• Title/Summary/Keyword: 관절내

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The effect of steroid for fibrous dysplasia of the humerus combined with multiple cystic lesion (낭종성 병변을 동반한 상완골의 섬유성 골이형성증에서 steroid의 효과 - 증례 보고 -)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bo-Hyun;Won, Jung-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.20-26
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    • 2002
  • Fibrous dysplasia is a benign pathologic condition in which the normal cancellous bone is replaced by the fibro-osseous tissue. It is found mostly in the femur, tibia, skull, rib, and humerus. Clinically it may develops pain, progressive deformity, and pathologic fracture. Curettage with bone graft has been the most popular treatment method thesedays. A 17-year-old female who had fibrous dysplasia of the humerus combined with multiple cystic lesion was treated by intralesional steroid injection into the lesion total 2 times. The follow-up plain X-ray which was taken 11 months after steroid injection reveals decrease in size and increase in bone density and cortex thickness. The follow-up MRI reveals significant decrease in size and signal intensity. The signal intensity was decreased to that of normal bone marrow in T2 weighted image. She complains no pain and lives symptom free in last follow-up at 2 years and 8 months after steroid injection.

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Malignant Transformation of Giant Cell Tumor Not Associated with Radiotherapy (방사선 조사 없이 속발한 거대 세포종의 악성 전환)

  • Lee, Sang-Hoon;Oh, Joo-Han;Yoo, Kwang-Hyun;Suh, Sung-Wook;Ahn, Jun-Hwan;Kim, Han-Soo;Lim, Soo-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.12-19
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    • 2002
  • Purpose : Giant cell tumors(GCT) sometimes undergo malignant transformation after the radiotherapy, but very rarely do without radiotherapy. We reviewed the clinical experiences of the malignant transformation of GCT to suggest the guidelines for diagnosis and treatment of them. Materials and Methods : We examined four patients of pathologically proven malignant transformation of GCT, which occurred after the operative treatment alone without radiation, from September 1985 to January 2001. The mean follow-up period after the malignant transformation was 2.4 years(range, 1.3~4 years). Results : The mean time-interval from the initial diagnosis to the malignant transformation was 6.9 years(range, 2.2~13.5 years). The locations of tumors were soft tissues of proximal upper arm, proximal femur, distal femur and proximal tibia. The histology of malignant GCT was osteosarcoma in 3 cases and malignant fibrous histiocytoma in 1 case. Local recurrence developed in 1 patient and the pulmonary metastasis developed in 3 patients which transformed to osteosarcoma. Conclusion : Thorough sampling of the surgical specimen appears to be a very important factor for diagnosing the malignant transformation of GCT. In case of suspicion of malignancy in radiographs, the incisional biopsy should be followed by definite treatment rather than the improper resection.

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Metastatic Pathologic Fractures in Lower Extremities Treated with the Locking Plate (잠김 금속판을 이용한 하지의 전이성 병적 골절에 대한 치료)

  • Seo, Chang-Young;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.80-86
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    • 2010
  • Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

Dedifferentiated Parosteal Osteosarcoma - A Case Report - (역분화성 방골성 골육종 - 증례 보고 -)

  • Sung, Ki-Sun;Chang, Moon-Jong;Lim, Kyung-Sub
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.195-200
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    • 2007
  • Dedifferentiated parosteal osteosarcoma is an uncommon variant of osteosarcoma. Dedifferentiation is known to be associated with a greater metastatic potential and a more rapid lethal clinical course. Thus recognition of dedifferentiation is important to establish the treatment strategy. But there may be few significant clinical clues to distinguish between dedifferentiated parosteal osteosarcoma and conventional one. A 29-year-old woman presented with 2-year history of discomfort and swelling in her proximal thigh. Examination showed a large, hard, non-mobile mass. Radiographs revealed a large ossified mass attached to the proximal femur. Diagnosis of parosteal osteosarcoma was established by MRI and needle biopsy. But she had a history of abrupt severe thigh pain and increased swelling before surgery. Follow up MRI showed enlargement of mass with invasion to muscle around tumor. The patient underwent an en-bloc resection of tumor and reconstruction. Histological examination showed parosteal sarcoma with dedifferentiation. The patient expired due to local recurrence of tumor and distant lung metastasis 2 months after the surgery. In case with rapid growth of a lesion or unusual severe pain, one must have a high index of suspicion with regard to dedifferentiation.

