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Cephalometric Predisposing Factors of the Snoring and Obstructive Sleep Apnea (코골이 및 폐쇄성 수면 무호흡증의 두부 규격 방사선 계측학적 기여 인자)

  • Seo, Eun-Woo;Lee, Ho-Kyung;Han, Min-Woo;Seo, Mi-Hyun;Kim, Hyun-Jun;Song, Seung-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.3
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    • pp.161-166
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    • 2013
  • Purpose: This study was intended to perform a cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram were also investigated. Methods: Fifty patients who had visited the Sleep Disorder Clinic at the Ajou University Hospital and evaluated with the polysomnograph (PSG) and cephalogram, were included in the study. The patients had the apnea-hypopnea episode over 5 times per hour (apnea-hypopnea index $[AHI]{\geq}5$) were diagnosed as OSA after the overnight PSG. To evaluate the hard and soft tissue profiles, the cephalometric radiograms were taken at the maximal intercuspation. The correlation between the patient's age, height, weight, body mass index (BMI) and AHI was inspected in the OSA and control group. The difference between the OSA and control group was evaluated (Mann-Whitney U Test). The cephalometric influencing factors to OSA were analyzed (Pearson's correlation coefficient) statistically using SPSS statistics. Results: The OSA Group had a significantly higher BMI than the control group. The mean lower facial height (ANS-Me) was longer in the OSA group; however, statistically significant difference was not detected in the anteroposterior craniofacial measurements. The distance between mandibular plane and hyoid bone of the OSA group was significantly longer than that of the control group. The hyoid position (MP-Hyoid) had a positive correlation between AHI (P<0.001). However, the measurements of oropharyngeal airway were not different between the two groups. The hypothesis, that the antero-posteriorly narrow oropharyngeal airway may aggravate the airway resistance and give rise to a higher AHI, was rejected in the study. Conclusion: We suggest that the lateral cephalogram may be utilized as a useful method to evaluate OSA. The patients with a lower hyoid position can be expected to have higher risks of OSA. However, a comprehensive intraoral inspection, including the soft palate and tonsilar hypertrophy, is emphasized, as the lateral cepahlogram cannot visualize the oropharyngeal status completely.

Failure of Reproduction Management in an Inbreeding English Bulldog (근친교배 잉글리쉬 불독에서 번식 관리의 실패)

  • Kim, Min-Jung;Park, Sol-Ji;Kim, Geon-A;Park, Eun-Jung;Moon, Joon-Ho;Choi, Ji-Yei;Choi, Woo-Jae;Lee, Byeong-Chun;Jang, Goo
    • Journal of Veterinary Clinics
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    • v.30 no.5
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    • pp.384-386
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    • 2013
  • A two-year-old, female English bulldog was referred for breeding by artificial insemination with frozen semen of male English bulldog, a litter of female bulldog's grandfather. Intrauterine artificial insemination was done two days after the ovulation day. Sperm was evaluated after thawing by computer assisted sperm analyzer, and its motility was 89.8% with normal shape. Pregnancy bearing eight fetuses was diagnosed by ultrasonography and radiography. Cesarean section was performed sixty days after the artificial insemination. Eight pups were delivered with safe, but the entire pup had abnormalities including severe bow-legged malformations, cleft lip, cleft palate, and enlarged cranial part.

Evaluation of Inflammatory Disease in the Nasal Cavity and Paranasal Sinuses using CT in Dogs and Cats (개와 고양이에서 컴퓨터단층촬영술을 이용한 비강의 염증성 질병 평가)

  • Choi, Ho-Jung;Lee, Ki-Ja;Park, Seong-Jun;Jeong, Seong-Mok;Song, Kun-Ho;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.42-45
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    • 2010
  • Inflammatory sinonasal disease was diagnosed in five dogs and two cats with clinical signs of nasal discharge and epistaxis. Survey radiography and CT were performed in all of patients. CT scan of the rostral cranium was performed with a thickness of 2 or 5 mm. Nasal cytology and culture from nasal smear were performed immediately after CT examination. Remarkable increase of opacity in the nasal cavities and frontal sinuses was observed in only 3 cases. On CT images, the cavitating lesions were isodense in nasal cavity (7 cases), frontal sinuses (3 cases), and nasopharynx (2 cases) with destruction of the nasal septum (4 cases), maxillary turbinates (5 cases), maxilla (3 cases), and hard palate (3 cases). The lesions were enhanced after intravenous contrast administration in 5 cases and were not enhanced in 2 cases. Inflammatory cells were observed in nasal cytology. Most of the cultures from nasal smear were bacteria. CT is useful to diagnose sinonasal disease and is more accurate in demonstrating the extent and character of lesions of nasal cavity than radiography.

