• 제목/요약/키워드: prosthesis treatment

검색결과 494건 처리시간 0.028초

The Effect of Fluid Shear Stress on Endothelial Cell Adhesiveness to Modified Polyurethane Surfaces

  • Gilson Khang;Lee, Sang-Jin;Lee, Young-Moo;Lee, Jin-Ho;Lee, Hai-Bang q
    • Macromolecular Research
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    • 제8권4호
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    • pp.179-185
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    • 2000
  • Generally vascular grafts with a relatively large inner diameter (> 5 mm) have been successfully employed for replacement in the human body. However, the use of small diameter grafts is limited, because these grafts rapidly occlude due to the thrombosis. The ideal blood-contacting surface of a prosthesis would be an endothelial cell (EC) lining, because the confluent monolayer of healthy ECs that culture natural blood vessels represents the ideal nonthrombogenic surface. For vascular graft application, the stable EC adhesion on surface under How conditions is very important. In this study, the adhesive strength of ECs attached on polymer surfaces coated with collagen type IV (Col IV), fibronectin (Fn), laminin (Ln), and treated with corona was investigated onto polyurethane (PU) films. The EC-attached PU surfaces were mounted on parallel-plate flow chambers in a How system prepared for cell adhesiveness test. Three different shear stresses (100, 150, and 200 dyne/㎠) were applied to the How chambers and each shear stress was maintained for 120 min to investigate the effect of shear stress and surface treatment condition on the EC adhesion strength. It was observed that the EC adhesion strength on the surface-modified PU films was in the order of Ln≡Fn > Col IV > corona 》 control. More than 70% of the adhered cells were remained on surface-modified PU surface after applying the shear stress,200 dyne/㎠ for 2 hrs, whereas the cells were completely detached on the control PU surface within 10 min after applying the same shear stress. It seems that the type of adsorbed proteins and hydrophilicitv onto the PU surfaces play very important roles for cell adhesion strength.

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Surgical Management of Mitral Regurgitation in Patients with Marfan Syndrome during Infancy and Early Childhood

  • Kim, Eung Re;Kim, Woong-Han;Choi, Eun Seok;Cho, Sungkyu;Jang, Woo Sung;Kim, Yong Jin
    • Journal of Chest Surgery
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    • 제48권1호
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    • pp.7-12
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    • 2015
  • Background: Mitral regurgitation is one of the leading causes of cardiovascular morbidity in pediatric patients with Marfan syndrome. The purpose of this study was to contribute to determining the appropriate surgical strategy for these patients. Methods: From January 1992 to May 2013, six patients with Marfan syndrome underwent surgery for mitral regurgitation in infancy or early childhood. Results: The median age at the time of surgery was 47 months (range, 3 to 140 months) and the median follow-up period was 3.6 years (range, 1.3 to 15.5 years). Mitral valve repair was performed in two patients and four patients underwent mitral valve replacement with a mechanical prosthesis. There was one reoperation requiring valve replacement for aggravated mitral regurgitation two months after repair. The four patients who underwent mitral valve replacement did not experience any complications related to the prosthetic valve. One late death occurred due to progressive emphysema and tricuspid regurgitation. Conclusion: Although repair can be an option for some patients, it may not be durable in infantile-onset Marfan syndrome patients who require surgical management during infancy or childhood. Mitral valve replacement is a feasible treatment option for these patients.

Bilateral Patellar Groove Replacement in a Dog with Iatrogenic Trochlear Groove Damage

