• Title/Summary/Keyword: Radiographic method

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Regenerative effect of recombinant human bone morphogenetic protein-2/absorbable collagen sponge (rhBMP-2/ACS) after sequestrectomy of medication-related osteonecrosis of the jaw (MRONJ)

  • Min, Song-Hee;Kang, No-Eul;Song, Seung-Il;Lee, Jeong-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.3
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    • pp.191-196
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    • 2020
  • Objectives: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein-2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement properties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. Materials and Methods: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after sequestrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. Results: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann-Whitney U-test, P<0.05). Conclusion: Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.

A RADIOGRAPHIC STUDY OF THE EXPERIMENTAL LESIONS IN THE MAXILLARY SINUS (상악동의 실험병소에 관한 X선학적 연구)

  • Lee Joo Hyun;Hwang Eui Hwan;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.24 no.1
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    • pp.115-124
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    • 1994
  • The purpose of this study was to examine the differences in representation of a globular radiopaque mass on the pantomograms and Waters' views and to compare the efficacy of periapical radiograms, pantomograms and Waters' views in detection of defects on the internal walls of the maxillary sinus. This study was performed with dried human skull. For the study of difference of radiopaque mass shadow in the two views, rubber ball with a diameter of 10㎜ was used as the experimental lesion. It was placed successively on the internal wall of the anterior, posterior, medial, lateral walls and floor of the maxillary sinus. To examine the detectability of defects for radiographic techniques, defects were formed in the anterior, posterior, medial, lateral walls, and floor of the maxillary sinus. They were formed with 0.5㎜, 0.75㎜, 1.0㎜, 2.0㎜ and 3.0㎜ sized steel round burs with a slow speed dental handpiece. By subsequently plugging the holes with zinc oxide eugenol paste, radiopaque defects were produced. After that the periapical radiograms, the pantomograms and the Waters' views were taken each and every defect. The obtained results were as follows: 1. Rubber balls placed on each internal wall of the maxillary sinus were correctly depicted on the posterior wall and the floor in case of the pantomogram, and on the anterior wall and the medial wall in case of the Waters' view. 2. On the detectability of defects for each radiographic technique, radiolucent defects were detected in different places for each technique. Periapical radiogram could detect 1.0㎜ defect on the floor of the maxillary sinus, pantomogram could detect 2.0㎜ defect on every internal wall of the maxillary sinus, and Waters' view could detect 3.0㎜ defect on the anterior wall of the maxillary sinus. 3. On the detectability of defects for each radiographic technique, radiopaque defects were detected in different places for each technique. Periapical radiogram could clearly detect 0.5㎜ defect on the floor of the maxillary sinus, pantomogram could detect 0.5㎜ defect on every internal wall of the maxillary sinus, and finally Waters' view could detect 0.5㎜defect on the anterior wall of the maxillary sinus but 0.75㎜ defect on the anterior wall, lateral wall and floor of the maxillary sinus. As the result, the periapical radiogram is the most simple and satisfactory method for investigating in the maxillary sinus. The pantomogram is suitable method for screening of changes in the maxillary sinus. And the Waters' view is available for detect of lesion in the anterior wall of the maxillary sinus. For the purpose of accurate diagnosis and evaluation of lesion in the maxillary sinus, these techniques supplement each other.

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A literature review on clinical/ laboratory misfit evaluation on implant-prosthesis (임플란트와 상부보철물의 임상적/실험적 부적합 평가에 관한 문헌고찰)

  • Kim, Jong-Hoi;Cho, Woong-Rae;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of the Korean dental association
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    • v.56 no.9
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    • pp.462-478
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    • 2018
  • The presence of implant-prosthesis misfits can cause various complications. It is very important to detect misfits to prevent such complications. There are various evaluation methods for misfit assessment including clinical methods and laboratory in vitro methods. The clinical misfit evaluation includes radiographic analysis, visual observation, probing, Sheffield test, evaluation with disclosing materials, and screw resistance test. The laboratory in vitro evaluation method includes indirect modelling evaluation and direct metrological visualization. Of the indirect modelling methods, photoelastic stress analysis, finite element analysis, strain gauge analysis, and microbial colonization analysis were reviewed. Of the direct metrological visualization, microscopic analysis, 3-D photogrammetric analysis, coordinate measuring analysis, and radiographic analysis were reviewed. In this review, the characteristics, advantages and disadvantages of each method were evaluated.

