• 제목/요약/키워드: guided surgery

검색결과 564건 처리시간 0.021초

Computer guided implant surgery와 CAD/CAM을 활용한 전악 수복 증례 (Full mouth rehabilitation utilizing computer guided implant surgery and CAD/CAM)

  • 김성진;한중석;김성훈;윤형인;여인성
    • 대한치과보철학회지
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    • 제57권1호
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    • pp.57-65
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    • 2019
  • Computer guided implant surgery와 computer-aided design/computer-aided manufacturing, computer guided implant surgery (CAD/CAM) 기술의 발전은 수복 기반 임플란트 치료의 완성도를 한층 더 높였으며, 3D printing을 통한 국소의치의 제작도 빈도가 늘고 있다. 본 증례는 디지털 치의학의 작업 흐름을 따라서 콘빔컴퓨터단층촬영을 통한 치료 계획 수립 및 수술용 스텐트의 제작과 그를 바탕으로 한 임플란트 식립을 하였으며, 맞춤 지대주와 보철물을 제작하였다. 그 후 전자 서베잉과 3D printing을 통한 국소의치 금속 구조물 및 최종적으로 지르코니아 온레이의 제작을 통해 전악 수복을 완성하여 기능과 심미적으로 만족스러운 결과를 얻을 수 있었다.

비골골절의 비관혈적 정복술 중 사용한 초음파의 유용성 (Usefulness of Ultrasound-Guided Closed Reduction of Nasal Bone Fracture)

  • 이성표;석정훈;최원석;김태범;양완석
    • 대한두개안면성형외과학회지
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    • 제9권1호
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    • pp.12-16
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    • 2008
  • Purpose: Closed reduction is most common treatment method for nasal bone fracture but it requires secondary correction operation commonly. For preventing secondary revision, we applied ultrasonography during closed reduction of nasal bone fracture and examined the result of operation. Methods: 80 patients were sorted into 2 groups, ultrasound-guided closed reduction group(n=40) and manual closed reduction group(n=40). We classified the unilateral fracture involving lower 1/2 of nasal bone into type I, the bilateral fracture involving lower 1/2 of nasal bone into type III and the fracture of upper 1/2 of nasal bone into type III. The occurrence rate of overcorrection and undercorrection were evaluated by comparing preoperative and postoperative MDCT(Multi Direction Computed Tomography). Results: In manual closed reduction group, overcorrection were found in 4 patients and undercorrection were found in 3 patients. In ultrasound-guided closed reduction group, overcorrection was not observed and undercorrection was observed in 2 patients. Conclusion: Intraoperative ultrasound evaluation of nasal bone fracture resulted in reduced occurrence rate of secondary nasal deformities, showed easier detection of the fractured site and have superiority upon simple physical examination or simple x-ray.

키토산 차단막의 유도골재생 효과 (THE EFFECT ON GUIDED BONE REGENERATION OF THE CHITOSAN MEMBRANE)

  • 문진석;박영주;박준우;이용찬;조병욱;안병근
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권4호
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    • pp.256-263
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    • 2002
  • Using the rat's skull, the study on the biodegradability and guided bone regeneration of the chitosan membrane was performed. The results are as follows: 1. The biodegradability of the chitosan membrane could not be confirmed, but after 12 weeks, this membrane did not yet break into small pieces and there was no specific local tissue reaction. 2. It was not certain whether the pore size of this membrane was affected on osteoblastic activity. 3. After 6 weeks, the bony defect area of rat's skull was not completely filled, but on high magnification it showed that the osteoclasts and the osteoblasts were observed in the regenerating area. In conclusion, the chitosan membrane developed in this study was fit for guided bone regeneration.

