Patients with Down's syndrome have several dental complications such as small teeth caused by underdevelopment of dentin and enamel, periodontitis, agenesis of teeth, prolonged retention of primary teeth and malocclusion due to narrow palate. Removable denture with maxillary double crowns would be a good treatment option to solve the problems of the patient with Down's syndrome. Double crowns compensate the insufficient support and retention of denture and easily solve the cross bite problem. Double crowns also allow easy repair of denture in case of abutment teeth extraction. In this case, 26-year-old female patient with Down's syndrome and dental phobia had small number of teeth with enamel hypoplasia, prolonged retention of primary teeth and dental cross bite. Prosthetic treatment was done using removable denture with double crowns in the maxilla. In the mandible, teeth preparation was done on enamel margin without anesthesia. Anterior laminate and posterior complete zirconia crown restorations were performed. As a result, the cross bite was effectively corrected by denture with double crowns. Pronunciation and appearance were also improved without extraction of teeth and dental anesthesia.
Journal of Dental Rehabilitation and Applied Science
/
v.36
no.4
/
pp.262-271
/
2020
To restore a tooth with a fracture line extending below the marginal bone level, a surgical crown lengthening procedure accompanied by ostectomy could be considered to expose the fracture line and reestablish the biologic width. However, this procedure could lead to esthetic failure, especially in the anterior teeth. Therefore, orthodontic extrusion, which elevates the fracture line from within the alveolar socket without sacrificing the supporting bone and gingiva, is recommended. This technique allows for the proper placement of the crown on a sound tooth structure, with the reestablishment of the biologic width. Alternatively, surgical extrusion is an one-step procedure that is simpler and less time-consuming than orthodontic extrusion; placing and adjusting the orthodontic appliance does not require multiple visits. This study presents successful restoration in 2 cases with a crown-tooth root fracture of the maxillary central incisor treated using a multidisciplinary approach through orthodontic extrusion or surgical extrusion followed by successful restoration.
Journal of Physiology & Pathology in Korean Medicine
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v.36
no.4
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pp.138-142
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2022
This study aimed to evaluate the effectiveness of Korean rehabilitation treatement for patients with post-TKR. The medical records of inpatients undergoing Korean rehabilitation treatment after TKR from 2016.01.01. to 2021.12.31. during the admission, were analyzed retrospectively. The effect of treatment was evaluated by using a numeric rating scale(NRS) and range of motion(ROM) of knee. Statistical analysis was done using the IBM SPSS statistics 26 program. If the period of hospitalization was within 7 days or change of NRS and ROM was not recorded properly, the case was excluded. All inpatients received acupuncture treatment, Electro-acupuncture. Soyeom pharmaco-acupuncture were used at a high rate. Blood letting cupping therapy, dry cupping therapy, Interferential Current Therapy(ICT) continuous passive motion(CPM), cryotherapy were used at a high rate. A significant improvement was noted when comparing the NRS and knee ROM results at the time of admission and discharge. Korean medical rehabilitation can be effectively used for patients who have undergone TKR, to relieve pain and enable returning to daily activities. It is expected to be helpful in future studies of post-TKR in Korean Medicine. Also It can be used for medical treatment of post-TKR in Korean Medicine Hospital and clinic. However, further research with a high level of evidence is necessary to support this finding.
The purpose of this study was to evaluate changes in mandibular movement patterns after orthognathic surgery in skeletal Class III patients. The sample consisted of 20 Class III malocclusion patients(9 males, 11 females). Just before and after(2-7months) surgery, maximum opening & closing movement, mandibular border movement on sagittal, frontal and horizontal planes were recorded using Sirognathograph & BioPak EGN. On each record, 21 items were measured and statistically analyzed. The results were as follows 1. Angle of protrusive movement on sagittal plane showed greatest change after surgery. Also, as the incisal guidance was established by surgery, straight path of protrusive movement became curved line. 2. Maximum opening distance and maximum antero-posterior distance on maximum opening & closing movement, maximum opening distance on sagittal plane, angle of left lateral excursion on frontal plane were statistically significant after snrgery(p<0.01). 3. Maximum width of lateral excursion on frontal plane, distane of right lateral excursion and angle of maximum left lateral excursion on horizontal plane were statistiraily significant after surgery(p<0.05). 4. Maximum opening distance and maximum antero-posterior distance on maximum opening & closing movement showed significant differences according to post-surgical time(p<0.05). More recovery of range of movement occured in 5-7month group than in 2-3month group. 5. As the occlusal interferences were removed by orthognathic surgery, irregular opening & closing path became smooth curve.
