Mucosal malignant melanoma is an uncommon tumor of the head and neck, and patient cannot easily recognize the lesion. Most patients are diagnosed with advanced lesions, and the 5-year survival rate is very low. Therefore, intraoral pigmented lesions require an incisional biopsy for differential diagnosis from malignant melanoma. As the size of the tumor increases, lesion showing vertical growth and lymph node metastasis increases, and the prognosis becomes poor. In this study, we report a case of mucosal malignant melanoma in the oral cavity that shows radial growth and no lymph node metastasis despite its relatively large size.

Salivary duct carcinoma is a highly malignant tumor that arises from salivary gland. Pathologically, Salivary duct carcinoma is similar to high-grade breast ductal carcinoma. The tumor is commonly associated with pain and facial paralysis and is known to have high rates of recurrence and metastasis. Surgical resection and postoperative radiation is mainstream of the treatment. In this study, we report a case of this tumor which was seen predominantly benign-looking in fine needle aspiration biopsy. The features of this tumor are presented with a review of literature.

Intraosseous hemangioma of the jaws is a rare disease as compared to other skeletal and soft tissue hemangiomas. Preoperative differential diagnosis is critical in that severe bleeding can cause both intra and postoperative complications. Surgical excision of the intraosseous hemangioma can be performed with the use of steroid injection or sclerosing agent into the lesion before the surgical approach. However, even with the embolization of the blood vessels before surgical excision, there still exists a risk of massive hemorrhage during the procedure for the larger lesions. In this report, we present a case of which first tentatively diagnosed as ameloblastoma thus the use of sclerosing agents or vascular embolization was not considered before the surgery. Although there was a strong tendency to intraoperative bleeding, delicate hemostasis was achieved with surgicel(Ethicon SARL, Johnson and Johnson, Switzerland), bosmin(Jeil Pharm, Republic of Korea), and electrocautery. The final histopathological examination confirmed an intraosseous hemangioma of the mandible. The patient is undertaken for follow-up period of 1 year and the prognosis is under favorable condition.

Adenoid cystic carcinoma(ACC) is an uncommon tumor of the head and neck. It is one of the most common malignant tumor of the salivary glands. Although ACC has clear pathologic features, it can be diagnosed as a benign lesion in terms of cytological and radiologic aspects. In this paper, we report a rare case of ACCACC on tongue that is diagnosed as ACC but appears as a benign lesion in cytological and radiologic views.

Cemento-ossifying fibroma is a benign fibrous lesion with an unknown cause, mostly asymptomatic, painless swelling of the affected jaw. This is a case report on a cystic lesion found on radiographic examination in a patient with an extraction of mandibular left tooth. A 29-year-old female was referred to Pusan National University Dental Hospital due to a radiopaque lesion in the left mandible. On the medical history examination, the left lower mandibular tooth had been extracted 4 years ago, and there were no specific findings in the general medical history. According to histopathologic findings, along with proliferation of spindle cells, cementum-like substances were observed along with irregularly shaped osseous calcified substances containing osteocytes in the cellular fibrous connective tissue. In this study, we report a case that showed cystic changes due to tooth extraction, which made it complicated to determine the differential diagnosis from the existing fibrous-osseous lesion.

