Purpose: Immediate implantation presents challenges regarding site healing, osseointegration, and obtaining complete soft-tissue coverage of the extraction socket, especially in the posterior area. This last issue is addressed herein using the double-membrane (collagen membrane+high-density polytetrafluoroethylene [dPTFE] membrane) technique in two clinical cases of posterior immediate implant placement. Methods: An implant was placed immediately after atraumatically extracting the maxillary posterior tooth. The gap between the coronal portion of the fixture and the adjacent bony walls was filled with allograft material. In addition, a collagen membrane (lower) and dPTFE membrane (upper) were placed in a layer-by-layer manner to enable the closure of the extraction socket without a primary flap closure, thus facilitating the preservation of keratinized mucosa. The upper dPTFE membrane was left exposed for 4 weeks, after which the membrane was gently removed using forceps without flap elevation. Results: There was considerable plaque deposition on the outer surface of the dPTFE membrane but not on the inner surface. Moreover, scanning electron microscopy of the removed membrane revealed only a small amount of bacteria on the inner surface of the membrane. The peri-implant tissue was favorable both clinically and radiographically after a conventional dental-implant healing period. Conclusions: Secondary closure of the extraction socket and immediate guided bone regeneration using the double-membrane technique may produce a good clinical outcome after immediate placement of a dental implant in the posterior area.
Submerged implants require secondary surgical uncovering of implants after healing period of 3-6 months. In surgical methods, there are surgical scalpel, tissue punch, electro-surgical, and laser-used uncovering, and so forth The objectives of this study are investigation and assessment of 1) thermal change in clinical application for uncovering of HA-coated implant and pure titanium implant irradiated by pulsed Nd-YAG, $CO_2$, and Er-YAG laser. 2) surface change of cover screws aaer irradiation using laser energy. The temperature of apex & side wall of implants were recorded at 10sec, 20sec, 30sec after 30sec irradiation to implant healing screw; 1) pulsed Nd-YAG laser; 2W, 20pps, contact mode 2) $CO_2$ laser; water-infused & non-water infused state, 2.5-3.5W, contibuous mode, noncontact mode 3) $CO_2$ laser ; non-water infused state, 3W, superpulse, noncontact. mode 4) Er-YAG laser; (1) non-water infused state, 10pps, 60mj, contact mode (2) water-infused state, 10pps, 60mj, 80mj, 101mj, contact mode. According to the results of this study, pulsed Nd-YAG laser is not indicated because of increased thermal change and pitting of metal surface of implant cover screw. By contrast, $CO_2$ laser & Er-YAG laser are presumed to indicate because of narrow range of thermal change & near abscence of thermal damage of metal surface. Dental laser is thought to be much helpful to surgical procedure when it is used as optimal power and time condition considering characteristics and indications of each laser. Further research is needed to verify that these techniques are safe and beneficial to implant success.
The purpose of this study was to observe the effect of dental varnish applied with fluoride to dental pulp by comparing the groups of commercial fluoride product $Duraphat^{(R)}$, $Copalite^{(R)}$ after 1 Mole sodium fluoride application, Cavity $Sealer^{(R)}$ after 1 Mole sodium fluoride application with the control group not applied the dental varnish. After Cl V Cavity form was prepared on the buccal surface of the crowns with the total 75 teeth by using 5 dogs, average weight of 13.2Kg, dental varnish and silver analgram were placed. This study was performed by 3, 7, 21, 28, 56 days each. The dogs were sacrificed to extract the teeth, cut at the apical one fourth, and prepared histologic examination by fixing with 10% buffered formalin perfusion at sacrifice and decalcification in 10% nitric acid. The specimens were embedded in paraffin, stained with Hematoxylin and Eosin, and serially sectioned with 6 ${\mu}$width each. Microscopic evaluation of serial sections at the various time periods among the different groups revealed the following results: 1. In the control group, the marked change of the odontoblastic layer was showed on the 3 days group, and it was decreased gradually. Healing response, such as hyperplasia, was seen on the 28 days group and it was continued to the 56 days group. 2. In the experimental group with Cavity $Sealer,^{(R)}$ a slight hemorrhage was seen in the odontoblastic layer on the 3 days group, and the healing response with the hyperplasia of the odontoblast was showed on the 21, 28 days group. It was completely healed on the 56 days group. 3. In the Duraphat R group, a slight hemorrhage showed on the 3 days group and the disarrangement of the Odontoblastic layer was seen on the 7, 21, 28 days group. Odontoblasts showed hyperplasia on the 28 days group, and healed completely on the 56 days group. 4. In the $Copalite^{(R)}$ group, the 7 days group showed remarkable hemorrhage in the odontoblastic layer and stroma, and also it showed reticular degeneration with the disarrangement of the odontoblastic layer and congestion. Each group showed disarrangement. Healing ability of this group was greater than that of the control group, but less than that of the $Duraphat^{(R)}$ and Cavity $Sealer^{(R)}$ group.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제26권3호
