• Title/Summary/Keyword: fixation point

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Reconstruction of Philtral Column with Overlapping of Orbicularis Oris Muscle Flap in Secondary Cleft Lip Nose Deformity (이차성 구순열 환자에서 상구순 구륜근 피판중첩을 이용한 인중주의 재건)

  • Kwon, Seok Min;Park, Jun;Yang, Won Yong;Yoo, Young Cheun;Kang, Sang Yoon
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.574-580
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    • 2008
  • Purpose: Philtral deformity is a stigma of secondary cleft lip nose. It occurs from the false arrangement of orbicularis oris muscle and the scar of previous operation. Various methods have been used to correct this deformity. We successfully corrected philtral deformity using overlapping of orbicularis oris muscle flap. Methods: From November 2000 to August 2007, we performed 39 cases of correction of philtral deformity in secondary cleft lip nose with overlapping of orbicularis oris muscle flap. Their age ranged from 5 to 53 years old. Existing scar tissue of previous operation was deepithelialized and preserved as scar flap. Lateral orbicularis oris muscle flap was elevated, advanced and overlapped upon medial muscle flap after dissection of orbicularis oris muscle of both sides. Reconstruction of philtral column was made from overlapping area by fixation of end part of lateral muscle flap to the point between philtral dimple and column. The degree of muscle flap advancement was decided by correction state of lateral muscle bulging. Correction of nostril floor depression or whistle deformity was also performed with preserved scar flap, if necessary. Results: Realignments of orbicularis oris muscle were possible in the majority of the patients and final results of philtral reconstruction were satisfactory mostly. Correction of nostril floor depression and whistle deformity was also achieved. Additional correction was performed later to 4 patients in whom insufficient reconstruction was noted. No significant complication was observed. Conclusion: More natural and symmetric philtrum was acquired with overlapping of orbicularis oris muscle flap. To the authors' knowledge, it is an easy and effective method for correction of philtral deformity through anatomical rearrangement of distorted orbicularis oris muscle with relatively simple procedure.

Absorbable Plate as a Perpendicular Strut for Acute Saddle Nose Deformities

  • Kim, Jong-Gyu;Rhee, Seung-Chul;Cho, Pil-Dong;Kim, Deok-Jung;Lee, Soo-Hyang
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.113-117
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    • 2012
  • Background : Nasal pyramid fractures accompanied by saddle nose deformities are not easily corrected by closed reduction. We used an absorbable plate as a perpendicular strut to support the collapsed "keystone area" and obtained good results. Methods : Between September 2008 and June 2011, 18 patients who had nasal pyramid fractures with saddle nose deformities underwent surgery. Pre- and postoperative facial computed tomographic images and photographs were taken to estimate outcomes. The operative technique included the mucoperichondrial dissection of the nasal septum, insertion of an absorbable plate prepared to an appropriate length to support the "keystone area", and fixation of the absorbable plate strut to the cartilaginous septum. Results : Functional and esthetic outcomes were satisfactory in all patients. Eleven patients assessed the postoperative appearance of the external nose as 'markedly improved' and 7 patients as 'improved'. The 5 surgeons scored the results as a mean of 4.5 on a 5-point scale. Conclusions : The use of an absorbable plate as a perpendicular strut requires no additional procedures because the plate is gradually absorbed. The mechanical strength provided by a buttress between the "keystone area" and the maxillary crest lasts for a long time before the strut is absorbed.

THE HISTOLOGIC STUDY OF THE GRAFTED hBMP-I FOR IMMEDIATE IMPLANT FIXATION (발치 후 즉시 임플란트 식립시 이식된 hBMP-I의 조직학적 고찰)

