• Title/Summary/Keyword: Distraction rate

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THE USE OF DISTRACTION OSTEOGENESIS TO TREAT HEMIFACIAL MICROSOMIA: A CASE REPORT (반안면 왜소증 환자에서의 골신장술: 증례보고)

  • Baik, Sung-Mun;Kim, Su-Gwan;Kim, Hak-Kyun;Moon, Seong-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.559-566
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    • 2007
  • Distraction osteogenesis(DO) is a surgical method of bone formation that involves an osteotomy and sequential stretching of the healing callus by gradual movement and subsequent remodeling. DO is used to correct facial asymmetry, such as in patients with hemifacial microsomia, maxillary or mandibular retrusion, cleft lip and palate, alveolar defects, and craniofacial deficiency. It is accomplished with the aid of a distraction device, which is secured with screws placed directly into bone, for a predetermined length of time. Hemifacial microsomia is characterized by unilateral facial hypoplasia, often with unilateral shortening of the mandible and subsequent malocclusion. Patients with hemifacial microsomia and facial asymmetry have a vertically short maxilla, tilted occlusal plane, and short mandible. Early treatment is necessary to avoid subsequent impaired midfacial growth. The standard treatment of these malformations consists of the application of bone grafts, which can lead to unpredictable growth. The new bone-lengthening procedure represents a limited surgical intervention and opens up a new perspective for treatment, especially in younger children with severe deformities. This report describes a case of hemifacial microsomia(Type-II left-sided hemifacial microsomia). The patient, a 10-year-old child, visited our clinic for facial asymmetry correction. He had a hypoplastic mandible, displaced ear lobe, 10 mm canting on the right side, and malocclusion. We planned DO to lengthen the left mandible in conjunction with a Le Fort I osteotomy for decanting and then perform a right intraoral vertical ramus osteotomy(IVRO). Progressive distraction at a rate of 0.5 mm/12 hours was initiated 7 days postoperatively. The duration of DO was 17 days. The consolidation period was 3 months. Satisfactory results were obtained in our case, indicating that DO can be used successfully for functional, aesthetic reconstruction of the mandible. We report a case involving DO in conjunction with orthognathic surgery for correcting mandibular hypoplasia with a review of the literature.

A STUDY ON THE VERTICAL AUGMENTATION OF THE ALVEOLAR RIDGE BY DISTRACTION OSTEOGENESIS IN DOGS (성견에서 치조골 신장술을 이용한 수직적 골 증강에 관한 연구)

  • Lee, Joo-Ho;Lim, Ju-Hwan;Cho, In-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.45 no.1
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    • pp.107-118
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    • 2007
  • Statement of problem: Implant-type distractor uses a removable distraction device that has an appearance similar to that of a dental implant and utilizes many of the same techniques for placement as are used for dental implants. Material and method: In this study, 48 implant type titanium distractors were inserted into the osteotomized alveolar bone of 12 beagle dogs. After a 7-day latency period, the alveolar bone was augmented by 5mm vertically at a rate of 1.0 mm/day. The dogs were sacrificed after 4weeks, 8weeks and 12 weeks for radiographic, histologic, and histomorphometric analysis. Result: Copper equivalent value showed significant difference between 4 weeks and the other weeks(8, 12 weeks)(p<0.05). But there was no significant difference between maxillary and mandibular groups. In the bone to metal contact analysis, there was a significant difference between 4 weeks and 12 weeks(p<0.05). On the contrary, there was no significant difference between maxilla and mandible. The bone area showed significantly higher values in 12 weeks compared to 4 weeks(p<0.05). Histologically mineralization began at the host bone margins. At 12 weeks, increasing accumulation of $Ca^{++}$ element was confirmed. Conclusion: From the results above, the new bone formation was increased according to consolidation period. Especially there was significant difference between 4 weeks and 12 weeks(p<0.05). Implant type distractors used in this study to augment vertical ridge defect may prove to be a clinically useful treatment option in selected cases.

Corticotomy and the molar uprighting (피질골 절제술을 응용한 구치의 원심직립 이동)

  • Kim, Sang-Cheol;Kang, Kyung-Hwa;Oh, Seung-Hwan;Lee, In-Seong;Kim, Seon-Young
    • The korean journal of orthodontics
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    • v.34 no.5 s.106
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    • pp.465-472
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    • 2004
  • Tooth movement facilitated by corticotomy and distraction osteogenesis, a new paradigm in orthodontics, was discussed. Molar uprighting was thought to be either difficult or nearly impossible. In this study, a section of cortical bone, which may act as resistance to tooth movement in alveolar bone, was removed. Active bone deposition was also made possible in the tension side This forms the main concept of tooth movement facilitated by corticotomy and distraction osteogenesis. Molars in two cases were uprighted at such a speedy rate as we could not imagine in conventional tooth movement. which lead to reduction of the total treatment period. And molar uprighting was possible without side effects. for example, supraversion oif the tooth or anterior anchorage loss. These were the superior aspects to conventional orthodontics.

