• Title/Summary/Keyword: Short implants

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Local Drug Delivery System Using Biodegradable Polymers

  • Khang, Gil-Son;Rhee, John M.;Jeong, Je-Kyo;Lee, Jeong-Sik;Kim, Moon-Suk;Cho, Sun-Hang;Lee, Hai-Bang
    • Macromolecular Research
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    • v.11 no.4
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    • pp.207-223
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    • 2003
  • For last five years, we are developing the novel local drug delivery devices using biodegradable polymers, especially polylactide (PLA) and poly(D,L-lactide-co-glycolide) (PLGA) due to its relatively good biocompatibility, easily controlled biodegradability, good processability and only FDA approved synthetic degradable polymers. The relationship between various kinds of drug [water soluble small molecule drugs: gentamicin sulfate (GS), fentanyl citrate (FC), BCNU, azidothymidine (AZT), pamidronate (ADP), $1,25(OH)_2$ vitamin $D_3$, water insoluble small molecule drugs: fentanyl, ipriflavone (IP) and nifedipine, and water soluble large peptide molecule drug: nerve growth factor (NGF), and Japanese encephalitis virus (JEV)], different types of geometrical devices [microspheres (MSs), microcapsule, nanoparticle, wafers, pellet, beads, multiple-layered beads, implants, fiber, scaffolds, and films], and pharmacological activity are proposed and discussed for the application of pharmaceutics and tissue engineering. Also, local drug delivery devices proposed in this work are introduced in view of preparation method, drug release behavior, biocompatibility, pharmacological effect, and animal studies. In conclusion, we can control the drug release profiles varying with the preparation, formulation and geometrical parameters. Moreover, any types of drug were successfully applicable to achieve linear sustained release from short period ($1{\sim}3$ days) to long period (over 2 months). It is very important to design a suitable formulation for the wanting period of bioactive molecules loaded in biodegradable polymers for the local delivery of drug. The drug release is affected by many factors such as hydrophilicity of drug, electric charge of drug, drug loading amount, polymer molecular weight, the monomer composition, the size of implants, the applied fabrication techniques, and so on. It is well known that the commercialization of new drug needs a lot of cost of money (average: over 10 million US dollar per one drug) and time (average: above 9 years) whereas the development of DDS and high effective generic drug might be need relatively low investment with a short time period. Also, one core technology of DDS can be applicable to many drugs for the market needs. From these reasons, the DDS research on potent generic drugs might be suitable for less risk and high return.

Use of custom glenoid components for reverse total shoulder arthroplasty

  • Punyawat Apiwatanakul;Prashant Meshram;Andrew B. Harris;Joel Bervell;Piotr Lukasiewicz;Ridge Maxson;Matthew J. Best;Edward G. McFarland
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.343-350
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    • 2023
  • Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications. Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported. Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both). Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.

EFFECT OF ANCHORAGE SYSTEMS ON LOAD TRANSFER WITH MANDIBULAR IMPLANT OVERDENTURES : A THREE-DIMENSIONAL PHOTOELASTIC STRESS ANALYSIS (하악 임플란트 overdenture에서 anchorage system이 하중전달에 미치는 영향)

