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Kim JY, Yong HS, Kim TY, Kim JY, Jeon KJ, Huh JK. Volumetric changes in temporomandibular joint space following trans-oral vertical ramus osteotomy in patients with mandibular prognathism: a one-year follow-up study. Sci Rep 2024; 14:942. [PMID: 38200085 PMCID: PMC10781718 DOI: 10.1038/s41598-023-51050-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
This study measured and analyzed chronological changes in temporomandibular joint space volume by compartment following transoral vertical ramus osteotomy (TOVRO) using reconstructed 3-dimensional (3D) images of patients with mandibular prognathism. It included 70 joints of 35 patients who underwent TOVRO between January 2018 and December 2021. Computed tomography (CT) or cone-beam CT (CBCT) was performed before surgery (T0) and at 3 days (T1), 6 months (T2), and 12 months postoperatively (T3). These scans were then analyzed using 3D software. The volumes of the overall (Vjs), anterior (Vajs), posterior (Vpjs), medial (Vmjs), and lateral (Vljs) joint spaces were calculated at each time point. A linear mixed model and repeated-measures covariance pattern with unstructured covariance were used to evaluate significant changes in joint space volume over time. Vjs significantly increased to 134.54 ± 34.28 mm3 at T3 compared to T0 (p < 0.001). Vpjas and Vljs increased by 130.72 ± 10.07 mm3 and 109.98 ± 7.52 mm3 at T3 compared to T0, respectively (p < 0.001). However, no significant difference was observed between T0 and T2 in Vajs and Vmjs (p = 0.9999). The observed volume increases in Vpjs and Vljs appeared to contribute to the overall Vjs increase.
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Affiliation(s)
- Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-Ro, Gangnam-Gu, Seoul, 06273, Korea
| | - Hae-Seong Yong
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-Ro, Gangnam-Gu, Seoul, 06273, Korea
| | - Tae-Yeong Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-Ro, Gangnam-Gu, Seoul, 06273, Korea
| | - Jun-Young Kim
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-Ro, Gangnam-Gu, Seoul, 06273, Korea.
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Jeong CH, Lim SY, Um JE, Lim HW, Hwang KH, Park KM, Yun JS, Kim D, Huh JK, Kim HS, Yook JI, Kim NH, Kwak YH. Micellized protein transduction domain-bone morphogenetic protein-2 accelerates bone healing in a rat tibial distraction osteogenesis model. Acta Biomater 2023; 170:360-375. [PMID: 37611691 DOI: 10.1016/j.actbio.2023.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023]
Abstract
The clinical application of growth factors such as recombinant human bone morphogenetic protein-2 (rh-BMP-2), for functional bone regeneration remains challenging due to limited in vivo efficacy and adverse effects of previous modalities. To overcome the instability and short half-life of rh-BMP-2 in vivo, we developed a novel osteogenic supplement by fusing a protein transduction domain (PTD) with BMP-2, effectively creating a prodrug of BMP-2. In this study, we first created an improved PTD-BMP-2 formulation using lipid nanoparticle (LNP) micellization, resulting in downsizing from micrometer to nanometer scale and achieving a more even distribution. The micellized PTD-BMP-2 (mPTD-BMP-2) demonstrated improved distribution and aggregation profiles. As a prodrug of BMP-2, mPTD-BMP-2 successfully activated Smad1/5/8 and induced mineralization with osteogenic gene induction in vitro. In vivo pharmacokinetic analysis revealed that mPTD-BMP-2 had a much more stable pharmacokinetic profile than rh-BMP-2, with a 7.5-fold longer half-life. The in vivo BMP-responsive element (BRE) reporter system was also successfully activated by mPTD-BMP-2. In the in vivo rat tibia distraction osteogenesis (DO) model, micro-computed tomography (micro-CT) scan findings indicated that mPTD-BMP-2 significantly increased bone volume, bone surface, axis moment of inertia (MOI), and polar MOI. Furthermore, it increased the expression of osteogenesis-related genes, and induced bone maturation histologically. Based on these findings, mPTD-BMP-2 could be a promising candidate for the next-generation osteogenesis drug to promote new bone formation in DO surgery. STATEMENT OF SIGNIFICANCE: This study introduces micellized bone morphogenetic protein-2 (mPTD-BMP-2), a next-generation osteogenic supplement that combines protein transduction domain (PTD) and nano-sized micelle formulation technique to improve transduction efficiency and stability. The use of PTD represents a novel approach, and our results demonstrate the superiority of mPTD-BMP-2 over rh-BMP-2 in terms of in vivo pharmacokinetic profile and osteogenic potential, particularly in a rat tibial model of distraction osteogenesis. These findings have significant scientific impact and potential clinical applications in the treatment of bone defects that require distraction osteogenesis. By advancing the field of osteogenic supplements, our study has the potential to contribute to the development of more effective treatments for musculoskeletal disorders.
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Affiliation(s)
- Cheol Hee Jeong
- Department of Oral Pathology, Yonsei University College of Dentistry, Seoul, 03722, Korea; Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Song-Yi Lim
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea
| | - Jo Eun Um
- MET Life Science, Seoul, 03722, Korea
| | - Hyo Won Lim
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea
| | | | - Kyeong-Mee Park
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Jun Seop Yun
- Department of Oral Pathology, Yonsei University College of Dentistry, Seoul, 03722, Korea; Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Dohun Kim
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, 06273, Korea
| | - Hyun Sil Kim
- Department of Oral Pathology, Yonsei University College of Dentistry, Seoul, 03722, Korea; Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, 03722, Korea; MET Life Science, Seoul, 03722, Korea
| | - Jong In Yook
- Department of Oral Pathology, Yonsei University College of Dentistry, Seoul, 03722, Korea; Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, 03722, Korea; MET Life Science, Seoul, 03722, Korea
| | - Nam Hee Kim
- Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, 03722, Korea; MET Life Science, Seoul, 03722, Korea.
| | - Yoon Hae Kwak
- Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea.
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Huh JK. Establishment of a new health insurance procedure code for oral and maxillofacial bone graft in Republic of Korea. J Korean Assoc Oral Maxillofac Surg 2023; 49:169-170. [PMID: 37641898 PMCID: PMC10466010 DOI: 10.5125/jkaoms.2023.49.4.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Affiliation(s)
- Jong-Ki Huh
- Department of Oral and Maxillofacial Surgey, Yonsei University Gangnam Severance Hospital, Seoul, Korea
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Ku JK, Han D, Huh JK, Kim JY. Buccal nerve schwannoma mimicking a salivary gland tumor: a rare case report. J Korean Assoc Oral Maxillofac Surg 2023; 49:148-151. [PMID: 37394934 DOI: 10.5125/jkaoms.2023.49.3.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/05/2022] [Accepted: 01/11/2021] [Indexed: 07/04/2023] Open
Abstract
Schwannomas are benign tumors originating from myelinating cells constituting nerve sheaths but rarely contain cellular elements of the nerve. The authors encountered a 47-year-old female patient with a schwannoma on the anterior mandibular ramus arising from the buccal nerve, measuring 3 cm×4 cm. Surgical resection was performed with preservation of the buccal nerve via microsurgical dissection. After one month, the sensory function of the buccal nerve was recovered without complications.
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Affiliation(s)
- Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Dawool Han
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Yoon K, Kim JY, Kim SJ, Huh JK, Kim JW, Choi J. Explainable deep learning-based clinical decision support engine for MRI-based automated diagnosis of temporomandibular joint anterior disk displacement. Comput Methods Programs Biomed 2023; 233:107465. [PMID: 36933315 DOI: 10.1016/j.cmpb.2023.107465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 01/13/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND OBJECTIVE MRI is considered the gold standard for diagnosing anterior disc displacement (ADD), the most common temporomandibular joint (TMJ) disorder. However, even highly trained clinicians find it difficult to integrate the dynamic nature of MRI with the complicated anatomical features of the TMJ. As the first validated study for MRI-based automatic TMJ ADD diagnosis, we propose a clinical decision support engine that diagnoses TMJ ADD using MR images and provides heat maps as the visualized rationale of diagnostic predictions using explainable artificial intelligence. METHODS The engine builds on two deep learning models. The first deep learning model detects a region of interest (ROI) containing three TMJ components (i.e., temporal bone, disc, and condyle) in the entire sagittal MR image. The second deep learning model classifies TMJ ADD into three classes (i.e., normal, ADD without reduction, and ADD with reduction) within the detected ROI. In this retrospective study, the models were developed and tested on the dataset acquired between April 2005 to April 2020. The additional independent dataset acquired at a different hospital between January 2016 to February 2019 was used for the external test of the classification model. Detection performance was assessed by mean average precision (mAP). Classification performance was assessed by the area under the receiver operating characteristic (AUROC), sensitivity, specificity, and Youden's index. 95% confidence intervals were calculated via non-parametric bootstrap to assess the statistical significance of model performances. RESULTS The ROI detection model achieved mAP of 0.819 at 0.75 intersection over union (IoU) thresholds in the internal test. In internal and external tests, the ADD classification model achieved AUROC values of 0.985 and 0.960, sensitivities of 0.950 and 0.926, and specificities of 0.919 and 0.892, respectively. CONCLUSIONS The proposed explainable deep learning-based engine provides clinicians with the predictive result and its visualized rationale. The clinicians can make the final diagnosis by integrating primary diagnostic prediction obtained from the proposed engine with the patient's clinical examination findings.
