• Title/Summary/Keyword: Complete occlusion

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Use of a Rigid-Tipped Microguidewire for the Endovascular Treatment of Cavernous Sinus Dural Arteriovenous Fistulas with an Occluded Inferior Petrosal Sinus

  • Deniwar, Mohamed Adel;Kwon, Boseong;Song, Yunsun;Park, Jung Cheol;Lee, Deok Hee
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.688-696
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    • 2022
  • Objective : Transvenous embolization (TVE) via an occluded inferior petrosal sinus (IPS) in a cavernous sinus dural arteriovenous fistula (CSDAVF) is challenging, often requiring navigation of a microcatheter through resistive obstacles between the occluded IPS and shunted pouch (SP), although the reopening technique was successfully performed. We report five cases of successful access to the cavernous sinus (CS) or SP using the rigid-tipped microguidewire such as chronic total occlusion (CTO) wire aiming to share our initial experience with this wire. Methods : In this retrospective study, four patients with CSDAVF underwent five procedures using the CTO wire puncture during transfemoral transvenous coil embolization. Puncture success, shunt occlusion, and complications including any hemorrhage and cranial nerve palsy were evaluated. Results : Despite successful access through the occluded IPS, further entry into the target area using neurointerventional devices was impossible due to a short-segment stricture before the CS (three cases) and a membranous barrier within the CS (two cases). However, puncturing these structures using the rigid-tipped microguidewire was successful in all cases. We could advance the microcatheter over the rigid-tipped microguidewire for the navigation to the SP and achieved complete occlusion of the SP without complications. Conclusion : The use of the rigid-tipped microguidewire in the TVE via the occluded IPS of the CSDAVF would be feasible and safe.

Feasibility & Limitations of Endovascular Coil Embolization of Anterior Communicating Artery Aneurysms

  • Hwang, Sung-Kyun;Benitez, Ronald;Veznedaroglu, Erol;Rosenwasser, Robert H.
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.89-95
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    • 2005
  • Objective : The purpose of this study is to analyze aneurysm morphology and define limitations and feasibility in endovascular Gugliemi detachable coil[GDC] embolization for anterior communicating artery [ACoA] aneurysms. Methods : From January 2000 through October 2003, 123patients were treated with endovascular coil embolization for ACoA aneurysms. There were 75women and 48men, with a mean age of 63years. All ruptured aneurysms were treated within 15days of rupture. Aneurysm morphology was classified according to neck size and projection of aneurysm dome as follows-A : neck of aneurysm <4mm & anterior projection, B : neck of aneurysm [4mm & anterior projection, C : neck of aneurysm<4mm & posterior [superior] projection, D : neck of aneurysm [4mm & posterior [superior] projection, E : neck of aneurysm<4mm & inferior projection, and F : neck of aneurysm [4mm & inferior projection. Endovascular procedures were categorized as either "successful" or "unsuccessful". Clinical follow-up was estimated at discharge and at 6months, post treatment results were classified according to Glasgow Outcome Scale[GOS]. Results : Successful embolization for ACoA was performed in 86patients of 123patients [69.9%]. Complete or near complete aneurysm occlusion was observed in 102patients [82.9%]; a neck remnant was observed in 6patients [4.9%]; partial embolization was done in 3patients [2.4%]; and embolization was attempted in 12patients [9.8%]. Among 55patients with follow-up angiographic results, 18patients [32.7%] were defined as recanalization of the aneurysm sac. Morphological analysis demonstrated that anterior projecting aneurysms and morphological classifications [morphological classifications worsens [A - D] chances of successful coil occlusion significantly decrease] were major factors in successful embolization, and, inferiorly projecting and wide neck [${\ge}4mm$] aneurysms are highly related to recanalization of aneurysms. Conclusion : Endovascular coil embolization of ACoA aneurysms shows good outcome in our study. Nevertheless, there is a limitation in the endovascular approach to ACoA, even though advanced modern techniques evolve rapidly. Compensatory surgical approach with the endovascular approach is required for successful treatment of ACoA aneurysms.

