukoplakias and OSCCs mostly showed increased expression of MMP-2 and MMP-9 in the epithelium and connective tissue compared with normal mucosa. 2. There was a significant difference in the epithelial expression of MMP-2 and MMP-9 between irritation fibroma and oral leukoplakia. 3. There was a significant difference in the epithelial and stromal expression of MMP-2 and MMP-9 between irritation fibroma and OSCC. 4. There was a significant difference in the stromal expression of MMP-9 between oral leukoplakia and OSCC. We concluded that rritation fibroma, oral leukoplakia and OSCC have somewhat different characteristics of MMP-2 and MMP-9 expressions, which perhaps result from different pathogenesis.
Human Hertwig's epithelial root sheath/epithelial rests of Malassez (HERS/ERM) cells are epithelial remnants of teeth residing in the periodontium. Although the functional roles of HERS/ERM cells have yet to be elucidated, they are a unique epithelial cell population in adult teeth and are reported to have stem cell characteristics. Therefore, HERS/ERM cells might play a role as an epithelial component for the repair or regeneration of dental hard tissues; however, they are very rare population in periodontium and the primary isolation of them is considered to be difficult. To overcome these problems, we immortalized primary HERS/ERM cells isolated from human periodontium using SV40 large T antigen (SV40 LT) and performed a characterization of the immortalized cell line. Primary HERS/ERM cells could not be maintained for more than 6 passages; however, immortalized HERS/ERM cells were maintained for more than 20 passages. There were no differences in the morphological and immunophenotypic characteristics of HERS/ERM cells and immortalized HERS/ERM cells. The expression of epithelial stem cell and embryonic stem cell markers was maintained in immortalized HERS/ERM cells. Moreover, immortalized HERS/ERM cells could acquire mesenchymal phenotypes through the epithelial-mesenchymal transition via TGF-${\beta}1$. In conclusion, we established an immortalized human HERS/ERM cell line with SV40 LT and expect this cell line to contribute to the understanding of the functional roles of HERS/ERM cells and the tissue engineering of teeth.
The purpose of this paper was to observe the influence of Ga-As semiconductor-low power generating laser on she appearance and actions of tenascin, extracellular matrix, as healing process of intentional wound on the experimental animals is taking place. 35 rabbits were divided into control and experimental group. ; and on each, 3mm-long and 2mm-deep, surgical wounds were created on buccal oral mucosa and thoracodorsal portion of skin. Ga-As laser was applied to the experimental group starting a day of the day the wounds were created , the laser was applied for 5 minutes every other day. Tissue samples were taken after the 2, 4, 7, 10, and 14 days after wound formation. Then tile healing process of experimental and control groups were observed and compared, using light microscope. Afterwards, the samples were immunohistochemical stained and again observed tenascin by quantitative measuring. The following results were obtained : 1. Tenascin was observed prevalently on epithelial cells, border area of dermis, and interstitial matrix between connective tissue layers in both experimental and control groups. 2. In oral mucosa, the experimental group showed significant increase in the appearance of tenascin after 4 days compared to the control group, but after 10 days, it decreased to a point which is even less than the control group. 3. In the skin samples, the pattern of appearance of tenascin was the same in both groups, but there was some difference concerning when the peak period was shown, In the experimental group, the peak period of tenascin expression was the 7 days after wound formation in epithelium and connective tissue. In the control group, the peak period was 10 days after. 4. In both the experimental and control groups, tenascin first appeared in the epithelium near the wound area and submucosa, and then spread on the underlying connective tissue. In conclusion, appearance of tenascin is closely related to regeneration of epithelium and development of granulation tissue : therefore, low power laser, which fastnes appearance of tenascin, is sure to faciltate healing process of oral mucosa.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제25권4호
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pp.311-323
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1999
The osteonectin is a sort of glycoprotein which is secreted in human tissues. The osteonectin is generally detected in number of normal or neoplastic human tissues in vivo, but hasn't been studied the role of osteonectin in developing human teeth and odontogenic tumors. We evaluated degree of the expression of osteonectin immunohistochemically in 20 cases of developing tooth germ which growth from fetus 5 to 38 weeks, and total 51 odontogenic tumors whitch has taken from routine biopsy, such as 10 ameloblastomas, 5 cases of adenomatoid odontogenic tumors and odontomas and odontogenic fibromas, 4 cases of cementomas and calcifying epithelial odontogenic cyst and odontogenic keratocyst and dentigerous cysts and periapical cysts, and 3 cases of ameloblastic fibromas and myxomas. The results were as follows: 1. The osteonectin on the bud stage of tooth germ was strongly expressed in the epithelial dental lamina and in the outer dental epithelium on the early bell stage, and also strongly expressed in the inner dental epithelium on the late bell stage of tooth germs. 2. In ameloblastoma, the osteonectin was strongly expressed in the epithelial tumor component and especially in the acanthomatous types. 3. In both of calcifying epithelial odontogenic tumor and adenomatoid odontogenic tumors, the osteonectin was moderately expressed on the duct like spindle cells and epithelial tumor cells around calcification areas. 4. In odontogenic tumors originated from epithelial-mesenchymal tissues, the osteonectin was moderately expressed on the epithelial tumor components and in odontogenic cysts, it was expressed in ghost cells and calcification areas only. These were summaried the osteonectin may be strongly related to the developing tooth germ and odontogenic tumors and could be regulated hard tissue of human tooth in morphogenesis and involved with calcification mechanism in development odontogenic tumors.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제29권4호
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pp.249-256
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2003
The lack of sufficient oral mucosa available for intra-oral reconstruction has been dealt with by the use of skin or oral mucosa grafts harvested from donor sites but grafts requires more than one surgical procedures and could cause donor site morbidity. Many investigators have attempted to increase available soft tissue by tissue engineered skin or oral mucosa replacements for clinical applications. But, reconstructed mucosa by several methods have low physical properties such as rolling and contraction. The aims of this study were to develope an in vitro experimental model that maintains an epithelial-mesenchymal interaction by organotypic raft culture, and to characterize biologic properties of three-dimensionally cultured oral mucosa embedded with Polydioxanone mesh by histological and immunohistochemical analysis. The results were as follows; 1. Oral mucosa reconstructed by three-dimensional organotypic culture revealed similar morphologic characteristics to equvalent normal oral mucosa in the point that they show stratification and differentiation. 2. The expression of cytokeratin 10/13 and involucrin in the cultured tissue showed the same pattern with normal oral mucosa suggesting that organotypic co-culture condition is able to induce cellular differentiation. 3. After insertion of polydioxanone mesh, increased tensile strength were observed. These results suggest that three-dimensional organotypic co-culture of the oral mucosa cell lines with the dermal equvalent consisting type I collagen and fibroblasts reproduce the morphologic and immunohistochemical characteristics similar to those in vivo condition. And increased physical properties by use of polydioxanone mesh will helpful for clinical applications.
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