• Title/Summary/Keyword: rigid fixation

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Surgical management of edentulous/atrophic mandibular fracture: a report of two cases

  • Lim, Jae-Seok;Kwon, Jin-Il;Kim, Bong-Chul;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.1
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    • pp.50-54
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    • 2012
  • According to Luhr's classification, a fracture in the mandible with a width of less than 15-20 mm is considered to be an atrophic mandibular fracture and its incidence is very rare. Because of the reduced cross-sectional area and smaller contact area of the fractured ends as well as the poorly vascularized bony structure and delayed bone healing, an atrophic mandibular fracture is a great challenge for oral and maxillofacial surgeons. Surgeons tend to perform closed reduction, because open reduction is considered a non-life-saving surgery among elderly patients. Thus, most of them have limited experience in surgical management. According to recent reports, open reduction yields a good result, and the Association for Osteosynthesis (AO) group has recommended open reduction. This is a case report of our two experiences of open reduction and rigid fixation of atrophic mandibular fractures by the AO principle. Articles were also reviewed here.

CEPHALOMETRIC ANALYSIS OF POSTSURGICAL BEHAVIOR OF MANDIBULAR PROGNATHISM (하악전돌증의 술후 동태에 관한 두부계측학적 분석)

  • Kim, Jong-Ryoul;Kim, Tae-Kyu;Chung, In-Kyo;Yang, Dong-Kyu;Park, Sao-Byung;Son, Woo-Sung;Rhee, Byung-Tae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.2
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    • pp.123-128
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    • 1993
  • For the purpose of studying postsurgical stability of mandibular prognathism, 18 patients(8 men and 10 women) were selected who underwent sagittal split ramus osteotomy and lateral cephalograms taken preoperatively, immediate postoperatively, and over 6-month follow-up were traced and analysed. The following results were obtained. 1. Average magnitude of setback vas 11.0mm, and aberage relapse was 3.0mm, so the rate of relapse was 27%. 2. Magnitude of mandibular setback contributed to relapse. 3. The patients of less than 10mm setback showed average 10% of relapse rate, and it was of little clinical significance. 4. Proper detachment of pterygomasseteric sling prevention of clockwise rotation of proximal segment and rigid fixation are recommended for the better postoperative stability.

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Treatment of Old Maxilla Fracture by Le Fort I Osteotomy (Le Fort I 골절단술을 이용한 진구성 상악골 골절의 치험 2예)

  • Park, Hyung-Sik;Kwon, Jun-Ho;Lee, Jae-Hwi
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.243-248
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    • 1989
  • This is a report of 2 cases on old maxilla fractures accompanied with sagittal palatal fracture and severe malocclusion. We treated them by using of classic Le Fort I osteotomy and modified Le Fort I osteotomy along the old fracture lines satisfactorily. The results obtained from treatment are as follows : 1. Careful examination and correct care on sagittal palatal fracture should be need during initial diagnosis and emergency care of maxilla fracture showed malocclusion. 2. Although early definite treatment of maxilla injuries is difficult due to major organ injuries associated with accident, the positive effort to induce normal occlusion is always necessary as soon as possible. 3. In the cases of malocclusion due to transverse discrepancy of maxillary dentition associated with injury as like as our cases, classic and modified Le Fort I osteotomy and rigid internal fixation were useful to correct occlusion, to ease operation and return normal functions early.