THREE DIMENSIONAL PHOTOELASTIC ANALYSIS OF STRESS OF EDENTULOUS MANDIBULE ACCORDING TO VARIOUS RIDGE SHAPES AND ARTIFICIAL TEETH SIZES (잔존치조제 형태 및 총의치 인공치 크기가 무치하악 응력발생에 미치는 영향에 관한 3차원적 광탄성응력분석)

  • Choi Chang-Deog;Yoo Kwong-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.30 no.3
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    • pp.457-478
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    • 1992
  • Electrical resistance strain gauges, brittle-coatings, Moir'e fringe analysis, photoelasticity methods, etc, have been employed in the study of stress analysis and three-dimensional photoelasticity method used in this experiment. The author fabricated a total of 24 samples of maxillary and mandibular edentulous ridges with normal and sharp shapes using epoxy resin, one of the photoelastic materials. In addition, complete denture made from artificial resin teeth in other twoo sizes, large and medium size, were affixed to the specimens and attached to an articulator. The following results were attained by cutting 9 slice specimens into 6mm thick portions, in accordance with the three dimensional photoelastic stress freezing method, to analyze stress distribution status under specific static loading in the central, lateral and protrusive occlusions of the shape of edentulous ridge. 1. In the case of central occlusion, when complete resin artificial teeth in large and medium sizes were used on normal and sharp alveolar ridges, high stress distribution was broadly shown in the labio-buccal sides, and low and concentrated in the lingual sides, in all cases. Generally, the highest stresses were shown at the top of the alveolus, or at 2mm below the top of the alveolus, particularly in the specimen 2, 3, and stresses were more or less the same in the symmetrical right and left sides. 2. In the case of lateral occlusion, when the same load was applied, high stresses were shown broadly at the working sides in both the labio-buccal and lingual sides, and low and concentrated at the balanced sides. The highest stresses were shown in the top of the alveolus on the working sides in specimen 2 portion, and the lowest stresses at the balanced sides in specimen 6, slightly higher stresses were shown at retromolar parts in the balanced sides. 3. In the case of protrusive occlusion, high stresses were broadly shown at the labio-buccal sides, and slightly higher stresses at the top 2, 4, and 6mm parts of the alveolus with concentration. The highest stresses were shown in specimen No. 5 and the lowes stresses in specimen 1, 9 and stresses were more of less the same at the symmetrical right and left sides.

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Approach to prosthetic treatment for patients with open bite due to mandibular displacement: Case report (하악변위로 인한 개방교합 환자의 보철치료: 증례보고)

  • Seo, Min-Gyung;Chi, Seung-Seok;Ko, Kyung-Ho;Park, Chan-Jin;Cho, Lee-Ra;Huh, Yoon-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.420-430
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    • 2022
  • Open bite is accompanied by decrease in tooth contact and overbite, and causes collapse of occlusal plane, mastication difficulties, speech disorders, changes in appearance, and lower occlusal force than normal. Open bite caused by temporomandibular joint disorder in adults with complete occlusion must be corrected after removal or stabilization of the causative factors. Orthodontic treatment, occlusal adjustment, prosthetic treatment, and surgical treatment can be the option of occlusal correction. This report describes about estimating the cause of occlusion change in two patients who developed an open bite due to mandibular displacement in adults with complete occlusion and different treatment approaches accordingly. In one patient, satisfactory result was obtained in functional and esthetic aspects through occlusal adjustment after stabilization of the temporomandibular joint.