Dental Treatment of a Wolf-Hirschhorn Syndrome Patient: A Case Report (Wolf-Hirschhorn syndrome 환아의 치과 치료 치험례)

  • Kim, Miae;Park, Jihyun;Mah, Yonjoo
    • JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.43 no.3
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    • pp.313-319
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    • 2016
  • Wolf-Hirschhorn syndrome (WHS), associated with the deletion of the short arm of chromosome 4, causes multiple congenital malformations. Patients suffer from various deformities, including mental and growth disorders, epilepsy, hypotonia, congenital heart defects, and atypical craniofacial features. The "Greek warrior helmet appearance" is the most characteristic feature, with a prominent glabella, high arched eyebrow, broad nasal bridge, and hypertelorism. Cleft lip with or without cleft palate is observed in 30% of patients. Dental structure anomalies also exist including multiple tooth agenesis and over-retained primary molars caused by MSX1 gene impairment, and cone-shaped and taurodontic teeth. This case, a 9-year-old girl with WHS, showed intellectual disability, delayed growth development, previous occurrence of seizures, otitis media, and the typical facial features of WHS. Dental findings included multiple congenital missing teeth, over-retained primary teeth, and severe caries on the primary molars. Dental treatments were performed under general anesthesia. This report documents the characteristics of WHS, including general and oral features, and discusses the importance of oral hygiene and preventive dental management.

Oral Symptoms of Intractable Ulcerating Enterocolitis of Infancy and Differential Diagnosis: A Case Report (난치성 궤양성 소장결장염 영아의 구강 내 증상과 감별진단: 증례보고)

  • Min, Hyoseon;Choi, Hyungjun;Lee, Jaeho;Choi, Byungjai;Lee, Hyoseol
    • JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.41 no.1
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    • pp.80-84
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    • 2014
  • Intractable ulcerating enterocolitis is an uncommon inflammatory bowel disease syndrome of neonatal onset first described in 1991. Intractable ulcerating enterocolitis usually presents in the neonate with a mouth ulceration and the subsequent development of perianal disease and colitis. In this case report, an infant, 18 days from birth, with ulcerative lesion on hard palate for systemic differential diagnosis about oral lesion is referred from the department depiatrics. At that time, there is no abnormality, except oral lesion-like Aphthous ulcer. The patient was discharged from pediatrics, but returned to the hospital 3weeks later with blood diarrhea. As a result of endoscopy, there were large ulcerating lesions and the patient was diagnosed intractable ulcerating enterocolitis. Early recognition of Intractable ulcerating enterocolitis appears to be beneficial because colectomy, as opposed to immunosuppression, appears to be effective in controlling disease symptoms and progression. Most of the infants who were affected intractable ulcerating enterocolitis were normal at birth and oral manifestation appeared earlier than others. So, it is very meaningful for dentists to know about Intractable ulcerating enterocolitis.

Usefulness of Mouth Guard when the Endotracheal Intubation Is Indicated for Treacher Collins Syndrome Patient (Treacher Collins 증후군 환아의 기관 삽관 시 마우스가드의 활용)

  • Choi, Haein;Choi, Byungjai;Choi, Hyungjun;Song, Jeseon;Lee, Jaeho
    • JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.41 no.1
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    • pp.40-46
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    • 2014
  • Treacher Collins syndrome (TCS) is autosomal dominant disorder that occurs approximately 1 in 25,000 to 50,000 live births. The main signs of syndrome are hypoplasia of facial bone and microtia. One in third of them is associated with cleft palate and often shows dental hypoplasia. TCS patients need several number of surgery with general anesthesia throughout their life time for recovery of function and esthetic. Endotracheal intubation of TCS patient is very difficult due to microstomia, retrognathia, choanal stenosis, and decreased oropharyngeal airway. Therefore, general anesthesia of adolescent TCS patient with immature incisor roots has high risk of causing dental trauma. This case is regarding TCS patient who was referred to the Department of Pediatric Dentistry, Yonsei University for avulsed upper left central incisor during endotracheal intubation. The purpose of this report is to emphasize the usefulness of mouth guard to prevent dental trauma when endotracheal intubation is needed for TCS patient.

TREATMENT OF PALATAL ABSCESS OF ODONTOGENIC ORIGIN IN CHILDREN: CASE REPORTS (소아에서 발생한 치성 기원 구개 농양의 치험례)

  • Ryu, Jae-Ryang;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.38 no.4
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    • pp.421-426
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    • 2011
  • Most of the intraoral infections origin in odontogenic infection. Odontogenic infection spreads out along the least resistant path. In maxilla, the thickness between periapical area and cortical bone is narrower on the buccal side than the palatal side. So infection usually spreads out along the buccal side rather than the palatal side. The failure of root canal treatment more frequently occurs on the buccal root compared to the palatal root. So the palatal abscess is rarer than the buccal abscess. It is difficult to differential diagnosis palatal abscess from salivary gland tumors, benign neural tumors and cysts on the palate. Therefore, when the palatal swelling is observed in children, you need to prevent the systemic spread of infection by early diagnosis of the odontogenic palatal abscess. In these cases, the patient who complained of the pain in deciduous teeth and the palatal swelling was diagnosed with odontogenic palatal abscess. The patient was treated with extraction and antibiotic medication. The palatal abscess was resolved, and we report after treatments.

