As the uses of dental implants are prevailing, the need for sinus bone graft is increasing. Deproteinized bovine bone mineral (DBBM) was not mentioned in 1996 Sinus Bone Graft because of the deficit of the available data. Since then, many clinical and laboratory reports support the use of DBBM in the sinus bone graft procedure. In this report, the histological and clinical successes of sinus bone grafting with DBBM is discussed with available literatures. After sinus bone grafts with DBBM, the proportion of new bone formed was similar or superior to natural maxillary posterior alveolar bone after healing period of 6 months to 1 year. It seems that the grafted DBBM is not be either resorbed nor replaced with bone, but this may not disturb the osseointegration of dental implants installed into it. The clinical survival rates of dental implants installed on the sinus grafted with DBBM was similar to those installed on the ungrafted posterior maxillary alveolar ridge or grafted with autogenous bone. So, it can be concluded that DBBM can be used successfully in the sinus bone graft.
Alveolar Process ; Bone Transplantation ; Dental Implants ; Heterografts ; Maxillary Sinus ; Osseointegration ; Survival Rate ; Transplants*

The endoscopic assisted approach for the treatment of condylar fracture is a less invasive alternative treatment modality and is considered to be able to overcome the limited access to the operation field to obtain an accurate reduction and fixation. Six patients with condylar neck and subcondylar fracture underwent the endoscopic assisted open reduction and internal fixation through the transoral approach at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The endoscope was inserted through an intraoral incision and the reduction of fracture fragment was performed via a transbuccal approach with two transcutaneous stab incisions. Five patients showed anatomic reduction without any complications. One patient, whose fracture site was fixed with a single plate, showed displacement of fractured condylar segment during the follow up period. No patient had any facial nerve damage.
Endoscopes ; Endoscopy ; Facial Nerve ; Follow-Up Studies ; Humans ; Neck ; Seoul ; Surgery, Oral

PURPOSE: This study was performed to evaluate relationship between the inferior alveolar nerve injury and the findings of panoramic and tomographic images for preventing inferior alveolar nerve injury after the 3rd molar extraction. MATERIAL AND METHOD: From April, 2005 to June, 2005, The 190 patients who visited in the Department of Oral and Maxillofacia Surgery, Chonnam National University Hospital and the panoramic radiographies were taken for extraction of the mandibular third molar, was selected. Among 215 mandibular third molars, Scanora tomographic imagings were taken in the 90 teeth which were overlaped to the mandibular canal in the panoramic imagies. In panoramic radiographies, the angulation, the level, the root morphology, and the superimposition sign of the mandibular third molars with the mandibular canal were evaluated. In the tomographic radiographies, the location and distance of the mandibular third molar from the canal were also evaluated. The relationships between these findings and the inferior alveolar nerve injury were examined. RESULTS: In the panoramic findings, the inferior alveolar nerve injuries were occurred in the darkened roots (5 molars, 7%), the uncontinuous radiopaque image (3 molars, 7%), and the depositioned mandibular canal (2 molars, 10%). In the tomographic findings of 90 molars, 20 molars also had the superimposition imagies. Five molars in those molars (25%) had the inferior alveolar nerve injury after extraction. There were 10 patients who had the inferior alveolar nerve injury. The sensory was began to be recovered in 9 patients, except 1 patient, within 2 weeks, then fully recovered within 3 months. CONCLUSION: These results indicate that the depth mandibular third molar and the superimposition sign may be related with the risk of the inferior alveolar nerve injury after extraction.
Humans ; Jeollanam-do ; Mandibular Nerve* ; Molar ; Molar, Third* ; Radiography, Dental, Digital ; Radiography, Panoramic ; Tooth

The osteoradionecrosis of the mandible can be a serious complication of radiotherapy for malignancies of the head and neck. The cause and pathogenesis of osteoradionecrosis are unclear and anecdotal. There are various treatment-, patient- and tumor-related risk factors on development of osteoradionecrosis. The treatment of osteoradionecrosis relies on conservative measures (antibiotics, debridement, irrigation and HBO) and surgical measures (sequestrectomy, marginal resection and segmental resection with or without reconstruction). But the indications are not defined. We present the two cases of patients who were not controlled by conservative treatment but good-resulted by surgical treatment.
Debridement ; Head ; Humans ; Mandible* ; Neck ; Osteoradionecrosis* ; Radiotherapy ; Risk Factors

