• Title/Summary/Keyword: Bone drilling

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Effect of platelet-rich plasma on bone regeneration in ovariectomized osteoporotic rats (골다공증 유발 쥐에서 혈소판 농축 혈장이 골 재생에 미치는 영향)

  • Cho, Jong-Moon;Kang, Jeong-Kyung;Suh, Kyu-Won;Ryu, Jae-Jun
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.1
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    • pp.16-27
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    • 2010
  • Purpose: The aim of this experimental study is to observe the effect of platelet-rich plasma (PRP) on early bone regeneration of rats both in normal condition and in osteoporosis induced by ovariectomy. Material and methods: Total 40 Sprague-Dawley female rats were divided into 4 groups. A 8-mm-diameter calvarial critical-sized defect (CSD) was made by drilling with trephine at the center of calvaria in cranium of every rat. Every CSD was augmented with an osteoconductive synthetic alloplastic substitute ($MBCP^{TM}$) and PRP as follows. Group A; 10 non-ovariectomized rats grafted with only $MBCP^{TM}$. Group B; 10 non-ovariectomized rats grafted with $MBCP^{TM}$ and PRP. Group C; 10 ovariectomized rats grafted with only $MBCP^{TM}$. Group D; 10 ovariectomized rats grafted with $MBCP^{TM}$ and PRP. At 4 weeks after graft, every rat was sacrificed. And histomorphometric analysis was performed by measuring calcified area of new bone formation within the CSD. Results: Comparing four groups, results were obtained as follows. 1. In non-ovariectomized groups, PRP showed a positive effect somewhat but not significant (P > .05). 2. In ovariectomized groups, PRP showed a positive effect significantly (P < .05). 3. In PRP untreated groups, ovariectomy diminished bone regeneration significantly (P < .05). 4. In PRP treated groups, ovariectomy diminished bone regeneration somewhat but not significant (P > .05). Conclusion: Within the limitation of this study, it can be concluded that PRP in combination with an osteoconductive synthetic alloplastic substitute has an effect on bone regeneration more significantly in ovariectomized osteoporotic rats than in normal rats.

Usefulness of $^{99m}Tc$-MDP Bone Scintigraphy for Assessing Vascular Ingrowth on Hydroxyapatite Ocular Implant ($^{99m}Tc$-MDP 골신티그라피를 이용한 Hydroxyapatite 안구 보충물의 혈관 신생 평가 및 임상적 유용성)

  • Kang, Bong-Joo;Sohn, Hyung-Sun
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.484-492
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    • 1999
  • Purpose: This study was to evaluate the clinical usefulness of $^{99m}Tc$-MDP bone scintigraphy for assessing vascular ingrowth into the ocular implants after enucleation or evisceration. Materials and Methods: Twenty-four patients (M:F=7:17, mean age: 36 years), who buried a coralline hydroxyapatite after uncomplicated enucleation or evisceration surgery were studied. Dynamic and static scintigraphy on the orbit fossa were obtained after injection of 740 MBq $^{99m}Tc$-MDP to evaluate the status of vascularization. The study was performed from the 3 to 33 weeks after surgery. According to the visual analysis, activity greater than nasal bridge was graded as 4, equal to the nasal bridge as 3, less than nasal bridge but greater than normal orbit as 2, greater than normal orbit but less than grade 2 as 1. Uptake ratio was also calculated by measuring the implants activity (H) and contralateral orbit activity (N). Grading score and uptake ratio were compared with clinical outcome of vascularization. Additionally, we also analyzed the vascularization status as time lapse between primary surgery and scintigraphic study and surgical methods. Results: Twenty-one patients who had bone scintigraphy at 11 weeks after surgery showed increased uptake above grade 2 and greater H/N ratio than 1.16. Of these, 19 patients who had drilling surgery for permanent peg application showed adequate bleeding during the procedure. The activity grade and uptake ratio were inversely correlated with vascular ingrowth. Higher than grade 2 or greater than 1.56 in H/N ratio seemed to be an indicator for better prognosis. Accomplishment of vascularization was not affected by the surgical way such as enucleation or evisceration. Conclusion: $^{99m}Tc$-MDP bone scintigraphy can be a useful method to evaluate the vascularized status of implants. Adequate time for $^{99m}Tc$-MDP bone scintigraphy may be 11-20 weeks after enucleation or evisceration.

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Open Treatment of Anterior Impingement Syndrome of the Ankle in Elite Level Soccer Players (축구 선수에서 발생한 족관절 전방 충돌 증후군의 개방적 수술의 치료 결과)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, J-Young;Kim, Eung-Soo;Cha, Seung-Do
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.76-80
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    • 2004
  • Purpose: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. Materials and Methods: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. Results: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. Conclusion: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.

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Planning of Dental Implant Placement Using 3D Geometric Processing and Finite Element Analysis (3차원 기하 처리와 유한요소 분석을 이용한 치아 임플란트 식립 계획 수립)

  • Park, Hyung-Wook;Park, Chul-Woo;Kim, Myong-Soo;Park, Hyung-Jun
    • Korean Journal of Computational Design and Engineering
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    • v.17 no.4
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    • pp.253-261
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    • 2012
  • In order to make dental implant surgery successful, it is important to perform proper planning for dental implant placement. In this paper, we propose a decent approach to dental implant placement planning based on geometric processing of 3D models of jawbones, a nerve curve and neighboring teeth around a missing tooth. Basically, the minimum enclosing cylinders of the neighboring teeth around the missing tooth are properly used to determine the position and direction of the implant placement. The position is computed according to the radii of the cylinders and the center points of their top faces. The direction is computed by the weighted average of the axes of the cylinders. For a cylinder whose axis passes the position along the direction, its largest radius and longest length are estimated such that it does not interfere with the neighboring teeth and the nerve curve, and they are used to select the size and type of an implant fixture. From the geometric and spatial information of the jawbones, the teeth and the fixture, we can construct the 3D model of a surgical guide stent which is crucial to perform the drilling operation with ease and accuracy. We have shown the validity of the proposed approach by performing the finite element analysis of the influence of implant placement on bone stress distribution. Adopted in 3D simulation of dental implant placement, the approach can be used to provide dental students with good educational contents. It is also expected that, with further work, the approach can be used as a useful tool to plan for dental implant surgery.

Optimization of orthodontic microimplant thread design (교정용 마이크로 임플란트의 나사산 디자인 최적화)

  • Kim, Kwang-Duk;Yu, Won-Jae;Park, Hyo-Sang;Kyung, Hee-Moon;Kwon, Oh-Won
    • The korean journal of orthodontics
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    • v.41 no.1
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    • pp.25-35
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    • 2011
  • Objective: The purpose of this study was to optimize the thread pattern of orthodontic microimplants. Methods: In search of an optimal thread for orthodontic microimplants, an objective function stability quotient (SQ) was built and solved which will help increase the stability and torsional strength of microimplants while reducing the bone damage during insertion. Selecting the AbsoAnchor SH1312-7 microimplant (Dentos Inc., Daegu, Korea) as a control, and using the thread height (h) and pitch (p) as design parameters, new thread designs with optimal combination of hand p combination were developed. Design soundness of the new threads were examined through insertion strain analyses using 3D finite element simulation, torque test, and clinical test. Results: Solving the function SQ, four new models with optimized thread designs were developed (h200p6, h225p7, h250p8, and h275p8). Finite element analysis has shown that these new designs may cause less bone damage during insertion. The torsional strength of two models h200p6 and h225p7 were significantly higher than the control. On the other hand, clinical test of models h200p6 and h250p8 had similar success rates when compared to the control. Conclusion: Overall, the new thread designs exhibited better performance than the control which indicated that the optimization methodology may be a useful tool when designing orthodontic microimplant threads.

Outcome of Suture Suspension Arthroplasty for Thumb Carpometacarpal Joint Arthritis (무지 수근중수 관절염에 대한 현수 봉합 관절성형술의 결과)

  • Kim, Sehun;Gong, Hyun Sik;Lee, Se Yeon;Lee, Minho;Kim, Jihyeung;Baek, Goo Hyun
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.223-229
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    • 2018
  • Purpose: A number of procedures were introduced to stabilize the 1st metacarpal bone after resection of the trapezium in the thumb carpometacarpal joint (CMCJ) arthroplasty. However, some surgical procedures may inevitably damage normal structures, such as harvesting tendons or drilling of a bone for tendon passage. Suture suspension arthroplasty is relatively less invasive and easier to perform than the previously described surgical methods. The purpose of this study was to report the therapeutic efficiency of the suture suspension arthroplasty. Methods: We retrospectively reviewed 12 patients who underwent suture suspension arthroplasty for the treatment of thumb CMCJ arthritis. Pain visual analogue scale (VAS), satisfaction about surgical outcomes, and the disabilities of the arm, shoulder and hand (DASH) scores were measured to evaluate the functional outcomes and the Trapezial Space Ratios were measured. Satisfaction was measured in the range of "very dissatisfied" (0) to "very satisfied" (10). Results: The mean follow-up period was 23 months. Pain VAS score improved significantly from 7.0 to 2.9 (p<0.05). And mean satisfaction scale was 6.9. However, there was no significant difference in DASH scores between before and after surgery (p=0.06). The mean trapezial space ratio was calculated to be 0.45 before surgery, 0.33 immediately after surgery, 0.23 at the last follow-up. Conclusion: Suture suspension arthroplasty is a satisfactory surgical procedure. And compared with other procedures, there is no significant difference in the reduction of the trapezial space. It may be useful in advanced thumb CMCJ arthritis.