Worldwide, oral cancer accounts for 2%–4% of all cancer cases. It is estimated that more of 90% of all oral neoplasms are oral squamous cell carcinoma (OSCC). The aims of this study were to evaluate follow-up outcomes in patients with OSCC invading the mandibular body bone who underwent primary radical resection and reconstructive surgery by fibular free flap or CAD-CAM T-mesh with pathological study on two cases. In this article, two cases of mandibular reconstruction in patients with OSCC invading the mandibular body bone are reported. A 68-year-old male patient visited the authors’ clinic with pain on the left mandibular region. After wide excision and segmental mandibulectomy on the mandibular OSCC, a enterocutaneous fibular free flap from right leg was used to cover the intraoral mucosal defect. The other 51-year-old female patient visited the authors’ clinic with pain on the right mandibular region. After wide excision and segmental mandibulectomy on the mandibular OSCC, reconstruction was done with a reconstruction plate and a fibula free flap from right leg. Unfortunately, fibular free flap was lost due to infection of the flap at post-operative 1month, secondary reconstruction using a custom-made type T-mesh and iliac PCBM was done to repair on the mandibular defect after four years postoperatively. The customized CAD-CAM T-mesh was made prior to the operation according to mirror image of remained jaw. Patients with OSCC invading the mandibular body bone are required an accurate segmental mandibulectomy immediate reconstructive surgery with various methods and followed by adjuvant radiation with or without chemotherapy in order to improve the quality of life through the restoration of the oral function and esthetics after surgery. Postoperative CCRT was determined according to the final pathologic findings such as lymph node metastasis and main lesion free margin safety, and this has an essential relationship in the prognosis of postoperative recurrence. We reviewed reliable treatment options on two patients of OSCC in mandible with pathologic findings.Worldwide, oral cancer accounts for 2%–4% of all cancer cases. It is estimated that more of 90% of all oral neoplasms are oral squamous cell carcinoma (OSCC). The aims of this study were to evaluate follow-up outcomes in patients with OSCC invading the mandibular body bone who underwent primary radical resection and reconstructive surgery by fibular free flap or CAD-CAM T-mesh with pathological study on two cases. In this article, two cases of mandibular reconstruction in patients with OSCC invading the mandibular body bone are reported. A 68-year-old male patient visited the authors’ clinic with pain on the left mandibular region. After wide excision and segmental mandibulectomy on the mandibular OSCC, a enterocutaneous fibular free flap from right leg was used to cover the intraoral mucosal defect. The other 51-year-old female patient visited the authors’ clinic with pain on the right mandibular region. After wide excision and segmental mandibulectomy on the mandibular OSCC, reconstruction was done with a reconstruction plate and a fibula free flap from right leg. Unfortunately, fibular free flap was lost due to infection of the flap at post-operative 1month, secondary reconstruction using a custom-made type T-mesh and iliac PCBM was done to repair on the mandibular defect after four years postoperatively. The customized CAD-CAM T-mesh was made prior to the operation according to mirror image of remained jaw. Patients with OSCC invading the mandibular body bone are required an accurate segmental mandibulectomy immediate reconstructive surgery with various methods and followed by adjuvant radiation with or without chemotherapy in order to improve the quality of life through the restoration of the oral function and esthetics after surgery. Postoperative CCRT was determined according to the final pathologic findings such as lymph node metastasis and main lesion free margin safety, and this has an essential relationship in the prognosis of postoperative recurrence. We reviewed reliable treatment options on two patients of OSCC in mandible with pathologic findings.

Odontogenic keratocyst (OKC), also known as keratocystic odontogenic tumor, is a distinct clinicopathologic lesion that can be clearly identified by histologic examination. Clinically, OKC is characterized by a high recurrence rate. This report describes a rare case of OKC with mural calcification in the maxilla of a 47-year-old male patient. Orthopantomography and Cone Beam Computed Tomography showed full opacification with calcification and lateral wall resorption in the left maxillary sinus, destroying the sinus floor. Hard tissue deposits have rarely been reported in the connective tissue walls of OKC. The importance of calcified material formation to the biological behavior of OKCs is unclear. Although its prognostic value has not been studied, the presence of calcification materials does not appear to increase the risk of recurrence. Study of a number of samples would be needed to determine the nature of the correlation between the presence of calcified materials and recurrence.

To accurately determine the resection margin for maxillary cancer, it is important to closely examine the extent of tumor infiltration into the maxilla, nasal cavity, maxillary sinus, palate, and surrounding tissues. Various methods have been described for the resection of maxillary tumors, such as alveolectomy, partial maxillectomy, subtotal maxillectomy, total maxillectomy, and extended maxillectomy. The objective of this study was to introduce external carotid artery (ECA) ligation on the ipsilateral side, a perioperative bleeding control method with fewer complications. Incidence of major bleeding during maxillectomy is a rare but potentially life-threatening complication. Cases of temporary bleeding from an internal maxillary artery or other sites can be stopped, packed, and compressed. However, bleeding control is eventually achieved by ligation of the ECA or selective embolization. Herein, we report the case of a 60-year-old male with squamous cell carcinoma of the right maxilla, which was eventually treated with subtotal maxillectomy along with an elective ECA ligation for intraoperative bleeding control. The procedure produced no preoperative or postoperative bleeding. ECA ligation is a simple, effective, safe, and (at the operator’s discretion) recommended method of perioperative bleeding control during maxillectomy.

Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of squamous cell carcinoma arising in various anatomical sites. This article describes a case history of BSCC of the floor of mouth with mandibular involvement, and further discusses the appropriate management of such case with reference to the literature review. A 52-year-old male patient was referred to our clinic from another university hospital. Segmental mandibulectomy with supraomohyoid neck dissection and mandible reconstruction with left fibular free flap under general anesthesia was performed, followed by radiotherapy. Histopathological examination on the tumor lesion revealed features of squamous cell carcinoma with comedo-type necrosis. A diagnosis of BSCC was given by the oral pathology specialist. Basaloid squamous cell carcinoma (BSCC) is a biphasic variant of SCC with both basaloid and squamous cell histology. A recent report showed that there is no significant difference in the prognosis. Due to the lack of accumulated research, close follow-up and continuous research are deemed necessary. Treatment that focuses on the stage of the tumor is appropriate. A periodic follow-up observation is also very important due to the occurrence of distant metastasis to the lungs.

Tissue engineering has been rapidly developed in oral and maxillofacial reconstruction. Biocompatible scaffold from chemically composites seeded with stem cells is essential and several growth factors for bone formation and angiogenesis are also required. To overcome limited activity of new bone formation with scaffolds, several biomechanical stimulation methods on cells have been made to grow cells in scaffold. Several bioreactors have been developed for real tissue growth in culture laboratory. In addition to biological stimulants like BMP, growth factors and exogenous drugs, biomechanical stimulation technique has also been known as an effective method in cell differentiation. We developed our own bioreactor with tensile mechanical strains. Then we tested with it for detection of suitable biomechanical effect on the cell differentiation and proliferation. And we also compared the results with the effect of low intensity pulsed ultrasound (LIPUS). Mechanical strain group showed more rapid reaction with cell differentiation and proliferation than non-mechanical strain group. Mechanical strain groups stimulated with 0.5∼0.7Hz for 6 hours and 8 hours showed more active cell differentiation than the group with 0.5∼0.7Hz for 2.5 hours tensile strain stimulation. Group of LIPUS also showed more rapid reaction in cell differentiation and proliferation. LIPUS with 3MHz showed more cell reaction than the LIPUS group with 1MHz. Our results showed the positive effect on differentiation and proliferation of cell with mechanical tensile strain, LIPUS both.

The vascular origin diseases occurring in the oral and maxillofacial region can be divided into hemangiomas and vascular malformation. They are rare and early lesions are not easy to diagnosis, so they may be misdiagnosed as clinicians, or the method and timing of treatment may be inappropriate. For 10 years, from August 2005 to August 2015, we analyzed the clinical records, diagnosis, treatment, and prognosis of 23 patients with hemangioma or vascular malformation confirmed by clinical, histopathological or radiological examination of maxillofacial lesions at department of oral and maxillofacial surgery, Pusan National University Hospital and Pusan National University Dental Hospital. Chief complants of patients were mainly swelling, mass, and spot-like lesion on various intraoral sites. Treatments were performed with excision, embolization, sclerotherapy, depending on each lesions condition. Arteriovenous malformation cases were more frequently recurred than other lesions. Prognosis of lesions were relatively good but close observation should be needed.

Squamous odontogenic tumor (SOT) is a relatively rare, benign, small (rarely > 1.5 cm in diameter), but locally infiltrative and occasionally aggressive odontogenic epithelial lesion that appears to have harmatomous and neoplastic characteristics [1]. SOT is often asymptomatic, although it can present with mildly painful gingival swelling or tooth mobility. Radiographically, SOT is usually visualized as an irregularly or triangularly shaped unilocular radiolucency associated with the lateral roots of teeth. We report a case of the squamous odontogenic tumor occurring in a 60-year-old female in the right posterior maxilla with unusual radiographic and clinical appearances.

