• 제목/요약/키워드: Preoperative implant planning

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Use of 3D Printing Model for the Management of Fibrous Dysplasia: Preliminary Case Study

  • Choi, Jong-Woo;Jeong, Woo Shik
    • Journal of International Society for Simulation Surgery
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    • 제3권1호
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    • pp.36-38
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    • 2016
  • Fibrous dysplasia is a relatively rare disease but the management would be quite challenging. Because this is not a malignant tumor, the preservation of the facial contour and the various functions seems to be important in treatment planning. Until now the facial bone reconstruction with autogenous bone would be the standard. Although the autogenous bone would be the ideal one for facial bone reconstruction, donor site morbidity would be the inevitable problem in many cases. Meanwhile, various types of allogenic and alloplastic materials have been also used. However, facial bone reconstruction with many alloplastic material have produced no less complications including infection, exposure, and delayed wound healing. Because the 3D printing technique evolved so fast that 3D printed titanium implant were possible recently. The aim of this trial is to try to restore the original maxillary anatomy as possible using the 3D printing model, based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. And we molded Titanium mesh to reconstruct three-dimensional maxillary structure during the operation. This prefabricated Titanium-mesh implant was then inserted onto the defected maxilla and fixed. Three dimensional printing technique of titanium material based on the computer simulation turned out to be successful in this patient. Individualized approach for each patient could be an ideal way to restore the facial bone.

하악정중부에서 자가골 채취시 절치관의 해부학적인 변이에 대한 평가 (ASSESSMENT OF THE ANATOMIC VARIATION OF MANDIBULAR INCISIVE CANAL IN CHIN BONE HARVESTING)

  • 김지혁;김세호;권광준;김성민;박영욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권3호
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    • pp.226-229
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    • 2006
  • The interforaminal region is usually considered as a safe region in the chin bone graft without important vital anatomical structures to be damaged. But the accurate anatomy of the interforaminal region, with its potential clinical relationships, is controversial. Moreover some complications suggesting damage of incisive terminal branches after chin bone harvesting are reported such as sensory discomfort and pain etc. In order to verify incisive innervation of symphyseal area, we examined the cross-sectional CT scan images taken for preoperative planning of implant placement with chin bone graft and some parameters were measured; (1) visuality rating of incisive canal (2) vertical and horizontal diameter of canal (3) distance from lower border of the incisive canal to the lower border of the mandible (4) shortest distance from anterior border of the incisive canal to the anterior border of the mandible. We report the positive outcome that decrease the complications related with the damages of incisive branch during bone harvesting from the chin.

임플란트 식립 부위의 골밀도 평가에 관한 연구 (The study of bone density assessment on dental implant sites)

  • 박수원;장수미;최병환;손한나;박봉찬;김창환;손장호;성일용;이지호;조영철
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권5호
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    • pp.417-422
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    • 2010
  • Introduction: Bone density is one of the important factors for the long term success of endosseous implants. The bone density varies from site to site and from patient to patient. A preoperative evaluation of the bone density is quite useful to oral surgeons for planning dental implantation. More accurate information on the bone density will help surgeons identify suitable implant sites, thereby increase the success rate of dental implantation. This study examined the correlation between the bone density measured preoperatively by computed tomography (CT) and the implant primary stability measured by resonance frequency analysis. Furthermore, the effects of the implant sites, gender, age and generalized systemic disorder patients on the bone density and primary implant stability were examined. Materials and Methods: One hundred and fourteen patients were selected. None of the patients had undergone a tooth extraction or bone graft history in the previous year. Preoperatively, the patients underwent CT scanning to evaluate the Hounsfield unit (HU), and resonance frequency analysis (RFA) was used to evaluate the implant primary stability at the time of implant installation. All implants were 4.0 mm diameter and 11.5 mm length US II. All patients were recorded and the HU and implant stability quotient (ISQ) value were evaluated according to the sites, gender and age. Results: The highest HU values were found in the mandibular anterior site ($827.6{\pm}151.4$), followed by the mandibular molar site ($797{\pm}135.1$), mandibular premolar site ($753.8{\pm}171.2$), maxillary anterior site ($726.3{\pm}154.4$), maxillary premolar site ($656.7{\pm}173.8$) and maxillary molar site ($621.5{\pm}164.9$). The ISQ value was the highest in the mandibular premolar site ($81.5{\pm}2.4$) followed by the mandibular molar site ($80.0{\pm}5.7$), maxillary anterior site ($77.4{\pm}4.1$), mandibular anterior site ($76.4{\pm}11.9$), maxillary premolar site ($74.2{\pm}14.3$) and maxillary molar site ($73.7{\pm}7.4$). The mean HU and ISQ value were similar in females and males. (HU: P=0.331, ISQ: P=0.595) No significant difference was also found in the age group respectively. However, the correlation coefficients between the variables showed a closed correlation between the HU and ISQ value. Conclusion: These results showed close correlation between the bone density (HU) and primary stability value (ISQ) at the time of implant installation (Correlation coefficients=0.497, P<0.01). These results strengthen the hypothesis that it might be possible to predict and quantify the initial implant stability and bone density from a presurgical CT diagnosis.

