• Title/Summary/Keyword: Post-operative stability

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Follow-up Comparison of Two Different Types of Anterior Thoracolumbar Instrumentations in Trauma Cases : Z-plate vs. Kaneda Device

  • Park, Jung-Keun;Kim, Keun-Su
    • Journal of Korean Neurosurgical Society
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    • v.41 no.2
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    • pp.77-81
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    • 2007
  • Objective : In a variety of thoracolumbar diseases, corpectomy followed by interbody bone graft and anterior instrumentation has allowed direct neural decompression and reconstruction of the weight-bearing column by short segments fusion. In this study, we compared spinal stability of the two different anterior thoracolumbar instruments : Z-plate and Kaneda device representing plate and two-rods type, respectively. Methods : A retrospective review was performed for all the patients with thoracolumbar diseases or traumas treated with anterior corpectomy, autologous iliac bone graft, and fixation with instruments from 1996 to 2000. For the anterior instrumentation, Z-plate or Kaneda device was used for 24 [M:F=5:9, average age=37] and 12 [M:F=9:3, average age=41] patients, respectively. The plain AP and lateral flexion-extension films were taken immediately after surgery and at each follow-up. The sagittal and coronal Cobb's angles at the operation segments were used to observe the change of initial fixation status. The surgical time length and bleeding amount of the two groups were compared. Intra-operative and post-operative instrument associated complications were evaluated. Student t-test was used for statistical analysis and p-value less than 0.05 was considered to be significant. Results : Mean follow-up durations for Z-plate and Kaneda device were 24 and 21 months, respectively. The fusion rate was 91% for Z-plate and 100% for Kaneda device. Two cases of Z-plate group showed instrumentation failure during the follow up period, in which additional surgery was necessary. The mean differences of sagittal Cobb's angles among the AP images immediate after surgery and at follow-up were 7 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. The mean differences of coronal Cobb's angles were 5 and 2 degrees for Z-plate and Kaneda device, respectively [p<0.05]. No Intra-operative complication has occurred in both groups. There was no difference in surgery time and bleeding amount between two groups. Conclusion : We think that Kaneda device [rod type] is stronger than Z-plate [plate type] to keep the spinal stability after anterior thoracolumbar surgery.

Effect of dimethyl sulfoxide on bond durability of fiber posts cemented with etch-and-rinse adhesives

  • Shafiei, Fereshteh;Memarpour, Mahtab;Sarafraz, Zahra
    • The Journal of Advanced Prosthodontics
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    • v.8 no.4
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    • pp.251-258
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    • 2016
  • PURPOSE. This study was undertaken to investigate whether use of an adhesive penetration enhancer, dimethyl sulfoxide (DMSO), improves bond stability of fiber posts to root dentin using two two-step etch-and-rinse resin cements. MATERIALS AND METHODS. Forty human maxillary central incisor roots were randomly divided into 4 groups after endodontic treatment and post space preparation, based on the fiber post/cement used with and without DMSO pretreatment. Acid-etched root dentin was treated with 5% DMSO aqueous solution for 60 seconds or with distilled water (control) prior to the application of Excite DSC/Variolink II or One-Step Plus/Duolink for post cementation. After micro-slicing the bonded root dentin, push-out bond strength (P-OBS) test was performed immediately or after 1-year of water storage in each group. Data were analyzed using three-way ANOVA and Student's t-test (${\alpha}$=.05). RESULTS. A significant effect of time, DMSO treatment, and treatment${\times}$time interaction were observed (P<.001). DMSO did not affect immediate bonding of the two cements. Aging significantly reduced P-OBS in control groups (P<.001), while in DMSO-treated groups, no difference in P-OBS was observed after aging (P>.05). CONCLUSION. DMSO-wet bonding might be a beneficial method in preserving the stability of resin-dentin bond strength over time when fiber post is cemented with the tested etch-and-rinse adhesive cements.

Key-hole Technique in Treatment of A-C Dislocation - Preliminary Report - (Key-hole 술식을 이용한 급성 견봉쇄골관절 탈구의 치료-예비보고-)

  • Choi Chang-Hyuk;Kwun Koing-Woo;Kim Shin-Kun;Lee Sang-Wook;Yun Young-Jun
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.8-13
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    • 1999
  • The results of the operative treatment of the Grade III acromioclavicular joint injury is defined by the durability of the reduced joint and free of exertional pain. Several surgical techniques have been applied to reduce and stabilize the joints effectively. Resection of clavicular lateral end and subacromial decompression also could be applied to prevent post-operative arthritic change. Biomechanical studies reveals the role of clavicular elevation and rotation to achieve more than 90 degrees of elevation. It also serves as a attachment site of deltoid and trapezius muscle. The stability and mobility of the both acromioclavicular and coracoclavicular joint are important to get full functional recovery. We modified the methods of coracoacromial ligament transfer described by Weaver-Dunn and by Shoji et a!. to pre­vent pullout of the transferred ligament and to get more improved functional results. Main technical point was harvesting full thickness bone block and fix it through the key-hole to reduce pull out angle.

