PURPOSE: The application of computer-aided technology to implant dentistry has created new opportunities for treatment planning, surgery and prosthodontic treatment, but the correct selection and combination of available methods may be challenging in times. Hence, the purpose of this case report is to present a combination of several computer-aided tools as approaches to manage complicated implant case. MATERIAL AND METHODS: A 47 year-old female patient with severe dental anxiety, high expectations, financial restrictions and poor compliance presented for a fixed rehabilitation. A CT scan with a radiographic template obtained with software (SimPlant, Materialize, Leuven, Belgium) was used for treatment planning. The surgical plan was created and converted into a stereolithographic model of the maxilla with bone-supported surgical templates (SurgiGuide, Materialise, Leuven, Belgium), that allowed for the precise placement of 7 implants in a severely resorbed edentulous maxilla. After successful osseointegration, an accurate scan model served as the basis for the fabrication of a one-piece milled titanium framework using the Procera (Nobel Biocare, Gothenburg, Sweden) technology. The final rehabilitation of the edentulous maxilla was rendered in the form of a screw-retained maxillary metal-reinforced resin-based complete prosthesis. RESULTS: Despite challenging circumstances, 7 implants could be placed without bone augmentation in a severely resorbed maxilla using the SimPlant software for pre-implant analysis and the SurgiGuide-system as the surgical template. The patient was successfully restored with a fixed full arch restoration, utilizing the Procera system for the fabrication of a milled titanium framework.
Proceedings of the Korean Society of Medical Physics Conference
/
2002.09a
/
pp.32-34
/
2002
Over the past two decades there has been a tremendous growth in the number of synchrotron radiation facilities in the world and also in Japan. The high flux and brightness radiation which derive from the third generation low emittance rings provide an ideal source for many applications in the medical sciences. The application of synchrotron radiation to medical imaging started in the early 80's in U.S.A, followed by European countries such as Germany and Russia. In Japan, researchs on intravenous coronary angiography started in 1884 at the Institute for High Energy Phisics(KEK) in Tsukuba. At present, it is the only application of syncrotron radiation which is at the stage of human study. In '90s, newer techniques such as phase and refraction contrast imaging appeared which are at the in vitro or animal study stage. Various types of x-ray CT have also been developed for three-dimensional imaging of the subjects. The present status of medical applications of synchrotron radiation in Japan is reviewed.
Journal of Dental Rehabilitation and Applied Science
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v.23
no.4
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pp.373-384
/
2007
The purpose of this study was to analyse the stress distribution on the craniofacial suture and cranium after application of RME. Twelve years and six months old boy and twenty years old adult male were chosen for taking computed-tomography for FEM. From DICOM visual information, it was processed by 3-dimensional image construction program Mimics 10.01. Hounsfield unit(HU) which shows gray scale of CT image is picked for revealing mechanical properties of each model. The models have been accomplished with various range of physical properties. After applying 5.0 mm expansion, the maxillary complex model was obeserved for analyzing displacement and stress distribution of the model. The amount of transverse expansion of child and adult maxilla is different according to its location. It appears that it decreases gradually with the distance from separation site. In child, maximum compressive stress located broad area in zygomatic buttress department and the ends of frontal process of maxilla, pterygoid plate, and bones surrounding orbit. However, in adult maximum compressive stress was located smaller area and the stres was higher than child.
Journal of Dental Rehabilitation and Applied Science
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v.23
no.4
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pp.359-371
/
2007
Recently, many studies were reported accurate analysis of facemask effect due to the development of the personal computers and computer programs. The aim of this study is appropriate protraction direction of facemask using finite element study with computer aided design and computer aided measurement. The construction of the three dimensional FEM was based on the computer tomography(CT) scans of 13.5 year-old male subject. Protraction force of 500 mg was applied at 0, 30, 60 and 90 degrees downwards to the Frankfort horizontal plane, and maxillary displacement and stress distribution were measured. When 60 degree force was applied, it showed forward movement of premolar roots area and downward movement of anterior nasomaxillary area, and others showed clockwise rotation movement of the nasomaxillary complex. Finally, we can produce the protraction of maxillary bone without rotation of maxilla about 60 degrees.