  • Lee, Eun-Young;Kim, Kyoung-Won;Choi, Hee-Won;Um, In-Woong;Chung, Ho-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.4
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    • pp.316-322
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    • 2004
  • A low molecular weight component named bone morphogenetic protein(BMP) chemically isolated from the organic matrix of bone, induce postfetal connective tissue cells surrounding small blood vessels to differentiate into cartilage and bone. The end product of BMP is a spherical ossicle of lamella bone filled with red bone marrow for the functional loading. This is a important point that the graft material is embedded the defect site during the implant surgery. Because present knowledge of the relationship between BMP and bone regeneration arises mainly from studies of induced bone formation in heterotopic sites, it would be helpful to determine whether BMP plays any part in the process of bone healing. The BMPs have been shown to play crucial roles in normal skeletal development as well as bone healing and are able to activate transcription of genes involved in cellular migration, proliferation, and differentiation. The delivery of BMP on matrices has been efficacious in the treatment of defect bone in implant surgery. The purpose of the histologic study was to evaluate the effect of DLB(demineralized lyophilized bone) coated with purified human BMP(hBMP-I) in immediate implant surgery with bony defect to obtain the functional structure of implant asap. The ability of a graft of hBMP-I to accelerate bony defect repair provides a rationale for its use in immediate implant surgery that have large bone defect in edentulous area.

STUDY OF MAXILLARY CORTICAL BONE THICKNESS FOR SKELETAL ANCHORAGE SYSTEM IN KOREAN (Skeletal Anchorage System의 식립을 위한 한국인 악골의 피질골 두께에 대한 연구)

  • Kim, Ji-Hyuck;Joo, Jae-Yong;Park, Young-Wook;Cha, Bong-Kuen;Kim, Soung-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.4
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    • pp.249-255
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    • 2002
  • Recently, Skeletal Anchorage System (SAS) has been focused clinically with the view point that it could provide the absolute intraoral anchorage. First, it began to be used for the patient of orthognathic surgery who had difficulty in taking intermaxillary fixation due to multiple loss of teeth. And then, its uses have been extended to many cases, the control of bone segments after orthognathic surgery, stable anchorage in orthodontic treatment, and anchorage for temporary prosthesis and so on. SAS has been developed as dental implants technique has been developed and also called in several names; mini-screw anchorage, micro-screw anchorage, mini-implant anchorage, micro-implant anchorage (MIA), and orthosystem implant etc. Now many clinicians use SAS, but the anatomical knowledges for the installed depth of intraosseous screws are totally dependent on general experiences. So we try to study for the cortical thickness of maxilla and mandible in Korean adults without any pathologic conditions with the use of Computed Tomography at the representative sites for the screw installation.

Tabbed Tissue Expanders Improve Breast Symmetry Scores in Breast Reconstruction

  • Khavanin, Nima;Gust, Madeleine J.;Grant, David W.;Nguyen, Khang T.;Kim, John Y.S.
    • Archives of Plastic Surgery
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    • v.41 no.1
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    • pp.57-62
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    • 2014
  • Background Achieving symmetry is a key goal in breast reconstruction. Anatomically shaped tabbed expanders are a new tool in the armamentarium of the breast reconstruction surgeon. Suture tabs allow for full control over the expander position and thus inframammary fold position, and, in theory, tabbed expanders mitigate many factors responsible for poor symmetry. The impact of a tabbed expander on breast symmetry, however, has not been formally reported. This study aims to evaluate breast symmetry following expander-implant reconstruction using tabbed and non-tabbed tissue expanders. Methods A chart review was performed of 188 consecutive expander-implant reconstructions that met the inclusion criteria of adequate follow-up data and postoperative photographs. Demographic, oncologic, postoperative complication, and photographic data was obtained for each patient. The photographic data was scored using a 4-point scale assessing breast symmetry by three blinded, independent reviewers. Results Of the 188 patients, 74 underwent reconstruction with tabbed expanders and 114 with non-tabbed expanders. The tabbed cohort had significantly higher symmetry scores than the non-tabbed cohort ($2.82/4{\pm}0.86$ vs. $2.55/4{\pm}0.92$, P=0.034). Conclusions The use of tabbed tissue expanders improves breast symmetry in tissue expander-implant-based breast reconstruction. Fixation of the expander to the chest wall allows for more precise control over its location and counteracts the day-to-day translational forces that may influence the shape and location of the expander pocket, mitigating many factors responsible for breast asymmetry.

