• Title/Summary/Keyword: surgical extrusion

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ERUPTION GUIDANCE OF IMPACTED MANDIBULAR FIRST MOLAR (매복된 하악 제1대구치의 맹출 유도)

  • Lee, Doo-Young;Song, Je-Seon;Lee, Jae-Ho;Choi, Byung-Jai;Kim, Seong-Oh
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.226-232
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    • 2010
  • Incidence of tooth impaction varies from 5.6 to 18.8% of the population. Failure of eruption of the first and second permanent molars is rare; the prevalence in the normal population is 0.01% in case of the first permanent molar, and 0.06% in case of the second permanent molar. Permanent molars are particularly important for providing sufficient occlusal support and co-ordinating facial growth. Failure of eruption of permanent molars may result in various complications such as decrease in vertical dimension, posterior open bite, extrusion of antagonistic teeth, resorption and inclination of adjacent teeth, formation of cyst and so on. Treatment options of impacted teeth are periodic observation, surgical exposure, surgical exposure with subluxation, orthodontic relocation, and surgical extraction before prosthetic treatment. Early diagnosis and treatment are important, because delayed treatment induces various problems such as decreased spontaneous eruptive force, decreased successful percentage, increased treatment period, increased various complications. Prevalence of the failure of mandibular first molars is rare but eruptive guidance before extraction of impacted teeth is necessary due to importance of permanent molars. We reported two cases of surgical exposure of impacted mandibular first molar. In these cases, we could observe different result of the impacted mandibular first molar after surgical exposure.

Upper eyelid platinum weight placement for the treatment of paralytic lagophthalmos: A new plane between the inner septum and the levator aponeurosis

  • Oh, Tae Suk;Min, Kyunghyun;Song, Sin Young;Choi, Jong Woo;Koh, Kyung Suk
    • Archives of Plastic Surgery
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    • v.45 no.3
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    • pp.222-228
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    • 2018
  • Background The most common surgical treatment for paralytic lagophthalmos is the placement of a weight implant in the upper eyelid; however, this technique confers the risks of implant visibility, implant extrusion, and entropion. In this study, we present a new technique of placing platinum weight implants between the levator aponeurosis and inner septum to decrease such complications. Methods A total of 37 patients with paralytic lagophthalmos were treated between March 2014 and January 2017 with platinum weight placement (mean follow-up, 520.1 days). After dissecting through the orbicularis oculi muscle, the tarsal plate and levator aponeurosis were exposed. The platinum weights (1.0-1.4 g) were fixed to the upper margin of the tarsal plate and placed underneath the orbital septum. Results Five patients could partially close their eye after surgery. The average distance between the upper eyelid and the lower eyelid when the eyes were closed was 1.12 mm. The rest of the patients were able to close their eye completely. Three patients patient developed allergic conjunctivitis after platinum weight insertion, which was managed with medication. None of the patients complained of discomfort in the upper eyelid after surgery. Visibility or extrusion of the implant were observed in three patients. Conclusions Postseptal weight placement is a safe and reproducible method in both primary and secondary upper eyelid surgery for patients with paralytic lagophthalmos. It is a feasible method for preventing implant visibility, implant exposure, and entropion. Moreover, platinum is a better implant material than gold because of its smaller size and greater thinness.

INTRA-ALVEOLAR TRANSPLANTATION OF COMPLETELY CROWN-ROOT FRACTURED TOOTH WITH DEMINERALIZED FREEZED DRIED BONE GRAFT (치은연 하방으로 파절된 치아의 탈회냉동건조골을 이용한 Intra-alveolar transplantation)

  • Lim, Hyoung-Soo;Kim, Dong-Phil;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.344-350
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    • 2000
  • Incidence of crown-root fracture due to traumatic injury, have been reported 3% in the permanent dentiton, 2% in the deciduous dentition. There are two treatment methods for crown-root fractured teeth with pulp exposure, when the fracture line was located under the alveolar crest. One way is the extrusion by orthodontic force the other way is intra-alveolar transplantation which occlusally repositioning of apical fragment in the alveolar socket. Since intra-alveolar transplantation has introduced in 1970s, it was practiced as alternative to orthodontic extrusion. As the result, this method may thoughted that had a good prognosis. As a result of trauma, completely crown-root fracture was occured in the maxillary right central incisor in this case. We couldn't reposition the deepest fracture line above the alveolar crest by the conventional surgical extrusion, because apical fragment was too short. Thus, after extraction of apical fragment, we repositioned it to the socket following demineralized freezed dried bone graft, which possible to support the apical fragment. At the 15-month recall examination, the root still showed normal mobility and there was not observed any in flammatory or replacement root resorption in the periapical radiograph.

