• Title/Summary/Keyword: Internal Implant

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Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review

  • Tsung-Chun Huang;Jian-Jr Lee;Kuo-Hui Yang;Chia-Huei Chou;Yu-Chen Chang
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.557-562
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    • 2023
  • Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique "transaxillary capsulorrhaphy" to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

A three-dimensional finite-element analysis of influence of splinting in mandibular posterior implants (스프린팅이 하악 구치부 임플랜트 보철물의 응력분산에 미치는 영향에 관한 삼차원 유한요소분석 연구)

  • Baik, Sang-Hyun;Jang, Ik-Tae;Kim, Sung-Kyun;Koak, Jai-Young;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.157-168
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    • 2008
  • Statement of problem: Over the past two decades, implant supported fixed prosthesis have been widely used. However, there are few studies conducted systematically and intensively on the splinting effect of implant systems in mandible. Purpose: The purpose of this study was to investigate the changes in stress distributions in the mandibular implants with splinting or non-splinting crowns by performing finite element analysis. Materials and methods: Cortical and cancellous bone were modeled as homogeneous, transversely isotropic, linearly elastic. Perfect bonding was assumed at all interfaces. Implant models were classified as follows. Group 1: $Br{{\aa}}nemark$ length 8.5mm 13mm splinting type Group 2: $Br{{\aa}}nemark$ length 8.5mm 13mm Non-splinting type Group 3: ITI length 8.5mm 13mm splinting type Group 4: ITI length 8.5mm 13mm Non-splinting type An load of 100N was applied vertically and horizontally. Stress levels were calculated using von Mises stresses values. Results: 1. The stress distribution and maximum von Mises stress of two-length implants (8.5mm, 13mm) was similar. 2. The stress of vertical load concentrated on mesial side of implant while the stress of horizontal load was distributed on both side of implant. 3. Stress of internal connection type was spreading through abutment screw but the stress of external connection type was concentrated on cortical bone level. 4. Degree of stress reduction was higher in the external connection type than in the internal connection type.

The effect of screw tightening techniques on the detorque value in internal connection implant superstructure (내부연결 임플란트 상부구조물에서 나사조임술식이 풀림토크값에 미치는 영향)

  • Choi, Jung-Han
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.4
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    • pp.243-250
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    • 2010
  • Purpose: This study evaluated the effect of different screw tightening sequences and methods on detorque values in a well-fitting implant superstructure. Materials and methods: A fully edentulous mandibular master model and a metal framework directly connected to four parallel implants (Astra Tech) with a passive fit to each other were fabricated. Six stone casts were made with a splinted impression technique to represent a 'well-fitting' situation with the metal framework. Detorque values were measured twice after screw tightening using 20 Ncm. Detorque values and minimum detorque values for three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and for two tightening methods (two-step and one-step) were analyzed using multi-way analysis of variance and two-way analysis of variance, respectively, at a .05 level of significance. Results: The mean detorque values for screw tightening sequences ranged from 12.8 Ncm (2-4-3-1) to 13.1 Ncm (2-3-1-4), and for screw tightening methods were 13.1 Ncm (two-step) and 11.8 Ncm (one-step). The mean of mimimum detorque values for screw tightening sequences were 11.1 Ncm (1-2-3-4) and 11.2 Ncm (2-4-3-1 and 2-3-1-4), and for screw tightening methods were 11.2 Ncm (two-step) and 9.9 Ncm (one-step). No statistically significant differences among three screw tightening sequences were found for detorque values and for mimimum detorque values. But, statistically significant differences between two screw tightening methods were found for two values. Two-step screw tightening method showed higher detorque value (P = .0003) and higher minimum detorque value (P = .0035) than one-step method. Conclusion: Within the limitations of this study, the screw tightening sequence was not a critical factor for the detorque values in a well-fitting implant superstructure by the splinted impression technique. But, two-step screw tightening method showed greater detorque values than one-step method.

A 10-year retrospective study on the risk factors affecting the success rate of internal connection implants after prosthetic restoration (내부연결 임플란트의 보철 수복 후 성공률에 미치는 위험요소에 관한 10년간의 후향적 연구)