Odontogenic keratocyst (OKC), also known as keratocystic odontogenic tumor (KCOT), is an emerging odontogenic tumor originating from the dental lamina. It is an aggressive lesion with a squamous epithelium and a recurrence rate of 15-35%.1 Radiologically, there is a clear, smooth, or shell-like border showing a unilocular or multifocal, polycystic radiographic picture. Hard tissue formation in OKC is a very rare phenomenon and occurs in the form of dystrophic calcification, cartilaginous tissue or dentinoid.2 In this article, we report the case of OKC with calcification. OKC with radiopaque lesion is very rare, these are considered as dystrophic calcification, dentinoid formation, ossification. The incidence of dystrophic calcification in recurrent OKC is low, so it can be inferred that the recurrence rate of OKC with dystrophic calcification is lower than that of conventional OKC.

Background: Mucoepidermoid carcinoma (MEC) is the most common malignant epithelial tumor of the salivary gland in the oral cavity. In South Korea, it occurs most frequently in the palate, retromolar area, floor of the mouth, buccal mucosa, and other areas of the oral cavity. MEC is rare in children and adolescents under 20 years of age, but it is the most common malignant salivary gland tumor in this group. Reconstructive surgery is often required due to cystic lesions or resection of malignancy in the oral cavity. Buccal fat pad (BFP) is a flap that is reliable and suitable for reconstructing oral defects because it has a low complication rate and small volume change over time. Case Presentation: We report the case of a 12-year-old female patient with low-grade MEC on light soft palate with no neck metastasis. After tumor resection the palatal mucosal defect was reconstructed with a BFP flap. Conclusion: The purpose of this article is to discuss the features and treatment methods of MEC that is rarely occurring in children, and the usefulness of BFP for reconstruction. Therefore, we will make a precise diagnosis and treatment as we examine the clinical feature and review the literature.

This study was planned to evaluate the efficacy of surgical treatment in stage 2 medication related osteonecrosis of jaw(MRONJ) patients. Retrospective analysis was performed about patients who were treated with medication related osteonecrosis of jaw from 2015 to 2017. 25 Patients were treated by a single surgeon at the Department of Oral Surgery, Dental Hospital, Pusan National University. The treatment methods they received were conservative or surgical. The results of treatment were classified as "fail" and "success" and the prognosis according to the treatment method was compared. Conservative treatment 14.29% (2 cases), sequestrectomy 64.29% (9 cases) and saucerization 21.43% (3 cases) were performed in the MRONJ group, and 2 treatment failures were encountered after conservative treatment and 1 after saucerization. Surgical treatment resulted in better outcomes in stage 2 MRONJ patients. Furthermore, treatments were deemed successful when surrounding necrotic bone containing sequestrum was reliably removed. Therefore, this study suggests that the treatment of "stage 2" MRONJ should actively consider surgical treatment.

The fruit of Kochia scoparia Scharder is traditionally used as a medicinal ingredient to treat allergic skin diseases and inflammatory diseases in China, Japan and Korea. Recently, several studies reported that K. scoparia had potential for the cytotoxicity of human cancer cells. To investigate the anti-cancer effect of K. scoparia on oral cancer and to determine the specific type of cell death induced by MEKS treatment. We investigated the anti-cancer effects of K. scoparia, methanol extract (MEKS) in HSC4 human oral cancer cells. We examined the effects of MEKS on the proliferation rate, cell cycle arrest, 7-AAD-ANNEXIN V double stain, reactive oxygen species (ROS) generation and activation of apoptosis and necroptosis-associated proteins in HSC4 cells. MTT assay results demonstrated that MEKS decreased the proliferation rates of HSC4 cells in a dose-dependent manner with an IC50 value of 45.3 μg/ml. MEKS at 50 μg/ml significantly increased the sub-G1 DNA contents of HSC4 cells to 84.8%, versus untreated cells. However, the activation of apoptosis-associated proteins such as cleaved caspase 3, cleaved caspase 8, cleaved caspase 9 and cleaved Poly (ADP-ribose) polymerase (PARP) did not detect. The level of Bax protein markedly increased in MEKS-treated HSC4 cells. In addition, the cell viability of the DPQ pre-treated HSC4 cells with MEKS treatment was significantly greater than that of MEKS treated-cells. These results suggest that MEKS inhibits cell proliferation and induces necroptosis in oral cancer cells and that MEKS may have potential chemotherapeutic value for the treatment of human oral cancer.