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Treatment of ankylosed posterior teeth: Subluxation and Extrusion Method (골유착 대구치의 교정적 치험례)

  • Mun, Cheol-Hyeon
    • The Journal of the Korean dental association
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    • v.38 no.10 s.377
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    • pp.962-968
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    • 2000
  • 치조골과 백악질이 치근막에 의하여 경계되어지지 않고 직접 접촉된 상태인 골유착치는 치조골성장장애, 불안전 맹출, 대합치의 정출, 인접치와의 불안정한 관계 등 다양한 문제를 야기한다. 골유착치의 진단은 방사선 사진에서 치근막의 소실, 타진시의 독특한 소리, periotest를 이용한 동요도 검사 등 다양한 방법이 사용되나 그 신뢰성은 높지 않은 편이다. 따라서 저자는 통산적인 방법은 견인을 시행한 후 견인여부를 평가하여 골유착 여부를 판단하는 임상적 진단법을 사용하고 있다. 골유착치의 치료는 subluxation & extrusion법, autotransplantation법, corticotomy법, segmental osteotomy법, ostectomy법등 다양한 방법이 제시되고 있다. Subluxation & extrusion법은 적용이 간편한 장점이 있으나 골유착의 재발로 인한 교정치료의 실패가능성이 높은 단점이 있다. 본 증례는 다수치의 부분맹출 및 골유착으로 인한 구치부 개방교합이 주소인 환자로 소구치는 통산적인 교정치료법으로 골유착된 대구치는 subluxation & extrusion법을 적용하여 양호한 치료 결과를 얻을 수 있었다.

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Anterior Cruciate Ligament Reconstruction Using Autologous Bone-patellar Tendon-bone (자가 골-슬개건-골을 이용한 전방십자인대 재건술)

  • Kyung, Hee-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.88-91
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    • 2010
  • 전방십자인대 재건술시 자가건 선택에 대해서는 많은 논쟁의 소지가 존재하며 많은 보고들이 나오고 있으나, 현 시점에서 이식건으로써 자가 골-슬개건-골이 표준(gold standard)라는 주장은 이제 변화하고 있으며, 골-건 고정방법의 개선에 따른 조기 슬관절 안정성의 호전으로 자가 슬괵건의 사용이 점점 증가되고 있는 추세이다. 자가 골-슬개건-골은 이식건으로써 강한 물성, 튼튼한 고정, 장기 추시에서 높은 성공률 등으로 젊고, 강한 활동을 요하는 운동선수에서 종종 선택되고 있으며 조기에 강한 활동으로의 운동 복귀를 할 수 있다. 그러나 슬관절 전방 통증, 무릎을 꿇을 때의 통증, 슬개골골절, 슬개-대퇴 관절의 염발음 및 대퇴사두근력의 감소 등 이식물 채취로 인한 공여부 이환이 문제가 되었다. 그래서 자가 골-슬개건-골의 이식건으로서의 문제점 및 문헌상 고찰을 하여 논하고자 한다.

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The Role of Bone Scans in Routine Preoperative Evaluations of Non-Small Cell Lung Cancer Patients. (비소세포 폐암의 병기에 있어 통상적인 골 스캔의 역할)

  • 김영태;홍장미;이재익;이정상;성숙환;김주현
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.659-663
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    • 2002
  • The objective of this study was to assess the usefulness of bone scans in routine preoperative examinations of patients with newly diagnosed non-small cell lung carcinoma. Material and Method: We reviewed the medical records of 258 patients who were newly diagnosed with non-small cell lung cancer in our hospital between January 2000 and December 2000. More than half of the patients (132) were deemed to be inoperable due to their advanced stage based on the CT scans. The remaining 126 patients were considered potentially operable. For these patients, clinical evaluation including the presence of bone pain, serum alkaline phosphatase, and calcium levels was used as clinical predictors of bone metastasis. All patients received bone scans. Bone X-rays, MRI or bone biopsy were performed to confirm the presence of bone metastasis. The usefulness of the bone scan was evaluated by comparing its power of predicting bone metastasis to that of the clinical information. Result: In all patients, the positive and negative predictive values of bone scans for the bone metastasis were 44%, and 99%, respectively. Those of the clinical information were 38% , and 94%. However, in potentially operable patients, the negative predictive value of the clinical information was as high as 99%. Conclusion: If newly diagnosed non-small cell lung cancer patients are presented as potentially operable on the basis of CT scan with no clinical evidence of distant metastases, curative resection could be considered without performing routine bone scans because of the low probability of bone metastasis. However, if there are positive clinical findings, further evaluations, including bone scan should be followed as metastasis will be documented in more than 30% of patients.

