• Title/Summary/Keyword: Joint prosthesis

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The clinical appication of stomatognathic function and occlusion for the restorative dentistry (수복치료를 위한 구강악계의 임상적 응용)

  • Kang, Dong Wan;Lim, Seung Jin;Lee, Seung Hoon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.17 no.3
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    • pp.145-154
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    • 2001
  • In the past, many dentist were interested mainly in the mechanical aspects such as tooth preparation and retainer types for making dental restoration. But, these days, the concept of restorative treatment emphasizes the importarce of gnatic system and masticatory muscles in addition to oral cavity. So, the current considerations for the fixed prosthodontic treatment include the stabilization of temporomandibular joint and neuromuscualr system and the relationship of periodontal ligament and occlusion. To achieve the above objectives, occlusal splint has been used as one of the mouth preparations for restorative treatment. The objectives of occlusal splint are as follows; 1. To use as preliminary application for periodontal-occlusal treatment 2. To provide proper vertical dimension 3. To control abnormal habits and parafunction 4. To treat the temporomandibular disease and myofascial pain 5. To establish the new therapeutic position In some cases, the patients had improper vertical dimension and occlusal interferences caused by prostheses reconstucted using centric relation recorded without considering the health of TMJ and manticatory muscle. And these prosthesis act as primary source that cause pathologic phenomenon in periodontal ligament, muscles and TMJ. Physiologically, in order to make the treatment occlusion guided by proper centric relation method, the method should be guided after the use of occlusal splint for some period. The main objective of prosthetic treatment is to maintain the function and health of stomatognathic system. So, one of the most important things that have to be performed by clinicians is a clinical ability to do the correct diagnosis and treatment planning based on the stomatognatic function and occlusion.

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Correction of anterior ridge defect for conventional prosthesis (보철 치료시 전치부 치조제 결손부의 처치)

  • Chung, Jae-Eun;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Rhyu, In-Chul;Chung, Chong-Pyoung;Han, Soo-Boo
    • Journal of Periodontal and Implant Science
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    • v.38 no.4
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    • pp.729-736
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    • 2008
  • Purpose: Anterior ridge defect after tooth extraction results in unfavorable appearance. Ridge augmentation procedures should be preceded by careful surgical-prosthetic treatment planning, and various techniques can be used in anterior ridge augmentation. Materials and Methods: Three patients showed deformed ridges after tooth extraction. Three different techniques ; onlay-interpositional connective tissue graft; bovine hydroxyapatite graft with free connective tissue graft; bovine hydroxyapatite graft with resorbable collagen membrane following free connective tissue graft; were used for anterior ridge augmentation. Result: Soft tissue graft can be used in small amount of ridge defect, hard tissue graft combined with soft tissue graft can be used in large amount of ridge defect. After ridge augmentation, about three months of healing period, augmented tissue was stabilized. The final restoration was initiated after this healing period, and the tissue form was maintained stable. Conclusion: Careful diagnosis and surgical-prosthetic treatment planning with joint consultation prior to surgery should be performed in order to attain an optimal esthetic results.

Use of Expandable Prostheses in Malignant Bone Tumors in Children (소아 악성 골종양의 치료에서 확장형 종양대치물의 이용)

  • Han, Il-Kyu;Lee, Sang-Hoon;Cho, Hwan-Seong;Oh, Joo-Han;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.10-16
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    • 2008
  • With the advent of effective chemotherapy and the realization of high economic cost associated with amputation, limb salvage surgery has become the standard of treatment in children with primary malignant bone tumors. Reconstruction after resection of malignant bone tumors of children has to address the leg length inequality and also has to be durable to cope with high functional demands of young patients. Expandable endoprostheses have been used in children for achieving limb length equality with substantial risk of complications. Recently, significant advances in prosthetic designs have reduced the morbidities associated with these prostheses. The purpose of this study was to review the indications, characteristics, complications and recent developments of expandable endoprostheses used for malignant bone tumors in children.

