The hindfoot in the human body is known to play an important function for weight bearng, shock absorption and locomotion. The defect of hindfoot presents serious problems of the leg length discrepancy and weight bearing. Therefore, it is essential to reconstruct the defect of hindfoot. Up to date, many surgical modalities from a skin graft to the innervated osteocutaneous flap have been developed, but a completely satisfactory method of reconstruction has not been found. The ideal reconstructive method should provide sufficient padding tissue and sensibility. In the Department of Orthopaedic Surgery, capital Armed Forces General Hospital, two cases of hindfoot defect due to explosion were reconstructed by the midplantar fasciocutaneous flap with free iliac bone graft. The results of our procedure were very acceptable one year after the operations.
Absorption ; Arm ; Explosions ; Hospitals, General ; Human Body ; Leg ; Locomotion ; Methods ; Shock ; Skin ; Transplants ; Weight-Bearing ; Wounds and Injuries

PURPOSE: The aims of this study were to measure the distance of the intraosseous vascular anastomosis in the anterolateral wall of the maxillary sinus from different reference points, and to correlate the location of the intraosseous vascular anastomosis with the tooth position and the residual bone height of the maxilla. METHODS: Computed tomography (CT) images were taken from 283 patients undergoing dental implants placement in the posterior maxilla. Three horizontal lines were drawn at the ridge crest, maxillary sinus floor, and the position of the anastomosis. A vertical second line at the center of each tooth was drawn perpendicular to the horizontal lines. The distance from the ridge crest to the maxillary sinus floor and the distance from the maxillary sinus floor to the bony canal were measured from the intersections of the horizontal and vertical lines. The residual alveolar bone height was used to categorize three groups: group 1,<4 mm; group 2, between 4 and 8 mm; and group 3, >8 mm. RESULTS: The residual bone height values of different tooth positions were significantly different (P=0.0002). The distance from the maxillary sinus floor to the intraosseous vascular anastomosis was significantly different between groups 1 and 3 (P=0.0039). At the molar sites, a moderate negative correlation was found between the residual bone height and the distance from the maxillary sinus floor to the intraosseous anastomosis. The distances of the alveolar ridge crest and the maxillary sinus from the intraosseous vascular anastomosis were not significantly different between sexes. CONCLUSIONS: Within the limitations of this study, sites with a higher residual bone height in the molar regions were at a relatively high risk of artery damage during window osteotomy preparation; therefore, we recommend taking more precautions when using a lateral approach for sinus elevation.
Alveolar Bone Loss ; Alveolar Process ; Arteries ; Dental Implants ; Humans ; Maxilla ; Maxillary Artery ; Maxillary Sinus ; Molar ; Mouth, Edentulous ; Osteotomy ; Sinus Floor Augmentation ; Tomography, X-Ray Computed ; Tooth*

No abstract available.
Gastroenteritis* ; Humans* ; Rotavirus*

PURPOSE: The aim of this report is to investigate the efficacy of anorganic bovine bone xenograft(Bio-Oss(R) ) at maxillary sinus floor augmentation. MATERIALS AND METHODS: Two male patients who missed maxillary posterior teeth were included. They were performed maxillary sinus floor augmentation using anorganic bovine bone xenograft(Bio-Oss(R) ). After 10 or 13 months, the regenerated tissues were harvested using trephine drills with 2 or 4mm diameter and non-decalcified specimens were made. The specimens were examined histologically and histomorphometrically to investigate graft resorption and new bone formation. RESULTS: Newly formed bone was in contact with Bio-Oss(R) particles directly without any gap between the bone and the particles. The proportions of newly formed bone were 23.4~25.3% in patient 1(Pt.1) and 28.8% in patient 2(Pt.2). And the proportions of remained Bio-Oss(R) were 29.7~30.2% in Pt.1 and 29.2% in Pt.2. The fixtures installed at augmented area showed good stability and the augmented bone height was maintained well. CONCLUSION: Anorganic bovine bone xenograft(Bio-Oss(R) ) has high osteoconductivity and helps new bone formation, so that it can be used in maxillary sinus floor augmentation.
Humans ; Male ; Mandrillus ; Maxillary Sinus ; Osteogenesis ; Sinus Floor Augmentation ; Tooth ; Transplants

