• Title/Summary/Keyword: Anterior plate

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The use of precontoured plates for midshaft clavicle fractures is not always the best course of treatment

  • Manmohan Patel;Mohtashim Ahmad;Natwar Agrawal;Sumit Tulshidas Patil;John Ashutosh Santoshi;Bertha Rathinam;Kusum Rajendra Gandhi
    • Anatomy and Cell Biology
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    • v.56 no.4
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    • pp.456-462
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    • 2023
  • Plate fixation has become the preferred approach for treating displaced midshaft clavicle fractures. However, plate fixation of the clavicle presents several unique challenges, including its complex bony architecture and its immediate subcutaneous location. In many cases, we have observed that precontoured implants do not conform to the clavicular anatomy, and many patients complain of postoperative implant-related discomfort. A total of 111 clavicles, both left and right sides, were examined to match two commonly used designs of anatomical pre-contoured superior anterior clavicle plates, with and without lateral extension. The anteroposterior (AP) plane congruence of the plate to the underlying bone, the vertical gap between the bone and plate, and the length of the plate that was off the bone either anteriorly and/or posteriorly at both ends of the clavicle were measured. The scoring system was used to determine the fit of the implant on the clavicle as anatomic, good, or poor. We found that the maximum superior bow of the clavicle was lateral to the midline by 30.75 mm and 30.5 mm on the right and left sides, respectively. The magnitude of the bow was 4.28 mm and 4.46 mm on the right and left sides, respectively. We also found that the plate was a poor fit in 75.86% of cases on the left side and 73.5% of cases on the right side. Manipulating the plates during surgery was very difficult in the AP plane.

Maxillary reconstruction using tunneling flap technique with 3D custom-made titanium mesh plate and particulate cancellous bone and marrow graft: a case report

  • Takano, Masayuki;Sugahara, Keisuke;Koyachi, Masahide;Odaka, Kento;Matsunaga, Satoru;Homma, Shinya;Abe, Shinichi;Katakura, Akira;Shibahara, Takahiko
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.43.1-43.5
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    • 2019
  • Background: Reconstructive surgery is often required for tumors of the oral and maxillofacial region, irrespective of whether they are benign or malignant, the area involved, and the tumor size. Recently, three-dimensional (3D) models are increasingly used in reconstructive surgery. However, these models have rarely been adapted for the fabrication of custom-made reconstruction materials. In this report, we present a case of maxillary reconstruction using a laboratory-engineered, custom-made mesh plate from a 3D model. Case presentation: The patient was a 56-year-old female, who had undergone maxillary resection in 2011 for intraoral squamous cell carcinoma that presented as a swelling of the anterior maxillary gingiva. Five years later, there was no recurrence of the malignant tumor and a maxillary reconstruction was planned. Computed tomography (CT) revealed a large bony defect in the dental-alveolar area of the anterior maxilla. Using the CT data, a 3D model of the maxilla was prepared, and the site of reconstruction determined. A custom-made mesh plate was fabricated using the 3D model (Okada Medical Supply, Tokyo, Japan). We performed the reconstruction using the custom-made titanium mesh plate and the particulate cancellous bone and marrow graft from her iliac bone. We employed the tunneling flap technique without alveolar crest incision, to prevent surgical wound dehiscence, mesh exposure, and alveolar bone loss. Ten months later, three dental implants were inserted in the graft. Before the final crown setting, we performed a gingivoplasty with palate mucosal graft. The patient has expressed total satisfaction with both the functional and esthetic outcomes of the procedure. Conclusion: We have successfully performed a maxillary and dental reconstruction using a custom-made, pre-bent titanium mesh plate.

Anchor Plate Efficiency in Postoperative Orthodontic Treatment Following Orthognathic Surgery via Minimal Presurgical Orthodontic Treatment

  • Jeong, Tae-Min;Kim, Yoon-Ho;Song, Seung-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.4
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    • pp.154-160
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    • 2014
  • Purpose: The efficiency of an anchor plate placed during orthognathic surgery via minimal presurgical orthodontic treatment was evaluated by analyzing the mandibular relapse rate and dental changes. Methods: The subjects included nine patients with Class III malocclusion who had bilateral sagittal split osteotomy at the Division of Oral and Maxillofacial Surgery, Department of Dentistry in Ajou University Hospital, after minimal presurgical orthodontic treatment. During orthognathic surgery, anchor plates were placed at both maxillary buttresses. The anchor plates were used to move maxillary teeth backward and for maximum anchorage of Class III elastics to minimize mandibular relapse during the postoperative orthodontic treatment. The lateral cephalometric X-ray was taken preoperatively (T0), postoperatively (T1), and one year after the surgery (T2). Seven measurements (distance from Pogonion to line Nasion-Nasion perpendicular [Pog-N Per.], angle of line B point-Nasion and Nasion-Sella [SNB], angle of line maxilla 1 root-maxilla 1 crown and Nasion-Sella [U1 to SN], distance from maxilla 1 crown to line A point-Nasion [U1 to NA], overbite, overjet, and interincisal angle) were taken. Measurements at T0 to T1 and T1 to T2 were compared and differences tested by standard statistical methods. Results: The mean skeletal change was posterior movement by $13.87{\pm}4.95mm$ based on pogonion from T0 to T1, and anterior movement by $1.54{\pm}2.18mm$ from T1 to T2, showing relapse of about 10.2%. There were significant changes from T0 to T1 for both Pog-N Per. and SNB (P<0.05). However, there were no statistically significant changes from T1 to T2 for both Pog-N Per. and SNB. U1 to NA that represents the anterior-posterior changes of maxillary incisor did not differ from T0 to T1, yet there was a significant change from T1 to T2 (P<0.05). Conclusion: This study found that the anchor plate minimizes mandibular relapse and moves the maxillary teeth backward during the postoperative orthodontic treatment. Thus, we conclude that the anchor plate is clinically very useful.