PRIMARY STABILITY OF IMPLANTS IN ILIUM OF CADAVER BY THE METHODS OF RECIPIENT SITE PREPARATION (사체의 장골에서 수용부 형성방법에 따른 임플란트 일차 안정성)

  • Sim, Jung-Woo;Cho, Jin-Yong;Kook, Min-Suk;Park, Hong-Ju;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.2
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    • pp.180-186
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    • 2008
  • Purpose: This study was performed to evaluate the effect of the implant recipient site preparation methods on primary stability of implants with the instruments of $Osstell^{TM}$ and $Periotest^{(R)}$ in the iliac bone of cadaver. Methods and materials: The 8 iliac bones in 4 cadavers and implants treated with resorbable blasting media (RBM) were used. $Periotest^{(R)}$ (Simens AG, Germany) and $Osstell^{TM}$ (Model 6 Resonance Frequency Analyser: Integration Diagnostics Ltd., Sweden) were used to measure primary stability of implants. Implants were inserted into the iliac crest of the cadaver. In control group, the recipient site was prepared according to the manufacturer's recommendation: 1.8 mm guide drill, 2.0 mm initial drill, 2.7 mm pilot drill, 2.7 mm twist drill, 3.0 mm twist drill, 3.3 mm pilot drill, 3.3 mm twist drill, and 3.3 mm countersink drill as well as tapping drill were used in order. In the group 1, implant recipient sites were prepared by sequentially drilling from 1.8 mm guide drill to 3.0 mm twist drill and then inserted implants without countersinking and tapping. In the group 2, implant recipient sites were prepared to 3.0 mm twist drill and countersink drill and then inserted implants without tapping. In the group 3, the sites were prepared to 3.0 mm twist drill and countersink drill as well as tapping drill. In the group 4, the sites were prepared to 3.3 mm twist drill. In the group 5, the sites were prepared to 3.3 mm twist drill and countersink drill. A total of 60 implants were placed (n=10). The stability was measured using $Osstell^{TM}$ and $Periotest^{(R)}$ mesiodistally and buccolingually. To compare the mean stability of each group statistically, One-way ANOVA was used and correlation of instrument were analyzed using SPSS 12.0. The results obtained were as follows; 1. The stability of group 1 measured using $Osstell^{TM}$ and $Periotest^{(R)}$ buccolingually showed the highest, and there are significant difference statistically between control group and experimental group 1,2,4 in each instruments respectively (p<0.05). 2. The stability of group 1 measured using $Osstell^{TM}$ and $Periotest^{(R)}$ mesiodistally showed the highest. There are significant difference statistically between control group and all experimental groups in $Osstell^{TM}$, and between control group and experimental group 1,2,3,4 (p<0.05). 3. There are high correlation between the measurements of $Osstell^{TM}$ and $Periotest^{(R)}$ (p<0.05). Conclusion: These results indicate that the primary stability of implant can be obtained by the recipient sites preparation with smaller diameter drill than that of implant or minimal drilling.

Assessment of Vascularization within Hydroxyapatite Ocular Implant by Bone Scintigraphy: Comparative Analysis of Planar and SPECT Imaging (Hydroxyapatite 안구보충물삽입술 후 골신티그라피를 이용한 섬유혈관증식 평가: 평면영상과 SPECT 영상에서의 비교)

  • Lim, Seok-Tae;Sohn, Myung-Hee;Park, Soon-Ah
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.475-483
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    • 1999
  • Purpose: Complete fibrovascular ingrowth within the hydroxyapatite ocular implant is necessary for peg drilling which is performed to Prevent infection and to provide motility to the ocular prosthesis. We compared planar bone scintigraphy and SPECT for the evaluation of the vascularization within hydroxyapatite ocular implants. Materials and Methods: Seventeen patients (M:F: 12:5, mean age; $50.4{\pm}17.5$ years) who had received a coralline hydroxyapatite ocular implant after enucleation surgery were enrolled. Patients underwent Tc-99m MDP planar bone and SPECT imaging by dual head gamma camera after their implant surgery (interval: $197{\pm}81$ days). Uptake on planar and SPECT images was graded visually as less than (grade 1), equal to (grade 2), and greater than (grade 3) nasal bridge activity. Quantitative ratio of implanted to non-implanted intraorbital activity was also measured. Vascularization within hydroxyapatite implants was confirmed by slit lamp examination and ocular movement. Results: All but three patients were considered to be vascularized within hydroxyapatite implants. In visual analysis of planar image and SPECT, grade 1 was noted in 9/18 (50%) and 6/18 (33%), respectively. Grade 2 pattern was 7/18 (39%) and 4/18 (22%), and grade 3 pattern was 2/18 (11%) and 8/18 (44%) respectively. When grade 2 or 3 was considered to be positive for vascularization, the sensitivity of planar and SPECT imaging were 60% (9/15) and 80% (12/15), respectively. In 3 patients with incomplete vascularization, both planar and SPECT showed grade 1 uptake The orbital activity ratios on planar imaging were not significantly different between complete and incomplete vascularization ($1.96{\pm}0.87$ vs $1.17{\pm}0.08$, p>0.05), however, it was significantly higher on SPECT in patients with complete vascularization ($8.44{\pm}5.45$ vs $2.20{\pm}0.87$, p<0.05). Conclusion: In the assessment of fibrovascular ingrowth within ocular implants by Tc-99m MDP bone scintigraphy, SPECT image appears to be more effective than planar scintigraphy.

