• 대한치과보철학회지
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• 제62권2호
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• pp.131-139
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• 2024

무치악 환자에서 임플란트를 이용한 보철치료는 임플란트 고정성 보철, 임플란트 융합 국소 의치, 하이브리드 보철물, 임플란트 유지 및 지지 피개의치 등의 다양한 방법이 있다. 본 증례에서는 중등도 이상의 만성 치주염에 이환 되어 전악 발치가 필요한 환자에서 computer guided surgery를 이용하여 계획된 위치에 임플란트를 식립하였다. 상악은 불량한 골질로 초기고정력이 충분하지 않아 지연 부하를 시행하였고 골 유착 기간 동안 임시 의치를 사용하였다. 하악은 안정적인 초기 고정을 얻어 즉시 부하를 이용하여 환자의 불편감을 감소시켰다. 임플란트 일차 안정은 즉시 부하를 얻기 위해 가장 중요한 요소로 여겨지기 때문에 수술 전 반드시 임상적, 방사선학적 평가를 통해 잔존 치조골 양 및 골질을 파악해야 한다.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.16-20
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• 2014

Objective : Two-dimensional fluoroscopy-based computerized navigation for the placement of pedicle screws offers the advantage of using stored patient-specific imaging data in providing real-time guidance during screw placement. The study aimed to describe the accuracy and reliability of a fluoroscopy-based navigation system for pedicle screw insertion. Methods : A total of 477 pedicle screws were inserted in the lower back of 96 consecutive patients between October 2007 and June 2012 using fluoroscopy-based computer-assisted surgery. The accuracy of screw placement was evaluated using a sophisticated computed tomography protocol. Results : Of the 477 pedicle screws, 461 (96.7%) were judged to be inserted correctly. Frank screw misplacement [16 screws (3.3%)] was observed in 15 patients. Of these, 8 were classified as minimally misplaced (${\leq}2mm$); 3, as moderately misplaced (2.1-4 mm); and 5, as severely misplaced (>4 mm). No complications, including nerve root injury, cerebrospinal fluid leakage, or internal organ injury, were observed in any of the patients. Conclusion : The accuracy of pedicle screw placement using a fluoroscopy-based computer navigation system was observed to be superior to that obtained with conventional techniques.

• 대한치과교정학회지
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• 제51권5호
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• pp.321-328
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• 2021

Objective: To examine the accuracy of computer-aided intraoperative navigation (Ci-Navi) in bimaxillary orthognathic surgery by comparing preoperative planning and postoperative outcome. Methods: The study comprised 45 patients with congenital dentomaxillofacial deformities who were scheduled to undergo bimaxillary orthognathic surgery. Virtual bimaxillary orthognathic surgery was simulated using Mimics software. Intraoperatively, a Le Fort I osteotomy of the maxilla was performed using osteotomy guide plates. After the Le Fort I osteotomy and bilateral sagittal split ramus osteotomy of the mandible, the mobilized maxilla and the distal mandibular segment were fixed using an occlusal splint, forming the maxillomandibular complex (MMC). Real-time Ci-Navi was used to lead the MMC in the designated direction. Osteoplasty of the inferior border of the mandible was performed using Ci-Navi when facial symmetry and skeletal harmony were of concern. Linear and angular distinctions between preoperative planning and postoperative outcomes were calculated. Results: The mean linear difference was 0.79 mm (maxilla: 0.62 mm, mandible: 0.88 mm) and the overall mean angular difference was 1.20°. The observed difference in the upper incisor point to the Frankfort horizontal plane, midfacial sagittal plane, and coronal plane was < 1 mm in 40 cases. Conclusions: This study demonstrates the role of Ci-Navi in the accurate positioning of bone segments during bimaxillary orthognathic surgery. Ci-Navi was found to be a reliable method for the accurate transfer of the surgical plan during an operation.

• Journal of International Society for Simulation Surgery
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• 제2권2호
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• pp.47-51
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• 2015

Faces play a key role in revealing the personalized attributes such as the identity, emotion, health condition, etc. Due to the importance of faces, computer-assisted face modeling and reconstruction have been actively studied both in computer vision and graphics community. Especially, face reconstruction and realistic face synthesis are well-grounded research problems and various approaches have been proposed during the last decade. In this paper, we discuss a wide range of existing work in face modeling by introducing their target applications, categorizing them upon their methodology and addressing their strength and weakness on performance. Finally, we introduce remaining research issues and suggest the future research direction in face modeling. We believe that this paper provides a high-level overview on face modeling techniques and helps understand the major research issues and the trends of methodology.

