Digital immediate implantation and aesthetic immediate loading on maxillary incisor displaced due to root fracture: a case report

To obtain better esthetic results when immediately placing a dental implant, the soft tissue surrounding the implant must be conditioned during healing of the extraction socket. To this end, the emergence profile can be customized through immediate restoration of the provisional prosthesis, and good clinical results can be obtained at the time of definitive restoration in the future, resulting in high patient satisfaction. In this case, horizontal root fracture occurred after trauma to both maxillary central incisors.Immediate implant placement and loading was planned considering aesthetics and alveolar bone condition. By taking an impression using a digital intraoral scanner, a digital diagnostic wax-up was performed to make a more aesthetic prosthesis without applying external force to the traumatized teeth. Based on this, the ideal placement location was determined and immediate implant placement was performed using a 3D printed surgical guide. The provisional prosthesis was restored 5 days after placement, and the definitive zirconia crown was restored through soft tissue conditioning and customization using the shape of the provisional prosthesis for 3 months.

Improvement of peri-implant complications through customized prosthesis restoration allowing soft tissue space: a case report

The concept of ‘Implant Supracrestal Complex (ISC)’ was introduced as a way to determine the impact of implant prosthetic design form on both short-term clinical outcomes and the long-term prognosis of bone and soft tissues around the implant.Implant-prosthesis-abutment complex design forms, such as implant-abutment design, junction, and location, can have important implications for the stable and healthy long-term maintenance of the tissues around the implant. In this case, a customized concave abutment and a prosthesis with an emergence angle of about 30 degrees were restored to a patient suffering from chronic soft tissue inflammation and pain after restoration of an implant prosthesis. It was confirmed that the new prosthesis improved complications by allowing sufficient bone and soft tissue space, achieved appropriate soft tissue sealing, and maintained the longterm stability of the implant.

Association between Bone Mineral Density and Serum Iron Indices in Premenopausal Women in South Korea / 가정의학회지

Background@#Osteoporosis is characterized by a decrease in bone mineral density (BMD) and increased risk of fragility fractures. Serum iron level may interact with bone health status. This study investigated the correlations of BMD with serum iron level, hemoglobin level, and total iron-binding capacity (TIBC). @*Methods@#We performed a retrospective analysis of data from the medical records of premenopausal women in South Korea. The women’s BMDs and the Z scores of the BMDs were verified using dual-energy X-ray absorption. The participants were stratified into quartiles for analyses of the associations of BMD with serum iron level, TIBC, and hemoglobin level. @*Results@#A simple linear regression analysis revealed associations of changes in BMD with iron level (β=-0.001, standard error [SE]=0.001, P<0.001), hemoglobin level (β=0.015, SE=0.003, P<0.001), and TIBC (β=0.001, SE=0.001, P<0.001). This pattern was also observed in a multiple linear regression analysis. A multivariate logistic regression analysis of iron level and TIBC for low BMD revealed odds ratios of 1.005 (P<0.001) and 0.995 (P<0.001), respectively. @*Conclusion@#This study demonstrated clear relationships of changes in BMD with serum iron level and TIBC, and thus confirms the usefulness of these markers in the clinical evaluation of iron storage and BMD in younger women.

Large left atrial myxoma causing mitral annular dilation, functional mitral stenosis with concealed atrial septal defects / 대한마취과학회지

No abstract available.

Effect of ulinastatin on perioperative organ function and systemic inflammatory reaction during cardiac surgery: a randomized double-blinded study / 대한마취과학회지

BACKGROUND: This study evaluated the efficacy of ulinastatin for attenuating organ injury and the release of proinflammatory cytokines due to cardiopulmonary bypass (CPB) during cardiac surgery. METHODS: Patients undergoing valvular heart surgery employing CPB were assigned to receive either ulinastatin (group U, n = 13) or a placebo (group C, n = 11) before the commencement of CPB. Hemodynamic data, parameters of major organ injury and function, and proinflammatory cytokines were measured after the induction of anesthesia (T1), after CPB (T2), at the end of anesthesia (T3), and at 24 hours after surgery (POD). RESULTS: The demographic data, CPB duration, and perioperative transfusions were not different between the groups. PaO2/FiO2 in group U was significantly higher than that in group C at T3 (3.8 +/- 0.8 vs. 2.8 +/- 0.7, P = 0.005) and at POD (4.0 +/- 0.7 vs. 2.8 +/- 0.7, P < 0.001). Creatine kinase-MB at POD in group U was significantly lower than that in group C (17.7 +/- 8.3 vs. 33.7 +/- 22.1, P = 0.03), whereas troponin I at POD was not different between the groups. Creatinine clearance and the extubation time were not different between the groups at POD. The dopamine infusion rate during the post-CPB period in group U was significantly lower than that in group C (1.6 +/- 1.6 vs. 5.5 +/- 3.3 microg/kg/min, P = 0.003). The interleukin-6 and tumor necrosis factor-alpha concentrations at T1, T2, and T3 as well as the incidences of postoperative cardiac, pulmonary and kidney injuries were not different between the groups. CONCLUSIONS: Ulinastatin pretreatment resulted in an improved oxygenation profile and reduced inotropic support, probably by attenuating the degree of cardiopulmonary injury; however, it did not reduce the levels of proinflammatory cytokines.

Effect of preoperative warming during cesarean section under spinal anesthesia / 대한마취과학회지

BACKGROUND: Postoperative hypothermia and shivering is a frequent event in patients during cesarean section under spinal anesthesia. We assessed the effect of preoperative warming during cesarean delivery under spinal anesthesia for prevention of hypothermia and shivering. METHODS: Forty five patients undergoing elective cesarean section were randomly assigned to three groups. Group F received warmed intravenous fluid (40degrees C). Group A patients were actively warmed by forced air-warming. Group C was the control group. Forced air-warming and warmed fluid was maintained for the 15 min preceding spinal anesthesia. Core temperature (tympanic membrane) and the skin temperature of arm and thigh were measured and shivering was graded simultaneously. RESULTS: The core temperature at 45 min decreased less in Groups F and A than Group C (-0.5degrees C +/- 0.3degrees C vs -0.6degrees C +/- 0.4degrees C vs -0.9degrees C +/- 0.4degrees C, respectively; P = 0.004). The arm temperature at 15 min and 30 min exhibited a greater increase in Group A than Group F and Group C (P = 0.001 and P = 0.012, respectively). Leg temperature increased similarly among the three groups. The incidence of shivering was significantly less in Group A and Group F than Group C (20%, 13.3%, and 53.3%, respectively; P = 0.035). CONCLUSIONS: Preoperative forced air-warming and warmed fluid prevents hypothermia and shivering in patients undergoing elective cesarean delivery with spinal anesthesia.

Topical Epinephrine-soaked Gauze-induced Ventricular Tachycardia during Skin Grafting: A Case Report / 대한구급학회지

Topical epinephrine is useful to reduce bleeding during skin grafting. However, even though a clear operative field is obtained, systemic absorption of topical epinephrine can occur and this may cause severe hypertension, arrhythmias, ventricular tachycardia, myocardial ischemia, pulmonary edema, or cardiac arrest. We managed a case of cardiac arrhythmia during general anesthesia, which was induced by gauze soaked in topical epinephrine used for skin grafting of burn wounds. A 26-year-old woman developed premature ventricular complexes and ventricular tachycardia during surgery when epinephrine-soaked gauze was applied to the skin donor and burn wound sites to control oozing. The patient was resuscitated immediately and within 10 minutes the vital signs had normalized. It is recommended that caution is exercised when epinephrine-soaked gauze is applied to a large area of skin.