  • Kim, Yongrak;Park, Yunsik;Park, Jiyoung;Jeong, Seong Mok;Lee, Haebeom
    • 한국임상수의학회지
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    • 제33권5호
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    • pp.295-299
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    • 2016
  • A 2-year-old, 1.94 kg spayed female Toy Poodle was referred for revision surgery for patellar reluxation following surgery for bilateral medial patellar luxation (MPL). Intermittent non-weight-bearing lameness of the right hindlimb and weight-bearing lameness of the left hindlimb were evident on general inspection. A physical examination revealed that there was a bilateral grade 4 MPL. On radiographs, the medial and lateral trochlear ridge was bilaterally worn out. Patellar groove replacement (PGR) was performed in two stages to replace the bilateral femoral trochlea that had a severely worn out groove. Corrective femoral osteotomy with increasing anteversion angle, tibial tuberosity transposition, medial releasing, lateral imbrications and PGR were performed on the right hindlimb. Six months after surgery on the right hindlimb, a PGR prosthesis was positioned medially on the frontal plane and tibial tuberosity transposition and lateral imbrications were performed on the left hindlimb. Two weeks after surgery, reluxation of the patella occurred on the left hindlimb. The tibial tuberosity transposition was performed to realign the patella more laterally than the previous surgery, and a patellar sling was applied. Two years after the last surgery, the patient showed no pain on the stifle joint and satisfactory weight-bearing ambulation. Reluxation did not recur. PGR maybe a successful treatment for dogs with iatrogenically damaged and/or worn out patellar grooves.

Early implant failure: a retrospective analysis of contributing factors

  • Kang, Dae-Young;Kim, Myeongjin;Lee, Sung-Jo;Cho, In-Woo;Shin, Hyun-Seung;Caballe-Serrano, Jordi;Park, Jung-Chul
    • Journal of Periodontal and Implant Science
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    • 제49권5호
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    • pp.287-298
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    • 2019
  • Purpose: The aim of this retrospective study was to determine the prevalence of early implant failure using a single implant system and to identify the factors contributing to early implant failure. Methods: Patients who received implant treatment with a single implant system ($Luna^{(R)}$, Shinhung, Seoul, Korea) at Dankook University Dental Hospital from 2015 to 2017 were enrolled. The following data were collected for analysis: sex and age of the patient, seniority of the surgeon, diameter and length of the implant, position in the dental arch, access approach for sinus-floor elevation, and type of guided bone regeneration (GBR) procedure. The effect of each predictor was evaluated using the crude hazard ratio and the adjusted hazard ratio (aHR) in univariate and multivariate Cox regression analyses, respectively. Results: This study analyzed 1,031 implants in 409 patients, who comprised 169 females and 240 males with a median age of 54 years (interquartile range [IQR], 47-61 years) and were followed up for a median of 7.2 months (IQR, 5.6-9.9 months) after implant placement. Thirty-five implants were removed prior to final prosthesis delivery, and the cumulative survival rate in the early phase at the implant level was 95.6%. Multivariate regression analysis revealed that seniority of the surgeon (residents: aHR=2.86; 95% confidence interval [CI], 1.37-5.94) and the jaw in which the implant was placed (mandible: aHR=2.31; 95% CI, 1.12-4.76) exerted statistically significant effects on early implant failure after adjusting for sex, age, dimensions of the implant, and type of GBR procedure (preoperative and/or simultaneous) (P<0.05). Conclusions: Prospective studies are warranted to further elucidate the factors contributing to early implant failure. In the meantime, surgeons should receive appropriate training and carefully select the bone bed in order to minimize the risk of early implant failure.

Surgical Treatment of Degenerative Mitral Valve Regurgitation in the Elderly: Comparison of Early and Long-Term Outcomes Using Propensity Score Matching Analysis

  • Lee, Joon Seok;Kim, Kyung Hwan;Choi, Jae Woong;Hwang, Ho Young;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • 제51권6호
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    • pp.367-375
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    • 2018
  • Background: It is unclear whether mitral valve (MV) repair for degenerative mitral regurgitation (MR) provides the same advantages in the elderly that it does in the general population. Methods: From 1994 to 2016, 188 elderly patients (mean age, $68.3{\pm}5.50years$) underwent MV repair (n=153) or MV replacement (n=35) for primary degenerative MR. Early and long-term outcomes were compared before and after propensity score matching (PSM). Results: Before PSM, there was a significant difference in operative mortality (p=0.011). Overall survival and freedom from cardiac-related death (CRD) at 5, 10, and 15 years were significantly higher in patients who underwent MV repair (p=0.039 and p=0.007, respectively). In the multivariable analysis, MV replacement was an independent risk factor of CRD. After PSM, operative mortality was not significantly lower in patients who underwent MV repair (p=0.125). Overall survival and freedom from CRD at 5, 10, and 15 years showed no significant difference between the 2 groups in the PSM cohort (p=0.207, p=0.47, respectively). There was no significant difference in freedom from reoperation before or after PSM (p=0.963 and p=0.575, respectively). Conclusion: MV repair for primary degenerative MR might be a valid option in the elderly population if successful repair is possible.