  • Seoin Lee;Min-Jeong Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.2
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    • pp.113-124
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    • 2023
  • Purpose. The purpose of this study is to help increase the success rate by analyzing the types and characteristics of implant prosthesis and the survival rate. Materials and methods. Among implants placed between 2011 and 2020 at Sanbon Dental Hospital, College of Dentistry, Wonkwang University, a case restored by a prosthetic surgeon was investigated for the characteristics and correlation of failure. The causes of failure were classified as failure of osseointegration, peri-implantitis, fixture fracture, abutment fracture, screw fracture, screw loosening, prosthesis fracture, and loss of prosthesis retention. Prosthetic method, cantilever presence, placement location, etc. were analyzed for their correlation with implant failure. Results analysis was derived through Chi-square test and Kaplan-Meier survival analysis using SPSS ver 25.0 (IBM, Chicago, IL, USA). Results. A total of 2587 implants were placed, of which 1141 implants were restored with Single Crown and 1446 implants with Fixed Partial Denture, and the cumulative survival rate was 88.1%. The success rate of SC was 86.2% (984) and the success rate of FPD was 89.6% (1295), showing statistically significant differences, among which factors that had significant differences were abutment fracture, screw fracture, and screw loosening (P < .05). Conclusion. As a result of the 10-year follow-up, more failures occurred due to biomechanical factors than biological factors. Further studies on the success of implants will be needed in the future.

Influence of crestal module design on marginal bone stress around dental implant (임플란트 경부 디자인이 변연골 응력에 미치는 영향)

  • Lim, Jung-Yoel;Cho, Jin-Hyun;Jo, Kwang-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.3
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    • pp.224-231
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    • 2010
  • Purpose: This study was to investigate how the crestal module design could affect the level of marginal bone stress around dental implant. Materials and methods: A submerged implant of 4.1 mm in diameter and 10 mm in length was selected as baseline model (Dentis Co., Daegu,Korea).A total of 5 experimental implants of different crestal modules were designed (Type I model : with microthread at the cervical 3 mm, Type II model : the same thread pattern as Type I but with a trans-gingival module, Type III model: the same thread pattern as the control model but with a trans-gingival module, Type IV model: one piece system with concave transgingival part, Type V model: equipped with beveled platform). Stress analysis was conducted with the use of axisy mmetric finite element modeling scheme. A force of 100 N was applied at 30 degrees from the implant axis. Results: Stress analysis has shown no stress concentration around the marginal bone for the control model. As compared to the control model, the stress levels of 0.2 mm areas away from the recorded implant were slightly lower in Type I and Type IV models, but higher in Type II, Type III and Type V models. As compared to 15.09 MPa around for the control model, the stress levels were 14.78 MPa, 18.39 MPa, 21.11 MPa, 14.63 MPa, 17.88 MPa in the cases of Type I, II, III, IV and V models. Conclusion: From these results, the conclusion was drawn that the microthread and the concavity with either crestal or trans-gingival modules maybe used in standard size dental implants to reduce marginal bone stress.

Rigid Fixation using Bioabsorbable Mesh and Screws in Facial Bone Fracture (흡수성 망상판과 나사를 이용한 안면골절의 견고정법)

  • Shin, Dong-Hyeok;Kim, Deok-Jung;Kim, Soo-Young;Hwang, Eun-A;Choi, Hyun-Gon;Kim, Soon-Heum;Uhm, Ki-Il
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.717-720
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    • 2010
  • Purpose: Absorbable plate and screw fixation is widely used technique for internal rigid fixation in craniomaxillofacial surgery. However, there are some potential problems associated with the use of plate. The purpose of this study is to evaluate the feasibility of bone fixation in facial fracture using absorbable mesh in place of absorbable plate. Methods: The records of 55 patients with zygomaticomaxilla fractures treated by open reduction, performed by the author from February 2008 to May 2009, were retrospectively reviewed. Patients were selected to receive absorbable mesh fixation. The incidence of all complications including infection, hypoesthesia, and deformity was examined. Analysis with postoperative computed tomography follow-up demonstrates degree of reduction. Results: Forty-six patients met criteria for inclusion in the study. All patients went on to satisfactory healing without complication. Postoperative computed tomography revealed good bony alignment similarly non affected side. Conclusion: This study demonstrates that the rigid internal fixation of fractured bone fragments using absorbable mesh is more effective than absorbable plate, especially in comminuted fracture of maxilla.

Force Analysis of Wrist Joint to Develop Wrist Implant and Mechanical Hand Using Optimization Technique and Finite Element Method (인공수근관절과 의수를 개발하기 위한 최적설계법과 유한요소법에 의한 수근관절의 역학적해석)

  • Jung-Soo Han
    • Journal of the Korean Society of Safety
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    • v.12 no.3
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    • pp.178-184
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    • 1997
  • Many mathematical techniques have been developed to determine the muscle forces and force distribution in biomechanical human model, because it is so important to understand internal forces resisting external loading. However, a three-dimensional mathematical model of wrist joint, which is essential to develop solid modeling and artificial wrist joint, has not been well developed. This study proposed to define three-dimensional mathematical model of distal radius and ulna of the human wrist and to develop a detailed two-dimensional finite element through comparisons to existing analytical models and experimental tests. This mathematical model were accurately recreated, allowing the internal tendon force as well as force transmission and distribution through the distal radios and ulna during dynamic loadings. The results found in this study indicate and support the findings of other investigator that cyclic loading condition results in higher compression force on distal radius and ulna and may be source of wrist disorder.

