• 제목/요약/키워드: Neck Bone

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Collar design이 임플랜트 주위 변연골 흡수에 미치는 영향 (The influence of Collar design on peri-implant marginal bone tissue)

  • 김지환;정문규;문홍석;한동후
    • 대한치과보철학회지
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    • 제46권1호
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    • pp.53-64
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    • 2008
  • 임플랜트 주위 변연골의 흡수는 임플랜트의 기능적 및 심미적 성공에 큰 장애가 되는 요인이다. Adell은 임플랜트에 지대주 연결 후 첫 1년간 평균적으로 1.5mm의 변연골 소실을 보이고, 이 후에는 매년 0.1mm이하의 변연골 흡수가 있었다고 하였다(Adell et al.,1981). 이러한 변연골 흡수를 막기위한 많은 노력들이 행해져 왔다. 특히 임플랜트 collar의 특징에 따라서 변연골의 흡수가 달라질 수 있다. 본 연구의 목적은 임플랜트 collar에서의 laser microtexturing(microgroove)이 변연골 흡수에 미치는 영향에 대해 알아보고자 하는 것이다. 4종류의 임플랜트 총 101개를 식립한 환자 53명에서 임플랜트 식립시부터 보철물 장착한 후 평균 6개월 후 정기 검사 시까지의 임플랜트 주위 변연골의 흡수를 측정하여 비교하였다. 생물학적 폭경을 충분히 확보한 임플랜트(ITI standard)와 생물학적 폭경이 부족한 임플랜트 (ITI esthetic plus, Silhouette IC Laser-$Lok^{TM}$, Silhouette IC)에서 변연골 흡수의 차이를 비교하였고, 임플랜트 주위 변연골의 흡수에 대한 laser를 이용한 미세나사산의(Silhouette IC Laser-$Lok^{TM}$) 영향을 알아보았다. 다음의 결과를 얻었다. 1. ITI standard와 Silhouette IC Laser-$Lok^{TM}$ 이 ITI esthetic plus 와 Silhouette IC 보다 임플랜트 주위 변연골의 흡수가 적었고 (p<0.05), ITI standard 와 Silhouette IC Laser-$Lok^{TM}$ 사이에는 변연골의 흡수가 유의차가 없었고(P>0.05), ITI esthetic plus와 Silhouette IC 사이에도 변연골의 흡수가 유의차가 없었다(P>0.05). 2. 사용된 임플랜트 전체에 대한 상하악의 비교에서는 상하악 사이에서 임플랜트 주위 변연골의 흡수는 통계학적으로 유의한 차이가 없었다(p>0.05). 3. 흡수각도에 대한 비교에서도 4종류 임플랜트 그룹 간에 통계학적으로 유의한 차이는 없었다(P>0.05). 본 연구에서 제한이 있긴 하지만, 임플랜트 디자인에서 생물학적 폭경이 부족한 경우(ITI esthetic plus, Silhouette IC)에는 생물학적 폭 경 보상을 위한 임플랜트 주위 변연골의 흡수가 있었음을 보여주고 있으나, laser를 이용한 microgroove 가 부여된 임플랜트에서는 collar의 거칠기와 laser microtexturing 등의 특징에 의해 임플랜트 주위 변연골의 흡수가 적게 일어난 것이 관찰되었다. 심미적인 요구도가 높은 전치부에서 충분한 생물학적 폭경이 확보된 임플랜트를 식립할 경우 변연골의 흡수에 따른 치은퇴축에 의해 metal collar의 노출이 우려되기에 충분한 생물학적 폭경이 부여되지 않은 임플랜트를 선정하게 되는데 이때 collar에서의 laser microtexturing은 변연골의 유지에 도움이 되었다. 이것은 조직의 단단한 부착으로 인한 안정화로 추정해 볼 수 있는데, 이에 대해서는 더 장기간의 연구와 더 많은 수의 임플랜트를 대상으로 한 연구와 조직학적인 연구도 필요할 것으로 사료된다.

