• The korean journal of orthodontics
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• v.38 no.6
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• pp.397-406
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• 2008

Objective: The purpose of this study was to provide clinical guidelines to indicate the best location for mini-implants as it relates to the cortical bone thickness and root proximity. Methods: CT images from 14 men and 14 women were used to evaluate the buccal interradicular cortical bone thickness and root proximity from mesial to the central incisor to the 2nd molar. Cortical bone thickness was measured at 4 different angles including $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, and $45^{\circ}$. Results: There was a statistically significant difference in cortical bone thickness between the second premolar/first permanent molar site, central incisor/central incisor site, between the first/second permanent molar site and in the anterior region. A statistically significant difference in cortical bone thickness was also found when the angulation of placement was increased except for the 2 mm level from the alveolar crest. Interradicular spaces at the 1st/2nd premolar, 2nd premolar/1st permanent molar and 1st/2nd permanent molar sites are considered to be wide enough for mini-implant placement without root damage. Conclusions: Given the limits of this study, mini-implants for orthodontic anchorage may be well placed at the 4 and 6 mm level from the alveolar crest in the posterior region with a $30^{\circ}$ and $45^{\circ}$ angulation upon placement.

• The korean journal of orthodontics
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• v.40 no.3
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• pp.167-175
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• 2010

Objective: The aim of this study was to validate the Periotest values for the prediction of orthodontic mini-implants' stability. Methods: Sixty orthodontic mini-implants (7.0 mm $\times$ $\emptyset1.45$ mm; ACR, Biomaterials Korea, Seoul, Korea) were inserted into the buccal alveolar bone of 5 twelve month-old beagle dogs. Insertion torque (IT) and Periotest values (PTV) were measured at the installation procedure, and removal torque (RT) and PTV were recorded after 12 weeks of orthodontic loading. To correlate PTV with variables, the cortical bone thickness (mm) and bone mineral density (BMD) within the cortical bone and total bone area were calculated with the help of CT scanning. Results: The BMD and cortical bone thickness in mandibular alveolus were significantly higher than those of the maxilla (p < 0.05). The PTV values ranged from -3.2 to 4.8 for 12 weeks of loading showing clinically stable mini-implants. PTV at insertion was significantly correlated with IT (-0.51), bone density (-0.48), cortical bone thickness (-0.42) (p < 0.05) in the mandible, but showed no correlation in the maxilla. PTV before removal was significantly correlated with RT (-0.66) (p < 0.01) in the mandible. Conclusions: These results show that the periotest is a useful method for the evaluation of mini-implant stability, but it can only be applied to limited areas with thick cortical and high density bone such as the mandible.

• 대한치주과학회:학술대회논문집
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• 2005.11a
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• pp.167-167
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• 2005

• The korean journal of orthodontics
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• v.38 no.3
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• pp.187-201
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• 2008

Objective: The aim of this study was to determine whether cortical punching stimulates the expression of matrix metalloproteinase-1, -8, and -13 in orthodontic tooth movement in rats. Methods: A total of 32 male sprague-dawley rats at 15 weeks old were divided into two groups of 16 rats each, to form the tooth movement with cortical punching (TMC) group and tooth movement only (TM) group. A total of 20 gm of orthodontic force was applied to rat incisors to cause experimental tooth movement. Cortical punching was performed on the palatal side near the central incisor with a 1.0 mm width microscrew in the TMC group. The duration of tooth movement was 1, 4, 7, and 14 days. Results: Measurements of the mRNA expression were selected as the means to determine the identification of expression of MMP-1, -8, and -13. In the TMC group, the expression of collagen type I was greater than that of the TM group from day 4 to day 14. Expression of TIMP-1 in the TM group was greater than that of the TMC group in the pressure side of PDL and alveolar bone cell at day 4. In the TMC group, TIMP-1 was expressed at the osteoclast, but not at the tooth surface of the TM group at day 14, Maximum induction of the mRNA of MMP-1 was observed on day 4 in the TMC group, but it was observed on day 7 in the TM group. MMP-8 mRNA of the TMC group was twice greater than that of the TM group at f days. In the TMC group, maximum induction of MMP-13 mRNA was observed on day 1. Conclusions: These findings suggested that cortical punching can stimulate remodeling of PDL and alveolar bone connective tissues during experimental orthodontic tooth movement in rats.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.3
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• pp.255-265
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• 2009

Recently many studies have been published on application of immediate loaded implants. However, the immediate loading protocol has not been well documented. The purpose of the present study was to evaluate the stress distribution between bone-implant interfaces and the effect of implant length in the anterior maxilla using 3 dimensional finite element analyses. The diameter 4.0 mm threaded type implants with different length(8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm) were used in this study. The bone quality of anterior maxillary bone block was assumed to D3 bone. Bone-implant interfaces of immediately loaded implant were constructed using a contact element for simulating the non osseointegration status. For simplification of all the processing procedures, all of the material assumed to be homogenous, isotropic, and linearly elastic. The 178 N of static force was applied on the middle of the palatoincisal line angle of the abutment with $120^{\circ}$ angle to the long axis of abutment. Maximum von Mises stress were concentrated on the labial cortical bone of the implant neck area, especially at the cortical-cancellous bone interfaces. Compared the different length, highest peak stress value was observed at the 8.5 mm implants and the results indicated a tendency towards favorable stress distribution on the bone, when the length was increased. Presence of cortical bone was very important to immediate loading, and it appears that implants of a length more than 13 mm are preferable for immediate loading at the anterior maxilla.

