• Title/Summary/Keyword: Surgical repositioning

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ERUPTING GUIDANCE OF IMPACTED MAXILLARY PERMANENT INCISOR WITH APICALLY REPOSITIONED FLAP (근단 변위 판막술을 이용한 상악 영구 절치의 맹출 유도)

  • Im, Ye-Jin;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.4
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    • pp.512-518
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    • 2010
  • The impaction of the maxillary permanent incisor is a common clinical problem and is mostly found at the "labial to the alveolar process." Surgical exposure and orthodontic treatment with fixed orthodontic appliances can be considered if normal eruption of the labillay impacted tooth is not expected. Surgical exposure of the impacted tooth, that is usually under the attached gingiva or is surrounded by alveolar bone through gingivectomy and removal of alveolar bone, may give a rise to complications such as diminution in the width of the attached gingiva, inflammation of the gingiva, and the loss of marginal alveolar bone. Therefore, closed eruption technique, which includes surgical exposure and orthodontic treatment with fixed orthodontic appliances followed by repositioning of surgical flap, is preferred. However, apically repositioned flap of the impacted tooth, which is beneath the movable submucosal area or is above the alveolar crestal area, can prevent unwanted exposures and facilitate successful tooth eruption. In this report, we described esthetic results of three patients with unerupted maxillary permanent incisor who were performed with an apically positioned flap without the loss of attached gingiva.

ORTHODONTIC TRACTION AFTER THE TRAUMATIC INTRUSION OF UPPER CENTRAL INCISOR (외상에 의하여 함입된 상악 중절치의 교정적 견인)

  • Han, Yoon-Beum;Lee, Jae-Ho;Choi, Hyung-Jun;Sohn, Hyung-Kyu;Kim, Seong-Oh;Song, Je-Seon;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.2
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    • pp.293-297
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    • 2009
  • Traumatic intrusion is a type of injury that involves axial displacement of a tooth toward the alveolar bone. Its occurance is relatively rare compared to other types of luxation in permanent dentition. It is more common in boys than in girls, and most common etiology of intrusion is fallen down. Various complication may occur following traumatic intrusion, such as pulp necrosis, root resorption, pulp obliteration and marginal bone loss. In addition, traumatic intrusion is commonly combined with hard or soft tissue injuries. Therefore, it is difficult to establish proper treatment plan. Choice of treatment for an intruded tooth by trauma include waiting for spontaneous re-eruption, orthodontic repositioning, and surgical repositioning. In this case, we repositioned the intruded central incisor using orthodontic traction, in a six-year old girl, which failed to re-erupt spontaneously.

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Evaluation of the feasibility of bony window repositioning without using a barrier membrane in sinus lateral approach (상악동측방접근법시 차폐막을 사용하지 않는 골창재위치술의 유용성 평가)

  • Jeon, Seung-Hwan;Cho, Yong-Seok;Lee, Byung-Ha;Im, Tae-Yun;Hwang, Kyung-Gyun;Park, Chang-Joo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.2
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    • pp.122-126
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    • 2011
  • Introduction: In the lateral window approach for a maxillary sinus bone graft, there has been considerable controversy regarding the placement of a barrier membrane over the osteotomy site. In particular, when there is no damage to the Schneiderian membrane, clinicians should decide whether to use a barrier membrane or not, considering the benefits and costs. This study presents the clinical cases to demonstrate that only repositioning the detached window can lead to satisfactory bony healing of the grafted material without using a barrier membrane in the lateral approach for a maxillary sinus bone graft. Materials and Methods: Five consecutive patients were treated with the same surgical procedures. After performing the antrostomy on the lateral maxillary wall using a round carbide bur and diamond bur, the bony window was detached by a gentle levering action. After confirming no perforation of the Schneiderian membrane, the grafting procedure was carried out the detached window of the lateral maxillary wall was repositioned over the grafted material without using a barrier membrane. A gross examination was carried out at the postoperative 6 month re-entry, and the the preoperative and postoperative dental computed tomography (CT) at re-entry were compared. Results: All the procedures in the 5 patients went on to uneventful healing with no complications associated with the bone graft. Satisfactory bone regeneration without the interference of fibrous tissue on the gap between the repositioned window and lateral wall of the maxillary sinus was observed in the postoperative 6 month re-entry. The CT findings at re-entry revealed the, reconstruction of the external cortical plate including repositioned bony window. In addition, the loss of the discontinuity of the lateral maxillary wall was confirmed. Conclusion: This preliminary report showed that the detached window, which was just repositioned on the grafted material, could function as a barrier membrane in the lateral approach for a maxillary sinus bone graft. Therefore additional morphometric and histologic studies will be needed.

