• Journal of Periodontal and Implant Science
• /
• 제40권4호
• /
• pp.194-200
• /
• 2010

Purpose: There is no consensus regarding the relationship between the width of keratinized mucosa and the health of periimplant tissues, but clinicians prefer to provide enough keratinized mucosa around dental implants for long-term implant maintenance. An apically positioned flap during second stage implant surgery is the chosen method of widening the keratinized zone in simple procedures. However, the routine suture techniques used with this method tend to apply tension over the provisional abutments and decrease pre-existing keratinized mucosa. To overcome this shortcoming, a pre-fabricated implant-retained stent was designed to apply vertical pressure on the labial flap and stabilize it in a bucco-apical direction to create a wide keratinized mucous zone. Methods: During second stage implant surgery, an apically displaced, partial thickness flap with a lingualized incision was retracted. A pre-fabricated stent was clipped over the abutments after connecting to the provisional abutment. Vertical pressure was applied to displace the labial flap. No suture was required and the stent was removed after 10 days. Results: A clinically relevant amount of keratinized mucosa was achieved around the dental implants. Buccally displaced keratinized mucosa was firmly attached to the underlying periosteum. A slight shrinkage of the keratinized zone was noted after the healing period in one patient, but no discomfort during oral hygiene was reported. Clinically healthy gingiva with enough keratinized mucosa was achieved in both patients. Conclusions: The proposed technique is a simple and time-effective technique for preserving and providing keratinized tissue around dental implants.

• 구강회복응용과학지
• /
• 제28권1호
• /
• pp.37-46
• /
• 2012

치주치료의 궁극적 목표는 치주질환으로 상실된 치주조직의 재생이라고 볼 수 있다. 치주재생술식 후 회복을 평가하는 단계에서, 탐침과정이 초기 회복기의 신생조직에 위해한 영향을 줄 수 있다. 치아동요도는 치주조직이 치아를 지지하고 있는 상태를 평가하는 중요한 지표로 사용된다. 이에 본 연구에서는 치아동요도와 다른 임상지표간의 상관관계를 조사하고, 치아동요도를 측정하는 Periotest$^{(R)}$가 재생술식 후 초기 회복기에 탐침의 필요성을 배제할 수 있는지를 조사하고자 하는 것이다. 치주재생수술을 받은 25명의 환자, 29개의 치아를 대상으로 하였다. 부착수준, 치주낭 심도, 치아동요도 (Periotest$^{(R)}$ value PTV)등의 임상지표를 연구시작단계, 시술 후 6개월, 12개월에 측정하였다. 재생수술 후 모든 임상지표들이 개선되었고 (p<0.05), 각각의 시기에 부착수준, 탐침깊이, 치은퇴축과 PTV 사이의 통계적으로 유의한 상관관계가 관찰되었다. 또한 각 시기 사이의 임상지표와 PTV변화량의 상관관계에서 치주낭깊이와 부착수준이 상관관계가 있는 것으로 관찰되었다. 이상의 결과들로 치주재생술식 이후 임상지표들의 개선을 기대할 수 있으며, 재생술식 이후 회복기에 임상지표의 측정에 PTV가 보조적 역할을 할 수 있을 것으로 사료된다.

• Journal of Korean Neurosurgical Society
• /
• 제48권6호
• /
• pp.490-495
• /
• 2010

