open access
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ISSN : 0376-4672
Necrotizing fasciitis of the head and neck is a rare but potentially fatal infection that often arises from odon-togenic sources and can rapidly spread along fascial planes to adjacent vital structures. We report a case of a 62-year-old male with diabetes who developed odontogenic necrotizing fasciitis originating from the left man-dibular premolar region, which progressed to involve the ophthalmic area. Despite initial incision and drainage with intravenous antibiotics, the infection rapidly advanced with fistula formation and extensive necrosis. The patient underwent repeated debridement, vacuum-assisted closure therapy, and subsequently wide surgical exci-sion followed by reconstructive procedures including a split-thickness skin graft and a pectoralis major flap. With timely multidisciplinary management and strict glycemic control, the patient achieved favorable recovery without recurrence.
Minocycline, a broad-spectrum tetracycline antibiotic, is known to cause tissue pigmentation, although involve-ment of alveolar bone is rare and often underrecognized. This report describes a case of blue-gray alveolar bone pigmentation discovered incidentally during extraction of bilaterally impacted mandibular third molars in a 17-year-old male. The patient had a history of prolonged minocycline use following orthopedic surgery. Despite the pigmentation, the affected bone demonstrated normal density and structure, and postoperative healing was uneventful. Although histopathologic confirmation was not pursued, the patient’s medical history and clinical presentation were consistent with minocycline-induced pigmentation. Awareness of this uncommon condition is essential to prevent misdiagnosis, avoid unnecessary intervention, and reassure patients. Current evidence sug-gests that such pigmentation does not adversely affect bone quality or healing capacity. This case highlights the importance of recognizing minocycline-induced bone pigmentation to prevent misdiagnosis and unnecessary intervention.
Orbital floor and medial wall fractures often require surgery but conventional extraoral approaches can cause scarring, eyelid malposition, and sensory changes. We report a 19-year-old male with left orbital floor, medial wall, and nasal bone fractures after a fall. The medial wall was repaired endoscopically via the ethmoid sinus, and the orbital floor was reconstructed through an intraoral transantral approach using titanium miniplates and screws. The nasal bone fracture underwent closed reduction. Postoperative CT confirmed accurate anatomical restoration. The patient achieved full recovery of ocular motility and symmetry without diplopia or enophthal-mos, experiencing only transient infraorbital hypoesthesia. This case illustrates that combining intraoral trans-antral and endoscopic transnasal approaches provides precise, minimally invasive reconstruction for complex orbital fractures while reducing soft-tissue trauma, scarring, and postoperative complications.
Periodontal plastic surgery (PPS) encompasses surgical procedures aimed at correcting anatomical deficiencies such as inadequate width and thickness of attached gingiva, gingival recession (GR), aberrant frenulum attach-ment, and shallow vestibular depth. The primary objectives of PPS are to ensure sufficient width and thickness of keratinized gingiva, manage GR through root coverage of exposed root surfaces, deepen the vestibule for functional improvement, and enhance esthetic outcomes and patient satisfaction. This review presents a com-prehensive summary of the fundamental concepts, major surgical techniques, and recent advances in PPS that are essential for clinical practice.
Periodontal disease is a chronic inflammatory condition affecting the supporting tissues of the teeth and is highly prevalent worldwide. Its association with systemic diseases such as cardiovascular disease and diabetes underscores the importance of prevention and long-term management. This review outlines a comprehensive, ev-idence-based approach to periodontal therapy, emphasizing a stepwise clinical protocol. Treatment begins with oral hygiene instruction, followed by non-surgical periodontal therapy and re-evaluation. If necessary, surgical interventions—including resective and regenerative osseous procedures—are performed. Regenerative therapy encompasses techniques such as guided tissue regeneration, bone grafting, and the use of growth factors, aiming to restore periodontal attachment structures. Postoperative care includes personalized supportive periodontal therapy guided by Periodontal Risk Assessment (PRA), allowing for individualized recall intervals based on patient risk profiles. By synthesizing current knowledge and treatment principles, this review aims to provide practical clinical guidance for the effective management of periodontitis.
Since the introduction of health insurance coverage for dental implants in 2014 for individuals aged 75 and older, the policy has expanded to cover up to two implants for those aged 65 and older. As a result, more than 600,000 health insurance-covered implant procedures are now performed annually at the local clinic. As of December 2024, South Korea has entered a super-aged society—with over 20% of the population aged 65 and older—it is expected that the number of dental implant procedures for the elderly will continue to increase. With the rise in implant procedures, the incidence of peri-implantitis is also growing. Initially described as a condition similar to periodontitis, peri-implantitis has since been systematically defined through ongoing research. At the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions, peri-implantitis was defined as“a pathological condition of dental plaque origin occurring in the tissues surroundings dental implants, characterized by inflammation of the mucosa surrounding the implant and subsequent progressive loss of sup-porting bone”. In response to this, the Korean Academy of Periodontology published a consensus report in 2024, which outlines a classification system for peri-implantitis based on bleeding on probing, probing depth, and the condition of surrounding alveolar bone. Treatment approaches for peri-implantitis are generally similar to those for periodontitis. Both non-surgical and surgical therapies aim to remove plaque and calculus, control inflam-mation, and promote reattachment of the peri-implant supporting tissues. The aim of this study is to review the latest periodontal perspectives on the treatment of peri-implantitis.
