Macroglossia can cause dentomusculoskeletal deformities, instability of orthodontic and orthognathic surgical treatment, and create masticatory, speech and airway management problems. To determine whether a reduction glossectomy is necessary, it will important to identify the signs and symptoms of macroglossia. Development of dentoskeletal changes directly related with tongue size, such as an anterior open bite or a Angle Class III malocclusion tendency, would indicate that reduction glossectomy may be beneficial. For reduction glossectomy, several techniques have been reported. However, in most techniques the tip of tongue is removed. So its excision causes the loss of most mobile and sensitive portion of the tongue, and creates ankylosed, globular tongue. To avoid such problems, central tongue reduction technique have been proposed. This article will introduce central tongue reduction for anterior openbite case associated with macroglossia.
Airway Management ; Congenital Abnormalities ; Glossectomy ; Macroglossia* ; Malocclusion ; Malocclusion, Angle Class III ; Open Bite ; Tongue*

PURPOSE: This study was performed to evaluate the features of pulmonary lobes and fissure in Korean and to compare with the previous results. MATERIALS AND METHODS: HRCT scans of 82 healthy Korean adults, performed with scan interval of 1.5/2.0 cm, were reviewed. RESULTS: Located mostly on inner aspect, incidences of incomplete oblique and horizontal fissure were 60% (Rt 48%, Lt 39%) and 51% respectively, lower than 70--80% and 60--75% of western studies. Superolateral oblique fissure, inferior accessory fissure, left horizontal fissure and other accessory fissure were shown in 1%, 13%, 7%, and 8% respectively. Lower lobe upper part faced laterally (Rt 91%, Lt 82%) while lower part faced medially (Rt 61%, Lt 79%). Right middle lobe ws highest posteromedially (49%) and was convex (97%). CONCLUSION: Features of pulmonary lobes and fissure in Korean were similar to the results of previous reports but with lower incidence of variation.
Adult ; Humans ; Incidence

PURPOSE: Visual internal urethrotomy is a standard therapy for incomplete urethral stricture, and may also be a reasonable initial treatment for a short complete urethral stricture. The success rate and final results of the repeated internal urethrotomy were retrospectively assessed to figure out the appropriate indication for visual internal urethrotomy as an initial treatment for incomplete pendulous and bulbous urethral stricture; according to the stricture free month. MATERIALS AND METHODS: Between January 1990 and December 1999, an internal urethrotomy was primarily performed on 166 patients with urethral strictures. The exclusion criteria were complete urethral and posterior urethral stricture. Retrograde urethrography was performed under fluoroscopic control. When the stricture recurred, the urethrotomy was repeated as the primary procedure. RESULTS: With regard to the time to recurrence, the success rate of the group of stricture recurrence at 6 months was significantly lower than that of the stricture free group at 6 months. CONCLUSIONS: With regard to the stricture site and length, the stricture free month might be considered as an important predictor of the outcome of a repeated internal urethrotomy, and visual internal urethrotomy might be considered as an initial treatment method for incomplete urethral stricture under the following conditions; a bulbous stricture, a stricture length under 20mm, and stricture free at 6 months.
Constriction, Pathologic ; Endoscopy ; Humans ; Recurrence ; Reoperation ; Retrospective Studies ; Urethral Stricture*

PURPOSE: One of the most frequent complications related to dental implants is peri-implantitis, and the characteristics of implant surfaces are closely related to the progression and resolution of inflammation. Therefore, a technical modality that can effectively detoxify the implant surface without modification to the surface is needed. The purpose of this study was to evaluate the effect of erbium-doped: yttrium, aluminium and garnet (Er:YAG) laser irradiation on the microstructural changes in double acid-etched implant surfaces according to the laser energy and the application duration. METHODS: The implant surface was irradiated using an Er:YAG laser with different application energy levels (100 mJ/pulse, 140 mJ/pulse, and 180 mJ/pulse) and time periods (1 minute, 1.5 minutes, and 2 minutes). We then examined the change in surface roughness value and microstructure. RESULTS: In a scanning electron microscopy evaluation, the double acid-etched implant surface was not altered by Er:YAG laser irradiation under the condition of 100 mJ/pulse at 10 Hz for any of the irradiation times. However, we investigated the reduced sharpness of the specific ridge microstructure that resulted under the 140 mJ/pulse and 180 mJ/pulse conditions. The reduction in sharpness became more severe as laser energy and application duration increased. In the roughness measurement, the double acid-etched implants showed a low roughness value on the valley area before the laser irradiation. Under all experimental conditions, Er:YAG laser irradiation led to a minor decrease in surface roughness, which was not statistically significant. CONCLUSIONS: The recommended application settings for Er:YAG laser irradiation on double acid-etched implant surface is less than a 100 mJ/pulse at 10 Hz, and for less than two minutes in order to detoxify the implant surface without causing surface modification.
Dental Implants ; Inflammation ; Microscopy, Electron, Scanning ; Peri-Implantitis ; Yttrium

