• The Journal of Korean Academy of Prosthodontics
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• v.53 no.3
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• pp.244-249
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• 2015

With the recent progress of digital technology, the computer guided surgery utilizing a guide template in the placement of implant has been actively performed, and the method employing the intraoral scanner at the implant prosthesis introduced. Fabrication method of the guide template can be largely classified into design-related rapid prototyping (RP) system and vector milling system, and each of the method has its own weakness in the clinical application despite of excellent accuracy. Thus, in this case study, a working model was fabricated by the wax RP technology using images acquired by CBCT and an intraoral scanner, and the metal bushing was picked up with orthodontic resin cast upon the wax model. Using this method, a surgical guide template was fabricated and used in surgery. From this, we could obtain a satisfactory outcome clinically in the implant placement and the fabrication of the final prostheses and thus report this case herein.

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.716-721
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• 2014

Background The aim of this study was to review the recipient vessels used in our cases of facial reanimation with free functional muscle transfer and to identify patient variables that may predict when the facial vessels are absent. From this we present a protocol for vessel selection in cases when the facial artery and/or vein are absent. Methods Patients were identified from November 2006 to October 2013. Data was collected on patient demographics, facial palsy aetiology, history of previous facial surgery/trauma and flap/recipient vessels used. A standard operative approach was adopted and performed by a single surgeon. Results Eighty-seven eligible patients were identified for inclusion amongst which 98 hemifaces were operated upon. The facial artery and vein were the most commonly used recipient vessels (90% and 83% of patients, respectively). Commonly used alternative vessels were the transverse facial vein and superficial temporal artery. Those with congenital facial palsy were significantly more likely to lack a suitable facial vein (P=0.03) and those with a history of previous facial surgery or trauma were significantly more likely to have an absent facial artery and vein (P<0.05). Conclusions Our algorithm can help to guide vessel selection cases of facial reanimation with free functional muscle transfer. Amongst patients with congenital facial palsy or in those with a previous history of facial surgery or trauma, the facial vessels are more likely to be absent and so the surgeon should then look towards the transverse facial vein and superficial temporal artery as alternative recipient structures.

• Clinics in Shoulder and Elbow
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• v.22 no.1
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• pp.16-23
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• 2019

Background: We aimed to evaluate whether the use of our novel patient-specific guide (PSG) with 3-dimensional reconstruction in reverse total shoulder arthroplasty (RTSA) would allow accurate and reliable implantation of the glenoid and humeral components. Methods: 20 fresh-frozen cadaveric shoulders were used. The PSG group (n=10) and conventional group (n=10) was evaluated the accuracy and reproducibility of implant positioning between before and after surgery on the computed tomography image. Results: The superoinferior and anteroposterior offset in the glenoid component were $0.42{\pm}0.07$, $0.50{\pm}0.08$ in the conventional group and $0.45{\pm}0.03$, $0.46{\pm}0.02$ in the PSG group. The inclination and version angles were $-1.93^{\circ}{\pm}4.31^{\circ}$, $2.27^{\circ}{\pm}5.91^{\circ}$ and $0.46^{\circ}{\pm}0.02^{\circ}$, $3.38^{\circ}{\pm}2.79^{\circ}$. The standard deviation showed a smaller difference in the PSG group. The anteroposterior and lateromedial humeral canal center offset in the humeral component were $0.45{\pm}0.12$, $0.48{\pm}0.15$ in the conventional group and $0.46{\pm}0.59$ (p=0.794), $0.46{\pm}0.06$ (p=0.702) in the PSG group. The PSG showed significantly better humeral stem alignment. Conclusions: The use of PSGs with 3-dimensional reconstruction reduces variabilities in glenoid and humerus component positions and prevents extreme positioning errors in RTSA.

