• The Journal of the Korean bone and joint tumor society
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• v.6 no.4
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• pp.152-162
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• 2000

Purpose : To verify radiological changes of limb salvage operation using tumor prosthesis. Materials and Methods : Sixty-nine cases which used tumor prosthesis were reviewed. They have been followed up for average four years and nine months. We evaluated radiographs by ISOLS(International Symposium On Limb Salvage) radiological implants evaluation system immediate postoperatively, at postoperative 1 year and last follow-up. After converting 'excellent, good, fair, poor' to '4, 3, 2, 1' for stastical analysis, data were analyzed according to the use of cement, anatomical sites, diagnosis implant designs and age (<20 year vs. ${\geq}$20 year) using t-test and ANOVA. Results : The outcomes of cemented type prostheses were superior in remodelling and interface but inferior in anchorage. The scores of proximal femur and distal tibia were worse in bone remodelling. Osteosarcoma group had lower scores in anchorage and implant articular problem. There were no significant differences according to four different implant designs and age. Conclusion : In the intermediate term follow-up radiological evaluation, cemented type prosthesis were better in the aspects of bony resorption and osteolysis, and cementless one in anchorage. Distal femur and proximal tibia have higher scores in bony resorption, and osteosarcoma was worse tumor entity in anchorage and articular problem, and chemotherapy may be the cause.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.2
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• pp.250-262
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• 2007

Statement of problem: It was reported high success rate of implant-supported fixed prostheses using with $5{\sim}6$ implants on anterior mandible. Recently, immediate loading protocol was focused to overcome disadvantages of classic 2-stage delayed loading protocol. Purpose: This clinical study was to evaluate stability changes with time of immediately loaded and delayed loaded implants in edentulous mandible and to compare stability changes with time according to implantation sites. Materials and methods: Five or six implants were placed on anterior mandible depending on the arch shape. The immediately loading group was consisted of 8 patients received their prostheses within $24{\sim}48$ hours after implantation. The delayed loading group was consisted of 8 patients received their definitive prostheses following classical prosthetic procedures after a healing period of 3 months. All patients were recalled every 6 months for check-up. The evaluations of radiographic examination, ISQ value measurement and recording of complication were done. To evaluate marginal bone level, intraoral periapical radiographs were taken with long cone paralleling technique. At every evaluation recall, all prostheses were removed and ISQ values were measured with OsstellTM on individual implants. Results: 1. None of implants was failed. All implants showed stable marginal bone levels and ISQ values. 2. Marginal bone level changes with time showed statistically significant difference between immediately loading group and delayed loading group (P<0.001). 3. ISQ value changes with time did not show statistically significant difference between immediately loading group and delayed loading group (P=0.079). ISQ value decreased with time in both groups, however, all implants showed stable ISQ value at 30 months-recall evaluation. 4. Marginal bone level changes with time did not show statistically significant differences among implantation sites (P=0.604). 5. ISQ value changes with time showed statistically significant differences among implantation sites (P=0.047). ISQ values of most posterior implants decreased with time comparing to other implants. Conclusion: Although the marginal bone level of the terminal abutment didn't different with the other implants, ISQ value of the terminal abutment was lower than that of the other implants. Therefore, further clinical evaluation would be needed in this point of view.

• Journal of Periodontal and Implant Science
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• v.47 no.5
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• pp.264-272
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• 2017

