• Title/Summary/Keyword: External Implant

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Correlations between anatomical variations of the nasal cavity and ethmoidal sinuses on cone-beam computed tomography scans

  • Shokri, Abbas;Faradmal, Mohammad Javad;Hekmat, Bahareh
    • Imaging Science in Dentistry
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    • v.49 no.2
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    • pp.103-113
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    • 2019
  • Purpose: Anatomical variations of the external nasal wall are highly important, since they play a role in obstruction or drainage of the ostiomeatal complex and ventilation and can consequently elevate the risk of pathological sinus conditions. This study aimed to assess anatomical variations of the nasal cavity and ethmoidal sinuses and their correlations on cone-beam computed tomography (CBCT) scans. Materials and Methods: This cross-sectional study evaluated CBCT scans of 250 patients, including 107 males and 143 females, to determine the prevalence of anatomical variations of the nasal cavity and ethmoidal sinuses. All images were taken using a New Tom 3G scanner. Data were analyzed using the chi-square test, Kruskal-Wallis test, and the Mann-Whitney test. Results: The most common anatomical variations were found to be nasal septal deviation (90.4%), agger nasi air cell (53.6%), superior orbital cell(47.6%), pneumatized nasal septum(40%), and Onodi air cell(37.2%). Correlations were found between nasal septal deviation and the presence of a pneumatized nasal septum, nasal spur, and Haller cell. No significant associations were noted between the age or sex of patients and the presence of anatomical variations (P>0.05). Conclusion: Radiologists and surgeons must pay close attention to the anatomical variations of the sinonasal region in the preoperative assessment to prevent perioperative complications.

Maxillo-mandibular Defect Reconstruction with Bilateral Free Fibula Flaps with Dental Implant Placement and Immediate Loading: A Case Report of the Three-team Approach

  • Nazarian, David;Dikarev, Aleksei;Mokhirev, Mikhail;Zakharov, Georgy;Fedosov, Alexander;Potapov, Maksim;Chernenkiy, Mikhail;Vasilev, Yuriy;Kyalov, Grigoriy;Chausheva, Saniyat;Khachatryan, Arbak;Tevosyan, Artur;Arakelyan, Gevorg
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.652-655
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    • 2022
  • Patients with advanced malignant tumors, including both jaws, is a challenging task for a head and neck surgeon. Current treatment landscape demonstrates good functional, anatomical, and aesthetic results in patients who could previously receive only palliative care. The extensive tissue defects resulting from oncological resections in the head and neck region require immediate reconstruction due to the exposure of vital structures and their contact with the external environment. A patient was operated using a three-team multidisciplinary approach involving simultaneous work of three specialized teams of maxillofacial and reconstructive microsurgeons, as well as an implantologist and a prosthodontist. This approach allowed simultaneous tumor resection with subsequent reconstruction of the intraoperative defect involving bilateral harvesting of two revascularized free fibular osteomusculocutaneous flaps with dental implantation and simultaneous rehabilitation of dentition with crowns.

Resorbability and histological reaction of bioabsorbable membranes (수종의 흡수성 차단막의 생체 분해도와 조직학적 반응)

