• 대한두개안면성형외과학회지
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• 제14권2호
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• pp.119-123
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• 2013

Except for special situations, it is generally agreed that best results in the treatment of facial fractures is expected if reduction is done within the first 2 or 3 weeks after injury. We reduced facial bone fractures at 4 to 7 weeks after trauma. A 44-year-old female patient underwent open reduction for her right zygomaticomaxillary complex fracture at 7 weeks after injury. A 59-year-old female patient underwent surgery for the right mandible body and left parasymphysis fractures at 4 weeks after injury. Using traditional approaches, granulation tissue and callus were removed from the fracture sites, and malunited fracture lines were separated by a small osteotome. We reduced the displaced fractured zygoma and mandible to their normal anatomical positions and fixed them using titanium plates. No complications such as asymmetry, malunion, malocclusion, or trismus were seen. Unfavorable asymmetric facial contours were corrected, and we obtained good occlusion with favorable bony alignment. The functional and aesthetic outcomes were satisfactory. Through removal the callus and limited osteotomy, a successful approach to the previously fractured line was possible, and an exact correction with symmetry was obtained. This method can be a good option for obtaining good mobility and clinical results in treating delayed facial bone fractures.

• 동의생리병리학회지
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• 제23권4호
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• pp.860-865
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• 2009

Osteoclasts are bone-resorbing multinucleated cells derived from the monocyte/macrophage lineage. The differentiation of osteoclasts are regulated by osteoblastic cells expressed RANKL, which is the most critical molecule for osteoclast differentiation. In this study, we found that water extracts of cuscuta inhibited RANKL-mediated osteoclast differentiation by direct action on bone marrow macrophages (BMMs) without cytotoxicity. In BMMs, water extracts of cuscuta inhibited the mRNA expression of c-Fos, NFATc1, TRAP, and OSCAR. Also, the protein expression of c-Fos and NFATc1 was inhibited by water extracts of cuscuta treatement. Water extracts of cuscuta inhibited the phosphorylation of p38, ERK, and JNK in BMMs treated with RANKL. However, water extracts of cuscuta did not inhibit RANKL-induced I-${\kappa}B$ activation. Water extract of cuscuta failed to inhibit bone resorption by osteoclasts cultured on hydroxyapatite plates. These results suggest that cuscuta may be a promising drug for use against bone disorders such as osteoporosis and rheumatoid arthritis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권5호
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• pp.276-284
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• 2019

Objectives: This study sought to compare efficiency results between the use of a customized implant (CI) and a reconstruction plate (RP) in mandibular defect reconstruction in an animal model. Materials and Methods: Fifteen rabbits underwent surgery to create a defect in the right side of the mandible and were randomly divided into two groups. For reconstruction of the mandibular defect, the RP group (n=5) received five-hole mini-plates without bone grafting and the CI group (n=10) received fabricated CIs based on the cone-beam computed tomography (CBCT) data taken preoperatively. The CI group was further divided into two subgroups depending on the time of CBCT performance preoperatively, as follows: a six-week CI (6WCI) group (n=5) and a one-week CI (1WCI) group (n=5). Daily food intake amount (DFIA) was measured to assess the recovery rate. Radiographic images were acquired to evaluate screw quantity. CBCT and histological examination were performed in the CI subgroup after sacrifice. Results: The 1WCI group showed the highest value in peak average recovery rate and the fastest average recovery rate. In terms of reaching a 50% recovery rate, the 1WCI group required the least number of days as compared with the other groups ($2.6{\pm}1.3days$), while the RP group required the least number of days to reach an 80% recovery rate ($7.8{\pm}2.2days$). The 1WCI group showed the highest percentage of intact screws (94.3%). New bone formation was observed in the CI group during histological examination. Conclusion: Rabbits with mandibular defects treated with CI showed higher and faster recovery rates and more favorable screw status as compared with those treated with a five-hole mini-plate without bone graft.

• Archives of Plastic Surgery
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• 제49권3호
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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.