Computer guided implant surgery와 immediate loading을 활용한 무치악 환자의 전악 임플란트 고정성 보철물 수복 증례 (Implant-supported fixed prosthesis restoration of fully edentulous patient using computer-guided implant surgery and immediate loading: A case report)

  • 성현미;설경희;강선우;김정한
    • 대한치과보철학회지
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    • 제62권2호
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    • pp.131-139
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    • 2024
  • 무치악 환자에서 임플란트를 이용한 보철치료는 임플란트 고정성 보철, 임플란트 융합 국소 의치, 하이브리드 보철물, 임플란트 유지 및 지지 피개의치 등의 다양한 방법이 있다. 본 증례에서는 중등도 이상의 만성 치주염에 이환 되어 전악 발치가 필요한 환자에서 computer guided surgery를 이용하여 계획된 위치에 임플란트를 식립하였다. 상악은 불량한 골질로 초기고정력이 충분하지 않아 지연 부하를 시행하였고 골 유착 기간 동안 임시 의치를 사용하였다. 하악은 안정적인 초기 고정을 얻어 즉시 부하를 이용하여 환자의 불편감을 감소시켰다. 임플란트 일차 안정은 즉시 부하를 얻기 위해 가장 중요한 요소로 여겨지기 때문에 수술 전 반드시 임상적, 방사선학적 평가를 통해 잔존 치조골 양 및 골질을 파악해야 한다.

Clinical and radiological outcomes of ultrasound-guided barbotage using a spinal needle and subacromial steroid injection for calcific tendinitis of the shoulder

  • Lee, Jun Pyo;Kim, Doo Sup;Han, Jin Young;Baik, Seung Hoon;Kwak, Ji Woong;Kim, Sung Hwa
    • Clinics in Shoulder and Elbow
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    • 제25권2호
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    • pp.140-144
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    • 2022
  • Background: Ultrasound (US)-guided techniques reported for the treatment of calcific tendinitis have mostly demonstrated good results. This study investigates the effect of US-guided barbotage using a spinal needle in patients with calcific tendinitis of the shoulder. Methods: Thirty-six patients with calcific tendinitis of the shoulder treated by US-guided barbotage with a spinal needle and subacromial steroid injection were included in the study. We evaluated clinical outcomes based on American Shoulder and Elbow Surgeons (ASES) score, Constant score, and visual analog scale (VAS) for pain score. Radiological outcomes were assessed by X-ray imaging at each visit. Results: Our results showed that US-guided barbotage and subacromial steroid injection produced good clinical and radiological outcomes in patients with calcific tendinitis of the shoulder. Of the 36 patients, only one required surgical treatment, while the others showed improvement without any complications. Compared to values before the procedure, calcific deposit size and VAS, ASES, and Constant scores showed significant improvement 6 weeks after the procedure. No significant correlation was found between the initial calcific deposit size and clinical outcomes at each time point. Conclusions: In patients with calcific tendinitis of the shoulder, US-guided barbotage using a spinal needle and subacromial steroid injection can yield satisfactory clinical and radiological results.

골 재생을 위한 생물학적 유도막 (BIOLOGIGIC MEMBRANE FOR GUIDED BONE REGENERATION)

  • 홍종락;강나라;정필훈
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권1호
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    • pp.17-24
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    • 2004
  • The purpose of this study was to evaluate the stability and efficacy of biologic membrane made of freeze-dried cartilage as a barrier to facilitate guided bone regeneration in experimental non-healing bone defects in the rat mandible. Nine adult Sprague-Dawley rats (400-500g) were used in experiment. 5.0mm in diameter were created on the mandibular angle area by means of slow-speed trephine drill. In microscopic examination, dynamic immature bone forming at 2 weeks and its calcification at 4 weeks were observed. The membrane made of lyophilized cartilage taken from human costal cartilage seems to be very effective for guided bone regeneration as a biologic membrane and the scaffold for attachment of cells or local drug delivery system of growth factor, which may meet the ideal requirement of a barrier membrane and graft materials.

외상환자에서의 초음파 유도 하지 국소 신경차단술의 유용성 (The Efficacy of Ultrasound-Guided Lower Extremity Nerve Block in Trauma Patients)

  • 권성민;오진록;신지수
    • Journal of Trauma and Injury
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    • 제28권3호
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    • pp.87-90
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    • 2015
  • Purpose: We evaluated the efficacy of ultrasound-guided lower extremity nerve block in trauma patients. Methods: From July 2013 to April 2014, 17 patients with multiple trauma had lower extremity nerve block for immediate management of open wound in the lower extremity. We evaluated the patient satisfaction of the anesthesia and any complications related to the block. Results: During the lower extremity nerve block, incomplete nerve block occurred in one patient. This is the second case, the reason for this was the lack of technique. There was no anesthetic complications. Conclusion: Ultrasound-guided lower extremity nerve block in trauma patients is an effective anesthesia technique in the immediate management of open wound in lower extremities.