PURPOSE: Many researches showed loss of alveolar bone in fresh extraction socket and even in case of immediate implant placement. The aim of this study was to evaluate the effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets. MATERIALS AND METHODS: Immediate implants were placed into artificially induced periapical lesion of mandibular premolars after complete debridement using buccal bone defect made by a 6mm trephine bur in 4 mongrel dogs. Before flap repositioning, a non-resorbable barrier membrane was placed on the buccal defect in the experimental group. No membrane was placed in the control group. In 12 weeks after placement, the dogs were sacrificed and undecalcified histologic specimens were prepared. The vertical distance from the smooth-rough surface interface(SRI) to gingiva, 1st bone contact and bone crest were measured in buccal and lingual side. The horizontal thicknesses of gingiva and bone at 0, 1, 2 and 3 mm below SRI were measured. RESULTS: The buccal bone was resorbed more than lingual bone in both groups and there was statistical significance(p<0.05). The distances from SRI to 1st bone contact were 2.45+/-2.35 mm in experimental group and 4.49+/-3.10 mm in control group. In all vertical level, lingual bone was thicker than buccal bone(p<0.05). CONCLUSION: Buccal bone was reduced more than lingual bone in immediate implant placement into periapically infected extraction sockets. Placement of non-resorbable barrier membrane reduced the buccal bone resorption. However there was no statistical significance.
Animals ; Bicuspid ; Bone Resorption ; Debridement ; Dogs ; Gingiva ; Hyoid Bone ; Membranes

BACKGROUND: TiUnite(TM) is a highly crystalline and phosphate enriched titanium oxide surface which has a unique porous surface structure. This improved implant surface enhances bone response and reduces healing period. It also assures early stability of implant. These help to increase the success of implant. The aim o f this s tudy i s to e valuate the survival r ate of TiUnite TM surfaced single implant. MATERIALS AND METHODS: A retrospective analysis of 89 TiUnite(TM) surfaced implants replacing a single tooth was assessed according to their dental record. The age of the patients ranged from 17 to 82 years (mean age: 45.8 +/- 14.6). Data were recorded regarding the survival rate of these implants. RESULTS: Fifty-two implants (57%) were placed in the maxilla, and 37 (43%) in the mandible. Over 75% were placed in the posterior area. Of the placed implants, 67% were the wide type, while 25% were the regular type and only 8% were of the narrow type. The single implants produced an overall clinical survival rate of 96.6% over the observation period (mean 17.9 months). Among 89 implants, only 2 implants were removed and one implant was submerged. CONCLUSION: According to t he se data, TiUnite(TM) surfaced implant in a single tooth restoration showed favorable survival rate although this study was done in a short term period.
Crystallins ; Dental Records ; Humans ; Mandible ; Maxilla ; Retrospective Studies ; Survival Rate* ; Titanium ; Tooth

BACKGROUND: Repeated dis/re-connection of implant abutment caused bone loss around implant fixtures due to the new formation of biologic width of the mucosal-implant barrier. The aim of this clinical study was to evaluate whether the repeated dis/re-connection of implant abutment cause bone loss clinically and the effect of cleansing methods on a bone loss during the early healing period. METHODS: A total 50 implants were installed in 20 patients and repeated dis/re-connection of abutment was performed at the time of surgery and once per week for 12 weeks. 0.9% normal saline solution as group1 and 0.1% chlorhexidine solution as group 2 was used to clean abutments. All patients had radiographs taken at the placement of implant and 4, 8, and 12 weeks postoperatively. The data for bone loss around implant were analyzed. RESULTS: The marginal bone loss at 12 weeks were 1.28+/-0.51mm, 1.32+/-0.57mm in the mesial and distal sides in group1, 1.94+/-0.75mm, 1.81+/-0.84mm in group 2, respectively. In view of marginal bone loss, there was not a significant statistical difference between groups. CONCLUSIONS: Repeated dis/re-connection of implant abutment may not cause marginal bone loss around implant fixture although limited samples and short-term observation period. In spite of more bone loss in group 2, there was no statistical significant difference between groups. In context of those results, the clinical significance of the repeated dis/re-connection of implant abutment and the cleansing method of abutments is debatable when it comes to marginal bone loss during early healing period.
Alveolar Bone Loss ; Chlorhexidine ; Humans ; Sodium Chloride

