• Archives of Plastic Surgery
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• v.35 no.6
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• pp.739-742
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• 2008

Purpose: Breast augmentation is one of the common procedures in plastic surgery today. The shape, size and insertion plane of the implant is decided preoperatively by physical examination of the breast. Pectus excavatum is one of the most common anomalies of chest wall, characterized by a depression of the anterior chest wall. For patients with a mild type of pectus excavatum, the main purpose of the treatment is aesthetic rather than functional improvement. Two most surgical treatment options for skeletal deformity are the Ravitch technique and minimally invasive Nuss repair. Other options for soft tissue repair are implant insertion and autologous soft tissue augmentation. We performed a surgical operation with Nuss procedures and breast augmentation for a patient with mild pectus excavatum and hypoplastic breast. Methods: A 32 year-old female was presented with hypoplastic breast. Preoperative chest CT was performed, showing pectus excavatum. After Nuss procedure, we inserted saline implant(275 cc textured round breast implant, moderate profile) submuscularly to restore adequately projected breast. Results: Patient's postoperative course was uneventful without any complication. After 6 months of follow-up period, the patient had an excellent result, with high patient satisfaction and no complications. Conclusion: For patients with a mild type of pectus excavatum, who do not have cardiopulmonary symptoms and requires for aesthetic improvement, this simple approach with Nuss procedure and breast augmentation achieves excellent aesthetic correction with low complication rate and high patient satisfaction.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.3
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• pp.268-274
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• 2020

Functional and esthetic recovery through reconstruction of the oral and maxillofacial system is important for patients who underwent mandibulectomy due to lesions such as oral cancer. The fibula free flap, which is frequently used in the reconstruction of the mandible, is easy to prosthetic restoration with implant placement. However, patients with growing periods have difficulty in treatment with implants when the size of the fibula is small and residual growth remains. This case is an 11-year-old female patient who underwent mandibulectomy due to osteosarcoma and reconstruction of the mandible using a fibular free flap. Functional and esthetic recovery were obtained through prosthetic restoration using implant-supported fixed prostheses. Implantation site, number of implants, and type of prostheses were considered. Implant-supported fixed prostheses were delivered at 13 years old, and after an additional 1 year observation, stable results were obtained. However, observing changes in the maxillofacial system through further examinations is necessary.

• Radiation Oncology Journal
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• v.16 no.2
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• pp.167-175
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• 1998

Purpose : It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or sing1e plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms(cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. Materials and Methods : Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent(5 cases) or primary(3 cases) cervical cancers or primary vaginal cancer(1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a sing1e plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material$(Provil^{(R)})$. The applicators were customized individually according to the tumor size and its location Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles(Microselectron Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. Results : Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant procedure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. Conclusion : The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylanide and dental mold material $(Provil^{(R)})$.

• Journal of Periodontal and Implant Science
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• v.45 no.1
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• pp.30-35
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• 2015

Purpose: Implant beds with an insufficient amount of cortical bone or a loss of cortical bone can result in the initial instability of a dental implant. Thus, the objective of this study was to evaluate the effect of bone cement grafting on implant initial stability in areas with insufficient cortical bone. Methods: Two different circumferential defect depths (2.5 mm and 5 mm) and a control (no defect) were prepared in six bovine rib bones. Fourteen implants of the same type and size ($4mm{\pm}10mm$) were placed in each group. The thickness of the cortical bone was measured for each defect. After the implant stability quotient (ISQ) values were measured three times in four different directions, bone cement was grafted to increase the primary stability of the otherwise unstable implant. After grafting, the ISQ values were measured again. Results: As defect depth increased, the ISQ value decreased. In the controls, the ISQ value was $85.45{\pm}3.36$ ($mean{\pm}standard$ deviation). In circumferential 2.5-mm and 5-mm defect groups, the ISQ values were $69.42{\pm}7.06$ and $57.43{\pm}6.87$, respectively, before grafting. These three values were significantly different (P<0.001). After grafting the bone cement, the ISQ values significantly increased to $73.72{\pm}8.00$ and $67.88{\pm}10.09$ in the 2.5-mm and 5.0-mm defect groups, respectively (P<0.05 and P<0.001). The ISQ value increased to more than double that before grafting in the circumferential 5-mm defect group. The ISQ values did not significantly differ when measured in any of the four directions. Conclusions: The use of bone cement remarkably increased the stability of the implant that otherwise had an insufficient level of stability at placement, which was caused by insufficient cortical bone volume.

