The purpose of this study was to observe the tissue response to the orthodontic force applied immediately after buccal horizontal subapical osteotomy of maxilla. Five mongrel cats weighing about 2.5 Kg were used for this experiment. The left upper canine and premolar of each cat served as a experimental side and the right ones as a control side. On the experimental side, a 100gm orthodontic force was applied between the upper canine and premolar immediately after the osteotomy. On the control side, the same orthodontic force was applied without the osteotomy. After 7days, the experimental animals were sacrificed. The results were as follows: 1. In the pressure zones of the experimental group, significant increase of osteoclasts and direct resolution along the alveolar bone surface was observed as compared with those of the control group. 2. In the pressure 2ones of the experimental group, a less extensive hyalinized zone was observed than those of the control group. 3. In the pressure zones of both group, no root resorption was found. 4. Tn the tension zones of the experimental group, new bone deposition increased along the alveolar bone surface as compared with those of the control group. In conclusion, the results suggest the possibility that early orthodontic treatment after orthognathic surgery may have some benefits if the stability of the repositioned segment at surgery is secured.
Objective: The purpose of this study was to evaluate the effect of length and shape of cutting flute on mechanical properties of orthodontic mini-implants. Methods: Three types of mini-implants with different flute patterns (Type A with 2.6 mm long flute, Type B with 3.9 mm long and straight flute, Type C with 3.9 mm long and helical flute) were inserted into the biomechanical test blocks (Sawbones Inc., USA) with 2 mm and 4 mm cortical bone thicknesses to test insertion and removal torque. Results: In 4 mm cortical bone thickness, Type C mini-implants showed highest maximum insertion torque, then Type A and Type B in order. Type C also showed shortest total insertion time and highest maximum removal torque, but Type A and B didn't showed statistically significant difference in insertion time and removal torque. In 2 mm cortical bone thickness, there were no significant difference in total insertion time and maximum removal torque in three types of mini-implants, but maximum insertion torque of Type A was higher than two other Types of mini-implants. Conclusions: Consideration about length and shape of cutting flute of mini-implant is also required when the placement site has thick cortical bone.
Despite of technical difficulties, the combination of occlusal projection and densitometric digital analysis may ultimately provide a means of detection of subtle bone loss at the facial and lingual side of dental implant (Oblique occlusal view is more useful for $ITI^{(R)}$ dental implant due to its contour of shoulder as like tulip flower). In this study, conventional periapical projections of x-ray beam had shown more high sensitivity to detect the bony defects than oblique occlusal projections in alveolar crest obscured by dental implants or not, even if the difference was not statistically significant. Unlike conventional periapical projections. occusal projections combined with densitometric digital analysis technique may provide a means for detection of subtle bone change at the all around of implants without obscuring effect by implant itself. Although the results from this in vitro study were performed under limited circumstances, these results might afford more possibility and versatile modality of diagnosis options to clinician in the implant practice.
Statement of problem: Modification of titanium implant surface has potential to ensure clinically favorable performance that several surface modification technologies have been introduced. Among the methods. anodizing method and sol-gel hydroxyapatite coating method have gained much interest due to its roughness and chemical composition of the coating layer, but more of its biocompatibility result is required. Purpose : The purpose of this study was to compare bone-implant interface shear strength of four different surface treated implants as time elapsed. Resonance frequency analysis(RFA) and removal torque measurement methods were employed to measure implant stability at one week and six week after implantation. Material and method: A total of 80 screw-shaped implant [20 machined, 20 resorbable media blasted(RBM), 20 anodized, and 20 anodized+hydroxyapatite sol-gel coated] were prepared, and one of each group was implanted in the tibia of a New Zealand white rabbit that total 20 of them were used. In order to test the implant stability and implant-tissue interface contact changing in the bone bed, each 10 rabbit were sacrificed 1 week and 6 week later while resonance frequency and removal torque were measured. One-way analysis of variance and the Tukey test were used for statistical analysis. Results : The results were as follows. 1. There was no statistically significant difference of implant stability quotients(ISQ) value in RFA between individual groups after 1 week of implantation and 6 weeks(p>0.05). But, there was statistically significant increase of ISQ value in 6 weeks group compared to 1 week group(p<0.05). 2. There was no statistically significant difference in removal torque analysis between individual groups after 1 week of implantation and 6 weeks(p>0.05). but there was statistically significant increase in all 4 groups after 6 weeks compared to 1 week later(p<0.05). 3. There was no statistically significant difference in removal torque analysis between anodized group and HA coating after anodic oxidation 6 weeks later(p>0.05), but significant difference was appeared in both groups compared to RBM group and smooth-machined group(p<0.05). Conclusions : It can be suggested that changes in surface characteristics affect bone reactions. Anodized and anodized+hydroxyapatite sol-gel coating showed significantly improved bone tissue response to implants, but further study on the effect of hydroxyapatite dissolution is needed.
