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BONE DENSITY AND HISTOMORPHOMETRY ASSESSMENT OF DENTAL IMPLANT USING COMPUTERIZED TOMOGRAPHY (컴퓨터 영상을 이용한 임플란트 식립부위의 골밀도와 조직학적 연구)

  • Son, Jang-Ho;Choi, Byung-Hwan;Park, Soo-Won;Cho, Yeong-Cheol;Sung, Iel-Yong;Lee, Ji-Ho;Byun, Ki-Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.2
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    • pp.136-142
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    • 2009
  • Bone density in the recipient implant site seems to be an important factor for long term success of endosseous implants. Preoperative evaluation of bone density is very helpful to assist the clinician with the treatment planning of implant therapy. Accurate information on bone density will help the surgeon identify suitable implant sites, thereby improving the success rate of the procedure. Purpose; The aim of this study was to evaluate a correlation between bone density measured preoperatively with computerized tomography and histologically measured bone density by bone biopsy. Patients and methods; Twenty seven patients were selected. All the patients were in good health, with no systemic disorder and additional bone graft. Preoperatively the patients underwent CT scanning to evaluate Houmsfield Unit(HU). Each patients wore a surgical template for implant placement. During surgery 2mm in diameter and 6mm in length specimens were taken. Histomorphometric analysis was performed using digitalized image analysis software Axiovision 4.3. Also, the Resonance frequency analysis(RFA) and insertion torque values were recorded. Results; The highest histomorphometric values was found in the posterior mandible $32.3{\pm}3.8$, followed by $29.9{\pm}2.6$ for the posterior maxilla, $29.4{\pm}2.6$ for the anterior maxilla, $28.6{\pm}2.3$ for the anterior mandible(p=0.214). The hounsfield unit was $989.2{\pm}258.1$ in the posterior mandible, $845.0{\pm}241.5$ in the anterior maxilla, $744.5{\pm}92.6$ in the anterior mandible, $697.3{\pm}136.9$ in the posterior maxilla(p=0.045). This results may suggest that there are strong correlation between the histomorphometric values and hounsfield unit(r=0.760, p<0.05). The RF measurements were $81.9{\pm}2.4$ ISQ in the posterior mandible, $79.0{\pm}1.4$ ISQ in the anterior mandible, $78.3{\pm}4.6$ ISQ in the posterior maxilla, $76.5{\pm}5.0$ ISQ in the anterior maxilla(p=0.048). The insertion torque values was $43.2{\pm}4.2\;Ncm$ in the posterior mandible, $42.0{\pm}0.0\;Ncm$ in the anterior mandible, $41.3{\pm}4.1\;Ncm$ in the posterior maxilla, $40.8{\pm}3.8\;Ncm$ in the anterior maxilla(p=0.612). This results may suggest that there are statistical significance between the hounsfield unit and the insertion torque values(r=0.494, p<0.05), the histomorphometric values and the insertion torque values(r=0.689, p<0.05). But there was no correlation between histomorphometric values and ISQ. There was no statistical significance in age and gender effect on parameters. Conclusions; There was significant correlations between bone density and implant stability parameters. The bone density measurements using preoperative CT may help clinicians to predict primary stability before implant insertion, which is associated with implant survival rates.

A proposal of landmarks for craniofacial analysis using three-dimensional CT imaging (3차원 CT 영상을 이용한 두개악안면 분석을 위한 계측점의 제안)

