• Title/Summary/Keyword: Bone level

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Short Segment Screw Fixation without Fusion for Unstable Thoracolumbar and Lumbar Burst Fracture : A Prospective Study on Selective Consecutive Patients

  • Kim, Hee-Yul;Kim, Hyeun-Sung;Kim, Seok-Won;Ju, Chang-Il;Lee, Sung-Myung;Park, Hyun-Jong
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.203-207
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    • 2012
  • Objective: The purpose of this prospective study was to evaluate the efficacy and safety of screw fixation without bone fusion for unstable thoracolumbar and lumbar burst fracture. Methods: Nine patients younger than 40 years underwent screw fixation without bone fusion, following postural reduction using a soft roll at the involved vertebra, in cases of burst fracture. Their motor power was intact in spite of severe canal compromise. The surgical procedure included postural reduction for 3 days and screw fixations at one level above, one level below and at the fractured level itself. The patients underwent removal of implants 12 months after the initial operation, due to possibility of implant failure. Imaging and clinical findings, including canal encroachment, vertebral height, clinical outcome, and complications were analyzed. Results: Prior to surgery, the mean pain score (visual analogue scale) was 8.2, which decreased to 2.2 at 12 months after screw fixation. None of the patients complained of worsening of pain during 6 months after implant removal. All patients were graded as having excellent or good outcomes at 6 months after implant removal. The proportion of canal compromise at the fractured level improved from 55% to 35% at 12 months after surgery. The mean preoperative vertebral height loss was 45.3%, which improved to 20.6% at 6 months after implant removal. There were no neurological deficits related to neural injury. The improved vertebral height and canal compromise were maintained at 6 months after implant removal. Conclusion: Short segment pedicle screw fixation, including fractured level itself, without bone fusion following postural reduction can be an effective and safe operative technique in the management of selected young patients suffering from unstable burst fracture.

Stress Analysis on the Splinted Conditions of the Two Implant Crowns with the Different Vertical Bone Level (치조골 높이가 다른 2개 임플란트 금관의 고정연결 조건에 따른 응력분석)

  • Jeon, Chang-Sik;Jeong, Sin-Young;Kang, Dong-Wan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.21 no.2
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    • pp.169-182
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    • 2005
  • The purpose of this study was to compare the stress distribution around the surrounding bone according to the splinted and non-splinted conditions on the finite element models of the two implant crowns with the different vertical bone level. The finite element model was designed with the parallel placement of the two fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st and 2nd molars. As the bone quality, the inner cancellous bone and the outer 2 mm cortical bone were designed, and the cortical and cancellous bone were assumed to be perfectly bonded to the implant fixture. The splinted model(Model 1) had 2 mm contact surface and the non-splinted model(Model 2) had $8{\mu}m$ gap between two implant crowns. Two group (Splinted and non-splinted) was loaded with 200 N magnitude in the vertical and oblique directions on the loading point position on the central position of the crown, the 2 mm and 4 mm buccal offset point from the central position. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual and mesio-distal sections. The results were as follows; 1. In the vertical loading condition of central position, the stress was distributed on the cortical bone and the cancellous bone around the thread of the fixture in the splinted and non-splinted models. In the oblique loading condition, the stress was concentrated toward the cortical bone of the fixture neck, and the neck portion of 2nd molar in the non-splinted model was concentrated higher than that of 1st molar compared to the splinted model. 2. In the 2 mm buccal offset position of the vertical loading compared to the central vertical loading, stress pattern was shifted from apical third portion of the fixture to upper third portion of that. In the oblique loading condition, the stress was distributed over the fixture-bone interface. 3. In the 4 mm buccal offset position of the vertical loading, stress pattern was concentrated on the cortical bone around the buccal side of the fixture thread and shifted from apical third portion of the fixture to upper third portion of that in the splinted and non-splinted models. In the oblique loading, stresses pattern was distributed to the outer position of the neck portion of the fixture thread on the mesio-distal section in the splinted and non-splinted models. Above the results, it was concluded that the direction of loading condition was a key factor to effect the pattern and magnitude of stress over the surrounding bone of the fixture under the vertical and oblique loading conditions, although the type with or without proximal contact did not effect to the stress distribution.

