• Title/Summary/Keyword: Virtual patient

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MDCT Angiography of the Subclavian Artery Thrombosis of the 3D Findings (쇄골하동맥 혈전증에서의 MDCT 혈관조영술의 3D 영상)

  • Kweon, Dae Cheol
    • Journal of the Korean Society of Radiology
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    • v.12 no.7
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    • pp.813-819
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    • 2018
  • To demonstrate the 3D usefulness of MDCT, a 73-year-old male patient with subclavian thrombosis was obtained 3D images of maximum intensity projection (MIP), volume rendering, and multiplanar reformation (MPR) to clearly detect and locate the subclavian artery. The data will be provided to the patient for diagnosis and treatment. The scan data were acquired as 3D CT images MIP, volume rendering, curved MPR, and virtual endoscopy images. In the 3D program, the ascending aorta was measured as 364.28 HU, the left carotid artery was 413.77 HU, and the left subclavian artery was 15.72 HU. MIP coronal image shows the closure of the subclavian artery in the left side. Three-dimensional volume images were obtained with 100% permeability and 87-1265 HU. The coronal curved MPR and sagittal curved MPR images show the closure of the subclavian artery due to thrombus using 3D image processing. In the case of subclavian arterial occlusion due to thrombosis, the patient is scanned with MDCT and 3D image processing can be used to confirm occlusion of subclavian artery.

Late reconstruction of extensive orbital floor fracture with a patient-specific implant in a bombing victim

  • Smeets, Maximiliaan;Snel, Robin;Sun, Yi;Dormaar, Titiaan;Politis, Constantinus
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.5
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    • pp.353-357
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    • 2020
  • Fractures of the orbital floor and walls are among the most frequent maxillofacial fractures. Virtual three-dimensional (3D) planning and use of patient-specific implants (PSIs) could improve anatomic and functional outcomes in orbital reconstruction surgery. The presented case was a victim of a terrorist attack involving improvised explosive devices. This 58-year-old female suffered severe wounds caused by a single piece of metal from a bomb, shattering the left orbital floor and lateral orbital wall. Due to remaining hypotropia of the left eye compared to the right eye, late orbital floor reconstruction was carried out with a personalised 3D printed titanium implant. We concluded that this technique with PSI appears to be a viable method to correct complex orbital floor defects. Our research group noted good aesthetic and functional results one year after surgery. Due to the complexity of the surgery for a major bony defect of the orbital floor, it is important that the surgery be executed by experienced surgeons in the field of maxillofacial traumatology.

A Study on the Performance of Dynamic Restraint Manipulator for Drilling Alveolar Bone in Mandible (하악골의 치조골 골삭제를 위한 동적 제약 기구부의 성능에 관한 연구)

  • Kim, Gwang-Ho;Lee, Dong-Woon;Jeong, Sang-Hwa
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.19 no.12
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    • pp.105-112
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    • 2020
  • The increase in the edentulous jaw which occurs in the aged population has led to personal dental health concerns. In the case of dental implant surgery, the duration of a patient's recovery depends on the surgical plan and their physicical ability. A device may be required to assist a physician in controlling vibration reduction of free-hand drilling and prescribing a good treatment plan that is suitable for the patient's condition. In this work, an artificial tooth-root implant assistant manipulator was studied. The structure and the vibration analysis of the dynamic restraint manipulator that is for drilling the alveolar bone in the mandible bone were performed, and the structural stability was analyzed. Further, a virtual prototype of an artificial tooth-root implant assisted manipulator was fabricated and tested. Hence, the state of the Remote Center of Motion (RCM) point and the driving state of the manipulator were confirmed. Furthermore, the drilling experiments were performed by using materials similar to a human jawbone in order to evaluate the performance of the drilling process that is operated using the assistant manipulator.

Using 3-dimensional digital smile design in esthetic restoration of anterior teeth: A case report (3차원 Digital Smile Design을 활용한 전치부 심미수복 증례)

  • Hong, Sungman;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Pae, Ahran;Kim, Hyeong-Seob;Kwon, Kung-Rock
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.451-458
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    • 2021
  • Currently, digital technology is being used in various fields of dental treatment. In particular, in the case of anterior esthetic restoration, the traditional restoration method cannot contain facial information and it is difficult for the patient to predict the treatment result. However, in the case of esthetic restoration through digital design, the visualization of the prosthesis design and the ease of reflecting patient feedback, and expecting the treatment result is available. In this case, the patient confirmed the results of restoration treatment using a digital method before treatment and obtained consent for treatment in an anterior tooth trauma patient. In addition, since the conventional digital smile design method uses only the patient's facial and smile information, the design was made on a two-dimensional plane, and its application was somewhat limited. However, in this case, a three-dimensional virtual patient was created and thus the designed restoration was viewed from various angles. Through this case, it was possible to obtain a high degree of satisfaction with the ease of communication with the patient and the technician during the esthetic restoration using the digital method, the simplicity of the procedure, and the treatment result.