  • Kim Jin-Yeol;Jeon Young-Chan;Jeong Chang-Mo
    • The Journal of Korean Academy of Prosthodontics
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    • v.40 no.5
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    • pp.507-524
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    • 2002
  • Load transfer of implant overdenture varies depending on anchorage systems that are the design of the superstructure and substructure and the choice of attachment. Overload by using improper anchorage system not only will cause fracture of the framework or screw but also may cause failure of osseointegration. Choosing anchorage system in making prosthesis, therefore, can be considered to be one of the most important factors that affect long-term success of implant treatment. In this study, in order to determine the effect of anchorage systems on load transfer in mandibular implant overdenture in which 4 implants were placed in the interforaminal region, patterns of stress distribution in implant supporting bone in case of unilateral vertical loading on mandibular left first molar were compared each other according to various types of anchorage system using three-dimensional photoelastic stress analysis. The five photoelastic overdenture models utilizing Hader bar without cantilever using clips(type 1), cantilevered Hader bar using clips(type 2), cantilevered Hader bar with milled surface using clips(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4), and Hader bar using clip and ERA attachments(type 5), and one cantilevered fixed-detachable prosthesis(type 6) model as control were fabricated. The following conclusions were drawn within the limitations of this study, 1. In all experimental models. the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. Maximum fringe orders on ipsilateral distal implant supporting bone in a ascending order is as follows: type 5, type 1, type 4, type 2 and type 3, and type 6. 3. Regardless of anchorage systems. more or less stresses were generated on the residual ridge under distal extension base of all overdenture models. To summarize the above mentioned results, in case of the patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant and unfavorable antero-posterior spread. selecting resilient type attachment or minimizing distal cantilever bar is considered to be appropriate methods to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

CYTOCOMPATIBILITY OF THERMALLY OXIDIZED TI-AG ALLOYS (열산화 처리된 Ti-Ag 합금의 세포적합성)

  • Kim, Ho-Joong;Oh, Keun-Taek;Ee, Zi-Whan;Kim, Kyoung-Nam;Han, Dong-Hoo
    • The Journal of Korean Academy of Prosthodontics
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    • v.42 no.4
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    • pp.333-343
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    • 2004
  • Statement of problem: In its preceding work, change in surface characteristics were investigated in consideration that both microtopograpy and macroscopic configuration of implants surface are two of the most important factors, in that they can construct agreeable environment by raising surface energy, to affect osseointegration and biocompatibility explained by cell proliferation. Purpose: This study focused on examining cytocompatibility of dental implants materials Ti-Ag alloys, of which mechanical and electrochemical superiority to cp-Ti or Ti6Al4V were verified, in comparison with that of cp-Ti, and Ti6Al4V. Materials and methods: In this regard, MTT tests for L-929, the fibroblast connective tissues and cell proliferation tests for osteoprogenitor cells, MC3T3-E1 were performed on cp-Ti, Ti6Al4V, and Ti-Ag alloys following thermal oxidation according to appropriate heat treatment temperature(untreated, 400, 600, $800^{\circ}C$) and heat treatment duration(untreated, 0.5, 1, 4 hr). Results: The MTT tests on fibroblasts L-929 resulted in cell viability of over 90% in all experimental group entities, where, especially, the 100% of the viability for Ti-Ag alloys specimens accounted for the slightest adverse effect of ions release from those alloys on the cell. In MC3T3-E1 proliferation tests, the population of cells in the experimental group was roughly increased as experimentation proceeded, after two to four days. Proliferation showed highest viability for most of specimens, including Ti2.0Ag, treated at $600^{\circ}C$. Conclusion: In conclusion, it is the heat treatment temperature, not the duration that has considerable effects on thermal oxidation of specimens. Ti-Ag alloys treated at $600^{\circ}C$ proved to have the best surface morphology as well as cytocompatibility when compared with Ti or Ti6Al4V for short-term biocompatibility tests.

Full-mouth rehabilitation with pressed ceramic technique using provisional restorations (Pressed ceramic technique을 이용하여 제작되는 완전 도재관 완전 구강 회복 증례)

  • Roh, Hyun-Sik;Woo, Yi-Hyung;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.1
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    • pp.47-51
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    • 2013
  • With the introduction of dental implants, restoration of missing teeth with conventional fixed or removable partial dentures is being replaced with implants. Especially, with young patients, not only longevity but also esthetic factors need to be considered. Implant restorations provide long-term success functionally but, esthetic complications such as, marginal exposure due to gingival recession, loss of the papilla and dark color of metal abutments may occur. Recently, zirconia restorations with CAD/CAM technology provide functional, biocompatible and esthetic restorations possible. All-ceramic restorations using the pressed ceramic technique show better fracture toughness values than those of the conventional porcelain veneering technique. Pressed ceramic technique creates the veneer design in wax and the lost wax technique is used to create the restoration. The final contour of the restoration may be controlled during wax-up. A 22-year old female patient was restored with dental implants and zirconia restorations using the pressed ceramic technique presenting short-term but optimistic prognosis.