Effect of Bone Quality on Insertion Torque during Implant Placement; Finite Eelement Analysis (임플란트 식립 시 골질이 주입회전력에 미치는 영향에 관한 삼차원 유한요소 분석)

  • Jeong, Jae Doug;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.2
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    • pp.109-123
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    • 2009
  • The aim of the study was to assess the influence of insertion torque of bone quality and to compare axial force, moment and von Mises stress using finite element analysis of plastoelastic property for bone stress and strain by dividing bone quality to its thickness of cortical bone, density of trabecular bone and existence of lower cortical bone when implant inserted to mandibular premolar region. The $Br{\aa}nemark$ MKIII. RP implant and cylindrical bone finite model were designed as cortical bone at upper border and trabecular bone below the cortical bone. 7 models were made according to thickness of cortical bone, density of trabecular bone and bicortical anchorage and von Mises stress, axial force and moment were compared by running time. Dividing the insertion time, it seemed 300msec that inferior border of implant flange impinged the upper border of bone, 550msec that implant flange placed in middle of upper border and 800msec that superior border of implant flange was at the same level as bone surface. The maximum axial force peak was at about 500msec, and maximum moment peak was at about 800msec. The correlation of von Mises stress distribution was seen at both peak level. The following findings were appeared by the study which compared the axial force by its each area. The axial force was measured highest when $Br{\aa}nemark$ MKIII implant flange inserts the cortical bone. And maximal moment was measured highest after axial force suddenly decreased when the flange impinged at upper border and the concentration of von Mises stress distribution was at the same site. When implant was placed, the axial force and moment was measured high as the cortical bone got thicker and the force concentrated at the cortical bone site. The influence of density in trabecular bone to axial force was less when cortical bone was 1.5 mm thick but it might be more affected when the thickness was 0.5 mm. The total axial force with bicortical anchorage, was similar when upper border thickness was the same. But at the lower border the axial force of bicortical model was higher than that of monocortical model. Within the limitation of this FEA study, the insertion torque was most affected by the thickness of cortical bone when it was placed the $Br{\aa}nemark$ MKIII implant in premolar region of mandible.

Quantitative Analysis of Thallium-201 Scintigraphy in Bone Tumor (골종양에서 탈륨 스캔의 정량적 분석)

  • Shin, Duk-Seop;Cho, Ihn-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.45-51
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    • 2003
  • Purpose: This study was designed to know the ability of thallium-201 scintigraphy to discriminate malignant bone tumor from benign by analysing the quantitative thallium uptake ratio. Materials and Methods: We took thallium-201 scintigraphy prospectively with other imaging studies in 82 bone tumor suspecting patients. The results of scintigraphy were read qualitatively and calculated quantitatively, and retention indexes were estimated. For the statistical analysis the patients were divided as four group; high grade malignant bone tumor, benign bone tumor, giant cell tumor and low grade malignant bone tumor. Results: The mean thallium uptake ratio was 4.14 in early phase and 2.26 in delayed phase in high grade malignant bone tumor group, 1.16 and 1.09 in benign bone tumor, 3.15 and 1.94 in giant cell tumor, and 1.41 and 1.31 in low grade malignant bone tumor. Retention indexes were 0.62, 0.97, 0.66, 0.93 in same order. The thallium uptake ratio and retention indexes were statistically correlated in high grade malignant bone tumor and benign bone tumor group(p<0.001). Conclusion: Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors.

