• Title/Summary/Keyword: Bone screw

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Computer-Assisted Orthopaedic Surgery in Bone Tumor (항법장치를 이용한 골종양 수술)

  • Cho, Hwan-Seong;Park, Il-Hyung;Mun, Jong-Uk;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.1-6
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    • 2009
  • The usefulness and accuracy of computer-assisted surgery have been evaluated clinically in many orthopedic fields, such as, joint replacement arthroplasty, cruciate ligament reconstruction, and pedicle screw placemen. Recently several preliminary reports have been issued on the application of navigation to bone tumor surgery. The main advantage of navigation-assisted bone tumor surgery is that it provides highly accurate three-dimensional radiological information for intraoperative guidance. In particular, distances from tumors to resection margins can be precisely determined using intraoperative three-dimensional images. Accordingly, the technique allows preservation of function to be maximized by minimizing unnecessary resection. However, surgeons should recognize that the accuracies of navigation systems in bone tumor surgery have some hidden pitfalls. Here, based on our clinical results, we describe the surgical techniques used and include some cautionary notes.

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BICOMPATIBILITY OF BICOMTALS IN RABBIT BONE (임플란트 생체금속들과 골조직간의 생체적합도에 관한 연구)

  • Han, Chong-Hyun;Hoe, Seong-Joo;Chung, Chong-Pyong;Ku, Young;Rhyu, In-Chul;Choi, Yong-Chang
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.3
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    • pp.557-565
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    • 1997
  • Screw-shaped implants of commercially pure (c.p.) titanium, c.p. niobium, c.p. zirconium, and stainless steel(Sus 304) were inserted in the rabbit tibial bone over 12 weeks of follow-up. New developed torque gauge instrument was used to evaluate the implant holding power and a image analysis program coupled to a microscope was used for histomorphometry. The three best consecutive threads of each implant were measured. Quantitative analyses at 12 weeks revealed a partial bone contact to the four kinds investigated metals. There were no obvious adverse tissue reactions to any of the biomaterials. At 12 weeks the average removal torques for titanium, niobium and zirconium were better than that needed for Sus 304 screws, on the other hand high score of bony contact ratio of titanium and niobium were showed in comparison to those of zirconium and Sus 304. There was no significant differences in the amount of interfacial bone of zirconium and Sus 304 whereas there was significant difference in the torque forces of niobium and Sus 304. Three months after implant insertion, the average removal torque was 6.64 Ncm for the titanium, 6.57 Ncm for the niobium, 6.38 Ncm for the zirconium, and 4.25 Ncm for the Sus 304. On average bone contacts there were 51.24% in the titanium, 48.19% in the niobium, 31.79% in the zirconium, 23.54% in the Sus 304. Biocompatibility of the titanium, niobium and zirconium was acceptable level in comparison to the Sus 304.

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Finite element analysis of cortical bone strain induced by self-drilling placement of orthodontic microimplant (Self-drilling 방식의 마이크로임플란트 식립에 의해 발생하는 피질골 스트레인의 유한요소해석)

  • Park, Jin-Seo;Yu, Won-Jae;Kyung, Hee-Moon;Kwon, Oh-Won
    • The korean journal of orthodontics
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    • v.39 no.4
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    • pp.203-212
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    • 2009
  • Objective: The aim of this study was to evaluate the strain induced in the cortical bone surrounding an orthodontic microimplant during insertion in a self-drilling manner. Methods: A 3D finite element method was used to simulate the insertion of a microimplant (AbsoAnchor SH1312-7, Dentos Co., Daegu, Korea) into 1 mm thick cortical bone. The shape and dimension of thread groove in the center of the cortical bone produced by the cutting flute at the apical of the microimplant was obtained from animal test using rabbit tibias. A total of 3,600 analysis steps was used to calculate the 10 turns and 5 mm advancement of the microimplant. A series of remesh in the cortical bone was allowed to accommodate the change in the geometry accompanied by the implant insertion. Results: Bone strains of well higher than 4,000 microstrain, the reported upper limit for normal bone remodeling, were observed in the peri-implant bone along the whole length of the microimplant. Level of strains in the vicinity of either the screw tip or the valley part were similar. Conclusions: Bone strains from a microimplant insertion in a self-drilling manner might have a negative impact on the physiological remodeling of cortical bone.

