BACKGROUND: Teeth requiring extraction before radiotherapy in head & neck cancer patients should be removed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it was not uncommon for the radiotherapist and cancer patient to feel an urgent need to process with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy, were considered and applied based on the experimental study. MATERIALS AND METHODS: Eighteen dogs were processed for histopathologic wound healing. The effect of the primary endodontic treatment and extraction before early radiotherapy was examined. RESULTS: No specific complication, such as, post-extraction wound infection, radiation osteitis and osteoradionecrosis, were encountered despite the early radiotherapy. CONCLUSION: Based on the experimental study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for the early radiotherapy in head and neck cancer patients.
Animals ; Dental Care ; Dogs ; Head ; Head and Neck Neoplasms ; Humans ; Osteitis ; Osteoradionecrosis ; Tooth ; Tooth Extraction ; Wound Healing ; Wound Infection

Castleman's disease(CD) is rare in childhood. It is defined as a localized nodal hyperplasia in mediastinum or cervical area. It is also called angiofollicular lymph node hyperplasia, lymph nodal hamartoma, giant lymph node hyperplasia. It was first described in 1956 by Castleman et al. as a lesion of mediastinal mass. The etiology of CD is not clear. The histologic classification of CD is hyaline vascular and plasma cell type. The hyaline-vascular type is more frequent, and characterized by small hyaline-folliclees and interfollicular capillary proliferation. The plasme cell type is characterized by the large follicles with intervening sheets of plasma cells. The clinical classification of CD is solitary and multicentric type. The solitary type is usually asymptomatic but, the multicentric type is usually combined systemic manifestations, such as fever, anemia, hyperglobulinemia. Complete surgical resection of involved lymph nodes is both diagnostic and therapeutic. The prognosis of solitary type is good, in a general way. We experienced CD cases in five-year-old girl, who had a 4x3 cm solid mass in postrior triangle of neck, right. The mass was removed completely and confirmed Castleman's disease microscopically. The histopathologic finding was a proliferation of germinal centers with hyaline thickening of the wall and the interfollicular stroma showed hyperplastic vessels admixed with lymphocytes, plasma cells and eosinophils. She discharged after six days of operation and her prognosis was good.
Anemia ; Capillaries ; Classification ; Eosinophils ; Female ; Fever ; Germinal Center ; Giant Lymph Node Hyperplasia* ; Hamartoma ; Humans ; Hyalin ; Hyperplasia ; Lymph Nodes ; Lymphocytes ; Mediastinum ; Neck ; Plasma Cells ; Prognosis

INTRODUCTION: Tooth requiring extraction before radiotherapy in head and neck cancer patients should be performed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it is not uncommon for the radiotherapist and cancer patient to feel an urgent need to proceed with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy were considered and applied based on a literature review MATERIALS AND METHODS: The clinical study involved 120 head and neck cancer patients who were treated at Wonju Christian Hospital, Wonju College of Medicine, Yonsei University, from January 1995 to December 2004. RESULTS: In the clinical study, there were no specific complications, such as, post-extraction wound infections, radiation osteitis and osteoradionecrosis over the recent 10 years despite the early radiotherapy. CONCLUSION: Based on the clinical study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for early radiotherapy in head and neck cancer patients.
Dental Care ; Head ; Head and Neck Neoplasms ; Humans ; Osteitis ; Osteoradionecrosis ; Tooth ; Tooth Extraction ; Wound Infection

PURPOSE: The purpose of this study was to characterize the osseointegration of the fibronectin-coated implant surface. METHODS: Sand-blasted, large-grit, acid-etched (SLA) surface implants, with or without a thin calcium phosphate and fibronectin coating, were placed in edentulous mandibles of dogs 8 weeks after extraction. All dogs were sacrificed forhistological and histomorphometric evaluation after 4- and 8-week healing periods. RESULTS: All types of implants were clinically stable without any mobility. Although the bone-to-implant contact and bone density of the SLA implants coated with calcium phosphate (CaP)/fibronectin were lower than the uncoated SLA implants, there were no significant differences between the uncoated SLA surface group and the SLA surface coated with CaP/fibronectin group. CONCLUSIONS: Within the limits of this study, SLA surfaces coated with CaP/fibronectin were shown to have comparable bone-to-implant contact and bone density to uncoated SLA surfaces.
Animals ; Bone Density ; Calcium ; Calcium Phosphates ; Coated Materials, Biocompatible ; Dental Implants ; Dogs ; Fibronectins ; Mandible ; Osseointegration

The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.
Debridement ; Drainage ; Mandibular Fractures ; Tooth ; Tooth, Nonvital ; Wound Infection

Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.
Adult ; Airway Obstruction ; Blood Platelets ; Cerebral Palsy ; Drainage ; Emergencies ; Glycosaminoglycans ; Hemorrhage ; Humans ; Hydrocarbons, Iodinated ; Infection Control ; Male ; Mentally Disabled Persons ; Purpura, Thrombocytopenic ; Rubber ; Scurvy ; Shock ; Sutures ; Wound Infection