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A Case of Massive Pulmonary Gangrene Complicated by Klebsiella Pneumonia (클렙시엘라 폐렴의 합병증으로 발생한 광범위 폐괴저)

  • Ha, Jun-Wook;Eom, Kwang-Seok;Jang, Seung Hun;Bahn, Joon-Woo;Kim, Dong-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.381-385
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    • 2004
  • Pulmonary gangrene is a rare and severe complication of bacterial pneumonia, where a pulmonary segment or lobe is sloughed due to parenchymal devitalization of the parenchyma, with secondary anaerobic infection and necrosis caused by pulmonary vascular thrombosis. Prior to the antibiotic era, massive pulmonary gangrene was potentially fatal. Herein, a case of pulmonary gangrene in a 67-year-old man is reported. He complained of fever, chills, dyspnea and purulent sputum of 5 days duration. The plain chest radiograph showed well-marginated right upper lobe consolidation, with bulging minor fissure, suggestive of a Klebsiella infection. A contrast CT scan demonstrated consolidation of the right upper lobe, with a central necrotizing portion. Klebsiella species was confirmed from both sputum and blood cultures. After appropriate antibiotics, the chest X-ray and CT scan 3 weeks later showed a large cavity with an air-fluid level, sloughing-off and extrusion of necrotic lung tissue, suggestive of pulmonary gangrene. Seven months later, the right gangrenous lung showed severe volume loss on a chest radiograph. The management of pulmonary gangrene has been somewhat controversial. Herein, it was managed without surgical drainage or resection. If the antibiotic therapy had failed, then a surgical approach would have been considered.

Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment

  • de Almeida Cardoso, Mauricio;de Molon, Rafael Scaf;de Avila, Erica Dorigatti;Guedes, Fabio Pinto;Filho, Valter Antonio Ban Battilani;Filho, Leopoldino Capelozza;Correa, Marcio Aurelio;Filho, Hugo Nary
    • The korean journal of orthodontics
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    • v.46 no.1
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    • pp.42-54
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    • 2016
  • The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects.

Case Report : Non-surgical Treatment of Inferior Alveolar Nerve Injury as a Result of Overinstrumented Root Canal Treatment (근관 충전제의 과충전에 의한 하치조 신경손상에 관한 비수술적 치료 증례)

  • Bae, Kook-Jin;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Cho, Young-Gon;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.36 no.3
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    • pp.199-205
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    • 2011
  • During root canal treatment, overinstrumentation with hand or mechanically driven files can perforate the mandibular canal, allowing the extrusion of endodontic sealers, dressing agents, and irrigant solutions out of the tooth and into the canal. The patient may report symptoms such as pain, hyperesthesia, hypoesthesia, anesthesia, dysesthesia and paresthesia. Such problems must be resolved as quickly as possible to avoid irreversible sequelae caused by certain neurotoxic materials that form part of endodontic sealants. Although there have been no controlled trials of treatment protocols involving endodontically related injuries to the inferior alveolar nerve, the normal therapeutic sequence for this complication is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause. However, total resolution of pain and reduction in or disappearance of paraesthesia after a non-surgical management have been reported. Antiepileptic drugs such as gabapentin or pregabalin have been used for the treatment of neuropathic pain. This article describes a case of inferior alveolar nerve(IAN) damage after endodontic treatment of a mandibular right second molar and the treatment with non-surgical approach using prednisone and gabapentin medication, monitoring the patient's condition with clinical neurosensory examination and current perception threshold test(Neurometer).

THE MANAGEMENT OF TRAUMATICALLY INTRUDED TEETH : A CASE REPORT (외상에 의해 함입된 치아의 치료증례)

  • Han, Young-Hee;Kim, Kwang-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.21 no.2
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    • pp.518-524
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    • 1994
  • A traumatically intruded tooth is one that is forcefully and abruptly dispaced from its position into the surrounding alveolar bone. Although intrusion of permanent teeth is infrequent, the sequelae compromise the longevity of the tooth and often include pulp necrosis, internal and external root resorption, rupture of periodontal ligament and loss of marginal bone. The purpose of this study was to examine three common management techniques for traumatic intrusion, observation for re-eruption, surgical repositioning & fixation and orthodontic extrusion. In the recent, the accepted treatment was to allow the permanent teeth to reerupt spontaneously for 6-8 weeks. If this did not occur, orthodontic traction was applied. The pulpal status of the teeth was monitored and either calcium hydroxide therapy or conventional endodontics was instituted following pulpal necrosis depending on the maturity of the root end. Pulpectomy and a calcium hydroxide filling were also the treatment of choice if there was evidence of internal or external root resorption. This will reduce the chance of root resorption and provide a period of monitoring prior to a definitive root canal filling.

