Although pancreatic leiomyosarcoma (PLM) is a rare malignant pancreatic cancer, it usually shows aggressive biological features such as invasion to an adjacent organ or distant metastasis at the time of diagnosis. Radical resection is the best treatment modality but effective chemotherapies have not been identified. A 58-year-old female was referred to us complaining of intermittent left upper quadrant abdominal discomfort. Imaging studies revealed a 10-cm mass in the pancreatic tail. The patient underwent laparoscopic distal pancreatectomy with splenectomy, and the pathological findings were consistent with PLM. Imaging studies 14 months after surgery revealed multiple liver metastases. Because the patient was young with a sufficient remnant liver, we performed laparoscopic metastatectomy without any postoperative complications. Patients with PLM need frequent check-ups, even after curative resection. The role of laparoscopic resection should be confirmed in the future.
Diagnosis ; Drug Therapy ; Female ; Humans ; Laparoscopy ; Leiomyosarcoma* ; Liver* ; Middle Aged ; Neoplasm Metastasis* ; Pancreatectomy ; Pancreatic Neoplasms ; Postoperative Complications ; Splenectomy ; Tail

Increasing the vertical dimesion affects not only functional problems but also the facial appearance. In particular, when restoring the reduced vertical dimension, it is important to evaluate facial appearance because the change affects the patient’s aesthetics. Cephalometric radiographs can predict changes in the facial appearance through skeletal and vertical classifications using anatomical indicators, and the changes before and after treatment can be easily observed, which could serve as good data in evaluating treatment success. In this study, comparative evaluation was performed through cephalometric radiography, and the aesthetic and functional improvement was confirmed.

Successful cases of the implant-assisted removable partial denture and implant overdentures are reported in which a few implants are additionally placed to secure the maintenance, support, and stability of the denture when there are a few residual teeth. When the lateral force applied to the tooth abutment and implant surveyed crown is minimized, the horizontal and rotational movement of the denture is significantly reduced which is an effective method that can improve the address in patients who complain of reduced retention and stability of their dentures. In this case, a small number of implants were placed to fabricate an implant-assisted removable partial denture with implant surveyed crown in the maxilla and implant overdenture with Locator® attachment in the mandible to improve the retention, stability, and support of the dentures. The patient was satisfied with both functional and aesthetic aspects after the final dentures were delivered.

Situs inversus totalis (SIT) is a rare condition in which the viscera are transposed in a mirror image reversal. We report two cases of laparoscopic cholecystectomy (LC) performed for SIT patients. A 63-year old male patient with SIT was diagnosed with symptomatic gallstones. We performed LC by 3-port method. The patient was discharged uneventfully on postoperative day 2. A 57-year old female patient with SIT underwent LC for acute cholecystitis. Due to severe inflammation an assistant was needed. The patient was discharged uneventfully on postoperative day 3. Over 80 cases of LCs in SIT patients have been reported so far and LC has become the standard treatment. The current report confirms the safety of laparoscopy in such cases. Laparoscopic cholecystectomy can be performed safely in SIT patients if care is taken. Surgeons need to be careful of reversed anatomy and unaccustomed working hand.
Cholecystectomy, Laparoscopic* ; Cholecystitis, Acute ; Female ; Gallstones ; Hand ; Humans ; Inflammation ; Laparoscopy ; Male ; Methods ; Situs Inversus* ; Surgeons ; Viscera

Esthetic restoration of maxillary anterior implant heavily depends on the direction of installation of implant fixture. In patients with malpositioned implant, it is crucial to communicate the limitations of prosthetic outcome with the patient before starting on a restoration. To facilitate the communication, three-dimensional virtual representation by superimposing facial and intraoral digital scans with Computed Tomography (CT, dicom file) was used for visualization of the limitations of prosthesis. Through digital diagnostic wax-up, the profile of right maxillary anterior incisor implant was expected to be protrusive, which the patient was not satisfied with. Since the patient already had done root canal treatment on left maxillary anterior incisor due to previous trauma, a new prosthetic design including both right and left maxillary anterior incisors was presented to the patient. The second design was chosen and his comments were delivered to dental lab. The patient was satisfied with the new prosthesis, aesthetically and functionally.