• Journal of the Korean Orthopaedic Association
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• v.55 no.5
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• pp.405-410
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• 2020

Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.1
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• pp.47-57
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• 2010

An undisturbed healing process without micromotion at the implant-bone interface is essential for achievement of osseointegration of dental implant. Therefore, initial stability was advocated as prerequisite for successful clinical outcome. Adequate bone quality and quantity were important to achieve initial stability and to prevent early failures. However there were few published data available regarding the effect of design change in implant geometry on initial stability of the implants. The purpose of the current study was to assess the initial stability of various designs of implants when placed into artificial bone materials of varying qualities and shapes of insertion holes. Within the scope of this study, the following results were drawn. Bone quality was major importance to achieve initial stability. Initial stability was higher on GS II which had additional design feature of double thread. With a tapered design of implant such as GS III showed a higher initial stability than straight one. An insertion hole with the similar shape of implant would lead to reduce a compression force on cortical bone and enhance a bone anchorage on cancellous bone.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.3
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• pp.214-221
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• 2011

Purpose: To date most of finite element analysis assumed the presence of 100% contact between bone and implant, which is inconsistent with clinical reality. In human retrieval study bone-implant contact (BIC) ratio ranged from 20 to 80%. The objective of this study was to explore the influence of bone-implant contact pattern on bone of the interface using nonlinear 3-dimensional finite element analysis. Materials and methods: A computer tomography-based finite element models with two types of implant (Mark III Br${\aa}$nemark$^{(R)}$, Inplant$^{(R)}$) which placed in the maxillary 2nd premolar area were constructed. Two different degrees of bone-implant contact ratio (40, 70%) each implant design were simulated. 5 finite element models were constructed each bone-implant contact ratio and implant design, and sum of models was 40. The position of bone-implant contact was determined according to random shuffle method. Elements of bone-implant contact in group W (wholly randomized osseointegration) was randomly selected in terms of total implant length including cortical and cancellous bone, while ones in group S (segmentally randomized osseointegration) was randomly selected each 0.75 mm vertically and horizontally. Results: Maximum von Mises strain between group W and group S was not significantly different regardless of bone-implant contact ratio and implant design (P=.939). Peak von Mises strain of 40% BIC was significantly lower than one of 70% BIC (P=.007). There was no significant difference between Mark III Br${\aa}$nemark$^{(R)}$ and Inplant$^{(R)}$ in 40% BIC, while average of peak von Mises strain for Inplant$^{(R)}$ was significantly lower ($4886{\pm}1034\;{\mu}m/m$) compared with MK III Br${\aa}$nemark$^{(R)}$ ($7134{\pm}1232\;{\mu}m/m$) in BIC 70% (P<.0001). Conclusion: Assuming bone-implant contact in finite element method, whether the contact elements in bone were wholly randomly or segmentally randomly selected using random shuffle method, both methods could be effective to be no significant difference regardless of sample size.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.73-78
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• 2011

Purpose: This study was aimed to evaluate the result of inlay cortical strut bone grafts for large cysts or cavitary bone lesions in long bones. Materials and Methods: Seven patients with large cyst or cavitary bony lesions were managed with curettage, allogeneic inlay cortical strut and cancellous bone grafts. Additional plate and screw fixations were performed in 6 patients. There were three SBCs, two FDs with secondary ABC changes, one FD and one post-cement spacer removal state. Three of them had pathologic fractures. Progression of bone healing and mechanical support and functional result were evaluated. The mean follow-up period was 25.4 months. Results: Incorporations into host bones were progressed in all, average 4.2 months in six metaphyseal regions and 5.8 months in five diaphyseal regions respectively. Full structural supports were achieved in all except one patient without any additional procedures. No allograft-related complication was developed. Mean functional score according to the MSTS criteria was 29.6 at last follow up. Conclusion: Inlay cortical strut graft provided additional mechanical stability and bone stock for screw purchase in large cyst or cavitary defects of long bones, which allow early mobilization and excellent functional outcome.

• The korean journal of orthodontics
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• v.31 no.1 s.84
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• pp.97-105
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• 2001

In many cases of orthodontic treatment the upper anterior teeth are retracted. Periodontal problems may arise during incisor retraction, if the amount of tooth movement and the amount of remodeling in the anterior cortical bone are not the same. Therefore in this study, to find out the relationship between the amount of tooth movement and the amount of bone remodeling during retraction of the upper anterior teeth, lateral cephalograms of 56 female patients over 18-year-old were taken before and after treatment. Among the 56 patients, two groups were divided according to the type of root movement during retraction. 26 patients mainly moved by tipping and 30 by bodily movement. The cephalograms taken before and after treatment were superimposed upon the true horizontal plane. In the Tip-Group, the horizontal bone remodeling/tooth movement ratio was 1:1.63, and in the Torque-Group it was 1:1.66. Because the amount of tooth movement and the amount of bone remodeling were not the same in both groups, in the Tip-Group the root apex moved away from the palatal cortical plate and closer to the labial cortical plate, whereas in the Torque-Group the root moved away from the labial cortical plate and closet to the palatal cortical plate. Therefore, there are limitations in the amount of incisor retraction in patients with a very thin anterior cortical plate in the maxilla, and in patients with severe skeletal discrepancies orthognathic surgery should be considered and when orthodontic camouflage treatment is the only possible method, the orthodontist must be aware of the limitations of treatment.