한국 남성의 연령에 따른 부위별 골밀도 변화 및 골 소실률 (Age-Related Bone Mineral Density, Accumulated Bone Loss Rate at Multiple Skeletal Sites in Korean Men)

  • 김영란;이태용;이지현
    • 한국산학기술학회논문지
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    • 제15권6호
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    • pp.3781-3788
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    • 2014
  • 국민건강영양조사 제 5기 1 2차년도에 참여한 남성을 대상으로 연령에 따른 부위별 골밀도 변화, 골 소실률에 대해서 알아보고자 시도 하였다. 연령에 따른 골밀도 변화를 가장 잘 보여 주기 위해 Cubic regression을 사용하였고, 척추, 대퇴경부, 대퇴골 전자부, Ward 부위 골밀도 차이는 분산분석을 이용하여 분석하였다. 연구결과, 요추, 대퇴골 전체, 대퇴경부, 대퇴골 전자부, Ward 부위의 최대 골밀도는 20-24세였으며, 75-79세에서 골 소실률이 가장 높았다. 따라서, 남성에서는 75세 이상에서 골다공증의 집중적인 관리가 필요할 것이며, 남성에서의 골다공증 진단기준은 국제 임상 골밀도 학회(The International Society for Clinical Densitometry; ISCD)의 지침을 따르는 방안을 고려해 봐야 할 것이다.

대퇴골 경부 골절 환자에서 골다공증 평가를 위한 다중검출 CT의 이용: 이중에너지 X-선 흡수계측법과의 비교 (Multidetector Computed Tomography in Patients with Femoral Neck Fracture for Assessing Osteoporosis: Comparison with Dual Energy X-Ray Absorptiometry)

  • 이효정;황지영
    • 대한영상의학회지
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    • 제82권1호
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    • pp.173-181
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    • 2021
  • 목적 대퇴골 경부 골절 환자를 대상으로 골다공증 평가를 위해 다중검출 전산화단층촬영(multidetector computed tomography; 이하 MDCT)에서의 감쇠 계수(Hounsfield unit; 이하 HU)와 이중 에너지 X선 흡수 계측법(dual energy X-ray absorptiometry; 이하 DXA)을 비교하였다. 대상과 방법 2016년 6월부터 12월까지 MDCT와 DXA를 모두 시행한 42명의 대퇴골 경부 골절 환자가 본 연구의 대상으로 포함되었다. MDCT에서는 정상 대퇴골 경부의 해면골에서 HU를 측정하였으며 DXA에서는 동 부위의 골밀도 및 T 값을 얻었다. HU와 골밀도 및 T 값의 상관관계를 Spearman 상관계수를 이용하여 분석하였다. 결과 대퇴골 경부 골절 환자의 골밀도와 T 값의 평균은 각각 0.650 g/cm2과 -2.4이었다. 정상, 골감소증, 골다공증 환자 군의 HU의 평균은 각각 131.9, 98.9, 41.3이었다. HU는 골밀도(r2 = 0.670; p < 0.001) 및 T 값(r2 = 0.676; p < 0.001) 모두와 양의 상관관계를 보였다. 결론 다중검출 전산화단층촬영에서 감쇠계수의 측정은 골다공증 선별검사를 위한 유용한 진단적 도구가 될 수 있다.

폐경 후 여성의 골격상태에 영향을 미치는 요인분석 (Some Factors Affecting Bone Mineral Status of Postmenopausal Women)

  • 오세인;이행신;이미숙;김초일;권인순;박상철
    • 대한지역사회영양학회지
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    • 제7권1호
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    • pp.121-129
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    • 2002
  • Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were $1.02 \pm 0.02 g/cm^2 and 0.81 \pm 0.02 g/cm^2 respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 $\pm$ 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p< 0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.

