[Show abstract][Hide abstract] ABSTRACT: Purpose: This study evaluated woven silk textile for burn wound dressing materials in an animal model. Methods: Ten rats were used in this experiment. Full-thickness 2×2 cm burn wounds were created on the back of the rats under anesthesia. In the experimental group, the wounds were treated with three different dressing materials from woven silk textile. In the control group, natural healing without any dressing material was set as control. The wound surface area was measured at five days, seven days, and 14 days. Wound healing was evaluated by histologic analysis. Results: There were no statistically significant differences among groups at five days post injury. The mean defect size at seven days was largest in Group 3 (462.87 mm 2), and smallest in Group 1 (410.89 mm 2), not a significant difference (P =0.341). The mean defect size at 14 days was smallest at the Group 3 (308.28 mm 2) and largest in the control group (388.18 mm 2), not a significant difference (P =0.190). The denuded area was smaller in Group 1 (84.57 mm 2) and Group 2 (82.50 mm 2) compared with the control group (195.93 mm 2), not statistically significant differences (P =0.066, 0.062). The difference between Group 3 and control was also not statistically significant (P =0.136). In histologic analysis, the experimental groups re-epithelialized more than control groups. No evidence was found of severe inflammation. Conclusion: The healing of burn wounds was faster with silk weave textile more than the control group. There was no atypical inflammation with silk dressing materials. In conclusion, silk dressing materials could be used to treat burn wounds.
Maxillofacial Plastic and Reconstructive Surgery. 11/2014; 36(6):280-284.
[Show abstract][Hide abstract] ABSTRACT: The radial forearm free flap (RFFF) is a thin and pliable tissue with many advantages for tongue reconstruction. However, tongues reconstructed with RFFF occasionally need revision surgery because inadequate defect measurement at primary surgery can lead to bulkiness and limited movement of reconstructed tongue. In this case, the patient underwent partial glossectomy and RFFF reconstruction for treatment of tongue cancer five years prior. We could not make a lower denture for the patient, because the alveolo-lingual sulcus of tongue was almost lost. So we performed vestibuloplasty with a modified Kazanjian method on the lingual vestibule of the mandibular right posterior area, and defatting surgery to debulk the flap. After surgery, we observed that the color and texture of the revised tongue changed to become similar with adjacent tissue. The patient obtained a more functional and esthetic outcome. Accordingly, we present a case report with a review of relevant literature.
Maxillofacial Plastic and Reconstructive Surgery. 11/2014; 36(6):298-302.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to evaluate silkworm-cocoon-derived silk membrane (SM) for application in guided bone regeneration (GBR) and to compare it with commercially available GBR membranes, such as collagen membrane (CM) and polytetrafluoroethylene membrane (PM). The SM, CM, and PM membranes were examined via scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR) analysis, and tensile strength evaluation. Thirty rats were used for the experiments. Critical-sized parietal bone defects (diameter: 8.0 mm) were divided into three groups according to the applied GBR membrane. The rats were sacrificed 4 or 8 weeks after surgery and evaluated by micro-compiterized tomography (µ-CT) and histology. The FTIR analysis of the SM was similar to that of the CM. The SEM images showed that the surface characteristics of the SM differed from those of the CM and PM. The SM showed a complex network structure of silk fibers. The wet SM was also more resistant to tensile stress than the wet CM and PM. The µ-CT results of the animal study showed that the bone volume of the SM group was higher than those of the CM and PM groups 4 weeks after the operation (p<0.05). The histological analysis showed that the new bone regeneration of the SM group was higher than those of the CM and PM groups 4 and 8 weeks after the operation (p<0.05). This study demonstrated that the tensile strength of the wet SM was higher than the tensile strength of the wet CM and PM groups. The bone formation of the SM group was higher than those of the other two groups.
Macromolecular Research 09/2014; 22(9):1018-1023. · 1.64 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There are many treatment options in management of mandibular condylar neck fractures. Closed reduction is the most conservative treatment; however, achievement of anatomic reduction is difficult, and there are some risks of mandibular functional impairment. Open anatomic reduction and internal fixation have some advantages; therefore, many oral and maxillofacial surgeons have attempted to achieve anatomic reduction through the open approach and extracorporeal reduction and fixation. However, when using this method, there is some risk of resorption of the fractured mandibular condylar head. Therefore, we designed a modified extracorporeal reduction technique, without detaching the lateral pterygoid muscle in order to maintain the blood supply to the fractured mandibular condylar head. We believe that this minor modification may minimize the risk of resorption of the fractured mandibular condylar head. In this article, we introduce this technique in detail, and report on two cases.