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The Development of Classification System of Dental Services for Temporomandibular Joint Disorders (측두하악장애 의료행위분류에 관한 연구)

  • Song, Yun-Heon;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.257-268
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    • 2005
  • It is recently suggested in Korea that Resource-Based Relative Value Scale (RBRVS) is an alternative plan of Korean Dental Fee Schedule which has been operated on a fee-for-service basis since the introduction of the national health insurance program in 1977. RBRVS applicable to diagnosis and treatment for temporomandibular disorders (TMD), a common cause of orofacial pain, is needed to be estimated in Korea and the establishment of the standard terminology of dental procedures for TMD should be preceded. The purposes of this study were to develop a new classification system of health care service items for TMD and to investigate time needed for each item, which enables RBRVS to be estimated prior to establishment the payment system of health care services for TMD. The dental service items for TMD in this study were categorized through Delphi process which 10 TMD specialists were participated in and the time needed for each service item was investigated by work sampling and time study method with a stopwatch. The results of this study demonstrated the new classification system of dental services for TMD comprising 151 service items and exhibited the average time for each items ranging from 7.22 min for cold laser therapy to 171.71 min for direct fabrication of anterior repositioning splint. Conclusively, it is suggested that the classification system for TMD developed in this study, considering specific characteristics on basis of resources for health care service of dental procedures, should be helpful to estimate payment level for each service item.

Relationship between the facial bone thickness and gingival biotype of the anterior maxilla in Koreans (한국인의 상악 전치부 순측골 두께와 치은 생체형(gingival biotype)의 상관관계)

  • Park, Ji-Hun;Kim, Yeun-Kang;Kim, Hyoung-Min;Joo, Ji-Young;Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.3
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    • pp.169-177
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    • 2015
  • Purpose: The objects of this study were to examine the thickness of labial plate of anterior maxillary teeth and the gingival biotype in Koreans and to evaluate whether there is a correlation between the gingival biotype and the thickness of labial plate. Materials and Methods: This study was performed on 335 teeth of 57 subjects at the Pusan National University Dental Hospital. Cone Beam Computed Tomography (CBCT) was used to measure the thickness of labial plate at 4 mm, 6 mm, 8 mm from the cementoenamel junction and the gingival biotype was determined by the visibility of periodontal probe. Results: Thin facial bone less than 1 mm was observed in 87% at 4 mm, 88% at 6 mm and 90% at 8 mm. In 21% of total objects, thin gingival biotype was observed. There is no correlation between the thickness of labial plate and gingival biotype. Conclusion: Additional thorough radiographic examination such as CBCT was mandatory for aesthetic dental implant in the anterior dentition besides clinical oral examination.

Recurrent Herpetic Stomatitis Mimicking Post-Root Resection Complication (치근 절제술의 합병증으로 오인 가능한 재발성 구내 헤르페스)

  • Hong, Sung-Ok;Lee, Jae-Kwan;Chang, Hoon-Sang
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.418-425
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    • 2013
  • This case report describes about recurrent herpetic stomatitis mimicking post-root resection complication. A 49 year-old male patient was diagnosed vertical root fracture of the mesiobuccal root of his left maxillary first molar (#26). The mesiobuccal root was resected following root canal treatment of the same tooth. 19 months later, the patient presented with pain on left hard palate after a barbecue party. Intra oral examination revealed a gum boil-like blister at the hard palate corresponding to the apex of the palatal root of #26. On clinical examination, there was bleeding on probing and the periodontal pocket depth was measured less than 5 mm with no tooth mobility. On a periapical radiograph, periodontal ligament space widening was observed. Tracing the sinus tract with gutta percha cone was attempted, however, it was impossible. Extending the field of vision, small multiple round ulcerations were observed at the palate front which caused pain to the patient. Therefore, the pain was considered a non odontogenic and the patient was referred to the department of oral medicine. The patient was diagnosed recurrent herpetic stomatitis and after 3 days of antiviral medication, the pain and ulceration were subsided.

