• 대한족부족관절학회지
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• 제20권2호
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• pp.67-72
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• 2016

Purpose: The purpose of this study was to assess the 2-year follow-up results of patients with a trimalleolar fracture, who had undergone an anterior incision cannulated screw fixation of the posterior malleolar fragment, which had more than 25% of articular involvement or had no cortical continuity with the distal tibia. Materials and Methods: Among 28 patients with a trimalleolar fracture who had undergone fixation of the posterior malleolar fragment between February 2005 and February 2010, 14 patients, who underwent an anterior incision cannulated screw fixation of posterior malleolar fragment and were followed-up for more than 2 years, were selected. The postoperative clinical and radiological findings immediately and at the 1- and 2-year follow-up were compared. The clinical findings were evaluated as American Orthopaedic Foot and Ankle Society (AOFAS) score. The radiological assessment was evaluated as the maintenance of reduction, period to bone union, and the presence of nonunion, malunion, and complications. Results: The clinical outcome by mean AOFAS score revealed 83.0 points in the group with preoperative displacement below 2 mm and 80.7 points in the group with preoperative displacement above 2 mm postoperatively. The mean AOFAS score was 91.7 and 93.1 points in the group with preoperative displacement below 2 mm on 1- and 2-year follow-up, respectively, and 89.8 and 91.7 points in group with the preoperative displacement above 2 mm on 1- and 2-year follow-up, respectively. After a 2-year follow-up among 14 cases selected for this study, 13 cases showed an excellent reduction state and only 1 case (7.1%) showed a displacement of more than 2 mm. No complication were encountered in the group with preoperative displacement below 2 mm. On the other hand, among 8 patients in the group with preoperative displacement above 2 mm, there were 3 with limitations of the range of motion of the ankle joint (37.5%) and 1 post-traumatic arthritis (12.5%) at the 2-year follow-up. Conclusion: Anterior incision cannulated screw fixation of the posterior malleolar fragment could be a valuable method for the treatment of trimalleolar fractures that provides satisfactory results.

• Journal of Oral Medicine and Pain
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• 제23권4호
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• pp.379-385
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• 1998

A patient with TMJ osteoarthritis and anterior open bite was treated with an intermaxillary traction device. Pretreatment examination revelaed a pain in both TMJ during mouth opening, moderate tendernesso f left sternocleidomastoid and right trapezius muscles. Anterior open Bite was aobserved with interincisal distance of 2mm. Tomograms and MRI showed anterior disc displacement withouit reductoin of both temporomandibular joints, and the condyles were flattened and slightly eroded. A pair of full-coverage occlusal appliances was made on both maxillary and mandibular dentition, with pivoting fulcrum on the site of the second moalr. Traction force was gained by the intermaxillary orthodontic elastics which were hooked by orthodontic brackets on the labial surfaces of the upper and lower anterior and premolar teeth. After 8 weeks of traction treatment, the joint pain was subsided completely and the anterior open bite was closed to get an edge to edge relationship of anterior teeth.

• 치과방사선
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• 제24권2호
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• pp.337-345
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• 1994

Arthrography of the temporomandibular joint is a useful method of demonstrating the soft tissue abnormalities related to disc dysfunction. In this study, 19 asymptomatic joints, 31 joints with anterior disc displacement with reduction, 31 joints with anterior disc displacement without reduction which were classified by arthrotomography under fluoroscopy were evaluated to determine the linear measurement of anterior recess of inferior joint space and the relationship between the condylar anterior translation and the severity of the internal derangements. Their fluoroscopic images were also evaluated to describe the characteristics of condylar paths in internal derangements of the temporomandibular joints. The results were as follows; 1. The mean lengths of the anterior recess in asymptomaic group. reduction group. and non-reduction group were 8.7±1.6㎜. 11.2±1.7㎜, 12.8±1.7㎜ respectively. The length of the anterior recess was increased according to the severity of the internal derangements(P<0.05). 2. Linear measurements of anterior movement of condyle on maximum mouth opening were 13.1 ±4.2㎜, 15.9±4.1㎜, 5.0±3.7㎜ in asymptomatic group. reduction group, and non-reduction group respectively. Compared with asymptomatic group, reduction group showed hypermobolity of the condyle and non-reduction group showed hypomobility. 3. Condyles moved beyond the crest of articular eminence in 80% of reduction group and did not reach it in 70% of non-reduction group. 4. The condyle moved mainly superiorly in reduction group(66%) and horizontally in asymptomatic group(47%). There were no cases to move superiorly in non-reduction group.

