• Title/Summary/Keyword: Class III treatment

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Application of CAD-CAM technology to surgery-first orthognathic approach (디지털 기술을 이용한 선수술 악교정치료)

  • Kim, Yoon-Ji;Gil, Byung-Gyu;Ryu, Jae-Jun
    • The Journal of the Korean dental association
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    • v.56 no.11
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    • pp.622-630
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    • 2018
  • For successful surgery-first approach, accurate prediction of skeletal and dental changes following orthognathic surgery is essential. With recent development of digital technology using computer-aided design/computer-aided manufacturing (CAD/CAM) technology, attempts to provide more predictable orthodontic/orthognathic treatment have been made through 3D virtual surgery and digital tooth setup. A clinical protocol for the surgery-first orthognathic approach using virtual surgery is proposed. A case of skeletal Class III patient with facial asymmetry treated by the surgery-first approach using digital setup and virtual surgery is presented. Advantages and limitations of applying CAD/CAM technology to orthognathic surgery are discussed.

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Systemic Review of Pramlintide, a New Drug for the Treatment of Diabetes Mellitus (새로운 당뇨병 치료제 Pramlintide의 Systematic Review)

  • Shanmugam, Srinivasan;Jung, Hee-Yong;Yong, Chul-Soon;Choi, Han-Gon;Kim, Jung-Ae;Yoo, Bong-Kyu
    • YAKHAK HOEJI
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    • v.50 no.6
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    • pp.386-392
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    • 2006
  • Pramlintide, a synthetic analogue of human hormone amylin, is the first of a new class of amylinomimetic compounds. Present study was undertaken to compile and analyze the clinical trials of pramlintide, and thereby to facilitate the design of the bridging study for the earlier introduction of the drug, which might be needed by diabetes patients in Korea. Sixty-two articles from Pubmed and MEDLINE search were used to analyze the trials of pramlintide along with prescribing information and New Drug Application packet obtained form the manufacturer. The efficacy of the new drug was attributed to three mechanisms: delay of gastric emptying time, inhibition of post-prandial glucagon secretion, and reduction of food intake by enhanced satiety. Clinical trials consistently identified the effectiveness of the drug for the treatment of type 1and type 2 diabetes who have failed to achieve glycemic control despite optimal therapy with insulin. However, the six pivotal Phase III clinical trials were peformed with mostly caucasian and some black and hispanic people. None of the trials documented the proportion of either Asian or Korean participants. Since Korean diabetes patients show different epidemiology and characteristics in their disease state, it appears that the bridging study of pramlintide should be designed in the level of full scale Phase III clinical trial along with pharmacokinetic and pbarmacodynamic studies.

A Case of Severe Aconitine Intoxication with Ventricular Tachycardia, Successfully Treated by a Combination of Two Anti-arrhythmic Drugs (두 가지 항부정맥 약제를 병용 투여하여 성공적으로 치료한 심실빈맥이 동반된 부자중독 1례 보고)

  • Ryoo, Seung-Mok;Sohn, Chang-Hwan;Oh, Bum-Jin;Kim, Won;Lim, Kyoung-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.2
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    • pp.105-108
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    • 2011
  • Aconitine is an anti-inflammatory agent with therapeutic uses in oriental medicine as an analgesic and for treatment of stroke. Because of its sodium channel effect, aconitine can promote undesirable, wide complex tachyarrhythmia. If tachycardia develops during use of aconitine, class Ia and class III anti arrhythmic drugs can be utilized for treatment. However there are no single anti-arrhythmia agents which are uniformly effective. We report a case, characterized by wide complex tachyarrhythmia and severe hypotension, which was successfully treated by simultaneous injections of amiodarone and lidocaine. A 59-year-old woman exhibiting clinical signs of drowsiness as a result of ingesting 6 g of aconitine, was admitted to the emergency department. Initially, wide complex tachyarrhythmia (ventricular tachycardia and pulse rate of 180 beats/min) and severe hypotension (blood pressure of 53/26 mmHg) was observed. After simultaneous injection of amiodarone and lidocaine, the patient's rhythm pattern changed to an accelerated junctional rhythm with ventricular premature complex. Two hours later, the patient's heart pattern became a sinus rhythm. As demonstrated by this case, simultaneous injections of amiodarone and lidocaine can be useful in treating ventricular arrhythmia induced by aconitine.

