ABSTRACT
Excessive occlusal wear can result in unacceptable damage to the residual teeth structure, anterior guidance and masticatory function. An 86-year-old man presented with worn dentition and anterior deep bite due to loss of the posterior support. Two implants covered by Korean national health insurance, fixed partial denture and direct composite resin were used to restore the dentition, instead of removable prosthesis. The occlusal vertical dimension was increased by 2 mm in the premolar area and shortened dental arch concept was applied. This treatment was a less expensive alternative to full-mouth rehabilitation with positive esthetic and functional outcomes after 7 months of follow-up.
Subject(s)
Aged, 80 and over , Humans , Bicuspid , Dental Arch , Dental Implants , Dentition , Denture, Partial, Fixed , Follow-Up Studies , National Health Programs , Overbite , Prostheses and Implants , Rehabilitation , Tooth , Tooth Attrition , Tooth Wear , Vertical DimensionABSTRACT
Tooth wear is known as a normal physiological process which gradually progresses. It is reported that vertical dimension can be kept stable because amount of physiologically worn loss could be compensated by growth of alveolar bone and tooth eruption. However, excessive tooth wear as pathologic wear can cause pathologic pulp, disharmony with occlusal plane, functional disorders and esthetic problems so that full mouth rehabilitation could be needed in these cases. Recovery of function and esthetic improvement should be considered for alteration of the vertical dimension. Determination of the vertical dimension of occlusion is needed to be in harmony with the neuromuscular system. This clinical report describes 36 year-old female patient who had chief complaint of severely worn dentition and esthetic discomfort. An increase of 2.0 mm at maxillary incisal edge was done to restore vertical dimension. It was based on the degree of tooth wear and esthetics.
Subject(s)
Female , Humans , Ceramics , Dental Occlusion , Dentition , Esthetics , Mouth Rehabilitation , Physiological Phenomena , Recovery of Function , Rehabilitation , Tooth Eruption , Tooth Wear , Tooth , Vertical DimensionABSTRACT
Tooth wear is known as a normal physiological process which gradually progresses. It is reported that vertical dimension can be kept stable because amount of physiologically worn loss could be compensated by growth of alveolar bone and tooth eruption. However, excessive tooth wear as pathologic wear can cause pathologic pulp, disharmony with occlusal plane, functional disorders and esthetic problems so that full mouth rehabilitation could be needed in these cases. Recovery of function and esthetic improvement should be considered for alteration of the vertical dimension. Determination of the vertical dimension of occlusion is needed to be in harmony with the neuromuscular system. This clinical report describes 36 year-old female patient who had chief complaint of severely worn dentition and esthetic discomfort. An increase of 2.0 mm at maxillary incisal edge was done to restore vertical dimension. It was based on the degree of tooth wear and esthetics.
Subject(s)
Female , Humans , Ceramics , Dental Occlusion , Dentition , Esthetics , Mouth Rehabilitation , Physiological Phenomena , Recovery of Function , Rehabilitation , Tooth Eruption , Tooth Wear , Tooth , Vertical DimensionABSTRACT
INTRODUCTION: This study compared the alveolar bone density of the mandible according to gender, age and position using Cone-beam computed tomography (CT). MATERIALS AND METHODS: The maxillofacial CT scan data was obtained from 60 Korean patients. In addition, the alveloar bone density of 5 males and 5 females with normal occlusion aged from 10 to 70 years was measured at the buccal cortical bone, cancellous bone and lingual cortical bone, as well as at the position of the incisors, canines, premolars and molars. RESULTS: The age-specific mean bone density was highest in patients in their third decade. The buccal cortical bone of the molars showed the highest bone density. Males in their fifties and sixties had a higher bone density in the cancellous bone in the region of the premolars and the buccal cortical bone of the molars, respectively, than females but there was no significant difference between males and females in the other parts. The cancellous bone density was highest in those in their twenties and thirties, and tended to decline up to their seventh decade. CONCLUSION: These results revealed a significantly different bone density according to gender, age and position in the Korean population. In addition, it is possible to predict the bone density based on these results.