PURPOSE: The guided bone regeneration (GBR) technique is widely used in periradicular surgery. However, there is still some controversy regarding the effectiveness of GBR in promoting bone healing after periradicular surgery. The purpose of this study was to evaluate the resorbable membrane on the osteointegration of immediate implants in sites with periradicular lesion that had been removed by periradicular surgery. MATERIALS AND METHODS: Six roots of lower second premolars and 15 roots of lower third and fourth premolars of dogs were used as control and experimental teeth, respectively. Periradicular lesions were induced only in the experimental teeth. Twelve weeks later, the control and experimental teeth were extracted and implants were placed immediately. Periradicular lesions were removed with osteotomy, curettage and saline irrigation. Resorbable membranes were used in experimental group 1 but not in experimental group 2. After 12 week of healing period, the implants were clinically not mobile and showed no signs of infection. Data obtained by histomorphometric analysis were analyzed by Kruskal-Wallis test. RESULTS: The control group showed a significantly higher bone to implant contact (BIC) (74.14+/-16.18) than experimental group 1 (40.28+/-15.96) and 2 (48.70+/-17.75)(p<0.05). However, there was no significant difference between experimental group 1 and 2. CONCLUSION: Although BIC in experimental groups were lower than in control group, immediate implant can be successfully placed at extraction socket with periradicular lesion and osseous defect. However, the use of resorbable membrane in bony defect created during periradicular surgery was questioned.
Animals ; Bicuspid ; Bone Regeneration ; Curettage ; Dogs ; Membranes ; Nitrogen Mustard Compounds ; Osteotomy ; Tooth

Since the earliest descriptions of pain related to injury of the nervous system, it has been recognized that the characteristics of this type of pain differ markedly from those of pain due to nonneural tissue damage. Later as new analgesics were developed, it became clear that neurogenic pain was very often refractory to these drugs. Recently neuropathic pain is defined as "pain initiated or caused by a primary lesion or dysfunction in the nervous system." Inflammatory reaction and neuropathic pain are often considered to be distinct entities. The development of neuropathic pain involves not only neuron but also inflammatory cells, chemokines, and glial cells. Treatment of neuropathic pain is difficult and frequently unrewarding. The basic principles are (1)the identification and elimination of the underlying pathologic mechanism that maintains central sensitization; (2)the use of nonsteroidal anti-inflammatory drugs to reduce peripheral sensitization and modulate the activity of nociceptors; (3)the use of tricyclic antidepressants to induce sleep and decrease lancinating and burning neuropathic pain; (4)a trial of gabapentin, pregabalin, lamotrigine and topamax; (5)the use of lidocaine patch for intractable trigeminal neuralgia; (6)sympathetic blockade for complex regional pain syndrome while patients are stick sympathetically maintained; (7)dorsal column stimulation; (8)intrathecal therapies including morphine, clonidine, and GABAB agonists when other less invasive therapies have failed. In this article we reviewed the role of peripheral inflammation for development of neuropathic pain, diagnosis, and new opportunities for treatment of neuropathic pain, especially focused on medical treatments with antiepileptics and antidepressants.
Amines ; Analgesics ; Anticonvulsants ; Antidepressive Agents, Tricyclic ; Burns ; Chemokines ; Clonidine ; Cyclohexanecarboxylic Acids ; gamma-Aminobutyric Acid ; Humans ; Inflammation ; Lidocaine ; Morphine ; Nervous System ; Neuralgia ; Neuroglia ; Neurons ; Pregabalin ; Triazines

59 children seen from Jan. 1990 to Jun. 1994 with epilepsy were retrospectively reviewed to evaluate the tendency of recurrence and the risk factors after the antiepileptic drug discontinuation. The population consisted of 59 children who were seizure free for more than 2 years and followed up for more than 1 year after the discontinuation via department of pediatrics, Yonsei University, Wonju College of Medicine. We analyzed risk factors of recurrence(age of seizure onset, seizure frequency before treatment, interval from seizure onset to start of treatment, duration from neurologic disorders, and EEG done just before discontinuation) between non-recurrent group(43 patients) and recurrent group(16 patients). The results were as follows: 1) In 59 patients with epilepsy, 16(27.1%) patients showed recurrence after the discontinuation and 14(87.5%) patients of those were developed during taperring and within less than 1 year. The probability of recurrent seizure by Kaplan-Meier curve at 12 and 24 months after discontinuation are 23.7% and 33.6% respectively. 2) There were significant differences on seizure frequency before treatement, duration from start of treatment to control (9.5months vs 31.1months), and associated neurologic disorders(11.6% vs. 56.2%) between non-recurrent and recurrent group. 3) There were no significant differences on age at seizure onset(70.6 months vs. 58.5months), interval from seizure onset to start of treatment(9.5months vs. 6.6months), length of seizure free(49.7months vs 39.3months), abnormal EEG finding done just before withdrawal(23.2% vs. 25.0% ) between non-recurrent and recurrent group.
Child ; Electroencephalography ; Epilepsy* ; Gangwon-do ; Humans ; Nervous System Diseases ; Pediatrics ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Seizures