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Radicular Pain due to Subsidence of the Nitinol Shape Memory Loop for Stabilization after Lumbar Decompressive Laminectomy

  • Son, Byung-Chul;Kim, Deog-Ryeong
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.61-64
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    • 2015
  • A number of dynamic stabilization systems have been used to overcome the problems associated with spinal fusion with rigid fixation recently and the demand for an ideal dynamic stabilization system is greater for younger patients with multisegment disc degeneration. Nitinol, a shape memory alloy of nickel and titanium, is flexible at low temperatures and regains its original shape when heated, and the Nitinol shape memory loop (SML) implant has been used as a posterior tension band mostly in decompressive laminectomy cases because the Nitinol implant has various characteristics such as high elasticity and a tensile force, flexibility, and biological compatibility. The reported short-term outcomes of the application of SMLs as posterior column supporters in cervical and lumbar decompressive laminectomies seem to be positive, and complications are minimal except for the rare occurrence of pullout and fracture of the SML. However, there was no report of neurological complications related to neural compression in spite of the use of the loop of SML in the epidural space. The authors report a case of delayed development of radiating pain caused by subsidence of the SML resulting epidural compression.

STABILITY OF TWO-JAW SURGERY FOR MANDIBULAR PROGNATHISM (하악전돌증 환자에 대한 양악 수술의 안정성)

  • Kwon, Tae-Geon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.4
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    • pp.348-356
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    • 2001
  • The factors related to relapse in 20 skeletal class III patients who performed two-jaw surgery with Le Fort I maxillary osteotomy and bilateral sagittal split ramus osteotomy was investigated. All patients were fixed with miniplate on the maxilla and three screws at each mandible. Cephalograms taken at preoperative, immediate postoperative and 8 months postoperative after surgery were traced and digitized. 1.The horizontal and vertical relapse of maxilla and mandibular chin points was within 1mm postoperatively. Compare to the preceding report concerning the mandibular set-back surgery only group, this reveals two-jaw surgery for mandibular prognathism using rigid fixation is more stable. 2.Although there was no significant relapse tendancy was observed at chin points, the screw tip land-marks moves anterio-superiorly and each side of the screws moved as a one unit. The screw tip points moved similar direction to the masticatory force and this movements might be influenced by the muscular tension to the distal segment of the mandible. 3.According to the regression analysis, the amount of horizontal and vertical movement of mandibular set-back influenced the mandibular relapse. However, direction and amount of maxillary surgical movement did not inf1uenced the maxillary and mandibular relapse.

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POST-OPERATIVE INFECTIONS FOLLOWING THE ORTHOGNATHIC SURGERY : CASE REPORTS (악교정 수술후 발생한 감염 4증례)

  • Kim, Jong-Sup;Park, Chin-Ho;Park, Hee-Dae;Lee, Chang-Kon;Lee, Hee-Keung;Chin, Byung-Rho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.1
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    • pp.46-54
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    • 1995
  • Postoperative infection following orthognatic surgery is rare. When postoperative infections occur, the initial treatment consists of incision and drainage of the affected area, culturing to identify bacterial stains and verify antibiotic sensitivity, and the institution of the appropriate antibiotic regimen. Some plates and screws may eventually require removal, the initial therapy should be attempted to retain the plates and screws until adequete healing has taken place. In orthoganthic surgery, intra-operative complications as a lesion of inferior alveolar nerve, fracture of osteomised segments, incomplete sectioning, malposition of segments, haemorrhage may occur. The surgeon should be familiar with possible complications to be caused and how to manage them. Prevention of postoperative infection following the orthognathic surgery consists of minimal periosteal reflection, aseptic management of operation field, proper surgical technique, rigid fixation, prophylactic antibiotics.

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Biomechanics and Occlusion for Implant-Supported Prosthesis (임플란트 보철의 생역학과 교합)

  • Koo, Cheol-Ihn;Kwak, Jong-Ha;Chung, Chae-Heon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.18 no.2
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    • pp.127-144
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    • 2002
  • There is an increasing appreciation of the vital role that biomechanics play in the performance of oral implant. The aim of this article is to provide some basic principles that will allow a clinician to formulate a biomechanically valid treatment plan. However, at this point in the history of oral implantology, the clinician should realize that we do not know enough to provide absolute biomechanical rules that will guarantee success of all implants in all situations. To examine the biomechanical questions, one must begin with an analysis of the distribution of biting forcess to implants. Related topics, such as stress transfer to surrounding tissues and interrelationships between bone biology and mechanical loading are major subjects, deserving a separate discussion. Once rigid fixation, angulation, crestal bone level, contour, and gingival health are achieved, stress beyond physiologic limits is the primary cause of initial bone loss around implants. The restoring dentist has specific responsibilities to reduce overload to the bone-implant interface. These include proper diagnosis, leading to a treatment plan designed with adequate retention and form, and progressive loading to improve the amount and density of bone and further reduce the risk of stress beyond physiologic limits. The major remaining factor is the development of occlusal concept in harmony with the rest of the stomagnetic system.

