• Title/Summary/Keyword: Implant direction

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Evaluation of Metal Volume and Proton Dose Distribution Using MVCT for Head and Neck Proton Treatment Plan (두경부 양성자 치료계획 시 MVCT를 이용한 Metal Volume 평가 및 양성자 선량분포 평가)

  • Seo, Sung Gook;Kwon, Dong Yeol;Park, Se Joon;Park, Yong Chul;Choi, Byung Ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.1
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    • pp.25-32
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    • 2019
  • Purpose: The size, shape, and volume of prosthetic appliance depend on the metal artifacts resulting from dental implant during head and neck treatment with radiation. This reduced the accuracy of contouring targets and surrounding normal tissues in radiation treatment plan. Therefore, the purpose of this study is to obtain the images of metal representing the size of tooth through MVCT, SMART-MAR CT and KVCT, evaluate the volumes, apply them into the proton therapy plan, and analyze the difference of dose distribution. Materials and Methods : Metal A ($0.5{\times}0.5{\times}0.5cm$), Metal B ($1{\times}1{\times}1cm$), and Metal C ($1{\times}2{\times}1cm$) similar in size to inlay, crown, and bridge taking the treatments used at the dentist's into account were made with Cerrobend ($9.64g/cm^3$). Metal was placed into the In House Head & Neck Phantom and by using CT Simulator (Discovery CT 590RT, GE, USA) the images of KVCT and SMART-MAR were obtained with slice thickness 1.25 mm. The images of MVCT were obtained in the same way with $RADIXACT^{(R)}$ Series (Accuracy $Precision^{(R)}$, USA). The images of metal obtained through MVCT, SMART-MAR CT, and KVCT were compared in both size of axis X, Y, and Z and volume based on the Autocontour Thresholds Raw Values from the computerized treatment planning equipment Pinnacle (Ver 9.10, Philips, Palo Alto, USA). The proton treatment plan (Ray station 5.1, RaySearch, USA) was set by fusing the contour of metal B ($1{\times}1{\times}1cm$) obtained from the above experiment by each CT into KVCT in order to compare the difference of dose distribution. Result: Referencing the actual sizes, it was appeared: Metal A (MVCT: 1.0 times, SMART-MAR CT: 1.84 times, and KVCT: 1.92 times), Metal B (MVCT: 1.02 times, SMART-MAR CT: 1.47 times, and KVCT: 1.82 times), and Metal C (MVCT: 1.0 times, SMART-MAR CT: 1.46 times, and KVCT: 1.66 times). MVCT was measured most similarly to the actual metal volume. As a result of measurement by applying the volume of metal B into proton treatment plan, the dose of $D_{99%}$ volume was measured as: MVCT: 3094 CcGE, SMART-MAR CT: 2902 CcGE, and KVCT: 2880 CcGE, against the reference 3082 CcGE Conclusion: Overall volume and axes X and Z were most identical to the actual sizes in MVCT and axis Y, which is in the superior-Inferior direction, was regular in length without differences in CT. The best dose distribution was shown in MVCT having similar size, shape, and volume of metal when treating head and neck protons. Thus it is thought that it would be very useful if the contour of prosthetic appliance using MVCT is applied into KVCT for proton treatment plan.

Three dimensional analysis of tooth movement using different sizes of NiTi wire on NiTi scissors-bite corrector (NiTi scissors-bite corrector의 와이어 굵기에 따른 3차원적 치아 이동 양상)

  • Jeon, Hyun-Ju;Park, Sun-Hyung;Jung, Sang-Hyuk;Chun, Youn-Sic
    • The korean journal of orthodontics
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    • v.39 no.1
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    • pp.43-53
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    • 2009
  • Objective: The purpose of this study was to compare the difference in three dimensional tooth movement using three different wire sizes($0.018{\times}0.025-in,\;0.016{\times}0.022-in$ 0.016-in) on a NiTi scissors-bite corrector. Methods: Computed tomography(CT) images of the experimental model before and after tooth movement were taken and reconstructed into three dimensional models for superimposition. The direction and the amount of tooth movement were measured and analyzed statistically. Results: The lingual and intrusive movements of the crown of the maxillary second molar were increased as the size of the NiTi wire increased. The roots of the maxillary second metals moved buccally except for the 0.016-in group. The intrusive movement of the roots of the maxillary second molars was increased as the size of the NiTi wire increased. Due to the use of orthodontic mini-implants, anchorage loss was under 0.2 mm on average. Conclusions: The $0.018{\times}0.025-in$ NiTi wire was most effective in lingual and intrusive movement of the maxillary second molar which was in scissors-bite position. Indirect skeletal anchorage with a single orthodontic mini-implant was rigid enough to prevent anchorage loss.