This study was designed to investigate the effect of intra-articular injection of hyaluronic acid for the treatment of internal derangements of the temporomandibular joint(TMJ). Sixteen patients with internal derangements of TMJ in 1 male and 15 females aged 68 to 18 years comprised the study material. The patients'complaint was limited mouth opening and pain during function. Patients were divided into 3 groups(articular disc displacement with reduction, articular disc displacement without reduction, osteoarthritis group). The preauricular area was disinfected anesthetized locally with 2% lidocaine hydrochloride. Arthrocentesis was performed. Hyaluronic acid(1.5 cc) was then injected into the superior compartment of the TMJ. Active range of motion exercises were instituted at approximately 24 hours postoperatively. Antibiotics and NSAID, three times daily by mouth, was prescribed for 3 days. Clinical evaluation of the patients was done before the procedure, immediately after the procedure, final follow-up visit postoperatively. Pain during function was assessed using visual analog scales(VAS). Maximal mouth opening was recorded as a distance between upper incisal edge and lower incisal edge. Intra-articular injection of hyaluronic acid caused significant reduction of pain during function, significant increase of maximal opening range. These findings suggest that intra-articular injection of hyaluronic acid is useful for decreasing patient reports of pain while increasing functional mobility of the mandible in internal derangements of the TMJ.
Anti-Bacterial Agents ; Exercise ; Female ; Follow-Up Studies ; Humans ; Hyaluronic Acid* ; Injections, Intra-Articular* ; Lidocaine ; Male ; Mandible ; Mouth ; Osteoarthritis ; Range of Motion, Articular ; Temporomandibular Joint*

PURPOSE: In order to clarify the correlation of mandibular setback using bilateral intraoral vertical ramus osteotomy (BIVRO) and post-surgical transverse mandibular width (TMW), this study examined the pre- and postsurgical changes in hard and soft tissues of TMW and the relationship of TMW and the amount of mandibular setback. PATIENTS AND METHODS: One-hundred seven patients who had undergone BIVRO were evaluated radiographically and clinically. A comparison study of the changes in hard and soft tissue after surgery in all 107 patients was performed with preoperative, 1 month, 3 month, 6 month and 1 year postoperative posteroanterio cephalograms and clinical photographs by tracing. And this changes were evaluated in parts to amounts of mandibular setback. RESULTS: Statistically significant increases of TMW in hard and soft tissue from preoperative to postoperative 1 month were seen. TMW in hard tissue from 1 month to 1 year postopertive were gradually decreased. TMW in soft tissue was not changed uniformly but almost equal to pre-operative width. And there was no significant correlation between TMW and amount of mandibular setback. CONCLUSIONS: The results show that mandibular setback using BIVRO did not significantly influence increasing of TMW in soft tissue.
Humans ; Osteotomy*

The purpose of this study was to isolate and identify the bacteria in chronic maxillary sinusitis (CMS) lesions from 3 patients and to determine the antimicrobial susceptibility of them against 10 antibiotics. One of them was odontogenic origin and the others were non-odontogenic origin. Pus samples were collected by needle aspiration from the lesions and examined by culture method. Bacterial culture was performed in three culture systems (anaerobic, CO2, and aerobic incubator). Identification of the bacteria was performed by 16S rRNA gene (16S rDNA) nucleotide sequencing method. To test the sensitivity of the bacteria isolated from the maxillary sinusitis lesions against seven antibiotics, penicillin G, amoxicillin, tetracycline, ciprofloxacin, cefuroxime, erythromycin, clindamycin, and vancomycin, minimum inhibitory concentration (MIC) was performed using broth dilution assay. Our data showed that enterobacteria such as Enterobacter aerogenes (30%), Klebsiella pneumoniae (25%), and Serratia marcescens (15%) were predominately isolated from the lesion of non-odontogenic CMS of senile patient (70 year old). Streptococcus spp. (40.3%), Actinomyces spp. (27.4%), P. nigrescens, M. micros, and P. anaerobius strains were isolated in the lesion of odontogenic CMS. In the lesion of non-odontogenic CMS, Streptococcus spp. (68.4%), Rothia spp. (13.2%), and Actinomyces sp. (10.5%) were isolated. The susceptibility pattern of 10 antibiotics was determined according to the host of the bacteria strains ratter than the kinds of bacterial species. Even though the number of CMS was limited as three, these results indicate that antibiotic susceptibility test must be accompanied with treatment of CMS. The combined treatment of two or more antibiotics is better than single antibiotic treatment in the presence of multidrug-resistant bacteria in the CMS lesions.
Actinomyces ; Amoxicillin ; Anti-Bacterial Agents ; Bacteria* ; Cefuroxime ; Ciprofloxacin ; Clindamycin ; Enterobacter aerogenes ; Enterobacteriaceae ; Erythromycin ; Genes, rRNA ; Humans ; Klebsiella pneumoniae ; Maxillary Sinus* ; Maxillary Sinusitis* ; Microbial Sensitivity Tests ; Needles ; Osteomyelitis ; Penicillins ; Serratia marcescens ; Streptococcus ; Suppuration ; Tetracycline ; Vancomycin

