• Title/Summary/Keyword: Direct anterior approach

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Diastema closure with direct composite: architectural gingival contouring (레진 직접법을 이용한 치가이개의 수복: 치은 형태 회복술)

  • Kim, Yeon-Hwa;Cho, Yong-Bum
    • Restorative Dentistry and Endodontics
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    • v.36 no.6
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    • pp.515-520
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    • 2011
  • One of the most challenging task in closing anterior diastema is avoiding "black triangle" between the teeth. This paper reports a case that the closure of diastema in anterior teeth could be successfully accomplished using direct adhesive restorations and gingival recontouring. The traditional technique using Mylar strip was modified to increase the emergence profile with natural contours at the gingival-tooth interface. Mylar strip was extended out of the sulcus by approximately 1 mm high from the gingival margin, and a small cotton pellet was used to provide the emergence contour. This modified approach is acceptable for the clinical situation.

A Case of Giant Sacral Chordoma (천추부에 발생한 거대 척색종 치험 1례)

  • Suh, Bum-Sin;Na, Young-Cheon;Park, Jong-Tae
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.702-704
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    • 2010
  • Purpose: Chordoma is a rare primary osseous tumor arising from the remnants of the primitive notochord. It occurs once in 2,000,000. It is characterized by its slow growth, high frequency to invade destroy bone by direct extension. We experienced giant sacral chordoma and reconstructed with gluteal advancement flap. Methods: A 52-year-old woman presented with a 2-years history of gluteal pain. In the biopsy study revealed sacral chordoma. MRI study showed $13{\times}12{\times}10\;cm$ sized m0cs. We approached anterior and posterior resection and reconstructed with bilateral gluteus maximus advancement flap. Results: After the operation, blader and anal function were slightly decreased. But, 4 months later those were almost fully recovered. There was no significant complication and recurrence after 2-years follow-up. Conclusion: Chordoma is characterized by its slow growth, high frequency to invade and destroy bone by direct extension. Wide surgical resection is the only curative procedure. We report a ase of giant sacral chordoma which was successfully treated by anterior and posterior approach and reconstructed with bilateral gluteal advancement flap.

LABIAL APPROACH OF PULP TREATMENT AND RESIN RESTORATION ON DISCOLORED NECROTIC PRIMARY ANTERIOR TOOTH (변색된 유전치의 순측접근에 의한 치수치료 및 레진수복)

  • Chae, Moon-Hee;Song, Je-Seon;Choi, Hyung-Jun;Kim, Seong-Oh
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.2
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    • pp.84-88
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    • 2014
  • Traditional method of pulpectomy for a necrotic primary anterior tooth was done on lingual side. But it could not recover the discoloration of crown effectively. For the purpose of treating the discoloration of crown after lingual pulpectomy, additional methods of crown restoration were needed like : celluloid crown, open-faced crown, rasin-faced crown. Neverthless, these kinds of complete coverage methods had some disadvantages such as possibility of tooth fracture by increased tooth preparation. In order to overcome the shortcomings of lingual pulpectomy, labial treatment could be considered as an alternative. It is a method that treats necrotic pulp through the labial access opening. After finishing the pulp treatment, discolored labial tooth structure was removed extending from access opening. Discoloration of deep area could be masked effectively using opaque sealant. Cavity on labial side was restored with composite resin. This labial approach method has several advantages. First, it gives a direct vision for effective pulp treatment which is also very useful for children with poor behavior. Second, most of lingual tooth structure could be saved and occlusal contact of lingual surface remains undisrupted. Only nonfunctional discolored labial surface may removed. Third, complete removal of discolored part of a labial tooth and immediate resin restoration could be done effectively after pulp treatment. Moreover, it also could be used for pulp treatment having serious dental caries on labial surface with sound lingual tooth structure. This report presents cases with discolored upper anteior primary tooth, approaching labial side with successful restoration.

