• Title/Summary/Keyword: Implant Treatment

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개의 다엽성 골종양 제거후 커스텀 메이드 인공뼈를 이용한 두개골성형술 (Cranioplasty with Custom-made Artificial Bone after Resection of Multilobular Bone Tumor in a Dog)

  • 최성진;혼나미 무네키;류 이리;야마모토 케니치;오바 신스케;에치고 료스케;스즈키 시게키;니시무라 료헤이;정웅일;사사끼 노부오;모치즈키 마나부
    • 한국임상수의학회지
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    • 제31권1호
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    • pp.46-50
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    • 2014
  • 두개골에 종괴를 가진 7세 암컷 웰키코기가 내원하였다. 종괴는 다엽성 골종양으로 진단되었으며, 외과적으로 제거하었다. 종양 제거후 발생한 대형 골결손부를 치료하기 위해 3D 잉크젯 프린터로 제작한 커스텀 메이드 인공뼈를 결손부에 이식하였다. 이식후 4.3년동안 CT촬영을 통해 변화를 관찰하였다. 인공뼈는 관찰기간동안 주변 두개골과 성공적으로 유합되어 결손부를 수복하고 있었으며, 이식후 6개월부터 점차적인 인공뼈의 흡수상이 확인되었다. 커스텀 메이드 인공뼈가 대형 골결손부의 또 다른 치료방법으로서 사용될 수 있을 것이라 기대된다.

백서의 피하조직에 Gelatin Matrix Implant (Fibrel®) 매식시 조직변화에 관한 연구 (TISSUE CHANGE AFTER EMBEDDING GELATIN MATRIX IMPLANT(FFIBREL®) IN SUBCUTANEOUS TISSUE OF RATS;HISTOLOGIC, IMMUNOHISTOCHEMICAL AND SCANNING ELECTRON MICROSCOPIC STUDY)

  • 김홍진;이종헌;김경욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제20권4호
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    • pp.341-354
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    • 1998
  • GMI (Fibrel${(R)}$) is one of the dermal filling substances which have been successfully used for the treatment of depressed cutaneous scar and wrinkles. It's major components are; Gelatin powder, which provides a framework for the clot to form and remains stable under the scar, and ${\varepsilon}$-aminocaproic acid, which inhibits the production of fibrinolysin, and Plasma, which provides the necessary ingredients for collagen synthesis. GMI has advantages of low immunogenicity and increased longevity. It has been known to induce fibroblast activity and promote new collagen synthesis. We used 34 Sprague-Dawley rats which were bred under the same condition and duration. 18 of experimental animals were undergone cardiac puncture, and their blood were collected, centrifugated, and stored in freezer. Out of 16 animals, control group were injected with 2ml plasma into the subcutaneous tissue of Lt. scapular, while experimental group were implanted of 2 ml GMI into the Rt. same area. Experimental animals were sacrificed at the 3rd day, 5th day, 1st week and 2nd week respectively after implantation of GMI. To observe the histopathologic change of GMI and surrounding tissue reaction of GMI, we had examined with H&E staining, immunohistochemical staining with vimentin, ${\alpha}$-SMA, S-100 under LM and SEM. The obtained results were as follows ; 1. In LM study, the inflammatory cell infiltrations and granulation tissue formation were observed, and muscle tissues were well attached with adipose tissues in the control group. In the experimental group, inflammatory cell infiltrations had been observed by the 2nd week and irregular adipiose tissues and well differentiated mesenchymal tissues were examined. 2. In immunohistochemical study, the experimental group of ${\alpha}$-SMA study, there were a prominent positive response on endothelial development of granulation tissues and mesenchymal tissues compare with the control group. In vimentin study, positive response on mescenchymal fibroblast continued to 2nd week, but negative in the control group. In S-100 study, both groups were positively responded on irregular adipose tissues. 3. In SEM study, collagen fibers were embedded by the plasma by the 5th day in the control group, and in the 3rd day experiment GMI were resorved but communited with collagen fiber till the 1st week. Collagen fibers were infilt-rated into GMI at the 2nd week and the infilltrated GMI were conglomerated with the mature adipose cells and the collagen fibers. From the above results, GMI implantation in the subcutaneous tissue of Sprague-Dawley rat, the mild infiltration of inflammatory cells were showed till 2nd week and the granulation tissues were observed. GMI were nearly resorbed till 2nd week, but well attached with adipose tissue and collagen fibers. The endothelium and fibroblasts were actively proliferated. Adipose tissues and mesenchymal tissue cells were observed. As already expressed, GMI showed resorptive change in course of time without any early immune reaction, and seemed to induce fibroblast activity and promote new collagen synthesis.