Controlled release of nerve growth factor from heparin-conjugated fibrin gel within the nerve growth factor-delivering implant

  • Lee, Jin-Yong;Kim, Soung-Min;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.1
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    • pp.3-10
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    • 2014
  • Objectives: Although nerve growth factor (NGF) could promote the functional regeneration of an injured peripheral nerve, it is very difficult for NGF to sustain the therapeutic dose in the defect due to its short half-life. In this study, we loaded the NGF-bound heparin-conjugated fibrin (HCF) gel in the NGF-delivering implants and analyzed the time-dependent release of NGF and its bioactivity to evaluate the clinical effectiveness. Materials and Methods: NGF solution was made of 1.0 mg of NGF and 1.0 mL of phosphate buffered saline (PBS). Experimental group A consisted of three implants, in which $0.25{\mu}L$ of NGF solution, $0.75{\mu}L$ of HCF, $1.0{\mu}L$ of fibrinogen and $2.0{\mu}L$ of thrombin was injected via apex hole with micropipette and gelated, were put into the centrifuge tube. Three implants of experimental group B were prepared with the mixture of $0.5{\mu}L$ of NGF solution, $0.5{\mu}L$ HCF, $1.0{\mu}L$ of fibrinogen and $2.0{\mu}L$ of thrombin. These six centrifuge tubes were filled with 1.0 mL of PBS and stirred in the water-filled beaker at 50 rpm. At 1, 3, 5, 7, 10, and 14 days, 1.0 mL of solution in each tubes was collected and preserved at $-20^{\circ}C$ with adding same amount of fresh PBS. Enzyme-linked immunosorbent assay (ELISA) was done to determine in vitro release profile of NGF and its bioactivity was evaluated with neural differentiation of pheochromocytoma (PC12) cells. Results: The average concentration of released NGF in the group A and B increased for the first 5 days and then gradually decreased. Almost all of NGF was released during 10 days. Released NGF from two groups could promote neural differentiation and neurite outgrowth of PC12 cells and these bioactivity was maintained over 14 days. Conclusion: Controlled release system using NGF-HCF gel via NGF-delivering implant could be an another vehicle of delivering NGF to promote the nerve regeneration of dental implant related nerve damage.

Clinical evaluation of retained preload and cement washout in screw- and cement-retained implant prosthesis (나사 시멘트 유지형 임플란트 보철물의 잔여 전부하 및 시멘트 파손에 대한 임상평가)

  • Chung, Chae-Heon;Son, Mee-Kyoung;Kim, Seok-Gyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.4
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    • pp.301-309
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    • 2015
  • Purpose: The aim of this study was to evaluate the clinical performance of screw- and cement-retained implant prosthesis (SCP) design in terms of retained preload of abutment screws and cement washout. Materials and methods: Patients with the partial posterior edentulous areas comprised the study group. Implants were placed, and SCPs were delivered after 3 to 6 months healing. Follow-up examinations were performed. The implant survival rate and the prosthetic success rate were evaluated. The retained preload ratio of abutment screws and the prosthetic decementation ratio were measured. Results: Twenty one SCPs (forty three implants)in twenty patients were followed up to 64 months. All of the implants survived during the follow-up period (mean follow-up: 34 months). The prosthetic success rate was 100 % considering no abutment, screw, porcelain or metal frame fractures, as well as no screw loosening. The retained preload ratio of SCPs at the end of follow-up period was 97.61% (${\pm}16.29$) and the decementation ratio was 9.5 %. Conclusion: Within the limitations of this clinical study, SCP design showed favorable short-term clinical performances in respect of screw loosening and cement washout.

