• Title/Summary/Keyword: Prosthesis failure

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Replacement of the Prosthetic Heart Valves -Clinical analysis of 12 cases- (인공심장판막의 재치환술)

  • 김덕실;전상훈
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.164-170
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    • 1996
  • From January 1986 to June 1993, 12 patients Aad required reoperation: 9 had undergone mitral and 3 aortic valve replacement. Five were male and 7 female, and ages ranged from 29 to 61 years. Replacement of the prosthetic heart valve was performed at a mean interval of 98 $\pm$ 1 months after the Hrst operation. In aortic valve replacement patients the mean interval was 115 $\pm$ 2 months and in mitral valve replacement patients 98 $\pm$ 4 months. Primary tissue failure was the most frequent reason of replacement (10 patients) followed by valve thrombosis (1 patient) and prophylactic replacement (1 patient) in order. The most pronounced pathology of the failed prosthetic heart valves seen in the primary tissue failure group was calcification, perforation, shrinkage and tearing of the cusps. There was one early operative death (8.3%) due to intractable low cardiac output and acute renal failure. Eleven early survivors had successful operative results and there was no late death.

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Splinted and non-splinted implant-supported restorations : prosthetic considerations for restoring multiple adjacent teeth (Splinted or Non-splinted: 다수의 인접한 치아 결손부 수복을 위한 임플란트 보철)

  • Yoon, Hyung-In
    • The Journal of the Korean dental association
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    • v.54 no.3
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    • pp.198-205
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    • 2016
  • The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.

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Retreatment of fractured implant overdenture due to long-term maintenance failure (장기간의 유지관리 실패로 인해 파절된 임플란트 피개의치 재수복 증례)

  • Kim, Minjee;Hong, Seoungjin;Paek, Janghyun;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.3
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    • pp.235-242
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    • 2018
  • Periodontal and prosthodontic maintenance of implant overdenture is a very important factor for the long term success of the prosthesis and implants. Failure of maintenance can lead to prosthetic failure due to peri-implant bone loss and fracture and wear of the prosthesis or components. In this case, the existing gold milled bars were reconstructed with cobalt chrome milled bar in a manner that does not interfere with the external shape for the retreatment of fractured implant overdenture by maintenance failure. Two implants of mandible were selected strategically and the CM LOC attachments were connected to the two implants, and implant overdentures were fabricated. As a result, prosthesis with a functional and esthetic design that facilitates good hygiene management of the patient was delivered, which is advantageous for long term maintenance, and regular check-ups were scheduled for proper maintenance.

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.

Clinical Experience of Carbomedics Prosthetic Heart Valve (Carbomedics 인조 심장판막의 임상적 경험)

  • Jeon, Sang-Hyeop;Kim, Jong-Won
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.817-821
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    • 1995
  • The CarboMedics Medical valve has become our mechanical valvular prosthesis of choice because of favorable hemodynamic results that associated with marked clinical improvement and low incidence of thromboembolism after it,s uses. The data for this study was collected from August 1988 to July 1993,five years period. There were total of 57 patients[female 40,male 17 in this series with 4 isolated aortic valve,26 isolated mitral valve,11 double valve and a triple valve replacement. The mean follow up time was 32 months. Postoperatively,58% of cases were in New York Heart Association[NYHA functional class I,and mild and moderate symptoms[NYHA class II were present in 36% and there were very few patients remaining in higher functional classes. In postoperative echocardiographic study, showed marked improved cardiac function. The overall early mortality was 3.5% and the late mortality was one case after triple valve replacement due to sudden death. The causes of early death were attributed to early prosthetic valve endocarditis and heart failure.

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Clinical Analysis of St. Jude Medical Prosthesis (St. Jude Medical 기계판막의 임상적 연구)

  • 최순호
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.171-181
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    • 1991
  • Result of St. Jude Medical valve replacement are presented in 106 patients who underwent operation from January 1985 through July 1989. The patient were 52 males and 56 females. Total 136 of St. Jude Medical valves were implanted; 91 in mitral position, 45 in aortic position. The hospital mortality rate was 5.7%o[6 patients] and the late mortality rate was 2.0%[2 patients]. The causes of death were low cardiac output in 5, iatrogenic right ventricular rupture in 1, heart failure in 1, ventricular arrhythmia in l. And, the causes of valve related complication were anticoagulant related hemorrhage in 5 patients[0.03% /patient-year] and thromboembolism[0.01% /patient-year] in 2 patients. In conclusion, the performance of the St. Jude Medical valve compare most favorably with other artificial valves. But it remains still hazards of mechanical prosthesis such as thromboembolism and anticoagulant related hemorrhage.

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Leaflet Escape of Edwards Duromedics Mechanical Heart Valve -Report of 1 case- (Edwards Duromedics 기계판막의 판엽 이탈 -1예 보고-)

  • 김재현;나찬영;백만종;서홍주;김종환;오삼세
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.373-375
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    • 2004
  • Edwards Duromedics Valve has been suspended from the market since May 1988 due to the frequent reports of leaflet escape. There were 2 case-reports of leaflet escapes in this country. We report a case of leaflet escape in an Edwards Duromedics bileaflet valve, in the mitral position.

