• Journal of the korean academy of Pediatric Dentistry
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• v.28 no.3
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• pp.421-429
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• 2001

Since Non-Extraction treatment in some orthodontic case shows unstable result and unfavorable profile, extraction is selected as inevitable treatment option for the harmonious profile, facial skeleton, and the stable dentition on both arches. For the achievement of proper goal, premolars, molars, sometimes incisors or canines are selected to be extracted. The first Premolar is usually extracted for relieving the crowded dentition with which the molar relations are class I to gain stable dentition and proper profile, but often results in the depression of profile or the loss of vortical dimension. On the contrary, the extracton of the second molar helps maintaining the fullness of profile and the vertical dimension, prevents additional space closural procedures which often make the procedures complicated, relieves both anterior and posterior crowding, and substitutes the extraction fossae for newly erupting 3rd molars. From the point of recurrence, the second molar extraction procedure, therefore, is more beneficial. This cases showed the good results of second molar extraction procedures in the patients with class I crowding.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.163-169
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• 2013

Designs of total elbow arthroplasty have been evolving with clinical experiences. Newer implants are expected to resolve current limitations and improve long term outcomes. This review article focuses on the basic knowledge of unlinked and convertible total elbow arthroplasty. There have been a variety of designs of unlinked total elbow prostheses. Some implants are still used in the market, while others are no longer commercially available. Modified and newer designs include more congruent contact surface, stemmed implant, and radiocapitellar arthroplasty. Two convertible elbow prostheses have been developed, and one implant is currently available in Korea. Conversion from an unlinked to a linked mode is performed by adding a linking cap. Unlinked total elbow arthroplasty, which restores native elbow kinematics, has a biomechanical rationale of lowering polyethylene wear and loosening of implants. It can be indicated in younger and higher demand patients, who have adequate bone stock and soft tissues. Convertible total elbow arthroplasty broadens implant selection and simplifies revision surgery. These newer prostheses possibly improve the long term outcomes and resolve disadvantages of linked prostheses in total elbow arthroplasty.

• Archives of Reconstructive Microsurgery
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• v.18 no.2
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• pp.55-61
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• 2009

Purpose: To analyze the clinical and radiologic results of the shoulder arthrodesis in brachial plexus injury patients with flail upper extremity. Material and Method: From Aug 1978 to April 2008, 29 shoulders in 29 patients with brachial plexus injury with shoulder fusion, we evaluated 20 shoulders in 20 patients, more than 1 year follow up. The average follow-up period was 6.45years (range: 1year~24years). There were 13 men and 7 women, and the mean age at the time of trauma was 32.0years(2~65 years). The type of injury was a motorcycle accident in 11 patients, in car accident in 5, pedestrian accident in 3, and fall from a height in 1. The lesion of injury was root and trunk in 1 patient, trunk and cord in 1, trunk in 18. Surgery was performed on the whole arm type paralysis in 12 patients, lower arm type paralysis in 8 patients. The preoperative visual analog scale score was 8.7(7~10). When the trapezius and serratus anterior muscle were in function, operation was performed. 18 patients were processed to the additional operation. Gracilis free flap in 6 patients, neurotization in 3, Steindler flexor plasty in 6, and tendon transfer in 3 were performed. Fixation was conducted with cancellous screws in 13 patients, Knoles pins in 5, and cancellous screws and Knoles pins in 2. The position of the arthrodesis at operation was $28.5^{\circ}$($20~45^{\circ}$) in abduction, $30.3^{\circ}$($20~45^{\circ}$) in flexion, and $30.8^{\circ}$($20~40^{\circ}$) in internal rotation. Result: The follow up visual analog scale score was 3.4(0~7). Postoperatively, shoulder spica cast was applied for 15.3weeks(8-20weeks). The median time to bony union was 17.7weeks(9~28weeks). Average range of motion was $32.0^{\circ}$($15~40^{\circ}$) of abduction, $24.0^{\circ}$($10~40^{\circ}$) of flexion, and $18.5^{\circ}$($10~30^{\circ}$)of internal rotation. Conclusion: The shoulder fusion in brachial plexus injury patients is one of the good methods to relieve pain, improve the function and stabilize the flail shoulder joint.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.44-52
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• 2009

Purpose: We assessed the radiographic and clinical results of one surgeon's experience treating proximal humerus fractures with a locked proximal humeral plate. Materials and Methods: Twenty patients with unstable proximal humerus fractures were treated with a locking compression plate between February 2005 and September 2007. The average age of the patients was 60.6 years, and the average postoperative follow-up period was 22.3 months. The clinical results were evaluated using the Constant and DASH scores. The radiologic results were evaluated by the Paavolainen method, which measures the neck shaft angle and humeral head height. Results: At the last follow-up examination, the mean Constant score was 75.3 and 15 cases (75%) had excellent or good results; the mean DASH score was 16.4. The mean neck shaft angle was $137.1^{\circ}$, and 19 cases (95%) had good results by the Paavolainen method. There was one delayed union, malunion, and screw loosening. Conclusion: The patients treated with a locking compression plate had relatively good clinical and radiologic results, and a low complication rate. Moreover, the patients could exercise earlier due to good reduction and initial stability. Treatment of unstable proximal humerus fractures with a locking compression plate is a reliable method.