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A case of severe mandibular retrognathism with bilateral condylar deformities treated with Le Fort I osteotomy and two advancement genioplasty procedures

  • Nakamura, Masahiro;Yanagita, Takeshi;Matsumura, Tatsushi;Yamashiro, Takashi;Iida, Seiji;Kamioka, Hiroshi
    • The korean journal of orthodontics
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    • v.46 no.6
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    • pp.395-408
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    • 2016
  • We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.

The study on the cleft lip and/or palate patients who visited Dept. of Orthodontics, Seoul National University Dental Hospital during last 11 years (1988.3-1999.2) (최근 11년간 서울대학교병원 교정과에 내원한 순구개열 환자의 내원 현황에 관한 연구(1988.3 - 1999.2))

  • Yang, Won-Sik;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.29 no.4 s.75
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    • pp.467-481
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    • 1999
  • Cleft lip and/or palate is one of the most common congenital craniofacial anomalies. According to previous epidemiologic studies, incidence of cleft lip and/or palate has been increasing nowadays. However, there is no report about epidemiologic study of cleft lip and/or palate patients who visited dept. of orthodontics in Korea. So the purpose of this study was to provide the epidemiological characteristics and important basic clinical data for the diagnosis and the treatment of the cleft lip and/or palate patients. With the orthodontic and cleft charts, diagnostic models and X-ray films from 250 patients with cleft lip and/or palate who visited Dept. of Orthodontics, Seoul National University Dental Hospital during the last 11 years, the authors investigated patient's visiting yew, types of cleft, patient's gender, and Angle's classification of malocclusion, and surgery timing. The results were as follows ; 1. The number of cleft patients who visited Dept. of Orthodontics, SNUDH increased during 1988-1990 and then it declined until 1992. From 1993 to 1996, it showed a stationary trend. After 1997 it showed an overwhelmingly increasing trend. 2. In the cleft type, the ratio of cleft lip cleft lip and alveolus cleft palate : cleft lip and palate was 7.6:19.2:9.6:63.6. In cleft position, unilateral clefts were more than bilateral ones (cleft lip 79:21, cleft lip and alveolus 77:23, cleft lip and palate 75.5:24.5). In cleft side, left clefts were mote than right clefts (cleft lip 53.3:46.7 cleft lip and alveolus 59.5:40.5, cleft lip and palate 59.2:40.8). 3. In gender ratio, males were more than females in cleft lip (57.9:42.1), cleft lip and alveolus (68.8:31.2) and cleft lip and palate (76.1:23.9). But in cleft Palate females were more than males as 41.7: 58.3. 4. In the age groups, 7-12 year group was the most abundant as $52\%$, and then 0-6 year group ($20.4\%$), 13-18 year group ($17.2\%$), more than 18 yew group ($10.4\%$) were followed as descending order. 5. Most of the cleft lip repair surgeries were operated in 0-3 month ($60.3\%$) and 4-6 month ($17.9\%$). 6. The cleft palate repair surgeries were done in 1-2 year ($31.7\%$), 0-1 year ($25.6\%$), 2-3 year ($12.1\%$), more than 5 year ($11.6\%$) as descending order. 7. The lip scar revision surgeries were done before admission at elementary school in $60\%$. (4-6 you ($27.5\%$), 6-8 year ($19.6\%$), more than 10 year ($19.6\%$), 2-4 year ($13.7\%$) as descending order) 8. The rhinoplasties were done before admission at elementary school in $51.7\%$. (0-2 year ($7.1\%$), 2-4 year ($14.3\%$), 4-6 year ($21.4\%$), 6-8 year ($14.3\%$)). 9. The pharyngeal flap were done at 6 Y (72.5 months) after birth on average and there was even distribution of surgery timing. 10. In relationship between Angle's classification of malocclusion and cleft types, Class I was most abundant and Class III, Class II were followed as descending order in cleft lip group. But Class III was most abundant and Class I, Class II were followed as descending order in cleft lip and alveolus group, cleft palate group, and cleft lip and Palate group. The percentage of frequency in Class III malocclusion was overwhelmingly higher in cleft lip and palate group than any other groups. 11. Because the frequency of class III malocclusion was most prevalent in all age groups, anterior crossbite was the most common chief complaint of cleft patients.