Objective : Bone cement augmentation procedures such as percutaneous vertebroplasty and balloon kyphoplasty have been shown to be effective treatment for acute or subacute osteoporotic vertebral compression fractures. The purpose of this study was to determine the efficacy of bone cement augmentation procedures for long standing osteoporotic vertebral compression fracture with late vertebral collapse and persistent back pain. Methods : Among 278 single level osteoporotic vertebral compression fractures that were treated by vertebral augmentation procedures at our institute, 18 consecutive patients were included in this study. Study inclusion was limited to initially, minimal compression fractures, but showing a poor prognosis due to late vertebral collapse, intravertebral vacuum clefts and continuous back pain despite conservative treatment for more than one year. The subjects included three men and 15 women. The mean age was 70.7 with a range from 64 to 85 years of age. After postural reduction for two days, bone cement augmentation procedures following intraoperative pressure reduction were performed. Imaging and clinical findings, including the level of the vertebra involved, vertebral height restoration, injected cement volume, local kyphosis, clinical outcome and complications were analyzed. Results : The mean follow-up period after bone cement augmentation procedures was 14.3 months (range 12-27 months). The mean injected cement volume was 4.1 mL (range 2.4-5.9 mL). The unipedicular approach was possible in 15 patients. The mean pain score (visual analogue scale) prior to surgery was 7.1, which decreased to 3.1 at 7 days after the procedure. The pain relief was maintained at the final follow up. The kyphotic angle improved significantly from $21.2{\pm}4.9^{\circ}$ before surgery to $10.4{\pm}3.8^{\circ}$ after surgery. The fraction of vertebral height increased from 30% to 60% after bone cement augmentation, and the restored vertebral height was maintained at the final follow up. There were no serious complications related to cement leakage. Conclusion : In the management of even long-standing osteoporotic vertebral compression fracture for over one year, bone cement augmentation procedures following postural reduction were considered safe and effective treatment in cases of non-healing evidence.

• 대한정형외과스포츠의학회지
• /
• 제1권2호
• /
• pp.138-142
• /
• 2002

목적: 스포츠와관련된급성아킬레스건파열의직접봉합및건외막피복술의결과및예후를평가하였다. 대상및방법: 1997년부터2001년까지수술후1년이상추시가능했던21예를대상으로하였다. 30대가$55\%$로가장많았으며축구후에생긴파열이5예로가장많았고, 양측이간격을두고파열된경우가2예로확인되었다. 수술은수상후1주이내에시행하였으며, 단단봉합술후주위건외막조직을충분히봉합하여혈액순환을최대한유지한상태로봉합부를피복하였다. 수술후슬관절을25도굴곡, 족관절은족저굴곡된상태로6주간장하지석고고정후2주간격으로단하지석고고정및족관절첨족을기능적위치로전환하여10주째90도족배굴곡상태로회복시켰다. 결과는Hooker의기준을이용하여수술후평균28개월에평가하였다. 결과: 환측이정상측에비해발뒤꿈치-지면거리가평균0.7cm 감소하였고, 20회체중부하족저굴곡후에는0.8 cm 감소하였으며, 하퇴둘레는0.3 cm 감소하였고, 능동적운동범위는족배굴곡과족저굴곡이각각3도와5도가감소하였다. 수술결과는1 6예에서우수, 5예에서양호를보였으며재파열이나상처부위괴사및감염의후유증은없었다. 결론: 아킬레스건파열의단단봉합술후주위건외막조직의충분한피복봉합은건의치유와수술후유착방지에, 그리고수술후주기적족관절족배교정은잔여첨족변형의예방에좋은치료방법이다

• Journal of Periodontal and Implant Science
• /
• 제36권1호
• /
• pp.223-237
• /
• 2006

The purpose of the present study was to evaluate the effect of bone graft materials including deproteinized bovine bone(DBB), demineralized freeze-dried bone(DFDB), freeze-dried bone(FDB) on bone formation in guided bone regeneration using perforated titanium membrane(TM). 16 adult male rabbits(mean BW 2kg) were used in this study and 4 rabbits allotted to each test group. Intramarrow penetration(diameter 6.5mm) was done with round carbide bur on calvaria to promote blood supply and clot formation in the wound area. The test groups were devided into 4 groups as follows: TM only(test 1), TM +DBB(test 2), TM +DFDB(test 3), TM +FDB(test 4). Perforated titanium membrane was contoured in rectangular parallelepiped shape(0.5mm pore diameter, 10mm in one side, 2mm in inner height), filled the each graft material and placed on the decorticated carvaria. Perforated titanium membrane was fixed with resorbable suture materials. The animals were sacrificed at 2, 8 weeks after the surgery. Non-decalcified preparations were routinely processed for histologic analysis. The results of this study were as follows: 1. Perforated titanium membrane was biocompatible. 2. Perforated titanium membrane had capability of maintaining the space during the healing period but invasion of soft tissue through the perforations of titanium membrane decreased the space available for bone formation. 3. In test 1 group without bone graft material, the amount of bone formation and bone maturation was better than other test groups. 4. Among the graft materials, the effect of freeze-dried bone on bone formation was best. 5. In the test groups using deproteinized bovine bone, demineralized freeze-dried bone, bone formation was a little. The spacemaking capability of the membrane may be crucial for bone formation. The combined treatment with the perforated titanium membrane and deproteinized bovine bone or demineralized freeze-dried bone failed to demonstrate any added effect in the bone formation. Minimization of size and numbers of perforations of titanium membrane or use of occlusive titanium membrane might be effective to acquire predictable results in the vertical bone formation.

