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Multicentric retrospective clinical study on the clinical application of mini implant system.

Young Kyun KIM ; In Sung YEO ; Yang Jin YI ; Un Kyu KIM ; Kyung Nam MOON ; Seung Joon JEON ; Yong Seok CHO ; Pil Young YUN

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2010;36(4):325-330. doi:10.5125/jkaoms.2010.36.4.325

INTRODUCTION: Mini-implant system is applicable to areas of narrow space and area requiring temporary loading support. The purpose of this study was to evaluate the clinical outcome of a mini-implant system as well as the application of mini-implant system in the dental clinical field. MATERIALS AND METHODS: The patients who had been operated from Jan 2007 to Dec 2007 in the four dental facility including Seoul National University Bundang Hospital were enrolled. To evaluate the factors associated with the clinical outcome, the patients were classified according to gender, age, area of surgery, type of implant, diameter and length of the implant, and the purpose of the mini-implant system application. RESULTS: From 147 implants, only three implants failed, one of them was for temporary loading. There were no serious surgical or prosthetic complications in this study. CONCLUSION: An analysis of the preliminary data revealed a satisfactory clinical outcome. However, more long-term evaluation of narrow ridge type as well as the patient's satisfaction on the use of a provisional type mini-implant system is needed.
Dental Facilities ; Humans ; Retrospective Studies

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The prospective preliminary clinical study of open reduction and internal fixation of mandibular angle fractures using 2 miniplates.

Seung Bin YANG ; Chang Su JANG ; Ju Won KIM ; Jin Hyuk YIM ; Jwa Young KIM ; Byoung Eun YANG

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2010;36(4):320-324. doi:10.5125/jkaoms.2010.36.4.320

INTRODUCTION: The placement of a single miniplate is not sufficient to achieve rigid fixation in mandibular angle fractures. It often causes difficulties in reducing the intermaxillary fixation (IMF) period. Consequently, the placement of 2 miniplates is preferable. The intraoral approach in an open reduction and internal fixation (ORIF) of a mandibular angle fracture with 2 miniplates is often challenging. Accordingly, an alternative of transbuccal approach is performed. However, this method leaves a scar on the face and can result in facial nerve injury. This clinical study suggests a protocol that can maintain rigid fixation without a transbuccal approach in mandibular angle fractures. MATERIALS AND METHODS: The subjects were 7 patients who sustained fractures of the mandibular angle and treated at Department of Oral and maxillofacial surgery, Sacred Heart Hospital, Hallym University. ORIF under general anesthesia was done using the intraoral approach. One miniplate was inserted on external oblique ridge of the mandible, and the other was placed on lateral surface of the mandibular body with contra-angle drill and driver. A radiographic assessment and occlusal contact point examination was carried out before surgery, and 2, 4 and 6 weeks after surgery. RESULTS: The mean operation time was 80 minutes. Regarding the occlusion state, the number of contact points increased after surgery. Paresthesia and infection were reported to be complications before surgery. CONCLUSION: The placement of 2 miniplates using contra-angle drill for ORIF of mandibular angle fractures allows early movement of the mandible without IMF. We propose this approach to reduce the patients' discomfort and simplify the surgical procedure.
Anesthesia, General ; Cicatrix ; Facial Nerve Injuries ; Heart ; Humans ; Mandible ; Mandrillus ; Paresthesia ; Prospective Studies ; Surgery, Oral

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Retropharyngeal space abscess due to spread of odontogenic infection: two cases report.

Tae Young JUNG ; Byung Moo CHAE ; Yong Seon JEONG ; Sang Jun PARK

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2010;36(4):314-319. doi:10.5125/jkaoms.2010.36.4.314

Odontogenic infections are a normally locally confined, self-limiting process that is easily treated by antibiotic therapy and local surgical treatment. However, it may spread into the surrounding tissues through a perforation of the bone, and into contiguous fascial spaces or planes like the primary or secondary fascial spaces. If the infection extends widely, it may spread into the lateral pharyngeal and retropharyngeal space. The retropharyngeal space is located posterior to the pharynx. If an odontogenic infection spreads into this space, severe life-threatening complications will occur, such as airway obstruction, mediastinitis, pericarditis, pleurisy, pulmonary abscess, aspiration pneumonia and hematogenous dissemination to the distant organs. The mortality rate of mediastinitis ranges from 35% to 50%. Therefore, a rapid evaluation and treatment are essential for treating retropharyngeal space abscesses and preventing severe complications. Recently, we encountered two cases of a retropharyngeal space abscess due to the spread of an odontogenic infection. In all patients, early diagnosis was performed by computed tomography scanning and a physical examination. All patients were treated successfully by extensive surgical and antibiotic therapy.
Abscess ; Airway Obstruction ; Early Diagnosis ; Humans ; Lung Abscess ; Mediastinitis ; Pericarditis ; Pharynx ; Physical Examination ; Pleurisy ; Pneumonia, Aspiration

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The conservative care by early endodontic drainage of infected teeth in the line of a mandibular fracture: report of a case.

