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MANAGEMENT OF ECTOPICALLY ERUPTING PERMANENT MOLARS BY THE DEGREE OF IMPACTION (매복 정도에 따른 대구치 이소맹출의 치험례)

  • Lee, Ji-Hyun;Kim, Ji-Yeon;Park, Ki-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.136-142
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    • 2010
  • Ectopic eruption is defined as the eruption of the tooth in an abnormal position or orientation. In the molar region, ectopic eruption may cause distal root resorption and premature exfoliation of the neighbor teeth and uncontrolled space loss is followed. Prolonged partial impaction of the permanent molar may also cause undetected caries or abscess formation of the neighbor teeth. While 66% of ectopically erupting permanent molars are corrected spontaneously without treatment, the treatment is necessary for the irreversible ectopic eruption cases. The optimal treatment approach depends on a number of factors including the clinical eruption status of the molar, amount of enamel ledge and the mobility of the neighbor tooth, and the presence of pain or infection. This case report presents the results of treatment of the ectopically erupting maxillary first permanent molars and mandibular second molars using elastic separators or modified Halterman appliance with or without surgical approach.

Decreased of Clusterin mRNA Expression of Epididymis Following Exposure to Bisphenol A Diglycidyl Ether during Gestation and Lactation in Sprague-Dawley Rats (임신 및 수유기간 동안 Bisphenol A Diglycidyl Ether 노출에 의한 랏트 부고환 clusterin mRNA 발현량 감소)

  • Kang, Dae-Woong;Kwon, Su-Kyoung;Yang, Yun-Jung;Chun, Young-Jin;Hong, Yeon-Pyo
    • Environmental Analysis Health and Toxicology
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    • v.23 no.4
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    • pp.291-299
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    • 2008
  • Bisphenol A diglycidyl ether(BADGE)는 비스페놀 A와 에피클로로하이드린의 축합에 의해 만들어지는 물질로 상업용 액상 에폭시 수지의 주성분이다. 본 연구는 clusterin mRNA 발현이 BADGE의 노출된 생식기계 독성에 연관되어 있는지를 연구하기 위해 수행하였다. BADGE는 SPF Sprague-Dawley 임신 랏트에 임신 6일부터 수유기가지 하루에 한 번 0(대조군)과 375mg/kg/day를 경구 투여하였다. 수컷 새끼는 일반 사항과 몸무게, 일반 발달 지표(예, 항문과 생식기 사이의 거리, 이개개전, 절치붕출, 유두잔류, 안검개열, 고환하강, 포피박리 등)등을 관찰하였다. 대조군과 투여군에서 다섯 마리의 수컷 새끼는 출생 후 3, 6와 9주에 부검하여 부고환의 조직학적 변화 등을 관찰하였다. BADGE 375 mg/kg/day 투여군에서 항문과 생식기 사이의 거리는 대조군보다 길어지는 경향을 보였다. 출생 후 6주와 9주에서 부고환의 상대 무게는 대조군보다 약간 증가하였으나 조직학적인 변화는 관찰되지 않았다. BADGE 투여 군에서 clusterin mRNA 발현량은 대조군에 비해 3주에 56%, 6주에 57% 그리고 9주에 86% 감소하였다. 이런 결과는 랏트의 부고환에서 clusterin은 BADGE에 반응하는 유전자 중 하나일 수 있다는 가능성을 나타낸다.

Nasal Reconstruction with Chondrocutaneous Preauricular Free Flap and Interpositional Vascular Graft: A Case Report (연골피부 이개전방 유리피판 및 혈관 간치이식술을 이용한 코재건례)

  • Yun, Min Ji;Eun, Seok Chan;Kim, Min Ho;Baek, Rong Min
    • Archives of Craniofacial Surgery
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    • v.12 no.2
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    • pp.111-115
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    • 2011
  • Purpose: Reconstruction of a full thickness defect of the nose is a difficult task for plastic surgeons because the anatomical characteristic, shape, and function of the nose all need to be taken into consideration. Most often, a local flap or a composite graft is used, but for a large defect, reconstruction using free flaps is the most ideal method. In free flap reconstruction, the chondrocutaneous preauricular area can be a suitable donor site. We performed a chondrocutaneous preauricular free flap with an interpositional vascular graft for reconstruction of a nasal ala. Methods: A 46 year-old male presented to the hospital with a right alar deformity induced by a dog bite. During the surgery, the existing scar tissue was removed and thereby a newly formed full thickness defect was reconstructed using the chondrocutaneous preauricular free flap with an interpositional vascular graft harvested from the descending branch of the lateral femoral circumflex vessel between the facial and superficial temporal vessels of the free flap. Results: The flap survived without flap loss and showed symmetry in its overall shape, contour, texture, and color. The patient was satisfied with the results and the surgery yielded no additional scars at the nasolabial fold area. Conclusion: The chondrocutaneous preauricular free flap is a valuable method in reconstruction of full thickness defects of the nose, and using the descending branch of the lateral femoral circumflex vessel as the interpositional vascular graft at the anastomotic site produces reliable results.

