The incidence of vertebral artery injury during the anterior approach to the cervical spine is rare, but potentially lethal. The authors describe two cases of vertebral artery injury during anterior cervical decompression surgery. In the first case, infection was the cause of the vertebral artery injury. During aggressive irrigation and pus drainage, massive bleeding was encountered, and intraoperative direct packing with hemostatic agents provided effective control of hemorrhage. Ten days after surgery, sudden neck swelling and mental deterioration occurred because of rebleeding from a pseudoaneurysm. In the second case, the vertebral artery was injured during decompression of cervical spondylosis while drilling the neural foramen. After intraoperative control of bleeding, the patient was referred to our hospital, and a pseudoaneurysm was detected by angiography four days after surgery. Both pseudoaneurysms were successfully occluded by an endovascular technique without any neurological sequelae. Urgent vertebral angiography, following intraoperative control of bleeding by hemostatic compression in cases of vertebral artery injury during anterior cervical decompression, should be performed to avoid life-threatening complications. Prompt recognition of pseudoaneurysm is mandatory, and endovascular treatment can be life saving.
Objective: The purpose of this study was to develop superimposition method on the lower arch using 3-dimensional (3D) cone beam computed tomography (CBCT) images and orthodontic 3D digital modeling. Methods: Integrated 3D CBCT images were acquired by substituting the dental portion of 3D CBCT images with precise dental images of an orthodontic 3D digital model. Images were acquired before and after treatment. For the superimposition, 2 superimposition methods were designed. Surface superimposition was based on the basal bone structure of the mandible by surface-to-surface matching (best-fit method). Plane superimposition was based on anatomical structures (mental and lingual foramen). For the evaluation, 10 landmarks including teeth and anatomic structures were assigned, and 30 times of superimpositions and measurements were performed to determine the more reproducible and reliable method. Results: All landmarks demonstrated that the surface superimposition method produced relatively more consistent coordinate values. The mean distances of measured landmarks values from the means were statistically significantly lower with the surface superimpositions method. Conclusions: Between the 2 superimposition methods designed for the evaluation of 3D changes in the lower arch, surface superimposition was the simpler, more reproducible, reliable method.
Purpose : This study was to determine the relationship between age and the mandibular cortical bone thickness on panoramic radiograph. Materials and Methods : Panoramic radiographs of 360 patients (180 men and 180 women) over 20 years old, who visited the Chonbuk National University Hospital from January to December in 2007, were assessed. The subjects were divided into 5 age groups. Five indices such as cortical bone thickness at the gonion (GI), antegonion (AI), and below the mental foramen (MI), the panoramic mandibular index (PMI), the mandibular cortical index (MCI) were measured on panoramic radiographs. Results : All five indices including GI, AI, MI, PMI, and MCI showed significant differences between third decade and over 8 decade groups (p<0.05). PMI, MI and GI showed significant differences with gender statistically (p<0.05). Conclusion : The mandibular cortical bone thickness showed negative correlation with age, and the value of the thickness (PMI, MI, and GI) was greater in men than in women.
Ha, Seung-Ryong;Kim, Sung-Hun;Song, Seung-Il;Hong, Seong-Tae;Kim, Gy-Young
The Journal of Advanced Prosthodontics
/
v.4
no.4
/
pp.254-258
/
2012
Implant-supported overdenture is a reliable treatment option for the patients with edentulous mandible when they have difficulty in using complete dentures. Several options have been used for implant-supported overdenture attachments. Among these, bar attachment system has greater retention and better maintainability than others. SFI-Bar$^{(R)}$ is prefabricated and can be adjustable at chairside. Therefore, laboratory procedures such as soldering and welding are unnecessary, which leads to fewer errors and lower costs. A 67-year-old female patient presented, complaining of mobility of lower anterior teeth with old denture. She had been wearing complete denture in the maxilla and removable partial denture in the mandible with severe bone loss. After extracting the teeth, two implants were placed in front of mental foramen, and SFI-Bar$^{(R)}$ was connected. A tube bar was seated to two adapters through large ball joints and fixation screws, connecting each implant. The length of the tube bar was adjusted according to inter-implant distance. Then, a female part was attached to the bar beneath the new denture. This clinical report describes two-implant-supported overdenture using the SFI-Bar$^{(R)}$ system in a mandibular edentulous patient.