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Evaluation the absorbed dose in brain of dental radiography (치과방사선 검사에서 두부(brain)의 흡수선량 평가)

  • Jeon, Woon-Sun;Han, Dong-Kyoon
    • Journal of the Korean Society of Radiology
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    • v.5 no.6
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    • pp.343-349
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    • 2011
  • This study was aimed to evaluate the absorbed dose in brain of dental radiography. For radiographic exposure, PLD(photoluminescence dosimetry) chips placed in Rando phantom to measurement the absorbed dose to pituitary gland, orbit, maxillary sinus and submandibular glands, thyroid gland, esophagus. Equipments were used Kodak 2200, Kodak 8000C dental radiographic systems and computed tomography(Lightspeed VCT). The absorbed doses were measured at the same exposure parameters and distance by the clinical factor(kV, mA, sec). The result were as follows ; The absorbed dose for intra-oral radiography were 0.02~2.47cGy, the greatest absorbed dose was 2.47cGy for thyroid gland in maxillary right molar projection. the lowest adsorbed dose was 0.02cGy for submandibular glands in lower anterior projection. The absorbed dose for extra-oral radiography were 0.36~3.44cGy of cephalometric method, 0.14~12.82cGy of panoramic method, 8.17~253.63cGy of computed tomography, the greatest adsorbed dose was 253.63cGy for submandibular glands in maxillary CT scan. the lowest adsorbed dose was 0.14cGy for orbit in panoramic method. As a result, extra-oral radiography was measured more than intra-oral radiography. In particular, method which used computed tomography was measured more than 100 times than intra-oral radiography highly. Therefore, you must show a guideline in extra-oral radiography and an effort to reduce absorbed dose is demanded.

Comparison between Intramedullary Nailing and Percutaneous K-Wire Fixation for Fractures in the Distal Third of the Metacarpal Bone

  • Moon, Sung Jun;Yang, Jae-Won;Roh, Si Young;Lee, Dong Chul;Kim, Jin Soo
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.768-772
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    • 2014
  • Background To compare clinical and radiographic outcomes between intramedullary nail fixation and percutaneous K-wire fixation for fractures in the distal third portion of the metacarpal bone. Methods A single-institutional retrospective review identified 41 consecutive cases of metacarpal fractures between September 2009 and August 2013. Each of the cases met the inclusion criteria for closed, extra-articular fractures of the distal third of the metacarpal bone. The patients were divided by the method of fixation (intramedullary nailing or K-wire). Outcomes were compared for mean and median total active motion of the digit, radiographic parameters, and period until return to work. Complications and symptoms were determined by a questionnaire. Results During the period under review, 41 patients met the inclusion criteria, and the fractures were managed with either intramedullary nailing (n=19) or percutaneous K-wire fixation (n=22). The mean and median total active range of motion and radiographic healing showed no statistically significant difference between the two groups. No union failures were observed in either group. The mean operation time was shorter by an average of 14 minutes for the percutaneous K-wire fixation group. However, the intramedullary nailing group returned to work earlier by an average of 2.3 weeks. Complications were reported only in the K-wire fixation group. Conclusions Intramedullary nailing fixation is advisable for fractures in the distal third of the metacarpal bone. It provides early recovery of the range of motion, an earlier return to work, and lower complication rates, despite potentially requiring a wire removal procedure at the patient's request.