A 3D-printing Bone Model for Surgical Planning of Total Hip Replacement after Failed Triple Pelvic Osteotomy

  • Han, Kyungjin;Park, Jiyoung;Yoon, Jangwon;Lee, Young-Won;Choi, Ho-Jung;Jeong, SeongMok;Lee, Haebeom
    • 한국임상수의학회지
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    • 제34권6호
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    • pp.463-466
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    • 2017
  • A 3-year-old, 26 kg, castrated male Chow Chow was presented for assessment of weight-bearing lameness of the left hind limb. The patient had a history of triple pelvic osteotomy on the left side to correct hip dysplasia 2 years prior to his presentation of clinical signs and underwent total hip replacement on the right coxofemoral joint 1 year later. Upon physical examination, pain and crepitus were noted on the left hip joint during extension. Radiological examination revealed coxofemoral joint subluxation and moderate degenerative bone changes on the left hip joint and pelvic axis, which relates to acetabular angles that were changed after triple pelvic osteotomy (TPO). Preoperative computed tomography was used for 3-dimensional printing to establish an accurate surgical plan. The changed angles of the acetabulum after TPO were evaluated, and rehearsal surgery was performed using a 3-demensional printing bone model. Three months after the THR surgery, the function of the affected limb had improved, with no lameness. Complications, such as luxation and implant failure, were not observed until 6 months after the operation. Accurate evaluation of acetabulum angles and rehearsal surgery using a 3D-printed bone model is effective for total hip replacement after unsuccessful TPO.

The thickness of alveolar bone at the maxillary canine and premolar teeth in normal occlusion

  • Jin, Seong-Ho;Park, Jun-Beom;Kim, Namryang;Park, Seojin;Kim, Kyung Jae;Kim, Yoonji;Kook, Yoon-Ah;Ko, Youngkyung
    • Journal of Periodontal and Implant Science
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    • 제42권5호
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    • pp.173-178
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    • 2012
  • Purpose: The main purpose of this study was to investigate bone thickness on the buccal and palatal aspects of the maxillary canine and premolars using cone-beam computed tomography (CBCT). The differences between left- and right-side measurements and between males and females were also analyzed. Methods: The sample consisted of 20 subjects (9 males and 11 females; mean age, $21.9{\pm}3.0$) selected from the normal occlusion sample data in the Department of Orthodontics, The Catholic University of Korea. The thickness of the buccal and palatal bone walls, perpendicular to the long axis of the root were evaluated at 3 mm and 5 mm apical to cemento-enamel junction (CEJ) and at root apex. Results: At the canines and first premolars regions, mean buccal bone thickness of at 3 mm and 5 mm apical to CEJ were less than 2 mm. In contrast, at the second premolar region, mean buccal bone thickness at 3 mm and 5 mm apical from CEJ were greater than 2 mm. Frequency of thick bone wall (${\geq}2mm$) increased from the canine to the second premolar. Conclusions: This result should be considered before tooth extraction and planning of rehabilitation in the canine and premolar area of maxilla. Careful preoperative analysis with CBCT may be beneficial to assess local risk factors and to achieve high predictability of success in implant therapy.