• Title/Summary/Keyword: Surgical exposure

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INTRA-ALVEOLAR TRANSPLANTATION OF COMPLETELY CROWN-ROOT FRACTURED TOOTH WITH DEMINERALIZED FREEZED DRIED BONE GRAFT (치은연 하방으로 파절된 치아의 탈회냉동건조골을 이용한 Intra-alveolar transplantation)

  • Lim, Hyoung-Soo;Kim, Dong-Phil;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.344-350
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    • 2000
  • Incidence of crown-root fracture due to traumatic injury, have been reported 3% in the permanent dentiton, 2% in the deciduous dentition. There are two treatment methods for crown-root fractured teeth with pulp exposure, when the fracture line was located under the alveolar crest. One way is the extrusion by orthodontic force the other way is intra-alveolar transplantation which occlusally repositioning of apical fragment in the alveolar socket. Since intra-alveolar transplantation has introduced in 1970s, it was practiced as alternative to orthodontic extrusion. As the result, this method may thoughted that had a good prognosis. As a result of trauma, completely crown-root fracture was occured in the maxillary right central incisor in this case. We couldn't reposition the deepest fracture line above the alveolar crest by the conventional surgical extrusion, because apical fragment was too short. Thus, after extraction of apical fragment, we repositioned it to the socket following demineralized freezed dried bone graft, which possible to support the apical fragment. At the 15-month recall examination, the root still showed normal mobility and there was not observed any in flammatory or replacement root resorption in the periapical radiograph.

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AUTOTRANSPLANTATION OF IMPACTED MAXILLARY CANINES (매복된 상악 견치의 자가치아이식을 통한 치험례)

  • Kim, Tae-Wan;Kim, Hyun-Jung;Kim, Young-Jin;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.2
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    • pp.326-333
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    • 2003
  • The appropriate treatment for eruption guide of impacted teeth necessitates the formulation of a comprehensive treatment plan, which is dependent upon a number of factors such as the condition of the deciduous teeth, dental and skeletal relationship, dental age of the patient, willingness of the patient to undergo extensive dental treatment and financial considerations. If the etiology of the eruption disturbance has been identified, the elimination of the causes and various procedures can be used for eruption guide. Particularly the transplantation is a valuable alternative to extraction of impacted teeth, where surgical exposure and subsequent orthodontic realignment are difficult or impossible. This report present three cases of autotransplantation of impacted maxillary canine. As the result in these cases, atraumatic removal of donor tooth during operation is prerequisite to an optimal clinical result. Due to a high possibility of pulp necrosis, endodontic treatment of fully developed transplanted teeth should be undertaken. In complex case, autotransplantation can save time and less expensive than orthodontic forced eruption. Recipient socket should be prepared to a size that is slightly larger than the root of the donor tooth, and can be prepared with open or close procedure depends on root size of donor tooth and buccolingual width at transplantion site.

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Maxillary Incisor Replacement with the Ectopically Erupting Canine : Case Reports (이소맹출하는 견치의 상악 전치로의 대체사용 : 증례보고)

  • Lim, Jieun;Choi, Sungchul;Park, Jaehong;Choi, Yeongchul;Kim, Kwangchul;Ann, Hyojung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.335-341
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    • 2013
  • Impacted maxillary canines are the most frequently impacted teeth after the third molars. The exact etiology of impacted maxillary canines is unknown, but several complications may result from impacted maxillary canines. An early detection of ectopically erupting teeth can lead to performing interceptive treatment such as early extraction of primary canine and provide the best long-term results. In the absence of prevention, clinicians should consider orthodontic treatment followed by surgical exposure of the canine to bring it into occlusion. However, in cases when the finding ectopically erupting teeth and severe root resorption of adjacent teeth are found late, malposed canine can replace the injured teeth. In these presented cases, early diagnosis and treatment of ectopic eruption and root resorption were not performed. The maxillary incisor replacement with ectopically erupting canine can be the alternative treatment of choice with successful results. The reconstructed canine is planned to be checked periodically for the condition of composite resin restoration. Orthodontic treatment and dental implant are planned. This report shows that when early diagnosis was not done, maxillary incisor replacement with ectopically erupting canine could prevent uncertain prognosis of the adjacent teeth with root resorption and provide esthetic satisfactory with time saved and cost reduced.