Radiographic Classification and its Clinical Features for Metaphyseal Cortical Defect of the Distal Femur (대퇴골 원위부 골간단의 피질골 결손에 대한 방사선학적 분류 및 그에 따른 임상적 경과관찰)

  • Park, Il-Hyung;Oh, Chang-Wug;Min, Woo-Kie
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.17-22
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    • 1999
  • Over 60 cases were enlisted, but only 31 cases among 24 patients were eligible with a minimum follow-up of 1 year and complete medical documents with imaging data. There were 18 boys and 6 girls, and 7 patients had bilateral lesions. The age of the patients ranged from 2 to 20 years(mean:10.5 years). At their first visit, most lesions had a highly characteristic location and radiographic appearance of radiolucent lesion(s) ranging from 1 to 3cm, except for one case of 5.5 cm in the posteromedial comer of distal femoral metaphysis. The margins were generally well-defined, although some were ill-defined. After reviewing our cases from the viewpoint of clinical course and radiographic patterns, we divided these lesions into two types. Type I is the osteolytic lesion excavated into the posteromedial aspect of the distal femur without cortical defect; and type II is the buldged out lesion of the femur with cortical irregularity into the surrounding soft tissues. Both types have distinctive clinical courses. Type I lesions were easy to make a definite diagnosis with plain radiographs alone, but in type II, it was sometimes very difficult to differentiate it from malignant tumors or chronic localized osteomyelitis. For this lesion, Gd-enhanced MRI was the most effective method for differential diagnosis. In this study, biopsy was not necessary to confirm the diagnosis. Clinical symptoms of type I were very minor or even absent. Many of them were accidentally found after minor trauma around the knee joint. Clinical symptoms disappeared far earlier than radiographical lesions. No treatment such as restriction of activity or drugs was necessary. For type II, the clinical symptoms were more accentuated and lasted longer, and it was necessary to restrict the activity for a certain period in many cases. However, all were self-limited.

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Fixation with Suture Material in Akin Osteotomy (봉합사 고정을 이용한 Akin 절골술)

  • Young, Ki-Won;Lee, Kyung-Tai;Kim, Jae-Young;Cha, Seung-Do;Kim, Eung-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.138-141
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    • 2004
  • Purpose: The purpose of this study was to document the results of fixation with ethibond suture in akin osteotomy and its advantages. Materials and Methods: From May 2001 to January 2004, Akin osteotomy was performed in 218 patients. We reviewed 110 patients (114 feet) who were possible radiographic evaluation more than 6 months after operation. 110 feet had hallux valgus and 4 feet had hallux valgus interphalangeus. 105 patients were female and 5 were male. The average age was 43.8 years old (18 to 68 years old). The average follow up was 9 months (6 to 23 months). After performing the Akin osteotomy at 7 mm from the proximal articular surface of the proximal phalanx, one hole is made on either side of the osteotomy site with a K-wire. The passer was passed through the both holes and the ethibond was passed. And then, the ethibond was tied tightly. 2 sutures in 66 feet and 1 suture in 48 feet were made. Radiographic bone union at 6 months follow up was regarded as success and loss of the reduction, nonunion was regarded as failed. Results: In the radiographic evaluation, bony union were made at 6 months follow up in all feet. There was no difference between 2 sutures and 1 suture, and the knots were removed in 3 feet because of skin irritation. Conclusion: The fixation of the osteotomy site using suture material was an effective method in Akin osteotomy. The advantage of this procedure was unnecessity of the material removal.

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Presumptive Diagnosis of Mycoplasma pneumoniae Pneumonia in Children (소아에서 마이코플라즈마 폐렴의 예기적 진단)

