• Title/Summary/Keyword: Bone screws

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Delayed formation of sterile abscess after zygomaticomaxillary complex fracture treatment with bioabsorbable plates

  • Doh, GyeongHyeon;Bahk, Sujin;Hong, Ki Yong;Lim, SooA;Han, Kang Min;Eo, SuRak
    • Archives of Craniofacial Surgery
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    • v.19 no.2
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    • pp.143-147
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    • 2018
  • We present a patient who showed a sterile abscess after facial bone fixation with bioabsorbable plates and screws. He had zygomaticomaxillary complex and periorbital fracture due to falling down. The displaced bones were treated by open reduction and internal fixation successfully using bioabsorbable plate system. However, at postoperative 11 months, abrupt painless swelling was noted on the previous operation sites, left lateral eyebrow and lower eyelid. By surgical exploration, pus-like discharge and degraded materials were observed and debrided. The pathologic analysis revealed foreign body reaction with sterile abscess. This complication followed by bioabsorbable device implantation on maxillofacial bone surgery has been rarely reported in which we call attention to the maxillofacial plastic surgeons.

Aesthetic Correction of a Protrusive Forehead through Repositioning of the Anterior Wall of the Frontal Sinus

  • Han, Daniel Seungyoul;Park, Jin Hyung
    • Archives of Craniofacial Surgery
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    • v.15 no.3
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    • pp.129-132
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    • 2014
  • Facial skeletal remodeling was revolutionized more than 30 years ago, by the work of Tessier and other craniofacial surgeons. However, the need to correct the skeleton in the upper third of the face is not frequently diagnosed or treated in aesthetic facial surgery. Here, we report on the aesthetic correction of a protrusive forehead. A patient visited our hospital for aesthetic contouring with a prominent forehead. The anterior wall of the frontal sinus was removed with a craniotome via the bicoronal approach. After the excised bone was repositioned, it was fixed with a titanium mesh plate and screws. An electric burr was used to contour the supraorbital rim and frontal bone. Once the desired shape was achieved, the periosteum was replaced, and the wound was closed in layers. When performed properly, frontal sinus contouring could significantly improve the appearance in patients with a prominent forehead. Plastic surgeons must carefully evaluate patients with a prominent forehead for skeletal remodeling that involves the accurate and safe repositioning of the anterior wall of the frontal sinus.

THE EFFECT OF REPETITIVE DISTRACTION AND COMPRESSION ON NEW BONE FORMATION DURING DISTRACTION (골신장술시 반복적인 압축과 신장 방법이 골형성에 미치는 영향)

  • Yoon, Byung-Wook;Kim, Yeo-Gab;Oh, Jung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.5
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    • pp.407-416
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    • 2008
  • Purpose: The aim of the present study is to evaluate the effect of repetitive distraction and compression on new bone formation during distraction period. Materials and methods: Sixteen healthy rabbits, weighing about 2.5kg, were used in this experiment. A unilateral mandibular osteotomy was performed in the left mandible and the distractor(Track 1 $plus^{(R)}$, Gebruder Martin $GmbH^{(R)}$, Germany) was fixed with four screws (Cross driver screw $TI^{(R)}$, Gebruder Martin $GmbH^{(R)}$, Germany). After 4 days, the mandibles were distracted at a rate of 0.6mm/day for 10 days to obtain the amount of 6mm distraction in the control group(n=4). In the experimental group A(n=6), they were distracted at a rate of 1.2mm/day for 5 days and then compression of 0.6mm length and distraction of 0.6mm per 12 hours were carried out as counter direction for 5 days, relatively. In the experimental group B(n=6), distraction of 1.2mm length and compression of 0.6mm length per 12 hours were repeated for 10 days to obtain the amount of 6mm distraction finally. The experimental animals were sacrificed at 2 and 4 weeks after surgery and block specimens were obtained. With histologic and histomorphometric analysis, we observed the histologic changes of the cells and bone formation after H-E and Masson- Trichrome staining and then, measured Bone Deposition Rate with TOMORO $ScopeEye^{TM}$ ver. 3.5(Olympus, Japan), Results: Histologically, new bone formation was examined in all experimental groups and the control. But, the ability of bone formation of the experimental group A was somewhat better than any other groups. On the histomorphometric analysis, Bone Deposition Rate was higher in the experimental group A$(50.67{\pm}4.36%)$ than in the control group$(45.94{\pm}3.97%)$ and in the experimental group B$(42.68{\pm}5.70%)$. These data showed significant differences statistically(p<0.05). Conclusion: These results show that the distraction osteogenesis using repetitive compression and distraction force in the early consolidation period may be effective for new bone formation.

