• Journal of Chest Surgery
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• v.54 no.6
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• pp.539-542
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• 2021

Resection and reconstruction of the chest wall for the radical surgical treatment of malignant soft tissue tumors are currently considered a substantial challenge for thoracic surgeons. We present an unusual case of infantile fibrosarcoma with tropomyosin 3-neurotrophic receptor tyrosine kinase 1 fusion in a 13-year-old patient. The surgical treatment consisted of radical resection of the right posterior chest wall and reconstruction with the use of the STRATOS (Strasbourg Thoracic Osteosynthesis System) titanium rib bridge system. The patient had a favorable postoperative course and received respiratory-ventilatory rehabilitation, adjuvant therapy with chemotherapeutic agents, immunotherapy, and radiotherapy.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.1-4
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• 2016

Absorbable plates are used widely for fixation of facial bone fractures. Compared to conventional titanium plating systems, absorbable plates have many favorable traits. They are not palpable after plate absorption, which obviates the need for plate removal. Absorbable plate-related infections are relatively uncommon at less than 5% of patients undergoing fixation of facial bone fractures. The plates are made from a mixture of poly-L-lactic acid and poly-DL-lactic acid or poly-DL-lactic acid and polyglycolic acid, and the ratio of these biodegradable polymers is used to control the longevity of the plates. Degradation rate of absorbable plate is closely related to the chance of infection. Low degradation is associated with increased accumulation of plate debris, which in turn can increase the chance of infection. Predisposing factors for absorbable plate-related infection include the presence of maxillary sinusitis, plate proximity to incision site, and use of tobacco and significant amount of alcohol. Using short screws in fixating maxillary fracture accompanied maxillary sinusitis will increase the rate of infection. Avoiding fixating plates near the incision site will also minimize infection. Close observation until complete absorption of the plate is crucial, especially those who are smokers or heavy alcoholics. The management of plate infection is varied depending on the clinical situation. Severe infections require plate removal. Wound culture and radiologic exam are essential in treatment planning.

• Proceedings of the KWS Conference
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• 2002.10a
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• pp.539-544
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• 2002

Titanium and titanium alloy are excellent in corrosion resistance and specific intensity, and also in the biocompatibility. On the other hand, the brazing is bonding method of which productivity and reliability are high, when the complicated and precise structure of the thin plate is constructed. However, though conventional titanium-based brazing filler metal was excellent in bond strength and corrosion resistance, it was disadvantageous that metal structure and mechanical property of the base metal deteriorated, since the brazing temperature (about 1000 C) is considerably high. Authors developed new brazing filler metal which added Zr to Ti-Cu (-Ni) alloy which can be brazed at 900 C or less about 15 years ago. In this paper, the development of more low-melting-point brazing filler metal was tried by the addition of the fourth elements such as Ni, Co, Cr for the Ti-Zr-Cu alloy. As a method for finding the low-melting-point composition, eutectic composition exploration method was used in order to reduce the experiment point. As the result, several kinds of new brazing filler metal such as 37.5Ti-37.5-Zr-25Cu alloy (melting point 825 C) and 30Ti-43Zr-25Cu-2Cr alloy (melting point: 825 C) was developed. Then, the brazing joint showed the characteristics which were almost equal to the base metal from the result of obtaining metallic structure and strength of joint of brazing joint. However, the brazing filler metal composition of the melting point of 820 C or less could not be found. Consequentially, it was clarified that the brazing filler metal developed in this study could be practically sufficiently used from results such as metal structure of brazing joint and tensile test of the joint.

• International Journal of Korean Welding Society
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• v.2 no.2
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• pp.14-18
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• 2002

