• Title/Summary/Keyword: Osteotome

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THE COMPARATIVE EVALUATION USING HATCH REAMER TECHNIQUE AND OSTEOTOME TECHNIQUE IN SINUS FLOOR ELEVATION (상악동저 거상술 시 Osteotome 술식과 Hatch Reamer 술식의 비교평가)

  • Cho, Seong-Woong;Kim, Sang-Jung;Lee, Dong-Keun;Kim, Chin-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.2
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    • pp.154-161
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    • 2010
  • Many edentulous posterior maxilla are found to be compromised by alveolar resorption and increased pneumatization of the sinus. One of the surgical procedures to overcome this anatomical limitation is sinus floor elevation with bone graft, which is reported as more appropriate and more successful procedure. Commonly, if the residual bone height is over 5mm, sinus floor elevation is operated through transcrestal approach using osteotome technique. But, it is possible for patients to feel discomfort during operation and dizziness after operation while malleting, sinus floor elevation, using osteotome technique. Some instruments and methods has been used to overcome these problems and use more easily. The aim of this study is to compare between the surgical procedure of sinus floor elevation using Hatch reamer technique and that of sinus floor elevation using osteotome technique. From 2004 Feb to 2007 Oct, we investigate patients (osteotome group: 72, Hatch reamer group: 70) who were given implant surgery with sinus floor elevation (osteotome group: 92, Hatch reamer group: 98). We analysed gender, age, residual bone height, amount of sinus floor elevation, used graft material, total success rate, failure rate by residual bone height and implant type and discomfort during operation, etc. The results obtained were as follows. 1. In the amount of sinus elevation was osteotome group was $3.85{\pm}1.02\;mm$ and Hatch reamer group was $3.93{\pm}1.38\;mm$. There was no statistically significant difference between the two groups (P > 0.05). 2. At the total success rate, osteotome group was 92.4% and Hatch reamer group was 94.9%. There was no statistically significant difference between the two groups (P > 0.05). 3. On the discomfort during the operation by using numerical rating scale, osteotome group was $2.87{\pm}0.83$ and Hatch reamer group was $1.12{\pm}0.64$. There was statistically significant difference between the two groups (P < 0.05). The Hatch reamer group clinical results was similar to osteotome group and we thought that Hatch reamer technique can overcome the faults of osteotome technique.

The effect of osteotome technique on primary implant stability according to implant fixture diameter (임플란트 일차 안정성에 있어서 고정체 지름에 따른 osteotome 술식의 효과)

  • Kim, Su-Hyun;Lee, Jae-Kwan;Park, Chan-Jin
    • Journal of Periodontal and Implant Science
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    • v.35 no.3
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    • pp.789-798
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    • 2005
  • Primary stability is a fundamental criteria of implant success. There has been various trials to increase initial stability and bone to implant contact. The objective of osteotome technique is to preserve all the existing bone by minimizing or even eliminating the drilling sequence of the surgical protocol. The bone layer adjacent to the osteotomy site is progressively compacted with various bone condensers(osteotomes) this will result in a denser bone to implant contact. This improved bone density helps to optimize primary implant stability in low density bone. The use of wide implant is one of methods to increse primary stability. They can be used in special situations in which they can increase the surface area available for implant anchorage and improve their primary stability The aim of this study was to evaluate the influence of the osteotome technique and implant width on primary stability. Osteotome technique was compared with conventional drilling method by resonance frequency measurments according to the implant fixtures diameter. The results were as follows: 1. The average of ISQ value was sightly higher in osteotome technique, but there was not statistically significant in regular and narrow implant(p <0.05). 2. Either osteotome technique or conventional technique. ISQ value was significantly higer as increasing of implant diameter(p <0.05). 3. ISQ value of drilling technique was higer than those of osteotome technique in wide implant. It was assumed to be caused by difference in final preparation diameter.

Ultrasonic Osteotome Assisted Posterior Endoscopic Cervical Foraminotomy in the Treatment of Cervical Spondylotic Radiculopathy Due to Osseous Foraminal Stenosis

  • Ye Jiang;Chen Li;Lutao Yuan;Cong Luo;Yuhang Mao;Yong Yu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.4
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    • pp.426-437
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    • 2023
  • Objective : To investigate the efficacy and safety of the posterior endoscopic cervical foraminotomy (PECF) using ultrasonic osteotome for the treatment of cervical osseous foraminal stenosis, focusing on introduction of the advantages of ultrasonic osteotome in partial pediculectomy and ventral osteophyte resection in PECF. Methods : Nineteen patients with cervical osseous foraminal stenosis who underwent PECF using ultrasonic osteotome in our institution between April 2018 and April 2021 were enrolled in this study. All the patients were followed up more than 12 months. The patients' medical data, as well as pre- and postoperative radiologic findings were thoroughly investigated. The visual analogue score (VAS), Japanese Orthopaedic Association (JOA) score, cervical dysfunction index (Neck disability index, NDI), and modified MacNab criteria were used to assess the surgical efficacy. Results : All the patients were successfully treated with PECF using ultrasonic osteotome. The pre- and postoperative VAS, NDI, and JOA scores were significantly improved (p<0.05). According to the modified MacNab criteria, 17 patients were assessed as "excellent", two patients were assessed as "good" at the last follow-up. There was no dura tear, nerve root damage, incision infection, neck deformity, or other complications. Conclusion : Adequate nerve root decompression can be accomplished successfully with the help of ultrasonic osteotome in PECF, which has the advantage of reducing the probability of damage to the nerve root and dura mater, in addition to the original merits of endoscopic surgery.

The Effect of Osteotome Technique on Primary Implant Stability according to Bone Quality (임플란트 일차 안정성에 있어서 골질에 따른 osteotome 술식의 효과)

  • Baek, Seung-Jae;Lee, Jae-Kwan;Park, Chan-Jin
    • Journal of Periodontal and Implant Science
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    • v.35 no.3
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    • pp.777-788
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    • 2005
  • The primary stability of implants is an important factor to predict the osseointegration. Recently, the resonance frequency analysis has been used to measure the primary stability. It is an objective method to monitor the stability of implants during healing phase. This study is to validate the differences in the effect of the osteotome method according to the bone quality as well the thickness of cortical bone. Two hundred seventy implants of 3.75mm in diameter(Neoplant, Neobiotech, Korea) were placed in 135 bovine ribs. The bone quality is classified into 3 classes according to the number of bone marrow spaces which implants would be placed, and then classified into 9 subclasses after the ribs were trimmed. Two implants were placed in 15 specimens of each class. The conclusion were as follows: 1. In case of less dense cancellous bone, the oseotome method is more effective in primary stability rather than the drilling method(p <0.05). 2. If there was cortical bone, it is more advantagous to get stronger primary stability. 3. If cancellous bone is more dense or if cortical bone exists, there is no statistical significance between drilling and osteotome method(p <0.05).

Use of an Ultrasonic Osteotome for Direct Removal of Beak-Type Ossification of Posterior Longitudinal Ligament in the Thoracic Spine

  • Kim, Chi Heon;Renaldo, Nicholas;Chung, Chun Kee;Lee, Heui Seung
    • Journal of Korean Neurosurgical Society
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    • v.58 no.6
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    • pp.571-577
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    • 2015
  • Direct removal of beak-type ossification of posterior longitudinal ligament at thoracic spine (T-OPLL) is a challenging surgical technique due to the potential risk of neural injury. Slipping off the cutting surface of a high-speed drill may result in entrapment in neural structures, leading to serious complications. Removal of T-OPLL with an ultrasonic osteotome, utilizing back and forth micro-motion of a blade rather than rotatory-motion of drill, may reduce such complications. We have applied the ultrasonic osteotome for posterior circumferential decompression of T-OPLL for three consecutive patients with beak-type OPLL and have described the surgical techniques and patient outcomes. The preoperative chief complaint was gait disturbance in all patients. Japanese orthopedic association scores (JOA) was used for functional assessment. Scores measured 2/11, 5/11, 2/11, and 4/11 for each patient. The ventral T-OPLL mass was exposed after posterior midline approach, laminotomy and transeversectomy. The T-OPLL mass was directly removed with an ultrasonic osteotome and instrumented segmental fixation was performed. The surgeries were uneventful. Detailed surgical techniques were presented. Gait disturbance was improved in all patients. Dural tear occurred in one patient without squeal. Postoperative JOA was 6/11, 10/11, 8/11, and 8/11 (recovery rate; 44%, 83%, 67%, and 43%) respectively at 18, 18, 10, and 1 months postoperative. T-OPLL was completely removed in all patients as confirmed with computed tomography scan. We hope that surgical difficulties in direct removal of T-OPLL might be reduced by utilizing ultrasonic osteotome.

