1.MANDIBULAR RECONSTRUCTION WITH ALLOGENEIC MANDIBLE AND AUTOGENOUS ILIAC CNACELLOUS BONE.
Dong Keun LEE ; Eun Young LEE ; Yong Woan KIM ; Huk Do KWON
Journal of the Korean Association of Oral and Maxillofacial Surgeons 1997;23(4):767-776
To repair bony defects with transplanted bone in the body, fresh autogenous bone is undoubtly. A retrospective study was made of a consecutive patient who underwent mandibular reconstruction with PMCB and allogeneic mandibular crib in November 1996. Free autogenous iliac bone in the form of particulate cancellous bone and marrow was densely packed into the allogenous mandibular crib that was adapted to bridge the mandibular discontinuity defect. Freeze dried allogenous mandibular bone was traded by Wonkwang bone bank. Freeze dried allogenous mandibular bone was used as allogeneic crib carrying the PMCB. This case was undergone successful healing with the formation of a continuous bony union with the remaining mandible. The rate of resorption was assessed by sequeal panoramic radiographs, that is, a day of postoperative period, 3 months of postoperative period, 6 months of postoperative period, 12 months of postoperative period. The mean horizontal dimension of the mandibular defect was 58mm and the mean vertical dimension of the reconstructed segments was 30mm. The bony height reconstructed segments retained about 78% of the bony height of a 1-year period. We estimated that autogenous PMCB grafts and allogenous crib grafts were the most successful and esthetic grafts in mandibular discontinuity reconstruction.
Bone Banks
;
Bone Marrow
;
Humans
;
Infant Equipment
;
Mandible*
;
Mandibular Reconstruction*
;
Postoperative Period
;
Retrospective Studies
;
Transplants
;
Vertical Dimension
2.A CASE REPORT OF GARRE.
Journal of the Korean Association of Oral and Maxillofacial Surgeons 1997;23(4):763-766
Garre's Sclerosing Osteomyelitis is seen primarily in children and young adult and occasionally in older individuals. It is also known as chronic nonsupprative sclerosing osteomyelitis, proliferative periositis of Garre, periostits ossificans. It is commonly associated with carious molar and a history of past toothache. Radiogrphically, a focal area of well-calcified bone proliferation may be seen that is smooth and often has a laminated apperance. This disease is thought to occur because of a low-grade infection or irritation that influence the potentially active periosteum of young individuals to lay down new bone. Its treatment is directed toward removing identifiable source of inflammation. Following successful treatment of dental pathology, remodeling of the mandible generally occurs naturally but the deformity may remain and surgical recontouring may be required. We report a case of Garre's sclerosing osteomyelitis, treated by surgical recotouring and antibiotic therapy, in 9-year old female with literature review.
Child
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Congenital Abnormalities
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Female
;
Humans
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Inflammation
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Mandible
;
Molar
;
Osteomyelitis
;
Pathology
;
Periosteum
;
Toothache
;
Young Adult
3.CHONDROBLSTOMA ON TEMPOROMANDIBULAR JOINT, A CASE REPORT.
Hyun Ho CHANG ; Seung Yun HAN ; Hyung Mo AHN ; Won Jong CHOI ; Jae Seung KIM
Journal of the Korean Association of Oral and Maxillofacial Surgeons 1997;23(4):756-762
Chondroblastoma is a rare primary bone tumor which originates from cartilage, and represents approximate 1% af all bone tumor. The chondroblastoma arises most frequently from the epiphysis of the long bones with the humerus being the commonest site. It afflicts usually the young under 25 years with greater incidence in male. As there is no cartilage cell on craniofacial bone which is mainly fromed by intramembranous ossification, the chondroblastoma on the craniofacial bone is extremely rare. But the chondroblastoma recurred frequently in craniofacial bone when the mass is excised incompletely or curretted and, as the tumor has the outstanding ability of local invasiveness, it destructs the adjacent bone. In addition, it is difficult to diagnose differentially from sarcoma or giant cell tumor histopathologically. Due to the entities described above, it is necessary to remove the entire tumor mass as complete as possible, to treat with radiation pre or postoperatively for preventing from recurrence, and to observe for a long time. The chondroblastoma on temporal bone is rare and is difficult to diagnose and treat successfully. So we'd like to present a case of chondroblastoma which was originated from temporal side of TMJ with literatural review.