Kim, Dae-Dong;Kang, Dae-Young;Cho, In-Woo;Song, Young-Gyun;Shin, Hyun-Seung;Park, Jung-Chul
Journal of Dental Rehabilitation and Applied Science
/
v.35
no.4
/
pp.235-243
/
2019
Osseointegration has been reported to be a dynamic process in which the alveolar bone comes in direct contact with the implant. Various methods were tried to evaluate degree of osseointegration and the measurement of bone-implant contact (BIC) have been commonly used among them. To properly assess the BIC, only histologic analysis is available. However, few studies evaluated BIC of successfully osseointegrated implants in humans. Thus, this is a unique opportunity when implants should be explanted due to inappropriate positioning of implant, presence of pain or sensory disturbance, or broken screw or fixture. This report presents a case of the implant underwent 3-year functional load and a histologic analysis after the fixture fracture. The histomorphometric analysis revealed 53.1% of BIC measured along the whole implant and 70.9% measured only in subcrestal area, respectively. In the present study, although the implant was fractured, a high degree of BIC was observed.
Ahn, Hee Chang;Youn, Dong Hyun;Choi, Matthew Seung Suk;Chang, Jung-Woo;Lee, Jang Hyun
Archives of Craniofacial Surgery
/
v.16
no.3
/
pp.131-135
/
2015
Background: Variable methods have been introduced for reduction of the zygomatic fractures. The Dingman elevator is used widely to reduce these fractures but is inappropriate in certain types of fractures which require atypical traction vectors. We introduce and examine an alternate method of reducing zygomatic fractures using wire and hook traction. Methods: A retrospective study was performed for all zygomatic fracture patients admitted between 2008 and 2014. Medially rotated fractures were reduced by using a wire looped through an intermaxillary screw secured on the medial side of the zygoma. Laterally rotated fractures were reduced using a hook introduced through an infrazygomatic skin incision. Results: No accidental bleeding or incomplete reduction was observed in any of the cases. Postoperative imaging demonstrated proper reduction immediately after the operation. Follow-up computed tomography study at 1 month after operation also demonstrated proper reduction and healthy union across the previous site of fracture. Conclusion: The hook and wire method allowed precise application of traction forces across zygomatic fractures. The fractured bone fragment could be pulled in the direction precisely opposite to the vector of impact at the time of trauma. Soft tissue damage due to dissection was minimized. In particular, this method was effective in reducing rotated bone fragments and can be an alternative option to using the zygoma elevator.
