• Title/Summary/Keyword: Apical surgery

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Comparison of limited- and large-volume cone-beam computed tomography using a small voxel size for detecting isthmuses in mandibular molars

  • de Souza Tolentino, Elen;Andres Amoroso-Silva, Pablo;Alcalde, Murilo Priori;Yamashita, Fernanda Chiguti;Iwaki, Lilian Cristina Vessoni;Rubira-Bullen, Izabel Regina Fischer;Duarte, Marco Antonio Hungaro
    • Imaging Science in Dentistry
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    • v.51 no.1
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    • pp.27-34
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    • 2021
  • Purpose: This study was performed to compare the ability of limited- and large-volume cone-beam computed tomography (CBCT) to display isthmuses in the apical root canals of mandibular molars. Materials and Methods: Forty human mandibular first molars with isthmuses in the apical 3 mm of mesial roots were scanned by micro-computed tomography (micro-CT), and their thickness, area, and length were recorded. The samples were examined using 2 CBCT systems, using the smallest voxels and field of view available for each device. The Mann-Whitney, Friedman, and Dunn multiple comparison tests were performed (α=0.05). Results: The 3D Accuitomo 170 and i-Cat devices detected 77.5% and 75.0% of isthmuses, respectively (P>0.05). For length measurements, there were significant differences between micro-CT and both 3D Accuitomo 170 and i-Cat(P<0.05). Conclusion: Both CBCT systems performed similarly and did not detect isthmuses in the apical third in some cases. CBCT still does not equal the performance of micro-CT in isthmus detection, but it is nonetheless a valuable tool in endodontic practice.

Video-assisted Thoracoscopic Stapled Resection for Spontaneous Pneumothorax (비디오 흉강경을 이용한 자연성 기흉의 치료)

  • 박진상
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.297-302
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    • 1995
  • Video-assisted thoracic surgery [VATS is emerging as a viable alternatives to thoracotomy when surgical treatment of spontaneous pneumothorax is required.Apical blebs and bullaes of the lung can be resected,and pleural abrasion can be accomplished with minimal postoperative pain and a shorter postoperative stay in hospital. We compared our results with thoracoscopic management of spontaneous pneumothorax in 20 patients [group I with a group of 32 patients previously subjected to lateral limited thoracotomy [group II . Indications for operation, sex distribution, and average age [groupI, 24.7 years ; group II, 34.4 years were comparable. Operation time [112.42 54.7 min versus 124.8 35.3 min ; P 0.03 and chest tube duration [64.4 52.3 hours versus 97.7 45.4 hours ; P 0.01 were less in group I. Postoperative hospital stay was less in group I[3.84 0.99 days;P 0.01 , as was the use of parenteral narcotics after 48 hours. [5/20=25% versus25/32=78% . Pain was quantitated by verbal rating scale in postoperative 1 to 3 days. Patients undergoing VATS experienced significantly less postoperative pain. Postoperative complication was less in group I[1/20=5% versus 3/32=8.3% . In conclusion, Video-assisted thoracoscopic management of spontaneous pneumothrax allows performance of the standard surgical procedure while avoiding the thoracotomy incision.Video-assisted thoracic surgery [VATS is safe and offers the potential benefits of shorter postoperative hospital stays and less pain with cosmetic benefits.

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The Comparative Study On Scanning Electron Microscopic Findings Of Retrived ePTFE Membrane With Clinical Conditions (제거된 ePTFE 막의 주사전자현미경적 소견과 치주임상상태의 비교연구)