Kim, Jeong-Ju;Oh, Ju-Hwan;Moon, Ok-Ryun;Kwon, Soon-Man
Health Policy and Management
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v.17
no.3
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pp.26-49
/
2007
The purpose of this study is to analyze the equity of health care utilization by income groups in terms of both quantity and quality of care, which is measured by expenditure, type of care, and type of health care institutions. Equity in health care utilization is measured by HIwv index, based on the survey of 1,480 Gwangju-Jeonnam residents. Health care utilization in terms of the probability and quantity of outpatient and inpatient care show equitable or pro-poor inequitable distribution, whereas the distribution of health care expenditure, which can account for the quality of care, is pro-rich inequitable, implying that the better off tend to use more expensive medical care. In terms of the types of care, simple visits for basic care show equitable distribution, whereas the distribution of the utilization of traditional tonic medicine, comprehensive health examination, CT, MRI, and ultrasound is pro-rich inequitable. Utilization of general hospitals and traditional health institutions show pro-rich inequitable distribution, hospitals and dental care institutions equitable, and physician clinics and public health centers pro-poor inequitable.
Purpose: This study was designed to investigate the effects of voxel size, the oversampling technique, and the direction and area of measurement on modulation transfer function (MTF) values to identify the optimal method of MTF measurement. Materials and Methods: Images of the wire inserts of the SedentexCT IQ phantom were acquired, and MTF values were calculated under different conditions(voxel size of 0.1, 0.2, and 0.3 mm; 5 oversampling techniques; simulated pixel location errors; and different directions and areas of measurement). The differences in the MTF values across various conditions were evaluated. Results: The MTF 10 values showed smaller standard deviations than the MTF 50 values. Stable and accurate MTF values were obtained in the 0.1-mm voxel images. In the 0.3-mm voxel images, oversampling techniques of 11 lines or more did not show significant differences in MTF values depending on the presence of simulated location errors. MTF 10 values showed significant differences according to the direction and area of the measurement. Conclusion: To measure more accurate and stable MTF values, it is better to measure MTF 10 values in small-voxel images. In large-voxel images, the proper oversampling technique is required. MTF values from the radial and tangential directions may be different, and MTF values vary depending on the measured area.
Micro-computed tomography (microCT) is an important tool for preclinical vascular imaging, with micron-level resolution. This non-destructive means of imaging allows for rapid collection of 2D and 3D reconstructions to visualize specimens prior to destructive analysis such as pathological analysis. Objectives. The aim of this study was to suggest a method for ex vivo, postmortem examination of stented arterial segments with microCT. And ex vivo evaluation of stents such as bare metal or drug eluting stents on in-stent restenosis (ISR) in rabbit model was performed. The bare metal stent (BMS) and drug eluting stent (DES, paclitaxel) were implanted in the left or right iliac arteries alternatively in eight New Zealand white rabbits. After 4 weeks of post-implantation, the part of iliac arteries surrounding the stent were removed carefully and processed for microCT. Prior to microCT analysis, a contrast medium was loaded to lumen of stents. All samples were subjected to an X-ray source operating at 50 kV and 200 ${\mu}A$ by using a 3D isotropic resolution. The region of interest was traced and measured by CTAN analytical software. Objects being exposed to radiation had different Hounsfield unit each other with values of approximately 1.2 at stent area, 0.12 ~ 0.17 at a contrast medium and 0 ~ 0.06 at outer area of stent. Based on above, further analyses were performed. As a result, the difference of lengths and volumes between expanded stents, which may relate to injury score in pathological analysis, was not different significantly. Moreover, ISR area of BMS was 1.6 times higher than that of DES, indicating that paclitaxel has inhibitory effect on cell proliferation and prevent infiltration of restenosis into lumen of stent. And ISR area of BMS was higher ($1.52{\pm}0.48mm^2$) than that of DES ($0.94{\pm}0.42mm^2$), indicating that paclitaxel has inhibitory effect on cell proliferation and prevent infiltration of restenosis into lumen of stent. Though it was not statistically significant, it showed that the extent of neointema of mid-region of stents was relatively higher than that of anterior and posterior region in parts of BMS as showing cross-sectional 2-D image. suggest that microCT can be utilized as an accessorial tool for pathological analysis.
