The authors reviewed 50 patients of congenital dislocation of the hip who had surgical treatment at the Department of Orthopedic Surgery, Seoul National University Children's Hospital from October, 1985 to August, 1993. We investigated the contributing factors to coxa magna after surgical treatment and it's relationship to the avascular necrosis of femoral head, and observed the influnce of coxa magna on the development of the hip joint. Coxa magna was defined as a femoral head with the greatest diameter 15% greater than the opposite side. To assess the development of the acetabulum in the hips with coxa magna, radiographical horizontal and vertical parameters were measured preoperatively, and at postoperative 1 year, 2 year, and 3 year or more. Twenty-one of fifty hips had coxa manga. The incidence of coxa magna increased in patients who had open reduction at younger age(average 30 months), compared to older age(average 44 months). Neither femoral osteotomy nor pelvic osteotomy increased statistically the incidence of coxa magna. Avascular necrosis of femoral head did not necessarily resulted in coxa magna. There were not statistically significant differences in the coverage ratios of femoral head by the acetabulum between coxa magna positive and negative groups, because lateral acetabular growth accompanied in accordance with enlargement of femoral head in the majority of cases with coxa magna. Open reduction alone caused concomitant vertical overgrowth of ipsilateral hemi-pelvis with resultant pelvic tilt and leg length inequality(IHD>5mm, upto 2cm) in 6 of 10 cases. The patients, who had coxa magna with good radiological results by Severin's classification, underwent open reduction at younger age and had lesser enlargement of the femoral head, compared to those with fair or poor results.
Acetabulum ; Classification ; Dislocations ; Head ; Hip Joint ; Hip ; Humans ; Incidence ; Leg ; Necrosis ; Orthopedics ; Osteotomy ; Seoul

Recently the esthetic demands of clinicians and patients made the surgeon try to regenerate bone defects and gingival tissue after extraction. For that, many surgical methods were used and socket preservation have been evaluated simple, effective and good prognosis in the implant placement. Bone grafting was one of the methods for socket preservation. This study was to evaluate the histologic view of the effects on healing of the extraction sockets when deproteinized bovine bone mineral and tetracycline coated deproteinized bovine bone mineral was implanted 1. In control group, at 4 weeks after implantation, the extraction sockets were filled with connective tissue. And after 8 weeks, osteoblasts were observed in newly formed trabecular among the fibrous connective tissue in the extraction sockets. 2. In experimental 1 group, there was connective tissue and new bone trabecular around newly formed woven bone at 4 weeks. And many osteoblasts were observed in various direction at 8 weeks. 3. In experimental 2 group, there was a lot of new bone made around the bone powder after 4 weeks, and the thicker bone trabecular, lamellar bone and irregular osteoblasts arrangement were observed at 8 weeks. From the results of this study, tetracycline coated BBP would be better than the other groups in the lamellar bone formation and be faster in the bone formation rate.
Animals ; Bone Transplantation ; Connective Tissue ; Dogs* ; Humans ; Osteoblasts ; Osteogenesis ; Prognosis ; Tetracycline

BACKGROUND: Lowe and Ernst's square root of time model employs direct injection of liquid agent into breathing circuit for low flow anesthesia. Intermittent injections of the agent by Lowe's method change rapidly arterial partial pressure of the agent and fail to maintain hemodynamic stability to surgical stimuli. We designed to investigate the possibility and safety of low flow anesthesia with continuous infusion of liquid enflurane into breathing circuit. METHODS: Twenty patients, ASA physical status I or II, undergoing gastrectomy under inhalational general anesthesia were randomly divided into two groups. Anesthesia was maintained with a fresh gas flow of O2 500 ml/min and continuous infusion of liquid enflurane. An identical semiclosed Dr ger circle anesthesia system was used to all patients. Liquid enflurane calculated by the Lowe's method (group I) or simplified by patient's weight (group II) was continuously infused directly into inspiratory limb of breathing circuit using syringe pump. Inspiratory and expiratory concentrations of enflurane, enflurane consumptions, hemodynamic parameters, carboxyheomoglobin were checked intraoperatively. Hepatic and renal functions were evaluted postoperatively. RESULTS: Liquid enfurane was initially infused at a rate in ml/hr of 16.1 0.8 weight in kg in group I and 1.0 weight in kg in group II. After 5 minutes the infusion rate was reduced to 20% of this value and then well adjusted to maintain blood pressure within 20% of the reference preoperative value. Enflurane consumptions and recovery time were similar between the two groups. There were no clinical significant changes in arterial blood gas, carboxyheomoglobin, and hepatic and renal functions. CONCLUSIONS: These data show that low flow anesthesia with continuous infusion of liquid enflurane into breathing circuit is safe and effective, and that the infusion method simplified by patient's weight may easily be applied to clinical practice for low flow anesthesia.
Anesthesia* ; Anesthesia, General ; Blood Pressure ; Enflurane* ; Extremities ; Gastrectomy ; Hemodynamics ; Humans ; Partial Pressure ; Respiration* ; Syringes