From the point of view of ground operations principle, Chosin Link-up operation discussion of the US 1st Marine Division (지상작전의 원칙 측면에서 미 제1해병사단의 장진호 연결작전 고찰)

  • Kim, Kyu-Bin;Choi, Yong-Yoel
    • Journal of National Security and Military Science
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    • s.13
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    • pp.1-41
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    • 2016
  • US 8th Army in the attack on the Western Front was a situation that was frustrated by the 13th Corps Communist army. To this time support this, goals that have been granted to the US 1st Marine Division that initiated the attack in Mupyonri direction, lack the potential to achieve was not decisive. It was a operation specific erroneous judgment that occurred because there was no one accurately grasp the battlefield of the situation the wrong UN Forces Command. Tactical victory can be to maximize the operation outcomes. However, there is no possible failure of the operation is to expand the tactical success. This is because the failure of the operation, because directly linked to the success or failure of the war. Tactical victory can be to maximize the operation outcomes. However, operation specific failure is not it possible to expand the tactical victory. Therefore tactical success of the US 1st Marine Division, can not compensate for operation specific failure of the United Nations Forces Command. However, Chinese Communist Army 9th Corps is obsessed only victory of tactics to annihilate the US 1st Marine Division, by being fixation to the Chosin whole area, it was not possible to run a operational operation. Therefore tactical success df the US 1st Marine Division, Chinese Communist Army 9th Corps is to extinguish the ability to increase the number of the 13th Corps of the Western Front, 8th Army US have contributed to have escaped the crisis. In addition, the US 10th Corps while maintaining the combat force, by an important role to withdraw through the sea, was able to complement the misjudgment of the operation.

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HORIZONTAL AUGMENTATION WITH AUTOGENOUS BLOCK BONE AND IMPLANT PLACEMENT (자가 블록골을 이용한 치조골수평증강술과 임프란트 식립)

  • Ahn, Ji-Yeon;Kim, Young-Kyun;Yun, Pil-Young;Hwang, Jung-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.5
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    • pp.444-450
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    • 2007
  • In general, labiolingual or buccolingual widths of residual alveolar bone are insufficient in edentulous area, because of alveolar resorption. Horizontal augmentation is bone graft procedure with a view to reinforcing horizontally insufficient bone quantity for installation of implants. The standard method is taking appropriate amount of block bone from intraoral or extraoral autogenous bone, and solid fixation with screws or mini-plate on labial or buccal side of residual alveolar bone. The purpose of this study is to discuss clinical usefulness of horizontal augmentation with autogenous block bone by observation and analysis of course of 41 implants installed to 12 patients by horizontal augmentation in Seoul National University Bundang Hospital from July, 2002 to December, 2005. The mean age of patients is 52.7, from 19 to 70, and the number of men and women is each 2 and 10. Block bone was taken from symphysis, body, ramus of mandible or iliac bone. And 6 types of implants were installed simultaneously or not, the diameters of implants are from 3.3 to 5.5mm, the lengths are from 8 to 15mm. The operator added artificial bone grafting material and optionally covered with membrane. The mean periods of observation after operation and final prosthetics were 28.6 and 17.0 months. As a result, 40 among 41 implants survived, the survival rate was 97.6%. Average 0.9mm crestal resorption was observed at final point of time by periapical view of each patients. Major complication related to the procedure was numbness in 7 patients.

A Study on Transition Factor of Audit Opinion (감사의견(監査意見)의 추이요인(推移要因)에 관한 연구(硏究))

  • Chung Youn-Hae
    • Management & Information Systems Review
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    • v.7
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    • pp.141-168
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    • 2001
  • The causes that the transparency of Korean accounting information was rated low, a short supply of faithful and transparent accounting information from the limitation of external audit environment must be pointed out. Purpose of the external audit is a expression of the auditors about that financial statements an enterprise made public were appropriately drew up in accordance with the corporate accounting principles from important point of view. Analysis of the audit opinion and so fourth according to 6,541 individual audit reports and introduced to the bill securities forward committee as a subject of external audit according to the raw of corporation external audit show that considerable change to the contents of audit report. This show as it is that uncertainty of future that is now being faced by our enterprise, because corporation which present audit reports since 1997 because of enterprise dishonor and contents of existence probability as a continued enterprise following to general economic crisis after 1998 occupy important position in special matters of audit report. Also, increase in special matters is due to application of the corporate accounting principles revised on December 11, 1998. In 1999, audit opinion under limitation(limitation, incongruity and rejecting opinion) increased greatly according to existence doubt as a continued enterprise, and this is the consequence of strengthening audit to the continues enterprise because of limited enterprise dishonor according to the stagnancy of business activities after 1997. Now financial supervisory service put in effect electromagnetic public announcement system about a project report of listed corporation (including an audit report) keeping pace with a documentary public announcement system as first phase since 1999 and expand to the unlisted corporation from 2000. As electromagnetic public announcement of public announcement documents including audit documents of external audit subject get a duty, approach of external user to the accounting information will be easier. Fixation of this system will make deep and wide analysis to the audit opinion, and this will draw up a plan to reconsider confidence of accounting information.