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Clinical problems of computer-guided implant surgery

  • Moon, Seong-Yong;Lee, Kyoung-Rok;Kim, Su-Gwan;Son, Mee-Kyoung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제38권
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    • pp.15.1-15.6
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    • 2016
  • Background: The utilization of a cone-beam computed tomography (CT)-assisted surgical template allows for predictable results because implant placement plans can be performed in the actual surgery. In order to assess the accuracy of the CT-guided surgery, angular errors and shoulder/apex distance errors were evaluated by data fusion from before and after the placement. Methods: Computer-guided implant surgery was performed in five patients with 19 implants. In order to analyze differences of the implant fixture body between preoperative planned implant and postoperative placed implant, angular error and distance errors were evaluated. Results: The mean angular errors between the preoperative planned and postoperative placed implant was $3.84^{\circ}{\pm}1.49^{\circ}$; the mean distance errors between the planned and placed implants were $0.45{\pm}0.48mm$ horizontally and $0.63{\pm}0.51mm$ vertically at the implant neck and $0.70{\pm}0.63mm$ horizontally and $0.64{\pm}0.57mm$ vertically at the implant apex for all 19 implants. Conclusions: It is important to be able to utilize these methods in actual clinical settings by improving the various problems, including the considerations of patient mouth opening limitations, surgical guide preparation, and fixation.

광범위 당뇨병성 족부 및 하퇴부 궤양의 피부이식술에 사용된 초음파 유도 신경 차단: 술기 보고 (Ultrasound-guided Nerve Block for Skin Grafting on Large Diabetic Ulcer of Foot and Leg: A Technical Report)

  • 송재황;강찬;황득수;황정모
    • 대한족부족관절학회지
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    • 제18권3호
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    • pp.133-136
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    • 2014
  • Skin grafting is often required for diabetic ulcerative foot lesions. In skin grafting, effective regional or local anesthesia into the donor and recipient areas plays a significant role in continuous control of pain. We report on a technique of ultrasound-guided nerve block on the femoral, sciatic, and lateral femoral cutaneous nerves in large split-thickness skin grafting for ulcer of the foot and leg.

요추 및 천추부에 대한 초음파 유도하 중재 시술 (Ultrasound-Guided Injections in the Lumbar and Sacral Spine)

  • 고광표;송재황;김환정;김상범;민영기
    • 대한척추외과학회지
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    • 제25권4호
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    • pp.185-195
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    • 2018
  • 연구 계획: 문헌 조사 목적: 초음파를 이용한 중재 시술은 임상적으로 흔하게 경험할 수 있는 하요추부 통증이 보존적 치료에 실패한 경우 수술적 치료 이전에 흔하게 시행하게 되는 치료이다. 이 연구의 목적은 요추 및 천추부에 대한 초음파 유도하 중재 시술에 대해 고찰해 보고자 함에 있다. 선행 연구문헌의 요약: 초음파를 이용한 중재 요법은 근육, 인대, 건, 혈관, 신경 등의 연부조직을 직접 관찰할 수 있으며, 환자나 시술자에게 방사선 노출이 없고, 컴퓨터 단층 촬영이나 C형 투시검사 장비처럼 넓은 장소를 필요로 하지 않는 장점들을 가지고 있기 때문에 점차 그 사용이 늘고 있다. 대상 및 방법: 요추부의 정상, 비정상 초음파 소견과 요추 및 천추부에서 시행할 수 있는 초음파 유도하 중재 요법에 대하여 문헌 고찰과 함께 기술을 하였다. 결과: 요천추부의 정확한 초음파 중재 시술을 위해서는 검사 시 환자의 자세 및 해부학과 정상, 비정상 초음파 소견 등에 대한 숙지가 필요하다. 초음파를 이용하면 후방 관절 내 주사 및 내측 분지 차단술, 경막외 차단술, 선택적 신경근 차단술, 천장관절 주사를 효과적으로 시행할 수 있다. 결론: 요추 및 천추부에서 초음파 유도하 중재 요법은 요천추부 통증의 치료에서 효과적으로 사용할 수 있는 술기이다.