Journal of the Korean Academy of Esthetic Dentistry
/
v.27
no.1
/
pp.24-40
/
2018
Often there are edentulous patients with severe vertical resorption of the alveolar ridge so that implant placement in the mandibular posterior is impossible. In this case, implants can be placed in the anterior portion of the mandible and the patient can be treated with an implant assisted overdenture, but the inherent discomfort of the removable prosthesis can not be overcome. However, if implants are appropriately placed between the mental foramen of both sides and a fixed hybrid prosthesis is fabricated to the patient, the patient will be satisfied without the inconvenience of the removable prosthesis. However, the treatment plan should be well designed to prevent disadvantages and expected complications of fixed hybrid prosthesis. Based on my clinical experience, I will explain treatment plan and protocol in detail.
Paek, Sun-Ho;Ahn, Byoung-Keun;Kim, Sun-Hae;Sohn, Hong Bum;Han, Ho Jin;Kang, Soo-Man
The korean journal of orthodontics
/
v.23
no.1
s.40
/
pp.1-15
/
1993
This study was undertaken to investigate the midline having the least difference between the right and left structures among the lines that had been used in the study of the craniomaxillofacial asymmetry. The sample of this study consisted of twenty six Korean girls(average 18.9 years old) having normal facial appearance and occlusion. On the frontal cephalometric films of the sample, we divided the whole craniomaxillofacial area into four portions, i.e., cranial, upper facial, lower facial, and dental portion. So, we have found the midlines having the least difference in the whole craniomaxillofacial area itself, and in the each divided four portions, furtherly in the other portions from aimed portion. The findings were as follow: 1. In the whole craniomaxillofacial area, the connecting line between crista galli and anterior nasal spine and the perpendicular bisecting line between right and left foramen rotundums were suitable for the midline. 2. In the cranial portion, established all six lines were suitable for midlines. In the other portions, the perpendicular bisection line between both condylion, the line passing the contact point between right and left mandibular central insisiors among the perpendicular lines between right and left mandibular central incisial tips were suitable midlines fer evaluating the asymmetry of cranial portion. 3. In the upper facial portion, the perpendicular bisecting line between right and left zygions was the most suitable midline. In the other portions, the line between the crista galli and the most superior point of the odontoid process, the perpendicular bisecting line between right and left gonions, the perpendicular bisecting line between right and left condylions, and perpendicular bisecting line between right and left foramens rotundum were suitable midlines for evaluating the asymmetry of the upper facial portion 4. In the dental portion, the perpendicular bisecting lines between right and left buccal cusps of both maxillary first molars and between right and left mandibular first molars were suitable midlines. In the other portions, the perpendicular bisecting line between right and left landmarks crossing the lesser wing of the sphenoid bone and orbit, the perpendicular bisecting line between right and left mental foramens, and the connecting line between crista galli and prosthion were suitable midlines for evaluating the asymmetry of dental portion. 5. In the lower facial portion, the perpendicular bisecting lines between right and left condylions and between right and left gonions were suitable midlines. In the other portions, the line between the crista galli and anterior nasal spine, the perpendicular bisecting line between right and left foramen rotundums, and the perpendicular bisecting lines between right and left buccal cusps of both mandibular first molars and between right and left maxillary first molars were suitable midlines for evaluating the asymmetry of the lower facial portion.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.21
no.2
/
pp.165-179
/
1991
This study was performed to understand the irradiation effects on the mandibular condyle and mandibular growth in developing white rats. Forty eight white male rats of the Sprague-Dawley strain aged 4 weeks, were devided into two groups; control group and experimental group. A single target dose of l0Gy of radiation was given to the mandibular condylar area and the observations of the photo analysis, radiologic, histopathologic and immunohistochemical study revealed as follows; 1. Animals killed one week after irradiation showed lesser increase in body weights, no difference in photo analysis and decreased thickness of cartilagenous layers of the condyle than the control group. 2. Two weeks after irradiation the weight increases were almost same in both irradiated and control groups and in photo analysis, the distance from Mental Foramen to Incisal tip (Mf-It) was longer than the controls. Repair processes were taken place in irradiated group, but the cartilagenous layers were thinner than the controls. 3. By the third week after exposure further repair was seen in the trabeculae and the distance from Condylion to Mandibular plane (Cd-Cd') was longer than the controls and the weight increases were almost same as the controls. 4. At 4 weeks after irradiation the cells of proliferating zone repaired to almost normal findings, but the cartilagenous cell layers were still thinner than the control animals. In photo analysis, the distances from Menton to Anterior Notch (Me-An), from First Molar to Mandibular plane (Fm-Fm') were shorter and the weight increases were lesser than the controls. 5. In the S-100 antibody, the positive cells were increased in number, but decreased reactivities were seen at the proliferating zone of the irradiated groups. In the Monoclonal Anti-Proteoglycan antibody and Type Ⅰ collagen antibody, the irradiated groups showed little decreased number of positive cells and in the Type Ⅱ collagen antibody, the differences between irradiated and control groups were undetectable in immunohistochemical study.