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Primary Total Elbow Replacement for Treatment of Complex Distal Humerus Fracture: Outcomes of Short-term Follow-up

  • Kim, Du-Han;Kim, Beom-Soo;Baek, Chung-Sin;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • v.23 no.1
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    • pp.20-26
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    • 2020
  • Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

Micro Total Hip Replacement in Two Dogs with Legg-Calvé-Perthes Disease

  • Roh, Yoon-seok;Heo, Su-Young;Yoon, Jang-won;Park, Jiyoung;Jeong, Seong-Mok;Lee, Hae-beom
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.454-458
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    • 2017
  • A Maltese (case 1) and a Pomeranian (case 2) presented with acute right and left hind limb weight-bearing lameness. On physical examination, they exhibited severe pain and crepitus on the coxofemoral joint of affected hind limb. In addition, decreased thigh girth measurements were noted compared with the opposite leg. Radiological exam revealed necrotic areas in the femoral head of affected hind limb. These dogs were diagnosed with Legg-$Calv{\acute{e}}$-Perthes disease (LCPD). The dogs underwent micro total hip replacement (THR). After surgery, at 3 years (case 1) and 7 months (case 2), both dogs recovered normal activity. The thigh girth and lameness scores were apparently improved in the affected limbs of both dogs. No complications of prosthesis implants, such as loosening, were noted. The clinical outcomes of these cases indicate that dogs with LCPD can be successfully treated with micro THR and have a good prognosis immediately after surgery.

High Grade Surface Osteosarcoma - Case Report - (고등급 표면(High Grade Surface) 골육종 - 증례 보고 -)

  • Lee, Bong-Jin;Lee, Sung-Rak;Yoo, Tae-Yeul;Eom, Ki-Seong;Ha, Chang-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.32-37
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    • 2002
  • High grade surface osteosarcoma is the most rare subtype of osteosarcoma arising on the surface of bone, accounting for less than 1% of the total number of osteosarcomas. Only a few case reports and studies have been reported in the world. In Korea, only one case out of 127 osteosarcomas has been described up to now, but there was no information about the patient, clinicopathologic features and treatment. We experienced a case of high grade surface osteosarcoma in the subtrochanteric area of a 66-year-old female and treated her with neoadjuvant chemotheraphy, wide resection and limb salvage operation with tumor prosthesis and adjuvant chemotheraphy. This tumor is identical to conventional high grade intramedullary osteosarcoma in histology, treatment and prognosis. So, this tumor should be differentiated from other surface osteosarcomas such as parosteal osteosarcoma and periosteal osteosarcoma.

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Proximal Humerus Brown Tumor with Primary Hyperparathyroidism in Pregnancy (임신중 발생한 원발성 부갑상선 기능 항진증을 동반한 상완골 근위부의 Brown tumor)

  • Jung, Sung-Taek;Kim, Hyun-Jeong;Lee, Dam-Seon;Park, Gi-Heon
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.173-179
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    • 2007
  • Brown tumor is tumor like lesion resulted from hyperparathyroidism, and it has been rarely reported recently. We evaluated a 29-year-old woman who had brown tumor on proximal humerus caused by primary hyperparathyroidism. She first had presented pain and swelling over the upper arm, and was suspected as giant cell tumor in biopsy combined with hyperparathyroidism. Wide marginal excision and tumor prosthesis were performed. However, it was confirmed as brown tumor resulted from parathyroid adenoma according to laboratory findings and radioactive isotopes image, and surgical excision of adenoma relieved clinical symptoms. We report this case with a review of literatures.

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Bilateral Patellar Groove Replacement in a Dog with Iatrogenic Trochlear Groove Damage