Periodontally Diseased Root and Normal Root as Studied by Electron Probe Microanalysis & SEM (정상 치근과 치주질환에 이환된 치근면의 Electron Probe Microanalysis와 주사전자 현미경에 의한 연구)

  • Kim, Jong-Sig;Kim, Chong-Yeo;Lim, Sung-Bin;Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.29 no.2
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    • pp.401-415
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    • 1999
  • Root surfaces affected by periodontal disease undergo various forms of changes. Cementum exposure from gingival recession may result in absorption of calcium, phosphorus, and fluoride and subsequent hypermineralization and increased radiodensity. Although some reports have suggested that inorganic content with root cementum might show various changes depending upon age or extent of periodontal disease, but no consensus can be reached regarding the the distribution of various elements. The present study examines the difference in mineral content between healthy and periodontal diseased roots by analyzing three areas per tooth along the root surface in cervico-apical direction using electron probe and scanning electron microscope. Healthy tooth that was extracted for orthodontic purpose was used as control. Experimental teeth include those with periodontal pocket depth exceeding 6mm and those with gingival recession and periodontal pocket depth of 2-4mm. Levels of Ca, P, Mg and Na were measured using wavelength dispersive x-ray spectrometer at three areas per tooth. The examined areas were located apical to cemento-enamel junction in control and periodontal ligament-depleted areas in experimental teeth. The corresponding areas were also examined with scanning electron microscope(x70) The results are as follows. 1. Minerals were detected in order of Ca, P, Mg and Na. In all root surfaces, levels of Ca and P were higher in dentin than in cementum. 2. Level of Mg was twice as high in dentin than in cementum. There was no significant difference in the level of Mg and Na between normal and periodontal diseased roots or between the various locations in the same root. 3. Level of Ca and P in the surface cementum showed no difference between normal and periodontal diseased root, although the areas in dentin with high level of either ion also showed high level of corresponding ion in cementum. 4. Difference in the Ca and P content between various locations within the same root was noted, although no coherent pattern existed. These results suggest that although the mineral content of the root cementum in periodontitis-affected tooth is affected by exogenous ions from saliva and food, but there was no difference in the mineral contents between normal and periodontally diseased root.

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Guided Tissue Regeneration Using Barrier Membrane and Osseous Grafts in Surgically Created Furcation Defects in Dogs (성견의 외과적 치근이개부 골결손에 차폐막과 골이식재를 이용한 조직유도재생술시 치유양상)

