• Title/Summary/Keyword: 골 흡수

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Midterm Results of Bipolar Hemiarthroplasty for Unstable Intertrochanteric Femoral Fractures Using a Type 3C Cementless Stem (불안정성 대퇴골 전자간 골절에 3C형 무시멘트 대퇴 스템을 이용한 고관절 반치환술의 중기 결과)

  • Chung, Woochull;Cho, Hong Man;Kim, Sun do;Park, Jiyeon;Kwon, Kihyun;Lee, Young
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.503-510
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    • 2020
  • Purpose: Bipolar hemiarthroplasty is used as an alternative to open reduction and internal fixation for unstable intertrochanteric fractures in elderly patients. Recent advances in medical systems and technologies have resulted in increased survival rates after intertrochanteric fractures of the femur, requiring selection of the appropriate femoral stems considering the mid- to long-term duration of survival. Hemiarthroplasty was performed for unstable intertrochanteric fractures using a double tapered quadrilateral femoral stem (C2 stem), and the clinical and radiological results were evaluated as a five-year follow-up post-surgery. Materials and Methods: From January 2004 to December 2013, 43 patients (43 hips) who underwent hemiarthroplasty with a C2 stem were enrolled in this study. Their mean age was 78.6 years (range, 70-84 years), and the mean follow-up period was 85.4 months (range, 60-96 months). During the follow-up period, clinical parameters, such as the changes in pain, walking ability, and functional status, were examined. Radiologically, changes in the proximal femur, such as osteoporosis and bone resorption of cortical bone, were noted. Complications that occurred during the follow-up period, such as dislocation and prosthetic features, were also reviewed. Results: Initially, the pain was relieved postoperatively, but it increased four years after surgery. The walking ability was reduced by two steps in nine patients after 60 months, and the Harris hip score was reduced significantly postoperatively after two to three years. Radiologically, cortical osteoporosis occurred in 14 patients. Five patients developed cortical bone resorption. Four of them showed nonunion of the trochanteric fracture fragments, and three of them suffered reverse oblique fractures. Conclusion: Careful selection considering the general health condition and remaining lifespan of the patient would be necessary for primary hip hemiarthroplasty using a 3C type cementless femoral stem for unstable intertrochanteric fractures in elderly patients with osteoporosis.

Implant supported prosthetic rehabilitation of severely atrophic mandible with fixed detachable prosthesis (심하게 흡수된 하악골에서 fixed detachable prosthesis를 이용한 임플란트 지지 보철 수복증례)

  • Lee, Hak-Joo;Lim, Young-Jun;Kwon, Ho-Beom;Kim, Myung-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.2
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    • pp.180-186
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    • 2017
  • Implant supported prostheses have improved the quality of lives of totally edentulous patients. However, there are some limitations on the number of implants related to the residual bone level or the economic concern and so on. In this situation, applying fixed detachable prosthesis with bilateral cantilevers can be considered. This clinical report describes implant supported prosthetic rehabilitation of a patient with severe bone resorption. The patient was satisfied and felt comfortable with upper complete denture and lower fixed detachable prosthesis.

A Study about the Change of Locations of the Center of Resistance According to the Decrease of Alveolar Bone Heights and Root Lengths during Anterior Teeth Retraction using the Laser Reflection Technique (Laser 반사측정법을 이용한 전치부 후방 견인시 치조골 높이와 치근길이 감소에 따른 저항중심의 위치변화에 관한 연구)

  • Min, Young-Gyu;Hwang, Chung-Ju
    • The korean journal of orthodontics
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    • v.29 no.2 s.73
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    • pp.165-181
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    • 1999
  • Treatment mechanics should be individualized to be suitable for each patient's personal teeth and anatomic environment to get a best treatment result with the least harmful effects to teeth and surrounding tissues. Especially, the change of biomechanical reaction associated with that of the centers of resistance of teeth should be considered when crown-to-root ratio changed due to problematic root resorption and/or periodontal disease during adult orthodontic treatment. At the present study, in order to investigate patterns of initial displacements of anterior teeth under certain orthodontic force when crown-to-root ratio changed in not only normal periodontal condition but also abnormal periodontal and/or teeth condition, the changes of the centers of resistance for maxillary and mandibular 6 anterior teeth as a segment were studied using the laser reflection technique, the lever & pulley force applicator and the photodetector with these quantified variables reducing alveolar bone 2mm by 2mm for each of maxillary 6 anterior teeth until the total amount of 8mm and root 2mm by 2mm for each of mandibular 6 anterior ones until the total amount of 6mm. The results were as follows: 1. Under unreduced condition, the center of resistance during initial displacement of maxillary 6 anterior teeth was located at the point of about $42.4\%$ apically from cemento-enamel junction(CEJ) of the averaged tooth of them and kept shifting to about $76.7\%$ with alveolar bone reduction. 2. The distance from the averaged alveolar crest level of maxillary 6 anterior teeth to the center of resistance for the averaged tooth of them kept decreasing with alveolar bone reduction, but the ratio to length of the averaged root embedded in the alveolar bone was stable at around $33\%$ regardless of that. 3. Under unreduced condition, the center of resistance during initial displacement of mandibular 6 anterior teeth was located at the Point of about $43\%$ apically from CEJ of the averaged tooth of them and this ratio kept increasing to about $54\%$ with root reduction. But the distance from CEJ to the center of resistance decreased from around 5.3mm to around 3.3mm, that is to say, the center of resistance kept shifting toward CEJ with the shortening of root length. 4. A unit reduction of alveolar bone had greater effects on the change of the centers of resistance than that of root did during initial Phase of each reduction. But both of them had similar effects at the middle region of whole length of the averaged root.

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The effect of progressive tensional force on mRNA expression of osteoprotegerin and receptor activator of nuclear factor ${\kappa}B$ ligand in the human periodontal ligament cell (기계적 자극이 치주인대 세포의 osteoprotegerin과 receptor activator of nuclear factor ${\kappa}B$ ligand mRNA 발현에 미치는 영향)

  • Lee, Kie-Joo;Lee, Syng-Ill;Hwang, Chung-Ju;Ohk, Seung-Ho;Tian, Yu-Shin
    • The korean journal of orthodontics
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    • v.35 no.4 s.111
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    • pp.262-274
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    • 2005
  • Tooth movement is a result of mutual physiologic responses between the periodontal ligament and alveolar bone stimulated by mechanical strain. The PDL cell and osteoblast are known to have an influence on bone formation by controlling collagen synthesis and alkaline phosphatase activation. Moreover. recent studies have shown that the PDL cell and osteoblast release osteoprotegerin (OPG) and the receptor activator of nuclear factor ぉ ligand (RANKL) to control the level of osteoclast differentiation and activation which in turn influences bone resorption. In this study. progressively increased, continuous tensional force was applied to PDL cells. The objective was to find out which kind of biochemical reactions occur after tensional force application and to illuminate the alveolar bone resorption and apposition mechanism. Continuous and progressively increased tensile force was applied to PDL cells cultured on a petriperm dish with a flexible membrane The amount of $PGE_2$ and ALP synthesis were measured after 1, 3, 0 and 12 hours of force application. Secondly RT-PCR analysis was carried out for OPG and RANKL which control osteoclast differentiation and MMP-1 -8, -9, -13 aud TIMP-1 which regulate the resolution of collagen and resorption of the osteoid layer According to the results. we concluded that progressively increased, concluded force application to human PDL cells reduces $PGE_2$ synthesis, and increases OPG mRNA expression.