Purpose: The purpose of this study was to identify clinical complications in removable partial denture (RPD) with implant-supported surveyed prostheses, and to analyze the factors associated with the complications such as location of the implant, splinting adjacent prostheses, the type of retentive clasps, Kennedy classification, and opposing dentition. Materials and Methods: A retrospective clinical study was carried out for 11 patients (7 male, 4 female), mean age of 67.5, who received RPD with Implant-supported surveyed prostheses between 2000 and 2016. The mechanical complications of 11 RPDs and 37 supporting implant prostheses and the state of natural teeth and peripheral soft tissue were examined. Then the factors associated with the complications were analyzed. Results: The average of 3.4 implant-supported prostheses were used for each RPD. Complications found during the follow-up period of an average of 42.1 months were in order of dislodgement of temporary cement-retained prostheses, opposing tooth fracture/mobility, screw fracture/loosening, clasp loosening, veneer porcelain fracture, marginal bone resorption and mobility of implant, artificial tooth fracture. Complications occurred more frequently in anterior region compared to posterior region, non-splinted prostheses compared to splinted prostheses, surveyed prostheses applied by wrought wire clasp compared to other clasps, and natural dentition compared to other removable prostheses as opposing dentition. There were no significant differences in complications according to the Kennedy classification. Conclusion: All implant-assisted RPD functioned successfully throughout the follow-up. However, further clinical studies are necessary because the clinical evidences are still not enough to guarantee the satisfactory prognosis of implant-assisted RPD for long-term result.
The evaluation of malocclusion has to be done quantitatively and qualitatively. This will be lead toward an analysis of malocclusion severity as well as treatment difficulty. The method of proper evaluation of malocclusion severity and treatment difficulty is necessary to assess treatment effect and efficiency for the orthodontists and to establish fundamentals for planning and executing the health-related policies in private and public institutions. The purposes of this study as the first part of the objective and quantitative analysis of malocclusion were 1) to measure treatment difficulty based on the opinions of several orthodontists. and 2) to investigate the relationships between objective malocclusion severity and subjective treatment difficulty 100 pairs of dental casts that had various types and severity of malocclusion were selected from the orthodontic departments of Kyurghee University and Samsung Medical Center The objective malocclusion severity was measured with the PAR (Peer Assessment Rating) index and the subjective treatment difficulty was evaluated by 8 experienced orthodontists. The relationships between objective malocclusion severity and subjective treatment difficulty were statistically evaluated. There were significant relationships between objective malocclusion severity and subjective treatment difficulty especially in the measurements of the upper anterior alignment, the buccal occlusion. the overjet, the overbite and the midline discrepancy en the malocclusion components. The results of this study can provide the background knowledge to develop a new occlusal index. which contains both the malocclusion severity and treatment difficulty for Korean orthodontists.
Kim, Jae-Do;Park, Woong;Jo, Myung-Rae;Son, Jung-Whan;Lee, Young-Gu
The Journal of the Korean bone and joint tumor society
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v.10
no.2
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pp.61-70
/
2004
Purpose: We studied to decide the operative indication of the metastatic tumor in pelvis according to the oncologic results, the Eastern Cooperative Oncologic Group (ECOG) performance status and complication. Materials and methods: From May 1994 to May 2003, 9 patients who were performed on palliative treatment and 10 paitents on operative treatment due to metastatic tumor of pelvic bone were investigated. On palliative/operative group, the mean age of patients was 57.6/48.0 years old and the ratio of male to female was 5:4/7:3. Primary origins were 3 cases from kidney, 3 from cervix and 2 of lung, 2 of myeloma, 2 of Non-Hodgkin's Lymphoma, and 1 from breast, bladder, testis, prostate, stomach, liver and retroperitoneal leimyosarcoma respectively. The palliative treatment was performed in 5 cases with radiotherapy, 1 with chemotherapy, 2 with combined chemo-radiotherapy and 1 with percutaneous cementation. The operative methods were 1 case of bone cement insertion after curettage, 2 of Girdlestone with internal hemipelvectomy and 7 of reconstruction after wide excision. Reconstructions were done.: 1 case of bone cementation, 5 of autograft prosthesis composite with irradiation or pastuerization and 1 of saddle prosthesis. We have observed the oncologic results, the ECOG performance status and complication. Results: The oncologic results of palliative/operative groups are NED 0/1, AWD 2/6, DOC 1/2 and DOD 6/1. The ECOG performance status was changed from 1.5 into 4.3 in palliative group and from 2.6 into 2.2 in operative group. The complications were 3 cases of the prosthesis failure and 2 of infection. Conclusion: The indication of operation of metastatic pelvic tumor is decided in consideration of the patient's condition, the grade of malignancy in primary tumor and the life expectancy.