Study of the Plating Methods in the Experimental Model of Mandibular Subcondyle Fracture (하악골 과두하부 골절 실험모델에서 견고정을 위한 플레이트 고정방법 연구)

  • Lee, Won;Kang, Dong Hee
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.12-16
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    • 2011
  • Purpose: This study examined the biomechanical stability of four different plating techniques in the experimental model of mandibular subcondyle fracture. Methods: Twenty standardized bovine tibia bone samples ($7{\times}1.5{\times}1.0cm$) were used for this study. Each of the four sets of tibia bone was cut to mimic a perpendicular subcondyle fracture in the center area. The osteotomized tibia bone was fixed using one of four different fixation groups (A,B,C,D). The fixation systems included single 2.0 mm 4 hole mini adaption plate (A), single 2.0 mm 4 hole dynamic compression miniplate (B), double fixation with 2.0 mm 4 hole mini adaption plate (C), double fixation with a 2.0 mm 4 hole mini adaption plate and 2.0 mm 4 hole dynamic compression miniplate (D). A bending force was applied to the experimental model using a pressure machine (858 table top system, $MTS^{(R)}$) until failure occurred. The load for permanent deformation, maximum load of failure were measured in the load displacement curve with the chart recorder. Results: Double fixation with a 2.0 mm 4 hole mini adaption plate and a 2.0 mm 4 hole dynamic compression miniplate (D) applied to the anterior and posterior regions of the subcondyle experimental model showed the highest load to failure. Conclusion: From this study, double fixation with an adaption plate and dynamic compression miniplate fixation technique produced the greatest biomechanical stability. This technique may be considered a useful means of fixation to reduce the postoperative internal maxillary fixation period and achieve early mobility of the jaw.

A CASE REPORT OF RECURRENT FIBROUS DYSPLASIA OF THE JAWS (악골에 발생한 fibrous dysplasia의 일증예)

  • Suh, Gene-Kwan;Kwon, Hak-Joo;Chai, Young-Soo;Lee, Yong-Oh
    • The Journal of the Korean dental association
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    • v.10 no.2
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    • pp.115-119
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    • 1972
  • The authors have observed a recurrent fibrous dysplasia at the lower left canine region of a 16 years old Korean male admitted the Taegue Presbyterian Hospital on Nov. 28, 1968. Subtotal mandible resection was performed for the radical treatment and metal plate attached to anterior and posterior fragments by means of stainless steel wire and the result was satisfactory.

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Combined Surgical and Orthodontic Treatment of Bimaxillary Dento-Alveolar Protrusion: A Report of Case (전방부분절 골절단술에 의한 상하악 전돌증의 악교정 1 예)

  • Byun, Sang-Kil;Lee, Hee-Keung;Jin, Byung-Rho;Oh, Meung-Chull;Kim, Tae-Joo;Kim, Young-Jun
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.271-279
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    • 1985
  • The authors treated a case of bimaxillary dentoalveolar protrusion corrected by anterior segmental osteotomies: As presurgical treatment & process, closing of the upper anterior spacing with fixed appliances was worked out, cephalometric predicition & model surgery was done, and fabrication of intra-arch acrylic resin splints were made. It was not necessary to make an intermaxillary fixation with wire after surgery. Only intramaxillary fixation of anterior retracted mobile segment with resin plate was required for 8 weeks. After surgical treatment, leveling of the upper and lower arch with rectangular arch wire were accomplished as the Intrusion of anterior teeth proceeded. We will continue to improve the class II molar relationship by using class II elastics and have a good occlusiion through the orthodontic treatment.