Purpose: This study evaluated trends in tooth extraction due to acute and chronic periodontal disease (PD) using data from the National Health Insurance Service-National Sample Cohort for 2002-2013. Methods: A random sample of 1,025,340 individuals was selected as a representative sample of the population, and a database (DB) of diagnostic and prescription codes was followed up for 12 years. We used multivariate logistic regression analysis to assess the incidence of total extraction (TE), extraction due to periodontal disease (EPD), and immediate extraction due to periodontal disease (IEPD) according to sociodemographic factors (sex, age, household income, health status, and area of residence). Results: The incidence of tooth extraction was found to be increasing, and at a higher rate for TE in PD patients. In 2002, 50.6% of cases of TE were caused by PD, and this increased to 70.8% in 2013, while the number of cases of IEPD increased from 42.8% to 54.9% over the same period. The incidence rates of extraction due to acute and chronic PD increased monotonically. We found that the incidence rates of TE, EPD, and IEPD were all 2-fold higher among patients with high income levels and those who were not beneficiaries of health insurance. Conclusions: The rates of TE, EPD, and IEPD have been steadily increasing despite dental healthcare policies to expand public health insurance coverage, increasing the accessibility of dental clinics. Moreover, the effects of these policies were found to vary with both income and education levels. Consistent patient follow-up is required to observe changes in trends regarding tooth extraction according to changes in dental healthcare policies, and meticulous studies of such changes will ensure optimal policy reviews and revisions.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.2
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• pp.121-134
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• 2004

This article describes a clinical protocol for the conventional rehabilitation of patient diagnosed with partial anodontia. A combined dental therapy approach was used and included endodontic therapy and root capping on the maxillary central incisors, fabrication of a maxillary overdenture, and fabrication of mandibular konus overdenture supported by 3 konus abutments. Within this protocol, tooth-supported overdenture prostheses are used for 2 purposes: first, to obtain the most rigid retention and function at an established maxillary-mandibular relationship; and second, to continuously maintain function and esthetic appearance applying immediate dentures after teeth extraction. The idea behind this protocol and its associated clinical procedures is presented along with a discussion compared with implant therapy. In the case introduced, and after 7 years of observation, the therapy can be seen as a success. We increased the occlusal vertical height in this case, but it would be more appropriate to see this as recovering the occlusal vertical height that was lost. The process of increasing the occlusal vertical height, that is restoration of the face, modification of the extrinsic occlusion of the incisors, and retraction of the mandible is very difficult and important. Ultimately, class III malocclusion is fixed, adequate occlusal vertical height is gained, and the retracted posterior anodontial portion is restored by prosthodontic dentures based on the rigid support theory. The result of the therapy done on the later-achieved malocclusion with partial anodontia on the posterior portion must consider the following in order to maintain the safety of the esthetics of the tooth and face for a period of time: 1) occlusal restoration with an ideal occlusal vertical height, 2) allowance of the final occlusion induced by the functional relationship of the upper and lower jaw, 3)final occlusion functionally induced by the lip competence limit.

• Journal of Periodontal and Implant Science
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• v.41 no.1
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• pp.10-16
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• 2011

Purpose: Avulsed tooth can be completely recovered, if sound periodontal ligament (PDL) of tooth is maintained. Although a lot of storage solutions have been explored for the better storage of avulsed tooth, there is a shortcoming that the preservation time is much short. On the other hand, there has been studies that (-)-epigallocatechin-3-gallate (EGCG), the most abundant polyphenol in green tea, which is related to the anti inflammatory, antioxygenic, and antibacterial effects, allows the successful preservations of tissues and cells. This study evaluated the effect of EGCG on avulsed-teeth preservation of Beagle dogs for a period of time. Methods: The atraumatically extracted teeth of Beagle dogs were washed and preserved with 0/10/$100\;{\mu}M$ of EGCG at the time of immediate, period 1 (4 days in EGCG-contained media and additional 1 day in EGCG-free media), period 2 (8 days in EGCG-contained media and additional 2 days in EGCG-free media) and period 3 (12 days in EGCG-contained media and additional 2 days in EGCG-free media). Then, the cell viabilities of preserved teeth was calculated by dividing optical density (OD) of 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay with OD of eosin assay to eliminate the measurement errors caused by the different tissue volumes. Results: From the results, the immediately analyzed group presented the highest cell viability, and the rate of living cells on teeth surface decreased dependent on the preservation period. However, the $100\;{\mu}M$ of EGCG-treated group showed statistically significant positive cell activity than EGCG-free groups throughout preservation periods. Conclusions: Our findings showed that $100\;{\mu}M$ EGCG could maintain PDL cell viability of extracted tooth. These results suggest that although EGCG could not be a perfect additive for tooth preservation, it is able to postpone the period of tooth storage. However, further in-depth studies are required for more plausible use of EGCG.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.92-98
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• 2010