  • Chung, Eun-Hee;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.26 no.4
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    • pp.967-987
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    • 1996
  • The present study was to evaluate the healing patterns of guided tissue regeneration( GTR) using resorbable $Vicryl^{(R)}$(polyglactin 910) mesh and nonresorbable expanded polytetrafluoroethylene(ePTFE) membrane with or without bone grafting using autogeneous bone and demineralized freeze-dried bone allograft(DFDBA) in the grade II furcation defects. Mucoperiosteal flaps were reflected buccally in the mandibular 2nd, 3rd and 4th premolar areas and furcation defects were created surgically by removing $5{\times}6mm$ alveolar bone in 4 dogs. Root surfaces were thoroughly debrided of periodontal ligament and cementum, and notches were placed on root surface at the most apical bone level. In the right and left mandibular quadrant, each tooth was received $Vicryl^{(R)}$ mesh(ACE Surgical Supply Co., USA) only, $Vicryl^{(R)}$ mesh with DFDBA, $Vicryl^{(R)}$ mesh with autogeneous bone grafts, ePTFE membrane($Core-tex^{(R)}$ membrane, W.L. Gore & Associates Inc., USA) only, ePTFE membrane with DFDBA or ePTFE membrane with autogeneous bone grafts. For the fluorescent microscopic examination, fluorescent agents were injected at 2, 4 and 8 weeks after surgery. Four weeks after surgery, 2 dogs were sacrificed and ePTFE membranes were removed from remaining 2 dogs, which were sacrificed at 12 weeks after surgery. Undecalcified tissues were embedded in methylmethacrylate and $10{\mu}m$ thick sections were cut in a buccolingual direction. These sections were stained with hematoxylin-eosin stain and Masson's trichrome stain, and evaluated by descriptive histology and linear measurements. The results were as follows : 1) $Vicryl^{(R)}$ mesh group showed less connective tissue attachment than ePTFE membrane group. 2) The combination of GTR using $Vicryl^{(R)}$ mesh and osseous grafts resulted in new attachment and new bone formation more than GTR using $Vicryl^{(R)}$ mesh only. 3) GTR using ePTFE membrane, with or without osseous grafts, enhanced periodontal regeneration. 4) Root resorption and dentoalveolar ankylosis were observed in the areas treated with the combination of GTR and DFDBA. It was suggested that the effect of adjunctive bone grafting in GTR procedure depends on the materials and the physical properties of barrier membranes. $Vicryl^{(R)}$ mesh performed a barrier function and the use of adjunctive bone grafting may enhance the periodontal regeneration.

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Radiologic study of intraosseous path of the inferior alveolar cantal, mental canal, and mental foramen for endosseous implants (인공치아 매식술을 위한 하악관, 이관, 이공의 골내 주행에 관한 방사선학적 연구)

  • Hong, So-Mi;Kwon, Young-Hyuk;Park, Joon-Bong;Herr, Yeek;Lee, Man-Sup
    • Journal of Periodontal and Implant Science
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    • v.26 no.4
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    • pp.933-948
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    • 1996
  • The purpose of this study was to examine the anatomic structures of the mandible-inferior alveolar canal, mental foramen, mental canal-with panoramic radiography and conventional tomography and to compare both radiographic techniques in conjunction with endosseous implants. In this study 14 adult dentulous mandibles -27 cases of right and left side of mandibles- were examined and the results were as follows. 1. The distance between superior border of the inferior alveolar canal and the alveolar ridge crest showed a decreasing tendency from the mental foramen to 4cm posterior to the mental foramen. 2. The mean diameter of the inferior alveolar canal was $4.11{\pm}0.50mm$ with panoramic radiography and $3.29{\pm}0.59mm$ with conventional tomography. 3. The inferior border of the inferior alveolar canal and inferior border of the mandible was closest at 2cm posterior to the mental foramen but it was not statistically significant. the mean distance was $1l.64{\pm}2.95mm$ in panoramic radiography and $1l.68{\pm} 2.91mm$ in conventional tomography. 4. The inferior alveolar canal located lingually in bucco-lingual direction 16%(mental foramen), 54%(lcm posterior to the mental foramen), 68%(2cm posterior to the mental foramen), 50%(3cm posterior to mental foramen), 55%(4cm posterior to the mental foramen). 5. Mean length of the anterior loop of the mental canal was 2.73mm, and the loop below 2mm was 35% and 15% of mental canal was invisible in panoramic radiography. 6. The minimum interforaminal distance was 56.7mm, the maximum distance was 73.2mm and the mean distance was 66.42mm in panoramic radiography. 7. The mean distance between midpoint of the mental canal and alveolar ridge crest was 16.24mm and the mean buccolingual angulation of the mental canal was $52.98^{\circ}$ in conventional tomography. 8. In comparison of panoramic radiography and conventional tomography, inferior alveolar canal is better visualized with conventional tomography than panoramic radiography from the mental foramen to the 2cm posterior to the mental foramen, while visiblity of conventional tomography prominently decreased in 4cm posterior to the mental foramen and alveolar ridge crest is better visualized with panoramic radiography than conventional radiography at the mental foramen and at 4cm posterior to the mental foramen. In radiologic examination of anatomic structures of the mandible for endosseous implants, panoramic radiography and conventional tomography can be effectively used when it is used to overcome the anatomic limitations.

