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MAXILLARY ADVANCEMENT USING RIGID EXTERNAL DISTRACTION(RED) IN CLEFT LIP AND PALATE PATIENT : CASE REPORT (견고 구외 골신장술을 이용한 구순구개열 환아의 치험례)

  • Yu, Nan-Young;Kim, Sung-Min;Lee, Ju-Hyun;Seo, Hyun-Woo;Park, Ho-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.709-716
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    • 2005
  • Patients with cleft tip and palate present severe maxillary hypoplasia due to scar of lip and palate, often accompanied by compromised mastication, speech abnormalities. Sometimes maxillary hypoplasia persist even though active orthodontic treatment was done. In theses cases, patients born with cleft lip and palate will be potential candidates for maxillary advancement with bone grafting after growth to correct the functional deformities and improve aesthetic facial proportions. But, maxillary advancement using standard surgical approaches has several limitations : increased relapse tendency after maxillary advancement, necessity of additional bone graft and mandibular setback surgery. Distraction osteogenesis is current treatment modality to overcome these limitations, thus has become popular for treatment of maxillary hypoplasia associated cleft lip and palate, craniosyntosis. Especially, rigid external distraction, contrary to internal device, has advantages : better vector control of osteotomized segment, effective traction of the bony segments, the ease of the application and removal the distraction device. This study showed that relatively successful result could be generated by using rigid external distraction osteogenesis(RED) in the case of cleft lip and palate with severe maxillary hypoplasia, 6 years 7 months old.

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Clinical Study on the Dental Abnomalities of Number and Morphology in Cleft Alveolus Patients (치조열 환자에서 치아의 선천결손과 형태이상에 관한 연구)

  • Seo, Min-Gyo;Leem, Dae-Ho;Ko, Seung-O;Shin, Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.13 no.1
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    • pp.1-10
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    • 2010
  • 구순구개열은 선천성 악안면 기형중에서 발생률이 가장 높은 질환이며 특히 동양인에게 높은 빈도로 발생된다. 그리고 순구개열에서는 파열부 조직의 선천적 상실과 파열부 봉합 수술 후 형성된 반흔에 의한 상악골의 열성장과 상악궁의 협착, 코의 형태 이상, 등과 함께 치아의 수, 크기와 형태 및 맹출 이상도 높은 빈도로 동반된다. 선천성 치아 발육 이상이 구순열 또는 구개열 가진 환자에게서 종종 보고되고 있다. 이런 치아 이상은 과잉치, 결손치, 크기, 형태, 맹출시기, 법랑질 광화 등의 많은 특징을 포함한다. 이번 연구의 목적은 다음과 같다. 1. 구순열 또는 구개열을 가진 환자의 선천성 치아 결손 발병률을 결정하여 정상인과 비교하는 것이다. 2. 상하악에서 파열이 있는 부위와 없는 부위의 제2소구치 결손가능성을 비교 하는 것이다. 구강악안면외과에서 구순구개열로 진단한 환자 중 2005년 1월~2009년 8월까지 전북대학교 구강악안면외과에서 치조열부위 자가골이식수술을 받은 32명의 환자로 초진시의 교정 chart, 구강악안면외과 chart, x-ray(파노라마, 치근단사진, 교합사진(상악), 석고 모델, 구강내 외 임상사진을 사용하여 순구개열군 별로 매복치, 과잉치, 결손치, 왜소치의 유무와 위치를 조사하여 다음과 같은 결론을 얻었다. 1. 결손치는 비교적 높은 발생빈도(53.1%)를 보였으며, 치아별 발생빈도는 상악 측절치와 상악 제2소구치, 하악 제2소구치 순이었다. 구순구개열군이 구순치조열군에 비해 발생률이 높게 나타났다. 그리고 구순구개열군 내에서 양측성이 편측성에 비해 결손치의 발생률이 높게 나타났다. 2. 왜소치는 71.6%에서 발견되었으며, 치아별 발생빈도는 상악측절치에서 가장 많았다. 구순치조열군이 구순구개열군에 비해 발생률이 높게 나타났다. 3. 치조열을 가진 환자에 있어 상/하악간 제2소구치의 선천적 결손에 유의한 차이가 있었다. 4. 구순구개열이 인접한 상악측절치의 발생중인 미성숙 조직에 영향을 미치며 파열부위와 좀 더 떨어져 있는 상악 제2소구치에도 일정한 영향을 미침을 이번 연구를 통해 다시 확인할 수 있었다.