RIGID FIXATION BY MINIPLATE IN THE MANDIBULAR SAGITTAL SPLITRAMUS OSTEOTOMY. (하악골 시상골 골절단술시 MINIPLATE에 의한 RIGID FIXATION)

  • Cho, Byoung-Ouck;Lee, Youg-Chan;Yang, Yong-Seog;You, Ha-Sik
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.2
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    • pp.48-54
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    • 1990
  • This is a report of 4 cases of the surgical correction of mandibular prognathism with chief complaint of mastication difficulty, facial asymmetry and protrusive chin. We performed sagittal spit ramus osteotomy for the prognathism, we used the repositioning plate for conserving the condylar segment into its original position and fixed the osteotomized bone segments rigidly with adjustable monocortical plate. Intermaxillary fixation was performed during 2 weeks. As a results, we found the following advantage. 1. Rigid fixation effect like the fixation by the tandem screw. 2. Decreased postoprative swelling. 3. It is needless to do the stab incision for the transbuccal set instrument. 4. It is more convenient to perform the rigid fixation in the monocortical plate method than screw technique.

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Comparative Study for Osteosynthesis of Femoral Neck Fractures: Cannulated Screws versus Femoral Neck System

  • Youngho Cho;Jae-uk Shin;Sangwoo Kim
    • Hip & pelvis
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    • v.35 no.1
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    • pp.47-53
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    • 2023
  • Purpose: The purpose of this study is to compare the radiological results of fixation using the femoral neck system (FNS) and cannulated screw (CS) for treatment of femoral neck fractures. Materials and Methods: A retrospective study of patients with femoral neck fractures who underwent internal fixation and had follow-up of more than six months from 2010 to 2020 was conducted. A total of 87 patients were enrolled in the study. The FNS group included 20 patients and the CS group included 67 patients. Classification of fractures was performed according to Garden and Pauwels classification. Operation time, intraoperative blood loss, sliding distance of the implant, lateral soft tissue irritation caused by implants, and complications were evaluated. Results: The mean operation time was 40.30 minutes in the FNS group and 46.84 minutes in the CS group. The mean intraoperative bleeding volume was 51.25 mL in the FNS group and 72.16 mL in the CS group. Bone union was achieved in 18 patients in the FNS group (90.0%) and in 61 patients in the CS group (91.0%). The mean sliding distance of the implant was 4.06 mm in the FNS group and 3.92 mm in the CS group. No patients in the FNS group and 12 patients in the CS group complained of soft tissue irritation. Conclusion: A shorter operative time, less intraoperative bleeding, and less irritation of soft tissue were observed in the FNS group. FNS could be an alternative to CS for fixation of femoral neck fractures.

Allogeneic Inlay Cortical Strut Grafts for Large Cysts or Post-curettage Cavitary Bony Defects (거대 낭종성 골병소 또는 소파 후 잔유 골 결손부에 시행한 내재형 동종 피질 지주골 이식술)

  • Chung, Yang-Guk;Kang, Yong-Koo;Kim, Chol-Jin;Lee, An-Hi;Park, Jeong-Mi;Bahk, Won-Jong;Yoo, Hyun-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.73-78
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    • 2011
  • Purpose: This study was aimed to evaluate the result of inlay cortical strut bone grafts for large cysts or cavitary bone lesions in long bones. Materials and Methods: Seven patients with large cyst or cavitary bony lesions were managed with curettage, allogeneic inlay cortical strut and cancellous bone grafts. Additional plate and screw fixations were performed in 6 patients. There were three SBCs, two FDs with secondary ABC changes, one FD and one post-cement spacer removal state. Three of them had pathologic fractures. Progression of bone healing and mechanical support and functional result were evaluated. The mean follow-up period was 25.4 months. Results: Incorporations into host bones were progressed in all, average 4.2 months in six metaphyseal regions and 5.8 months in five diaphyseal regions respectively. Full structural supports were achieved in all except one patient without any additional procedures. No allograft-related complication was developed. Mean functional score according to the MSTS criteria was 29.6 at last follow up. Conclusion: Inlay cortical strut graft provided additional mechanical stability and bone stock for screw purchase in large cyst or cavitary defects of long bones, which allow early mobilization and excellent functional outcome.