Management of Eruption Disturbances of the Mandibular First Molar : A Case Report (맹출장애를 가진 하악 제1대구치의 치료 : 증례 보고)

  • Jeon, Hyunsoon;Yang, Yeonmi;Baik, Byeongju;Kim, Jaegon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.314-320
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    • 2013
  • With a prevalence rate of 0.01%, the presence of eruption disturbances of mandibular first molar has rarely been in populations. Eruption disturbances of permanent molars have been usually manifested as impaction, primary retention, and secondary retention. The treatments of eruption disturbances are carried out by: periodic observation; surgical exposure; forced eruption after surgical exposure; forced eruption with luxation; surgical repositioning; and extraction. This case report show successfully erupted mandibular first molars by various treatment methods on five patients diagnosed with impaction, primary retention, and secondary retention, respectively. Eruption disturbances of the mandibular first molar can be properly diagnosed with impaction, primary retention, and secondary retention by clinical and radiographic examination at normal eruption time of the mandibular first molar. The treatment should be done synthetically, considering eruption state of affected tooth, the relationship between the affected tooth and the adjacent or opposite tooth, the patient's age, treatment compliance, and economic state.

TREATMENT OF ANTERIOR OPEN BITE WITH BIMAXILLARY ANTERIOR SEGMENTAL OSTEOTOMY AND GENIOPLASTY (양악 전방분절골절단술과 이부 성형술을 통한 개방교합의 치험례)

  • Hwang, Yong-In;Hong, Sun-Min;Park, Jun-Woo;Rhee, Gun-Joo;Cho, Hyung-Jun;Cheon, Se-Hwan;Park, Yang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.355-364
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    • 2008
  • Skeletal anterior open bite is a difficult problem to correct in orthodontic treatment. To treat adult patients who have skeletal anterior open bite, we considered two methods. Combination treatment of orthodontics & surgery and camouflage orthodontic treatment. In adults, treatment of severe skeletal anterior open bite consists mainly of surgically repositioning the maxilla or the mandible. However, camouflage therapy is often the treatment of choice for skeletal open bite patients who have mild to moderate skeletal discrepancies when growth modification is no longer possible. But excellent results generally require careful coordination of the orthodontic and surgical phases of treatment. This is a case report of a skeletal anterior open bite patients who were treated with orthodontic treatment and orthognathic surgery. First case was diagnosed as skeletal class I malocclusion & bimaxillary protrusion with anterior open bite, and finally treatment ended for removal of open bite with orthodontic procedure and bimaxillary anterior segmental osteotomy surgery. Second case was diagnosed as skeletal class II malocclusion with open bite & mandibular retrusion, and was treated with only camouflage orthodontics because she feared to have a surgery. In a regular follow up visit after debonding we proposed to the patient advanced genioplasty, and in her agreement her facial esthetics was improved through the surgery.

Clinical analysis of expandble metallic stent in benign tracheal & bronchial disease (양성 기관, 기관지 질환에서 확장성 금속 스텐트 사용에 관한 임상적 고찰)

  • Lee Sung Soo;Kim Do Hyung;Paik Hyo Chae;Lee Doo Yun
    • Korean Journal of Bronchoesophagology
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    • v.10 no.2
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    • pp.17-21
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    • 2004
  • Background Insertion of tracheal stent in the treatment of benign tracheal & bronchial disease has increased since the introduction of expandable metallic stent. Material & Methods : Between Jan, 1995 and Feb. 2004, eight patients who had benign tracheo-bronchial disease underwent insertion of expandable metallic tracheal stent. We retrospectively analyzed stent insertion indications, complications, and following the result. Results : Surgical indications were post-intubation tracheal stenosis (1 case), tracheal stenosis following tracheal surgery (2 cases), tracheo-esophageal fistula (2 cases), broncho-pleural fistula(1 case), left main bronchus stenosis following bronchoplasty (1 case), and left main bronchus stenosis due to mediastinal repositioning (1 case). Expandable metallic tracheal stent was inserted in five patients to resolve dyspnea caused by airway obstruction, and to prevent recurrent pneumonia in three patients. The complication developed in 6 patients $75\%$; 3 cases of distal stenosis due to growth of granulation tissue, and one case each of tearing of posterior membrane, aggravation of tracheo-esophageal fistula, and airway partial obstruction due to stent migration. The stent was removed in 5 patients and tracheal surgery (tracheal resection and end to end anastomosis with primary repair of esophagus, pericardial patch tracheo-bronchoplasty, tracheal repair and omental wrapping) was performed in 3 patients. Conclusion Insertion of self expandable metallic stent in benign tracheo-bronchial disease is an effective means of relieving dyspnea for only a short period, and it did not increase the long term survival. Better means of treatment of benign tracheo-bronchial stenosis in necessary.

