• Title/Summary/Keyword: implant failure

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Re-establishment of occlusal plane in a patient with a failed implant prosthesis (실패한 임플란트 보철수복물을 가진 환자의 교합평면 재설정)

  • Kang, Hyeon-Goo;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Cho, Lee-Ra;Park, Chan-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.2
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    • pp.141-153
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    • 2018
  • A non-physiological occlusal plane caused by continuous tooth loss, occlusal wear, and failure of a prosthesis may result in an unattractive appearance and functional problems, such as reduced masticatory efficiency and occlusal interference. Therefore, when undertaking prosthetic treatment for edentulous patients or patients with a collapsed occlusal plane, it is important to establish an occlusal plane that is compatible with masticatory function. The patient in this case report had undergone restoration of a completely edentulous maxilla using an implant-supported fixed prosthesis. On follow-up examination in the following 6 years, mechanical complications were observed in the existing implant prosthesis, including porcelain chipping, occlusal wear, and screw loosening. Moreover, due to occlusal wear and supraeruption of the opposing anterior teeth, as well as loss of some posterior teeth, the occlusal plane had collapsed. Following diagnosis, the patient underwent full mouth rehabilitation, involving additional implant installation in edentulous sites, recreation of the existing prosthesis, and prosthetic restoration of all remaining teeth.

Evaluating the effects of age on the long-term functional outcomes following anatomic total shoulder arthroplasty

  • Troy Li;Akiro H. Duey;Christopher A. White;Amit Pujari;Akshar V. Patel;Bashar Zaidat;Christine S. Williams;Alexis Williams;Carl M. Cirino;Dave Shukla;Bradford O. Parsons;Evan L. Flatow;Paul J. Cagle
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.231-237
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    • 2023
  • Background: In the past decade, the number of anatomic total shoulder arthroplasty (aTSA) procedures has steadily increased. Patients over 65 years of age comprise the vast majority of recipients, and outcomes have been well documented; however, patients are opting for definitive surgical treatment at younger ages.We aim to report on the effects of age on the long-term clinical outcomes following aTSA. Methods: Among the patients who underwent TSA, 119 shoulders were retrospectively analyzed. Preoperative and postoperative clinical outcome data were collected. Linear regression analysis (univariate and multivariate) was conducted to evaluate the associations of clinical outcomes with age. Kaplan-Meier curves and Cox regression analyses were performed to evaluate implant survival. Results: At final follow-up, patients of all ages undergoing aTSA experienced significant and sustained improvements in all primary outcome measures compared with preoperative values. Based on multivariate analysis, age at the time of surgery was a significant predictor of postoperative outcomes. Excellent implant survival was observed over the course of this study, and Cox regression survival analysis indicated age and sex to not be associated with an increased risk of implant failure. Conclusions: When controlling for sex and follow-up duration, older age was associated with significantly better patient-reported outcome measures. Despite this difference, we noted no significant effects on range of motion or implant survival. Level of evidence: IV.

Clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients: a retrospective study

  • Han, Ji-Young;Park, Seo Hee;Kim, Joohyung;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of Periodontal and Implant Science
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    • v.51 no.3
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    • pp.163-178
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    • 2021
  • Purpose: The aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients. Methods: In total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs). Results: Twelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22-23.91; P=0.026) than patients with stage I (grade A or B) periodontitis. Conclusions: Although fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.

The Dome Technique for Managing Massive Anterosuperior Medial Acetabular Bone Loss in Revision Total Hip Arthroplasty: Short-Term Outcomes

