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*

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*

PURPOSE: Pink gingival esthetic especially on the anterior teeth has been an important success criterion in implant-supported restoration. Inter-implant papillae are a critical factor for implant esthetics, and various techniques for inter-implant papilla reconstruction have been introduced. The aim of this study is to suggest and evaluate a surgical technique for reconstructing inter-implant papillae. METHODS: A 28-year-old man had an implant placed on the #13 and #14 area. Four months after implant placement, a second stage surgery was planned for inter-implant papilla reconstruction. At the time of the abutment connection, I-type incisions were performed on the #13i & #14i area followed by full-thickness flap elevation and connection of a healing abutment on underlying fixtures without suture. RESULTS: Two weeks after the second stage implant surgery, soft tissue augmentation between the two implants was achieved. CONCLUSIONS: I-shaped incisions for papilla reconstruction performed during the second stage implant surgery were useful for inter-implant papilla reconstruction and showed a good esthetic result.
Adult ; Dental Implants ; Dental Papilla ; Esthetics ; Esthetics, Dental ; Humans ; Sutures ; Tooth

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

PURPOSE: The aim of this study is to compare two different gingival depigmentation techniques using an erbium:yttrium-aluminum-garnet (Er:YAG) laser and rotary instruments. METHODS: Two patients with melanin pigmentation of gingiva were treated with different gingival depigmentation techniques. Ablation of the gingiva by Er:YAG laser was performed on the right side, and abrasion with a rotary round bur on the opposite side. RESULTS: The patients were satisfied with the esthetically significant improvement with each method. However, some pigment still remained on the marginal gingival and papilla. The visual analog scale did not yield much difference between the two methods, with slightly more pain on the Er:YAG laser treated site. CONCLUSIONS: The results of these cases suggest that ablation of the gingiva by an Er:YAG laser and abrasion with a rotary round bur is good enough to achieve esthetic satisfaction and fair wound healing without infection or severe pain. Prudent care about the gingival condition, such as the gingival thickness and degree of pigmentation along with appropriate assessment is needed in ablation by the Er:YAG laser procedure.
Gingiva ; Humans ; Hyperpigmentation ; Melanins ; Pigmentation ; Wound Healing

PURPOSE: The objective of this study was to compare and evaluate the inflammatory responses of three widely used suture materials in the keratinized gingiva and buccal mucosa of beagle dogs. METHODS: Silk, polyglycolic acid, and nylon sutures were placed within the mandibular keratinized gingiva and maxillary buccal mucosa of four male beagle dogs. Biopsies were taken 3, 7, and 14 days after suturing. Specimens were prepared with hematoxylin-eosin stain for evaluation under a light microscope. RESULTS: The suture materials placed in the oral mucosa elicited more inflammatory reactions than did those placed in the keratinized gingiva. The multifilament suture materials caused more inflammatory tissue reactions than did the monofilament suture materials in the oral mucosa. CONCLUSIONS: If oral hygiene is well maintained and suture materials are placed in the keratinized gingiva, silk, nylon, and polyglycolic acid are considered to be proper suture materials for oral surgery. However, it is advisable to use monofilament suture materials if the suture site is within the oral mucosa.
Animals ; Biopsy ; Dogs ; Gingiva ; Humans ; Keratins ; Light ; Male ; Mouth Mucosa ; Nylons ; Oral Hygiene ; Polyglycolic Acid ; Silk ; Surgery, Oral ; Sutures

The present study was performed to evaluate the effect of Tetracycline-HCl on the change of implant surface microstructure according to application time. Implant with hydroxyapatite surface was were utilized. Implant surface was rubbed with 50mg/ml Tetracycline-HCl solution and sterilized saline for 1/2min., 1min., 1 1/2min., 2min., 2 1/2min. and 3min. respectively in the test group. Then, specimens were processed for scanning electron microscopic observation and measured surface roughness by optical interferometer. The results of this study were as follows. 1. Hydroxyapatite surface showed that round particles were deposited irregularly. 2. The roughness of surfaces conditioned with Tetracycline-HCl and saline was lessened and the cracks were increased relative to the application time. In conclusion, the detoxification with 50mg/ml Tetracycline-HCl must be applied respectively with appropriate time according to hydroxyapatite implant surfaces.
Durapatite*

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