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Clinical Experience of the Dynamic Stabilization System for the Degenerative Spine Disease

  • Lee, Soo-Eon;Park, Sung-Bae;Jahng, Tae-Ahn;Chung, Chun-Kee;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • 제43권5호
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    • pp.221-226
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    • 2008
  • Objective : The aim of the present study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases. Methods : The study population included 20 consecutive patients (13 females, 7 males) with a mean age of $61{\pm}6.98$ years (range 46-70) who underwent decompression and dynamic stabilization with the Dynesys system between January 2005 and August 2006. The diagnoses included spinal stenosis with degenerative spondylolisthesis (9/20, 45%), degenerative spinal stenosis (5/20, 25%), adjacent segmental disease after fusion (3/20, 15%), spinal stenosis with degenerative scoliosis (2/20, 10%) and recurrent intervertebral lumbar disc herniation (1/20, 5%). All of the patients completed the visual analogue scale (VAS) and the Korean version of the Oswestry Disability Index (ODI). The following radiologic parameters were measured in all patients : global lordotic angles and segmental lordotic angles (stabilized segments, above and below adjacent segments). The range of motion (ROM) was then calculated. Results : The mean follow-up period was $27.25{\pm}5.16$ months (range 16-35 months), and 19 patients (95%) were available for follow-up. One patient had to have the implant removed. There were 30 stabilized segments in 19 patients. Monosegmental stabilization was performed in 9 patients (47.3%), 9 patients (47.3%) underwent two segmental stabilizations and one patient (5.3%) underwent three segmental stabilizations. The most frequently treated segment was L4-5 (15/30, 50%), followed by L3-4 (12/30, 40%) and L5-S1 (3/30, 10%). The VAS decreased from $8.55{\pm}1.21$ to $2.20{\pm}1.70$ (p<0.001), and the patients' mean score on the Korean version of the ODI improved from $79.58%{\pm}15.93%$ to $22.17%{\pm}17.24%$ (p<0.001). No statistically significant changes were seen on the ROM at the stabilized segments (p=0.502) and adjacent segments (above segments, p=0.453, below segments, p=0.062). There were no patients with implant failure. Conclusion : The results of this study show that the Dynesys system could preserve the motion of stabilized segments and provide clinical improvement in patients with degenerative spinal stenosis with instability. Thus, dynamic stabilization systems with adequate decompression may be an alternative surgical option to conventional fusion in selected patients.

Calcium sulfate제재가 치주인대세포에 미치는 영향 (The effects of calcium sulfate on periodontal ligament cells)

  • 이준호;김소영;최성호;채중규;조규성
    • Journal of Periodontal and Implant Science
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    • 제28권2호
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    • pp.235-247
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    • 1998
  • Calcium sulfate has a long history of medical use as an implant material. The biocompatibiliry of the material has been clearly established. Bone ingrowth concomitant with resorption occurs rapidly with efficient conduction of bone from particle to particle. Calcium sulfate also has a potential for functioning as a good bamer membrane. The purpose of this study was to compare the biocompatibility of different types of calcium sulfate grafting materials including an expelimental calcium sulfate compound on periodontal ligament cells in vitro as a preliminary test towards the development of a more convenient and useful form of grafting material which could promote regeneration of periodontal tissue. Human periodontal ligament cells were collected from the premolar teeth extracted for orthodontic treatment. cells were cultured in a.MEM culture medium containing 20% FBS, at $37^{\circ}C$ and 100% humidity, in a 5% CO2 incubator. Cells were cultured into 96 well culture plate $1{\times}104$ cells per well with $\alpha$-MEM and incubated for 24 hours. After discarding the medium, those cells were cultured in $\alpha$-MEM contained with 10% FBS alone (control group), in medcal-grade calcium sulfate(MGCS group), in plaster(plaster group), experimental calcium sulfate paste(CS paste group) for 1, 2, 3 day respectively. And then each group was characterized by examining of the cell counting, MTI assay, collagen synthesis. The results \vere as follows. 1. In the analysis of cell proliferation by cell counting, both medical-grdde calcium sulfate group and plaster group showed no stastically significant difference at day 1, 2, 3 accept for plaster group at day 1 compared to control group, but there was stastically significant difference between CS paste group and all other groups at day 1, 2, 3(P<0.05). 2. In the analysis of cytotoxicity by MIT assay, both medical-grade calcium sJlfate group and plaster group showed no stastically significant difference compared to control group at day 1, 2, 3 but there was stastically significant difference between CS paste group and all other groups at day 1, 2, 3(P<0.OS). 3. In the analysis of collagen synthesis by immunoblotting assay, high level was detected for medical-grade calcium sulfate group and plaster group at day 1, 2, 3 compared to CS paste group. On the basis of these results, medical-grade calcium sulfate and plaster was shown to possess biocompatibility whereas the CS paste had unfavourable outcome. This observation shows a need for modification of the materials contained in calcium sulfate paste.

