• Title/Summary/Keyword: bone plate and screw

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Orthognathic surgery for patients with fibrous dysplasia involved with dentition

  • Udayakumar, Santhiya Iswarya Vinothini;Paeng, Jun-Young;Choi, So-Young;Shin, Hong-In;Lee, Sung-Tak;Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.37.1-37.7
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    • 2018
  • Background: Fibrous dysplasia (FD) is characterized by the replacement of normal bone by abnormal fibro-osseous connective tissue and typically treated with surgical contouring of the dysplastic bone. When dysplastic lesions involve occlusion, not only is surgical debulking needed, orthognathic surgery for correction of dentofacial deformity is mandatory. However, the long-term stability of osteotomized, dysplastic bone segments is a major concern because of insufficient screw-to-bone engagement during surgery and the risk of FD lesion re-growth. Case presentation: This case report reviewed two patients with non-syndromic FD that presented with maxillary occlusal canting and facial asymmetry. Le Fort I osteotomy with recontouring of the dysplastic zygomaticomaxillary region had been performed. The stability of osseous segments were favorable. However, dysplastic, newly formed bone covered the previous plate fixation site and mild bony expansion was observed, which did not influence the facial profile. Including the current cases, 15 cases of orthognathic surgery for FD with dentition have been reported in the literature. Conclusion: The results showed that osteotomy did not appear to significantly reduce the long-term stability of the initial fixation insufficiency of the screw to the dysplastic bone. However, based on our results and those of the others, long-term follow-up and monitoring are needed, even in cases where the osteotomized segment shows stable results.

Fatigue Characterization of Glass/Polypropylene Composite Bone Plates Locked with an Artificial Tibia under Moisture Environment (인조골에 체결된 유리섬유/폴리프로필렌 복합재료 고정판의 수분 환경 피로 특성)

  • Han, Min-Gu;Chang, Seung-Hwan
    • Composites Research
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    • v.26 no.5
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    • pp.328-333
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    • 2013
  • In this study, bone plate made of glass/polypropylene composite material which was applied to an artificial bone was tested to check the service ability under fatigue loading. To check serviceability of composite bone plates fatigue test was carried out considering changes in the moisture absorption rate, locking position of screws and loading condition. Test results showed that all the tested specimens had the fatigue life more than one million cycles which was much higher fatigue life than the expected value of 650,000 cycles. Screw position was not critical impact on the deformation of the fracture site. In this paper, the mechanical performance of the glass/polypropylene composite was verified by fatigue test under various water absorption conditions, and this result may give useful information on the design of composite bone plate.

INFLUENCE OF MINIPLATE SHAPES AS SKELETAL ANCHORAGE FOR APPLICATION OF ORTHOPEDIC FORCE: A THREE-DIMENSIONAL FINITE ELEMENT ANALYSIS (악정형력 적용을 위한 골내 고정원으로서 미니플레이트 형상의 영향: 3차원 유한요소법적 연구)

  • Lee, Nam-Ki;Baek, Seung-Hak;Choi, Dong-Soon;Park, Young-Wook;Kim, Ji-Hyuck;Cha, Bong-Kuen
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.345-352
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    • 2008
  • Purpose: This study was performed to evaluate the stress distribution in the bone and the displacement distribution of the miniscrew under orthopedic force with two different types of miniplate design as skeletal anchorage for orthopedic treatment. Materials and methods: Finite element models were made for 6-hole miniplate (0.8mm in thickness), which were designed in two different shapes-one is curvilinear shaped (C plate, Jeil Medical Co., Korea) and another, Y shaped (Y plate), fixed with 3 pieces of miniscrew 2mm-diameter and 6mm-long respectively. A traction force of 4 N was applied in $0^{\circ}$, $30^{\circ}$ and $60^{\circ}$ to imaginary axis connecting two unfixed distalmost holes of the miniplate. Results: The maximum von Mises stress in the bone was much greater in the cortical portion rather than in the cancellous portion. C plate showed greater maximum von Mises stress in the cortical bone than Y plate. The maximum displacement of the miniscrew was greater in C plate than Y plate. The more increased the angle of the applied orthopedic force, the greater maximum von Mises stress in the bone and maximum displacement of the miniscrew. It was observed that in C plate, the von Mises stress in the bone and displacement of the miniscrew were distributed around the distalmost screw-fixed area. Conclusions: The results suggest that Y plate should have the advantage over C plate and in the placement of the miniplate, its imaginary axis should be placed as parallel as possible to the direction of orthopedic force to obtain its primary stability.

