Background: Radial neck fracture in children is rare. This study attempted to evaluate the outcome of surgically treated patients and any associated complications. Methods: This study evaluated 23 children under 15 years of age with radial neck fracture who were treated with open reduction between 2006 and 2016 to determine their range of motion, postoperative complications, and radiographic outcomes. The results were assessed clinically using the Mayo clinic elbow performance score. Results: The mean follow-up duration for patients was 34.6 months. The average postoperative angulation was 3.6°. Hypoesthesia was reported in only 9% of patients, and none of the patients complained of postoperative pain. The postoperative X-ray results were excellent in 60% and good in 40%. No radiographic complications were identified. The elbow score was excellent in 87% and good in 13% (mean score, 96.74). There was a statistical relationship between range of motion limitations and age, degree of fracture, initial displacement, and surgical pin removal time. Conclusions: Although most patients accept the closed reduction method as a primary treatment, the present study suggests that an open-reduction approach has been associated with optimal therapeutic outcomes for patients in whom closed reduction was not satisfactory or indicated.
Minyoung Yang;Hyuntae Kim;Ji-Soo Song;Teo Jeon Shin;Hong-Keun Hyun;Young-Jae Kim;Jung-Wook Kim
대한소아치과학회지
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제51권3호
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pp.310-320
/
2024
Impaction of the tooth can cause functional and esthetic problems, so early intervention is critical. This report describes two cases of orthodontic traction of impacted mandibular canine and mandibular premolar teeth using a modified mandibular lingual arch soldered with traction hooks rather than a conventional orthodontic appliance. By planning the position and shape of the traction hooks with consideration for the three-dimensional position and angulation of the impacted teeth, clinicians can apply the intended direction and magnitude of traction force. Furthermore, this appliance can be used for multiple impacted teeth in various locations within the mandibular arch by modifying the position and shape of the traction hooks.
The purpose of this study was to establish the principle and the clinical application of dynamic tomogram of a human head by using the dental machine. For this study, a block of wax with details lying at three parallel planes and a human dry skull were used. This experiment was reexamined the dynamic tomogram with specialized radiographic device and view box, and the radiograms taken by the change of exposure time according to the numbers of film used in x-ray taking and taken according to the change of kVp and the types of film were analyzed density with the densitometer. From this study, the obtained results were as follows: 1. When the underexposed radiograms taken by angulation of clockwise and counter-clockwise direction of the film and skull. were superimposed and moved laterally, it was possible to focus on right and left jaws and teeth. 2. The superimposition of the two underexposed radiograms according to each condition of x-ray taking showed some differencies in density visually, and the measurement of density with the densitometer was 1.23 to 1.57 in 75kVp and 1.34 to 1.70 in 90kVp. 3. The superimposition of the two underexposed radiograms according to the kinds of x-ray film showed almost equal density visually, and the measurement of density with the densiometer was 1.34 to 1.37. 4. When seven radiograms taken by each condition of x-ray taking were superimposed on the view box, a intense rear light of view box didn't transilluminate film density regardless of the conditions of x-ray taking. Even though seven radiograms taken according to types of film were superimposed on the view box, a more intense rear light of view box was required to transilluminate total density of films. 6. Long film-object distance resulted in the enlargement and blurring of radiographic images.
Purpose: The aim of this study is to identify the usefulness of unilateral mandibular angle ostectomy, so-called "Lateral Angle Reduction", in asymmetric prognathism patients by the assessment of postoperative stability and esthetic results Patients and methods: For the retrospective study, 10 skeletal class III mandibular asymmetry patients who were performed SSRO and unilateral mandibular angle ostectomy, Lateral Angle Reduction, was selected. Lateral and posterioanterior cephalogram was taken before surgery (T0), 1day after surgery (T1) and 6month after surgery (T2). To know the esthetic results the facial width and lateral facial contour were examined on posterioanterior cephalogram and to know the postoperative stability B point and Incisor inferius was examined on lateral cephalogram. Statistical analysis was performed. Results: From T0 to T1, Intergonial width was significantly decreased, dominantly at shortened side but no significant changes at lengthened side. Those were well-maintained during 6 months. Lateral facial angle and Ramus angle was significantly decreased on only shortened side from T0 to T1. As a result, after surgery, there were no significant differences in all measurements between shortened side and lengthened side. Ramus deviation angle in shortened side and ramus angle in lengthened side which reflect the angulation of ramus on frontal plane didn't show significant changes after surgery and during postsurgical periods. Lower dental midline showed no statistical changes during postsurgical period. The relapse rate on B-point was 11.92%. Conclusion: Unilateral "Lateral angle reduction" in the asymmetric mandible is valuable to obtain the narrow lower face and symmetric facial contour with a good stability.