Maxillofacial Plastic and Reconstructive Surgery. 01/2014; 36(1).
[Show abstract][Hide abstract] ABSTRACT: Post-traumatic anterior open bite can occur as a result of broken balance among the masticatory muscles. The superior hyoid muscle group retracts the mandible downward and contributes to the anterior open bite. Denervation of the digastric muscle by injection of botulinum toxin type A (BTX-A) can reduce the power of the digastric muscle and help to resolve the post-traumatic anterior open bite. A patient with a bilateral angle fracture had an anterior open bite even after undergoing three operations under general anesthesia and rubber traction. Although the open bite showed some improvement by the repeated operation, the occlusion was still unstable six weeks after the initial treatment. To eliminate the residual anterior open bite, BTX-A was injected into the anterior belly of the digastric muscle. Following injection of BTX-A, the anterior open bite showed immediate improvement. Complication and relapse were not observed during follow-up. Long-standing post-traumatic open bite could be successfully corrected by injection of BTX-A into the anterior belly of the digastric muscle without complication.
Journal of the Korean Association of Oral and Maxillofacial Surgeons. 08/2013; 39(4):188-92.
[Show abstract][Hide abstract] ABSTRACT: The present study was undertaken to examine the effects of cisplatin plus 4-hexylresorcinol (4-HR) combination therapy on oral mucosal melanoma (OMM) using cultured primary OMM cells in a tumour xenograft model. Cultured primary OMM cells were used for the MTT assay and DNA microarray. OMM cells were implanted into the submandibular glands of nude mice. The mice were then treated with cisplatin only or cisplatin plus 4-HR. Tumour size changes, survival rate and tumour metastasis were compared between the two groups by observation, micro-positron emission tomography (PET) and histological examination. In the MTT assay, the cisplatin plus 4-HR group showed significantly higher inhibition of OMM cell growth compared to the other groups (p < 0.05). DNA microarray results showed significant inhibition of matrix metalloproteinase (MMP)-2 gene expression upon 4-HR application. The necropsy and micro-PET results showed that the mice from the cisplatin-only group had more distant metastases than the mice from the cisplatin plus 4-HR combination group (p = 0.002). MMP-2 expression was lower in the primary tumours in the cisplatin plus 4-HR combination group than in the cisplatin-only group (p < 0.001). Overall survival was longer in mice from the cisplatin plus 4-HR combination group than in the cisplatin-only group (p = 0.049). In conclusion, the combined effect of cisplatin and 4-HR resulted in fewer metastases and longer survival than cisplatin-only treatment in the OMM xenograft model.
[Show abstract][Hide abstract] ABSTRACT: Bisphosphonates (BP) are widely used in medicine for inhibiting bone resorption; however bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a major side effect of BP. To date, there have been no specific reports on the incidence of BRONJ among Koreans. This study investigated the preliminary results from a nationwide survey of BRONJ in the Departments of Oral and Maxillofacial Surgery (OMFS) at individual training hospitals.
A total of 15 OMFS departments (10 from dental schools, 4 from medical schools, and 1 from a dental hospital) participated in a multi-centric survey. This study assessed every BRONJ case diagnosed between January 2010 and December 2010. The patient age and BP type were evaluated.
A total of 254 BRONJ cases were collected. The majority of BRONJ cases were associated with oral BP therapy, while 21.8% of the cases were associated with intravenous administration. Alendronate was the drug most frequently related to BRONJ (59.2% of cases), followed by risedronate (14.3%) and zolendronate (17.0%). The average age of BRONJ patients was 70.0±10.1 years, with a range of 38-88 years of age. With the number of BP patients in Korea reported to be around 600,000 in 2008, the estimated incidence of BRONJ is at least 0.04% or 1 per 2,300 BP patients.
The results suggest that the estimated incidence of BRONJ in Korea is higher than the incidence of other countries. Future prospective studies should be carried out to investigate the exact epidemiological characteristics of BRONJ in Korea.
Journal of the Korean Association of Oral and Maxillofacial Surgeons. 02/2013; 39(1):9-13.