Subject(s)
Aged , Female , Humans , Male , Aging , Bicuspid , Bone Density , Cone-Beam Computed Tomography , Incisor , Mandible , MolarABSTRACT
STUDY DESIGN: This is a retrospective study. OBJECTIVES: We wanted to compare the clinical and radiographic outcomes of laminoplasty and laminectomy & fusion to treat multilevel cervical spondylosis. SUMMARY OF LITERATURE REVIEW: Laminoplasty and laminectomy & fusion are being increasingly used to treat multilevel cervical spondylosis, but definitive guidelines have not yet been established. MATERIALS AND METHODS: Fifty eight patients who were followed up for more than a year and who were treated for multilevel cervical spondylosis with either laminoplasty or laminectomy & fusion between March 2000 and March 2009 were reviewed. Twenty eight patients who underwent laminectomy & fusion were matched with 30 patients who underwent laminoplasty. RESULTS: The laminoplasty group showed statistically significant improvements in the Japanese Orthopaedic Association (JOA) score and Visual analogue scale (VAS) score. The cervical lordosis for the preoperative and latest sagittal alignment in the laminoplasty group decreased from 14 degrees to 5 degrees and the cervical kyphosis in the laminectomy & fusion group increased from 10 degrees to 15 degrees with no statistically significant difference. However, 3 cases with less than 5 degrees of cervical lordosis in the laminoplasty group showed progression of kyphosis at the last follow-up. CONCLUSIONS: The clinical outcomes of laminoplasty for multilevel cervical spondylosis were better than those of laminectomy & fusion. However, it is considered that additional study for laminectomy & fusion is needed to prevent the long-term progress of cervical kyphosis in cases with preoperatively decreased cervical lordosis of less than 5 degrees, though it is impossible to make such comparisons with the small number of cases in our study.
Subject(s)
Animals , Humans , Asian People , Follow-Up Studies , Kyphosis , Laminectomy , Lordosis , Retrospective Studies , SpondylosisABSTRACT
STUDY DESIGN: A retrospective study. OBJECTIVES: To evaluate the clinical results of surgical treatment for a lower lumbar fracture with a neurological deficit. SUMMARY OF LITERATURE REVIEW: There are several methods for treating lower lumbar fractures with neurological deficits but no definitive guidelines have been established. MATERIALS AND METHODS: From 2000 to 2008, this study reviewed 26 patients who had undergone surgery to treat a lower lumbar fracture with a neurological deficit and could be followed up for more than 12 months. The changes in the kyphotic angle, changes in the vertebral body height, compromise ratio of the spinal canal, recovery of neurological deficit, and clinical results were evaluated. RESULTS: There were 15, 7 and 4 cases with a third, fourth and fifth lumbar fracture, respectively. There are 19, 2 and 5 cases of an unstable bursting fracture, chance fracture and translational injury, respectively. The compromise ratio of the spinal canal improved from 67.2+/-9.4% to 16.4+/-4.6%, and the changes in the kyphotic angle improved from 14.5+/-3.2degrees to 7.6+/-2.4degrees postoperatively and 9.7+/-4.3degrees at the last follow-up. The changes in the vertebral body height improved from 41.3+/-8.4% to 23.4+/-6.3% and the bone union rate was 92.3%. The neurological deficit recovered with 1.27degrees according to the Frankel classification and good functional results were obtained in 84.6% of cases. CONCLUSIONS: Recovery of the neurological deficit and good clinical results were obtained with the recovery of the kyphotic angle and bone union with posterior decompression and instrumented posterolateral fusion in lower lumbar fractures with a neurological deficit.