The purpose of orthodontic treatment is to produce functional occlusion and to create or maintain facial esthetic harmony. The soft-tissue covering of the face also plays an important role in facial esthetics, speech and other physiologic functions. The study of the soft-tissue profile is important for the planning of orthodontic treatment. The author studied cephalometric X-ray films on 49 patients (23boys, 26 girls) with Angle's class II division 1 malocclusion, ranged from 9 to 13 years of age. Roentgenocephalmetric X-ray films were taken pre and post orthodontic care. Tracings were made in usual manner. The obtained results were as follow. 1. There was no significant sexual difference on mean changes. 2. In the comparison of the soft-tissue thickness changes, Ls-Ls' and Si-Si' in male subjects were remarkable. 9. There were significant correlations between osseous (Ss') change and soft-tissue (Ss) chang, of maxilla in male and female subjects subsequent to orthodontic treatment. 4. The ratios between the protraction of the Ss' and that of the Ss were 1:1.5 in all sexes, the ratios between the Si' and that of the Si were 1:1.4 in male and 1:1.2 in female. 5. There were significant correlations between maxillary central incise. angulation change $({\angle}A)$ and upper lip inclination change $({\angle}B)$ in all sexes. 6. There were little correlations between change in distance difference of Is and Ii and change in distance difference of Ls and Li in all sexes in all sexes.
Objective: Treating Class II subdivision malocclusion with asymmetry has been a challenge for orthodontists because of the complicated characteristics of asymmetry. This study aimed to explore the characteristics of dental and skeletal asymmetry in Class II subdivision malocclusion, and to assess the relationship between the condyle-glenoid fossa and first molar. Methods: Cone-beam computed tomographic images of 32 patients with Class II subdivision malocclusion were three-dimensionally reconstructed using the Mimics software. Forty-five anatomic landmarks on the reconstructed structures were selected and 27 linear and angular measurements were performed. Paired-samples t-tests were used to compare the average differences between the Class I and Class II sides; Pearson correlation coefficient (r) was used for analyzing the linear association. Results: The faciolingual crown angulation of the mandibular first molar (p < 0.05), sagittal position of the maxillary and mandibular first molars (p < 0.01), condylar head height (p < 0.01), condylar process height (p < 0.05), and angle of the posterior wall of the articular tubercle and coronal position of the glenoid fossa (p < 0.01) were significantly different between the two sides. The morphology and position of the condyle-glenoid fossa significantly correlated with the three-dimensional changes in the first molar. Conclusions: Asymmetry in the sagittal position of the maxillary and mandibular first molars between the two sides and significant lingual inclination of the mandibular first molar on the Class II side were the dental characteristics of Class II subdivision malocclusion. Condylar morphology and glenoid fossa position asymmetries were the major components of skeletal asymmetry and were well correlated with the three-dimensional position of the first molar.
The purpose of the present study was to investigate associations between periapical and bitewing techniques by assessing the crestal alveolar bone. This article also reports the ability of these two techniques to correctly detect evidence of interproximal dental caries, and comparison between the interproximal overlapping of teeth. Bitewing and periapical radiographs were used from posterior quardants of 243 dental students in Seoul National University. The distance from cemento-enamel junction to the alveolar crest (CEJ-AC) was measured for each proximal surface from the distal of cuspid to the distal of second molar. Data were arranged according to the proximal surface examined, and bitewing and periapical measurements were compared using paired tests. The obtained results were as follows: 1. In maxilla, a significant t ratio with a P value of 0.05 or less reached for 100% and in mandible, reached for 94%. 2. The anatomic limitations imposed on periapical radiographic technique, most often result in somewhat foreshortened radiographic images. This situation would tend to be accentuated by the anatomical restrictions of the hard palate. 3. Consequently, since the significant differences frequently exist between measurements obtained from bitewing and periapical techniques, it is important to define which technique is used. 4. The number of the interproximal overlapping was the largest medial side of the maxillary second molar, while the smallest at the distal side of the mandibular second premolar. And the overall number of the interproximal overlapping was more (538) in the periapical technique than in the bitewing technique (372). 5. The interproximal dental carious lesions were detected more (74) on the bitewing films than on the periapical ones (23). The fact was resulted from the small number of interproximal overlapping and relative easi- ness of obtaining horizontal angulation in taking the bitewing radiographs.