Fractures located at the metaphyseal/diaphyseal junction at the base of the fifth metatarsal were first described by Sir Robert Jones in 1902. However, ever since, there has been disagreement and debate regarding the diagnosis, classification, pathomechanics, the incidences, and potential causes of delayed unions and nonunions, and the optimal method of treatment. It appears to be widely agreed that proximal fractures of the metaphyseal/diaphyseal region of the fifth metatarsal are prone to delayed union or even nonunion. Several classifications of proximal fifth metatarsal stress fractures have been devised. Torg et al. classified fractures involving the proximal part of the diaphysis of the fifth metatarsal into three types. The Torg classification is a good grading system that can be used to determine the type of surgery needed as well as for the prediction of prognosis. The ''plantar gap'' might add to the decision-making process for surgery and improve the prediction of patient prognosis. In addition, the new classification using 'plantar gap' might be used for classification of fifth metatarsal stress fracture. Fifth metatarsal stress fractures can be treated conservatively or surgically, and excellent results have been reported for surgery with rapid recovery in athletes. Intramedullary screw fixation has become a popular form of fixation for fifth metatarsal stress fractures. Bone grafting presents the problems of a longer recovery time and additional skin incision for harvesting. The modified tension band wiring is an useful and simple option for surgical treatment of challenging fifth metatarsal stress fractures.
Statement of problem. Resonance frequency analysis has been increasingly served as a non-invasive and objective method for clinical monitoring of implant stability. Many clinical studies must be required for standardized data using RFA. Purpose. This study was performed to evaluate RFA value changes in two anodized implant groups. Material and method. Among a total of 24 implants, twelve screw shaped implants as a test group (H2-R8.5) were manufactured, which had a pitch-height of 0.4 mm, an outer diameter of 4.3 mm, a length of 8.5 mm, and external hexa-headed, were turned from 5 mm rods of commercially pure titanium (ASTM Grade IV, Warantec Co., Seoul, Korea), and another twelve implants as a control group were $Br{\aa}nemark$ Ti-Unite MK4 (diameter 4.0 mm, length 8.5 mm). Each group was installed in tibia of rabbit. Two implants were placed in each tibia (four implants per rabbit). Test two implants were inserted in right side and control two in left side. ISQ values were measured using $Osstell^{TM}$ (Integration Diagnostics Ltd. Sweden) during fixture installation, and 12 weeks later and evaluated the RFA changes. Results. Mean and SD of baseline ISQ values of test group were $75.0{\pm}3.4$ and $68.7{\pm}8.1$ for control group. Mean and SO of ISQ values 12 weeks after implant insertion were $73.2{\pm}4.7$ for test group and $72.6{\pm}3.9$ for control group. There were no statistically significant differences between groups in ISQ values after 3 months (P>0.05). From the data, RFA gains after 3 months were calculated, and there was statistically significant difference between groups (P<0.05). Conclusion. Although there were RFA changes between groups, implant stability after experimental period shows alike tendency and good bone responses.
Lee, Seung Ku;Kim, Choong Hyun;Cheong, Jin Hwan;Bak, Koang Hum;Kim, Jae Min;Oh, Suck Jun
Journal of Korean Neurosurgical Society
/
v.30
no.5
/
pp.605-610
/
2001
Objective : The authors investigated the efficacy of the calcium sulfate(OsteoSet$^{(R)}$ pellets) as an autograft extender when used to perform posterolateral lumbar fusions. Patients and Methods : Twenty patients who underwent lumbar posterolateral arthrodesis for various spinal diseases between October 1999 and March 2000 were evaluated. Arthrodesis was performed by transpedicular screw fixation and bone grafting with a mixture of autograft + calcium sulfate in a 1 : 1 ratio. At time intervals of 1, 2, 3, and 6 months, postoperative radiographs were obtained to review the resorption of calcium sulfate and the evidence of fusion. A modified Lenke scale was used to assess the status of the fusion. Results : At 2 months after operation, the average modified Lenke scale score for the OsteoSet$^{(R)}$ pellets group was 3.8. However at 6 months after operation, the average modified Lenke scale score for the OsteoSet$^{(R)}$ pellets group was 1.8. Resorption of calcium sulfate pellets was revealed in all cases at 6 months after surgery. Conclusion : It is presumed that a combination of calcium sulfate and autograft can play a role as an effective autograft extender in the posterolateral spinal fusion.
Background: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. Methods: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. Results: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was $3.09^{\circ}$. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. Conclusions: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.
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