• Title/Summary/Keyword: Implant fracture

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Clinical Experiences and Usefulness of Cervical Posterior Stabilization with Polyaxial Screw-Rod System

  • Hwang, In-Chang;Kang, Dong-Ho;Han, Jong-Woo;Park, In-Sung;Lee, Chul-Hee;Park, Sun-Young
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.311-316
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    • 2007
  • Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.

Clinical remarks about esthetics in the case of full zirconia restoration utilizing Zirkonzahn Prettau® block (지르코잔 프레타우 블럭을 이용한 Full Zirconia 수복 시 심미에 관한 임상적 소견)

  • Park, Jong-Chan
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.22 no.1
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    • pp.30-46
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    • 2013
  • Porcelain fused to metal crown has been used mostly over the last 50 years for restorations in dentistry. However, the patients' awareness of aesthetic aspect, biocompatibility and the problems such as an allergy to metals led to the growing interest in the 'metal free restoration'. In particular, the price of the precious metals that have been mainly used to date has risen drastically, which made them impossible to play their role as oral restorative materials anymore, and in addition, the PFM restoration has intrinsic problems of chipping and fracture. Therefore, the CAD/CAM has been drawing more attention than ever due to the popular needs for the material that is more aesthetic and stronger for restoration of the molar implant. Considerations in carrying out the full zirconia restoration are as follows: 1) strength, 2) combination work, 3) light penetrability, 4) treatment of cracks, 5) the color reproducibility of the block, 6) the abrasivity of antagonistic tooth, 7) low temperature degradation. In this presentation, the color reproducibility of the block will be discussed. One of the biggest reasons for avoiding the full zirconia restoration is that it is difficult to reproduce the natural color compared to the conventional PFM restoration. Thus, many clinicians show reluctance due to the exposure of the ugly block when the coloring on the surface is removed after occlusal adjustment. From the experience of using blocks by Zirkonzahn for more than 4 years, it is considered that these problems can be addressed to some degrees. Accordingly, how to make restorations that are well in harmony with surrounding prosthesis or natural teeth will be discussed.

Effects of Dichloromethane Fraction of Phlomidis Radix on Bone Formation in Human Fetal Osteoblasts (속단의 dichloromethane 분획물이 태아골모세포의 골형성 유도에 미치는 효과)

  • Lee, Young-Joon;Choi, Hee-In;Kim, Yun-Chul;Shin, Hyung-Shik;You, Hyung-Keun
    • Journal of Periodontal and Implant Science
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    • v.33 no.2
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    • pp.259-269
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    • 2003
  • The ideal goal of periodontal therapy is the regeneration of periodontal tissue repair of function. Although is very difficult to attain the goal, recent advances in periodontal wound healing concepts encourage hope reaching it. Recently many efforts are concentrated on the regeneration potential of material used in traditional Korean medicine. Phlomidis Radix has been used for the treatment of blood stasis, bone fracture and osteoporosis in traditional Korean medicine. The purpose of this study is to examine effects of dichloromethane fraction Phlomidis Radix on Bone Formation in Human Fetal Osteoblasts. Human fetal osteoblastic cell line(hFOB1 1.19 ;American Type Culture Collection, Manassas, VA) were used and cells were cultured containing DMEM and dichloromethane fraction Phlomidis Radix(100 ng/ml , 1 ${\mu}$/ml, 10 ${\mu}$/ml) at 34$^{\circ}C$ with 5% $CO_2$ in 100% humidity. MTT was performed to examine the viability of the cell, and alkaline phosphatase activity was analyzed to examine the mineralization. Also bone calcification nodules were evaluated. The cellular activity of hFOB1 was increased in 100 ng/ml, 1 ${\mu}$/ml , 10 ${\mu}$/ml of dichloromethane fraction of Phlomidis Radix and especially significant increation was showed in 100 ng/ml of dichloromethane fraction of Phlomidis Radix at 6days (p <0.05). ALP level of hFOB1 was significantly increased in 100 ng/ml , 1 ${\mu}$/ml, 10 ${\mu}$/ml of dichloromethane fraction of Phlomidis Radix and especially more increation was showed in 10 ${\mu}$/ml of dichloromethane fraction of Phlomidis Radix (p <0,05). Calcification nodules of hFOB1 significantly increased in 10 ${\mu]$/ml of dichloromethane fraction of Phlomidis Radix at 21 days of incubation(p<0.05). The results indicate that dicholoromethane fraction of Phlomidis Radix has excellent effects on mineralization of hFOB1.