Full mouth rehabilitation with vertical dimension increase in patient with severely worn out dentition: A case report (과도한 치아 마모를 보이는 환자에서 수직고경 증가를 동반한 전악 수복 증례)

  • Kim, Dae-Sung;Jeong, Chang-Mo;Yun, Mi-Jung;Huh, Jung-Bo;Lee, Hyeonjong;Lee, So-Hyoun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.2
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    • pp.210-219
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    • 2021
  • Excessive teeth wear can lead to reduced chewing efficiency, occlusal plane collapse, and facial changes. Full mouth rehabilitation with a change in vertical dimension may cause pain in the temporomandibular joint, masticatory muscle and teeth, so an accurate diagnosis and treatment plan is required. In this case, a 69-year-old man had excessive teeth wear with a loss of posterior support. We evaluated the degree of adaptation to the increased vertical dimension with the removable occlusal splint and provisional restoration. We report this case because the treatment result has been functionally and aesthetically satisfactory by providing stable anterior guidance, proper posterior teeth disclusion, and even contact of all teeth in centric occlusion.

Simultaneous Reconstruction of a Subtotal Maxillectomy and Columella Deficit using Radial Forearm and Preauricular Free Flaps (요측전완과 이개전부 유리피판을 이용한 아전상악절제술과 비주결손의 동시 재건)

  • Yoon, Taekeun;Eun, Seokchan;Cho, Sung-Woo;Rhee, Chae-Seo
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.53-57
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    • 2022
  • Reconstruction of subtotal maxillectomy defects with columella deficit is challenging. We report a unique case of facial reconstruction using a free radial forearm flap and a free preauricular flap for the maxillectomy and columella deficit. A 73-year-old woman was diagnosed with recurrent sebaceous carcinoma of the nose. We performed wide excision, including areas of the right cheek, nose, upper lip, maxilla, and columella. The resultant subtotal maxillectomy defect was reconstructed using a three-dimensional flap. First, a free radial forearm flap was transfered to resurface the nasal, oral, and external facial side. Second, a preauricular flap was positioned into the columella defect and anastomosed with the distal portion of the radial forearm flap pedicle. The two flaps survived, and the patient recovered uneventfully. We believe the radial forearm and preauricular double free flaps with the pedicle connection method were effective in reconstructing the present case of subtotal maxillectomy defect.

Full mouth rehabilitation on the patient with maxillary anterior diastema and posterior bite collapse with orthodontic treatment (상악 전치부 치간 이개와 구치부 교합지지 상실을 가진 환자에서 교정치료를 동반한 완전 구강회복 증례)

  • Lee, Seon-Ki
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.1
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    • pp.60-68
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    • 2022
  • A patient with severe periodontitis has causative factors that cause pathological tooth movement, the occlusion is disintegrated, and the vicious cycle of worsening periodontitis is repeated. In particular, when pathological tooth movement occurs in the maxillary anterior region, the patient has an aesthetic sense of atrophy, and the quality of life was reduced. Therefore, when orthodontic treatment was added to patients with severe periodontitis, it promotes the formation of new bone, reduces periodontal cysts, and obtains clinical attachment, which leads to favorable results in prosthetic restoration, thereby enabling ideal occlusion, function and aesthetics. Periodontal treatment, orthodontic treatment, natural tooth restoration, and implant prosthesis were planned for patients with pathological tooth movement in the anterior region due to loss of occlusal support in the posterior region. As a result, an ideal restoration space was secured, a stable restoration of occlusal contact was formed, and the maxillary anterior teeth were aesthetically improved.