PURPOSE: The aim of this case report is to present a case of incomplete bone formation after sinus augmentation. METHODS: A patient having alveolar bone resorption of the maxillary posterior edentulous region and advanced pneumatization of the maxillary sinus was treated with sinus elevation using deproteinized bovine bone in the Department of Periodontology, Kyung Hee University School of Dentistry and re-evaluated with computed tomography (CT) follow-up. RESULTS: Even though there were no significant findings or abnormal radiolucency on the panoramic radiograph, incomplete bone formation in the central portion of the augmented sinus was found fortuitously in the CT scan. The CT scan revealed peri-implant radiolucency in the apical portion of the implant placed in the augmented maxillary sinus. Nevertheless, the dental implants placed in the grafted sinus still functioned well at over 15 months follow-up. CONCLUSIONS: The result of this case suggests that patients who received maxillary sinus augmentation may experience incomplete bone formation. It is possible that 1) osteoconductive graft material with poor osteogenic potential, 2) overpacking of graft material that restricts the blood supply, and 3) bone microbial contamination may cause the appearance of incomplete bone formation after sinus augmentation. Further studies are needed to elucidate the mechanism of this unexpected result and care must be taken to prevent it.
Bone Resorption ; Dental Implants ; Dentistry ; Durapatite ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Osteogenesis ; Transplants

PURPOSE: The present study was performed to evaluate the effect of erbium:yttrium-aluminium-garnet (Er:YAG) laser irradiation on the change of hydroxyapatite (HA)-coated implant surface microstructure according to the laser energy and the application time. METHODS: The implant surface was irradiated by Er:YAG laser under combination condition using the laser energy of 100 mJ/pulse, 140 mJ/pulse and 180 mJ/pulse and application time of 1 minute, 1.5 minutes and 2 minutes. The specimens were examined by surface roughness evaluation and scanning electron microscopic observation. RESULTS: In scanning electron microscope, HA-coated implant surface was not altered by Er:YAG laser irradiation under experimental condition on 100 mJ/pulse, 1 minute. Local areas with surface melting and cracks were founded on 100 mJ/pulse, 1.5 minutes and 2 minutes. One hundred forty mJ/pulse and 180 mJ/pulse group had surface melting and peeling area of HA particles, which condition was more severe depending on the increase of application time. Under all experimental condition, the difference of surface roughness value on implant surface was not statistically significant. CONCLUSIONS: Er:YAG laser on HA-coated implant surface is recommended to be irradiated below 100 mJ/pulse, 1 minute for detoxification of implant surface without surface alteration.
Dental Implants ; Durapatite ; Electrons ; Freezing

PURPOSE: The purpose of this study was to evaluate exophytically vertical bone formation in the mandibular premolar area of beagle dogs by the concept of guided bone regeneration with a titanium reinforced e-PTFE membrane combined with human demineralized freeze-dried bone. MATERIALS AND METHODS: Four one-year old beagle dogs were divided into control and experimental group. All mandibular premolars were extracted and surgical vertical defects of 5 mm in height were created in the extracted sockets. At 8 weeks after the extraction, TR e-PTFE membrane sized with 8 mm in length, 5 mm in width, and 4 mm in height was placed on the decorticated mandible, fixed with metal pins and covered with full-thickness flap and assigned as control group. In experimental group, decorticated mandibule was treated with TR e-PTFE membrane and human demineralized freeze-dried bone. The animals were sacrificed at 16 weeks after the regenerative surgery, and new bone formation was assessed by histomorphometric as well as statistical analysis. RESULTS: Average of new bone formation was 38% in the control group, whereas was 25% in the experimental group (p<0.05). Average of connective tissue formation was 42% in the experimental group, whereas was 30% in the control group (p<0.05). The lamellar bone formation with haversian canals was observed in the both groups. In the experimental group, the particles of human demineralized freeze-dried bone were observed after 16 weeks and complete resorption of graft was not observed. CONCLUSION: On the basis of these findings, we conclude that titanium reinforced e-PTFE membrane may be used alone for vertical guided bone regeneration, but demineralized freeze-dried bone has no additional effect on vertical guided bone regeneration.
Animals ; Bicuspid ; Bone Regeneration ; Connective Tissue ; Dogs ; Haversian System ; Humans ; Mandible ; Membranes ; Osteogenesis ; Titanium ; Transplantation, Heterologous ; Transplants

