• 제목/요약/키워드: fracture healing

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미성숙 상악 영구 중절치에서의 치근파절 치험례 (TREATMENT FOR ROOT FRACTURE ON THE IMMATURE MAXILLARY PERMANENT CENTRAL INCISOR)

  • 김기백;김선미;최남기;양규호
    • 대한소아치과학회지
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    • 제34권3호
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    • pp.454-460
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    • 2007
  • 성장 발육중인 어린이나 청소년에서 치아에 가해지는 외상성 손상은 성인에 비하여 흔히 일어난다. 외상이 일어난 후부터 적절한 치료가 시행될 때까지 소요된 시간은 특히 예후를 결정하는데 중요한 요소이며, 외상성 치아 손상을 입은 환자를 검사하고 치료하는데 사용되는 시간이 제한되어 있기 때문에, 만약 적절한 치료가 시간 내에 시행되지 않는다면 환자에게 심각한 결과를 초래할 수 있다. 이전 연구들에 의하면, 외상의 발생율은 8-10세 아이들에게서 가장 흔하고, 가장 많이 이환된 치아는 상악 영구 중절치이며, 남자의 경우가 여자보다 2:1로 빈도가 높았다. 상악 중절치의 치근 완성시기는 평균 10세 정도로 알려져있다. 외상성 손상에 이환된 호발 연령대의 상악 영구 중절치는 대부분 발육중인 미성숙된 치아로, 혈류공급이 왕성하여 손상시 재혈관화에 의한 치유가 비교적 쉽게 일어날 수 있어 치수 생활력에 대한 긍정적인 예후가 기대될 수 있다. 본 증례는 외상성 손상을 받은 미성숙 상악 영구 중절치의 치근파절 치험례로, 통상적인 근관치료를 하지 않고 보존적인 술식을 통하여 치아의 생활력을 유지할 수 있었기에 그 치료 경과 및 결과를 보고하는 바이다.

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소 족지 단중족증의 치료결과 - 합병증을 중심으로 - (The Outcome of the Treatment of Lesser toe Brachymetatarsia - focus on complications -)

  • 이호승;윤준오;박수성;김유진
    • 대한족부족관절학회지
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    • 제7권1호
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    • pp.13-20
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    • 2003
  • Purpose: We analysis the outcome and complications of treatment of lesser toe brachymetatarsia. Materials and Methods: We analysed 28 patients 35 cases of lesser toe brachymetatarsia. Mean post operative follow up period was 2 years 8 months. All of the patients were female and mean age at operation was 21 years old. 2 cases of third metatasal bone and 33 cases of fourth metatarsal bone were operated. 8 metatarsal bones were treated using one staged lengthening with tricortical bone graft and 27 metatarsal bones were treated using callotasis with monofixator. Results: The average amount of lengthening was 13.3mm(12mm-15mm) in one staged lengthening, while 14.4mm(4mm-23mm) in callotasis. Average percentile increase was 28.9%(26%-34%) in one staged lengthening and 32%(18%-46%) in callotasis. The average healing index of callotasis was 76 days/cm (41 days/cm-166 days/cm). Satisfied outcomes in 4 cases of 8 cases (50%) after one staged lengthening and 17 cases of 27 cases (63%) after callotasis. 6 complications in 4 cases were occurred after one staged lengthening; insufficient length gain in 3 cases, fracture on the junction of graft bone and metatarsal bone in 1 case, plantar bowing deformity in 1 case and bony fusion of metatarsophalangeal joint in 1 case. 17 complications in 10 patients were occurred after callotasis ; metatarsophalangeal joint stiffness in 8 cases, metatarsophalangeal joint subluxation in 2 cases, overlengthened metatarsal bone in 2 cases, tapering of callus in 1 case, fracture of callus in 1 case, premature consolidation of callus in 1 case, osteomyelitis of metataral head in 1 case and plantar bowing deformity in 1 case. Conclusion: Although one staged lengthening and gradual lengthening using callotasis are effective treatment for lesser toe brachymetatarsia, complications not rarely occured after lengthening. Insufficient lengthening are most common complication after one staged lengthening while metatarsophalangeal joint stiffness lire most common complication after callotasis.