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Affiliation(s)
- Kyubaek Yoon
- School of Mechanical Engineering, Yonsei University, 50 Yonsei Ro, Seodaemun Gu, Seoul 03722, Republic of Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sun-Jong Kim
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
| | - Jongeun Choi
- School of Mechanical Engineering, Yonsei University, 50 Yonsei Ro, Seodaemun Gu, Seoul 03722, Republic of Korea.
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Ku JK, Baik SH, Kim JY, Huh JK. Effect of a vertical incision on postoperative swelling after an impacted mandibular third molar extraction: two cases with split-mouth designed magnetic resonance imaging analysis. J Korean Assoc Oral Maxillofac Surg 2023; 49:91-95. [PMID: 37114447 PMCID: PMC10151696 DOI: 10.5125/jkaoms.2023.49.2.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 04/29/2023] Open
Abstract
This study examined the effects of a vertical incision on postoperative edema after third molar extraction. The study design was that of a comparative split-mouth approach. Evaluation was performed via magnetic resonance imaging (MRI). Two patients with homogeneous bilateral impacted mandibular third molars were enrolled. These patients underwent facial MRI within 24 hours after simultaneous extraction surgery. Modified triangular flap and enveloped flap incisions were made. Postoperative edema was evaluated by MRI and was assessed according to anatomical space. The two pairs of homogeneous extractions demonstrated that vertical incisions were associated qualitatively and quantitatively with extensive postoperative edema. The edema associated with these incisions spread toward the buccal space, beyond the buccinator muscle. In conclusion, a vertical incision with mandibular third molar extraction was related to edema in the buccal space and the fascial space, which contributed to clinical facial swelling.
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Affiliation(s)
- Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Sung Hyun Baik
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Park W, Huh JK, Lee JH. Author Correction: Automated deep learning for classification of dental implant radiographs using a large multi-center dataset. Sci Rep 2023; 13:6559. [PMID: 37085669 PMCID: PMC10121713 DOI: 10.1038/s41598-023-33768-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Affiliation(s)
- Wonse Park
- Korean Academy of Oral and Maxillofacial Implantology (KAOMI) Implant Research Institute, Seoul, Korea
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Korean Academy of Oral and Maxillofacial Implantology (KAOMI) Implant Research Institute, Seoul, Korea.
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
| | - Jae-Hong Lee
- Korean Academy of Oral and Maxillofacial Implantology (KAOMI) Implant Research Institute, Seoul, Korea.
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, 54896, Korea.
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Park WS, Huh JK, Lee JH. Automated deep learning for classification of dental implant radiographs using a large multi-center dataset. Sci Rep 2023; 13:4862. [PMID: 36964171 PMCID: PMC10039053 DOI: 10.1038/s41598-023-32118-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/22/2023] [Indexed: 03/26/2023] Open
Abstract
This study aimed to evaluate the accuracy of automated deep learning (DL) algorithm for identifying and classifying various types of dental implant systems (DIS) using a large-scale multicenter dataset. Dental implant radiographs of pos-implant surgery were collected from five college dental hospitals and 10 private dental clinics, and validated by the National Information Society Agency and the Korean Academy of Oral and Maxillofacial Implantology. The dataset contained a total of 156,965 panoramic and periapical radiographic images and comprised 10 manufacturers and 27 different types of DIS. The accuracy, precision, recall, F1 score, and confusion matrix were calculated to evaluate the classification performance of the automated DL algorithm. The performance metrics of the automated DL based on accuracy, precision, recall, and F1 score for 116,756 panoramic and 40,209 periapical radiographic images were 88.53%, 85.70%, 82.30%, and 84.00%, respectively. Using only panoramic images, the DL algorithm achieved 87.89% accuracy, 85.20% precision, 81.10% recall, and 83.10% F1 score, whereas the corresponding values using only periapical images achieved 86.87% accuracy, 84.40% precision, 81.70% recall, and 83.00% F1 score, respectively. Within the study limitations, automated DL shows a reliable classification accuracy based on large-scale and comprehensive datasets. Moreover, we observed no statistically significant difference in accuracy performance between the panoramic and periapical images. The clinical feasibility of the automated DL algorithm requires further confirmation using additional clinical datasets.
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Affiliation(s)
- Won-Se Park
- Korean Academy of Oral and Maxillofacial Implantology (KAOMI) Implant Research Institute, Seoul, Korea
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Korean Academy of Oral and Maxillofacial Implantology (KAOMI) Implant Research Institute, Seoul, Korea.
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
| | - Jae-Hong Lee
- Korean Academy of Oral and Maxillofacial Implantology (KAOMI) Implant Research Institute, Seoul, Korea.
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, 54896, Korea.
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Ku JK, Kim YK, Huh JK, Um IW, Lee E, Kim C. Allogeneic Demineralized Dentin Matrix as rhBMP-2 Carrier: A Retrospective Clinical Study. Int J Oral Maxillofac Implants 2022; 37:1138-1144. [DOI: 10.11607/jomi.9692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Jung JH, Ko JH, Ku JK, Kim JY, Huh JK. Sensory change after implant surgery: related factors for recovery. J Korean Assoc Oral Maxillofac Surg 2022; 48:297-302. [DOI: 10.5125/jkaoms.2022.48.5.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Joon-Ho Jung
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Ji-Hoon Ko
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Abstract
The purpose of this study is to evaluate the degree of spontaneous bone healing after cyst enucleation as well as its contributing factors. Pre- and post-operative computed tomography (CT) scans of consecutive patients who had undergone jaw cyst enucleation were retrospectively analyzed. The outcome variable was healing ratio, which was calculated using the volume of the cyst before surgery and the volume of the defect in the bone after surgery. Predictor variables including duration of observation, pre-operative cyst size, age, gender, and involved jaw were analyzed to determine their influence. Forty-four subjects (30 Male and 14 Female, average 40.7 ± 15.7 years) were included in this study. Healing ratio was significantly lower during the first year (33.5 ± 32.8%) compared to the second (74.5 ± 24.2%) and subsequent years (74.2 ± 17.8%). In 35 patients who had follow-ups of over 1 year, the healing ratio was not affected by the pre-operative cyst size and upper/lower jaw except gender (p = 0.037, female > male) and age (p = 0.021, younger than 30 years > 30 years and older). The residual defect was significant larger in cysts 3 cc or larger (1.64 ± 1.54 cc) compared to smaller cysts (0.43 ± 0.42 cc, p = 0.006). The residual defect volume of large cysts was similar to those of the pre-operative volume of small cysts (1.47 ± 0.72 cc). In conclusion, spontaneous bone healing ratio of post-enucleation defects was about 73.5% after 12 months. Large cysts (> 3 cc) had larger defect, comparable to the volume of small cysts, but with altered contour. Additional treatment such as a bone graft may be considered especially in large cysts.
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Affiliation(s)
- Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University Health Service, Seoul, Republic of Korea
| | - Michael Han
- Department of Oral and Maxillofacial Surgery, University of Illinois Chicago, Illinois, USA
| | - Atapol Yongvikul
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
- Department of Oral and Maxillofacial Surgery, Masterpiece Hospital, Bangkok, Thailand
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.
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Yongvikul A, Kim JY, Ku JK, Jung JH, Huh JK. Needle orientation for temporomandibular joint arthrocentesis in Koreans. Cranio 2022:1-7. [PMID: 35261328 DOI: 10.1080/08869634.2022.2047509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate the highest opportunity skin puncture point and needle orientation according to facial asymmetry and classification. METHODS Computed tomography of 136 patients was analyzed. Horizontal and vertical angles and distances from the canthal-tragal line were investigated to determine the puncture point and needle's angle. RESULT All patients' average points were 7.39 (±2.85) mm anterior to the tragus and 3.44 (±4.18) mm below the canthal-tragal line with an angle of 8.53 (±6.90)° anteriorly and 32.26 (±7.23)° superiorly. Regarding asymmetry, there was a statistical difference in horizontal angle, depth, and canthal-tragal distance between the deviated and non-deviated sides. Especially, vertical distances were 4.44 (±4.66) mm and 2.59 (±4.11) mm in the deviated and non-deviated sides, respectively (p < 0.001). CONCLUSION In closed-mouth, the puncture point was closer to the tragus and lower than the conventional point. The point in the deviated side should be considered lower than the non-deviated side.
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Affiliation(s)
- Atapol Yongvikul
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Joon-Ho Jung
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Park H, Moon IS, Chung C, Shin SJ, Huh JK, Yun JH, Lee DW. Comparison of peri-implant marginal bone level changes between tapered and straight implant designs: 5-year follow-up results. J Periodontal Implant Sci 2021; 51:422-432. [PMID: 34965621 PMCID: PMC8718336 DOI: 10.5051/jpis.2101180059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/05/2021] [Accepted: 05/10/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The aim of this study was to compare straight and tapered implant designs in terms of marginal bone loss, the modified plaque index (mPI), and the modified bleeding index (mBI) for 5 years after functional loading. METHODS Twelve patients were recruited. Two types of implants were placed adjacent to each other: 1 straight implant and 1 tapered implant. Marginal bone loss, mPI, and mBI were measured every year for 5 years after loading. RESULTS The straight implants showed 0.2±0.4 mm of marginal bone loss at 5 years after loading, while the tapered implants showed 0.2±0.3 mm of marginal bone loss; this difference was not statistically significant (P=0.833). Our analysis also showed no statistically significant differences in mPI (straight implants: 0.3±0.3 vs. tapered implants: 0.2±0.3; P=0.414) or in mBI (straight implants: 0.3±0.4 vs. tapered implants: 0.2±0.3; P=0.317) at 5 years after prosthesis delivery. CONCLUSIONS Straight and tapered implants showed no significant differences with respect to marginal bone loss, mPI, and mBI for 5 years after loading.
