Purpose: The purpose of this study was to analyze the frequency and patterns of intra-articular lesions detected during ankle fracture surgery using ankle arthroscopy. Materials and Methods: Thirty patients (31 ankles) who underwent open reduction and internal fixation combined with ankle arthroscopy for acute ankle fracture at Inje University Busan Paik Hospital from June 2011 to September 2013 were evaluated. The ankle fractures were classified according to the AO/OTA (AO Foundation and Orthopaedic Trauma Association) classification and the intraarticular injuries were identified by ankle arthroscopy. Osteochondral lesions of the talus were divided into nine subtypes based on their locations, and the ligament injuries were classified according to avulsion fracture and rupture. Results: Using arthroscopy, abnormality in the distal tibiofibular ligament was found in 21 cases and osteochondral lesions and defects of the talus larger than 5 mm were detected in 26 cases. Among ligament injuries, anterior inferior tibio-fibular ligament injury was found in 14 cases, posterior inferior tibio-fibular ligament injury was found in two cases, deep deltoid ligament injury was found in three cases, and deep transverse tibio-fibular ligament injury was found in five cases. The locations of the osteochondral lesions were on the antero-lateral, antero-medial, centro-medial, centro-central, centro-lateral, and postero-lateral talus in 11, one, two, one, two, and nine cases, respectively. Conclusion: With early diagnosis and treatment arthroscopy performed at the time of intra-articular fracture surgery is expected to result in a good outcome.
In this research, experimental and numerical simulations were adopted to investigate the effects of ligament angle on compressive strength and failure mode of rock-like material specimens containing two non-coplanar filled fissures under uniaxial compression. The experimental results show that with the increase of ligament angle, the compressive strength decreases to a nadir at the ligament angle of 60∘, before increasing to the maximum at the ligament angle of 120∘, while the elastic modulus is not obviously related to the ligament angle. The shear coalescence type easily occurred when α < β, although having the same degree difference between the angle of ligament and fissure. Numerical simulations using PFC2D were performed for flawed specimens under uniaxial compression, and the results are in good consistency with the experimental results. By analyzing the crack evolution process and parallel bond force field of rock-like material specimen containing two non-coplanar filled fissures, we can conclude that the coalescence and propagation of crack are mainly derived from parallel bond force, and the crack initiation and propagation also affect the distribution of parallel bond force. Finally, the displacement vectors in ligament region were used to identify the type of coalescence, and the results coincided with that obtained by analyzing parallel bond force field. These experimental and numerical results are expected to improve the understanding of the mechanism of flawed rock engineering structures.
The effect of bench drying or removal of the periodontal ligament with NaOCl upon periodontal healing and root resorption after replantation of molars was studied in rats. A total of 40 Sprague-Dawley female rats were used and fed a powdered purina rat chow diet containing 0.4% beta-aminoproprionitrile. The maxillary first molars were extracted and the periodontal ligaments were removed either by bench drying for 15 minutes or by immersion in 2.5% NaOCl solution. The rats were sacrificed at 5, 10, and 21 days by heart infusion. In order to observe the effect of 0.5% stannous fluoride, 10−4M, 10−2M, and 1M etidronate disodium on the early stage of periodontal healing, the periodontal ligament was removed with 2.5% NaOCl followed by immersion of the molar in the respective solutions for 5 minutes. The rats were sacrificed after 10 days and the following results were obtained. 1. The removal of the periodontal ligament with 2.5% NaOCl seemed to be more effective than bench drying, since the resorption area in the NaOCl treated group showed a gradual increase whereas a decline in resorption area from 5 days to 21 days was observed in the bench dried group. 2. The application of 0.5% stannous fluoride seemed to enhance the periodontal ligament attachment and active migration of fibroblasts could be observed. 3. The application of 10−4M, 10−2M, and 1M etidronate disodium led to a good periodontal ligament attachment. No evident areas of root resorption were found. 4. The use of β-APN made it possible to extract the maxillary first molar with all five roots intact.
Purpose: Evaluation of alveolar bone is important in the diagnosis of dental diseases. The periodontal ligament space is difficult to clearly depict in cone-beam computed tomography images because the reconstruction filter conditions during image processing cause image blurring, resulting in decreased spatial resolution. We examined different reconstruction filters to assess their ability to improve spatial resolution and allow for a clearer visualization of the periodontal ligament space. Materials and Methods: Cone-beam computed tomography projections of 2 skull phantoms were reconstructed using 6 reconstruction conditions and then compared using the Thurstone paired comparison method. Physical evaluations, including the modulation transfer function and the Wiener spectrum, as well as an assessment of space visibility, were undertaken using experimental phantoms. Results: Image reconstruction using a modified Shepp-Logan filter resulted in better sensory, physical, and quantitative evaluations. The reconstruction conditions substantially improved the spatial resolution and visualization of the periodontal ligament space. The difference in sensitivity was obtained by altering the reconstruction filter. Conclusion: Modifying the characteristics of a reconstruction filter can generate significant improvement in assessments of the periodontal ligament space. A high-frequency enhancement filter improves the visualization of thin structures and will be useful when accurate assessment of the periodontal ligament space is necessary.