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Treatment of Posttraumatic Facial Deformity Patient with Brown's Syndrome: Case Report (외상 후 브라운 증후군을 동반한 안면 변형 환자의 치험례)

  • Park, Byung-Chan;Kim, Yong-Ha;Kim, Tae-Gon;Lee, Jun-Ho;Kim, Myung-Mi
    • Archives of Craniofacial Surgery
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    • v.11 no.1
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    • pp.33-36
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    • 2010
  • Purpose: Brown's syndrome is characterized by the limited elevation in adduction from mechanical causes around the superior oblique tendon trochlea complex. In this particular case, post-traumatic facial deformity accompanied by Brown's syndrome was observed. We would like to report the satisfying cosmetic results obtained by reconstructing orbital roof and superior orbital rim and repositioning of zygoma. Methods: A 12-year-old patient was observed with facial deformity with strabismus in her right eye and orbital dystopia after the car accident and was eventually diagnosed with traumatic Brown's syndrome. Reconstructive surgeries could not be performed at the time of trauma due to the cerebral hemorrhage. At the second year after the trauma, a depressed fracture of the right orbital roof and superior orbital rim were reconstructed via the intracranial approach, and orbital dystopia was corrected via the zygoma triple ostectomy. In addition, a strabismus surgery was performed one year after her plastic surgery. Results: Facial deformity with orbital dystopia and strabismus was confirmed to be fully reconstructed after the surgery. Moreover, when the patient came in for a follow-up thirteen years after the operation, a developmental imbalance of the facial bones, diplopia, or any other surgical complications were not to be found. Conclusion: After the trauma, the patient with Brown's Syndrome accompanied by post-traumatic facial deformity, who went under the corrective surgeries after the meticulous examination and assessment pre-surgically, was able to acquire cosmetic satisfaction via those operations.

Thoracic Spinal Cord Stimulation and Radiofrequency Thermocoagulation of Lumbar Sympathetic Ganglion in a Patient with Complex Regional Pain Syndrome in the Lower Extremity -A case report- (복합부위통증증후군 환자에서 척수자극술과 교감신경 고주파열응고술 -증례 보고-)

  • Kim, Shi Hyeon;Moon, Dong Eon;Park, Chong Min;Ryu, Keon Hee;Seo, Kyung Soo;You, Sie Hyun
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.240-245
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    • 2005
  • Herein is described the successful treatment of complex regional pain syndrome type II with the combination treatment of spinal cord stimulation and radiofrequency thermocoagulation of the lumbar sympathetic ganglion. A 62 years old male patient, suffering from CRPS type II in his left lower extremity, visited our pain clinic. Medication and nerve blockade produced only slight improvement in his symptoms and signs. Therefore, a linear type spinal cord simulator was inserted into the thoracic epidural space, using a non-surgical percutaneous approach, with the cephalad lead located at the T11 level. Two months later, the repositioning of the electrode to the T12 level for more effective pain control, with radiofrequency thermocoagulation of lumbar sympathetic ganglion also performed at the left L2 and 3 levels for the control of trophic change. These resulted in significant pain relief and decreased trophic change, with no complications, after which the patient was able to resume a normal life.

Treatment of Transposition of the Maxillary Canine Using Various Treatment Modalities (다양한 치료법을 사용한 상악 견치 전위의 치료)

  • Kim, Hyosun;Kim, Yoojun;Jang, Kitaeg;Kim, Youngjae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.1
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    • pp.54-63
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    • 2014
  • Transposition is a unique and extreme form of ectopic eruption where a tooth develops and erupts in a position, normally occupied by an adjacent tooth. Generally, three treatment options are available when the maxillary canine and first premolar are transposed. In the first treatment option, the transposed position of the teeth can be maintained such that the first premolar is moved to the position of the canine. Second, extraction of the maxillary first premolar can be considered. Third, the position of the transposed teeth can be corrected such that their normal positions in the arch are restored. Factors that should be considered in treatment modality decision include function, occlusion, periodontal support, treatment time, patient cooperation, and esthetic demands. This report describes cases of maxillary canine-premolar transposition treated with each of the three aforementioned treatment options. In the first case, transposed teeth were arranged in their transposed position. The second case was an extraction case. In the third case, orthodontic treatment and surgical repositioning were conducted.

A Case of Postpneumonectomy Syndrome Treated with Endobronchial Stent (기관지 스텐트 삽입으로 치료한 전폐절제술후 증후군 1예)

  • Jeong, Seong-Hyun;Cho, Hye-Jin;Lee, Hyoung-No;Lee, Hyung-Sook;Sheen, Seung-Soo;Oh, Yoon-Jung;Park, Kwang-Joo;Hwang, Sung-Chul;Won, Jae-Hwan;Park, Kyung-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.325-331
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    • 2002
  • Postpneumonectomy syndrome is a rare complication that usually occurs in younger patients within the first year after a right total lung resection. Its clinical presentations are stridor, dyspnea, and recurrent pulmonary infections. An airway obstruction secondary to the extreme mediastinal shift and ratation after a pneumonectomy is the main mechanism. It is commonly complicated with tracheobronchomalacia due to longstanding airway compression. The management modalities involve a repositioning of the mediastinum with volume expansion of the pneumonectomy site by a expandable prosthesis. however, other methods including an endobronchial stent insertion should be considered in the presence of a tracheobronchomalacia or in poor surgical candidates. Here we describe a case of postpneumonectomy syndrome complicated by a bronchomalacia, which was successfully treated with a self-expandable endobronchal stent.