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심미적인 결과를 얻기 위한 치근 피개술 (Esthetic Root Coverage for Gingival Recession)

  • 안명환
    • 대한심미치과학회지
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    • 제26권1호
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    • pp.4-16
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    • 2017
  • 현대의 치과 치료에서는 환자들의 심미적 요구도가 점점 높아지고 있다. 그리고, 이러한 심미 치과 영역에서 치은을 비롯한 연조직이 차지하는 비중은 매우 크다고 할 수 있다. 자연치나 임플란트 주위 조직을 분명히 이해하고 적절한 치료를 해줌으로써 환자들의 요구도를 만족시킬 수 있을 것이다. 연조직 부위의 심미를 pink esthetic이라고도 하는데, 이 pink esthetic에서 가장 중요한 영향을 미치는 것이 치은선이라고 할 수 있다. 이 치은선은 순측 치은의 높이, 치간유두의 높이, 그리고 이 둘을 잇는 자연스러운 곡선으로 구성되어 있다. 자연치에서 치은 퇴축이 발생한 경우, 순측 치은의 높이를 비롯한 자연스러운 치은선이 치근쪽으로 이동하게 되고, 더 많은 치아의 치근 부위가 노출되게 되어 비심미적인 모습을 보이게 된다. Root coverage technique(치근피개술)은 자연치의 치은 퇴축(marginal tissue recession)을 치료하기 위해서 오랜 기간동안 사용되어 왔던 술식으로, 치주 성형수술 영역에서는 대표적인 술식중의 하나라고 할 수 있다. 최근에는 임플란트 술식이 매우 보편화되었는데, 그만큼 임플란트의 부작용 또한 급증하고 있다고 할수 있다. 전치부 영역에서 임플란트의 부작용은 자주 심미적인 문제를 동반하게 된다. 기존의 전통적인 root coverage technique은 이러한 치과 임플란트 영역의 심미적 문제의 해결을 위해 많이 사용되고 응용되고 있다. 현재 우리나라의 대다수의 치과에서 임플란트 치료가 시행되고 있는 현실을 생각한다면 그 심미적 부작용의 극복을 위해, root coverage technique을 비롯한 연조직 처치를 숙지하는 것은 매우 유용하다고 할 수 있을 것이다. 이번 글에서는 대표적인 치근 피개술식들을 간단하게 살펴볼 것이며, 더 좋은 심미적 결과를 위한 단계별 고려사항들에 대해서 다뤄보려고 한다.

A useful additional medial subbrow approach for the treatment of medial orbital wall fracture with subciliary technique

  • Kim, Seung Min;Kim, Cheol Keun;Jo, Dong In;Lee, Myung Chul;Kim, Ji Nam;Choi, Hyun Gon;Shin, Dong Hyeok;Kim, Soon Heum
    • 대한두개안면성형외과학회지
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    • 제20권2호
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    • pp.101-108
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    • 2019
  • Background: To date, a variety of surgical approaches have been used to reconstruct the medial orbital wall fracture. Still however, there is still a controversy as to their applicability because of postoperative scars, injury of anatomical structures and limited visual fields. The purpose of this study was to introduce a useful additional medial subbrow approach for better reduction and securement more accurate implant pocket of medial orbital wall fracture with the subciliary technique. Methods: We had performed our technique for a total of 14 patients with medial orbital wall fracture at our medical institution between January 2016 and July 2017. All fractures were operated through subciliary technique combined with the additional medial subbrow approach. They underwent subciliary approach accompanied by medial wall dissection using a Louisville elevator through the slit incision of the medial subbrow procedure. This facilitated visualization of the medial wall fracture site and helped to ensure a more accurate pocket for implant insertion. Results: Postoperative outcomes showed sufficient coverage without displacement. Twelve cases of preoperative diplopia improved to two cases of postoperative diplopia. More than 2 mm enophthalmos was 14 cases preoperatively, improving to 0 case postoperatively. Without damage such as major vessels or extraocular muscles, enophthalmos was corrected and there was no restriction of eyeball motion. Conclusion: Our ancillary procedure was useful in dissecting the medial wall, and it was a safe method as to cause no significant complications in our clinical series. Also, there is an only nonvisible postoperative scar. Therefore, it is a recommendable surgical modality for medial orbital wall fracture.