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Affiliation(s)
- Han Park
- Department of Periodontology, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Ik-Sang Moon
- Department of Periodontology, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Chooryung Chung
- Department of Orthodontics, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Su-Jung Shin
- Department of Conservative Dentistry, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jeong-Ho Yun
- Department of Periodontology, Institute of Oral Bioscience, Jeonbuk National University College of Dentistry, Jeonju, Korea.
| | - Dong-Won Lee
- Department of Periodontology, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea.
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Kim JY, Ku JK, Lee S, Huh JK, Han MD. What Is the Perception of an Esthetic Lower Facial Third Profile in the Korean Layperson Population? J Oral Maxillofac Surg 2021; 80:838-849. [PMID: 35033506 DOI: 10.1016/j.joms.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this study is to investigate whether there were differences in perception of facial profile esthetics at the upper lip, gnathic, and genial levels according to observer gender and age in the Korean layperson population. METHODS Ten male (M1 to M10) and 10 female (F1 to F10) silhouettes with differing facial profiles at the level of the upper lip, mandibular, and chin were created from a male and female facial profile deemed well-balanced and orthognathic by reviewer consensus. These silhouettes were presented to 288 participants who were asked to rank the 5 most attractive male and female profiles. The participants were composed of 144 males and 144 females divided into 4 age groups: group I (under 20 years), group II (20 to 39 years), group III (40 to 59 years), and group IV (over 60 years). The most preferred profile and observer scores were investigated and calculated. Descriptive analysis, χ2 test, and analysis of variance were used for statistical analysis according to age and gender. RESULTS The most preferred male and female silhouettes were orthognathic profiles. There was no significant difference according to gender when rating male (P = .281) and female (P = .442) silhouettes. No statistically significant difference was observed even when analyzed according to age groups. Although the difference in observer scores among each ranking showed a statistical difference according to age groups, the overall rankings showed a similar pattern both in male and female silhouettes. In the same age group, no difference in rank scores according to gender was observed. Severe concave profiles were found to have the lowest rank. CONCLUSIONS An orthognathic profile was rated as the most desirable in the Korean layperson population, with few differences in perception of esthetic facial profile according to age and gender.
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Affiliation(s)
- Jae-Young Kim
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Jeong-Kui Ku
- Fellow, Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Soyeon Lee
- Resident, Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Jong-Ki Huh
- Professor, Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Michael D Han
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, IL.
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Ku JK, Baik SH, Kim JY, Huh JK. Follow-up evaluation of temporomandibular joints using magnetic resonance imaging after mandibular trauma: Case series analysis of young adult males. Dent Traumatol 2021; 38:136-142. [PMID: 34808038 DOI: 10.1111/edt.12719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND/AIMS A relationship between mandibular fractures and traumatic temporomandibular joint (TMJ) conditions has been suggested in many studies. Although magnetic resonance imaging (MRI) is the best option for a TMJ evaluation, few studies have evaluated the TMJ condition after a mandibular fracture using MRI follow-up. The aim of this study was to evaluate the TMJ for post-traumatic conditions following a mandibular fracture using follow-up MRI. MATERIALS AND METHODS Fourteen TMJs of seven young adult males (aged 19-21 years) with mandibular fractures were analyzed by MRI, and 12 TMJs of six patients were evaluated by follow-up MRI after the trauma. Regarding the intensity of MRI, the pathologic condition of TMJ was classified into acute joint inflammation, marrow edema, and joint space widening. RESULTS Thirteen joints (92.9%) showed pathologic conditions, including 11 with acute joint inflammation (84.6%), 10 with joint space widening (76.9%), and six with marrow edema (46.2%). Five out of 12 evaluated joints were injected with dexamethasone. Among these, four joints healed within one week, and one healed within one month. Among the seven untreated TMJs, four and one joint healed within one week and one month, respectively, but two joints of one patient did not improve until one month. Although that patient received arthrocentesis, the right joint showed osteoarthritis six months after the trauma. CONCLUSIONS Most TMJs were acutely damaged due to mandibular trauma and healed within one week to one month. A follow-up examination could be considered at one month after the injury to confirm the possibility of traumatic TMJ disorder, such as osteoarthritis.
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Affiliation(s)
- Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Sung Hyun Baik
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Ku JK, Kim JY, Jun MK, Jeong YK, Huh JK. Influence of General and Local Anesthesia on Postoperative Pain after Impacted Third Molar Surgery. J Clin Med 2021; 10:jcm10122674. [PMID: 34204470 PMCID: PMC8234107 DOI: 10.3390/jcm10122674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 11/22/2022] Open
Abstract
This study examined the effects of general anesthesia on the postoperative pain level after third molar extractions compared to local anesthesia. This retrospective study included patients who underwent four simultaneous third molar extractions under general or local anesthesia and had records of their postoperative pain levels (visual analog scale, VAS). The pain level was determined in the early (Postoperative day; POD < #3) and late (POD #3-7) periods. The operation time and recently modified difficulty index were analyzed to validate the homogenous condition of the extraction. Of the 227 male inpatients (aged 20.9 ± 1.3 years), 172 and 55 patients underwent third molar extractions under local and general anesthesia, respectively. The age and difficulty index were distributed equally, but the operation time was longer in general anesthesia than in local anesthesia (p < 0.001). The early and late periods featured similar pain outcomes. The operation time correlated with the total periods with a correlation coefficient of 0.271 (p < 0.001). In conclusion, the postoperative pain following whole third molar extraction was related to the operation time rather than the anesthetic methods.
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Affiliation(s)
- Jeong-Kui Ku
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul 06273, Korea; (J.-K.K.); (J.-Y.K.)
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul 06273, Korea; (J.-K.K.); (J.-Y.K.)
| | - Mi-Kyoung Jun
- Sae-e Dental Clinic, 109-8, Songwon-ro, Jangan-gu, Suwon 16294, Korea;
| | - Yeong Kon Jeong
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Hospital, Armed Forces Medical Command, Seongnam 13634, Korea;
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul 06273, Korea; (J.-K.K.); (J.-Y.K.)
- Correspondence: ; Tel.: +82-2-2019-4560; Fax: +82-2-3463-4052
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Huh JK. Orthognathic surgery of temporomandibular disorders. J Korean Assoc Oral Maxillofac Surg 2021; 47:63-64. [PMID: 33911037 PMCID: PMC8084739 DOI: 10.5125/jkaoms.2021.47.2.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Kim JY, Kim D, Jeon KJ, Kim H, Huh JK. Using deep learning to predict temporomandibular joint disc perforation based on magnetic resonance imaging. Sci Rep 2021; 11:6680. [PMID: 33758266 PMCID: PMC7988137 DOI: 10.1038/s41598-021-86115-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/08/2021] [Indexed: 12/22/2022] Open
Abstract
The goal of this study was to develop a deep learning-based algorithm to predict temporomandibular joint (TMJ) disc perforation based on the findings of magnetic resonance imaging (MRI) and to validate its performance through comparison with previously reported results. The study objects were obtained by reviewing medical records from January 2005 to June 2018. 299 joints from 289 patients were divided into perforated and non-perforated groups based on the existence of disc perforation confirmed during surgery. Experienced observers interpreted the TMJ MRI images to extract features. Data containing those features were applied to build and validate prediction models using random forest and multilayer perceptron (MLP) techniques, the latter using the Keras framework, a recent deep learning architecture. The area under the receiver operating characteristic (ROC) curve (AUC) was used to compare the performances of the models. MLP produced the best performance (AUC 0.940), followed by random forest (AUC 0.918) and disc shape alone (AUC 0.791). The MLP and random forest were also superior to previously reported results using MRI (AUC 0.808) and MRI-based nomogram (AUC 0.889). Implementing deep learning showed superior performance in predicting disc perforation in TMJ compared to conventional methods and previous reports.
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Affiliation(s)
- Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Dongwook Kim
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Hwiyoung Kim
- Department of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.
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Kim JY, Han MD, Jeon KJ, Huh JK, Park KH. Three-dimensional assessment of the anterior and inferior loop of the inferior alveolar nerve using computed tomography images in patients with and without mandibular asymmetry. BMC Oral Health 2021; 21:71. [PMID: 33593343 PMCID: PMC7885493 DOI: 10.1186/s12903-021-01424-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/04/2021] [Indexed: 11/15/2022] Open
Abstract
Background The purpose of this study was to investigate the differences in configuration and dimensions of the anterior loop of the inferior alveolar nerve (ALIAN) in patients with and without mandibular asymmetry. Method Preoperative computed tomography images of patients who had undergone orthognathic surgery from January 2016 to December 2018 at a single institution were analyzed. Subjects were classified into two groups as “Asymmetry group” and “Symmetry group”. The distance from the most anterior and most inferior points of the ALIAN (IANant and IANinf) to the vertical and horizontal reference planes were measured (dAnt and dInf). The distance from IANant and IANinf to the mental foramen were also calculated (dAnt_MF and dInf_MF). The length of the mandibular body and symphysis area were measured. All measurements were analyzed using 3D analysis software. Results There were 57 total eligible subjects. In the Asymmetry group, dAnt and dAnt_MF on the non-deviated side were significantly longer than the deviated side (p < 0.001). dInf_MF on the non-deviated side was also significantly longer than the deviated side (p = 0.001). Mandibular body length was significantly longer on the non-deviated side (p < 0.001). There was no significant difference in length in the symphysis area (p = 0.623). In the Symmetry group, there was no difference between the left and right sides for all variables. Conclusion In asymmetric patients, there is a difference tendency in the ALIAN between the deviated and non-deviated sides. In patients with mandibular asymmetry, this should be considered during surgery in the anterior mandible.