Rhinoplasty using Various Autogenous Tissues (다양한 자가조직을 활용한 비성형술)

  • Han, Ki-Hwan;Yeo, Hyeon-Jung;Choi, Tae-Hyun;Kim, Jun-Hyung;Son, Dae-Gu
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.37-45
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    • 2010
  • Purpose: In Korean rhinoplasty, alloplasts such as silicone rubber have been used for dorsal and tip augmentations. However, alloplasts have produced complications such as deviation, exposure, and infection. Although autogenous tissue is an ideal material, the amount of the cartilage in Korean is not sufficient. Therefore, the authors developed a method to harvest the maximum amount of the septal and conchal cartilage. The authors first performed a complete septal extension graft for short and retruded columella and then performed nasal augmentation using various autogenous tissues. Methods: These surgical techniques were performed on 11 patients. Their average age was 27 years. An open approach with a V-shaped columellar labial incision was performed. At first, the complete septal extension graft was fixed on the entire caudal margin of the septum, and the alar cartilage was suspended to the septal extension graft to make the tip projected and the columella advanced caudally. A temporal fascial ball was used for radix augmentation. For dorsal augmentation, a batten-shaped septal cartilage graft wrapped with or without the temporal fascia or a diced cartilage graft wrapped with the temporal fascia was performed. For nasal tip augmentation, a shield graft and a cap graft or a folded conchal cartilage graft was performed.Results: The mean follow-up period was 11.2 months. The overall results were natural and satisfactory. Two patients underwent slight absorption and caudal displacement. With the exception of these cases, no complications were observed. Conclusion: Korean rhinoplastic surgeons are accustomed to using the alloplasts despite of serious complications. When rhinoplasty using autogenous tissue was performed, some complications occurred such as the displacement of the diced cartilage graft wrapped with the fascia, but many of the complications of alloplastic rhinoplasty were avoided. Therefore, we propose that by this time Korean rhinoplastic surgeons need to change their preference from alloplastic rhinoplasty to autogenous rhinoplasty.

Dynamic Computed Tomography based on Spatio-temporal Analysis in Acute Stroke: Preliminary Study (급성 뇌졸중 환자의 시공간 분석 기법을 이용한 동적 전산화 단층 검사: 예비 연구)

  • Park, Ha-Young;Pyeon, Do-Yeong;Kim, Da-Hye;Jung, Young-jin
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.543-547
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    • 2016
  • Acute stroke is a one of common disease that require fast diagnosis and treatment to save patients life. however, the acute stroke may cause lifelong disability due to brain damage with no prompt surgical procedure. In order to diagnose the Stroke, brain perfusion CT examination and possible rapid implementation of 3D angiography has been widely used. However, a low-dose technique should be applied for the examination since a lot of radiation exposure to the patient may cause secondary damage for the patients. Therefore, the degradation of the measured CT images may interferes with a clinical check in that blood vessel shapes on the CT image are significantly affected by gaussian noise. In this study, we employed the spatio-temporal technique to analyze dynamic (brain perfusion) CT data to improve an image quality for successful clinical diagnosis. As a results, proposed technique could remove gaussian noise successfully, demonstrated a possibility of new image segmentation technique for CT angiography. Qualitative evaluation was conducted by skilled radiological technologists, indicated significant quality improvement of dynamic CT images. the proposed technique will be useful tools as a clinical application for brain perfusion CT examination.

Clinical Study on Mesothelioma of the Pleura (원발성 흉막중피종의 임상적 고찰)