Purpose: To analyze results of treating acromioclavicular injuries using clavicle hook plates. Materials and Methods: Between February 2008 and April 2010, 18 patients with acromioclavicular joint injury treated by clavicle hook plates were reviewed. Using the Rockwood classification, 7 dislocations were classified as type III injuries and 11 as type V injuries. Implant removal was done at least 3 months from initial fixation. Simple X-rays were taken for comparing the state of reduction, and clinical outcomes were evaluated by the Korean Shoulder Scoring System and the American Shoulder Elbow Society score. The average follow-up period was 9 months. Results: On weight bearing X-rays, the average coracoclavicular distance showed a 114% increase compared to the contralateral side at the time of injury. It decreased to 23% by the last follow-up. The mean Korean Shoulder Scoring System and the American Shoulder Elbow Society score were 80 and 74 at the last follow-up. Conclusion: The immediate stability these plates provide allows rapid rehabilitation. Clavicle hook plate fixation for acromioclavicular joint dislocation is considered an effective method for ensuring satisfactory results both radiologically and clinically.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.13-19
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• 2014

Purpose: The purpose of this study was to retrospectively evaluate the survival of periodontally hopeless teeth that were intentionally extracted and replanted after a delay and to compare the radiographic characteristics of the survival group with those of the failure group. Methods: The clinical and radiographic data from patients who underwent delayed intentional replantation between March 2000 and July 2010 were reviewed. Twenty-seven periodontally hopeless teeth were extracted and preserved in medium supplemented with antibiotics for 10-14 days. The teeth were then repositioned in the partially healed extraction socket and followed for 3 to 21 months. The radiographic parameters were analyzed using a paired t test and the cumulative survival rate was analyzed using Kaplan-Meier analysis. Results: Seven replanted teeth failed and the overall cumulative survival rate was 66.4%. In the survival group, the amount of bone loss was reduced from 68.45% to 34.66% three months after replantation. There was radiologic and clinical evidence of ankylosis with 5 teeth. However, no root resorption was found throughout the follow-up period. In the failure group, bone formation occurred from the bottom of the socket. However, a remarkable radiolucent line along the root of a replanted tooth existed. The line lengthened and thickened as time passed. Finally, in each case of failure, the tooth was extracted due to signs of inflammation and increased mobility. Conclusions: Delayed intentional replantation has many advantages compared to immediate intentional replantation and could serve as an alternative treatment for periodontally involved hopeless teeth. However, techniques for maintaining the vitality of periodontal structures on the tooth surface should be developed for improved and predictable results.

• Journal of Periodontal and Implant Science
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• v.47 no.4
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• pp.211-218
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• 2017

Purpose: The purpose of the present study was to perform a pattern analysis in patients with temporomandibular disorder (TMD) resulting from unilateral mastication due to chronic periodontitis. Methods: Thirty participants with signs or symptoms of TMD who engaged in unilateral mastication due to periodontitis-related discomfort (test group) were selected. Another 30 subjects exhibiting signs or symptoms of TMD resulting from unilateral mastication not due to chronic periodontitis (control group) were also recruited. An interview-based questionnaire was administered, and an examination of the temporomandibular joint (TMJ) with determination of periodontal status was performed. Results: The duration of unilateral mastication was significantly longer in the control group than in the test group. There was a significant negative correlation between the duration of unilateral mastication and the Community Periodontal Index score. Using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I algorithms, all the subjects were assigned to 3 main groups. The test group exhibited significantly a higher diagnostic distribution of group III (arthralgia, osteoarthritis, or osteoarthrosis), and in both the test and control groups, the number of diagnoses was larger for the non-chewing side. The control group showed a significantly higher diagnostic distribution of group I (myofacial pain), and in both the test and control groups, the number of diagnoses was larger for the chewing side. Conclusions: The results of the present study indicate that unilateral mastication due to chronic periodontitis could induce not only pain but also structural TMJ changes if adequate treatment is not administered and supported within a short time from the onset of the condition. Therefore, immediate treatment of chronic periodontitis is recommended to prevent not only the primary progress of periodontal disease, but also secondary TMJ-related problems. Furthermore, subjects who have suffered chronic long-term periodontitis without treatment should be urged to undergo a TMJ examination.