Cartilage
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Chondroblastoma
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Epiphyses
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Giant Cell Tumors
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Humans
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Humerus
;
Incidence
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Male
;
Recurrence
;
Sarcoma
;
Temporal Bone
;
Temporomandibular Joint*
4.RECONSTRUCTION WITH METAL PLATE AND ILIAC BONE GRAFT ON AMELOBLASTOMA.
Young Rae MAENG ; In Suk KIM ; Sung Soo SHIN ; Gee Jeong UM ; Sang Hun PARK ; Jun woo PARK ; Gun Joo RHEE
Journal of the Korean Association of Oral and Maxillofacial Surgeons 1997;23(4):749-755
This is to report a case of immediate reconstruction after hemimandibulectomy by using of bicorticocancellous block bone harvested from the iliac crest in the case of an ameloblastomaon the mandible. Because the lesion involved condylar area, it was reconstructed with titanium artificial condyle attached to A/O metal plate. Three weeks after the operation, infection developed with suppuration and was well treated with adequate antibiotic therapy and drainage. The patient has been followed up over a four-year period and taken an orthopantomogram every three or six month for the examination of mandibular movement, the potentiality of recurrence and the remodeling of the grafted bone. At present, the patient is satisfied with her appearence and has a normal occlusion with proper masticatory function, and there is no sign of recurrence.
Ameloblastoma*
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Drainage
;
Humans
;
Mandible
;
Mandibular Osteotomy
;
Recurrence
;
Suppuration
;
Titanium
;
Transplants*
5.CLINICAL EVALUATION ON THE MOUTH REHABILITATION USING DENTAL IMPLANTS.
Young Duck JEE ; Kyu Hwan CHOI ; Bok Gi MIN ; Won Bo SHIM ; Dong Keun LEE
Journal of the Korean Association of Oral and Maxillofacial Surgeons 1997;23(4):736-748
The use of osseointegrated implants is an accepted procedure for the treatment of Total, or partial edentulism and offers good predictability of long-term success. Osseointegration implies a firm and direct interlocking between vital bone and screw-shaped titanium implants. There should be not to interposed tissue between fixture and bone. This study was undertaken to assess the clinical condition, complication, and prosthodontic aftercare of different implant systems. One hundred fifty-nine patients treated with a total of 503 endosseous implants (364 Steri-oss threaded type, 69 Integral cylinder with HA coated type, 35 Steri-oss threaded with HA coated type, 21 Steri-oss cylinder with HA coated type and 14 3i implant type), Most of the implant were placed in type B and C bone quantity and type 2 and 3 bone quality according to Lekhorm and Zarb. The success rate of Steri-oss threaded type during healing and function was 92%, Steri-oss threaded type with hydroxyapatite coated was 91%, Steri-oss cylinder type with hydroxyapatite coated was 90%, Integral cylinder type with hydroxyapatite coated was 90% and 3i implant type was 93%. One hundred twenty-nine patients had been treated with implant prosthesis. 79 of these patients had received a fixed type prosthesis and 50 patients had received a removable type prosthesis. There were no differences between the implant systems with regard to age, gender. Failures were associated with poor bone quality, smaller implant sizes, a surgical installation technique and stress distribution when in function. Visual analgoue scales recorded as satisfied results functionally and esthetically, but 15% dissatified with chewing ability.
Aftercare
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Dental Implants*
;
Durapatite
;
Humans
;
Mastication
;
Mouth Rehabilitation*
;
Mouth*
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Osseointegration
;
Prostheses and Implants
;
Prosthodontics
;
Titanium
;
Weights and Measures
6.MANDIBULAR SETBACK OSTEOTOMY WITH REDUCTION CHEILOPLASTY.
