치성 피부 누공 환자의 진단과 치료

김성준(Sung-Joon Kim),감세훈(Se Hoon Kahm) 대한치과의사협회 2016 대한치과의사협회지 Vol.54 No.9

The odontogenic cutaneous fistula in facial area is uncommon but, well defined disease. It is difficult to diagnose from the dental origin of cutaneous sinus tract. Most patients may visit to the dermatologists or general hospital without cause of disease. They usually be treated by repeated surgical excisions, biopsies, and antibiotic medications, but suffered from recurrences. We studied odontogenic cutaneous fistula through retrospective study in Jeju Special Self-Governing Province between 1 January 2009 and 12 December 2015. There were 3 males, 5 females from 14 to 78 years old with an average age of 50.4 years old. Only 2 patients felt the toothache, others didn’t detect it. They suffered from recurrences and repeated treatments for 3 to 11 months with an average period of 7.9 months. They visited average 2.8 hospitals before a precise diagnosis in a dental clinic. All cases were fully healed endodontic treatment or extraction of origin teeth without recurrences. In conclusion, the cause of cutaneous fistula in facial area can be odontogenic. If dentists or doctors diagnose a patient with cutaneous fistula on face, they should check dental problems or take x-ray views for precise diagnosis. It could be helpful for differential diagnosis.

최근 5년간 구강악안면 감염 환자의 임상통계학적 연구

장소정(So-Jeong Jang),이용근(Yong-Geun Lee),안융(Yung Ahn),임대호(Dae-Ho Leem),백진아(Jin-A Baek),신효근(Hyo-Keun Shin) 대한구강악안면외과학회 2006 대한구강악안면외과학회지 Vol.32 No.5

Infections of the oral and maxillofacial region are one of the most common conditions for which a patient presents to a maxillofacial surgeons. Although these infections can arise from a variety of source, dental disease is the most common etiology. So, odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often respond to antimicrobial chemotherapy or surgical intervention, such as extraction of teeth, incision and drainage through clinical features. But, odontogenic infections have the potential to spread via the fascial spaces in the head and neck region, and, they spread to cavernous sinus, deep musculofascial space and other vital structure. We have undertaken clinical studies on infections in the oral and maxillofacial regions by analyzing retrospectively hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Chonbuk National University Hospital past 5 years from 2000 to 2004. And, the patients’age, sex, medical history, causes of the infection, surgical intervention, and other clinical parameters were reviewed. The obtained results were as follows : 1. The most frequent cause of oral and maxillofacial infection was odontogenic. And in the odontogenic cause, dental caries was the most common cause (47.2%). 2. The most common fascial space involved was the submandibular space (15.7%), followed by the buccal space (14.8%). 3. 60.4% of all patients required surgical drainage of the abscess, endodontic treatment or tooth extraction or periodontal treatment with drainage. 4. The most causative organism isolated from the pus culture were streptococcus viridans (53.9%). 5. Underlying medical problems were found in 136 patients (41.9%), the most common being hypertension (27.9%) and diabetes (14.7%).

WHO 분류에 따른 치성종양의 임상 및 병리조직학적 연구

유태민,유미현,이의웅,차인호,김진 대한구강악안면병리학회 2003 대한구강악안면병리학회지 Vol.27 No.4

World Health Organization(WHO) revised the classification of neoplasms and other tumours related to odontogenic apparatus in 1992. The aim of this study was to classify the odontogenic tumors of Korean according to the WHO Histologic classification. A total of 271 cases were reviewed for the study which were diagnosed as odontogenic tumors at the department of Oral Pathology, Yonsei University College of Dentistry for the period from Jan. 1997 to March 2003. Clinical and pathology reports were reviewed & radiographic feature were examined. The following results were obtained : 1. Among 271 cases, 269 cases(99.3%) were diagnosed as benign odontogenic tumors, and the remaining 2 cases(0.7%) were malignant tumors, which were diagnosed as odontogenic ghost cell carcinoma and squamous cell carcinoma ex odontogenic cyst. 2. Four cases were not able to classify into the WHO classification. All of them were belonged to mixed odontogenic tumors; two cases of adenomatoid odontogenic tumor with calcifying epithelial odontogenic tumor, one case of adenomatoid odontogenic tumor with odontoma, odotogenic cyst and one case of ameloblastoma with immature odontoma. 3. The most frequent odontogenic tumour was odontoma(45.2%), followed by ameloblastoma (29.2%), odontogenic fibroma(9.2%) 4. One case of atypical amelobalstoma and one case of calcifying odontogenic cyst with ameloblastic fibroma were not able to subclassify histologically. 5. Male to female ratio of odontogenic tumors was 1.2:!. Odontogenic tumors mainly occured in the first and second decade, occurred twice as much as in the mandible than in the maxilla 6. The odontogenic tumors was discovered by routine oral x-ray examination, whereas the chief complaint of ameloblastoma were swelling, pain. 7. Ameloblastoma, adenomatoid odontogenic tumor, calcifying odontogenic cyst and odontoma were related to the impacted teeth and tooth displacement. The root resorption was frequently observed in ameloblastoma and calcifying odontogenic cyst.