• The Journal of Korean Academy of Prosthodontics
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• v.22 no.1
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• pp.33-50
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• 1984

The purpose of this study was to investigate whether the ashed tooth powder is utilized as an alternative material of the implant to recovery the bony defect. For this purpose its biocompatibility was evaluated comparing to the synthetic calcium phosphate compounds, such as Syntograft and Calcitite, as well as the vacuum firing porcelain (Ceramco Inc.) which is anticipated to use as a matrix to aid sintering. Bony defects to exposure the bone marrow, $3{\times}5$ mm in size, were created in the right and left tibias of fifteen rabbits, and then the ashed tooth powder at $950^{\circ}C$, the porcelain powder, Syhtograft and Calcitite were inserted in the defects of twelve rabbits of the experimental group and the blood clot only was filled in the defects of three rabbits of the control group. The experimental and control rabbits were sacrificed at 1st, 2nd 3rd week after implantation and the histologic examination was performed. The ashed tooth powder in order to make the needed form of the implant was molded using the cylindrical mold 1 cm high, 1 cm in diameter under the pressure of $1000kg/cm^2$ and the ashed tooth powder was sintered at $1100^{\circ}C$ for 1 hour and the mixture of the porcelain powder and the ashed tooth powder at the weight ratio of 7:3, 6:4, 5:5, 4:6 were molded in the same manner and were sintered at $925^{\circ}C$. From this sintered material, square shaped implants were prepared in the dimension of $2{\times}4{\times}6mm$. The prepared implants were surgically placed in the subperiosteum of lateral surfaces of the right and left mandibular bodies. The dogs were sacrificed at 4 weeks, and then the specimens were examined using the light and scanning electron microscopes. The results of this study were obtained as follows: 1. Any inflammatory response was not noted after implanting of the ashed tooth powder, Syntograft, Calcitite and the porcelain powder during the whole experimental period after implantation. 2. Induction of the new bone formation was significantly shown in the ashed tooth powder, Syntograft and Calcitite. 3. The more the porcelain powder was contained in the implants, the more the porosity was and the bigger the pore size was under the scanning electron microscope. And there was ingrowing of the fibrous connective and the osteoid tissue. 4. The osteoid tissues were found to be directly fused to the implant of the ashed tooth powder, and the mixture implant of the porcelain powder and the ashed tooth powder at the weight ratio of 4:6 under the light and scanning electron microscopes.

• Archives of Plastic Surgery
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• v.45 no.2
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• pp.158-164
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• 2018

Background During breast augmentation, the transaxillary approach provides the advantage of allowing the mammary prosthesis to be placed through incisions that are remote from the breast itself, thereby reducing the visibility of postoperative scars. For patients experiencing capsular contracture who do not want additional scars, the previous transaxillary scar can be used for site change and implant exchange. Methods This study analyzed 17 patients (34 breasts) with submuscular breast implants with grade III-IV capsular contracture who received treatment from 2010 to 2015. The mean age of the patients was 29 years (range, 20-38 years). The inclusion criterion was a pinch test of more than 3 cm at the upper pole of the breast. Previous axillary scars were used to expose the pectoralis fascia, and submuscular breast implants were removed carefully. The dissection underneath the pectoralis fascia was performed with endoscopic assistance, using electrocautery under direct visualization. Results The mean follow-up period was 14 months (range, 6-24 months). The entire dissection plane was changed from the submuscular plane to the subfascial plane. Round textured gel implants were used, with a mean implant size of 220 mL (range, 160-300 mL). Two patients developed grade II capsular contracture. There were no cases of malposition or asymmetry. Three patients complained of minor implant palpability. None of the patients required additional surgery. Conclusions Endoscopic subfascial conversion may be an effective technique for treating capsular contracture and avoiding scarring of the breast in selected patients.