• Clinics in Shoulder and Elbow
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• v.15 no.1
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• pp.8-15
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• 2012

Purpose: The object of this study was to investigate the difference in torque and pullout strength between the standard anchor insertion (5.0 mm) with a small awl (3.7 mm) and larger anchor insertion (6.5 mm), with a standard awl (5.0 mm) in osteoporotic humeral head. Materials and Methods: The embalmed 24 paired cadaveric shoulders were assigned to either Group A or B. After measuring the bone mineral density (BMD) of the ROI (region of interest) in the humeral head, 5.0 mm suture anchors were inserted using a 3.7 mm awl in Group A1, and the same 5.0 mm anchors were inserted using a 5.0 mm awl in Group A2. The 5.0 mm anchors were inserted using a 5.0 mm awl in Group B1, and 6.5 mm anchors were inserted using a 5.0 mm awl in Group B2. We measured the torques at the time of the anchor insertion and pullout strengths. Results: There was no significant difference in the BMD between the groups. The torque of A1 (20.6 $cN{\cdot}m$) was significantly higher than that of A2 (13.2 $cN{\cdot}m$), and the torque of B2 (20.8 $cN{\cdot}m$) was significantly higher than that of B1(12.1 $cN{\cdot}m$). However, the difference in the increased torque between group A and B was not significant. The pullout strength of A1 (204.2 N) was significantly higher than that of A2 (152.9 N), and the pullout strength of B2 (210.9 N) was significantly higher than that of B1 (149.5 N). However, the difference in the increased pullout strength between Group A and B was not significant. Conclusion: In severe osteoporosis, the use of a larger suture anchor with a standard awl increased the torque and pullout strength significantly, in comparison to the use of the same sized suture anchor and awl. If there is an inadequate interval between the anchors on the greater tuberosity, the use of a 3.7 mm awl and 5.0 mm anchor will be beneficial compared to that of a 5.0 mm awl and 6.5 mm anchor, considering that an increase in the pullout strength does not depend on the awl size.

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.126-152
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• 2003

The purpose of this study was to evaluate the value of passive caudal gliding mobilization of the glenohumeral joint on the range of motion (ROM) of active and passive abduction; to evaluate the value of pain relief through visual analogue scale (VAS); to evaluate the correlation between improvement of shoulder abduction and intra-articular movement measured by fluoroscopy in frozen shoulder patients. The subjects consisted of twenty-one patients with clinically diagnosed frozen shoulder (11 males, 10 females) between 40 and 63 years of age (mean age : 52.7 years). The traction and caudal gliding mobilization based on the convex-concave rule in the resting position and at end range of abduction was peformed for 15 minutes per day and was repeated 10 times during a 2 week period. The ROM of abduction was measured by goniometer and pain was measured by VAS. The intra-articular movement was measured by fluoroscope, Neurostar Plus TOP (Siemens, Germany). ROM measurements of each patient was acquired at pre-treatment, immediate post-treatment and 2 week post-treatment. Statistical analysis was performed using SPSS 10.0 for Windows software and data was analyzed using the paired-test and the pearson correlation. The results of this study are as follows: 1. There was a significant decrease of VAS between pre-treatment data and 2 week post-treatment data (P<.05) but no significant difference between pre-treatment and immediate post-treatment data (P>.05). 2. There was a significant increase in ROM of active and passive abduction in the pre-treatment data, immediate post-treatment data, and in 2 week post-treatment data (P<.05). 3. With regard to results of the joint play test, there was a significant difference in the grade of traction between pre-treatment data and immediate post-treatment data and between pre-treatment data and 2 week post-treatment data (P<.05). There was no significant difference between immediate post-treatment data and 2 week post-treatment data (P>.05). 4. With regard to results of the joint play test, there was a significant difference in the grade of caudal gliding between pre-treatment data and immediate post-treatment data and between pre-treatment data and 2 week post-treatment data (P<.05). There was no significant difference between immediate post-treatment data and 2 week post-treatment data (P>.05), 5. With regard to the results of fluoroscopic findings, there was a significant change of the glenohumeral joint space between pre-treatment data and immediate post-treatment data and between immediate post-treatment data and 2 week post-treatment data (P<.05). There was no significant change of the glenohumeral joint space between immediate post-treatment data and 2 week post-treatment data (P>.05). 6. With regard to the results of fluoroscopic findings, there was a significant change of acromiohumeral joint space between the three data (pre-treatment data, immediate post-treatment data, 2 week post-treatment data) (P<.05). 7. Mobility grade by joint play test was significantly increased and was correlated to improved ROM of active and passive abduction (P<.05). In this study of frozen shoulder, passive caudal gliding techniques of the glenohumeral joint results in statistically significant changes in active and passive abduction as well as in VAS. There is also a significant correlation between joint play test and ROM of abduction.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.4
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• pp.359-370
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• 2012

