• Journal of Korean Neurosurgical Society
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• v.60 no.3
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• pp.335-347
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• 2017

Intravenous recombinant tissue plasminogen activator had been the only approved treatment for acute ischemic stroke since its approval in 1995. However, the restrictive time window, numerous contraindications, and its low recanalization rate were all limitations of this modality. Under those circumstances, endovascular stroke therapy went through a great evolution during the past two decades of intravenous thrombolysis. The results of the 2013 randomized trials for endovascular stroke therapy were neutral, although they were limited by insufficient imaging screening at enrollment, early-generation devices with less efficacy, and treatment delays. Huge progress was made in 2015, as there were five randomized clinical trials which all demonstrated the safety and efficacy of endovascular stroke treatment. Despite differences in detail patient enrollment criteria, all 5 trials employed key factors for good functional recovery; (1) screening with non-invasive imaging to identify the proximal occlusion and exclude a large infarct core, (2) using highly effective modern thrombectomy devices mainly with stent retriever, and (3) establishment of a fast workflow to achieve effective reperfusion. The results of those trials indicate that modern thrombectomy devices can allow for faster and more effective reperfusion, which can lead to improved clinical outcomes compared to intravenous thrombolysis alone. These advances in mechanical thrombectomy are promising in the global fight against ischemic stroke-related disability and mortality. Two current mainstreams among such mechanical thrombectomy techniques, "stent retriever thrombectomy" and "direct clot aspiration", are the topic of this review. Stent retriever thrombectomy using Solitaire and Trevo retriever will be firstly discussed. And, the commonalities and the differences between two major clot aspiration thrombectomy techniques; a direct aspiration first pass technique (ADAPT) and forced arterial suction thrombectomy (FAST), will be additionally explained. Finally, details regarding the combination of direct clot aspiration and stent retriever thrombectomy, the switching strategy and the Solumbra technique, will be described.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.36 no.4
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• pp.161-167
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• 2014

Purpose: The reconstruction of mandibular defects poses many difficulties due to the unique, complex shape of the mandible and the temporomandibular joints. With development of microvascular anastomosis, free tissue transplantation techniques, such as deep circumflex iliac artery (DCIA) flap and fibular free flap (FFF), were developed. The DCIA offers good quality and quantity of bone tissue for mandibular segmental defect and implant for dental rehabilitation. Virtual surgical planning (VSP) and stereolithography-guided osteotomy are currently successfully applied in three-dimensional mandibular reconstruction, but most use FFF. There are only a few articles on reconstruction with the DCIA that assess the postoperative results. Methods: Three patients admitted during a five month period (April of 2013 to August of 2013) underwent resection of mandible and DCIA musculo-osseous reconstruction using a VSP and stereolithographic modeling and assessment of outcomes included technical accuracy, esthetic contour, and functional outcomes. Results: This technique yielded iliac bone segment with excellent apposition and duplication of the preoperative plan. Flap survival was 100 percent and all patients maintained preoperative occlusion and contour. Conclusion: Based on our experience, we offer considerations and logically consistent protocols by classification of mandibular defects, and demonstrate the benefits in VSP and stereolithographic modeling of mandibular reconstructive surgery with DCIA flap.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.1
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• pp.79-87
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• 2017

The open bite malocclusion is a common clinical entity and has multifactorial causes. Development of effective treatment plan and management is dependent on proper diagnosis. The skeletal open bite patient requires a coordinated orthodontic and orthognathic surgical approach to achieve stable occlusion, acceptable esthetics, and improved function. But in case of open bite with severely decayed dentition, restoration in the entire dentition is necessary. Using the facial analysis and diagnostic wax-up, the most effective treatment was prosthetic rehabilitation. The provisional restorations were fabricated to satisfy esthetic and functional requirements, which result in the uniformly distributed occlusal force, anterior and canine guidance. The inter-arch relationship, labio-dental harmony, and the soft tissue aspect, which is important to estimate the longevity were evaluated. Definitive restorations of monolithic zirconia were made by replicating provisional restorations by using the latest CAD/CAM technology. They were delivered to the patient and clinical follow-up observation was satisfactory.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.58-63
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• 2013

Purpose: The aim of this study was to measure the peri-implant bone length surrounding implants that penetrate the sinus membrane at the posterior maxilla and to evaluate the survival rate of these implants. Methods: Treatment records and orthopantomographs of 39 patients were reviewed and analyzed. The patients had partial edentulism at the posterior maxilla and limited vertical bone height below the maxillary sinus. Implants were inserted into the posterior maxilla, penetrating the sinus membrane. Four months after implant insertion, provisional resin restorations were temporarily cemented to the abutments and used for one month. Then, a final impression was taken at the abutment level, and final cement-retained restorations were delivered with mutually protected occlusion. The complications from the implant surgery were examined, the number of failed implants was counted, and the survival rate was calculated. The periimplant bone lengths were measured using radiographs. The changes in initial and final peri-implant bone lengths were statistically analyzed. Results: Nasal bleeding occurred after implant surgery in three patients. No other complications were found. There were no failures of the investigated implants, resulting in a survival rate of 100%. Significantly more bone gain around the implants (estimated difference=-0.6 mm, P=0.025) occurred when the initial residual bone height was less than 5 mm compared to the >5 mm groups. No significant change in peri-implant bone length was detected when the initial residual bone height was 5 mm or larger. Conclusions: This study suggests that implants penetrating the sinus membrane at the posterior maxilla in patients with limited vertical bone height may be safe and functional.