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The Use of Calcium Sulfate as a Treatment of Benign Bone Tumor (양성 골종양 치료시 calcium sulfate의 이용)

  • Han, Chung-Soo;Yoon, Kyung-Ho;Ha, Jeong-Han
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.31-37
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    • 2003
  • Introduction: The purpose of this study is to assess the efficacy of calcium sulfate as a bone graft substitute in the treatment of benign bone tumor. Materials and Method: Between December 2000 and November 2001, 18 patients with a benign bone tumor were treated with crettage and the defects were filled with calcium sulfate (Osteoset$^{(R)}$:Wright Medical Co. USA) as a bone graft substitute. Average age was 28.4 years and mean follow up period was 12.3 months. Calcium sulfate mixed with autograft was used in 6 cases, calcium sulfate with allograft in 2 cases, and calcium sulfate alone was used in 10 cases. The degree of absorption of calcium sulfate and new bone formation at plain radiograph was analyzed at immediate postoperative and postoperative 3 months and 6 months follow up. Results: At 3 months postoperatively, 92% of calcium sulfate was absorbed, and at 6 months postoperatively, 89% of new bone formation was observed. There was no difference in the resorption and new bone formation between the group using bone graft and the group osteoset$^{(R)}$ alone, different preoperative diagnosis and even different locations. There was no complication. Conclusion: Calcium sulfate(Osteoset$^{(R)}$) is a safe and effective bone graft substitute in the treatment of benign bone tumors, especially for the children in whom autograft is not recommandable.

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The effect of Ca-P coated bovine bone mineral on bone regeneration around dental implant in dogs (개 모델에서의 임플란트 주위 골결손시 Ca-P 표면 처리된 이종골의 효과)

  • Cho, Su-Yeon;Jeon, Hye-Ran;Lee, Sun-Kyoung;Lee, Seoung-Ho;Lee, Jun-Young;Han, Geum-A
    • Journal of Periodontal and Implant Science
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    • v.36 no.4
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    • pp.913-923
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    • 2006
  • 목적 : 최근 발치 후 즉시 임플란트 식립은 널리 사용되는 수술 방식이다. 이 연구의 목적은 임플란트 주위 골결손시 Ca-P으로 표면 처리된 이종골을 사용하여 골재생을 평가하기 위함이다. 재료와 방법 : 두 마리의 개 모델에서 하악 소구치와 제일 대구치를 발치하였다. 발치 6주 후 trephine bur를 이용하여 7.5 mm 지름과 5 mm 깊이를 가진 결손부를 형성하였다. 이 후 이 결손부의 중앙에 3.5 mm 지름과 15mm 길이의 fixture(GS II)를 식립하였다. 결과적으로 임플란트와 주변을 둘러싸고 있는 골 사이에는 2.0 mm정도의 gap이 만들어진다. 준비된 결손부 내로 자기골 또는 $Biocera^{(R)}$를 채웠다. 각각 4주, 8주 후 조직 절편을 제작하였다. 조직학적 평가를 위해 Block biopsy를 시행하였다. 결과 : 두 집단 모두 임상적으로 골이 완전히 채워졌다. 자가골이 이식된 부위(control)의 평균 골-임플란트 접촉(BIC)은 각각 4주째 $28.2{\pm}19%$였고, 8주째 $44.9{\pm}9%$였다. $Biocera^{(R)}$가 이식된 부위(test)의 평균 BIC는 각각 4주째 $34.6{\pm}27%$였고, 8주째 $27.6{\pm}23%$였다. 자가골이 이식된 부위(control)의 평균 골밀도는 각각 4주째 $32.7{\pm}25%$, 8주째 $37.4{\pm}17%$였다. 골-임플란트 접촉(BIC)과 골밀도의 평균 비율(%)은 비슷하였다. 조직학적으로 자가골과 이종골 이식 부위 모두 주변골과 잘 조화를 이루었고 유사한 치유 양상이 관찰되었다. 자가골과 이종골 이식 부위간 유의한 차이는 없었다.(P>0.05) 결론 : 임플란트 주위 2 mm의 골 결손부위에 자가골 또는 이종골로 채운 경우 유사한 결과를 얻었다. 이 결과 임플란트 fixture 주위의 골 결손부 해소를 위해 자가골을 대체할 수 있는 재료로 $Biocera^{(R)}$를 사용할 수 있음을 보여준다.