Immediate implant placement into extraction sites with periapical lesions in the esthetic zone: a case report (치근단 병소를 가진 치아의 발치 후 즉시 임플란트 식립 및 보철을 통한 심미성 회복)

  • Yi, Jae-Young;Kim, Jee-Hwan;Han, Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.3
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    • pp.191-197
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    • 2012
  • Esthetics is important in restoring maxillary anterior area. Alveolar bone resorption and loss of interdental papilla may be minimized by immediate implantation. Previous studies showed successful results with the immediate implantation in healthy extraction socket, while many of these studies objected the immediate implantation into extraction sites with periapical lesions. Recent studies, however, reported successful results of the immediate implantation into extraction sites with periapical lesions with careful debridement of extraction sockets and general medication of antibiotics prior to implantation. A 73-year-old female visited the department of Prosthodontics in ${\bigcirc}{\bigcirc}$ University Dental Hospital with the chief complaint of fallen post-core and crown on left maxillary incisor. Although the incisor was with vertical root fracture and periapical lesion, the immediate implantation following the extraction of tooth was planned. Thorough socket debridement, irrigation with chlorhexidine, and tetracycline soaking were followed by immediate implantation. The general medication of antibiotics (Moxicle Tab.$^{(R)}$, 375 mg) was prescribed before and after the surgery. Immediate provisional restoration was delivered two days after the surgery, and the definitive metal-ceramic restoration was placed about six months later after reproducing the emergence profile from the provisional restoration. This case presents satisfying result esthetically and functionally upto two years after the placement of prosthesis with the harmonious gingival line and no loss of marginal bone.

Full-mouth rehabilitation with pressed ceramic technique using provisional restorations (Pressed ceramic technique을 이용하여 제작되는 완전 도재관 완전 구강 회복 증례)

  • Roh, Hyun-Sik;Woo, Yi-Hyung;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.1
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    • pp.47-51
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    • 2013
  • With the introduction of dental implants, restoration of missing teeth with conventional fixed or removable partial dentures is being replaced with implants. Especially, with young patients, not only longevity but also esthetic factors need to be considered. Implant restorations provide long-term success functionally but, esthetic complications such as, marginal exposure due to gingival recession, loss of the papilla and dark color of metal abutments may occur. Recently, zirconia restorations with CAD/CAM technology provide functional, biocompatible and esthetic restorations possible. All-ceramic restorations using the pressed ceramic technique show better fracture toughness values than those of the conventional porcelain veneering technique. Pressed ceramic technique creates the veneer design in wax and the lost wax technique is used to create the restoration. The final contour of the restoration may be controlled during wax-up. A 22-year old female patient was restored with dental implants and zirconia restorations using the pressed ceramic technique presenting short-term but optimistic prognosis.

Valplast$^{(R)}$ flexible removable partial denture for a patient with medically compromised conditions : a clinical report (전신적 질환자 및 예후가 불량한 환자에서 Valplast$^{(R)}$ 탄성 국소의치의 적용)

  • Choi, Bohm;Kim, Seong-Hun;Lee, Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.295-300
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    • 2009
  • Statement of problem: As the number of elders is growing with the advancement of medicine, partially or fully edentulous patients have increased. Medically compromised conditions are common in the older population so that it should be taken into account in prosthetic treatment planning as well as their economic conditions. In the older patients, removable prosthesis has been preferred to implant prosthesis. However, cast metal based removable partial dentures also has several limitations. Purpose: In this report, we present several cases of Valplast$^{(R)}$ flexible denture which were fabricated in patients who had medically compromised conditions or whose remaining teeth showed a relatively poor prognosis. Results & Conclusion: This article describes an alternative treatment for a partially edentulous patient with mouth opening limitation, after cancer surgery, compromised general condition and questionable remaining teeth. In these patients, Valplast$^{(R)}$ flexible denture was used because of its unique characteristics and the results were all satisfactory. Patients had 1-2 check-up and there were no postoperative pain or fracture of denture up to now.

EFFECTS OF ELECTRICAL STIMULATION ON THE NORMAL PERIODONTIUM (전기자극이 정상 치주조직에 미치는 영향)