• Child Health Nursing Research
• /
• 제5권2호
• /
• pp.185-197
• /
• 1999

In the family life cycle, the most important task the families with school children should perform is ‘child education’ and ‘socialization’ However, economic stress on poor families with school children presents multiple problems through the shortage of resources necessary for child education and socialization, inappropriateness of family appraisal, and the insufficiency of the control channels for the efficient management of these confined resources and appropriate appraisal. The objectives of this article are : First, to report research on the actual conditions of the poor families in one area of Cheju and on the relevant health welfare policy, and to examine the appropriateness of the direction and the substance of this policy in terms of the intervention in economic stress on the poor families under the categories of resource management and control of appraisal. Second, to analyze qualitative data extracted from the memoirs of single-parent families living in several areas of Korea under the conceptual framework constructed by literature review in order to get a better understanding of the stress which poor families with school children have experienced. And third, to confirm the factors that can be risk factor but, at the same time, strength to these poor families from presented data and to use them as the basic data from which an intervention model can be developed, based on resource management and control of appraisal. The findings of this article are : First, while the number of absolute poor families in one area of Cheju is increasing and, as a result, the danger of the possibility that multiple problems will occur is also growing, the supporting level of the current policy is no more than a direct resource offer and there is no evidence that resource management is being professionally carried out. When it comes to control of appraisal, due to absence of the professional human resources in this matter, policy performances such as technical education training can have a negative impact. Second, a conceptual framework introduced in this article, ; Economic Pressure → Helplessness → Poor self-esteem → Marital Conflict → Parent-Child financial conflict → Inappropriate socialization → Poor child social competence : is partly verified. And third, judging from the results of the qualitative data, it is confirmed that the healing families, having overcome poverty, show several positive characteristics including : hope, strength, and social support. These findings are identified with the factors of resiliency considered above. According to these results, this article suggests the following. The anti -poverty policy in the future should focus not only on a direct resource offer but also on resource management and the control of appraisal that can magnify its effects. In particular, close attention should be paid to school children since they are in the most crucial period for socialization. Moreover, an emotional labor is such an essential resource for intervention that skilled nurses should play pivotal roles.

• 생물환경조절학회지
• /
• 제20권4호
• /
• pp.304-310
• /
• 2011

본 연구는 기존의 농가 보급형 고구마 저장고에 가열기(본체), 환기팬, 배풍구 팬, 습도 조절을 위한 관으로 구성된 간이 큐어링 설비를 부가시킨 후, 그 효과를 검증하기 위하여 수행되었다. 6일간의 큐어링 처리 기간 동안 저장고 내 기온 및 상대습도는 $32^{\circ}C$, 90%로 설정되었다. 고구마의 저장 기간(6 개월) 동안 1개월에 1회씩 표본을 수집하여 물리화학적 품질을 측정한 결과, 부패율과 부패 정도를 함께 보여주는 McKinney Index는 큐어링 처리구의 경우 0.83%였으며, 큐어링 처리를 하지 않은 대조구의 경우 5.08%였다. 큐어링 처리구의 경도 및 당도, 건물율은 모두 대조구보다 높았으며, 대조구의 표피색이 큐어링 처리구보다 빠르게 변하여 큐어링 처리가 저장기간 동안 고구마의 변색을 지연시켰음을 알 수 있었다. 본 연구를 통하여 간이 큐어링 설비를 이용한 큐어링 처리는 초기 비용이 많이 소모되는 일반 큐어링 설비를 대체하여 고구마의 물리화학적 품질을 증진시킬 수 있으며, 저장 기간을 늘릴 수 있음을 알 수 있었다.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제13권1호
• /
• pp.16-29
• /
• 1991