PURPOSE: The aim of this study was to investigate healed bovine bone particles (Bio-Oss(R)) and absorbable collagen sponge (CollaPlug(R)) applied extraction socket site at 4-6 months' post-extraction. MATERIAL AND METHODS: From August, 2004 to October, 2005, 17 sockets in 5 adult patients were selected out of the patients whose received ridge preservation using bovine bone particles and absorbable collagen sponges at Department of oral and maxillofacial surgery in Samsung Medical Center. There were 5 male patients, ages 30 to 58 years. Immediate postoperation and 4-6 months after operation study models were compared to evaluate the ridge dimension by measuring vertical height and horizontal width of alveolar ridge. RESULTS: The measurements at 4-6 months revealed, in the ridge dimension, a loss of vertical height of 0.91+/-0.40mm and horizontal width of 1.25+/-0.58mm. There was no adverse reaction. CONCLUSION: This study suggests that treatment of extraction sockets with graft materials and collagen sponges is valuable in preserving alveolar bone in extraction sockets and preventing alveolar ridges defects.
Adult ; Alveolar Process ; Collagen ; Humans ; Male ; Porifera ; Surgery, Oral ; Transplants

The fibroblast in the periodontal ligaments received various stress. Among them, compression and tension are quite important and they are related to the remodeling of tooth and alveolar bone. We studied the change of expression of interleukin-6 (IL-6) and interleukin-8 (IL-8) in the fibroblasts of the periodontal ligaments by real-time RT-PCR and ELISA. In results, the relative activity of IL-6 mRNA in 2 hours after was 1.54+/-0.08 and 1.00+/-0.05 in control and test, respectively (P<0.05). Its 12 hours after was 1.23+/-0.06 and 2.78+/-0.14 in control and test, respectively (P<0.05). The relative activity of IL-8 mRNA in 2 hours after was 1.00+/-0.05 and 0.24+/-0.01 in control and test, respectively (P<0.05). Its 12 hours after was 1.23+/-0.06 and 0.63+/-0.03 in control and test, respectively (P<0.05). The concentration of IL-6 was 1.02+/-0.16 ng/ml, 0.90+/-0.14 ng/ml, and 1.32+/-0.12 ng/ml (P<0.05) in control, 2, and 12 hours after, respectively. The concentration of IL-8 was 2.26+/-0.17 ng/ml, 1.70+/-0.26 ng/ml (P<0.05), and 0.84+/-0.47 ng/ml (P<0.05) in control, 2, and 12 hours after, respectively. In conclusion, the expression of IL-6 was significantly increased after the application of the static compressive force, but IL-8 was significantly decreased. Considering their known function, their expression is quite important in tooth and bone resorption.
Bone Resorption ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts* ; Interleukin-6* ; Interleukin-8 ; Periodontal Ligament* ; RNA, Messenger ; Tooth

The objective of this study is assessment of the efficacy of upper joint space arthrocentesis on prevention of TMJ injury from patient with mantibular fractures. We divided the patients into two groups, one which consist of 24 patients who are taken arthrocentesis while open reduction of mandibular fracture, the other which consist of 27 patients without arthrocentesis from Jan 1999 to Dec 2001. We measured maximum mouth opening, excursive movement range respectively one week, one month, three months later after operation. The patients were instructed to mark on 10 cm VAS for evaluation of TMJ pain during resting, mouth opening, and mastication. We evaluated the signs and symptoms of temporomandibular disorder clinically and radiographically 6 months later. The result of this study is that there is a reduction of pain and increase of range of mandibular motion in both groups but in patients with arthrocentesis there is relatively reduction of pain and increase of range of mandibular motion compared with control group. On the points of 6 months later, temporomandibular disorder occurred in 4 patients (16.7%) in group with arthrocentesis and 13 patients (47.1%) in control group. In conclusion, we think that supplemental therapy such as arthrocentesis is helpful for the recovery of jaw function and prevention of the development of temporomandibular disorder after facial trauma.
Humans ; Jaw ; Joints ; Mandibular Fractures* ; Mastication ; Mouth ; Temporomandibular Joint Disorders ; Temporomandibular Joint*