  • Suk, Hun-Joo;Kwon, Suk-Hoon;Kim, Chang-Sung;Choi, Seong-Ho;Jeon, Dong-Won;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.32 no.4
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    • pp.781-800
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    • 2002
  • The major goals of periodontal therapy are the functional regeneration of periodontal supporting structures already destructed by periodontal disease. There have been many efforts to develop materials and therapeutic methods to promote periodontal wound healing. With the development of non-resorbable membrane, GTR has proved to be the representive technique of periodontal regeneration. However, due to various clinical problems of non-resorbable membrane, resorbable membrane was developed and it showed to be clinically effective. The newly developed Para-Dioxanone membrane has a characteristic of non-woven fabric structures which is different from the generally used membranes with structure of mesh form. In addition, Chitosan membrane has been developed to apply its adventage maximally in GTR. Although a number of different types of membranes had been clinically used, researches on absorption rate of membranes were inadequate and limited to subjective opinions. However, since long term period of resorption and space maintenance are required in implant or ridge augmentation, accurate verification of resorption rate is clinically important. In this study, we had implanted Resolut(R), Biomesh(R), Para-Dioxanone membrane and Chitosan membrane (Size : 4mm ${\times}$ 4mm) on dorsal side of Sprague Dawley rat, and sacrified them after 4 weeks, 8 weeks, 12 weeks respectively. Histologic observation was carried out, and the following results were obtained by calculating the objective resorption rate. 1. In case of Resolut(R), external resorption took place initially, followed by internal resorption. Surface area are 5.76${\pm}$2.37$mm^2$, 4.90${\pm}$l.06$mm^2$, 4.90${\pm}$0.98$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.6${\pm}$4.5%, 52.8${\pm}$9.4%, 56.4${\pm}$5.1% respectively. 2. Biomesh(R) showed a pattern of folding, relatively slow resorption rate with small size of membrane. Surface area are 3.62${\pm}$0.82$mm^2$, 3.63${\pm}$0.76$mm^2$, 4.07${\pm}$1.14$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 26.1${\pm}$5.8%, 30.9${\pm}$3.4%, 29.2${\pm}$3.6%, respectively. 3. Para-Dioxanone membrane was surrounded by fibrous conncetive tissue externally, and resorption took place internally and externally. Surface area are 5.96${\pm}$1.05$mm^2$, 4.77${\pm}$10.76$mm^2$, 3.86${\pm}$0.84$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 30.7${\pm}$5.1%, 53.3${\pm}$4.4%, 69.5${\pm}$3.1%, respectively. 4. Each fiber of Chitosan membrane was surrounded by connective tissue and showed external resorption pattern. It showed little invasion of inflammatory cells and excellent biocompatability. The resorption rate was relatively slow. Surface area are 6.01${\pm}$2.01$mm^2$, 5.49${\pm}$1.3$mm^2$, 5.06${\pm}$1.38$mm^2$ at 4 weeks, 8 weeks, 12 weeks respectively, and invasion rate of connective tissue to membrane are 31.3${\pm}$3.6%, 38.4${\pm}$3.80%, 39.7${\pm}$5.6%, respectively. Consequently, Para-Dioxanone membrane and Chitosan membrane are found to be clinically effective for their excellent tissue reaction and biocompatibility. Futhermore, the advantage of bone regenerating ability as well as the relatively long resorption period of Chitosan membrane, it might be widely used in implant or ridge augmentation.

Detorque values of abutment screws in a multiple implant-supported prosthesis (다수 임플란트 지지 보철물에서 지대주 나사의 풀림 토크값에 대한 연구)

  • Lee, Ju-Ri;Lee, Dong-Hwan;Hwang, Jae-Woong;Choi, Jung-Han
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.4
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    • pp.280-286
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    • 2010
  • Purpose: This study evaluated the detorque values of screws in a multiple implant-supported superstructure using stone casts made with 2 different impression techniques. Material and methods: A fully edentulous mandibular master model and a metal framework directly connected to four implants (Br${\aa}$nemark $System^{(R)}$; Nobel Biocare AB) with a passive fit to each other were fabricated. Six experimental stone casts (Group 1) were made with 6 non-splinted impressions on a master cast and another 6 experimental casts (Group 2) were made with 6 acrylic resin splinted impressions. The detorque values of screws ($TorqTite^{(R)}$ GoldAdapt Abutment Screw; Nobel Biocare AB) were measured twice after the metal framework was fastened onto each experimental stone cast with 20 Ncm torque. Detorque values were analyzed using the mixed model with the fixed effect of screw and reading and the random effect of model for the repeated measured data at a .05 level of ignificance. Results: The mean detorque values were 7.9 Ncm (Group 1) and 8.1 Ncm (Group 2), and the mean of minimum detorque values were 6.1 Ncm (Group 1) and 6.5 Ncm (Group 2). No statistically significant differences between 2 groups were found and no statistically significant differences among 4 screws were found for detorque values. No statistically significant differences between 2 groups were also found for minimum detorque values. Conclusion: In a multiple external hexagon implant-supported prosthesis, no significant differences between 2 groups were found for detorque values and for minimum detorque values. There seems to be no significant differences in screw joint stability between 2 stone cast groups made with 2 different impression techniques.