Titanium and titanium alloy are excellent in corrosion resistance and specific intensity, and also in the biocompatibility. On the other hand, the brazing is bonding method of which productivity and reliability are high, when the complicated and precise structure of the thin plate is constructed. However, though conventional titanium-based brazing filler metal was excellent in bond strength and corrosion resistance, it was disadvantageous that metal structure and mechanical property of the base metal deteriorated, since the brazing temperature ( about $1000^{\circ}C$ ) is considerably high. Authors developed new brazing filler metal which added Zr to Ti-Cu (-Ni) alloy which can be brazed at $900^{\circ}C$ or less about 15 years ago. In this paper, the development of more low-melting-point brazing filler metal was tried by the addition of the fourth elements such as Ni, Co, Cr for the Ti-Zr-Cu alloy. As a method for finding the low-melting-point composition, eutectic composition exploration method was used in order to reduce the experiment point. As the result, several kinds of new brazing filler metal such as 37.5Ti-37.5-Zr-25Cu alloy (melting point: $825^{\circ}C$) and 30Ti-43Zr-25Cu-2Cr alloy (melting point: $825^{\circ}C$) was developed. Then, the brazing joint showed the characteristics which were almost equal to the base metal from the result of obtaining metallic structure and strength of joint of brazing joint. However, the brazing filler metal composition of the melting point of $820^{\circ}C$ or less could not be found. Consequentially, it was clarified that the brazing filler metal developed in this study could be practically sufficiently used from results such as metal structure of brazing joint and tensile test of the joint.

• International Journal of Korean Welding Society
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• v.3 no.2
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• pp.40-45
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• 2003

A series of experiments has been carried out to investigate the effect of titanium, boron and nitrogen on the microstructure and toughness of simulated heat affected zone (HAZ) in quenched and tempered (QT) type 490MPa yield strength steels. For acquiring the same strength level, the carbon content and carbon equivalent could be lowered remarkably with a small titanium and boron addition due to the hardenability effect of boron during quenching process. Following the thermal cycle of large heat input, the coarsened grain HAZ (CGHAZ) of conventional quenched and tempered (QT) type 490MPa yield strength steels exhibited a coarse bainitic or ferrite side plate structure with large prior austenite grains. While, titanium and boron bearing QT type 490MPa yield strength steels were characterized by the microstructure in the CGHAZ, consisting mainly of the fine intragranular ferrite microstructure. Toughness of the simulated HAZ was mainly controlled by the proper Ceq level, and the ratio of Ti/N rather than titanium and nitrogen contents themselves. In the titanium­boron added QT steels, the optimum Ti/N ratio for excellent HAZ toughness was around 2.0, which was much lower than the known Ti/N stoichiometric ratio, 3.4. With reducing Ti/N ratio from the stoichiometric ratio, austenite grain size in the coarse grained HAZ became finer, indicating that the effective fine precipitates could be sufficiently obtained even with lower Ti/N level by adding boron simultaneously. Along with typical titanium carbo­nitrides, various forms of complex titanium­ and boron­based precipitates, like TiN­MnS­BN, were often observed in the simulated CGHAZ, which may act as stable nuclei for ferrite during cooling of weld thermal cycles

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.2
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• pp.126-131
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• 2010

Objectives: This study is aimed to determine any differences in the postoperative stability between absorbable and titanium plate systems for fixation in orthognathic surgery with simultaneous maxillomandibular procedures especially including maxillary posterior impaction and advancement. Study Design: Forty patients with dentofacial deformities were randomly assigned into titanium (4 males and 6 females) and absorbable (17 males and 13 females) fixation group. All patients had undergone surgical alterations of maxilla with posterior impaction and advancement. A comparison study of the change in the maxillary position after the simultaneous surgery was performed with 1-day, 6-months postoperative lateral cephalograms compared to preoperative lateral cephalogram by tracing. Wilcoxon rank sum test was used for statistical analysis. Result: The position of the maxilla was stable after surgery and was not changed significantly from 1 day to 6 month after the simultaneous maxillomandibular surgery both in the experimental (absorbable plates) and control (titanium plates). Conclusion: This study suggests that application of absorable plating system in the fixation of maxillary segment in the simultaneous maxillomandibular procedures, leads to a predictable short-term postoperative skeletal stability comparable to the titanium plating system. Long term follow-up and further studies will be needed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.184-188
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• 2013

Post-traumatic enophthalmos is a relatively common problem following orbitozygomatic fractures. Bony-volume expansion and soft tissue atrophy are considered the main etiological causes of this condition. Enophthalmos is corrected mostly through reducing the enlarged orbit volume. Autogenous graft and various alloplastic materials are used for this purpose. Porous polyethylene is highly biocompatible, durable, and remarkably stable. Also, the titanium plate embedded in a porous polyethylene sheet provides radiographic visibility and increased sheet strength and contour retention. We present experiences of titanium reinforced porous polyethylene for correction of the traumatic enophthalmos with literature review.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.43.1-43.5
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• 2019

