Journal of the Korean Association of Oral and Maxillofacial Surgeons最新文献

Lesch-Nyhan syndrome (LNS) is a rare X-linked recessive disorder caused by a mutation in the hypoxanthine phosphoribosyltransferase 1 (HPRT1) gene. This syndrome is characterized by excessive production of uric acid, mental retardation, self-mutilation, choreoathetosis, and spasticity. The most distinctive symptom is compulsive self-mutilation. For patients with LNS, different methods have been tried to reduce self-biting behaviors including restraints, behavioral treatment, medications, deep brain stimulation, tooth extraction and botulinum toxin A injection. In this report, we present a case of LNS undergoing cheiloplasty due to self-mutilation and tooth extraction of the left deciduous maxillary canine.

Schwannomas exhibit histopathological variation that leads to diagnostic dilemmas, although less frequent in the oral cavity. We describe a case with unique histopathology and no relevant clinical history that adds to the breadth of literature on the diversity presented by Schwannoma. A 60-year-old female patient presented with a small dome-shaped, asymptomatic swelling on the alveolar ridge 6 years in duration. Histopathologically, it showed rich cellular pathology with a unique arrangement of tumor cells forming irregular rosettes. Each rosette presented with a central core of fibrincollagenous material and the tumor cells were arranged on the periphery, exhibiting epithelioid change with evidence of mild cellular and nuclear pleomorphism. On immunohistochemical evaluation, the cells were strongly and diffusely positive for S-100 and negative for Ki-67. A diagnosis of benign Schwannoma with a rosette-like arrangement with epithelioid change was made. The case report emphasizes the risk of misdiagnosis and the importance of awareness regarding rare histopathological variants of Schwannoma.

Re-ankylosis is a common postoperative complication of temporomandibular joint (TMJ) ankylosis surgery. Various surgical options to prevent reankylosis, both with and without interpositional material, have been discussed in the literature. However, no standardized protocol has been suggested for management or prevention of TMJ ankylosis. This paper discusses the probable causes behind TMJ re-ankylosis and presents a case of unilateral TMJ re-ankylosis, which was managed by gap arthroplasty using an autologous abdominal dermal fat graft as an interpositional material and closely monitored for signs of relapse. Autologous fat graft acted as an effective barrier between the glenoid fossa and mandibular condyle, thus preventing dead space, hematoma and heterotrophic bone formation. A brief review of the literature and update on TMJ re-ankylosis are also presented.

Objectives: Orthognathic surgery is a corrective intervention for maxillofacial deformities. Bleeding is a major concern for oral and maxillofacial surgeons. Various agents, such as hemocoagulase, tranexamic acid, and aprotinin have been developed to reduce intraoperative bleeding and transfusion requirements. Therefore, in this study we aimed to investigate the effects of hemocoagulase and tranexamic acid, as well as their simultaneous use, to reduce bleeding during orthognathic surgery. Patients and.

Methods: This retrospective study included patients who had undergone simultaneous orthognathic surgery of the maxilla and mandible between January 2013 and September 2022 and were classified into three groups based on drugs administered: hemocoagulase (Botropase), tranexamic acid, and a combination of both drugs. We recorded patient age, sex, weight, blood loss, and duration of surgery. Red blood cell (RBC), hemoglobin, hematocrit, and platelet levels were measured before, immediately after, and one day after surgery.

Results: No statistically significant differences were found in blood loss, RBC, hemoglobin, hematocrit, or platelet levels between any of the groups. There were no differences in the drug effects between Le Fort I and bilateral mandibular sagittal split osteotomies, with or without double genioplasty. However, there were significant reductions in RBC, hemoglobin, hematocrit, and platelet levels during genioplasty.

Conclusion: Tranexamic acid, hemocoagulase, and their combination had similar efficacy in patients who underwent Le Fort Ⅰ and bilateral mandibular sagittal split osteotomies with and without genioplasty.

A midline or median cleft lip is rare, and a midline cleft associated with a unilateral cleft and a proboscis-like structure is rarer still. We present a case managed at our center in which a 5-year-old male had a median cleft of the upper lip with an associated 'proboscis' and a microform unilateral cleft lip.

Objectives: This case series aims to introduce the nasal floor approach for extracting inverted mesiodens.

Materials and methods: Through a retrospective chart review between January 2022 and February 2023, we included the mesiodens patients using nasal floor approach, and analysis the location of mesiodens from the anterior nasal spine (ANS), total operation time, and complications.

Results: Each mesiodens was located 10 to 12 mm from the ANS and was covered with a cortical layer of the nasal floor. All mesiodens were successfully extracted without exposing the adjacent incisors or nasopalatine nerve within 30 minutes from draping to postoperative dressing.

Conclusion: The nasal floor approach is an efficient extraction method that reduces bone removal and prevents anatomical damage while removing the mesiodens just below the nasal floor bone.

Objectives: Understanding the lingual nerve's precise location is crucial to prevent iatrogenic injury. This systematic review seeks to determine the lingual nerve's most probable topographical location in the posterior mandible.

Materials and methods: Two electronic databases were searched, identifying studies reporting the lingual nerve's position in the posterior mandible. Anatomical data in the vertical and horizontal dimensions at the retromolar and molar regions were collected for meta-analyses.

Results: Of the 2,700 unique records identified, 18 studies were included in this review. In the vertical plane, 8.8% (95% confidence interval [CI], 1.0%-21.7%) and 6.3% (95% CI, 1.9%-12.5%) of the lingual nerves coursed above the alveolar crest at the retromolar and third molar regions. The mean vertical distance between the nerve and the alveolar crest ranged from 12.10 to 4.32 mm at the first to third molar regions. In the horizontal plane, 19.9% (95% CI, 0.0%-62.7%) and 35.2% (95% CI, 13.0%-61.1%) of the lingual nerves were in contact with the lingual plate at the retromolar and third molar regions.

Conclusion: This systematic review mapped out the anatomical location of the lingual nerve in the posterior mandible, highlighting regions that warrant additional caution during surgeries to avoid iatrogenic lingual nerve injuries.

Plexiform neurofibroma is a rare benign tumor and a special subtype of neurofibromatosis 1. This report is a literature review with a case of patient with facial hemorrhage observed at the site of neurofibroma removal in the right lower face due to minor trauma. Through PubMed search, using terms ((facial hematoma) OR (facial bleeding)) AND (neurofibromatosis), 86 articles were identified, and five related articles (six patients) were finally selected. Of the six patients, two had previously undergone embolization. However, as a result, all patients received open surgery to remove hematomas. The hemostatic methods mentioned were vascular ligation (five patients), hypotensive anesthesia (two patients), and postoperative blood transfusion (four patients). In conclusion, spontaneous or minimally traumatic bleeding is possible in neurofibromatosis patients. In most cases, it can be resolved by vascular ligation under hypotensive anesthesia. Optionally, prior embolization and supplementary tissue adhesive may be used.