• The Journal of Korean Society for Radiation Therapy
• /
• v.26 no.2
• /
• pp.329-336
• /
• 2014

Purpose : To evaluate the dose on a contralateral breast and the usefulness of shielding according to the distance between the contralateral breast and the side of the beam by breast size when patients who got breast implant receive radiation therapy. Materials and Methods : We equipped 200 cc, 300 cc, 400 cc, and 500 cc breast model on the human phantom (Rando-phantom), acquired CT images (philips 16channel, Netherlands) and established the radiation treatment plan, 180 cGy per day on the left breast (EclipseTM ver10.0.42, Varian Medical Systems, USA) by size. We set up each points, A, B, C, and D on the right(contralateral) breast model for measurement by size and by the distance from the beam and attached MOSFET at each points. The 6 MV, 10 MV and 15 MV X-ray were irradiated to the left(target) breast model and we measured exposure dose of contralateral breast model using MOSFET. Also, at the same condition, we acquired the dose value after shielding using only Pb 2 mm and bolus 3 mm under the Pb 2 mm together. Results : As the breast model is bigger from 200 cc to 500 cc, The surface of the contralateral breast is closer to the beam. As a result, from 200 cc to 500 cc, on 180 cGy basis, the measurement value of the scattered ray inclined by 3.22 ~ 4.17% at A point, 4.06 ~ 6.22% at B point, 0.4~0.5% at C point, and was under 0.4% at D point. As the X-ray energy is higher, from 6 MV to 15 MV, on 180 cGy basis, the measurement value of the scattered ray inclined by 4.06~5% at A point, 2.85~4.94% at B point, 0.74~1.65% at C point, and was under 0.4% at D point. As using Pb 2 mm for shield, scattered ray declined by average 9.74% at A and B point, 2.8% at C point, and is under 1% at D point. As using Pb 2 mm and bolus together for shield, scattered ray declined by average 9.76% at A and B point, 2.2% at C point, and is under 1% at D point. Conclusion : Commonly, in case of patients who got breast implant, there is a distance difference by breast size between the contralateral breast and the side of beam. As the distance is closer to the beam, the scattered ray inclined. At the same size of the breast, as the X-ray energy is higher, the exposure dose by scattered ray tends to incline. As a result, as low as possible energy wihtin the plan dose is good for reducing the exposure dose.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.3
• /
• pp.341-349
• /
• 2008

Purpose: The purpose of this study was to evaluate the $Osstem^{(R)}$ implants (US II/SS II implants) through the retrospective study for the clinical success rate during the installation of the $Osstem^{(R)}$ implants (US II/SS II implants) by using of the procedures of maxillary sinus floor elevation. Materials and methods: The current study was researched in the 6 medical institutions: Chonnam National University, Chosun University, Pusan DaeDong Hospital, Bundang Seoul National University Hospital, Ap-Seon Clinic, and All Clinic. Based on the total number of 116 patients whose treatment was the installation of the US II/SS II implants with the procedures of the maxillary sinus floor elevation, they were conferred on the dental records of the patients under the joint consultation of the 6 medical institutions. On the dental recording charts, there were included in as the following; the name of the institutions, gender, age, with or without smoking or drinking, with or without the generalized diseases, the height of the alveolar bone on the operational sites, elapsed edentulous state period, the state of the opposed or adjacent teeth, the methods of the maxillary sinus floor elevation, secondary time period for surgery, the lengths, types, and diameters of implants, with or without bone transplantation or the types of bone, postoperative current bone height, current adjacent soft tissue state of the implants, with or without the success of the installations of the implants. We have done our survey with the clinical and radiolographical examinations and dental questionaries. The success and survival rate of the implants was evaluated. Results 1. Total number of the patients with the installation of the US II implants were 62. The 252 numbers of US II implants were installed on the 89 maxillary sinuses. The patient's mean age was 54.1 years old and there were 36 men and 27 women. 2. Total number of patients with the installation of SS II implant were 57. The 165 numbers of SS II implants were planted on the 80 maxillary sinuses. Their mean age was 48.7 years old and there were 37 men and 20 women. 3. The follow-up period was 30.7 months(21-49 mon) on average. The vertical bone loss of installed implants after the procedures of the maxillary sinus elevation was 1.1 mm on average in SS II and 1.3 mm on average in US II. There existed no statistical significance on each group. The mean enlarged bone height after the maxillary sinus floor elevation was 8.2 mm. 4. For the procedures of the maxillary sinus elevation, the Lateral approach technique occupied 87.1%, which was the most used one. In addition, the most frequently used transplanted bone was autogenous bone only which was 72.7% during the maxillary sinus floor elevation. 5. The complication of maxillary sinus floor elevation were perforation of sinus membrane, disesthesia on doner site, exposure of cover screw and exposure of maxillar bone. 6. The survival rate of US II and SS II after maxillary sinus floor elevation was 99.2% and 95.8%, respectively. And the success rate of US II and SS II after maxillary sinus floor elevation was 97.6% and 89.7%, respectively. Conclusion : On the evaluation of the analysis of our study, both US II and SS II implants showed the excellent clinical results by use of the procedures of maxillary sinus floor elevation.