APPLICATION OF FINITE ELEMENT ANALYSIS TO EVALUATE IMPLANT FRACTURES

  • Kim Yang-Soo;Kim Chang-Whe;Lim Young-Jun;Kim Myung-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.44 no.3
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    • pp.295-313
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    • 2006
  • Statement of problem. Higher fracture rates were reported for Branemark implants placed in the maxilla and for 3.75 mm diameter implants installed in the posterior region. Purpose. The purpose of this study was to investigate the fracture of a fixture by finite element analysis and to compare different diameter of fixtures according to the level of alveolar bone resorption. Material and Methods. The single implant and prosthesis was modeled in accordance with the geometric designs for the 3i implant systems. Models were processed by the software programs HyperMesh and ANSA. Three-dimensional finite element models were developed for; (1) a regular titanium implant 3.75 mm in diameter and 13 mm in length (2) a regular titanium implant 4.0 mm in diameter and 13 mm in length (3) a wide titanium implant 5.0 mm in diameter and 13 mm in length each with a cementation type abutment and titanium alloy screw. The abutment screws were subjected to a tightening torque of 30 Ncm. The amount of preload was hypothesized as 650 N, and round and flat type prostheses were 12 mm in diameter, 9 mm in height were loaded to 600 N. Four loading offset points (0, 2, 4, and 6 mm from the center of the implants) were evaluated. To evaluate fixture fracture by alveolar bone resorption, we investigated the stress distribution of the fixtures according to different alveola. bone loss levels (0, 1.5, 3.5, and 5.0 mm of alveolar bone loss). Using these 12 models (four degrees of bone loss and three implant diameters), the effects of load-ing offset, the effect of alveolar bone resorption and the size of fixtures were evaluated. The PAM-CRASH 2G simulation software was used for analysis of stress. The PAM-VIEW and HyperView programs were used for post processing. Results. The results from our experiment are as follows: 1. Preload maintains implant-abutment joint stability within a limited offset point against occlusal force. 2. Von Mises stress of the implant, abutment screw, abutment, and bone was decreased with in-creasing of the implant diameter. 3. With severe advancing of alveolar bone resorption, fracture of the 3.75 and the 4.0 mm diameter implant was possible. 4. With increasing of bending stress by loading offset, fracture of the abutment screw was possible.

MINISCREW STABILITY REGARDING DESIGN OF MINISCREW AND THICKNESS OF CORTICAL BONE (교정용 미니스크류의 디자인과 피질골의 두께에 따른 역학적 안정성 평가)

  • Kweon, Young-Sun;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.3
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    • pp.250-259
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    • 2011
  • The aim of this study was to suggest a design for an orthodontic miniscrew which may work most favorably in the thin cortical bone of the adolescent. In this study, orthodontic miniscrews with different diameters, lengths, and body types were manufactured and implanted in two artificial bone samples with different cortical bone thickness. Maximum insertion torque, maximum removal torque, and lateral alteration torque were measured. As a result, the bone quality, body type, diameter, and the length all had their effects on the maximum insertion torque, maximum removal torque, and lateral alteration torque. Cortical bone thickness was the most important factor. In initial stability, conical types showed better results than cylindrical types. Increase in the diameter had favorable effects in achieving mechanical stability. Increase in the length did not have as much influence as the other factors did on the initial stability, but there was a statistically significant difference between screws of 6 mm and 8 mm lengths(p<0.05). In conclusion, the conical type screw with a diameter of 1.8 mm is most favorable in the thin cortical bone of the adolescent. In terms of length, the 8 mm screw is expected to perform better than the 6 mm screw.

Intercalary Tricortical Iliac Bone Graft in the Surgical Treatment of Nonunion of Midshaft Clavicular Fractures (쇄골 간부 불유합에서의 개재 삼면피질 장골 이식술)

  • Cho, Chul-Hyun;Jang, Hyung-Gyu
    • Clinics in Shoulder and Elbow
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    • v.15 no.1
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    • pp.32-36
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    • 2012
  • Purpose: The purpose of this study was to evaluate the radiologic and clinical outcomes after intercalary tricortical iliac bone graft with plate fixation for the nonunion of midshaft clavicular fractures. Material and Methods: Between September 2007 and May 2011, 10 patients who were treated by the intercalary tricortical iliac bone graft, with plate fixation for clavicle nonunion, were studied. The mean follow-up period was 30.7 (12~57) months. After the sclerotic bone was excised to the bleeding cortical bone, we interposed the tricortical iliac bone to provide structural support and restore clavicle length, and then fixed the plate and screws. The radiologic outcomes on the serial plain radiographs and clinical outcomes, according to UCLA, ASES and Quick DASH scores, were analyzed. Results: Bony union was obtained in all cases (100%) and the average union time was 18.4 (14~24) weeks. The average respective UCLA and ASES scores improved from 16.7 and 52.1 preoperatively to 27.4 and 83.6 postoperatively (p<0.05). The average Quick DASH score was 40.5, at the final follow-up. Complications were 2 shoulder stiffness, and one case had removal of device and arthroscopic surgery at 11 months, postoperatively. There were no implant failure or infection. Conclusion: Intercalary tricortical iliac bone graft, with plate fixation for the nonunion of midshaft clavicular fractures, is a good option that can provide structural support and restore clavicle length, as well as high union rate.