[Show abstract][Hide abstract] ABSTRACT: Purpose: For reconstruction of craniomaxillofacial defects caused by tumor, trauma, infection etc, free flap transplantation with microvascular surgery is a very useful method. Thrombus formation at the anastomosis site is the major cause of graft failure. 4-Hexylresorcinol (4-HR) is generally known as an antiseptic and antiparasitic agent. This study was conducted in order to evaluate the effect of 4-HR on blood coagulation in vitro. In addition, we investigated thrombus formation and endothelial repair of an injured vessel in an animal model. Methods: In the in vitro experiment, we compared blood coagulation time between the 4-HR treated group and normal blood. Thirty rats were used for in vivo animal experiments. After exposure of the right femoral vein, a micro vessel clamp was placed and the femoral vein was intentionally cut. Microvascular anastomosis was performed on all rats using 10-0 nylon under microscopy. The animals were divided into two groups. In the experimental group (n=15), 4-HR (250 mg/kg) mixed with olive oil (10 mL/kg) was administered per os daily. Animals in the control group (n=15) were given olive oil only. The animals were sacrificed at three days, seven days, and fourteen days after surgery and rat femoral vein samples were taken. Vascular patency and thrombus formation were investigated just before sacrifice. Histologic analysis was performed under a microscope. Results: Results of an in vitro blood coagulation test showed that coagulation time was delayed in the 4-HR treated group. The results obtained from an in vivo 4-HR administered rat model showed that the patency of all experimental groups was better at thirty minutes, seven days, and fourteen days after microvascular anastomosis than that of the control group at seven and fourteen days after anastomosis, and the amount of thrombus in the experimental groups was much less than that of the control group. Endothelial repair was observed in the histologic analysis. Conclusion: Findings of this study demonstrated that blood coagulation was delayed in the vitro 4-HR treated group. In addition, good vascular patency, anti-thrombotic effect, and repair of venous endothelial cells were observed in the vivo 4-HR administered rat group.
Maxillofacial Plastic and Reconstructive Surgery. 01/2013; 35(5).
[Show abstract][Hide abstract] ABSTRACT: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a disease characterized by jaw necrosis and delayed wound healing in patients who had received bisphosphonates. Buccal fat pad (BFP) can be used as a pedicled flap in the posterior region of the oral cavity. BFP pedicle flap needs simple surgical technique and it shows less donor site morbidity and aesthetic problem than other vascularized flap. BFP pedicled flap was fed by 3 arteries-facial, internal maxillary, and transverse facial artery. Osteomyelitis was generally related with poor blood supply. Thus, rich blood supply of BFP pedicle flap can have a potential advantage to BRONJ patients. In this case report, we presented 3 BRONJ patients treated by BFP pedicle flap after sequestrectomy.
Maxillofacial Plastic and Reconstructive Surgery. 01/2013; 35(3).
[Show abstract][Hide abstract] ABSTRACT: Oblique facial cleft is a rare congenital deformity. Its incidence has been reported as 0.24% of all reported cases of facial cleft. We report on a patient who had a left-sided oblique facial cleft with anopthamia, including lip and palate, nose alar base, and medial canthus. The patient also had a right-sided oblique facial cleft, which included lip and palate, nose alar base, medial canthus, and upper eye brow. Primary closure of the facial cleft was performed using multiple Z-plasty after excision of scar tissue.
Maxillofacial Plastic and Reconstructive Surgery. 01/2013; 35(4).
[Show abstract][Hide abstract] ABSTRACT: A 60-year-old male complained of headache, nasal discharge, and diplopia for over one month with a history of left upper molar extraction, and he had recently experienced severe discharge of purulent exudate from his left antrum. Under the diagnosis of maxillary sinusitis, the Caldwell-Luc operation was performed, and several fragments of amorphous white mucoroid materials were removed. In the histological observation, sinus mucosa was relatively well preserved, but showed diffuse infiltration with eosinophilic polymorphonuclears. Huge molds of mucormycosis were associated with the surface of mucosa. He was treated with amphotericin-B deoxycholate, resulting in the uneventful healing of the antral lesion. The current case of antral mucormycosis was very rare but effectively treated by surgical removal of antral mucosa and the following antibiotic therapy for the strong inhabitants of fungal molds. We also presumed that the patient was superinfected with commensal fungus of mucormycosis during broad spectrum antibiotic therapy for the previous dental infection.
Maxillofacial Plastic and Reconstructive Surgery. 01/2013; 35(6).
