• Journal of Korean Neurosurgical Society
• /
• 제30권11호
• /
• pp.1314-1319
• /
• 2001

Objects : Because of the nonspecific nature of symptoms in tuberculous spondylitis, a delay in the diagnosis can result in progressive neurologic deficits. The authors evaluate the clinical and the radiological results of the 10 cases of surgically treated tuberculous spondylitis. Clinical materials & Methods : We retrospectively analyzed the medical records of 10 patients with tuberculous spondylitis who were treated between February 1996 and March 2000. Six patients were female, and four were male. Mean age was 43 years old, and mean follow-up period was 20.5 months. All patients were treated with 12 months of antituberculous medication postoperatively, and were followed by complete blood count, ESR, spine X-ray and MRI. Results : The lumbar spine was involved in 5 patients, the thoracic in 4, and the thoracolumbar in one. The infected vertebral bodies were 2.8 in average. The associated lesions were pulmonary tuberculosis in 3 cases, and renal tuberculosis in one. Five patients were treated by anterior debridement and fusion with bone graft using anterior instrumentation, 2 with anterior debridement and fusion with bone graft(Hong Kong procedure only), 1 with Hong Kong procedure with posterior spinal instrumentation, and 2 were managed with posterior debridement and posterior spinal instrumentation. All patients improved after operation, and the average kyphotic angle decreased postoperatively. Postoperatively, one patient had a fistula at the operative site. Conclusion : The debridement and minimal level fusion of motion segment with instrument fixation is one of surgical option for tuberculous spondyltis to preserve the spine motion segment as much as possible. Spine instability and kyphosis were prevented by anterior and posterior spinal instrumentation. But, large number of cases and longer period follow-up study in future will be needed to confirm the long term results.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제38권
• /
• pp.2.1-2.9
• /
• 2016

Background: We reviewed the biological and mechanical properties of porous hydroxyapatite (HA) compared to other synthetic materials. Computer-aided design/computer-aided manufacturing (CAD/CAM) was also evaluated to estimate its efficacy with clinical and radiological assessments. Method: A systematic search of the electronic literature database of the National Library of Medicine (PubMed-MEDLINE) was performed for articles published in English between January 1985 and September 2013. The inclusion criteria were (1) histological evaluation of the biocompatibility and osteoconductivity of porous HA in vivo and in vitro, (2) evaluation of the mechanical properties of HA in relation to its porosity, (3) comparison of the biological and mechanical properties between several biomaterials, and (4) clinical and radiological evaluation of the precision of CAD/CAM techniques. Results: HA had excellent osteoconductivity and biocompatibility in vitro and in vivo compared to other biomaterials. HA grafts are suitable for milling and finishing, depending on the design. In computed tomography, porous HA is a more resorbable and more osteoconductive material than dense HA; however, its strength decreases exponentially with an increase in porosity. Conclusions: Mechanical tests showed that HA scaffolds with pore diameters ranging from 400 to $1200{\mu}m$ had compressive moduli and strength within the range of the human craniofacial trabecular bone. In conclusion, using CAD/CAM techniques for preparing HA scaffolds may increase graft stability and reduce surgical operating time.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제40권2호
• /
• pp.68-75
• /
• 2014

Objectives: This study was performed to analyze the cumulative survival rate of Osstem implants (Osstem Implant Co., Ltd.) over a seven-year period. Materials and Methods: A total of 105 patients who had 467 Osstem implants that were placed at the Section of Dentistry, Seoul National University Bundang Hospital (Seongnam, Korea) from June 2003 through December 2005 were analyzed. The life table method and a cross-tubulation analysis, log rank test were used to evaluate the survival curve and the influence that the prognostic factors. The prognostic factors, i.e., age and gender of patients, diameter and length, type of implants, bone graft history and loading time were determined with a Cox proportional hazard model based on logistic regression analysis. Results: The seven-year cumulative survival rate of Osstem implants was 95.37%. The Cox proportional hazard model revealed that the following factors had a significant influence on survival rate; increased diameter, reduced prosthetic loading period and performance of bone grafting. Conclusion: The osstem implants showed satisfactory results over the seven-year study period.

• 대한족부족관절학회지
• /
• 제14권2호
• /
• pp.140-145
• /
• 2010

Purpose: The diabetic charcot neuroarthropathy of ankle is an infrequent site (around 5%), but is definitely the location that, because of the instability and progressive deformity it involves, cause ulceration in a high percentage of patients, and this can then become a reason for amputation. However, the treatment of this disastrous disease is still challenging. We analyzed the clinical and radiological results of ankle arthrodesis by our fixation method in Charcot neuroarthropathy. Materials and Methods: Seven cases that were diagnosed as charcot neuroarthropathy of ankle arthrodesis were followed for more than 16 months postoperatively. Mean age was 57 years, and the mean follow-up period was 27 months. Anterior approach was used in arthrodesis, and internal fixation by 3 or more cannulated screws and hybrid type external fixation were used. Auto iliac bone for grafting was combined in all cases. External fixator was kept for 3 months without weight-bearing. Then, boots brace was applied for more 3 months allowing partial weight-bearing. Four cases had minor complications such as pin site infection. Preoperative and postoperative AOFAS score, time to fusion and postoperative complications were checked. Results: Postoperative fusion was completed in all cases, and the mean time to fusion was 3.4 months. No postoperative complication was checked. At the last follow-up, the mean AOFAS score had increased from 54 points to 72 points. Patient's satisfaction was over 80%. Conclusion: Satisfactory results were obtained after ankle arthrodesis using internal and hybrid type external fixation combined with auto iliac bone graft in charcot neuroarthropathy with minor complications.