  • Park, Jeong-Min;Choi, Byung-Son;Lee, Seok-Cho;Kim, Hyung-Seop
    • Journal of Periodontal and Implant Science
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    • v.26 no.1
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    • pp.133-142
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    • 1996
  • Ten intrabony defects in 10 patients were treated by flap surgery including root surface debridement and placement of an expanded polytetrafluoroethylene(ePTFE) membrane. The membranes were removed after 4-6 weeks. This study was performed to examine the retrived ePTFE membrane by scanning electron microscopy(SEM) for bacterial contamination and adherent connective tissue elements, and to compare it with clinical conditions. The cervical portion of the membrane, which in most cases had become partially exposed to the oral cavity, had a bacterial deposit. Small bacterial colonies and a scatter of single cells in some instances extended into the apical portion of the membrane. Fibroblast-like cells, erythrocytes and fibrous structures were seen in the apical portion of the membrane. Outer surface of membrane tends to more bacterial contamination than inner surface(p<0.01), and upper portions more than lower portions(P<0.01). Comparison of ultrastructural findings and clinical conditions revealed that extent of bacterial contamination of the membrane correlated with gingival inflammation and extent of membrane exposure, but it was not significant statistically. The results suggested that gingival inflammation and membrane exposure affect periodontal regeneration by the use of ePTFE membrane.

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Persistent pain after successful endodontic treatment in a patient with Wegener's granulomatosis: a case report

  • Ricardo Machado;Jorge Aleixo Pereira;Filipe Colombo Vitali;Michele Bolan;Elena Riet Correa Rivero
    • Restorative Dentistry and Endodontics
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    • v.47 no.3
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    • pp.26.1-26.10
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    • 2022
  • Wegener's granulomatosis (WG) is a condition with immune-mediated pathogenesis that can present oral manifestations. This report describes the case of a patient diagnosed with WG 14 years previously, who was affected by persistent pain of non-odontogenic origin after successful endodontic treatment. A 39-year-old woman with WG was diagnosed with pulp necrosis and apical periodontitis of teeth #31, #32, and #41, after evaluation through a clinical examination and cone-beam computed tomography (CBCT). At the first appointment, these teeth were subjected to conventional endodontic treatment. At 6- and 12-month follow-up visits, the patient complained of persistent pain associated with the endodontically treated teeth (mainly in tooth #31), despite complete remission of the periapical lesions shown by radiographic and CBCT exams proving the effectiveness of the endodontic treatments, thus indicating a probable diagnostic of persistent pain of non-odontogenic nature. After the surgical procedure was performed to curette the lesion and section 3 mm of the apical third of tooth #31, the histopathological analysis suggested that the painful condition was likely associated with the patient's systemic condition. Based on clinical, radiographic, and histopathological findings, this unusual case report suggests that WG may be related to non-odontogenic persistent pain after successful endodontic treatments.

An Evaluation of the Thoracotomy in Spontaneous Pneumothorax (개흉술을 시행하였던 자발성 기흉의 임상적 고찰)

  • An, Byeong-Hui;Jang, Won-Chae
    • Journal of Chest Surgery
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    • v.26 no.5
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    • pp.390-394
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    • 1993
  • This study elvaluated clinically the surgical results of the thirty-eight patients who had exploratory thoracotomy for spontaneous pneumothorax between Jan. 1989 and Nov. 1992. Thirty three, or 86.8%, of the patients were male. The most frequent age of the spontaneous pneumothorax requiring thoracotomy was between fifteen years and twenty years. Sudden onset dyspnea and chest pain, which developed in thirty-five patients[89.5%], were the major chief complaints. Bleb and Bulla located in the both upper lobes were the most frequent causes of spontaneous pneumothorax for exploratory thoracotomy. There was no operative death. Postoperative morbidity included three cases of residual air space in the apical pleural space, tow cases of atrial fibrillation, and one each case of reoperation for bleeding, mediasitinitis, and sternal osteomyelitis. All postoperative complications were treated without any serious problems. This study suggests that early exploratory thoracotmy is desirable for patients with prolonged air-leak, massive air-leak, or multiple blebs and giant bullae on the computed tomography of the chest.

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A Case of Tracheal Diverticulum that is an Incidental Finding at Preoperative Computed Tomography (수술전 컴퓨터 단층 촬영에서 우연히 발견된 기관 게실 1예)

  • Lee, Dong-Hoon;Jo, Si-Young;Lee, Chang-Joon;Lee, Joon-Kyoo
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.1
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    • pp.77-79
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    • 2011
  • Tracheal diverticulum is very rare, that is usually an incidental finding at routine chest computed tomography scan. Differential diagnosis of tracheal diverticulum includes pharyngocele, laryngocele, Zenker diverticulum, apical lung hernia, blebs and bulla, and pneumomediastinum. Treatment options can be devided into medical and surgical. The majority of patients is asymptomatic and requires no specific intervention. We experienced one case of tracheal diverticulum in patient with tongue cancer and report it with reviews of literature.