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Affiliation(s)
- Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Michael D Han
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago College of Dentistry, Chicago, IL, USA
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
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Kim M, Lee S, Ko DR, Kim DH, Huh JK, Kim JY. Craniofacial and dental injuries associated with stand-up electric scooters. Dent Traumatol 2020; 37:229-233. [PMID: 33184996 DOI: 10.1111/edt.12620] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM With the recent increased share of stand-up electric scooters (e-scooters), it is common to see people riding e-scooters on the roads in Korea. The aim of this study was to investigate traumatic injuries to the craniofacial region related to e-scooter accidents and to determine the role of dentists (especially oral and maxillofacial surgeons) in the evaluation of patients with trauma at the emergency department due to an e-scooter accident. MATERIALS AND METHODS This retrospective study investigated the medical records of patients who visited the Gangnam Severance Hospital Emergency Care Center for trauma related to e-scooter use from January 1, 2017 to March 31, 2020. Medical records were reviewed to determine the injuries sustained to the craniofacial region related to e-scooter use, including location of the injury (eg, cranium, craniofacial bone, teeth, soft tissue) and the type of trauma (eg, fracture, laceration, abrasion, contusion, concussion). RESULT A total of 256 patients' medical records were evaluated. Among them, 125 patients (48.8% of all patients) had sustained craniofacial trauma. Laceration (n = 56, 44.8%) was the most common type of craniofacial injury, followed by cerebral concussion (n = 49, 39.2%), dental injury (n = 27, 21.6%), and craniofacial bone fracture (n = 16, 12.8%). CONCLUSION Dentists should always consider the possibility of brain trauma and perform a complete craniofacial and oral examination when assessing patients after e-scooter accidents as outlined by the International Association of Dental Traumatology guidelines. Additionally, it is necessary to educate e-scooter riders about the importance of wearing protective devices, such as helmets, to reduce the risk of injuries to the craniofacial region.
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Affiliation(s)
- Minsik Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Soyeon Lee
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Dong Ryul Ko
- Department of Emergency Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Dae-Hoon Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Kim JY, You HS, Huh JK, Park KH. Is There a Difference in Condyle Position Changing Pattern Between Deviated and Non-Deviated Sides After Intraoral Vertical Ramus Osteotomy in Facial Asymmetry? J Oral Maxillofac Surg 2019; 78:629.e1-629.e10. [PMID: 31887295 DOI: 10.1016/j.joms.2019.11.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/27/2019] [Accepted: 11/30/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE The position changing pattern of the condyles after intraoral vertical ramus osteotomy (IVRO) on the deviated and non-deviated sides is not clearly known. This study was conducted to evaluate the changes in condylar position after IVRO in patients with facial asymmetry and to compare the deviated and non-deviated sides using computed tomography imaging. MATERIALS AND METHODS This retrospective cohort study investigated patients with a diagnosis of mandibular prognathism with facial asymmetry who had undergone bilateral IVRO with Le Fort I osteotomy. Condylar positions were recorded on the non-deviated and deviated sides in the midaxial, midsagittal, and coronal planes at 3 time points using 3-dimensional analysis software: preoperatively (T1), at 6 months postoperatively (T2), and at 12 months postoperatively (T3). Linear and angular changes in condyle position were measured and analyzed between T1, T2, and T3. Reliability and comparative analyses were conducted. RESULTS Thirty-two patients were involved in this study. At T2, the most superior point of the condyle moved to 1.15 ± 0.24 mm (inferiorly) and 0.88 ± 0.23 mm (anteriorly) on the deviated side (P = .0002 and P = .0005, respectively) and to 0.99 ± 0.25 mm (inferiorly) and 1.08 ± 0.34 mm (anteriorly) on the non-deviated side, showing significant differences (P < .0001 and P = .0007, respectively) compared with T1. The condyle position showed a tendency to recover to its original position by T3. However, there were no statistically significant differences between T2 and T3 (P > .05). Furthermore, there were no statistically significant differences between the deviated and non-deviated sides over the entire follow-up period (P > .05). CONCLUSIONS The condyles did not completely recover to their preoperative positions until 12 months postoperatively. There was no significant difference between the deviated and non-deviated sides in mandibular prognathism with facial asymmetry.
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Affiliation(s)
- Jae-Young Kim
- Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Han-Sol You
- Resident, Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jong-Ki Huh
- Professor, Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Kwang-Ho Park
- Professor, Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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Kim JY, Yong HS, Park KH, Huh JK. Modified difficult index adding extremely difficult for fully impacted mandibular third molar extraction. J Korean Assoc Oral Maxillofac Surg 2019; 45:309-315. [PMID: 31966975 PMCID: PMC6955420 DOI: 10.5125/jkaoms.2019.45.6.309] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/10/2019] [Accepted: 11/02/2019] [Indexed: 12/02/2022] Open
Abstract
Objectives The aim of this study was to evaluate the validity of the existing classification and difficulty index of impacted mandibular third molars in clinical situations and propose a more practical classification system. Materials and Methods This study included 204 impacted mandibular third molars in 154 patients; panoramic x-ray images were obtained before tooth extraction. Factors including age, sex, and pattern of impaction were investigated. All impacted third molars were classified and scored for spatial relationship (1–5 points), depth (1–4 points), and ramus relationship (1–3 points). All variables were measured twice by the same observer at a minimum interval of one month. Finally, the difficulty index was defined based on the total points scored as slightly difficult (3–4 points), moderately difficult (5–7 points), very difficult (8–10 points), and extremely difficult (11–12 points). Results The strength of agreement of the total points scored and difficulty index were 0.855 and 0.746, respectively. Most cases were classified as moderately difficult (73.0%). Although only 13 out of 204 cases (6.4%) were classified as extremely difficult, patients classified as extremely difficult were the oldest (P<0.05). Conclusion For difficulty classification, the authors propose one more difficult category beyond the existing three-step difficulty index: the clinician should consider the patient's age in the difficulty index evaluation.
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Affiliation(s)
- Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Hae-Sung Yong
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Choi HW, Kim B, Kim JY, Huh JK, Park KH. Three-dimensional computed tomography evaluation of craniofacial characteristics according to lateral deviation of chin. Maxillofac Plast Reconstr Surg 2019; 41:57. [PMID: 31867294 PMCID: PMC6898705 DOI: 10.1186/s40902-019-0241-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/20/2019] [Indexed: 11/23/2022] Open
Abstract
Background The relationship between the lateral deviation of chin and the upper and middle facial third asymmetry is still controversial. The purpose of this study is to evaluate the correlation of upper and middle facial third asymmetry with lateral deviation of chin using 3-dimensional computed tomography. The study was conducted on patients who underwent orthognathic surgery from January 2016 to August 2017. A total of 40 patients were included in this retrospective study. A spiral scanner was used to obtain the 3-dimensional computed tomography scans. The landmarks were assigned on the reconstructed 3-dimensional images, and their locations were verified on the axial, midsagittal, and coronal slices. The Pearson correlation analysis was performed to evaluate the correlation between chin deviation and difference between the measurements of distances in paired craniofacial structures. Statistical analysis was performed at a significance level of 5%. Results In mandible, the degree of chin deviation was correlated with the mandibular length and mandibular body length. Mandibular length and mandibular body length are shorter on the deviated-chin side compared to that on the non-deviated side (mandibular length, r = −0.897, p value < 0.001; mandibular body length, r = −0.318, p value = 0.045). In the upper and middle facial thirds, the degree of chin deviation was correlated with the vertical asymmetry of the glenoid fossa and zygonion. Glenoid fossa and zygonion are superior on the deviated-chin side than on the non-deviated side (glenoid fossa, r = 0.317, p value = 0.046; zygonion, r = 0.357, p value = 0.024). Conclusion Lateral deviation of chin is correlated with upper and middle facial third asymmetry as well as lower facial third asymmetry. As a result, treatment planning in patients with chin deviation should involve a careful evaluation of the asymmetry of the upper and middle facial thirds to ensure complete patient satisfaction.