Three Dimensional Printing Technique and Its Application to Bone Tumor Surgery (3차원 프린팅 기술과 이를 활용한 골종양 수술)

  • Kang, Hyun Guy;Park, Jong Woong;Park, Dae Woo
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.466-477
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    • 2018
  • Orthopaedics is an area where 3-dimensional (3D) printing technology is most likely to be utilized because it has been used to treat a range of diseases of the whole body. For arthritis, spinal diseases, trauma, deformities, and tumors, 3D printing can be used in the form of anatomical models, surgical guides, metal implants, bio-ceramic body reconstruction, and orthosis. In particular, in orthopaedic oncology, patients have a wide variety of tumor locations, but limited options for the limb salvage surgery have resulted in many complications. Currently, 3D printing personalized implants can be fabricated easily in a short time, and it is anticipated that all bone tumors in various surgical sites will be reconstructed properly. An improvement of 3D printing technology in the healthcare field requires close cooperation with many professionals in the design, printing, and validation processes. The government, which has determined that it can promote the development of 3D printing-related industries in other fields by leading the use of 3D printing in the medical field, is also actively supporting with an emphasis on promotion rather than regulation. In this review, the experience of using 3D printing technology for bone tumor surgery was shared, expecting orthopaedic surgeons to lead 3D printing in the medical field.

Three Dimensional Stress Analysis of a Dental Implant with Central Cavity (중공을 가지는 치과용 임플란트의 3차원 응력해석)

  • Kim, Jin-Gon;Lee, Jae-Kon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.5
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    • pp.2197-2202
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    • 2011
  • In this study, we propose a new short dental implant and investigate its bio-mechanical characteristics by using three dimensional finite element analyses. The proposed dental implant has the central cavity which can be integrated with the core of cancellous bone remained by trepanning drill. We take the Bicon short implant as a reference model for studying the effects according to the shape of cavity. The parametric finite element model using ANSYS APDL has been built to determine which length, diameter and thread of central cavity would be effective to dissipate stress. The reduction of undesirable stress in adjacent bone which can suppress bone defects and the eventual failure of implants. The numerical results shows that the cavity of well-determined shape has the beneficial effects on reducing the bone absorption in cancellous bone.

Short Segment Screw Fixation without Fusion for Unstable Thoracolumbar and Lumbar Burst Fracture : A Prospective Study on Selective Consecutive Patients

  • Kim, Hee-Yul;Kim, Hyeun-Sung;Kim, Seok-Won;Ju, Chang-Il;Lee, Sung-Myung;Park, Hyun-Jong
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.203-207
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    • 2012
  • Objective: The purpose of this prospective study was to evaluate the efficacy and safety of screw fixation without bone fusion for unstable thoracolumbar and lumbar burst fracture. Methods: Nine patients younger than 40 years underwent screw fixation without bone fusion, following postural reduction using a soft roll at the involved vertebra, in cases of burst fracture. Their motor power was intact in spite of severe canal compromise. The surgical procedure included postural reduction for 3 days and screw fixations at one level above, one level below and at the fractured level itself. The patients underwent removal of implants 12 months after the initial operation, due to possibility of implant failure. Imaging and clinical findings, including canal encroachment, vertebral height, clinical outcome, and complications were analyzed. Results: Prior to surgery, the mean pain score (visual analogue scale) was 8.2, which decreased to 2.2 at 12 months after screw fixation. None of the patients complained of worsening of pain during 6 months after implant removal. All patients were graded as having excellent or good outcomes at 6 months after implant removal. The proportion of canal compromise at the fractured level improved from 55% to 35% at 12 months after surgery. The mean preoperative vertebral height loss was 45.3%, which improved to 20.6% at 6 months after implant removal. There were no neurological deficits related to neural injury. The improved vertebral height and canal compromise were maintained at 6 months after implant removal. Conclusion: Short segment pedicle screw fixation, including fractured level itself, without bone fusion following postural reduction can be an effective and safe operative technique in the management of selected young patients suffering from unstable burst fracture.