It is well known that troponin T(below TnT) is present in the myocardial cells and released during myocardial damage, so it`s very specific enzyme to myocardium. Availability of cardiac specific TnT in assessing perioperatively myocardial damage was evaluated from 34 open heart surgery patients. They consisted of 11 ischemic heart, 13 acquired valvular heart and 10 congenital heart cases. Patients were divided into two groups, group A(patients with myocardial damage) and group B(patients without myocardial damage), according to the symptom of chest pain suspecting angina and the ECG findings of ST segment and T wave changes which show myocardial ischemia and injury. Serum TnT levels were measured by enzyme immunoassay method preoperatively, immediately postoperatively, postoperative day 1, day 2, day 3, and day 7. We observed and analyzed the changes of serum TnT levels in two groups and compared the serum TnT levels with CK-MB levels measured at the same time. In group A, serum TnT levels showed 1.37$\pm$0.26$\mu$g/L, 3.16$\pm$0.66$\mu$g/L, 2.39$\pm$0.74$\mu$g/L, 2.49$\pm$0.76$\mu$g/L, and 1.23$\pm$0.60$\mu$g/L, immediate postoperatively, postoperatively day1, day2, day3, and day7, respectively. It was observed there were significant differences compared with those of group B(0.38$\pm$0.04$\mu$g/L, 0.34$\pm$0.05$\mu$g/L, 0.25$\pm$0.03$\mu$g/L, 0.24$\pm$0.04$\mu$g/L, and 0.11$\pm$0.03$\mu$g/L) during identical periods(P<0.01). Serum CK-MB level in group A significantly elevated to 145.04$\pm$35.08 IU/L on the postoperative day 1 compared to group B(31.28$\pm$5.87 IU/L, P<0.05), However, it stiffly decreased from day 2 and returned to preoperative level at day 3. When serum TnT level more than 1.0$\mu$g/L is thought to reflect myocardial damage, serum TnT had 100% of sensitivity and 87% of specificity in diagnosing the postoperative myocardial damage(p<0.01). I conclusion, serum TnT levels increased significantly at very early stage of myocardial damage and persisted much longer period than CK-MB. This suggests that serum TnT has more advantage and availability in assessing the perioperatively myocardial damage than any other tests.
The purposes of this study were to compare the soft tissue changes following hard tissue change after surgery between the one jaw and two-jaw surgery in skeletal class III patients and to get the reference of the incisal inclination at presurgical orthodontics. For this study 24 patients for the two-jaw surgery group and 18 patients for one jaw surgery group were selected. Lateral cephalograms were taken at pretreatment, after presurgical orthodontic treatment, immediately after surgical treatment and at least 6 months after surgery. They were traced and analyzed on skeletodental structure and soft tissue. The results were as follows: 1. After surgery, maxilla, maxillary incisors and upper lip were moved anteriorly and superiorly in two-jaw surgery group. Mandible and mandibular incisors were moved posteriorly and superiorly, and thickness of lower lip was increased in both group but there were no statistically significant difference. Anterior facial height was more decreased in two-jaw surgery group (p<0.05). At least 6 months after surgery, by the postorthodontic treatment, maxillary incisors were moved labially 1.44mm, mandible and mandiibular incisors were moved lingually 1.43mrn, 1.26mm respectively in one jaw surgery group. But there was no statistically significant changes of hard tissue in two :jaw surgery group. 2. The correlation coefficients of maxillary hard and soft tissue horizontal changes were high in two jaw surgery group and the ratios for soft tissue to A point were 19% at Sri, 80% at SLS, 82% at LS. The ratios for soft tissue to B point were 92% at LI, 104% at ILS in one jaw surgery group, 89% at LI, 101% at ILS in two-jaw surgery group. 3. The correlation coefficients and change ratios of mandibular incisors and LL HS on lower lip horizontal changes were 0 0.89 and 75%, 85% in one jaw surgery group, 0.93, 0.90 and 76%, 87% in two-jaw surgery group. The correlation coefficients of maxillary incisors and Sn, SLS and LS on upper lip horizontal changes were 072, 0.76 and 0.75 in two jaw surgery group and ratios of changes were 57%, 58% and 59%. 4. The regression equations between skeletal horizontal discrepancy and incisal inclinaton were taken in one jaw surgery group. Those were FMIA=57.48-2.17ANB, U1-SN=-75.02+2.17SNB and $R^2$ were 0.63, 063 respectively. So if there is skeletal horizontal discrepancy by mandibular prognathism in one jaw surgery case, we consider attaining more labial inclination of maxillary incisors than normal and more lingual inclination of mandibular incisors than normal. But correlation coefficient of the regression equations in two jaw surgery group was low, so, that equation was not reliable.
In this study, 1,495 cases of computerized data collected as disease entities of oral and maxillofacial injuries among patient visiting S university hospital located in Seoul in 2009 were analyzed and following results were obtained. It was found that the injury incidence in male was greater than in female (1.49:1), it occurred most frequently in the age of 7~14 years old (19.6%), and its most frequent cause was falling down (25.9%). Injuries occurred in other place including beach and open-air (24.7%) most frequently, often developed in anterior teeth (43.2%) and posterior teeth (43.1%), their incidence was relatively higher between 15:00~17:00 (10.4%) and 19:00~23:00 (7.1%) O'clock. In the relationship between causes of the injury and the diagnosis based on the international classification of disease), falling, fall, impingement, violence, traffic accident, sports and own making accident caused most frequently lip and oral open injuries (S01.5), open fracture of tooth (S02.51), close fracture of tooth (S02.50), close fracture of mandible (S02.60), close fracture of tooth (S02.50), respectively. From the above results, it is necessary to understand general characteristics of oral and maxillofacial injuries and to consider their trends for the establishment of systematic complement policies and for the performing safety training and public relations activities.
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