Subject(s)
Humans , Body Height , Classification , Decompression , Follow-Up Studies , Retrospective Studies , Spinal Canal , Treatment OutcomeABSTRACT
PURPOSE: To document the incidence and analyze the causes of anterior knee pain following closed intramedullary nailing for tibial fractures. MATERIALS AND METHODS: Between January 2005 and February 2007, 50 tibial fractures (48 patients) were treated using locked intramedullary nails. We examined the relationship between postoperative anterior knee pain and age, gender distribution, mechanism of injury, cause and type of fracture, method of patellar tendon incision, and position of the nails on radiography. Anterior knee pain was assessed using a visual analogue scale (VAS). Pearson chi-square test was used to assess the incidence of knee pain. RESULTS: At a mean follow-up period of 16 months (range 13-30 months), 23 cases (46%) had developed anterior knee pain. Knee pain was more common in woman (p=0.000), but there was no statistically significant difference with regard to age, cause or type of fracture, reaming or incision technique. If the knee apex distance was below -30 mm on radiological analysis, there was no statistically significant increase in postoperative knee pain (p=0.000). Nail removal resolved or improved the symptoms in 77% of patients with anterior knee pain. CONCLUSION: Based on these data, nail prominence correlated with increased knee pain. We believe surgeons can decrease the severity of knee pain after tibial nailing by burying the tip of the nail as reflected on lateral radiographs.
Subject(s)
Female , Humans , Follow-Up Studies , Fracture Fixation, Intramedullary , Incidence , Knee , Nails , Patellar Ligament , Tibial FracturesABSTRACT
PURPOSE: To predict the feature and stability of intertrochanteric fractures with posterior fragment using preoperative 3D computed tomography and to investigate the importance of the posterior fragment in treatment of unstable intertrochanteric fracture. MATERIALS AND METHODS: 15 cases of unstable fractures with posterior fragment which were treated with nail only between October 2006 to August 2007 were classified into 2 groups: study group (5 cases with cannulated screw fixation of posterior fragment) and control group (10 cases without cannulated screw fixation). The average difference of neck-shaft angle, neck screw sliding distance and the complications in the two groups were compared retrospectively after a follow up of at least 3 months. RESULTS: The average difference of neck-shaft angle in study and control group was 3.8 and 7.5 degree (p>0.05), respectively. The average difference of neck screw sliding distance was 1.6 and 6.6 mm (p<0.05), respectively. Complication which required reoperation was not noted in study group and complications of 3 cases about neck screw lateral protrusion, proximal migration and Z-effect phenomenon were noted in control group. CONCLUSION: The recognition and fixation of the posterior wall was found to be an important predictive factor in unstable intertrochanteric fracture treatment.
Subject(s)
Follow-Up Studies , Hip Fractures , Nails , Neck , Reoperation , Retrospective StudiesABSTRACT
OBJECTIVE: In order to investigate Korean children's developmental friar-anxiety theme and it's nature, self-rating Fear-Anxiety Survey Schedule far children was designed and applied to general population. Reliability and validity of this scale were tested. METHOD: Korean version of Fear-Anxiety Survey Schedule for Children(FASSC) was administered to 365 elementary school children and 211 middle school adolescents. The self-rating scale was developed from Ollendick's Revised Survey Schedule for Children(FSSC-R). Some anxiety theme items were newly added and some overlapping FSSC-R items were deleted. Total 59-items questionaire form also was modified from 3-point degree checking forms to 3-point degree frequency ones. RESULTS: 1) FASSC turned out to be a better suNey tool than FSSC-R in relibility, concurrent validity, factor structure, and internal consistency. 2) Five subfactor scores by age and sex were consistent with previous known developmental change of fear-anxiety theme. 3) We considered that FASSC represented more friar-related aspect than the anxiety one, because FASSC total score decreased with age. CONCLUSION: For the purpose of applying survey schedule to clinical population and differentiation study between friar and anxiety, pure Korean version of Anxiety Survey Schedule for Children that containing only anxiety themes without fear ones.