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Affiliation(s)
- Hyo-Won Choi
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Bola Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Jeong CW, Kim KH, Jang HW, Kim HS, Huh JK. Dr. Chan-Woo Jeong, et al.'s reply. Cranio 2019; 37:408. [PMID: 31581937 DOI: 10.1080/08869634.2019.1664546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Chan-Woo Jeong
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry , Seoul , Republic of Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, Gangnam Severance Hospital, Institute of Craniofacial Deformity, Yonsei University College of Dentistry , Seoul , Republic of Korea
| | - Hyo-Won Jang
- Department of Oral and Maxillofacial Surgery, Chung-Ang University College of Medicine , Seoul , Republic of Korea
| | - Hye-Sun Kim
- Kwangwhamun Sun Dental Clinic , Seoul , Republic of Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry , Seoul , Republic of Korea
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Kim B, Choi HW, Kim JY, Park KH, Huh JK. Differential Diagnosis and Treatment of Septic Arthritis in the Temporomandibular Joint: A Case Report and Literature Review. ACTA ACUST UNITED AC 2019. [DOI: 10.14476/jomp.2019.44.3.127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Bola Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyo-Won Choi
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Seong WJ, Kotsakis G, Huh JK, Jeong SC, Nam KY, Kim JR, Heo YC, Kim HC, Zhang L, Evans MD, Conrad H, Schumacher RJ. Clinical and microbiologic investigation of an expedited peri-implantitis dog model: an animal study. BMC Oral Health 2019; 19:150. [PMID: 31307461 PMCID: PMC6632201 DOI: 10.1186/s12903-019-0837-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 06/27/2019] [Indexed: 11/10/2022] Open
Abstract
Background Animal studies are pivotal in allowing experimentation to identify efficacious treatment protocols for resolution of peri-implantitis. The purpose of this investigation was to characterize an expedited dog peri-implantitis model clinically, radiographically, and microbiologically. Methods Eight hound dogs underwent extractions (week 0) and implant (3.3 × 8.5 mm) placement with simultaneous surgical defect creation and ligature placement for induction of peri-implantitis (week 10). Ligatures were replaced at 6 weeks (week 16) and removed after 9 weeks (week 19) when supporting bone loss involved approximately 50% of the peri-implant bone. Microbial samples from the defects and healthy control implant sites collected at week 19 were analyzed utilizing a microarray. Clinical measures of inflammation were obtained and radiographic bone loss was measured from periapical radiographs. Radiographic depth and width measurements of bony defect were repeated at weeks 10 (baseline), 16, and 19. Canonical analysis of principal coordinates was used to visualize overall differences in microbial abundance between peri-implantitis and healthy implants. Results This accelerated disease protocol led to intrabony defect creation with a mean depth and width of 4.3 mm and 3.5 mm, respectively after 9 weeks of ligature placement. Microbial identification revealed 59 total bacteria in peri-implant sites, 21 of which were only present in peri-implant sites as compared to healthy controls. Overall microbial beta diversity (microbial between-sample compositional diversity) differed between peri-implantitis and healthy implants (p = 0.009). Conclusions Within the limitations of this study, this protocol led to expedited generation of peri-implant defects with a microbial profile indicative of a shift to disease and defect patterns conducive to regenerative treatment. However, the possibility of potential spontaneous resolution of lesions due to the lack of a chronicity interval as compared to chronic disease models need to be further clarified and considered during preclinical peri-implantitis model selection. Electronic supplementary material The online version of this article (10.1186/s12903-019-0837-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wook Jin Seong
- Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
| | - Georgios Kotsakis
- Department of Periodontics, School of Dentistry, UTHealth, San Antonio, TX, USA
| | - Jong-Ki Huh
- Department of Oral & Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, South Korea
| | - Soo Cheol Jeong
- Department of Restorative Dentistry, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | - Ki Young Nam
- Department of Dentistry, College of Medicine, Keimyung University, Daegu, South Korea
| | - Jong Ryul Kim
- Department of Endodontology, Maurice H. Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
| | - Young Cheul Heo
- Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, School of Dentistry, Pusan National University, Pusan, South Korea
| | - Lei Zhang
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - Michael D Evans
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - Heather Conrad
- Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Robert J Schumacher
- Center for Translational Medicine, University of Minnesota, Minneapolis, MN, USA
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Yoo J, Moon IS, Yun JH, Chung C, Huh JK, Lee DW. Effect of initial placement level and wall thickness on maintenance of the marginal bone level in implants with a conical implant-abutment interface: a 5-year retrospective study. J Periodontal Implant Sci 2019; 49:185-192. [PMID: 31285942 PMCID: PMC6599752 DOI: 10.5051/jpis.2019.49.3.185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/10/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose Implant wall thickness and the height of the implant-abutment interface are known as factors that affect the distribution of stress on the marginal bone around the implant. The goal of this study was to evaluate the long-term effects of supracrestal implant placement and implant wall thickness on maintenance of the marginal bone level. Methods In this retrospective study, 101 patients with a single implant were divided into the following 4 groups according to the thickness of the implant wall and the initial implant placement level immediately after surgery: 0.75 mm wall thickness, epicrestal position; 0.95 mm wall thickness, epicrestal position; 0.75 mm wall thickness, supracrestal position; 0.95 mm wall thickness, supracrestal position. The marginal bone level change was assessed 1 day after implant placement, immediately after functional loading, and 1 to 5 years after prosthesis delivery. To compare the marginal bone level change, repeated-measures analysis of variance was used to evaluate the statistical significance of differences within groups and between groups over time. Pearson correlation coefficients were also calculated to analyze the correlation between implant placement level and bone loss. Results Statistically significant differences in bone loss among the 4 groups (P<0.01) and within each group over time (P<0.01) were observed. There was no significant difference between the groups with a wall thickness of 0.75 mm and 0.95 mm. In a multiple comparison, the groups with a supracrestal placement level showed greater bone loss than the epicrestal placement groups. In addition, a significant correlation between implant placement level and marginal bone loss was observed. Conclusions The degree of bone resorption was significantly higher for implants with a supracrestal placement compared to those with an epicrestal placement.
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Affiliation(s)
- Jaehyun Yoo
- Department of Periodontology, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Ik-Sang Moon
- Department of Periodontology, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jeong-Ho Yun
- Department of Periodontology, Institute of Oral Bioscience, Chonbuk National University School of Dentistry, Jeonju, Korea
| | - Chooryung Chung
- Department of Orthodontics, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Dong-Won Lee
- Department of Periodontology, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Kim JY, Kim DH, Jang HW, Park KH, Huh JK. Effect of bisphosphonate on temporomandibular joint in osteopenia-induced rats by botulinum toxin A injection on masticatory muscle: a preliminary study. Maxillofac Plast Reconstr Surg 2019; 41:11. [PMID: 30915317 PMCID: PMC6397824 DOI: 10.1186/s40902-019-0193-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 02/15/2019] [Indexed: 11/17/2022] Open
Abstract
Background Botulinum toxin injection on the masticatory muscle induces the osteopenic condition on the ipsilateral condyle. Bisphosphonate suppresses bone resorption and is used to treat osteopenic or osteoporotic condition. This study aimed to evaluate the effect of bisphosphonate administration on prevention of condylar resorption and botulinum toxin A-induced disuse osteopenia in rats. Results The volume of the condyle and bone volume/tissue volume (BV/TV, %) showed a strong tendency towards statistical significance (p = 0.052 and 0.058). Trabecular thickness (Tb.Th, mm) and trabecular number (Tb.N, 1/mm) were significantly smaller in the Botox group than in the other groups (p < 0.05). The volume of the condyle and BV/TV in the bisphosphonate 100 and bisphosphonate 200 groups showed similar values when compared with the control group. Conclusion Bisphosphonate administration after botulinum toxin A injection in the masticatory muscles appears to prevent condyle resorption and botulinum toxin-induced disuse osteopenia in rats.
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Affiliation(s)
- Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273 South Korea
| | - Dae-Hoon Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273 South Korea
| | - Hyo-Won Jang
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273 South Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273 South Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273 South Korea
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Yoon S, Kim JY, Jeong CH, Park J, Huh JK, Park KH. Three-dimensional analysis of the anterior loop of the inferior alveolar nerve in relation to the growth pattern of the mandibular functional subunit. Maxillofac Plast Reconstr Surg 2018; 40:30. [PMID: 30430101 PMCID: PMC6215787 DOI: 10.1186/s40902-018-0170-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 09/05/2018] [Indexed: 11/30/2022] Open
Abstract
Background The purpose of the present study was to investigate the differences in the position and shape of the anterior loop of the inferior alveolar nerve (ALIAN) in relation to the growth pattern of the mandibular functional subunit. Methods The study was conducted on 56 patients among those who had undergone orthognathic surgery at the Gangnam Severance Hospital between January 2010 and December 2015. Preoperative computerized tomography (CT) images were analyzed using the Simplant OMS software (ver.14.0 Materialise Medical, Leuven, Belgium). The anterior and inferior lengths of ALIAN (dAnt and dInf) and each length of the mandibular functional subunits were measured. The relationship between dAnt, dInf, and the growth pattern of the mandibular subunits was analyzed. Results The length of the anterior portion of ALIAN (dAnt) reached 3.34 ± 1.59 mm in prognathism and 1.00 ± 0.97 mm in retrognathism. The length of the inferior portion of ALIAN (dInf) reached 6.81 ± 1.33 mm in prognathism and 5.56 ± 1.34 mm in retrognathism. The analysis of Pearson’s correlation coefficiency on all samples showed that the lengths of functional subunits were positively correlated with the loop depth. The length of the symphysis area in prognathic patients was positively correlated with the anterior loop depth (p = 0.005). Conclusions Both the anterior and inferior length of ALIAN are longer in prognathic patients. Especially, it seems to be associated with the growth of the symphysis area.