Jae Bum PARK ; Soo Il JUNG ; Sang Hun AHN ; Doe Gyeun KIM ; Jae Jin AHN
Journal of the Korean Association of Oral and Maxillofacial Surgeons 1997;23(4):728-735
The face and notably the lips are important structures not only of aestheticvalue but also for expression, vibrancy and vitality. Sometimes we are encountered with the functional and aesthtetic lip problems especially in the patients with mandibular prognathism, such as excessive vermilion exposure, lip incompetence and hyperactivity of mentalis muscle. The etiologic factors are usually related to excessive anterior facial height, secondary to the abnormal development of perioral muscle, salivary gland and the swelling of lymphatic gland. Sometimes orthognathic surgery (mandibular setback osteotomy) alone is not accepted regarding to aesthetic value, there is likely to be a corresponding interest in adjunctive procedures such as genioplasty and soft tissue procedures. This article urges the incorporation of reduction cheiloplasty. It is a relatively minor procedure that can be easily reproducible and yields excellent, predictatable results with few complications. We treated two patients who have excessive vermilion exposure and marked abnormal lip eversion using reduction cheiloplasty combined with mandibular setback osteotomy, followed by improved facial harmony and patients were pleased.
Genioplasty
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Humans
;
Lip
;
Orthognathic Surgery
;
Osteotomy*
;
Prognathism
;
Salivary Glands
7.CLINICOPATHOLOGIC ANALYSIS OF THE PLEOMORPHIC ADENOMA.
Yeong Mi KIM ; Yong Gyoo LEE ; Chin Soo KIM
Journal of the Korean Association of Oral and Maxillofacial Surgeons 1997;23(4):716-727
The author studied on the 197 cases of the pleomorphic adenoma which had been diagnosed with biopsy during the period of 1985 to 1996 at the Kyungpook National University Hospital. This study contains the statistical analysis of the clinico-pathological findings such as sex, age, location, chief complaint, duration, treatment method, size, recurrence, and treatment department in relation to anatomical location. The result were as follows : 1. The treatment department in oxter were ENT(16.2%), GS(22.8%), OMFS(18.8%), PS(12.2%). 2. The incidence of pleomorphic adenoma were parotid gland(57.8%), palatal salivary gland(20.3%), submandibular gland(17.2%), other minor salivary glands(4.5%). 3. The tumors were more common in females than males, with a male to female ratio of 1 : 1.85. 4. The peak age of ocurrence was in the forth decade. 5. The duration of the most cases were less than 5 years. 6. Although the size of the tumors was variable, the incidence was highest between 3cm and 4cm(25.4%). 7. The most prevalent chief complaint was swelling(94.9%). 8. Conservative treatment was performed 30.0%, and radical treatment was employed 70.0%. 9. The recurrence rate is 8.1%, and recurrence used to be relatively common with conservative treatment. 10. The rate of malignant transformation is 1%. 11. The anatomical location has no relationship with the factors of sex, duration, and malignant transformation. 12. There was statistical significance on the anatomical location to the treatment department, age, chief complaint, size, treatment method, recurrence (P<0.05).
Adenoma, Pleomorphic*
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Biopsy
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Female
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Gyeongsangbuk-do
;
Humans
;
Incidence
;
Male
;
Recurrence
8.DEVELOPMENT OF Le FORT II AND I COMBINED OSTEOTOMY FOR CORRECTION OF MIDFACIAL DEFORMITY : THE RATIONALE AND TECHNIQUE.
Myung Jin KIM ; An Na YI ; Il Woo NAM ; Jong Won KIM ; Sung Gon KIM
Journal of the Korean Association of Oral and Maxillofacial Surgeons 1997;23(4):704-715
Many authors reported the etiology of hypoplasia of the nasomaxillary complex as trauma, infection, underdevelopment. To correct these deformities, Le Fort II Osteotomy and its modification has been popularly applied. This method enabled total advancement of nasomaxillary complexes and acquirememt of midfacial esthetics. But it has some limitations such as various occlusal deviation or lateral shifting of nasomaxillary complex in case of nasomaxillary retrusion. We grouped these patients as follows : 1. Nasomaxillary retrusion without shifting of nasomaxillary complex (1) Anteroposterior deviation of occlusal plane (2) Lateral deviation of occlusal plane(including canting) (3) Supero-inferior deviation of occlusal plane (4) Combined disturbance of occlusal plane without shifting of nasamaxillary complex 2. Lateral shifting of nasomaxillary complex with or without deviation of occlusal plane We performed Le Fort II and I combined osteotomy on eleven cases of midfacial deformity from June 1994 to July 1997 and in most of the cases, followed up maximum 36 months and could acquire positional stability and improvement of facial eathetics.
Congenital Abnormalities*
;
Dental Occlusion
;
Esthetics
;
Humans
;
Osteotomy*
9.PROGNOSIS FOLLOWING THE LAG-SCREW FIXATION FOR THE FRACTURED MANDIBULAR CONDYLE.