Prediction Model for Reduced Bone mass in Women using Individual Characteristics & Life Style Factors (여성의 개인적 특성과 생활양식요인을 이용한 골량감소 예측모형)

  • Lee, Eun-Nam;Lee, Eun-Ok
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.83-109
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    • 1998
  • This study was carried out to identify the Important modifiable risk factors for reduced bone mass and to construct prediction model which can classify women with either low or high bone mass. Through the literature review, individual characteristics such as age, body weight, height, education level, family history, age of menarche, postmenopausal period, gravity, parity, menopausal status, and breast feeding period were identified and factors of life style such as past milk consumption, past physical activity, present daily activity, present calcium intake, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of reduced bone mass in women. Four hundred and eighty women aged between 28 and 76 who had given measurement bone mineral density by dual energy x-ray absortiometry in lumbar vertebrae and femur from July to October, 1997 at 4 general hospitals in Seoul and Pusan were selected for this study. Women were excluded if they had a history of any chronic illness such as rheumatoid arthritis, diabetes mellitus, hyperthroidism, & gastrointestinal disorder and any medication such as calcium supplements, calcitonin, estrogen, thyroxine, antacids, & corticosteroids known affect bone. As a result of these exclusion criteria, four hundred and seventeen women were used for analysis. Multiple logistic regression model was developed for estimating the likelihood of the presence or absence of reduced bone mass. A SAS procedure was used to estimate risk factor coefficient. The results are as follows For lumbar spine, the variables significant were age, body weight, menopause status, daily activity, past milk consumption, and past physical activity(p<0.01), while for femoral Ward's triangle, age, body weight, level of education, past milk consumption, past physical activity(p<0.001). Past physical activity, present daily activity and past milk consumption are the most powerful modifiable predictors in vertebrae and femur among the predictors. When the model performance was evaluated by comparing the observed outcome with predicted outcome, the model correctly identified 74.1% of persons with reduced bone mass and 84.5% of persons with normal bone mass in the lumbar vertebrae and 82.9% of persons with reduced bone mass and 75.0% of persons with normal bone mass in the femoral Ward's triangle. On the basis of these results, a number of recommendations for the management of reduced bone mass may be made : First, those woman who are classified as high risk group of the reduced bone mass in the prediction model should examine the bone mineral density to further examine the usefulness of this model. Second, the optimal amount of milk consumption and a regular weight bearing exercise in childhood, adolescence, and early adult should be ensured.

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Early Detection of Bone Metastasis in Malignancy With whole Body Bone Scan (전신골격주사(全身骨格走査)를 이용(利用)한 골전이(骨轉移)의 조기발견(早期發見))

  • Kim, Myung-Duk;Jung, Soon-Il;Choi, Kang-Won;Kim, Byung-Kuk;Koh, Chung-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.13 no.1_2
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    • pp.45-53
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    • 1979
  • Bone scans with $^{99m}Tc$-MDP (methylene diphosphonate) was analysed in 112 patients with various type of biopsy proven malignant tumor who visited Seoul National University Hospital from March 1979 to August 1979. The results were as follows; 1. Of the 112 cases, bone scans were positive in 61 cases (54.1%), while only 27 cases (24.1%) were positive in roentgenogram. 2. Of the 61 cases with positive bone scan, bone metastases were found in 25 cases by roentgenogram. Of the 51 cases with negative bone scan, bone metastasis was found in only 1 case by roentgenogram. 3. In comparison of bone scan and roentgenogram by number of regions, 137 regions were positive in bone scan or roentgenogram. Of these, 46 regions (33.5%) were both bone scan and roentgenogram positive, 89 regions (65.0%) were bone scan positive roentgenogram negative, and 2 regions were bone scan negative roentgenogram positive. 4. Bone scan and roentgenographic findings had significant correlation with the presence of bone pain but no significant correlation with the elevated level of serum alkaline phosphatase, acid phosphatase, Ca, and P. From above result, we found that bone scan was more sensitive than roentgenogram in early detection of bone metastasis in malignant tumors.