Dong Yub MO ; Jae Ha YOO ; Byung Ho CHOI ; Sung Han SUL ; Ha Rang KIM ; Chun Ui LEE

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2010;36(4):309-313. doi:10.5125/jkaoms.2010.36.4.309

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

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Emergency bleeding control in a mentally retarded patient with active oral and maxillofacial bleeding injuries: report of a case.

Dong Yub MO ; Jae Ha YOO ; Byung Ho CHOI ; Sung Han SUL ; Ha Rang KIM ; Chun Ui LEE

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2010;36(4):303-308. doi:10.5125/jkaoms.2010.36.4.303

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

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Study on bisphosphonate-related osteonecrosis of the jaw (BRONJ): case report and literature review.

Yeo Gab KIM ; Baek Soo LEE ; Yong Dae KWON ; Joon Ho SUH ; Sang Mi JEEN

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2010;36(4):291-302. doi:10.5125/jkaoms.2010.36.4.291

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a side effect of Bisphosphonates (BPs) use. These days, oral bisphosphonates are normally prescribed to treat osteoporosis. Intravenous BPs are used extensively to treat osteolytic bone lesions related to multiplemyeloma and bone metastasis of solid cancers, breast cancer or prostate cancer. As the prescription of BPs is universalized and the number of people treated with BPs is increasing, an accurate understanding and proper management of BRONJ are required. The aim of this study was to improve the clinicians'understanding of BRONJ by reviewing the literature. To achieve this, this paper introduces case reports as well as the current concept of BRONJ based on the 2009 updates by American Association of Oral and Maxillofacial (AAOMS) including the definition, epidemiology, etiology, diagnosis, treatment and prevention of BRONJ.
Bisphosphonate-Associated Osteonecrosis of the Jaw ; Breast Neoplasms ; Diphosphonates ; Jaw Diseases ; Neoplasm Metastasis ; Osteonecrosis ; Osteoporosis ; Prescriptions ; Prostatic Neoplasms

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Treatment of huge mandibular cyst with enucleation after decompression under local anesthesia.

Yong Hoon CHA ; Hyung Jun KIM ; In Ho CHA ; Woong NAM

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2010;36(4):286-290. doi:10.5125/jkaoms.2010.36.4.286

Various treatment methods for huge cystic lesion of the jaw exist, such as, resection of the involved bone, enucleation and decompression. Among these methods, enucleation after decompression is a conservative technique that decreases the size of the cystic cavity and reduces the risk of intrabony defects, which could be induced by primary enucleation. In addition, it can save the adjacent anatomic structures. In these cases, the decompression combined with partial enucleation, which was performed before complete cyst enucleation was performed on huge cystic lesions of the mandible. During the process, a decrease in the size of the lesion and the growth of normal oral tissues was observed. The size of the lesion decreased until the time of complete enucleation, and surgery could be performed under local anesthesia. No damage to inferior alveolar nerve was observed. We report these cases with a review of the relevant literature.
Anesthesia, Local ; Decompression ; Jaw ; Mandible ; Mandibular Nerve

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Sclerotherapy of benign oral vascular lesion with sodium tetradecyl sulfate: cases report.

Kyung Wook KIM ; Jin Kyu SANG ; Jae Ho CHEONG

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2010;36(4):280-285. doi:10.5125/jkaoms.2010.36.4.280

Hemangioma and vascular malformation is a common vascular benign lesion in the head and neck region. The lesion is a congenital malformation observed in neonates. The treatment this lesion includes surgical excision, cryotherapy, selective embolization and treatment with sclerotic agents. We present three cases of benign oral vascular lesions treated with an intralesional injection of sodium tetradecyl sulfate. The lesions virtually disappeared after three sessions of sclerotherapy, leaving an inconspicuous scar. No side effects were observed. Sclerotherapy with sodium tetradecyl sulfate is effective in treating benign oral vascular lesions, and the use of the sodium tetradecyl sulfate provides alternative or support for surgical methods.
Cicatrix ; Cryotherapy ; Head ; Hemangioma ; Humans ; Infant, Newborn ; Injections, Intralesional ; Neck ; Sclerotherapy ; Sodium ; Sodium Tetradecyl Sulfate ; Vascular Malformations

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Guided bone regeneration using two types of non-resorbable barrier membranes.