It is improtant that performing prophylaxis procedure on an infected implant surface in order to treat periimplantitis should not change the surface roughness and composition, so that the surface can be recovered to almost same condition as initial implant surface. This thesis, therefore, studied an effect of various oral hygiene instrument on implant surface. A surface roughness measurement instrument and an injection electron microscope were used to observe a change on surface. The purpose of this study was to obtain a clinical guideline during implant care and peri-implantitis treatment. The result were as follows 1. Ra values (surface roughness value) at experimental group 1, group 2, and group 5 were increased significantly as compared with comparison group (p<0.05). 2. When compared experimental group 1 with each exprimental groups at which prohylaxis procedure was performed, mean values of Ra at experimental group 2, group 3, group 6, and group 7 were decreased significantly(p<0.05). 3. Mean value of Ra was lowest at experimental group 2, and highest at experimental group 2, and highest at experimental group 5. 4. Analysis of SEM showed that was significant surface change at experimental group 2, group 3, group 4, group 5, and group 6 as compared with comparison group(X1000). 5. Analysis fo EDX showed that a quantity of Ti on surface for experimental group 6 was very similar to that for comparison group. In conclusion, air-powder abrasive and citric acid, plastic instrument are safe methods to use for performing prophylaxis procedure on implant care or for cleaning and sterilization process on treatment of peri-implantitis, based on the result that those method did not affect implant surface roughness and Ti composition.
Citric Acid ; Oral Hygiene* ; Peri-Implantitis ; Plastics ; Sterilization

Several effective treatment methods and materials have been developed for the treatment of furcation involvement. Currently, the combination of guided tissue regeneration (GTR) and bone grafts is the most commonly prescribed method of treating furcation involved defects. But because these cases often present with poor accessibility, placement of the membrane may be difficult and consequently, clinically impractical. In this study, the alveolar bone healing patterns of adult beagle dogs presenting with alveolar bone destruction treated by one of two methods - treatment using solely bone aIlografts (BBP(R)), or treatment using bone allografts (BBP(R)) stabilized by a fibrin adhesive - were comp ared. The effects of the fibrin adhesive on the initial stabilization of the newly formed bone, subsequent regeneration of bone, and the feasibility of the clinical application of the fibrin adhesive were analyzed. The results of the study were as follows: 1. Clinical signs of inflammation at the 4-8 week interval were not observed: but signs of mild inflammation were histologically observed at the 4-week interval. 2. Allografts stabilized by fibrin adhesive showed good bone formation, whereas defects treated with only the allograft material showed incomplete alveolar bone regeneration. 3. Allografts stabilized by fibrin adhesive showed a decrease in the amount old bone with a concurrent increase in the formation of new lamellar bone four weeks post-op, whereas defects treated with only the allograft material showed no new lamellar bone formation at the same interval. 4. In detects treated with only the allograft material, the defective area was filled with connective tissue 8- weeks post-op, whereas fibrin adhesive stabilized allografts showed viable connections between the original bone and the newly formed bone, in addition to neovascularization 8-weeks post-op. The results of this study show that concurrent use of fibrin adhesive materials can stabilize the allograft material and aid in new bone formation Although the stability of fibrin adhesives fall short of the results achievable by GTR membranes, in cases presenting with poor accessibility that contraindicate the use of membranes, fibrin adhesive materials provide a viable and effective alternative to graft stabilization and new bone formation.
Adhesives ; Adult ; Allografts ; Animals ; Bone Regeneration* ; Connective Tissue ; Dogs ; Fibrin Tissue Adhesive* ; Fibrin* ; Guided Tissue Regeneration ; Humans ; Inflammation ; Membranes ; Osteogenesis ; Regeneration ; Transplants

