Calcipex II has been widely used for root canal irrigation in endodontic treatment. It is a product of calcium oxide-based water soluble paste containing fine granular resin materials1). It was known that these granular materials were hardly dissolved in tissue and subsequently elicited foreign body granuloma by recruiting macrophages. Sometimes serious complications involving regional osteomyelitis and maxillary sinusitis were followed in long time after the endodontic treatment using Calcipex II materials2, 3). And then the removed surgical specimen should be carefully examined to detect whether there exists Calcipex II material-related foreign body reaction or not. As the fine granular materials are too small in size, about 1 μm in diameter, and slightly translucent, it is difficult to find out the fine granular materials scattered throughout the granulomatous lesion even in the high magnification view. Here, we firstly found that the fine granular materials of Calcipex II showed bright birefringence under the polarizing microscope, and that the Calcipex II granules dispersed in chronic granulomatous lesion could be easily detected by their bright birefringence. The present study demonstrated a case of peri-implantitis involved with Calcipex II granule-related periapical granuloma, exhibiting numerous bright birefringence spots in the polarizing microscope observation.

Odontomas are mixed odontogenic tumors in which both the epithelial and mesenchymal components have undergone functional differentiation. Two types of odonotma are histomorphologically recognized: complex and compound. Complex odontomas have little or no morphologic similarity to normal tooth formation, and they commonly found in the posterior mandible. They are typically asymptomatic, and the most common presenting symptom is usually lack of eruption of a permanent tooth. The recommended treatment for an odontoma is conservative surgical excision. No tendency for recurrence has been noted. An eight-year-old girl was presented with swollen mouth floor. Radiographically, there were radiopaque mass on anterior mandible with impacted lower left central incisor. Under midazolam intraoral sedation and N2O-O2 inhalation sedation, the odontomas were surgically removed. The diagnosis was complex odontoma. After follow-up of 28 months period, there was no recurrence. The impacted tooth erupted spontaneously and the space for the erupted tooth was regained orthodontically.

The aim of this study was to present the clinical, radiological, and histopathological findings of 20 new Korean GOC cases with a brief literature review. The mean age of 20 GOC patients was 43.5 years (range, 29-73 years) with a strong predilection for male (male-to-female ratio, 4:1). Nine cases were located in the maxilla and 11 cases in the mandible. Eight cases involved the anterior areas of the jaws and 12 cases were located in the posterior area. Most of the cases (16/20, 80.0%) showed a well-defined unilocular radiolucency and some showed cortical perforation (55.6%) and bony expansion (72.2%) in computed tomography. The most common histopathological feature was eosinophilic cuboidal cells (100%), followed by clear cells (95.0%), mucous cells (85.0%), variations in thickness (85.0%), and intraepithelial microcysts (80.0%). All cases were surgically treated by enucleation and no recurrences were found in routine follow-up.

Although recombinant human Bone Morphogenetic Proteins-2 (rhBMP-2) is clinically useful for bone regeneration, induction of new bone formation requires a large amount of rhBMP-2 in humans. Many investigators have been concentrated efforts on searching materials which enhance the effect of rhBMP-2, and then heparin was found as a potentiating material to rhBMP-2. The purpose of this study were histomorphometrically to analyze the enhancing effect of heparin to rhBMP-2 and to study the mode of actions of heparin to rhBMP-2. Stem cells obtained from rabbit adipose tissue were divided into 4 groups according to heparin concentrations(0, 0.25, 2.5, and 25 μg/ml) with a constant rhBMP-2 concentration(150 ng/ml) and cultured for 2, 4, and 8 days. Naphtol AS phosphate-fast blue BB staining for alkaline phosphatase content and Alizarin red staining for calcium content were performed as time schedules and the morphology and osteoblastic activity were observed closely. 5 μg/ml rhBMP-2 was mixed with the following doses of heparin: 0, 0.25, 2.5, and 25 μg/ml. Each mixture was blotted into 0.5 g of multiporous anorganic bovine bone and was inserted into the critical sized calvarial defects(diameter of 0.8-mm) of rabbits. After 1, 3, and 6 weeks, the harvested tissues were processed and stained using H&E and Masson’s trichrome methods. And the areas of newly formed bone in the grafted material were measured and statistically analyzed. During culture experiment of adipose stem cells with rhBMP-2 and heparin, the degree of osteoblastic differentiation was increased with increasing heparin concentration, but the cellular degeneration was accelerated at higher concentration of heparin as time passed. Consequently the osteoblastic differentiation of progenitor cells were accelerated as the concentration of heparin increased. In addition, the progenitor cells exhibited full differentiations early showing fast degeneration. The higher the concentration of heparin, larger newly formed bone in grafted materials was obtained in initial period. However, the increased amount of the newly formed bone in grafted materials was progressively decreased at the higher concentration of heparin as time passed. In conclusion, the heparin has influence on the osteoinductive effect of rhBMP-2 in the initial stage of bone formation. The use of heparin with rhBMP-2 could offer cheaper, safer, and improve clinical results in grafting procedures.

The maxillofacial region is susceptible to damage because facial bone is prominent. The aim of this study is to evaluate the incidence, etiology, seasonal distribution, and patterns of maxillofacial injuries and investigate the percentage of bone fractures on CT scans by patient’s gender and age. Electronic medical records of 1,483 patients who had maxillofacial injuries and visited the Emergency Medical Center of Chonnam National Hospital were evaluated. Age, gender, etiology, seasonal occurrence, frequency of fracture, and the pattern of bone fracture were analyzed by using IBM SPSS Statistics 21 (SPSS Inc., Chicago, IL, USA). Male to female ratio was 2.82:1. The most common causes of injury were falls or collisions (male 40.09%, female 48.2%), followed by traffic accidents and violence. The number of injuries related to sporting accidents, assult, and industrial accidents was higher in male patients than that of female patients. With regard to the seasonal occurrence, 434 cases (29.26%) occurred in the summer, while 306 cases (20.63%) occurred in the winter. In this study, 946 patients (63.79%) were identified to have facture and 537 patients (36.21%) were found to be without fracture on CT scans. The orbital bone (41.38%) was the most commonly fractured in the mid facial structures. The most common fracture site in the mandible was the body of the mandible (23.13%). The patterns of maxillofacial injuries were various based on gender, age, cause of injury, and season.