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Long-term Follow-up Study of Sternocostoclavicular Hyperostosis (흉골늑골 쇄골간 과골증의 장기추시결과)

  • Kim, Jeung-Il;Suh, Keun-Tak
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.103-111
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    • 2006
  • Purpose: Sternocostoclavicular hyperostosis (SCCH) is a disease of unknown etiology, which is characterized by periosteal reaction and endosteal hyperossification of the sternum, clavicles and upper ribs as well as ossification of the surrounding soft tissue. SCCH is a well recognized but uncommon condition which is important differential diagnosis to consider to avoid misdiagnosis and to differentiate the condition from malignant process. But few studies have reported long-term clinical result of SCCH. We report long-term clinical result of SCCH. Materials and Methods: From 1986 to 2000, 17 cases of SCCH were followed up over two to 14 years. We evaluated the radiologic, pathologic and clinical results. Results: Four men and thirteen women were studied. The age when first symptom appeared were raged from17 to 60(average-48.7) There are no specific bacteriological, serological or histological finding. Usually a permanent increase in the erythrocyte sedimentation rate is found. The radiological examination showed the signs of proliferate destructive arthritis in most case. The majority of patients respond to NSAIDs and antibiotics. Conclusion: Sternocostoclavicular hyperostosis is uncommon benign condition, but important condition in the differential diagnosis of inflammatory or malignant process of this joint.

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Arthroscopic Ankle Arthrodesis (관절경하 족근관절 고정술)

  • Bae Dae Kyung;Yoon Kyoung Ho;Ko Byoung Won;Cho Nam Su
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.148-153
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    • 2000
  • Purpose : This study was conducted to analyze the results of arthroscopic ankle arthrodesis and to verify the advantages of the technique compared to open ankle arthrodesis. Materials and Methods : Between October 1992 and August 1996, the arthroscopic ankle arthrodesis had been performed in five patients(six ankle joints): two patients with seropositive rheumatoid arthritis(one patient surgically treated bilaterally), two with osteoarthritis and one with tuberculous arthritis. There were one man and 4 women. Average age was 48 years ranging from 38 to 65 years. Follow up period was average 45 months(range, $12\~80$). Results : All patients were successfully treated with ankle joint arthrodesis under arthroscopic control. The mean time to fusion was 10 weeks(range, $6\~15$). There was a $100\%$ fusion rate without any complication. Conclusion : The arthroscopic ankle arthrodesis was successful in all cases with less morbidity and short hospital stay. It was technically feasible with excellent predictability.

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A Clinical Study of Femur Neck Fractures (대퇴 경부 골절의 임상적 고찰)

  • Koo, Hwan-Mo;Ahn, Myun-Whan;Ihin, Joo-Choul
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.69-80
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    • 1990
  • A clinical analysis was done on 23 patients(24 hips) with fracture of the femoral neck, who had been admitted and treated at our Orthopedic department during the period of 4 years, from Jan, 1984 to May 1988. The results were as follows : 1. 23 patients were comprised of 4 males and 19 females, and 11 patients were over 65 years old. 2. 18 cases of 24 cases were due to minor traumas such as slipping down, and for over 65 years old, all cases were due to simple minor traumas, 8 cases were showed a severe osteoporosis, below grade 3 of the Singh's index. 3. 14 cases of 24 cases were displaced subcapital fractures, and 6 cases displaced transcervical fractures. Only 4 cases were the undisplaced transcervical fractures. 4. In treatment of fractures internal fixations after manipulation were performed in 14 cases and primary arthroplasties in 10 cases. Secondary arthroplasties were done in complicated 4 cases of 14 cases treated with internal fixations. 5. Complications after internal fixation were developed in 7 cases out of 14 cases, avascular necrosis in 6, nonunions in 2, pin migrations in 3, and metal failure in 1 case. 6. In 14 arthroplasty immediate surgical fitness of femoral stem were related to late loosening of femoral stem(correlation coefficient r=-0.68, p<0.01).