Ji Young LEE ; Young Kyun KIM ; Pil Young YUN ; Ji Su OH ; Su Gwan KIM

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2010;36(4):275-279. doi:10.5125/jkaoms.2010.36.4.275

INTRODUCTION: Guided bone regeneration (GBR) is a common procedure for the treatment of bone defects and bone augmentation. The non-resorbable barriers are well-documented barriers for GBR because of their stability and malleability. However, few GBR studies have focused on the different types of non-resorbable barriers. Therefore, this study examined the clinical results of different non-resorbable barriers for GBR; expanded polytetrafluoroethylene (e-PTFE) (TR-Gore Tex, Flagstaff, AZ, USA), and high-density polytetrafluoroethylene (d-PTFE) (Cytoplast membrane, Oraltronics, Bremen, Germany). MATERIALS AND METHODS: The analysis was performed on patients treated with GBR and implant placement from January 2007 to October 2007 in the department of the Seoul National University Bundang Hospital. The patients were divided into two groups based on the type of non-resorbable barrier used, and the amount of bone regeneration, marginal bone resorption after prosthetics, implant survival rate and surgical complication in both groups were evaluated. RESULTS: The implants in both groups showed high survival rates, and the implant-supported prostheses functioned stably during the follow-up period. During the second surgery of the implant, all horizontal defects were filled with new bone, and there was no significant difference in the amount of vertical bone defect. CONCLUSION: In bone defect areas, GBR with non-resorbable barriers can produce favorable results with adequate postoperative management. There was no significant difference in bone regeneration between e-PTFE and d-PTFE.
Bone Regeneration ; Bone Resorption ; Follow-Up Studies ; Humans ; Membranes ; Polytetrafluoroethylene ; Prostheses and Implants ; Survival Rate

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Template therapy for mouth opening limitation by temporomandibular joint disorders.

Gi Cheol LEE ; Seung Woo SHIN ; Sung Woon PYO

Journal of the Korean Association of Oral and Maxillofacial Surgeons.2010;36(4):270-274. doi:10.5125/jkaoms.2010.36.4.270

INTRODUCTION: Limited mouth opening is a representative clinical symptom of temporomandibular disorders (TMD) with anterior disc displacement without reduction (ADDWOR). Various treatment methods have been proposed for patients with ADDWOR. This study examined the clinical effectiveness of template therapy for patients with mouth opening difficulty due to the ADDWOR. MATERIALS AND METHODS: A total of 14 patients (female 12, male 2, average age: 29.1+/-14.4), who had been treated in the template clinic, Sooncheonhyang University Bucheon Hospital, from January of 2006 to December of 2008, were enrolled in this study. The subjects were selected according to the following criteria: more than 2 weeks after the onset of locking, mouth opening range < 35 mm, and confirmed ADDWOR without a synovial pathology by magnetic resonance imaging (MRI). All patients were treated with the template appliance, instructed to wear it while sleeping and exercise for at least 10 hours per day. The maximum mouth opening (MMO) range and pain recognition scores before and after template therapy were recorded and compared. A paired t-test and Wilcoxon's signed rank test were used for statistical analysis. RESULTS: After the periodical follow up, significant improvement in the opening range was observed in the template treatment group. The average MMO range before treatment was 30.2+/-3.5 mm and the average MMO after treatment and follow up was 47.1+/-4.7 mm. The mean amount of mouth opening increment was 16.9+/-5.4 mm (P<0.01) and the pain recognition scores before and after treatment was also improved.(P=0.001) CONCLUSION: The template appliance proved to be efficient for the treatment of TMD with a closed lock and painful joint due to ADDWOR.
Displacement (Psychology) ; Follow-Up Studies ; Humans ; Joints ; Magnetic Resonance Imaging ; Male ; Mouth ; Range of Motion, Articular ; Temporomandibular Joint ; Temporomandibular Joint Disorders

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