• 제목/요약/키워드: Block bone

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Distal Fibular Rotational Plasty for Chronic Peroneal Tendon Recurrent Dislocation: A Technical Report (만성 비골건 재발성 탈구에서 원위 비골 회전 성형술: 술기 보고)

  • Suh, Jae Wan;Park, Hyun-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.168-172
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    • 2020
  • Chronic recurrent peroneal dislocation often responds poorly to conservative treatment. Surgical treatment has been reported to be more effective than conservative treatment, and various surgical treatment methods are available: superior peroneal retinaculum repair or reattachment, peroneal groove deepening procedures, rerouting procedures, or bone block procedures. Although various treatment options have been reported, there is no consensus regarding which treatment is better. This paper proposes a distal fibular rotational plasty that can prevent recurrent peroneal dislocations and recover its function well by securing a stable peroneal tendon excursion space.

Biomimetic characteristics of mussel adhesive protein-loaded collagen membrane in guided bone regeneration of rabbit calvarial defects

  • Song, Woong-Kyu;Kang, Joo-Hyun;Cha, Jae-Kook;Lee, Jung-Seok;Paik, Jeong-Won;Jung, Ui-Won;Kim, Byung-Hoon;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.48 no.5
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    • pp.305-316
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    • 2018
  • Purpose: The aim of the present study was to evaluate the biocompatibility and barrier function of mussel adhesive protein (MAP)-loaded collagen membranes in guided bone regeneration (GBR). Methods: Eight male New Zealand white rabbits were used. Four circular defects (diameter: 8 mm) were created in the calvarium of each animal. The defects were randomly assigned to 1) a negative control group, 2) a cyanoacrylate (CA)-loaded collagen membrane group (the CA group), 3) a MAP-loaded collagen membrane group (the MAP group), and 4) a group that received a polycaprolactone block with MAP-loaded collagen membrane (the MAP-PCL group). Specimens were harvested at 2 weeks (n=4) and 8 weeks (n=4) postoperatively for observational histology and histometric analysis. Results: In the histologic analysis, MAP was completely absorbed without any byproducts. In contrast, some of the CA adhesive remained, showing an inflammatory reaction, at 8 weeks. In the MAP-PCL group, the MAP-loaded collagen membranes served as a barrier membrane despite their fast degradation in GBR. No significant difference was found in the amount of new bone between the MAP-PCL and MAP groups ($1.82{\pm}0.86mm^2$ and $2.60{\pm}0.65mm^2$, respectively). Conclusions: The MAP-loaded collagen membrane functioned efficiently in this rabbit calvarial GBR model, with excellent biocompatibility. Further research is needed to assess clinical applications in defect types that are more challenging for GBR than those used in the current model.

LOW GRADE OSTEOSARCOMA ON THE MANDIBLE;A CASE REPORT (하악골에 발생된 Low grade 골육종;증례보고)

  • Kim, Ho-Sung;Jeong, Jong-Cheol;Sung, Dae-Kyung;Lee, Gye-Hyeok;Choi, Jae-Uk;Kim, Sung-Beom;Seo, Ji-Hoon;Cho, Hyun-Yi
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.1
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    • pp.92-97
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    • 2000
  • Osteosarcoma is a primary malignant tumor arising most often in the long bone, but rare in jaw bone. Especially osteogenic sarcoma of the mandible is a rare tumor, comprising less than 0.5% of all head and neck tumors. Osteosarcoma occurs chiefly in young persons, and presenting very survival rates. Histopathologically this tumor can be classified three types, osteoblastic, fibroblastic, chondroblastic and classified from low grade to high grade by anaplasia or mitosis of the tumor cells. Sometimes, the exact diagnosis of osteosarcoma is difficult especially in low grade osteosarcoma, even if clinical or radiographical findings suggest to osteosarcoma. So suspcious to malignant bone tumor in clinical or radiological findings, biopsy should be taked from deep portion and multiple area, and sharing the patient history and radiographs with pathologist will assist in the development of the diagnosis. We report a case of low grade osteosarcoma on the mandible initially difficulty in accurate diagnosis. The patient visited our hospital for routine dental treatment but radiographic findings displayed ill-defined radiolucency with osteoid formation on the mandible. Final diagnosis was difficulty in initial biopsy but subsequent biopsy taked from deep portion presented infiltrative growth and mitosis of the tumor cell in some area with small osteoid bone formation, so we could reach final diagnosis as low grade sarcoma. We treated this patient with bloc resection of the mandible and immediate reconstruction with iliac corticocancellous block.