EXPRESSION OF PROLIFERATING CELL NUCLEAR ANTIGEN AND TYPE I COLLAGEN IN THE ELONGATED BONE IN THE MANDIBLE OF ADULT MONGREL DOGS (성견 하악 골체부 신장시 신장부위의 증식세포핵항원과 제 1형 교원질 발현에 관한 연구)

  • Lim, Sun-Mo;Ahn, Byoung-Keun;Park, Young-Ju;Park, Hee-Geon;Park, Jun-Woo;Rhee, Gun-Joo;Lee, Yong-Chan;Cho, Byoung-Ouck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.385-396
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    • 2001
  • The purpose of this experiment was to examine the histological changes and the pattern of expression of proliferating cell nuclear antigen(PCNA) and type I collagen in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. Seven adult male mongrel dogs weighing over 20kg were used for this experiment. The author excluded 3 animals because they died before the planned time of sacrifice. The custom-made linear extraoral device and 4 bicortical fixation screws 2.3mm in diameter, 50mm in total length, 15mm in screw length were used in each animal. The distal part of the distractor produced a 0.75mm gap between proximal and distal bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side from each animal was experimental side and the left side was left intact and served as control. At the experimental side, the mandibular body was osteotomized. After 5-day latency period, the segments were distracted with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were sacrificed at the 4th. 17th, and 32th day after the end of the distraction. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with Masson trichrome and examined under the light microscope. The immunohistochemical examinations using anti-PCNA antibody and anti-type-I collagen antibody were performed to examine the pattern of the expression of PCNA and type I collagen, respectively. Results : 1. The mean increment of the distance between the proximal and distal screw-holding parts of the distractor was 6.8mm. The average elongation of the mandible in the experimental side was 5.3mm. The loss of elongation was 1.5mm in average. 2. New bone was already observed at the 4th. day after the end of distraction. But, bony union was not completed in the distraction gap at the 32th. day after the end of distraction by radiographic and microscopic examinations. 3. The expression rate of PCNA positive cells in the distraction gap had a tendency of decrease from 35.1-68.8% initially, to 49.1%, and finally to 17.6-27.2%. But at the final period, the tissue of the elongated gap still had the ability of cell proliferation. On the other hand, the expression of PCNA positive cells in the control side were negligible through the experimental period. 4. PCNA positive cells were observed primarily both at the central fibrous zone and at the region of just adjacent to CFZ which initiated new bone formation. 5. The expression pattern of the type I collagen was not zone-specific. They were observed diffusely throughout the elongation gap. 6. The predominant mechanism of new bone formation in the distraction gap was intramembranous. But, some of the regenerated bone was formed by endochondral ossification.

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Effect of vibration during local anesthesia administration on pain, anxiety, and behavior of pediatric patients aged 6-11 years: A crossover split-mouth study

  • Hegde, Kuthpady Manasa;Neeraja, R;Srinivasan, Ila;Murali Krishna, DR;Melwani, Anjana;Radhakrishna, Sreeraksha
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.3
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    • pp.143-149
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    • 2019
  • Background: Uncooperative behavior of children due to dental anxiety may interfere with the effective delivery of dental care and compromise the quality of treatment provided. Injection of local anesthesia is one of the most anxiety-inducing stimuli in pediatric dentistry. This study aimed to compare the efficacy of a child-friendly device, having a combined effect of vibration and distraction, with the conventional method of injection on pain, anxiety, and behavior of pediatric patients aged 6-11 years. Methods: This randomized, crossover, split-mouth study included 30 children requiring a bilateral inferior alveolar nerve block. The children were equally divided into two groups: group 1, aged 6-8 and group 2, aged 9-11 years. All children were injected with anesthesia using the conventional and device method in two separate sessions. They were assessed for anxiety by measuring the pulse rate before and during the administration of local anesthesia. Behavior was assessed using Faces, Legs, Activity, Cry, Consolability (FLACC) scale, and the child's experience while receiving anesthesia was assessed using the Wong Bakers Pain Rating Scale. Results: Results showed that the children who received local anesthesia using the device method had a lower mean pulse rate, FLACC scores, and pain rating scores than those who received local anesthesia using the conventional method. Conclusion: The device method was more effective than the conventional method in managing pain, anxiety, and behavior of patients aged 6-11 years. The device is a cost effective, simple, and child-friendly product for administrating local anesthesia in pediatric patients.

Use of corticotomy for canine and molar retraction (피질골 절제술을 응용한 견치 및 대구치의 후방 견인)

  • Kim, Sang-Cheol;Kim, Sun-Young;Kim, Hyun-Sook;Jung, Hye-Seung;Kim, Hyun-Tae;Jo, Jin-Woo
    • The korean journal of orthodontics
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    • v.35 no.2 s.109
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    • pp.153-161
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    • 2005
  • Tooth movement facilitated by corticotomy and distraction osteoseresis was discussed. In this study, a portion of cortical bone which can provide resistance to tooth movement in alveolar bone was removed Active bone deposition was thor Possible in the tension side. Teeth moved at such a speedy rate as we could not imagine from conventional orthodontic treatment. which lead to the reduction of the total treatment Period Posterior movement of the canine or molar teeth was possible without any side effects such as anchorage loss, root resorption or Periodontal breakdown.

Effectiveness of thaumaturgic distraction in alleviation of anxiety in 4-6-year-old children during inferior alveolar nerve block administration: a randomized controlled trial

  • Payal Kothari;Aditi Mathur;Rashmi Singh Chauhan;Meenakshi Nankar;Sunnypriyatham Tirupathi;Ashrita Suvarna
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.3
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    • pp.143-151
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    • 2023
  • Background: Dental anxiety is a matter of serious concern to pediatric dentists as it may impede the efficient delivery of dental care. If not adequately resolved, a persistent negative response pattern may emerge. Thaumaturgy, commonly known as magic trick, has become popular recently. It is a tool that distracts and relaxes the child by using magic trick while the dentist performs necessary treatment. Hence, the aim of this study was to evaluate the effectiveness of Thaumaturgic aid in alleviation of anxiety in 4-6 - year-old children during administration of local anesthesia using the inferior alveolar nerve block (IANB) technique. Methods: Thirty children aged between 4-6 years with dental anxiety requiring IANB were included in this study. Patients were divided equally into two groups: Group I, thaumaturgic aid group and Group II, conventional non-pharmacological group using randomization. Anxiety was measured before and after using the intervention with Raghavendra Madhuri Sujata-Pictorial scale (RMS-PS), Venham's anxiety rating scale, and pulse rate. All the data were tabulated and compared using statistical analysis. Results: Children in thaumaturgy group (Group- I) exhibited significantly lower anxiety during IANB in comparison with children in the conventional group (Group- II) and the difference was statistically significant. Conclusion: Magic tricks are effective in reducing anxiety among young children during IANB; Moreover, it expands the arsenal of behavior guidance techniques for treatment of children with anxiety and plays an important role in shaping the behavior of a child in pediatric dentistry.

Calcaneal Malunion (종골의 부정 유합)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.2
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    • pp.79-86
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    • 2012
  • Calcaneal fractures account for 2% of all fractures and approximately 60 to 70% of tarsal fractures. These fractures typically are the result of high-energy injury, such as a motor vehicle accident or a fall from a height. The potential for disabling malunion following intrarticular displaced calcaneal fracture is high, regardless of treatment. Fracture displacement typically results in loss of hindfoot height, varus and widening of the hindfoot, with possible subfibular impingement and irritation of the peroneal tendon and/or sural nerve. Frequently, subtalar joint develops posttraumatic arthritis. In symptomatic patients with calcaneal malunion, systemic evaluation is required to determine the source of pain. Nonsurgical treatment, such as activity and shoe modification, bracing, orthoses, and injection, is effective in many patients. Surgical treatment may involve simple ostectomy, subtalar arthrodesis with or without distraction, or corrective calcaneal osteotomy. A high rate of successful arthrodesis and of patient satisfaction has been reported with surgical manamgent.

Effects of Advancing Age on Drivers' Cognitive Workload (연령 증가에 따른 주행 중 인지 부하의 특성 변화)

  • Lee, Yong-Tae;Kim, Man-Ho;Son, Joon-Woo
    • Journal of the Ergonomics Society of Korea
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    • v.28 no.3
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    • pp.73-79
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    • 2009
  • Driving is a complex psychomotor task often interrupted by secondary activities that increase cognitive workload and divert attention away from the roadway. The risk of inattentive driving is known to vary with age. To assess the characteristics of advancing age on driver's cognitive workload under dual task condition, we evaluate the performance of 96 drivers divided into three age groups: 20's, 40's, and 60's. This study considers driver's cognitive workload in the context of urban and highway driving. Error rate & Dual task cost are used to measure driver's cognitive workload. Results indicate that age impacts cognitive workload during dual task driving conditions.

A Case Report on Cervical Myelopathy Applied Chuna Treatment (추나 요법을 적용한 경수부 척수 손상 환자의 경과관찰 1례)

  • Lee, Jin-Bok;Cho, Yi-Hyun;Im, Jeong-Gyun;Jeong, Si-Yeong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.1
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    • pp.81-89
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    • 2010
  • Objects : This study was to report a clinical effect of Chuna Treatment for a patient diagnosed by Magnetic Resonance Imaging(MRI) as Cervical Myelopathy. Methods: In order to alleviate shoulder pain and neck stiffness, the patient was treated by acupuncture therapy, herbal medicine, phamacopucture, cervical traction technique of Chuna treatment and conservative managements. To evaluate the effect of the treatment, Recovery rate of Hirabayashi, VAS(Visual Anlaogue Scale), NDI and ROM(Range of Motion) were used. Lhermitte's sign, Valsalva test, Distraction test, Compression test and Spurling test were carried out. Results: VAS, NDI and ROM were improved and Recovery rate was 100%. Conclusions: Korean Treatment can be effectively used for a patient with Cervical Myelopathy. Further clinical studies are needed to verify the findings.

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