• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.3
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• pp.310-312
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• 2000

Leukemia is a malignancy caused by precursor cells of white blood cell. It is a malignant tumor of hematopoietic organs, characterized by the disorder of hematopoietic function due to the proliferation of immature bone marrow cells or lymphatic cells and by abnormal tissue infiltration of leukemic cells. The major signs of leukemia are caused by the failure of bone marrow function. As the number of red blood cells decreases, anemia is to appear. The number of white blood cells in leukemia is usually increased but immature white blood cells circulating the body has little defense ability, thus become susceptible to infection. 27 year-old female patient who was treated chemotherapy and bone marrow transplantation after diagnosed as chronic myelogenous leukemia(CML) was diagnosed as osteomyelitis in mandible after clinical and dental radiographic film examination. Because of the result of examination, the involved tooth of the patient was extracted accompanied by sequestrectomy and saucerization under general anesthesia. After the patient had long term medication of antibiotics, the lesion was healed. Therefore. author, et al. report this case with literature review.

• Archives of Reconstructive Microsurgery
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• v.3 no.1
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• pp.90-96
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• 1994

The rectus abdominis muscle is versatile alone or as a musculocutaneous flap and useful for defects of moderate size requiring well vascularized tissue in the extremities. The muscle is long, thin and thus well suites for the hand, anterior tibial and ankle defects. The anatomical location makes dissection convenient for the working teams simultaneously in the same field. Authors have performed rectus abdominis free muscle transplantation in 10 cased to fit defects or cavities in the lower extremities at Chonbuk National University Hospital from June 1992 through August 1994. The results were as follows: 1. 7 cases of the 10 were exposed lower extremities from the vehicle trauma and rectus abdominis free muscles were transplanted at average of the 40th hospital day. 2. In chronic osteomyelitis, saucerization and parenteral antibiotics infusion therapy were combined with in 2 cases. 3. 9 of 10 cases were in complete success except 1 case, 67-yrs-old female, who was sustained the high-energery motor vehicle trauma. 4. Split thickness skin graft was performed on the well-grown surface of the rectus abdominis muscle in the extremities at the 4th postoperative week and taken well without any complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.2
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• pp.103-109
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• 2024

Teriparatide has been effective in treating people diagnosed with medication-related osteonecrosis of the jaw (MRONJ). However, its efficacy is not well established to be accepted as a standard of care. The objective of this paper was to investigate the efficacy of recombinant human parathyroid hormone for the treatment of MRONJ. We report three cases of MRONJ patients with osteoporosis as the primary disease who were treated with a teriparatide agent along with other adjunctive measures. Each patient was administered a teriparatide injection subcutaneously for 16 weeks, 36 weeks, or 60 weeks. Surgical intervention including partial resection, sequestrectomy, decortication, and saucerization took place during the teriparatide administration. Complete lesion resolution was identified clinically and radiographically in all three patients. In patients diagnosed with MRONJ, teriparatide therapy is an efficacious and safe therapeutic option to improve healing of bone lesions. These findings demonstrate that teriparatide in combination with another therapy, especially bone morphogenetic protein, platelet-rich fibrin, or antibiotic therapy, can be an effective protocol for MRONJ.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.470-476
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• 2011