The endodontically treated tooth is generally restored with post and core, owing to the brittle and the loss of large amount of tooth structure. The purpose of this study was to evaluate the clinical status of fixed prostheses to improve the quality of dental care. In order to assess the clinical status of fixed prostheses, a total of 101 individuals (aged 30-89, 66 women and 35 men loaded with 125 fixed prostheses) who treated in the Department of Prosthodontics, Pusan National University Dental Hospital, between January 1990 to December 2005 were examined. The results of this study were as follows: 1. Length of service of fixed prostheses was $9.7{\pm}3.4$ years (mean), 11.1 years (median). 2. Age and sex of patient was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 3. Location of fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longevity of fixed prostheses was low in anterio-posterior combination region (median:9.2 years). 4. Longevity of fixed prostheses made of base metal ceramic(median:12.0 years) and noble metal ceramic (median:11.3 years) is long (P<.05). 5. Number of units in fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 6. Condition of opposing dentition was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 7. Dental caries, periapical disease, tooth fracture were frequent complications. In 51.9% of the cases, abutment state after removing fixed prostheses was needed to be extracted.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.2
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• pp.88-94
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• 2020

Purpose: The purpose of this study was to analyze the sagittal root position of maxillary anterior teeth and report the frequency of each classification in Korean for immediate implant placement. Materials and Methods: A retrospective review of cone-beam computed tomography (cone-beam CT) images was conducted on 120 patients (60 male and 60 female) who fulfilled the inclusion criteria. After reorientation of the axis, cone-beam CT images were evaluated and the relationship of the sagittal root position (SRP) of the maxillary anterior teeth to its associated osseous housing was recorded. Class I, II, and III were classified respectively when the root was positioned on the labial, central, and palatal aspect of the alveolar bone. Class IV was the position that at least two thirds of the root is engaging both the labial and palatal cortical plates. Then, the angulation of the root axis and the alveolar bone axis was measured. Descriptive statistics and Kruskal-Wallis test were used to compare the angulation according to the root position and SRP class. Results: The frequency distribution of sagittal root position of maxillary anterior teeth indicated that 81.1%, 10.3%, 1.9%, and 6.7% were classified as Class I, II, III, and IV, respectively. The sagittal angulation at approximately 77.5% of central incisor, lateral incisor, and canine was < 20 degrees, but the angle at more than 42.7% of canine was ≥ 20 degrees. Within the class, the angulation was statistically significantly greater in Class I (16.19) compared to Class II (8.72) and Class III (9.93), and smaller in Class IV (3.79). Conclusion: Within the limitation of this study, a majority of the maxillary anterior roots were positioned close to the buccal cortical plate. However, some roots have very thin alveolar bone and sagittal angulation larger than 30 degrees. Therefore, cone-beam CT analyses of the sagittal root position and the sagittal angulation are recommended for the selection of the appropriate dental implant treatment approach.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.61-66
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• 2009

Purpose: Several authors have reported excellent results of delayed reconstruction of non-union & malunion in displaced mid-shaft fractures of the clavicle and these results were equal to that of immediate fixation. But direct comparison between these treatments is rare. We evaluated the results between the immediate fixation group and delayed reconstruction group for treating displaced mid-shaft fractures of the clavicle. Materials and Methods: We studied the results of 18 cases with immediate fixation of displaced mid-shaft fractures of the clavicle and 15 cases with delayed reconstruction of non-union & malunion after conservative management, and these cases were seen from March 2000 to February, 2006. The final postoperative outcome was analyzed according to the clinical outcomes with using the Constant score and the radiological findings of bony union. Results: The constant score was low in the delayed reconstruction group compare to that of the immediate fixation group (p value=0.045). For the pain score & the activities of daily living score, a statistically significant difference was seen between the two groups (p<0.05), but not for the range of motion score & the power score (p>0.05). Radiological findings of bony union were seen for both groups at an average of 8.8 weeks for the immediate fixation group and at an average of 9.8 weeks for the delayed reconstruction group. Conclusion: Though the delayed reconstruction group was shown good clinical and radiological results, the immediate fixation group had a significantly better pain score, a better activities of daily living score and a better Constant score. It is important to choose the initial treatment option for displaced mid-shaft fractures of the clavicle after sufficient explanation to patients about the merits and demerits between these two treatment options.