• 제목/요약/키워드: Surgical stability

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악교정 수술후 하악 근원심 골편의 위치 변화와 안정성에 관한 연구 (A STUDY OF THE CHANGE OF MANDIBLE POSITION AND THE STABILITY AFTER ORTHOGNATHIC SURGERY)

  • 남광호;이상철
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권2호
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    • pp.95-101
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    • 2003
  • The purpose of this study was to evaluate the patterns of skeletal changes of proximal and distal segments after one jaw surgery and two jaw surgery with posterior impaction using SSRO on mandible in order to determine the skeletal origin of relapse and compare the stability of surgical methods in anterior open bite. The points and lines from lateral cephalometrics were measured before, after surgery, and at least 6-month follow up period. And then, the positional change of the proximal and distal segment were evaluated respectively. The results obtained were as follows; In cases of two jaw surgery, the results were stabler because they had less relapse factors. In cases of one jaw surgery, the value of APD were increased but it didn't relapse to the original value. Both of proximal and distal segments were responsible for the relapse tendency. But in one jaw surgery, the rotation of proximal segment was more responsible, and in two jaw surgery, the rotation of distal segment was.

구순구개열 환자의 Le Fort I 골절단술 후 상악골의 위치적 안정성에 관한 연구 ; 예비보고 (Skeletal Stability after Le Fort I Osteotomy in the Cleft Patients; Preliminary Report)

  • 김명진;유호석;김종원;김규식
    • 대한구순구개열학회지
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    • 제2권1_2호
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    • pp.15-22
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    • 1999
  • It is well known that the postoperative skeletal instability after Le Fort I osteotomy for advancement of maxilla in the cleft patients is one of the major surgical problems. So we had tried to compare the amount of relapse after Le Fort I advancement surgery in the horizontal and vertical positional change, angular change of reference points between cleft patients and non-cleft patients. Longitudinal records of 10 consecutive cleft patients (test group) and 20 non-cleft patients (control group) were analyzed. Lateral cephalograms were taken preoperatively, immediately postoperatively, and 2, 6, 12 months postoperatively. We measured horizontal and vertical changes (ANS, PNS, AI) and angular change (SNA) of the reference points and lines. In the test group, horizontal relapse of ANS, PNS, AI point are 36.4%, 37.5%, 32.0% respectively at 12 months postoperatively. The vertical relapse of ANS, PNS, AI are 25.3%, 32.3%, 39.1% respectively at 12 months postoperatively. The angular change of SNA is 33.6% at 12 months postoperatively. In the control group, horizontal relapse of ANS, PNS, AI point are 23.8%, 30.2%, 21.7% respectively at 12 months postoperatively. The vertical relapse of ANS, PNS, AI are 22.7%, 27.3%, 25.1% respectively at 12 months postoperatively. The angular change of SNA is 22.2% at 12 months postoperatively. The cleft patients have a larger tendency of skeletal and dental relapse compared with non-cleft patients after Le Fort I surgery. So the oral and maxillofacial surgeons must keep in mind these facts in order to minimize the relapse phenomenon from the beginning of surgical planning to postoperative care.

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하악지 시상 골절단술 이후 흡수성 나사를 사용하여 고정한 환자에서 술 후 안정성에 대한 연구 (STABILITY AFTER SURGICAL CORRECTION OF MANDIBULAR PROGNATHISM USING BILATERAL SAGGITAL SPLIT RAMUS OSTEOTOMY AND FIXATION WITH POLY-L/DL-LACTIDE COPOLYMER SCREWS ($BIOSORB^{TM}FX$))

  • 권택균;김용덕;신상훈;김욱규;김종렬;정인교
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권2호
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    • pp.160-163
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    • 2005
  • This study was designed to assess skeletal stabilily after surgical correction of mandibular prognathism by bilateral saggital split ramus osteotomy(BSSRO) and fixation with absorbable screws. From July 2001 to September 2003, 30 patients with Class III malocclusion were treated with BSSRO and mandibular setback. They underwent fixation with Biosorb$^{TM}$ FX screws. Cephalograms were obtained preoperatibely, 2 or 3 days postoperatively, and about 12 months after the operation. Changes in the position of lower incisor tip, B point, and pogonion were examined on lateral cephalograms. The mean mandibular setback just after surgery was 10.6mm. 12 months after surgery, mean relapse at pogonion represented 17.9% and 15.1% at B point. Our results suggest that fixation of the bony segments with absorbable screws after BSSO may be used effectively in properly selected cases.