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pp.238-244
/
2000
The present study was aimed to investigate the effect of osseointegration according to implant placement timing in the distracted alveolar bone using intraoral distraction device. Six adult mongrel dogs of either sex, weighing about 15kg, were used. The animals were divided into 4-week and 8-week groups according to the timing of implant installation. The left upper and lower premolars and first molars were extracted and an alveoloplasty was performed to simulate an atrophic ridge. After 12 weeks of healing, a segmental osteotomy was made and an intraoral distraction device which was designed for augmentation of vertical height of the edentulous ridge was applied. Latency period was allowed for 5 days and then distraction was made at a rate of 1.2mm/day for 8 days. Four or eight weeks after distraction, implants were installed. Twelve weeks after implant installation, the animals were sacrificed. Macroscopic, radiographic, and histologic examinations of distracted alveolar ridge were performed. No significant abnormalities such as infection and dehiscence of overlying soft tissue were observed. Radiographically, there was slight bone resorption around the medial and distal edges of the alveolar bone segment, and a new bone deposition was observed in the neighboring alveolar crest area in the both groups. The satisfactory osseointegration was achieved in the distracted gap of the both groups, but fibrous tissue appeared on the buccal side of implant in the distracted gap in 4-week group. These results suggest that proper timing of implant installation is 8 weeks rather than 4 weeks after distraction when dental implant is to be placed onto the distracted bone.
The purpose of this study is to observe the effect of formocresol and glutaraldehyde to tooth germs and periapical tissues after perforation of interradicular portion of pulpal floor and application of physiological saline solution in control groups, formocresol and glutaraldehyde in experimental groups. The following results were obtained 1. In control groups, normal healing processes were seen, and, on the sixteenth day, the epithelization of injured areas was completed. Inflammatory reactions were limited to the injured surface, and the underlying alveolar bone were normal and successive tooth germs were normal. 2. In both formocresol groups and glutaraldehyde groups, tissue reactions were identical. Inflammatory reactions were slightly compared with control groups, but the surface epithelizations were delayed compared with control group. 3. In both formocresol and glutaraldehyde groups, necrosis was seen in superficial tissue of bone marrow, and, at 24th day, center area of bone marrow on the successive tooth germs were losed and replaced with connective tissue, and superficial soft tissue of the injured area was connected with soft tissue on the successive tooth germ. In remaining alveolar bone, osteoclastic reaction was remarkable. 4. In both formocresol and glutaraldehyde groups, there is no injury to the successive tooth germs. 5. In both formocresol and glutaraldehyde groups, periodontal membrane was normal, but the partial resorption of cementum and dentin near the injured area were seen.
A cone-shaped active magnetic healing spindle system for high speed internal grinding with built-in motor that has 7.5kW power and maximum rotational speed of 50,000 rpm is designed and built. Using cone-shaped AMB(Active Magnetic Bearing) system, the axial rotor dick and magnets of conventional 5-axis actuating design can be eliminated. so this concept of design provides a simple magnetic bearing system. In this paper, the cone-shaped electromagnets are designed by magnetic circuit theory, and a de-coupled direct feedback PID controller is applied to control the coupled magnetic bearings. The designed crone-shaped AMB spindle system is built and constructed with a digital control system, which has TMS320C6702 DSP, 16 bit AD/DA, switching power amplifier and gap sensors. As the AMB system provides high damping ratio eliminating overshoot and resonance speed, this spindle runs up to 40,000 rpm stably with about 5${\mu}{\textrm}{m}$ of runout.
