Modified Difficult Index Adding Extremely Difficult for Fully Impacted Mandibular Third Molar Extraction

ope

Differential Diagnosis and Treatment of Septic Arthritis in the Temporomandibular Joint: A Case Report and Literature Review

Septic arthritis of the temporomandibular joint (TMJ) is an uncommon disease caused by microbial pathogens through hematogenous infection, local spread, or iatrogenic infection. As the symptoms have an insidious onset, the early stage of septic arthritis is often confused with other diseases. A 49-year-old man was referred for increasing preauricular pain, swelling, and restricted mouth opening. He had been initially diagnosed as having a conventional temporomandibular joint disorder and trigeminal neuralgia and had been treated for the same. Imaging studies including panoramic view, lateral tomography, computed tomography with contrast enhancement, and magnetic resonance imaging were performed. Erosive bone change with displacement of the involved condyle, diffuse swelling of adjacent soft tissue, and fluid collection in the joint space were noted. Needle aspiration of the joint space and bacterial culture confirmed the diagnosis of septic arthritis of the TMJ and he was treated with antibiotic therapy and surgical drainage. Clinicians should always consider the diagnosis of septic arthritis of the TMJ in patients with preauricular pain or swelling.ope

Three-dimensional computed tomography evaluation of craniofacial characteristics according to lateral deviation of chin

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.ope

Immunohistochemical Characterization of Combined Adenomatoid Odontogenic Tumor and Calcifying Epithelial Odontogenic Tumor - Report of 3 Cases and Review of the Literature -

Combined epithelial odontogenic tumors are very rare and represent hybrid lesion comprising adenomatoid odontogenic tumor intermixed with calcifying epithelial odontogenic tumor. The authors present 3 cases of combined epithelial odontogenic tumor which contained diagnostic areas for both adenomatoid odontogenic tumor and calcifying epithelial odontogenic tumor. Their behaviour and histogenesis were discussed.ope

Chronic Sialodochitis in Parotid Gland : case report

Sialodochitis is an inflammatory disease on salivary gland duct. Although most of sialoadenitis includes inflammatory status of ductal system, an unusual behavior such as localized inflammation only in the duct is rarely observed. Sialodochitis is a very rare disease that was first reported by Kussmaul in 1879. Common symptoms of chronic sialodochitis are an excretion of mucous plugs and a swelling of the cheek. Sialodochitis may be associated with a type Ⅰ hypersensitivity in the salivary duct and parotid gland, because of the large amount of eosinophils in saliva, and the common allergic history such as bronchial asthma and allergic rhinitis. The management of sialodochitis depends on the severity of disease. The surgical procedure such as drainage operation, sialodochoplasty, or superficial parotidectomy can be selected. We report the case of chronic sialodochitis with literature reviewope

CHANGES OF THE HYOID BONE POSITION AND THE UPPER AIRWAY DIMENSION AFTER ORTHOGNATHIC SURGERY IN SKELETAL CLASS III PATIENTS

After orthognathic surgery in skeletal class III patients, the hyoid bone position and the upper airway dimension could be changed due to mandibular setback. There has been many studies about airway dimension of the patients with skeletal class II malocclusion or obstructive sleep apnea. but not with skeletal class III. The purpose of this study was to examine the change of position of the hyoid bone and the consequent change of airway space as the result of retrusion of mandible after orthognathic surgery in skeletal Cl III malocclusion patients. It is also to apply this results in predicting, diagnosing and treating the subsequent obstructive sleep apnea. Forty patients who were diagnosed as skeletal Cl III maloccusion, received orthoganthic surgery of both jaws including mandibular setback, and were followed up post-operatively for more than 6 months were selected. There were 10 male patients 30 female patients. The preoperative and postoperative lateral cephalograms were traced and the distances and angles were measured. The nasopharyngeal space increased postoperatively while the oropharyngeal space decreased. Except for the change of oroparyngeal space, the changes in male patients were greater than female patients. The hyoid bone moved in the posterior-inferior direction, and the change was greater in males than in females. If the postoperative mandibular setback is great, then a significant decrease of airway space and posterior and inferior movement of the hyoid bone were observed. This can result in symptoms related to obstructive sleep apnea. This result should be considered in the diagnosis and treatment planning of orthognathic surgery patients.ope

Changes in the fractal dimension of peri-implant trabecular bone after loading: a retrospective study

PURPOSE: To assess bony trabecular changes potentially caused by loading stress around dental implants using fractal dimension analysis. METHODS: Fractal dimensions were measured in 48 subjects by comparing radiographs taken immediately after prosthesis delivery with those taken 1 year after functional loading. Regions of interest were isolated, and fractal analysis was performed using the box-counting method with Image J 1.42 software. Wilcoxon signed-rank test was used to analyze the difference in fractal dimension before and after implant loading. RESULTS: The mean fractal dimension before loading (1.4213±0.0525) increased significantly to 1.4329±0.0479 at 12 months after loading (P<0.05). CONCLUSIONS: Fractal dimension analysis might be helpful in detecting changes in peri-implant alveolar trabecular bone patterns in clinical situations.ope

