• Advances in materials Research
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• v.1 no.4
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• pp.311-347
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• 2012

Infections are caused due to the infiltration of tissue or organ space by infectious bacterial agents, among which Staphylococcus aureus bacteria are clinically most relevant. While current treatment modalities are in general quite effective, several bacterial strains exhibit high resistance to them, leading to complications and additional surgeries, thereby increasing the patient morbidity rates. Titanium dioxide is a celebrated photoactive material and has been utilized extensively in antibacterial functions, making it a leading infection mitigating agent. In view of the property amelioration in materials via nanofication, free-standing titania nanofibers (pure and nominally doped) and nanocoatings (on Ti and Ti6Al4V implants) were fabricated and evaluated to assess their efficacy to mitigate the viability and growth of S. aureus upon brief (30 s) activation by a portable hand-held infrared laser. In order to gauge the effect of exposure and its correlation with the antibacterial activities, both isolated (only titania substrate) and simultaneous (substrate submerged in the bacterial suspension) activations were performed. The bactericidal efficacy of the IR-activated $TiO_2$ nanocoatings was also tested against E. coli biofilms. Toxicity study was conducted to assess any potential harm to the tissue cells in the presence of photoactivated materials. These investigations showed that the photoactivated titania nanofibers caused greater than 97% bacterial necrosis of S. aureus. In the case of titania-coated Ti-implant surrogates, the bactericidal efficacy exceeded 90% in the case of pre-activation and was 100% in the case of simultaneous-activation. In addition to their high bactericidal efficacy against S. aureus, the benignity of titania nanofibers and nanocoatings towards tissue cells during in-vivo exposure was also demonstrated, making them safe for use in implant devices.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.571-575
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• 2014

Background Disulfiram implantation is a widely used treatment alternative for alcohol abuse, yet reports on the surgical aspect of disulfiram implantation with respect to patient and drug-related treatment efficacy and wound complications are very limited. We present our clinical experiences with disulfiram implantation and discuss the surgical outcomes obtained with different anatomical planes for implantation. Methods Medical records of all patients referred to our clinic from the psychiatry department between 2007 and 2013 for disulfiram implantation were retrospectively analyzed. Implantation was carried out using 10 sterile Disulfiram tablets (WZF Polfa S.A.), each tablet containing 100 mg of disulfiram. The procedure was carried out by implanting the tablets randomly in either a subcutaneous or an intramuscular plane. The location and the plane of implantation and the complications were recorded for each patient and compared to determine the differences in the outcomes. Results A total of 32 implantation procedures were evaluated for this study. Twenty-five implants were placed in the intramuscular plane (78.2%), while seven implants were placed subcutaneously (21.8%). Exposure was encountered in three of the seven subcutaneous implants (42.9%), while no exposure was seen with the intramuscular implants. Incomplete absorption of the tablets was encountered in one patient with a previous subcutaneous implant who presented 1 year later for re-implantation as part of the continuation of therapy. Conclusions To overcome the issue of treatment continuation in the case of disulfiram therapy, which may be ceased due to frequently encountered wound complications, we believe that implantation in the subscapular intramuscular plane allows both uneventful healing and an out-of-reach implant location.

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.229-237
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• 2015

Purpose: The aim of this study was to determine the clinical feasibility of using dehydrothermally cross-linked collagen membrane (DCM) for bone regeneration around peri-implant dehiscence defects, and compare it with non-cross-linked native collagen membrane (NCM). Methods: Dehiscence defects were investigated in twenty-eight patients. Defect width and height were measured by periodontal probe immediately following implant placement (baseline) and 16 weeks afterward. Membrane manipulation and maintenance were clinically assessed by means of the visual analogue scale score at baseline. Changes in horizontal thickness at 1 mm, 2 mm, and 3 mm below the top of the implant platform and the average bone density were assessed by cone-beam computed tomography at 16 weeks. Degradation of membrane was histologically observed in the soft tissue around the implant prior to re-entry surgery. Results: Five defect sites (two sites in the NCM group and three sites in the DCM group) showed soft-tissue dehiscence defects and membrane exposure during the early healing period, but there were no symptoms or signs of severe complications during the experimental postoperative period. Significant clinical and radiological improvements were found in all parameters with both types of collagen membrane. Partially resorbed membrane leaflets were only observed histologically in the DCM group. Conclusions: These findings suggest that, compared with NCM, DCM has a similar clinical expediency and possesses more stable maintenance properties. Therefore, it could be used effectively in guided bone regeneration around dehiscence-type defects.

• Journal of Periodontal and Implant Science
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• v.35 no.4
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• pp.1073-1079
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• 2005

1. Objective. The aim of this study was to investigate whether dental implant exposure to the maxillary sinus cavity increases the risk of maxillary sinus complications. 2. Study design. An implant was placed bilaterally in the maxillary sinus of eight adult female mongrel dogs in a way that it penetrated the bone and mucous membrane of the maxillary sinus floor to the extent of 2 mm, 4 mm, or 8 mm. The implants were left in place for six months. 3. Results. Radiographic and histologic examinations did not show any signs of pathologic findings in the maxillary sinus of the eight dogs. 4. Conclusion. This study indicates that implant protrusion into the maxillary sinus cavity is not related to the development of sinus complications.

