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A RADIOGRAPHIC STUDY ON THE MUCOSAL CYST OF THE MAXILLARY SINUS (상악동 점액성 낭에 관한 방사선학적 연구)

  • Park Eung-Chun;Kim Jae-Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.23 no.2
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    • pp.277-285
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    • 1993
  • This study was performed to evaluate the role of Waters' view and panoramic view for the interpretation of mucosal cyst of the maxillary sinus and to determine the radiographic features of that according to the sites and sizes. For this study, clinically 25 cases of mucosal cyst of the maxillary sinus were used, and experimentally with two dry skulls, rubber ball of 15mm in diameter for marked radiopacity, and two jelly balls of 8 and 20㎜ in diameter for the similar radiopacity to cyst were used. The 25 cases with 25 panoramic views and 15 Waters' views were first analyzed, and secondly, the radiographic features of artificial lesions attached to the each wall of the antrum on Waters' view and panoramic view were analyzed. The obtained results were as follows: At clinical analysis, 1. 4 cases of 13-14㎜, 4 cases of 15-19mm, 14 cases of 20-25㎜, 3 cases of over 30㎜ in dia- meter were found on panoramic views. And 24 cases of 25 cases showed no relationship with teeth, and only 1 case was associated with advanced periodontal disease 2. The majority of mucosal cysts appeared to arise the posterior portion of the floor of the sinus and were superimposed with the inominate line of zygoma and the horizontally linear image of hard palate on panoramic view. 3. Only 2 cases of 15 cases were identified on both films. At experimental analysis, 4. On Waters' view, the images of the artificial lesion of the anterior portion and midportion of the floor of the sinus were lessend in diameter compared with the real size. On panoramic views, the images of the lesion were more radiolucent with lessened diameter than images on Water' view. 5. The images of the lesion of the posterior wall and the posterior portion of the floor of sinus on panoramic view were well detected by the preeducated group but not or poorly detected by the non-preeducated observer group. 6. On Waters' view, both observer groups recognized that the cystic images of the posterior portion of the floor of the maxillary sinus were superimposed with the petrous portion of the skull.

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A Case Report of Cleidocranial Dysostosis (쇄골 두개 이골증의 증례보고)

  • Lim C.Y.;Kim S.W.;Ahn H.K.;You D.S.;Park T.W.
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.7 no.1
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    • pp.49-52
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    • 1977
  • The authors had observed a case of cleidocranial dysostosis of 42 years old unmarried woman. The observation was founded upon roentgenogram of skull P-A view, orthopantomograph, cephalometric view, chest P-A view and wrist X-ray view. The patient gave a dwarfic impression with 145㎝ body height and concaved mandibular prognastic facial feature. The palate was narrowed and extremely high arched. The eruption state of teeth were extremely poor, only four teeth were erupted, composed of upper third molar and lower three deformed teeth. The skull P-A view of roentgenogram reveals overlying metopic suture, extends from the nasion to the sagittal suture, and the suture are delayed up to date and many wormian bones are formed. On the cephalometric view the maxilla is underdeveloped and produce the false mandibular prognathism. Twenty four impacted teeth can be detected by orthopantmograph, twelve in upper jaw and twelve in lower jaw. There are many supernumerary teeth, one in upper jaw and seven in lower jaw. On the chest P-A view, the clavicles are totally aplastic, but a vestige of clavicle is visible in the right side. On the wrist roentgenogram, the epiphyseal ossification of distal phalanx, mesial phalanx and proximal phalanx is delayed.

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Anterior maxillary defect reconstruction with a staged bilateral rotated palatal graft

  • Jung, Gyu-Un;Pang, Eun-Kyoung;Park, Chang-Joo
    • Journal of Periodontal and Implant Science
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    • v.44 no.3
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    • pp.147-155
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    • 2014
  • Purpose: In the anterior maxilla, hard and soft tissue augmentations are sometimes required to meet esthetic and functional demands. In such cases, primary soft tissue closure after bone grafting procedures is indispensable for a successful outcome. This report describes a simple method for soft tissue coverage of a guided bone regeneration (GBR) site using the double-rotated palatal subepithelial connective tissue graft (RPSCTG) technique for a maxillary anterior defect. Methods: We present a 60-year-old man with a defect in the anterior maxilla requiring hard and soft tissue augmentations. The bone graft materials were filled above the alveolar defect and a titanium-reinforced nonresorbable membrane was placed to cover the graft materials. We used the RPSCTG technique to achieve primary soft tissue closure over the graft materials and the barrier membrane. Additional soft tissue augmentation using a contralateral RPSCTG and membrane removal were simultaneously performed 7 weeks after the stage 1 surgery to establish more abundant soft tissue architecture. Results: Flap necrosis occurred after the stage 1 surgery. Signs of infection or suppuration were not observed in the donor or recipient sites after the stage 2 surgery. These procedures enhanced the alveolar ridge volume, increased the amount of keratinized tissue, and improved the esthetic profile for restorative treatment. Conclusions: The use of RPSCTG could assist the soft tissue closure of the GBR sites because it provides sufficient soft tissue thickness, an ample vascular supply, protection of anatomical structures, and patient comfort. The treatment outcome was acceptable, despite membrane exposure, and the RPSCTG allowed for vitalization and harmonization with the recipient tissue.

