• Title/Summary/Keyword: Anterior implant

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Autotransplantation of Premolars and Esthetic Rehabilitation in a Traumatized Teenage Patient with Challenging Oral Problems: A Case Report (어려운 구강 문제를 가진 외상당한 청소년 환자의 소구치 자가이식 및 심미적 회복: 증례 보고)

  • Kho, Junhee;Park, Howon;Lee, Juhyun;Seo, Hyunwoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.2
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    • pp.213-218
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    • 2020
  • The loosely structured periodontal ligament and low mineralized bone surrounding erupting teeth provide minimal resistance to an extrusive force. The maxillary central incisors are the most frequently avulsed due to trauma. The prognosis of replanted teeth is affected by extra-alveolar period and conditions. Implant-supported restorations are contraindicated in adolescent patients with poor prognosis traumatized teeth. Autotransplantation of premolar to the anterior region provides a viable treatment alternative. This case report describes the autotransplantation of premolars and esthetic rehabilitation in a teenage patient with traumatized incisors, poor oral hygiene, and severe crowding. Comprehensive and long-term treatments were performed to improve complex and challenging oral problems.

Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen

  • Choi, Kyunghak;Jung, Kwang-Hwan;Keum, Min Ae;Kim, Sungjeep;Kim, Jihoon T;Kyoung, Kyu-Hyouck
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.18-22
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    • 2020
  • Purpose: Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery. Methods: This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients. Results: A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44-98), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal. Conclusions: Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination.

Complicated Wound Infection Following Transvenous Endocardial Pacemaker (경정맥(經靜脈) 내적(內的) Pacemaker 이식후(移植後) 발생(發生)한 복잡한 감염합병증(感染合?症)의 1치험례(治驗例))

  • Lee, D.Y.;Yoon, Y.J.;Cho, B.K.;Hong, S.N.
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.265-270
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    • 1976
  • Implantation of a permanent pacemaker is a widely accepted procedure for the patient with complete heart block.As a result of these device, the prognosis for patients with Adams-Stokes syndrome caused by complete A-V block and other cardiac arrhythmia have become much more optimistic. Permanent pacemaker implantation by means of a transvenous approach has made the operative risk much less and the procedure simpler. However, a number of complications have been reported in the literature regarding transvenous endocardial pacemaker implantation during the last a decade. The patient presented in this paper is a 26-year old girl who was implanted with a permanent pacemaker at 14 years of age because of a congenital A-V block. Following first exchange of pulse generator, the electrode (lead) was fractured, so that by the pulse generator, a change to the transvenous technique of implantation was made, After this, there were episodes of recurrent wound infection on three occasions, even though the site of pulse generator implantation was exchanged to the contralateral side of chest wall, massive doses of antibiotics were administered and sensitivity tests for coagulase positive staphylococcal infection were performed. Though there was no definite evidence of blood stream infection by blood culture, we decided not to use the transvenous technique and not to implant the pulse generator in the chest wall because the venous system and the entire anterior chest wall appeared to be diseased or contaminated by virulent pyogenic organisms. Finally this intractable systemic and local wound infection was successfully controlled by myocardial lead implantation via a subxiphoid approach and implantation of the pulse generator far down in the abdominal wall. The causes and routes of recurrent wound infection and possible blood born infection in this particular patient are still obscure. We strongly believe that myocardial pacemaker implantation is much safer than transvenous endocardial pacemaker implantation & myocardial pacemaker implantation is a definite method for controlling such an intractable wound infection. following transvenous pacemaker implantation.

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A Study on the Interface Micromotions of Cementless Artificial Hip Replacement by Three-Dimensional FEM (무시멘트형 인공고관절 대치술후 초기의 경계면 미세운동의 3차원 FEM 연구)

  • Kim, S.K.;Chae, S.W.;Choi, H.Y.
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.12
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    • pp.71-74
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    • 1994
  • In cementless total hip arthroplasty(THA), an initial stability of the femoral component is mandatory to achieve bony ingrowth and secondary long term fixation. Bone ingrowth depends strongly on relative micromotion and stress distributions at the interface. Primary stability of the femoral component can be obtained by minimizing the magnitude of relative micromotions at bone-prosthesis interface, Hence an accurate evaluation of interface behavior and stress/strain fields in the bone implant system may be relevant for better understanding of clinical situations and improving THA design. However, complete evaluation of load transfer in the bone remains difficult to assess experimentally, Hence, recently finite element method (FEM) was introduced in orthopaedic research field to fill the gap due to its unique capacity to evaluate stress in structure of complex shape, loading and material behavior. The authors developed the 3-dimensional numerical finite element model which is composed of totally 1179 elements off and 8 node blick. We also analyzed the micromotions at the bone-stem interface and mechanical behavior of existing bone prosthesis for a loading condition simulating the single leg stance. The result indicates that the values of relative motion for this well fit Multilock stem were $150{\mu}m$ in maximum, $82{\mu}m$ in minimum, and the largest relative motion developed in medial region of proximal femur with anterior-posterior direction. The proximal region of the bone was much larger in motion than the distal region and the stress pattern shows high stress concentration on the cortex near the tip of the stem. These findings indicates that the loading in the proximal femoral bone in the early postoperative situation can produce micromotions on the interface and clinically cementless TEA patient should not be allowed weight bearing strictly early in the postoperative period.

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The association between radiographic embrasure morphology and interdental papilla reconstruction using injectable hyaluronic acid gel

  • Lee, Won-Pyo;Seo, Yo-Seob;Kim, Hee-Jung;Yu, Sang-Joun;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.46 no.4
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    • pp.277-287
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    • 2016
  • Purpose: The purpose of this study was to evaluate the clinical efficacy of enhancing deficient interdental papilla with hyaluronic acid gel injection by assessing the radiographic anatomical factors affecting the reconstruction of the interdental papilla. Methods: Fifty-seven treated sites from 13 patients (6 males and 7 females) were included. Patients had papillary deficiency in the upper anterior area. Prior to treatment, photographic and periapical radiographic standardization devices were designed for each patient. A 30-gauge needle was used with an injection-assistance device to inject a hyaluronic acid gel to the involved papilla. This treatment was repeated up to 5 times every 3 weeks. Patients were followed up for 6 months after the initial gel application. Clinical photographic measurements of the black triangle area (BTA), height (BTH), and width (BTW) and periapical radiographic measurements of the contact point and the bone crest (CP-BC) and the interproximal distance between roots (IDR) were undertaken using computer software. The interdental papilla reconstruction rate (IPRR) was calculated to determine the percentage change of BTA between the initial and final examination and the association between radiographic factors and the reconstruction of the interdental papilla by means of injectable hyaluronic acid gel were evaluated. Results: All sites showed improvement between treatment examinations. Thirty-six sites had complete interdental papilla reconstruction and 21 sites showed improvement ranging from 19% to 96%. The CP-BC correlated with the IPRR. More specifically, when the CP-BC reached 6 mm, virtually complete interdental papilla reconstruction via injectable hyaluronic acid gel was achieved. Conclusions: These results suggest that the CP-BC is closely related to the efficacy of hyaluronic acid gel injection for interdental papilla reconstruction.

Association of gingival biotype with the results of scaling and root planing

  • Sin, Yeon-Woo;Chang, Hee-Yung;Yun, Woo-Hyuk;Jeong, Seong-Nyum;Pi, Sung-Hee;You, Hyung-Keun
    • Journal of Periodontal and Implant Science
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    • v.43 no.6
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    • pp.283-290
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    • 2013
  • Purpose: The concept of gingival biotype has been used as a predictor of periodontal therapy outcomes since the 1980s. In the present study, prospective and controlled experiments were performed to compare periodontal pocket depth (PPD) reduction and gingival shrinkage (GSH) after scaling and root planing (SRP) according to gingival biotype. Methods: Twenty-five patients diagnosed with chronic periodontitis participated in the present study. The PPD and GSH of the labial side of the maxillary anterior teeth (from the right canine to the left canine) were evaluated at baseline and 3 months after SRP. Changes in the PPD following SRP were classified into 4 groups according to the gingival thickness and initial PPD. Two more groups representing normal gingival crevices were added in evaluation of the GSH. The results were statistically analyzed using the independent t-test. Results: In the end, 16 patients participated in the present study. With regard to PPD reduction, there were no significant differences according to gingival biotype (P>0.05). Likewise, sites with a PPD of over 3 mm failed to show any significant differences in the GSH (P>0.05). However, among the sites with a PPD of under 3 mm, those with the thin gingival biotype showed more GSH (P<0.05). Conclusions: PPD changes after SRP were not affected by gingival biotype with either shallow or deep periodontal pockets. GSH also showed equal outcomes in all the groups without normal gingival crevices. The results of SRP seem not to differ according to gingival biotype.

Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis

  • Lee, Hyeong-Geun;Kim, Yong-Deok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.5
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    • pp.232-239
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    • 2015
  • Objectives: The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated. Materials and Methods: Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images. Results: No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was $74.6%{\pm}8.4%$. Conclusion: Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone.

Study on tooth mortality after periodontal therapy (치주 치료 후 치아 상실에 관한 연구)

  • Kim, Hyung-Seop;Seok, Jeong-Jin;Kim, Hyun-Chul;Lee, Su-Jeong;Choi, Seoung-Hwan
    • Journal of Periodontal and Implant Science
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    • v.33 no.2
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    • pp.215-223
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    • 2003
  • The main goal of periodontal treatment is the long-term maintenance of teeth. Periodic maintenance program is need to prevent periodontal disease and maintain healthy periodontium. Hirschfeld and Wasserman(1978) studied 600 treated periodontal patients. This study categorized periodontal patients using well-maintained, downhill, extreme downhill groups. The purpose of our study is to evaluate effect of periodontal treatment and analyse tooth loss after periodontal treatment using this classification. The study population of j9 patients had been treated and maintained for mean 5.8 years. All patients were on a periodic maintenance program at 2-, 3-, 4, or 6-month intends. The avenge age of the patients at the time of original therapy was 49.6 years. To analyse tooth loss, modified classification was used on the basis of response to therapy using by Hirschfeld and Wasserman in 1978. The results were as follows : 1. 59 treated patients were lost mean 1.42 teeth per patient for 5.8 years of maintenance period. 2. Maxillary first molars were most frequently lost but mandibular lateral incisors were lost no tooth during maintenance period. 3. Tooth mortality received surgical treatment had similar to received nonsurgical treatment. 4. Tooth loss was more frequent in maxillary teeth than mandibular teeth, and posterior teeth than anterior teeth, and more frequent tendency in male than female.

Full mouth implant rehabilitation with double scanning of provisional restoration (임시치아 double scanning을 이용한 전악 임플란트 수복 증례)

  • Yang, Dong-Hun;Yang, Hong-So;Park, Sang-Won;Lim, Hyun-Pil;Yun, Kwi-Dug;Vang, Mong-Sook
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.3
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    • pp.252-257
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    • 2014
  • It is important to produce a provisional restoration reflecting the patient's jaw relation, occlusal plane, lip support, shape of teeth, and occlusion type for fully edentulous patients before making a definite prosthesis. The patient introduced in this study showed bad prognosis of remained tooth after severe periodontal diseases. Therefore, remaining teeth were extracted and replaced with dental implants. Provisional restorations were fabricated and the the patient's vertical and horizontal jaw relationship, occlusal plane, amount of overjet and overbite, size of teeth, and length of anterior tooth were recorded. Provisional restorations were scanned and CAD/CAM techniques were used to fabricate a monolithic zirconia bridge, which contour is identical with the provisional restorations. The patient was satisfied with the treatment results on functional, esthetic aspects and the prosthesis retained stable during the four-month clinical observation period.

Dose Evaluation of the Man Adjacent to an Implanted Patient During the Prostate Cancer Brachytherapy (전립선암의 근접치료 시 이식환자에 근접한 사람의 선량평가)

  • Park, Euntae;Kim, Junghoon
    • Journal of the Korean Society of Radiology
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    • v.10 no.1
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    • pp.39-44
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    • 2016
  • This study is fulfilled to evaluate the exposure dose nearby a patient during the brachytherapy of the prostate cancer treatment and to minimize the radiation exposure by evaluating the exposure dose of the person near the relevant implanted patient, technicians and gardians. The experiment method is used on the study is MCNPX that is stood on the basis monte-carlo method and implant the source to MIRD-type phantom in $^{192}Ir$, $^{125}I$, and $^{103}Pd$ in virtual space. For dose evaluations according to distance, the radiation dose on the patient near the corresponding implanted patient is evaluated by each distance of 30, 50, 100, 200 cm to anterior from the implanted patient. As a result, $^{192}Ir$ showed a higher dose than $^{125}I$ and $^{103}Pd$ in every distance.