THE EFFECT OF AUTOLOGOUS PLATELET-RICH PLASMA (PRP) ON BONE FORMATION AROUND DENTAL IMPLANT IN THE RABBIT: A HISTOMOR-PHOMETRIC AND REMOVAL TORQUE STUDY

  • Yi Yang-Jin;Yang Jae-Ho;Lee Sun-Hyung;Kim Yung-Soo;Kwon Sang-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.39 no.6
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    • pp.659-681
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    • 2001
  • Platelet-rich plasma(PRP) has been known to increase the rate and degree of bone formation by virtue of growth factors in concentrated platelets. Although its great healing effect on bone defect or pre-implantation site preparation in conjunction with bone substitute has been reported, the effect associated with implant is unknown. The purpose of this study was to investigate the effect of PRP on rapid osseointegration of endosseous dental implants in the rabbit tibiae. Twenty two adult female New Zealand white rabbits, weighing approximately 2.7-3.3kg, were used for this study. Twelve of the 22 animals were used for histomorphometric analysis and ten of the 22 were for removal torque test. Each animal received two implants in each tibia (two treated with PRP and two as control) and was given fluorochrome intramuscularly. For histomorphometric analysis, rabbits were divided into four groups according to the healing period. At 1 week, 2 weeks, 4 weeks and 8 weeks postoperatively, each three animals were sacrificed serially and the amount and rate of bone formation around dental implant were examined on the undecalcified sections under fluorescent microscope, polarized microscope and light microscope connected to a personal computer equipped with image analysis system. For removal torque test, rabbits were divided into two groups and removal torque tests were performed at 4 weeks, 10 weeks after implant placement. In total, 88 screw shaped, commercially pure titanium implants (Neoplant, Neobiotech, Seoul, Korea) were used in this study. Labeling pattern reflected differences of two groups in bone formation rate at each period. Histomorphometrically, PRP group showed significantly higher bone volume within threads compared to control group at 2 weeks ($70.30{\pm}4.96%$ vs. $50.68{\pm}6.33%$; P < .01) and 4 weeks ($82.59{\pm}5.94%$ vs. $72.94{\pm}4.57%$; P < .05 ). PRP group at 1, 2 and 4 weeks revealed similar degree of bone volume formation comparable to control group at 2, 4 and 8 weeks, respectively. On the other hand, while PRP group showed higher bone-implant contact ($47.37{\pm}8.09%$) than control group ($33.16{\pm}13.47%$) at 2 weeks, there were no significant differences between PRP group and control group for any experimental period. Removal torque values also showed no significant differences between PRP group and control group at any experimental period (P > .05). These findings imply that PRP could induce rapid, more bone formation around implant during early healing period and get faster secondary stability for reducing healing period, though it has not induced bone maturation enough to resist functional loading.

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Clinical, histologic, and histometric evaluation of implants with microthreaded crest module and SLA surface (SLA로 표면처리한 microthreaded crest module 임프란트의 임상적, 조직학적, 조직계측학적 분석)

  • Moon, Sang-Kwon;Pang, Eun-Kyoung;Kim, Chang-Sung;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.34 no.1
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    • pp.127-138
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    • 2004
  • Background: Crestal bone loss known as saucerization is a frequently observed phenomenon. Recent studies have shown that implants with micothreaded crest module reduced the force concentration in the crestal region thus resulting in no or reduced crestal bone loss. This study presents a clinical, histologic, and histometric evaluation of implants with microthreaded crest module and SLA surface. Methods: The implants were placed in the mandible of 5 beagle dogs weighing 10-15kg. Four premolars were bilaterally extracted 8 weeks prior to implant placement. Mucoperiosteal flap was elevated and drilling with increasing diameter was performed under saline irrigation. After countersinking 2 implants were placed in each side resulting in 4 implants per dog. Healing period of 8 weeks was allowed before sacrificing the animals. Histologic preparation was performed for histologic and histometric analysis. Bone to implant contact as well as percentage of bone area inside threads were measured. T-test was used for statistical analysis with pvalue p<0.05. Results: 1. Healing was uneventful without any cover screw exposure. New bone formation around the implants was observed without any inflammatory infiltration. 2. Bone to implant contact in the microthread and thread were 43.90 ${\pm}$ 20.30 %, and 53.19 ${\pm}$ 20.97 % respectively. The overall bone to implant contact was 48.54 ${\pm}$ 20.95 %. 3. Percentage of bone area inside threads were 54.43 ${\pm}$ 10.39 %, and 38.44 ${\pm}$ 16.44 % for the microthread and thread respectively. There was statistically significant difference(p<0.05). The overall percentage of bone area inside threads was 46.67 ${\pm}$ 15.68 %.

Effects of electrical stimulation on healing of endo-osseous titanium implants in circumferential defect (전기자극이 성견 골결손부에 매식된 임플란트 주위조직의 치유에 미치는 영향)

  • Shim, Jae-Chang;Kim, Young-Jun;Chung, Hyun-Ju;Kim, Ok-Su
    • Journal of Periodontal and Implant Science
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    • v.34 no.1
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    • pp.177-193
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    • 2004
  • Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggested that electrical currents promote osseointegration around dental implants. The purpose of this study was to determine the effect of direct microcurrent to endosseous titanium implants placed in bone defects. The right and left 2nd, 3rd and 4th mandibular premolars in ten mongrel dogs (15Kg of weight) were extracted. One monthe later, Ti-machined screw type implants(3.8 mm diameter x 8.5 mm length, $AVANA^{(R)}$, Ostem) were placed in surgically created circumferential defect area(width 5mm, depth 4mm). The implants were divided into three groups according to the treatment modalities: Control group- implants without electrical stimulation; Experimental group I- implants with allogenic demineralized freeze dried bone grafting; and Experimental group II-implants allogenic demineralized freeze dried bone grafting and electric stimulation. The animals were sacrificed in the 4th and 8th week after implant placement and un-decalcified specimens were prepared for histological and histometrical evaluation of bone-implant contact ratio (BIC) and bone formation area ratio (BFA) in defect area. Some specimens at 8 weeks after implantation were used for removal torque testing. Histologically, there was connective tissue infiltration in the coronal part of defect area in control and the experimental group I, whereas direct bone contact was found in the experimental group II without connective tissue invasion. Average BIC ratios at 4 weeks of healing were 60.1% in the experimental group II, 47.4% in the experimental group I and 42.7% in the control. Average BIC ratios at 8 weeks after implantation were 67.6% in the experimental group II, 55.9% in the experimental group I and 54.6% in the control. The average BFA ratio was 84.0% in the experimental group II, 71.8% in the experimental group I and 58.8% in the control at 4 weeks, and the BFA ratios were 89.6% in the experimental group II, 81.4% in the experimental group I and 70.5% in the control at 8 weeks after implantation. The experimental group II showed also significantly greater BIC and BFA ratios compared to the control and the experimental group I (p<0.05). The removal torque values at 8 weeks after implantation were 56 Ncm in the experimental group II, 49 Ncm in the experimental group I and 43 Ncm in the control. There was a statistically significant difference among 3 groups (p<0.05). These results suggest that electrical stimulation improve and accelerate bone healing around endosseous titanium implants in bone defect.

Treatment of Medial Patellar Luxation by Placement of a Cortical Screw on the Medial Side of the Tibial Crest in a Dog (개에서 경골 조면 내측에 피질골 나사못을 장착하는 방법에 의한 내측 슬개골 탈구 치료 증례)

  • Kang, Byung-Jae;Yoon, Daeyoung;Rhew, Daeun;Kim, Yongsun;Lee, Seunghoon;Kim, Wan Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.133-136
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    • 2014
  • An 8 kg, 9-month-old castrated male Shiba Inu presented with a history of intermittent bilateral hind limb lameness. On examination, grade III medial patellar luxation of the bilateral hind limbs was diagnosed. A novel surgical method involving relatively noninvasive tibial tuberosity transposition was used to restore normal alignment of the quadriceps mechanism. The procedure involved an incision on the medial cortical bone of the tibial tuberosity along the tibial crest and placement of a cortical screw on the medial side of the tibial crest to laterally transpose the tibial tuberosity. Lameness and patellar luxation of bilateral hind limbs were improved at a 3-month postoperative examination. This technique could be considered an effective treatment for medial patellar luxation in skeletal immature patients.