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Bony Fragment Excision Followed by Multiple Drilling and Fragment Fixation Using Bio-absorbable Pins for Bilateral Osteochondral Fracture of the Lateral Talar Dome: A Case Report (양측 족관절에 발생한 외측 거골원개 골연골의 골절에 대한 골편제거 후 다발성 천공술 및 생흡수성 핀을 이용한 골편고정: 증례 보고)

  • Lee, Yong Jae;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.201-207
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    • 2019
  • An osteochondral fracture is considered to be an injury involving the cartilage and subchondral bone. Acute traumatic osteochondral fractures can be related to joint instability because abnormal joint motion causes shearing and rotatory stress. Acute osteochondral fractures are frequently missed or misdiagnosed as a pure soft tissue injury. Thus, surgeons' proactive attention is highly required as articular cartilage has limited potential for self-repair and these lesions may develop osteoarthritis. In order to minimize the progression of post-traumatic osteoarthritis, it is important to properly identify and treat osteochondral fractures. Yet, little is known about the operative management of acute osteochondral fractures of the talus. We report here on a case of a middle-aged male with acute osteochondral fractures of the bilateral lateral talar dome. We applied different operative methods on each side with regard to fragment size and stability. A favorable clinical outcome was obtained at 18 months follow-up.

SURGICAL CORRECTION OF SEVERE MANDIBULAR PROGNATHISM BY OBWEGESER II AND RIGID INTERNAL FLXATION (심한 하악골 전돌증 환자의 외과적 치험례)

  • Lee, Geon-Ho;Kwon, Dae-Geon;Jang, Do-Geon;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.1
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    • pp.33-42
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    • 1994
  • Obwegeser II method and Rigid fixation conserving the condylar position has been performed on 5 patients with severe mandibular prognathism, and we obtained the result after the follow up study follows. 1. Obwegeser II method is considered to move the distal segment passively when surgical correction of severe open bite correction and large amount of set back above 15mm is needed. 2. In one case that has more change of condylar position after operation, documented immediate post-operative relapse have been occurred 3. In the others that have adequate control of condylar position, passive set back and firm skeletal fixation, more functional and esthetic improvement and more post-operative stability has been achieved

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An Evaluation of Initial Stability after Maxillary Posterior Impaction (상악의 후상방 회전이동을 시행한 환자에서의 초기 안정성 평가)

  • Ahn, Sang-Wook;Kwon, Taek-Kyun;Lee, Sung-Tak;Song, Jae-Min;Kim, Tae-Hoon;Hwang, Dae-Seok;Shin, Sang-Hoon;Chung, In-Kyo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.3
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    • pp.225-232
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    • 2011
  • Purpose: This study was designed to retrospectively evaluate the postsurgical initial stability of the Le Fort I osteotomy with posterior impaction and rigid internal fixation for the correction of mandibular prognathism with midface deficiency. Particular attention was paid to the magnitude and direction of the initial postsurgical change. Methods: 20 healthy patients with mandibular prognathism and midface deficiency participated in this study. All patients underwent Le Fort I osteotomy with posterior impaction and mandibular setback BSSO by one surgeon. Preoperative (T0), immediate postoperative (T1) and follow-up period (T2) cephalograms were taken and analyzed. Change between T0~T1 and T1~T2 was measured and analyzed. Results: Between T0~T1, significant differences were observed in all measurements except the ANS point and mandibular plane angle. Between T1~T2, only the occlusal plane angle was significantly changed. No significant changes were found in all other measurements. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions. Conclusion: This study indicates that Le Fort I osteotomy with posterior impaction is stable at initial stages. Although changes in the occlusal plane angle were observed, it was caused by tooth movement after post-operative orthodontic treatment. However, more studies with larger samples are required to form definitive conclusions.