• The Journal of Advanced Prosthodontics
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• v.7 no.4
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• pp.329-337
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• 2015

PURPOSE. This retrospective study aims at the evaluation of implant-supported overdentures (IODs) supported by ceramo-galvanic double crowns (CGDCs: zirconia primary crowns + galvano-formed secondary crown). MATERIALS AND METHODS. In a private practice, 14 patients were restored with 18 IODs (mandible: 11, maxilla: 7) retained by CGDCs on 4 - 8 implants and annually evaluated for technical and/or biological failures/complications. RESULTS. One of the 86 inserted implants failed during the healing period (cumulative survival rate (CSR) implants: 98.8%). During the prosthetic functional period (mean: $5.9{\pm}2.2years$), 1 implant demonstrated an abutment fracture (CSR-abutments: 98.2%), and one case of peri-implantitis was detected. All IODs remained in function (CSR-denture: 100%). A total of 15 technical complications required interventions to maintain function (technical complication rate: 0.178 treatments/patients/year). CONCLUSION. Considering the small sample size, the use of CGDCs for the attachment of IODs is possible without an increased risk of technical complications. However, for a final evaluation, results from a larger cohort are required.

• Journal of the Korean Society for Precision Engineering
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• v.31 no.5
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• pp.375-380
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• 2014

To enhance biocompatibility between the orthopedic implant stem and obsteoblast cells, bone-forming cells, micro-size holes are patterned in Ti plate surface. Initially, the house built laser power stabilization system is applied to the laser micro patterning machine to convince repeatable result. Various pulse widths are irradiated Ti plate and relationship between diameters of patterned holes and pulsed width is derived. Effect of multi pulse is observed and optimal pulse number is considered to avoid heat affected zone. After MG-63 osbeoblast cells are cultured, micro patterned Ti plates are compared with control plates. In SEM image, cells are well aligned and aggregation is observed in both 60, and $100{\mu}m$ patterned plates. Finally, free form surface stem model is prepared to test micro hole patterning.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.50.1-50.6
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• 2016

Background: The aim of this study was to evaluate the clinical outcomes of implants that were placed within the maxillary sinus that has a perforated sinus membrane by the lateral window approach. Methods: We examined the medical records of the patients who had implants placed within the maxillary sinus that has a perforated sinus membrane by the lateral approach at the Department of Oral and Maxillofacial Surgery of Chonnam National University Dental Hospital from January 2009 to December 2015. There were 41 patients (male:female = 28:13). The mean age of patients was $57.2{\pm}7.2years$ at the time of operation (range, 20-76 years). The mean follow-up duration was 2.1 years (range, 0.5-5 years) after implant placement. Regarding the method of sinus elevation, only the lateral approach was included in this study. Results: Ninety-nine implants were placed in 41 patients whose sinus membranes were perforated during lateral approach. The perforated sinus membranes were repaired with a resorbable collagen membrane. Simultaneous implant placements with sinus bone grafting were performed in 37 patients, whereas delayed placements were done in four patients. The average residual bone height was $3.4{\pm}2.0mm$ in cases of simultaneous implant placement and $0.6{\pm}0.9mm$ in cases of delayed placement. Maxillary bone graft with implant placement, performed on the patients with a perforated maxillary sinus membrane did not fail, and the cumulative implant survival rate was 100%. Conclusions: In patients with perforations of the sinus mucosa, sinus elevation and implant placement are possible regardless of the location and size of membrane perforation. Repair using resorbable collagen membrane is a predictable and reliable technique.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.3
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• pp.215-223
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• 2010

Purpose: The present study was aimed to evaluate the level of cortical bone strain during the placement of an implant. The primary concern was to investigate if the extent of overloading area near the marginal bone could be affected by microthread fabricated at the cervical 1/3 of an implant. Materials and methods: Three dimensional finite element analysis was used to simulate the insertion of 3 implants. Control model was $4.1{\times}10$ mm implant (Submerged model, Dentis Co,, Daegu, Korea) equipped with a main thread only. Type I was with main thread and microthread, and Type II had similar thread pattern but was of tapered body. A PC-based finite element software (DEFORM 3D ver 5, SFTC, Columbus, OH, USA) was used to calculate a total of 3,600 steps of analysis, which simulated the whole insertion. Results: Results showed that the strain field in the marginal bone within 1 mm of the implant wall was higher than 4,000 micro-strain in the control model. The size of bone overloading was 1-1.5 mm in Type I, and greater than 2 mm in Type II implants. Conclusion: These results indicate that the marginal bone may be at the risk of resorption on receiving the implant for all 3 implant models studied. Yet, the risk was greater for Type I and Type II implants, which had microthread at the cervical 1/3.