Using the PNF Approach to Improve Respiratory Function in Patients with Cervical Spinal Cord Injuries (고유수용성촉진법을 이용한 호흡운동이 경수 손상환자의 호흡기능에 미치는 영향 : 증례보고)

  • Song, Gui-Bin;Kim, Jung-Bin
    • PNF and Movement
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    • v.12 no.2
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    • pp.115-121
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    • 2014
  • Purpose: The study aimed to examine the influence of PNF direct and indirect breathing treatments for patients with cervical spinal cord injuries who had breathing problems. Methods: For each cervical spinal cord patient, force vital capacity (FVC), peak expiratory flow, maximum phonation time (MPT), rib cage width, and VAS were measured pre-intervention and four weeks after post-intervention. The indirect method and the direct method were used for interventions. We treated patients with the indirect method using scapular anterior depression pattern, bilateral extensor pattern with rhythmic initiation, and a combination of isotonic. We treated patients with the direct method, applying pressure on the sternum and using rhythmic initiation (hold relax and stretch reflex) for the rib cage. Training occurred for 50 minutes a day and three days per week for four weeks. Results: FVC, MPT, peak expiratory flow, and rib cage width were increased and decreased at the VAS point for rolling after treatment. Conclusion: Patients with cervical spinal cord injuries who had breathing problems felt uncomfortable when they had conversations on a couch. We found that PNF direct and indirect treatments improved rib cage width and breathing functions of patients with cervical spinal cord injuries.

The new approach to maxillary and mandibular anterior dental arch forms - In Korean normal occlusion models (상하악 전치부 치열궁 형태에 대한 새로운 접근 - 한국성인 정상교합자 모델에서)

  • Ha, Man-Hee;Son, Woo-Sung;Yang, Hoon-Chul
    • The korean journal of orthodontics
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    • v.31 no.3 s.86
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    • pp.347-355
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    • 2001
  • Maxillary and mandibular anterior dental arches often have the problems of occlusal relation and esthetics by malformations of teeth, congenital missing, et at. Though the clinician usually use the anterior ratio to overcome this problems, he has the limitation of a direct application this ratio to the prediction of anterior occlusal relationship by the change of anterior ratio as dental arch form, intercanine width, segment depth and arch perimeter. So this study examine maxillary and mandibular anterior dental arch forms by least square method using Korean normal occlusion models(man : 20 casts, woman : 20 casts). Maxillary and mandibular anterior dental arches of Korean normal occlusion models are curve fitted to polynomial function, beta function, hyperbolic cosine function in order. And this accuracy of curve fitting is constant regardless of man/woman and maxilla/mandible. The relationships between intercanine width, segment depth, and arch perimeter based on this owe fitted dental arch form are acquired. This relationships will give the prediction of anterior dental arch form and the information of more accurate anterior ratio according to intercanine width.

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Extended Application of Endoscopic Repair for Frontal Sinus Fractures (전두동 골절에서 내시경적 치료의 확대 적용)

  • Jeong, Jae-Yeon;Lim, So-Young;Pyon, Jai-Kyong;Bang, Sa-Ik;Oh, Kap-Sung;Mun, Goo-Hyun
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.613-618
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    • 2010
  • Purpose: The coronal approach for repair of frontal sinus fractures is associated with significant adverse sequelae including a long scar, alopecia, paresthesias, and, uncommonly, facial nerve injury. To minimize these complications, an endoscopic approach for repair of frontal sinus fractures was developed. The authors now present the results of an endoscopy-assisted approach for the treatment of frontal sinus fractures. Methods: From 2002 to 2009, five patients with frontal sinus fracture underwent endoscopic repair. Two slit incisions were placed in the scalp, and one or two stab incisions directly over the fractures were placed in the forehead. After subperiosteal dissection, fracture segments were reduced under direct vision and fixed with microplates or fibrin glue. Results: All patients had good cosmetic results and remained free of sinus complaints. There were no perioperative complications reported. Conclusion: Endoscopic repair of frontal sinus fractures is an efficacious technique that significantly reduces patient morbidity. A relatively wide range of anterior table fractures can be reduced using an endoscope. In cases of complicated comminuted fractures, fibrin glue helps to achieve satisfactory endoscopic reduction. Endoscopic repair is an alternative treatment for various anterior table fractures of the frontal sinus.

Subbrow Approach as a Minimally Invasive Reduction Technique in the Management of Frontal Sinus Fractures

  • Lee, Yewon;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il;Kim, Soon Heum;Kim, Cheol Keun;Jo, Dong In
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.679-685
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    • 2014
  • Background Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures. Methods Between March 2011 and March 2014, 13 patients with isolated frontal sinus fractures were treated by open reduction and internal fixation through a subbrow incision. The subbrow incision line was designed to be precisely at the lower margin of the brow in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above the superior orbital rim. The fracture site of the frontal bone was reduced, and bone fixation was performed using an absorbable plate and screws. Results Contour deformities were completely restored in all patients, and all patients were satisfied with the results. Scars were barely visible in the long-term follow-up. No complications related to the procedure, such as infection, uncontrolled sinus bleeding, hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed. Conclusions The subbrow approach allowed for an accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by providing a direct visualization of the fracture. Considering the surgical success of the reduction and the rigid fixation, patient satisfaction, and aesthetic problems, this transcutaneous approach through a subbrow incision is concluded to be superior to the other reduction techniques used in the case of an anterior table frontal sinus fracture.

A biceps-bicaudatus sartorius muscle: dissection of a variant with possible clinical implications

  • Konstantinos Natsis;Christos Koutserimpas;Trifon Totlis;George Triantafyllou;George Tsakotos;Katerina Al Nasraoui;Filippos Karageorgos;Maria Piagkou
    • Anatomy and Cell Biology
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    • v.57 no.1
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    • pp.143-146
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    • 2024
  • The current cadaveric report describes an unusual morphology of the sartorius muscle (SM), the biceps-bicaudatus variant. The SM had two (lateral and medial) heads, with distinct tendinous origins from the anterior superior iliac spine. The lateral head was further split into a lateral and a medial bundle. The anterior cutaneous branch of the femoral nerve emerged between the origins of the lateral and medial heads. SM morphological variants are exceedingly uncommon, with only a few documented cases in the literature, and several terms used for their description. Although their rare occurrence, they may play an important role in the differential diagnosis of entrapment syndromes, in cases of neural compressions, such as meralgia paresthetica, while careful dissection during the superficial inter-nervous plane of the direct anterior hip approach is of utmost importance, to avoid adverse effects due to the altered SM morphology.

Thoracolumbar Spine Injury (흉요추부 손상)

  • Ahn, Myun-Whan
    • Journal of Yeungnam Medical Science
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    • v.19 no.2
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    • pp.73-91
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    • 2002
  • Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.

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Surgical Experience of Transsphenoidal-Supradiaphragmatic Intradural Approach to Presellar and Suprasellar Lesions

  • Park, Min-Woo;Kim, Jae-Min;Kim, Jae-Hoon;Bak, Koang-Hum;Kim, Choong-Hyun;Jeong, Jin-Hyeok
    • Journal of Korean Neurosurgical Society
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    • v.39 no.5
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    • pp.329-334
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    • 2006
  • Objective : In selected cases, the transsphenoidal approach[TSA] can be extended anteriorly to the tuberculum sellae, chiasmatic sulcus, and planum sphenoidale to obtain direct exposure of the suprasellar cisterns and its contents. We applied this modification of the TSA to various lesions of the presellar and suprasellar areas. We evaluate our clinical experience of this technique and review the related literature. Methods : From 1999 to 2004, we used the transsphenoidal supradiaphragmatic intradural approachs[TSIAs] in 9 patients who had various lesions at the pre- and suprasellar regions. Concomitant presellar extension of the bone window was performed with the sublabial or transnasal transseptal transphenoidal techniques. After removal of the lesions, sellar or anterior cranial floor was repaired with silicone plate substitute. Results : The TSIAs have been applied in the following cases : four tuberculum sellae meningiomas, two craniopharyngiomas, two Rathke's cleft cysts, and one non-functioning macroadenoma. The complications were one case of visual acuity decrease and one cerebrospinal fluid rhinorrhea. Conclusion : The TSIA is easily applicable through a minor modification of the standard TSA. It is suitable for removing lesions located in the presellar and suprasellar area adjacent to the pituitary stalk with minimal brain manipulation and decreased morbidity.