• Journal of Periodontal and Implant Science
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• 제36권4호
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• pp.797-808
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• 2006

Objective : The purpose of this study was to evaluate the physicochemical properties and cytocompatibility of microporous, spherical biphasic calcium phosphate(BCP) ceramics with a 60/40 $hydroxyapatite/{\beta}$ -tricalcium phosphate weight ratio for application as a bone graft substitute. Materials and Methods : Microporous, spherical BCP granules(MGSB) were prepared and their basic characteristics were compared with commercially available BCP(MBCP; Biomatlante, France) and deproteinized bovine bone mineral(Bio-Oss; GBistlich-Pharma, Switzerland, BBP; Oscotec. Korea), Their physicochemical properties were evaluated by scanning electron microscopy, X-ray diffractometry, Fourier-transform infrared spectroscopy, inductively coupled plasma atomic emission spectrometer, and Brunauer-Emmett-Teller method. Cell viability and proliferation of MC3T3-El cells on different graft materials were evaluated. Results : MGSB granules showed a chemical composition and crystallinity similar with those in MBCP, they showed surface structure characteristic of three dimensionally, well-interconnected micropores. The results of MTT assay showed increases in cell viablity with increasing incubation times. At 4d of incubation, MGSB, MBCP and BBP showed similar values in optical density, but Bio-Oss exhibited significantly lower optical density compared to other bone substitutes(p <0,05). MGSB showed significantly greater cell number compared to other bone substitutes at 3, 5, and 7d of incubation(p <0,05), which were similar with those in polystyrene culture plates. Conclusion: These results indicated the suitable physicochemical properties of MGSB granules for application as an effective bone graft substitute. which provided compatible environment for osteoblast cell growth. However, further detailed studies are needed to confirm its biological effects on bone formation in vivo.

• Structural Engineering and Mechanics
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• 제88권5호
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• pp.501-519
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• 2023

This paper introduces a new hybrid structural connection joint that combines shear walls with section steel beams, fundamentally resolving the construction complexity issue of requiring pre-embedded connectors in the connection between shear walls and steel beams. Initially, a quasi-static loading scheme with load-deformation dual control was employed to conduct low-cycle repeated loading experiments on five new connection joints. Data was acquired using displacement and strain gauges to compare the energy dissipation coefficients of each specimen. The destruction process of the new connection joints was meticulously observed and recorded, delineating it into three stages. Hysteresis curves and skeleton curves of the joint specimens were plotted based on experimental results, summarizing the energy dissipation performance of the joints. It's noteworthy that the addition of shear walls led to an approximate 17% increase in the energy dissipation coefficient. The energy dissipation coefficients of dog-bone-shaped connection joints with shear walls and cover plates reached 2.043 and 2.059, respectively, exhibiting the most comprehensive hysteresis curves. Additionally, the impact of laminated steel plates covering composite concrete floors on the stiffness of semi-rigid joint ends under excessive stretching should not be disregarded. A comparison with finite element analysis results yielded an error of merely 2.2%, offering substantial evidence for the wide-ranging application prospects of this innovative joint in seismic performance.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.196-205
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• 2023

Purpose: Surgical stabilization of rib fractures (SSRF) is widely used in patients with flail chests, and several studies have reported the efficacy of SSRF even in multiple rib fractures. However, few reports have discussed the hardware failure (HF) of implanted plates. We aimed to evaluate the clinical characteristics of patients with HF after SSRF and further investigate the related factors. Methods: We retrospectively reviewed the electronic medical records of patients who underwent SSRF for multiple rib fractures at a level I trauma center in Korea between January 2014 and January 2021. We defined HF as the unintentional loosening of screws, dislocation, or breakage of the implanted plates. The baseline characteristics, surgical outcomes, and types of HF were assessed. Results: During the study period, 728 patients underwent SSRF, of whom 80 (10.9%) were diagnosed with HF. The mean age of HF patients was 56.5±13.6 years, and 66 (82.5%) were men. There were 59 cases (73.8%) of screw loosening, 21 (26.3%) of plate breakage, 17 (21.3%) of screw migration, and seven (8.8%) of plate dislocation. Nine patients (11.3%) experienced wound infection, and 35 patients (43.8%) experienced chronic pain. A total of 21 patients (26.3%) underwent reoperation for plate removal. The patients in the reoperation group were significantly younger, had fewer fractures and plates, underwent costal fixation, and had a longer follow-up. There were no significant differences in subjective chest symptoms or lung capacity. Conclusions: HF after SSRF occurred in 10.9% of the cases, and screw loosening was the most common. Further longitudinal studies are needed to identify risk factors for SSRF failure.