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치근파절로 변위된 상악 중절치의 디지털을 이용한 즉시 임플란트 식립 및 심미 수복 증례 (Digital immediate implantation and aesthetic immediate loading on maxillary incisor displaced due to root fracture: a case report)

  • 송지은;박송이;박찬;윤귀덕;임현필;박상원
    • 구강회복응용과학지
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    • 제39권4호
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    • pp.267-275
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    • 2023
  • 디지털 자료를 이용한 진단 및 즉시 임플란트 식립, 그리고 보철 수복 방법은 전통적인 방법에 비하여 비교적 간단한 자료 채득을 통해 치료 과정을 간소화하고 정확도를 개선하며 데이터의 다양한 활용이 가능하다는 장점이 있다. 임플란트 즉시 식립 시 더 나은 심미적 결과를 얻기 위해서는 발치와의 치유 중에 임플란트 주변 연조직을 개선해야 한다. 이를 위하여 임시 보철물의 즉시 수복을 통해 출현윤곽의 형태를 적절하게 유도할 수 있으며, 향후 최종 수복시에 좋은 임상결과를 얻을 수 있어 환자 만족도가 높다. 본 증례는 상악 좌우 중절치에 외상 후 수평 치근파절이 발생함에 따라 심미성과 치조골 상태를 고려한 발치 후 임플란트 즉시 식립 및 부하를 계획하였다. 디지털 구강 스캐너를 이용한 인상 채득을 통해 외상 치아에 외력을 가하지 않으면서 보다 심미적인 보철물의 제작을 위한 디지털 진단 왁스업을 시행하였으며, 이를 토대로 이상적인 식립 위치를 결정하고 3D 프린팅 수술용 가이드를 이용한 임플란트 즉시 식립을 시행하였다. 식립 5일 후 임시 보철물을 수복하였으며, 3개월 동안 임시 보철물의 형태를 이용한 연조직 개선 및 형태 유도 과정을 거쳐 최종 지르코니아 보철물 수복하였다.

Treatment of Surgical Site Infection and Delayed Union in Fetlock Arthrodesis of a Mare

  • Lee, Sang-Kyu;Kim, Jinyoung;Seo, Jong-pil;Lee, Inhyung;Kang, Byung-Jae
    • 한국임상수의학회지
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    • 제37권3호
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    • pp.157-162
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    • 2020
  • A 6-year-old Thoroughbred mare presented to the Korea Racing Authority Equine Hospital with dropping of the left front fetlock due to an injury sustained while racing. Radiographic examination revealed a comminuted fracture of both proximal sesamoid bones of the affected fetlock. Arthrodesis of the fetlock joint using a broad dynamic compression plate with a tension band wire was performed as a salvage procedure for the future use as a broodmare. After surgery, however, a delayed union of the bones and surgical site infection was present for a prolonged period. Staphylococcus aureus was persistently identified from the surgical site, and antimicrobial therapies were based on antibiotic sensitivity tests, including regional perfusions. The removal and replacement of surgical implants associated with seropurulent discharge was based on coordinating the development of fetlock ankylosis and infection control over 13 months. Firstly, seven screws associated with surgical drainage were replaced and bone morphogenetic protein-2 (BMP-2) and local antibiotics were placed into the surgical site to accelerate bone fusion at postoperative month 7. Further six screws, along with drainage, were removed at postoperative month 10. The plate and screws were removed from the limb due to the progression of bone fusion at postoperative month 13; BMP-2 and local antibiotics were also used. Delayed healing of arthrodesis due to surgical site infection and implant instability were treated by implant removals and antibiotic therapies, and the horse eventually showed improved weight-bearing ability of the affected limb.

