• Title/Summary/Keyword: 골 결손

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Experimental Study on the Effect of Transforming Growth $Factor-{\beta}$ to Periodontal Regeneration in Class III Furcation Defects (3급 치근분지부 골결손에서 transforming growth $factor-{\beta}$가 치주조직의 재생에 미치는 영향에 관한 시험적 연구)

  • Kim, Young-Joon
    • Journal of Periodontal and Implant Science
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    • v.31 no.2
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    • pp.421-436
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    • 2001
  • Transforming growth $factor-{\beta}(TGF-{\beta})$is a polypeptide biologic mediator considered to play a role in promoting bone formation in bony defect area. The purpose of this study was to examine the effect of $TGF-{\beta}$ to the periodontal regeneration of class III furcation defect in dogs. Classs III furcation defects were surgically created on the third and the fourth premolars bilaterally in the mandibles of eight mongrel dogs. Experimental periodontitis were induced by placing small cotton pellets into the created defects for 3 weeks. Experimental sites were divided into 4 groups according to the treatment modalities: Group I-Surgical debridement only; Group II-allogenic demineralized freeze dried bone grafting; Group III-allogenic demineralized freeze dried bone soaked in $TGF-{\beta}(4ng/10{\mu}l)$grafting; Group IV-allogenic demineralized freeze dried bone soaked in $TGF-{\beta}(20ng/10{\mu}l)$ grafting. The animals were sacrificed in the 8th week after periodontal surgery and the decalcified and undecalcified specimens were for histological and histometric examination. Although no significant differences was seen in the length of epitheial growth and connective attachment, group III showed the least apical migration among treatment groups. The amount of bone repair was significantly greater in group III, IV compared to group I and group II. New attachment formation was significantly greater in group III and group IV compared to group I and group II. These results suggest the allogenic demineralized freeze dried bone with $TGF-{\beta}$ in class III furcation defect has the potentiality of promoting alveolar bone formation and periodontal regeneration.

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Radiologic Outcome of Beta-Tricalcium Phosphate as a Bone Substitute in Orthopaedic Surgery (정형외과 수술에서 골대체제로써 Beta-Tricalcium Phosphate 사용에 대한 방사선학적 결과)

  • Park, Hyungseok;Moon, Jeong Eun;Cho, Yong Jin
    • The Korean Journal of Health Service Management
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    • v.13 no.4
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    • pp.133-144
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    • 2019
  • Objectives: To analyze the radiologic results of patients treated with bone defects treated with beta-tricalcium phostphate (β-TCP) in orthopedic surgery. Methods: Medical records of 49 patients, consisting of 24 (49.0%) men and 25 (51.0%) women were retrospectively reviewed. Graft incorporation was evaluated based on Irwin's radiologic staging. Results: The explanatory power of the total regression equation in Irwin's stage at 3 months postoperatively according to three explanatory variables, namely graft tightness, age at diagnosis, and lesion volume, was 65.6%; the explanatory power of Irwin's stage at 6 months postoperatively according to two variables, namely lesion volume and graft tightness, was 32.9%; and the explanatory power of Irwin's stage at 9 months postoperatively for two variables, namely longitudinal lesion length and graft tightness in the total regression, was 30.8%. Conclusions: Graft tightness, lesion volume, age at diagnosis, and longitudinal lesion length are the common factors affecting graft incorporation.

Prosthetic reconstruction of maxillary defect resulting from a traumatic fall in an elderly patient: A case report (낙상에 의해 상악 전치부에 외상을 입은 노인 환자에서 수술을 배제하고 고정성 보철물을 이용하여 수복한 증례)

  • Bae, Yoonjoo;Choi, Sunyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.1
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    • pp.75-80
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    • 2019
  • Fall is the most common cause of trauma in the elderly and a major reason of dental injury. Maxillary anterior region is the most vulnerable area to the traumatic fall. Loss of teeth and adjacent tissue in this area results in maxillofacial defects and inappropriate maxillomandibular relationship. Reconstruction of the loss requires comprehensive and careful planning to fulfill not only functional but also esthetic demand. Prosthetic approach can avoid surgically extensive intervention, reducing both treatment cost and time. This clinical report describes a 78-year-old woman with the loss of teeth and alveolar bone in maxillary anterior region due to a traumatic fall, rehabilitated with a metal-ceramic fixed dental prosthesis using gingival porcelain.

