Oronasal fistula (ONF) is an epithelialized tract between the oral and nasal cavities, for which various flaps are used in surgical closure. ONF may lead to regurgitation of food into the nasal cavity, nasal obstruction, halitosis, and other symptoms that contribute to patient discomfort and impaired quality of life. Surgical closure is challenging, occasionally requiring multiple procedures and carrying a risk of recurrence. The nasolabial flap (NLF) is a well-established local flap for soft tissue reconstruction in the orofacial region; superiorly based flaps are typically used for defects of the nasal dorsum, tip, and ala, while inferiorly based flaps are applied to defects of the nasal floor, lips, and buccal mucosa. The NLF provides dependable vascularity and favorable donor-site esthetic outcomes. Although superiorly based NLFs are not commonly used for intraoral reconstruction, this case report suggests that they can serve as a feasible option for ONF closure in carefully selected patients when the flap lies within an appropriate distance from the maxilla.

Purpose: This review was conducted to systematically assess the impact of bisphosphonates (BPs) and denosumab, used as anti-resorptive therapies, on the incidence of dental implant failure. Methods: Electronic and manual searches were performed in accordance with the described search protocol. Only articles that met the inclusion criteria were selected. The primary outcome was implant failure, while secondary outcomes included biological complications and comorbidities. Following data extraction, a quality assessment and meta-analysis were conducted. Results: Fourteen eligible studies were included in the analysis following a qualitative evaluation. BP administration, regardless of the timing of anti-resorptive therapy, did not significantly increase the risk of implant failure (odds ratio [OR], 1.40; 95% confidence interval, 0.83–2.34). Subgroup analysis revealed a slightly higher, although statistically insignificant, risk of failure in patients with a follow-up period of 3 years or more compared to those with a follow-up duration of less than 3 years (with ORs of 2.82 and 1.53, respectively).Due to a lack of eligible studies, a meta-analysis for denosumab could not be conducted. Conclusions Our findings suggest that BP treatment does not compromise the survival of dental implants. Specifically, in patients with osteoporosis, implant failure rates were not significantly influenced by the administration of BPs before the placement of dental implants, suggesting that low-dose BP therapy may not contraindicate implant placement.Nevertheless, regular check-ups and maintenance periodontal treatment must not be neglected, and concomitant biological factors should be considered to ensure the long-term success of implant rehabilitation.

The upper lip is a functionally and aesthetically important area of the face. Therefore, reconstruction of an upper lip defect needs sufficient consideration to ensure functional and aesthetic recovery. Several methods, such as wedge resection, rotation flaps, advancement flaps, and myomucosal advancement flaps, have been used to reconstruct vermilion defects. However, it is challenging to reconstruct a vermilion defect because of the possibility of residual asymmetry or scars and restrictions to normal lip movement after the reconstruction. We present the case of a 51-year-old female that had an upper lip vermilion defect caused by a dog bite. The lip defect was reconstructed using a mucosal V-Y advancement flap. This mucosal flap was based on the orbicularis oris muscle with a branch of the superior labial artery to ensure sufficient blood supply. Therefore, flap survival was excellent, and there was no constriction of the flaps. Moreover, the color and contour were matched to the adjacent lip tissue, and re-establishment of the white roll and adequate lip volume were achieved. This mucosal V-Y advancement flap technique represents a reliable method to repair mucosal defects without vascular compromise of the flap.

The mentum plays an important role in the aesthetics of the face, and genioplasty is performed to improve an unbalance of the mentum. Among the various surgical approaches, setback genioplasty is used to create an aesthetic jaw-end appearance by moving the mentum backward when it protrudes more than normal. However, conventional setback genioplasty may be aesthetically disadvantageous because the profile of the mentum could become flat. This case study attempted to overcome the limitations of conventional setback genioplasty by rotating the position of the menton and pogonion.We devised a new method for setback genioplasty by rotating the segment anteroinferiorly. Using virtual surgery, we were able to specify the range of surgery more accurately and easily, and the surgery time was reduced. This case report showed the difference in chin soft tissue responses between conventional setback genioplasty and setback genioplasty with rotation.

BACKGROUND: Postoperative infection occurs when bone graft material is dislodged into the maxillary sinus cavity and most of the patients are often uncomfortable with the drainage and irrigation procedures to eradicate the infection. In this case report, we share a technique in treating patients with such condition. MATERIAL AND METHODS: A 47-year-old patient was referred after sinus elevation using the crestal socket osteotome, bone graft, and implant insertion at a local clinic. Clinical and radiographic findings confirmed the diagnosis of right maxillary sinusitis. A surgical and medical treatment regimen was applied. RESULTS: By using this technique for irrigation, we were able to achieve successful results, and the patient was satisfied due to less discomfort during the irrigation process. CONCLUSION: This method is a patient-friendly technique for sinus irrigation. It is not only limited to sinus grafted patients, but also maxillary sinusitis patients in any other type of odontogenic infection.
Diagnosis ; Drainage ; Humans ; Maxillary Sinus* ; Maxillary Sinusitis* ; Methods ; Middle Aged ; Transplants*

BACKGROUND/AIMS: The objective of this study was to compare the degree of hepatic enhancement and image quality using contrast media of different iodine concentrations with the same iodine dose. METHODS: From July 2011 to June 2013, 50 patients with chronic liver disease who underwent baseline and follow-up 128-slice multidetector computed tomography(MDCT) using contrast media with 350 mg I/mL (group A) and 400 mg I/mL (group B) iodine concentrations were included in this prospective study. The patients were randomly allocated to one of two protocols: 350 mg I/mL initially and then 400 mg I/mL; and 400 mg I/mL initially and then 350 mg I/mL. The bolus tracking technique was used to initiate the arterial phase scan. The computed tomography values of hepatic parenchyma, abdominal aorta and portal vein were measured. The degrees of hepatic and vascular enhancement were rated on a 4-point scale for qualitative assessment. The paired Student t test was used to compare outcome variables. RESULTS: The mean hepatic enhancement was significantly higher in group B than in group A during the portal (p = 0.025) and equilibrium phases (p = 0.021). In all phases, group B had significantly higher mean liver-to-aorta contrast (p < 0.05) and mean visual scores for hepatic and vascular enhancement (p < 0.001). CONCLUSIONS: This study showed that a higher iodine concentration (400 mg I/mL) in contrast media was more effective at improving hepatic enhancement in portal and equilibrium phase images and overall image quality using 128-slice MDCT in chronic liver disease patients.
Aorta, Abdominal ; Contrast Media ; Follow-Up Studies ; Humans ; Iodine* ; Liver Diseases* ; Liver* ; Multidetector Computed Tomography* ; Portal Vein ; Prospective Studies

OBJECTIVE: This study aimed to examine clinical practice patterns in the management of pregnant women admitted with threatened preterm labor (TPL) in Korea. METHODS: Data from women admitted with a diagnosis of TPL were collected from 22 hospitals. TPL was defined as regular uterine contractions with or without other symptoms such as pelvic pressure, backache, increased vaginal discharge, menstrual-like cramps, bleeding/show and cervical changes. Data on general patient information, clinical characteristics at admission, use of tocolytics, antibiotics, and corticosteroids, and pregnancy outcomes were collected using an online data collections system. RESULTS: A total of 947 women with TPL were enrolled. First-line tocolysis was administered to 822 (86.8%) patients. As a first-line tocolysis, beta-agonists were used most frequently (510/822, 62.0%), followed by magnesium sulfate (183/822, 22.3%), calcium channel blockers (91/822, 11.1%), and atosiban (38/822, 4.6%). Of the 822 women with first-line tocolysis, second-line tocolysis were required in 364 (44.3%). Of 364 with second-line, 199 had third-line tocolysis (37.4%). Antibiotics were administered to 29.9% of patients (284/947) with single (215, 22.7%), dual (26, 2.7%), and triple combinations (43, 4.5%). Corticosteroids were administered to 420 (44.4%) patients. Betamethasone was administered to 298 patients (71.0%), and dexamethasone was administered to 122 patients (29.0%). CONCLUSION: Practice patterns in the management of TPL in Korea were quite various. It is needed to develop standardized practice guidelines for TPL management.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Back Pain ; Betamethasone ; Calcium Channel Blockers ; Dexamethasone ; Diagnosis ; Female ; Humans ; Korea ; Magnesium Sulfate ; Muscle Cramp ; Obstetric Labor, Premature* ; Physician's Practice Patterns ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Premature Birth ; Retrospective Studies* ; Tocolysis ; Tocolytic Agents ; Uterine Contraction ; Vaginal Discharge

Segniliparus species is a novel genus that is reported to be the new emerging respiratory pathogens. Here, we report a very rare case of S. rugosus pulmonary infection in an immunocompetent patient with non-cystic fibrosis. The organism was identified by 16S rRNA gene sequencing. The patient was successfully treated with antibiotics.
Anti-Bacterial Agents ; Fibrosis* ; Genes, rRNA ; Humans ; Nontuberculous Mycobacteria ; Respiratory Tract Infections ; Sequence Analysis, RNA

BACKGROUND: We investigated the prevalence of latent tuberculosis infection (LTBI) among the health care workers (HCWs) and analyzed its risk factors in South Korea. METHODS: A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant and tuberculin skin test (TST), QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay, and chest radiography were performed. RESULTS: A total of 493 participants, 152 (30.8%) doctors and 341 (69.2%) nurses were enrolled in eight tertiary referral hospitals. The mean age of the subjects was 30.6 years old, and 383 (77.7%) were female. Of the 152 doctors, 63 (41.4%) and 36 (23.7%) were positive by TST and by QTF-GIT, respectively, and among the 341 nurses, 119 (34.9%) and 49 (14.4%) had positive TST and QFT-GIT results, respectively. Overall, the agreement between the two tests was 0.22 by the chance corrected proportional agreement rate (kappa coefficient) in 493 subjects. Experience of working in tuberculosis (TB)-related departments was significantly associated with positive LTBI test results by QFT-GIT assay, not by TST. In multivariate analysis, only age was independently associated with increased risk of a positive TST result, while age and experience of working in TB-related departments (odds ratio, 2.29; 95% confidence interval, 1.01-5.12) were independently associated with increased risk of a positive QFT-GIT result. CONCLUSION: A high prevalence of LTBI was found among South Korean HCWs. Considering the association between the experience of working in TB-related departments and high risk of LTBI, QFT-GIT may be a better diagnostic test for LTBI than TST in HCWs.
Delivery of Health Care ; Demography ; Diagnostic Tests, Routine ; Female ; Health Personnel ; Humans ; Interferon-gamma Release Tests ; Latent Tuberculosis ; Multivariate Analysis ; Prevalence ; Surveys and Questionnaires ; Republic of Korea ; Risk Factors ; Skin Tests ; Tertiary Care Centers ; Thorax ; Tuberculin ; Tuberculin Test ; Tuberculosis