  • Lee, Chang Eon;Park, Su Jin;Kim, Won Duck
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.89-95
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    • 2012
  • Background: As Mycoplasma pneumoniae pneumonia has increased in Korea, its relevance to infants, toddlers, and adolescents has magnified as well as. However, it is difficult to perform the serological test and PCR test routinely for diagnosis in actual clinical practice. Thus, the authors conducted this study to help clinicians do presumptive diagnosis of Mycoplasma pneumoniae pneumonia using clinical, radiological, and hematological findings. Methods: The study population consisted of 224 children between 1 month and 14 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups of 100 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the ELISA method. Groups with negative result in Mycoplasma IgM antibody test were classified into the viral group (98 patients with respiratory virus) and the bacterial group (46 patients with the bacteria detected in the blood sputum culture or antibiotic treatment except macrolide improved the patient's condition). These groups were compared and analyzed using clinical, hematological, and radiographic differences and scoring system. Results: Clinical, hematological, and radiographic characteristics of Mycoplasma pneumoniae pneumonia have shown the intermediate level results between bacterial pneumonia and viral pneumonia. In terms of scoring system, the mean score of Mycoplasma pneumoniae pneumonia was 4.23, which was the intermediate level between bacterial pneumonia (mean score=6.67) and viral pneumonia (mean score=1.48). Conclusion: Results suggest that the combination of the scoring system information can increase the accuracy in the diagnosis even if they may have difficulties on diagnosis, because clinical manifestations, hematological, and radiographic findings are nonspecific.

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TISSUE REACTION FOLLOWING BY COMBINATION OF DISTRACTION AND COMPRESSION FORCE ON DISTRACTION OSTEOGENESIS OF THE MANDIBLE IN THE RAT (백서 하악골에서 신연골형성술시 신장력과 수축력 복합적용후의 조직반응)

  • Kim, Uk-Kyu;Shin, Sang-Hun;Chung, In-Kyo;Lee, Kwang-Ho;Park, Bong-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.2
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    • pp.103-113
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    • 2002
  • Distraction osteogenesis is a biologic process of new bone formation between the surfaces of bone segments that are gradually separated by incremental traction. Distraction osteogenesis is clinically applied as a new treatment modality of mandibular hypoplasia or bony defect area in maxillofacial area by many studies of distraction devices and method. But, disadvantages of distraction osteogenesis shows unfavorably long consolidation period and relapse tendency. Therefore, this experiment was designed to investigate the effectiveness of combined application of distraction and compression force for improving of bone quality and shortening of treatment period during distraction osteogenesis. Twenty-five Sprague-Dawley rats with $300{\sim}350gm$ were used. These were divided into two group as distraction group and combination group. The distraction group was added with conventional method during distraction osteogenesis, but the combination group was applied with compression force in the consolidation period. The rats were sacrificed for gross finding, radiographic and histologic findings at 3, 6 weeks after distraction. The results were as follow: 1. On radiographic finding, all combination of distraction and compression force group appeared more radiopacity than distraction group both at 3 weeks and 6 weeks after distraction group. 2. On histologic finding, the formation of mature lamellar bone were showed increasingly in combined group at 6weeks after distraction group. From this study, we may suggest that compression force application in consolidation period during distraction osteogenesis can be useful method to improve bone quality and to shorten the treatment period. But more experimental and clinical studies is necessitated on ideal application timing and method of compression force application during distraction osteogenesis.

Treatment of Lateral Malleolar Fractures with Cannulated Screws in Danis-Weber type B Ankle Fractures (Danis-Weber B형 족근 관절 골절에 있어 유경 나사를 이용한 비골 외 과 골절의 치료)

  • Park, Yong-Wook;Chung, Yung-Khee;Yoo, Jung-Han;Park, Hong-Jun;Yu, Sun-O;Kang, Ki-Man
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.2
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    • pp.129-135
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    • 2001
  • Purpose: To evaluate the radiographic results of the treatment for Danis-Weber type B lateral malleolar fracture with 2 cannulated screws. Materials and Methods: Thirty-four cases of Danis-Weber type B lateral malleolar fracture were available. Follow-up averaged 8 months (6-25 months). The medial clear space for lateral displacement of talus, talo-crural angle for lateral malleolar shortening, and malunion evidence of lateral malleolar fracture were observed. Results: Medial clear space was from 2mm to 4mm in 34 cases. Talo-crural angle was from $73^{\circ}$ to $82.5^{\circ}$ in 33 cases. One case was complicated with malunion of lateral malleolus. But, we found the same condition in the immediate post- operative radiographic film. Conclusion: We believe that the 2 cannulated screws fixation for Danis-Weber type B lateral malleolar simple fractures is an excellent treatment method.

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