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Muller's Muscle-Levator Aponeurosis Advancement Procedure for Blepharoptosis (뮐러근과 거근건막의 전진술에 의한 안검하수의 교정)

  • Baik, Bong Soo;Kim, Tae Bum;Hong, Wang Kwang;Yang, Wan Suk
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.219-226
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    • 2005
  • Muller's muscle-levator aponeurosis advancement procedure was performed to correct mild to moderate congenital blepharoptosis with moderate to good levator function and to correct severe aquired blepharoptosis with poor levator function. Through the blepharoplasty incision, the upper half of the tarsal plate was exposed and the orbital septum was opened to show the levator aponeurosis. The Muller's muscle was dissected from the superior margin of the tarsal plate and from the posteriorly located conjunctiva with sharp scissors. The Muller's muscle and levator aponeurosis were advanced on the anterior surface of the tarsal plate as a composite flap and fixed approximately 3 to 4 mm inferior to the upper edge of the tarsal plate with three horizontal 6-0 nylon mattress sutures. The amount of advancement of the composite flap was controlled by the location of the upper eyelid margin 2 mm below the upper limbus in primary gaze after the first suture in the middle portion of the flap. The excess flap was trimmed off with scissors, but trimming was usually not necessary in cases of mild to moderate ptosis. Nine cases underwent this Muller's muscle-levator aponeurosis advancement procedure from September 2003 to September 2004. Five cases were congenital blepharoptosis with 2-4 mm ptosis and more than 5 mm of levator function, but three of the four acquired ptosis cases had more than 4 mm ptosis with poor levator function. The age of the patients ranged from 7 to 81 years. In operative results, all patients except one traumatic case were within 1 mm of the desired eyelid height in primary gaze. This procedure can provide not only tightening of the Muller's muscle but also advancement and firm fixation of the levator aponeurosis to the tarsal plate, yielding predictable results.

Morphological and genetic characterization and the nationwide distribution of the phototrophic dinoflagellate Scrippsiella lachrymosa in the Korean waters

  • Lee, Sung Yeon;Jeong, Hae Jin;You, Ji Hyun;Kim, So Jin
    • ALGAE
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    • v.33 no.1
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    • pp.21-35
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    • 2018
  • The phototrophic dinoflagellate genus Scrippsiella is known to have a worldwide distribution. Here, we report for the first time, the occurrence of Scrippsiella lachrymosa in Korean waters. Unlike the other stains of S. lachrymosa whose cultures had been established from cysts in the sediments, the clonal culture of the Korean strain of S. lachrymosa was established from motile cells. When the sulcal plates of S. lachrymosa, which have not been fully described to date, were carefully examined using scanning electron microscopy, the Korean strain of S. lachrymosa clearly exhibited the anterior sulcal plate (s.a.), right sulcal plate (s.d.), left sulcal plate (s.s.), median sulcal plate (s.m.), and posterior sulcal plate (s.p.). When properly aligned, the large subunit (LSU) rDNA sequence of the Korean strain of S. lachrymosa was ca. 1% different from those of two Norwegian strains of S. lachrymosa, the only strains for which LSU sequences have been reported. The internal transcribed spacer (ITS) rDNA sequence of the Korean strain of S. lachrymosa was also ca. 1% different from those of the Scottish and Chinese strains and 3% different from those of the Canadian, German, Greek, and Portuguese strains. Thus, the Korean S. lachrymosa strain has unique LSU and ITS sequences. The abundances of S. lachrymosa in the waters of 28 stations, located in the East, West, and South Sea of Korea, were quantified in four seasons from January 2016 to October 2017, using quantitative real-time polymerase chain reaction method and newly designed specific primer-probe sets. Its abundances were >$0.1cells\;mL^{-1}$ at eight stations in January and March 2016 and March 2017, and its highest abundance in Korean waters was $26cells\;mL^{-1}$. Thus, S. lachrymosa has a nationwide distribution in Korean waters as motile cells.

Unicortical Bone Necrosis of the Fibula Free Flap Associated to the Fixation with a Nonlocking 2.0-mm Reconstruction Plate and Screws

  • Pereira, Gustavo N.;Ribeiro, Diogo;Saraiva, Luis;Freitas, Hugo;Santos, Ana R.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.413-417
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    • 2022
  • The authors present a unique case of osteonecrosis of a cortical half of a fibula free flap that has not been reported in the literature yet. This complication was associated with the impairment of the vascularization of periosteum in the cortical half of fibula that was fixated with a nonlocking reconstructive 2.0-mm plate and screws but other factors could have been involved. The patient was submitted to excision of a cemento-ossifying fibroma that resulted in a left hemimaxilectomy mesoinfrastructure defect classified as the Cordeiro type 2B. The 42-year-old female patient was submitted to reconstruction with an osteomusculocutaneous fibula free flap plus a segment of fibula graft. The two bone segments of the free flap used to reconstruct the anterior and left alveolar crest were fixated with a reconstructive 2.0-mm plate of matrixMANDIBLE system. The only reported complication was an oronasal fistula that healed with conservative treatment and the referred osteonecrosis of the external cortical half of the fibula free flap with plate exposure at 2.5 years postoperatively. Surgical excision of the osteonecrosed cortical half of the fibula with the plate and screws was performed, while the other cortical underwent bone union as corroborated by computed tomography scans.