Kim, Ho Geol;Im, Ju Ha;Hong, Su Min;Gu, Ji-Hyang;Ha, Hyun Ju;Oh, Min-Seok
Journal of Korean Medicine Rehabilitation
/
v.31
no.3
/
pp.73-84
/
2021
Objectives The objective of the study is to review the Korean traditional medicine treatment used in cruciate ligament injury. Methods According to patients, treatment methods, research design, evaluation tools, outcome, we searched for studies which performed Korean traditional medical treatment on patient with cruciate ligament injury. Results In 11 studies, total number of patents were 78. Patients were conducted with 11 kinds of treatment, which is acupuncture, herbal medicine, pharmacopuncture, electro-acupuncture, burning acupuncture, moxibustion, physiotherapy, exercise, Chuna and cupping. The most commonly used measurement was visual analog scale. Conclusions Throughout the study, we could organize Korean traditional medicine treatment for patient with cruciate ligament injury. However it is difficult to figure out among the 11 intervention which interventions were effective in improving symptom. Therefore, further researches like randomized clinical trial and systematic review is needed in order to enhance the evidence of the Korean traditional medicine.
Ahn, Gil Yeong;Lee, Tae Hun;Hwang, Sung Hyun;Lee, Kyung Jin
Journal of the Korean Orthopaedic Association
/
v.56
no.1
/
pp.93-97
/
2021
Calcification in the tendon is a common disease especially in the rotator cuff. The condition can be treated conservatively in the chronic stage, but surgically in the acute stage. On the other hand there are few reports of calcification in the cruciate ligament of the knee joint, especially calcification of the posterior cruciate ligament. A 51-year-old patient with symptomatic calcification in the mid-substance of the posterior cruciate ligament was treated conservatively. The symptoms did not improve after eight months of conservative treatment, so arthroscopic surgery was performed. During arthroscopic removal of the calcification, the ligament was damaged beyond preservation. Eventually a posterior cruciate ligament reconstruction was performed. At two years after surgery, radiography confirmed no recurrence of the calcification, and the patient was free. We report this case study with a review of the relevant literature.
Journal of the korean academy of Pediatric Dentistry
/
v.21
no.2
/
pp.439-455
/
1994
The purpose of this study was to investigate the distribution of nerves in the periodontal ligament of a dog's primary teeth by each developing stage. The distribution of nerves in the periodontal ligament were investigated by means of immunohistochemistry for detection of neurofilament protein (NFP). The results were as follows: The NFP-immunoreactive nerve fibers were found to be densely distributed in the apical third of the periodontal ligament, while they were sparse in the coronal two third, in both primary and permanent teeth. In generally the density of distribution and degree of arborization of nerve fibers in periodontal ligament of primary teeth revealed a poor appearance compared with that of permanent teeth. Periodontal ligament in anterior teeth showed more abundant nerve innervation than posterior teeth, and the periodontal ligament of the bifurcation area in posterior teeth roots were not observed to have nerve fiber. The density of nerve distribution in the periodontal ligament of primary teeth was reduced according to the physiological root resorption and nerve fibers were not observed in the surrounding area on the root of the exfoliation stage in primary teeth. The distribution of nerve fibers in mucogingival tissue, was poor innervated according to the aging of the dogs. A more abundant distribution of nerve fiber was represented in the lingual mucogingival tissue than in the labial side. Most of the nerve endings in the periodontal ligament of primary teeth showed a tree-like appearance. However, the typical Ruffini-like nerve endings were not observed.
Epidermal growth factor(EGF) is one of polypeptide growth factors. EGF has been reported as a biological mediator which regulates activities of wound healing process including the cell proliferation, migration and metabolism. The purposes of this study is to evaluate the effects of EGF on the human periodontal ligament cells and human gingival fibroblast cells that promote regeneration of periodntal tissue. The mitogenic effects of epidermal growth factor on human periodontal ligament cells and human gingival fibroblasts were evaluated by determining the incorporation of 5-Bromo-2'-deoxy-uridine into DNA of the cells in a dose dependent manner. The prepared cells were the primary cultured gingival fibroblast and periodontal ligament cells from humans, the fourth or sixth subpassages were used in the experiments. Cells were seeded in DMEM containing 10% FBS. 1, 10, 50, 100, 200ηg/ml and epidermal growth factor were added to the quiescent cells for 24 hours, 48 hours and 72 hours. They were labeled with 10\{mu}l/200{\mu}l 5-Bromo-2'-deoxy-uridine for the last 6 hours of each culture. The results of the five determinants were presented as mean and S.D.. The results were as follows : The DNA synthetic activity of human gingival fibroblasts were increased dose dependently by epidermal growth factor at 24 hours, 48 hours and 72 hours. The mitogenic effects were similar at the 24 and 48 hours of epidermal growth factor, but the DNA synthetic activity of human gingival fibroblasts generally decreased at 72 hours. The DNA synthetic activity of human periodontal ligament cells were increased dose dependently by epidermal growth factor at 24 hours but the DNA synthetic activity decreased at 200ηg/ml of each hour. Generally the maximum mitogenic effects were observed at the 48 hours application of epidermal growth factor. The DNA synthetic activity of human periodontal ligament cells generally decreased lower at 24, 72 hours than at 48 hours the application of epidermal growth factor. In the comparison of DNA synthetic activity between human gingival fibroblasts and human periodontal ligament cells, human periodontal ligament cells had slightly higher proliferation activity than human gingival fibroblasts for a longer time at the high dosage of the epidermal growth factor. In conclusion, epidermal growth factor have important roles in the stimulation of DNA synthesis in human periodontal ligament cells and human gingival fibroblasts, and thus may be useful for clinical applications in periodontal regenerative procedures.