• Journal of International Society for Simulation Surgery
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• v.2 no.2
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• pp.83-86
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• 2015

Recently, computer-assisted surgery is popular for performing well-planned operations. Computer-aided navigation system is helpful in maxillofacial surgery with real time instrument positioning and clear anatomic identification. Generally, segmental mandibulectomy and reconstruction flap surgery have done by extra-oral approach such as, submandibular approach. This case report describes performing intra-oral segmental mandibulectomy and reconstruction with monocortical deep circumflex iliac artery (DCIA) flap and CT guided implant surgery by using computer-aided surgical guide and navigation for managing ameloblastoma in a 31 years old female patient.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.283-292
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• 2022

For fixed prosthetic treatment using implants, implants must be placed in a suitable location for prosthetic treatment. During surgery, minimally invasive prosthetic restoration is possible using a flapless method using a surgical guide. The patient in this case was an 86-year-old male patient who wanted treatment due to discomfort when using conventional dentures. Due to systemic disease, the patient had difficulty using removable local dentures, so full dentures for the maxilla and fixed implants for the mandible were restored. Because there is a high risk of bleeding due to systemic disease, the implant was placed in a flapless method using a surgical guide. Finally, prostheses were fabricated with maxillary full denture and mandibular screw-retained zirconia, and this report shows satisfactory esthetic and functional recovery.

• The Journal of Advanced Prosthodontics
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• v.8 no.3
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• pp.207-213
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• 2016

PURPOSE. A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. MATERIALS AND METHODS. For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (${\alpha}=.05$). RESULTS. The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. CONCLUSION. The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.111-112
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• 2018

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.43.1-43.5
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• 2015

Image-guided surgery potentially enhances intraoperative safety and outcomes in a variety of craniomaxillofacial procedures. We explore the efficiency of one intraoperative navigation system in a single complex craniofacial case, review the initial and recurring costs, and estimate the added cost (e.g., additional setup time, registration). We discuss the potential challenges and benefits of utilizing image-guided surgery in our specific case and its benefits in terms of educational and teaching purposes and compare this with traditional osteotomies that rely on a surgeon's thorough understanding of anatomy coupled with tactile feedback to blindly guide the osteotome during surgery. A 13-year-old presented with untreated syndromic multi-suture synostosis, brachycephaly, severe exorbitism, and midface hypoplasia. For now, initial costs are high, recurring costs are relatively low, and there are perceived benefits of imaged-guided surgery as an excellent teaching tool for visualizing difficult and often unseen anatomy through computerized software and multi-planar real-time images.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.6
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• pp.381-389
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• 2013

Two patients with partial edentulous maxilla were scheduled to undergo installation of implant fixtures using a tooth-supported surgical template based on computer assisted treatment planning. After 3-dimensional (3D) computed tomographic scanning was transferred to the OnDemand3D (Cybermed Co., Seoul, Korea) software program for virtual planning, fixtures of MK III Groovy RP implant of the Br${\aa}$nemark System (Nobel Biocare AB Co., G$\ddot{o}$teborg, Sweden) was installed using the In2Guide (CyberMed Co., Seoul, Korea) tooth-supported surgical template with a Quick Guide Kit (Osstem Implant Co., Seoul, Korea) system in the posterior maxilla of each patient. Sinus floor elevation with a xenogenic bone graft procedure was also performed simultaneously in one patient. Fixture installations were completed successfully without complications, such as sinus mucosa perforation, bony bleedings, fenestrations, or others. During the last two-year follow-up period after prosthetics delivery, each implant was found to be fine with no other minor complications. The entire procedures are reported and the literatures on use of tooth-supported surgical template was reviewed.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.1
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• pp.57-65
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• 2019

Computer aided design and manufacturing and implant surgery using a guide template improve restoration-driven implant treatment procedures. This case utilized those digital technologies to make definitive prostheses for a patient. According to the work flow of digital dentistry, cone beam computed tomography established the treatment plan, which was followed to make the guide template for implant placement. The template guided the implants to be installed as planned. The customized abutments and surveyed fixed restorations were digitally designed and made. The metal framework of the removable partial denture was cast from resin pattern using an additive manufacturing technique, and the artificial resin teeth were replaced with the zirconia onlays for occlusal stability. These full mouth rehabilitation procedures provided functionally and aesthetically satisfactory results for the patient.