Myung Rae KIM ; Ju Ho OH ; Jang Woo CHOI
Journal of the Korean Association of Oral and Maxillofacial Surgeons 1997;23(4):696-703
PURPOSE: This is to evaluate the clinical results and radiologic changes of the mandibular condyle fractures following the open reduction and fixation using the Lag-screws introduced by Eckelt and Martin Co. MATERIALS & METHODS: Ten patients who had been treated by the Lag-screw fixation for the unilateral fracture of the mandibular condyle at the high level and followed up for over 6 months(ranged from 24 weeks to 33 weeks). The incisal opening by time elapsed, displacement of the fragments, bone resorption around the Lag-screws, operating time consumed, and untoward complications were evaluated. The data were tested by repeated measure ANOVA and paired t-test. RESULTS: The maximum mouth opening was increased by time as follows ; 20.2+/-2.8mm soon after reduction. 26.3+/-3.9 at the 2nd week, 37.7+/-4.2mm at the 4th week, 44.4+/-4.3mm in PO 2 months(P<0.05). The bone resorption at anterior to lag-screw nut was measured to 1.9+/-1.0mm, while the posterior resorption was 2.6+/-1.9mm on average(P<0.05). Reduction and fixation of the fragments by Lag-screw were done within 80 minutes including the skin closure. The clicking sound of the TMJ(40%), weakness of the marginal branch(60%) were complicated but transient for 4-8weeks. There were no signs of bony displacement, but loosening of screws were observed at the time of removal. CONCLUSION: Open reduction and fixation with condylar Lag-screw(Martin co., Germany) thru the ramus can be a good option to reduce the high level(Kruger's Level III & IV) fracture of the mandibular condyle with anterior or medial displacement. However, this procedure requires 2nd surgery to remove the devices and it may complicate improper reduction for delayed fractures and in case of 's' curved mandibular ramus.
Bone Resorption
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Humans
;
Mandibular Condyle*
;
Mouth
;
Nuts
;
Prognosis*
;
Skin
10.Cervicofacial infection in a Nigerian tertiary health institution: a retrospective analysis of 77 cases.
Benjamin FOMETE ; Rowland AGBARA ; Daniel Otasowie OSUNDE ; Charles N ONONIWU
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2015;41(6):293-298
OBJECTIVES: Infection involving the orbit, zygomatic space, lateral pharyngeal space, or hemifacial and oral floor phlegmon is referred to as cervicofacialvinfection (CFI). When diagnosis and/or adequate treatment are delayed, these infections can be life-threatening. Most cases are the result of odontogenic infections. We highlight our experiences in the management of this life-threatening condition. MATERIALS AND METHODS: This was a retrospective study of patients who presented with CFI from December 2005 to June 2012 at the Oral and Maxillofacial Surgery Clinic or the Accident and Emergency Unit of Ahmadu Bello University Teaching Hospital (Zaria, Nigeria). The medical records of all patients who presented with either localized or diffuse infection of the maxillofacial soft tissue spaces were retrospectively collected. Data collected was analyzed using SPSS version 13.0 and are expressed as descriptive and inferential statistics. RESULTS: Of the 77 patients, 49 patients (63.6%) were males, a male to female ratio of 1:7.5. The ages ranged from two years to 75 years with a mean of 35.0+/-19.3 years, although most patients were older than 40 years. The duration of symptoms prior to presentation ranged from 6 to 60 days, with a mean of 11.0+/-9.4 days. More than 90% of the patients presented to the clinic within the first 10 days. The most commonly involved anatomical space was the submandibular space (n=29, 37.7%), followed by hemifacial space (n=22, 28.6%) and buccal space (n=7, 9.1%). Ludwig angina accounted for about 7.8% of the cases. CONCLUSION: CFI most commonly involves the submandibular space, typically affects individuals with a low level of education, and is influenced by traditional medical practices. Despite improved health care delivery, CFI remains a significant problem in developing countries.
Cellulitis
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Delivery of Health Care
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Developing Countries
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Diagnosis
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Education
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Emergency Service, Hospital
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Female
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Hospitals, Teaching
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Humans
;
Ludwig's Angina
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Male
;
Medical Records
;
Orbit
;
Retrospective Studies*
;
Surgery, Oral