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Reconstruction of Combined Oral Mucosa-Mandibular Defects Using the Vascularized Myoosseous Iliac Crest Free Flap

  • Jung, Hwi-Dong;Nam, Woong;Cha, In-Ho;Kim, Hyung Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4137-4140
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    • 2012
  • The authors present five cases of combined oral mucosa-mandible defects reconstructed with the vascularized internal oblique-iliac crest myoosseous free flap. This technique has many advantages compared to other conventional methods such as the radial flap, scapula flap, and fibula flap. Vascularized iliac crest flaps provide sufficient high-quality bone suitable for reconstructing segmental madibular defects. Although fibular flaps allow longer donor bone tissue to be harvested, the iliac crest can provide an esthetic shape for mandibular body reconstruction and also provides sufficient bone height for dental implants. Conventional vascularized iliac crest myoosseous flaps have excessive soft tissue bulk for reconstruction of intraoral soft tissue defects. The modification discussed in the present article can reduce soft tissue volume, resulting in better functional reconstruction of the oral mucosa. Another advantage is that complete replacement of the oral mucosa is observed in as early as one month post-operation. The final mucosal texture is much better than that obtained with other skin paddle flaps, which is especially beneficial for the placement of dental implant prostheses. Donor site morbidity looks to be similar to, if not less than that observed for other modalities in terms of function and esthetics. For combined oral mucosa-mandible defects, the vascularized internal oblique-iliac crest myoosseous free flap shows good results with respect to hard and soft tissue reconstruction.

The Efficacy of Bioabsorbable Mesh as an Internal Splint in Primary Septoplasty

  • Kim, Jee Nam;Choi, Hyun Gon;Kim, Soon Heum;Park, Hyung Jun;Shin, Dong Hyeok;Jo, Dong In;Kim, Cheol Keun;Uhm, Ki Il
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.561-564
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    • 2012
  • Nasal bone fractures are often accompanied by septal fractures or deformity. Posttraumatic nasal deformity is usually caused by septal fractures. Submucosal resection and septoplasty are commonly used surgical techniques for the correction of septal deviation. However, septal perforation or saddle nose deformity is a known complication of submucosal resection. Hence, we chose to perform septoplasty, which is a less invasive procedure, as the primary treatment for nasal bone fractures accompanied by septal fractures. During septoplasty, we used a bioabsorbable mesh as an internal splint. We used the endonasal approach and inserted the mesh bilaterally between the mucoperichondrial flap and the septal cartilage. The treatment outcomes were evaluated by computed tomography (CT) and the nasal obstruction symptom evaluation (NOSE) scale. The CT scans demonstrated a significant improvement in the septal deviation postoperatively. The symptomatic improvement rated by the NOSE scale was greater at 1 month and 6 months after surgery compared to the preoperative status. There were no cases of extrusion or infection of the implant. In cases of moderate or severe septal deviation without dislocation from the vomerine groove on the CT scan, our technique should be considered one of the treatments of choice.

Development of a wireless telemetry system based on MICS standard (MICS 표준에 기반한 무선 텔레메트리 시스템 개발)

  • Lee, Seung-Ha;Park, Il-Yong
    • Journal of Sensor Science and Technology
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    • v.18 no.1
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    • pp.63-71
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    • 2009
  • It is said that the desirable bio-signal measurement and stimulation system should be an implantable type if the several problems such as biocompatibility, electrical safety, and so on are overcome. In addition to the biocompatibility issue, a robust RF communication and a stable electrical power source for the implantable bio-signal measurement and stimulation system are very important matters. In this paper, a wireless telemetry system which adopts the FCC's approved MICS (medical implant communication service) protocol and a wireless power transmission has been proposed. The proposed system composed of a base station (BS) and an implantable medical device (IMD) has the advantages that the interference with other RF devices can be reduced by the use of the specially assigned MICS frequency band of 402.MHz to 405 MHz. Also, the proposed system includes various functions of a multi-channel bio-signal acquisition and an electric stimulation. Since the electrical power for the IMD can be provided by the inductive link between PCB patterned coils, the IMD needs no battery so that the IMD can be smaller size and much less dangerous than the active type IMD which includes the internal battery. Finally, the validity as a wireless telemetry system has been demonstrated through the experiments by using the implemented BS and IMD.