Introduction: The incidence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) has increased gradually in patients who have undergone surgical treatment for osteomyelitis. In this study, a retrospective analysis of BRONJ patients was carried out using the data of osteomyelitis patients treated surgically. Materials and Methods: Osteomyelitis patients, who underwent curettage, sequestrectomy, saucerization or decortications, and partial mandibulectomy at Seoul National University Dental Hospital from 2004 to 2010 were enrolled in this study. The patients were classified and categorized into two groups based on the surgical records and progress notes. One group comprised of patients with osteomyelitis and osteoporosis, and the other group included patients with osteomyelitis only. The epidemiological data of the BRONJ patients was analyzed to identify any trend in the incidence of BRONJ in osteomyelitis patients. Results: Among 200 patients who underwent surgical intervention for osteomyelitis, 64 (32.0%) were identified as having osteoporosis as the underlying disease. In these 64 patients, more than 81.3% had been prescribed bisphosphonates. Females were far more affected by BRONJ than males. The incidence of BRONJ also increased with age. The posterior part of the mandible was affected more frequently by BRONJ. Conclusion: Although the availability of potent antibiotics and increased oral hygiene care can reduce the overall incidence of osteomyelitis, BRONJ can increase the total incidence. To prevent BRONJ, it is recommended that an oral examination be performed before prescribing bisphosphonates. Moreover, the patients should be educated about the potential risks of dental procedures that might be causal factors for BRONJ. Furthermore, patient swho take bisphosphonates for the treatment of osteoporosis should undergo periodic follow up oral examinations to prevent BRONJ.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.127-138
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• 2004

Background: Crestal bone loss known as saucerization is a frequently observed phenomenon. Recent studies have shown that implants with micothreaded crest module reduced the force concentration in the crestal region thus resulting in no or reduced crestal bone loss. This study presents a clinical, histologic, and histometric evaluation of implants with microthreaded crest module and SLA surface. Methods: The implants were placed in the mandible of 5 beagle dogs weighing 10-15kg. Four premolars were bilaterally extracted 8 weeks prior to implant placement. Mucoperiosteal flap was elevated and drilling with increasing diameter was performed under saline irrigation. After countersinking 2 implants were placed in each side resulting in 4 implants per dog. Healing period of 8 weeks was allowed before sacrificing the animals. Histologic preparation was performed for histologic and histometric analysis. Bone to implant contact as well as percentage of bone area inside threads were measured. T-test was used for statistical analysis with pvalue p<0.05. Results: 1. Healing was uneventful without any cover screw exposure. New bone formation around the implants was observed without any inflammatory infiltration. 2. Bone to implant contact in the microthread and thread were 43.90 ${\pm}$ 20.30 %, and 53.19 ${\pm}$ 20.97 % respectively. The overall bone to implant contact was 48.54 ${\pm}$ 20.95 %. 3. Percentage of bone area inside threads were 54.43 ${\pm}$ 10.39 %, and 38.44 ${\pm}$ 16.44 % for the microthread and thread respectively. There was statistically significant difference(p<0.05). The overall percentage of bone area inside threads was 46.67 ${\pm}$ 15.68 %.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.1
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• pp.1-8
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• 2011

Introduction: The utility of the C-terminal cross-linking telopeptide test (CTX) as a method for staging Bisphosphonate-related osteonecrosis of the jaws (BRONJ) and its healing process was examined. Materials and Methods: A total 19 patients who were diagnosed with BRONJ underwent a fasted morning CTX test, were enrolled in this study. The serum CTX values ranged from 50 to 630 pg/mL (mean 60). The risk assessment was rated according to the CTX values of the individual patient (minimal risk, ${\geq}$ 150 pg/mL, moderate, 100 to 150 pg/mL, high, ${\leq}$100 pg/mL). The BRONJ scores were then calculated according to the number of BRONJ lesions and their stage. The operation was done as soon as possible, regardless of BORNJ stage. Results: The mean duration of bisphosphonate therapy was 4.1 years. Of the 19 patients, 15, 2 ans 2 received alendronate, risedronate and zoledronate, respecively. Of the 19 patients who underwent a sequestrectomy, saucerization and smoothing, 15 healed after the initial surgery, 1 patient healed after one more surgical procedure, 3 patients did not heal completely but showed improvement in symptoms. Therefore, 17 out of the 19 patients healed completely with complete mucosal coverage and the elimination of pain. The risk assessment using the CTX value and disease severity were not correlated (r=-0.264, P=0.275). In addition, the risk assessment using CTX value and healing after surgery were not correlated (r=-0.147, P=0.547). Conclusion: The serum CTX should be considered carefully by clinicians as part of overall management. Early surgical intervention is of benefit in the treatment of stage II BRONJ.