Post-operative Stability of Counter Clockwise Rotation of the Mandibular Plane in Skeletal CIII with Anterior Openbite Patients (전치부 개교합을 가진 골격성 3급 부정교합 환자에서 하악의 반시계 방향 회전 시 술 후 안정성)

  • Ryu, Jeong-Min;Ryu, Kyung-Sun;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Joon;Kim, Yeo-Gab;Ohe, Joo-Young;Park, Seong-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.4
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    • pp.252-259
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    • 2012
  • Purpose: This study evaluated the postoperative stability of counter clockwise rotation of the mandibular plane in anterior openbite patients, who have had one jaw surgery performed. Methods: This study includes patients with skeletal class III malocclusion accompanied by anterior openbite among the patients who have had BSSRO performed, resulting in counter clockwise rotation of the mandibule. We excluded the patients with genioplasty and segmental surgery, and included 23 patients who underwent BSSRO. Results: We found no statistical significance between the amount of counter clockwise rotation in the mandible in the Pearson correlation test. Also, there was no significant difference between Group 1 (< $3^{\circ}$) and Group 2 (> $3^{\circ}$). Conclusion: This study evaluated the amount of horizontal relapse, and the degree of relapse. Stable results were obtained. Although there was no statistical significance between the degree of openbite and the amount of horizontal relapse, the group with a greater amount of openbite had a greater amount of relapse.

Orthognathic surgery on Skeletal Class III patiens with collapsed vertical dimension: case report (수직고경이 붕괴된 골격성 III급 부정교합자의 악교정 수술 치험례)

  • Choi, Youn-Kyung;Kim, Yong-Deok;Park, Soo-Byung;Kim, Yong-Il;Kim, Seong-Sik;Son, Woo-Sung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.1
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    • pp.70-79
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    • 2016
  • Patients who lost posterior teeth due to periodontitis or dental caries have collapsed vertical dimension, unstable occlusion and change of the mandibular position. In particular, patients in orthognathic surgery, clinician should re-establish the pre-operative stable position of mandibular condyle in articular fossa and favorable vertical dimension for high post-operative stability of mandible. Therefore, interdisciplinary approach and co-operation, including prosthetics, orthodontics, oral and maxillofacial surgeon, from diagnosis and treatment plan is important to get a good outcome. This case report was patients who had collapsed occlusal plane due to severe dental caries on maxillary molars with skeletal Class III malocclusion. Before orthognathic surgery, resetting of maxillary occlusal plane with temporary removable denture was performed. Then successful multidisciplinary approach was done and lead to acceptable clinical outcome.

Clinical analysis of early reoperation cases after orthognathic surgery (악교정수술 후 조기 재수술 증례의 분석)

  • Lee, Ju-Hwan;Lee, In-Woo;Seo, Byoung-Moo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.1
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    • pp.28-38
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    • 2010
  • The factors influencing the relapse and recurrence of skeletal deformity after the orthognathic surgery include various factors such as condylar deviation, the amount of mandibular set-back, stretching force by the soft tissues and muscles around the facial skeleton. The purpose of this report is to recognize and analyze the possible factors of reoperation after orthognathic surgery, due to early relapses. Six patients underwent reoperation after the orthognathic surgeries out of 110 patients from 2006 to 2009 were included in this study. In most cases, clincal signs of the insufficient occlusal stability, anterior open bite, and unilateral shifting of the mandible were founded within 2 weeks postoperatively. Although elastic traction was initiated in every case, inadequate correction made reoperation for these cases inevitable. The chief complaints of five cases were the protruded mandible combined with some degree of asymmetric face and in the other one case, it was asymmetric face only. Various factors were considered as a major cause of post-operative instability such as condylar sagging, counter-clockwise rotation of the mandibular segment, soft tissue tension related with asymmetrical mandibular set-back, preoperatively existing temporomandibular disorder (TMD), poor fabrication of the final wafer, and dual bite tendency of the patients.

Office-based 2-stage Posterior Maxillary Segmental Osteotomy for Mandibular Implant Placement: Clinical Study

  • Jeong, Bong-Jin;Oh, Yeonjin;Jo, Hyunmi;Jung, Junho;Choi, Byung-Joon;Ohe, Joo-Young
    • Journal of Korean Dental Science
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    • v.13 no.2
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    • pp.67-72
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    • 2020
  • Purpose: This clinical study presented the effectiveness of 2-stage posterior maxillary segmental osteotomy (PMSO) under local anesthesia in gaining interarch space to restore the posterior mandibular segment with dental implants. Materials and Methods: Nine patients who received two-stage PMSO for mandibular implant placement from 2003 to 2011 were included in the study. Of the 9 patients, 7 were female and 2 were male. Ages ranged form 28 to 72 (mean 46.6). Potential complications were investigated such as sinus infection, survival of bone segment, inflammatory root resorption of adjacent teeth, relapse of bone segment and timing of implant placement, delivery of implant prosthesis and stability of bone segment. Result: None of the patients showed relapse or complication. Bone segments were stabilized by opposed implant prosthesis. Conclusion: Office-based 2-stage PMSO under local anesthesia can be considered a stable and predictable procedure. Also pedicle damage can be avoided by allowing favor of blood supply to the bone segments. From these advantages, it can be concluded that this surgical procedure can decrease post-operative complications.