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Experimental Study on Dry Waterproofing Technology Using Synthetic Polymer Sheet Comprised of Synthetic Resin Metal Sheets and Tri-Layered Filler (합성수지 메탈시트와 3면겹침용 채움재가 공법화된 합성고분자계 시트를 이용한 건식화 방수기술에 대한 실험적 연구)

  • Koo, Ja-Ung;Kim, Bum-Soo;Lee, Jung-Hun;Song, Je-Young;Oh, Sang-Keun
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2017.11a
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    • pp.139-140
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    • 2017
  • This technology employs a method of forming a single-ply PLUS waterproofing sheet layer comprised of applying a single-ply synthetic polymer layer on a vibrating structure (steel frame, RC) or an inclined surface by using a T joint lap-filling coil and an embedded metal coated sheet. The T - joint reinforcing lap-filling coil was used to block the ingress channel of the rainwater by applying the material in the vulnerable area where the three sides of the waterproof sheet overlapped. Conventional waterproofing techniques have a problem in that the waterproof sheet is pierced because the end portion of the waterproof sheet applied to the vertical portion is fixed by a nail, and the sealant applied to the end portion of the sheet cannot easily secure long-term waterproof durability due to the influence of the external environment. Therefore, the developed technology secured the waterproof durability against the vertical part by using the embedded metal sheet. In addition, automatic hot-air fusing is used to improve the quality of waterproof construction and point fixation method using fixed hardware. This is a technology that is not significantly restricted in the high degradation level regions of domestic waterproof construction environments in Korea such as low-temperature environment, wet floor.

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Load response of the natural tooth and dental implant: A comparative biomechanics study

  • Robinson, Dale;Aguilar, Luis;Gatti, Andrea;Abduo, Jaafar;Lee, Peter Vee Sin;Ackland, David
    • The Journal of Advanced Prosthodontics
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    • v.11 no.3
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    • pp.169-178
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    • 2019
  • PURPOSE. While dental implants have displayed high success rates, poor mechanical fixation is a common complication, and their biomechanical response to occlusal loading remains poorly understood. This study aimed to develop and validate a computational model of a natural first premolar and a dental implant with matching crown morphology, and quantify their mechanical response to loading at the occlusal surface. MATERIALS AND METHODS. A finite-element model of the stomatognathic system comprising the mandible, first premolar and periodontal ligament (PDL) was developed based on a natural human tooth, and a model of a dental implant of identical occlusal geometry was also created. Occlusal loading was simulated using point forces applied at seven landmarks on each crown. Model predictions were validated using strain gauge measurements acquired during loading of matched physical models of the tooth and implant assemblies. RESULTS. For the natural tooth, the maximum vonMises stress (6.4 MPa) and maximal principal strains at the mandible ($1.8m{\varepsilon}$, $-1.7m{\varepsilon}$) were lower than those observed at the prosthetic tooth (12.5 MPa, $3.2m{\varepsilon}$, and $-4.4m{\varepsilon}$, respectively). As occlusal load was applied more bucally relative to the tooth central axis, stress and strain magnitudes increased. CONCLUSION. Occlusal loading of the natural tooth results in lower stress-strain magnitudes in the underlying alveolar bone than those associated with a dental implant of matched occlusal anatomy. The PDL may function to mitigate axial and bending stress intensities resulting from off-centered occlusal loads. The findings may be useful in dental implant design, restoration material selection, and surgical planning.