  • Chang, Hye-Sook;Baik, Hyoung-Seon
    • The korean journal of orthodontics
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    • v.32 no.5 s.94
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    • pp.313-325
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    • 2002
  • Three-dimensional CT imaging is efficient in examining specific structures in the craniofacial area by reproducing actual measurements through minimization of errors from patient movement and image magnification. Due to the rapid development of digital image technology and the expansion of treatment range a need for developing three -dimensional analysis has become urgent. Therefore the purpose of this study was to evaluate the percentage of error and magnification of three-dimensional CT using a dried skull and Vworks $program^{TM}$ (Cybermed Inc., Seoul, Korea) and also to obtain landmarks that are easy to designate and reproduce in three-dimensional images using the Vmorph-proto $program^{TM}$ (Cybermed Inc., Seoul, Korea). The following conclusions were obtained, 1. In the comparison of actual measurements from the dried skull and the three-dimensional image obtained from the Vworks program, the mean error was 0.99mm and the magnification was 1.04%. 2. Clinically useful hard tissue landmarks from three-dimensional images were Supraorbitale, Lateral orbital margin, Infraorbitale, Nasion, ANS, A point, Zygomaticomaxilla, Upper incisor, Lower incisor, B point, pogonion, Menton, PNS, Condylar inner margin, Condylar outer margin, Porion, Condylion, Gonionl, Gonion2, Gonion3, Sigmoid notch and Basion. 3. Clinically useful soft tissue landmarks from three-dimensional images were Endocanthion, Exocanthion, Soft tissue Nasion, Pronasale, Alare lateralis, Upper nostril point, Lower nostril point, Subnasale, Upper lip point, Cheilion, Stomion, Lower lip center, Soft tissue B, Pogonion, Menton and Preaurale. The Vworks program can be considered a clinically efficient tool to produce and measure three-dimensional images. Most of the hard and soft tissue landmarks proposed above are anatomically important points which are also easily reproducible and designated. These landmarks can be beneficial in three-dimensional diagnosis and the prediction of changes before and after surgery.

The effects of pregnancy on alveolar bone turnover during experimental tooth movement in rats (백서에서 실험적 치아이동시 임신이 치조골 교체(Turnover)에 미치는 영향에 대한 연구)

  • Kim, Young-Sun;Lee, Ki-Soo
    • The korean journal of orthodontics
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    • v.30 no.4 s.81
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    • pp.413-421
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    • 2000
  • The purpose of this study was to observe the effects of pregnancy on the experimental tooth movement and alveolar bone turnover process of Sprague-Dawley female rat. Sixty rats were divided into pregnant-tooth movement group(P-Tm), normal-tooth movement group(N-Tm) and normal group(N). Maxillary first molar appliances were inserted bilaterally and activated to 40grams. To measure the amount of tooth movement, x-ray was taken 2 times after appliance insertion and before sacrifice. Animals were sacrificed at 1,3,7,14 days(N=5). Just after sacrifice, alveolar bones were collected and frozen immediately for biochemical analysis. Tooth movement was assessed cephalometrically and tartrate-resistant acid(TRAP) and alkaline phosphatase (ALP) activities were measured in extracts of paradental alveolar bone. The results were as follows: 1. The amount of tooth movement in P-Tm group was greater than that of N-Tm group(p<0.01). 2. Alveolar bone ALP of normal tooth movement group was not significantly different from the control, TRAP was significantly different from the control(p<0.01). In normal tooth movement group, alveolar bone ALP was increased gradually and peak(day 7) fell off significantly at day 14(p<0.05). The Peak of alveolar bone TRAP(day 7) fell off slightly, sustained day 14(p<0.01). 3. Alveolar bone ALP and TRAP of pregnant tooth movement group were not significantly different from that of normal tooth movement group. In pregnant tooth movement group, alveolar bone ALP was increased at day 3(p<0.01) and fell off significantly at day 7-14, alveolar bone TRAP were increased at day 3 and sustained day 14. 4. The peak of alveolar bone phosphatases in pregnant tooth movement group(day3) preceded the peak in normal tooth movement group(day7) (p<0.01). According to the above results, we suggested that bone resorption activity was increased in alveolar bone of pregnant rat, and the degree of tooth movement in pregnancy may be greater than that of normal group because of high bone turnover of alveolar bone in pregnant rat.

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Effect of the lower third molar on the treatment of Class III malocclusion (하악 제3대구치 발거 시기가 III급 부정교합의 치료에 미치는 영향)