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Neutrophil-Lymphocyte Ratio as Inflammatory Marker for Delirium: An Exploratory Study (섬망 관련 염증표지자로서 호중구-림프구비의 임상적 활용 가능성에 대한 탐색적 연구)

  • Park, Jaesub;Yang, Soyoung;Park, Sunyoung;Song, Jung-Eun
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.169-175
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    • 2021
  • Objectives : Delirium is a temporary brain dysfunction and systemic inflammation is important factor in its pathophysiology. Whether the neutrophil-lymphocyte ratio (NLR), one of the inflammatory markers, can be used as an inflammatory marker in delirium patients was investigated in comparison with C-reactive protein (CRP). Methods : We retrospectively reviewed the medical records of patients who were referred for consultation for delirium at hospital for one year. The NLR and CRP values at admission and delirium status were divided into the medical and the surgical treatment group, and the interaction between them was analyzed through repeated measures ANOVA. Results : NLR was maintained without significant difference before and after delirium in the medical treatment group and the surgical treatment group, but CRP decreased in the medical treatment group and increased in the surgical treatment group during delirium, showing a significant interaction. Conclusions : In delirium patients, the NLR remained constant, but the CRP differed according to the treatment group and the delirium state. This suggests the possibility that NLR could be used complementary to CRP as an inflammatory marker in delirium patients.

Anatomical Direct Reduction of Bony Mallet Finger Using Modified-Intrafocal Pinning Technique (변형-내초점 핀 고정술을 이용한 골성 망치 수지의 해부학적 직접 정복)

  • Kang, Sang-Woo;Park, Ji-Kang;Jung, Ho-Seung;Cha, Jung-Kwon;Kim, Kook-Jong
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.248-253
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    • 2018
  • Purpose: The purpose of this study was to evaluate the clinical results of anatomic reduction of bony mallet finger using modified-intrafocal pinning technique. Methods: From March 2014 to October 2017, 18 patients with bony mallet finger were treated with modified-intrafocal pinning technique. Kirschner-wire was used to directly reduction the bony fragment, and extension block pinning and distal interphalangeal joint fixation were additionally performed to minimize the loss of reduction. Postoperative pain, range of motion, and radiological evaluation were performed. Duration of bone healing, functional recovery and complication rate were evaluated and Crawford's criteria was used to determine functional outcome after surgery. Results: Bone union was achieved in all cases after a postoperative mean of 6 weeks (5-7 weeks). An average of $2.8^{\circ}$ ($0^{\circ}-10^{\circ}$) extension loss occurred in all patients. All patients showed satisfactory joint congruency and reformation of the joint surface, the mean flexion angle of the distal interphalangeal joint at the final follow-up was $72.2^{\circ}$ ($70^{\circ}-75^{\circ}$). According to Crawford's classification, 12 patients (66.7%) were excellent and 6 patients (33.3%) were good. Conclusion: Modified-intrafocal pinning technique is a method of obtaining anatomical bone healing by directly reduction and fixation of the bony fragment. Combined with other conventional percutaneous pinning procedures, it is expected that good results can be obtained if applied to appropriate indications.