Strategies for Managing Dementia Patients through Improving Oral Health and Occlusal Rehabilitation: A Review and Meta-analysis

  • Yeon-Hee Lee;Sung-Woo Lee;Hak Young Rhee;Min Kyu Sim;Su-Jin Jeong;Chang Won Won
    • Journal of Korean Dental Science
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    • 제16권2호
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    • pp.128-148
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    • 2023
  • Dementia is an umbrella term that describes the loss of thinking, memory, attention, logical reasoning, and other mental abilities to the extent that it interferes with the activities of daily living. More than 50 million individuals worldwide live with dementia, which is expected to increase to 131 million by 2050. Recent research has shown that poor oral health increases the risk of dementia, while oral health declines with cognitive decline. In this narrative review, the literature was based on the "hypothesis" that dementia and oral health have a close relationship, and appropriate oral health and occlusal rehabilitation treatment can improve the quality of life of patients with dementia and prevent progression. We conducted a literature search in PubMed and Google Scholar databases, using the search terms "dementia," "major neurocognitive disorder," "dentition," "occlusion," "tooth loss," "dental prosthesis," "dental implant," and "occlusal rehabilitation" in the title field over the past 30 years. A total of 131 studies that scientifically addressed dementia, oral health, and/or oral rehabilitation were included. In a meta-analysis, the random effect model demonstrated significant tooth loss increasing the dementia risk 3.64-fold (pooled odds ratio=3.64, 95% confidence interval [2.50~5.32], P-value=0.0348). Tooth loss can be an important indicator of cognitive function decline. As the number of missing teeth increases, the risk of dementia increases. Loss of teeth can lead to a decrease in the ascending information to the brain and reduced masticatory ability, cerebral blood flow, and psychological atrophy. Oral microbiome dysbiosis and migration of key bacterial species to the brain can also cause dementia. Additionally, inflammation in the oral cavity affects the inflammatory response of the brain and the complete body. Conversely, proper oral hygiene management, the placement of dental implants or prostheses to replace lost teeth, and the restoration of masticatory function can inhibit symptom progression in patients with dementia. Therefore, improving oral health can prevent dementia progression and improve the quality of life of patients.

3급 부정교합 환자의 교합수직고경 증가를 동반한 보철 수복 (Prosthetic rehabilitation in a Class III malocclusion patient with increasing occlusal vertical dimension)

  • 최하은;송한솔 ;고경호 ;허윤혁 ;박찬진 ;조리라
    • 구강회복응용과학지
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    • 제39권3호
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    • pp.133-145
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    • 2023
  • 하악전돌 양상을 보이는 3급 부정교합은 골격성 3급과 치아변위에 의한 가성 3급으로 나눌 수 있다. 골격성 부정교합은 수복공간 확보 및 심미적, 기능적 결과를 얻기 위해 적절한 수직 및 수평 악간관계를 설정하면 양호한 치료결과를 얻을 수 있다. 본 증례는 하악 전돌과 전치부 마모 및 교합수직고경의 감소를 보이는 환자에서 임플란트와 고정성 보철물을 이용하여 완전구강회복을 시행하였다. 모형 분석과 디지털 진단을 시행 후 수직고경을 거상한 임시수복물을 제작하여 구치부 지지를 확보하고 안정적인 중심교합을 평가하였고, 이를 반영한 최종보철물로 양호한 기능과 심미를 회복할 수 있었기에 이를 보고하는 바이다.

Bioactive glass의 장기 임상적 평가 (Clinical Long-term Assessment of Bioactive Glass Graft)