재생술식을 이용한 치근단 병소를 동반한 백악질 열리의 치료 (Treatment of cemental tear associated with periapical lesion using regenerative surgery; A case report)

  • 강효진;정겨운;방은경
    • 대한치과의사협회지
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    • 제54권5호
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    • pp.365-373
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    • 2016
  • Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

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홍화씨 추출물의 국소투여가 백서 두개골 결손부 재생에 미치는 영향 (Effects of Locally Applicated Safflower Seeds Extract on Bone Regeneration of Rat Calvarial Defects)

  • 김덕규;홍성우;유경태;서재진;김흥식;유형근;신형식
    • Journal of Periodontal and Implant Science
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    • 제29권2호
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    • pp.297-313
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    • 1999
  • The ultimate goal of periodontal treatment is the regeneration of periodontal tissues which have been lost due to periodontal disease. Recently, many natural medicines have been studied for their potential of anti-bacterial, anti-inflammatory and regenerative effects in periodontal tissues. Safflower seeds have been traditionally used as a drug for treatment of fracture and blood stasis in oriental medicine. The objective of the present study is to examine the biologic effects of safflower seeds extract on bone formation and regeneration of rat calvarial defects. The calvarial defects were made with 8mm trephine bur and extract of safflower seeds were placed directly at these defects. 24 rats were divided into control and experimental groups, and each group was sacrificed at 1 week, 4 weeks and 8 weeks. To study a histopathology related to bone regeneration, Goldner's Masson Trichrome stain and histomorphologic measuring was done at each weeks. In the early phase of bone healing, less inflammatory infiltration and capillary proliferation was found in experimental group compared to control. Dense bony tissues and matured bone structures in defect areas were found in experimental groups. And area of new bone formation was significantly increased at 8 weeks in experimental group. These results indicate that direct local application of safflower seeds extract reduces the early inflammatory response and promotes the regeneration of new bone in calvarial defects of rats.

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Effects of Collagen Tripeptide Supplement on Photoaging and Epidermal Skin Barrier in UVB-exposed Hairless Mice

  • Pyun, Hee-Bong;Kim, Minji;Park, Jieun;Sakai, Yasuo;Numata, Noriaki;Shin, Jin-Yeong;Shin, Hyun-Jung;Kim, Do-Un;Hwang, Jae-Kwan
    • Preventive Nutrition and Food Science
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    • 제17권4호
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    • pp.245-253
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    • 2012
  • Collagen tripeptide (CTP) is a functional food material with several biological effects such as improving dry skin and wound and bone fracture healing. This study focused on the anti-photoaging effects of CTP on a hairless mouse model. To evaluate the effects of CTP on UVB-induced skin wrinkle formation in vivo, the hairless mice were exposed to UVB radiation with oral administration of CTP for 14 weeks. Compared with the untreated UVB control group, mice treated with CTP showed significantly reduced wrinkle formation, skin thickening, and transepidermal water loss (TEWL). Skin hydration and hydroxyproline were increased in the CTP-treated group. Moreover, oral administration of CTP prevented UVB-induced MMP-3 and -13 activities as well as MMP-2 and -9 expressions. Oral administration of CTP increased skin elasticity and decreased abnormal elastic fiber formation. Erythema was also decreased in the CTP-treated group. Taken together, these results strongly suggest that CTP has potential as an anti-photoaging agent.