MANDIBULAR EXPANSION IN A CONGENITAL AGLOSSIA PATIENT (선천적 무설증 환자에서의 하악골 확장)

  • Cho, Jae-Yong;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Hahn, Se-Hyun;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.4
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    • pp.673-677
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    • 2003
  • Congenital aglossia is a very rare condition. The oral manifestations of an aglossia include micrognathia, high arched or cleft palate, defects of the lower lip, an absence of lateral incisors and a mandibular growth deficiency. Although the etiology of congenital aglossia is unclear, both genetic and teratogenic mechanisms have been proposed. Treatment of aglossia patients depends on the nature and severity of the condition which includes surgical rehabilitation of the tongue tip to some extent, orthopedic expansion of the mandible to guide mandibular growth, and mandibular expansion by a distraction osteogenesis. In the present case, a 6 year old female aglossia patient with situs inversus was treated. A bonded hyrax screw was used to increase her mandibular primary intercanine width and intermolar width. A second phase orthodontic and surgical treatment will be possible after some retention phase.

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Maxillary Resorption under Complete Dentures Opposing Mandibular Implant Supported Fixed Prosthesis: A Literature Review and Case Report (하악 임플란트 고정성 보철에 대합되는 상악 총의치 하방의 골흡수에 대한 고찰 및 증례보고)

  • Kim, Bo-Kuk;Kim, Yu-Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.426-433
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    • 2013
  • When restoring edentulous patients with lower complete denture, the smaller supportive and retentive area of mandible can lead to poor support and stability, denture dislodgement and pain resulting discomfort. In this situation, implant prosthesis can improve esthetics, stability and occlusal force. Whereas, patients with a upper complete denture can adjust more easier because of palate. Therefore, it is suggested to rehabilitate fully edentulous patients with lower implant-supported, upper complete denture as one of the treatment options. So, we are going to report the case and literature review about how the lower implant prosthesis opposing to upper complete denture affects the bone resorption of maxillary residual ridge.

Increase of the Width of Peri-implant Keratinized Tissue using Apically Positioned Flap: Case Report (근단 변위 판막술을 사용한 임플란트 주위 각화조직 폭경의 증대: 증례보고)

  • Chee, Young-Deok;Seon, Hwa-Kyeong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.407-417
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    • 2013
  • The one of peri-implant soft tissue problems seen during the maintenance phase of implant therapy is an inadequate zone of keratinized tissue. Keratinized tissue plays a major role around teeth and dental implants, helping in maintaining and facilitating oral hygiene. A free gingival graft (FGG) is chosen to correct the soft tissue defects and provide optimal peri-implant health in order to increase the long-term prognosis of the implant reconstruction. However, the patient treated with FGG has pain and discomfort on donor site such as palate. It is also technically demanding, time consuming, and the color match of the tissue is often less than ideal. An apically positioned flap (APF) is selected for increasing the keratinized tissue simply while or after the second stage implant surgery. This case report shows successfully increasing the width of peri-implant kenratinized tissue through APF procedure on small site of dental implant instead of FGG.

A Giant Sebaceous Epithelioma on the Scalp: A Case Report (두피에 발생한 거대 피지샘 상피종 1례)

  • Kim, Eun Yeon;Kim, Sun Goo;Kim, Yu Jin;Lee, Se Il
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.76-79
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    • 2012
  • Purpose: Sebaceous epithelioma (sebaceoma) is a benign tumor with sebaceous differentiation. It presents primarily as a yellowish papule or nodule on the face and scalp. It must be differentiated from basal cell carcinoma and other appendageal tumors. We report a giant sebaceous epithelioma on the scalp and describe the immunohistochemical character of the cells in sebaceous epithelioma to epithelial membrane antigen (EMA). Methods: A 55-year-old-man who presented with 5-cm-diameter 2-cm-height, round shape exophytic ulcerated tumor on his head presented for treatment. The patient had noticed the lesion 40 years prior as a small yellowish plaque and 18 months ago, the plaque started to grow progressively larger. We excised the lesion with 1 cm resection margin, considering the possibility of malignancy because this lesion grossly resembled basal cell carcinoma (BCC). The defect was repaired with the use of a splitthickness skin graft. Results: When we excised the lesion, the margin was clear. Histology showed nodules that consisted of an admixture of basaloid cells and mature adipocytes lacking an organized lobular architecture. Strong expression of EMA on mature adipose cells confirmed the differential diagnosis from BCC with sebaceous differentiation because of the absence of a nuclear palisade pattern and cleft-like spaces on the hematoxylin and eosin (H&E) section. Conclusion: We treated the giant sebaceous epithelioma on the scalp with surgical excision and a split-thickness skin graft. It is important to know that the diagnosis of sebaceous epithelioma should be made based on the histologic pattern of the H&E section. Immunohistochemistry with EMA can help to confirm the differential diagnosis between sebaceous epithelioma and BCC.

