• 구강회복응용과학지
• /
• 제17권3호
• /
• pp.145-154
• /
• 2001

In the past, many dentist were interested mainly in the mechanical aspects such as tooth preparation and retainer types for making dental restoration. But, these days, the concept of restorative treatment emphasizes the importarce of gnatic system and masticatory muscles in addition to oral cavity. So, the current considerations for the fixed prosthodontic treatment include the stabilization of temporomandibular joint and neuromuscualr system and the relationship of periodontal ligament and occlusion. To achieve the above objectives, occlusal splint has been used as one of the mouth preparations for restorative treatment. The objectives of occlusal splint are as follows; 1. To use as preliminary application for periodontal-occlusal treatment 2. To provide proper vertical dimension 3. To control abnormal habits and parafunction 4. To treat the temporomandibular disease and myofascial pain 5. To establish the new therapeutic position In some cases, the patients had improper vertical dimension and occlusal interferences caused by prostheses reconstucted using centric relation recorded without considering the health of TMJ and manticatory muscle. And these prosthesis act as primary source that cause pathologic phenomenon in periodontal ligament, muscles and TMJ. Physiologically, in order to make the treatment occlusion guided by proper centric relation method, the method should be guided after the use of occlusal splint for some period. The main objective of prosthetic treatment is to maintain the function and health of stomatognathic system. So, one of the most important things that have to be performed by clinicians is a clinical ability to do the correct diagnosis and treatment planning based on the stomatognatic function and occlusion.

• Journal of Periodontal and Implant Science
• /
• 제38권4호
• /
• pp.729-736
• /
• 2008

Purpose: Anterior ridge defect after tooth extraction results in unfavorable appearance. Ridge augmentation procedures should be preceded by careful surgical-prosthetic treatment planning, and various techniques can be used in anterior ridge augmentation. Materials and Methods: Three patients showed deformed ridges after tooth extraction. Three different techniques ; onlay-interpositional connective tissue graft; bovine hydroxyapatite graft with free connective tissue graft; bovine hydroxyapatite graft with resorbable collagen membrane following free connective tissue graft; were used for anterior ridge augmentation. Result: Soft tissue graft can be used in small amount of ridge defect, hard tissue graft combined with soft tissue graft can be used in large amount of ridge defect. After ridge augmentation, about three months of healing period, augmented tissue was stabilized. The final restoration was initiated after this healing period, and the tissue form was maintained stable. Conclusion: Careful diagnosis and surgical-prosthetic treatment planning with joint consultation prior to surgery should be performed in order to attain an optimal esthetic results.

• 대한골관절종양학회지
• /
• 제14권1호
• /
• pp.10-16
• /
• 2008

효과적인 항암 약물요법의 발달과 사지의 절단술에 따르는 기능적인 경제적인 비효율성은 뼈의 원발성 암 환자에서 사지 구제술의 발달을 가져 왔다. 소아에서의 사지 구제술은 종양의 광범위 절제 시 성장판이 같이 절제되어 건측과의 사지 길이 차이가 발생하게 될 수 있고 소아 환자들의 왕성한 활동성 때문에 견고하고 내구성 있는 재건술이 필요하다. 소아 환자에서 악성 골종양의 절제 후 성장한 만큼 대치물의 길이도 같이 늘일 수 있는 확장형 종양 대치물(expandable tumor prosthesis)을 이용한 재건술이 시행되어 왔으나 모든 환자에서 만족스러운 결과를 가져오진 못하였다. 최근 들어 확장형 종양 대치물의 발달로 합병증의 발생을 줄이면서 비침습적인 방법으로 사지 길이를 맞추고 종양 대치물의 수명을 길게 하는 시도들이 늘고 있다. 본 논문에서는 확장형 종양 대치물의 적응증, 특성 및 합병증 등에 대해서 짚어 보고자 한다.