The Esthetic Impact of Extraction and Nonextraction Treatments on Korean People (발치, 비발치를 동반한 교정치료 전후의 안모의 변화에 관한 인지도)

  • Lee, Se-Hyeong;Chung, Dong-Hwa;Cha, Kyung-Suk;Lee, Jin-Woo;Lee, Sang-Min
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.2
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    • pp.119-126
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    • 2013
  • The concept of extraction in orthodontic treatment has been changed many times. Even today, criteria of extraction or nonextraction is still changing. In this study, changes depending on the evaluator's perception of treatment outcomes were compared in both extraction and nonextraction cases. In this study, premolar extracted 59 patients and nonextracted 60 patients, totally 119 patients who finished orthodontic treatment in Dankook University Dental Hospital orthodontic clinic were enrolled. Evaluation sections made up of specialists and laypersons assessed soft tissue traced from lateral cephalometric radiographs with visual analogue scale before and after the treatment. And the results were statistically analyzed. Thus, the conclusions drawn are as follows: 1. Average score is 5.76 in extraction, which is larger than 5.28 of nonextraction case. Improvement of facial profile was more favorably accepted in extraction case. 2. 5.875 in the group of specialists were higher evaluation than 5.165 in the group of layperson. 3. Specialists gave significantly higher ratings in the extraction than nonextraction. 4. A higher rating in extraction case of the layperson group has no significant difference with nonextraction case. 5. Nonextraction patients were given higher ratings from specialist group. 6. A higher rating of specialist group in extraction case has no significant difference with layperson group.

Marginal and Internal Fit of Copings Made by CAD/CAM using Different Scanning Methods (서로 다른 스캔 방식을 이용하여 CAD/CAM에 의해 제작된 코핑의 변연 및 내면의 적합성)

  • Cho, Young Beom;Chae, Heon Chung;Kim, Hee Jung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.366-376
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    • 2013
  • The purpose of this study is to evaluate the marginal and internal fit of coping made by CAD/CAM using different scanning methods. Zirconia coping was made by each CAD/CAM system followed by intra-oral scanning, model optical scanning and model contact scanning. It was embedded into Epoxy Resin and was cut by buccal to lingual. AMD (Absolute marginal discrepancy), MG (Marginal gap), GA (Gap of axial), GL (Gap of line angle) and GO (Gap of occlusal) of each sample were measured. The result is as followed; 1. The mean value of AMD in Group 1, Group 2, Group 3 are $141.21{\pm}42.94{\mu}m$, $140.63{\pm}31.64{\mu}m$, $109.37{\pm}28.42{\mu}m$. The averages of MG in Group 1, Group 2, Group 3 are $82.52{\pm}43.99{\mu}m$, $90.28{\pm}27.93{\mu}m$, $66.55{\pm}28.77{\mu}m$. Statistically there is no difference in AMD and MG among the three Groups (Anova, P>0.05). 2. GA of Group 2 revealed statistically difference compared with Group 1 and Group 3 (Anova, P<0.05). 3. GL and GO of Group 1 showed statistically significant differences compared with Group 2 and Group 3 (Mann-whitney test (P<0.05). Zirconia copings made by 3 ways of scanning methods have no difference with conventional ceramics in AMD and MG which are known as the most important factors.

Anatomical Characteristics of the Mandibular Median Lingual Foramen: the Assessment of the CBCT (CBCT를 이용한 하악 정중설공의 해부학적 평가)

  • Lee, Go-Woon;Kim, Ok-Su
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.337-346
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    • 2013
  • It is necessary to consider the median lingual foramen carefully to prevent the bleeding due to the damage of the sublingual artery for implant surgery. This study is to evaluate the frequency, location, diameter and the number of the Mandibular median lingual foramen regarding gender and age in the CBCT. Sixty two images of cone beam computed tomography (CBCT) whose visited the Chonnam National University Dental hospital from Sept. 2010 to Apr. 2011 were evaluated. Frequency, number, location and the diameter of Mandibular median lingual foramen shown in the CBCT image were evaluated. Sixty two patients (100%) had at least one median lingual foramen and fifty six patients (90.32%) had multiple foramens. Forty patients (66.13%) showed the median lingual foramen on the location between Mn. central incisors. The mean vertical position of the genial spine and the median lingual foramen was 24.21 mm and 14.52 mm, respectively. And the relative mean vertical dimension of median lingual foramen was 0.45. The mean diameter of the foramen was 0.93 mm. CBCT demonstrated the frequency, location, diameter and the number of median lingual foramen. It is necessary to take CBCT before implant placement to prevent the bleeding.