THE BONE CHANGES OF THE MIDPALATAL SUTURE AFTER RAPID PALATAL EXPANSION IN YOUNG ADULT DOGS (유성견에서 상악골 급속확장 후 정중구개봉합부에서의 골조직 변화)

  • Park, Chang-Wook;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.27 no.3 s.62
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    • pp.391-399
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    • 1997
  • Rapid palatal expansion(RPE) is a method of inducing the new bone formation in the palate by separation of the midpalatal suture, which can be done conveniently by placing heavy force across the maxillary dental arch. This experiment was undertaken to examine the histologic changes after RPE and during retention period. Four young adult dogs(a control dog, three experimental dogs) aged 4 to 6 months old were used for this experiment. Expansion screw($Hyrax^{\circledR}$, Dentarum Inc.) was delevered to the palate and fumed 180 degrees every morning and evening for 8 days, giving a total expansion of 7.2mm. A control dog was sacrified at the starting point of this study without any treatment and three experimental dogs were sacrified after RPE, 14-day retention, and 28-day retention in each. Thereafter, those samples were observed with hematoxylin-eosin(H-E) stain, ground section(Villanueva stain), alkaline phosphatase(ALP) stain, tartrate-resistant acid phosphatase(TRA) stain. The results were as followings: 1. After RPE, collagen fiber bundles were stretched along the midpalatal suture and few osteoblasts were flattened-inactive state and also, a little osteoid tissues was observed. Few multinucleated osteoclasts which had TRAP-positive activity in their cytoplasm were seen in horizontal section, whereas a few osteoclasts were seen in frontal section, especially in the nasal floor side of palatal bone. 2. After 14-day retention, collagen fiber bundles were stretched along the midpalatal suture and few osteoblasts which had ALP-positive activity in their cytoplasm were seen. Few multinucleated osteoclasts which had TRAP-positive activity in their cytoplasm were seen in horizontal section, whereas a few osteoclasts were seen in frontal section, especially in the nasal floor side of palatal bone. 3. After 28-day retention, collagen fiber bundles were arranged like those of control dog and osteoblasts which showed a lot of immature bone formation were cuboidal shape and exhibited ALP-positive activity in their cytoplasm. Few multinucleated osteoclasts which had TRAP-positive activity in their cytoplasm were seen in horizontal section, whereas a few osteoclasts were seen in frontal section, especially in the nasal floor side of palatal bone. According to the above results, the new bone formation after rapid palatal expansion was examined after 14-day retention and significantly increased after 28-day retention.

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Tracheal Reconstruction with Perichondrial Graft - An Experimental Study in Rabbits - (연골피막편 이식후 기관 결손부위의 재생에 관한 실험적 연구(제 1 보))

  • 이원상;서장수;이성은;홍원표;박찬일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.10.3-11
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    • 1982
  • Recently through the advancement of medical and surgical managements and the development of low pressure cuffed endotracheal tube, incidence of tracheal stenosis was decreased significantly. Though its incidence was decreased markedly, stenosis was developted unfortunately in the situations such as long term use of respirator, heavy infection, trauma of the trachea and long term intubation etc. Tracheal stenosis had been handled with various methods such as mechanical dilatation, tissue graft techniques, luminal augumentation and end to end anastomosis due to their individual advantages but their effects were not satisfactory. In 1959 Lester had been found the regenerated cartilage from the perichondrium of the rib incidentaly. Since then Skoog, Sohn and Ohlsen were reported chondrogenic potential of perichondrium through the animal experiments. Though many different materials have been tried to rebuild stenosis and gaping defect of trachea, tracheal reconstruction has been a perplexing clinical problems. We choose the perichondrium as the graft material because cartilage is the normal supporting matrix of that structure and it will be an obvious advantage to be able to position perichondrium over a defect and obtain new cartilage there. The young rabbits, which were selected as our experimental animals, were sacrified from two to eight weeks after surgery. The results of our experiment were as follows; 1) In control group, the defect site of trachea was covered with fibrosis and vessels but graft site was covered with hypertrophied perichondrium and vessels. 2) Respiratory mucosa was completely regenerated in defect sites both control and grafted groups. 3) The histologic changes of the grafted sites were as follows: 2 weeks- microvessel dilatation, inflammatory reaction, initiation of fibrosis 4 weeks- decreased microvessel engorgement, submucosal fibrosis, decreased inflammatory reaction immatured cartilage island was noted in the grafted perichondrium (one specimen) 6 weeks- mild degree vascular engorgement submucosal fibrosis. chronic inflamatory reaction cartilage island and endochondrial ossification was noted in the grafted perichondrium (Two specimens) 8 weeks- minute vascular engorgement dense submucosal fibrosis. loss of inflammatory reaction. cartilage island was noted in the grafted perichondrium (two specimens) 4) There was no significant differences in regeneration between active surface in and out groups. 5) We observed immatured cartilage islands and endochondrial ossification in the perichondrial grafted groups where as such findings were not noted in control groups except fibrosis. We concluded that perichondrium was the adequate material for the reconstruction of defected trachea but our results was not sufficient in the aspect of chondrogenic potential of perichondrium. So further research has indicated possibility of chondrogenic potential of perichondrium.

