Dong-Mok Ryu

Neurilemmoma of the mandible

Abstract Intraosseous neurilemmoma is rare, representing less than 1% of benign primary bone tumors. The site most commonly involved is the mandible. We report on a neurilemmoma of the mandible in a 30-year-old woman. A panoramic radiograph of the mandible showed a well-defined unilocular osteolytic lesion with a thin uniform sclerotic margin located in the body of the mandible. The CT scan confirmed a well-defined osteolytic lesion with thinning of the cortex of the body of the left side of the mandible. Histologically, the lesion was a moderately cellular neoplasm with distinct palisading and numerous Verocay bodies. Ultrastructurally, the cytoplasmic membranes were distinct and coated by amorphous bands of basal lamina. Complete excision was achieved by removing the tumor from the inferior alveolar nerve.

Analysis of digitalized panorama and cone beam computed tomographic image distortion for the diagnosis of dental implant surgery.

Objectives: To evaluate the tooth image measurements according to the tooth location and to calculate the magnification rate for comparison and analysis in digitalized panoramic and cone beam computed tomographic (CBCT) images. Methods: A diagnostic template was fabricated and delivered on the preimplant sites. A 5-mm gutta-percha cone or a metal ball was inserted in the coronal part of each tooth. Panoramic images were obtained with Ortho stage (AUTO III N CM; Asahi, Japan) or Promax (Planmeca, Helsinki, Finland) and CBCT images were obtained with PANORAMIC CT (PSR9000N; Asahi) for each patient and the same region. The vertical length of the gutta-percha cone or the metal ball was measured and compared with the panoramic and CBCT images according to the tooth location. Magnification rate was compared between the 2 types of panoramic machines. Results: About 1.09 to 1.28 magnification occurred in panoramic images, depending on the tooth location. The magnification rate was significantly different between the panoramic machines (Ortho stage, 1.27; Promax. 1.17). Almost no magnification of images occurred in CBCT images with no difference to the tooth location. Conclusions: In panoramic radiography, it is inappropriate to apply a general magnification ratio covering the whole image. For a more accurate implant surgery, the use of a metal ball or a premeasured gutta-percha cone on the preimplant site as standard measurement is recommended. However, in recently introduced CBCT, magnification of images did not occur, allowing it being used for accurate clinical procedures.

Acupuncture Therapy and Herbal Medicine Accelerating Temporal Space Abscess after Tooth Extraction: A Case Report

Numerous oral and maxillofacial surgeons have found facial space infections after tooth extraction. Most of these infections can be managed easily, but some of them could be life-threatening. Among the facial infections, temporal space infections are rare. Most temporal space infections could be observed as secondary to maxillary third molar infections, maxillary sinusitis, and maxillary sinus fractures. Note, however, that there are insufficient studies on temporal space abscess due to mandibular second molars, especially with acupuncture. A 74-year-old female came to our hospital with severe trismus and facial swelling on the right temporal, buccal, posterior auricular, and cervical regions. The patient had undergone extraction of tooth #47 secondary to dental caries by a general dentist about a month ago. After the dental procedure, the patient had been treated with acupuncture therapy around the right temporomandibular joint area at the oriental medicine clinic. We performed emergency incision and drainage under general anesthesia and started antibiotic treatment with IV ampicillin/sulbactam 3 g every 24 hours and vancomycin 1 g every 24 hours for 5 days. The patient’s symptoms subsided and ultimately disappeared. Temporal space abscess after mandibular molar extraction is quite rare. In this case, the spreading mechanism against gravity is considered to be acupuncture therapy.

Myxoma of the mandible.

Abstract Myxoma of the jaw bone is a peculiar and rare tumor. A case of myxoma of the mandible is described in a 38-year-old man. The plain X-ray showed multiple osteolytic destructive lesions in the molar root area. CT scans demonstrated osteolytic expansile lesions with mild enhancement of the solid portion of the mass. Histologically, the tumor is composed of plump stellate cells with abundant amorphous myxoid stroma.

Reconstruction of large oroantral defects using a pedicled buccal fat pad

BackgroundOroantral communicating defects, characterized by a connection between the maxillary sinus and the oral cavity, are often induced by tooth extraction, removal of cysts and benign tumors, and resection of malignant tumors. The surgical defect may develop into an oroantral fistula, with resultant patient discomfort and chronic maxillary sinusitis. Small defects may close spontaneously; however, large oroantral defects generally require reconstruction. These large defects can be reconstructed with skin grafts and vascularized free flaps with or without bone graft. However, such surgical techniques are complex and technically difficult. A buccal fat pad is an effective, reliable, and straightforward material for reconstruction.Case presentationThis report describes three cases of reconstruction of large oroantral defects, all of which were covered by a pedicled buccal fat pad. Follow-up photography and radiologic imaging showed successful closure of the oroantral defects. Furthermore, there were no operative site complications, and no patient reported postsurgical discomfort.ConclusionIn conclusion, the use of the pedicled buccal fat pad is a reliable, safe, and successful method for the reconstruction of large oroantral defects.

Arch coordination does not affect the stability in class III orthognathic surgery patients.

Abstract The purpose of this study was to evaluate if the arch coordination manifested by preorthodontics had an effect on the short-term stability after orthognathic surgery by evaluating the B point, menton, overjet, and overbite. The subjects were 10 healthy adult female and male Koreans (mean age, 24.9 years) with insufficient arch coordination and 10 healthy adult female and male Koreans (mean age, 22 years) with sufficient arch coordination. All subjects had sagittal split ramus osteotomy with 1-piece maxillary Le Fort I surgery with/without genioplasty done from the same practitioner at Kyung Hee University Hospital at Gangdong from 2009 to 2011. All arch widths of the maxilla and mandible were measured. Cephalometric tracings of the subjects were made of the presurgical and postsurgical period with a follow-up at 3 months. Relapse was measured according to cephalometric tracing changes using the V-ceph Cephalometric Analysis Software version 5.5(Osstem, Seoul, South Korea). Insufficient arch coordination did not definitively affect the overall treatment outcome. There was significant difference in the horizontal dimensions of the mandible (vertical plane to point B, overjet) in the study group. The study group showed instability in orthodontic factors, whereas skeletal factors were stable. Vertical dimensions (horizontal plane to point B, horizontal plane to menton, overbite) were not statistically significant.