• The Journal of Advanced Prosthodontics
• /
• 제10권2호
• /
• pp.138-146
• /
• 2018

PURPOSE. The purpose of this study was to analyze the effects of the splinted implant prosthesis in a reconstructed mandible using three-dimensional finite element analysis. MATERIALS AND METHODS. Three-dimensional finite element models were generated from a patient's computed tomography data. The patient had undergone partial resection of the mandible that covered the area from the left canine to the right condyle. The mandible was reconstructed using a fibula bone graft and dental implants. The left mandibular premolars and molars remained intact. Three types of models were created. The implant-supported prosthesis was splinted and segmented into two or three pieces. Each of these models was further subcategorized into two situations to compare the stress distribution around normal teeth and implants. Oblique loading of 300 N was applied on both sides of the mandible unilaterally. The maximum von Mises stress and displacement of the models were analyzed. RESULTS. The stress distribution of the natural mandible was more uniform than that of the reconstructed fibula. When the loading was applied to the implant prosthesis of reconstructed fibula, stress was concentrated at the cortical bone around the neck of the implants. The three-piece prosthesis model showed less uniform stress distribution compared to the others. Displacement of the components was positively correlated with the distance from areas of muscle attachment. The three-piece prosthesis model showed the greatest displacement. CONCLUSION. The splinted implant prosthesis showed a more favorable stress distribution and less displacement than the separated models in the reconstructed mandible.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제46권4호
• /
• pp.220-227
• /
• 2020

Objectives: Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder. These patients lose their teeth at a young age and are in need of prosthetic rehabilitation. The aim of this systematic review was to assess the success of dental implant placement in these patients. Materials and Methods: An electronic search was performed in PubMed Central, Scopus, and Web of Science using the keyword "Papillon-Lefèvre syndrome" AND "dental implant" OR "prosthodontics". Articles reporting implant placement in patients with PLS until July 2019 were included. Results: Assessment of the included 11 articles reporting 15 cases showed 136 implant placements in these patients. Implant failure occurred in 3 patients (20 implants). The peri-implantitis and failure rate was higher in the maxilla. Meta-analysis showed the probability of failure to be 7% (95% confidence interval [CI] 0%-31%) for maxillary implants and 2% (95% CI 0%-9%) for mandibular implants. The follow-up time ranged between 1 and 20 years. Healing after bone graft and implant placement in these patients was uneventful. Conclusion: Dental implants may be a viable treatment option for PLS patients. Implantation can help preserve alveolar bone if the patients' immunological and growing conditions are well-considered and proper oral hygiene and compliance with the maintenance program are continued.

• Imaging Science in Dentistry
• /
• 제46권2호
• /
• pp.109-115
• /
• 2016

Purpose: Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). Materials and Methods: Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. Results: Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. Conclusion: Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy.

• The Journal of Advanced Prosthodontics
• /
• 제7권6호
• /
• pp.423-430
• /
• 2015

PURPOSE. To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth $Ankylos^{(R)}$ implants. MATERIALS AND METHODS. This was a retrospective clinical study that analyzed 450 single $Ankylos^{(R)}$ implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position. RESULTS. The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05). CONCLUSION. The $Ankylos^{(R)}$ implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture.

• Archives of Reconstructive Microsurgery
• /
• 제22권2호
• /
• pp.52-56
• /
• 2013

Purpose: We had proceeded seven iIpsilateral dorsalis pedis vascularized pedicle flaps in the distal leg and foot to cover the restricted size defects and followed-up average for 5 years and 9 months to evaluate the survival rate, neurosensory function and cosmesis in final results. Materials and Methods: From January 1999 through October 2012, we have performed iIpsilateral dorsalis pedis vascularized pedicle flaps in the distal leg and foot to cover the restricted size defect (average around $3.6{\times}2.4cm$) in 7 cases and average age was 41.6 years (21.5 to 59.0 years). Lesion site was posterior heel in 4 cases, distal anterior leg in 3 cases. Donor structure was the dorsalis pedis artery and the first dorsal metatarsal vessel and deep peroneal nerve in 3 cases and the dorsalis pedis artery and the first dorsal metatarsal vessel in 4 cases. Results: Seven cases (100%) were survived and defect area was healed with continuous dressing without skin graft. The sensory function in the neurovascular flap was restored to normal in 3 cases. Cosmesis was good and fair in 7 cases (85.7%). Conclusion: Ipsilateral dorsalis pedis vascularized pedicle flap in the distal leg and foot is one of the choice to cover the exposed bone and soft tissues without microsurgical procedure.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제26권6호
• /
• pp.666-671
• /
• 2000

Objectives: This study evaluated the availability of mandibular symphysis corticocancellous block grafts in patients treated for reconstruction of intraoral jaw defects. Materials & Methods: 8 patients with mandibular and maxillary bony defects were treated with corticocancellous block of symphysis. The types of defects included 4 pathologic jaw defects and 4 vertical and/or horizontal alveolar deficiencies. The age ranged from 13 to 45 years. Additional treatments such as plate fixation, alloplastic bony substitutes, and/or barrier membrane application were perfomred. They were evaluated for complications and healing of defects. Follow-up period ranged from 6 to 15 months. Results: 2 patients experienced complications such as wound dehiscence and mild resorption of exposed bone. None of the patients needed secondary operation. Paresthesia of lip, chin, and teeth were recovered completely by 6 months postoperatively. Reconstructed wound showed favorable healing and bony consolidation. Conclusion: Corticocancellous block of mandibular symphysis can be used for the reconstruction of a variety of intraoral local jaw defects selectively. Advantages were easy fixation of graft, possibility of restoration of original alveolar contour, and decreased donor site morbidity.