[Show abstract][Hide abstract] ABSTRACT: Purpose: Vascular endothelial growth factor (VEGF)-C and its tyrosine kinase receptor, VEGF receptor (VEGFR)-3 are recently known to have lymphangiogenic activities in various tumor types. In this study, we determined whether the expression of lymphangiogenic factors correlate with nodal metastasis or survival in a nude mouse model of oral squamous cell carcinoma (OSCC). Methods: Three OSCC cells (KB, SCC4, SCC9) were xenografted into the right mandibular gland of athymic nude mice. The mice were followed for tumor development and growth, and the mice were sacrificed when they had lost more than 20% of their initial body weight, or the diameter of the induced tumor exceeds 20 mm. After necropsy, the murine tumors were examined histologically and radiologically (micro-positron emission tomography computed tomography) for regional or distant metastasis. We performed immunohistochemical assays with anti-VEGF-C, VEGFR-3, CD105, and D2-40 antibodies. Immunofluorescence double staining for LYVE-1/CD31 was also performed. To quantify the VEGF-C and VEGFR-3 level in the cancer tissue, Western blotting was performed. Finally, we determined the correlation between the degree of expression of VEGF-C/VEGFR-3 and the mean survival time. Results: OSCC tumor cells into the mandibular gland of the nude mice successfully resulted in the formation of recapitulating orthotopic tumor. Tumor cells of the induced tumor did not express VEGF-C. VEGF-C/VEGFR-3 expression was mainly distributed in the endothelial cells of the stromal area. There were no correlation between the degree of expression of VEGF-C/VEGFR-3 and the mean survival time of mice injected with different OSCC cell lines. Conclusion: An recapitulating orthotopic model of OSCC in nude mice was established, which copies the cervical nodal metastasis of human OSCC. Overexpression of lymphangiogenic factors seems to have no effect on survival of hosts in this in vivo experiment.
Maxillofacial Plastic and Reconstructive Surgery. 01/2013; 35(1).
[Show abstract][Hide abstract] ABSTRACT: Maxillary sinus hypoplasia (MSH) is an uncommon clinical disease that represents a persistent decrease in sinus volume, which results from centripetal reaction of the maxillary sinus walls. We present a unilateral MSH case of a 46-year-old male patient with a history of nasal obstruction and headache for 3 years. He had a history of Caldwell Luc operation (CLOP) 10 years ago, and no enophthalmos, hypoglobus or facial asymmetry. After confirming the right diagnosis of MSH, filled with bone in the computed tomography scan, hyperplastic bone was removed by the CLOP approach. The uncinate process and infundibular passage were found to be degenerated and ostium was also examined to be obstructed under endoscopic confirmation. MSH can be mistaken for chronic maxillary sinusitis because of the plain x-ray appearance, so the aggravated state of MSH can be the result of surgeon's misjudgment. With additional literature reviews, this rare experience is first introduced in our Korean oral and maxillofacial surgery field.
Maxillofacial Plastic and Reconstructive Surgery. 01/2012; 34(2).
[Show abstract][Hide abstract] ABSTRACT: Purpose: Vascular endothelial growth factor (VEGF) plays a key role in tumor angiogenesis and lymphangiogenesis including induction of endothelial cell proliferation, migration and capillary tube formation. E7080 (S1164, Selleck chemical, Houston, TX, USA) is a muti-targeted kinase inhibitor, which targets VEGF receptor-2, 3 (VEGFR-2, 3) and inhibits survival and proliferation of tumor cell. The purpose of this study was to determine the anti-tumor effect of E7080 on oral squamous cell carcinoma. Methods: An oral squamous cell carcinoma cell line, SCC-9 was used in this study. E7080 was applied to SCC-9 cells by 3 different concentrations (1, 5, 10 ). Control means no application of E7080. The cellular growth was evaluated by real-time cell electronic sensing and MTT assay. The signal transduction was evaluated by Western blotting. Results: In experimental group, SCC-9 cell proliferation was decreased and the VEGFR-3 downstream pathways were inhibited compared with control. Furthermore, increasing the concentration of E7080, the ability of E7080 to disturbance of SCC-9 cell proliferation was increased. Conclusion: Proliferation of SCC-9 cells was inhibited by E7080, which was through by inhibition of VEGFR-3 downstream pathway. In vivo study with E7080 will be required to provide therapeutic benefits in oral squamous cell carcinoma.
Maxillofacial Plastic and Reconstructive Surgery. 01/2012; 34(4).