A Study of Internal Ultrastructure on the RGP Contact Lens (RGP 콘택트 렌즈의 내부 미세구조에 대한 연구)

  • Kim, Douk Hoon
    • Journal of Korean Ophthalmic Optics Society
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    • v.6 no.1
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    • pp.55-58
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    • 2001
  • The rigid gas permeable(RGP) contact lens has nearly side effect on the cornea. So that, this lens has used the clinical reflective correction of the eye. This study have used several methods for research the fine internal structure on the RGP contact lens by scanning electron microscopy. The results have indicated that the postfixation of 1% $OsO_4$ and tannic acid is responsible for a fine structure in the internal plane of RGP contact lens. These internal surface of contact lens appeared the several shape of the hole of the stereo shape form with arrangement of round form. But, on the contact lens with non-postfixation, the stereo shape have not present and the boundary of the vesicle have not clear. Maybe, these results suggest that the fixation methods have effect on the morphological characters of materials on the RGP contact lens.

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Modified Lapidus procedure for the Treatment of Hallux Valgus (무지 외반증 환자에서 변형 Lapidus 술식을 이용한 치료)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, J-Young;Lee, Se-Young
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.179-186
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    • 2003
  • Purpose: The purpose of this study was to evaluate the result of modified Lapidusprocedure for Hallux valgus associated with first ray hypermobility Materials and Methods: A retrospective study was conducted between Aug. 1999 and Oct. 2003. We evaluated 20 cases (12patients)of hallux valgus that performed modified Lapidus procedure. We asked to patient about postoperative satisfaction in terms of overall, pain, and appearance. preoperative and postoperative AOFAS score for the forefoot was calculated, also preoperative and postoperative radiologic evaluation was done. Results: In terms of satifaction, overall rate was 70%, pain relief and appearance were 70% and 70%. preoperative mean Hallux valgus angle and mean intermetatarsal angle were 42.6degree and 19.4degree. after procedure, at last follow up, mean hallux valgus angle and mean intermetatarsal angle were 16degree and 8.7degree. In terms of complication, nonunion was seen in 3 cases and recurrence of hallux valgus deformity was 2 cases. Conclusion: In consideration of high complication rate, modified Lapidus prociduremust be improved in terms of more rigid fixation technique, etc.

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Reconstruction of Mandibular Bone Defect Using a Titanium Mesh with Autogenous Particulate Cortical Bone Graft by an Intraoral Approach: A Case Report (구강내 접근으로 자가 분쇄 피질골과 Titanium Mesh를 이용한 광범위한 하악골 골결손부 재건: 증례보고)

  • Choi, Seok-Tai;Leem, Dae-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.6
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    • pp.466-472
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    • 2012
  • The loss of mandibular continuity due to trauma, neoplasm, or infection results in major esthetic and biologic compromise. The reconstruction of the mandibular bone defect still poses a challenge to oral and maxillofacial surgeons. There have been a number of variety graft materials. Among them, free block bone graft with rigid fixation has been widely used. However, cases using free block bone grafts may lead to a marked invasion of the donor site, mal-union, and absorption of the block bone. In this respect, particulate cortical bone using a titanium mesh tray can be an effective alternative option in order to achieve a proper bone contour and good oral rehabilitation. We have developed an intraoral approach for the mandibular reconstruction method using a titanium mesh tray with autogenous particulate cortical bone graft.