1. A case report of nasopalatine cyst and review of literature:
J.Korean Academy of Oral Surg.,8:15-22,1982
This is the report of extensive nasopalatine duct cyst developed in the midline of maxilla.
1) The patient, 32y-o female, has being suffered from the swelling and pain on the upper anterior palatal and labial gingival area, and discharge through labial fistula.
2) radiographic findings revealed well-circumscribed round radiolucent shadow on the anterior midpalate which was diagnosed as extensive nasopalatine duct cyst.
3) Histopathological findings showed the figures of typical nasopalatine duct cyst.
4) It was treated by a combination of marsupialization,enucleation and primary closure.
2.Treatment of mandibular fractures in children by using the
acrylic splint with circumferential wiring: J.Korean Academy
of Oral Surg.,9:47-53,1983
The mandibular fracture in children is rare than in adults. The features of fracture and techniques of treatment of mandibular fracture in children is various and poses special problems of reduction and immobilization of the fractured fragment.
Acrylic resin splint with circumferential wiring is a valuable fixation which permits the movement of the jaw immediately after operation. The present studies reveal that acrylic resin splint with circumferential wiring may be successful fixation for the management of mandibular fracture in children.
3.Orthognathic surgical correction of facial asymmetry from
unilateral condylar hyperplasia: J.Korean Academy of Max.-Fac.
Plastic Surg.,5:29-37,1983
This is to report a case of facial asymmetry from unilateral condylar hyperplasia.
1) The patient, 29 years old female, has being suffered from facial asymmetry and masticatory disturbance for 12 years.
2) Clinical and radiographic examinations revealed hyperplasia of right mandibular condyle and elongation of condylar neck which was diagnosed as condylar hyperplasia.
3) We obtained excellent and functional results by the treatments of subcondylar ostectomy and pre& post-operative orthodontic treatment.
4.An experimental study of the histopathological changes on
the resected surface after condylectomy:Kyung Hee Univ.
Dental J.,5:213-222,1983
The Purpose of this study was to observe histopathological changes of the resected surface following unilateral condylectomy.
In order to carry out this experiment, 16 whites rats weighing about 150 grams were selected and divided into a control group and 6 experimental groups according to experimental period.
Under general anesthesia with thiopental sodium, all experimental animals were condylectomized and intermaxillary fixation was not applied to permit free chewing movements.
Experimental rats were sacrificed consecutively on the 3rd day, 1st, 2nd, 4th, 6th, and 8th week after condylectomy, and the mandibles were dissected out to produce tissue specimen.
The specimens were fixed with 10% neutral formalin solution, decalcified by 5% nitric acid and embedded in paraffin as usual manner. The embedded specimens were sectioned in 5-7nanometer with microtome, and stained with hematoxylin-eosin and observed through the microscopic study.
1)On the 2nd week, the covering connective tissue on the resected surface was replaced by fibrous connective tissue which became more dense on the 6th week, and superior thickened dense connective tissue and inferior loose connective tissue were observed on the newly formed condyle at 8th week.
2)The border between condylar stump and fibrous connective tissue began to disappear gradually and a few fibrocartilage cells arising by metaplasia of local fibroblasts near the resected surface were observed 2nd week.
3)The cartilage formation on the cut surface was observed from 4th week and the whole articular surface of mandible was covered with fibrocartilage layer similar to normal condyle on the 8th week.
4)The maturation of the fibrous connective tissue and cartilage formation were revealed on the posterior articular portion prior to the anterior articular portion.
5.Cystic hygroma:J.Korean Academy of Oral Max.-Fac.Surg.,
10:9-18,1984
This is to report a case of cystic hygroma occurred in the left submandibular area of 12 years old male patient.
The patient was admitted to Dept. of Oral and Maxillofacial surgery, Kyung-Hee University Medical Center with the chief complaints of left submaxillary swelling.