  • Shim, Tae-Sun;Kim, Ho-Joong;Choe, Hyung-Seok;Lee, Hyuk-Pyo;Seo, Ji-Young;Kim, Young-Whan;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.2
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    • pp.135-142
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    • 1991
  • We reviewed 15 cases of mesothelioma of the pleura, of which three cases were localized benign form and 12 cases were malignant diffuse form. The tumors were distributed equally in both sexes, and occured most commonly in fifth to seventh decades. The history of exposure to asbestos was present in only one case. The chief complaints were mainly chest pain and dyspnea. Associated symptoms were cough, sputum, hemoptysis, weight loss, anorexia, chill. On physical examination, unilateral, decreased breathing sound was main feature. The simple chest radiograph showed masses in all localized mesotheliomas (100%) and in 2 diffuse mesotheliomas (17%). 8 cases of diffuse mesotheliomas (67%) showed unilateral pleural effusions. Pleural effusions were mainly bloody (67%), and almost all were exudates. In all localized mesotheliomas, final diagnosis was made by open thoracotomy. In diffuse mesotheliomas, final diagnosis was made by open thoracotomy in 7 cases, chest wall mass biopsy in 2 cases, thoracoscopic biopsy in 1 case, pleural biopsy in 1 case, and pleural biopsy combined with axillary lymph node biopsy in 1 case. Localized mesotheliomas were treated by simple excision with good prognosis. In diffuse mesotheliomas, surgical treatment (pleuropneumonectomy, pleurectomy), chemotherapy, or radiotherapy, alone or in combination, were used with dismal prognosis. The prognostic factors were not found due to the small number of cases, incomplete follow up, and early drop out.

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The effect of irradiated cancellous human bone on exophytic bone formation in residual ridge of the beagle dog (방사선 조사 망상골이 외방형 골형성에 미치는 영향)

  • Chung, Mi-Hyun;Herr, Yeek;Kwon, Young-Hyuk;Park, Joon-Bong;Chung, Jong-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.37 no.4
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    • pp.791-803
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    • 2007
  • The purpose of this study was to evaluate exophytically vertical bone formation in residual ridge of the beagle dog by the concept of guided bone regeneration with a titanium reinforced e-PTFE membrane combined with irradiated cancellous human bone. Twelve male beagle dogs(mean age 1.5 years and mean weight 12kg) were used for this study. The alveolar ridges after extraction of all mandibular premolars were surgically and horizontally removed. At 8 weeks after extractions, full-thickness flap was reflected and cortical bone was removed with round bur and copious irrigation. Rectangular parallelepiped(10mm in length, 5mm in width, and 4mm in height) bended with titanium-reinforced e-PTFE(TR e-PTFE) membrane was placed on the decorticated alveolar ridge, fixed with metal pins and covered with full-thickness flap and assigned as a control group. Test groups ere treated with TR e-PTFE membrane filled with irradiated cancellous human bone. Of twelve beagle dogs, four control dogs and four test dogs without membrane exposure to oral cavity were sacrificed at 8 and 16 weeks respectively. The surgical sites were dissected out, fixed in 4% buffered formaldehyde, dyed using a Villanueva staining technique, and processed for embedding in plastic resin. The cutting and grinding methods were routinely processed for histologic and histomophometric analyis of exophytic bone formation as well as statistical analysis. The results of this study were as follows: 1. Exophytic bone formation in the both of experimental groups was increased respectively after surgery from 23.40% at 8 weeks to 46.26% at 16 weeks in the control groups, from 40.23% at 8 weeks to 47.11% at 16 weeks in the test groups(p<0.05). 2. At 8 weeks after surgery, exophytic bone formation was made 40.23% in the test groups and 33.40% in the control groups. Exophytic bone formation was significantly made in the test group more than in the control group. At 16 weeks after surgery, exophytic bone formation was made 44.11% in the test groups and 46.26% in the control groups. Exophytic bone formation was made in the test groups more than in the control groups, but there was no statistically significant differences. 3. The membrane was fixed with metal pins to closely contact it to the bone surface. So, collapse and deviation of the membrane could be prevented and in growth of connective tissue also could be blocked from the periphery of the membrane. On the basis of these findings, wee suggest that intraoral experimental model for exophytic bone formation may be effective to evaluate the effect of bone graft material. And it indicates that combined use of membrane and ICB graft material is more effective than use of membrane only for exophytic bone formation.