Procedures for treatment of molar furcation invasion defects range from open flap debridement, apically repositioned flap surgery, hemisection, tunneling or extraction, to regenerative therapies using bone grafting or guided tissue regenerative therapy, or a combination of both. Several clinical evaluations using regenerative techniques have reported the potential for osseous repair of treated furcation invasions. Regenerative treatment of maxillary molars are more difficult due to the multiple root anatomy and multiple furcation entrances therefore, purpose of this study was to evaluated histologically self-curing glass-ionomer cement and light-curing glass-ionomer cement as a barrier in the treatment of a bi-furcated maxillary premolar. Five adult beagle dogs were used in this experiment. 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 maxillary third(P3), forth(P4) and fifth(P5) premolar. 2 month later experimental group were self-curing glass-ionomer cement and light-curing glass-ionomer cement. After 4, 8 weeks, the animals were sacrificed by vascular perfusion. Tissue block was excised including the tooth and prepared for light microscope with Gomori's trichrome staining. Results were as follows. 1. In all experiment group, there were not epithelial down growth and glass ionomer cement were encapsulated connective tissue. 2. In 4 weeks experiment I group slighly infiltrated inflammatory cells but not disturb the new bone or new cementum formation. 3. In 8 weeks, experiment groups I, II were encapsulated fine connective tissue. 4. Therefore glass-ionomer cement filling to the grade III maxillary furcations with multiple root anatomy and multiple furcation entrances were possible clinical methods and this technique is useful method for Maxillary furcation involvement.
Adult ; Animals ; Bicuspid ; Bone Transplantation ; Connective Tissue ; Debridement ; Dental Cementum ; Dogs* ; Furcation Defects ; Glass Ionomer Cements ; Humans ; Molar ; Perfusion ; Tooth

The major cause of periodontal disease is microorganism in the dental plaque. Gingival sulcular fluid, which is exudate released from the tissue near crevicular epithelium is related with inflammation. The purpose of this study was to evaluate the argon laser efficiency between the clinical index and onset of collagenase of gingival sulcular fluid. Material divided 16 patients into 4 groups. The first control was without treatmemt. The second was with just treatment of argon laser, The third was treated by scaling and root planning and the fourth was treated with both scailing and root planning and argon laser. The level of periocheck test, the index of bleeding, and the depth of periodontal pocket were evaluated from for 128 teeth of 64 anterior teeth and 64 posterior teeth. The results were as follows; 1. In the score of periocheck test, root planing group(group 3) was significantly reduced more than the group without treatment(group 1) and the argon laser treatment(group 2) for results of 3 days and 7 days. But root planing plus argon laser treatment(group 4) in the 7days after experiment, was significantly reduced than no treatment(group 1) and root planing treatment(group 3)(P < 0.05), in the 3 days after experiment, was significantly reduced than root planing(group3)(P < 0.05). The score of periocheck test to the root planning group(group 3) were significantly reduced between days1, day3 and day7(P < 0.05). Root planning plus argon laser group(group 4) were significantly reduced to 1 or 7days and 3 or 7days(P < 0.05). The argon laser group(group 2) didn't show any changes. 2. In the case of sulcus bleeding index, the root planning group(group 3) and root planning plus argon laser group(group 4) were reduced more than without treatment group(group 1)(P < 0.05) and sulcus bleeding index in the root planning group(group 3) were reduced more than the argon laser group(group 2)(P < 0.05). 3. There wasn't any changes of pocket depth between the control and the experiment group as with experiment periods also.
Argon* ; Collagenases* ; Dental Plaque ; Epithelium ; Exudates and Transudates ; Gingiva* ; Hemorrhage ; Humans ; Inflammation ; Periodontal Diseases ; Periodontal Pocket ; Root Planing ; Tooth