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Affiliation(s)
- Seungkyu Yoon
- 1Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273 South Korea
| | - Jae-Young Kim
- 1Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273 South Korea
| | - Cheol-Hee Jeong
- 1Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273 South Korea
| | - Jengbin Park
- Department of Dentistry, Armed Forces Guri Hospital, Guri-si, Korea
| | - Jong-Ki Huh
- 1Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273 South Korea
| | - Kwang-Ho Park
- 1Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273 South Korea
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Jeong CH, Yoon S, Chung SW, Kim JY, Park KH, Huh JK. Subcutaneous emphysema related to dental procedures. J Korean Assoc Oral Maxillofac Surg 2018; 44:212-219. [PMID: 30402412 PMCID: PMC6209696 DOI: 10.5125/jkaoms.2018.44.5.212] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 01/09/2023] Open
Abstract
Objectives The objective of this study was to analyze 11 cases of subcutaneous emphysema associated with dental procedures from a single hospital and discuss approaches for accurate diagnosis and treatment of the condition. Materials and Methods The medical records of 11 patients who were treated for subcutaneous emphysema related to dental procedures between January 2009 and April 2017 were analyzed retrospectively. Patients with subcutaneous emphysema within the facial area or that spread to the neck and beyond, including the facial region, were assigned to two groups and compared in terms of age, sex, and durations of antibiotic use, hospitalization, and follow-up until improvement. The correlation between location of the origin tooth and range of emphysema spread was analyzed. Results The average durations of antibiotic use during conservative treatment and follow-up until improvement were 8.55 days (standard deviation [SD], 4.46 days) and 1.82 weeks (SD, 1.19 weeks), respectively. There was no intergroup difference in duration of antibiotic use (P=0.329) or follow-up (P=0.931). Subcutaneous emphysema was more common after dental procedures involving the maxilla or posterior region than after those involving the mandible or anterior region. There was no significant difference in air distribution according to location of the air orifice (maxilla, mandible, or both; P=0.106). Conclusion Upon adequate conservative treatment accompanied by prophylactic antibiotic treatment considering the risk of infection, patients showed signs of improvement within a few days or weeks. There was no significant difference in treatment period between patients with subcutaneous emphysema localized to the facial region and those with subcutaneous emphysema spreading to the neck or beyond. These findings need to be confirmed by analysis of additional cases.
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Affiliation(s)
- Cheol-Hee Jeong
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Seungkyu Yoon
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Seung-Won Chung
- Department of Dentistry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Gho WG, Choi Y, Park KH, Huh JK. Expression of collagenases (matrix metalloproteinase-1, 8, 13) and tissue inhibitor of metalloproteinase-1 of retrodiscal tissue in temporomandibular joint disorder patients. J Korean Assoc Oral Maxillofac Surg 2018; 44:120-127. [PMID: 29963493 PMCID: PMC6024060 DOI: 10.5125/jkaoms.2018.44.3.120] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/09/2018] [Accepted: 02/12/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of this study was to reveal how collagenases (matrix metalloproteinase [MMP]-1, 8, 13) and tissue inhibitor of metalloproteinase 1 (TIMP-1) are expressed in immunohistochemistry of retrodiscal tissue in temporomandibular joint disorder patients. MATERIALS AND METHODS This study was conducted on 39 patients who underwent discoplasty or discectomy. Immunohistochemical staining was undertaken and expression levels of MMP-1, 8, 13, and TIMP-1 were evaluated. The status of internal derangement of disc, osteoarthritis, and joint effusion were analyzed using magnetic resonance imaging (MRI). Disc status observed during operation was also categorized. RESULTS The more severe disc derangement was observed on MRI, the more increased expression of MMPs and TIMP-1 appeared. Regarding MMP-13 expression, 86.7% of late-stage disc displacement patients showed grade II or III. Expression level of MMPs or TIMP was not statistically significant associated with joint effusion level. In perforation and/or adhesion groups, all patients showed grade II or III expression of MMP-13. Once perforation occurred, MMP-13 showed increased expression with statistical significance. CONCLUSION MMP-1 and MMP-13 expression seem to be related to progression of osteoarthritis whereas MMP-8 does not seem to have a specific role with regard to temporomandibular joint disorders. TIMP-1 is considered to be partly related to internal derangement rather than osteoarthritis, but it is not significant.
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Affiliation(s)
- Won Gyung Gho
- Department of Dentistry, Myongji Hospital, Goyang, Korea
| | - Yuri Choi
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
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Kim JY, Jeon KJ, Kim MG, Park KH, Huh JK. A nomogram for classification of temporomandibular joint disk perforation based on magnetic resonance imaging. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:682-692. [PMID: 29574057 DOI: 10.1016/j.oooo.2018.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 02/08/2018] [Accepted: 02/15/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim of this study was to analyze risk factors and establish a prediction model for temporomandibular joint (TMJ) disk perforation by constructing a nomogram. STUDY DESIGN The study included a total of 282 joints in 274 patients. All patients underwent open TMJ surgery after obtaining magnetic resonance imaging (MRI), from 2005 to 2015. The presence or absence of disk perforation was confirmed during the operation. Patients were classified into 2 groups: perforation and nonperforation groups. We investigated demographic data and the characteristics of the disk, joint space, and bone on MRI. A logistic regression analysis was performed to analyze risk factors. A nomogram was constructed and validated internally and externally. RESULTS Risk factors for disk perforation were increased age, disk shape (eyeglass or amorphous), low bone marrow signal, abnormal joint space, and 2 or more bony changes in the condyle and fossa. The area under the receiver operating characteristic curve of the nomogram was 0.908 (95% confidence interval [CI] 0.869-0.946) in the internal validation and 0.889 (95% CI 0.804-0.973) in the external validation with good suitability. CONCLUSIONS We were able to predict the probability of disk perforation with analyzed risk factors and constructed a nomogram, which may be helpful in proper diagnosis and treatment.
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Affiliation(s)
- Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Kug-Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yongin Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Myeong-Gyun Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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Abstract
OBJECTIVE The relationship between bite force and torus palatinus or mandibularis remains to be explained. The major aim of this study was to determine the correlation between bite force and oral tori. METHODS The bite force of 345 patients was measured with a bite force recorder; impressions of the shape and size of the oral tori were taken on plaster models prior to orthodontic treatments. Subsequently, the relationship between oral tori and bite force was analyzed. RESULTS The size, shape, and incidence of torus palatinus was not significantly correlated with bite force. However, the size of torus mandibularis increased significantly in proportion to the bite force (p = 0.020). The occurrence of different types of oral tori was not correlated with the bite force. DISCUSSION The size of torus mandibularis provides information about bite force and can thus be used to clinically assess occlusal stress.
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Affiliation(s)
- Chan-Woo Jeong
- a Department of Oral and Maxillofacial Surgery , Gangnam Severance Hospital, Yonsei University College of Dentistry , Seoul , Republic of Korea.,b Department of Oral and Maxillofacial Surgery , Ildong Hospital , Pocheon-si , Republic of Korea
| | - Kyung-Ho Kim
- c Department of Orthodontics, Institute of Craniofacial Deformity , Gangnam Severance Hospital, Yonsei University College of Dentistry , Seoul , Republic of Korea
| | - Hyo-Won Jang
- a Department of Oral and Maxillofacial Surgery , Gangnam Severance Hospital, Yonsei University College of Dentistry , Seoul , Republic of Korea
| | - Hye-Sun Kim
- a Department of Oral and Maxillofacial Surgery , Gangnam Severance Hospital, Yonsei University College of Dentistry , Seoul , Republic of Korea.,d Kwangwhamun Sun Dental Clinic , Seoul , Republic of Korea
| | - Jong-Ki Huh
- a Department of Oral and Maxillofacial Surgery , Gangnam Severance Hospital, Yonsei University College of Dentistry , Seoul , Republic of Korea
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Kim DH, Lee EH, Cho ES, Kim JY, Jeon KJ, Kim J, Huh JK. Temporomandibular joint synovial chondromatosis extending to the temporal bone: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2017; 43:336-342. [PMID: 29142869 PMCID: PMC5685864 DOI: 10.5125/jkaoms.2017.43.5.336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/09/2017] [Accepted: 09/11/2017] [Indexed: 11/07/2022] Open
Abstract
Synovial chondromatosis is a rare benign lesion originating from the synovial membrane. It presents as adhesive or non-adhesive intra-articular cartilaginous loose bodies. Although the causes of synovial chondromatosis have not been fully elucidated, inflammation, external injury, or excessive use of joints have been suggested as possible causes. Synovial chondromatosis has been reported to occur most frequently at large joints that bear weights, with a rare occurrence at the temporomandibular joint (TMJ). When synovial chondromatosis develops at TMJ, clinical symptoms, including pain, joint sounds, and mouth opening may common. Moreover, synovial chondromatosis rarely spreads to the mandibular condyle, glenoid cavity, or articular eminence of TMJ. The goal of this study was to discuss the methods of surgery and other possible considerations by reviewing cases of patients who underwent surgery for synovial chondromatosis that extended to the temporal bone.
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Affiliation(s)
- Dae-Hoon Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Eun Hee Lee
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Eunae Sandra Cho
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Kug-Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea.,Department of Dentistry, Yongin Severance Hospital, Yongin, Korea
| | - Jin Kim
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Kim HK, Lim JH, Jeon KJ, Huh JK. Bony window approach for a traumatic bone cyst on the mandibular condyle: a case report with long-term follow-up. J Korean Assoc Oral Maxillofac Surg 2016; 42:209-14. [PMID: 27595088 PMCID: PMC5009195 DOI: 10.5125/jkaoms.2016.42.4.209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/21/2016] [Accepted: 04/26/2016] [Indexed: 11/07/2022] Open
Abstract
Traumatic bone cyst (TBC) occurs preferentially on the mandibular symphysis and body, but rarely on the mandibular condyle. When TBC occurs in the condylar area, it can usually be related with or misdiagnosed as a temporomandibular joint disorder. A 15-year-old female patient visited the Temporomandibular Joint Clinic with a 5-year history of pain and noise localized in the left temporomandibular joint. On imaging, a well demarked oval-shaped radiolucent lesion was observed on the left condyle head. The patient underwent cyst enucleation and repositioning of the bony window on the lateral cortex of the affected condyle head under the impression of subchondral cyst or TBC; however, no cystic membrane was found. The bone defect resolved and showed no recurrence on the serial radiographic postoperative follow-up for 43 months after surgery.