Coronary Artery Dissection Secondary to Blunt Chest Trauma - A Case Report- (흉부 둔상에 의한 관상 동맥 박리 -1례 보고-)

  • 서강석;조용근;이종태
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.66-68
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    • 1998
  • A 27-year-old male presented with an anterior myocardial infarction following blunt chest trauma sustained in motorcycle accident. On examination, there was no visible wound on the chest wall. Echocardiogram showed dyskinesia over anterior left ventricular wall. Subsequent coronary angiogram demonstrated dissection at the proximal portion of the left anterior descending coronary artery and left ventriculogram showed apical anerysm and thrombus. He was treated by coronary artery bypass graft.

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Coexistence of Bronchial Atresia and Bronchogenic Cyst -A Case of Report- (동반된 기관지 폐쇄와 기관지성 낭종 - 1례 보고 -)

  • 이장훈;이정철;한승세;이동협;정태은
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.73-76
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    • 1998
  • We report very rare case of concurrent bronchial atresia and bronchogenic cyst. Morphologic apical segment of right upper lobe directly stemmed from right main bronchus. Bronchogenic cyst was communicating with atretic segmental bronchus and both were filled with mucus. The etiology is not well known, however it is likely that a single insult arround the 5th∼6th week causes both malformations.

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Traumatic Ventricular Septal Defect Secondary to Nonpenetrating Chest Trauma -A Case Report- (비관통성 외상에 의한 심실중격결손증 -수술치험 1례-)

  • 홍기표
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.161-165
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    • 1994
  • We have experienced a case of ventricular septal defect due to blunt chest trauma. A 22 year old male patient was admitted due to chest pain after Motor cycle accident on July 1st,1993. On 5th hospital day, sudden onset of dyspnea was noted and auscultation represented newly developed systolic murmur. A cardiac catheterization and Left ventriculogram revealed ruptured septum at the apical portion. Because there was open wound on anterior chest wall and congestive heart failure was medically controlled, the patient was discharged for elective operation. He was readmitted on August 14th, 1993.At operation, ventricular septal defect was found in apico-posterior muscular septal area, about 2.0 x 1.5 cm in size. The defect was repaired by double velour patch with interrupted suture and ventriculotomy was closed with Teflon felt. The patient`s postoperative course was uneventful and discharged 10 days postoperatively without complication. The patient have been followed up~ for 2 months. He is on functional class I with small amount of residual shunt at the ventricular septum.

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Surgical Treatment of a Submitral Left Ventricular Aneurysm and the Patient Present with Recurrent Ventricular Tachycardia (재발성 심실성 빈맥이 동반된 승모판하 좌심실류의 외과적 치료)

  • Kim, Young-Sam;Cho, Jung-Soo;Yoon, Yong-Han;Kim, Joung-Taek;Baek, Wan-Ki;Kim, Kwang-Ho
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.180-183
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    • 2010
  • Submitral left ventricular aneurysm (SMLVA) is a rare disease entity that exclusively occurs in the black population. We herewith report on a surgical case of SMLVA in a 68-year-old male who presented with ventricular tachycardia. He underwent surgical repair under standard hypothermic cardiopulmonary bypass. In the state of apical elevation, a vertical ventriculotomy was made directly over the aneurysm, which was located at the posterobasal aspect of the left ventricle. Radiofrequency ablation was performed on the endocardium all around the neck of the aneurysm and then patch endoaneurysmorrhaphy was carried out with particular care not to injure the mitral valve and subvalvular structure. His postoperative recovery was uneventful. There has been no dysfunction of the mitral valve or recurrence of the ventricular tachycardia at 2 years' follow-up.