  • Tyler J. Humphrey;Colin M. Baker;Paul M. Courtney;Wayne G. Paprosky;Hany S. Bedair;Neil P. Sheth;Christopher M. Melnic
    • Hip & pelvis
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    • v.35 no.2
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    • pp.122-132
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    • 2023
  • Purpose: The dome technique is a technique used in performance of revision total hip arthroplasty (THA) involving intraoperative joining of two porous metal acetabular augments to fill a massive anterosuperior medial acetabular bone defect. While excellent outcomes were achieved using this surgical technique in a series of three cases, short-term results have not been reported. We hypothesized that excellent short-term clinical and patient reported outcomes could be achieved with use of the dome technique. Materials and Methods: A multicenter case series was conducted for evaluation of patients who underwent revision THA using the dome technique for management of Paprosky 3B anterosuperior medial acetabular bone loss from 2013-2019 with a minimum clinical follow-up period of two years. Twelve cases in 12 patients were identified. Baseline demographics, intraoperative variables, surgical outcomes, and patient reported outcomes were acquired. Results: The implant survivorship was 91% with component failure requiring re-revision in only one patient at a mean follow-up period of 36.2 months (range, 24-72 months). Three patients (25.0%) experienced complications, including re-revision for component failure, inter-prosthetic dual-mobility dissociation, and periprosthetic joint infection. Of seven patients who completed the HOOS, JR (hip disability and osteoarthritis outcome score, joint replacement) survey, five patients showed improvement. Conclusion: Excellent outcomes can be achieved using the dome technique for management of massive anterosuperior medial acetabular defects in revision THA with survivorship of 91% at a mean follow-up period of three years. Conduct of future studies will be required in order to evaluate mid- to long-term outcomes for this technique.

Total Ankle Replacement (족관절 인공 관절 치환술)

  • Choi, Gi-Won;Choi, Woo-Jin;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.132-138
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    • 2011
  • Although first generation total ankle replacement (TAR) had high failure rates, recent investigations have reported good results of the newer generations of TAR due to advances in implant designs and techniques. Patient selection is critical to performing TAR to obtain promising outcomes and to decrease complication rate. As the current concepts of correcting the accompanying deformity have been established, TAR in moderate to severe varus deformity of the ankle result in favorable outcomes and indications for TAR are expanding. Correction of deformity and hindfoot fusion should be performed in conjunction with TAR if needed. If radiolucency around components or osteolysis is progressive during follow-up, CT should be carried out as a confirmative diagnostic method. TAR is an effective treatment modality alternative to ankle fusion. However, we should recognize that TAR is a demanding procedure, which requires accurate techniques, enough experience, and preoperative plan for a concomitant deformity.

Minimal incision Wolter Plate Fixation on the Displaced Lateral End Fracture of the Clavicle and the Acromioclayicular Dislocation (견봉쇄골탈구와 원위쇄골골절에서 소절개를 이용한 Wolter금속판 내고정술)

  • Ko, Sang-Hun
    • Clinics in Shoulder and Elbow
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    • v.5 no.1
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    • pp.23-28
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    • 2002
  • Purpose Displaced lateral end fracture of clavicle and acromioclavicular dislocation type Ⅲ∼Ⅵ may be required surgical treatment. Material and Methods : From May 1998 to March 2001, we operated with Welter plate with minimal incision by one surgeon. Immediately, pendulum and passive exercise was initiated after surgery. The shoulder function was evaluated using UCLA score. Average follow up was on 28(12∼45) months. Results : All 11 patients were regained satisfactory function. Average UCLA score was 31.9(29~35) at last follow up. Conclusion . The merit of Welter plate fixation with minimal incision is simple technique, reduced surgical time, smaller scar than large plate, strong fixation, early exercise, reduced implant failure. The disadvantage is expensive, skin irritatatation by long hook. But Welter plate fixation with minimal incision is a good method of internal fixation and excellent clinical result in surgical treatment of type H displaced lateral end fracture of the clavicle and type Ⅲ∼Ⅵ acromioclavicular dislocation.

Factors affecting fracture of full contour monolithic zirconia dental prosthesis in laboratory process (구치부 심미수복, 풀지르코니아 크라운의 파절원인과 그 해결방안)

  • Lee, Soo Young
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.23 no.2
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    • pp.77-79
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    • 2014
  • There are several factors affected fractures of full contour zirconia (FCZ) dental prosthesis in laboratory process. First, residual moisture can cause zirconia cracks. Complete dry is requisite before zirconia sintering to prevent zirconia cracks. Second, slow cooling rate is essential to prevent cracks during zirconia sintering process. Cracks in bridge pontic area, thick dental implant prosthesis can be prevented by slow cooling rate such as 3 degree Celsius per minute during zirconia sintering. Third, slow heating rate and slow cooling rate during staining and glazing procedure is necessary to inhibit thermal shock of sintered dental zirconia. Lower preheat temperature of porcelain furnace is recommended. Finally, using diamond disc to open embrasure can lead cracks.

Experimental Study of the "Korean Artificial Heart" in Calf (송아지를 이용한 한국형 인공심장의 동물실험에 관한 보고)

  • 서경필
    • Journal of Chest Surgery
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    • v.22 no.2
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    • pp.202-211
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    • 1989
  • We experienced a series of animal experimental studies of the total artificial heart in 1988. So called, "Korean Heart* was used in this study, which is developed and fabricated in the Department of Biomedical Engineering, College of Med., S.N.U.. "Korean Heart" is a Rolling-Cylinder Motor-Driven type which is a newly developed electromechanical heart over the shortcomes of the previous artificial hearts, especially pneumatic type. The advantages of the "Korean Heart" are total implantability, quiet and smooth movement, small size fittable in oriental people, etc. The animal experiments were performed two times, as an assist device in sheep and total artificial heart implant experiment in calf weighing 100 kg. After total implantation, the artificial heart was well functioned in movement and hemodynamic control. So that, the calf was recovered excellently, which was able to stand up by herself and take an oral intake. Total survival time was 100 hours and the cause of death was a sudden pumping failure [electrical connection problem]. Several postoperative laboratory results almost within normal limits and no hemolysis, but in autopsy, the multiple thromboembolic findings were seen at the lung and kidney.n at the lung and kidney.

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Failure of Intravenous Sedation due to Significant Hypertension -A Case Report- (혈압 상승으로 인한 의식하 진정 요법의 실패 -증례보고-)

  • Koh, Se-Wook
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.7 no.2
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    • pp.126-130
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    • 2007
  • Sedation is often indicated for the relief of anxiety for outpatient oral surgery. In combination with local anesthesia, it is safe and effective method of treatment. However, it is not always effective in allowing the physician to complete the planned oral surgery procedure. On occasion, a procedure is left unfinished due to patient combativeness and discomfort and hypertension in spite of increase in sedative doses. Episodic increases in blood pressure were most commonly caused by light anesthesia or sedation and by the patient's experience of pain during treatment. Female patient was 42 years old. blood pressure is 150/90 mmHg. Extraction and implant surgery was done under IV sedation. During seadtion, her blood pressure was increased (200/100 mmHg). Surgery was stopped. She was done monitoring blood pressure. The blood pressure was decreased to 130/90 mmHg. Sedation was failed due to significant hypertension. Blood pressure is seldom increased during sedation but we should evaluate the patient's medical history and know guideline for hypertension crisis.

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Total Ankle Replacement Arthroplasty (족관절의 인공관절 치환술)

  • Sung, Il Hoon;Kim, Hyun Uk
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.1
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    • pp.1-6
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    • 2015
  • Total ankle replacement has been performed for treatment of end stage arthritis of the ankle, hopefully being an alternative to ankle arthrodesis. However, due to its high failure rates, earlier versions of ankle replacements were not regarded as successful procedures. The latest design has shown increasingly positive results. Total joint replacement of the ankle itself is still regarded as a demanding procedure and much more challenging than that of the hip and knee in many aspects. Several studies, however, have pointed out that it is becoming the viable, accepted alternative for arthrodesis with advanced implants, appropriate patient selection, and proper training experience of procedures. Compared with arthrodesis, it shows equal or better outcomes in pain relief, range of motion, and patient's satisfaction. We are attempting to review its biomechanical characteristics, implant design, indications, complications, clinical outcomes, and survival rate.