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The Use of Multiple Fenestrations of the Dura in Acute Traumatic Subdural Hematoma in Elderly (노인 급성 외상성 경막하출혈 환자에서 시행한 다발성 경막천공술의 이용)

  • Park, Jongtae;Yun, Jikwang
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.226-228
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    • 2013
  • Elderly patients with acute subdural hematomas have higher mortality and lower functional recovery rates compared with those of other head-injured patients. Early and widely surgical decompression and active intensive care represent the best way to assist these patients. However, abrupt decompression of the hematoma can lead to brain disruption and secondary ischemia in the brain surrounding the craniectomy site. Acute brain swelling and brain extrusion, which take place shortly after decompression, can lead to a catastrophic situation during the operation due to the impossibility of appropriate closure of the dura and scalp. To avoid the deleterious consequences of disruption of brain tissue, we have adopted multiple fenestrations of the dura in a mesh-like fashion and gradual release of subdural clots through the small dural openings that are left open. This is especially important in cases in which there are massive amount of subdural hematomas with small parenchymal lesion and severe midline shifts in elderly patients. Further clinical experiences should be conducted in a more selected series patients to estimate the impact of this technique on morbidity and mortality rates.

Diagnostic Imaging of Intervertebral Disk Disease in 3 Dogs (추간판 질환 3례에서의 진단영상)

  • 엄기동;장동우;서민호;정주현;최호정;이기창;이희천;이영원;최민철
    • Journal of Veterinary Clinics
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    • v.18 no.3
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    • pp.284-287
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    • 2001
  • Three dogs referred to Veterinary Medical Teaching Hospital, Seoul National University were diagnosed as intervertebral disc disease. Physical examination, neurologic examination, survey radiograph, and myelography were performed in patients. Case 1 showed narrowing intervertebral space and calcified intervertebral disc material in survey radiograph. Case 2 showed increased opacity in the intervertebral opacity in survey radiograph. All of 3 cases showed extradural pattern during myelography. In survey radiography, radiographic signs consistent with intervertebral disc herniations include narrowing of the disc space and the dorsal intervertebral articular process joint space, small intervertebral foramen, increase opacity in the intervertebral foramen and extruded, mineralized disc material within the vertebral canal. Myelography is useful for evaluating the spinal cord and the cauda equina. Indication for myelography includes confirming a spinal lesion seen or suspected on survey radiograph, defining the extent of a survey lesion, finding a lesion not observed on survey radiograph, and distinguishing between surgical and nonsurgical lesion. In presentcases, two of three cases show radiographic signs of IVDD with survey radiograph and all of three case show extradural pattern during myelography. It is observed that intervertebral disc disease is one of the most important indication for radiographic examination and myelography of the vertebral column of small animals.

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Three-dimensional bio-printing and bone tissue engineering: technical innovations and potential applications in maxillofacial reconstructive surgery

  • Salah, Muhja;Tayebi, Lobat;Moharamzadeh, Keyvan;Naini, Farhad B.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.18.1-18.9
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    • 2020
  • Background: Bone grafting has been considered the gold standard for hard tissue reconstructive surgery and is widely used for large mandibular defect reconstruction. However, the midface encompasses delicate structures that are surrounded by a complex bone architecture, which makes bone grafting using traditional methods very challenging. Three-dimensional (3D) bioprinting is a developing technology that is derived from the evolution of additive manufacturing. It enables precise development of a scaffold from different available biomaterials that mimic the shape, size, and dimension of a defect without relying only on the surgeon's skills and capabilities, and subsequently, may enhance surgical outcomes and, in turn, patient satisfaction and quality of life. Review: This review summarizes different biomaterial classes that can be used in 3D bioprinters as bioinks to fabricate bone scaffolds, including polymers, bioceramics, and composites. It also describes the advantages and limitations of the three currently used 3D bioprinting technologies: inkjet bioprinting, micro-extrusion, and laserassisted bioprinting. Conclusions: Although 3D bioprinting technology is still in its infancy and requires further development and optimization both in biomaterials and techniques, it offers great promise and potential for facial reconstruction with improved outcome.