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Carotid Cavernous Sinus Fistula with Abducens Nerve Palsy after Le Fort I Osteotomy : A Case Report (상악골절단술 후 외전신경마비를 동반한 경동맥 해면정맥동루)

  • Lee, Won-Hak;Kim, Dong-Ryul;Hong, Kwang-Jin;Lee, Jeong-Gu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.2
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    • pp.243-248
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    • 2000
  • Carotid cavernous sinus fistula(CCSF) is an abnormal communication at the base of the skull between the internal carotid artery and the cavernous sinus. Fistula is almost associated with extensive facial trauma as a result of direct or indirect forces. Most fistulas of traumatic origin develop as a result of fractures through the base of the skull, which cause the laceration of the internal carotid artery near the cavernous sinus. The signs and symptoms of CCSF are pulsating exophthalmosis, orbital headache, pain, orbital or frontal bruit, loss of visual acuity, diplopia and ophthalmoplegia. Angiography reveals a definite CCSF and a detachable balloon embolization is known to be the treatment of choice. Even though carotid cavernous sinus fistula is an uncommon complication after orthognathic surgery, several cases of CCSF due to congenital anomalies, pre-existing aneurysms and abnormally thickened maxillary posterior wall have been reported in the literature. We have experienced a case of CCSF after Le Fort I osteotomy for maxillary advancement in skeletal class III patient and the cause, pathogenesis, diagnosis and treatment of this case.

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A CASE REPORT OF ALLOPLASTIC PARANASAL AUGMENTATION AS AN ADJUNCTIVE TREATMENT OF MANDIBULAR SET-BACK (하악골 전돌증 환자의 악교정술시 부가적 방법으로서의 이물성형 재료를 이용한 비익기저부증강술)

  • Lee, Tae-Yung;Kim, Myung-Sub
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.100-103
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    • 1991
  • In the treatment of mandibular prognathism with concomitant features of narrow alar base and some paranasal deficiency, simultaneous paranasal augmentation for the additional esthetic effect can be considered, if it is determined to correct the mandibular prominence and class III by a mandibular set-back. Alloplastic augmentation has several advantages upon the autogenous means in the respect of dimensional stability and simplicity of operation. This is a case report of silastic paranasal augmentation performed simultaneously with mandibular set-back surgery which has a period of 15 months of follow-up postoperatively.

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D-galactose induces astrocytic aging and contributes to astrocytoma progression and chemoresistance via cellular senescence

  • Jingang Hou;Yeejin Yun;Jianjie Xue;Mengqi Sun;Sunchang Kim
    • Molecular Medicine Reports
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    • v.20 no.5
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    • pp.4111-4118
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    • 2019
  • The administration of D-galactose triggers brain aging by poorly understood mechanisms. It is generally recognized that D-galactose induces oxidative stress or affects protein modifications via receptors for advanced glycated end products in a variety of species. In the present study, we aimed to investigate the involvement of astrocytes in D-galactose-induced brain aging in vitro. We found that D-galactose treatment significantly suppressed cell viability and induced cellular senescence. In addition, as of the accumulation of senescent cells, we proposed that the senescence-associated secretory phenotype (SASP) can stimulate age-related pathologies and chemoresistance in brain. Consistently, senescent astrocytic CRT cells induced by D-galactose exhibited increases in the levels of IL-6 and IL-8 via NF-κB activation, which are major SASP components and inflammatory cytokines. Conditioned medium prepared from senescent astrocytic CRT cells significantly promoted the viability of brain tumor cells (U373-MG and N2a). Importantly, conditioned medium greatly suppressed the cytotoxicity of U373-MG cells induced by temozolomide, and reduced the protein expression levels of neuron marker neuron-specific class III β-tubulin, but markedly increased the levels of c-Myc in N2a cells. Thus, our findings demonstrated that D-galactose treatment might mimic brain aging, and that D-galactose could contribute to brain inflammation and tumor progression through inducing the accumulation of senescent-secretory astrocytes.