PURPOSE: The aim of this study is to report a case of oral bisphosphonate-related osteonecrosis of the jaw (BRONJ) resulting in implant failure. METHODS: A patient suspected of having BRONJ was referred to the Department of Periodontology, Kyung Hee University School of Dentistry for the evaluation and treatment of exposed bone around implants. RESULTS: The patient, who had been taking oral bisphosphonates (BPs) for about a year, was successfully treated with systemic antibiotics, chlorhexidine mouth rinse, explantation, and surgical debridement of necrotic bone. CONCLUSIONS: The results of this case suggest that a patient taking BPs orally should be treated cautiously. Appropriate management including cessation of BPs and respective dental treatment may reduce the development of BRONJ.
Anti-Bacterial Agents ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Chlorhexidine ; Debridement ; Dentistry ; Diphosphonates ; Humans ; Mouth ; Osteonecrosis ; Osteoporosis

PURPOSE: The subepithelial connective tissue graft(SCTG) has been proven to be a highly predictable treatment modality for coverage of gingival recession. This case report was performed to evaluate the effect of various root coverage procedures using SCTG on gingival recession. MATERIALS AND METHODS: Three patients presents with Miller's class I recession defect on the maxillary canine. Each other SCTG(coronally advanced flap, Bruno's Tech., envelope Tech.) were performed for root coverage. Clinical parameters assessed included recession depth, recession width, and keratinized gingival width. Measurements were taken at baseline and 2 months and follow up end. RESULTS: The average of root coverage was 4 mm(100% of the pre-operative recession depth) at the 2, 5 months examination. The average increase of keratinized tissue between the baseline and the 2 months amounted to 3.2mm. CONCLUSION: Within the above results, various root coverage using SCTG is an effective procedure to Miller's class I recession defect and patient could be satisfied aesthetic requirement.
Connective Tissue ; Follow-Up Studies ; Gingival Recession ; Humans ; Keratins ; Transplants

Fimbriae (fimA) of Porphyromonas gingivalis are filamentous components on the cell surface and are thought to play an important role in the colonization and invasion of periodontal tissue. P. gnigivalis fimA gene encoding fimbrillin, a subunit of fimbriae, has been classified into 5 genotypes (typesI to V) based on the nucleotide sequences. In the present study, we examined the prevalence of these fimA genotypes in patients with dental implant and the relationship between prevalence of these genotypes and peri-implantitis. Dental plaque specimens obtained from 80 peri-implant sulci of 50 patients with dental implants were analyzed by 16S rRNA fimA gene-directed PCR assay. P. gingivalis were detected in 74.4% of the samples of the control group (healthy peri-implant sulci; probing depth<5mm) and in 92.0% of the samples of the test group (peri-implant sulci with peri-iimplantitis; probing depth> or =5mm). Among the P. gingivalis-positive samples of the control group, the most prevalent fimA type was typeI(29.3%), followed by typeII(26.8%). In contrast, a majority among the P. gingivalis-positive samples of the test group was typeII(56.5%), followed by typeI(43.5%). TypeII fimA genotype organisms were detected more frequently in the test group and a significant difference in the occurrence of typeII was observed between test and the control groups. A correlation between specific fimA types and peri-implant health status was found in typeII(OR 3.545) and only a weak relationship was revealed in typeIV(OR 3.807). These findings indicate that P. gingivalis strains that possess typeII fimA are predominant in peri-implant sulci with peri-implantitis and are closely associated with peri-implant health status. P. gingivalis with typeII fimA may be involved in peri-implantitis.
Base Sequence ; Colon ; Dental Implants ; Dental Plaque ; Genotype* ; Humans ; Peri-Implantitis* ; Polymerase Chain Reaction ; Porphyromonas gingivalis* ; Porphyromonas* ; Prevalence*