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The effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets (치근단 병소를 갖는 발치와에 즉시 임플란트 식립 시 비흡수성 차폐막이 치조골의 흡수에 미치는 영향에 관한 연구)

  • Shin, Seung-Yun;Yang, Seung-Min;Kye, Seung-Beom
    • Journal of Periodontal and Implant Science
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    • v.39 no.1
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    • pp.71-76
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    • 2009
  • Purpose: Many researches showed loss of alveolar bone in fresh extraction socket and even in case of immediate implant placement. The aim of this study was to evaluate the effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets. Materials and methods: Immediate implants were placed into artificially induced periapical lesion of mandibular premolars after complete debridement using buccal bone defect made by a 6mm trephine bur in 4 mongrel dogs. Before flap repositioning, a non-resorbable barrier membrane was placed on the buccal defect in the experimental group. No membrane was placed in the control group. In 12 weeks after placement, the dogs were sacrificed and undecalcified histologic specimens were prepared. The vertical distance from the smooth-rough surface interface(SRI) to gingiva, 1st bone contact and bone crest were measured in buccal and lingual side. The horizontal thicknesses of gingiva and bone at 0, 1, 2 and 3mm below SRI were measured. Results: The buccal bone was resorbed more than lingual bone in both groups and there was statistical significance(p<0.05). The distances from SRI to 1st bone contact were $2.45{\pm}2.35\;mm$ in experimental group and $4.49{\pm}3.10\;mm$ in control group. In all vertical level, lingual bone was thicker than buccal bone(p<0.05). Conclusion: Buccal bone was reduced more than lingual bone in immediate implant placement into periapically infected extraction sockets. Placement of non-resorbable barrier membrane reduced the buccal bone resorption. However there was no statistical significance.

Effects of plant-derived natural products on inflammatory bone destructive disease

  • Ko, Seon-Yle
    • International Journal of Oral Biology
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    • v.44 no.4
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    • pp.130-143
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    • 2019
  • Rheumatoid arthritis, osteoarthritis, and periodontal disease are bone destructive diseases mainly caused by inflammation. Various studies are being conducted to develop treatments for inflammatory bone destructive diseases. Many of these studies involve plant-derived natural compounds. In these studies, cell differentiation, signal transduction pathways, and bone resorption were measured at the cellular level. In disease-induced animal models, the amount of inflammatory mediators or matrix destructive enzymes and serum metabolic markers were measured. This study examined the effects of plant-derived natural compounds, such as flavonoids, on inflammatory bone destructive diseases. In addition, we structurally classified various substances used to maintain bone health and summarized the biological effects and related mechanisms of the components.

Two-Dimensional Finite Element Analysis of Bone Resorption from the Artificial Hip Replacement (인공고관절 골흡수로 인한 응력분포 변화의 2차원 유한요소 해석)

  • Choi, Hyung-Yeon;Chae, Soo-Won;Kim, Sung-Kon
    • Journal of Biomedical Engineering Research
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    • v.16 no.1
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    • pp.25-32
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    • 1995
  • Clinically, proximal bone resorption in the femur is frequently seen postoperatively on the follow up XI-rays after total hip replacement (THR). We developed the finite element model of cementless THR. The model is two dimensional side plate model, whereby the three dimensional structural integrity of the bone can be accounted for by a separate two dimensional mesh, a side plate. The subject of this article is the development and application of this two dimensional side plate FEM to study the reverse effect of the various degree of bone resorption of femur after THR. The results of this study indicates that 1) two dimensional side plate model is good and simple alternative to complex three dimensional model and 2) the severity of the proximal bone resorption has the effect of more increasing stress on the cortex at the level of femoral stem tip.

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Assessment of the permanent canine bone support after secondary bone graft In UCLP patients (편측성 순구개열 환자에서 이차 골이식후 맹출된 영구 견치의 치조골 지지도에 관한 연구)