Cystic hygroma is a benign neoplasm of developmental origin that are characterized by large endothelial-lined space and found predominantly in the region of the head and neck, commonly in the posterior triangle of the neck, but in this case, the lesion was found in the anterior triangle.
In this case, cystic hygroma is not invade the floor of the mouth and the base of the tongue and surgically excised specimen is ovoid, lobulated and 6x2x4cm in size and that is filled with watery, straw colored fluid.
The histological appearance is that of multiple dilated and collapsed lymphatic channels lined by a single layer of flattened endothelium.
Focal lymphocytic infiltration as well as small spouts or buds of lymphangiomatous tissue t extend into adjacent tissue.
It is the best treated by surgical excision soon after recognition in order to prevent extensive local growth and expansion.
This case is of interest because their diagnosis was made when the patient was 12 years old.
6.Arteriovenous malformation occurring in face:J.Korean Academy
of Oral Max.-Fac. Surg.,10:159-171,1984
An arteriovenous malformation(AVM) may be defined condition in which arteries communicate with veins through channels other than the normal capillary networks.
The common unifying clinical element is severe bleeding which can result from this type of lesion.
Most sophisticated diagnostic studies include selective arteriogram and ultrasound flowmeter.
The treatment for such mass is predicted upon a total elimination of all diseased tissue.
AVM located in the spinal cord and cerebral vessel is particularly poorly treated with surgical excision.
Therefore, the technique of intraarterial embolization was first used for these lesions. Certain extensive lesions that are considered inoperable may be treated with embolization alone.
The author had managed a patient, 15 years old male, with AVM of the left face involving mandible. Through femoral artery, embolization with polyvinyl alcohol(PVA) was performed.
At the first embolization(1983/12/30), PVA were embolized into his left facial, lingual, and internal maxillary arteries.
In march 1984, he had repeated gingival bleeding. An angiographic study of the carotid aeries demonstrated the AVM fed by left external carotid artery and right facial artery.
At that time,PVA were embolized into his left face, lingual arteries and right facial arteries.
Sixty days postoperatively, no signs of AVM had recurred.
7.TMJ remodelling after condylar fracture in a growing child:
J.Korean Academy of oral Max.-Fac.Surg.,:10:81-90,1984
This is a case report that deals with TMJ remodeling after both condylar fractures in a puberty child.
The patient, 14 years old boy, was referred to our department from local clinic for the evaluation of the traumatic injuries on the face which was developed by traffic accident 10 days ago.
On the basis of clinical and radiographic examinations, he was diagnosed as both mandibular condyles and symphysis fractures, right maxillary alveolar fracture, and multiple teeth injury.
The mandibular and maxillary fractures were treated with closed reduction and intermaxillary fixation with arch bar and multiple loop wiring. IMF was applied for two weeks and early movement of jaw was carried out to prevent TMJ ankylosis. Endodontic and prosthodontic treatments were performed for the restoration of the missing teeth. Patient was examined periodically for the evaluation of TMJ function and remodelling.
On the 10th day after trauma(on the admission day), the intracapsular both condylar fractures were observed in the panoramic view. The both fragments were displaced anteriorly which were located below the articular eminences. The contour of fragments was superimposed with condylar stump in the panoramic view. In the P-A view, both fragments were slightly displaced to the medial side.
On the 3rd week after trauma(after removal of IMF), the contour of condylar fragments were slightly disappeared and the radiopacity of the both TMJ was observed, but the sigmoid notches and coronoid processes were seen as normal contour.
8.Mandibular osteomyelitis:J.Korean academy of Max.-Fac.Plastic
Surg.,6:19-30,1984
These are to report two cases of osteomyelitis occurred in the mandibles of 22 year-old and 36 year-old male patients.
They were admitted to Dept.Of Oral surgery, Kyunghee Univ.Med.Ctr. with the chief complaints of left facial swelling, pain and mouth opening interference.
The one was treated by conservative treatment without sequestrectomy, and the order was treated by extensive sequestrectomy from left mandibular body to left condylar region.
