• Title/Summary/Keyword: bone distraction

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Physiological Changes and Clinical Implications of Syndromic Craniosynostosis

  • Sakamoto, Hiroaki;Matsusaka, Yasuhiro;Kunihiro, Noritsugu;Imai, Keisuke
    • Journal of Korean Neurosurgical Society
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    • v.59 no.3
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    • pp.204-213
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    • 2016
  • Syndromic craniosynostosis has severe cranial stenosis and deformity, combined with hypoplastic maxillary bone and other developmental skeletal lesions. Among these various lesions, upper air way obstruction by hypoplastic maxillary bone could be the first life-threatening condition after birth. Aggressive cranial vault expansion for severely deformed cranial vaults due to multiple synostoses is necessary even in infancy, to normalize the intracranial pressure. Fronto-orbital advancement (FOA) is recommended for patients with hypoplastic anterior part of cranium induced by bicoronal and/or metopic synostoses, and posterior cranial vault expansion is recommended for those with flattening of the posterior part of the cranium by lambdoid synostosis. Although sufficient spontaneous reshaping of the cranium can be expected by expansive cranioplasty, keeping the cranial bone flap expanded sufficiently is often difficult when the initial expansion is performed during infancy. So far distraction osteogenesis (DO) is the only method to make it possible and to provide low rates of re-expansion of the cranial vault. DO is quite beneficial for both FOA and posterior cranial vault expansion, compared with the conventional methods. Associated hydrocephalus and chronic tonsillar herniation due to lambdoid synostosis can be surgically treatable. Abnormal venous drainages from the intracranial space and air way obstruction should be always considered at any surgical procedures. Neurosurgeons have to know well about the managements not only of the deformed cranial vault and the associated brain lesions but also of other multiple skeletal lesions associated with syndromic craniosynostosis, to improve treatment outcome.

Use of corticotomy for canine and molar retraction (피질골 절제술을 응용한 견치 및 대구치의 후방 견인)

  • Kim, Sang-Cheol;Kim, Sun-Young;Kim, Hyun-Sook;Jung, Hye-Seung;Kim, Hyun-Tae;Jo, Jin-Woo
    • The korean journal of orthodontics
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    • v.35 no.2 s.109
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    • pp.153-161
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    • 2005
  • Tooth movement facilitated by corticotomy and distraction osteoseresis was discussed. In this study, a portion of cortical bone which can provide resistance to tooth movement in alveolar bone was removed Active bone deposition was thor Possible in the tension side. Teeth moved at such a speedy rate as we could not imagine from conventional orthodontic treatment. which lead to the reduction of the total treatment Period Posterior movement of the canine or molar teeth was possible without any side effects such as anchorage loss, root resorption or Periodontal breakdown.

Pelvic Symphyseal Distraction Osteotomy for Constipation Management Secondary to Pelvic Stenosis (골반강 협착증으로 인해 발생한 변비를 가진 고양이에서의 골반강 확장술을 이용한 치료 증례)

  • Oh, Kwang-Seon;Choi, Sung-Jin;Kim, Nam-Soo;Kim, Min-Su;Lee, Ki-Chang;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.527-530
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    • 2014
  • A 7-year-old neutered male Korean domestic short-haired cat was referred to our clinic to treat constipation which had persisted for 6 months. The rectal examination revealed narrowing of the right lateral portion of the pelvic canal. A reduced pelvic canal diameter by pelvic fracture malunion was revealed on radiography. The pelvic canal diameter ratio measured from preoperative was 0.68. Based on rectal and radiographic examinations, constipation caused by pelvic canal narrowing was confirmed. Pelvic symphyseal distraction-osteotomy and iliac wedge osteotomy were performed. An iliac osteotomy of the ilium was performed to ease the pelvic symphyseal distraction. After the symphysis was split longitudinally, pelvic symphyseal distraction was maintained by using a spacer made of poly-methyl-methacrylate. The osteotomy of the ilium was fixed using a bone plate and screws. Increased pelvic canal diameter was confirmed on post-operative radiography and the postoperative pelvic canal diameter ratio was 0.91. The patient received antibiotics, NSAIDs, crystalloids and Lactulose for post-operative care. The cat recovered normal defecation abilities and did not have constipation at one week postoperatively. No episodes of constipation persisting longer than 6 months have been reported by owners in previous studies. Pelvic symphyseal distraction osteotomy and iliac wedge osteotomy may prove to be a useful surgical procedure to treat pelvic canal stenosis that is caused by pelvic fracture malunion.

Alveolar Cleft Reconstruction Using Chin Bone and Autogenous Tooth Bone Graft Material: Reports of 5 Cases

  • Jeong, Kyung-In;Lee, Junho;Kim, Kyung-Wook;Um, In-Woong;Hara, Shingo;Mitsugi, Masaharu;Kim, Young-Kyun
    • Journal of Korean Dental Science
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    • v.6 no.1
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    • pp.13-21
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    • 2013
  • Purpose: To report the successful results of using chin bone graft and autogenous tooth bone graft material (AutoBT) in alveolar cleft patients. Materials and Methods: Five patients with alveolar cleft defects underwent alveolar bone grafting. Three patients were treated using chin bone graft, and the other two patients underwent AutoBT graft. After implant site development using chin bone graft in the fi rst three cases, endosseous implant restorations were placed. In case #4 and 5, AutoBT graft material was placed to guide the normal eruption of partially impacted maxillary right canine and to the upper docking site after distraction osteogenesis. Result: Successful implant restorations with closure of the oronasal fistula were achieved in alveolar cleft defect reconstruction using either chin bone graft (Case #1, 2, 3) or AutoBT graft material (Case #4, 5). Case #4 showed enlarged follicle of the right maxillary canine, indicating a normal eruption guide pattern. Conclusion: Both chin bone graft and AutoBT graft showed favorable outcomes in reconstructing alveolar cleft defects. Autogenous tooth bone graft opens up the possibility of avoiding harvesting autogenous bone graft with complications and morbidities.

RECONSTRUCTION OF SEVERE BUCCO-LINGUAL BONE RESORPTION AREA USING "RIDGE SPLITTING TECHNIQUE" (심한 협-설골 위축에서 치조골 수평 확장술을 이용한 골 재건)

  • Yeo, Duck-Sung;Lim, So-Yeon;Lee, Hyun-Jin;Ahn, Mi-Ra;Sohn, Dong-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.6
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    • pp.590-594
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    • 2006
  • Dental implant has become one of the important option for completely or partially edentulous patients, But it is challenging to reconstruct the severely atrophic ridge. Insufficient bone volume could restrict to place the wide and long implant and because of excessive interocclusal clearance, improper prosthetics could be produced. In this case bone augmentation for implant dentistry is necessary procedure to improve the insufficient bone volume. Therefore, bone augmentation or GBR is the most important procedure for successful implant placement and for ideal crown- root ratio. There are various bone augmentation techniques have been introduced recently; like block bone graft, distraction osteogenesis, inlay graft, onlay graft, etc.... In severe bucco-lingual resorption area, ridge splitting is the first choice of the treatment, because it provides a place for implantation and also has compaction effect. This technique may be indicated for sharp mandible and maxillary ridges in patients whose bone quantity is inadequate for primary stabilization. We report that the clinical experience of bone augmentation using ridge splitting technique in bucco-lingual bone resorption area.

Biomechanical comparison of bone staple techniques for stabilizing tibial tuberosity fractures

  • Kyu-Tae Park;Min-Yeong Lee;Hwi-Yool Kim
    • Korean Journal of Veterinary Research
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    • v.63 no.3
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    • pp.24.1-24.6
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    • 2023
  • This study compared the biomechanical properties of bone-stapling techniques with those of other fixation methods used for stabilizing tibial tuberosity fractures using 3-dimensionally (3D)-printed canine bone models. Twenty-eight 3D-printed bone models made from computed tomography scan files were used. Tibial tuberosity fractures were simulated using osteotomy. All samples were divided into 4 groups. Group 1 was stabilized with a pin and tension-band wire; group 2, with a pin and an 8 mm-wide bone staple; group 3, with 2 horizontally aligned pins and an 8 mm-wide bone staple; and group 4 with a 10 mm-wide bone staple. Tensile force was applied with vertical distraction until failure occurred. The load and displacement were recorded during the tests. The groups were compared based on the load required to cause displacements of 1, 2, and 3 mm. The maximum failure loads and modes were recorded. The loads at all displacements in group 4 were greater than those in groups 1, 2, and 3. The loads at 1, 2, and 3 mm displacements were similar in groups 1 and 3. There was no significant difference between groups 1 and 3. Groups 1 and 4 provided greater maximum failure loads than groups 2 and 3. Failure occurred because of tearing of the nylon rope, tibial fracture, wire breakage, pin bending, and fracture around the bone staple insertion. In conclusion, these results demonstrate that the bone-stapling technique is an acceptable alternative to tension-band wire fixation for the stabilization of tibial tuberosity fractures in canine bone models.