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Application of SP Monitoring in the Pohang Geothermal Field (포항 지열 개발지역에서의 SP 장기 관측)

  • Lim Seong Keun;Lee Tae Jong;Song Yoonho;Song Sung-Ho;Yasukawa Kasumi;Cho Byong Wook;Song Young Soo
    • Geophysics and Geophysical Exploration
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    • v.7 no.3
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    • pp.164-173
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    • 2004
  • To delineate geothermal water movement at the Pohang geothermal development site, Self-Potential (SP) survey and monitoring were carried out during pumping tests. Before drilling, background SP data have been gathered to figure out overall potential distribution of the site. The pumping test was performed in two separate periods: 24 hours in December 2003 and 72 hours in March 2004. SP monitoring started several days before the pumping tests with a 128-channel automatic recording system. The background SP survey showed a clear positive anomaly at the northern part of the boreholes, which may be interpreted as an up-flow Bone of the deep geothermal water due to electrokinetic potential generated by hydrothermal circulation. The first and second SP monitoring during the pumping tests performed to figure out the fluid flow in the geothermal reservoir but it was not easy to see clear variations of SP due to pumping and pumping stop. Since the area is covered by some 360 m-thick tertiary sediments with very low electrical resistivity (less than 10 ohm-m), the electrokinetic potential due to deep groundwater flow resulted in being seriously attenuated on the surface. However, when we compared the variation of SP with that of groundwater level and temperature of pumping water, we could identify some areas responsible to the pumping. Dominant SP changes are observed in the south-west part of the boreholes during both the preliminary and long-term pumping periods, where 3-D magnetotelluric survey showed low-resistivity anomaly at the depth of $600m\~1,000m$. Overall analysis suggests that there exist hydraulic connection through the southwestern part to the pumping well.

Treatment of Osteochonritis Dissecans of Femoral Condyle (대퇴골과 박리성 골연골염의 치료)

  • Lee Dong-Chul;Kwon Soon;Son Wook-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.49-54
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    • 2002
  • Purpose : To analyze the clinical results of treatment for the osteochondritis dissecans of femoral condyle by age, the type of lesion and method of treatment. Methods : From March 1991 to February 2000, 17 patients (20 cases) with osteochondritis dissecans of the femoral condyle were followed up over 1 year. Three patients had bilateral lesion. There were 12 cases with trauma history (9 cases with sports injury and 3 cases with direct trauma). The initial symptoms were pain, clicking, locking, giving way in the order of frequency, pain was revealed in all cases. Clinical evaluation of IKDC and Hughston method were used for subjective and objective function. Results : The number of male patient was 12, and the mean age was 19.8 year old (11$\~$50). The location of the lesion was 14 cases in medial femoral condyle and 6 cases in lateral femoral condyle. The arthroscopic findings of the lesion in 15 cases were as follows, early separation in 6 cases, partially detachment in 4 cases, and crators and complete detachment in 5 cases. 5 cases were treated with mutiple drilling and 5 cases with Herbert screw fixation, 3 cases with Herbert screw fixation and bone graft. In early stage, 7 cases were treated with conservative method. In the grading of Hughston score, 6 cases were graded as excellent, 9 cases as good, 15 cases were graded as good to excellent. Based on the IKDC scale, 1 case was graded as normal, 6 as nearly normal, and 10 as abnormal. Conclusions : The trauma seemed to be important factor in occurrence of osteochondritis dissecans of the femoral condyle. The clinical results of juvenile period showed better than adolescence and adult period, it is necessary to detect the lesion as soon as possible. The result of subjective evaluation was worse than the Hughston evaluation. It was caused by limiting involvement of sports activity and limited activity in the adolescence.

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