Purpose: This study was aim to examine the effect of extract from several herbs on wound treatment which are grown naturally in Namwon province. Methods: Adult male Sprague-Dawley rats were assigned to 6 of 2 group: control group (C, n=6), experimental group (E, n=6). Rats in E group had 3 sessions (everyday) for 4 days or 8 days of the extract treatment which was composed of German chemomile, Teatree and Lavender (CTL). Results: CTL extract on wound-induced mice showed significantly the increase of wound treatment rate (WTR), epidermal gap (EP) and collagen density (CD), compared with control. Conclusion: CTL extract may be a putative resources for cure or treatment of wound.
The perception of the 20 adverse events of targeted therapy for metastatic renal cell carcinoma was compared among medical professionals. Thirty-seven oncologists, 167 nurses and 79 pharmacists participated in the survey, and the response rate was 61.9%, 98.2%, 84.9%, respectively. Results showed that the most serious adverse event was GI perforation (8.83 points, 10 being the most serious), whereas the least serious was anemia (5.32 points). There were significant differences among oncologists, nurses and pharmacists especially for the moderately-serious adverse event such as wound-healing complication and lymphopenia. Adverse Events Composite Score (AECS) for each targeted therapy was calculated by multiplying adverse event incidence rate and seriousness score. Sunitinib had the highest score at 6.86 point and bevacizumab had the lowest at 2.1. Among professional groups oncologists showed the lowest AECS, whereas nurses had the highest. The gap on the perception of the adverse events among medical professionals needs to be reduced to get better outcomes of medical therapies for cancer patients.
Robin Deville;Justin Issard;Anna Vayssette;Jalal Assouad
Journal of Chest Surgery
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제56권6호
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pp.449-451
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2023
We report a case of chest wall resection for painful chest wall nonunion, 5 years after traumatic flail chest and a first attempt at surgical treatment. The decision was made to perform surgery again after 2 years of unsuccessful well-conducted analgesic treatment. During surgery, we found the same sites of pseudarthrosis and decided to perform parietectomy of the fifth, sixth, and seventh ribs. A Gore-Tex patch was used to bridge the gap created by the resection. In immediate postoperative care, the patient's pain was quickly and sufficiently eased by stage 1 and 2 pain killers. The results of bone samples taken from the pseudarthrosis sites all found Propionibacterium acnes. Five months after surgery, the patient had considerable improvement in pain sensations. Computed tomography showed healing of ribs, the plate in place, and no sign of complications.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제34권5호
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pp.571-577
/
2008
Introduction: Possible etiologic factors associated with bone loss around implants after implantation are surgical trauma, occlusal overload, periimplantitis, presence of micro gap and the formation of biologic distances. Tarnow et al. observed that the crestal bone loss was greater when the distance between the implants was <3mm than when the implants were ${\geq}\;3mm$ apart. The aim of this study was to evaluate the influence of different interimplant distance on marginal bone and crestal bone resorption in the beagle dogs. Materials and methods: The mandibular premolars of 5 dogs were extracted bilaterally. After 12 weeks of healing, each dog received 7 implants. On each side, implants were separated by 2mm (Group 1) and by 5mm (Group 2). After 16 weeks of healing, the dogs were sacrificed. Marginal bone loss was determined through linear measurements made between the implant-abutment junctions and the most coronal portions of the bone in contact with the implant surface. A line was drawn uniting the implant-abutment junctions of the adjacent implants, and a linear measurement was made at the midpoint in the direction of the most coronal peak of the interimplant bone crest to determine the crestal bone loss. Both of them was measured radiologically and histologically. Result and conclusion: In radiological analysis, the mean of marginal bone loss was $1.26{\pm}0.14mm$ for group 1 and $1.23{\pm}0.34mm$ for group 2, the mean of crestal bone loss was $1.10{\pm}0.14mm$ for group 1 and $1.02{\pm}0.30mm$ for group 2. The results were not statistically significant between 2 groups. In histological analysis, the mean of marginal bone loss was $1.63{\pm}0.48mm$ for group 1 and $1.62{\pm}0.50mm$ for group 2, the mean of crestal bone loss was $1.23{\pm}0.35mm$ for group 1 and $1.15{\pm}0.39mm$ for group 2. The differences were also not statistically significant. The clinical significance of this result is that the increase in the crestal bone loss results in the increase in the distance between the base of the interproximal contact of the crowns and the bone crest, and this determines if papilla will be present or absent between implants. Considering this fact, keeping up sufficient interimplant distance is important to minimize crestal bone loss.
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