• Journal of Periodontal and Implant Science
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• 제44권4호
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• pp.184-193
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• 2014

Purpose: The aim of the present study was to evaluate the in vivo accuracy of flapless, computer-aided implant placement by comparing the three-dimensional (3D) position of planned and placed implants through an analysis of linear and angular deviations. Methods: Implant position was virtually planned using 3D planning software based on the functional and aesthetic requirements of the final restorations. Computer-aided design/computer-assisted manufacture technology was used to transfer the virtual plan to the surgical environment. The 3D position of the planned and placed implants, in terms of the linear deviations of the implant head and apex and the angular deviations of the implant axis, was compared by overlapping the pre- and postoperative computed tomography scans using dedicated software. Results: The comparison of 14 implants showed a mean linear deviation of the implant head of 0.56 mm (standard deviation [SD], 0.23), a mean linear deviation of the implant apex of 0.64 mm (SD, 0.29), and a mean angular deviation of the long axis of $2.42^{\circ}$ (SD, 1.02). Conclusions: In the present study, computer-aided flapless implant surgery seemed to provide several advantages to the clinicians as compared to the standard procedure; however, linear and angular deviations are to be expected. Therefore, accurate presurgical planning taking into account anatomical limitations and prosthetic demands is mandatory to ensure a predictable treatment, without incurring possible intra- and postoperative complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권2호
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• pp.158-165
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• 2011

A 73-year-old Korean female patient with a fully edentulous mandible was planned to have five implant fixtures installed in the anterior mandible for the fixed prosthesis. After 3-dimensional (3D) computed tomographic scanning was transferred to OnDemand3D$^{(R)}$ (Cybermed Co., Seoul, Korea) software program for the virtual planning, five fixtures of MK III Groovy RP implants of Branemark System$^{(R)}$ (Nobel Biocare AB Co., Goteborg, Sweden) were installed in the anterior mandible between both mental foramens using In2Guide$^{(R)}$ (CyberMed Co., Seoul, Korea) mucosa-supported surgical template with Quick Guide Kit$^{(R)}$ (Osstem Implant Co., Seoul, Korea) systems. Fixture installations were completed successfully without any complications, such as mental nerve injury, bony bleedings, fenestrations and other unexpected events. Postoperative computed tomographic scans were aligned and fused to the planned implant, then angular and linear deviations were compared with the planned virtual implants. The mean angular deviation between the planned and actual implant axes was $3.42{\pm}1.336^{\circ}$. The mean distance between the planned and actual implant at the neck area was $0.544{\pm}0.290$ mm horizontally and $0.118{\pm}0.079$ mm vertically. The average distance between the planned and actual implant at the apex area was $1.166{\pm}0.566$ mm horizontally and $0.14{\pm}0.091$ mm vertically. These results could be considered more precise and accurate than previous reports, and even our recent results. The entire procedures of this case are reported and reviewed.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.41.1-41.6
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• 2019

Backgrounds: The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation: A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion: For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

• 임상간호연구
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• 제22권1호
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• pp.99-108
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• 2016

Purpose: This study aims to develop Tablet PC-based multimedia educational contents on the procedures from surgery preparation to recovery for hospitalized patients who are going to undergo thoracic surgery and their families. Methods: The educational contents were created based on literature review and a survey of needs in patients and their families who were admitted to a hospital in Seoul from Dec. 2013 to May 2014. The contents were developed in conjunction with a film production company. The educational materials including texts, images, sounds, and videos were developed appling the ADDIE (analysis, design, development, implementation, and evaluation) model. Results: Two multimedia educational contents were developed for the patients with coronary artery bypass graft or lung surgery. Each content consisted of six subdivisions of self-learning for 20 minutes. The developed educational contents were completed after testing content validity by 30 medical experts. Conclusion: This study recommends that the Tablet PC-based educational contents for thoracic and cardiovascular patients and their families be used in general wards and intensive care units to relieve their anxiety before surgery and reduce postoperative complications.

• Journal of Korean Neurosurgical Society
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• 제50권6호
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• pp.523-527
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• 2011

A 67-year-old woman presented for evaluation of severe coccygeal pain. The computed tomography scans and magnetic resonance imaging showed an asymmetric midline sacral tumor invading the right lower portion of S2. To preserve both S2 nerve roots and to obtain negative surgical margins, a modified mid-sacrectomy with an aid of a computed navigation system was performed. The sacral tumor was excised en bloc with negative tumor margins. Both S2 nerve roots were preserved and additional reconstruction was not necessary because of minimal resection of the sacroiliac joint. We report a case of a sacral chordoma which was excised en bloc with adequate surgical margins by a computer-assisted modified mid-sacrectomy. The computed navigation system may be a useful tool for tumor targeting and safe osteotomies in sacral tumor surgery via the posterior only approach.

• The Journal of Advanced Prosthodontics
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• 제8권3호
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• pp.207-213
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• 2016

PURPOSE. A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. MATERIALS AND METHODS. For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (${\alpha}=.05$). RESULTS. The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. CONCLUSION. The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance.