1.A ramus cortical bone harvesting technique without bone marrow invasion
Jeong-Kui KU ; Min-Soo GHIM ; Jung Ho PARK ; Dae Ho LEEM
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2023;49(2):100-104
Autogenous bone grafts from the mandibular ramus are a known source of inadequate bone volume scenarios of the residual alveolar ridge. However, the conventional block-type harvesting technique cannot prevent bone marrow invasion, which can cause postoperative complications such as pain, swelling, and inferior alveolar nerve injury. This study aims to suggest a complication-free harvesting technique and present the results of bone grafting and donor sites. One patient received two dental implants with a complication-free harvesting technique that involves creation of ditching holes with a 1 mm round bur. Sagittal, coronal, and axial osteotomies produced grid-type cortical squares using a micro-saw and a round bur to confirm the cortical thickness. The grid-type cortical bone was harvested from the occlusal aspect, and the harvesting was extended through an additional osteotomy on the exposed and remaining cortical bone to prevent bone marrow invasion. The patient did not suffer postoperative severe pain, swelling, or numbness.After 15 months, the harvested site exhibited new cortical bone lining, and the grafted area had healed to a cortico-cancellous complex with functional loading of the implants. Our technique, grid-type cortical bone harvesting without bone marrow invasion, allowed application of autogenous bone without bone marrow invasion to achieve acceptable bone healing of the dental implants and to regenerate the harvested cortical bone.
2.Facial hematoma induced spontaneously or by minimal trauma in a facial plexiform neurofibroma: a case report and literature review
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2023;49(3):152-156
Plexiform neurofibroma is a rare benign tumor and a special subtype of neurofibromatosis 1. This report is a literature review with a case of patient with facial hemorrhage observed at the site of neurofibroma removal in the right lower face due to minor trauma. Through PubMed search, using terms ((facial hematoma) OR (facial bleeding)) AND (neurofibromatosis), 86 articles were identified, and five related articles (six patients) were finally selected. Of the six patients, two had previously undergone embolization. However, as a result, all patients received open surgery to remove hematomas.The hemostatic methods mentioned were vascular ligation (five patients), hypotensive anesthesia (two patients), and postoperative blood transfusion (four patients). In conclusion, spontaneous or minimally traumatic bleeding is possible in neurofibromatosis patients. In most cases, it can be resolved by vascular ligation under hypotensive anesthesia. Optionally, prior embolization and supplementary tissue adhesive may be used.
3.Coronoidectomy for reduction of superolateral dislocation of mandible condyle
Hyun SEOK ; Seung-O KO ; Jin-A BAEK ; Dae-Ho LEEM
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2022;48(3):182-187
Superolateral dislocation of the condyle is a rare mandibular fracture. The treatment goal is to return the dislocated condyle to its original position to recover normal function. This study reports on superolateral dislocation of the condyle with mandibular body fracture. The mandibular body was completely separated, and the medial pole of the condyle head was fractured. The condyle segment was unstable and easily dislocated after reduction. The temporalis muscle on the condyle segment might have affected the dislocation of the condyle. A coronoidectomy was performed to disrupt the function of the temporalis muscle on the condyle segment in order to successfully reduce the dislocated condyle. Coronoidectomy is a simple procedure with minimal complications. We successfully performed a coronoidectomy to reduce the superolateral displaced condyle to its original position to achieve normal function. Coronoidectomy can be effectively used for reduction of superolaterally displaced condyles combined with severe maxilla-mandibular fractures.
4.Conservative management with Carnoy’s solution in ameloblastoma involving two unerupted teeth: a report of two cases
Sang Min LEE ; Jeong-Kui KU ; Dae Ho LEEM ; Jin-A BAEK ; Seung-O KO
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2021;47(1):40-46
Marsupialization is widely used as a primary treatment modality for reducing size of large cysts. However, there is no recommendation for specific duration of marsupialization. In addition, Carnoy’s solution usually is applied at the time of enucleation as a fixative agent. In this report, we present an appropriate marsupialization duration of ameloblastoma involving two unerupted teeth. In this present study, marsupialization using a Foley catheter was performed in two cases of ameloblastoma of the mandible involving two adjacent impacted teeth. Carnoy’s solution was applied for 3-5 minutes after enucleation in both patients. Periodically during marsupialization, the size of the radiolucency was measured in panoramic view, and clinical examination was performed. No remarkable paresthesia or soft tissue injury was observed after application of Carnoy’s solution or during follow-up.We recommend 12 to 16 weeks as an adequate marsupialization duration for a large ameloblastoma involving two impacted teeth based on increased radiopacity along the margins of the lesions. Poor oral hygiene was an issue after 12 weeks of marsupialization in one case. There were no remarkable complications with Carnoy’s solution in either case. The Foley tube has a two-way system that is more effective for irrigating the cavity than is the conventional one-way system.
5.Classification of postoperative edema based on the anatomic division with mandibular third molar extraction
Yeong Kon JEONG ; Jeong-Kui KU ; Sung Hyun BAIK ; Jae-Seek YOU ; Dae Ho LEEM ; Sun-Kyu CHOI
Maxillofacial Plastic and Reconstructive Surgery 2021;43(1):4-
Purpose:
Several investigations have been performed for a postoperative edema after extraction, but the results have been controversial due to low objectivity or poorly reproducible assessments of the edema. The aim of this study was to suggest a classification and patterns of postoperative edema according to the anatomical division associated with extraction of mandibular third molar as a qualitative evaluation method.
Methods:
This study was conducted forty-four mandibular third molars extracted and MRI was taken within 48 h after extraction. The postoperative edema space was classified by MRI (one anatomic component—buccinator muscle—and four fascial spaces—supra-periosteum space, buccal space, parapharyngeal space, and lingual space), and evaluated independently by two examiners. The inter-examiner reliability was calculated using Kappa statistics.
Results:
The evaluation of buccinator muscle edema showed good agreement and the fascial spaces showed constant high agreement. The incidence of postoperative edema was high in the following order: supra-periosteum space (75.00%), buccinator muscle (68.18%), parapharyngeal space (54.55%), buccal space (40.91%), and lingual space (25.00%).
Conclusion
Postoperative edema could be assessed clearly by each space, which showed a different tendency between the anatomic and fascial spaces.
6.Nasal septal abscess with a dental origin:a case report and a review of the literature
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2021;47(2):135-140
Since the first report of a nasal septal abscess (NSA) from a dental origin (1920), six articles have been published in the English literature to date. The most common cause of NSA is an infection of the nasal septal hematoma after trauma. This is a report of an uncommon cause of NSA with a dental origin. A PubMed search performed regardless of year and country using the terms (“nasal septal abscess”) OR (“nasal septum abscess”) initially yielded 229 articles. After screening, seven articles (eight patients) were selected. Addition of two related articles produced a total of nine articles (10 patients) to be included. The age of the included patients ranged from 7 to 69 years (mean, 32.82 years; standard deviation, ±23.86 years). The sex composition was as followed: males (n=7; 63.6%), females (n=4; 36.4%). Dental histories were various: periapical lesions, caries, extraction, endodontic therapy, and cystic lesions. The maxillary incisor dominated as the tooth of origin. Early diagnosis and treatment of NSAs are important to avoid not only facial deformity, but also severe complications (e.g., intracranial infection). If NSA is suspected in patients without facial trauma, the possibility of a dental origin, especially from the maxillary incisor area, should be considered.
7.Nasal septal abscess with a dental origin:a case report and a review of the literature
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2021;47(2):135-140
Since the first report of a nasal septal abscess (NSA) from a dental origin (1920), six articles have been published in the English literature to date. The most common cause of NSA is an infection of the nasal septal hematoma after trauma. This is a report of an uncommon cause of NSA with a dental origin. A PubMed search performed regardless of year and country using the terms (“nasal septal abscess”) OR (“nasal septum abscess”) initially yielded 229 articles. After screening, seven articles (eight patients) were selected. Addition of two related articles produced a total of nine articles (10 patients) to be included. The age of the included patients ranged from 7 to 69 years (mean, 32.82 years; standard deviation, ±23.86 years). The sex composition was as followed: males (n=7; 63.6%), females (n=4; 36.4%). Dental histories were various: periapical lesions, caries, extraction, endodontic therapy, and cystic lesions. The maxillary incisor dominated as the tooth of origin. Early diagnosis and treatment of NSAs are important to avoid not only facial deformity, but also severe complications (e.g., intracranial infection). If NSA is suspected in patients without facial trauma, the possibility of a dental origin, especially from the maxillary incisor area, should be considered.
