• Title/Summary/Keyword: bone distraction

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Tissue changes of pulp and periodontium on rapid tooth movement with osteotomy in dogs (골절단을 이용한 급속 치아이동 후 치수 및 치주조직 변화)

  • Kang, Kyung-Hwa;Kim, Eun-Cheol;Lee, Sun-Kyung;Lim, Chae-Woong;Matduda, Kiku;Tae, Ki-Chul;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.34 no.2 s.103
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    • pp.131-142
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    • 2004
  • The movement of tooth-bone segments by osteotomy can simultaneously shift tooth and surrounding alveolar bone in a relatively short period. The purpose of this study was to evaluate the tissue changes in pulp, periodontal ligament, and alveolar bone in rapid tooth-bone movement with osteotomy. The mandibular 3rd premolar of a dog was extracted and cortical bones of the buccal and lingual area were eliminated, and then cortical bones around the mesial and distal area of root, and below the root apex of the mandibular 4th premolar were osteotomized. After a one-week latency period, a tooth-borne distraction device was activated for 6 days. And pulp, periodontal ligament and alveolar bone were evaluated clinically, radiologically, histologically and immunohistochemically at 0, 1, 2, 4, 6, 8 weeks of the consolidation Period and conclusions were roached as follows. 1. Latency period didn't affect total amount or tooth movement and healing process of tissue during consolidation period. 2. Bone formation continued through 8 weeks of consolidation in distracted side, with a high peak at 1-2 weeks, and the lowest at 6-8 weeks or consolidation. 3. At 1 week of consolidation, alveolar bone resorption, osteoclast appearance and inflammatory cell infiltration were the most active, and dentinoclasts characteristically appeared on the pulp and pressure side of the periodontal ligament. 4. The expression of $TGF-\beta$ was area-specific, as it was strong-positive at bone matrix, osteoblast osteoclast of alveolar bone, and dentinoclast inside pulp, but weak in pulp, cementoblast and acellular cementum. 5. The expression of $TGF-\beta$ was generally observed at the initial 1-2 weeks of consolidation at vessels, periodontal ligament cells, and osteoblast near alveolar bone on the distraction side of the periodontal ligament, and was significantly decreased after 6 weeks of consolidation.

Temporomandibular joint reconstruction using autogenous tissue (임상가를 위한 특집 3 - 자가 조직이식을 통한 턱관절 재건)

  • Lee, Jong-Ho;Lee, Jung-Woo;Lee, Jin-Yong;Kim, Soung-Min;Kim, Myung-Jin
    • The Journal of the Korean dental association
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    • v.50 no.5
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    • pp.262-269
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    • 2012
  • TMJ reconstruction is one of the most challenging surgical treatment, and many methods using autogenous and alloplastic materials have been reported for making neocondyle. Although alloplastic materials which include aclylic, synthetic and total joint system are recently widely used, many surgeons agree that autogenous TMJ reconstruction is gold standard until now. In this article, classification of the TMJ defects and the various TMJ reconstruction methods using autogenous source were introduced with review of literature.

Physical Therapy Following Leg Lengthening and Deformity Correction by Ilizarov Method : Clinical Commentary (Ilizarov 술식을 이용한 하지 연장술 및 변형 교정술 후 물리치료)

  • Kim, Tae-Youl;Hwang, Tae-Yeun
    • Journal of Korean Physical Therapy Science
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    • v.1 no.2
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    • pp.355-365
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    • 1994
  • Ilizarov limb lengthening has been the new method to deal with a variety of orthopaedic problems. Ilizarov apparatus consists of stainless steel rings that surround the limb and are interconnected by threaded rods. Tensioned wires pierce the bone in the plane of each ring and are tightly attached to the ring. Ilizarov has reported distraction osteogenesis with the use of the typical fixator that allows functional loading. The purpose of this commentary is to introduce a four-stage rehabilitation protocol currently used by the authors in the physical therapy management of a post -limb lengthening. Each treament stage corresponds to a medical stage in the lengthening process. Treatment goals for each of the physical therapy treatment stage are presented to guide treatment planning. Two case examples are presented to illustrate the use of the management goals in treatment planning.

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Clinical Experience of Anterior Cervical Interbody Fusion with the PCB System (전방 경추 유합술에서의 PCB System의 임상적 경험)

  • Kim, Sung Han;Kim, Ho Jin;Kang, Jae Kyu;Doh, Jong Oung;Lee, Chun Dae
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1170-1176
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    • 2001
  • Objective : The purpose of the study was to evaluate the clinical and radiological results after discectomy and Lubboc bone graft in the surgical management of the cervical diseases with a new titanium interbody implant and integrated screw fixation(PCB) by anterior approach. Methods : The authors retrospectively analyzed 28 cases of anterior cervical fusion with PCB system and Lubboc bone(xeno graft) from september 1998 to december 2000. Twenty-eight patients with cervical diseases underwent decompression cervical lesion and followed from 5 to 27 months with a mean follow-up of 14 months. There patients were evaluated with clinically and radiologically at immediate postoperative period and at 3, 6, 9, and 12 months. Result : The authors investigated the pre- and postoperative intervertebral disc space, clinical outcomes, radiography fusion rate, and Cobb angle in the fixed segments by anterior approach. The lordotic angles and height of disc space were increased after the operation. The clinical outcome of patients follow-up was good or excellent result based on Odom's criteria with improvement of clinical symptom in about 92.9% of the cervical diseases. Two patients showed loosening of the lower and upper cervical screw of PCB instruments, and two patients showed swallowing difficulty and wound infection Conclusion : The PCB system is a new implant for anterior cervical interbody fusion in the degenerative cervical disease and disc herniations. It provides immediate stability and segment distraction. The results of this study indicate that the PCB system is safe, easy handling of hardware, less complications, high fusion rate, and has provide the keeping the intervertebral disc space height and lordotic angles.

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Evaluation of the Usefulness of Virtual Reality Equipment for Relieving Patients' Anxiety during Whole-Body Bone Scan (전신 뼈 검사 환자의 불안감 해소를 위한 가상현실 장비의 유용성 평가)

  • Kim, Hae-Rin;Kim, Jung-Yul;Lee, Seung-Jae;Baek, Song-Ee;Kim, Jin-Gu;Kim, Ga-Yoon;Nam-Koong, Hyuk;Kang, Chun-Goo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.1
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    • pp.27-32
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    • 2022
  • Purpose When performing a whole-body bone scan, many patients are experiencing psychological difficulties due to the close distance to the detector. Recently, in the medical field, there is a report that using virtual reality (VR) equipment can give pain relief to pediatric patients with weak concentration or patients receiving severe treatment through a distraction method. Therefore, in this paper, VR equipment was used to provide psychological stability to patients during nuclear medicine tests, and it is intended to evaluate whether it can be used in clinical practice. Materials and Methods As VR equipment, ALLIP Z6 VR (ALLIP, Korea) was used and the experiment was conducted after connecting to a mobile phone. The subjects were 30 patients who underwent whole-body bone examination from September 1, 2021 to September 30, 2021. After intravenous injection of 99mTc-HDP, 3 to 6 hours later, VR equipment was put on and whole body images were obtained. After the test, a survey was conducted, and a Likert scale of 5 points was used for psychological anxiety and satisfaction with VR equipment. Hypothesis verification and reliability of the survey were analyzed using SPSS Statistics 25 (IBM, Corp., Armonk, NY, USA). Results Anxiety about the existing whole-body bone test was 3.03±1.53, whereas that of anxiety after wearing VR equipment was 2.0±1.21, indicating that anxiety decreased to 34%. When regression analysis of the effect of the patient's concentration on VR equipment on anxiety about the test, the B value was 0.750 (P<0.01) and the t value was 6.181 (P<0.01). decreased and showed an influence of 75%. In addition, overall satisfaction with VR equipment was 3.76±1.28, and the intention to reuse was 66%. The Cronbach α value of the reliability coefficient of the questionnaire was 0.901. Conclusion When using VR equipment, patients' attention was dispersed, anxiety was reduced, and psychological stability was found. In the future, as VR equipment technology develops, it is thought that if the equipment can be miniaturized and the resolution of VR content images is increased, it can be used in various clinical settings if it provides more realistic stability to the patient.