• Clinics in Shoulder and Elbow
• /
• 제23권1호
• /
• pp.20-26
• /
• 2020

Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

• 한국임상수의학회지
• /
• 제34권6호
• /
• pp.454-458
• /
• 2017

A Maltese (case 1) and a Pomeranian (case 2) presented with acute right and left hind limb weight-bearing lameness. On physical examination, they exhibited severe pain and crepitus on the coxofemoral joint of affected hind limb. In addition, decreased thigh girth measurements were noted compared with the opposite leg. Radiological exam revealed necrotic areas in the femoral head of affected hind limb. These dogs were diagnosed with Legg-$Calv{\acute{e}}$-Perthes disease (LCPD). The dogs underwent micro total hip replacement (THR). After surgery, at 3 years (case 1) and 7 months (case 2), both dogs recovered normal activity. The thigh girth and lameness scores were apparently improved in the affected limbs of both dogs. No complications of prosthesis implants, such as loosening, were noted. The clinical outcomes of these cases indicate that dogs with LCPD can be successfully treated with micro THR and have a good prognosis immediately after surgery.

• 대한골관절종양학회지
• /
• 제8권1호
• /
• pp.32-37
• /
• 2002

고등급 표면(high grade surface) 골육종은 골의 표면에서 발생하는 골육종의 희귀한 아형으로, 발생빈도는 전체 골육종의 1%에 못 미친다고 한다. 몇 편의 증례 보고와 연구 논문에서 이 고등급 표면 골육종을 소개하였는데, 국내의 경우 127예의 골육종 중 1예가 고등급 표면 골육종이었음을 기술한 논문이 있으나, 환자 및 진단과 치료에 대한 정보가 포함되어 있지 않았다. 저자들은 66세 여자 환자의 대퇴골 전자하부에서 발생한 고등급 표면 골육종 1예를 진단하고, 수술 전 항암 화학 요법, 광범위 절제술과 사지 구제술 및 수술 후 항암 화학 요법을 시행하였다. 이 종양은 위치만 골 표면에서 발생할 뿐 조직학적으로 전형적인 골수강내 골육종과 같으며, 다른 표면 골육종과는 달리 치료나 예후에 있어 전형적인 골수강 내 골육종과 같기 때문에, 진단과 치료에 있어 방골성 골육종이나 골막성 골육종 등의 표면 골육종과 구별하여야 할 것으로 생각한다.

• 대한골관절종양학회지
• /
• 제13권2호
• /
• pp.173-179
• /
• 2007

Brown tumor는 부갑상선 기능 항진증에 의한 골격의 종양유사병변으로 드물게 보고되는 질환이다. 저자들은 29세 여자환자의 상완골 근위부에 발생한 일차성 부갑상선 기능항진증에 의한 brown tumor에 대해 보고하고자 한다. 내원 3개월전부터 상박부 동통 및 부종을 주소로 내원한 환자로 골조직 검사상 거대세포종양이 의심되었으며 광범위 변연절제술 및 종양대치물을 이용한 재건술을 시행하였다. 술후 다발성 관절통 및 전신 무력감 호소하였으며 혈액검사 및 방사성 동위원소검사에서 부갑상선 선종에 의한 일차성 부갑상선 기능항진증 진단되었다. 일차성 부갑상선 기능항진증에 의한 brown tumor로 진단 후 부갑상선 선종의 외과적 절제술 시행하였으며, 수술 후 임상적 증세의 호전을 보인 증례이다. 이에 문헌 고찰과 함께 보고하고자 한다.