한국인 남성 운동선수군에서 Osteocalcin 유전자의 C298T 다형성의 분포와 골밀도와의 관계 (The Distribution of C298T Polymorphism in the Oseteocalcin Gene from Korean Male Athletes and its Association with Bone Mineral Density)

  • 정인근;강병용;김지영;오상덕;하남주
    • 약학회지
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    • 제50권1호
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    • pp.26-32
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    • 2006
  • Osteocalcin is a vitamin K dependent and bone specific protein which plays an important role in the regulation of bone and calcium metabolism. In this study, we evaluated the relationship between the C298T polymorphism in the osteocalcin gene and bone mineral density (BMD) in Korean young men and their interaction with physical activity. BMDs of the femoral neck and lumbar spine were measured using dual energy X-ray absorptiometry, and the C298T polymorphism in the osteocalcin gene determined using polymerase chain reaction (PCR)-HindIII restriction fragment length polymorphism (RFLP) method. We did not observe any significant differences in the femoral neck and lumbar spine BMDs across genotypes of this polymorphism in controls, athletes or combined groups, respectively (P>0.05). Therefore, our data suggest that the C298T polymorphism in the osteocalcin gene is not a suitable genetic marker for the susceptibility to BMD.

혈압에 따른 골밀도와 체질량 지수와의 상관관계 연구 (A Study on Correlation between the Blood Pressure and Bone Mineral Density or Body Mass Index)

  • 주정용;송범용;육태한
    • Journal of Acupuncture Research
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    • 제26권5호
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    • pp.1-10
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    • 2009
  • Objectives : This study was conducted to investigate how Bone Mineral Density(BMD) and bone mass index(BMI) differ according to classification of blood pressure which JNC 7(The seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure) indicated. Methods : We measured BMD and BMI of lumbar spine($L_2-L_4$) and femoral neck of 9816 people, and then we analyzed them according to classification of blood pressure. Results : The number of prehypertension group was the most, and Stage 2 hypertension group was the least. As the hypertension was increasing, BMD of lumbar and femoral neck were decreasing, and BMI was increasing. In men, as the blood pressure was increasing, BMI was increasing. But the BMD was irrelevant. In women, the distribution was similar to the total. Conclusions : As the hypertension was increasing, BMI was increasing and BMD was decreasing. And it was more remarkable in women.

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Biomechanical Comparative Study for Osteosynthesis of Pauwels Type III Femoral Neck Fractures: Conventional Devices versus Novel Fixed Angle Devices

  • Dae-Hyun Park;Young-Chae Seo;Yong-Uk Kwon;Soo-Hwan Jung;Seung-Jin Yoo
    • Hip & pelvis
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    • 제34권1호
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    • pp.35-44
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    • 2022
  • Purpose: Osteosynthesis has been recommended for treatment of Pauwels type III femoral neck fractures in young patients. However, no implant of choice has been reported so far. This study was conducted in order to compare the fixation stability of two conventional fixation methods with three different novel fixed angle devices in this type of fracture. Materials and Methods: A total of 25 composite femurs (4th Generation Saw bone; Pacific Research Laboratories, USA) corresponding to human bone were used. Pauwels type III fracture type was uniformly reproduced. Specimens were fixed with a cannulated screw, cannulated screw with cable, and Intertan nail, dynamic hip screw, and IKEY nail. Measurement of failure loads and the rotational change of the femoral head fragment was performed for evaluation of fixation stability. Results: All implants were compared with cannulated screw and dynmaic hip screw. No meaningful improvement was observed for the cannulated screw with cable compared with the cannulated screw and dynamic hip screw. Meaningful improvement in load-to-failure and y-rotation and z-rotation was observed for both the Intertan nail and IKEY nail compared with the cannulated screw. However, compared with the dynamic hip screw, only the IKEY nail showed improvement in the same profile but the Intertan nail did not. Conclusion: Among novel fixed angle devices, meaningful improvement was observed for the IKEY nail compared with conventional implants. Strengths of this implant include biomechanical stability and simplicity of surgical technique, indicating that it may be another good option for osteosynthesis of Pauwels type III femoral neck fractures.