Influence of Implant Abutment Systems on Detorque Value and Screw Joint Stability (임플랜트 지대주 종류가 나사풀림력과 연결부의 안정성에 미치는 영향)

  • Bae, Byung-Ryong;Choi, Yu-Sung;Cho, In-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.2
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    • pp.97-109
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    • 2010
  • Purpose : This study was designed to evaluate the influence of implant abutment materials on detorque value and screw joint stability before and after dynamic fatigue test. Materials & Methods : The external hexagonal fixture and three different groups of abutment (titanium abutments, zirconia abutments, and UCLA abutments) were used. The detorque value before loading and after loading (cyclic loading up to $10^5$ cycles) of the abutment screw were measured. Result : 1. There was no significant difference in detorque value before loading among the each group. 2. There was no significant difference in detorque value after loading among the each group. 3. Detorque values before and after cyclic loading in each group were not significantly different. 4. There was no significant difference in loss percentage of removal torque before loading among the each group. 5. There was no significant difference in loss percentage of removal torque after loading among the each group. 6. There was no significant difference in loss percentage of removal torque according to loading among the each group. Conclusion : Short term screw loosening of three types of abutment was not significantly different. When bite force was applied, there was no significant difference in screw loosening between before loading and after loading.

A Literature Review on Nano-Modified Implant Surfaces (나노구조 표면에 관한 문헌고찰)

  • Park, Go-Woon;Cha, Min-Sang;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.2
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    • pp.141-151
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    • 2013
  • The nano-surface modification techniques could be classified; internal modifications which enhance surface roughness and porosity in nano level and external modifications as nano particle coating. Nano-modified implant surface has various morphograpies such as nanotube, nanopit, nanonodule and polymorphic structures. Creating surface depends upon preparation method and material, however, there is no standard preparation technique not yet. The nano-modified surfacet is electrochemically stable comparing with the surface modified in micron level. Nano-modified surface has little cytotoxicity, stimulates osteoblast proliferation and differentiation. Moreover, it decreases soft tissue intervention by interrupting the proliferation of fibroblast. Nanostructure has similar size and shape with cells and proteins, consequently leads to good biocompatibility and enhanced osseointegration. However, the actual effect in vivo is limited, due to the distance of effect. Even if nano-modified surface has antibiotic property due to photocatalysis, short duration time makes clinical application questionable. Further investigations should focus on the optimal nano-modified surface, which has many potentials.

Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?

  • Troy Li;Kenneth H. Levy;Akiro H. Duey;Akshar V. Patel;Christopher A. White;Carl M. Cirino;Alexis Williams;Kathryn Whitelaw;Dave Shukla;Bradford O. Parsons;Evan L. Flatow;Paul J. Cagle
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.245-251
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    • 2023
  • Background: For anatomic total arthroscopic repair, cementless humeral fixation has recently gained popularity. However, few studies have compared clinical, radiographic, and patient-reported outcomes between cemented and press-fit humeral fixation, and none have performed follow-up for longer than 5 years. In this study, we compared long-term postoperative outcomes in patients receiving a cemented versus press-fit humeral stem anatomic arthroscopic repair. Methods: This study retrospectively analyzed 169 shoulders that required primary anatomic total shoulder arthroplasty (aTSA). Shoulders were stratified by humeral stem fixation technique: cementation or press-fit. Data were collected pre- and postoperatively. Primary outcome measures included range of motion, patient reported outcomes, and radiographic measures. Results: One hundred thirty-eight cemented humeral stems and 31 press-fit stems were included. Significant improvements in range of motion were seen in all aTSA patients with no significant differences between final cemented and press-fit stems (forward elevation: P=0.12, external rotation: P=0.60, and internal rotation: P=0.77). Patient reported outcome metrics also exhibited sustained improvement through final follow-up. However, at final follow-up, the press-fit stem cohort had significantly better overall scores when compared to the cemented cohort (visual analog score: P=0.04, American Shoulder and Elbow Surgeon Score: P<0.01, Simple Shoulder Test score: P=0.03). Humeral radiolucency was noted in two cemented implants and one press-fit implant. No significant differences in implant survival were observed between the two cohorts (P=0.75). Conclusions: In this series, we found that irrespective of humeral fixation technique, aTSA significantly improves shoulder function. However, within this cohort, press-fit stems provided significantly better outcomes than cemented stems in terms of patient reported outcome scores. Level of evidence: III.

Alveolar Bone Formation in Dogs using Vicryl Absorbable Mesh(Polyglactin 910) and Decalcified Freeze-Dried Bone Grafting (흡수성 차폐막과 동종탈회동결건조골 이식에 의한 치조골 재생의 병용효과)