한국인 치성종양의 역학적 연구

이의웅(Eui Wung Lee) 대한구강악안면외과학회 1998 대한구강악안면외과학회지 Vol.24 No.1

저자는 현재 새로이 제정된 WHO 조직분류법에 의한 국내의 치성종양에 대한 임상적 기초자료가 거의 없는 실정이므로 이에 대한 기초적 자료를 얻고자 1985년부터 1996년까지 12년간 연세대학교 치과대학 구강병리학교실에 접수된 총 4913예의 조직생검 기록지를 기초로 이중 1992년 WHO 분류법에 의한 치성종양으로 최종 진단된 총 156명의 환자의 조직표본을 재검경후 병록기록지와 수술전 방사선 사진 등을 이용하여 역학조사를 시행한바 다음과 같은 결론을 얻었다. 1. 양성종양 10종류만이 관찰되었고 악성으로 분류할 수 있는 치성종양은 1례도 관찰되지 않았다. 또한 총 4913례의 생체조직 검사 의뢰건수중 치성종양으로 확진된 증례수는 156례(3.18%)이었다. 2. 총 156례의 치성종양중 법랑아세포종이 66례(42.3%)로 가장 많았으며 다음이 치아종 64례(41.0%), 선종양치성종양 7례(4.5%), 골화성섬유종 6례(3.8%) 등의 순이었다. 3. 성별 빈도는 총 156례중 남자가 83명(53.2%)으로 여자 73명(46.8%)보다 다소 높았으나 치아종과 점액종에서는 여성에서 각기 53.1%, 75.0%로 높은 빈도를 나타냈다. 4. 연령별 빈도를 보면 총 156례중 대부분인 134례(85.9%)가 40세이전에 발생하였으며, 연령군별분포도를 살펴보면 10대가 60명(38.5%)으로 가장 빈발하였고 다음이 20대 37명(23.7%), 30대 22명(14%), 10세이전 15명(9.6%)의 순이었다. 5. 부위별로는 전체적으로 상악보다는 하악에서 약 2배가량(67.3%)빈발하였다. 법랑아세포종은 97.5%가 하악에서 발생하였으며 대구치부(45.5%), 우각부(28.1%), 하악지부(10.7%) 순으로 호발하였으나 치아종은 57.8%가 상악에서 발생하며 전치부(44.9%)에서 가장 높은 빈도를 보였다. 6. 법랑아세포종은 검사예의 62.1%에서 매복치와 연관된 것으로 관찰되었으며 주위치아의 변위(27.3%)보다는 치근흡수(53.0%)가 많이 관찰되었다. 치아종의 경우 종양으로 인한 영구치의 매복(62.5%)과 치아변위(75.0%)가 많이 발견되는 반면 치근흡수는 7.8%의 낮은 빈도를 나타냈다. 7. 법랑아세포종에서는 주소중 안면부종이 53례(80.3%)로 가장 많았고 다음이 동통 6례(9.1%)의 순이었다. There have been many different histological typing of odontogenic tumours and numerous reports on the epidemiological studies of the odontogenic tumours depending upon various these histological typing. Neoplasms and other tumours related to the odontogenic apparatus was classified into 21 entities by WHO in 1992 The purpose of this study is to get the clinically basic data of the odontogenic tumours in Korean according to this newly made WHO histological classification. The total of 4913 biopsied specimens were reviewed from the dept of Oral Pathology, College of Dentistry, Yonsei University for the period of Jan. 1985. to Dec. 1996. and among them 156 cases were diagnosed into the odontogenic tumours. The following results were obtained : 1. Odontogenic tumours were 156 cases(31.8%) of the total 4913 biopsy cases. Only the 10 different benign entities were observed in 156 cases of odontogenic tumour. 2. The most frequent odontogenic tumour was ameloblastoma(42.3%) and followed odontomas(41.0%), adenomatiod odontogenic tumours (4.5 per cent) and ossifying fibroma(3.8% ) in order. 3. Overall male to female ratio was 1.14(53.2%) to 1(46.8%), but female ratio is higher than male in odontoma(53.1%) and myxoma(75.0%) respectively. 4. 134 cases(85.9%) of all odontogenic tumours were observed under the age of forty. Age distribution showed 60 cases(38.5%) in the second decade, 37 cases(23.7%) in the third decade, 22 cases(14%) in the fourth decade and 15 cases(9.6%) in the first decade of life. 5. The ratio odontogenic tumours of the mandible to maxilla was about 2 : 1. Odontogenic tumour occured predominantly in the molar region(29.6%) and gonial region(17.08%) of the mandible and anterior region(18.8%) of the maxilla. Ameloblastoma occurred mostly in the molar region(45.5%), gonial region(28.1%), ascending ramus region(10.7%) and premolar region(9.1%) of the mandible, while odontomas predominated in the anterior region(44.9%) of the maxilla. 6. Most ameloblastomas were related with more the impacted teeth(62.1%) and root resorption(53.0%) than teeth migration(27.3%). In case of odontoma, teeth impaction(62.5%), teeth migration(75.0%) and root resorption(7.8%) were observed. 7. In the ameloblastomas, facial swelling was the most frequent chief complaint(80.3%) and followed by pain(9.1%)