Background: Reconstructive surgery is often required for tumors of the oral and maxillofacial region, irrespective of whether they are benign or malignant, the area involved, and the tumor size. Recently, three-dimensional (3D) models are increasingly used in reconstructive surgery. However, these models have rarely been adapted for the fabrication of custom-made reconstruction materials. In this report, we present a case of maxillary reconstruction using a laboratory-engineered, custom-made mesh plate from a 3D model. Case presentation: The patient was a 56-year-old female, who had undergone maxillary resection in 2011 for intraoral squamous cell carcinoma that presented as a swelling of the anterior maxillary gingiva. Five years later, there was no recurrence of the malignant tumor and a maxillary reconstruction was planned. Computed tomography (CT) revealed a large bony defect in the dental-alveolar area of the anterior maxilla. Using the CT data, a 3D model of the maxilla was prepared, and the site of reconstruction determined. A custom-made mesh plate was fabricated using the 3D model (Okada Medical Supply, Tokyo, Japan). We performed the reconstruction using the custom-made titanium mesh plate and the particulate cancellous bone and marrow graft from her iliac bone. We employed the tunneling flap technique without alveolar crest incision, to prevent surgical wound dehiscence, mesh exposure, and alveolar bone loss. Ten months later, three dental implants were inserted in the graft. Before the final crown setting, we performed a gingivoplasty with palate mucosal graft. The patient has expressed total satisfaction with both the functional and esthetic outcomes of the procedure. Conclusion: We have successfully performed a maxillary and dental reconstruction using a custom-made, pre-bent titanium mesh plate.

• Archives of Craniofacial Surgery
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• v.10 no.2
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• pp.81-85
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• 2009

Purpose: The inferior orbital wall is the most vulnerable to injury and inadequate reconstruction of inferior orbital fracture result in postoperative complications include enophthalmos, ocular dystopia and diplopia. Although the anatomical reconstruction of the inferior orbital wall is necessary to prevent these complications, the complexity of inferior orbital wall makes it difficult. We fabricated and remodeled the titanium micro-mesh plate for the anatomical reconstruction of inferior orbital wall. Methods: Twenty-nine patients with inferior orbital wall blow-out fracture were operated and twelve of them presented large extensive fracture. We intraoperatively fabricated and remodeled the Titanium-micro mesh to angulated lazy S shape similar to contralateral uninjured orbit. The preoperative and postoperative facial CT scan verified the 3-dimensional and anatomical reconstruction of the fractures. The mean follow-up was 19.7 months and postoperative complications was evaluated. Results: All cases showed the exact anatomical reconstruction, but there were minor complications in two cases. one patient had postoperative diplopia until 3months after surgery and the other patient had persistent enophthalmos (2 mm), but no further surgical correction was required. Conclusion: The comprehensive understanding of orbital convexity is the most important factor for anatomical reconstruction of inferior orbital fracture. We could prevent postoperative complications after inferior orbital wall reconstruction by intraoperative fabrication and anatomical remodeling of Titanium micro-mesh.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.2
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• pp.147-156
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• 2006

Statement of problem: The high melting temperature and chemical reactivity of titanium necessitates casting machines different from those used in conventional casting. Despite the new developments in Ti casting systems , inadequate mold filling and internal porosity are frequently observed casting defects. Therefore, the study on the fabrication technique including sprue design to solve these casting defects is still necessary. Purpose: The purpose of this study was to evaluate the effect of sprue design and cross sectional area of sprue on the internal porosity. Materials and methods: 30 simulated cast three units titanium crowns were prepared. 5 cast crowns for each with different sprue design(sinlge sprue, double sprue and plate sprue) of two cross sectional areas (small and large cross sectional areas) were fabricated. The sections of titanium castings were photographed in a microscope at ${\times}100$ magnification to record internal porosities. Results and Conclusion: Within the limits of this study, the following conclusions were drawn: 1. There was a significantly lower in internal porosity of titanium castings for large cross sectional area of sprue group than the small group (P<.05) 2. There was no significant difference in internal porosity among sprue designs in similar cross sectional area of sprue (P>.05).