Comparison of Bone Ages in Early Puberty: Computerized Greulich-Pyle Based Bone Age vs. Sauvegrain Method (초기 사춘기의 골연령 비교: 전산화된 Greulich-Pyle 기반 골연령 대비 Sauvegrain 방법)

  • Sang Young Lee;Soo Ah Im
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1081-1089
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    • 2022
  • Purpose To compare the computerized Greulich-Pyle based bone age with elbow bone age. Materials and Methods A total of 2126 patients (1525 girls; 601 boys) whose elbow bone age was within the evaluable range by the Sauvegrain method, and who simultaneously underwent hand radiography, were enrolled in the study. The 1st-bone age and VUNO score of the hand were evaluated using VUNOMed-BoneAge software. The correlation between the hand and elbow bone age was analyzed according to the child's gender and the probability of 1st-bone age. Results The correlation between VUNO score and elbow bone age (r = 0.898) was higher than the correlation between 1st-bone age and elbow bone age (r = 0.879). Moreover, the VUNO score showed a better correlation with the elbow bone age in patients with a 1st-bone age probability of less than 70%, or in girls. Elbow bone age was more advanced compared to hand bone age, and this difference increased until the middle of puberty and gradually decreased in the latter half. Conclusion The computerized Greulich-Pyle based hand bone age showed a significant correlation with the elbow bone age at puberty. However, since the elbow bone age tends to advance faster than the hand bone age, caution is required while judging the bone age during puberty.

Mid-term Results of Arthroscopic Anterior Cruciate Ligament Reconstruction using Autologous Bone-Patellar tendon-Bone versus Hamstring tendon (자가 골-슬개건-골과 슬괵건을 이용한 관절경적 전방 십자 인대 재건술의 중기 추시 결과)

  • Sim, J.A.;Kwak, J.H.;Lee, B.K.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.45-49
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    • 2006
  • 목적: 자가 골-슬개건-골과 슬괵건을 이용한 전방 십자 인대 재건술의 5년 중기 추시 결과를 비교 분석하고자 한다. 대상 및 방법: 전방 십자 인대 재건술을 시행한 후 5년 이상 추시 관찰이 가능한 65예를 대상으로 하였고, 골-슬개건-골이 38예, 슬괵건이 27예였다. 술 후 평가는 Lysholm 점수, 관절 운동 범위, 대퇴부 중간 부위 둘레 길이, Lachman 검사, 축 이동 검사, KT 2000 관절 계측기를 시행하였고, 술 후 합병증을 평가하였다. 결과: Lysholm 점수는 골-슬개건-골군과 슬괵건국에서 각각 평균 91점, 94.2점으로 슬괵건군이 우수하였고, 대퇴부 중간 부위 둘레 길이는 건측에 비해 각각 평균 1.7cm, 1.3cm의 차이를 보였다. 양 군간에 관절 운동 범위, Lachman 검사, 축 이동 검사 및 KT 2000 관절 계측 결과는 통계적으로 유의한 차이가 없었으나, 술 후 합병증은 과도한 보행이나 운동 후 슬관절 동통이 골-슬개건-골군에서 7예, 슬괵건 군에서 4예 관찰되었고, 전방 슬관절 동통이 골-슬개건-골군에서 4예 관찰되어, 골-슬개건-골군에서 더 많이 발생하였다. 결론: 5년 중기 추시에서 자가 슬괵건군이 우수한 슬관절 기능, 적은 합병증 등 임상적으로 우수하였으나 장기 추시가 요할 것으로 사료된다.

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Post Traumatic Osteolysis of the Pubic Bone Simulating Malignancy or Osteomyelitis - A Case Report - (악성 골종양이나 골수염으로 오인된 치골부위의 외상 후 골 용해 - 증례 보고 -)

  • Song, Kyeong-Seop;Kim, Hyung-Gyu;Park, Byeong-Mun;Kim, Jong-Min;Jung, Sung-Hoon;Yang, Bong-Seok
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.180-184
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    • 2007
  • The etiology of post-traumatic, and presumably post-fracture, osteolysis of the pubic bone is unknown, although the pathological process is similar to bony destruction related to bone tumor or osteomyelitis. We have seen and wish to report one patient in whom destruction of the pubic bone was a prominent feature of the healing process following trauma.

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