모녀간의 골밀도 : 신체 측정치 및 체조성, 골지표, 영양소 섭취량 및 에너지 소비량과의 관계 (Bone Mineral Density of Korean Mother-daughter Pairs : Relations to Anthropometric Measurement, Body Composition, Bone Markers, Nutrient Intakes and Energy Expenditure)

  • 이희자
    • Journal of Nutrition and Health
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    • 제29권9호
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    • pp.991-1002
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    • 1996
  • The objectives of this study were to obtain normative data for 45 mother-daughter pairs on spine, femur(neck, ward's triangle, trochanter) and total body BMD (bone mineral density) measured by dual energy X-ray absorptiometry, anthropometric measurement, body composition, biochemical markers, nutrient intakes and energy expenditure, to determin the interrelations of these factors within each group, to measure familial resemblance for each variable. We observed significantly positive correlations between height, weight, head, hip and calf circumferences, tricep, femur and calf skinfold thickness, total lean body mass(=weight-total fat body mass-bone mineral content), protein and fat intakes, Ca index, serum total protein and albumin of monter-daughter pairs(p<.05-p<.001). Among mothers, age, osteocalcin, higher, weight, Ca and energy intakes were predictors of BMDs. Among daughters, weight and energy intake were predictors of BMDs. The BMD in lumbar spine(r=.48, p<.01), femoral neck(r=.38, p<.05), ward's triangle(r=.36, p<.05) of the mothers were significantly correlated with those of the daughters, after adjustment for mother's age, hight, weight, osteocalcin, Ca and energy intakes and daughter's weight, energy intake. In regression analyses, mother's BMD also were positively associated with daughter's BMD in lumbar spine, femoral neck, ward's triangle. Our findings support that mothers with low BMD tended to have daughters with low BMD. In the age groups studied, as well genetic factors as environmental factors may have an important role in determining BMD. This study suggests that women may successfully enhance their genetically determined BMD through adequate nutrient intakes and weight bearing exercise.

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두경부 양성 골종의 임상적 분석 (Clinical Analysis of Benign Osteomas on Head and Neck region)

  • 송진우;최환준;최창용;김미선
    • 대한두개안면성형외과학회지
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    • 제9권1호
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    • pp.1-7
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    • 2008
  • Osteomas are most often located in the femur, tibia, humerus, spine, and talus. They are rare in the skull. Osteomas in the head and neck regions are benign bone neoplasms usually found in the frontoethmoid area. The developmental theory postulates that osteomas develop at the sites of fusion of tissues different embryological origin such as occur at the junction of the embryonic cartilaginous frontal and ethmoid bones. Trauma and infection have also been implicated as causative factors, but many patients with osteoma deny any preceding history of these. Osteomas are usually produce symptoms primary to cosmetic problems and secondary to pressure on adjacent structures. The objects of this study are from a 5-year period of April of 2002 to April of 2007, consisting of 48 male patients and 52 female. There were 33 cases of frontal bone osteomas, 5 cases of madibular bone osteomas, 5 cases of occipital bone osteomas, 6 cases of symptomatic paranasal sinus osteomas, 48 cases of asymptomatic paranasal sinus osteomas, and 3 cases of mastoid osteomas. We reviewed medical records of patients to find out their presentations, diagnostic considerations, therapeutic options, and outcomes. Patients were followed up six months postoperatively on the average. The authors experienced 48 cases of osteoma in the head and neck lesion, which were removed via direct approach or endoscopic approach. The 100 cases who came to the hospital with or without symptoms after diagnosis healed completely without sequelae. During the follow-up periods, excellent functional and cosmetic results were observed with an inconspicuous scar. There was no specific complications related to this procedure. Results of surgery in most cases were satisfied. We discussed the surgical procedure and the characteristics of the osteomas, and we report several cases with the review of literatures.

부갑상선 종양의 치험 6례 (Treatment Experiences of Parathyroid Gland Tumors in 6 Cases)

  • 조우성;김우주;유익원;황호연;백승국;우정수;권순영;정광윤
    • 대한두경부종양학회지
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    • 제23권2호
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    • pp.165-169
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    • 2007
  • Parathyroid gland tumor is an uncommon disease. The symptoms of parathyroid gland tumor appear in various features such as general weakness, renal stones, bone diseases and malignancies in some cases. We summarized the clinical features of 6 cases of parathyroid gland tumors with literatures.