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Effects of Postoperative Radiation Therapy for Prevention of Keloids and Hypertrophic Scars (켈로이드와 비후성 반혼에서 재발을 방지하기 위한 수술후 방사선치료의 효과)

  • Kang, Ki-Mun;Choi, Ihl-Bohng;Kim, In-Ah;Jang, Jee-Young;Shinn, Kyung-Sub
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.269-276
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    • 1997
  • Purpose : To evaluate the effects of surgical excision followed by radiation therapy for Prevention of keloids and hypertrophic scars. Materials and Methods : From October 1987 to April 1995, radiation therapy was applied to 167 sites in 106 patients with surgical excision in an attempt to prevention of recurrence against keloids and hypertrophic scars. The main etiology of the keloids and hypertrophic scars were surgery in $49.2\%,\;trauma\;in\;25.0\%,\;ear-piercing\;in\;5.4\%,\;and\;burn\;in\;5.4\%$, The Patients' ages ranged from 3 to 70 years with a median of 32 years. Radiation therapy used ranged from 6 to 8MeV electron beam. Radiation therapy was delivered within 24 hours of surgical excision. Several dose schedules were used, varing from 400cGy in 1 daily fraction to 1900cGy in 4 daily fractions. The average total dose was 1059cGy, and the average dose per fraction was 433cGy. All patients were followed up from 24 to 114 months with a median follow up of 49 months. Results : The overall recurrence rate was $12.6\%$ (21/167) The overall 1-year and 2-year recurrence rates were $10.2\%\;and\;11.4\%$, respectively Among 21 recurrent sites, seventeen sites $(81\%)$ were confirmed within 12 months after surgical excision. Period to recurrence ranged from 1 month to 47 months with a median recurrence time of 9.6 months, The history of previous therapy was only a significant factor in recurrence. Twenty-four patients had history of previous therapy recurrence rates was significantly higher in this group than those without history of Previous therapy $(22.6\%\;vs.\;11.0\%,\;p=0.04)$. There was no serious complication related to radiation therapy. Conclusion : This study suggests that surgical excision followed by radiation therapy is an effective method of preventing keloids and hypertrophic scars.

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Effect of Tightening Torque on Abutment-Fixture Joint Stability using 3-Dimensional Finite Element Analysis (임플란트 지대주나사의 조임회전력이 연결부 안정성에 미치는 영향에 관한 3차원 유한요소해석 연구)

  • Eom, Tae-Gwan;Suh, Seung-Woo;Jeon, Gyeo-Rok;Shin, Jung-Wook;Jeong, Chang-Mo
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.2
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    • pp.125-135
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    • 2009
  • Statement of problem: Loosening or fracture of the abutment screw is one of the common problems related to the dental implant. Generally, in order to make the screw joint stable, the preload generated by tightening torque needs to be increased within the elastic limit of the screw. However, additional tensile forces can produce the plastic deformation of abutment screw when functional loads are superimposed on preload stresses, and they can elicit loosening or fracture of the abutment screw. Therefore, it is necessary to find the optimum tightening torque that maximizes a fatigue life and simultaneously offer a reasonable degree of protection against loosening. Purpose: The purpose of this study was to present the influence of tightening torque on the implant-abutment screw joint stability with the 3 dimensional finite element analysis. Material and methods: In this study, the finite element model of the implant system with external butt joint connection was designed and verified by comparison with additional theoretical and experimental results. Four different amount of tightening torques(10, 20, 30 and 40 Ncm) and the external loading(250 N, $30^{\circ}$) were applied to the model, and the equivalent stress distributions and the gap distances were calculated according to each tightening torque and the result was analyzed. Results: Within the limitation of this study, the following results were drawn; 1) There was the proportional relation between the tightening torque and the preload. 2) In case of applying only the tightening torque, the maximum stress was found at the screw neck. 3) The maximum stress was also shown at the screw neck under the external loading condition. However in case of applying 10 Ncm tightening torque, it was found at the undersurface of the screw head. 4) The joint opening was observed under the external loading in case of applying 10 Ncm and 20 Ncm of tightening torque. 5) When the tightening torque was applied at 40 Ncm, under the external loading the maximum stress exceeded the allowable stress value of the titanium alloy. Conclusion: Implant abutment screw must have a proper tightening torque that will be able to maintain joint stability of fixture and abutment.