• Journal of the Korean Orthopaedic Association
• /
• v.54 no.5
• /
• pp.427-434
• /
• 2019

Purpose: This study evaluated the long term clinical and radiographic results and the survival rates of unicompartmental knee arthroplasty (UKA). In addition, the factors affecting the survival of the procedure were analyzed and the survival curve was compared according to the affecting factors. Materials and Methods: Ninety-nine cases of UKA performed between December 1982 and January 1996 were involved: 10 cases with Modular II, 44 cases with Microloc, and 45 cases with Allegretto prostheses. The mean follow-up period was 16.5 years. Clinically, the hospital for special surgery (HSS) scoring system and the range of motion (ROM) were evaluated. Radiographically, the femorotibial angle (FTA) was measured. The survival rate was analyzed using the Kaplan-Meier method. Cox regression analysis was used to identify the factors affecting the survival according to age, sex, body mass index, preoperative diagnosis, and type of implant. The Kaplan-Meier survival curves were compared according to the factors affecting the survival of UKA. Results: The overall average HSS score and ROM was 57.7 and 134.3° preoperatively, 92.7 and 138.4° at 1 year postoperatively, and 79.1 and 138.4° at the last follow-up (p<0.001, respectively). The overall average FTA was varus 0.8° preoperatively, valgus 4.1° at postoperative 2 weeks, and valgus 3.0° at the last follow-up. The overall 5-, 10-, 15- and 20-year survival rates were 91.8%, 82.9%, 71.0%, and 67.0%, respectively. The factors affecting the survival were the age and type of implant. The risk of the failure decreased with age (hazard ratio=0.933). The Microloc group was more hazardous than the other prostheses (hazard ratio=0.202, 0.430, respectively). The survival curve in the patients below 60 years of age was significantly lower than those of the patients over 60 years of age (p=0.003); the survival curve of the Microloc group was lower compared to the Modular II and Allegretto groups (p=0.025). Conclusion: The long-term clinical and radiographic results and survival of UKA using old fixed bearing prostheses were satisfactory. The selection of appropriate patient and prosthesis will be important for the long term survival of the UKA procedure.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.39 no.4
• /
• pp.204-213
• /
• 2023

Invasive or non-invasive reduction of fractures could be conducted as treatments of traumatic maxillofacial bone fractures. But when suboptimal reduction or malunion of maxillofacial bone fracture occurs, malocclusion could occur as a result of the lost relationship of the mandible and midface. This malocclusion is called post-traumatic malocclusion and orthognathic surgery, orthodontic treatment, selective grinding and prosthetic reconstruction are suggested as treatments for post-traumatic malocclusion after securement of stable TMJ. Stable TMJ is essential for occlusal rehabilitation to prevent occlusal change and relapse of malocclusion. Centric relation and adapted centric posture are suggested as start points of occlusal rehabilitation because they are most stable TMJ position. This case report presents a case in which post-traumatic malocclusion occurred after reduction of panfacial fracture. To rehabilitate full mouth occlusion, selective grinding and prosthetic reconstruction of implant supported fixed prostheses were conducted in centric relation and showed satisfying results in functional and occlusal aspects.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.22 no.4
• /
• pp.430-435
• /
• 2000

Cleft lip and palate is one of the congenital anomalies which need comprehensive and multidisciplinary treatment plan because 1) oral cavity is an important organ with masticatory function as a start of digestive tract, 2) anatomic symmetry and balance is esthetically important in midfacial area, and 3) it is also important to prevent psycho-social problems by adequate restoration of normal facial appearance. There are many different protocols in the treatment of cleft lip and palate, but our department has adopted and modified the $Z{\"{u}}rich$ protocol, as published in the Journal of Korean Cleft Lip and Palate Association in 1998. The first challenge is feeding. Type of feeding aid ranges from simple obturators to active orthopedic appliances. In our department we use passive-type plate made up of soft and hard acrylic resin which permits normal maxillary growth. We use Millard's method to restore normal appearance and function of unilateral complete cleft lip. In consideration of both maxillary growth and phonetic problems, we first close soft palate at 18 months of age and delay the hard palate palatoplasty until 4 to 5 years of age. When soft palate is closed, posterior third of the hard palate is intentionally not denuded to allow normal maxillary growth. In hard palate palatoplasty the mucoperiosteum of affected site is not mobilized to permit residual growth of the maxilla. We have treated a patient with unilateral complete cleft lip and palate by Ajou protocol, which is a kind of modified $Z{\"{u}}rich$ protocol. It is as follows: Infantile orthopedics with passive-type plate such as Hotz plate, cheiloplasty with Millard's rotation-advancement flap, and two stage palatoplasty. It is followed by orthodontic treatment and secondary osteoplasty to augment cleft alveolus, orthognathic surgery, and finally rehabilitation with conventional prosthodontic treatment or implant installation. The result was good up to now, but we are later to investigate the final result with longitudinal follow-up study according to master plan by Ajou protocol.