Purpose: This study assessed the accuracy of linear and angular measurements on panoramic radiographs taken at different positions in vitro. Materials and Methods: Two acrylic models were fabricated from a cast with normal occlusion. Straight and $75^{\circ}$ mesially and lingually angulated pins were placed, and standardized panoramic radiographs were taken at standard position, at an $8^{\circ}$ downward tilt of the occlusal plane compared to the standard position, at an $8^{\circ}$ upward tilt of the anterior occlusal plane, and at a $10^{\circ}$ downward tilt of the right and left sides of the model. On the radiographs, the length of the pins above (crown) and below (root) the occlusal plane, total pin length, crown-to-root ratio, and angulation of pins relative to the occlusal plane were calculated. The data were subjected to repeated measures ANOVA and LSD multiple comparisons tests. Results: Significant differences were noted between the radiographic measurements and true values in different positions on both models with linear (P<0.001) and those with angulated pins (P<0.005). No statistically significant differences were observed between the angular measurements and baselines of the natural head posture at different positions for the linear and angulated pins. Conclusion: Angular measurements on panoramic radiographs were sufficiently accurate and changes in the position of the occlusal plane equal to or less than $10^{\circ}$ had no significant effect on them. Some variations could exist in the pin positioning (head positioning), and they were tolerable while taking panoramic radiographs. Linear measurements showed the least errors in the standard position and $8^{\circ}$ upward tilt of the anterior part of the occlusal plane compared to other positions.
Ozkir, Serhat Emre;Unal, Server Mutluay;Yurekli, Emel;Guven, Sedat
The Journal of Advanced Prosthodontics
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제8권2호
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pp.131-136
/
2016
PURPOSE. The aim of this study was to observe stress concentration in the implant, the surrounding bone, and other components under the pull-out force during the crown removal. MATERIALS AND METHODS. Two 3-dimensional models of implant-supported conventional metal ceramic crowns were digitally constructed. One model was designed as a vertically placed implant ($3.7mm{\times}10mm$) with a straight abutment, and the other model was designed as a 30-degree inclined implant ($3.7mm{\times}10mm$) with an angled abutment. A pull-out force of 40 N was applied to the crown. The stress values were calculated within the dental implant, the abutment, the abutment screw, and the surrounding bone. RESULTS. The highest stress concentration was observed at the coronal portion of the straight implant (9.29 MPa). The stress concentrations at the cortical bone were lower than at the implants, and maximum stress concentration in bone structure was 1.73 MPa. At the abutment screws, the stress concentration levels were similiar (3.09 MPa and 3.44 MPa), but the localizations were different. The stress at the angled abutment was higher than the stress at the straight abutment. CONCLUSION. The pull-out force, applied during a crown removal, did not show an evident effect in bone structure. The higher stress concentrations were mostly observed at the implant and the abutment collar. In addition, the abutment screw, which is the weakest part of an implant system, also showed stress concentrations. Implant angulation affected the stress concentration levels and localizations. CLINICAL IMPLICATIONS. These results will help clinicians understand the mechanical behavior of cement-retained implant-supported crowns during crown retrieval.
The purpose of this study was to compare the distributing pattern of stress on the finite element models of two units implant prosthesis with one angulated placement of two implant fixtures. The two unit implant crowns simulated to mandibular first and second molars were made. The two kinds of finite element models were designed according to angulation of fixture ($4.0mm{\times}11.5mm$) : Model 1($15^{\circ}$ buccally angulated placement of one fixture on second molar area), Model 2($15^{\circ}$ lingually angulated placement of one fixture on second molar area). Axial loads of 200N were applied to the center of central fossa and to distance of 2mm and 4mm apart from the center of central fossa. Von-Mises stresses were recorded and compared in the fixtures, and buccolingual section of implants. The results were as follows: 1. Under axial loading at the central fossa, the stress was distributed along the straight fixture except apical portion, while on buccally or lingually angulated placement, the highest stresses were concentrated in the neck portion on the opposite side of the angulated fixture. 2. With offset distance increasing, the stresses were concentrated greater in buccal neck of lingually angulated fixture than in lingual neck of buccally angulated fixture. From the above results, in designing of the occlusal scheme for implant prosthesis with the angulated fixture, occlusal contacts should be placed to distribute stress axially in maximum intercuspation and to avoid offset force during eccentric movements.
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