Long-term Stability after Reduction of Mandible Fracture by Keyhole Plate: Evaluation at the Time of Plate Removal

  • Cheon, Kyeong-Jun;Cho, Seoung-Won;Jang, Won-Seok;Kim, Ju-Won;Yang, Byoung-Eun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제42권
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    • pp.6.1-6.6
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    • 2020
  • Background: Various types of miniplates have been developed and used for the reduction of facial bone fractures. We introduced Yang's Keyhole (YK) plate, and reported on its short-term stability. The purpose of this study was to evaluate the long-term stability of the YK plate, as a follow-up study, by examining the patients who had used the YK plate among the patients with the reduction of mandible fractures and who visited for plate removal. Methods: We reviewed the medical records of 16 patients who underwent mandibular fracture fixation using a YK plate (group I) and 17 patients who underwent mandibular fracture fixation using a conventional plate (group II). Assessment was then made on malunion, occlusal stability, discomfort during the application, and clinical symptoms. Results: From January 2015 to December 2017, a total of 36 patients underwent mandibular fracture surgery using a YK plate. A total of 16 patients received plate removal. Among them, 15 were male and 1 female. The average age was 26 years. The applied surgical sites were the 12 on mandibular angle, 4 on mandibular symphysis, and 2 on subcondyle. The application period of YK plate was an average of 335 days. During the same period, 45 people underwent surgery on the conventional plate. A total of 17 patients received plate removal. Among them, 15 were male and 2 females. The average age was 36 years. The applied surgical sites were the 8 on mandibular angle, 4 on mandibular symphysis, and 2 on subcondyle. The application period of the conventional plate was an average of 349 days. No malocclusion occurred at the time of removal, and occlusion was stable. No patient complained of joint disease or discomfort. Conclusion: The YK plate system, in which the screw was first inserted and the plate was applied, for clinical convenience did not cause any particular problem and no significant difference from the conventional plate.

하악골 전돌증 환자에서 하악지 시상분할골 절단술 적용술 후 초기 안정성 평가 (Initial Stability after Bilateral Sagittal Split Ramus Osteotomy Application in Patients with Mandibular Prognathism)

  • 권명희;임대호;백진아;신효근;고승오
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제33권3호
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    • pp.218-224
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    • 2011
  • Purpose: The purpose of this study is to evaluate the post-operative skeletal stability after surgical correction of patients with mandibular prognathism by bilateral sagittal split ramus osteotomy (BSSRO) and to evaluate the horizontal relapse tendency after the surgery. Methods: Twenty-six patients with Class III dental and skeletal malocclusion were selected for this retrospective study. Fifteen of them underwent BSSRO for mandibular setback and eleven of them underwent two-jaw surgery (Lefort I and BSSRO). In each patient, lateral cephalometric radiographs were taken pre-operatively, post-operatively within 1 week, and post-operatively after eight months. After tracing of the cephalometric radiographs, various parameters were measured. The analyses were done by linear measurement to evaluate the change in position of hard tissue B point, pogonion and mandibular plan angle by examination on lateral cephalograms. Results: The horizontal relapse rate was 27.1% at B point and 31.6% at pogonion in patients who underwent BSSRO. The horizontal relapse rate of the group where the amount of correction exceeded 10 mm was 25.69% at B point. Conclusion: There were no statistical differences on the magnitude of setback and direction of rotation of the mandible in mandibular stability. There were also no statistical differences between single mandibular surgery and two-jaw surgery for mandibular stability.

Clinical Significance of Radiological Stability in Reconstructed Thoracic and Lumbar Spine Following Vertebral Body Resection

  • Sung, Sang-Hyun;Chang, Ung-Kyu
    • Journal of Korean Neurosurgical Society
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    • 제56권4호
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    • pp.323-329
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    • 2014
  • Objective : Vertebral body replacement following corpectomy in thoracic or lumbar spine is performed with titanium mesh cage (TMC) containing any grafts. Radiological changes often occur on follow-up. This study investigated the relationship between the radiological stability and clinical symptoms. Methods : The subjects of this study were 28 patients who underwent corpectomy on the thoracic or lumbar spine. Their medical records and radiological data were retrospectively analyzed. There were 23 cases of tumor, 2 cases of trauma, and 3 cases of infection. During operation, spinal reconstruction was done with TMC and additional screw fixation. We measured TMC settlement in sagittal plane and spinal angular change in coronal and sagittal plane at postoperative one month and last follow-up. Pain score was also checked. We investigated the correlation between radiologic change and pain status. Whether factors, such as the kind of graft material, surgical approach, and fusion can affect the radiological stability or not was analyzed as well. Results : Mean follow-up was 23.6 months. During follow-up, $2.08{\pm}1.65^{\circ}$ and $6.96{\pm}2.08^{\circ}$ of angular change was observed in coronal and sagittal plane, respectively. A mean of cage settlement was $4.02{\pm}2.83mm$. Pain aggravation was observed in 4 cases. However, no significant relationship was found between spinal angular change and pain status (p=0.518, 0.458). Cage settlement was seen not to be related with pain status, either (p=0.644). No factors were found to affect the radiological stability. Conclusion : TMC settlement and spinal angular change were often observed in reconstructed spine. However, these changes did not always cause postoperative axial pain.