Delayed Foreign Body Reaction Caused by Bioabsorbable Plates Used for Maxillofacial Fractures

  • Jeon, Hong Bae;Kang, Dong Hee;Gu, Ja Hea;Oh, Sang Ah
    • Archives of Plastic Surgery
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    • 제43권1호
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    • pp.40-45
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    • 2016
  • Background Bioabsorbable plates and screws are commonly used to reduce maxillofacial bones, particularly in pediatric patients because they degrade completely without complications after bone healing. In this study, we encountered eight cases of a delayed foreign body reaction after surgical fixation with bioabsorbable plates and screws. Methods A total of 234 patients with a maxillofacial fracture underwent surgical treatment from March 2006 to October 2013, in which rigid fixation was achieved with the Inion CPS (Inion, Tampere, Finland) plating system in 173 patients and Rapidsorb (Synthes, West Chester, PA, USA) in 61 patients. Their mean age was 35.2 years (range, 15-84 years). Most patients were stabilized with two- or three-point fixation at the frontozygomatic suture, infraorbital rim, and anterior wall of the maxilla. Results Complications occurred in eight (3.4%) of 234 patients, including palpable, fixed masses in six patients and focal swelling in two patients. The period from surgical fixation to the onset of symptoms was 9-23 months. Six patients with a mass underwent secondary surgery for mass removal. The masses contained fibrous tissue with a yellow, grainy, cloudy fluid and remnants of an incompletely degraded bioabsorbable plate and screws. Their histological findings demonstrated a foreign body reaction. Conclusions Inadequate degradation of bioabsorbable plates caused a delayed inflammatory foreign body reaction requiring secondary surgery. Therefore, it is prudent to consider the possibility of delayed complications when using bioabsorbable plates and surgeons must conduct longer and closer follow-up observations.

Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone

  • Moon, Sung Jun;Yang, Jae-Won;Roh, Si Young;Lee, Dong Chul;Kim, Jin Soo
    • Archives of Plastic Surgery
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    • 제41권6호
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    • pp.768-772
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    • 2014
  • Background To compare clinical and radiographic outcomes between intramedullary nail fixation and percutaneous K-wire fixation for fractures in the distal third portion of the metacarpal bone. Methods A single-institutional retrospective review identified 41 consecutive cases of metacarpal fractures between September 2009 and August 2013. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the distal third of the metacarpal bone. The patients were divided by the method of fixation (intramedullary nailing or K-wire). Outcomes were compared for mean and median total active motion of the digit, radiographic parameters, and period until return to work. Complications and symptoms were determined by a questionnaire. Results During the period under review, 41 patients met the inclusion criteria, and the fractures were managed with either intramedullary nailing (n=19) or percutaneous K-wire fixation (n=22). The mean and median total active range of motion and radiographic healing showed no statistically significant difference between the two groups. No union failures were observed in either group. The mean operation time was shorter by an average of 14 minutes for the percutaneous K-wire fixation group. However, the intramedullary nailing group returned to work earlier by an average of 2.3 weeks. Complications were reported only in the K-wire fixation group. Conclusions Intramedullary nailing fixation is advisable for fractures in the distal third of the metacarpal bone. It provides early recovery of the range of motion, an earlier return to work, and lower complication rates, despite potentially requiring a wire removal procedure at the patient's request.

경골에 시행한 생비골 및 생피부편 이식의 임상적 연구 (Clinical Study of Vascularized Osteocutaneous Fibular Transfer to the Tibia)

  • 이광석;김학윤;강기훈;심재학
    • Archives of Reconstructive Microsurgery
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    • 제2권1호
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    • pp.29-41
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    • 1993
  • 고려대학교 의과대학 정형외과학 교실에서 광범위한 연부조직결손을 동반한 감염된 경골결손 34례에 대하여 생비골 및 생피부편이식을 시행하고 얻은 결과는 다음과 같다. 1. 국소염증이 완전히 조절되지 않은 상태에서도 생비골 및 생피부편 이식이 가능하였다. 2. 생비골 및 생피부편 이식술을 동시에 시행함으로써, 생피부편의 임상상태로 생비골 이식의 성공여부를 간접적으로 알 수 있었다. 3. 추시기간동안 이식된 비골은 비후되었으며, 이식골의 흡수는 없었다. 4. 경골을 부분절제한 경우에는 이식비골의 골절은 발생되지 않았다. 5. 이식된 비골의 비후는 수술부위의 국소염증 상태에 영향을 받는 것으로 사료되었다.

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