Nonstructural Dysfunction of Mechanical Valve (인공판막의 비구조적 기능이상)

  • Shin, Jong-Mok;Jeong, Dong-Seop;Kim, Kyung-Hwan;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.34 no.1
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    • pp.91-93
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    • 2001
  • 기계판막의 비구조적 기능이상은 판막 치환 후 생길 수 있는 심각한 합병증 중의 하나이다. 이러한 기계판막의 비구조적 기능이상은 일반적으로 1) pannus나 조직 혹은 봉합물질에 의한 장애 2) 치환 판막 주위의 틈 3) 부적절한 판막의 크기나 위치, 판막 삽입시의 잘못 등에 의해 생긴다. 저자들은 상대적으로 작은 판막륜을 가진 환자에서 치환 판막의 잘못된 위치로 야기된 pannus 형성에 의한 판막의 기능부전을 경험하였으며, 이 환자에 대해 pannus 제거 후 판막륜 확장술(닉스 술식, Nicks procedure)을 포함한 판막 재치환술을 성공적으로 시행하여 이를 보고하는 바이다.

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Severe Hemolysis after St. Jude Medical Valve Replacement in the Aortic Position -A Redo Case Report - (판막치환술 후 심한 용혈 현상으로 재치환한 경험)

  • 조영철
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.706-710
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    • 1988
  • Intravascular hemolysis occurs in the majority of patient with mechanical valve prosthesis. The primary cause is mechanical trauma to red cells from turbulent blood flow through the prosthesis. Degree of hemolysis is dependent upon the type, size and material of valve and aggravated by paravalvular leakage. Clinically important hemolytic anemia is required medical management or consideration of reoperation. In severe hemolysis, reoperation is recommended without delay when seems to be renal failure. In this case, postoperative severe mechanical hemolysis was developed immediately after aortic valve replacement with St. Jude medical valve in a 13 year-old male patient. Neither significant paravalvular leakage nor valvular dysfunction was found through redo, but the mechanical valve was strongly suspected the cause of severe hemolysis. The St. Jude Medical valve was changed with Ionescu-Shiley bioprosthesis and any significant clinical problems were not noted through the postoperative course.

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THREE DIMENSIONAL FINITE ELEMENT STRESS ANALYSIS OF IMPLANT PROSTHESIS ACCORDING TO THE DIFFERENT FIXTURE LOCATIONS AND ANGULATIONS (임플랜트 지지 보철물에서 고정체의 식립위치와 각도에 따른 삼차원 유한요소법적 응력분석에 관한 연구)

  • Park Won-Hee;Lee Young-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.1
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    • pp.61-77
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    • 2005
  • Statement of problem. The implant prosthesis has been utilized in various clinical cases thanks to its increase in scientific effective application. The relevant implant therapy should have the high success rate in osseointegration, and the implant prosthesis should last for a long period of time without failure. Resorption of the peri-implant alveolar bone is the most frequent and serious problem in implant prosthesis. Excessive concentration of stress from the occlusal force and biopressure around the implant has been known to be the main cause of the bone destruction. Therefore, to decide the location and angulation of the implant is one of the major considering factors for the stress around the implant fixture to be dispersed in the limit of bio-capacity of load support for the successful and long-lasting clinical result. Yet, the detailed mechanism of this phenomenon is not well understood. To some extent, this is related to the paucity of basic science research. Purpose. The purpose of this study is to perform the stress analysis of the implant prosthesis in the partially edentulous mandible according to the different nature locations and angulations using three dimensional finite element method. Material and methods, Three 3.75mm standard implants were placed in the area of first and second bicuspids, and first molar in the mandible Thereafter, implant prostheses were fabricated using UCLA abutments. Five experimental groups were designed as follows : 1) straight placement of three implants, 2) 5$^{\circ}$ buccal and lingual angulation of straightly aligned three implants, 3) 10$^{\circ}$ buccal and lingual angulation of straightly aligned three implants. 4) lingual offset placement of three implants, and 5) buccal offset placement of three implants. Average occlusal force with a variation of perpendicular and 30$^{\circ}$ angulation was applied on the buccal cusp of each implant prosthesis, followed by the measurement of alteration and amount of stress on each configurational implant part and peri-implant bio-structures. The results of this study are extracted from the comparison between the distribution of Von mises stress and the maximum Von mises stress using three dimensional finite element stress analysis for each experimental group. Conclusion. The conclusions were as follows : 1. Providing angulations of the fixture did not help in stress dispersion in the restoration of partially edentulous mandible. 2. It is beneficial to place the fixture in a straight vertical direction, since bio-pressure in the peri-implant bone increases when the fixture is implanted in an angle. 3. It is important to select an appropriate prosthodontic material that prevents fractures, since the bio-pressure is concentrated on the prosthodontic structures when the fixture is implanted in an angle. 4. Offset placement of the fixtures is effective in stress dispersion in the restoration of partially edentulous mandible.