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Effects of implant alignment and load direction on mandibular bone and implant: finite element analysis (임플란트 배열과 하중 방향이 임플란트와 치조골에 미치는 유한요소 응력분석)

  • Chung, Hyunju;Park, Chan;Yun, Kwi-Dug;Lim, Hyun-Pil;Park, Sang-Won;Yang, Hongso
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.3
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    • pp.176-182
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    • 2020
  • Purpose: To evaluate the effects of load direction, number of implants, and alignment of implant position on stress distribution in implant, prosthesis, and bone tissue. Materials and Methods: Four 3D models were made to simulate posterior mandible bone block: two implants and 3-unit fixed dental prosthesis (FDP) with a pontic in the center (model M1), two implants and 3-unit FDP with a cantilever pontic at one end (model M2), FDP supported by three implants with straight line placement (model M3) and FDP supported by three implants with staggered implant configuration (model M4). The applied force was 120 N axially or 120 N obliquely. Results: Peak von Mises stresses caused by oblique occlusal force were 3.4 to 5.1 times higher in the implant and 3.5 to 8.3 times higher in the alveolar bone than those stresses caused by axial occlusal force. In model M2, the connector area of the distal cantilever in the prosthesis generated the highest von Mises stresses among all models. With the design of a large number of implants, low stresses were generated. When three implants were placed, there were no significant differences in the magnitude of stress between staggered arrangement and straight arrangement. Conclusion: The effect of staggering alignment on implant stress was negligible. However, the number of implants had a significant effect on stress magnitude.

Intraosseous anesthesia in symptomatic irreversible pulpitis: Impact of bone thickness on perception and duration of pain

  • Nilius, Manfred;Mueller, Charlotte;Nilius, Minou Helene;Haim, Dominik;Leonhardt, Henry;Lauer, Guenter
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.6
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    • pp.367-375
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    • 2020
  • Background: Intraosseous anesthesia (IO) allows the anesthetic solution to be injected directly into the cancellous bone. The anesthetic solution immediately reaches the periapical region, and thus the axonal area of the nerve, where it can temporarily disable the sodium pump. The effect is felt almost without any time delay, and only a small amount of anesthetic solution is required. Methods: This study aims to investigate the efficacy of IO using the AnestoⓇ device after infiltration anesthesia (IA) and/or inferior alveolar nerve block anesthesia (IANB) failed to work in symptomatic irreversible pulpitis (hot tooth). The 33 patients included in the study were treated additionally with 1.7 ml articaine hydrochloride with 1:100,000 epinephrine hydrochloride (UltracainⓇ D-S, Sanofi-Aventis, Frankfurt, Germany) IO. Results: The electrical pulp test showed that 95.76% of the volunteers reacted positively to the combination of IANB or IA with the IO. In women, the additive IO was effective at 97.22%. In men, the IO led to pain elimination in 94.00% of cases. The duration of the IO was less than a quarter of an hour (13.03 min). The IO worked longer in women than in men (13.61 min vs. 12.33 min). Overall, more than every third tooth that needed trepanation was located in the posterior area of the mandible (36.4%). Treatment of hot teeth in this area was associated with an increased pulse rate and increased residual pain. There was a moderate correlation (Spearman-Rho [IRI] = 0.280) between the Visual Analog Scale (VAS) score and bone density, and a significant correlation (IRI = 0.612) between subjective residual pain and bone width. The IO resulted in a moderate, transient increase in the pulse rate by approximately 20 bpm. This is similar to the temporary increase in heart rate after conventional anesthesia techniques in non-preloaded patients and can be considered clinically irrelevant. Conclusion: IO with the AnestoⓇ device as an extension and deepening of local pain elimination is recommended for the treatment of hot teeth.

Effects on the tissue reaction using compomer & Ketac Silver in the maxillary furcation in the beagle dogs (Compomer와 Ketac Silver로 성견 상악 이개부 병소 충전시 조직반응에 미치는 영향)

  • Ryu, Jea-Youn;Lim, Sung-Bin;Chung, Chin-Hyung;Lee, Chong-Heon
    • Journal of Periodontal and Implant Science
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    • v.33 no.4
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    • pp.705-715
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    • 2003
  • Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically compomer and Ketac Silver as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. With intrasulcular and crestal incision, mucoperiostcal flap was elevated. Following decortication with 1/2 high speed round bur, furcation defect was made on maxillary premolar. 2 month later one premolar was filled with compomer and the other premolar was filled with Ketac Silver. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with H-E staining. Results were as follows. 1. Compomer & Ketac Silver restoration were encapsulated fine connective tissue. 2. In 4 weeks, compomer & Ketac Silver restoration slightly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, compomer & Ketac Silver restoration were less infiltrated iflammatory cell and encapsulated fine connective tissue. 4. Therefore, compomer & Ketac Silver filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances is possible clinical method and this technique is useful method for maxillary furcation involvement but it is thought that periodic maintenance should be needed

THE ROLE OF BONE MORPHOGENETIC PROTEIN IN THE TOOTH CULTURE (치아 기관배양시 골형성단백의 역할에 관한 연구)