하악 편측 소수 잔존치 환자의 임플란트 보조 국소의치를 이용한 보철치료 증례 (Rehabilitation of mandibular edentulous patients with a few unilateral remaining teeth using implant-assisted removable partial denture: A case report)

  • 이범기;이용상
    • 대한치과보철학회지
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    • 제57권1호
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    • pp.42-48
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    • 2019
  • 하악 편측에 소수의 잔존치만 있는 증례에서 통상적인 국소의치로 수복하는 경우에 충분한 유지 및 저항을 얻기 어렵고, 무치악 치조제의 흡수에 따른 의치의 안정성 저하로 인해 잔존지대치에 유해한 힘이 가해질 것으로 예상된다. 이러한 경우에 다수의 임플란트를 이용한 고정성 보철로 수복하게 되면 여러 가지 장점이 있을 수 있으나, 해부학적, 경제적 요인에 의해 치료 방법으로 선택이 제한될 수 있다. 이에, 적은 수의 임플란트를 전략적 위치에 식립하여 임플란트 보조 국소의치(Implant-assisted removable partial denture, IARPD)의 제작을 대안으로 고려해 볼 수 있다. 본 증례보고에서는 전통적인 가철성 국소의치만으로는 적절한 지지, 유지, 안정이 어려운 두 임상증례에서 소수의 임플란트를 전략적 위치에 식립하고 로케이터(Locator) 부착장치를 적용하여 3년간 경과관찰을 통해 좋은 임상 결과를 확인하였기에 이를 보고하고자 한다.

단일 치관 수복 시 구강스캐너를 이용한 교합평가 활용 증례보고 (A case report of single crown restoration using an intraoral scanner for occlusal evaluation)

  • 송준범;이종혁;하승룡;최유성;최선영
    • 대한치과보철학회지
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    • 제59권3호
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    • pp.341-349
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    • 2021
  • 디지털 방식을 이용한 교합평가는 종래의 방식인 교합지와 occlusion foil 등에 비해 기록, 비교, 분석 등이 쉽고 간편하며 객관적 이라는 장점이 있다. 이에 본 증례보고에서는 교합평가에 디지털 기술을 활용하고자 단일 전장관 수복이 필요한 환자에서 구강스캐너(i500, Medit, Seoul, Korea)를 이용하여 매 내원시 교합을 평가하였으며, 비교를 위하여 교합지를 이용한 교합관계 확인과 디지털 교합분석장비(Dental prescale II, GC corporation, Tokyo, Japan)를 이용하여 교합관계를 평가하였다. 치료과정에서 구강스캐너를 이용한 방법과 기존의 교합지를 이용한 방법이 유사한 결과를 보여 향후 임상적으로 유용하게 사용될 수 있을 것으로 사료되었다.