Early Marginal Bone Loss around Submerged Implants According to the Patterns of Cover Screw Exposures (Submerged 임플란트에서 덮개나사 노출 양상에 따른 조기 변연골 상실)

  • Choi, Mee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.2
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    • pp.175-182
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    • 2013
  • The purpose of this study was to observe and analyze the initial marginal bone resorption changes according to the patterns of cover screw exposures during healing period followed by implants installation. Total 64 fixtures(TiUniteTM, NobelBiocare, Sweden) were installed in partially edentulous jaws of 28 patients, who were selected retrospectively and were shown at least one cover screw exposure. Cover screw exposures were defined at 1 month recall. According to the patterns of exposures, groups were categorized into group 1 (No exposure), group 2 (pin-point exposure), group 3 (less than 1/2 of cover screw), group 4 (more than 1/2 of cover screw), group 5 (total exposure). Periapical radiographs were taken in purpose of changes of marginal bone level between installation and 2 month recall. Healing abutments were secured on the exposure groups at 2 month recall. Results were as follows: 1. Marginal bone resorptions were identified whenever cover screws were exposed. 2. Group 2 and 3 were shown significantly increased bone loss more than other group (P <.05). 3. Group 4 and 5 were shown significantly increased bone loss more than group 1, however, less than other groups ( P <.05). Conclusionally, cover screw exposure may cause marginal bone resorptions, therefore, early connection of healing abutment is clinically helpful.

The Thermal and Rheological properties of Linear and Star-shaped Poly(L-lactic acid) (선형과 스타형 Poly(L-lactic acid)의 열적, 유변학적 특성)

  • Kim, Eun-Sub;Kim, Byoung-Chul
    • Proceedings of the Korean Fiber Society Conference
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    • 2003.04a
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    • pp.370-371
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    • 2003
  • Poly(lactic acid) is a thermoplastic and biodegradable polymer[1-3]. It has a wide range of application in medical fields such as sutures, screws for bone fractures and drug delivery systems. It has additional potential in other fields like agriculture and packaging. In recent years, there has been an increased interest in star-shaped polymers because they have a higher segment density within the distance of its radius of rotation than linear polymers have under the same conditions.[4] (omitted)

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Posterior Atlantoaxial Screw-Rod Fixation in a Case of Aberrant Vertebral Artery Course Combined with Bilateral High-Riding Vertebral Artery

  • Park, Young-Seop;Kang, Dong-Ho;Park, Kyung-Bum;Hwang, Soo-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.367-370
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    • 2010
  • We present a case of posterior atlantoaxial screw-rod fixation in a patient with an aberrant vertebral artery (VA) course combined with bilateral high-riding VA. An aberrant VA which courses below the posterior arch of the atlas (C1) that does not pass through the C1 transverse foramen and without an osseous anomaly is rare. However, it is important to consider an abnormal course of the VA both preoperatively and intraoperatively in order to avoid critical vascular injuries in procedures which require exposure or control of the VA, such as the far-lateral approach and spinal operations.

Screw Fixation without Fusion for Low Lumbar Burst Fracture : A Severe Canal Compromise But Neurologically Intact Case

  • Jang, Kun-Soo;Ju, Chang-Il;Kim, Seok-Won;Lee, Sung-Myung
    • Journal of Korean Neurosurgical Society
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    • v.49 no.2
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    • pp.128-130
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    • 2011
  • The low lumbar spine is deeply located in flexible segments, and has a physiologic lordosis. Therefore, burst fractures of the low lumbar spine are uncommon injuries. The treatment for such injuries may either be conservative or surgical management according to canal compromise and the neurological status. However, there are no general guidelines or consensus for the treatment of low lumbar burst fractures especially in neurologically intact cases with severe canal compromise. We report a patient with a burst fracture of the fourth lumbar vertebra, who was treated surgically but without fusion because of the neurologically intact status in spite of severe canal compromise of more than 85%. It was possible to preserve motion segments by removal of screws at one year later. We also discuss why bone fusion was not necessary with review of the relevant literature.