Rational treatment planning for implant treatment of the edentulous patients (완전무치악환자의 전악 임플란트 치료 계획 수립을 위한 체계적인 접근법)

  • Jeong-In Bae
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.2
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    • pp.54-68
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    • 2023
  • Treatment planning of edentulous patient with digital method is materialized by designing the surgical guide. When designing the surgical guide, we first implement the shape of the final prosthesis in the virtual space and then materialize the implantation plan based on this. However, it is challenging to make surgical guides for edentulous patients as their lack of both the reference for the arrangement of teeth and interocclusal relationship makes it hard to envision the shape of the final prosthesis. If there exists good partial or complete dentures or residual teeth, its teeth arrangement can be used as a reference for the virtual final prosthesis and the subsequent surgical guide. If such a reference is absent or unsatisfactory, a process of manufacturing a complete denture for diagnostic purposes and verifying it on patient's mouth is necessary and use it as a new reference for the virtual final prosthesis. But even if a surgical guide is produced through the reference from the thorough reflection of the virtual final prosthesis, when we use it in the surgical field, the intraoral condition of the patient may make the implants deviated from planned in the surgical guide. In the worst case, if the positioning of the surgical guide on the mouth is incorrect, it can lead to a catastrophic error that displaces all the implant, in which case the guided surgery would be much worse than the non-guided one. In this article, we will discuss how to obtain references of tooth arrangements in a timely manner and align or register them into a unified coordinate system in digital space, and also introduce how to transfer such an implantation plan from the virtual world into the patient's mouth of real world with minimum error. And lastly, I would like to express my opinion on the establishment of a rational and systematic protocol of guided surgery of the edentulous patients.

Flowering Periods, Genetic Characteristics, and Cross-Pollination Rate of Zoysia spp. in Natural Open-Pollination (자연 방임수분 상태에서 한국잔디류의 개화기간, 유전특성 및 타가수분율)

  • Choi, Dong-Keun;Yang, Geun-Mo;Choi, Joon-Soo
    • Asian Journal of Turfgrass Science
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    • v.22 no.1
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    • pp.13-24
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    • 2008
  • This study was carried out to provide basic information for the breeding of zoysiagrass synthetic varieties. For estimation of flowering periods, genetic characteristics, and cross-pollination rate, 5 combinations of zoysiagrass breeding lines were compared. Days to stigma emergence and anther exertion were observed in the field to calculate overlapping dates for cross-fertilization. Harvested seed from cross breeding combinations were planted to compare genetic characteristics using morphological traits of progenies. These data were used for determination of 7 phenotypic inheritance types with 8 morphological traits. Cross-pollination rates in 3 combinations of zoysiagrasses were estimated by using lower part color of grass shoots. Cross-pollination rates of zoysiagrass ranged from 11.3$\sim$48.9%, which indicated that zoysiagrass is an allogamous plant. When zoysiagrass breeding lines are properly combined, they may result in valuable synthetic cultivars.

A Clinical Study on Bone Grafting of Alveolar Clefts (치조열 환자의 골이식에 대한 임상적 연구)

  • Ryu, Sun-Youl;So, Kwang-Sub
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.256-262
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    • 1998
  • The aim of this study was to evaluate treatment plan and treatment procedure such as bone graft material, timing of bone graft and orthodontic treatment in 31 alveolar cleft bone graft patients treated at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital from Jan. 1992 to Dec. 1996. Results obtained were as follows : In total 31 patients of alveolar bone grafts, males(64.5%) were more than females(35.5%). The patients' age ranged between 2 - 33 years of age. Secondary bone grafting was the highest incidence(58.1%) when procedures were undertaken in patients between 6 - 16 years of age. In distribution of cleft side, unilateral clefts(93.5%) were the major part with the left side was larger than the right side. The Missing teeth were found most in lateral incisor, the supernumary teeth were found most between lateral incisor and canine. The most common occlusion before operation was class III malocclusion and anterior cross-bite(65.1%), orthodontic treatment was performed similarly between before and after the bone graft. The most common combined operation with alveolar bone graft was secondary cheiloplasty. The complications were 6 cases of bone defect, a case of oronasal fistula, 3 cases of dehiscence. PMCB and DFDB were used bone graft materials. In marginal bone height after operation, PMCB grafts were higher than DFDB grafts and marginal bone level was increased in the PMCB group but not in the DFDB group.

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