Prevalence and influencing factors of dysphagia in elderly patients

  • Son, Hyo-Jin;Park, Yu-Mi;Yim, Sun-Young;Heo, Yu-Ri;Son, Mee-Kyoung
    • 구강생물연구
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    • 제42권4호
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    • pp.208-215
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    • 2018
  • The purpose of this study was to identify the risk of dysphagia among patients that visited prosthodontics department, and evaluate the difference in risks arising from oral conditions and disease in order to preliminarily intervene the various influencing factors of dysphagia. A questionnaire was given to patients that were aged 65 years or older who visited the prosthodontics department between September to December 2017. The data was collected and analyzed using the t-test, $x^2-test$ and logistic regression analysis. The mean age of the patients was 75 years. Out of 300 patients, 206 patients (68.7%) had a risk of dysphagia. There were statistically significant differences between the -non-risk and risk groups, which included the number of natural teeth, total number of teeth including prosthesis, denture use, denture discomfort, number of tooth brushing, oral dryness, digestive system diseases, and musculoskeletal diseases. Among these, oral dryness was a risk factor while the total number of teeth, including natural teeth and prostheses, served as a protective factor. More than half of the elderly patients were at risk of dysphagia. Oral dryness is influenced by many factors and it should continuously be managed. Patients should fully recover their masticatory function by preserving the remaining teeth and compensating for the missing teeth. A dental practitioner should be fully aware of the risk of dysphagia in elderly patients and be able to intervene and offer proper patient health care in advance through treatment guidelines and education.

Classification and surgical management of temporomandibular joint ankylosis: a review

  • Upadya, Varsha Haridas;Bhat, Hari Kishore;Rao, B.H. Sripathi;Reddy, Srinivas Gosla
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권4호
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    • pp.239-248
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    • 2021
  • The paper reviews various classifications and surgical techniques for the treatment of temporomandibular joint ankylosis. PubMed, EBSCO, Web of Science, and Google Scholar were searched using a combination of keywords. Articles related to classification, resection-reconstruction of the temporomandibular joint, and management of airway obstruction were considered and categorized based on the objectives. Seventy-nine articles were selected, which included randomized clinical trials, non-randomized controlled cohort studies, and case series. Though several classifications exist, most classifications are centered on the radiographic extent of the ankylotic mass and do not include the clinical and functional parameters. Hence there is a need for a comprehensive staging system that takes into consideration the age of the patient, severity of the disease, clinical, functional, and radiographic findings. Staging the disease will help the clinician to adopt a holistic approach in treating these patients. Interpositional arthroplasty (IA) results in better maximal incisal opening compared with gap arthroplasty, with no significant difference in recurrent rates. Distraction osteogenesis (DO) is emerging as a popular technique for the restoration of symmetry and function as well as for relieving airway obstruction. IA, with a costochondral graft, is recommended in growing patients and may be combined with or preceded by DO in cases of severe airway obstruction. Alloplastic total joint replacement combined with fat grafts and simultaneous osteotomy procedures are gaining popularity. A custom-made total joint prosthesis using CAD/CAM can efficiently overcome the shortcomings of stock prostheses.

상악 무치악 환자에서 임플란트 지지 서베이드 크라운을 이용한 가철성 국소의치 수복 증례 (A case of removable partial denture restoration using implant supported surveyed crown in a maxillary edentulous patient)

  • 성시영;최연조;류재준
    • 대한치과보철학회지
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    • 제60권1호
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    • pp.29-36
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    • 2022
  • 상악 무치악 환자의 구강 회복을 계획할 때 치료 방법으로 임플란트를 이용한 고정성 보철 수복과 총의치 수복 또는 임플란트를 이용한 오버덴쳐 등을 고려할 수 있다. 총의치 수복의 경우 추가적인 수술이 필요 없고 상대적으로 경제적이며 임플란트 지지 고정성 보철 수복의 경우 일반적으로 총의치 수복에 비해 기능적인 부분이 우수하지만 임상적으로 임플란트 식립이 어려운 경우가 존재한다. 최근에는 환자의 요구 및 잔존 치조골의 상태 등을 고려하여 부분적으로 임플란트를 식립한 후 임플란트 지지 서베이드 크라운을 이용한 가철성 국소의치 수복도 시도되고 있다. 본 증례는 상악 전방부의 임플란트 지지 서베이드 크라운을 이용한 가철성 국소의치 수복을 시행한 증례로 심미 및 기능적으로 만족할 만한 결과를 보여 보고하는 바이다.