  • 이항빈;백정원;김창성;최성호;조규성;김종관;채중규
    • Journal of Periodontal and Implant Science
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    • 제32권1호
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    • pp.187-198
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    • 2002
  • The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Recently, bioactive glass that has been utilized in plastic surgery is being investigated for application in dental practice. But, there has not been any long-term assessment of bioactive glass when used in periodontal intrabony defects. The present study evaluates the long-term effects of bioactive glass on the periodontal regeneration in intrabony defects of human and the effect of plaqu control on long term treatment results after dividing patients into those who underwent 3-month regular check-up and those who didn't under go regular check-up The clinical effect on 74sites from 17 infrabony pockets of 11 patients were analyzed 36months after treatment. 51 sites which underwent regular check up were classified as the Follow-up group(F/U group), and 23 sites which did not undergo regular check up were classified as Non Follow-up group(Non F/U group). After comparing the probing depth, attachment loss, bone probing depth before and 36months after treatment, the following results could be concluded. 1. The changes of probing pocket depth showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.79${\pm}$0.68mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(0.61${\pm}$0.54mm) (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after baseline and 36 months after treatment in F/U group(1.44${\pm}$0.74mm) and did no show astatistically significant decrease between after baseline and 36months after treatment in Non F/U group(1.18${\pm}$1.54) (P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after baseline and 36 months after treatment in both F/U(1.35${\pm}$0.28) and Non F/U group(0.78${\pm}$0.55mm) (P<0.05). The results suggest that treatment of infrabony defects with bioactive glass resulted in significan reduction of attachment loss and bone probing depth 36months after the treatment. The use of bioactive glass in infrabony defects, combined with regular check-up and proper plaque control generally shows favorable clinical results. This measn that bioactive glass could be a useful bone substitute.

양극산화에 의한 티타늄 산화막의 표면 특성 및 생체 활성에 관한 연구 (SURFACE CHARACTERISTICS AND BIOACTIVITY OF ANODICALLY OXIDIZED TITANIUM SURFACES)

  • 이상한;조인호
    • 대한치과보철학회지
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    • 제45권1호
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    • pp.85-97
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    • 2007
  • Statement of problem: Recently, anodic oxidation of cp-titanium is a popular method for treatment of titanium implant surfaces. It is a relatively easy process, and the thickness, structure, composition, and the microstructure of the oxide layer can be variably modified. Moreover the biological properties of the oxide layer can be controlled. Purpose: In this study, the roughness, microstructure, crystal structure of the variously treated groups (current, voltage, frequency, electrolyte, thermal treatment) were evaluated. And the specimens were soaked in simulated body fluid (SBF) to evaluate the effects of the surface characteristics and the oxide layers on the bioactivity of the specimens which were directly related to bone formation and integration. Materials and methods: Surface treatments consisted of either anodization or anodization followed thermal treatment. Specimens were divided into seven groups, depending on their anodizing treatment conditions: constant current mode (350V for group 2), constant voltage mode (155V for group 3), 60 Hz pulse series (230V for group 4, 300V for group 5), and 1000 Hz pulse series (400V for group 6, 460V for group 7). Non-treated native surfaces were used as controls (group 1). In addition, for the purpose of evaluating the effects of thermal treatment, each group was heat treated by elevating the temperature by $5^{\circ}C$ per minute until $600^{\circ}C$ for 1 hour, and then bench cured. Using scanning electron microscope (SEM), porous oxide layers were observed on treated surfaces. The crystal structures and phases of titania were identified by thin-film x-ray diffractmeter (TF-XRD). Atomic force microscope (AFM) was used for roughness measurement (Sa, Sq). To evaluate bioactivity of modified titanium surfaces, each group was soaked in SBF for 168 hours (1 week), and then changed surface characteristics were analyzed by SEM and TF-XRD. Results: On basis of our findings, we concluded the following results. 1. Most groups showed morphologically porous structures. Except group 2, all groups showed fine to coarse convex structures, and the groups with superior quantity of oxide products showed superior morphology. 2. As a result of combined anodization and thermal treatment, there were no effects on composition of crystalline structure. But, heat treatment influenced the quantity of formation of the oxide products (rutile / anatase). 3. Roughness decreased in the order of groups 7,5,2,3,6,4,1 and there was statistical difference between group 7 and the others (p<0.05), but group 7 did not show any bioactivity within a week. 4. In groups that implanted ions (Ca/P) on the oxide layer through current and voltage control, showed superior morphology, and oxide products, but did not express any bioactivity within a week. 5. In group 3, the oxide layer was uniformly organized with rutile, with almost no titanium peak. And there were abnormally more [101] orientations of rutile crystalline structure, and bonelike apatite formation could be seen around these crystalline structures. Conclusion: As a result of control of various factors in anodization (current, voltage, frequency, electrolytes, thermal treatment), the surface morphology, micro-porosity, the 2nd phase formation, crystalline structure, thickness of the oxide layer could be modified. And even more, the bioactivity of the specimens in vitro could be induced. Thus anodic oxidation can be considered as an excellent surface treatment method that will able to not only control the physical properties but enhance the biological characteristics of the oxide layer. Furthermore, it is recommended in near future animal research to prove these results.