BACKGROUND: The amount and composition of fresh gas flow affect the consumption of inhalational anesthetics. The purpose of this study was to compare the enflurane consumption and economic aspects of low flow and high flow anesthesia. METHODS: Thirty patients, ASA physical status I or II, aged 20 65 yr., scheduled for gastrectomy under inhalational anesthesia, were studied. The patients were randomly assigned to one of three groups according to the fresh gas flow: O2 500 ml/min (group I); N2O 2 L/min - O2 1 L/min (group II); O2 3 L/min (group III). Anesthesia was maintained in group I by a continuous infusion of liquid enflurane into the inspiratory limb of the breathing circuit, using a syringe pump. In groups II and III, enflurane was administered by a conventional vaporizer. The cumulative dose of liquid enflurane was measured every 10 min during anesthesia. Hemodynamic parameters, inspired and expired enflurane concentrations, and enflurane consumptions were measured. RESULTS: There were no significant differences among the three groups in hemodynamic changes. The enflurane consumption was significantly less in group I than in groups II and III over time (P < 0.05). CONCLUSIONS: Low flow anesthesia offers economic advantages over high flow anesthesia.
Anesthesia* ; Anesthetics ; Enflurane* ; Extremities ; Gastrectomy ; Hemodynamics ; Humans ; Nebulizers and Vaporizers ; Respiration ; Syringes

BACKGROUND: The amount and composition of fresh gas flow affect the consumption of inhalational anesthetics. The purpose of this study was to compare the enflurane consumption and economic aspects of low flow and high flow anesthesia. METHODS: Thirty patients, ASA physical status I or II, aged 20 65 yr., scheduled for gastrectomy under inhalational anesthesia, were studied. The patients were randomly assigned to one of three groups according to the fresh gas flow: O2 500 ml/min (group I); N2O 2 L/min - O2 1 L/min (group II); O2 3 L/min (group III). Anesthesia was maintained in group I by a continuous infusion of liquid enflurane into the inspiratory limb of the breathing circuit, using a syringe pump. In groups II and III, enflurane was administered by a conventional vaporizer. The cumulative dose of liquid enflurane was measured every 10 min during anesthesia. Hemodynamic parameters, inspired and expired enflurane concentrations, and enflurane consumptions were measured. RESULTS: There were no significant differences among the three groups in hemodynamic changes. The enflurane consumption was significantly less in group I than in groups II and III over time (P < 0.05). CONCLUSIONS: Low flow anesthesia offers economic advantages over high flow anesthesia.
Anesthesia* ; Anesthetics ; Enflurane* ; Extremities ; Gastrectomy ; Hemodynamics ; Humans ; Nebulizers and Vaporizers ; Respiration ; Syringes

Instrumentation for periodontal therapy may induce marginal damage which increases plaque accumulation and result in periodontal disease. But there have not been many reports of instrumentations on the artificial crown so far. Therefore this study is conducted to evaluate the effects of various repeated instrumentations on the porcelain crown marginal portion. Of the 10 extracted periodontally diseased maxillary first premolars, were 12 proximal surface used in this study. The finishing line of the preparation was placed on the root surface below CEJ and then the crown was cast and cemented in usual manner. Every 4 surfaces of the 3 instruments-curet, ultrasonic scaler, and ultrasonic curet- is used. and four samples used in each instruments. The relevant procedures and measurements were repeated 3 times in each surfaces. Marginal gap is measured by the microscope and surface roughness, Scannig Probe Microscope. Measurements are made at 5 points in each surfaces, making 20 points in each instrument. The results evaluated statistically were as follows 1. As instrumentation was repeated, both marginal gap and roughness were increased in all group 2. In the hand curet, marginal gap was increased every instrumentation and roughness was increased after second. 3. In the ultrasonic scaler, both marginal gap and roughness were increased every instrumentation. 4. In the ultrasonic curet, marginal gap was increased after third instrumentation and roughness was increased after second. 5. Marginal gap and roughness used by the ultrasonic curet were lower than the others and no difference was seen between the hand curet and ultrasonic scaler From the results of this study, the ultrasonic curet was useful in some aspect, but careful instrumentation was needed. Furthermore it was important to minimize the instrumentation through complete periodontal therapy before setting and adequate plaque control.
Bicuspid ; Crowns* ; Dental Porcelain* ; Hand ; Periodontal Diseases ; Tooth Cervix ; Ultrasonics