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Affiliation(s)
- Hyoung Keun Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Hyung Lim
- Department of Dentistry, Korea University Ansan Hospital, Ansan, Korea
| | - Kug-Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yongin Severance Hospital, Yonsei University College of Dentistry, Yongin, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Huh JK, Yang DK, Jeon KJ, Shin SJ. Progression of periapical cystic lesion after incomplete endodontic treatment. Restor Dent Endod 2016; 41:137-42. [PMID: 27200282 PMCID: PMC4868877 DOI: 10.5395/rde.2016.41.2.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/08/2016] [Indexed: 11/11/2022] Open
Abstract
We report a case of large radicular cyst progression related to endodontic origin to emphasize proper intervention and follow-up for endodontic pathosis. A 25 yr old man presented with an endodontically treated molar with radiolucency. He denied any intervention because of a lack of discomfort. Five years later, the patient returned. The previous periapical lesion had drastically enlarged and involved two adjacent teeth. Cystic lesion removal and apicoectomy were performed on the tooth. Histopathological analysis revealed that the lesion was an inflammatory radicular cyst. The patient did not report any discomfort except for moderate swelling 3 days after the surgical procedure. Although the patient had been asymptomatic, close follow-ups are critical to determine if any periapical lesions persist after root canal treatment.
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Affiliation(s)
- Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
| | - Dong-Kyu Yang
- Department of Conservative Dentistry, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
| | - Kug-Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Su-Jung Shin
- Department of Conservative Dentistry, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea
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Abstract
AIM Chondroblastoma is a rare, benign bone tumor that accounts for approximately 1% of all primary bone tumors. Chondroblastoma that occurs at the temporomandibular joint can exhibit symptoms similar to those associated with other temporomandibular disorders. This case study aims to present an eight-year followup of chondroblastoma occurring at the temporomandibular joint. METHODOLOGY The patient presented swelling in the left temporomandibular joint and trismus. Based oncomputed tomography and magnetic resonance imaging findings, a provisional diagnosis of synovial chondromatosis was made. Complete excision of the lesion was performed under general anesthesia. RESULTS After histopathological examination, the lesion was finally diagnosed as chondroblastoma. Currently, 8 years after the operation, the patient has not experienced any symptoms or any notable complications. CONCLUSIONS Although chondroblastoma is a benign tumor, it shows aggressive characteristics with bone invasion. Therefore, precise diagnosis and proper treatment planning is crucial for successful treatment of chondroblastoma.
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Affiliation(s)
- Sung-Min Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University , Seoul, Korea
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Jeong CW, Youn T, Kim HS, Park KH, Huh JK. Contralateral recurrence of necrotizing sialometaplasia of the hard palate after five months: a case report. J Korean Assoc Oral Maxillofac Surg 2015; 41:338-41. [PMID: 26734562 PMCID: PMC4699936 DOI: 10.5125/jkaoms.2015.41.6.338] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/23/2015] [Accepted: 10/03/2015] [Indexed: 11/07/2022] Open
Abstract
Necrotizing sialometaplasia usually heals within 4 to 10 weeks with conservative treatment, and rarely recurs. When necrotizing sialometaplasia is present on the hard palate it may occur unilaterally or bilaterally. In this case, necrotizing ulceration occurred on the left hard palate of a 36-year-old woman after root canal treatment of the upper left first premolar under local anesthesia. After only saline irrigation the defect of the lesion completely healed and filled with soft tissue. After 5 months, however, a similar focal necrosis was found on the contralateral hard palate without any dental treatment having been performed on that side and progressed in similar fashion as the former lesion. We conducted an incisional biopsy and obtained a final pathological diagnosis for the palatal mass of necrotizing sialometaplasia. At the 3-year follow-up, the patient's oral mucosa of the hard palate was normal, without any signs and symptoms of the condition. We report a case of a second occurrence of necrotizing sialometaplasia on the contralateral side from the first, with a time lapse between the first and second occurrence.
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Affiliation(s)
- Chan-Woo Jeong
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Taegyun Youn
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Hyun Sil Kim
- Department of Oral Pathology and Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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40
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Kim DS, Kim JY, Jeong CW, Park KH, Huh JK. Conservative condylectomy alone for the correction of mandibular asymmetry caused by osteochondroma of the mandibular condyle: a report of five cases. J Korean Assoc Oral Maxillofac Surg 2015; 41:259-64. [PMID: 26568928 PMCID: PMC4641217 DOI: 10.5125/jkaoms.2015.41.5.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/24/2015] [Accepted: 08/14/2015] [Indexed: 11/12/2022] Open
Abstract
We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma.
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Affiliation(s)
- Dong Sung Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Chan-Woo Jeong
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Choi JY, Moon IS, Yun JH, Park KH, Huh JK, Lee DW. Effects of thread size in the implant neck area on peri-implant hard and soft tissues: an animal study. Clin Oral Implants Res 2015; 27:1187-92. [PMID: 26498561 DOI: 10.1111/clr.12720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this animal study was to examine the effects of thread size in the implant neck area on peri-implant tissues in terms of BIC and hard- and soft-tissue dimensions. MATERIALS AND METHODS Six Beagle dogs received experimental implants in the mandible 3 month after the removal of premolars and first molars (P2, P3, P4, and M1). Two different types of implants were installed in each animal: Anyone microthread(®) as Group 1 and Anyone(®) as Group 2. Resonance frequency test, intraoral radiography, micro-CT, and histomorphometry were used to evaluate peri-implant tissue after implantation periods of 4 and 8 weeks. RESULTS No remarkable complication was observed during the healing period in either group. Resonance frequency testing revealed no significant difference between groups. In radiographic evaluation, Group 2 showed more bone loss than Group 1. However, this difference was not statistically significant. In the micro-CT analysis, BIC and BIV values and soft-tissue height were not significant in both groups. Histological analysis revealed no significant difference in BIC ratio, bone density, or bone loss between groups. However, soft-tissue height was significantly greater in Group 2 than in Group 1 (P = 0.0004). CONCLUSION No difference in peri-implant hard or soft tissues was observed according to thread size in the implant neck area.
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Affiliation(s)
- Jay-Yong Choi
- Department of Periodontology, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ik-Sang Moon
- Department of Periodontology, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jeong-Ho Yun
- Department of Periodontology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Dong-Won Lee
- Department of Periodontology, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
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Kim SM, Lee JH, Kim HJ, Huh JK. Mouth opening limitation caused by coronoid hyperplasia: a report of four cases. J Korean Assoc Oral Maxillofac Surg 2014; 40:301-7. [PMID: 25551096 PMCID: PMC4279969 DOI: 10.5125/jkaoms.2014.40.6.301] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 10/09/2014] [Indexed: 01/27/2023] Open
Abstract
Coronoid process hyperplasia is a rare condition that causes mouth opening limitation, otherwise known as trismus. The elongated coronoid processes impinge on the medial surfaces of the zygomatic arches when opening the mouth, which limits movement of the mandible and leads to trismus. Patients with trismus due to coronoid process hyperplasia do not have any definite symptoms such as temporomandibular joint pain or sounds upon clinical examination, and no significant abnormal signs are observed on panoramic radiographs or magnetic resonance images of the temporomandibular joint. Thus, the diagnosis of trismus is usually very difficult. However, computed tomography can help with the diagnosis, and the condition can be treated by surgery and postoperative physical therapy. This paper describes four cases of patients who visited our clinic for trismus and were subsequently diagnosed with coronoid process hyperplasia. Three were successfully treated with a coronoidectomy and postoperative physical therapy.
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Affiliation(s)
- Sung-Min Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jin-Hyeok Lee
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Hak-Jin Kim
- Department of Oral and Maxillofacial Surgery, Yongin Severance Hospital, Yonsei University College of Dentistry, Yongin, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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43
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Lim JH, Huh JK, Park KH, Shin SJ. Autotransplantation of an impacted premolar using collagen sponge after cyst enucleation. J Endod 2014; 41:417-9. [PMID: 25476975 DOI: 10.1016/j.joen.2014.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 10/03/2014] [Accepted: 10/18/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION We report a case of successful autotransplantation of a premolar impacted with a dentigerous cyst and transplanted with collagen plugs for initial support. METHODS An 18-year-old man had an impacted premolar accompanied with a large dentigerous cyst. The tooth was extracted surgically and transplanted to an edentulous alveolar ridge, and a collagen sponge was inserted to ensure proper healing and initial support. Root canal treatment was performed 3 weeks after the surgery. RESULTS The previous lesion was healed, and the transplanted tooth was functional without any pathologic signs. CONCLUSIONS Our protocol provides a viable option for saving an impacted tooth in the case of cyst enucleation.
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Affiliation(s)
- Jae-Hyung Lim
- Department of Oral and Maxillofacial Surgery, Korea University Ansan Hospital, Ansan, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
| | - Su-Jung Shin
- Department of Conservative Dentistry, Yonsei University College of Dentistry, Seoul, Korea.