Improvement of fibrosed scar tissue elongation using self-inflatable expander

  • Jung, Gyu-Un;Kim, Jin-Woo;Pang, Eun-Kyoung;Kim, Sun-Jong
    • The Journal of the Korean dental association
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    • v.54 no.7
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    • pp.501-512
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    • 2016
  • We evaluated a self-inflatable osmotic tissue expander for its utility in creating sufficient soft tissue elongation for primary closure after bone grafting. Six patients with alveolar defects who required vertical augmentation of >6 mm before implant placement were enrolled. All had more than three prior surgeries, and flap advancement for primary coverage was restricted by severely fibrosed scars. Expanders were inserted beneath the flap and fixed with a screw. After 4 weeks, expander removal and bone grafting were performed simultaneously. A vertical block autograft and guided bone regeneration and distraction osteogenesis were performed. Expansion was sufficient to cover the grafted area without additional periosteal incision. Complications included mucosal perforation and displacement of the expander. All augmentation procedures healed uneventfully and the osseous implants were successfully placed. The tissue expander may facilitate primary closure by increasing soft tissue volume. In our experience, this device is effective, rapid, and minimally invasive, especially in fibrous scar tissue.

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DISTRACTION OSTEOGENESIS IN CASE OF CLEFT LIP AND PALATE PATIENT WITH SEVERE MAXILLARY DEFICIENCY (구순구개열로 인한 심한 중안면부 성장부전환자에서 골신장술의 치험례)

  • Lee Baek-Soo;Oh Jung-Hwan;Yoon Byong-Wook;Song Sang-Hun;Ryu Dong-Mok
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.2
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    • pp.131-135
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    • 2003
  • Severe maxilla1y deficiency can be caused by cleft lip and palate(CLP), other craniofacial deformities, atrophy in the edentulous maxilla, and trauma. Patients with maxillary deficiency present a difficult treatment challenge. Traditionally, this skeletal deformity has been treated by Le Fort osteotomy, skeletal repositioning, and fixation with mini-plates and screws. The drawbacks of this method include a limited amount of anterior maxillary advancement often requiring simultaneous mandibular setback, the inability to create new bone, and minimal soft tissue adaptation to the new position, all of which increase the potential of relapse in case of large advancement. The alternative method of maxillary distraction osteogenesis offers promising results for successfully treatment of these patients while potentially minimizing the risk of relapse.

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Airway Management in the Patients of Expected Difficult Intubation -A Case Report- (어려운 기관 내 삽관이 예상되는 환자의 기도관리 -증례 보고-)

  • O, Se-Ri;Lee, Jin-Han
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.10 no.2
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    • pp.190-196
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    • 2010
  • Difficult airway management including difficult intubation, difficult ventilation and difficult mask ventilation is a life threatening issue during anesthesia care. A 23-year-old woman with Treacher Collins syndrome was scheduled for distraction osteogenesis. She had hypoplasia of mandible and malar bone, bilateral deformities of auricles with partial deafness and antimongoloid slant of the palpebral fissures. A 56-year-old woman with mandibular hypoplasia due to childhood trauma was scheduled for distraction osteogenesis. She had a history of difficult intubation. We anticipated a difficult intubation and ventilation. Fiberoptic bronchoscopic guided awake intubation was selected for anesthesia induction. After intravenous injection of midazolam and remifentanil, 10% lidocaine pump spray on the pharyngolarynx with a direct laryngoscope and on the nasal canal. However fiberoptic bronchoscopic guided awake intubation was failed due to severe gag reflex. After intravenous injection of propofol and remifentanil using the target controlled infusion (TCI), mask ventilation was easily performed and, after intravenous injection of vecuronium, fiberoptic bronchoscopic guided intubation was easily performed using a wire reinforced endotracheal tube. The operation was completed successfully without any adverse events.

A two-year audit of non-vascularized iliac crest bone graft for mandibular reconstruction: technique, experience and challenges

  • Omeje, Kelvin;Efunkoya, Akinwale;Amole, Ibiyinka;Akhiwu, Benjamin;Osunde, Daniel
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.6
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    • pp.272-277
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    • 2014
  • Objectives: Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions. Materials and Methods: A retrospective review of medical records and patient case files from January 2012 to December 2013 was undertaken. All case files and other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed reconstruction were selected for review. Results: Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients' (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean $26.0{\pm}10.6years$). Indications for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmental resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients' postoperative reviews and radiographs revealed good facial profile and continued bone stability up to 1 year following NVIBG. Conclusion: NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.