치아종과 관련된 석회화 치성낭종

이재휘(Lee Jae Hwy),배정수(Bae Jung Soo),장동수(Jang Dong Soo),김진(Kim Jin),전용찬(Chun Young Chan) 대한구강악안면외과학회 1993 대한구강악안면외과학회지 Vol.19 No.2

The calcifying odontogenic cyst was first recognized as a separate entity by Gorlin and his associates in 1962. It is a rare lesion and accounts for only about 2% of all odontogenic tumors and cysts. The majority of calcifying odontogenic cysts are cystic, although approximately 15% are solid lesions. Hence, WHO in 1971 classified calcifying odontogenic cyst as a benign odontogenic tumor. The calcifying odontogenic cyst often occurs in association with, or contains areas histologically similar to, a variety of odontogenic tumors, such as complex and compound odontomas, ameloblastoma, ameloblastic fibroma, ameloblastic fibro-odontoma, odonto-ameloblastoma, calcifying epithelial odontogenic tumor, and adenomatoid odontogenic tumor. Among these, odontoma is most often found in relation to the calcifying odontogenic cyst, although only a few reports of calcifying odontogenic cyst found concurrently with true odontoma have been pulished. This report presents a case of calcifying odontogenic cyst associated with odontoma, reviews the current knowledge concerning this lesion, and attempts to clarify certain ambiguous histologic features of the tumor.

치성각화낭에서 발생한 법랑모세포종 - 증례보고 및 문헌고찰 -

권오인,김옥준,전상미,김지선,김상우,최홍란 대한구강악안면병리학회 2015 대한구강악안면병리학회지 Vol.39 No.2

Odontogenic cyst and odontogenic tumor shares developmental source. However, they have different histopathologic features, and they are classified respectively. Odontogenic cyst and tumor can share same physical region. It is called a hybrid lesion, a lesion showing the combined histopathological characteristics of two or more previously recognized odontogenic tumor and/or cysts of different categories. In this study, a hybrid lesion was researched. 61-year old man was referred to our department with a multilocular radiolucency in right mandibular angle. Incisional biopsy was carried out, and the patient was diagnosed with ameloblastoma. Odontogenic keratocyst was found with the tumor, and it was thought to be evolved via neoplastic transformation from lining epithelium of the keratocyst. After reviewing studies reporting hybrid lesions from odontogenic cyst and tumor, formation of a hybrid lesion was most frequent from a dentigerous cyst and an adenomatoid odontogenic tumor. A hybrid lesion commonly lead to misdiagnosis, and the prognosis is not always transparent. The close relationship between the odontogenic cyst and tumor has to be kept in mind in the diagnosis and treatment of the lesions in maxillofacial area

석회화 낭성 치성종양과 법랑모세포 섬유치아종이 혼합된 치성종양

김형수,윤정훈,최승현,나종찬,안미영,이준 대한구강악안면병리학회 2015 대한구강악안면병리학회지 Vol.39 No.2

Calcifying cystic odontogenic tumor (CCOT), also known as calcifying odontogenic cyst or Gorin cyst is a rare developmental lesion which arises from odontogenic epithelium. It has been classified as a benign odontogenic neoplasm related to odontogenic apparatus by the World Health Organization. CCOT may be associated with other odontogenic tumors, most frequently odontoma, a finding that is a rare event in other types of odontogenic cysts or tumors. This report describes a case of hybrid odontogenic tumor composed of CCOT and ameloblastic fibroma-odontoma of the impacted right maxillary canine region that occurred in a 14-year-old female.

Current Concepts and Occurrence of Epithelial Odontogenic Tumors: II. Calcifying Epithelial Odontogenic Tumor Versus Ghost Cell Odontogenic Tumors Derived from Calcifying Odontogenic Cyst

이석근,김연숙 대한병리학회 2014 Journal of Pathology and Translational Medicine Vol.48 No.3

Calcifying epithelial odontogenic tumors (CEOTs) and ghost cell odontogenic tumors (GCOTs) are characteristic odontogenic origin epithelial tumors which produce calcifying materials from transformed epithelial tumor cells. CEOT is a benign odontogenic tumor composed of polygonal epithelial tumor cells that show retrogressive calcific changes, amyloid-like deposition, and clear cytoplasm. Differentially, GCOTs are a group of transient tumors characterized by ghost cell presence, which comprise calcifying cystic odontogenic tumor (CCOT), dentinogenic ghost cell tumor (DGCT), and ghost cell odontogenic carcinoma (GCOC), all derived from calcifying odontogenic cysts (COCs). There is considerable confusion about COCs and GCOTs terminology, but these lesions can be classified as COCs or GCOTs, based on their cystic or tumorous natures, respectively. GCOTs include ameloblastomatous tumors derived from dominant odontogenic cysts classified as CCOTs, ghost cell-rich tumors producing dentinoid materials as DGCTs, and the GCOT malignant counterpart, GCOCs. Many authors have reported CEOTs and GCOTs variably express keratins, β-catenin, BCL-2, BSP, RANKL, OPG, Notch1, Jagged1, TGF-β, SMADs, and other proteins. However, these heterogeneous lesions should be differentially diagnosed to allow for accurate tumor progression and prognosis prediction.

편측 상악동을 침범한 치성 부비동염의 수술 전 진단 정확도 변화 및 치아 치료 시기에 따른 치료 성적 분석

최기용,모지훈,정영준 대한이비인후과학회 2019 대한이비인후과학회지 두경부외과학 Vol.62 No.11

Background and Objectives Unilateral sinusitis is caused by various factors. Odontogenicsinusitis; especially, is different from non-odontogenic sinusitis in clinical features and prognosis. The purpose of this study is to evaluate the prognosis of odontogenic sinusitis in accordancewith the changes in diagnostic accuracy over time and the timing of dental treatment. Subjects and Method 195 patients who underwent endoscopic sinus surgery for unilateralsinusitis within the interval from 2006 to 2017 were reviewed to analyze the etiologies andclinical characteristics. Preoperative CT was assessed to identify patients who had not been diagnosedwith odontogenic sinusitis in the past. In the unilateral bacterial sinusitis, we identifiedchanges in incidence, diagnostic accuracy, and outcome in the odontogenic sinusitis. Wedivided odontogenic sinusitis patients into three groups: preoperative and intraoperative dentaltreatment group, postoperative dental treatment group, and untreated group. Then we analyzedthe difference in prognosis of these three groups. Results The total number of patients with odontogenic sinusitis was 86 (44%), which accountedfor about 36% until 2011, but increased to about 48% after 2013. From 2006 to 2011,there were 15 cases of missed diagnosis of odontogenic sinusitis, but there was 1 case in 2012and no cases since 2013. The treatment outcome of unilateral bacterial sinusitis was significantlyincreased from 84.1% before 2011 to 96% after 2012. The success rate was 97.1% in thecase of accurate diagnosis of odontogenic sinusitis, but the success rate was 43.8% in case ofmissed diagnosis. In odontogenic sinusitis, the success rate was low when dental treatment wasnot performed. However, there was no difference in success rate among different dental treatmenttimings. Conclusion The incidence of odontogenic sinusitis has steadily increased over the last decade. The prognosis has been improved by appropriate treatment under accurate diagnosisthrough preoperative examination and radiological evaluation. There was no difference in theprognosis of odontogenic sinusitis according to the dental treatment time. Therefore, it is agood choice for tooth preservation to have an endoscopic sinus surgery first and then decidethe dental treatment timing

상아질성 유령세포종양: 증례보고와 문헌고찰

김성민,최소영,이재일,허경회,명훈,이종호,Kim, Soung Min,Choi, So Young,Lee, Jae Il,Huh, Kyung Hoe,Myoung, Hoon,Lee, Jong Ho 대한악안면성형재건외과학회 2013 Maxillofacial Plastic Reconstructive Surgery Vol.35 No.1

Dentinogenic ghost cell tumor (DGCT) is a rare epithelial odontogenic neoplasm, representing 1.9% to 2.1% of all odontogenic tumors. It is the neoplastic counterpart of the calcifying odontogenic cyst (COC), and characteristic islands of odontogenic epithelical cells contain numerous ghost cells and dysplastic dentin, and also have many common histological features with ameloblastoma. The 2005 World Health Organization (WHO) Classification of Odontogenic Tumours re-named this entity as calcifying cystic odontogenic tumor (CCOT) and defined the clinico-pathological features of the ghost cell odontogenic tumours, CCOT, DGCT and ghost cell odontogenic carcinoma (GCOC). We report a rare case of central DGCT in the posterior maxilla of a 31-year-old female with literature review, for the emphasis of Oral and Maxillofacial surgeon's role.