The effect of the thread depth on the mechanical properties of the dental implant

  • Lee, Sun-Young;Kim, Sung-Jun;An, Hyun-Wook;Kim, Hyun-Seung;Ha, Dong-Guk;Ryo, Kyung-Ho;Park, Kwang-Bum
    • The Journal of Advanced Prosthodontics
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    • 제7권2호
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    • pp.115-121
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    • 2015
  • PURPOSE. This study aimed to evaluate the effect of implant thread depth on primary stability in low density bone. MATERIALS AND METHODS. The insertion torque was measured by inserting Ti implants with different thread depths into solid rigid polyurethane blocks (Sawbones) with three different bone densities ($0.16g/cm^3$, $0.24g/cm^3$, and $0.32g/cm^3$). The insertion torque value was evaluated with a surgical engine. The static compressive strength was measured with a universal testing machine (UTM) and the Ti implants were aligned at $30^{\circ}$ against the loading direction of the UTM. After the static compressive strength test, the Ti implants were analyzed with a Measurescope. RESULTS. The Ti implants with deeper thread depth showed statistically higher mean insertion torque values (P<.001). Groups A and group B had similar maximum static compressive strengths, as did groups C and D (P>.05). After the static compressive strength, the thread shape of the Ti implants with deeper thread depth did not show any breakage but did show deformation of the implant body and abutment. CONCLUSION. The implants with deeper thread depth had higher mean insertion torque values but not lower compressive strength. The deep threads had a mechanical stability. Implants with deeper thread depth may increase the primary stability in areas of poor quality bone without decreasing mechanical strength.

The effect of implant shape and bone preparation on primary stability

  • Moon, Sang-Hyun;Um, Heung-Sik;Lee, Jae-Kwan;Chang, Beom-Seok;Lee, Min-Ku
    • Journal of Periodontal and Implant Science
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    • 제40권5호
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    • pp.239-243
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    • 2010
  • Purpose: The purpose of this study was to evaluate the effects of implant shape and bone preparation on the primary stability of the implants using resonance frequency analysis. Methods: Sixty bovine rib blocks were used for soft and hard bone models. Each rib block received two types of dental implant fixtures; a straight-screw type and tapered-screw type. Final drilling was done at three different depths for each implant type; 1 mm under-preparation, standard preparation, and 1 mm over-preparation. Immediately after fixture insertion, the implant stability quotient (ISQ) was measured for each implant. Results: Regardless of the bone type, the ISQ values of the straight-screw type and tapered-screw type implants were not significantly different (P>0.05). Depth of bone preparation had no significant effect on the ISQ value of straight-screw type implants (P>0.05). For the tapered-screw type implants, under-preparation significantly increased the ISQ value (P<0.05), whereas overpreparation significantly decreased the ISQ value (P<0.05). Conclusions: Within the limitations of this study, it is concluded that bone density seemed to have a prevailing effect over implant shape on primary stability. The primary stability of the tapered-screw type implants might be enhanced by delicate surgical techniques.

급성 족관절 외측 인대 파열의 수술적 치료 (The Surgical Treatment of Acute Rupture of the Lateral Ligaments of the Ankle)

  • 이근일;노수인;최익수
    • 대한족부족관절학회지
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    • 제5권1호
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    • pp.5-12
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    • 2001
  • Purpose: To find out the priority of which procedure has had a better outcome both clinically and radiographically between the two groups, one is treated by primary repair and the other by modified Brostr$\ddot{o}$m's procedure, by comparing the postoperative ankle joint stability and the patient's degree of satisfaction. Material and methods: 16 cases were taken into consideration whose number of severed ligaments were at least two or more of the lateral collateral ligaments of the ankle, and also were confirmed intraoperatively. Among them, 8 cases were treated with primary repair and the other 8 cases were treated with primary repair and the other 8 cases by modified Brostr$\ddot{o}$m's procedure. Results: There was no distinguishable difference for the patient's degree of satisfaction between the two procedures above mentioned. In 3 cases treated with primary repair, functional instability was observed. In case of postoperative ankle joint stability, 7 of 8 cases treated by modified Brostr$\ddot{o}$m's procedure has revealed increased joint stability. And 3 of 8 cases which were treated by primary repair have showed postoperative residual instability. Conclusion: Actually, the severed ligament can not maintain its normal strength though several months has elapsed, and possible residual instability could be remained. Therefore, it can be expected that modified Brostr$\ddot{o}$m's procedure also would be a .good method in obtaining suitable ankle joint stability as well as subtalar joint stability because of its reinforcement using extensor retinaculum.

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임상가를 위한 특집 3 - 악교정 수술환자의 진단과 교정치료 (Contemporary Diagnosis and Orthodontic Treatment in Orthognathic Surgery)

  • 백형선
    • 대한치과의사협회지
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    • 제50권2호
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    • pp.72-82
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    • 2012
  • 악교정 수술에 대한 관심이 증가되고, 환자 또한 증가되는 시점에서, 환자에 대한 정확한 진단이 우선되어야 하며, 환자의 요구에 의해서 수술시기가 죄우되는 것이 아니라, 술전 교정치료를 하고 수술하는 경우와 수술을 일찍하고 후에 교정치료를 하는 경우에 대한 결정은 치과교정의사와 구강악안면외과의사가 함께 최신의 다양한 방법 등을 통한 정확한 분석과 예측과정 후에 각각의 환자에 맞는 수술계획을 수립한 후 시행하여야 하며, 무엇보다도 최선의 치료 결과를 얻는 것이 가장 중요하다.