Alveolar Ridge Augmentation Using Titanium Reinforced Goretex (TRG) and Titanium Mesh in Severe Alveolar Bone Loss Area: Case Report (심하게 흡수된 치조제에 Titanium 강화 Gore-Tex (TRG) 및 Titanium Mesh로 수직적 골증대술을 실시한 증례보고)

  • Kim, Won-Jik;Yoon, Kyung-Sun;Hong, Su-Ryun;Choi, Jin-Kyung;Lee, Yong-Uk;Kim, Dong-Suk;Hyun, Jong-Oh;Cho, Hyo-Won;Choi, Ji-Hye;Jung, Tae-Woong;Bae, Yoon-Ki;Kwon, Sun-Kyu;Choi, Hyun-Joon;Lee, Hyun-Su;Yang, Su-Nam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.1
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    • pp.66-72
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    • 2011
  • A severely vertical resorbed ridge is a significant challenge in implant dentistry. To solve this problem, several augmentation techniques, such as guided bone regeneration (GBR), onlay bone grafts, distraction osteogenesis, and ridge splitting techniques, have been proposed and used for several years. Among these methods, vertical ridge augmentation using guided bone regeneration aims to build space and guide osteoblasts to this space to promote osteogenesis. The aim of guided bone regeneration is to maintain and stabilize the space and block the proliferation of adjacent soft tissue. In our hospital, we encountered a case of a woman in her forties with an atrophied mandible, who underwent implant surgery in the right mandible. Titanium reinforced Gore-Tex (TRG) was used to augment the mandible and titanium mesh was used in the left mandible. Favorable results were obtained. This report compares the two methods and reviews the relevant literature.

Compression Plate Fixation with Autogenous Bone Graft for Humerus Shaft Nonunion (상완골 간부 불유합에 대한 금속판 고정 및 자가골 이식술)

  • Cho, Chul-Hyun;Song, Kwang-Soon;Bae, Ki-Cheor;Kim, In-Kyoo;Kwon, Doo-Hyun
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.33-37
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    • 2009
  • Purpose: To evaluate the results of the compression plate fixation and autogenous bone graft in the management of humerus shaft nonunion. Materials and Methods: Eighteen cases were treated for humerus shaft nonunion using compression plate fixation and an autogenous iliac bone graft. The mean follow-up period was 28 months. Bony union was confirmed from the serial radiographs and the clinical outcomes were assessed according to ASES scoring system. Results: In 12 cases of initial plate fixation, the causes of nonunion were 6 cases of inadequate plate length, 2 with a broken plate, 2 with screw loosening, 1 infection and 1 noncompliance of a psychiatric patient. In 3 cases of initial intramedullary fixation, the cause of nonunion was a distraction of the fracture site. In 3 cases of external fixation, the cause of nonunion was inadequate fixation. All cases showed bony union after an average of 24 weeks. The clinical outcomes were 11 excellent, 6 good and 1 fair. Conclusion: In the treatment for nonunion, compression plate fixation with autogeneous bone graft after complete removal of the fibrous and necrotic tissue is believed to give satisfactory results.