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Transareolar-Perinipple Dual Pockets Breast Augmentation (횡유륜 유두주위절개를 통한 이중포켓 유방확대술)

  • Lee, Paik Kwon;Kim, Jee Hoon;Seo, Byung Chul;Oh, Deuk Young;Rhie, Jong Won;Ahn, Snag Tae
    • Archives of Plastic Surgery
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    • v.34 no.1
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    • pp.93-98
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    • 2007
  • Purpose: Many options are available for the incision and pocket selection in breast augmentation. Each method has its advantages and disadvantages. To leave an invisible operation scar and to achieve easier pocket dissection by the central location of the incision on the breast, we made a transareolar-perinipple incision. To overcome the disadvantages of the transareolar incision, originally advocated by Pitanguy in 1973, we modified the direction of incision line and dissection plane. Methods: To avoid the injury of 4th intercostal nerve responsible for nipple sensation, we made perinipple incision on the medial side of the nipple instead of trans-nipple incision and made the transareolar incision as 11-5 o'clock on the left side and 1-7 o'clock on the right side instead of 3-9 o'clock on both sides. To avoid the possible infection and breast feeding problem caused by the injury to the lactiferous duct, and the possible implant hernia caused by the incisions lying on a same plane of pocket dissection, we made a subcutaneous dissection just above the breast tissue medially down to the bottom of breast tissue and made a subglandular or subfascial pocket, which may avoid the injury of lactiferous duct and create different planes for skin incision and pocket dissection. Other advantages of the transareolar-perinipple incision include easier pocket dissection, less chance of hematoma, and as a result less postoperative pain because of the central location of the approach which allow finger dissection and meticulous bleeding control with direct vision, without any specialized instrument such as an endoscope or long mammary dissectors. As for pocket selection, we made dual pockets. We prefer subglandular or subfascial pocket. Also, we made a subpectoral pocket in the upper 1/4 of the pocket to add more volume on the upper part of the augmented breast, which can make aesthetically more desirable breasts in thin Asian women with small breasts. Possible disadvantages of our method are subclinical infection and scar widening, which could be overcome by meticulous operation techniques, antibiotic therapy, and intradermal tattooing. Results: From September, 2003 to August, 2005, 12 patients underwent breast augmentation using round smooth surface saline implants by our method. During the mean follow-up period of 13 months, there were no complications such as infection, hematoma, capsular contracture, and sensory change of nipple, and results were satisfactory. Conclusion: We suggest breast augmentation via transareolar-perinipple incision and dual pockets(subpectoral-subglandular or subfascial) as a valuable method in thin oriental women with small breasts.

The Content Analysis of the Textbooks of Dental Clinical Course (치과임상교과목 교재에 대한 내용분석)

  • Lee, Sun-Mi;Yoo, Jung-Sook;Ahn, Se-Youn;Lim, Mi-Hee;Han, Ji-Youn;Jun, Mi-Kyoung;Lee, Hyun-Ok;Won, Young-Soon
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.272-279
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    • 2015
  • This study was conducted to provide baseline data which could suggest a direction of role based efficient integrated clinical education by avoiding duplicate of contents through analyzing clinical courses. Among the 7 clinical courses, orthodontics and periodontology were the most published subjects which were published in 5 kinds of books and dental materials was the least published subject which was published in 2 kinds of books on investigation of overlapping contents based on titles that appeared on chapters and verses of all textbooks for clinical courses. Dental implant was covered in 4 subjects such as oral maxillofacial surgery, prosthodontics, periodontology and dental materials which was the most number. Other overlapping contents were restoration treatment, occlusion and malocclusion, temporomandibular joint diseases, anesthesia sedation, tooth trauma, systemic disease and dental treatment, dental casting, isolation techniques, tooth bleaching, pulp protection, gingivitis periodontitis, tooth development, etc. Reviews of textbooks of clinical courses should be conducted in a detailed manner by systematic, various studies in order to improve quality of the textbooks.