  • Son, Myung-Ho;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.34 no.5 s.106
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    • pp.394-407
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    • 2004
  • The Purpose of this study was to evaluate the effect of the lower third molar on treatment time and distal en masse movement of the lower dentition in Giass III malocclusions. Thirty subjects (9 males and 27 females) were selected, all of whom were diagnosed as Glass III malocclusion and treated by fixed appliances without premolar and/or molar extraction. They were divided into three groups Group 1 consisted of 12 subjects. whose lower third molars were not extracted during the whole orthodontic treatment. Group 2 consisted of 8 subjects. whose lower third molars were extracted after WEAW application and before removal of the orthodontic appliances. Group 3 consisted of 10 subjects whose lower third molars were extracted before MEAW application. For each subject. overall treatment time and duration of MEAW application were determined. In addition. pre-treatment and post-treatment lateral cephalometric radiographs were analyzed. All data were Processed statistically with ANOVA, and the conclusions were as follows: There was no significant difference among the groups in overall treatment time However, duration of MEAW application was longer in Group 2 than in Group 1 or Group 3. The overjet that was established after orthodontic treatment was largest in Group 3, in which the lower third molars were extracted befor MEAW application. After orthodontic treatment, IMPA decreased in Group 3. but increased in Group 1 and Group 2. There was no significant difference among the three groups in the translation of lower second molars However the tipping movement of lower second molars was significantly different, highest in Group 2 and lowest in Group 1 Therefore. it is thought to be better for the orthodontic treatment of Class III malocclusions to extract the lower third molars before MEAW application. In Group 2, the mandibular plane angle was decreased as a result of forward rotation of the mandible This skeletal change was thought to bring about the difficulty of treatment.

THE EFFECT OF ORTHODONTIC TREATMENT BY PREMOLAR EXTRACTION ON THE PRONUNCIATION OF THE KOREAN CONSONATS (소구치 발거를 통한 교정치료가 한국어 자음의 발음에 미치는 영향)

  • Lee, Jeong-Hee;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.27 no.1
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    • pp.91-103
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    • 1997
  • This paper aimed to study what the influences of orthodontic treatment of pronunciation are. We compared the duration and the acoustic wave patterns of Korean consonants pronounced by a control group with those of a patient who had his four premolars extracted and had been given orthodontic treatment The results were as follows : 1. Compared to the control group, the treatment group had a longer duration time of consonant pronunciation for all consonants but "ㅅ(s)" and "ㅌ($(t^h)$" in CV(consonant-vowel) pairs. Especially in the case of "ㅈ(dz)", "ㅆ$({\varphi}^h)$" for CV-pairs, and "ㄷ(d)" in VCV(vowel-consonant-vowel) clusters, the duration of consonant sound showed a sharp contrast between the control group and the treatment group. 2. There were clear differences in the acoustic wave patterns of "ㅉ(ts)", "ㅆ$({\varphi}^h)$" and "ㅊ$(c^h)$", all of which were in VCV-clusters. The acoustic wave pattern of "ㅉ(ts)", when pronounced by the treatment group, was stronger than the control group's. This phenomenon was most remarkable in the transitive section where the "ㅉ(ts)" sound flowed into the following vowel. When a preceding vowel shifted to the consonant "ㅆ$({\varphi}^h)$", the attack property of the appeared clearly in the acoustic waves of the treament group, while in the control group the starting point of consonart was indistinctive. Consonant duration for the treatment group was longer, and the appearance of a zero crossing point in the acoustic wave was more frequent. In the case of "ㅊ$(c^h)$", the treatment group produced a strong acoustic wave, and the property of aspiration was obvious in it. 3. When the treatment group pronounced "ㄷ(d)" and "ㅈ(dz)" in CV-pairs, the acoustic-wave was similar to that of aspirated "ㅌ$(t^h)$" and "ㅊ$(c^h)$". 4. The aspirated "ㅌ$(t^h)$" and "ㅊ$(c^h)$" pronounced by the treatment group showed the stronger airstream and acoustic wave form.

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A STUDY ON PROFILE CHANGE AND STABILITY OF TREATMENT AFTER WEARING FACE MASK (상악골 전방견인 장치 사용후 측모 변화 및 안정성에 대한 연구)

  • Park, Young-Chel;Shin, Ja-Young;Yu, Hyung-Seog
    • The korean journal of orthodontics
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    • v.27 no.1
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    • pp.1-20
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    • 1997
  • Skeletal Class III malocclusions are growth-related discrepancies, and the problems are more severe until growth is complete. Causes of skeletal Class III malocclusion are classified into mandibular overgrowth, maxillary deficiency, and combination of the two. Face mask has been recommended for treatment of Class III malocclusion with maxillary deficiency in the early time of growth. Numerous experiments were performed and clinical studies have been reported on face mask ; nevertheless, studies on profile changes and stability after treatment of face mask are considered to be somewhat insufficient. The author selected 50 patients who can be checked for follow-up. They had been diagnosed as skeletal Class III malocclusion with maxillary deficiency and then treated with face mask ; the sample group was divided according to sex, treatment beginning age, palatal suture opening (intraoral appliance). For each group, changing pattern of facial profile and stability of treatment observed, and comparison with 20 Korean normal children(Angle's Class I). The following results were obtained. 1. skeletal, dental, and soft tissue measurements indicated more changes in the amounts of maxillary forward movement during face mask treatment. 2. R.P.E. group showed more significant maxillofacial changes and La-Li group showed more dental changes. 3. Growth changes of maxilla induced in the treatment group during wearing face mask were much more than those of normal group. 4. Growth changes of maxilla in the treatment group after treatment of face mask were less than those of normal group. From the obtained aata, it can be concluded that there was a stimulative effect on forward growth of maxilla during the use of face mask ; however, on removal of face mask, the stimulative effect was eliminated and undergrowth tendency of maxilla resumed.