Corticotomy for orthodontic tooth movement

  • Lee, Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.6
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    • pp.251-258
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    • 2018
  • Corticotomy was introduced as a surgical procedure to shorten orthodontic treatment time. Corticotomy removes the cortical bone that strongly resists orthodontic force in the jaw and keeps the marrow bone to maintain blood circulation and continuity of bone tissues to reduce risk of necrosis and facilitate tooth movement. In the 21st century, the concept of regional acceleratory phenomenon was introduced and the development of the skeletal anchorage system using screw and plate enabled application of orthopedic force beyond conventional orthodontic force, so corticotomy has been applied to more cases. Also, various modified methods of minimally invasive techniques have been introduced to reduce the patient's discomfort due to surgical intervention and complications after surgery. We will review the history of corticotomy, its mechanism of action, and various modified procedures and indications.

Long-term Effects on the Cervical Spine after Anterior Locking Plate Fixation (경추 전방 잠금식 금속판이 장기적으로 경추에 미치는 영향)

  • Kim, Keun Su
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.493-500
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    • 2001
  • Objective : Anterior cervical locking plates are the devices for achieving anterior cervical spinal fusion. This study was conducted to evaluate the locking plate system regarding its long-term advantages and disadvantages in the view of interbody fusion rate, hardware-related failures, vertebral change close to the fusion segment and postoperative complications. Method : Eight-six patients, operated from Jan., 1996 to Jun. 1998, were followed-up for more than two years. All of the cases were fused with iliac bone graft and ORION locking plate(Sofamor Danek USA, Inc., Memphis, TN) fixation. The patients were discharged or transferred to rehabilitation department 2-7 days after operation. A comprehensive evaluation of the interbody fusion state, instrument failure, vertebral change and postoperative complications were made by direct interview and cervical flexion-extension lateral plain films. Results : There were 55 male and 31 female with a mean age of 45 years(18-75 years). The mean follow-up period was 29 months(24-43 months). Various disorders that were operated were 40 cervical discs, 6 cervical stenosis including OPLL, 2 infections, and 38 traumas. Fusion level was single in 59 cases, two levels of each disc space in 15 cases, and two levels after one corpectomy in 12 cases. There was no instrument failure. Pseudoarthrosis was observed in two cases(2%) without radiological instability. The other patients(98%) showed complete cervical fusion with stable instrument. Mild settling of interbody graft with upward migration of screws was found in 12 cases(14%). Anterior bony growth at the upper segment was found in 5 cases(6%). Postoperative foreign body sensation or dysphagia was observed in 12 cases(4%), and disappeared within one month in 7 cases and within six months in 4 cases. One patient complained for more than six months and required reoperation to remove paraesophageal granulation tissue. Conclusion : The results show that Orion cervical locking plate has some disadvantages of upward migration of screws, anterior bony growth at the upper segment, or possibility of esophageal compression even though it has advantages of high interbody fusion rate or low instrument failure. Author believe that anterior cervical locking plate in the future should be thinner, and should have short end from the screw hole, and movable screw with adequate stability.

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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.

PHOTOELASTIC STRESS ANALYSIS OF LOAD TRANSFER TO SATELLITE ABUTMENT AS AN IMMEDIATE ABUTMENT (인공치아의 즉시부하를 위해 새로이 개발된 인공치아 지대주(Satellite Abutment)의 광탄성 응력 분석)

  • Park, Sang-Kyu;Lee, Baek-Soo;Engelke, W;Kim, Boo-Dong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.6
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    • pp.472-479
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    • 2002
  • Since $Br^{\circ}anemark$ introduced the osseointegrated implants, they have been granted for useful methods for the restoration of oral function. The original $Br^{\circ}anemark$ protocol recommended long stress-free healing periods to achieve the osseointegration of dental implants. However, many clinical and experimental studies have shown that the osseointegration is no wonder in almost cases and that early and immediate loading may lead to predictable osseointegration. So we are willing to introduce the Satellite Abutment newly invented for immediate loading. We think that it will make the occlusal forces dispersed to surrounding bone and that we can restore the oral function immediately after implant installation not disturbing osseointegration. In case of using Satellite abutment, stress concentrated to bone contact area of implant was distributed not only fixation plate and screws but also superior, middle portion of implant and cortical layer of jaw bone. It was clearly decreased on the bone contact surfaces around dental implants. 1. Stress was decreased more than 76.5% when satellite straight abutment was used. 2. Stress was decreased more than 50% when satellite angled abutment was used. 3. The stress around dental implant was well distributed along the cortical bone surface and the fixation plate and screw. This study concludes that satellite abutment can be used as all immediate loading implant prothesis because it was possible to distribute periimplant occlusal stress through implant contact bone surface and cortical layer of jaw bone.