• 대한치과교정학회지
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• 제31권2호통권85호
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• pp.209-223
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• 2001

치조골 결손을 갖는 환자의 상악전치부 압하(intrusion)시 필수적인 pure intrusion을 위해 three-piece base arch appliance와 후방견인력의 적용이 필요하게 된다. Three-piece base arch appliance를 적용한 상악전치부 압하시의 상악 6전치, 치근막 및 치조골의 3차원 유한요소모델을 제작하였다. Three-piece base arch appliance를 이용한 상악 전치부압하시 치아 수에 따른 저항중심의 위치, 치조골 흡수에 따른 pure intrusion을 위한 후방견인력 변화 양상, 그리고 이때의 치조골 높이에 따른 저항중심의 수직적, 수평적 위치 변화의 상관관계에 대해 다음과 같은 결과를 얻었다. 1. 치축 경사도와 치조골 높이가 정상이고, 압하시 three-piece base arch appliance를 이용한 경우 압하 하중점이 전후방적으로 저항중심을 통과하기 위한 조건은 다음과 같다. 1) 2 전치군(중절치군)을 대상으로 한 경우에는 중절치 브라켓 원심면에서 후방 6mm 지점으로, 측절치 브라켓 전방 1/3부위에 위치 하였다. 2) 4 전치군(중절치와 측절치군)을 대상으로 한 경우에는 측절치 브라켓 원심면에서 후방 5mm지점으로, 측절치와 견치 브라켓 사이 공간의 후방 2/3부위에 위치하였다. 3) 6 전치군(중절치, 측절치와 견치군)을 대상으로 한 경우에는 견치 브라켓 원심면에서 후방 7mm 지점으로, 제 1소구치 브라켓 중앙부위에 위치하였다. 4) 치아 수 증가에 따른 저항중심의 후방이동을 관찰할 수 있었고, 4 전치군 보다 6 전치군에서 후방 이동량이 크게 나타났다. 2. 치조골 높이가 정상일 때, pure intrusion을 위한 후방견인력을 적용할 경우 수직 압하점은 저항중심과 같거나 약간 전방에 위치했다. 3. 동일한 압하력과 압하점 적용시 치조골 상실 증가에 따른 압하시 pure intrusion을 위한 후방견인력 변화는 다음과 같다. 1) 2 전치군과 4 전치군의 후방 견인력은 6 전치군의 후방 견인력에 비해 낮게 나타났다. 2) 치조골이 상실됨에 따라 각 치아군 후방견인력은 증가됨을 보였다. 4. 상악 전치부 치아군과 치조골 높이에 따른 저항중심의 수평적, 수직적 위치간 상관관계는 다음과 같다. 1) 2 전치군일 때, 치조골 상실에 따른 저항중심의 수직적 위치변화에 대한 수평적 위치 변화가 가장 크게 나타났다. 치아 수가 증가할수록 치조골 상실에 따른 저항중심의 수직적 위치 변화에 대한 수평적 위치변화는 작아지는 경향을 보였다. 2) 치조골 상실량이 커짐에 따라서는, 치아 수에 관계 저항중심의 수직적 위치변화에 대해 수평적 위치변화가 커졌다.