  • Lim, Kyung-Seok;Kwon, Young-Hyuk;Lee, Man-sup;Park, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.32 no.1
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    • pp.89-112
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    • 2002
  • The earliest reports of the use of electrical energy to directly stimulate bone healing seem to be in 1853 from England, the techniques involved the introduction of direct current into the non-united fracture site percutaneously via metallic needles, with subsequent healing of the defect. One endpoint of the periodontal therapy is to generate structure lost by periodontal diseases. Several procedural advances may support regeneration of attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical current which occurs in bone naturally, so that such bone may be particularly susceptible to electrical therapy. The purposes of this study were to observe the effects of electrical stimulation on the normal periodontium, to determine whether the electricity is the useful means for periodontal regeneration or not. Forty rats weighted about 100 gram were used and divided into 4 groups, the first group, there was no electrical stimulation with the connection of electrodes only. In the second group, there was stimulated by the 10 mA during 10 minutes per a day, in the third group was stimulated by the 25 mA , and the fourth by the 50 mA. At 3, 5, 10 and 15 days post-appliance , two rats in each group were serially sacrificed. and the maxillae and the mandible processed to paraffin, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was the distinct reversal line on the lingual alveolar crest, whereas a little changes in the labial alveolarcrest to the duration and amount of currents. 2. In 50 mA group, the cells were highly concentrated at the apex of anterior teeth, and was observed the necrotic tissue. In posterior root apex, the hypercementosis was appeared, and newly formed cementum layer has been increased continuously with the time. 3. The periodontal ligament fiber and Sharpey's fiber were arranged in order, and the bone trabeculae were increased as the experiment proceeded by, relatively the bone marrows were decreased. 4. In the pulp tissue, the blood vessels were increased with blood congestion in the experimetal specimens remarkably, and the dentinal tubules were obstructed . 5. The osteoblasts in alveolar bone proper had been showed highly activity, and also observed the formation of bone trabeculea. In the conclusion, it was suggested that the electrical stimulation has influence on the periodontium and the pulp tissue. However, there might be the injurious effects.

EFFECTS OF EXTRACTS OF DRYNARIAE RHIZOMA ON THE CHARACTERISTICS OF RAT CALARIA AND BONE MARROW CELLS (Drynariae Rhizoma추출물이 백서 두개관세포 및 골수세포 성상에 미치는 영향)

  • Lim, Kyung-Seok;Kwon, Young-Hyuk;Park, Joon-Bong;Kim, Sung-Jin;Choung, Se-Young;Park, Kun-Koo
    • Journal of Periodontal and Implant Science
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    • v.28 no.2
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    • pp.291-310
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    • 1998
  • This study was performed to evaluate the effects of extracts of Drynariae Rhizoma on the characteristics of rat calvaria cells(RCV) and bone marrow cells(RBM) which have the important role on the bone formation in vitro. Drynariae Rhizoma has been known as the useful herbal medicament for treatment of the wound healing including regeneration of bone fracture, and also has been used to treat the periodontal lesions, tooth mobility, gingival bleeding and pus discharge via sulcus in Oriental Medicine. In control group, the cells were cultured alone with Dulbeco's Modified Eagle's Medium contained with 10% fetal bovine serum, 100U/ml penicillin, $100{\mu}g/ml$ streptomycin, $0.5{\mu}g/ml$ amphotericin-B. In experimental group, extracts of Drynariae Rhizoma(0.1, 1, 5, 10, $50{\mu}g/ml$) were added into the above culture condition. And then each group was characterized by examing the cell proliferation at 1, 3, 7, 14, 21, 30th day, the amount of total protein synthesis and alkaline phosphatase activity of RCV at 2,4th day and those of RBM at 3, 6th day. And also, the calcified nodule of RCV was examed at 3, 5th day in three goup, control, experimental, culture with the PDGF group. The results were as follow ; 1. Both RCV and RBM cells in Drynariae Rhizoma-treated experimental group proliferated more rapidly than nontreated control group. The experimental group below $5{\mu}g/ml$ Drynariae Rhizoma-treated showed more prominent cell proliferation from the 7th day to the 21st day than the control group and above $10\;{\mu}g/ml$ treated group in RCV. 2. Amount of total protein synthesis was more increased in Drynariae Rhizomatreated group than in control group. In $5{\mu}g/ml$ Drynariae Rhizoma-treated group showed most prominent protein synthesis of the any other exrperimental group and control group. 3. Alkaline phosphatase activity also more increased in Drynariae Rhizomatreated group than control group. 4. Mineralized nodules in Drynariae Rhizoma-treated group were more than not in control group but also in PDGF-treated group. From the above results, Drynariae Rhizoma appeared to enhanced the proliferation, protein synthesis, alkaline phosphatase activity and cellular ability of mineralized nodule formation than PDGF. So that, we conclude that Drynariae Rhizoma enhances the activities of bone cells which have the important role on the periodontal regeneration and optimal application of Drynariae Rhizoma was thought to be useful as the means in bone regeneration.

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Analysis of vertical root fracture in endodontically versus nonendodontically treated teeth on patients with periodontitis (치주질환자에서 근관치료의 유무에 따른 수직 치근 파절의 실태분석)

  • Kim, Myung-Jun;Jang, Hyun-Seon;Kim, Dong-Kie;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.35 no.2
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    • pp.413-426
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    • 2005
  • 수직 치근파절은 특이성을 나타내지 않기 때문에 치과의사가 정확한 진단을 하기 어렵다. 따라서 수직 치근파절의 임상적 특징, 진단적 증상을 파악하여 향후 근관치료된 치아나 치료되지 않은 치아에서 수직 치근파절의 유발인자와의 관련성 및 고찰을 통해 수직 치근파절의 예방 및 치료에 응용할 수 있을 것으로 생각된다. 연구대상은 조선대학교 부속치과병원 치주과에 내원한 환자 중 최근 2년간 144명의 환자에서 근관치료를 받았거나 받지 않았던 치아 중 임상적 및 방사선학적으로 수직 치근파절로 진단된 156개의 증례를 대상으로 하였다. 모든 불확실한 증례에서 수직 지근파절의 최종 진단은 외과적 탐지를 통해 이루어졌고, 금이 간 치아와 관련될 수 있는 치근파절의 증례의 경우는 제외되었다. 근관치료된 치아와 치료되지 않은 치아, 환자의 나이와 성별, 치아종류 및 파절된 치근부위, 자각증상의 유무를 기준으로 각각의 수치와 백분율로 분류하였다. 수직 치근파절의 증상과 증후별로 분류하였으며, 진단방법에 의한 분류, 치료방법에 따른 분류, 근관 치료 후 수직 치근파절이 발생한 기간에 따른 분류를 시행하고 통계분석을 하여 다음과 같은 결과를 얻었다. 1. 근관치료를 받지 않았던 치아의 수직 치근파절의 발생율은 58%였다. 2. 성별에 따른 발생률에 있어서 남성의 호발양상을 나타내었다. 3. 근관치료된 치아에 있어서 치료되지 않은 치아에 비해 호발연령이 낮았다. 4. 전치부의 수직 치근파절은 관찰되지 않았으며 특히, 강한 교합력을 필요로 히는 구치부에서의 높은 발생율을 나타냈다. 5. 수직 치근파절의 가장 주된 증상 및 증후는 깊은 치주낭 깊이였다. 6. 근관 치료 후 수직 치근파절이 발생한 기간은 평균 5.7년이었다. 7. 다수 증례에 있어서 3개 이하의 결손치를 가졌고, 자각증상이 나타났다. 이상의 결괴에서 한국인에 있어서 근관치료를 받지 않은 치아의 수직 치근파절은 드문 현상이 아님을 알 수 있었고 남성과 구치부에 있어서의 높은 발생율을 알 수 있었다. 그 이유로는 강한 교합력, 딱딱한 음식의 저작습관, 치조골 흡수에 따른 낮은 저항성, 골 유연성의 저하 등으로 여겨진다. 그러나, 수직 치근파절은 아직까지 정확한 진단을 내리기는 여전히 어려운 상태이며, 이를 위한 다양한 진단방법 및 더 나은 연구가 필수적이라 하겠다. 그리고, 향후 보다 많은 증례에 대한 분석, 치주질환에 이환되지 않은 경우의 분석, 치료 후 생존 기간에 대한 고찰 등도 필요하리라 사료된다.

Removal of Residual Stress and In-vitro Recording Test in Polymer-based 3D Neural Probe (폴리머 기반 3차원 뉴런 프로브의 잔류 스트레스 제거 및 생체 외 신호 측정)

  • Nam, Min-Woo;Lim, Chun-Bae;Lee, Kee-Keun
    • Journal of the Microelectronics and Packaging Society
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    • v.16 no.2
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    • pp.33-42
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    • 2009
  • A polymer-based flexible neural probe was fabricated for monitoring of neural activities from a brain. To improve the insertion stiffness, a 5 ${\mu}m$ thick biocompatible Au layer was electroplated between the top and bottom polymer layers. The developed neural probe penetrated a gel whose elastic modulus is similar to that of a live brain tissue without any fracture, To minimize mechanical residual stress and bending from the probe, two new methods were employed: (1) use of a thermal annealing process after completing the device and (2) incorporation of multiple different layers to compensate the residual stress between top and bottom layers. Mechanical bending around the probe tip was clearly removed after employing the two processes. In electrical test, the developed probe showed a proper impedance value to record neural signals from a brain and the result remained the same for 72 hours. In simple in-vitro probe characterization, the probe showed a great removal of residual stress and an excellent recording performance. The in-vitro recording results did not change even after 1 week, suggesting that this electrode has the potential for great recording from neuron firing and long-term implant performance.

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