Purpose: This study aimed to evaluate the color stability and antibacterial properties of the surface of polyethyl methacrylate (PEMA) resin with zirconia nanoparticles added. Materials and Methods: The control group was pure PEMA resin, and the experiment group was PEMA resin 15 mm in diameter and 2.5 mm in thickness disk-shaped specimens with 2, 4 and 8 w/v% of zirconia nanoparticles added, which were respectively divided into Group Z2, Group Z4, and Group Z8. After analyzing the surface roughness and color stability of the specimens, their antibacterial properties were evaluated using Porphyromonas gingivalis (P. gingivalis). The Statistical analysis was performed using when normality was met in the Shapiro-Wilk test, one-way ANOVA was used to test parameters, and Tukey’s test was used as a post hoc test. When normality was not met, the Kruskal-Wallis test, a non-parametric test was used (P < 0.05). Results: The surface roughness measurement found that there was no significant difference between the experimental and control groups. The color stability evaluation showed that the Z2, Z4, and Z8 groups were within the color range of natural teeth.The adhesion of P. gingivalis was evaluated to be significantly reduced in Group Z2 compared to the control group (P < 0.05). In the Z2 group, Z4 group, and Z8 group, dead cells bacteria than the control group were observed. Conclusion In conclusion, PEMA resin with zirconia nanoparticles added was within the range of natural teeth in color and reduced the adhesion of P. gingivalis

In patients with myasthenia gravis, it is difficult to manufacture and maintain dentures because the muscles and nervous system in the oral cavity are not properly adjusted. In addition, excessively extended or thick dentures may cause muscle weakness by stimulating the muscles, so dentures should be manufactured in consideration of this. In this case, a denture was fabricated using the closed mouth technique in a patient with myasthenia gravis with mouth opening limitation. Using the closed mouth technique, the patient’s masticatory pressure and muscle movements were reproduced and denture with good retention were manufactured.

Computer-aided design–computer-aided manufacturing technology has been widely used in the manufacture of fixed prostheses including implants, but in the case of removable dentures, the analog method is still being used due to the errors such as a lack of fusion and over-fusion in selective laser meting process. With the recent development of CAD software, virtual surveying and framework design are made possible, and the designed file can be manufactured by milling or 3D printing. It replace the analog method of waxing and denture curing process and also can reduce the production time and cost. Therefore, this case is reported because good clinical results were obtained by digitally surveying on CAD software to produce a surveyed metal restoration and framework on maxillary and mandibular removable dentures.

The implant prosthesis of anterior maxilla requires careful consideration in planning. In order to satisfy both esthetic and functional needs of a patient, fusion of intra-oral scan in Cone-beam computed tomography (CBCT) and facial scan can be considered. Bony structures and soft tissues captured in CBCT and occlusal surfaces of intra oral scan were incorporated into personal characteristics from facial scan. The patient had insufficient buccal bone on maxillary anterior area. The maxillary implants could not be placed on the most ideal position. However, the “top down” approach completed by computer-generated arranging of teeth in implant planning and surgery with surgical guide resulted in esthetically and functionally satisfying result regardless of the limitation. Careful diagnosis with digital technique and the usage of surgical guide resulted in successful surgery and esthetic restoration. The temporary fixed prostheses were designed, restored and evaluated. The patient was not satisfied with the first design of temporary prosthesis, which showed uneven space distribution between teeth due to the position of maxillary implant. The design was modified by changing proximal emergence contours and line angle to alter the perceived since of incisors. The patient was satisfied with the new design of provisional restoration. A digital occlusion analyzer (Arcus Digma II, KaVo, Leutkirch, Germany) was used to measure inherent condylar guidance and anterior guidance of a patient to provide a definitive prosthesis.

Recently, through the development of CAD/CAM technology, it is also being used for fabricating dentures. Compared to conventional methods, when digital dentures are fabricated, the fabrication process is facilitated, and the number of visits to hospitals is reduced and errors are reduced. In this case, the vertical dimension was increased using a CAD program in a patient who needed vertical dimension recovery due to the use of old dentures, and the final denture was fabricated using a monolithic disc through the milling method. The centric relation was recorded using existing dentures, and using the information from the intraoral scan and the existing denture model scan, a trial denture was fabricated and delivered to the patient to evaluate the midline and occlusion. Based on the evaluation of the trial denture, the final denture was fabricated using a milling method and a monolithic disc, and the final denture showed satisfactory results functionally and aesthetically.