  • Oh, Eun-Chung;Chung, Hyun-Ju;Kim, Young-Jun
    • Journal of Periodontal and Implant Science
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    • v.29 no.3
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    • pp.469-484
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    • 1999
  • The purpose of this study was to evaluate new bone formation following guided bone regeneration by resorbable and nonresorbable membrane. Six adult mongrel dogs were used. The first, second, third, fourth premolars in the mandible of each dog were extracted. Two months after tooth extraction, a buccal dehiscence defect was surgically created on each edentulous area. The experimental sites were divided into three groups according to the treatment modalities ; Group I-a: surgical treatment only ; Group I -b: allogenic decalcified freezed dried bone grafting ; Group II-a : e- PTFE membrane placement only ; Group II-b : allogenic decalcified freezed dried bone grafting and e-PTFE membrane placement ; Group III-a : Vicryl(R) mesh placement only ; Group III-b : allogenic decalcified freezed dried bone grafting and Vicryl(R) mesh placement . The animals were sacrificed at 8 weeks after operation and the specimens were prepared for histologic and histometric examination. The results were as follows : Clinically, all defect sites were healed without exposure of barrier membrane after the eight weeks. In Group I-a, dense connective tissues were impinged in the bony defect area. Well vascularized and fibrous bone marrow indicated that bone formation was still taking place was found. In Group I-b, in areas closer to the periphery, lamellation of the newly formed bone would found. In Group II-a, beneath the e-PTFE membrane a dense layer of connective tissue covering the most external portions of the regenerated tissue was seen. The new bone surfaces were lined with osteoid and osteoblast. In Group II-b, a dense layer of connective tissue covering the most external portions of the regenerated tissue was observed beneath the e-PTFE membrane. A notable amount of alveolar ridge regeneration was seen with new rigdes with well-contoured form. In Group III-a, the new bone surface were lined with osteoid and osteoblast, indicating active bone formation. A clear demarcation could not be noted between the host bone and new bone. In Group III-b, a notable amount of alveolar ridge regeneration was seen with new ridges assuming wellcontoured form. In areas closer to the periphery, lamellation of the newly formed bone would found. As histometric examination, the amount of bone formation was gained from $12.8mm^2$ to $26.3mm^2$. It was significantly greater in group II-b and group III-b compared to other groups(p<0.05) . These results suggest that Vicryl(R) mesh after DFDB grafting used in guided bone regeneration could create and sustain sufficient space for new bone formation.

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Internal Fixation of Long Bone Fractures in 6 Calves (송아지에서 발생한 긴뼈골절의 내고정 치료 6례)

  • Park, Jin-Uk;Cho, Ki-Rae;Kim, Joong-Hyun;Choi, Seok-Hwa;Kim, Gon-Hyung
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.658-662
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    • 2007
  • The simple and easy treatment with cast or splint has been applied to stabilize long bone fractures in farm animals. Applying cast or splint is relatively easier than surgical fixation and may temporarily stabilize fracture site. However, the internal fixation provides strong stabilization and early recovery of limb function. In this report, we describe six cases of limb fractures in calves repaired by internal fixation. Fracture sites are various and affected ages are between 1 day and several months old. In some cases, patients were treated with cast or splint before admitting to Veterinary Medical Center. In these patients, regardless of initial treatment fractures were not immobilized. Consequently we decided to treat these patients with open reduction and internal fixation. The fracture repair with implants(bone plate, screw, cerclage wire, and intramedullary pin) were effective and satisfactory in calves which had been failed by application of cast. Although the cost of orthopedic treatment in farm animal is one of the most important considerations from the practical point of view, internal fixation has many benefits in newborn and young calves. And simplicity of postoperative management is also practically significant benefit expected from infernal fixation In conclusion, we suggest that internal fixation will produce better result than external coaptation in calve.

Force Analysis of Wrist Joint to Develop Wrist Implant and Mechanical Hand Using Optimization Technique and Finite Element Method (인공수근관절과 의수를 개발하기 위한 최적설계법과 유한요소법에 의한 수근관절의 역학적해석)

  • Jung-Soo Han
    • Journal of the Korean Society of Safety
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    • v.12 no.3
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    • pp.178-184
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    • 1997
  • Many mathematical techniques have been developed to determine the muscle forces and force distribution in biomechanical human model, because it is so important to understand internal forces resisting external loading. However, a three-dimensional mathematical model of wrist joint, which is essential to develop solid modeling and artificial wrist joint, has not been well developed. This study proposed to define three-dimensional mathematical model of distal radius and ulna of the human wrist and to develop a detailed two-dimensional finite element through comparisons to existing analytical models and experimental tests. This mathematical model were accurately recreated, allowing the internal tendon force as well as force transmission and distribution through the distal radios and ulna during dynamic loadings. The results found in this study indicate and support the findings of other investigator that cyclic loading condition results in higher compression force on distal radius and ulna and may be source of wrist disorder.

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