Surgical treatment of recurrent TMJ dislocation by eminectomy with discoplasty

Purpose: Various treatment methods have been utilized for recurrent dislocation of the TMJ (temporomandibular joint). The purpose of this study is to define the effect of the eminectomy with discoplasty that had been performed in patients with TMJ luxation. Materials and Methods: Twenty patients (22 joints), whose diagnosis were TMJ dislocation were selected in 772 patients (871 joints) who had been underwent TMJ surgery between 1988 and 2000. The selected patients were divided into two groups. Group I (12 joints) was the habitual-luxation group which involves the recurrent TMJ dislocation patients. Group II (10 joints) was the open lock-history group which involves the patients who had more than two episodes of TMJ luxation and TMJ disorders. The history of TMJ luxation, maximum mouth opening and other TMJ signs and symptoms before and after surgery were reviewed. Results: In group I, one patient who had been underwent both TMJ operation had a intermittent locking, but it disappeared after post-operative 32 months. In group II, intermittent pain was present in one patient who had bruxism, but it was disappeared by splint therapy. No more TMJ dislocations and other pains were checked in other patients of group I and II. Conclusion: Eminectomy with discoplasty may be used to successfully treat the TMJ habitual luxation accompanied with abnormal condition of the disc-condyle complex.ope

CEPHALOMETRIC NORMS OF THE HARD TISSUES OF KOREAN FOR ORTHOGNATHIC SURGERY

This study was performed to evaluate hard tissue cephalometric norms for Korean adults which can be implemented in surgical orthodontic treatment planning using selected horizontal reference plane especially for Koreans (Male: SN−7.5 ∘ SN−7.5∘ , Female: SN−9.0 ∘ SN−9.0∘ ) and a simplified analytical method. 70 males and 70 females consisting of freshmen of Yonsei University from 1996 to 1997 and students from the Dental College of Yonsei University were chosen according to clinical examination and cephalometric analysis. The samples had normal profiles, normal anteroposterior skeletal relationship(ANB angle of 0 ∘ 0∘ to 4 ∘ 4∘ and Wits appraisal of -4.0mm to 0mm), and Class I molar and canine relationship. They had no missing or supernumerary teeth and had no experience of orthodontic or prosthetic treatment. After the selection of 23 landmarks and the construction of horizontal and vertical reference lines, 22 skeletal and 12 dental measurements were taken. These consisted of vertical and horizontal linear measurements and angular measurements. The results were as follows. 1. Mean and standard deviation of the measurements were calculated for males and females. 2. Most of the skeletal vertical measurements, and maxillary and mandibular length were bigger in males than females. Whereas anterior facial height ratio(N-ANS/ANS-Me) as well as maxillary and mandibular antero-posterior position in relation to the vertical reference line(N-perpendicular) showed no signigicant difference between sexes. 3. Maxillary and mandibular dental antero-posterior position in relation to the vertical reference line(N-perpendicular) showed no significant difference between sexes. 4. The upper incisor show(U1-Stms) was 2.1±1.7mm 2.1±1.7mm in males and 3.3±1.7mm 3.3±1.7mm in females. In this study, hard tissue cephalometric norms of Korean adults for orthognathic surgery were obtained.ope

A radiographic study of changes of upper respiratory airway space after orthognathic surgery of both jaws in patients with skeletal class III malocclusion

PURPOSE: The aim of this study is the changes of upper respiratory airway space in patients with mandibular prognathism after 2-jaw orthognathic surgery in patients with skeletal classs III malocclusion. METHOD: We measured the lines between selected upper airway landmarks on lateral cephalometric xray films of skeletal class III 64 persons who had not been operated yet, were 6 months after operation. The test subjects were divided into 3 groups according to maxillary movement, as follows; maxillary advancement (MA) group, maxillary posterior impaction (MPI) group, maxillary posterior impaction and superior repositioning (MPI+MSR) group. RESULT: In this study, nasopharyngeal airway space in MPI+MSR group was significantly increased after operation (p<0.05). Oropharygeal and hypopharyngeal airway space in MA group and MPI group were significantly decreased after operation (p<0.05). From hyoid bone to anterior mandible point distance in MA group and MPI group were significantly decreased after operation (p<0.05). CONCLUSION: Oropharygeal and hypopharyngeal airway space were influenced more by mandibular setback than maxillary movement. Maxillary movement surgery as well as mandibular setback surgery should be taken into consideration in order to minimize symptoms related to obstructive sleep apnea syndrome after operation.ope