Comparison of implant survival rate by sinus lifting technique in implantation with sinus lift (상악동 거상술을 동반한 임플란트 식립 시에 거상술 방법에 따른 임플란트 생존율의 비교)

  • Park, Kwang-Su;Hong, Ki-Seok;Chung, Chin-Hyung;Lim, Sung-Bin
    • Journal of Periodontal and Implant Science
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    • v.38 no.3
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    • pp.445-452
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    • 2008
  • Purpose: The purpose of this study was comparison of survival rate of implant as two sinus elevation techniques and when window opening procedure had done it was comparison of survival rate of implant between the procedure of implantation after 6 month of sinus elevation to allow healing period and that of implantation with sinus elevation simultaneously. Material and Methods: All 79 of patients treated at DanKook University Dental Hospital Dept. of Periodontics for 164 implantation of maxillary posterior edentulous area with sinus elevation. Sinus elevation technique was divided of the technique : Osteotome technique and window opening technique. Result: 14 implants among 96 implants was failed implants of using osteotome for sinus elevation whereas one implant of 68 implants was failed of using window opening technique. Conclusion: Window opening technique had higher survival rate than osteotome technique. In case of window opening, there was no significant difference of immediate implantation and delayed implantation.

Clinical evaluation of $Br{\aa}nemark$ Ti-Unite implant and ITI SLA implant in the post maxillary area with sinus elevation technique. (상악동 거상술을 이용하여 구치부에 식립된 $Br{\aa}nemark$ Ti-Unite와 ITI SLA 임플란트의 임상적 평가)

  • Hong, Seong-Bae;Chai, Gyung-Joon;Jung, UI-Won;Kim, Chang-Sung;Chim, Joon-Sung;Choi, Seong-Ho;Cho, Kyoo-Sung;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.35 no.4
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    • pp.813-822
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    • 2005
  • The predictable outcome of implant placement in the atrophic maxilla with sinus floor elevation procedure(osteotome sinus floor elevation technique and window opening technique) is well documented. Aim of this study was to evaluate the efficacy of $Br{\aa}nemark$ Ti-Unite implant system and ITI SLA implant system placed in the atrophic posterior maxilla with sinus floor elevation procedure. Eighty patients received placement of $Br{\aa}nemark$ Ti-Unite implants(195 implants) in their atrophic posterior Maxilla with sinus floor elevation procedure(153 osteotome sinus floor elevation technique and 42 window opening procedure). Fifty patients received placement of ITI SLA implants(83 implants) in their atrophic posterior Maxilla with sinus floor elevation procedure(77 osteotome sinus floor elevation technique and 6 window opening procedure). Chart review were taken from each patient. The total failed implants were seven and the total implant survival rate was 96.4% in $Br{\aa}nemark$ Ti-Unite system. The total failed implants were one and the total implant survival rate was 98.8% in ITI SLA system. The implant survival rate with osteotome technique was 96% and 97.6% with window opening in $Br{\aa}nemark$ Ti-Unite system. The implant survival rate with osteotome technique was 98.7% and 100% with window opening. The implant survival rate with osteotome technique was 96% and 97.6% with window opening in ITI SLA system. The results of this evaluation show that the placement of $Br{\aa}nemark$ Ti-Unite system as well as ITI SLA system is a reasonable treatment option for patients with the atrophic posterior maxillary area.