• Journal of Trauma and Injury
• /
• v.29 no.4
• /
• pp.129-138
• /
• 2016

Purpose: Due to recent advances in internal fixation techniques, instrumentation and orthopedic implants there is an increasing number of humeral shaft fracture treated operatively. As a consequence, an increased number nonunion after operative fixation are being referred to our center. The aim of this study is to report the common error during osteosynthesis that may have led to nonunion and present a systematic analytical approach for the management of aseptic humeral shaft nonunion. Methods: In between January 2007 to December 2013, 20 patients with humeral shaft nonunion after operative procedure were treated according to our treatment algorithm. We could analysis x-rays of 12 patients from initial treatment to nonunion. In a subgroup of 12 patients the initial operative procedure were analyzed to determine the error that may have caused nonunion. The following questions were used to examine the cases: 1) Was the fracture biology preserved during the procedure? 2) Does the implant construct have enough stability to allow fracture healing? Results: In 19 out of 20 patients have showed radiographic evidence of union on follow up. One patient has to undergo reoperation because of the technical error with bone graft placement but eventually healed. There were 2 cases wherein the treatment algorithm was not followed. All patients had problems with mechanical stability, and in 13 patients had biologic problems. In the analysis of the initial operative fixation, only one of 12 patients had biologic problems. Conclusion: In our analysis, the common preventable error made during operative fixation of humeral shaft fracture is failure to provide adequate stability for bony union to occur. And with these cases we have demonstrated a systematic analytic management approach that may be used to prevent surgeons from reproducing the same fault and reduce the need for bone grafting.

• Journal of Periodontal and Implant Science
• /
• v.48 no.4
• /
• pp.213-223
• /
• 2018

Purpose: Oral lichen planus (OLP) is a chronic oral mucosal disease that has been recognized as an immune condition. The purpose of this study was to evaluate factors affecting the clinical outcomes of topical corticosteroid application on OLP lesions using dexamethasone gargle and ointment. Methods: The charts of patients who were clinically diagnosed with OLP and treated with dexamethasone from July 2003 to August 2017 at the Section of Dentistry of Seoul National University Bundang Hospital were thoroughly evaluated to identify subjects who were suitable for this retrospective study. For each patient, age at the index date, gender, medical history, and dental records related to OLP lesions and dexamethasone treatment were reviewed. Results: In total, 113 of the 225 patients were included in the present study. Among them, 79 patients were female (69.9%) and 34 were male (30.1%), with a mean age of 57.6 years. The average duration of dexamethasone treatment was 4.7 months and the mean follow-up period was 2.24 years. Improvements were observed within 1 year after dexamethasone treatment in most cases, and 17.7% of patients had a new OLP lesion after treatment. New OLP lesions were more frequently gingival than mucosal, although mucosal OLP lesions were more common than gingival OLP lesions in all age groups. In age- and gender-adjusted multivariate logistic regression, a history of malignant disease was found to be a significant factor affecting the formation of new lesions. Gingival OLP lesions and intermittent use of dexamethasone showed near-significant associations. In Kaplan-Meier failure analysis, history of malignancy, menopausal status, age, and the site of the OLP lesion were significant factors affecting clinical outcomes. Conclusions: The treatment outcomes of OLP were significantly influenced by age, history of malignancy, menopausal status, and the site of the OLP lesion, but not by factors related to dexamethasone treatment.

• Journal of Periodontal and Implant Science
• /
• v.39 no.3
• /
• pp.303-310
• /
• 2009