Kim, Min-Su;Yoon, Mi-Jung;Huh, Jung-Bo;Jeon, Young-Chan;Jeong, Chang-Mo
The Journal of Advanced Prosthodontics
/
v.4
no.2
/
pp.116-120
/
2012
Various options have been introduced for the selection of implant overdenture attachments. Attachment wear due to the repeated insertion and removal of dentures has caused problems such as decreased retention and the requirement for suprastructure remanufacturing. In these cases, a Locator bar system was applied using the drill and tapping technique to achieve total retrievability. In a 55-year-old female patient who showed three degrees of mobility in most of her teeth due to severe alveolar bone loss, a complete denture in the maxilla and an implant supported type overdenture in the mandible were planned after extracting all the remaining teeth. Six implants were placed from canine region to the distal molar region, and the locator was connected to the milled bar using the drill and tapping technique. For a 61-year-old female edentulous patient who complained of poor retention with old denture, a complete denture in the maxilla and an implant-tissue supported type overdenture in the mandible were planned. Four implants were placed in front of mental foramen, and the Locator was also connected to the Hader bar using the drill and tapping technique. With this technique, female parts can be easily replaced, and retention can be continuously maintained.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.30
no.5
/
pp.391-399
/
2004
Distraction osteogenesis has been thought to be promising technique for replacing bone graft in maxilla and mandible. The purpose of this study was to investigate the expression of osteonectin on distraction osteogenesis. Sixteen rabbits were used for this experiment. Osteotomy was performed between premolar and mental foramen. On the experimental group, distraction device was connected to the respective bone segments. On the control group, bone segments were fixed using plate and screws after osteotomy. Distraction was carried out at the rate of 0.7mm per day to obtain a 4.9mm elongation on the experimental group. After 3 days, 7 days, 14 days, and 28 days two rabbits of each group were sacrificed. The results obtained from this study were as follow : Experimental group was observed that the gaps between the distracted bone edges were occupied by new bone. Expression of Osteonectin were detected throughout the experiment in both groups and Expression of Osteonectin were markedly increased during distraction and consolidation period in experimental group than control group. From these results, it could be stated that distraction was shown to improve and accelerate bone formation and mechanical stress like distraction has considerable effects on osteonectin.
Park, Sung-Jin;Ha, Ho-Gyun;Jung, Ho;Lee, Sang-Keol;Park, Moon-Sun
Journal of Korean Neurosurgical Society
/
v.29
no.2
/
pp.249-254
/
2000
Objective : As a minimally invasive strategy, endoscopic technique was introduced for removal of the traumatic intracerebral hematoma. Material and Method : A 54-year-old man with three-day history of seizure and progressive mental deterioration after traffic accident was presented. Computerized Tomography(CT) of the brain showed a huge intracerebral hematoma on the right frontal lobe and ventricle. The operation was performed via right frontal superolateral keyhole with 2cm eyebrow skin incision. Using 0-degree and 30-degree angled lens 4mm rigid endoscopes, nearly all of the hematoma was evacuated under the direct endoscopic visualization and a ventricular catheter was exactly placed into the frontal horn of the right lateral ventricle at the end of procedure. Results : The seizure was discontinued and neurological status had been improved during postoperative periods. Postoperative CT demonstrated that most of the hematoma was removed and the ventricular drainge tube was exactly placed in the right foramen of Monro. Conclusion : With endoscopic technique, the authors successfully evacuated traumatic intracerebral hematoma and exactly placed the ventricular drainage catheter under direct visualization. This technique may be considered as an another option for removal of traumatic intracerebral hematoma.
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