8.The Vestibuloplasty Using Non-eugenolbased Non-zinc Oxide Oral Dressing Material
Journal of Korean Dental Science 2021;14(1):46-50
This study describes a patient with insufficient vestibular depth who was operated with a vestibuloplasty using a non-eugenol-based non-zinc oxide oral dressing material. Partial thickness flap was elevated on recipient. After stabilization of apical positioned flap, the dressing material was applied on the recipient site with additional fixation by suture. The patient presented minimal discomfort such as in pain, food impaction and management of oral hygiene. Adequate vestibular depth without relapse was observed until 4 weeks after surgery. The vestibuloplasty with the oral dressing material may be an option for obtaining proper vestibular depth without complications.
9.An unusual presentation of non-specific cystic degeneration of craniofacial fibrous dysplasia: a case report and review of literature
Inseok HONG ; Dong Cheol KANG ; Dae-Ho LEEM ; Jin-A BAEK ; Seung-O KO
Maxillofacial Plastic and Reconstructive Surgery 2020;42(1):31-
Background:
Fibrous dysplasia (FD) is a rare, sporadic, and benign congenital condition in which normal cancellous bone is replaced by fibro-osseous tissue with immature osteogenesis. FD localized in the cranial and facial bones is called craniofacial fibrous dysplasia (CFD). Cystic degeneration in CFD cases is rare; cystic degeneration appearing in both the maxilla and the mandible FD lesion is even rarer. The aim of this article was to report a case of fibrous dysplasia of the mandible and maxilla complicated by nonspecific cystic degeneration.Case presentationA 30-year-old woman presented with a rare case of non-specific cystic degeneration in a mandible and maxilla FD lesion that occurred 11 years after surgery. She was diagnosed with polyostotic CFD and underwent maxillary and mandibular bone contouring. Cyst enucleation under general anesthesia was performed in the mandibular region due to pain and discomfort.
Conclusions
In cases involving non-aggressive and non-invasive FD cystic degeneration in focal areas, conservative treatment is recommended. However, if cystic degeneration of FD develops rapidly and causes discomfort, pain, or dysfunction, surgical treatment should be considered.
10.An unusual presentation of non-specific cystic degeneration of craniofacial fibrous dysplasia: a case report and review of literature
Inseok HONG ; Dong Cheol KANG ; Dae-Ho LEEM ; Jin-A BAEK ; Seung-O KO
Maxillofacial Plastic and Reconstructive Surgery 2020;42(1):31-
Background:
Fibrous dysplasia (FD) is a rare, sporadic, and benign congenital condition in which normal cancellous bone is replaced by fibro-osseous tissue with immature osteogenesis. FD localized in the cranial and facial bones is called craniofacial fibrous dysplasia (CFD). Cystic degeneration in CFD cases is rare; cystic degeneration appearing in both the maxilla and the mandible FD lesion is even rarer. The aim of this article was to report a case of fibrous dysplasia of the mandible and maxilla complicated by nonspecific cystic degeneration.Case presentationA 30-year-old woman presented with a rare case of non-specific cystic degeneration in a mandible and maxilla FD lesion that occurred 11 years after surgery. She was diagnosed with polyostotic CFD and underwent maxillary and mandibular bone contouring. Cyst enucleation under general anesthesia was performed in the mandibular region due to pain and discomfort.
Conclusions
In cases involving non-aggressive and non-invasive FD cystic degeneration in focal areas, conservative treatment is recommended. However, if cystic degeneration of FD develops rapidly and causes discomfort, pain, or dysfunction, surgical treatment should be considered.

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