Kim, Seong-Ho;Park, Kui-Woon;Yoo, Hyung-Keun;Shin, Hyung-Shik
Journal of Periodontal and Implant Science
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v.25
no.3
/
pp.539-556
/
1995
Periodontal therapeutic modalities should be re-establishing and regenerating the periodontal tissue previously lost to the disease. To achieve periodontal regeneration, periodontal ligament cells must selective migrate to the deneded root surface, attached and proliferated it. Local pH concentration is one of the most factors that periodontal regeneration. The aims of this study were to examine on biological effects of pH to the human periodontal ligament cells in vitro, especially on the cell morphology, attachment, activity, vitality and viability. Human periodontal ligament cells were cultured from extracted tooth for non-periodontal reason. Immediately after extraction, any soft tissue adhering to the cervical parts of the roots was carefully removed with a sterile curette. To produce different pH levels in the media, Eagle's MEM was adjusted from pH 6.6 to 8.2 in 0.2 intervals with 1 M NaOH and 1 N HCl. After cultivation, Then, Periodontal ligament cells were cultured at pH ranging from 6.6-8.2. attachment assay was done at 1, 2 day incubation and activity assay was done at 1, 2, 3 day incubation. The experiments were evaluated by scaning electron microscopic techniques (HITACHIX-650 Scaning Electron Microanalyzer, Tokyo, Japan), MTT assay, and the cultured periodontal ligament cells were fixed in neutral formalin for 24 hours and immunohistochemically processed by PCNA for proliferating ability. The surviving cells in the medium showed slightly increased volume and widening intercellular distances at low concentration of pH than control group (pH 7.4), and apparently shrinkage at high concentration of pH than control group (pH 7.4). The results of the statistical analysis from the experiment on attachment, vitality and viability were as follows. Attachment of periodontal ligament cells at 1st and 2nd day, similar attachment rate of low concentration pH compared with control value (pH 7.4). But above pH 8.0, attachment rate were statistically significant decrease from control value(P<0.05). Periodontal ligament cell's activities were maximum at pH 7.6 by MTT assay. Similar with control value at low concentration of pH. But, the activities were statistically significant decrease at high concentraration of pH(P<0.05). Cellular proliferating rate (PCNA index) were statistically significant decrease from control value at low and high concentration of pH(p<0.05). This results suggested that hjgh concentration pH, in other words, alkali pH was cytotoxic effects on human periodontal ligament cells in vitro.
Purpose: To report the results of arthroscope assisted posterior cruciate ligament reconstruction without tourniquet, which has not yet been reported in documents within the country. Materials and Methods: Out of the 75 cases of arthroscope assisted posterior cruciate ligament reconstruction on patients with posterior cruciate ligament damage from January, 1998 to May,2003 in this hospital, study was done on 49 cases of patients with isolated posterior cruciate ligament damage, excluding 16 cases of patients who were applied tourniquet in extraarticular operation due to combined damage such as in lateral collateral ligament and posterolateral collateral ligament, and 10 cases where the postoperative observation period was less than 12 months. There were 13 cases where reconstruction was done using autogenous bone-patella tendon-bone, 19 cases using allogenous bone-patella tendon-bone, and 17 cases using allogenous achilles tendon. For assessment, the 49 cases were compared using Lysholm knee scoring scale. Results: The average duration of operation was 105 minutes. There were no severe complications such as swelling, bleeding, infection etc . Assessment results attained by Lysholm knee scoring scale was 74(fair) for cases where autogenous bone-patella ten-don-bone was used,75(fair) for cases where allogenous achilles tendon was used, and 76(fair) for cases where allogenous bone-patella tendon-bone was used. Conclusion: There are no difficulties to perform the arthroscopic assisted posterior cruciate ligament reconstruction. Reconstruction without tourniquet can be thought to prevent complications that could follow when using it.
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