미세혈관봉합술에서의 가장 큰 문제점은 봉합부에서의 내피손상과 혈전형성이라고 볼 수 있다. 이 연구의 목적은 봉합시 일어날 수 있는 내피손상부에서의 치유과정을 관찰코져 각각 다른 문합술인 혈관함입문합술과 혈관단단문합술을 백서 대퇴부동맥에 적용하여 개존율및 전자현미경적 관찰을 통하여 비교하였고 아울러 임상에의 적용 가능성을 검토코져 하였다. 저자는 미세현미경시야에서 혈관함입문합술 20례와 단단문합술 20례를 시행한후 1일, 3일, 1주, 2주, 3주에 각각 4마리씩 희생후 문합혈관부를 육안관찰후 주사전자현미경으로 조직변화를 관찰하여 다음의 결과를 얻었다. 1. 혈관 함입문합술 시술시 문합후 개존율은 90%였고 혈관 단단문합술은 85%였다. 2. 혈관 함입문합시 술후 3일째는 문합부에서의 혈소판 응집물이 기질화되었으며 함입으로 좁아져 있던 혈관내경이 약 1주째 혈관 합입부의 중막 위축현상으로 다소 넓어졌다. 3. 혈관 내피재생과정을 혈관 함입문합술에서는 7일에서 14일경에, 혈관 단단문합술에서는 14일에서 21일째 완성되었다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제33권5호
• /
• pp.470-478
• /
• 2007

The purpose of this study was to investigate the clinical, biomechanical, and histologic changes in new distraction osteogenesis(DO) technique combined with a compression stimulation in accordance to different compression-distraction force ratio. 23 adult male rabbits underwent open-osteotomy at the mandibular body area and a external distraction device was applied. In the control group of 8 rabbits, only a 8 mm of distraction was performed by conventional DO technique. In an experimental group of 15 rabbits, a distraction followed by a compression force was performed according to the ratio of compression-distraction suggested by authors. The rate of experimental group I was set up as a 2 mm compression versus 10 mm distraction and the rate of experimental group II was set up as a 3 mm compression versus 11 mm distraction. All the rabbits were sacrificed for a gross finding, biomechanical, histomorphometric and histologic findings at the time of 55 days from the operation day. The results were as follows: 1. On the gross findings, because all rabbits had a sufficient healing time, every distracted new bone had good bone quality and we could not find any difference among all three groups. 2. In the histologic findings, rapid bone maturation(wide lamellar bone formation in the cancellous and cortical bone areas) was observed in two experimental groups compared to the control group. 3. On the bone density tests, the experimental group II showed higher bone density than the other experimental group and control group(control group-$0,2906g/cm^2$, experimental group I-$0.2961g/cm^2$, experimental group II-$0.3328g/cm^2$). 4. On the biomechanical tests, the experimental group II had significantly higher bone microhardness than the other experimental group and control group(control group-252.7 MPa, experimental group I-263.5 MPa, experimental group II-426.0 MPa). 5. On the microhardness tests, when we compared the hardness ratio of distracted bone versus normal bone, we could find experimental group II had significantly higher hardness ratio than the other experimental group and control group(control group-0.47, experimental group I-0.575, experimental group II-0.80). From this study, we could deduce that the modified distraction osteogenesis method with a compression stimulation might improve the quality of bone regeneration and shorten the consolidation period in comparison with conventional distraction osteogenesis techniques.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제33권5호
• /
• pp.559-566
• /
• 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.