  • Chung, Il-Hyuk;Chung, Jong-Hoon;Choung, Pill-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.5
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    • pp.438-443
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    • 2004
  • Objectives : The proper development of the facial structures relies upon a sequence of tightly regulated signaling interactions between the ectoderm and mesoderm involving the participation of several families of signaling molecules. Among these, bone morphogenetic proteins (BMPs) have been suggested to be a key signal that regulates the development of the mandible and the initiation and morphogenesis of the teeth. The aim of this study was to examine the artificial development of the mandibular structures and to examine the role of BMPs on tooth morphogenesis and differentiation using an organ culture system. Materials and Methods : The tooth germs from Ed 11.5, 13.5 mice were dissected, and transplanted into the diastema of the mandible primordia. The mandibles containing the transplanted tooth germs were cultured in vitro. During this period, beads soaked with BMP4 were implanted around the transplanted tooth germs. In addition, a diastema block containing the transplanted tooth germ was dissected, then transferred to an adult mouse kidney. After the organ culture, the developing mandibular explant was removed from the kidney and prepared for the tissue specimens. Odontogeneis of the transplanted tooth germs was examined after Hematoxylin-eosin, Masson-trichrome staining. Results : Proliferation and differentiation of the tooth germs cultured in the diastema was observed. In the BMP4-treated tooth germs, the formation of the first and second molars was noted. The crown of the developing tooth showed the formation of a mature cusp with the deposition of enamel and dentin matrix. In conclusion, it was confirmed that BMP4 is involved in the formation of a dental crown and the differentiation of ameloblasts and odontoblasts of the molar tooth during the development of the transplanted tooth germs.

An Assessment of Image Analysis of Longitudinal Bone Changes (시간경과에 따른 골변화의 영상 분석에 관한 연구)

  • Kim Young-Jin;Kim Jae-Duk
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.27 no.1
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    • pp.73-86
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    • 1997
  • This study was performed to assess the analyzing methods developed to detect clinically and quantitatively longitudinal bone changes. Through preliminary experiment, accuracy of Cu-Eq value conversion to the mass of HA was examined. For main experiment, 15 intraoral radiograms taken at soon, 1st, 2nd, 4th, and 6th week after implantation of mixture in extracted sites of 3 cases were used. We took the radiograms with copper step wedge as test object and HA phantom X -ray taking was standardized by using Rinn XCP device customized directly to the individual dentition with resin bite block. The images inputted by Quick scanner into computer were digitized and analyzed by NIH image program. The stability of the copper equivalent transformation and the usefulness of two analyzing methods by ROI and Reslice were examined. Obtained results as follows: 1) On the Cu equivalent images, the coefficient of variation in the measurement of Cu-Eq. value of ROI ranged from 0.05 to 0.24 and showed high reproducibility. 2) All results obtained by resliced contiguous image were coincident with those obtained from the assessment by ROI and formation of plot profile. 3) On the stacked and resliced image at the line of interest, we could analyze directly and quantitatively the longitudinal changes at several portions by plot profile and qualitatively by surface plot. 4) Implant area showed marked resorption till 2 weeks after implantation and showed significant increase in Cu-Eq. value at 6th week(p<0.01) and periapical area showed increase in Cu-Eq. value at 6th week compared to after-operation's.

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Alveolar ridge augmentation with the perforated and nonperforated bone grafts

  • de Avila, Erica Dorigatti;Filho, Jose Scarso;de Oliveira Ramalho, Lizete Toledo;Real Gabrielli, Mario Francisco;Pereira Filho, Valfrido Antonio
    • Journal of Periodontal and Implant Science
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    • v.44 no.1
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    • pp.33-38
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    • 2014
  • Purpose: Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts. Methods: Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the alveolar process with the indication of reconstruction procedures to allow rehabilitation with dental implants; and the absence of systemic disease, local infection, or inflammation. The patients were randomly divided into two groups based on whether they received a perforated (inner surface) or nonperforated graft. After a 6-month healing period, a biopsy was performed and osseointegrated implants were installed in the same procedure. Results: Fibrous connective tissue was evident at the interface in patients who received nonperforated grafts. However, full union between the graft and host bed was visible in those who had received a perforated graft. Conclusions: We found that cortical inner side perforations at donor sites increased the surface area and opened the medullary cavity. Our results indicate an increased rate of graft incorporation in patients who received such perforated grafts.

Dose Distribution of Total Body Irradiation for Bone Marrow Transplantation in Leukemia (백혈병에서 골수이식을 위한 전신방사선조사시 선량분포 특성)

  • 김성규;김명세;신세원
    • Progress in Medical Physics
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    • v.7 no.2
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    • pp.47-55
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    • 1996
  • Total Body Irradiation(TBI) is one of the essential treatment modalities in bone marrow transplantation for leukemia and lymphoma. Various techniques and dose regimens were introduced with sevelal advantages and disadvantages. In TBI, lung block could reduce lung dose to 75% of original beam for decreasing lung dose with homogenous total body irradiation. Accurate provision for specified dose and the desired homogeneity are essential before clinical total body irradiation. When performed in total body irradiation, the problem obtain uniform dose distribution in brain, neck, lung, umbilicus, pelvis and leg. Authors compared to dose distribution with method 1 and method 2. The method 1 used compensating filters for homogeneous dose distribution(Minesota University Method). The method 2 used fixing frame made in aeryl developing authors. Results were following. 1. Method 1 was showed dose distribution from 95.6% to 100%, method 2 showed dose distribution from 95.4% to 100%. 2. Method 2 was showed different to 3.4% at skin region and midline in the brain. In the neck, showed different to 1.5%. In the umbilicus. showed different to 2.3%.

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