This study was performed to investigate the reproducibility of the horizontal and midsagittal planes, and to suggest a stable coordinate system for three-dimensional (3D) cephalometric analysis. Eighteen CT scans were taken and the coordinate system was established using 7 reference points marked by a volume model, with no more than 4 points on the same plane. The 3D landmarks were selected on V works (Cybermed Inc., Seoul, Korea), then exported to V surgery (Cybermed Inc., Seoul, Korea) to calculate the coordinate values. All the landmarks were taken twice with a lapse of 2 weeks. The horizontal and midsagittal planes were constructed and its reproducibility was evaluated. There was no significant difference in the reproducibility of the horizontal reference planes, But, FH planes were more reproducible than other horizontal planes. FH planes showed no difference between the planes constructed with 3 out of 4 points. The angle of intersection made by 2 FH planes, composed of both Po and one Or showed less than $1^{\circ}$ difference. This was identical when 2 FH planes were composed of both Or and one Po. But, the latter cases showed a significantly smaller error. The reproducibility of the midsagittal plane was reliable with an error range of 0.61 to $1.93^{\circ}$ except for 5 establishments (FMS-Nc, Na-Rh, Na-ANS, Rh-ANS, and FR-PNS). The 3D coordinate system may be constructed with 3 planes; the horizontal plane constructed by both Po and right Or; the midsagittal plane perpendicular to the horizontal plane, including the midpoint of the Foramen Spinosum and Nc; and the coronal plane perpendicular to the horizontal and midsagittal planes, including point clinoidale, or sella, or PNS.
Purpose: Reposition of the maxilla is a common technique for correction of midfacial deformities. To achieve the goal of the surgery, the maxilla should be repositioned based on the precisely planned position during surgery. The internal reference points (IRPs) and the external reference points (ERPs) are usually used to determine vertical dimension of maxilla, which is an important factor for confirming maxillary position. However, the IRPs are known to be inaccurate in determining the vertical dimension. In this study, we investigated the correlation of positional change of the modified IRPs with repositioned maxilla. Methods: The study group consisted of 26 patients with dentofacial deformities. For the simulation of the surgery, patient maxillary CT data and 3-D virtual surgery programs (V-$Works^{(R)}$ and V-$Surgery^{(R)}$) were used. IRPs of this study were set on both the lateral wall of piriform aperture, inferior margin of both infraorbital foramen, and the labial surfaces of the canine and first molar. The distance from the point on lateral wall of the piriform aperture to the point on the buccal surface of the canine was defined as IRP-C, and the distance from the point on the inferior margin of the infraorbital foramen to the point on the buccal surface of the $1^{st}$ molar was defined as IRP-M. After the virtual simulation of Le Fort I osteotomy, the changes in IRP-C and IRP-M were compared with the maxillary movement. All measures were analyzed statistically. Results: With respect to vertical movements, the IRP-C (approximately 98%) and the IRP-M (approximately 96%) represented the movement of the canine and the $1^{st}$ molar. Regarding rotating movement, the IRPs changed according to the movement of the canine and the $1^{st}$ molar. In particular, the IRP-C was changed in accordance with the canine. Conclusion: IRPs could be good indicators for predicting vertical movements of the maxilla during surgery.
Objective: The purpose of this study is to compare the surgical treatment with conservative treatment and to evaluate the effectiveness of drug-holiday in bisphosphonate related osteonecrosis of the jaw (BRONJ) patients who were diagnosed as stage 2. Patients and Method: From January 2012 to October 2014, seventy-two patients who visit to Pusan National University of Dental Hospital were diagnosed as stage 2 of BRONJ. All the patients had taken computed tomography(CT) and panoramic radiography. The surgical treatment including sequestrectomy of necrotic bone and curettage of soft tissue around the sequestrum were performed to fifty patients. Twenty-two patients underwent conservative treatment such as antibiotics medications, mouth rinsing and follow up checking for every two weeks. Prognosis of treatment was classified into 3 groups - response, unresponse, and worsens - according to clinical, radiographic symptoms. P-value less than 0.05 were regarded as significant. Results: In surgery group, forty-five patients (90%) were healed without recurrence or any complication and five patients (10%) showed the wound dehiscence or infection. In conservative treatment group, fifteen patients (68.2%) were healed without any complication, four patients (18.2%) did not show improvement and three(4.2%) patients$^{\circ}{\emptyset}$ symptoms increased. P-value among groups was 0.014. Evaluation of preoperative drug-holiday in surgery group did not show the effectiveness(p=0.478). Conclusion: Statistically, the prognosis of patients with stage 2 BRONJ treated with surgery was significantly better than conservative treatment. There was no statistical difference for the preoperative drug-holiday.
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