Ridge augmentation and implant placement on maxillary anterior area with deficient alveolar ridge : case report (상악전치부 결손부에서 골유도재생술식을 동반한 임플란트 수복의 증례보고)

  • Hong, Eun-jin;Goh, Mi-Seon;Jung, Yang-Hun;Yun, Jeong-Ho
    • The Journal of the Korean dental association
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    • v.57 no.3
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    • pp.149-160
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    • 2019
  • Atrophic alveolar ridge of maxillary anterior area is commonly observed after the extraction of teeth in patients with severely compromised periodontal disease, causing difficulties with implant placement. Successful esthetics and functional implant rehabilitation rely on sufficient bone volume, adequate bone contours, and ideal implant positioning and angulation. The present case report categorized the ridge augmentation techniques using guided bone regeneration (GBR) on the maxillary anterior site by Seibert classification. Case I patient presented for implant placement in the position of tooth #11. The alveolar ridge was considered a Seibert classification I ridge defect. Simultaneous implant placement and GBR were performed. Eight months after implantation, clinical and radiological examinations were performed. Case III patient presented with discomfort due to mobility of the upper maxillary anterior site. Due to severe destruction of alveolar bone, teeth #11 and #12 were extracted. After three months, the alveolar ridge was considered a Seibert classification III ridge defect. A GBR procedure was performed; implantation was performed 6 months later. Approximately 1-year after implantation, clinical and radiological examinations were performed. During the whole treatment period, healing was uneventful without membrane exposure, severe swelling, or infection in all cases. Radiographic and clinical examinations revealed that atrophic hard tissues and buccal bone contour were restored to the acceptable levels for implant placement and esthetic restoration. In conclusion, severely resorbed alveolar ridge of the maxillary anterior area can be reconstructed with ridge augmentation using the GBR procedure so that dental implants could be successfully placed.

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Cauda Equina Syndrome after Percutaneous Balloon Kyphoplasty for Pathologic Compression Fracture (병적 척추체 압박 골절 환자에서 경피적 풍선 척추 성형술 시행 후 발생한 마미 증후군)

  • Park, Sung Jun;Park, Myung Hoon;Park, Jae Woo;Cho, Kyu Jung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.90-94
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    • 2020
  • Percutaneous balloon kyphoplasty is an option for pain relief in pathological vertebral compression fractures. Complications related to cement leakage through cortical defects have been reported. On the other hand, dural compression due to retropulsion of the tumor mass is rarely reported. The authors report a case of a 65-year female patient who had cauda equina syndrome after a percutaneous balloon kyphoplasty in a pathological vertebral fracture, even though epidural compression were not found prior to surgery. Magnetic resonance imaging revealed retropulsion of the tumor mass into the spinal canal through the disrupted posterior vertebral cortex.

Revision after Instability Surgery (수술 후 재발한 견관절 불안정증의 치료)

  • Kim, Paul Shinil;Jo, Chris Hyunchul
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.374-382
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    • 2020
  • Recurrence is the most common complication after shoulder instability surgery, and the main causes of the postoperative recurrence of instability are trauma, misdiagnosis, and technical errors. The risk factors of recurrence may be classified as patient related, anatomical or technical. Causes of failure should be thoroughly evaluated by meticulous history taking, physical examination, and imaging studies, and followed by proper treatment of pathologic lesions. Nonoperative treatment should be considered initially in cases of recurred instability after shoulder instability surgery, but if this fails, repeated recurrence is prevented by performing appropriate anatomical reconstruction of ruptured Bankart lesions, capsular laxities, glenoid deficiencies and humeral head bone defects.

Prosthetic Treatment Strategies for Improving Denture Retention in Pediatric Patients with Hypohidrotic Ectodermal Dysplasia: a Report of Two Cases (저한성 외배엽 이형성증을 가진 소아 환자에서 의치 유지력 향상을 위한 보철 치료 전략: 두 가지 증례 보고)

  • Hongju Jeon;Seonmi Kim;Namki Choi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.4
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    • pp.483-494
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    • 2023
  • This report presents two cases concerning strategies for improving denture retention in pediatric patients with oligodontia caused by hypohidrotic ectodermal dysplasia (HED). Both patients presented with multiple missing teeth, conical canines, alveolar bone atrophy, and a skeletal Class III tendency. In the first case, a modified form of conical-crown-retained denture was used to cover the canines. This approach was carried out without tooth extraction or coping. In the second case of severe alveolar bone resorption and a distally tilted lower left canine, the tooth was restored with a hybrid ceramic crown. It was subsequently converted into a clasp-retained removable partial denture, utilizing a suction mechanism. Both patients are currently receiving regular check-ups for the maintenance of their prosthetic appliances and the evaluation of their growth patterns. This study presents innovative prosthetic treatment methods for pediatric patients with HED who have inadequate denture retention.