• Imaging Science in Dentistry
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• 제45권2호
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• pp.89-94
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• 2015

Purpose: This study was performed to evaluate the relationship between pterygoid plate asymmetry and temporomandibular joint disorders. Materials and Methods: Cone-beam computed tomography (CBCT) images of 60 patients with temporomandibular disorders (TMD) involving pain were analyzed and compared with images of 60 age-and gender-matched controls. Three observers performed linear measurements of the lateral pterygoid plates. Results: Statistically significant differences were found between measurements of the lateral pterygoid plates on the site that had pain and the contralateral site (p<0.05). The average length of the lateral pterygoid plates (LPPs) in patients with TMD was $17.01{\pm}3.64mm$ on the right side and $16.21{\pm}3.51mm$ on the left side, and in patients without TMD, it was $11.86{\pm}1.97mm$ on the right side and $11.98{\pm}1.85mm$ on the left side. Statistically significant differences in the LPP length, measured on CBCT, were found between patients with and without TMD (p<0.05). The inter-examiner reliability obtained in this study was very high for all the examiners (0.99, 95% confidence interval: 0.98-0.99). Conclusion: Within the limits of the present study, CBCT lateral pterygoid plate measurements at the side with TMD were found to be significantly different from those on the side without TMD. More research is needed to explore potential etiological correlations and implications for treatment.

• Clinics in Shoulder and Elbow
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• 제15권2호
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• pp.117-122
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• 2012

목적: 전위성 쇄골 간부 골절에서 관혈적 정복술 후 윤곽 성형된 잠김 압박 금속판(precontoured locking compression plate)을 이용하여 내고정을 시행한 환자를 대상으로 방사선학적 결과 및 임상적 결과를 분석하여 윤곽 성형된 잠김 압박 금속판의 유용성을 알아보고자 하였다. 대상 및 방법: 2009년 3월부터 2010년 2월까지 본원에서 쇄골 간부 골절에 대해 윤곽 성형된 잠김 압박 금속판을 이용하여 관혈적 정복 및 금속 고정술을 시행하고 1년 이상의 추시가 가능했던 34예를 대상으로 하였다. 수술 후 방사선학적 결과는 골유합 여부와 성별 및 나이에 따른 골유합 시기의 차이를 평가 하였으며 임상적 결과는 최종 추시 시 quick DASH Score 및 반대측과 관절 운동 범위의 차이를 평가 하여 분석하였다. 결과: 방사선학적 평가에서 모든 예에서 골유합을 얻을 수 있었으며 평균 골유합 기간은 12.3주였으며 성별 및 나이에 따른 골유합 기간은 통계학적으로 유의한 차이를 보이지 않았다(p=0.87). 임상적 평가에서 최종 quick DASH Score는 평균 23.5점 (12~42)이었으며, 최종 추시시 견관절의 운동은 건측과 비교 시 통계학적으로 유의한 차이를 보이지 않았다 (p=0.69). 결론: 전위성 쇄골 간부 골절에 대해 윤곽 성형된 잠김 압박 금속판을 이용한 내고정술은 정확한 해부학적 정복과 견고한 내고정을 유지 할 수 있어 조기 운동이 가능하여 견관절 운동의 회복과 함께 전례에서 골유합을 얻을 수 있어 쇄골 간부 골절 치료에서 유용하게 사용될 수 있다고 사료된다.

• 치과방사선
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• 제24권1호
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• pp.7-21
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• 1994

Fifty-two cases of traumatic bone cysts in 50 patients were analysed clinically and radiologically. The obtained results were as follows; 1. Women showed a slightly higher incidence than did men (56% of patients) and the average age proved to be 18.6 years. 2. The majority of the cases were asymptomatic. being detected incidentally. and over the half of the cases occurred in the mandibular symphyseal region. 3. All cases were unilocular and the largest diameter of the lesions varied from 1 to 10㎝, mean 3㎝. 4. Some degree of marginal condensation was present in 28 cases and 23 cases presented pencil-sketch appearance. 5. Many anatomical cortical plates (especially, mandibular inferior cortex and lamina durae) consisted of the margin of the lesions partly. 6. Erosive change of the mandibular inferior cortex was caused by 12 cysts, but cortical expansion only by 3 cysts including 2 cases of buccal expansion. 7. The lesion enveloped the roots of the adjacent teeth in 27 cases and scalloping was present between roots in 17 cases. 8. Lamina dura of the teeth was destroyed by only 1 cyst, and in 1 case root resorption was noticed. But there was no divergence of the roots of teeth.