Full mouth rehabilitation for a patient with vertical dimension loss using digital diagnostic analysis: A clinical report (수직고경이 감소된 환자의 디지털 진단 분석을 이용한 완전 구강 회복 증례)

  • Choi, Yeawon;Lee, Younghoo;Hong, Seoung-Jin;Paek, Janghyun;Noh, Kwantae;Kim, Hyeong-Seob;Kwon, Kung-Rock;Pae, Ahran
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.487-496
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    • 2021
  • Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient's occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient's condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient's condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods.

Diagnosis and Treatment of Malocclusions using the Invisalign System (인비절라인 시스템을 이용한 부정교합의 진단 및 치료)

  • Kim, Hyungsoo;Ahn, Jae-Hyun;Boyd, Robert L.
    • The korean journal of orthodontics
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    • v.33 no.1 s.96
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    • pp.21-29
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    • 2003
  • Recent developments in software technology have made it possible to create a virtual three-dimensional model of the dental arches from digitally scanned casts of a patient's dentition. This modelmay then be manipulated with software to produce stages of tooth movement from the initial malocclusion to the final desired occlusion. A sterolithograghic model is made for each stage of tooth movement which is the basis for construction of a series of clear and thin overlay appliances. These appliances are worn full time by the patient to move the teeth according to the programmed stages of movement. Malocclusions involving mild to moderate crowding and space closure have been proven to be successfully treated with this appliance. Experience with this appliance has demonstrated excellent patient compliance with less discomfort, improved esthetics and oral hygiene control, when compared with fixed orthodontic appliances. Orthodontic treatment with this appliance is a potentially useful alternative approach to fixed appliances for treatment of a variety of malocclusions in patients with fully erupted permanent teeth.

Digital technique in diagnosis and restoration of maxillary anterior implant: a case report (디지털 기법을 활용한 상악 전치부의 진단 및 수복 증례)

  • Haemin, Bang;Woohyung, Jang;Chan, Park;Kwi-Dug, Yun;Hyun-Pil, Lim;Sangwon, Park
    • Journal of Dental Rehabilitation and Applied Science
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    • v.38 no.4
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    • pp.249-256
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    • 2022
  • The implant prosthesis of anterior maxilla requires careful consideration in planning. In order to satisfy both esthetic and functional needs of a patient, fusion of intra-oral scan in Cone-beam computed tomography (CBCT) and facial scan can be considered. Bony structures and soft tissues captured in CBCT and occlusal surfaces of intra oral scan were incorporated into personal characteristics from facial scan. The patient had insufficient buccal bone on maxillary anterior area. The maxillary implants could not be placed on the most ideal position. However, the "top down" approach completed by computer-generated arranging of teeth in implant planning and surgery with surgical guide resulted in esthetically and functionally satisfying result regardless of the limitation. Careful diagnosis with digital technique and the usage of surgical guide resulted in successful surgery and esthetic restoration. The temporary fixed prostheses were designed, restored and evaluated. The patient was not satisfied with the first design of temporary prosthesis, which showed uneven space distribution between teeth due to the position of maxillary implant. The design was modified by changing proximal emergence contours and line angle to alter the perceived since of incisors. The patient was satisfied with the new design of provisional restoration. A digital occlusion analyzer (Arcus Digma II, KaVo, Leutkirch, Germany) was used to measure inherent condylar guidance and anterior guidance of a patient to provide a definitive prosthesis.