• 대한치과교정학회지
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• 제28권4호
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• pp.563-580
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• 1998

치열의 치군 후방이동을 유발하는 교정력에 의해 발생되는 개개 치아의 초기 변위와 응력분포를 평가하고자 본 연구를 시행하였다. 유한요소법을 이용하여 상악 치아와 치근막, 그리고 치조골의 해부학적 형태와 생체적 특성을 컴퓨터로 재현하고 모형화된 브라켓을 부착한 3 차원 유한요소 모델을 형성하였다. 치열의 치군 후방이동에 사용되는 구외력과 II급 악간고무, ideal arch wire와 MEAW(Multiloop Edgewise Arch Wire), 그리고 호선에 부여된 tip back bend 에 의해 야기되는 치아 변위를 비교, 분석하였다 그리고 이러한 치료방법을 상악 제 2 대구치를 발거한 경우와 발거하지 않은 경우에 각각 적용하여 상악 제 2대구치 존재유무에 따른 치아이동 양상의 변화를 분석한 결과 다음과 같은 결론을 얻었다. 1. 전치부 헤드기어에 의해 발생되는 치아변위는 후방 치체변위와 후방 경사변위, 그리고 수직변위 모두 치열 전방부에 집중되어 있었다. 2. Ideal arch wire에 II급 악간고무를 적용한 경우, 치아변위가 치열 전방부에 집중되었으나 ideal arch wire에 tip back bend를 부여하면 악간고무에 의한 견인력이 후방으로 전달되었다. 부여하는 tip back bend의 양이 증가할수록 전치부의 후방 치체변위와 설측 경사변위는 감소하였고 구치부의 후방 치체변위와 경사변위는 증가하였으며 II급 악간고무에 의한 전치부 정출이 감소하였다. 3. MEAW와 II급 악간고무를 적용한 결과, 치아변위 경향은 ideal arch wire와 II급 악간고무를 사용한 경우와 유사하였으나 작은 양의 치아변위와 함께 치열내 개개치아의 비교적 균등한 이동양상을 보였다. 4. 상악 제 2 대구치가 존재하는 유한요소 모델에 상악 제 1 대구치까지만 교정장치를 장착하고 후방이동을 시도한 결과 상악 제 1 대구치 치아이동이 감소하는 경향을 보였다.

• Journal of Oral Medicine and Pain
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• 제23권4호
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• pp.369-377
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• 1998

A patient with TMJ osteoarthritis and anterior open bite was treated with an intermaxillary traction device. Pretreatment examination revelaed a pain in both TMJ during mouth opening, moderate tendernesso f left sternocleidomastoid and right trapezius muscles. Anterior open Bite was aobserved with interincisal distance of 2mm. Tomograms and MRI showed anterior disc displacement withouit reductoin of both temporomandibular joints, and the condyles were flattened and slightly eroded. A pair of full-coverage occlusal appliances was made on both maxillary and mandibular dentition, with pivoting fulcrum on the site of the second moalr. Traction force was gained by the intermaxillary orthodontic elastics which were hooked by orthodontic brackets on the labial surfaces of the upper and lower anterior and premolar teeth. After 8 weeks of traction treatment, the joint pain was subsided completely and the anterior open bite was closed to get an edge to edge relationship of anterior teeth.

• The Journal of Advanced Prosthodontics
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• 제9권4호
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• pp.278-286
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• 2017

PURPOSE. The aim of this study was to determine the influence of long base lengths of a fixed partial denture (FPD) to rotational resistance with variation of vertical wall angulation. MATERIALS AND METHODS. Trigonometric calculations were done to determine the maximum wall angle needed to resist rotational displacement of an experimental-FPD model in 2-dimensional plane. The maximum wall angle calculation determines the greatest taper that resists rotation. Two different axes of rotation were used to test this model with five vertical abutment heights of 3-, 3.5-, 4-, 4.5-, and 5-mm. The two rotational axes were located on the mesial-side of the anterior abutment and the distal-side of the posterior abutment. Rotation of the FPD around the anterior axis was counter-clockwise, Posterior-Anterior (P-A) and clockwise, Anterior-Posterior (A-P) around the distal axis in the sagittal plane. RESULTS. Low levels of vertical wall taper, ${\leq}10-degrees$, were needed to resist rotational displacement in all wall height categories; 2-to-6-degrees is generally considered ideal, with 7-to-10-degrees as favorable to the long axis of the abutment. Rotation around both axes demonstrated that two axial walls of the FPD resisted rotational displacement in each direction. In addition, uneven abutment height combinations required the lowest wall angulations to achieve resistance in this study. CONCLUSION. The vertical height and angulation of FPD abutments, two rotational axes, and the long base lengths all play a role in FPD resistance form.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.49-55
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• 2014

Excessive lumbar flexion during sit-to-stand (STS) is a risk factor for lower back pain. Postural taping can prevent unwanted flexion of the lumbar spine. This study aimed to demonstrate the effect of taping the lower back on the lumbopelvic region and hip joint kinematics during STS. Sixteen healthy subjects participated. All subjects performed the STS with and without taping of the lower back. A three-dimensional motion analysis system was used to measure the kinematics of the lumbar spine, pelvis, and hip joint during STS. The angle of the peak lumbar flexion, pelvic anterior tilting, and hip flexion and angular displacement of the lumbar spine between starting position and maximal lumbar flexion were collected. Paired t-tests, or Wilcoxon's rank-sum test for non-parametric distribution, were used to assess differences in the measurements with and without taping. A p-value <.05 was taken to indicate a significant difference. Significant differences were observed in the angle of the peak lumbar flexion, pelvic anterior tilting, hip flexion and angular displacement of the lumbar spine (p<.05). Taping was associated with a significant decrease in the angle of peak lumbar flexion and angular displacement of the lumbar spine between the starting position and maximal lumbar spine flexion. In addition, the peak angle of pelvic anterior tilting and hip flexion were significantly increased with taping. The findings of this study suggest that taping the lower back can decrease excessive lumbar flexion, and increase the pelvic anterior tilting and hip flexion motion during STS.

• 대한치과교정학회지
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• 제10권1호
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• pp.29-36
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• 1980

Inclined plane, one of frequently used orthodontic appliances, may cause posterior displacement of mandible and injure the normal growth of temporomandibular joint. So author carried out the mandibular posterior displacement experimentally induced by inserting inclined plane in the rat incisors in order to investigate the histological reactions occuring in the temporomandibular joint of experimental animals. Following results were obtained. 1. The posterior displacement of condyle resulted in the widening of anterior synovial space with anterior condylar hyperplasia and posterior condylar atrophy. In addition, tissue changes were more severe in young rats than in adult rats. 2. The tissue reactions were localized only to condylar head ana there were no evidence of traumatic features in young rats. In adult rats, hemorrhage was an additional finding 1 week after experiment. 3. The remodelling processes were accompanied by the increasing or reduction of fibrous layer and subsequent replacement by cartilage layer occured massively and abruptly in young rats, it occured slightly and slowly in adult rats. 4. The remodelling process of injured condyle occured from 1 week to 4 weeks after experiment and completed between 8 weeks after experiment.

• Imaging Science in Dentistry
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• 제32권2호
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• pp.67-73
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• 2002

Purpose: To examine the possible relationship between condylar position and disk displacement in the temporomandibular joint. Materials and Methods: 79 temporomandibular joints in 40 patients having temporomandibular disorders were classified into three categories: no disk displacement (NDD) , disk displacement with reduction (DDWR), and disk displacement without reduction (DDWOR). Disk positions were assessed from clinical and MRI findings. The relationship between the three categories and condylar positions was evaluated using lateral individualized corrected tomography. Results: Clinical findings regarding the relationship between condyle and disk positions having anterior, centric, and posterior positions were 27%, 27%, and 46%, respectively, in NDD, 43%, 17%, and 40%, respectively, in DDWR, and 44%, 22%, and 34%, respectively, in DDWOR. There were no significant differences in condylar positions between each of the groups (P>0.05). In the relationship between condyle and disk positions with MRI findings, anterior, centric, and posterior positions were 38%, 38%, and 24%, respectively, in NDD, 29%, 21%, and 50%, respectively, in DDWR, and 44%, 9%, and 47% respectively, in DDWOR. There were significant differences in the condylar positions when MRI was utilized (P<0.05) Conclusion: There was a significant correlation between the condyle and disk positions with MRI findings on lateral individualized corrected tomography.