[Show abstract][Hide abstract] ABSTRACT: Purpose: The aim of this study was to evaluate the effect of 4-hexylresorcinol and hydroxyapatite combination graft on bone regeneration in the rabbit calvarial defect model. Methods: Ten New Zealand white rabbits were used for this study. Bilateral round shaped defects (diameter: 8.0 mm) were created on the parietal bone. 4-hexylresorcinol and hydroxyapatite combination graft material was grafted into the right parietal bone defect area (experimental). The left bone defect area was not filled with anything (control). The animals were sacrificed at 4 weeks and 8 weeks after grafting. A micro-computerized tomography of each specimen was taken, and the specimens were stained for histological analysis. Results: The average value of bone mineral density (BMD) and Bone volume (BV) was higher in the experimental group than in the control group at 4 weeks and 8 weeks after surgery. However, the difference was not statistically significant (P>0.05) at 8 weeks after grafting. The BMD and BV in the experimental group at 4 weeks after surgery was significantly higher than those in the control group (P
Maxillofacial Plastic and Reconstructive Surgery. 01/2012; 34(6).
[Show abstract][Hide abstract] ABSTRACT: Cisplatin is a representative anti-cancer drug and 4-hexylresorcinol (4-HR) is known as an antiparasitic and antiseptic agent. The aims of this study were to evaluate the effect of 4-HR on the activation of nuclear factor-κB (NF-κB) in cell cultures, to evaluate the antitumor effect of 4-HR plus cisplatin combination therapy in a xenograft model, and to evaluate transglutaminase-2 (TG-2) and phosphorylated NF-κB (pNF-κB) expression in the xenograft model. To determine the effect of 4-HR on NF-κB phosphorylation, co-immunoprecipitation and Western blot analysis were done in KB cells. To examine the in vivo effect of the cisplatin plus 4-HR combination therapy, KB cells were grafted into nude mice. Drugs were injected into the peritoneal cavity daily. Tumor size, body weight, and duration of survival were checked daily. Specimens from main mass were used in immunohistochemical staining for the analysis of TG-2 and pNF-κB expression. In the in vitro test, as the 4-HR concentrations increased, the fraction of the bound complex NF-κB-inhibitory-κB (IκB) increased. Consequently, the level of free IκB decreased. In the xenograft model, the cisplatin plus 4-HR group exhibited a significantly decreased tumor growth rate than in the saline group (P=0.039). The mean survival time of the cisplatin plus 4-HR group was 51.20±3.96 days and was significantly prolonged compared with the other groups (P<0.05). The body weight of the cisplatin plus 4-HR group had significantly less weight loss than the cisplatin only group (P=0.045). In the immunohistochemical analysis, the cisplatin plus 4-HR group had a significantly lower expression of TG-2 and pNF-κB compared to the saline group (P<0.05). In conclusion, cisplatin plus 4-HR combination therapy had clear advantages over the cisplatin only treatment such as similar tumor growth inhibition compared to the cisplatin only treatment despite the reduced dosage of cisplatin, less body weight loss, and prolonged survival time.
[Show abstract][Hide abstract] ABSTRACT: Resistance to chemotherapy is very important in the prognosis of tumors. Transglutaminase-2 (TG-2) mediated chemotherapy resistance has been widely reported. The objective of this study was to demonstrate the effect of 4-hexylresorcinol (4-HR) on TG-2 activity in nasopharyngeal squamous cell carcinoma cells (KB cells). Treatment with a mixture of 4-HR and cisplatin significantly decreased KB cell viability compared to treatment by cisplatin alone at 10 µg/ml (p<0.001). 4-HR inhibited TG-2 activity compared to cisplatin alone at 5, 10 and 20 µg/ml (p = 0.001, 0.001 and 0.003, respectively). Nuclear translocation of TG-2 was also inhibited by 4-HR treatment. 4-HR treatment also increased the fluorescence life-time of DAPI significantly compared to the untreated control or the cisplatin treated group (p<0.001). In conclusion, 4-HR inhibited TG-2 activity and showed a synergistic effect on tumor cell growth inhibition with cisplatin.
[Show abstract][Hide abstract] ABSTRACT: Purpose: This study evaluated the capability of bone formation with silk fibroin/nano-hydroxyapatite/corn starch composite scaffold as a bone defect replacement matrix when grafted in a calvarial bone defect of rabbits . Methods: Ten New Zealand white rabbits were used for this study and bilateral round-shaped defects were formed in the parietal bone (diameter: 8.0 mm). The silk fibroin 10% nano-hydroxyapatite/30% corn starch/60% composite scaffold was grafted into the right parietal bone (experimental group). The left side (control group) was grafted with a nano-hydroxyapatite (30%)/corn starch (70%) scaffold. The animals were sacrificed at 4 weeks and 8 weeks. A micro-computerized tomography () of each specimen was taken. Subsequently, the specimens were decalcified and stained with Masson's trichrome for histological and histomorphometric analysis. Results: The average and histomorphometric measures of bone formation were higher in the control group than in the experimental group at 4 weeks and 8 weeks after surgery though not statistically significant ( >0.05). Conclusion: The rabbit calvarial defect was not successfully repaired by silk fibroin/nano-hydroxyapatite/corn starch composite scaffold and may have been due to an inflammatory reaction caused by silk powder. In the future, the development of composite bone graft material based on various components should be performed with caution.
Maxillofacial Plastic and Reconstructive Surgery. 01/2011; 33(6).
[Show abstract][Hide abstract] ABSTRACT: Purpose: Tumor associated angiogenesis and/or lymphangiogenesis are known to be linked by VEGFR signaling pathways. These processes are regulated by several growth factors including VEGFR-2, VEGFR-3. E7080 is an orally active inhibitor of multiple tyrosine kinases including VEGFR-2, 3. Therefore, it was proposed that E7080 may inhibit angiogenesis and lymphangiogenesis. The aim of this study was to determine the effect of E7080 in a nude mouse model of OSCC. Methods: KB cells were xenografted into the submucosal tissue of the mouth floor of athymic mice. Seven days after the xenograft, the mice were randomized into 2 groups. E7080 were administered orally to the experimental group once per day. The mice were sacrificed 3 weeks after the treatment. The tumors were examined histopathologically. Immunohistochemical assays with anti- VEGF-C, VEGFR-2, VEGFR-3, phosphorylated VEGFR-2/3 (pVEGFR-2/3), and D2-40 antibodies were then performed. Results: The transplantation of human OSCC tumor cells into the mouth floor resulted in the formation of orthotopic tumors. The experimental (E7080 treatment) group showed a slowly increased tumor volume. Moreover, immunohistochemical staining demonstrated higher levels of VEGF-C, VEGFR-2, VEGFR-3, pVEGFR-2/3 and D2-40 expression in the control group than in the experimental group. Conclusion: These results suggest that E7080 may provide therapeutic benefits in OSCC.
Maxillofacial Plastic and Reconstructive Surgery. 01/2011; 33(1).
[Show abstract][Hide abstract] ABSTRACT: A case of Behcet's syndrome found in a 22 years old male was is reported along with the histological and immunohistochemical studiesfindings. He The patient had had received prolonged medical therapy of anti-inflammatory agents for the conjunctival ulcer, genital ulcer, oral ulcer, and intestinal ulcers since the first onset of the Behcet's syndrome about approximately 7 years agoearlier. Recently, he felt the athickening of both corners of his lip causing that caused mouth opening difficultydifficulties. A plastic rReconstructive surgery was performed to enlarge the size of the oral orifice by multiple Z-plasty incisions, and finallywhich resulted in proper enlargement of the circumferential length of the lip. During the operation, a scar-like thick fibrous tissue was obtained and examined pathologically. In theThe microscopic observation the revealed the submucosal lesion was to be diffusely fibrosed with the a distribution of sclerotic collagen bundles. Particularly, sSeveral foci of collagen degeneration were found observed in the deep connective tissue, and the degenerating collagen bundles were gradually lost their fibrillar appearance. In the immunohistochemical observations, the foci of collagen degeneration was were strongly positive for IgK, but almost negative for TNF lysozyme, and MMP-3. Taken together, it was presumed that tThe submucosal fibrosis was presumed to have firstly presented in this study was probablybeeninduced by the prolonged anti-inflammatory therapy, which may inhibit the removal of sclerosed collagen bundles by the cell-mediated immunity and proteolytic digestion of macrophages, and that it was secondarily aggravated by the deposition of immunoglobulins derived from an autoimmune origin. Therefore, even after the successful plastic surgery of the lip to ameliorate the mouth opening difficulty, the recurrent submucosal fibrosis of lip should be carefully managed in the follow-up treatment.
Maxillofacial Plastic and Reconstructive Surgery. 01/2011; 33(1).