MAXILLARY MOLAR DISTALIZATION WITH THE BONE-SUPPORTED PENDULUM (Bone-supported pendulum을 이용한 상악대구치 원심이동)

  • Jang, Yong-Gul;Park, Ho-Won;Lee, Ju-Hyun;Seo, Hyun-Woo
    • JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.36 no.3
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    • pp.464-474
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    • 2009
  • To distalize the maxillary molars, the traditional techniques such as extra-oral traction, Wilson distalizing arches, removable spring appliances and Schwarz plate-type appliances have been used. But, these need considerable patient cooperation. For minimal patient compliance, many practitioners use the pendulum appliances. Several clinical studies demonstrated pendulum is effective molar distalization appliance in the growing patient(using the premolars and the palate as anchorage). But unfortunately, maxillary anterior teeth also shift mesially as the molar moves distally. As a result anchorage loss is occurred. To overcome these disadvantages, we used bone-supported pendulum, combined the conventional pendulum with Skeletal Anchorage System(SAS). The miniscrew was implanted in the anterior paramedian region of the median palatal suture, which has comparatively sufficient bone thickness and is low risk to damage on the dental follicles. We report three cases, using bone-supported pendulum for the maxillary molar distalization in children. After treatment, we find out anchorage stability, minimal unfavorable anterior tooth movement and sufficient molar distalization.

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TREACHER COLLINS SYNDROME : A CASE REPORT (Treacher Collins 증후군 환아의 증례보고)

  • Park, Ji-Hyun;Kim, Seung-Hae;Song, Je-Seon;Kim, Seong-Oh;Lee, Jae-Ho
    • JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.37 no.3
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    • pp.374-380
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    • 2010
  • Treacher Collins syndrome(TCS) is a rare, incurable condition occurring in approximately 1 of 25,000 to 50,000 births. It may occur as a spontaneous mutation out of genetically normal parents or it may be manifested as an autosomal dominant pattern. TCS is characterized by facial deformities such as, underdevelopment of the maxilla, mandible and zygoma, malocclusion, bilateral deformities of auricles, antimongoloid slant of the palpebral fissures. The syndrome is often associated with cleft lip and palate, ear malformations and hearing loss, short stature, and anomalies of the heart and skeleton. Respiratory difficulty associated with air way obstruction may also be observed, and there is considerable difficulty in airway management during general anesthesia. It is necessary that dentists provide safe dental treatments and guidelines to TCS patients by providing adequate understanding about the characteristics of the syndrome and proper ways of managements. The purpose of this study is to report the dental and medical characteristics of the patient who visited the Department of Pediatric Dentistry, Yonsei University for multiple dental caries treatment and to review the literatures of TCS.

PYKNODYSOSTOSIS : A CASE REPORT (Pyknodysostosis 환아의 구강증상: 증례보고)

  • Kim, Nam-Hyuk;Lee, Jae-Ho;Kim, Seong-Oh;Choi, Hyung-Jun;Song, Je-Seon
    • JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.36 no.4
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    • pp.619-624
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    • 2009
  • Pyknodysostosis(PKND) is a rare sclerosing bone disorder that has an autosomal recessive trait, also known as Toulouse-Lautrec syndrome. Deficiency of the cathepsin enzyme K in the osteoclasts of PKND patients results in continuous endosteal bone deposits without osteoclastic resorption or remodeling. This causes a generalized increase in sclerosis and fragility of bones. Osteomyelitis in the mandible and recurrent fracture of the long bones are characteristic complicatons of PKND. The patients present typical features of PKND, such as short stature under 150 cm, open cranial suture and fontanelle, club-shaped phalanges, and underdevelopment of midface. This is a case of a 7-year-old girl with PKND, who visited our clinic with the chief complaint of anterior Open-bite and generalized crowding. The patient had been diagnosed as PKND by an orthopedist and manifested characteristic clinical and radiographic features, such as open cranial suture and fontanelle, obtuse madibular gonial angle, frontal and occipital bossing, grooved palate, club-shaped phalanges, and short stature. Orthodontic treatment was not considered because patients with PKND show abnormal bone resorption and remodeling. Instead, removal of deciduous teeth near exfoliation and TFA were performed, and periodic check-up is planned to maintain good oral hygiene.

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