The results were as follows: 1) In case of 22 y/o male, the patient has visited with the state of acute osteomyelitis, but it was changed to chronic osteomyelitis in spite of the massive antibiotic therapy. It was diagnosed as gram-negative osteomyelitis caused by klebiella pneumoniae through the several cultures.
2) In case of 22 y/o male, we observed in the radiogram, the sequestrum about 15X10mm in size that has occurred in the inferior border of mandible near the left mandibular angle region. After 7 weeks of conservative treatment without sequestrectomy, which consisted of local wound care and massive antibiotic therapy, the author could notice the resorption of sequestra in the radiogram. Six months later, in the follow- up check of the patient, we could observed marked bone regeneration without recurrence.
3) In case of 36 y/o male, extensive bone destruction was noted on the left mandibular body, angle, ascending ramus, mandibular notch and kindlier region. Following sequestrectomy, we could observed marked bone regeneration after 6 months.The author thought this bone regeneration as the results of osteogenesis of the periosteum and lingual cortical plate which had been remained healthy during the operation.
9.Surgical correction of facial asymmetry by intraoral vertical
subcondylar osteotomy:J.Korean Academy of Max.-Fac.Plastic
Surg.,7:21-31,1985
This is a case report and review of literature that deals with facial asymmetry corrected by intraoral vertical subcondylar osteotomy.
Patient, 22 years old lady, was referred to our department from local clinic for the evaluation of facial asymmetry and masticatory disturbance.
On the basis of clinical and radiographic examinations, she was diagnosed as asymmetrical mandible from unilateral condylar neck elongation without condylar enlargement.
Asymmetrical mandible was treated by intraoral vertical subcondylar osteotomy. IMF was applied for 6 weeks and no interosseous wiring was done between the fragments for the functional adaptation.
Patient was satisfied with the final esthetic and functional results by intraoral vertical subcondylar osteotomy.
10.Plexiform unicystic ameloblastoma in mandible:J.Kyung Hee
Univ.Medical Center,1:131-138,1985
11. The effects of immobilization and early movement on the
condylar repair after condylar shaving of the rabbits:
J.korean academy of oral and maxillofac.surg.,16:8-19,1990.
The present study was designed to compare the effects of the immobilization with the those of early movement on the condylar repair after condylar shaving of the rabbits.
In order to carry out this experiment, 20 rabbits weighing about 3.0Kg were selected and were randomly assigned to one of two different postoperative treatment groups: early active motion in the cage or immobilization with intermaxillary fixation. Additional two rabbits were used as normal controls.
Under the general anesthesia with sodium thiopental, superior aspect of the left condyle of all experimental animals was shaved with a fissure bur about 1mm in depth until bleeding bone was encountered and in the group 1 animals normal diet was permitted postoperatively and the group 2 animals were immobilized with intermaxillary fixation and feed liquid diet through intraoral tubing.
The experimental animals were sacrificed consecutively on the third day, first week, second week, and fourth week after condylar shaving and the mandibles were dissected out carefully to produce tissue specimen.
The specimens were fixed with 10% formalin solution for 24 hours and rinsed with phosphate buffer solution. It was decalcified with 5% nitric acid for 15 days. Thereafter the specimens were dehydrated in alcohol series, and embedded paraffin as usual manner. The embedded specimens were sectioned in 4-6naometer with microtome, stained with hematoxylin-eosin stain, Masson's trichrome stain and Koneff stain and observed through microscopic study.
The results were as follows.
1)Early movement stimulates histological repair than did immobilization with intermaxillary fixation.
2) All experimental groups revealed the differentiation of chondrocytes at the second week and it was more remarkable in the early movement group.
3) The repaired cartilagenous layer of the early movement group was thicker than that of immobilization group.
4) In the whole experimental period, bone marrow was intact in early movement group, however, it was degenerated in immobilization group.
5) All experimental groups revealed the cartilagenous covering and endochondral ossification.
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