Purpose: The aerosol generated by ultrasonic scaler can contain bacteria or virus which can penetrate into body through respiratory systems of dentists, dental hygienist or patients. The aim of this study is to evaluate the effect of chlorhexidine digluconate as preoperative mouthrinse or lavage for ultrasonic scaler on the reduction of viable organisms in aerosol produced during periodontal treatment using ultrasonic scaler. Methods: 30 patients with moderate chronic periodontitis were included and divided into 3 groups: Control (no preoperative mouthrinse and tap water as lavage), CHG (preoperative mouthrinse with 0.1% chlorhexidine digluconate and tap water as lavage), CHL (no preoperative mouthrinse and 0.1% chlorhexidine digluconate as lavage). Each patient received scaling or subgingival curettage for 30 min. In CHG group, mouthrinse with chlorhexidine digluconate was performed for 1 min. before treatment. Before, during and after scaling or subgingival curettage, air sampling was performed for 7 min. each (1000 L/7 min.) with trypticase-soy agar plate. Agar plates were incubated in $37^{\circ}C$ aerobically. The numbers of colony-forming units (CFU) were counted and compared. Results: The numbers of CFUs of the samples obtained during treatment were $97{\pm}14.0$ in control, $73.1{\pm}14.9$ in CHG group and $44.5{\pm}9.0$ in CHL group. The difference among the 3 groups was determined to be statistically significant (one-way ANOVA with Bonferroni's correction, p-value: 0.0003). In contrast, the numbers of CFU of samples obtained before and after treatment were not significantly different among the groups. Conclusions: Chlorhexidine digluconate used as preoperative mouthrinse or lavage for ultrasonic scaler can reduce the microorganisms in aerosol produced during periodontal treatment using ultrasonic scaler. Less number of microorganisms were detected when chlorhexidine was used as lavage for ultrasonic scaler.

• Journal of Periodontal and Implant Science
• /
• v.29 no.2
• /
• pp.371-387
• /
• 1999

The present study was performed to assess and compare the clinical and microbiological effects following local application of 2% minocycline gel or 0.1% chlorhexidine subgingival irrigation to augment scaling and root planing in patients with moderate to advanced chronic adult periodontitis. 32 healthy patients with moderate to advanced chronic adult periodontitis were enrolled in the study. In each patient, the quadrants that had 2 or more teeth with $5{\sim}8mm$ probing pocket depth and radiographic evidence of alveolar bone loss were selected and divided into test side and control side according to the split-mouth design. All patients received standardized oral hygiene instructions at the beginning of the study and all remaining teeth received scaling and root planing until 0 week. The 2% minocycline gel was applied to periodontal pocket at 0, 1, 2, 3 week in the test side. The 0.1% chlorhexidine solution and the normal saline were irrigated subgingivally for about 30 seconds in the positive control side and negative control side respectively. The clinical and microbiological analysis carried out at 0, 4, 8, and 12 weeks . The results of this study were as follows; 1. In saline irrigation group, there was no adjunctive effects in probing pocket depth reduction, sulcular bleeding index and no significant changes in relative proportions of subgingival bacteria. 2. The chlorhexidine irrigation as an adjunct to scaling and root planing results in reduction in the plaque index and sulcular bleeding index, but there was not statistically significant. The relative proportion of spirochetes was significantly reduced, but the proportion of motile rods was no significant reduction. 3. The minocycline gel delivered subgingivally as an adjunct to scaling and root planing provide significant benefit in reducing probing depths and sulcular bleeding index compared to saline and chlorhexidine irrigation groups. 4. The relative proportions of spirochetes and motile rods were significantly reduced and the proportions of cocci and non-motile bacteria were correspondingly increased in the minocycline gel group. In conclusion, minocycline gel delivered subgingivally as an adjunct to scaling and root planing induces clinical and microbial responses more favorable for periodontal health than saline and chlorhexidine subgingival irrigation.

• Journal of Periodontal and Implant Science
• /
• v.38 no.4
• /
• pp.629-638
• /
• 2008

Purpose: The purposes of this study were to compare and quantify the expression of Stromelysin-1 and MT-MMP-1 in the gingival tissues of patients with type 2 diabetes mellitus(DM) and healthy adults with chronic periodontitis. Materials and Methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was devided into three groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from systemically healthy 8 patients. Group 2 (n=8) is inflammed gingiva from patients with chronic periodontitis. Group 3 (n=8) is inflammed gingiva from patients with chronic periodontitis associated with type 2 DM. Tissue samples were prepared and analyzed by Western blotting. The quantification of Stromelysin-1 and MT-MMP-1 were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. Results: In the analysis of expression levels, Stromelysin-1 and MT-MMP-1 expressions were similar in group 1 and 2. Stromelysin-1 and MT-MMP-1 expressions was more increased in group 3 than group 1, 2. The difference between group 3 and group 1, 2 was statistically significant. Also, in the interrelationship of Stromelysin-1 and MT-MMP-1 expressions, expressions of Stromelysin-1 and MT-MMP-1 showed increasing tendency in chronic periodontitis associated with type 2 DM and it seems that the MT-MMP-1 expressions were increasing in proportion to Stromelysin-1 expressions. Conclusion: It is suggested that Stromelysin-1 and MT-MMP-1 may be partly involved in the progression of periodontal inflammation associated with type 2 DM, as related to a metabolism of other factors, such as AGE, plasmin and other inflammatory mediators. Therefore, the expression levels of Stromelysin-1 and MT-MMP-1 can be inflammatory markers of periodontal inflammed tissue with type 2 DM.