  • Kim, Yongrak;Park, Yunsik;Park, Jiyoung;Jeong, Seong Mok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.33 no.5
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    • pp.295-299
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    • 2016
  • A 2-year-old, 1.94 kg spayed female Toy Poodle was referred for revision surgery for patellar reluxation following surgery for bilateral medial patellar luxation (MPL). Intermittent non-weight-bearing lameness of the right hindlimb and weight-bearing lameness of the left hindlimb were evident on general inspection. A physical examination revealed that there was a bilateral grade 4 MPL. On radiographs, the medial and lateral trochlear ridge was bilaterally worn out. Patellar groove replacement (PGR) was performed in two stages to replace the bilateral femoral trochlea that had a severely worn out groove. Corrective femoral osteotomy with increasing anteversion angle, tibial tuberosity transposition, medial releasing, lateral imbrications and PGR were performed on the right hindlimb. Six months after surgery on the right hindlimb, a PGR prosthesis was positioned medially on the frontal plane and tibial tuberosity transposition and lateral imbrications were performed on the left hindlimb. Two weeks after surgery, reluxation of the patella occurred on the left hindlimb. The tibial tuberosity transposition was performed to realign the patella more laterally than the previous surgery, and a patellar sling was applied. Two years after the last surgery, the patient showed no pain on the stifle joint and satisfactory weight-bearing ambulation. Reluxation did not recur. PGR maybe a successful treatment for dogs with iatrogenically damaged and/or worn out patellar grooves.

The Effect of Uncinate Process Resection on Subsidence Following Anterior Cervical Discectomy and Fusion

  • Lee, Su Hun;Lee, Jun Seok;Sung, Soon Ki;Son, Dong Wuk;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.60 no.5
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    • pp.550-559
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    • 2017
  • Objective : Subsidence is a frequent complication of anterior cervical discectomy and fusion. Postoperative segmental micromotion, thought to be a causative factor of subsidence, has been speculated to increase with uncinate process resection area (UPR). To evaluate the effect of UPR on micro-motion, we designed a method to measure UPR area based on pre- and postoperative computed tomography images and analyzed the relationship between UPR and subsidence as a proxy of micro-motion. Methods : We retrospectively collected clinical and radiological data from January 2011 to June 2016. A total of 38 patients (53 segments) were included. All procedures included bilateral UPR and anterior plate fixation. UPR area was evaluated with reformatted coronal computer tomography images. To reduce level-related bias, we converted UPR area to the proportion of UPR to the pre-operative UP area (pUPR). Results : Subsidence occurred in 18 segments (34%) and positively correlated with right-side pUPR, left-side pUPR, and the sum of bilateral pUPR (sum pUPR) (R=0.310, 301, 364; p=0.024, 0.029, 0.007, respectively). Multiple linear regression analysis revealed that subsidence could be estimated with the following formula : $subsidence=1.522+2.7{\times}sum\;pUPR$($R^2=0.133$, p=0.007). Receiver-operating characteristic analysis determined that sum $pUPR{\geq}0.38$ could serve as a threshold for significantly increased risk of subsidence (p=0.005, area under curve=0.737, sensitivity=94%, specificity=51%). This threshold was confirmed by logistic regression analysis for subsidence (p=0.009, odds ratio=8.471). Conclusion : The UPR measurement method confirmed that UPR was correlated with subsidence. Particularly when the sum of pUPR is ${\geq}38%$, the possibility of subsidence increased.

Full mouth rehabilitation of a patient with severe tooth erosion with a digital crown lengthening guide (심한 부식 환자의 디지털 치관연장술 가이드를 이용한 전악 수복 증례)

  • Park, Yunjae;Hong, Seoung-Jin;Paek, Janghyun;Pae, Ahran;Kim, Hyeong-Seob
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.3
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    • pp.280-287
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    • 2019
  • In the oral cavity, the teeth undergo wear and corrosion throughout their lives. Progressive and constant tooth wear is a natural phenomenon of aging, but wear and corrosion due to specific factors are pathological factors. It can cause pathological damage of the occlusal surface, aesthetic problems, dimensional loss and jaw joint disorders. This case is a 26-year-old female patient with general tooth abrasion and erosion on the entire dentition. Diagnostic wax-up was fabricated based on the information including digital facial analysis, physiological stabilization, and evaluation of anterior crown length. Through the digital analysis, the necessary guides for crown lengthening were prepared and the mastication function and esthetics were evaluated by using temporary crowns. Definitive prosthesis was fabricated with the zirconia restorations. The results were satisfactory when they were observed 3 months of follow-up.