Relation of head posture and occlusal contact area using photo occlusion analysis (광조사교합분석법을 이용한 머리 위치와 교합접촉면적의 관계)

  • Kim, Chang-Hwan;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Cho, Lee-Ra;Park, Chan-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.2
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    • pp.90-97
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    • 2019
  • Purpose: Previous studies related with occlusal contact area were limited that interocclusal thickness level or the method of measurement has not been accurate in measuring. The purpose of this study was to investigate the relation between head posture and occlusal contact area using photo occlusion analysis. Materials and Methods: 54 subjects with complete dentition (44 men, 10 women / 23 to 33 years of age) were included. To identify the relationship between head posture and occlusal contact area, subjects took interocclusal record in maximal intercuspal position with three different positions(supine position ($0^{\circ}$) / inclined position ($45^{\circ}$) / upright position ($90^{\circ}$)) on the dental unit chair. Occlusal contact area was analyzed using photo occlusion analysis. Statistical analyses were performed with SPSS ver.25.0 at 95% confidence interval. Results: Head posture has no significant effect on the changes of occlusal contact area (P > 0.05). Conclusion: When interocclusal relation is stable, head posture does not change a interocclusal record because head posture has no significant effect on occlusal contact area. Analysis of occlusal contact area using photo occlsion analysis device is useful due to its material property and simplicity.

Complete denture fabricated by Jiro Abe's method for edentulous patient with severe alveolar ridge resorption: a case report (심한 치조제 흡수를 보이는 무치악 환자에서 Jiro Abe법에 의한 완전틀니 제작 증례)

  • Jun, Daejeon;Yang, Dong-Hun;Vang, Mongsook;Yang, Hongso;Park, Sangwon;Yun, Kwidug
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.4
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    • pp.338-345
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    • 2014
  • Fabrication of complete denture by Jiro Abe's method was introduced that enhance the retention and stability of denture by sealing around the denture border with mucous membrane to make negative pressure at the inner surface of denture base when swallowing or occlusion. In this case, taking impression and fabricating complete denture by the Jiro Abe's method for an edentulous patient with severe mandibular alveolar bone resorption allowed us to obtain clinically enhance stability of denture and improve satisfaction of patient.

A comparative study on the accuracies of resin denture bases and metal denture bases

  • Park Hwee-Woong;Kim Chang-Whe;Kim Yung-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.39 no.3
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    • pp.250-259
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    • 2001
  • Since the late 1930s, acrylic resins have been the materials of choice for the fabrication of complete denture bases. It has excellent esthetic properties, adequate strength, low water sorption, and low solubility. But acrylic resin has disadvantage of processing shrinkage that reduces denture retention and accuracy of denture occlusion. Metals also have been used in denture base material. Metals used in denture bases display excellent strength and dimensional stability. The major disadvantages associated with metal denture bases include increased cost, difficulty in fabrication, compromised esthetic qualities, and inability to re-base. The purpose of this study is to compare the artificial tooth movements of complete dentures with resin bases and metal bases after curing, deflasking, polishing immersion in water for 1 week and 4 weeks. Twenty-four maxillary complete resin denture bases with artificial teeth were fabricated. Twelve of them were resin based and other twelve of them were metal based. Fine crosses were marked on the incisal edges of right central incisors and distobuccal cusps of be second molars. Measurements were done for the changes of distances of reference points at the time of wax denture, after deflasking after decasting after polishing after immersion in water for 1 week and 4 weeks Meaurements were done to the accuracy of 0.001mm with a measuring microscope. The results were as follows : 1. Metal base showed significantly less tooth movement than resin base after curing and decasting (p<0.01). 2. Metal base showed significantly less tooth movement than resin base after polishing (p<0.01). 3. After immersion in water for 1 week and 4 weeks, metal base showed less movement than resin base. Difference was significant for anterior-posterior distances (p<0.01), but not significant for molar-to-molar distance (p>0.01). 4. 1 week and 4 weeks of immersion failed to compensate the initial processing shrinkage of metal and resin bases (p>0.01).

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Three-dimensional printed complete denture fabrication using the scan data from the conventional denture-making process (통상적인 총의치 제작과정에서의 스캔 정보를 활용한 three-dimensional printed complete denture의 제작)

  • Kim, Hyun-Min;Kim, Jong-Jin;Lee, Joo-Hee;Cha, Hyun-Suk;Baik, Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.3
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    • pp.196-202
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    • 2020
  • Recently three-dimensional (3D) printed complete dentures are becoming more widely recognized as one of the treatment options for the edentulous patients. Korean National Healthcare, however, has not yet approved the application of the 3D printed dentures, and in the cases where the dentures should be refabricated, the conventional fabrication process needs to be entirely repeated. However, during the conventional process, the digital scan data of some key steps could be easily obtained. In this clinical case, using these data, a new pair of 3D printed dentures that improved the limitations of the first conventional dentures were successfully fabricated.

Analysis of Clinical and Radiological Outcomes in Microsurgical and Endovascular Treatment of Basilar Apex Aneurysms

  • Jin, Sung-Chul;Ahn, Jae-Sung;Kwun, Byung-Duk;Kwon, Do-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.45 no.4
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    • pp.224-230
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    • 2009
  • Objective : We aimed to analyze clinical and radiological outcomes retrospectively in patients with basilar apex aneurysms treated by coiling or clipping. Methods : Outcomes of basilar bifurcation aneurysms were assessed retrospectively in 77 consecutive patients (61 women, 16 men), ranging in age from 25 to 79 years (mean, 53.7 years) from 1999 to 2007. Results : Forty-nine patients out of 77 patients (63.6%) presented with subarachnoid hemorrhages of the 49 patients treated with coiling, 27 (55.1 %) showed complete occlusion of the aneurysm sac. Of these, 13 patients (26.5%) developed coil compaction on angiographic or MRI follow-up, with recoiling required in 9 patients (18.4%). Procedural complications of coiling were acute infarction in nine patients and the bleeding of the aneurysms in six patients. The remaining 28 patients underwent microsurgery : twenty-six of these (92.9%) with microsurgery followed up with conventional angiography. Complete occlusion of the aneurysm sac was achieved in 19 patients (73.1%). Operation-related complications of microsurgery were thalamoperforating artery injuries in three patients, retraction venous injury in two, postoperative epidural hemorrhage (EDH) in one, and transient partial or complete occulomotor palsy in 14 patients. Glasgow Outcome Scores (GOS) were 4 or 5 in 21 of 28 (75%) patients treated with microsurgery at discharge, and at 6 month follow-up, 20 of 28 (70.9%) maintained the same GOS. In comparison, GOS of four or 5 was observed in 36 of 49 (73.5%) patients treated with coiling at discharge and at 6 month follow-up, 33 of 49 patients (67.3%) maintained the GOS from discharge. Conclusion : Basilar top aneurysms were still challenging lesions based on our series. Endovascular or microsurgery endowed with its inborn risks and procedural complications for the treatment of basilar apex aneurysms individually. Microsurgery provided better outcome in some specific basilar apex aneurysms. For reaching the most favorable outcome, endovascular modality as well as microsurgery was inevitably considered for each specific basilar apex aneurysm.

Long-term follow-up of early cleft maxillary distraction

  • Park, Young-Wook;Kwon, Kwang-Jun;Kim, Min-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.20.1-20.6
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    • 2016
  • Background: Most of cleft lip and palate patients have the esthetic and functional problems of midfacial deficiencies due to innate developmental tendency and scar tissues from repeated operations. In these cases, maxillary protraction is required for the harmonious facial esthetics and functional occlusion. Case presentation: A 7-year old boy had been diagnosed as severe maxillary constriction due to unilateral complete cleft lip and palate. The author tried to correct the secondary deformity by early distraction osteogenesis with the aim of avoiding marked psychological impact from peers of elementary school. From 1999 to 2006, repeated treatments, which consisted of Le Fort I osteotomy and face mask distraction, and complementary maxillary protraction using miniplates were performed including orthodontics. But, final facial profile was not satisfactory, which needs compromising surgery. Conclusions: The result of this study suggests that if early distraction treatment is performed before facial skeletal growth is completed, an orthognathic surgery or additional distraction may be needed later. Maxillofacial plastic and reconstructive surgeons should notify this point when they plan early distraction treatment for cleft maxillary deformity.