• 한국임상수의학회지
• /
• 제33권5호
• /
• pp.295-299
• /
• 2016

A 2-year-old, 1.94 kg spayed female Toy Poodle was referred for revision surgery for patellar reluxation following surgery for bilateral medial patellar luxation (MPL). Intermittent non-weight-bearing lameness of the right hindlimb and weight-bearing lameness of the left hindlimb were evident on general inspection. A physical examination revealed that there was a bilateral grade 4 MPL. On radiographs, the medial and lateral trochlear ridge was bilaterally worn out. Patellar groove replacement (PGR) was performed in two stages to replace the bilateral femoral trochlea that had a severely worn out groove. Corrective femoral osteotomy with increasing anteversion angle, tibial tuberosity transposition, medial releasing, lateral imbrications and PGR were performed on the right hindlimb. Six months after surgery on the right hindlimb, a PGR prosthesis was positioned medially on the frontal plane and tibial tuberosity transposition and lateral imbrications were performed on the left hindlimb. Two weeks after surgery, reluxation of the patella occurred on the left hindlimb. The tibial tuberosity transposition was performed to realign the patella more laterally than the previous surgery, and a patellar sling was applied. Two years after the last surgery, the patient showed no pain on the stifle joint and satisfactory weight-bearing ambulation. Reluxation did not recur. PGR maybe a successful treatment for dogs with iatrogenically damaged and/or worn out patellar grooves.

• Journal of Korean Neurosurgical Society
• /
• 제60권5호
• /
• pp.550-559
• /
• 2017

Objective : Subsidence is a frequent complication of anterior cervical discectomy and fusion. Postoperative segmental micromotion, thought to be a causative factor of subsidence, has been speculated to increase with uncinate process resection area (UPR). To evaluate the effect of UPR on micro-motion, we designed a method to measure UPR area based on pre- and postoperative computed tomography images and analyzed the relationship between UPR and subsidence as a proxy of micro-motion. Methods : We retrospectively collected clinical and radiological data from January 2011 to June 2016. A total of 38 patients (53 segments) were included. All procedures included bilateral UPR and anterior plate fixation. UPR area was evaluated with reformatted coronal computer tomography images. To reduce level-related bias, we converted UPR area to the proportion of UPR to the pre-operative UP area (pUPR). Results : Subsidence occurred in 18 segments (34%) and positively correlated with right-side pUPR, left-side pUPR, and the sum of bilateral pUPR (sum pUPR) (R=0.310, 301, 364; p=0.024, 0.029, 0.007, respectively). Multiple linear regression analysis revealed that subsidence could be estimated with the following formula : $subsidence=1.522+2.7{\times}sum\;pUPR$($R^2=0.133$, p=0.007). Receiver-operating characteristic analysis determined that sum $pUPR{\geq}0.38$ could serve as a threshold for significantly increased risk of subsidence (p=0.005, area under curve=0.737, sensitivity=94%, specificity=51%). This threshold was confirmed by logistic regression analysis for subsidence (p=0.009, odds ratio=8.471). Conclusion : The UPR measurement method confirmed that UPR was correlated with subsidence. Particularly when the sum of pUPR is ${\geq}38%$, the possibility of subsidence increased.

• 대한치과보철학회지
• /
• 제57권3호
• /
• pp.280-287
• /
• 2019

구강이라는 특수한 환경 속에서 치아는 평생을 거쳐 마모, 부식 등을 겪게 된다. 점진적이며 일정한 치아의 마모는 노화의 자연스러운 현상이나, 특정 요소에 의한 마모나 부식 등은 병적인 요소이며 교합면의 병리적 손상과 이에 따른 교합 부조화, 심미적 문제, 턱관절 장애 등을 야기할 수 있다. 본 증례는 26세의 젊은 여성 환자로 전반적인 치아의 마모와 부식이 동반된 상태였다. 디지털 안모 분석, 생리적 안정위, 전치부 치관 길이 평가 등을 통해 진단 납형을 제작하였다. 디지털 분석을 통해 치관연장술에 필요한 가이드를 제작하여 수술을 진행하였고 임시 보철물을 통하여 저작 기능 및 심미성을 회복하였다. 지르코니아 최종 보철로 수복하여 심미적, 기능적으로 만족할만한 결과를 얻었으므로 이 증례를 보고하고자 한다.