  • Park, Ki-Tae
    • The korean journal of orthodontics
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    • v.31 no.6 s.89
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    • pp.601-610
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    • 2001
  • The purpose of this retrospective study was to evaluate the level oi alveolar bone support of the erupted Permanent canine through the reconstructed cleft region compared to the contralateral canine on the non-cleft side. This study was limited to children with complete unilateral cleft lip and palate who underwent secondary alveolar iliac bone gvaft and the apices of the erupted canine roots were closed at the time of evaluation. With these criteria the study included 21 children whose average age at the time of bone graft reconstruction was 9.8 years, with a minimum of 12.4 years of age at the time of the evaluation. The study was limited to the use of iliac cancellous bone as the autograft material for reconstruction of the alveolar cleft. Cranial bone graft and other autogenous bone sources were excluded. The periapical radiographs were used to evaluate alveolar bone level of each canine. The percentages of root supported by the bone were established by dividing the amount of root covered with the bone by the anatomic root length. The canine oi the non-cleft side was used as an internal control and the canine on the cleft side was used as an experimental. There was a statistically significant difference in the alveolar bone support ratio between the control ($92.9\%$) and experimental canines ($8.7\%$). An average of $95\%$ level of alveolar bone support was achieved for the experimental canine in comparison to the control canine. Neither the presence of lateral incisor, nor the stage of root development of the canine at the time of the bone graft appeared to have affected the alveolar bone support ratio of the canine after the secondary bone graft.

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CALCIUM AND PHOSPHOROUS DISTRIBUTIONS IN THE ALVEOLAR BONE OF ORTHODONTICALLY TREATED CATS (교정력에 의한 고양이 치조골의 칼슘 및 인의 분포에 관한 연구)

  • Kim, Hye Kyoung;Lee, Jong Heun;Yang, Wan Sik
    • The korean journal of orthodontics
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    • v.11 no.1
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    • pp.17-23
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    • 1981
  • This experiment was performed to investigate the response of inorganic substances in alveolar bone in relation to the experimental tooth movement. Right canine in maxillary jaw was tipped in cats by coil springs generating 80 gm. force, in mandibular jaw, the force was 100 gm. force. Cats were divided into five groups and orthodontically treated for one hour, 1, 7, 14 and 28 days, respectively. Alveolar bone samples were obtained from tension and compression sites as well as from contralateral control sites. The level of calcium of alveolar bone was determined by atomic absorption spectrophotometry and inorganic phosphorus was measured by spectrophotometry. The results obtained were as follows: 1. In tension and compression site of maxillary alveolar bone, calcium levels were decreased at 1, 7 and 14 days, but recovered at 28 days. 2. The levels of inorganic phosphorus in compression site of maxillary alveolar bone had little change but in tension site of maxillary alveolar bone , phosphorous levels were decreased, 3. Calcium levels in tension and compression site of mandibular alveolar bone were decreased, especially at 28 days. 4. In tension and compression site of mandibular alveolar bone, inorganic phosphorus were slightly decreased from 1 day.

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Effect of Sodium Chloride Supplementation on Bone Metablism in Rats Consuming a Low Calcium Diet (저칼슘 식이 섭취시 식염첨가가 흰쥐의 골격대사에 미치는 영향)

  • 최미자
    • Journal of Nutrition and Health
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    • v.29 no.10
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    • pp.1096-1104
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    • 1996
  • This study was performed to evaluate the effect of sodium cholride supplementation on bone metabolism in female rats consuming a low calcium diet. Twenty five female rats were divided into three dietary groups (control Na : 0.1038%, 1% Na : 1.036%, 2% Na : 2.072%). All experimental diets contained 0.27% Ca and were fed to rats with deionized water for 7 weeks. Bone mineral density(BMD) and bone mineral content(BMC) of total body, spine and femur were measured using energy x-ray absorptiometry(DEXA) by small animal software. Then Ca efficiency was calculated from BMD and BMC. Serum Ca, P, Na and urine Ca, P, Na were determined. Urinary pyridinoline, serum ALP were measured to monitor bone resorption. Following 7 weeks, sodium cholride supplemented groups had higher urinary Ca excreteion, urinary pyridinoline, crosslinks value and serum ALP. There was no significant difference in case of serum Ca among all groups. Sodium chloride supplemnted groups had lower Ca effciency of total, spine and femur BMD and BMC than that of control group. In conclusion high salt intake not only increases urinary Ca excretion as urinary Na excretion does but also increase bone resorption and decrease Ca efficiency of each bone. It is been suggested that high salt intake may be harmful for bone maintenance. Therfore, the decrease of salt intake to the level of recommendation would be desirable.

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