• The Journal of the Korean dental association
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• v.22 no.7 s.182
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• pp.621-633
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• 1984

The possibility of expanding the linear range of the Kinesiograph was studied using a nonferromagnetic mechanical positioning device. The magnet was moved in linear steps of 5 mm through three planes parallel to the frame work carrying the sensors within working range of a 3 cm wide by 4 cm deep by 5 cm high three dimensional lattice and a matrix of 693 data points was achieved. For each data point, the three Kinesiograph outputs were associated with the values of actual position. Once three coordinates of observed values were known, actual values could be determined. A computer program was specially written in Fortran to deal with this work. Because each dat point was 5 mm apart from each other, there would be 480 cubes with 8 data points Further refinement of the system is possible using a smaller interval between each data point. In conclusion, a theoretical model was presented which, by means of computer support, would allow the absolute measurement of jaw position over the entire range of functional jaw movements.

• The Journal of the Korean dental association
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• v.54 no.10
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• pp.811-819
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• 2016

Panfacial fracture is extremely difficult to manage facial injuries but concomitant injuries and severe complications including facial esthetic and functional problems can make it harder. Thorough evaluation and closed co-work with other specialists is needed when reduction and fixation cannot be achieved quickly. Emergency bony support and soft tissue key suture provide the patients with airway integrity, hard and soft tissue vitality. A systemic treatment plan must be made by 3D CT image. This plan include airway management for surgery, sequence of reduction and fixation, approach method, soft tissue resuspension and reconstruction of lost tissue like inferior orbital wall, zygomaic buttress and soft tissue. From known to unknown structures, accurate reduction and fixation will provide proper occlusion, facial projection, width, hight and function. Consideration about facial retaining ligaments must be given to prevent soft tissue sagging.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.330-335
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• 2012

Shortened dental arch (SDA) as a treatment goal is the concept that stable occlusion and enough masticatory force can be achieved by restoration to the second premolars when the situation is not favorable. SDA could be applied both natural teeth and implant supported fixed prostheses. This case dealt with a patient who has grade 2 intellectual disability and a lot of missing teeth. Because of intellectual disability, patient cooperation during treatment could not be expected. Therefore every treatment should be done under general anesthesia. In addition to that, ridge resorption around molar area was severe and there were maxillary sinus pneumatization and maxillary sinusitis which increased failure probability. SDA concept was adopted to reduce risk factor and minimize general anesthesia. After the treatment, functional and esthetic improvement was achieved and oral hygiene was fortified by periodic recall check and education.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.2
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• pp.153-162
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• 2013

This study compared the marginal bone loss around dental implants that were placed in the canine areas of the mandibles and finded the survival rate of the implants, marginal bone loss around implants and prosthetic complications in 20 patients treated with overdentures retained with Locator attachments. Implants placed in this study showed a 95% survival rate and the average marginal bone loss was 1.21 mm($SD{\pm}0.60mm$) in 94.3 weeks of functional loading. Implant-retained overdentures had various prosthetic complications such as male change, metal cap loosening, Locator attachment loosening, denture teeth change, relining and denture fracture. Implant-retained overdentures using two implants and Locator attachments in the edentulous mandibles is considered as a stable way for long terms because of minimal invasive operation, simple prosthetic process and easy repair.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.3
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• pp.246-254
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• 2016

Nowadays, 3 dimentional (3D) printing, especially Direct Metal Laser Sintering (DMLS) system is used in dentistry. DMLS system has recently been introduced for fabrication metal framework for metal ceramic crowns to overcome the disadvantages of the casting method and computer aided design/computer aided manufacturing (CAD/CAM) milling system. DMLS system uses a high-temperature laser beam to selectively heat a substructure metal powder based on the CAD data with the framework design. A thin layer of the beamed area becomes fused, and the metal framework is completed by laminating these thin layers. Utilizing DMLS system to fabricate fixed prostheses is expected to achieve free-from shaping without mold and limitations from cutting tools, fabricate prostheses with complex geometry, prevent distortion and fabrication defects that inherent to conventional fabrication methods. The purpose of this case report is to demonstrate various fixed prostheses such as long span fixed prostheses, post to achieve satisfactory results in functional and esthetic aspects.

• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.4
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• pp.626-632
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• 2001

Ectodermal dysplasia is a hereditary disease characterized by congenital dysplasia of one or more ectodermal structures. Intraorally, common findings are anodontia or oligodontia, conical teeth, and, consequently, generalized spacing. This case presented the oral rehabilitation of a child with hypohidrotic ectodermal dysplasia. Oral rehabilitation is important from functional, esthetic, and psychologic perspectives. Due to the absence of teeth, the volume of alveolar bone and its growth are decreased, resulting in a loss of vertical dimension and protuberant lips. The treatment involved increasing the patient's vertical dimension of occlusion, fabricating a maxillary partial denture, and using magnets to help retain the mandibular partial denture. A 5-year 7-month old Korean boy was referred to the pediatric department for examination, evaluation and treatment of his disorder. we used magnets on '73 and '83 for enhanced retention of a mandibular overdenture. The magnet used in this case was the Magfit system(GC Co., Japan).