Positional Changes of the Internal Reference Points Followed by Reposition of the Maxilla - A Study of a 3D Virtual Surgery Program (상악골 재위치술 시행 시 골편의 이동량에 따른 내측기준점의 변화 - 3차원 가상수술 프로그램을 이용한 연구)

  • Suh, Young-Bin;Park, Jae-Woo;Kwon, Min-Su
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.5
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    • pp.413-419
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    • 2011
  • Purpose: Reposition of the maxilla is a common technique for correction of midfacial deformities. To achieve the goal of the surgery, the maxilla should be repositioned based on the precisely planned position during surgery. The internal reference points (IRPs) and the external reference points (ERPs) are usually used to determine vertical dimension of maxilla, which is an important factor for confirming maxillary position. However, the IRPs are known to be inaccurate in determining the vertical dimension. In this study, we investigated the correlation of positional change of the modified IRPs with repositioned maxilla. Methods: The study group consisted of 26 patients with dentofacial deformities. For the simulation of the surgery, patient maxillary CT data and 3-D virtual surgery programs (V-$Works^{(R)}$ and V-$Surgery^{(R)}$) were used. IRPs of this study were set on both the lateral wall of piriform aperture, inferior margin of both infraorbital foramen, and the labial surfaces of the canine and first molar. The distance from the point on lateral wall of the piriform aperture to the point on the buccal surface of the canine was defined as IRP-C, and the distance from the point on the inferior margin of the infraorbital foramen to the point on the buccal surface of the $1^{st}$ molar was defined as IRP-M. After the virtual simulation of Le Fort I osteotomy, the changes in IRP-C and IRP-M were compared with the maxillary movement. All measures were analyzed statistically. Results: With respect to vertical movements, the IRP-C (approximately 98%) and the IRP-M (approximately 96%) represented the movement of the canine and the $1^{st}$ molar. Regarding rotating movement, the IRPs changed according to the movement of the canine and the $1^{st}$ molar. In particular, the IRP-C was changed in accordance with the canine. Conclusion: IRPs could be good indicators for predicting vertical movements of the maxilla during surgery.

The propriety of Spatial Arrangement Condition of 119 Emergency Medical Service - Mainly Around H Town Area, Countrysid of Y city - (119지역대의 공간적 배치 현황의 적절성 -Y시 H면 지역을 중심으로-)

  • Yun, Jong-Geun;Choi, Kyu-Chul
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.374-380
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    • 2017
  • In this study, we analyzed the situation of the 119 emergency medical service zone of H town, countryside of Y city from January 1st, 2015 to December 31st, 2016 and then, on the basis of this analysis, we investigated the present condition of the patient-transportation service of the 119 emergency medical service to provide the basic data in order for patients to use the emergency medical service more efficiently. We analyzed the data with SPSS 21.0 using frequency analysis and, after positioning the virtual 119 emergency medical service, we analyzed the data of the transportation time and transportation distance by using GIS. The results of this study show that the use of the 119 emergency medical service for people over 65 years old represents approximately 57% of the total number of patients transported, The average distance and time of the real moving reaction are 6.41 km and 11.86 min, respectively. The distance and time from the pick-up location to the hospital are 18.24 km and 21.52 min, respectively. Given the present position of the 119 emergency medical service, the results of this analysis using GPS show that the (average) distance and time from the 119 emergency medical service to Jang * Ri town are 9.12 km and 12 min, and the (average) total distance and time to arrive at the hospital after the emergency medical service picks up the patient are 36.83 km and 62 min, respectively. In the case of the virtual emergency medical service, the total distance and time required to arrive at the hospital after the emergency medical service picks up the patient are 27.71km and 50min, respectively. The results of this study showed that the present position of the 119 emergency service does not provide the optimum distance and time from the patient's location to the hospital. Therefore, we consider that the repositioning of the 119 emergency medical center is necessary, in order to reduce the time required for the emergency medical service to move to the patient's location and then bring the patient to the hospital.

Fabrication of custom abutment using dental CAD/CAM system (임상가를 위한 특집 2 - CAD/CAM 시스템을 이용한 Custom abutment의 제작)

  • Kim, Hyeong-Seob
    • The Journal of the Korean dental association
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    • v.50 no.3
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    • pp.118-125
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    • 2012
  • CAD/CAM systems (computer-aided design / computer-aided manufacturing) used for decades in restorative dentistry have its application to implant dentistry. This study aimed to overview CAD/CAM systems used implant dentistry, especially emphasizing custom implant abutments manufacturing. CAD/CAM custom abutments present the advantages of being specific to each patient and providing a better fit than the stock and cast custom abutments. This cutting edge technology of virtual-designed and computer-milled implant abutments will likely replace traditional implant restorative protocols and become the standard for implant dentistry in the foreseeable future.