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ORTHODONTIC BRACKET SHEAR BOND STRENGTH TO Nd:YAG LASER Er:YAG LASER IRRADIATED ENAMEL (Nd : YAG 및 Er : YAG 레이저로 치아표면 조사시 브라켓 전단접착강도에 관한 실험적 연구)

  • Choi, Seung-Hoon;Yang, Won-Sik
    • The korean journal of orthodontics
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    • v.27 no.1
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    • pp.141-155
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    • 1997
  • The purpose of this study was to evaluate the effectiveness of the Nd:YAG laser and the Er:YAAG laser on etching enamel for direct bonding of orthodontic bracket. The advantages of laser etching rather than conventional acid etching are to reduce the subsurface demineralization rate, to inhibit the spillage of acid onto uninvolved ""its of enamel, and to save the clinical manipulation time involving drying, trashing and drying again. 189 freshly extracted human premolars were prepared for this research. 165 out of them were divided into 11 groups of 15 teeth. One group was acid etching and the rest groups were irradiated with Nd:YAG laser by four different energy levels(100mj 10pps, 100mj 20pps, 150mj 20pps, 200mj 20pps) and with Er:YAG laser by six different energy levels(60mj 5pps, 60mj 10pps, 100mj 10pps. 200mj 10pps, 200mj l5pps, 400mj 10pps). Shear bond strength was tested with Instron after 24 hours, one week, and three weeks. Twenty-four out of 189 teeth were divided into twelve groups untreated control, acid etching, and ten laser irradiation subgroups. And the ultrastructural enamel surfaces of each group were observed with scanning electron microscope. The results were as follows; 1. The means and the standard deviations of shear bond strength of Nd:YAG and Er:YAU laser irradiation by different energy levels were obtained. 2. Shear bond strengths of Er:YAG laser irradiation groups were higher than those of Nd:YAG laser irradiation groups at the identical energy level. 3. Maximum bond strengths was achieved at the energy of I50mj, 20pps in Nd:YAG laser irradiation groups or 60mj, 10pps in Er:YAG laser irradiation groups. 4. It was acceptible for direct bonding to irradiate lb0mj 20pps with Nd:YAG laser or to irradiate 60mj 10pps with Er:YAG laser considering the results of shear bond strength tests and SEM obsesvation.

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Comparison of palatal bone thickness between 3D model and lateral cephalometric radiograph (성인 구개부 측모두부계측방사선 사진과 3D model의 골두께 비교)

  • Jang, Min-Guk;Lee, Jin-Woo;Cha, Kyung-Suk;Chung, Dong-Hwa;Lee, Sang-Min
    • The korean journal of orthodontics
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    • v.41 no.5
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    • pp.312-323
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    • 2011
  • Objective: This study compared the bone thickness of the palate between lateral cephalogram and 3D model measurements. Methods: The subjects consisted of 30 adults (15 men,15 women) with a normal skeletal pattern and occlusion. The CT images were transformed to a 3D model, and were compared with the cephalometric image. Descriptive statistics for each variable were calculated. Results: In the 3D CT model, the mid-palatal area was the thickest part. It became thinner as the palate tapered laterally. In the male group, the thinnest portion was positioned 6 mm away from the mid-palate, while in the female group the thinnest portion was 8mm away from the mid-palate. Correlation analysis between the lateral cephalometric and 3D CT model revealed a significant correlation except in the mid palatal area and the area 2 mm lateral to the mid-palate in men, whereas there was a significant relationship in every area in the women. In both men and women, the highest correlation appeared in the area 8 mm lateral to the mid palate. Conclusions: Using regression analysis, an actual prediction of the bone thickness between the measured bone thickness of the lateral cephalometric radiograph and 3D model was made. This will provide useful information for mini-implant length selection when inserting into the palate.

Finite element analysis of effectiveness of lever arm in lingual sliding mechanics (Lingual sliding mechanics의 lever arm 효과에 대한 유한요소분석)

  • Kim, Kyeong-Hee;Lee, Kee-Joon;Cha, Jung-Yul;Park, Young-Chel
    • The korean journal of orthodontics
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    • v.41 no.5
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    • pp.324-336
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    • 2011
  • Objective: The aim of this study was to conduct three-dimensional finite element analysis of individual tooth displacement and stress distribution when a posterior retraction force of 200 g was applied at different positions of the retraction hook on the transpalatal arch (TPA) of a molar, and over different lengths of the lever arm on the maxillary anterior teeth in lingual orthodontics. Methods: A three-dimensional finite element model, including the entire upper dentition, periodontal ligaments, and alveolar bones, was constructed on the basis of a sample (Nissan Dental Product, Kyoto, Japan) survey of Asian adults. Individual movement of the incisal edge and root apex was estimated along the x-, y-, and z-coordinates to analyze tooth displacement and von Mises stress distribution. Results: When the length of the lever arm was 15 mm and 20 mm, the incisal edge and root apex of the anterior teeth was displaced lingually, with a maximum lingual displacement at the lever arm length of 20 mm. When the posterior retraction hook was on the root apex, the molars showed distal displacement. When the length of the lever arm was 20 mm, anterior extrusion was reduced and the crown of the canine displaced toward the buccal side, in which case, the retraction hook was on the edge, rather than at the center, of the TPA. Conclusions: The results of the analysis showed that when 6 anterior teeth were retracted posteriorly, lateral displacement of the canine and lingual displacement of the incisal edge and root apex of the anterior teeth occur without the extrusion of the anterior segment when the length of the lever arm is longer, and the posterior retraction hook is in the midpalatal area.

The effect of using laser for ceramic bracket bonding of porcelain surfaces (세라믹 브라켓 부착 시 레이저를 이용한 포세린 표면처리 효과)

  • An, Kyung-Mi;Sohn, Dong-Seok
    • The korean journal of orthodontics
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    • v.38 no.4
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    • pp.275-282
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    • 2008
  • Objective: The purpose of this study was to investigate the effect of using laser for ceramic bracket bonding of porcelain surfaces and to compare it with conventional treatment of porcelain surfaces. Methods: Ninety feldspathic porcelain specimens were divided into 9 groups of 10, with each group having different surface treatments performed. Surface treatment groups were orthophosphoric acid, orthophosphoric acid with silane, hydrofluoric acid, hydrofluoric acid with silane, sandblasted, sandblasted with silane, laser etched, laser etched with silane, and glazed surface served as a control group. In the laser etched groups, the specimens were irradiated with 2-watt superpulse carbon dioxide ($CO_2$) laser for 20 seconds. Ceramic brackets were bonded with light-cure composite resin and all specimens were stored in water at $37^{\circ}C$ for 24 hours. Shear bond strength was determined in megapascals (MPa) by shear test at 1 mm/minute crosshead speed and the failure pattern was assessed. For statistical analysis, one-way ANOVA and tukey test were used. Results: Statistical analysis showed significant differences between the groups. The HFA + S group showed the highest mean shear bond strength ($13.92{\pm}1.94\;MPa$). This was followed by SB + S ($10.16\;{\pm}\;1.27\;MPa$), HFA ($10.09\;{\pm}\;1.07\;MPa$), L + S ($8.25\;{\pm}\;1.24\;MPa$), L ($7.86\;{\pm}\;0.96\;MPa$), OFA + S ($7.22\;{\pm}\;1.09\;MPa$), SB ($3.41\;{\pm}\;0.37\;MPa$), OFA ($2.81\;{\pm}\;0.37\;MPa$), G ($2.46\;{\pm}\;1.36\;MPa$), Bond failure patterns of HFA and silane groups, except L + S, were cohesive modes in porcelain while adhesive failure was observed in the control group and the rest of the groups. Conclusions : A 2-watt superpulse $CO_2$ laser etching of porcelain surfaces can provide a satisfactory result for porcelain surface treatment for ceramic bracket bonding. Laser irradiation may be an alternative conditioning method for the treatment of porcelain surfaces.