Enlarged Lipogranuloma after Closed Reduction of Nasal Bone Fracture: A Case Report (비골골절 정복술 후 커진 지방육아종의 치험례)

  • Lee, Ji Won;Choi, Jae Il;Ha, Won;Yang, Wan Suk;Kim, Sun Young
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.63-67
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    • 2012
  • Purpose: Lipogranuloma is the reaction of adipose tissue to various oils, paraffin, and other hydrocarbons injected into subcutaneous tissue for cosmetic or other reasons. The authors experienced a case of sclerosing lipogranuloma on the nasal dorsum. Methods: A 42-year-old female, without a history of the injection of any foreign materials, was admitted on our hospital for a painless, irregular, and firm mass located on her nasal dorsum with step-off deformity. It was considered that the mass had developed after augmentation rhinoplasty. The size of mass had been increased after closed reduction of nasal bone fracture. On April 2011, under general anesthesia, the mass was removed by open rhinoplasty technique. In addition, a pathologic examination was performed. After the mass extirpation, dermofat graft was performed for the correction of depression deformity. Results: The histopathological findings demonstrated a Swiss cheese pattern with variably-sized vacuoles, which corresponded to lipid removed with tissue processing, and variable foreign body giant cell reaction, fat necrosis, and hyalinized fibrous tissue. The pathologic diagnosis is lipogranuloma replacing nasalis muscle. It has been considered that sclerosing lipogranuloma is caused by nerve injury during augmentation rhinoplasty and the ointment used after the closed reduction of nasal bone fracture, which infiltrated through the injured mucosa. Conclusion: During the treatment of rhinoplasty or nasal bone fracture, the nerve injury or the ointment use can lead to lipogranuloma. Therefore, careful dissection for avoidance of the nerve injury and limited use of ointment seems to be helpful in decreasing incidence of lipogranuloma.

Supernumerary Nostril: A Case Report (다비공증: 증례보고)

  • Hwang, So-Min;Kim, Hong-Il;Ahn, Sung-Min;Lim, Kwang-Ryeol;Jung, Yong-Hui;Song, Jennifer K.
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.60-62
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    • 2012
  • Purpose: Supernumerary nostril, also known as triple nostril or accessory nostril, is one of the extremely rare congenital nasal deformities which includes an additional nostril. Since Lindsey reported the first case of a supernumerary nostril, only 34 cases of supernumerary nostril have been reported world widely. And there was no any domestic case. In the present case, we described a case of supernumerary nostril and reviewed all the literature cases of supernumerary nostril. Methods: A 10-month-old female patient visited to the authors with an additional nostril located above her right nostril, which had been present since birth. Antenatal history was uneventful and the infant's birth was normal. On physical examination there were no other abnormalities and additional nostril was communicating with ipsilateral normal nasal cavity. We performed fistulectomy and local flap for the correction. Results: After 7 months postoperatively, the patient was doing well. The functional outcome was excellent and the cosmetic result was satisfactory. During the long term follow-up for 8 years, there were no specific problems. Conclusion: In supernumerary nostril, preoperative evaluation of other abnormalities is very important and we advocate that corrective surgery can be performed at an early age for patient's psychosocial development.

Craniofacial Deformity in a Patient with Dyke-Davidoff-Masson Syndrome: A Case Report (Dyke-Davidoff-Masson 증후군 환자의 두개골 변형: 증례보고)

  • Lee, Seung-Hyun;Lee, Hye-Kyung;Jeong, Hii-Sun
    • Archives of Craniofacial Surgery
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    • v.13 no.1
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    • pp.50-53
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    • 2012
  • Purpose: The Dyke-Davidoff-Masson syndrome is a rare disease entity that was first reported in 1993, and it is characterized by not only the cerebral hemiatrophy that is accompanied by the ipsilateral ventriculomegaly and ipsilateral compensatory osseous hypertrophy, but also the overgrowth of the paranasal sinuses. No studies have attempted to examine it from perspectives of the skull deformity and plastic surgery. Here, we report our case with a review of the literatures. Methods: A 45-year-old man with Dyke-Davidoff-Masson visited our medical institution with nasal bone fracture. Based on the previously taken brain MRI scans, we measured the degree of craniofacial deformity, and the horizontal distance, which is based on the margin of the skull, as well as the falx cerebri. Results: We made a comparison of the degree of craniofacial deformity. This showed that the mean horizontal distance on the axial view was shorter by approximately 28.46%, as compared with that of the left unaffected side. Conclusion: The Dyke-Davidoff-Masson is characterized by a concurrent presence of the atrophy of the cerebral hemisphere, with the cranial deformity. For the reconstruction of the bone and soft-tissue deformity with Dyke-Davidoff-Masson syndrome, it is needed to perform objective assessments.