Arthroscopic Reduction and Internal Fixation of Intra-articular Fractures of Lateral Tibial Plateau (관절면을 침범한 경골 외과 골절의 관절경적 정복 및 내고정술)

  • Lee, Kwang-Won;Lee, Hang-Ho;Yang, Dong-Hyun;Choy, Won-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.53-60
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    • 2006
  • Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.

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The Optimal Surgical Approach and Complications in Resecting Osteochondroma around the Lesser Trochanter (소전자부 주위의 골연골종 절제 시 적절한 외과적 접근법과 합병증)

  • Jeon, Dae-Geun;Cho, Wan Hyeong;Song, Won Seok;Kong, Chang-Bae;Lee, Seung Yong;Kim, Do Yup
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.33-39
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    • 2017
  • Purpose: Surgical risks associated with the resection of osteochondroma around the proximal tibia and fibula, as well as the proximal humerus have been well established; however, the clinical presentation and optimal surgical approach for osteochondroma around the lesser trochanter have not been fully addressed. Materials and Methods: Thirteen patients with osteochondroma around the lesser trochanter underwent resection. We described the chief complaint, duration of symptom, location of the tumor, mass protrusion pattern on axial computed tomography image, tumor volume, surgical approach, iliopsoas tendon integrity after resection, and complication according to the each surgical approach. Results: Pain on walking or exercise was the chief complaint in 7 patients, and numbness and radiating pain in 6 patients. The average duration of symptom was 19 months (2-72 months). The surgical approach for 5 tumors that protruded postero-laterally was postero-lateral (n=3), anterior (n=1), and medial (n=1). All 4 patients with antero-medially protruding tumor underwent the anterior approach. Two patients with both antero-medially and postero-laterally protruding tumor received the medial and anterior approach, respectively. Two patients who underwent medial approach for postero-laterally protruded tumor showed extensive cortical defect after resection. One patient who received the anterior approach to resect a large postero-laterally protruded tumor developed complete sciatic nerve palsy, which was recovered 6 months after re-exploration. Conclusion: For large osteochondromas with posterior protrusion, we should not underestimate the probability of sciatic nerve compression. When regarding the optimal surgical approach, the medial one is best suitable for small tumors, while the anterior approach is good for antero-medial or femur neck tumor. For postero-laterally protruded large tumors, posterior approach may minimize the risk of sciatic nerve palsy.

Temporary Use of External Fixators for Soft Tissue Lengthening in the Treatment of Complications after Limb Salvage Surgery (사지 구제술 합병증 치료에서 연부조직 연장을 위한 한시적 외고정 기기의 유용성)

  • Yoon, Pil-Whan;Kang, Hyun-Guy;Kim, Kap-Jung;Oh, Joo-Han;Lee, Sang-Hoon;Lee, Sang-Ki;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.134-140
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    • 2005
  • Purpose: We evaluated the effectiveness of temporary using the extendible external fixator (EF) for lengthening of soft tissue that contracture caused by tumor prosthesis removal in the treatment of complications after limb salvage surgery like deep infection and loosening. Materials and Methods: Five patients six cases were included who underwent extendible EF (Dyna-extor(r)). EF was applied after insertion of half pin to the proximal and distal bone of defect area. EF lengthening started at third day of post-operation, above 2-3 mm per day in the range of no neurological sign. Results: The treatment area was three in femur and two in tibia. Mean age when the time of EF apply was 22.2 years old (range 15-29), but its primary limb salvage operation had done in 13.4 years old (range 9-19), therefore mean times of interval between initial tumor prosthesis reconstruction and temporary EF apply was 8.8 years (range 3-14). One patient had EF for 150 days with 7.2 cm lengthening. Others 5 cases of 4 patients had EF for mean 37 days (range 25-50) and mean soft tissue lengthening was 5.8 cm. Three patients underwent re-insertion of tumor prosthesis and two patients underwent knee fusion as final operation and showed no evidence of infection through mean 22 months follow up period. Conclusion: Temporary using of extendible EF is an effective method for correction of leg shortening which occurred by soft tissue contracture in the complications of limb salvage operation or their treatment process, and it could be provide easily application of tumor prosthesis and knee fusion as final operation.

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