ORTHODONTIC TREATMENT OF THE PALATALLY IMPACTED MAXILLARY CANINE (구개측 매복된 상악 견치의 교정적 치험례)

  • Kam, Dong-Hoon;Kim, Jung-Wook;Hahn, Se-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.1
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    • pp.127-133
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    • 1998
  • An impacted tooth is defined pathologically as a tooth that remains under the mucosa of inside bone without eruption of the crown after a specific period of eruption. Clinically, the term includes those teeth, even before eruption period, that are not expected to erupt due to shape, position and alignment of tooth and lack of space. Canine is prone to impaction more than other teeth because it has the longest time to develop and a complex route from the place of formation to the site of eruption. The impaction incidence of maxillary canine is repoted 0.92$\sim$3.3% (Ferguson, 1990). In 1995 Orton reported that the incidence was 0.92$\sim$2.2% and palatal impaction was more frequent than labial impaction(85%:15%). In 1969 Johnston presented it was more common to woman than to man(3:1). The etiology includes systemic disease such as endocrine disorder, cleidocranial dysostosis, irradiation, Crouzon syndrome, ricketts, facial hemihypertrophy and hereditary and local problems such as ectopic position of the tooth, distance of tooth from its place of eruption, malformation of the tooth, presence of supernumerary teeth, trauma of tooth germ, infection of tooth germ, displacement of tooth germ or tooth by a neoplasm, ankylosis, overretention of deciduous predecessor, lack of space for the tooth in the dental arch and mucosal barrier due to gingival fibrosis. The maxillary canine is especially important as it has the longest root, provides guidance for lateral movement of the mandible and masticatory function and assumes an important role esthetically as it is located at mouth angle. If left untreated, it may cause migration and external, internal resorption of adjacent teeth, loss of arch length, formation of dentigerous cyst or tumors, infection and referred pain as well as malposition of the tooth. Therefore, periodic examination of the development and eruption of the maxillary canine is especially important in a growing child. This case study presents the results of treatment of palatally impacted maxillary canine utilizing surgical exposure and orthodontic tooth movement on patients visiting SNUDH dept. of pediatric dentistry.

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ERUPTION DISTURBANCE OF THE LOWER LEFT FIRST PERMANENT MOLAR CAUSED BY AMELOBLASTIC FIBROMA (법랑모세포섬유종에 의한 하악 제1대구치의 맹출 장애)

  • Kim, Seung-Hye;Song, Je-Seon;Son, Heung-Kyu;Choi, Hyung-Jun;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.102-108
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    • 2010
  • Impaction is the cessation of eruption process caused by physical obstacles on the eruption pathway, abnormal tooth position, or lack or space. It often occurs in association with supernumerary teeth, odontogenic tumor, or cystic lesions, and ameloblastic fibroma is one of the odontogenic tumors that can cause impaction of teeth. In many cases, ameloblastic fibroma occurs in association with one or more unerupted teeth. The proper management of ameloblastic fibroma is determined between conservative resection or more aggressive block resection, based size and morphologic features of the lesion and age of the patient. This is a case of a 8 year and 6 month old boy whose lower left permanent molar showed eruption disturbance. The impacted tooth was successfully repositioned favorably through surgical exposure and orthodontic traction using a modified halterman appliance. Long term follow-up, longer than 10 years, is planned considering relatively high recurrence rate and possibility of malignant transformation of ameloblastic fibroma, which cause impaction of the lower left permanent molar in this case.

Treatment of crown-root fracture with a modified crown fragment reattachment technique (변형된 치관부 파절편 재부착술식을 이용한 치관치근파절의 치료)

  • Song, Chang-Won;Song, Min-Ju;Shin, Su-Jung;Park, Jeong-Won
    • Restorative Dentistry and Endodontics
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    • v.35 no.5
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    • pp.395-400
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    • 2010
  • The development of adhesive dentistry has allowed that the crown fragment reattachment can be another option in the treatment of crown fracture. However, additional crown lengthening procedure or extrusion of the tooth may be necessary in the treatment of crown root fracture because subgingival fracture line in close proximity to the alveolar bone leads to challenges for restorative procedure and the violation of the biologic width. This case report presents a modified crown fragment reattachment technique of crown root fracture with pulp exposure, which was done without additional crown lengthening procedures. After the endodontic treatment, the patient was treated using a post insertion and the fragment reattachment technique, which made it possible to preserve the space for the biologic width and maintain a dry surgical field for adequate adhesion through the modification of the fractured coronal fragment. Since a coronal fracture was occurred and reattached afterward, it was observed that the coronal fragment was well maintained without the additional loss of periodontal attachment through 2-year follow up.