Rigid Fixation using Bioabsorbable Mesh and Screws in Facial Bone Fracture (흡수성 망상판과 나사를 이용한 안면골절의 견고정법)

  • Shin, Dong-Hyeok;Kim, Deok-Jung;Kim, Soo-Young;Hwang, Eun-A;Choi, Hyun-Gon;Kim, Soon-Heum;Uhm, Ki-Il
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.717-720
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    • 2010
  • Purpose: Absorbable plate and screw fixation is widely used technique for internal rigid fixation in craniomaxillofacial surgery. However, there are some potential problems associated with the use of plate. The purpose of this study is to evaluate the feasibility of bone fixation in facial fracture using absorbable mesh in place of absorbable plate. Methods: The records of 55 patients with zygomaticomaxilla fractures treated by open reduction, performed by the author from February 2008 to May 2009, were retrospectively reviewed. Patients were selected to receive absorbable mesh fixation. The incidence of all complications including infection, hypoesthesia, and deformity was examined. Analysis with postoperative computed tomography follow-up demonstrates degree of reduction. Results: Forty-six patients met criteria for inclusion in the study. All patients went on to satisfactory healing without complication. Postoperative computed tomography revealed good bony alignment similarly non affected side. Conclusion: This study demonstrates that the rigid internal fixation of fractured bone fragments using absorbable mesh is more effective than absorbable plate, especially in comminuted fracture of maxilla.

A study on the forming condition of a bone plate made of a glass/polypropylene composite (Twintex) (유리섬유/폴리프로필렌 복합재료 (Twintex)를 이용한 고정판 성형조건에 관한 연구)

  • Park, Seok-Won;Yoo, Seong-Hwan;Lee, Jae-Eung;Chang, Seung-Hwan
    • Composites Research
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    • v.23 no.6
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    • pp.55-60
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    • 2010
  • In this paper, tensile and bending tests of glass/polypropylene composite (Twintex) specimens fabricated by various forming conditions were carried out and the results were compared according to the forming conditions to find the appropriate condition for the forming composite bone plates. From the tests it was found that the most appropriate forming conditions were $230^{\circ}C$, 3MPa. Composite bone plates were formed using this condition by two different fabricating methods for screw holes: one was a net shape molding and the other was drilling. The forming and bending tests revealed that the drilling process provided much better bending stiffness of bone plates. This paper provided the most appropriate condition for forming composite bone plates and this result was also expected to offer informative data on forming of other Twintex structures.

THE CLINICAL STUDY OF FACIAL BONE FRACTURE

  • Lee, Dong-Keun;Yim, Chang-Joon;Yang, Hee-Chang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.12-20
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    • 1989
  • This is a retrospective study on 452 patients with maxillofacial bone fracture. The patients were treated at the Dept. of Oral and Maxillofacial Surgery, WON KWANG UNIV. HOSPITAL from Aug. 1, 1984 to Sept. 30, 1988. The results were as follows. 1. The facial bone fractures occured most frequently in the twenties (35.3%)and male were predominant(75%) than female. 2. The most frequent etiologic factor was traffic accident. 3. The most common location of facial bone fracture was mandible(57%). Zygomatic bone & arch(39.9%) were most common on middle 1/3 of the face and symphysis(37.1%) were most common on the mandible. 4. The time from injury to treatment was variable from under the 1 week (65%) to over the 1 week(35%). In most case of the patients were treated beyond the 3 days(51.5%). 5. The relationship of intermaxillary fixation period and treatment method was an intimate relationship. The IMF period was reduced by the use of plate and screw osteosynthesis. 6. The weight loss was proportioned to intermaxillary fixation period.

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