A study on the preorthodontic prediction values versus the actual postorthodontic values in Class III surgery patients (골격성 III급 부정교합 환자에서 술전 교정전 예측치와 교정 후 실측치의 차이에 관한 연구)

  • Hwang, Chung-Ju;Kwon, Hee-Jeong
    • The korean journal of orthodontics
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    • v.33 no.1 s.96
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    • pp.1-9
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    • 2003
  • The purpose of this study was to find out and evaluate discrepancies between preorthodontic prediction values and actual postorthodontic values and factors contributing to it in 45 patients(17 male, 28 female) who were diagnosed as skeletal Class III ma)occlusion and received presurgical orthodontic treatment and orthognathic surgery at Yonsei university dental hospital. Lateral cephalograms were analysed at pretreatment(T1), orthodontic Prediction(T2), immediately before surgery(T3) and designated the landmark as coordinates or X and Y axes. The samples were divided according to ALD, upper and lower incisor inclination(Ul to SN, IMPA), COS, extraction, the position of extracted teeth and the statistical significance was tested to find out the factors contributing to the prediction. The results were as follows: 1. Differences between preorthodontic prediction values and actual postorthodontic values(T2-T3) were statistically significant(p<0.05) in the x coordinates of U6mbc, L1x and in y coordinates of U1i, U1x, U6me, U6mbc, L6mbc 2. The accuracy of prediction is relatively higher in horizontal changes compared to vortical changes. 3. The statistical significance(p<0.05) between prediction and actual values is observed more in the landmarks of the maxilla than the mandible. 4. Differences between prediction and actual values of incisor and first molar were statistically significant(p<0.05) according to extraction vs non-extraction, extraction type, ALD in the maxilla and according to ALD, IMPA in the mandible. Discrepancies between preorthodontic prediction values and actual postorthodontic values and factors contributing to the prediction must be considered in treatment planning of Cl III surgical patients to increase the accuracy of prediction. Furthermore future investigations are needed on the prediction of vortical changes.

Three-dimensional changes in lip vermilion morphology of adult female patients after extraction and non-extraction orthodontic treatment

  • Liu, Zhi-Yu;Yu, Jie;Dai, Fan-Fan;Jiang, Ruo-Ping;Xu, Tian-Min
    • The korean journal of orthodontics
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    • v.49 no.4
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    • pp.222-234
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    • 2019
  • Objective: To investigate the three-dimensional lip vermilion changes after extraction and non-extraction orthodontic treatment in female adult patients and explore the correlation between lip vermilion changes and incisor changes. Methods: Forty-seven young female adult patients were enrolled in this study (skeletal Class III patients were excluded), including 34 lip-protruding patients treated by extraction of four first premolars (18 patients requiring mini-implants for maximum anchorage control and 16 patients without mini-implants) and 13 patients requiring non-extraction treatment. Nine angles, seven distances, and the surface area of the lip vermilion were measured by using pre- and post-treatment three-dimensional facial scans. Linear and angular measurements of incisors were performed on lateral cephalograms. Results: There were no significant changes in the vermilion measurements in the non-extraction group. The vermilion angle, vermilion height, central bow angle, height/width ratio, and vermilion surface area decreased significantly after the orthodontic treatment in the extraction groups, but the upper/lower vermilion proportion remained unchanged. Significant correlations were found between the changes in incisor position and those in vermilion angles, vermilion height, and surface area. Conclusions: Extraction of the four first premolars probably produced an aesthetic improvement in lip vermilion morphology. However, the upper/lower vermilion proportion remained unchanged. The variations in the vermilion were closely related to incisor changes, especially the upper incisor inclination changes.