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Lee JH, Kim SM, Kim HJ, Jeon KJ, Park KH, Huh JK. Characteristics of bony changes and tooth displacement in the mandibular cystic lesion involving the impacted third molar. J Korean Assoc Oral Maxillofac Surg 2014; 40:225-32. [PMID: 25368835 PMCID: PMC4217264 DOI: 10.5125/jkaoms.2014.40.5.225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 08/23/2014] [Accepted: 09/07/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The purpose of this retrospective study is to find the differentiating characteristics of cystic and cystic-appearing lesions that involve the impacted mandibular third molar by analyzing panoramic radiographs and computed tomography images, and to aid the preoperative diagnosis. MATERIALS AND METHODS Eighty-one patients who had a mandibular cystic or cystic-appearing lesion that involved impacted mandibular third molar and underwent cyst enucleation were included in the study. The preoperative panoramic radiograph and computed tomography findings were analyzed in accordance to the histopathologic type. RESULTS Most of the cystic lesions containing the mandibular third molar were diagnosed as a dentigerous cyst (77.8%). The occurrence of mesio-distal displacement of the third molar was more frequent in the odontogenic keratocyst (71.4%) and in the ameloblastoma (85.7%) than in the dentigerous cyst (19.1%). Downward displacement was primarily observed in each group. Odontogenic keratocyst and ameloblastoma showed more aggressive growth pattern with higher rate of bony discontinuity and cortical bone expansion than in dentigerous cyst. CONCLUSION When evaluating mandibular cystic lesions involving the impacted mandibular third molar, dentigerous cyst should first be suspected. However, when the third molar displacement and cortical bone absorption are observed, then odontogenic keratocyst or ameloblastoma should be considered.
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Affiliation(s)
- Jin-Hyeok Lee
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Sung-Min Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Hak-Jin Kim
- Department of Oral and Maxillofacial Surgery, Yongin Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Kug-Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yongin Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
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Kim NH, Cha YH, Kim HS, Lee SE, Huh JK, Kim JK, Kim JM, Ryu JK, Kim HJ, Lee Y, Lee SY, Noh I, Li XY, Weiss SJ, Jahng TA, Yook JI. A platform technique for growth factor delivery with novel mode of action. Biomaterials 2014; 35:9888-9896. [PMID: 25218859 DOI: 10.1016/j.biomaterials.2014.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 08/01/2014] [Indexed: 01/09/2023]
Abstract
Though growth factors allow tissue regeneration, the trade-off between their effectiveness and adverse effects limits clinical application. The key issues in current growth factor therapy largely derive from initial burst pharmacokinetics, rapid clearance, and proteolytic cleavage resulting in clinical ineffectiveness and diverse complications. While a number of studies have focused on the development of carriers, issues arising from soluble growth factor remain. In this study, we report a prodrug of growth factors constituting a novel mode of action (MoA). To mimic endogenous protein processing in cells, we developed a recombinant BMP-2 polypeptide based on a protein transduction domain (PTD) to transduce the protein into cells followed by furin-mediated protein cleavage and secretion of active growth factor. As proof of concept, a few micrograms scale of PTD-BMP-2 polypeptide sufficed to induce bone regeneration in vivo. As a simple platform, our technique can easily be extended to delivery of BMP-7 and DKK-1 as therapeutics for TGF-β and canonical Wnt signaling, respectively, to suppress the epithelial-mesenchymal transition (EMT), which constitutes a fundamental biological mechanism of many diseases. This technique largely overcomes the limitations of current soluble growth factors and opens the door to next generation growth factor therapeutics.
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Affiliation(s)
- Nam Hee Kim
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul 120-752, South Korea
| | - Yong Hoon Cha
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul 120-752, South Korea
| | - Hyun Sil Kim
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul 120-752, South Korea
| | - Soo Eon Lee
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul 110-799, South Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul 120-752, South Korea
| | - Jung Kook Kim
- Ortholution, 104 Suntechcity, 513-15, Sangdaewon-dong, Joongwon-gu, Seongnam-si, Kyunggi-do 462-725, South Korea
| | - Jeong Moon Kim
- Ortholution, 104 Suntechcity, 513-15, Sangdaewon-dong, Joongwon-gu, Seongnam-si, Kyunggi-do 462-725, South Korea
| | - Joo Kyung Ryu
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul 120-752, South Korea
| | - Hee-Jin Kim
- Department of Anatomy, Yonsei University College of Dentistry, Seoul 120-752, South Korea
| | - Yoonmi Lee
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul 120-752, South Korea
| | - Su Yeon Lee
- Department of Chemical Engineering, Seoul National Universtiy of Science and Technology, Seoul 139-743, South Korea; Convergence Institute of Biomedical Engineering and Biomaterials, Seoul National University of Science and Technology, Seoul 139-743, South Korea
| | - Insup Noh
- Department of Chemical Engineering, Seoul National Universtiy of Science and Technology, Seoul 139-743, South Korea; Convergence Institute of Biomedical Engineering and Biomaterials, Seoul National University of Science and Technology, Seoul 139-743, South Korea
| | - Xiao-Yan Li
- Division of Molecular Medicine and Genetics, Department of Internal Medicine and the Life Sciences Institute, University of Michigan, Ann Arbor, MI 48109, USA
| | - Stephen J Weiss
- Division of Molecular Medicine and Genetics, Department of Internal Medicine and the Life Sciences Institute, University of Michigan, Ann Arbor, MI 48109, USA
| | - Tae-Ahn Jahng
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul 110-799, South Korea.
| | - Jong In Yook
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul 120-752, South Korea.
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Lee SH, Ryu DJ, Kim HS, Kim HG, Huh JK. Alloplastic total temporomandibular joint replacement using stock prosthesis: a one-year follow-up report of two cases. J Korean Assoc Oral Maxillofac Surg 2013; 39:297-303. [PMID: 24516821 PMCID: PMC3912785 DOI: 10.5125/jkaoms.2013.39.6.297] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/06/2013] [Accepted: 11/25/2013] [Indexed: 12/04/2022] Open
Abstract
Alloplastic total replacement of the temporomandibular joint (TMJ) was developed in recent decades. In some conditions, previous studies suggested the rationale behind alloplastic TMJ replacement rather than reconstruction with autogenous grafts. Currently, three prosthetic products are available and approved by the US Food and Drug Administration. Among these products, customized prostheses are manufactured, via computer aided design/computer aided manufacturing (CAD/CAM) system for customized design; stock-type prostheses are provided in various sizes and shapes. In this report, two patients (a 50-year-old female who had undergone condylectomy for the treatment of osteochondroma extending to the cranial base on the left condyle, and a 21-year-old male diagnosed with left temporomandibular ankylosis) were treated using the alloplastic total replacement of TMJ using stock prosthesis. The follow-up results of a favorable one-year, short-term therapeutic outcome were obtained for the alloplastic total TMJ replacement using a stock-type prosthesis.
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Affiliation(s)
- Sang-Hoon Lee
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Da-Jung Ryu
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hye-Sun Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyung-Gon Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
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47
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Huh JK, Shin SJ. Misdiagnosis of florid cemento-osseous dysplasia leading to unnecessary root canal treatment: a case report. Restor Dent Endod 2013; 38:160-6. [PMID: 24010083 PMCID: PMC3761125 DOI: 10.5395/rde.2013.38.3.160] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 05/20/2013] [Accepted: 05/23/2013] [Indexed: 11/16/2022] Open
Abstract
This case report demonstrates an unnecessary endodontic treatment of teeth with florid cemento-osseous dysplasia (FCOD) due to a misdiagnosis as periapical pathosis and emphasizes the importance of correct diagnosis to avoid unnecessary treatment. A 30-year-old woman was referred to our institution for apicoectomies of the mandibular left canine and both the lateral incisors. The periapical lesions associated with these teeth had failed to resolve after root canal treatment over a 3-year period. Radiographic examinations revealed multiple lesions on the right canine, the second premolar, and both first molars as well as the anterior region of the mandible. Based on clinical, radiographic and histological evaluations, the patient condition was diagnosed as FCOD. The patient has been monitored for 2 years. To avoid unnecessary invasive treatment, accurate diagnosis is essential before treatment is carried out in managing FCOD.
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Affiliation(s)
- Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea
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48
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Chung CJ, Choi YJ, Kim IS, Huh JK, Kim HG, Kim KH. [Total alloplastic temporomandibular joint reconstruction combined with orthodontic treatment in a patient with idiopathic condylar resorption]. Orthod Fr 2012; 83:225-238. [PMID: 22944016 DOI: 10.1051/orthodfr/2012022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This case report describes the successful treatment of an adult patient with skeletal Class II open-bite malocclusion secondary to idiopathic condylar resorption. Total alloplastic joint reconstruction and counterclockwise rotation of the maxillomandibular complex combined with orthodontic treatment provided a satisfying outcome with maximum functional and esthetic improvement.
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Affiliation(s)
- Chooryung J Chung
- Department of Orthodontics, Gangnam Severance Hospital, 2112 Eonjuro, Gangnam-gu, Seoul, 135-720, Korea
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49
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Kim HS, Lee SH, Youn T, Kim HG, Huh JK. Anterior open bite with temporomandibular disorders treated with intermaxillary traction using skeletal anchorage system. J Korean Assoc Oral Maxillofac Surg 2012. [DOI: 10.5125/jkaoms.2012.38.5.284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Hye-Sun Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sang-Hoon Lee
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Taegyun Youn
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyung-Gon Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
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50
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Yoon HJ, Lee SH, Hur JY, Kim HS, Seok JH, Kim HG, Huh JK. Relationship between stress levels and treatment in patients with temporomandibular disorders. J Korean Assoc Oral Maxillofac Surg 2012. [DOI: 10.5125/jkaoms.2012.38.6.326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Hyung-Jun Yoon
- Department of Psychiatry, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea
| | - Sung-Hee Lee
- Department of Dentistry, Yongin Severance Hospital, Yonsei University, Yongin, Korea
| | - Jun-Young Hur
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hye-Sun Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jeong-Ho Seok
- Department of Psychiatry, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea
| | - Hyung-Gon Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
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