Protrusive maxillomandibular fixation for intracapsular condylar fracture: a report of two cases

  • Jeong, Yeong Kon;Park, Won-Jong;Park, Il Kyung;Kim, Gi Tae;Choi, Eun Joo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.5
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    • pp.331-335
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    • 2017
  • Clinical limitations following closed reduction of an intracapsular condylar fracture include a decrease in maximum mouth opening, reduced range of mandibular movements such as protrusion/lateral excursion, and reduced occlusal stability. Anteromedial and inferior displacement of the medial condyle fragment by traction of the lateral pterygoid muscle can induce bone overgrowth due to distraction osteogenesis between the medial and lateral condylar fragments, causing structural changes in the condyle. In addition, when conventional maxillomandibular fixation (MMF) is performed, persistent interdental contact sustains masticatory muscle hyperactivity, leading to a decreased vertical dimension and premature contact of the posterior teeth. To resolve the functional problems of conventional closed reduction, we designed a novel method for closed reduction through protrusive MMF for two weeks. Two patients diagnosed with intracapsular condylar fracture had favorable occlusion after protrusive MMF without premature contact of the posterior teeth. This particular method has two main advantages. First, in the protrusive position, the lateral condylar fragment is moved in the anterior-inferior direction closer to the medial fragment, minimizing bone formation between the two fragments and preventing structural changes. Second, in the protrusive position, posterior disclusion occurs, preventing masticatory muscle hyperactivity and the subsequent gradual decrease in ramus height.

Additional Surgical Method Aimed to Increase Distractive Force during Occipitocervical Stabilization : Technical Note

  • Antar, Veysel;Turk, Okan
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.277-281
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    • 2018
  • Objective : Craniovertebral junctional anomalies constitute a technical challenge. Surgical opening of atlantoaxial joint region is a complex procedure especially in patients with nuchal deformity like basilar invagination. This region has actually very complicated anatomical and functional characteristics, including multiple joints providing extension, flexion, and wide rotation. In fact, it is also a bottleneck region where bones, neural structures, and blood vessels are located. Stabilization surgery regarding this region should consider the fact that the area exposes excessive and life-long stress due to complex movements and human posture. Therefore, all options should be considered for surgical stabilization, and they could be interchanged during the surgery, if required. Methods : A 53-year-old male patient applied to outpatients' clinic with complaints of head and neck pain persisting for a long time. Physical examination was normal except increased deep tendon reflexes. The patient was on long-term corticosteroid due to an allergic disease. Magnetic resonance imaging and computed tomography findings indicated basilar invagination and atlantoaxial dislocation.The patient underwent C0-C3-C4 (lateral mass) and additional C0-C2 (translaminar) stabilization surgery. Results : In routine practice, the sites where rods are bound to occipital plates were placed as paramedian. Instead, we inserted lateral mass screw to the sites where occipital screws were inserted on the occipital plate, thereby creating a site where extra rod could be bound.When C2 translaminar screw is inserted, screw caps remain on the median plane, which makes them difficult to bind to contralateral system. These bind directly to occipital plate without any connection from this region to the contralateral system.Advantages of this technique include easy insertion of C2 translaminar screws, presence of increased screw sizes, and exclusion of pullout forces onto the screw from neck movements. Another advantage of the technique is the median placement of the rod; i.e., thick part of the occipital bone is in alignment with axial loading. Conclusion : We believe that this technique, which could be easily performed as adjuvant to classical stabilization surgery with no need for special screw and rod, may improve distraction force in patients with low bone density.

Vertical Reduction Using Atlantoaxial Facet Spacer in Basilar Invagination with Atlantoaxial Instability

  • Kim, Il-Sup;Hong, Jae-Taek;Sung, Jae-Hoon;Byun, Jae-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.528-531
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    • 2011
  • Although posterior segmental fixation technique is becoming increasingly popular, surgical treatment of craniovertebral junctional disorders is still challenging because of its complex anatomy and surrounding critical neurovascular structures. Basilar invagination is major pathology of craniovertebral junction that has been a subject of clinical interest because of its various clinical presentations and difficulty of treatment. Most authors recommend a posterior occipitocervical fixation following transoral decompression or posterior decompression and occipitocervical fixation. However, both surgical modalities inadvertently sacrifice C0-1 and C1-2 joint motion. We report two cases of basilar invagination reduced by the vertical distraction between C1-2 facet joint. We reduced the C1-2 joint in an anatomical position and fused the joint with iliac bone graft and C1-2 segmental fixation using the polyaxial screws and rods C-1 lateral mass and the C-2 pedicle.