In the presence of acute pericoronitis of mandilbular third molar, antibiotic therapy and early incision and drainage are the method of choice, followed by definitive surgical extraction of the tooth as soon as it becomes subacute. If excision of the overlying tissues is decided on, it should be done adequately. All overlying tissues must be throughly excised, and the crown portion of the unerupted tooth should be completely exposed. After excision has been completed, the wound should be managed with a surgical dressing. This should be allowed to remain approximately 7 days. And then, surgical extraction of the impacted mandibular third molar can be done usually. In this operation, there are many complications, such as, postoperative bleeding, infection, trismus, dysphasia and paresthesia. The surgeon are discredited and medicolegal problem may be occurred in the presence of many distressed complications. Therefore, the relatively nonsurgical treatment is the method of choice. So, authors selected the conservative treatment methods of incision and drainage, primary endodontic drainage, operculectomy without surgical extraction of the mandibular third molars. The results were more favorable without the postoperative complication in Wonju old offender prison.
Aphasia ; Bandages ; Criminals ; Crowns ; Drainage ; Hemorrhage ; Humans ; Infection Control ; Molar, Third ; Paresthesia ; Pericoronitis ; Postoperative Complications ; Prisoners ; Prisons ; Tooth ; Tooth, Unerupted ; Trismus

This study is an analysis of types of patients and distribution of implant site and survival rate of Xive(R) implant. The following results on patient type, implant distribution and survival rate were compiled from 324 implant cases of 140 patients treated at the periodontal dept. of Yonsei University Hospital and G dental clinic between February 2003 and April 2006. 1. There are no dissimilarities between men and women, with patients in their 30, 40, 50s accounting for 80% of patients and accounted for 82% of implant treatments; the largest share of patients and implant treatments. 2. Mn. posterior area accounted for 57% of implant treatments followed by Mx. posterior area(29%), Mx. anterior area(8%) and Mn. anterior area(6%). 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 96% and fully edentulous patient accounted for the remaining 4%. 4. The major cause of tooth loss is periodontal disease, followed by dental caries, trauma and congenital missing. 5. The distribution of bone quality for maxillae was 54.2% for typeIII, followed by 30.8% for type II, 15% for typeIV and 0% for typeI. As for mandible, the distribution was 63% for typeII, followed by 34% for typeIII, 2.5% for typeI and 0.5% for typeIV. 6. The distribution of bone quantity for maxillae was 55% for type C, followed by 35% for type B, 8% for type D and 2% for type A. As for mandible, the distribution was 60% for type B, followed by 32% for type C, 7% for type A and 0% for type D. 7. The majority of implants were those of 9.5-13 mm in length(95%) and regular diameter in width(82%). 8. The total survival rate was 98%. The survival rate was 97% in the maxillae region and 99% in the mandible region. 9. The survival rate in typeI was 83%, in typeII was 99%, in typeIII was 97% and in typeIV was 100%. As for the bone quantity, the survival rate in type A and D(100%) was most, followed by type B(99%) and type C(96%). The results showed that Xive(R) implant could be used satisfactorily compare for the other implant system. But we most to approach carefully in certain extreme condition especially with poor bone quality and quantity.
Crowns ; Dental Caries ; Dental Clinics ; Female ; Humans ; Male ; Mandible ; Maxilla ; Periodontal Diseases ; Prostheses and Implants ; Retrospective Studies* ; Survival Rate* ; Tooth Loss

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.
Avitaminosis ; Bandages ; Blood Platelets ; Capillaries ; Dehydration ; Drainage ; Dry Socket ; Female ; Fibrinogen ; Gelatin ; Gelatin Sponge, Absorbable ; Hemophilia B ; Hemorrhage ; Hemostasis ; Humans ; Hydrocarbons, Iodinated ; Liver ; Liver Cirrhosis ; Porifera ; Purpura, Thrombocytopenic ; Rubber ; Scurvy ; Thrombin ; Tooth ; Veins

The most common local cause of active gingival bleeding is the vessel engorgement and erosion by severe inflammation. Abnormal gingival bleeding is also associated with the systemic disturbances. Hemorrhagic disorders in which abnormal gingival bleeding is encountered include the following: vascular abnormalities (vitamin C deficiency or allergy), platelet disorders, hypoprothrombinemia (vitamin K deficiency resulting from liver disease), and other coagulation defects (hemophilia, leukemia). There are many conventional methods for gingival bleeding control, such as, direct pressure, electrocoagulation, direct suture, drainage, application of hemostatic agents and crushing and packing. If the active continuous gingival bleeding is not stopped in spite of the application of all conventional bleeding control methods, the life of patient is threatened owing to upper airway obstruction, syncope, vomiting and hypovolemic shock. Therefore, the rapid and correct hemostatic method is very important in the emergency dental care.
Airway Obstruction ; Blood Platelets ; Crowns ; Dental Care ; Drainage ; Electrocoagulation ; Emergencies ; Glycosaminoglycans ; Hemorrhage ; Hemorrhagic Disorders ; Humans ; Hypoprothrombinemias ; Inflammation ; Liver ; Liver Cirrhosis ; Shock ; Sutures ; Syncope ; Vomiting