• Archives of Plastic Surgery
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• v.44 no.5
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• pp.407-412
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• 2017

Background Among the various signs and symptoms of orbital fractures, certain clinical findings warrant immediate surgical exploration, including gaze restriction, computed tomographic (CT) evidence of entrapment, and prolonged oculocardiac reflex. Despite proper surgical reconstruction, prolonged complications such as diplopia and gaze restriction can occur. This article evaluated the prognostic factors associated with prolonged complications of orbital fractures with muscle incarceration. Methods The medical records of 37 patients (37 orbits) with an orbital fracture with muscle incarceration from January 2001 to January 2015 were reviewed. The presence of Incarcerated muscle was confirmed via CT, as well as by intraoperative findings. Various factors potentially contributing to complications lasting for over 1 year after the injury were categorized and analyzed, including age, cause of injury, injury-to-operation time, operative time, fracture type, nausea, vomiting and other concomitant symptoms and injuries. Results All patients who presented with extraocular muscle limitations, positive CT findings, and/or a positive forced duction test underwent surgery. Of the 37 patients, 9 (24%) exhibited lasting complications, such as diplopia and gaze restriction. The mean follow-up period was 18.4 months (range, 1-108 months), while that of patients who experienced prolonged complications was 30.1 months (range, 13-36 months). Two factors were significantly associated with prolonged complications: injury-to-operation time and nausea/vomiting. Loss of vision, worsening of motility, and implant complication did not occur. Conclusions Patients who present with gaze limitations, with or without other signs of a blow-out fracture, require a thorough evaluation and emergent surgery. A better prognosis is expected with a shorter injury-to-operation time and lack of nausea and vomiting at the initial presentation.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.257-277
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• 2000

New techniques for regenerating the destructed periodontal tissue have been studied for many years. Current acceptable methods of promoting periodontal regeneration are basis of removal of diseased soft tissue, root treatment, guided tissue regeneration, graft materials, and biological mediators. Platelet Rich Plasma has been reported as a biological mediator which regulates activities of wound healing progress including cell proliferation, migration, and metabolism. The purpose of this study is to evaluate the effects of using the Platelet Rich Plasma as a regeneration promoting agent for furcation involvement defect. Five adult beagle dogs were used in this experiment. The dogs were anesthetized with Ketamin HCl(0.1 ml/kg, IV)and Xylazine hydrochloride($Rompun^{(R)}$, Bayer, 0.1 ml/kg, IM) and conventional periodontal prophylaxis were performed with ultrasonic scaler and hand instruments. With intrasulcular and crestal incision, mucoperiosteal flap was elevated. Following decortication with 1/2 high speed round bur, degree II furcation defect was made on mandibular third(P3), forth(P4) and fifth(P5) premolar, and stopping was inserted. After 4 weeks, stopping was removed, and bone graft was performed. Ca-P was grafted in P3(experimental group I), Combination of Ca-P and plasma rich platelet were grafted in P4(experimental group II), and P5 was remained at control group.Systemic antibiotics(gentamicin sulfate)and anlgesics(phenyl butazone) were administrated intramuscular for 2 weeks after surgery. Irrigation with 0.1% Chlorhexidine Gluconate around operate sites was performed during the whole experimental period except one day immediate after surgery. Soft diets were fed through the whole experiment period. After 4, 8 weeks, the animals were sacrificed by perfusion technique. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. At 4 weeks after surgery, there were rapid osteogenesis phenomenon on the defected area of the Platelet Rich Plasma plus Ca-P BBP group and early trabeculation pattern was made with new osteoid tissue produced by activated osteoblast. Bone formation was almost completed to the fornix of furcation by 8 weeks after surgery. In conclusion, Platelet Rich Plasma can promote rapid osteogenesis during healing of periodontalregeneration.