• Journal of International Society for Simulation Surgery
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• v.1 no.2
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• pp.99-102
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• 2014

The skull defect can be made after the trauma, oncologic problems or neurosurgery. The skull reconstruction has been the challenging issue in craniofacial fields for a long time. So far the skull reconstruction with autogenous bone would be the standard. Although the autogenous bone would be the ideal one for skull reconstruction, donor site morbidity would be the inevitable problem in many cases. Meanwhile various types of allogenic and alloplastic materials have been also used. However, skull reconstruction with many alloplastic material have produced no less complications including infection, exposure, and delayed wound healing. Because the 3D printing technique evolved so fast that 3D printed titanium implant were possible recently. The aim of this trial is to try to restore the original skull anatomy as possible using the 3D printed titanium implant, based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. And we fabricated Titanium implant to reconstruct three-dimensional orbital structure in advance, using the 3D printer. This prefabricated Titanium-implant was then inserted onto the defected skull and fixed. Three dimensional printing technique of titanium material based on the computer simulation turned out to be very successful in this patient. Individualized approach for each patient could be an ideal way to manage the traumatic patients in near future.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.553-560
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• 1999

The aim of the present study was to evaluate the effect of the expanded polytetrafluoroethylene (e-PTFE) membrane exposure on the initial healing of the periodontal tissue in guided tissue regeneration (GTR) procedure. 90 sites selected from 90 patients were treated with gingival flap surgery supported by an e-PTFE membrane. The material included angular bony defects with probing attachment loss of > 5mm or degree II furcation involvement. Treated sites were classified with membrane exposure group and non-exposure group at membrane removal and evaluated healing type. The results were obtained as follows. 1. e-PTFE membrane was exposed at 61 sites (67.8%) among 90 sites. 2. Thirteen sites (14.4%) depicted rapid healing type, 65 sites (72.2%) depicted typical healing type, 9 sites (10%) showed delayed healing type and 3 sites (3.3%) were categorized as adversed healing type. 3. In e-PTFE membrane exposure group, 1 site (1.6%), 51 sites (83.6%), 6 sites (9.8%) and 3 sites (4.9%) showed rapid healing type, typical healing type, delayed healing type and adverse healing type respectively. 4. In e-PTFE membrane non-exposure group, 12 sites (41.3%), 14 sites (48.3%) and 3 sites (10.3%) showed rapid healing type, typical healing type and delayed healing type respectively. Adverse healing type was not observed. 5. The rate of favourable healing between e-PTFE membrane exposure group and non-exposure group was not statistically significant(p=0.56). These results suggest that the prevention of membrane exposure may be important to obtain rapid healing type. However favourable healing could be obtained with stringent infection control program even if membrane was exposed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.352-358
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• 2011

Purpose: This study evaluated the prognosis and survival rate of SLA (Sandblasted, Large-grit and Acid-etched) implants and it also evaluated the prosthodontic complications and the associated factors. Methods: Twenty seven patients (14 men and 13 women, mean age: 54.9) who visited Chosun University Hospital Implant Center with the chief desire for placement of an implant in an edentulous area from March, 2008 to December 2008 and who received placement of a SLA implant ($Implantium^{(R)}$, Dentium Co., Korea) were selected for this study. Results: The average follow-up period was 15 months and the study was based on the treatment records, radiographs and clinical examinations. A total of 69 implant cases were retrospectively assessed for the width and length of the implant, the primary and secondary stability, the combined surgery, the employed bone graft material and barrier membrane, the status of the opposing tooth, implant failure and the prosthetic complications. During the follow-up period (average: 15 months), the accumulative survival rate of the 69 implants in 27 patients was 100%. Complications such as infection, sinusitis and fixture exposure after surgery were seen for 5 implants in 4 patients. Complications such as screw loosening, contact loosening and peri-implant gingivitis after prosthodontic treatment occurred in 7 cases (10.14%). Conclusion: This study reports placement of SLA implants may cause various complications, yet the final accumulative survival rate was 100%. The SLA implant ($Implantium^{(R)}$) has an excellent clinical survival rate and outcome.

• Journal of Periodontal and Implant Science
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• v.44 no.2
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• pp.94-99
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• 2014

Purpose: Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the longterm outcome of this grafted gingiva. Methods: A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap. Results: At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue. Conclusions: Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.

• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.253-259
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• 2020

Mammography has the advantage of being economical, simple and effective in detecting microcalcification, but breast is a highly sensitive organ and is accompanied by the risk of an over-exposure. While accurate dose assessments are important to prevent this, current breast dose assessments are limited to breast implant patients. This purpose of this study was to identify dose variations due to tube voltages by forming a mock-up with breast implants for an accurate dosimetric assessment on breast implant patients. As a result, doses from the presence of breast implants were smaller than those from the absence of the mammal. As the result of the change of the voltage to 26, 28, 30, and 32 kV, the imcreased tube voltage included larger dose regardless of the presence of Breast implant. Therefore, it is believed that diagnosis recommendations for breast implants will be possible if further studies on internal and external bioretical imaging and quality assessment are carried out as the basis for this study.

• Journal of Periodontal and Implant Science
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• v.45 no.3
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• pp.82-93
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• 2015

Purpose: This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods: Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results: Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions: Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant.